ack.

If the patient can retain fluids taken by the mouth--such as hot coffee,
barley water, or soda water--these should be freely given, unless the
injury necessitates operative treatment under a general anaesthetic.

Transfusion of blood is most valuable as _a preliminary to operation_ in
patients who are bloodless as a result of haemorrhage from gastric and
duodenal ulcers, and in bleeders.

HAEMOPHILIA

The term haemophilia is applied to an inherited disease which renders the
patient liable to serious haemorrhage from even the most trivial
injuries; and the subjects of it are popularly known as "bleeders."

The cause of the disease and its true nature are as yet unknown. There
is no proof of any structural defect in the blood vessels, and beyond
the fact that there is a diminution in the number of blood-plates, it
has not been demonstrated that there is any alteration in the
composition of the blood.

The affection is in a marked degree hereditary, all the branches of an
affected family being liable to suffer. Its mode of transmission to
individuals, moreover, is characteristic: the male members of the stock
alone suffer from the affection in its typical form, while the tendency
is transmitted through the female line. Thus the daughters of a father
who is a bleeder, whilst they do not themselves suffer from the disease,
transmit the tendency to their male offspring. The sons, on the other
hand, neither suffer themselves nor transmit the disease to their
children (Fig. 64). The female members of a haemophilic stock are often
very prolific, and there is usually a predominance of daughters in their
families.

FIG 64.--Genealogical Tree of a Haemophilic Family.

Great-Great-Grandmother Great-Great-Grandfather
Mrs D. (Lancashire) F M (History not known
.| | as to bleeding)
.| |
.+----------+-------+
............|
.|
....|
.+---------+--------+
Great-Grandmother .| | |
(Married three .F MB MB
times) .|
.|
.|
By First Husband .| By Second By Third
..............| Husband Husband