Advice to the people in general, with regard to their health

by S. A. D. Tissot

§ 512. Hæmorrhages of the Nose, supervening in inflammatory Fevers, commonly prove a favourable Crisis; which Bleeding we should carefully avoid stopping; except it becomes excessive, and seems to threaten the Patient's Life.

As they scarcely ever happen in very healthy Subjects, but from a superfluous Abundance of Blood, it is very improper to check them too soon; lest some internal Stuffings and Obstructions should prove the Consequence.

A Swooning sometimes ensues after the Loss of only a moderate Quantity of Blood. This Swooning stops the Hæmorrhage, and goes off without any further Assistance, except the smelling to Vinegar. But in other Cases there is a Succession of fainting Fits, without the Blood's stopping; while at the same time slight convulsive Motions and Twitchings ensue, attended with a Raving, when it becomes really necessary to stop the Bleeding: and indeed, without waiting till these violent Symptoms appear, the following Signs will sufficiently direct us, when it is right to stop the Flux of Blood, or to permit its Continuance—As long as the Pulse is still pretty full; while the Heat of the Body is equally extended to the very Extremities; and the Countenance and Lips preserve their natural Redness, no ill Consequence is to be apprehended from the Hæmorrhage, though it has been very copious, and even somewhat profuse.

But whenever the Pulse begins to faulter and tremble; when the Countenance and the Lips grow pale, and the Patient complains of a Sickness at Stomach, it is absolutely necessary to stop the Discharge of Blood. And considering that the Operation of Remedies does not immediately follow the Exhibition or Application of them, it is safer to begin a little too early with them, than to delay them, though ever so little too long.

§ 513. First of all then, tight Bandages, or Ligatures, should be applied round both Arms, on the Part they are applied over in order to Bleeding; and round the lower Part of both Thighs, on the gartering Place; and all these are to be drawn very tight, with an Intention to detain and accumulate the Blood in the Extremities.

2, In Order to increase this Effect, the Legs are to be plunged in warm Water up to the Knees; for by relaxing the Blood-vessels of the Legs and Feet, they are dilated at the same time, and thence receive, and, in Consequence of the Ligatures above the Knees, retain the more Blood. If the Water were cold, it would repel the Blood to the Head; if hot, it would increase the Motion of it; and, by giving a greater Quickness to the Pulse, would even contribute to increase the Hæmorrhage.

As soon however, as the Hæmorrhage is stopt, these Ligatures [on the Thighs] may be relaxed a little, or one of them be entirely removed; allowing the others to continue on an Hour or two longer without touching them: but great Precaution should be taken not to slacken them entirely, nor all at once.

3, Seven or eight Grains of Nitre, and a Spoonful of Vinegar, in half a Glass of cool Water, should be given the Patient every half Hour.

4, One Drachm of white Vitriol must be dissolved in two common Spoonfuls of Spring Water; and a Tent of Lint, or Bits of soft fine Linen dipt in this Solution, are to be introduced into the Nostrils, horizontally at first, but afterwards to be intruded upwards, and as high as may be, by the Assistance of a flexible Bit of Wood or Whale-bone. But should this Application be ineffectual, the Mineral Anodyne Liquor of Hoffman is certain to succeed: and in the Country, where it often happens that neither of these Applications are to be had speedily, Brandy, and even Spirit of Wine, mixt with a third Part Vinegar, have answered entirely well, of which I have been a Witness.

The Prescription [Nº. 67], which I have already referred to, on the Article of Wounds, may also be serviceable on this Occasion. It must be reduced to Powder, and conveyed up the Nostrils as high as may be, on the Point or Extremity of a Tent of Lint, which may easily be covered with it. Or a Quill, well charged with the Powder, may be introduced high into the Nostrils, and its Countents be strongly blown up from its other Extremity: though after all the former Method is preferable.