Rule for treating bleeding

When treating bleeding, first stop the bleeding, and then treat the ulcer, if any. Bleeding caused by a permanent cause - corrosion or something of the like - can be stopped only by eliminating the cause, and if circumstances do not allow time for its elimination, then the bleeding is stopped by hemostatic agents, that is, by means of which the blood stops flowing. These means are known from Book One, but for the sake of protection we will talk about them again and say such means either divert the blood in the direction opposite to the place of its exit, or do not allow it to leave this place, or combine both of these abilities, as well as other properties

Means of the first type, that is, they divert the blood in the other direction, or they pull it in the opposite direction without creating another exit, as happens when cups are placed on the liver and bleeding from the right nostril stops, or they create another exit, as for example when a person suffering from nasal bleeding is done by narrow bloodletting from the arm on the opposite side of the bleeding nostril.

As for the methods of stopping the blood without creating another outlet, these are measures that prevent the movement and exit of the blood by means that either thicken the blood or cause numbness, and numbness is caused either by a medicine or by the condition of the patient’s body, for example, fainting often stops the blood.

The cause that locks the blood in place is something that plugs the outlet, either by constricting, or by closing and filling the wound, or by closing it without filling, or by forming a scab by cauterization with fire or by cauterizing medicine, or by creating a blood clot, or by sticking together, or by drying out, either by building up the meat, or by squeezing the vessel with the meat surrounding it which clogs and closes it tightly.

You should know that if the wound is accompanied by swelling, this makes many of these actions difficult, and it is impossible to tie the vessel with threads, insert a tampon there, or tighten it tightly.

his. In this case, you can only apply gluing and tightening or induce numbness or thicken the blood. If treatment by pulling, cutting or applying drugs is painful, this is very bad, any position that causes pain is also harmful.

The position of the wounded organ should combine two conditions, the first of which is the absence of pain, and the second is the elevation of the side where the blood is diverted; one should not resort to lowering or hanging - it facilitates the exit and outpouring of blood. If both goals mutually interfere with each other, then they tend to choose what is more convenient according to appearances and more tolerable due to the patient’s condition.

And now we need to outline these methods one by one, having previously indicated that you must first check and find out by the sign mentioned above - whether the vessel is an artery or a vein, the arteries devote more care and attention than is done in relation to the vein.

And then let’s say that with regard to diverting the blood to the side, but not to another outlet, this, in particular, is done by causing pain to any organ by rubbing, bandaging, tightening or cupping. This organ must be a participating organ, located in relation to the damaged organ at the other end of a straight line connecting them in the longitudinal or transverse direction. From the longitudinally or transversely opposed organs, the most distant one is selected, and the organ located close is not touched, for example, the distance between both sides of the head or both sides of the arm is too close to expect a complete deviation of the blood. When pulling, rubbing and similar actions, you should go from the place closest to the bleeding organ and go down from it. In case of arterial ruptures and similar injuries, one should not expect that this method will be sufficient to stop bleeding - it is only auxiliary; bloodletting from a distant involved side is also judged.

As for one of the two methods of the second type, that is, a thickening agent, for this purpose they feed a person suffering from frequent bleeding from the nose or from other places with foods that produce thick chyme and thicken the blood, for example, lentils, jujube and the like.

In the second method, the patient is given numbing substances or cold water and the body is cooled, or he is euthanized. Fainting is sometimes beneficial and stops bleeding.

And when using the other type of method mentioned above, you should keep in mind one circumstance, namely, that the artery sometimes adjoins the heart on more than one side - if this were so, you would get rid of the danger by blocking one side. No, sometimes a branch of some other artery comes to the other side of the heart, which diverges into it and leads blood into it in a different way than the one you closed, so that two blockages are required. First you must find out which side the beginning of the vessel is on - in some places, for example, on the neck it starts from the bottom, and in others, for example, on the hips or on the leg - from above, and when you determine the side, make a bandage and constriction there.

One of the methods used in this case is to try to pull the vessel out with a hook or with the help of a small cut in the meat that covers and hides it, and then it is wrapped in a rag and medicines are used, which we will talk about later. If it is a breaking vessel, then it is best to tie it with linen thread in the same way as a vessel that does not break, but a large one that does not stop bleeding. When you do this, apply the medicine and leave the bandage until the third or fourth day, and then, if you see that the adhesive medicine remains in place, under no circumstances tear it off and put something of the same kind around, slightly moisturizing. If it happens that the medicine comes off on its own when you remove the bandage covering it, then press the vessel with your finger below the wounded area along the vessel and completely squeeze it to avoid a rapid outpouring of blood, then separate the medicine that has come off or is loosely held in place and replace it with a new one. The position of the organ should be as it should be, namely, so that the mouth of the wound is above the beginning of the vessel, so that if the wound is located, for example, in the lower intestines or in the uterus, you arrange a mat that raises the lower parts of the body and lowers the upper parts, as painlessly as possible, and force the patient to maintain this position for three days until the bleeding stops.

