is
only the seventh day from the receipt of the injury, and it surely cannot
be pus. However, to satisfy myself, I used an exploring needle; and not
very much to my surprise, I discovered light colored arterial blood! Could
I be mistaken? I twisted the needle about, pressed it to one side, until
nearly a drachm of the blood had escaped. Fully convinced now that I had
a secondary hemorrhage to deal with, the question arose what to do. I
supposed that it came from one of the lumbar or inter-costal arteries that
had been injured by the supposed fracture of the process of the vertebra.
If so, it comes from an artery inclosed in a bony cavity, and one that
cannot contract and close spontaneously, and since its origin is so close
to the aorta, it will continue to bleed until the patient dies of
hemorrhage.
While I was thus examining the fluctuating mass, and conjecturing as to
origin and results, I fancied that the quantity of fluid was sensibly
increasing. However, I will not be positive that my imagination did not
assist in this accumulation.
But what shall I do? Cut down into this sinus, and hunt the bleeding
artery, and tie it? Could I find it? And could I tie it if I did find it?
Probably not; and more especially if it is a lumbar artery, and injured in
the foramen through which it passes from the vertebra. But the man will
probably bleed to death; and must I do nothing to prevent it? I concluded
to use pressure with a bandage for the present, and ask for the advice of
my brethren. Accordingly, compresses were placed along the spine, and the
body bandaged snugly.
On returning to town, I stated the case to doctors Brown and Thorne,
giving my theory for the hemorrhage,--that it was secondary, and probably
from a lumbar artery. They were of opinion that it would be almost an
impossibility to find the artery and tie it, and without seeing each
other, concluded that pressure was the remedy to be used. I would state
that at the last visit the pulse was 74, and temperature 99. This was at
about 9 A. M. I visited him again about 5 P. M., and found the pulse and
temperature the same. There was by this time considerable increase in the
quantity of fluid. I re-adjusted my compresses and bandaged again. On
Saturday morning I found the quantity of fluid about the same, perhaps
slightly increased. There was now considerable inflammation of the
integument, over a large part of the sinus, the skin appearing tense, and
the small b
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