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Bleeding

Bleeding

Description

Bleeding is described as blood flow from blood vessels, and may be internal or external. Minor bleeding is seldom serious, as in the case of a common nosebleed or menstruation.

In severe cases, as when an artery is torn or severed, blood may flow so rapidly a blood clot cannot form. Normally the damaged blood vessels contract, slowing the flow of blood and thus allowing a clot to form, which plugs the wound. The vessels can then heal.

Severe bleeding is said to have occurred if one-and-a-half pints or more of blood are lost from an adult, or more than a half pint from a child. This can lead to shock and, ultimately, death in a very short period of time. Therefore, the emergency procedure to stop blood loss takes priority over any other problem.

Emergency first aid for external bleeding requires the person lie down, with affected part raised, to slow down blood flow and forestall shock. Easily reached and visible debris should be removed from the wound. Do not remove anything which is deeply embedded. The priority is to stop the bleeding. Infection prevention is secondary.

Use the cleanest available pad (a towel, a piece of clothing) or, if no material is available, use the hands and press down firmly on the wound, holding the edges together if they separate. Direct pressure around any embedded objects rather than over them. For uncontrollable bleeding, apply pressure on the major artery between the wound and heart.

When the bleeding stops, tie the pad firmly over the wound so as to maintain pressure. Never remove the pad if bleeding recurs. Should bleeding recur, tie additional padding over any padding already in place.

Only a doctor should remove the dressing. Tourniquets should not be applied except in life-threatening situations. Tourniquets tend to do more damage than the original injury, including loss of the extremity. Anticoagulant drugs should not be given the individual.

However slight, bleeding from any body orifice may indicate internal problems. Keep the victim warm, motionless, and loosen tightly-bound clothing.

Do not give food or fluids: if emergency treatment is required, digestion will interfere with the use of anesthetics.

Follow the treatment above and seek medical attention immediately.

Causes

External and Internal
Deficiency in any blood clot factor, especially blood platelet count.

Vitamin K deficiency which may be due to:

Poor diet
Inability of intestinal wall to absorb fats, vitamin K being a fat-soluble vitamin

Liver diseases, which suppress the formation of prothrombin and other blood clotting factors, or which prevent the formation of bile which aids vitamin K absorption, including:

Hepatitis
Cirrhosis
Acute yellow atrophy

Low blood calcium

Iron deficiency anemia

Low dietary vitamin C causing defective blood platelet formation and is involved in the integrity of small blood vessel walls.

External

Cuts
Wounds
Injury
Nosebleeds may be caused by:
Nasal infection
Colds which produce crusting and damage to membranes
Facial injuries

Internal

Lacerated organs
Ulcers
Broken bones (without breakage of skin)
Use of oral contraceptives
Aspirin, which may cause gastrointestinal bleeding
Pregnancy; bleeding at this time may indicate a serious complication
Hemophilia
Thrombocytopenia
Varicose veins

Signs & Symptoms

External

Flow of blood from any area

Internal (Primarily the signs of incipient shock)

Weak or rapid pulseCold skin
Clammy skinThirst
AnxietyNausea
VomitingBruises
Acute painDilated pupils which respond slowly to light




Nutritional Supplements

Structure & Function: Circulatory Support

---------------------------------
General Supplements
---------------------------------

AdultChild/Adolescent
Acidophilus 2 - 3 tsp 1 - 2 tsp
Calcium400 - 800 mg 200 - 400 mg
Quercetin*
Vitamin E100 - 400 IU 50 - 200 IU
Vitamin K 1 - 5 mcg 0.5 - 2 mcg



* Please refer to the respective topic for specific nutrient amounts.

Note: All amounts are in addition to those supplements having a Recommended Dietary Allowance (RDA). Due to individual needs, one must always be aware of a possible undetermined effect when taking nutritional supplements. If any disturbances from the use of a particular supplement should occur, stop its use immediately and seek the care of a qualified health care professional.

Dietary Considerations

The blood clotting time and the fragility of blood vessels determine how much bleeding results from trauma or illness.

Prolonged blood clotting time can be due to vitamin K deficiency. This can be remedied through vitamin K supplements or by increasing the dietary intake of the following items in a Dietary Goals Diet:

Beef liverDark green leafy vegetables
CauliflowerGreen peas
CerealsChicken liver
Egg yolkMilk
Veal liver



Vitamin A toxicity may also decrease blood clotting time. Toxicity is associated with vitamin A doses greater than 50,000 IU per day.

Capillary fragility can be an indication of calcium deficiency. The integrity of blood vessels can be improved with calcium supplementation or by eating calcium-rich foods.

Vitamin C deficiency can also cause capillary fragility. It is manifested by a tendency to bruise, bleeding of the joints and gums, and petechial or pinpoint hemorrhages. Scurvy is the clinical condition for vitamin C deficiency in its extreme form. Scurvy is rare in the United States. Vitamin C supplementation or the addition of vitamin-rich foods to the diet will reverse the symptoms of vitamin C deficiency.

Anticoagulant properties of coumarins are increased if it is used in conjunction with salicylates such as aspirin or acidic sulfonamides. A tendency to bleed will occur. Gastric bleeding may be due to the usage of steroids. This medication should be taken with meals or, perhaps with antacids.

Homeopathic Remedy

Bleeding (Hemorrhage)

1.** Crotalus horridus - 6C to 15C or higher, depending on severity

2.* Phosphorus - 15C or higher

3.* Lachesis mutus tinct. - 30C once per day and 2X per per week for one month

4.** Ipecacuanha - 30C

5.***Ficus religiosa - 3X

6.***Cinnamomum - 3X to 30C probably the best, single remedy. Do not use with aconite

Treatment Schedule

Doses cited are to be administered on a 3X daily schedule, unless otherwise indicated. Dose usually continued for 2 weeks. Liquid preparations usually use 8-10 drops per dose. Solid preps are usually 3 pellets per dose. Children use 1/2 dose.

