d ends
of the vessel and so occludes the lumen. A bright-red or a white heat
cuts the vessel across without occluding it. The separation of the
slough produced by the charring of the tissues is sometimes attended
with secondary bleeding.

_Haemostatics_ or _Styptics_.--The local application of haemostatics is
seldom to be recommended. In the treatment of epistaxis or bleeding from
the nose, of haemorrhage from the socket of a tooth, and sometimes from
ulcerating or granulating surfaces, however, they may be useful. All
clots must be removed and the drug applied directly to the bleeding
surface. Adrenalin and turpentine are the most useful drugs for this
purpose.

Haemorrhage from bone, for example the skull, may be arrested by means of
Horsley's aseptic plastic wax. To stop persistent oozing from soft
tissues, Horsley successfully applied a portion of living vascular
tissue, such as a fragment of muscle, which readily adheres to the
oozing surface and yields elements that cause coagulation of the blood
by thrombo-kinetic processes. When examined after two or three days the
muscle has been found to be closely adherent and undergoing
organisation.

#Arrest of Accidental Haemorrhage.#--The most efficient means of
temporarily controlling haemorrhage is by pressure applied with the
finger, or with a pad of gauze, directly over the bleeding point. While
this is maintained an assistant makes digital pressure, or applies a
tourniquet, over the main vessel of the limb on the proximal side of the
bleeding point. A useful _emergency tourniquet_ may be improvised by
folding a large handkerchief _en cravatte_, with a cork or piece of wood
in the fold to act as a pad. The handkerchief is applied round the
limb, with the pad over the main artery, and the ends knotted on the
lateral aspect of the limb. With a strong piece of wood the handkerchief
is wound up like a Spanish windlass, until sufficient pressure is
exerted to arrest the bleeding.

When haemorrhage is taking place from a number of small vessels, its
arrest may be effected by elevation of the bleeding part, particularly
if it is a limb. By this means the force of the circulation is
diminished and the formation of coagula favoured. Similarly, in wounds
of the hand or forearm, or of the foot or leg, bleeding may be arrested
by placing a pad in the flexure and acutely flexing the limb at the
elbow or knee respectively.

#Reactionary Haemorrhage.#--Reactionary or intermed