m, as is generally understood, is an enlargement of a certain
part of an artery, this enlargement sometimes becoming of enormous size,
full of palpitating blood, and likely to rupture with fatal results at
any time. If by any means the blood can be allowed to remain quiet for
even a few hours in this aneurism it will form a clot, contract, and
finally be absorbed and disappear without any evil results. The problem
of keeping the blood quiet, with the heart continually driving it
through the vessel, is not a simple one, and in Hunter's time was
considered so insurmountable that some surgeons advocated amputation
of any member having an aneurism, while others cut down upon the tumor
itself and attempted to tie off the artery above and below. The first
of these operations maimed the patient for life, while the second was
likely to prove fatal.

In pondering over what he had learned about collateral circulation and
the time required for it to become fully established, Hunter conceived
the idea that if the blood-supply was cut off from above the aneurism,
thus temporarily preventing the ceaseless pulsations from the heart,
this blood would coagulate and form a clot before the collateral
circulation could become established or could affect it. The patient
upon whom he performed his now celebrated operation was afflicted with
a popliteal aneurism--that is, the aneurism was located on the large
popliteal artery just behind the knee-joint. Hunter, therefore, tied off
the femoral, or main supplying artery in the thigh, a little distance
above the aneurism. The operation was entirely successful, and in six
weeks' time the patient was able to leave the hospital, and with two
sound limbs. Naturally the simplicity and success of this operation
aroused the attention of Europe, and, alone, would have made the name of
Hunter immortal in the annals of surgery. The operation has ever since
been called the "Hunterian" operation for aneurism, but there is reason
to believe that Dominique Anel (born about 1679) performed a somewhat
similar operation several years earlier. It is probable, however, that
Hunter had never heard of this work of Anel, and that his operation
was the outcome of his own independent reasoning from the facts he had
learned about collateral circulation. Furthermore, Hunter's mode of
operation was a much better one than Anel's, and, while Anel's must
claim priority, the credit of making it widely known will always be
Hun