Commentaries on the Surgery of the War in Portugal, Spain, France, and the Netherlands: from the battle of Roliça, in 1808, to that of Waterloo, in 1815; with additions relating to those in the Crimea in 1854-55, showing the improvements made during and since that period in the great art and science of surgery on all the subjects to which they relate.Guthrie, G. J. (George James)
History
Commentaries on the Surgery of the War in Portugal, Spain, France, and the Netherlands: from the battle of Roliça, in 1808, to that of Waterloo, in 1815; with additions relating to those in the Crimea in 1854-55, showing the improvements made during and since that period in the great art and science of surgery on all the subjects to which they relate.
Guthrie, G. J. (George James)
Crimean War, 1853-1856 -- Medical care; Napoleonic Wars, 1800-1815 -- Medical care; Surgery, Military -- Europe -- History; War wounds -- Europe -- History
The _upper_ end of an artery retracts on being divided, and this
retraction is accompanied by a contraction of the cut extremity of the
vessel, which assumes the shape of the neck of a French wine-bottle
or Florence oil-flask. The contraction is confined in the first
instance to its very extremity, so that the barrier opposing the flow
of blood is formed by this part alone. The contraction, however, goes
on increasing for the space of an inch; it is usually filled up with
an internal coagulum of a round, pyramidal shape, adhering firmly to
the contracted end of the artery, loose at its apex, and extending
frequently as far as the first collateral branch, but rarely under
any circumstances beyond two inches; the very orifice of the artery
on the outside being in a few days covered by a layer of a yellowish
green-colored substance or fibrin, which indicates its situation in a
remarkable manner. Some of these processes are continued even after the
external wound has healed; the artery generally goes on diminishing and
contracting as far as it is useless, so that of three or four inches,
from one to two may be impervious, the remainder being contracted,
although still permeable by a probe. An accompanying nerve, where there
is one, would do the reverse, the cut extremity would become enlarged
or bulbous, gradually diminishing as it is traced upward, until it
regains its proper size.
The processes adopted by nature for closing the lower end of a divided
artery of the size of the femoral at the inferior part of the thigh
are somewhat different from those employed at the upper or opposite
extremity. The retraction or contraction of the _lower_ end of a
divided artery is neither so perfect nor so permanent as at its _upper_
end, and the small internal coagulum is in many instances altogether
wanting, or very defective in its formation. The closure of the lower
orifice being less perfectly accomplished than of the upper, it is
the more likely to suffer from secondary hemorrhage, which may be
distinguished from that from the upper end of the artery at an early
period after the accident, by the _venous color of the blood, and from
its flowing or welling out in a continuous stream, as water rises from
a spring, and not with an arterial impulse_.
Public-domain text, read in full here on John Shaqi.
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