xxvi INTRODUCTION
in the treatment of fractures and dislocations, the occasional ligation of arteries, amputations, cutting for stone and the excision of a few small and readily accessible tumors. In these limited fields Americans did their full share of original work.
Ligation of Arteries. — Early American operators were especially bold in the ligation of the large arteries, and have contributed proportionately more to this field than the surgeons of other nations. In this connection Valentine Mott, of New York, deserves first mention. He was the first to tie the innominate artery, May 18, 1818 (" Medical and Surgical Regis- ter," New York, 1818, vol. i). This carried his reputation to all parts of the civilized world; but that was a small part of his work in the ligation of arteries. Gross, in his memoir of Mott, published in 1868, says: "No surgeon, living or dead, ever tied so many vessels or so successfully for the cure of aneurysm, the relief of injury or the arrest of morbid growths." He credits Mott with having tied the femoral artery fifty-seven times, the carotid fifty-one times, the popliteal ten times, the subclavian eight times, the external iliac six times, the internal iliac twice and the common iliac once. In all he is said to have ligated great arteries of the body 135 times.
J. Kearny Rogers, of New York, first ligated the left subclavian artery between the scaleni muscles ("New York Journal of Medicine," 1846, vol. vi). Sir Astley Cooper had failed in such an operation attempted in 1809.
The subclavian artery was first tied on the scapular side of the scaleni muscles by Wright Post, of New York, then professor of surgery in the College of Pysicians and Surgeons, now Columbia University. Mott, in his memoir of Post ("Transactions of the Medical Society of New York," 1828), speaks of his ligation of the subclavian as follows: " But the masterly stroke of Dr. Post in surgery remains to be mentioned. It is certainly for the honor of our time, for the credit of America, and for the pride of our city that the first successful operation of tying the subclavian artery above the clavicle on the scapular side of the scaleni muscles for an aneurysm was first performed by him. To succeed in an operation of such delicacy and danger which had failed in the hands of such master spirits in surgery as Ramsden, Abernethy and Cooper was a triumph reserved for our friend."
The ligation of the common carotid artery was first done successfully in 1805 by Amos Twitchell, then of Keene, New Hampshire. He tied the common carotid artery for secondary hemorrhage following an accidental gun-shot injury at a regimental review. The hemorrhage occurred some days after the injury, and the artery is said to have spurted three or four feet, rendering the patient almost absolutely blood- less. It was then taught by surgeons and physiologists that it was unsafe
