TREATMENT 93 
and the re-application of a well soaked ant- 
septic pack is universally preventive. 
Hemorrhage 
The blood 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 blocd 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 wound is of such magnitude that in 
