BLEEDING FROM THE NOSE. 
75 
(6) EPISTAXIS (BLEEDING FROM THE NOSE). 
Bleeding from the nose may occur either without injury to or disease 
of the mucous membrane or as a symptom of disease of the mucous 
membrane, as in glanders and tumour formation. 
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 consider¬ 
able bleeding. Hence nasal bleeding is most frequently seen in this 
animal. It may be caused by external injuries, such as carelessly wiping- 
out the nose with a rough cloth, 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 and profuse bleeding, which 
is also liable to occur in mercurial poisoning. When nasal bleeding con¬ 
tinually recurs in horses without visible cause, it must awaken very great 
suspicion, particularly in animals which have been exposed to glanders 
infection. The quantity of blood so lost, and the time of bleeding, are 
exceedingly varied. In glanders, and other ulcerative processes, bleeding 
is occasionally so severe as to threaten immediate death. 
Treatment. Immediately bleeding becomes of a character to lequiie 
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 appropriately be added. 
In bleeding from the lower portions of the nostril, plugging may be 
necessary, but where this is resorted to the patient must be caiefully 
watched, and the plugs removed immediately the breathing is difficult. 
Or tracheotomy can be performed, a tampon canula inserted, and both 
nostrils plugged. Even this, however, will not invaiiably stop the 
bleeding. Insufflation of finely powdered alum has been lecommended, 
and is worth trying when the blood comes from the lower portions of 
the nostrils. Where fatal results threaten, secale cornutum (ergot) may 
be tried. Sohngen saw recovery in the horse aftei subcutaneous injec¬ 
tion of 12 grains extr. secal. cornut. Extractum hydrastis canadensis is 
useful, but adrenalin chloride is now the best hemostatic for bleeding 
from mucous membranes. Astrachanez plugged the nostril with tampons 
