Bleeding

“ Bleeding.—When a man is bleeding badly from a wound, press the wound or the flesh just above it—that is between the wound and the heart—press it hard with your thumb to try and stop the blood running in the artery. Then make a pad with something like a flat rounded pebble, and bind it over the wound. If bleeding violently, tie a handkerchief loosely round the limb above the wound, and twist it tight with a stick. ”

“ When this bleeding is spontaneous it comes from the mucous membranes, especially from the nose, but also from the mouth, bowel and bronchial tubes. Slight bruises are apt to be followed by extravasations of blood into the tissues; the swollen joints (knee especially) of a bleeder are probably due, in the first instance, to the escape of blood into the joint cavity or synovial membrane. It is always from the smallest vessels that the blood escapes, and may do so in such quantities as to cause death in a few hours. ”

“ Do not be afraid of the blood when you see any one bleeding, but hold the sides of the cut tightly with both of your hands. This will stop any bleeding until help comes. You may keep a person from bleeding to death by doing this when other persons are afraid of the blood. ”

“ Capillary bleeding comes from injured small veins. It flows slowly, and such bleeding is dangerous only if it continues. Always summon a surgeon or physician, and put in a hurry call for him. Force the patient to lie down in a level position, preferably upon his back.
If the leg or arm is wounded, elevate it. Cut away the clothing quickly, so that it may be exposed. Press the bleeding places, but cover your finger with gauze or a clean handkerchief, or compress the part by using a strong cloth bandage. ”

“ We may just mention that as a general rule he approves of bleeding after any accident. He disapproves of bleeding both at the onset and the crisis of a disease. In constitutions requiring bloodletting he holds that spring is the best season for it. Even in cases in which there is a deficiency of blood, but there is congestion in some particular part, he permits blood to be abstracted, in order to produce revulsion, the patient’s strength being recruited afterwards by a nourishing diet. ”

“ That bleeding may take place from the lung into the cavity of the chest is indisputable, but little or no blood will escape through a small wound; and its continuing to flow from such a wound will be a presumptive if not a conclusive proof that some artery external to the pleura has been wounded. Sucking, under ordinary circumstances, of a small wound, unattended by bleeding, does good by attracting the natural fluids to the parts, and thus causing them to swell so as to be placed in apposition in the most advantageous manner for their reunion. ”

“ Unless the blood is spurting in jerks from a cut artery, or bleeding very freely indeed, it is better to let the wound bleed, as this helps to wash out any dirt or germs that have got into it. When the bleeding has stopped, do not put on sticking plaster, because this keeps out the air and keeps in the sweat of the skin surrounding the wound, which is not healthful for the wound, and may also contain some weak pus germs. ”

“ The bleeding from a slight cut is never very severe and will generally stop of itself in a short time. It is best to let a slight cut bleed a little, as the bleeding carries away the germs which may have been on the edge of the knife or whatever caused the wound. ”

“ Little impression can be made on an acute disease by the slow removal of even a large quantity of blood, as the organs have time to accommodate themselves to the loss, which might, for any good it will do, as well be dispensed with. Either bleed rapidly or not at all. The nearer the commencement of an ailment, in which you employ bleeding, the operation is resorted to, the greater the chance of its doing good; no time ought, therefore, to be lost in using the lancet, when once it is known to be required. ”

“ Treatment.—Avoid, as much as possible, wounds and operations in "bleeding" families. Marriage of the women should be discouraged. For bleeding: rest, ice, tannic or gallic acid or adrenalin locally if the bleeding points can be reached. Plug the nostrils for nose-bleed both behind and in front.
SCURVY. (Scorbutus) .—A constitutional disease characterized by weakness, anemia, sponginess of the gums and tendencies to bleeding. ”

