A system of surgery . la-tion is not established,the part dies, under-going the changes de-scribed as dry gan-grene. More usuallyblood is carried into the empty vessels by the numerous anastomosesthat exist almost universally in the body. At first all the communicat-ing vessels dilate and participate in this, for the resistance they offerto the passage of blood is less than that offered by the capillaries, andthe blood flows from the full arteries in the direction of least resist-ance. Certain special vessels gradually enlarge, undergoing a truehypertrophy, and serve as the main channels of th
A system of surgery . la-tion is not established,the part dies, under-going the changes de-scribed as dry gan-grene. More usuallyblood is carried into the empty vessels by the numerous anastomosesthat exist almost universally in the body. At first all the communicat-ing vessels dilate and participate in this, for the resistance they offerto the passage of blood is less than that offered by the capillaries, andthe blood flows from the full arteries in the direction of least resist-ance. Certain special vessels gradually enlarge, undergoing a truehypertrophy, and serve as the main channels of the blood, while theothers contract to their normal size. (See Fig. 158.) The pulselessarteries are felt to beat again, and sometimes the enlarged anasto-mosing vessels can be felt beating under the finger. The temporarydeprivation of blood causes the vessels beyond the ligature to yield tothe pressure of the blood first brought to them through the anasto-mosing channels, and thus the pallor and coldness are followed by. -The first (a) and second (b) Stages of the St.^knot. (Ballance and Edmunds.) 534 INJURIES OF BLOOD-VESSELS. increased redness and heat in the part, which gradually subside asthe tissues recover their full vitality. A similar effect is seen afterthe removal of an Esmarchs bandage: the pallid anaemic tissuesblush, and then gradually resume their natural appearance. In somecases the sudden anaemia is attended with severe pain in the part,and in the case of an embolus the sudden acute pain may beassociated with tenderness of the empty arteries. Finally, the partis generally a little shrunken and cold, owing to the blood supplybeing below the normal. The treatment of such a part requires care. It should beplaced in the position most favourable to the circulation. As a rule, this is slightly raised, with the-jointsa little flexed. It should be swathed incotton wool, kept in place by a loosely-applied flannel bandage, and outside thisa hot bottle should be placed. Grea
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