HEMOSTASIS. 69 
IV. 
HEMOSTASIS. 
To reduce to the minimum the hemorrhage that takes place during 
aan operation, and to guard against that which may follow, are im- 
portant rules of general surgery. The red sheet formed by the 
“blood flowing from the small divided tissues veils them and also 
the organs that the instrument must spare; and although it obliges 
the operator to stop his work frequently, it has no serious conse- 
‘quences. On the contrary, arterial or venous hemorrhages may 
‘produce abundant waste of blood ; if they occur secondarily and are 
not promptly averted, often they are followed by death. They must 
be prevented or attended to in order tostop them definitively. Per- 
fect hemostasis is peculiarly important in the operations upon the 
abdominal organs ; if blood escapes in a great quantity in the peri- 
ttoneal cavity, the inflammation of the serous membrane is a compli- 
cation seriously to be looked for. And, generally, when blood 
accumulates on wounds after the closing of their edges or the appli- 
cation of a dressing, suppuration takes place, and the production of 
general disorders of an infectious nature is greatly assisted. 
I. Preventive or Pre-operatory Hemosiasis.—lt is used princi- 
pally for operations upon the extremities. In the case of animals, 
digital pressure, tourniquets, or compressors are seldom employed. 
Ligatures and the Esmarch process are the usual expedients. 
For horses, ordinarily, circular and total constriction of a leg is 
made with a loop of cord, placed round the fetlock or the coronet, 
and is twisted several times round the parts or submitted to a torsion 
made with a piece of wood acting as a tourniquet. The strong 
‘pressure made upon the vessels; where the cord is applied, cuts off 
the circulation, and the hemorrhage soon stops. This ligature has 
another effect besides. The conductibility of the compressed nerves 
is less free, the sensibility of the regions situated below the ligature 
is diminished, and the pain of the operation is thus much reduced. 
- Striction with an India-rubber tube or band is less primitive and 
Jess brutal. Take a strong tube, 50 or 60 centimeters long, stretch 
it in rolling it round the leg above the knee or the hock, tie both 
ends together or secure them with a strong thread (fig. 34). Hemo- 
static India-rubber bands and tubes are made with a metallic hook 
and eye, by which they can be well secured in making the proper 
compression. 
The method of Esmarch is advantageous, when, having to ampu-~ 
tate a leg (small animals), or to excise organs highly hyperemic 
‘(prolapsed uterus), one wishes to operate on dry tissues. The in-~ 