“ INTERNAL PILES. Symptoms.—The two prominent symptoms are bleeding and pain. The bleeding is usually dark. It may be slight and appear as streaks upon the feces or toilet paper; it may be moderate and ooze from the anus for some time after a stool, or it may be so profuse as to cause the patient to faint from loss of blood while the "bowels are moving." Death may follow in such a case unless the bleeding is stopped. The blood may look fresh and fluid or if retained for some time, it looks like coffee grounds, sometimes mixed with mucus and pus. ”

“ Pressure will soon stop this form of bleeding.
That will do for the first and most important of all emergencies. What have we to put in our box for this purpose? Nothing at all. All we require is a hand and presence of mind.
Now about the treatment of wounds. First stop the bleeding, if this is severe. Then wash your own hands. Wash them well. Plenty of soap and hot water. Good hard work with the nail brush. Your hands should be absolutely clean before you meddle with a wound.
Now you will want some antiseptic. The best of all is carbolic acid. ”

“ AND after this I saw, beholding, the body plenteously bleeding in seeming of [1] the Scourging, as thus:—The fair skin was broken full deep into the tender flesh with sharp smiting all about the sweet body. So plenteously the hot blood ran out that there was neither seen skin nor wound, but as it were all blood. And when it came where it should have fallen down, then it vanished. Notwithstanding, the bleeding continued awhile: till it might be seen and considered. ”

“ There is not in bleeding as in purging, conflicting and alternating effects of debility from evacuation, and irritation, [Pg 48] primary and sympathetic, from local stimulation; but a direct diminution of morbid action, more tranquil movements of the heart and capillary system, that is of the circulatory apparatus, and of the membranes, mucous, serous and cutaneous, &c. Bleeding, unlike most other remedial agents, produces a direct calmness and ease in the animal economy: it does not like them substitute one disturbance for another, or make the great appear the lesser evil. ”

“ The bleeding will be found useful, but to a less degree in the lower than in the upper limbs.... One must be careful not to assume that the patient is cured when he has been entirely relieved of his pain, because with the lapse of time fresh attacks are liable to occur; this disease, like certain other affections, possesses a periodic character.... ”

“ Bleeding or hemorrhage is the most constant symptom. The degree of hemorrhage depends on the kind, number and size of the blood-vessels severed. In arterial hemorrhage, the blood is bright red and spurts from the mouth of the cut vessel. In venous hemorrhage, the blood is darker and flows in a continuous stream. In abrasions and superficial wounds capillary hemorrhage occurs. Death may follow severe hemorrhage. ”

“ Great Wounds are generally attended with a considerable Loss of Blood, which has already exhausted the wounded Person; and the Fever is often a Consequence of this copious Loss of Blood. Now if under such a Circumstance, Bleeding should be ordered and performed, the Patient's Strength is totally sunk; the Humours stagnate and corrupt; a Gangrene supervenes, and he dies miserably, at the End of two or three Days, of a Series of repeated Bleedings, but not of the Wound. ”

“ The bleeding must be steadily repeated as the symptoms recur until relief [296] has been obtained, or until it becomes evident that the powers of the patient cannot resist the inroads of the disease and of the efforts made for its cure. The quantity of blood that may be lost in two or three days by powerful, healthy men is sometimes enormous, amounting to 100, 150, and even 200 ounces, with the happiest effect. ”

“ In any case of bleeding the patient may become weak or may faint, but unless the blood is flowing actively, this is not necessarily a serious sign, and the quiet condition of the circulation during the faint often assists nature in staying the bleeding, by allowing the blood to clot, and so block up any wound in a blood-vessel. ”

“ The blood in bleeder cases is, as a rule, normal, so far as our present means of investigation enable us to decide. When a hemorrhage has continued for some time, it is thin and watery, but at the beginning of the bleeding the blood is usually rich in corpuscles and fibrin and coagulates firmly. ”

