HEMORRHAGE. 715 



it is not from a defective supply of nutriment to the tissues generally, 

 but from a slow exhaustion of the nervous and muscular power, affect- 

 ing the brain, spinal cord, and" heart, due to a deficient supply of nu- 

 triment and of oxygen to them, in consequence of the diminution in 

 the number of the red corpuscles. 



Every one should be acquainted with the various forms of accidental hemor- 

 rhage, and their impromptu treatment. If it be general oozing from small 

 vessels, which is easily recognized, and if it proceed from a part to which 

 pressure can be applied, a handkerchief closely folded into the form of a pad, 

 and firmly bound over the spot by another handkerchief, will generally suffice 

 to stanch the bleeding for a time ; the part should then be kept elevated and 

 at rest. In hemorrhage from a rein, the blood is dark, and the stream flows 

 continuously, welling up over the surface. Moreover, pressure with the finger 

 on the side of the wound further from the heart, will almost entirely arrest 

 the bleeding ; whilst if pressure be applied on the side of the wound next to the 

 heart, the flow of blood becomes more copious. To arrest venous hemorrhage, 

 a small thick pad should be applied upon the wound, so as to extend a little 

 to the side further from the heart ; this should be firmly secured by a hand- 

 kerchief or bandage ; the chief pressure must be made on the side of the wound 

 away from the heart, because that is the direction from which the blood flows. 

 Arterial hemorrhage is known by the blood being bright, and projected in a 

 jet from the wound, sometimes to a considerable distance, usually by jerks, 

 though, if the artery be very small, there are merely slight intermissions in 

 the force of the jet, and, in wounds of very minute arteries, the jet is continu- 

 ous. Moreover, pressure on the side of the wound further from the heart has 

 no effect on the stream ; but pressure on the side nearer the heart, stops it. 

 To arrest arterial hemorrhage from a small artery, therefore, a pad of suitable 

 size should be applied upon the wound, and extend also on the side next to the 

 heart ; it must be, not merely firmly, but tightly bound by a handkerchief or 

 suitable bandage. If the artery be large and deep seated, very forcible pres- 

 sure becomes necessary, and in order to communicate this specially to the 

 artery itself, a small thick and unyielding kind of pad is necessary. This 

 should be made, not by folding a handkerchief, but by rolling it up as tightly 

 as possible, with .or without some firm substance inclosed within it. Beneath 

 the handkerchief used as a bandage, a short stick may be inserted on the side 

 of the limb opposite to the wound, and then be twisted round, so as to in- 

 crease the pressure. 



These directions apply to veins and arteries situated in the limbs. Upon 

 the head, simple pressure with the thumb or finger, will suffice to stop bleed- 

 ing from either kind of vessel, because the bones of the cranium afford a per- 

 fect means of counter-pressure. Wounds of the large vessels of the neck, re- 

 quire very special management ; but, as a general rule, direct pressure with a 

 pad, maintained in its place by the thumb, is the best means to have recourse 

 to, until proper assistance, by forceps and ligature, can be afforded. 



In cases of sudden and great loss of blood, living blood, drawn from 

 the veins of another person, has been injected into the veins of those 

 suffering from the hemorrhage. This is known as the transfusion 

 of blood. Two hundred years ago, Lower (1665) suggested this op- 

 eration, having found that animals, apparently dead from hemor- 

 rhage, were quickly revived, when blood, taken from another ani- 

 mal, was immediately injected into the veins. As an operation upon 

 the human subject, transfusion was perfected by Dr. Blundell. The 

 blood received into a warmed funnel connected with a proper syringe, 

 is immediately transferred to the veins of the patient, no time being 

 permitted for the occurrence of coagulation. The records of fifteen 



