230 PRACTICE OF PHYSIC. 



of little consequence, and hardly requiring any remedy. But, 

 even in young persons, when it recurs very frequently, and is 

 very copious, it will require particular attention, as it is to be 

 considered as a mark of arterial plethora ; and, as frequently 

 returning, it may increase the plethoric state ; which, in a more 

 advanced stage of life, may give the blood a determination to 

 parts from which the haemorrhagy would be more dangerous. 

 All this will more particularly require attention, according as 

 the marks of plethora, and of particular congestion, preceding 

 the haemorrhagy, are more considerable ; and as the flowing of 

 the blood is attended with a more considerable degree of febrile 

 disorder. 



DCCCXVI. When the epistaxis happens to persons after 

 their acme, returning frequently, and flowing copiously, it is 

 always to be considered as a dangerous disease, and as more 

 certainly threatening the consequences mentioned in the last 

 paragraph. 



DCCCXVII. When this haemorrhagy happens in the de- 

 cline of life, it may be considered as in itself very salutary : but, 

 at the same time, it is to be considered as a mark of a very dan- 

 gerous state of the system ; that is, as a mark of a very strong 

 tendency to a venous plethora in the vessels of the head : and I 

 have accordingly observed it often followed by apoplexy, palsy, 

 or such like diseases. 



DCCCXVIII. When an haemorrhagy from the nose hap- 

 pens in febrile diseases, as mentioned in DCCCXII., and is in 

 pretty large quantity, it may be considered as critical and salu- 

 tary ; but it is very apt to be profuse, and even in this way 

 dangerous. 



It upon some occasions occurs during the eruptive fever of 

 several exanthemata, and is in such cases sometimes salutary ; 

 but, if these exanthemata be accompanied with any putrid tend- 

 ency, this haemorrhagy, like artificial blood-lettings, may have 

 very bad effects. 



DCCCXIX. Having thus explained the several circum- 

 stances of epistaxis, I proceed to consider the management and 

 cure of it. I use the expression of management, because it 

 has been usually thought to require no cure, but that nature 

 should be allowed to throw out blood in this way very fre- 



