Considering  that  compression  and  ligature  of  the  carotids  have  been
foand  useful  in  epilepsy,  mania,  and  other  chief-diseases.  Dr.  Burrows
thinks  that  the  ligature  may  be  resorted  to  in  hopeless  cases  of  the  kind
alladed  to.
**  Although  the  ligature  of  the  common  carotid  is  attended  with  risk  to  life  in
some  cases  (perhaps  in  the  proportion  of  one  death  in  four  operations ),  still  ex-
perience proves  that  where  proper  precautions  have  been  taken  the  operation  is
not  so  dangerous  as  many  suppose.  Therefore,  in  violent  and  hopeless  cases  of
epilepsy  and  some  kindred  maladies,  which  are  characterised  by  extreme  cerebral
congestion,  it  appears  to  me  that,  other  remedies  failing,  this  operation  may  be
^rly  resorted  to.  1  am  aware  of  the  responsibility  of  advocating  a  remedy
attended  with  risk  to  life  ;  but  are  not  all  our  best  remedies  most  violent  poisons
in  the  hands  of  the  unskilful  ?  But  this  truth  does  not  forbid  their  use  by  the
more  expert.  So  may  this  powerful  method  of  influencing  the  cerebral  circula-
tion be  justifiable  in  aggravated  cases  of  the  class  referred  to,  and  where  the  pre-


418  Dr.  Burrows  oh  Disorders  of  the  [Oct.
