CHAPTEE XVIII 

 HEMOSTATICS OR STYPTICS 



These are agents used to control hemorrhage. They may be con- 

 veniently classified as those which act locally, " styptics," and those 

 which affect the body generally, " general hemostatics." They all 

 arrest hemorrhage in a manner similar to nature in spontaneously 

 closing a bleeding vessel. Ordinarily if an artery is cut, it con- 

 tracts within its sheath and the tissues fall in around the cut end. 

 In addition, if the bleeding is severe, the blood pressure will fall 

 and the coagulability of the blood increase. The choice of an 

 hemostatic depends upon the location of the hemorrhage and its 

 source; that is, is the bleeding point accessible, and is the source 

 of the blood arterial, venous or capillary ? Some mechanical means 

 should always be used to arrest hemorrhage from a large artery. 

 This may be accomplished either by ligature, clamp, forceps, torsion 

 or the actual cautery. Slight or capillary hemorrhage may often 

 be quite effectively stopped by local applications of astringents or 

 by vasoconstrictors. Among the most satisfactory of these agents is 

 cold, either in the form of cold water or ice. Adrenaline and the 

 styptics (astringents), tannin, alum, etc., are also quite serviceable. 

 In addition to the above some method must be employed to control 

 distant, inaccessible hemorrhages which can be reached only through 

 the circulation (getieral hemostatics). 



The principal local hemostatics are : 



1. Mechanical measures f All act by closing the vessels 



2. Cold < either by direct compression or 



3. Adrenaline. [through vasoconstriction. 



4. Agents favorable to the formation of a clot. Absorbent cotton, 

 gauze. Cobweb has been used for ages but is dirty. 



5. Those which act by precipitating the proteids of the blood. 

 Astringents, tannin, alum, etc. 



The general hemostatics are: 



1. Tannic acid group of drugs and mineral astringents. 



2. Agents to lower blood pressure. 



3. Vasoconstrictors, adrenaline, ergot, etc 



4. Coagulants. 



1. Tannic Acid Group. The various members of this group 

 have been recommended as general hemostatics but there is no foun- 



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