Injuries to head and neck / by H. Lawson Whale.

  • Whale, George Harold Lawson, 1876-1943
Date:
1919
Catalogue details

Licence: In copyright

Credit: Injuries to head and neck / by H. Lawson Whale. Source: Wellcome Collection.

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    INJURIES TO THE HEAD AND NECK CHAPTER I HAEMORRHAGE Secondary haemorrhage in wounds of the neck may, of course, occur at any moment after a man is wounded; but the patient s admission to hospital is the earliest time that can concern the surgeon in charge. Of 23 cases sufficiently grave for me to tie one of the carotid vessels, 10 occurred in the first three days, 20 (includ¬ ing the above-mentioned 10) before the end of the seventh day, and 3 between the latter and the eleventh day. The average period of incidence was four and a half days after the man was wounded. The most usual days were the first and third—4 cases occurred on the first, and 4 on the third day. A comparison of these figures was made in France with those indicating the period for secondary haemorrhage in wounds of other parts of the body; and it seems, as a result of this comparison, that in neck wounds the catastrophe may be expected earlier than elsewhere. The most probable reason for this is that in many cases the wound simultane¬ ously injures the mandible, pharynx, or larynx, and so gives egress to infective saliva. There are certain aggravating causes which, as would be expected, often determine the incidence of the bleeding. Such are coughing, swallowing, and in general movement, either of the head on the trunk, or of the body as a whole. It is no uncommon thing for a man with a deep wound in the neck to begin to bleed at the moment when he is lifted on to the stretcher to be taken to the X-ray room.
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