DISEASES OF THE NOSE. 



EPISTAXIS. BLEEDING FROM THE NOSE. 



Epistaxis as a primary and secondary affection. Causes — mechanical, 

 over exertion, blood pressure, new formations, diseased mucosa, disease of 

 the nasal venous plexus, disease of heart or lungs, in blood diseases, in 

 hsemorrhagic constitution, in bacteridian diseases of the respiratory organs. 

 Symptoms. Often one nostril, blood bright, red, clotted, sneezing, (not 

 retching, acid, nor cough). Treatment. Mechanical, astringent, cold, 

 plugging in solipedes and other animals : haemostatics. 



As a primary affection this occurs more frequently in the horse 

 than in any other domestic animal, though as a symptomatic dis- 

 ease it is common in all farm animals. 



Causes. The most common causes are mechanical injury of 

 the Schneiderian membrane, violent congestion of this membrane 

 during extraordinary excitement or exertions, as in coughing, in 

 a closely contested race, in a trying hunt, in drawing heavy 

 loads, especially if uphill and with a tight collar. It may coin- 

 cide with congestion of the brain acting to some extent as a vica- 

 rious discharge, or with the formation of new structures as poly- 

 pus, or cancer, in which, from the looseness and friability of their 

 texture, the vessels readily give way. The softened membrane is 

 equally liable to laceration or rupture during the progress of in- 

 flammation and particularly when fibrinous (croupous) exudations 

 arebaing detached. In all thesa casss animals of a strong, vigor- 

 ous constitution and with a full or plethoric habit are most liable 

 to be attacked. Various congestions of the mucosa in diseases of 

 the heart or lungs are additional causes. Disease or injury of 

 the cervical branch of the sympathetic nerve, and varicosity of the 

 pituitary venous plexus must be accepted as occasional causes. 



Epistaxis is also met with in states of general weakness and 

 with deteriorated blood, as in anaemia, in the course of various 

 fevers and in those hemorrhagic constitutions in which the altered 

 blood appears to find an easy passage through the debilitated or 

 ruptured coats of the bloodvessels. Thus it is seen in the so- 

 called purpura ^hemorrhagica in the horse, in small-pox in sheep, 

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