By EDWARD BORCK, M.D., St. Louis, Mo.
At first sight it seems almost superfluous to write or say a word about
any method of arresting hemorrhage from wounds; for the practitioner,
as a rule, is well acquainted with all the different manipulations and
appliances for the purpose, and enough may be obtained from the text
books. Nevertheless, to call attention to some useful, or old, or
apparently forgotten matter occasionally, seems not to be amiss, for it
refreshes our memory, stimulates us to think about and keeps before
our eyes important subjects. A few hints on the above, I hope, will
therefore be well received.
The treatment of hemorrhage, viz., the arresting of the same from open
wounds, is not only important to the surgeon as the basis of surgery,
but it is also of great importance to the laity, and especially to
those workmen who are perpetually in danger of being injured. It is
astonishing how unknowing the people seem to be, with any method to
check bleeding from a wound temporarily; even the most simple method of
pressure is in the majority of such accidents not resorted to. The sight
of a little blood does not alone upset a timid, nervous woman, but many
times the strongest of men; and why? because it naturally creates a
feeling of awe and detestation. If a person is wounded by a machine, or
otherwise, a crowd of all his fellow workmen gather around him, and look
on the poor fellow bleeding; half a dozen or more will start out on a
run in different directions to hunt a doctor, or some old woman who has
a reputation for stopping bleeding by sympathy, either of whom they are
likely to find "not at home." In the meantime the vital fluid trickles
away; nobody knows what to do; everybody does something, but none the
right thing. Now, it is true, it does not often happen that any one
bleeds to death, wise mother nature, as a rule, coming to their
assistance, especially in lacerated wounds; but the anemic condition
produced by excessive loss of blood is followed by severe consequences,
and is to be dreaded, for it retards recovery. To save all the blood
possible ought to be apprehended as an important matter by every one.
Hardly a week passes that some unfortunate is not brought to my office,
who has been badly injured in some way; he has been bleeding, perhaps,
the distance of several blocks, and arrives almost faint. In the most of
such cases they have something tied around their wounds, but hardly ever
in any manner so as to be equal to stop the bleeding. In exceptional
cases you find a tourniquet or the Spanish windlass applied. This,
when applied by a surgeon, may answer very well, but when applied by a
non-professional person it is invariably screwed up so tight that the
pain produced thereby is so great and intolerable that the patient
prefers rather to bleed to death. This is a great objection.
Therefore I will call attention to the method of forcible flexion; and
though extreme flexion has been practiced by surgeons in isolated cases,
still to Professor Adelman, of Dorpat, is due the credit of first having
systematized the following method: