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cal error, was useless and injurious; and that hæmorrhage was more dependent on the inosculation than the arborescence of vessels, or at least equally so, he determined to save the constitution of his patients from so grave and useless a hazard. “To tie up,” says he, “the carotid artery, before the performance of an operation, can only prove that the life of the patient is able to resist a double hazard, while his surgeon is gaining all the advantages which can be realized from such a precaution.” Again, continued he, “when we have ascertained that at least as many successful operations of the same kind have been performed without interfering with the main arteries, it can hardly be expected that we should agree to the necessity or even propriety of such a preliminary.” And further, “I have extirpated almost all the glands about the throat in succession,—the whole of the inferior maxillary and sublingual,—the lower portion of the parotid and many of the neighbouring lymphatic glands; repeatedly have I had occasion to expose the carotid artery and jugular vein; and have even dissected away tumours from the very coats of these vessels without encountering any immediate danger or subsequent inconvenience.”
Among other cases, may be noticed, as illustrative of practice on this principle, that of Mr. Joseph Brown of Orange county, New York. He was afflicted with an enormous carcinomatous tumour, extending from the lower part of the right cheek over a large part of the throat, complicated with fistula, caries of the lower maxillary bone, and enlarged lymphatic glands. This case, in the judgment of the profession here and in Europe, demanded a previous interference with the carotid. But McClellan, in the presence of his fellow professors and the students of Jefferson Medical College, successfully operated in accordance with, and in estab-
