Specific Treatment of Accidents.
—Broken Neck, Hanging, Strangulation.—The mode of death may possibly cause a separation or dividing of the blood vessels of the neck. If this is the case there will remain in the head and face a large amount of blood, which would soon become coagulated, causing a dark bluish turning black discoloration. The treatment then must be to get this blood from the face, so would recommend the common carotid for injection of fluid and the internal jugular vein for the removal of blood.
Raise both the artery and the vein to the surface, and insert the arterial tube in the artery toward the face, and inject a small quantity of fluid in order to cause a pressure on the venous system, then open the vein, insert the drainage tube and begin to remove the blood, and as the blood drains from the drainage tube inject slowly into the artery. This will help to push the blood out of the capillary system and into the blood bottle and thus clear up the face of its discoloration.
In these cases the raising of only one common carotid would hardly suffice, and it would be far better to operate on both carotids to get the best results. For this reason then the circular incision would be the best operation, and perhaps the use of the Y shaped drainage tube. With the Y shaped drainage tube both sides of the face could be injected at the same time, and the blood could be removed from both internal jugular veins, and the operator could not help but get good results. The removal of blood from the internal jugulars in this direct way will relieve the pressure in the capillaries and smaller veins and induce a better circulation to all the immediate tissues.
Body Severed.
—For these cases one should have a very good idea of the general arterial and venous circulations of the body, for many of the smaller as well as the larger vessels will be cut, necessitating one to tie them off.
If the body is severed below the diaphragm remove and cleanse all the loose and injured organs and tissues, place them in a bucket or pan and cover with fluid. Ligate all the injured arteries and veins in the upper and lower parts.
Inject the lower extremities from inside the abdominal cavity using the common iliac artery, observing the presence of the remaining united arteries and veins, which you can now see, for fluid will leak from them. The lock forceps will enable you to pick them up and with the aneurism needle dissect around the end of the vessel and tie each one tight.
Treat the upper extremity in the same way injecting either from the inside or the outside, according as the severity of the accident may lead you to decide. Inject from the inside upward through the aorta, or from the outside either through the radial, brachial, axillary or carotid.
The trunk may now be sewed together, beginning at the middle of the back. Sew each side up leaving the top open to receive the organs and the tissues which were removed. After these are placed more or less in position sprinkle hardening compound throughout the cavity. Now sew up the front and then place a strong bandage around the body.