As for the barrier with a plug, this can be done in a large vessel by preparing a tampon from hare hair, cobwebs, thin cotton paper or an old linen rag, which is sprinkled with adhesive or hemostatic drugs and placed into the vessel itself like a plug, and then the vessel is pulled over the top with a bandage Sometimes they use a tampon made from one hare's hair, and this saves you from worry.

The bandage should be applied constantly and not removed until the wound heals. As for the tampon, nature itself will take measures to gradually remove it or push it out, or decide something else.

When there is an obstruction without a plug, something similar is placed at the mouth of the wound and tightened without inserting the tampon deep into the vessel, or the bleeding is stopped with dressings, especially sponge dressings and tightly constricting bandages. In this case, the bandage is tightened differently from a bandage designed to attract blood. In the first case, bandaging should begin near the mouth and wrap the bandage, going backwards and gradually loosening the bandage, but here they do the opposite.

Know that tightening with bandages and dressings, if weak, will only have harmful consequences, that is, it will attract blood, and such a bandage will not have a beneficial effect, that is, blocking and stopping bleeding, you must act skillfully in this regard.

And when you have bandaged the vessel well, make a bandage on the opposite side as well, in order to deflect the material and resist the attractive effect of the first bandage. The dressing should stop bleeding without pain. Sometimes, of course, a painful bandage is necessary at first, but then it should be loosened little by little.

Sometimes you have to sew up a tear in the meat, connect its edges and bandage it, but often it is enough to connect the edges and apply a bandage you know, you apply a bandage that maintains the connection over the poured medicine to build up the meat. If the jugular vein has ruptured, you should press it at its beginning with the fingers of one hand and then apply the medicine and bandage to the mouth of the wound with the other hand.

As for the barrier through blood thickening, thickening is achieved either by a blocking bandage on the surface of the mouth, which is held all the time until the blood hardens and forms a barrier, or by some strongly cooling substance that acts on the blood and thickens it at the mouth. And pressing the wounded place with meat occurs, for example, if the vessel is cut across and first shrinks and is pulled in both directions, and then the meat closes the wound on the side from which the blood comes; this happens only in a fleshy place. Often it is necessary to cut off a branch at the end of the vessel so that it goes further into the depths, and then medicines are injected onto it; often the passage closes without bruising.

Tightening with a scab, when the danger is great, is carried out directly with fire or, in milder cases, with the help of cauterizing medicines, for example, pura, verdigris, vitriol, arsenic, as well as cumin and similar substances, which are sprinkled on the sore spot, also works and sea foam - this is often applied to the incision site and stops bleeding. However, this is dangerous in the sense that such a scab quickly falls off on its own or at the slightest pressure of blood escaping from under it, as well as from some other minor reason, and if the scab falls off, the trouble returns again. Therefore, doctors prescribe cauterization by fire using a thick, highly heated piece of iron, so that it forms a thick, deep scab, which does not fall off easily or falls off after due time, during which the flesh has time to grow. And from weak cauterization, a thin scab is formed, which falls off for the most insignificant reason and at the same time attracts a lot of matter and greatly heats it up. As for strong cauterization, it closes the wound with a strong scab, eliminates the gap, tightens and compresses it.

Here is a good, moderately effective cauterization: take egg white, add quicklime to it and spread it on hare hair or something similar, apply it and tie it to the wounded area.

Another good, often effective moxibustion is to take cumin and nura, apply it to the sore spot and make a bandage. Sometimes kalkatara and vitriol are added to Nura; these substances, while cauterizing, also have the ability to bind, and Nura cauterizes, but does not bind to any significant extent. The scab formed from cauterization with several binding substances lasts longer and the squeezed juice of donkey feces penetrates deeper and the feces substance itself strongly cauterizes and at the same time sticks together.

As for medicines that stop blood by adhesion, these are, for example, washed gypsum, boiled resin, starch, dust from a millstone, various gums, incense and ratiyanaj; dried grapes also work. They say that frogs also belong to this category, like the Samian star.

And medicines that stop bleeding by drying and thickening the meat are, for example, sabur, incense powder, crushed raisin seeds are good, as well as galls, smeared with oil and burned; when they stop burning, they are extinguished. This also includes burnt papyrus, calcined ratiyanaj, iron rust, horse feces and donkey feces - both in burnt or unburnt form - ashes from bones, ashes from shells - both of them should not be washed, because washed medicine belongs to number of gluers. A new sponge soaked in olive oil or wine and then burned will also help.