A Treatise on Anatomy, Physiology, and Hygiene Part 25

2d. When the blood is made impure by inhaling vitiated air, the action of the heart and arteries is diminished, which produces an effect similar to that which takes place when blood is drawn from a vein.

378. _Hemorrhage from divided arteries should be immediately arrested._ When large blood-vessels are wounded or cut, the flow of blood must be immediately stopped, or the person soon faints, and the heart ceases its action. If it is a large artery that is wounded, the blood will be thrown out in jets, or jerks, every time the pulse beats. The flow of blood can be stopped until a surgeon arrives, either by compressing the vessel between the wound and the heart, or by compressing the end of the divided artery in the wound.

376. State some of the effects that the mind has on circulation. 377.

What effect have the quant.i.ty and quality of blood upon the circulatory organs? Give ill.u.s.tration 1st. Ill.u.s.tration 2d. 378. What is necessary when large blood-vessels are wounded or cut?

[Ill.u.s.tration: Fig. 76. The track of the large artery of the arm. 1, The collar-bone. 9, The axillary artery. 10, The brachial artery.]

[Ill.u.s.tration: Fig. 77. B, The manner of compressing the artery near the collar-bone. A, The manner of compressing the large artery of the arm, with the fingers. C, The manner of compressing the divided extremity of an artery in the wound, with a finger.]

379. After making compression with the fingers, as described and ill.u.s.trated, take a piece of cloth or handkerchief, twist it cornerwise, and tie a hard knot midway between the two ends. This knot should be placed over the artery, between the wound and the heart, and the ends carried around the limb and loosely tied. A stick, five or six inches long, should be placed under the handkerchief, which should be twisted until the knot has made sufficient compression on the artery to allow the removal of the fingers without a return of bleeding. Continue the compression until a surgeon can be called.

What is shown by fig. 76? By fig. 77? 379. What is to be done after compressing the wound, as before described?

[Ill.u.s.tration: Fig. 78. A, B, The track of the large artery of the arm.

The figure exhibits the method of applying the knotted handkerchief to make compression on this artery.]

[Ill.u.s.tration: Fig. 79. A, C, The track of the large artery of the thigh.

B, The method of applying the knotted handkerchief to compress this artery. In practice, the twisting stick B should be placed opposite the knot over the artery A, C.]

380. When an artery of the arm is cut, elevating the wounded limb above the head will tend to arrest the flow of blood. In a wound of a lower limb, raise the foot, so that it shall be higher than the hip, until the bleeding ceases.

_Ill.u.s.tration._ On one occasion, the distinguished Dr. Nathan Smith was called to a person who had divided one of the large arteries below the knee. After trying in vain to find the bleeding vessel, so as to secure it, he caused the foot to be elevated higher than the hip. At the first instant the blood was forced from the wound about twelve inches; in a minute, it was diminished to three or four; and, in a short time, the bleeding ceased. This Dr. S. called his "_great_"

operation; and it was truly great in _simplicity_ and _science_.

What is shown by fig. 78 and 79? 380. What suggestion relative to the position of a limb when bleeding? Relate a simple operation by Dr.

Nathan Smith.

381. The practical utility of every person knowing the proper means of arresting hemorrhage from severed arteries, is ill.u.s.trated by the following incidents. In 1848, in the town of N., Ma.s.s., a mechanic divided the femoral artery; although several adult persons were present, he died in a few minutes from loss of blood, because those persons were ignorant of the method of compressing severed arteries until a surgeon could be obtained.

382. In 1846, a similar accident occurred in the suburbs of Philadelphia. While the blood was flowing copiously, a lad, who had received instruction on the treatment of such accidents at the Philadelphia High School, rushed through the crowd that surrounded the apparently dying man, placed his finger upon the divided vessel, and continued the compression until the bleeding artery was secured by a surgeon.

383. In "flesh wounds," when no large blood-vessel is divided, wash the part with cold water, and, when bleeding has ceased, draw the incision together, and retain it with narrow strips of adhesive plaster. These should be put on smoothly, and a sufficient number applied to cover the wound. In most instances of domestic practice, the strips of adhesive plaster are too wide. They should not exceed in width one fourth of an inch. Then apply a loose bandage, and avoid all "healing salves," ointments, and washes. In removing the dressing from a wound, both ends of the strips of plaster should be raised and drawn toward the incision. The liability of the wound re-opening is thus diminished.

