. Medical and surgical therapy . or splinters. When 64 WOUNDS OF THE VESSELS the artery is wounded the blood escapes into andaround the vascular sheath, into the cellular tissueand between the muscles, and, being unable to escapeexternally, forms what I have already called a diffuse arterialha?matoma. I have alreadyshown that, in tliecase of a bullet-wound with puiie-tiform orifices andan insignificanttrack, the hema-toma will formslowly and pro-gressively, rarelyanysize;whereas a shell-splinter, whichproduces a non-punctiform orificeand has a well-marked track,gives rise to a rapidly increasi
. Medical and surgical therapy . or splinters. When 64 WOUNDS OF THE VESSELS the artery is wounded the blood escapes into andaround the vascular sheath, into the cellular tissueand between the muscles, and, being unable to escapeexternally, forms what I have already called a diffuse arterialha?matoma. I have alreadyshown that, in tliecase of a bullet-wound with puiie-tiform orifices andan insignificanttrack, the hema-toma will formslowly and pro-gressively, rarelyanysize;whereas a shell-splinter, whichproduces a non-punctiform orificeand has a well-marked track,gives rise to a rapidly increasing haematoma, whichmay attain enormous diincnsions. These forms ofLsematoma may be regarded as typical, and will bedescribed in turn. Between them lies a range ofintermediate forms. Extensive hcematoma, developing rapidly.—When aman is brought to the dressing station some hoursafter being wounded with a very large diffuse haema-toma, he presents a combination of local symptomswhich allows the diagnosis to be made at a attaininggreat Fig. 33.—Arterial haematoma of the axilla.(Authors case.) THERA PEUTICAL CONSIDEBATIONS 65 The most noticeable sym})t()ni is marked swelling ofthe wounded limb, which differs in character accordingto whether the hsematoma is superficial or deep. Asuperficial hcematoma, such as that accompanying awound of the axillary or superficial femoral vessels,presents considerable swelling, which raises the skinof the injured area and forms a tumour of varying
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1918
