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Show .53 or STOPPING HEMORRHACY BY BANDAUE. or ARTERIAL AND venous BLOOD. which the veins in the neck are compressed, and the bleeding continues in consequence of the obstruction to the return of the blood from the head : by way of insisting upon this, 1 have made them gargle their throat with cold wine and water. lVe, at the same time, introduce by a probe or bougie, dossils of lint moistened with vinegar or spirits, into the nose, or even draw them through the back part of the nostril. Should the bleeding advance to an alarming degree, we must stop the cavities of the nose in this manner. A piece of Wire 33 It is absolutely necessary to distinguish betwixt venous The difference has certainly been and arterial bleeding. sometimes overlooked, and operations fit only for arteries performed for the wound of a vein ! The blood flows uniformly, and is of a darker colour when it proceeds from the vein, and it may be stemmed by pressure below the wound, and can al- ways he stopped by compression in the wound itself. Where the bleeding is venous-where it comes from deep parts-where it is dangerous to lay the bottom open-where not one large artery, but many lesser ones are wounded, then the sponge and graduated compress ought to be used ; as in the wellng out of blood from vessels lying deep under the angle of the jaw, or in the axilla. In the use of the sponge, there are some circumstances which, it attended to, may save the patient from distress. The sponge ought always to have a string attached to it, lest we be obliged to allow it to remain, when it will not be easily withdrawn from the cavity. A lesser piece should be placed A :llihu/‘M‘ ‘ 1M»... 4.1mm muui L "i if 'h 4‘" ‘ immediately on the bleeding point; a larger one over it, fill. ing the wound. The larger one may thus be taken away at an early period, while the lesser is suffered to remain. Sponges ought to be removed at the commencement of suppuration _. « "5.," :1 .‘vmwr-H-i‘ri‘l- fl I in all cases; otherwise the granulations shoot into them, and they are not afterwards to be brought away without pain and {a catheter wire for example) made with an eye to convey a double ligature, is thrust into the nostril until it appears in the throat; to facilitate which, it ought to be curved near the end, that it may turn down behind the velum; then with a pair of forceps, or a hook, or the finger, the ligature is seiz~ ed and drawn into the mouth. Having prepared a piece of sponge, or a dossil of lint, such as will just plug up the posterior: Opening of the nostril, we tie this to the ligature, and draw it through the mouth into the back of the nose ; then closing , i-‘~.. .(n-r... ..3!". ..-- .2 .a the anterior nostril by plugging it also, and tying the ends of the ligature over the plug, no blood can escape. This opera- tion may be particularly useful after the extirpation of pol)" pus tumours from the cavities of the nose. bleeding. They are dangerous when allowed to lie long in contact with the bone. I have seen caries of the ribs produc ed by allowing sponges to remain too long in the axilla. In wounds received in battle, and attended with haemorrha- fay, much mischief must proceed from the application of the tourniquet. It totally deprives the limb of circulation; and, it the wounded man is for a short time neglected, the limb must irrecoverably sull‘er. Besides, every man does not. romprehend the application of the tourniquet, when he could apply such a bandage as this, a ter profiling a sponzre or cloth Into the bleeding wound. [lwr [.7i-u ' .- |