A slight blow, brisk exercise, a strong bodily effort, a fit of sneezing, or the summer heat, is sufficient, in many boys, to set the nose bleeding. In some adult persons it happens periodically, and is habitual: and its suspension rather than its occurrence, becomes a token of disease or danger. In young women it frequently follows a suspension of the monthly discharge; and in men it is apt to take the place of Piles. In old age it is generally the result of congestion or fulness of the vessels of the head.

Usually the blood flows in a succession of drops; but these may follow each other so fast as to make a little stream. Sometimes a few drops only fall, at other times several pints.

Treatment

In childhood and early youth the bleeding is rather beneficial than otherwise, and if it does not occur too often, may be left to cure itself. It may be stopped at any time by applying cold water to the forehead and nose. A favorite domestic remedy is to slip a cold key down the neck, between the skin and the clothes.

When bleeding at the nose begins to show itself in advanced life, it is a symptom which cannot safely be neglected; for it indicates that the veins of the head are loaded. It is necessary to look out for disease of the heart, or for threatenings of Apoplexy.

On the other hand, when bleeding which is known to have been habitual, shall suddenly stop, or not appear at the regular periods, it is necessary to watch carefully for symptoms of determination of blood to the head.

A moderate hemorrhage is generally succeeded by a sense of relief and refreshment, but a large one may cause pallor, faintness, debility, and even death.

When the application of cold to the face and back of the neck are not sufficient to stop the bleeding, powdered Tannic or Gallic Acids snuffed up the nostrils, will often stop the bleeding at once. Finely-powdered charcoal is said to have the same effect. If neither of these applications have the effect of stopping the bleeding, the nostril must be plugged with pieces of lint or cotton steeped in a solution of sulphate of Zinc or Friar's Balsam, and then rolled in Tannic or Gallic Acid.

After the bleeding has ceased, the patient must be careful not to remove the lint or clotted blood, but should allow them to come away themselves; and in order to avoid any return of the hemorrhage, he must be kept as still and quiet as possible.

It sometimes happens that, when the bleeding is stopped outwardly, it still continues inwardly, and continues in such a degree as to threaten suffocation, particularly when the person falls asleep. In such cases, the bleeding may be stopped by introducing a pliable probe up the nostril, through the eye of which some strong threads have been passed, and so bringing it out at the mouth; then fastening pieces of sponge soaked in the Tannic Acid or Charcoal to their extremities, afterwards drawing them back to the inner openings of the nostrils, and tying the threads to a piece of cork or stick outside the nose, in such a way that they cannot give way.

When the bleeding arises in persons of full, plethoric habit, a frequent use of cooling purgatives and cooling diet will be advisable, and may possibly prevent a return of the complaint. When occasioned by too great a rush of blood to the head, leeches may be applied to the temples, or the patient may be cupped at the back of the neck.