BLEEDING FROM THE NOSE. 323 



these portions were not successful ; and on account of the comparatively 

 small value of the horse, the owner decided to have it killed. 



Necrosis of the cartilage of the nostril is described by Cadiot and Dollar. 

 The inner wing of the nostril was swollen and indurated over the region 

 corresponding to the cartilaginous plate, with which a sinus, masked by 

 granulations, communicated. This sinus was laid open and the parts 

 swabbed with iodine tincture. Treatment was inteimittent and a second 

 operation became necessary, but recovery occurred in four months. 



(G) EPISTAXIS (BLEEDING FROM THE NOSE). 



Bleeding from the nose may occur spontaneously without local 

 injury or disease, or as a symptom of disease of the mucous 

 membrane, as in ulceration, wounds and tumours. 



Extensive venous plexuses (centrum venosum) exist in the mucous 

 membrane of the nostril of the horse, and especially in that investing 

 the septum nasi. Injuries of these plexuses may give rise to con- 

 siderable bleeding. Hence nasal bleeding is most frequently seen 

 in this animal. It may be caused by external injuries, by fracture 

 of the nasal bones with dislocation of the fragments internally, 

 by other accidental wounds, occasionally from foreign bodies and 

 tumours in the nostril. Schindelka noted severe bleeding after 

 fracture of the septum. In a fifteen-year-old horse, which for ten 

 years had suffered periodically from epistaxis, especially after severe 

 exertion, Deigendesch found an angioma of the septum which had 

 become ulcerated. Great exertion, like racing, sometimes occasions 

 bleeding, as do dusty, irritating fodders. Bigoteau observed nasal 

 bleeding in a great number of horses which had been fed with dusty 

 sainfoin. It is further noteworthy that ulcerative changes like those 

 of glanders give rise to repeated bleeding, which is also liable to occur 

 in mercurial poisoning. The quantity of blood so lost, and the time 

 of bleeding, are exceedingly varied. Nasal bleeding also occurs in 

 anthrax and purpura. 



Diagnosis is not usually difficult ; though sometimes the source 

 of the blood may be in doubt. In haemoptysis, the blood is frothy, 

 and escapes by both nostrils in the horse, and by the mouth as well 

 in some animals ; and there are other symptoms, such as cough, 

 dyspnoea, noisy, rapid respiration. In bleeding from the stomach, 

 the blood is ejected by the mouth and nose in dogs and cattle, and 

 it is more or less altered, being black, coagulated, or in masses. 



Treatment. Immediately bleeding becomes of a character to 

 require therapeutic treatment, cold applications are made to the 

 head, and the nostril of the affected side washed out by means of 

 the irrigator, with cold water, to which tannin or vinegar may 



