To stop bleeding, Oribasius directs, in the first place, cooling and astringent applications to be used, and if these do not succeed, caustics, such as misy, chalcitis, copperas, or the actual cautery. Upon the whole, his account of hemorrhage is nearly the same as our author’s, only he says nothing of the ligature.
Aëtius treats of this subject in the same terms as Galen, recommending the ligature under the circumstances mentioned by him. Some of his styptics are powerful escharotics and astringents, such as copperas, chalcitis, alum, galls, quicklime, rosin, and frankincense. He informs us that Ammonius, the famous Alexandrian lithomist, used a composition of arsenic, sandarach, chalcitis, and quicklime.
Actuarius recommends a composition containing burnt copper, chalcitis, galls, frankincense, &c.
Palladius, in his Commentary on the ‘Epidemics’ of Hippocrates, treating of hemorrhage says, we often stop the bleeding by applying a ligature to the divided vessel.
Albucasis mentions four methods of stopping the discharge of blood from an artery: 1, by the cautery; 2, by dividing the artery across; 3, by using the ligature; 4, by styptics applied upon a bolster or compress, and tightly bandaged.
Averrhoes recommends to stop bleeding by styptics, the cautery, or the ligature. He says distinctly, that when the bleeding cannot be stopped, the artery or vein is to be secured with a thread.
Avicenna treats of all the modes of stopping hemorrhage with singular accuracy, but at so great length that we can only afford room for a few remarks. He recommends stupefying things, cold water, exposure to cold, escharotics, and the actual cautery. He also directs in extreme cases the vessel to be cut across, or a ligature to be applied, namely, a flaxen thread. His description of the process of taking up and tying an artery has quite a modern complexion. He also recommends the application of a compress with tight bandaging when the ligature cannot be applied.
Rhases makes mention of the cautery, of the application of snow, of the ligature, of styptics, and of cutting the vessel across. He mentions that Galen in certain cases approved of two ligatures, as it sometimes happens that the inferior portion will pour forth blood. He further speaks of his having occasionally used two or three ligatures for the sake of greater security. He also mentions torsion of the artery.
Haly Abbas gives an interesting account of hemorrhage, and makes mention of bandages and the ligature. He and Serapion agree in recommending strongly as a styptic a mixture of one part of frankincense, with a half part of aloes, applied upon the down of a hare. This is the application called the plaster of Galen, and is much recommended by Zacutus Lusitanus (Pract. Admin. i, 85), by Scultet (Arsinal de Chirurg. Tab. 33), by Brunus (Chirurg. Maj. i, 12), and Lanfrancus (Chir. parva. 5.)
The early modern writers on surgery make mention of all the ancient methods of stopping hemorrhage. Guy of Cauliac recommends the ligature upon the authority of Galen and Avicenna (iii, 1, 3.) It is also recommended by Brunus (i, 12), Theodoricus (i, 13), Rolandus (ii, 1), and Lanfrancus (iii, 1, 9.) It appears, therefore, that the use of the ligature for stopping hemorrhages was well understood by the ancients, and had never been lost sight of even in the darkest ages.