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Wednesday, March 16, 2016

HOMEOPATHIC APPROACH TO EPISTAXIS (NOSE BLEED)

 HOMEOPATHIC APPROACH TO EPISTAXIS (NOSE BLEED)




The inside of the nose (particularly the anterior frontal part) is covered with moist, delicate tissue (mucosa) that has a rich supply of blood vessels/tissues. These blood vessels or capillaries are quite delicate and close to the surface to their maximise efficiency to moderate the temperature of each breath of air so that it is just right for the head and the lungs. When this vascular tissue is injured or the cells are ruptured as a result of trauma, even as a result of something apparently minor, the capillary blood vessels bleed, sometimes heavily. Occasionally nose bleeds are spontaneous but regardless of how they are caused they can be embarrassing and distressful even though life threatening situations are extremely rare in the case of anterior nose bleeds. 

Are there different types of nose bleed

1. Anterior Nose BleedsThese are from the front of the nose and are most common representing about 90% of epistaxic (nose bleed) situations. The most frequent location is the nasal septum which is the wall between the two nostrils. In most cases, this type of nosebleed is not serious. It usually can be stopped with some local pressure and a little patience.

Reasons for Anterior Nose Bleed

i) Dry mucous membranes

This is the main cause for anterior nose bleeds caused by:
  • a hot climate or
  • hot stuffy indoor atmosphere

ii) Infection and/or Allergies

Which results in nasal inflammation and congestion causing blood vessels to widen (dilate), thus making them more vulnerable to injury. Nosebleeds occur most often in autumn/winter when upper respiratory infections which leave noses crusty and dried out are most common.

iii) Nose picking

Which results in rupture of the mucosal lining.

iv) Strenuous nose blowing

Producing ruptured vascular tissue as a result of a head cold.

v) Medications & Supplements

Including aspirin, ibuprofen, clopidogrel bisulfate (Plavix) or warfarin (Coumadin). Additionally some herbal remedies including Danshen, Dong quai, Feverfew, Garlic, Ginger, Ginko biloba, Ginseng, vitamin E and Omega 3 (fish oil) all of which exhibit blood thinning characteristics. If any these (or similar alternatives) have been prescribed you need to contact your physician and discuss the possibility of stopping them at least for a short period.

vi) Exposure to Chemicals and/or fumes

Which damage the nasal lining. The principle culprit here is secondhand cigarette smoke but nosebleeds can develop from on-the-job exposure to sulfuric acid, ammonia, gasoline or other chemical irritants.

vii) Hot Liquids & Showers

Drinking hot soup and beverages as well as hot water showers to the head can also result in undesirable blood vessel dilation.

viii) Constipation

Resulting in undue straining during bowel movements.


2. Posterior Nose Bleeds

These come from deep at the rear of the nose and are characterised by a blood flow down the throat and mouth even when the person is sitting. They occur usually in older people over 60 years and are more severe and can be difficult to control and stop. With age, arteries and blood vessels loose their elasticity and flexibility. Atherosclerosis as a consequence of high blood pressure damages arteries by scaring. These factors can hamper the contracting and retracting of an artery causing rupture and posterior nosebleed to persist. A posterior nose bleed can be life-threatening.

Reasons for Posterior Nose Bleed (in addition to those for Anterior Bleeds)

i) Medical Condition

Examples include kidney failure, thrombocytopenia (low platelet levels needed for clotting), haemophilia etc.

ii) Addictions including

Alcohol, Tobacco and Recreational Drugs (particularly cocaine) not only cause injury and bleeding to superficial blood vessels as a consequence of dilation but in addition interfere with normal blood platelet activity increasing the time needed for blood clot formation.

iii) Nose Scaring

As a result of previous trauma to nose or nose breakage. A scar (or cicatrix) can result in weakened superficial blood tissue around its edges.

iv) High Blood Pressure

Which exerts a continual, abnormally high pressure on your circulatory system.

v) Mental Stress / Tension

Stress increases the metabolic rate causing hormone surges, exhaustion, tension, headaches, irritability, aggression and hypertension. 



1st Aid for nose bleeding

  1. Don't panic. Keep calm. It is unlikely to be life threatening
  2. Sit upright
  3. Lean head slightly forward (Not backwards as this can cause choking or not too forward as this can encourage flow)
  4. Do not swallow blood, if blood flows down the throat spit it out. (Swallowing blood will make you feel nauseous and will later induce a bout of vomiting resulting in straining.)
  5. Breath through the mouth
  6. Remove any dentures.
  7. Pinch the soft part of the nose continuously for 10 mins. (between the tip and the bridge)
  8. Apply a cold compress to the back of the neck. This will also reinforce the slight forward tilt of the head. (Not the forehead as the head tends to tilt backwards in an effort to maintain the compress in position or the nose itself as it will be more difficult to maintain nasal pressure with a compress in place)
  9. Repeat the above twice more and if the bleeding has not ceased seek medical advice (ie a total time duration of 30 mins)
  10. Do not pack the nostrils with cotton wool or similar

 Homeopathy Approach .

from repertory

Nose; epistaxis, hemorrhage:


