Set the patient upright. Do not allow him to bend forward over a basin of water or anything of the sort. Place to the nose a dry linen handkerchief, pressing the comer of it as far as possible into the nostril from which the blood flows, holding it in place so as to allow a clot to form and close up the bleeding vessels. In the meantime, the patient's arms may be raised above his head, a procedure which will of itself often produce an immediate cessation of bleeding. If the bleeding still continues, throw into the nose with a syringe a strong solution of alum. Tannin and vinegar may be used in the same way. Application of ice to the neck is a very good measure, but bathing the face and snuffing cold water into the nose are measures which rarely accomplish any good. A great amount of good may be done by sponging the face with very hot water and snuffing into the nostrils a solution of chlorate of potash, ten grains to the ounce, as hot as can be borne. Hot water itself has a powerful effect to stop hemorrhage, especially when it comes in contact with the fine blood-vessels in the mucous membrane. In extreme cases, the extremities may be ligated so as to withdraw a considerable quantity of blood from the circulation. Care should be taken to warm the extremities, so as to relieve the pressure of blood in the head as much as possible. Some good may be derived from plugging the nostrils with cotton-wool or soft, dry muslin. In the worst cases, however, it becomes necessary to plug the posterior passages from the nose, known as the posterior nares. The best way to do this is quite well shown in Fig. 306.

Fig. 306. Plugging the Nose.

Fig. 306. Plugging the Nose.

A strong cord is passed through the nose by means of a gum elastic catheter or something of the kind, and the end is drawn out of the mouth. A plug of muslin or cotton-wool is attached to the cord, and the other end protruding from the nose is pulled upon with sufficient force to bring the plug snugly into place behind the soft palate. This measure rarely fails to accomplish the object for which it is employed. The plug should not be left in place more than forty-eight hours, and a string should be attached to it before it is drawn into position in order to withdraw it, as it must be removed in the same way in which it is applied.