“ The blood as it spurted from the vein would be collected in a container and measured. When enough blood was removed, the bleeding would [Pg 11] be stopped by a bandage or compress applied to the incision.
Larger Image Figure 5.—18th-19th century lancets and lancet cases. The cases are made of mother-of-pearl, silver, shagreen, and tortoise shell. (NMHT 308730.10. SI photo 76-9116.)
Teaching a medical student how to bleed has had a long tradition. Before approaching a patient, the student practiced opening a vein quickly and accurately on plants, especially the fruits and stems. ”

“ Those fainting fits, which are the effect of bleeding, or of the violent operation of purges, belong to this class. Such as happen after artificial bleeding are seldom dangerous, generally terminating as soon as the patient is laid upon the bed; indeed persons subject to this kind should always be bled lying, in order to prevent it. Should the fainting however continue longer than usual, volatile spirits may be held to the nose, and rubbed on the temples, &c. ”

“ They have all since borne healthy children. I have omitted the names of above one hundred persons who had the fever, from whom I drew thirty or forty ounces of blood, by two or three bleedings. I did not cure a single person without at least one bleeding. ”

“ If, however, the attention of the medical man is called to it early, it will always do well: until his directions are given, apply a nicely made bread and water poultice.
BLEEDING FROM THE NAVEL. Sometimes, a day or two after the cord separates, or at the time of separation, bleeding takes place from the navel: fortunately, this very seldom occurs; indeed, it is very rarely met with; and I only mention it, to observe that, upon its occurrence, the point of the finger should be placed over the part, and pressure steadily applied until medical assistance is obtained. ”

“ In this period it was considered an art to hold the lancet properly and to support the arm of the patient with delicacy and grace. [57] Many patients had by [Pg 12] repeated bloodlettings become inured to its potential danger and unpleasantness. In the mid-eighteenth century one British physician declared: “People are so familiarized to bleeding that they cannot easily conceive any hurt or danger to ensue, and therefore readily submit, when constitutional fear is out of the question, to the opening of a vein, however unskillfully advised.” ”

“ Topical bleeding is the chief remedy belonging to this division. Bleeding with leeches, or the scarificator, is employed in two different circumstances: First, when we detract directly from the inflamed part; as, for instance, from the surface of a phlegmon: Secondly, when we detract only from the neighbourhood of the inflamed part; for instance, from the skin which covers an inflamed joint. When we employ topical bleeding, in the first case, we may suppose, that the aperture, and effusion from the extremities of the inflamed vessels, produces, to a certain degree, a change of action. ”

“ Where arteries are evidently bleeding—which may be inferred from the spurting character of the hemorrhage—a tight bandage above the seat of the wound, if on one of the extremities, will often be followed by a cessation of the bleeding, and where only small vessels are cut, a bandage tightly applied over the wound itself may accomplish a similar result. ”

“ How many lives have been sacrificed by the practice of bleeding in feverish and inflammatory cases, from the non-adoption of wet-sheet packing, which causes no loss of strength, and leaves behind none of the debility and consequent long convalesence, which bleeding and strong medicines necessarily occasion. ”

“ It is a common notion that bleeding in the feet draws the humours downwards, and consequently cures diseases of the head and other superior parts: but we have already observed that, in all topical affections, the blood ought to be drawn as near the part as possible. When it is necessary, however, to bleed in the foot or hand, 573as the veins are small, and the bleeding is apt to stop too soon, the part ought to be immersed in warm water, and kept there till a sufficient quantity of blood be let. ”

“ If blood is dark, and comes in slow flow (venous) —
Tie a cloth around between end of limb and wound. Or use a tourniquet, loosening it in one hour.
Using a Tourniquet
In either case, bandage a clean gauze compress against wound. If unable to use these methods because of too rapid bleeding, press fingers into wound, but have another person tie as described. Do not use finger pressure if possible to avoid, for the wound should be kept clean.
Any of the following tend to stop bleeding:
Ice or ice water. Very hot water. Vinegar, 1 tbsp. to 4 tbsp. water. Salt, 1 tsp. to 4 tbsp. water. ”