A handbook of the theory and practice of medicine / by Frederick T. Roberts.
- Frederick Thomas Roberts
- Date:
- 1885
Licence: Public Domain Mark
Credit: A handbook of the theory and practice of medicine / by Frederick T. Roberts. Source: Wellcome Collection.
55/1050 page 37
![travasations vary in amount from minute points of blood to large clots, which are either distinct arid well-defined, or mixed up with the tissues of the structure involved ; there may be one or more collections of blood in the same organ. The blood is generally found coagulated more or less firmly, and at first presents a dark red colour. It may more or less speedily cause irritation of the surrounding tissues, as evidenced by redness, inflammatory exudation, softening, or even the formation of an abscess. Its colouring matter may also stain neighbouring structures. If the extravasation does not soon prove fatal, it undergoes the following changes:—1. The colour gradually becomes paler, at the same time changing to brown or yellow, and ultimately it may become almost white ; a granular pigment often forms simultaneously, along with crys- tals of hgematoidine. 2. The clot contracts in size, becoming firmer, and being surrounded with a strong fibrous capsule ; it also frequently itself undergoes organization into fibrous tissue, and becomes vascu- larized, in which condition it may remain permanently. 3. In some cases it is absorbed, leaving a cystic cavity containing fluid, which fluid may also ultimately be taken up, the walls of the cyst coming together, and only a hard cicatrix remaining, sometimes coloured by pigment. Occasionally nothing is left but altered blood pigment, of a yellow or black colour, especially on membranous surfaces; or there may be no trace of a previous hcemorrhage except a puckering and contraction. In some instances a clot softens and assumes a puriform appearance. Symptoms.—Active hfemorrhage is often preceded by premonitory symp- toms. Thus there may be general excitement of the circulation, with a quick, sharp, and full pulse; or local sensations of weight or fulness and heat are complained of, with increased pulsation, the extremities being at the same time cold. Special symptoms frequently indicate the approach, of bleeding in connection with particular organs. The actual symptoms may be described as general and local. General.—According to the quantity of blood lost, and the rapidity with which it escapes, haemorrhage may either be unattended with any general symptoms at all; or it proves more or less speedily fatal; or gives rise to faintness or syncope; or merely originates an aneemic con- dition. Local.—The local phenomena necessarily vaiy with the seat and amount of the haemorrhage. Instant death may result from the mere local effects of the blood effused. The symptoms usually observed are dependent upon :—a. Fhysical interference with the functions of an organ, owing to the mere presence of the blood, as when it escapes into the pericardium, and ]oresses upon the heart; or when a large quantity accumulates in the bronchial tubes, h. Destruction of tissues, which may be broken up or lacerated. This generally happens when extravasation takes place into the substance of an organ, the functions of which are tbus materially disturbed, c. Irritation by the coagulated blood, this being liable to give rise to more or less local inflammation, with its accompanying symptoms, d. Excitation of certain acts, which have for their object tlie discharge of the blood, should it escape on a free mucous surface. Thus blood in the stomach often causes vomiting; in the air- passages it excites cough. The amount and characters of the rejected blood vary consideraljly, and valuable indications are usually thus afforded as to the source of a htemorrhage. It is often more or less mixed with secretions and other materials. The presence of blood may be obvious to ordinary objective examination, as in the case of subcutaneous](https://iiif.wellcomecollection.org/image/b20400111_0055.jp2/full/800%2C/0/default.jpg)