381. Relate the first incident showing the utility of every person knowing the proper method of arresting the flow of blood from divided arteries. 382. The second incident. 383. How should "flesh wounds" be dressed?

_Observation._ The union of the divided parts is effected by the action of the divided blood-vessels, and not by salves and ointments.

The only object of the dressing is to keep the parts together, and protect the wound from air and impurities. _Nature_, in all cases of injuries, performs her own cure. Such simple wounds do not generally require a second dressing and should not be opened until the incisions are healed.

[Ill.u.s.tration: Fig. 80. The manner in which strips of adhesive plaster are applied to wounds.]

384. In wounds made by pointed instruments, as a nail, or in lacerated wounds, as those made by forcing a blunt instrument, as a hook, into the soft parts, there will be no direct and immediate union. In these cases, apply a soothing poultice, as one made of linseed meal, and also keep the limb still. It is judicious to consult a physician immediately, in punctured or lacerated wounds, because they often induce the most dangerous diseases.

385. Wounds caused by the bite of rabid animals or venomous serpents, should be immediately cleansed with pure water. In many instances, the application of suction, either with "cupping gla.s.ses," or the mouth, will prevent the introduction of the poisonous matter into the system by absorption. When this is effected, cover the wound with a soothing poultice, as one made of slippery elm bark.

What should be avoided? How should the strips of plaster be removed from a wound? How is the union of the divided parts effected? 384. How should punctured and lacerated wounds be dressed? 385. What is the treatment of wounds caused by the bite of rabid animals?

_Observation._ Although animal poisons, when introduced into the circulating fluid through the broken surface of the skin, frequently cause death, yet they can be taken into the mouth and stomach with impunity, if the mucous membrane which lines these parts is not broken.

[Ill.u.s.tration: Fig. 81. _a_, _a_, Representation of wounds on the back part of the arm and fore-arm _b_, _b_, Wounds on the anterior part of the arm and fore-arm. By bending the elbow and wrist, the incisions at _a_, _a_, are opened, while those at _b_, _b_, are closed. Were the arm extended at the elbow and wrist, the wounds at _a_, _a_, would be closed, and those at _b_, _b_, would be opened.]

386. The proper position of the limbs favors the union of wounds. If the incision be upon the anterior part of the leg, between the knee and ankle, extending the knee and bending the ankle will aid its closing. If it be upon the back part of the leg, by extending the foot and bending the knee, the gaping of the incision will be diminished.

When wounds occur upon the trunk or upper extremities, let the position of the person be regarded.

386 Does the proper position of the limbs favor the union of wounds?

CHAPTER XX.

ABSORPTION.

387. ABSORPTION is the process by which the materials of nutrition are removed from the alimentary ca.n.a.l, to be conveyed into the circulatory vessels. It is likewise the process by which the particles of matter that have become injurious, or useless, are removed from the ma.s.s of fluids and solids of which the body is composed. These renovating and removing processes are performed by two sets of vessels

ANATOMY OF THE LYMPHATIC VESSELS.

388. The vessels that act exclusively for the growth and renovation of the system, are found only in the alimentary ca.n.a.l. They are called lacteals. The vessels whose sole function is to remove particles of matter already deposited, are called _Lym-phatics_. The radicles, or commencement of the veins, in many, and it may be in all parts of the body, perform the office of absorption.

_Observation._ This fact accounts for the capacity of the venous system exceeding the arterial. Had the veins no other function to perform, beside returning the blood that had been distributed by the arteries, it would be reasonable to suppose that this system would be less than the arterial, but the reverse is known to be true.

389. The LYMPHATIC VESSELS, in structure, resemble the lacteals. They exist in great numbers in the skin and mucous membranes, particularly those of the lungs. Though no lymphatics have been traced to the brain, it is presumed that they exist there, as this part of the body is not exempt from the composition and decomposition, which are perpetual in the body. These vessels are extremely minute at their origin, so that in many parts of the system they cannot be detected without the aid of a microscope.