b. In the first-aid treatment of wounds always remember to dress and splint, if possible to do so, all bad flesh wounds the same as you would a fracture. This will insure immobility and tend largely toward the prevention of bleeding. Looking upon the heart as a pump you will understand that to stop the current of blood pumped through the arteries you must press upon the blood vessel between the wound and the heart. Pressure stops the current of blood in the same way that you would stop the flow of water in a leaky rubber hose or tube by pressing upon it between the leak and the pump, or other source of power. The points or places where you can best do this for the different parts of the body are illustrated in the figures. These points are chosen for pressure because the blood vessels which you wish to control there lie over a bone against which effective pressure can be made.

Plate 3.-Digital compression of carotid artery.

(1) Points for compression with thumb and fingers are the temporal artery which is reached by pressure with tips of fingers in front of the ear just above where the lower jaw can be felt working in its socket. A branch of this artery crosses the temple on a line from the upper border of the ear to above the eyebrow.

(2) The carotid artery may be compressed by pressing the thumb and fingers deeply into the neck in front of the strongly marked muscles which reaches from behind the ear to the upper part of the breastbone. Plate 3 shows pressure on the carotid of the left side.

(3) In bleeding from wounds of the shoulder or armpit the subclavian artery may be reached by pressing the thumb deeply into the hollow behind the middle of the collar bone. (Pl. 4.)

(4) In bleeding from any part of the arm or hand the brachial artery should be pressed outward against the bone just behind the inner border of the large muscle of the arm. (Pl. 5.)

(5) In bleeding from the thigh, leg, or foot, press backward with the thumbs on the femoral artery at the middle of the groin where the artery passes over the bone. The point is a little higher up than that indicated in plate 6.

c. There are two other simple means for helping to stop bleeding-such as elevating or holding an arm or leg upright when these parts are wounded, and by applying cold to the wound; but you will find the compress and bandage, or the pressure made by your fingers as described, to be most useful in the great majority of cases.

8. Hemorrhage (commonly known as bleeding).-a. Hemorrhage or bleeding is the escape of blood from any of the blood vessels as the result of injury or cut. There are three varieties of hemorrhage or bleeding:

(1) Arterial, or that coming from the arteries, which is the most dangerous on account of the great amount of blood which may escape in a short

time. In this form of hemorrhage the blood squirts from the artery with each pulsation of the heart and is bright red in color.

(2) Venous, from the veins. In this form of hemorrhage the blood flows in a slow, steady stream, and the color is dark red or purple.

(3) Capillary, which is merely an oozing of blood from a cut surface, and which is generally the least dangerous form, although it sometimes may be quite dangerous and difficult to control.

b. There are two general ways of stopping hemorrhage-that is, naturally and artificially. The natural way of arresting bleeding is the method

adopted by nature herself and is practically the process of forming a clot or plug in the blood vessel or wound which aids in the prevention of further escape of blood. A clot is a jellylike mass of coagulated blood, the formation of which is hastened or aided by exposure of the wound to the air. In this way nature may be able to stop quite severe bleeding. However, in many cases nature is unable to stop hemorrhage in this way without the loss of a great amount of blood, which is naturally weakening to the patient and if left too long might result in the patient bleeding to death; thus we are obliged to apply artificial means. One of the most important points to remember is that the patient should be kept quiet.

9. Tourniquet.-a. When, however, the bleeding continues after you have used these simpler means, or your fingers become tired in making the pressure, which they may do after 10 or 15 minutes, you will have to use what is called a "tourniquet," and generally will be obliged to improvise one out of material at hand. The principle of such a tourniquet is easily understood a pad or compress placed on the line of the artery and a strap or band to go over the pad and around the limb, so that when tightened it will press the pad down upon the artery and interrupt the flow of blood. In the arm, apply the tourniquet over the point shown for compression by the fingers; in the thigh, 4 or 5 inches below the groin, as it can not be applied higher up. (See plates 7 and 8.)

The pad or compress may be made of such an object as a cork or smooth round stone wrapped in some material to make it less rough, a bandage, a handkerchief, or a cravat being used for the strap. After tying the band closely around the limb, any degree of pressure may be made by passing a stick, bayonet, or something of that kind of sufficient length, and twisting or turning it around so that the pad is pressed firmly in place.

b. Improvised tourniquet.-Turn the stick slowly and stop at once when the blood ceases to flow, fixing the stick in place with another bandage. Remember that you may do harm in two ways in using this rough tourniquet: First, by bruising the flesh and muscles if you use too much force; and second, by keeping this pressure up too long and thus strangling the limb. It is a good rule to relax or ease up on this or any other tourniquet