If the hemorrhage is suppressed artificially, either by ligature, or by
otherwise well-applied pressure, no external coagulum is formed; there
appears only the internal bloody coagulum, the lymphatic effusion,
and consolidation of the compressed part. The natural contraction and
retraction cannot occur in vessels partially divided; hemorrhage,
therefore, is more violent and dangerous from a partial than from a
complete section. Again, transverse wounds are more dangerous than
longitudinal; in the latter, the edges of the wound are spontaneously
approximated on account of the structure of the vessels, whilst, from
the same cause, the margins of the latter continue separate, and, in
fact, the aperture is a complete circle; the lips of an oblique wound
will be more or less apart, in proportion as it approaches to the
transverse direction. When an artery has been punctured, the wound in
the sheath perhaps does not correspond with that in the vessel; blood,
therefore, accumulates between the vessel and its sheath, and there
coagulates. The wound is thus compressed, its edges kept in contact,
and the farther escape of blood prevented; the lips of the incision are
then agglutinated by effused lymph, and cicatrisation occurs. This,
however, cannot be expected to take place unless methodical pressure
has been applied from the first. Even from small punctures blood is
effused under the sheath and into the neighbouring cellular tissue,
rapidly, and in such quantity as to prevent adhesion. The effusion
continues, and a false aneurism is formed. If a considerable part of
the circumference has been divided, the lymph may be, and generally
is, superabundant, and often to such an extent as to close up the
canal of the artery at that point; but, if the aperture is minute and
in a longitudinal direction, lymph will seldom be effused in greater
quantity than is sufficient for the cicatrisation; and, though it
should be superabundant, it is afterwards removed by the absorbents.
In all cases, the cellular tissue round the wounded point is much
thickened and condensed by the deposition of lymph, but this gradually
disappears after cicatrisation has been completed. Sometimes, and
generally when the wound has been transverse and large, the process of
adhesion is disturbed, and suppuration occurs; in this case the wound
in the vessel communicates with the fistulous track in the externally
effused lymph, and may be the source of troublesome hemorrhage.
In other instances of extensive transverse wounds, the undivided
slip ulcerates, and the artery becomes obliterated, by means of the
same natural processes that occur in complete division. In cases of
laceration of an artery, when its coats have been forcibly torn rather
than divided, little or no bleeding takes place. The vessel retracts;
the lacerated margins of its inner coat become puckered up, so as to
contract greatly the orifice of the vessel; the lacerated sheath is
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