In most cases the bleeding is stopped as soon as the ala of the affected side of the nose is pressed against the septum with the finger, whereby the bleeding point is compressed.
The bleeding is most effectually stopped by tarnponing the affected side of the nose. The most simple remedy and one which can easily be taught the parents is the introduction of a cotton plug. A piece of ab sorbent cotton about 3-6 cm. in length is twisted on a cotton carrier or a flattened wire, exactly of the thickness that can just be forced into the nose. It is rotated horizontally and pushed firmly backwards, the tip of the nose being raised. This simple remedy nearly always suffices.
If the purpose is not attained by this alone, a tampon may be sat urated with a 20 per cent. solution of antipyrin, or 5 per cent. potas sium permanganate; a dry tampon may also he dusted with antipyrin or powdered ferri-pyrin. Chloride of iron is a good styptic, but on ac count of its injurious and corrosive action should not be employed. The — .
application of Penghawar-Jambi cotton is recommended. If, after sponging with cotton, the bleeding point is seen (which is easily done when it occurs at the point of predilection anteriorly on the septum), the physician can stop the bleeding by direct cauterization of the point with the nitrate of silver stick. Here, also, according to Siebenmann,
good hicrnostatic effects are obtained by pressing against the bleeding point a pledget of cotton dusted with powdered potassium perman ganate. Recently, also, adrenal preparations are often used; adrenalin 1 :1000, introduced OD small pledgets of cotton.
Complete tamponage is required only in extremely rare cases. Narrow strips of gauze are introduced (after cocainization if necessary) along the floor of the nasal cavity to the posterior nares until the nose is completely plugged. The torturing Bellocq's cannula which still enjoys its undeserved popularity is, at the present day, also forbidden by most specialists. In unusually obstinate and violent ht-emorrhage, subcu taneous injections of 20-50 Gm. of a 10 per cent. solution of gelatin (sterile on account of danger from tetanus) should be tried.