LIGATION OF ARTERY AND CONCOMITANT VEIN IN OPERATIONS ON THE LARGE BLOOD VESSELS

The beneficial effect of occluding the satellite vein when ligation of the artery becomes necessary in surgical conditions of the large blood vessels was first recognized by Sir Arthur Makins¹ in 1913. He found a lessened incidence of gangrene in following this procedure. Nevertheless, during the early part of the World War, careful preservation of the vein was practiced, but the occurrence of gangrene following ligation of the large artery to the extremity brought forth interesting and valuable investigations on the subject. Drummond² showed experimentally that ligation of both artery and vein produced "little or no change" in the condition of the loops of cat's intestines. When the artery alone was occluded, definite gangrene of the segment usually appeared within twenty-four hours. Van Kend³ attributed the decreased frequency of gangrene to a "slight rise in the blood pressure in the limb following application of a ligature to