Pye's surgical handicraft : a manual of surgical manipulations, minor surgery and other matters connected with the work of house surgeons and surgical dressers / [Walter Pye].

Walter Pye

Date:: 1891

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 / [Walter Pye]. Source: Wellcome Collection.

70/604 (page 46)

$of sloughing tissues, and the risks of securing the trunk higher up by ca separate operation. Ht^moirhage As in sloughing phagcthena, most malignant tuniours do not from maiienant ^ ^ vessels in the tissues among which they spread, and one of the most frequent causes of death in these cases ishJBmorrhage from a vessel which is mvolved in the mahg- nant ulceration. This would be more frequent still, wei^ it not that the vessels are so often previously obhterated. i he arrest in these cases, and the precautions to be taken are precisely those which have been mentioned for phagedsena, with the single exception, that it will never be right to attempt to put a ligature on the vessel at the seat of h™-- rha^e, that is, in the substance of a malignant gi^owth. i^ut in addition to this form of bleeding by invasion of vessels, malignant tumours are themselves generally very highly vas- cular, and in the later stages of their growth, break down, and then their ulcerated surfaces are apt to bleed, sometimes very profusely, as may readily be imagined, smce the blood supply of some of the softer sarcomata is abundant enough to cause the whole mass to pulsate. A variety of methods may be adopted for the arrest of this form of bleeding. Moderately firm pressui-e, cold as by aiScations of ice or the ether spray, the use of astrmgen Scs (Jnd it is in these cases especially that pads soaked in perchloride of iron, or made of styptic cotton or tow, mafbe usefully employed); all or any of these may in SffW Tases b'e f oid'effi lent.. In certain ^^^^^^^^^^^ of the main vessel of supply is indicated, as of the ng^ial artery in some cases of epithelioma of the tongue ; but the irtual cautery ^vill hardly ever be advisable. . 'men the ulcerated siiface of a malignant grow ^ - apt to bleed, but only occasionally, a go^^ fP?^^^^^^^^^^^^^ powder of equal parts of crude opium and Cmchona bark, which may be dusted on the part. ^„^.„^p<, exter- Oppnsionallv but very rarely, an aneurism ruptures exter Hremorihnge Uccasionaiiy, uuu v«= j , ^i^' „„j |],p,.p ore even one or Sn\r'-^^ nally, and causes ^;;tthth the oc^^^^^^^^^^ aneur... two cases ou ^e^^^d u which^^^^ p,oceedings which the cure or tne disease, j-uc id c i bleeding •$