The Control of Epistaxis by Arterial Ligation

The problem presented by the patient with a stubborn and persistent nosebleed always has been and always will be a constant source of trial and anxiety for the physician, the bleeder, and his family. The literature for the past 20 years is replete with splendid papers on the etiology and general conservative management of nosebleeds.* Some authors feel that haste in treatment need not be necessary, while others have recognized the mental apprehension attendant upon visible bleeding anywhere above the clavicle.† We have all observed that prolonged and persistent bleeding from the lower intestinal or vaginal tracts never excites the same degree of apprehension, even though the patient is bordering on surgical shock. The variety of methods of conservative treatment of persistent epistaxis is equaled only by the number of different etiological factors which may come into play. It is not the purpose of this paper to discuss any of