192 PRINCIPLES OF VETERINARY SURGERY 



seriousness of the sudden haemorrhage, where there is no 

 time for this absorption to take place. 



Death occurs from cardiac arrest, which in turn is caused 

 by the diminished volume of blood in its cavities, and the 

 starvation of its nerves. With a diminished volume of 

 blood to stimulate its coiitractions, and an impoverished, 

 anaemic state of the nerve centers which control its move- 

 ments, the heart falters and finally stops entirely. Internal 

 haemorrhage may cause death even when the loss is of sec- 

 ondary importance, according as its location directly or 

 indirectly affects vital organs. 



TREATMENT.— The loss of large quantities of blood 

 is always to be avoided in surgical operations, on account 

 of the depressing effect it always produces. It augments 

 shock, impedes regeneration, and favors complications. 

 The modern surgeon respects every drop of his patient's 

 blood, and makes every possible effort to preserve it. Dur- 

 ing the operation even the small bleeding vessels are care- 

 fully twisted as soon as they are met, the larger ones are 

 promptly ligated, and the very large ones are avoided when 

 possible or ligated before they are divided. When the 

 operation is over, the flow of blood is very carefully con- 

 trolled before the dressings are applied. 



The treatment of the patient that has lost large quan- 

 tities of blood consists of the free and repeated injections 

 of normal salt solution. These are given intravenously and 

 subcutaneously every few hours until the blood pressure 

 and the heart's action are revived. In addition, ammoniacal 

 stimulants and warm clothing are not to be omitted. Alco- 

 holic stimulants are harmful. 



HiEMOSTASIS. 



HiEMOSTASIS,— ARREST OF HEMORRHAGE, 



depends upon two influences, which may be described as. 



