HEMOSTASIS, 7 
hemorrhage. This is an excellent process when one has to operat 
‘in regions of dangerous structure. It is especially used to isolat: 
blood vessels (ligature of the jugular) and nerves (neurotomies) 
Wounds made by tearing and by enucleation behave as those mad 
with the bistoury ; they cicatrize nearly as easily and as quickly a: 
clean-cut sections. 
Scraping is made by removal with the drawing knife or the shart 
curette. It permits the excision, with little hemorrhage, of the 
granulations and fungosities which line fistulous tracts and walls o: 
Suppurating cavities, and the scraping of carious bones. 
The various modes of ligature are frequently employed to obtain 
the mortification and elimination of tumors, and of organs, in part 
or 77 ¢ofo (vagina, uterus). The best of these is the elastic ligature. 
But these means of exzeresis are useful only in a limited number 
of cases. It is the bistoury which is generally used; and often it 
divides tissues in which preventive hemostasis could not have been 
realized. Then the blood flows, in a stream or by spurts, as the 
instrument divides small blood vessels or arterioles. 
Capillary hemorrhages ordinarily stop spontaneously ; the very 
small vessels are depressed by the retraction of the tissues, and 
their microscopic mouths are soon obliterated. If the hemorrhages 
continue in streams, they can be arrested by affusion of cold boiled 
water, made with aseptic sponges or compresses, held up above the 
wound, and gradually squeezed. More active are the lotions with 
solution of alcohol, phenic acid or corrosive sublimate, which pro- 
duce a peculiar ‘‘pickling” of the living surfaces, coagulate the 
liquids, and, in general, rapidly correct capillary exudations. A 
strong phenic acid solution is the most advantageous. Not to be 
disturbed by these flows of blood, one must be careful to have pre- 
pared lots of little balls of cotton which have been dipped in an 
antiseptic solution. An assistant using these successively, after 
having squeezed them to rid them of the solution, should soak up 
the blood, dry the surfaces, and thus allow the surgeon to see clearly 
the parts upon which he is operating. Among the hemostatics of 
-old surgery now out of fashion we may mention : snow, ice, ether, 
chloroform, alum, metallic sulphates, perchloride of iron, nitrate of 
‘silver, vinegar, Rabel solution, the numerous ‘‘ hemostatic washes,” 
the absorbing powders,—flour, ashes, agarics, amadou, and the 
‘dangerous spider web. 
x 
When arterioles, small veins or canals of larger caliber are divided, 
one can arrest the blood by using compression. or plugging, cautert- 
zation, ligature, torsion, or “ forcipressure.” R 
Compression is useful in cases where one has no time to look for 
the end of the cut vessel. It is performed, as aforesaid, in the 
neighborhood of wounds or upon one of its lips, by pressing with 
