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Show 28 or Hmnionnnaoms. clothes or other foreign bodies will appear in the wound, enabling us to account for the outward The fistulous abscesses which remain long after trating wounds, must be managed according to principles of surgeryae. BLEEDING FROM SPONGY SURFACES. tube of the symptoms. these pene~ the general SHORT NOTICES REGARDING THE STOPPING 01" HZEMORRHAGIES. . P utillfiwll. . an". Mina , m t a t. THE first point concerning which the pupil requires inferno ation, is the fizz'ntz'ng from Itcemorr/mgg. He will soon find that, from an oozing of blood, an amazing quantity may be lost without the patient fainting, because whilst the blood flows thus gradually, the vessels contract equally over the system, and the heart and great vessels of the chest do not feel the loss, nor suffer any collapse. But when a great vessel is wounded, a few pulsations, the losing of a few ounces of blood, will so drain the heart and great vessels of blood, 29 the blood to the centre, and at the same time it excites the nervous systema‘s. The surgeon will not endeavour to revive the patient from his faintii g fit before he has secured him from a return of the heemorrhagy: he will often have to take advantage of this suspension of animation and feeble state of the circulation, to ‘ accomplish the ligature of the vessel. Towards the end of an operation, when the chief arteries have been secured, a little wine and brandy is given to rt: tore. the full action of the system, that all the arteries may bleed now which might otherways bleed after the dread and the coldness from exposure were removed. During the hmmorrhagy, there is an tutdulating, soft, and compressible pulse. \Vhen the bleeding is extreme, and passing to a dangerous state, the paleness of the face is accompa. nied by an anxious wildness 0r delirious look, which should command immediate attentionf. that the patient immediately faintst. A friend seeing the patient fain‘:, catches him up, but the surgeon lays him horizontally, by which means the blood flows more easily from the extremities to supply the heart, and the ascent of the blood to the brain is acilitated. Cold water sprinloed on the surface causes a contraction of the eX< . prsqrr-i-J-i‘t- a» l treme vessels, and a shock to the relaxed surface, which throws CF BLEEDING FROM DISEASED SURFACES. A VERY distressing occurrence is the bleeding from ulcerat- ed surfaces, from deep ill-conditioned wounds, or from the cavities of bones. Wilton a sore takes a sloughing disposition, it sometimes lays open great arteries, If the needle be used, it is driven amongst soft and dead or yielding parts, and the "‘ In concluding these initiatory views of Wounds, and especially of gunshot wounds, I should feel the impropriety of the shortness and bricthess of my remarks, ifI had it not in my power to refer to the more particula r information contained in Discourses on, the J‘v'hture and Cure of "hands, by Mr» John Bell. t 'l'h as I have seen in amputation, high in the thigh, in consequence ofa lllliititl'.(‘ In the application oi'thc tourniquet, a fechts of blood, full from the aorta, titliowul by 2; deep groan, and a fatal fainting. The man did not, in- ,_'._,4. "4...", m _,_.; deed, innnedlutch; die, but he never recovered. It does not require. the blot-ding ofun (ti-1c ' ' to produce this sudden eiiect. The bursting ofa Varicose yen in the tl .gh, in the course of which the valves have lost their pow‘ or, has i won suddwly fatal from the descent of the whole column of blood, o hich should supply the liCdl‘t. The circulation within the head is instantly zxti'cctcd by t not tension which prevails naturally in all the vessels, bring suddenly taken otl‘ vessel again bursts. This haemorrhagy occurs in a state of the system, in which the loss of a few ounces of blood may be fatal. Sometimes we have it in our power to tie the trunk of the artery ; for example, when there is secondary hacmorr- hagy after amputation, in which the styptlcs and dossils of lint, and the graduated compress and bandaging "ill avail nothing and in nhieh the tying of the bleeding artery will be attended pith repeated and sudden burstings forth of the. "" \Vhen death is dreaded from inanition, the scene changes, and stimulants to the nose and fauccs, hot water to the feet, Chatting of the limbs, and stimulating injections are used. ;' "1 best- marks become particularly important in lithTnni liamov hing}. |