It is commonly known as bleeding from the nose.
Causes of Epistaxis can be local or general.
Local Causes : Injury or trauma, Picking the nose, Foreign bodies in the nose, Nasal Diphtheria, New growths such as Polypus or Malignant tumour e.g. Carcinoma of Nasopharynx, Lupus, Syphillis, Talengiectasis (dilatation of the capillaries on a body surface, which may be heriditary ), A fractured base or depressed fracture of zygomatic bone or a Pitutary tumour.
General Causes : It may be associated with Hypertension, Mitral Stenosis, Portal Cirrohsis of the Liver, Enteric Fever, Whooping Cough, Blood diseases such as Leukaemia, Anaemia, Haemophilia and Purpura etc. and a Lowered Atmospheric Pressure such as occurs at High Altitudes.
Epistaxis may occur at Puberty without any apparent cause.
Otherwise Excessive Heat in general specially in Summers also considered a cause of Epistaxis where no other cause is perceptible or visualised.
The bleeding point is usually or often situated in Kiesselbach’s area, at the anterior and inferior part of the septum nasi.
Unilateral bleeding may occur in specific local condtions such as from tearing of the mucous membrane of the maxillary sinus. Slight intermittent epistaxis may occur in a case with carcinoma of nasopharynx. Blood which passes backwards from the nose may be coughed up and appear as haemoptysis. A careful examination of the nasopharyngeal area may reveal the bleeding point. In other cases the blood may be swallowed and vomited and appear as Haemetamasis or passed with stool and look like Malaena.
Bleeding usually stops in a short time , but it may be persistent and cause anaemia and debility.The prognosis depends on the cause . Epistaxis may be trivial , or it may be a symptom of a fatal disease.
Management varies with the cause of epistaxis. In children the bleeding usually stops on its own unless due to a foreign body, for which the removal is must. In other cases a cold compress may be applied to the nose with the patient lying down, or Plugging may be done in which a little cotton wool is inserted into the nostril and pressure applied over it. The cotton may be soaked in Callendulla or Millefolium or Ficus Religiosa or Hamamellis or Trillium Q. Epistaxis associated with a case of hypertension is a useful safety valve and does not require to be checked, unless very excessive.
ARNICA MONTANA : Epistaxis after a blow . Epistaxis in children growing rapidly, in fever and purpura . Bleeding from nose after every fit of coughing , dark fluid blood . Nose feels sore and coldness of the nose. Epistaxis in morning from washing face.
PHOSPHORUS : Haemorrhagic diathesis. Frequent and profuse bleeding. Epistaxis instead of menses, during scanty menses and with perspiration. Chronic catarrh with, small haemorrhages. Nasal polypi bleeds easily. Epistaxis after the detachment of the membrane in Diphtheria. Epistaxis with purpura haemorrhagica and while straining for the stool.
BELLADONNA : Epistaxis with red congested face. Coryza , mucus mixed with bright red blood. Epistaxis caused by light, motion and noise.
NITRIC ACID : Bleeding nostrils with soreness and coryza. Epistaxis with chest affections. Nasal Diphtheria with watery and excoriating discharge. Blisters and ulcers in the mouth. Better riding in a carriage.
ACONITE : Sudden onset. Epistaxis with bright red blood. May be caused by exposure to very hot weather.
IPECAC : Epistaxis bright red and profuse with persistent nausea. Coryza with stoppage of nose and nausea. Epistaxis caused by Haemophilia, Purpura with face pale .
HAMAMELIS : Epistaxis when the bleeding is of dark colour, profuse. Flow passive, non coagulable, with tightness in bridge of nose. Bad odour from nose. Epistaxis in Hemophilia
MILLEFOLIUM : Epistaxis without any apparent cause. Piercing pain from eyes to root of nose.
TRILLIUM : A graet haemorrhagic remedy with great faintness and dizziness. an excellent remedy for epistaxis which is bright red or dark and clotted. Application of its mother tincture (Q) on the affected part will arrest the bleeding from nose and teeth etc.
AMMONIUM CARB : Epistaxis after washing the face in the morning and after eating. Snuffles of children at night with long continued coryza.
CROTALUS HORRIDUS : Epistaxis in old and broken down constitutions. Blood blackish and stringy. May be given when other remedies fail. Deprived state of blood with flushes of face , vertigo and fainting.
VIPERA : A medicine par excellance for Epistaxis in cases of life long standing.
CROCUS SATIVA : Epistaxis. Dark stringy blood, clotted blood. Strings of dark blood hanging down the nose.
NATRUM SULPHURICUM : Epistaxis before during or after menses.
ARUM TRIPHYLLUM : Constant picking at the nose until it bleeds. Acrid, excoriating discharge, producing raw sores. Blood streaked dischrges.
AMMONIUM MUR : Bloody crusts from nostrils. Free acrid hot watery discharge corroding the lip. Ulceraative pain in the nostrils.
EUPIONUM : Epistaxis when menses intermits.
BRYONIA ALBA : Frequent bleeding from nose instead of menses. in the morning and relieves the headache.
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