MOTION OF THE HEART AND BLOOD 



the way in is open but the way out closed, so there 

 must be an engorgement or tumor? 



May not this happen in boils? As long as the swell- 

 ing is increasing and has not come to a final state, 

 a full pulse may be felt in the area, especially in 

 more acute tumors in which the swelling is sudden. 

 But these are for later investigation. However, 

 this happened in an accident I experienced. I was 

 thrown once from a carriage and struck my head 

 at a place where an arterial branch crosses the 

 temporal region. Immediately I felt, in the space 

 of about twenty pulsations, a tumor the size of an 

 egg but without either heat or great pain. It seems 

 the blood was pushed out with an unusual amount 

 and speed because of the nearness of the artery to 

 the place of injury. 



Now it also appears why, in phlebotomy, if we 

 wish the blood to flow longer and with greater 

 force, we ligate above the cut, not below. If such 

 a flow would come through the veins above, the 

 ligature would not only be of no aid, but would 

 positively hinder it, for if blood flowed downwards 

 from the upper part of an extremity through the 

 veins, it would more properly be tied below the 

 cut so the impeded blood would escape through 

 the cut more abundantly. But since it is forced 

 elsewhere through arteries into the veins lower 

 down, from which return is prevented by the liga- 

 ture, the veins swell, and being under tension can 

 eject their contents through the opening to some 



[91I 



