There is nothing in surgery of more importance than the proper treatment
of hemorrhage. Of the confusion and terror occasioned by the sight of a
human being from whom the blood is gushing in torrents, and whose
condition none of the spectators is able to relieve, no one can form an
adequate conception, but those who have witnessed it. In all such cases
there is one thing proper to be done, the prompt performance of which is
generally as certainly successful, as the neglect of it is inevitably
fatal. It is impossible to conceive of a more terrible situation than
that of a medical man who knows not what to do on such an emergency. He
is confused; he hesitates: while he is deciding what measures to adopt
the patient expires: he can never think of that man’s death without
horror, for he is conscious that, but for his ignorance he might have
averted his patient’s fate. The ancient surgeons were constantly placed
in this situation, and the dread inspired by it retarded the progress of
surgery more than all other causes put together. Not only were they
terrified from interfering with the most painful and destructive
diseases, which experience has proved to be capable of safe and easy
removal, but they were afraid to cut even the most trivial tumour. When
they ventured to remove a part, they attempted it only by means of the
ligature, or by the application of burning irons. When they determined
to amputate, they never thought of doing so, until the limb had
mortified, and the dead had separated from the living parts; for they
were absolutely afraid to cut into the living flesh. They had no means
of stopping hemorrhage, but by the application of astringents to the
bleeding vessels, remedies which were inert; or of burning irons, or
boiling turpentine, expedients which were not only inert but cruel.
Surgeons now know that the grand means of stopping hemorrhage is
compression of the bleeding vessel. If pressure be made on the trunk of
an artery, though blood be flowing from a thousand branches given off
from it, the bleeding will cease. Should the situation of the artery be
such as to allow of effectual external pressure, nothing further is
requisite: the pressure being applied, the bleeding is stopped at once:
should the situation of the vessel place it beyond the reach of external
pressure, it is necessary to cut down upon it, and to secure it by the
application of a ligature. Parè may be pardoned for supposing that he
was led to the discovery of this invaluable remedy by inspiration of the
Deity. By means of it the most formidable operations may be undertaken
with the utmost confidence, because the wounded vessels can be secured
the moment they are cut: by the same means the most frightful
hemorrhages may be effectually stopped: and even when the bleeding is so
violent as to threaten immediate death, it may often be averted by the
simple expedient of placing the finger upon the wounded vessel, until
there is time to tie it.
Public-domain text, read in full here on John Shaqi.
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