That this may the more clearly appear to everyone, I have here to
cite certain experiments, from which it seems obvious that the
blood enters a limb by the arteries, and returns from it by the
veins; that the arteries are the vessels carrying the blood from
the heart, and the veins the returning channels of the blood to
the heart; that in the limbs and extreme parts of the body the
blood passes either immediately by anastomosis from the arteries
into the veins, or mediately by the porosities of the flesh, or
in both ways, as has already been said in speaking of the passage
of the blood through the lungs whence it appears manifest that in
the circuit the blood moves from that place to this place, and
from that point to this one; from the centre to the extremities,
to wit; and from the extreme parts back to the centre. Finally,
upon grounds of calculation, with the same elements as before, it
will be obvious that the quantity can neither be accounted for by
the ingeata, nor yet be held necessary to nutrition.
The same thing will also appear in regard to ligatures, and
wherefore they are said to draw; though this is neither from the
heat, nor the pain, nor the vacuum they occasion, nor indeed from
any other cause yet thought of; it will also explain the uses and
advantages to be derived from ligatures in medicine, the
principle upon which they either suppress or occasion hemorrhage;
how they induce sloughing and more extensive mortification in
extremities; and how they act in the castration of animals and
the removal of warts and fleshy tumours. But it has come to pass,
from no one having duly weighed and understood the cause and
rationale of these various effects, that though almost all, upon
the faith of the old writers, recommend ligatures in the
treatment of disease, yet very few comprehend their proper
employment, or derive any real assistance from them in effecting
cures.
Ligatures are either very tight or of medium tightness. A
ligature I designate as tight or perfect when it so constricts an
extremity that no vessel can be felt pulsating beyond it. Such a
ligature we use in amputations to control the flow of blood; and
such also are employed in the castration of animals and the
ablation of tumours. In the latter instances, all afflux of
nutriment and heat being prevented by the ligature, we see the
testes and large fleshy tumours dwindle, die, and finally fall
off.
Ligatures of medium tightness I regard as those which compress a
limb firmly all round, but short of pain, and in such a way as
still suffers a certain degree of pulsation to be felt in the
artery beyond them. Such a ligature is in use in blood-letting,
an operation in which the fillet applied above the elbow is not
drawn so tight but that the arteries at the wrist may still be
felt beating under the finger.
Public-domain text, read in full here on John Shaqi.
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