Blood-black and thick: Croc., Merc., Nux, Puls.; black and thin: Crotal., Ham., Nitr. ac., Sec., Sulph. ac.; tenacious: Croc., Merc., Sec., Veratr.;
 pale: Bar., Carb. an., Crotal., Dig., Dulc., Kreos., Hyosc., Led., Sabad.;  
clotted: Arn., Bell., Cham., Croc., Fer., Ipec., Merc., Nitr. ac., Nux v., Puls., Rhus, Stram.; 
dark and non-coagulable: Ham., Lach.; 
dark and coagulating: Croc., Merc., Puls., Nux v.
 Bleeding-mornings: Agn. cas., Amb., Amm. carb., Bell., Berb., Bor., Bov., Bry., Calc., Canth., Caps., Carb. v., Chin., Colch., Dros., Graph., Hep., Kali carb., Kreos., Lach., Magn., Natr., Nitr. ac., Nux v., Phos., Rhus, Sep., Stann., Sulph., Thuj.; afternoon: Carb. an., Lyc., Natr. sulph., Nitr., Sulph.; evening: Ant. crud., Bor., Coff., Colch., Dros., Fer., Graph., Lach., Lyc., Phos., Sep., Sulph. ac., Sulph.; night: Bell., Calc., Carb. v., Graph., Magn. mur., Natr. m., Natr. sulph., Rhus, Veratr.; while sleeping: Bry., Merc., Natr. sulph., Nitr. ac., Puls., Sulph., Veratr.; 
when washing face: Amm. carb., Arn., Kali carb.; after dinner: Amm. carb., Arg. nit.
 Nosebleed-vicarious: Bry., Ham., Lach., Puls.; 
 before menses: Lach.; menses too scanty: Puls., Sec., Sep.; too profuse: Acon., Calc., Croc., Sabad.;  
amenorrhoea: Bry., Ham., Lach., Phos., Puls., Sep.;  
during pregnancy: Cocc., Sep.; climaxis: Bell., Bry., Ham., Lach., Nux v., Puls., Sep., Sulph. ac., Sulph.; in diphtheria: Ars., Carb. v., Chin., Lach., Merc. cyan., Nitr. ac., Phos.; in typhoids: Bry., Crot., Lach., Phos. ac. (no relief), Rhus; from anaemia: Carb. v., Chin., Cin., Fer., Sec.; from hyperaemia: Acon., Alum., Bell., Bufo, Cham., Croc., Graph., Melilotus, Rhus; from worms: Cin., Merc., Spig., Tereb.
 

Homoeopathic medicines for Epistaxis

Arnica montana

 Epistaxis, preceded by tingling; copious after every exertion, from mechanical causes; after washing face, during whooping-cough, typhus, etc.; nosebleed in growing children; discharge of several drops of thin blood from nose on first blowing it in the morning; blood bright-red, mixed with clots and leaving a bruised sensation behind. 

Ammonium carbonicum

 Epistaxis every morning on washing face, after dinner, after repeated sneezing, especially if after the flow has ceased a bloody mucus is often blown from the nose; epistaxis with dry coryza, especially at night, without the slightest air passing through; when stooping blood rushes to tip of nose. Hands look blue after washing in cold water and veins distended.
 

Carbo vegetabilis

 Frequent and continued nosebleed, especially in the morning and forenoon, or when pressing at a stool, great paleness of face during and after bleeding; fainting sometimes before; blood thin and black, aggr. at night, in old and debilitated persons, excited by motions or jarring, aggr. after debauch (Nux v.); often followed by a pain over chest.

Crocus sativus

 Discharge from one nostril of very tenacious, thick, stringy black blood, with cold sweat in large drops on forehead; suits women who menstruate long and profusely and are subject to fainting at the approach of menses; epistaxis in overgrown, delicate children; periodicity and chronicity; yellowish, sallow color of face; sour taste in mouth.
 

 Crotalus horridus

 Epistaxis at onset or during course of zymotic or septic diseases (Bapt.) or in broken-down constitutions with depraved state of blood, which is thin, dark and does not coagulate; flushes of face, vertigo, fainting; especially during diphtheria (Lach., Nitr. ac., Chin.).

Ferrum metallicum

 Profuse and repeated bleeding, nostrils continually full of clotted blood, especially in anaemic persons, subject to ebullitions, with an ashy pale face, flushing easily, who are always cold, even in bed; emaciated and weak from recurrent epistaxis (Chin.); epistaxis in children with frequent changes in color of face; blood light or lumpy, coagulates easily (Merc., Puls.). Fer. picr. will often relieve, where the metal fails. 

Hamamelis virginiana

 Flow passive, non-coagulable, with feeling of tightness at the bridge of the nose; profuse, idiopathic or vicarious, especially in young, anaemic girls or when there is haemoptysis at the same time. Mind calm, fulness of head.
 

Pulsatilla pratensis

 Nosebleed from suppressed menses, blood partly fluid and partly clotted, intermitting in intensity, aggr. by going into a warm room or in a recumbent position. Nosebleed with dry coryza in anaemic women whose courses are scanty, late or suppressed.


Agaricus

In this remedy bleeding from nose is generally seen in old people who does not want to do any work. Blood from nose comes out from blowing the nose, in early morning, immediately after rising. This is followed by violent bleeding from over work. There is profuse foetid discharge from nose. In general there is jerking twitching, trembling, and itching is characteristic symptom. A special delirium is seen in patient in patient sings, talks, but does not answer. Patient is very talkative.
Worse from-Open cold air, after eating, in cold weather, before a thunderstorm.
Better from- Moving about slowly.


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