Surgery; its theory and practice . all, a clot forms of an hour-glass shape, thus blocking up the wound, andhealing occurs by adhesive inflammation. A somewhat largerwound, when made longitudinally to the artery, may heal in thesame way; but when made transversely to the axis of the vessel,it assumes a diamond shape, in consequence of the elastic tensionof the coats, and the haemorrhage will probably not be arrested.The sur(;ical mei hods of arresj ing HyicMORRHAGE may be con-sidered under the heads of temporary and permanent methods. I. Tempo7ary methods.—The surgeon, if the bleeding point is
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Surgery; its theory and practice . all, a clot forms of an hour-glass shape, thus blocking up the wound, andhealing occurs by adhesive inflammation. A somewhat largerwound, when made longitudinally to the artery, may heal in thesame way; but when made transversely to the axis of the vessel, it assumes a diamond shape, in consequence of the elastic tensionof the coats, and the haemorrhage will probably not be arrested.The sur(;ical mei hods of arresj ing HyicMORRHAGE may be con-sidered under the heads of temporary and permanent methods. I. Tempo7ary methods.—The surgeon, if the bleeding point iswithin reach, need never fear haemorrhage, as mere pressure withthe finger will control it, whatever the size of the vessel, till hecan obtain the means of permanently arresting it. The pressuremay be made directly on the bleeding point, or between the SURGICAL METHODS OF ARRESTING HEMORRHAGE. 129 wound and the heart; in the former situation with the finger, Spencer Wells pressure-forceps (Fig. 30) or the tourniquet;- in Fig. 30.. Spencer Wells pressure-forceps, modified by Morrant Baker. the latter situation with the finger or the tourniquet, the pressurebeing then made in such a direction as to press the artery againstsome resisting structure, as a point of bone. The tourniquetsemployed are various (Fig. 31 and Fig. 32). The rubber tubeof the Esmarchs apparatus perhaps answers the best. An im-promptu tourniquet may be made by tying a pocket-handkerchiefloosely round the limb, and twisting it up tightly with a walking- FlG. 31. Fig. 32.