File:The practice of surgery (1910) (14756850626).jpg

Identifier: practiceofsurger00mumf (find matches)
Title: The practice of surgery
Year: 1910 (1910s)
Authors: Mumford, James Gregory, 1863-1914
Subjects: Surgery
Publisher: Philadelphia and London, W. B. Saunders company
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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, areforced to disgorge their contents. An excellent means of exertingperipheral pressure is by tight bandaging of the limbs and trunk withbroad flannel or rubber rollers. A still more effective method—amethod vastly more effective in my experience—is the application ofCriles pneumatic rubber suit, which can be inflated in a minute. It isextremely interesthig, during its application, to watch the surpiisingand almost instantaneous improvement in the patients pulse. Asimple and easy method of seeking the same end, but a method muchless effective, is to throw the patient into a modified Trendelenburgposition, by which maneuver the hearts action is relieved and thebasal centers are flooded by fresh blood. At the same time keep thepatient warm with hot bottles, or a hot-water bed and blankets. Saline solutions introduced into the circulation maj- be regardedeither as mechanical aids or as internal remedies, but, however that
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Pig. 468.—Criles pneumatic suit (Keens Surgery). may be, it is certain that the mere presence of an increased volume offluid in the circulation serves for a short time to relieve shock, and is,most of all, valuable if there be hemorrhage. There are four methodsof introducing saHne fluids: (1) By intravenous infusion—the injec-tion of the solution through a cannula directly into a vein, choosingpreferably one of the veins of the calf or at the bend of the elbow; (2)by intra-abdominal infusion; (3) b) rectal injections; (4) by subcu-taneous injections. As Crile remarks, it is well to give the intravenousinfusion gradually, since a great amount of fluid may cause acutedilatation of an anemic heart. One should not give more than a pint,as a inile, but this amount may be repeated at frequent intervals. Theintra-abdominal infusions are commonly practised in the course ofabdominal operations, the opened belly being filled with salt solutionand sewed up. This included solution is absorbed

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