ARTERIAL BLEEDENG. This is recognized by the florid redness of the blood, and by its issuing from the cut vessel in jets. There are excep tions to this, however. When an artery has been tied, and bleeding occurs from below the ligature, the How of blood is continuous and of a dark color. It is also dark during profound anes thesia. If a large artery be wounded, the first gush of blood may prove fatal, but generally there are rapid and feeble pulse, frequent and irregular breathing, intense pallor; cold, moist skin, possibly nausea and vomiting, and prostra tion merging into unconsciousness, and the pa tient faints; the artery draws up within its sheath (see ARTERY) : the blood. no bulger im pelled vigorously by the heart, clots between the cut end and the cellular tissue surrounding it; the inner and middle coats not only retract. but contract, and another clot forms within the arterial tube. These clots—which. with the faint ness and the contraction and retraction of the artery, are termed natural larmosiatics—a re suf ficient in many eases to prevent a recurrence of the bleeding: but we must be prepared to adopt some of the many surgical or artificial means for restraining the flow of blood till adhes(on (q.v.) can occur between the rut surface of the coats of the artery. The principal surgical means are Immediate pressure. which may be applied by pressing the finger-tip on the place whence the blood is seen to flow, and may be kept up by pads secured with a bandage to the part: pressure on the artery above, or as it mines to the cut part, which requires some knowledge of but not more than any intelligent person may easily acquire. Thus, pressing on the inside of the arm, about midway between its front and back, will press the brachial artery (q.v.) against the bone, and arrest any bleeding from wounds of the forearm and hand. Pressure on the middle of the groin with a thumb placed crosswise will control the stream of blood in the femoral artery, so that none can escape from any wound in thigh or leg below where the pressure is made. Pres
. sure on the course of the vessel may be very efficiently effected temporarily by tying a hand kerchief round the limb above where it is in jured. and then inserting a stick and twisting it sufficiently tight. This is the principle of the original tourniquet, which was invented byl\lorel, a French surgeon, at the siege of Besancon, in 1674. (See TOURNIQUET.) The objections to pres sure as a means of arresting hemorrhage are, that it is very painful, that it includes the vein, and thereby engorges the limb with blood, and may cause mortification if continued for any length of time. Actual cautery, or hot iron, is occasionally useful in bleeding from a bone, or at some points where pressure or ligatures cannot be efficiently applied. It is the oldest method of stopping bleeding, and until the Eighteenth Cen tury was much in use. If used, the iron should 1)2 at a white heat, the wound pressed for an in stant, and then the iron should be held in con tact with the bleeding vessel. It causes an eschar or slough, with shriveling of the artery; and if the latter be small, It effectually stops the bleeding until the eschar drops off, when the ves sel may be found still pervious at the wounded part, and the danger of bleeding be as great as at first. Ligature. or tying the artery, is a very old method of arresting hemorrhage, and cer tainly the best. A ligature snould be applied to each extremity of the cut artery. (See LIGA TURE.) Acupressure (q.v.) was introduced by the late Sir James Y. Simpson of Edinburgh, and was extensively used. It is useful in a few in stances where the arteries are too brittle to per mit ligation.