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302 RECENT TIMES.
PARE states that he was led to the attempt to ligature
vessels by the study of GALEN : he reintroduced this procedure
for the first time in an amputation in the lower part
of the thigh, in the year 1552. He afterwards adopted
ligature en masse in place of that of isolated arteries, tying
the nerves along with the vessels. The belief was that in
this way the discharge of the " nervous spirit" was pre- .
vented. For secondary haemorrhage the arterial trunks
were compressed by the external application of the fingers;
mention is also made of a method which, in the somewhat
Obscure description of it by A. PARE, appears to answer to
ligature in continuity.
Among the diseases liable to occur as the result of
wounds erysipelas, hospital gangrene, diphtheria, pyaemia,
trismus, and tetanus were noticed*
The technical procedure in lithotomy underwent a marked
improvement in the 16th century. The method in use up to
that time, described by CELSUS and simplified by PAULUS
AEGINETA, was amended by passing into the urethra, before
the operation, a curved hollow sound shaped like a catheter, ,..:
the convexity of which abutted on the perineum. As the
incision in the pars membranacea was made on the groove
of this sound, the hand of the operator took a more certain
direction—a matter of great importance for the result.
This procedure was called the operation with the large
instrument, and BERNARDO DI RAPALLO was looked upon
as its discoverer. It became more generally known through.
MARIANO SANTO. The disadvantages which sometimes
accompanied perineal lithotomy, namely, suppuration of
the prostate and of the ejaculatory ducts with the
impotence arising therefrom, but above all things the
impossibility of removing by the perineal wound either
very large or encysted stones, suggested the idea of
*
* F. WURTZ : Practica der Wundartzney, Basel 1642, S. 271, 538, 645 et seq;.
—TH. BILLROTH: Historische Studien iiber die Beurtheilung und Behandlung
der Schusswunden, Berlin 1859, s - "5 et seo -—WOLZENDOKFF im Deutschea
Archiv f. Gesch. d. Medicin, Bd. ii, S. 23 et seq.; Leipzig 1879.