Nosebleed by P. S. Bourdeau, M. D.

Review and Herald Publishing Association · Washington, D.C. · Jun 2, 1904

Nosebleed

By P. S. Bourdeau, M. D.

P. S. BOURDEAU, M. D.

The hemorrhage may come from any part of the nasal cavity, but most frequent from the interior part, especially from the vessels of the membrane which divides the two nasal cavities. While nosebleed rarely occurs with the newly born, it is quite common in childhood, occurring more frequently in boys than in girls. In the latter it occurs more frequently between the ages of twelve and fifteen.

Causes

Children who are kept indoor in overheated rooms, with very susceptible mucous membranes and flabby tissues, are the ones most prone to it. The cause may often be due to some local accident, such as a blow, a fall, picking the nose, in fact, any local irritation may bring it on. We often find it associated with nasal catarrh, and sometimes it is caused by the presence of an ulcer. Mental or physical overexcitement may bring it on. It may also be one of the first symptoms of typhoid or malarial fever or measles, and sometimes diphtheria.

Symptoms

Pain or a feeling of fulness in the head is often noticeable. The blood is usually from one nostril, and comes slowly, a drop at a time. The amount lost is not large at any one time; but if repeated often, may be sufficient to produce anemia even in the strongest children. Sometimes the bleeding may prove fatal. The blood may be swallowed, and thus be entirely overlooked. Usually the hemorrhage does not last longer than from ten to fifteen minutes. It is usually not serious unless it occurs late in the course of the infectious diseases mentioned above.

Treatment

The preventive treatment is important. To remove the predisposition the person should receive plenty of outdoor exercise, cold baths, vigorous friction of the whole body, and the question of proper food should receive special attention. The hemorrhage may often be arrested by pressing the nose between the thumb and finger, ice may be applied over the nose, or sometimes small pieces of ice may be inserted in the nostrils. Cold application should always be made to the back of the neck, and often ice placed in the mouth will reflexly cause contraction of the blood-vessels. Every constriction about the neck should be removed, and the patient kept quiet, preferably in the sitting position.

When the bleeding has stopped, the patient should not blow the nose for some time. If these means are not effectual in stopping the hemorrhage, valuable remedies which are applied locally are the peroxide of hydrogen, used in full strength, or the suprarenal extract in solution. When bleeding continues in spite of all these measures, the nasal cavities should be plugged anteriorly with cotton; and if this does not suffice, the cavities may be plugged posteriorly by a physician.