HEMORRHAGE AND TRAUMATIC ANAMIA, 167 
the heart and the pulse persist. A reflex condition produced by a kind 
‘of commotion upon the nervous centers, the shock is often but the first 
step towards fatal coma. 
The wounded, upon which it is observed, should be left in costal 
decubitus with the head dependent. They should receive irritating 
cutaneous friction, alcohol or ether in hypodermic injections, and 
stimulating douches. 
Local sfugor or traumatic local commotion, a peculiar condition 
observed with contused wounds, is characterized by anaesthesia, the 
absence of hemorrhage and the cold sensation received by feeling the 
edges .of the wound. Sometimes it exists alone, at other times it is 
accompanied with the general phenomena which constitute the traumatic 
shock. Round the wound there exists a benumbed zone, ordinarily 
extensive, which has a great tendency to mortification. 
The treatment must have for its object the prevention of this, the 
arousing of the circulation, and the restoration of vitality to the anatom- 
icalelements. Stimulating and tepid antiseptic lotions are particularly 
to be recommended. As long as the local stupor lasts, all surgical 
interference must be stopped, except in case of positive emergency. 
Ii. 
HEMORRHAGE AND TRAUMATIC ANAMIA. 
The abundant and continued hemorrhages that are observed with some 
traumatic lesions in animals, are not always in proportion to the caliber 
of the blood-vessels divided. Whether primitive or secondary, and 
in the latter case, precocious or tardy, they may result from an alteration 
of the vascular walls, a general morbid condition (leuceemia, hemophilia) 
or from various visceral affections (diseases of the liver or of the heart). 
‘Their effects depend upon numerous conditions: duration and quantity 
of the hemorrhage, its local or general cause, caliber of the injured 
vessels. With the exception of patients suffering from leucemia or 
adenie, itis extremely rare for animals to have fatal traumatic hemorrhages, 
unless the injured blood-vessels are of great dimensions. 
The means to use in these cases vary accordingly. The flow of blood 
from small blood-vessels ordinarily subsides by plugging, pressure, or 
cauterization. For large blood-vessels, ligature or the torsion is used. 
(See Hemostasis). 
Traumatic anemia is the consequence of the loss of a large 
quantity of blood. Sudden and considerable hemorrhages give rise to 
acute anemia; \ess abundant but repeated flows bring on chronz 
anemia, irks. § 
The complete obliteration of the bleeding vessels is, in all cases, the 
