What causes bleeding must always be the first question. If it is a symptom of a disease, the necessity of treating the disease rather than the bleeding is plain. In such a case, only a large and weakening hemorrhage calls for special measures on its account. This is true of the bleeding at the nose in the first week of typhoid fever, spitting of blood in consumption of the lungs, vomiting of blood in ulcer of the stomach, and bleeding from hemorrhoids or piles. It is well to state clearly that there are no remedies which are always certain to stop bleeding from any internal cavity of the body.

Nose-Bleeding

Often this is rather relieving than otherwise, in full-blooded young people, who without it would have had headache. The occasion for stopping it comes when it is so large in amount, or continues so long as to weaken by loss of blood.

How shall we stop it ? Tell the patient to avoid blowing his nose. Clotting (coagulation) is the natural way of stoppage of all hemorrhages. Bathe the forehead and outside of the nose and cheeks with cold water, or apply ice to the forehead (not too long at once, but enough to cause the impression of decided cold) ; or, if this does not suffice, to the back of the neck.

Put a plug of cotton well into the nostril from which the blood comes. If first dipped lightly in a strong solution of alum, it will be more effectual. Let the person keep quiet, with the head and shoulders raised. Holding both hands high above the head is said to help to stop bleeding at the nose.

Only one in a very large number of cases will be really dangerous. When all the above measures fail, a physician will be needed, who will effectually plug the bleed-ing nostril. For this a watch-spring arrangement is sometimes used, or an elastic catheter. If the latter, a string (waxed ligature) is put through the hole at the end of the instrument, and that is oiled and very gently passed back into the nostril until it can be felt at the opening above the throat. With forceps (nippers) one end of the string is then seized and brought out of the mouth. A piece of cotton is tied upon it, and then the catheter and the other end of the string are drawn out of the nose, and the cotton plug is held firmly against the back of the nostril. If still necessary, another plug may be again inserted in the front of the nostril.