MAY 6 1880

THE TURNEY ARTERY OCCLUDER, FOR ARRESTING HEMORRHAGE WITHOUT PRESSURE, CAUTERY, LIGATURE,

I have recently received from Dr. John P. Turney, of Alkali, Oregon, through Dr. H. V. V. Johnson, of McMinnville, same State, an instrument invented by the former gentlemen that bids fair to revolutionize existing methods of arresting hæmorrhage after amputation and other operations involving division of large arteries.

The instrument, as shown in the accompanying illustration, is exceedingly simple in its construction, and is equally effective in operation. It may be described as a crescentic or horseshoeshaped knife, the free extremity of which is pointed and barbed ; the other end of the crescent being fixed to a straight shank at a right angle to the flat surface of the blade. The convexity of the blade has a cutting edge, the concavity being rounded or dull.

The size of the instrument should vary with the artery to be
occluded, so that it is desirable to have at hand three or four sizes
for ordinary purposes.
It may be made for use with either hand

as desired, the left-handed instrument being probably more con-
venient for most operators. The instrument from which the
accompanying cut was taken, is a left-handed one, suitable for a
vessel the size of the radial artery, and was made by an Oregon
blacksmith. Its modus operandi is as follows: The cut extremity
of the vessel, having been seized by the forceps in the usual
manner, the barbed point of the occluder is passed through its
walls from above downwards, the cutting edge being held parallel
with the axis of the lumen; the barbed point, having pierced
both walls of the vessel (half an inch or less above the cut end) is
now made to describe a half circle by rotating the handle; this
brings it (the point) in contact with the under surface of the artery;
continuing the rotation both walls are again pierced, this time from
below upward, and as near as possible to the cut end.
The rotary
motion of the handle is now reversed, when the use of the barb

SPENCER CINTI

becomes apparent-catching the free end of the vessel and carrying it back through opening number one. The instrument is now free, with the exception of the small portion of the vessel caught on the barb, which may either be divided or slipped off with the forceps.

Briefly, the whole operation consists in making a hole in the vessel and drawing the cut end through it, and may be performed in half the time required to tie a ligature.

The position of the openings made in the vessel are indicated in the figure.

The advantages of arterial occlusion without a foreign body to be left in the wound are to obvious too require comment, while the main objection urged against torsion, that it "does not look safe," are effectually done away with. No surgeon who tests the instrument on the cadaver will be afraid to risk it on the living subject. Further than this, "the proof of the pudding" has been furnished by its inventor, who has used it without a failure many times on dogs, and once on an human subject in a double amputation, of which the original notes are subjoined.