Pye's surgical handicraft : a manual of surgical manipulations, minor surgery and other matters connected with the work of house surgeons and surgical dressers / edited by H.W. Carson.

  • Walter Pye
Date:
1931
Catalogue details

Licence: Public Domain Mark

Credit: Pye's surgical handicraft : a manual of surgical manipulations, minor surgery and other matters connected with the work of house surgeons and surgical dressers / edited by H.W. Carson. Source: Wellcome Collection.

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    SURGICAL HANDICRAFT SECTION I ON THE ARREST OF HAEMORRHAGE CHAPTER 1 OF HAEMORRHAGE GENERALLY WHEN the blood-vessels are divided or torn across, blood escapes in varying quantities—this is primary haemorrhage ; and according to the character of the vessel injured such haemorrhage or bleeding will be capillary, venous, or arterial. While the haemorrhage which results from injuries to the capillaries and veins is rarely serious, there are certain conditions which render it extremely dangerous : these will be considered later. Arterial haemorrhage must always be regarded as urgent, and in most instances active surgical measures will have to be undertaken to deal with the accident. Haemorrhage may be arrested by Natural Means, but in the case of the larger vessels such an arrest is usually called Temporary, and requires to be reinforced by such measures as will ensure complete and permanent closure of the wounded vessel. The process of temporary arrest is brought about by several factors : (1) Cut vessels, and especially torn vessels, tend to contract, this con¬ traction occurring much more readily in the case of veins than arteries ; (2) Effused blood coagulates, especially if exposed in the air, and the coagulated blood blocks the mouth of the vessel and acts as a fibrinous plug ; (3) Haemorrhage depends upon the force and velocity of the blood-stream, and is therefore much freer in the case of arteries than veins. After a certain quantity of blood has been lost, syncope comes on. This is a state of faintness, with depression of the heart’s action, pro¬ duced by haemorrhage and shock, and within certain limits is a fortunate occurrence, since the slackening of the circulation allows time for the formation of clots and for the contraction and retraction of the vessels within their sheaths. Moreover, the coagulability of the blood increases after a certain quantity has been shed.
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