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Encyclopedia Britannica - Main :: GUI-HAN |
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HAEMORRHAGE (Gr. ata, blood, and prryvvvac, to burst) , a general term for any escape of blood from a blood-vessel (see BLOOD). It commonly results from injury, as the tearing or cutting of a blood-vessel, but certain forms result from disease, as in scurvy and purpura. The chief
haemorrhage are arterial, venous and capillary. Bleeding from an artery is of a bright red colour, and escapes from the end of the vessel nearest the heart in jets synchronous with the heart's beat. Bleeding from a vein is of a darker colour; the flow is steady, and the bleeding is from the distal end of the vessel. Capillary bleeding is a general oozing from a raw surface. By extravasation of blood is meant the pouring out of blood into the areolar tissues, which become boggy. This is termed a bruise or ecchymosis. Epistaxis is a term given to bleeding from the nose. Haematemesis is vomiting of blood, the colour of which may be altered by digestion, as is also the case in melaena, or passage of blood with the faeces, in which the blood becomes dark and tarry-looking from the action of the intestinal fluids. Haemoptysis denotes an escape of blood from the air-passages, which is usually bright red and frothy from admixture with air. Haematuria means passage of blood with the urine.Cessation of bleeding may take place from natural or from artificial means. Natural arrest of haemorrhage arises from (r) the coagulation of the blood itself, (2) the diminution of the heart's action as in fainting, (3) changes taking place in the cut vessel causing its retraction and contraction. In the surgical treatment of haemorrhage minor means of arresting bleeding are: cold, which is most valuable in general oozing and local extravasations; very hot water, 130 to 16o F., a powerful haemostatic; position, such as elevation
chief
press
Haemorrhage has been classified as(1) primary, occurring at the time of the injury; (2) reactionary, or within twenty-four hours of the accident, during the stage of reaction; (3) secondary, occurring at a later period and caused by faulty application of a ligature or septic condition of the wound. In severe haemorrhage, as from the division of a large artery, the patient may collapse and death ensue from syncope. In this case stimulants and strychnine may be given, but they should be avoided until it is certain the bleeding has been properly controlled, as theytend to increase it. Transfusion of blood directly from the vein of a healthy person to the blood-vessels of the patient, and infusion of saline solution into a vein, may be practised (see SHOCK
condition known as haemophylia (q.v.) it is difficult to stop the flow of blood.The surgical procedure for the treatment of an open wound is-(1) arrest of haemorrhage; (2) cleansing of the wound and removal of any foreign bodies; (3) careful apposition of its edges and surfacesthe edges being best brought in contact by sutures of aseptic silk or catgut, the surfaces by carefully applied pressure; (4) free drainage, if necessary, to prevent accumulation either of blood or serous effusion; (S) avoidance of sepsis; (6) perfect rest of the part. These methods of treatment require to be modified for wounds in special
special
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