TREATMENT 93 



and the re-application of a well soaked anti- 

 septic pack is universally preventive. 



Hemorrhage 



The hlood loss, always considerable, often 

 reaches the danger point when large radicals 

 of the nutrient arteries are divided and the clos- 

 ing up of the wound is in some way delayed. 

 We depend more upon hasty work and prompt 

 closure of the cavity to limit the blood loss 

 than upon ligation or forcep hemostasia. Often 

 when blood is gushing from some part of the 

 wound in a threatening manner and a forcep 

 cannot be snapped upon it promptly we pack 

 the bleeding place with a hard wad of oakum 

 and let an assistant hold it down tight with a 

 long blunt instrument while the work proceeds 

 without further hindrance. While cognizant 

 of the fact that this is not a display of the best 

 surgery, it has always seemed impossible for 

 us to make any headway in the direction of sys- 

 tematic hemostasia in these operations and we 

 have come to the conclusion that less blood is 

 lost by hurrying through the work and then 

 depending upon the packing to prevent any 

 further loss. 



In exceptionally large withers, infiltrated 

 with an abundance of newly formed fibrous tis- 

 sue, the woimd is of such magnitude that in 



