THE ALUMNI JOURNAL. 



79 



toms of general poisoning come on as 

 shown by great constitutional depression 

 as well as extension of the swelling irom 

 the wound, liberal doses of whiskey or 

 brandy combined with aromatic spirits of 

 ammonia maj- be given, though no bene- 

 fit is to be derived from actual intoxica- 

 tion. In cases of stings of bees, wasps, 

 or spiders, an application of the spirits 

 of ammonia, or witch- haz^l extract or 

 laudanum and water is sufficient. If the 

 pain and swelling are very severe the 

 parts may be swathed in cloths dipped in 

 the lead water and laudanum lotion. 



Hemorrhage or Bleeding. — This is a 

 most important subject for your atten- 

 tion as by a knowledge of the means of 

 treating this symptom you will perhaps 

 be able to save life. Hemorrhage is an 

 accompaniment of almost all incised, 

 lacerated or penetrating wounds and in 

 many of them constitutes the most im- 

 portant indication for treatment. The 

 ordinary oozing from a small cut or 

 injury comes from the minutest blood 

 vessels known as capillaries and is easily 

 stopped by cold water or a piece of cotton 

 wool. If a vein is opened the flow of 

 blood is continuous and the color dark. 

 This is arrested without trouble by a 

 little pressure on the distal extremity of 

 the cut vein, or by applying a compress 

 directly over the injury. If an artery of 

 any size is cut, however, the blood is 

 bright red in color and as it is pumped 

 directly from the heart it flows in inter- 

 mittent jits or spurts corresponding to 

 the contractions of that organ. As the 

 veins accompany the arteries both are 

 usually severed by the same accident, so 

 that we have a mixed flow of bright red 

 and dark blood. Arterial hemorrhage is 

 the most dangerous form of bleeding and 

 the most difficult to stop. It, by any 

 means the circulation can be cut off, the 

 remaining blood in the vessel will become 

 coagulated or clotted and partially solidi- 

 fied. This is exactly what we wish to 

 bring about and it is on the principle of 

 clotting that our efforts to stop bleeding 

 depend. In severe hemorrhage we may 

 as a primary measure stuff a handker- 



chief or cloth or piece of absorbent cotton 

 into the wound and bind tightly on, or 

 bring pressure to bear directly with the 

 fingers in or over the wound. If this is 

 not successful you must then apply 

 pressure above the injury by means of 

 the artificial tourniquet. In any form of 

 bleeding from any part of the arm or 

 hand, leg or foot, there is one cardinal 

 point where the main arteries may be 

 compressed. In the upper extremity the 

 point is just to the inner side ot the 

 upper part of the arm behind the border 

 of the prominent (biceps) muscle. In the 

 lower extremity the main artery may be 

 compressed about an inch below the 

 groin at the inner part of the thigh. 

 Details of treatment : Lay the patient 

 down and keep the wounded point ele- 

 vated. Fold a handkerchief or piece of 

 cloth tightly, or take an apple, a turnip, 

 or a smooth round stone and apply 

 directly over the artery as a compress at 

 the point designated according to the 

 extremity affected. Then tie another 

 handkerchief, sleeve of shirt, suspender 

 or anything of its kind around the limb 

 over the compress ; carry around to 

 opposite side and fasten securely. If 

 this doesn't arrest the bleeding, pass a 

 cane, umbrella, or anj^ strong stick 

 through the knot and give it a twist or 

 turn. This will always arrest the bleed- 

 ing even though a leg or arm has been 

 cut off. A still better tourniquet is a 

 strip of strong rubber about a yard long 

 and three fourths of an inch wide. Wind 

 this about the limb tightly above the 

 injury and it will cut off all bleeding. 

 Keep the wound elevated and await the 

 coming of the doctor who will ligate the 

 vessel if necessary. Bleeding from the 

 face, mouth or head may sometimes be 

 arrested by firm pressure with the thumb 

 on the great vessels of the neck an inch 

 above the collar bone. In bleeding from 

 the face and scalp, however, as well as 

 from the trunk, we must generally relj' 

 upon the use of ice to the wound, styptic 

 or absorbent cotton, alum, tannin, per- 

 sulphate of iron or direct pressure over 

 the wound. 



