Elements of surgery: for the use of students : with plates (Volume 1).

  • John Syng Dorsey
Date:
1818
Catalogue details

Licence: Public Domain Mark

Credit: Elements of surgery: for the use of students : with plates (Volume 1). Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    retraction of the artery within its sheath, and a slight con- traction of its extremity, are the immediate and almost simultaneous effects of its division. The natural impulse however with which the blood is driven on, in some mea- sure counteracts the retraction and resists the contract- tion,* of the artery, the blood is effused into the cellular substance ])etween the artery and its sheath, and passing through the canal of the sheath which had been formed by the retraction of the artery, flows freely externally, or is extravasated into the surrounding cellular membrane, in proportion to the open or confined state of the wound. The retracting artery leaves the internal surface of the sheath uneven by lacerating or stretching the cellular fibres that connected them. These fibres entangle the blood as it flows, and thus the foundation is laid for the forma- tion of a coagulum at the mouth of the artery, and which appears to be completed by the blood as it passes through this canal of the sheath, gradually adhering and coagu- lating around its internal surface, until it completely fills it up from the circumference to the centre.'' (Jones.) The diminished force of the circulation of the blood, its speedy coagulation, and its extravasation into the sur- rounding cellular texture, are circumstances wliich con- tribute greatly to put a stop to the hemorrhage. The co- agulum which acts as a plug to tlie open orifice, is situ- ated not actually within this orifice, but within its sur- rounding sheath, and as it is outside of the vessel. Dr. Jones has called it external; a coagulum however, is found within the arterial tube, as high as the nearest col- lateral branch, this is not suflicient in volume to fill up the vessel and adheres to the artery no where except at the divided extremity; this clot is called the internal coa- gulum. • The retraction refers to the diminished lengthy and tlie contraction to the diminished volume or diameter of the artery.
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