Etiology

Excessive eating to hyperemia, and a catarrhal inflammation of the mucous membrane of the nose, are often the basic causes of nosebleeding. Young people develop a catarrhal inflammation and ulceration of the mucous membrane of the nose which is so annoying that they fall into the very bad habit of picking at the nose, and, by poisoning the mucous membrane with the fingernails, a very raw and irritable state of the mucous membrane is produced. The wounding of the mucous membrane with the fingernails develops in time an ulceration. This ulceration is often deep enough to cause a necrosis of a blood vessel of sufficient size to cause profuse bleeding. Again, the nosebleeding may come from constitutional derangements--a high blood pressure, dysemia, anemia, uremia, etc. This condition, with a little catarrhal ulceration, may cause the subject to be very much inclined to bleed at the nose. This style of bleeding is more profuse than the other. Then there is a nosebleeding which is due to a deficiency of fibrin in the blood. When this element is deficient, the blood loses its power to coagulate. Such cases as this make bleeding very dangerous. Cases such as this have been known to bleed to death. Unfortunately, the more these cases bleed, the easier it is for them to bleed.

Apoplectic subjects are inclined to have nosebleed. It is a conservative measure; for the oftener and the more the nosebleeds, the less becomes the blood pressure, which is one of the causative symptoms. If relief from the excessive blood pressure in the head is not had in some way, a blood vessel is liable to rupture, and the patient will then be in a state of apoplexy, with a clot on the brain and partial paralysis, if death does not occur very soon after the hemorrhage takes place.

Treatment

In the first class of cases the patients must be instructed to keep their fingers out of their noses. Digging at the nose must stop. The mucous membrane should be greased frequently with camphor ice. This will prevent a drying, and also relieve the irritation that causes the patient to dig at the mucous membrane.

The eating should be corrected. Too much starch, sugar, and fat are being eaten. If these are cut down decidedly, or suspended entirely for a while, the nose will have an opportunity to get well. In bleeding from congestive headaches, with high blood pressure, the patient should lie down, have the bowels washed out thoroughly, stop eating, and, as soon as the pulse drops down, there will be no more bleeding. In cases of high blood pressure, with a perverted state of the blood, profuse bleeding is an indication of arteriosclerosis and an apoplectic state of the blood vessels of the brain.

Those in this peculiar state must go without food until the blood pressure is completely overcome. Plugging up the nose may give a temporary and unpleasant relief; but this is not a proper treatment--it is inexcusable, bungling, and unscientific. Reduce the blood pressure; keep food and fluid away from the patient; keep the patient quiet; and in a reasonable time the bleeding will stop. Then the patient should be instructed to be careful about eating and drinking of any fluid, because there is no assurance that apoplexy or paralysis will not ensue before relief from the bleeding can be had.

It is dangerous for blood pressure to remain high enough to cause an occasional nosebleeding. The eating for people who have high blood pressure should be fruit, vegetable salads, and very light meals of meat; but starch, sugar, and fat should be kept away from them until they are safe--until the blood pressure is brought down to the normal.