d, and the patient
becomes extremely restless, gasping for breath, constantly throwing
about his arms and baring his chest in the vain attempt to breath more
freely. Faintness and giddiness are marked features. The diminished
supply of oxygen to the brain and to the muscles produces muscular
twitchings, and sometimes convulsions. Finally the pupils dilate, the
sphincters relax, and death ensues.

Young children stand the loss of blood badly, but they quickly recover,
as the regeneration of blood takes place rapidly. In old people also,
and especially when they are fat, the loss of blood is badly borne, and
the ill effects last longer. Women, on the whole, stand loss of blood
better than men, and in them the blood is more rapidly re-formed. A few
hours after a severe haemorrhage there is usually a leucocytosis of from
15,000 to 30,000.

#Treatment of the Bloodless State.#--The patient should be placed in a
warm, well-ventilated room, and the foot of the bed elevated. Cardiac
stimulants, such as strychnin or alcohol, must be judiciously
administered, over-stimulation being avoided. The inhalation of oxygen
has been found useful in relieving the urgent symptoms of dyspnoea.

The blood may be emptied from the limbs into the vessels of the trunk,
where it is more needed, by holding them vertically in the air for a few
minutes, and then applying a firm elastic bandage over a layer of cotton
wool, from the periphery towards the trunk.

_Introduction of Fluids into the Circulation._--The most valuable
measure for maintaining the circulation, however, is by transfusion of
blood (_Op. Surg._, p. 37). If this is not immediately available the
introduction of from one to three pints of physiological salt
solution (a teaspoonful of common salt to a pint of water) into a vein,
or a 6 per cent. solution of gum acacia, is a useful expedient. The
solution is sterilised by boiling, and cooled to a temperature of about
105 F. The addition of 5 to 10 minims of adrenalin solution (1 in 1000)
is advantageous in raising the blood-pressure (_Op. Surg._, p. 565).

When the intra-venous method is not available, one or two pints of
saline solution with adrenalin should be slowly introduced into the
rectum, by means of a long rubber tube and a filler. Satisfactory,
although less rapidly obtained results follow the introduction of saline
solution into the cellular tissue--for example, under the mamma, into
the axilla, or under the skin of the b