THE H^EMORRHAGIC DIATHESIS 77 



It has been advised, and the advice is physio- 

 logically sound, to apply normal human blood to the 

 oozing point. Unhappily, even if a mass of clot is 

 formed over the wound, it soon gets pushed away by 

 the collection of unclotted blood beneath it. For 

 the normal arrest of haemorrhage it is necessary either 

 that clotting should take place inside the bleeding 

 vessel or that it should fill the wound so tightly about 

 this vessel as to present a complete block to the flow. 

 It is often impossible to get the remedy near enough 

 to the actual rent in the artery or capillary to bring 

 this about, and the shape of the wound may not lend 

 itself to filling up tightly with firm clot. Neverthe- 

 less, the method is simple and painless, and has 

 sometimes succeeded. 



Styptics such as ferric chloride, tannin, or alum 

 may be applied to the wound, but they are painful 

 and lead to much sloughing, so it is well first to give 

 a brief trial to fresh normal blood applied by wool 

 pledgets, and to Wright's physiological styptic 

 (thrombokinase), composed of one part of minced 

 thymus in ten parts of normal saline. This produces 

 a firm clot, but does not act as quickly as the 

 escharotic styptics. 



Internally, Wright gives calcium salts, preferably 

 the lactate, but admittedly this is a bow drawn at a 

 venture, because the calcium is often absorbed very 

 badly, and may already be at the optimum in the 

 blood. The first difficulty may be obviated in some 

 patients by using magnesium lactate or carbonate. 

 The doses of any of these drugs should be 60 grains 

 for adults, and 15 grains for children, at once, followed 



