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You are viewing: H4H Monographs - Nose Bleed (Epistaxis) - Level 2

to H4H Monographs - Level 1

Dec 09
H4H Monographs 
Nose Bleed (Epistaxis)
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What is a 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 
in order to maximise their 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 Bleeds,
These 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. 

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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.

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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.

ii) 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.

For a full list
of 260 causes of Nosebleed
click More below
More Button

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1st Aid for 
Anterior (frontal) nose bleed
(this covers 90% of nose bleed situations)
1. Dont 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

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Homeopathics for Nose Bleed

During Bleeding

Take 2 pills of
Ferrum phosphate (Ferrum-phos) 12X or  6X
every 5 mins until bleeding stops.
(Max 6 doses over 30 mins)

After Bleeding Stops
Continue to take 2 pills of
Ferrum phosphate (Ferrum-phos) 12X or 6X
every 1 hr for 4 hrs (ie 4 doses)
Thereafter take AM and PM for the next 14 days.

When to Call the Emergency Services

When the bleeding has not ceased in 30 mins

When a Posterior Nose bleed is suspected

Recognising a Posterior Nose Bleed
The patient is elderly
2. When blood flows continually down the throat
3. When bleeding is of a gushing/pulsating/rapid nature
4. When bleeding continues for more than 30 mins
5. When bleeding stops but restarts
6. When there is an accompanying headache
(sign of tension/high blood pressure)
7. When there has been a high loss of blood
(often difficult to tell when the flow goes down the throat)
8. When the patient feels weak or faint,
(presumably from blood loss.)

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Nasal Cautery at A & E
Cautery will seal the bleeding point in the nose
This involves using as silver nitrate stick
which has the appearance of a match stick.
The procedure can be performed in the Accident & Emergency Centre
should further attempts at first aid fail.

Precautions to Take
after Nose Bleed has Ceased

Over the next 3 Days
Keep cool. No undue excitement
# Sneeze through the mouth
(ie with the mouth open)
# No hot showers
# No facial hot water applications
# No hot drinks or hot soups
# Review your medication programme
(particularly if you are on blood manipulating drugs/supplements)

Over the next 14 Days
Sit upright
# Sleep in a semi erect position with the head raised well above heart level
# No alcohol
# Do not strain or bend down to lift anything heavy or
engage in other strenuous activities.
(This can produce momentary surges in blood pressure 
which can cause the nose to bleed again.)
# Do not strain during bowel movements
(If necessary use Super Shield Probiotic to maintain proper metabolic function)
# Evaluate a Homeopathic/Supplement rgime
to raise the level of natural immunity against cold/cough/dry nose.

Blow your nose gently
# Stop nose picking
# Keep your childrens nails (and yours) clipped short
# Use a humidifier
(if your indoor climate is dry during the winter months)
# Avoid facial trauma by wearing a seatbelt and shoulder harness in the car and use
well-fitting headgear to protect your face during contact sports,
such as football or karate
# Use protective equipment to avoid breathing irritating chemicals at work
# Moisturise the inside of your nose with Calendula cream twice daily
(Not petroleum based jells or Vaseline as these contain alcohol and will dry the skin)
# Abstain from all Recreational Drug taking particularly cocaine
# Quit smoking

Homeopathics & Supplements
Apply Calendula cream inside nostrils twice daily to moisturise.
Take Homeopathic for hightened immunity against colds/cough/dry nose.
1 cap/day Super Shield Probiotic for metabolic function.

If Nose Bleeds Reoccur
If nosebleeds continue to reoccur or
if in the past you have suffered from
a pattern of nose bleeds
you may have an underlying medical condition.

For further information
in order to make a fully informed choice contact

Dr. Peter Darashah

Ph.D.,M.Sc (Lond), B.Sc., DIHom (Pract),FBIH, MARH

Nutrition Consultant & Homeopathic Physician

(087) 2621943

Consultations held at :-

The Natural Health Centre, 34 Princes Str.,Cork.

   H4H Monograph

Nose Bleeds
Nopse Bleed logo
Nose Bleed logo
Nose Bleed daigramme
Nose Bleed (General) 
Blood drops
Drops of Blood
Nose Bleed (Anterior)
Child nose picking
Child nose picking
Man nose picking
Man nose picking
Even the great nose pick!!
Even the great nose pick!!
Posterior nose bleed. CLICK FOR CLEAR PICTURE
Posterior nose bleed
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Emergency logo
First Aid logo
First Aid Box
Homeopathic 42 Remedy First Aid Kit
Homeopahtic 42 Remedy
First Aid Kit
First Aid sign
First Aid sign
Ferrum-phos tabs
Ferrum-phos tabs
Homeopathic remedies
Homeopathic remedy bottles
Homeopathic remedy bottle
Homeopathic dropper bottle

Ambulance arriving
The Emergency services
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Paramedic logo
Nasal Cautery external view
Nasal cautery external view
Nasal cautery internal view
Nasal cautery internal view


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