A technique for the total arterialization of the liver was recorded by Cohn and Herrod1 in 1952. These workers used an autogenous vascular graft consisting of a section of the jugular vein inserted between the aorta and the portal vein. The surgical procedure was lengthy but the end-result good. Using a cutting-suture technique, we
have been able efficiently to arterialize the liver by means of two fistulae: a reverselick fistula, which directs all the blood from the caudal vena cava into the portal vein, and (two or more weeks later) an aorticcaval fistula, through which a stream of arterial blood passes into the caudal vena cava (Fig. 6).
The technique for establishing an aorticcaval fistula has always been considered difficult, but by following the suggestion of Prof. J. Markowitz to use oiled doubled silk thread (0000) on fine seamstress steel needles (No. 9) it was found entirely practical. The