Page:The New International Encyclopædia 1st ed. v. 03.djvu/198

* BLEEDING. 168 BLEEK. easily acquire. Tlius, pressing on the inside of the arm, about midway between its front and back, will press the brachial artery (q.v.) against the bone, and arrest any bleeding from wounds of the forearm and hand. Pressure on the middle of the groin with a thumb placed crosswise will control the stream of blood in the femoral artery, so that none can escape from any wound in thigh or leg below where the pressure is made. Pres- . sure on the course of the vessel may be very efficiently effected temporarily by tying a hand- kercliief round the limb above where it is in- jured, and then inserting a stick and twisting it suliiciently tight. This is the principle of the 1 original tourniquet, which was invented by Jlorel, a French surgeon, at the siege of Besangon, in 1G74. (See Tourniquet. ) The objections to pres- sure as a means of arresting hemorrhage are, that it is very painful, that it includes the vein, and thereby engorges the limb with blood, and m.iv caise mortification if continued for any length of time. Actual cautery, or hot iron, is occasionally useful in bleeding from a bone, or at some points where pressure or ligatures cannot be efficiently applied. It is the oldest method of stopping bleeding, and until the Eighteenth Cen- tury was much in use. If used, the iron should ba at a white heat, the wound pressed for an in- stant, and then the iron should be held in con- tact with the bleeding vessel. It causes an eschar or slough, with shriveling of the artery; and if the latter be small, it effectually stops the bleeding until the eschar drops off, when the ves- sel may be found still pervious at the wounded part, and the danger of bleeding be as great as at first. Ligature, or tying the artery, is a very old method of arresting hemorrhage, and cer- tainly the best. A ligature snould be applied to each extremity of the cut artery. ( See Liga- ture.) Acupressure (q.v.) was introduced by the late Sir James Y. Simpson of Edinburgh, and Mas extensively used. It is useful in a few in- stances where the arteries are too brittle to per- mit ligation. Venous Bleeding. This is recognized by the dark color of the blood, and its continuous flow. Pressure is generally found sufficient to arrest it, and it should be applied directly over the woimded part. Ligatures are used somewhat as in the case of arterial hemorrhage. Acupressure is rarely used. In the case of large venous trunks, or sinuses, the vessel is packed with a gauze plug. CAPILLARY BtEEniNG. Tliis is distinguished by oozing, with a tendency to spontaneous arrest. It is rarely dangerous, except in hemorrhage from the mucous membrane of the stomach. Water at a temperature of llfi" F. will arrest it, or cold, or the actual cautery. The old styptics (as alum, tannin, cobwebs, etc.) are not used by surgeons, as they cause unclean clots, which invite sepsis and secondary hemorrhage. P.KEN('HYMATOi'S Bleeoing. This occurs in organs wherein small arteries empty directly into veins without intervening cajiillaries, as the spleen. Hot water, or cold, or dilute acetic acid may arrest it. Transfusion of blood irom another person, or introduction of salt solution into the venous system of the patient, is very fre- quently a resort in severe hemorrhage. Some persons have a congenital tendency to bleed (the hemorrhagic diathesis) ; if such a one have a trifling cut, or have a tooth pulled, he bleeds per- haps 10 death. A prudent surgeon will not per- form cutting operations on one of a hemorrhagic family. See Blood. Bleeding, or Bloodletting. Blood may be drawn from a vein (phlebotomy — venesection), or from an artery (arteriotomy ). The veins most commonly opened for this purpose are the me- dian basilic (see Arm), but those of the lower limbs are occasionally selected. The patient should be placed sitting up in bed, as he may lose a dangerous amount of blood without show- ing the usual premonitory symptoms if his head he kept low. The venous return should now be obstructed by a bandage, and when the veins swell, one should be selected, steadied with the left thumb, and slit obliquely with a lancet; the blood allowed to flow till the desired quantity has escaped. The surgeon's thumb should now be placed on the cut in the vein, and kept there till the bandage is removed, when a small pad of lint and figure-of-8 bandage will sufficiently pre- vent the bleeding, and the wound will speedily heal. Phlebotomy was at one time habitually re- sorted to in inflammatory diseases, and even when there was no positive disease it was often applied periodically at particular seasons, as spring and autumn, as a hygienic precaution. It is now rarely used. Local bloodletting by means ot cupping or leeches is used in certain con- ditions, such as pleurisy, sciatica, inflammation resulting from injury to a joint, etc. BLEEDING HEART YARD (once belong- ing to the Ilattons). The name of a part of Lon- don where very poor houses predominate. Why so called is not known, but there is a tradition that here the devil cast the heart of one of the Ladies Hatton after he had torn it from her body. The place is mentioned bv Dickens in Lit- lle Dorrit. BLEEK, blfik, Friedhicii (1793-1859). A German biblical scholar. He was born at Ahrcns- bijk, Holstein, July 4, 1793; educated at the University of Kiel (181214), and in Berlin, under de Wette, Xeander, and .Schleiermacher (1814-17). In 1818 he became tutor in theology in the University of Berlin. Soon afterwards he published essays on the Origin and Composition of the Sibylline Oracles, and on the Authorship and Design of the Book of Danict, in which he at- tracted attention by solid learning, thorough investigation, and candor of judgment. In 1823 he became professor extraordinary; and in 1829 he accepted the chair of theology in the Univer- sity of Bonn, where for thirty years he labored with constantly increasing success, due to the thoroughness of his investigations, the impartial- ity of his judgments, and the clearness of his methods of presentation. He died suddenly of apoplexy, Sunday, February 27, 18.59, having given his regular lecture on the previous day. His defense of the genuineness of the Gospel of Saint John is regarded as one of the strong- est that have yet appeared, and his critical labors on the Xew Testament are among the most important contributions to the maintenance of the evangelical faith that our time has j)roduced. Translated are his Introduction to the Old Testa- ment (London, 1809, 2 vols., reprinted 1875, 1 vol.), and his Introduction to the New Testa- ment (Edinburgh, 1809, 2 vols.), and Lectures on the Apocalypse (London, 1875) . His great work on the Epistle to the Hebrews ( 1 828-40, 3 vols. ) is untranslated. The Introductions just men- tioned were jjublished by his son from his notes