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Bleb

a blister, a thin tumor filled with a watery liquid arising upon the sur- BLEB, a blister, a thin tumor filled with a watery liquid arising upon the surcalled pemphigus. If produced by external irritation, or some similar cause, it is a vesicle. ternal irritation, or some similar cause, of the most serious accidents which can dicial Circuit in 1878; and Justice of the Supreme Court of the United States in BLEEDING happen to an animal, and constitutes the most anxious complication in surgical operations. As there is but a limited quantity of blood in the body (corresponding to about one-tenth of its weight), the sudden escape of a large portion of it is sufficient to cause death.

Arterial bleeding is recognized by the florid redness of the blood, and by its issuing from the cut vessel by jerks. There are exceptions to this, however. When an artery has been tied, and bleeding occurs from below the ligature, the flow of blood is continuous, and of a dark color.

The principal means of relief are: Immediate pressure, which may be applied by pressing the finger tip on the place whence the blood is seen to flow. This may be kept up by pads of lint, or a coin of convenient size wrapped in cloth, and secured with a bandage to the part.

Pressure on the artery above, or as it comes to the cut part. Pressure on the inside of the upper arm, about midway between its front and back, will press the brachial artery against the bone, and arrest any bleeding from wounds of the forearm and hand. Pressure on the middle of the groin with a thumb placed crosswise will control the stream of blood in the femoral artery, so that none can escape from any wound of the lower limb below where the pressure is made.

This pressure with the finger or thumb is very difficult to maintain with an adequate amount of firmness and continuity: hence it is well to substitute the handle of a door key wrapped in cloth. Pressure on the course of the vessel may be very efficiently effected by tying a handkerchief round the limb above where it is injured, and then inserting a stick, and twisting it sufficiently tight. Pressure on the main vessel leading to a limb is only a temporary method of stopping bleeding, since it is not only very painful to the patient, but fraught with danger to the limb, which may mortify if it be too long continued. Actual cautery, or hot iron, is occasionally useful in bleeding from a bone, or at some points where pressure cannot be efficiently applied.

Venous bleeding is recognized by the dark color of the blood, and its continuous flow. Pressure is generally found sufficient to arrest it, and it should be applied directly over the wounded part. În this case, pressure higher up the limb only does harm, by retarding the return flow of the circulation. Oozing from cut surfaces partakes more of the characters of venous than of arterial bleeding, as there is no vessel sufficiently large to demand the application of a ligature. The BLENDE actual cautery or cold may be used, or one of the many styptics-e. g., perchloride of iron-may be especially recommended; it may be applied on lint or a sponge; or local astringents, such as alum and tannin, may be employed; there are also the puff ball, mushroom, agaric, and matico leaves, cobwebs, felt, etc.

In bleeding, of whatever kind, the posture of the patient is a matter of great importance. The recumbent position is associated with a diminished force of the circulation, and should, therefore, be adopted in all serious cases. If the bleeding occur in one of the limbs, the raising of the injured part is in itself often sufficient to cut short the loss of blood, and this postural treatment should in all cases be employed in addition to the special local remedies above described. Bleeding from internal organs, as the stomach or the lungs, is a very serious symptom, and must be immediately and carefully treated whenever it occurs.