(Nose bleed; Epistaxis)
=Osteopathic Etiology= and =Pathology=.—Traumatism, such as picking
the nose, blows, and surgical operations; straining when coughing;
nasal tumors and ulcerations; lesions of the atlas, or any lesion of
the upper cervical vertebræ, that would interfere with the vasomotor
distribution to the nose and cause local congestion or weakness of the
blood vessels; obstructions to the general circulation; irregularities
or suppression of the menstrual flow may result in nose bleed, as
a vicarious menstruation; suppression of a habitual hemorrhoidal
discharge.
=Pathologically= the great frequency of nasal hemorrhage is due to the
great vascularity of the nasal mucous membrane. Usually in cases of
spontaneous origin, bleeding is from the region of the septal artery.
Spontaneous bleeding may also occur from posterior hypertrophies or
adenoid vegetations. The blood flowing downward into the fauces, is
expectorated in such cases, and may be mistaken for a hemorrhage from
the lungs.
=Treatment.=—The position of the individual is important. He should
assume a sitting posture, or as nearly so as possible. Holding the
nostrils tightly, or plugging them with a piece of cotton, will favor
the formation and retention of a clot, so that the hemorrhage may be
controlled. Pressure upon the carotid artery, or upon the facial artery
at the angle of the inferior maxilla, will slow the blood current
and favor the formation of a clot, also pressure on the sides of the
bridge of the nose may influence it. Correcting any lesions that may
exist in the superior cervical region, as derangement of the vertebræ
or contracted muscles, will remove obstructions or irritations to the
vasomotor system of the affected region, and thus equalize the vascular
system. Holding the arms above the head, and the application of ice to
the nose are of aid in some cases. Also, injection of cold or hot water
into the nostrils. In serious and obstinate cases, where other methods
fail, a plugging of the anterior and posterior nares should be resorted
to, using absorbent cotton or gauze.