72 WOUNDS AND BRUISES. 



should be picked up with a torsion forceps, drawn out, and given 

 about eight half twists, so as to form a twisted coil or knob that 

 will aid in securing the vessel. If a ligature be used, it should be 

 tied tightly by a reef knot (Fig. 32) with thread : silk for prefer- 

 ence. The other end may then be picked up. An attempt to 

 twist or tie should always be made, when there is persistent bleed- 

 ing in a jet. Bleeding from an artery may be often stopped by 

 getting hold of the cut end from which blood is being pumped out, 

 with the fingers, and exerting pressure on it for a few minutes ; or 

 by keeping up pressure on the side of the cut end with the finger, 

 or a pad (p. 66). 



Above all, the surgeon should never dread hsemorrhage, nor lose his 

 presence of mind when it occurs. If recourse be had to proper means, it 

 can always be, at least temporarily, arrested. On no account should any 

 one who pretends to the character of a surgeon, employ inefficient means 

 to stop it, and imagine that he can, by covering up the wound with rags, 

 handkerchief, &c., prevent the escape of blood. 'These procedures only hide 

 the loss that is going on, and, by increasing the warmth of the parts, 

 prevent -the contraction of the vessels, and favour the continuance of the 

 bleeding. Under all circumstances, therefore, bleeding wounds should be 

 opened up, the coagula gently removed from their surface by means of a 

 piece of soft sponge, or a stream of cold water and tjie part well cleaned. 

 In this way you look your enemy in the face and can adopt efficient means 

 for the permanent arrest of the haemorrhage. 



2. REMOVE ALL DIRT, CLOTS OF BLOOD, AND OTHER 

 FOREIGN MATTER.— This may be done by gently syringing the 

 jDart with recently boiled water which has been allowed to cool to 

 about blood-heat ; or, preferably, with a warm antiseptic solution, 

 such as 20 grains of chinosol, or half an ounce of oreolin or carbolic 

 acid to a pint of water. A piece of antiseptic cotton wool, or a 

 clean cotton rag soaked in an antiseptic solution should be used 

 instead of a sponge, which is difficult to render thoroughly clean. 

 The wound should not be touched more than is absolutely necessary. 

 If the injury be superficial and the parts unbruised, the blood may 

 be allowed to remain on, so as to form a scab, in which case, the 

 process of healing will be greatly facilitated by dusting the wound 

 with tannoform. 



3. DESTROY ANY PUTREFACTIVE GERMS THAT MAY 

 HAVE GAINED ACCESS TO THE WOUND, by the application 

 of an antiseptic (p. 67). 



4. BRING THE EDGES OF THE WOUND TOGETHER.— It is 



best in most cases to bring the divided surfaces together, as soon 

 as possible after the bleeding has ceased ; or if by bringing them 

 together and applying pressure, bleeding can be stopped. It may, 

 however, be necessary to leave the wound open for a few hours. 



