2nd. _Arterial._ The distinctive sign of this kind of bleeding
is that it issues forth from the wound in spurts, and not in a
continuous stream. Each spurt corresponds to a heart beat. This
variety of hæmorrhage can only occur if an artery is cut through,
i.e., a vessel which carries blood away from the heart to supply
the tissues of the body.
3rd. _Venous._ This bleeding is due to the wound of a vessel
which returns blood to the heart after it has circulated through
the tissues. These vessels are called veins. The blood is dark in
colour and issues from one definite spot in a continuous stream.
_Treatment._ For practical purposes only the first variety of hæmorrhage
need be considered here. Circumcision in an infant should never interfere
with an artery or vein; but in the event of this accident occurring a
pledget of cotton-wool or lint must be firmly compressed with bandage
around the bleeding point until the proper method can be adopted to deal
with it. This consists of seizing the bleeding point with an instrument
constructed for the purpose (artery forceps) and then twisting up the
tissue caught in the forceps, or applying a ligature. This is a purely
surgical proceeding, and as every case of hæmorrhage should without delay
receive qualified medical attention nothing further need be said on this
matter here.
In most cases the application of the dressing with very firm pressure
suffices to arrest the inevitable bleeding of every circumcision. _The
bandaging cannot be considered satisfactory until the blood ceases to
ooze through the dressing._ In adjusting the diapers it must be seen that
the thighs are tied together so that they are immovable, perfect rest
being indispensable for the control of hæmorrhage. This treatment is
merely a mechanical aid to the natural processes which arrest bleeding,
and in the vast majority of cases is perfectly successful.
There are however certain drugs which may be applied to a bleeding
surface to hasten the coagulation of the blood. These are called
_astringents_. These are not to be used indiscriminately as many of
them injure the tissues and interfere with the healing of the wound.
If pressure alone is insufficient to stop the hæmorrhage and the local
application of an astringent is to be tried, the part must first be
carefully washed with an antiseptic solution, so as to see precisely
where the bleeding is actually coming from. Strips of lint soaked in the
astringent solution are then carefully applied and retained in position
by the firm pressure of a bandage.
The following are the principal drugs which may be used in this way.
1.) Compound Tincture of Benzoin.
2.) Tincture of Hazeline.
3.) Strong solution of Alum in hot water.
4.) Solution of Tannic Acid (4 grains to the ounce.)
5.) Solution of Adrenalin Chloride.
The last of these has the reputation of being the most powerful
astringent known.
Public-domain text, read in full here on John Shaqi.
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