Legend

X = 1 to 10 dilution - weak (triturition)
C = 1 to 100 dilution - weak (potency)
M = 1 to 1 million dilution (very strong)
X or C underlined means it is most useful potency

Asterisk (*) = Primary remedy. Means most necessary remedy. There may be more than one remedy - if so, use all of them.

References

Boericke, D.E., 1988. Homeopathic Materia Medica.

Coulter, C.R., 1986. Portraits of Homeopathic Medicines.

Kent, J.T., 1989. Repertory of the Homeopathic Materia Medica.

Koehler, G., 1989. Handbook of Homeopathy.

Shingale, J.N., 1992. Bedside Prescriber.

Smith, Trevor, 1989. Homeopathic Medicine.

Ullman, Dana, 1991. The One Minute (or so) Healer.

Tissue Salts

Ferr. Phos.
Kali Mur.

May be alternated. Can relieve nosebleeds (epistaxis).

Herbal Approaches

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Herbs
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Butternut bark
Cayenne
Nettle

Nosebleed (Hoffmann)

Marigold
Witch Hazel

Note: The misdirected use of an herb can produce severely adverse effects, especially in combination with prescription drugs. This Herbal information is for educational purposes and is not intended as a replacement for medical advice.

Coagulant components        Effect

AgrimonyIncreases human blood coagulation up to 50%
GoldensealHeparin antagonist
MistletoeLectins, agglutinating activity
YarrowCoagulant, in vivo



It is also necessary to be aware of herbs which may have an anticoagulant effect and, therefore, potentiate medication.

Anticoagulant Components        Effect

Alfalfa 2Coumarin constituents
Angelica 2Coumarin constituents
Angelica 39, 44, 45Inhibits platelet aggregation
Anise /Aniseed 2Coumarin constituents
Arnica 2Coumarin constituents
Asafetida 2Coumarin constituents
Anticoagulant in vivo
Bogbean 2Hemolytic activity
Celery seed or extract 2Coumarin constituents
Cassia 2Inhibits platelet aggregation
Chamomile, German 2Coumarin constituents
Chamomile, Roman 2Coumarin constituents
Clove 2Eugenol powerful inhibitor of platelet activity
Cumin/Turmeric 34Inhibits platelet aggregation
Fenugreek 2Coumarin constituents
Feverfew 3Inhibits platelet aggregation in vitro
Fucus 2Anticoagulant action
Garlic 2, 7-16, 47Interaction with warfarin reported
Ganoderma 36, 37, 45Inhibits platelet aggregation
Ginger 2, 16-18Inhibition of platelet activity
Ginkgo 4Inhibits platelet aggregation
Ginseng 2, 5, 19-22, 45Reduction of blood coagulation2/
Decreases INR5
Horse chestnutCoumarin constituents
Horse radishPeroxidase stimulates synthesis of
Arachidonic acid metabolites
Isatis 38Inhibits platelet aggregation
LicoriceInhibition of platelet activity
MeadowsweetSalicylate constituents
Melilot 6Coumarin constituents
Methyl salicylate oil 26Inhibits platelet aggregation
Pau d'arco (Taheebo, Lapacho) 41, 48Coumarin constituents
PoplarSalicylate constituents
Prickly AshCoumarin constituents
QuassiaCoumarin constituents
Red clover 2, 42Coumarin constituents
Salvia 29, 40, 43, 45Inhibits platelet aggregation
Shitake 36Inhibits platelet aggregation
Sweet Woodruff 6Coumarin constituents
Tanacetum 31-33Anticoagulant
Tonka beans 6Coumarin constituents
Tremella 36Inhibits platelet aggregation
Danshen 26, 27Anticoagulant
Breviscopine 28Anticoagulant
Umbelliferae 30Coumarin constituents
WillowSalicylate constituents



These numbers refer to their respective references:

1. Coumadin Package insert.

2. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996.

3. Feverfew Monograph. In: Burnham TH, Hagemann RC, Threlkeld DS (eds.) The Lawrence Review of Natural Products. St. Louis: Facts and Comparisons. 1994.

4. Ginko Monograph. In: Burnhan TH, Hagemann RC, Threlkeld DS (eds.) The Lawrence Review of Natural Products. St. Louis: Facts and Comparisons. 1994.

5. Janetzky K & Morreale AP. Probable interaction between warfarin and ginseng. Am.J Health-Syst Pharm 1997; 54:692-3.

6. Ridker PM. Toxic effects of herbal teas. Arch Environ Health 1987;42(2):133-6.

7. Sunter WH. Warfarin and garlic. Letter to the Editor. Pharm J 1991; 246:722.

8. Burnhan BE. Garlic as a possible risk for postoperative bleeding. Letter to the Editor. Plast-Reconstr-Surg 1995:95(l):213.

9. Rose KD et al., Spontaneous spinal epidural hematoma with associated platelet dysfunction from excessive garlic ingestion. Neurosurgery 1990;26(5):880-2.

10. Srivastava KC & Tyagi OD. Effects of a garlic-derived principle (Ajoene) on aggregation and arachidonic acid metabolism in human blood platelets. Prostaglandins Leukot and Essent Fatty Acids 1993.49 (2) :587-95.

11. Gadkari JV & Joshi VD. Effect of ingestion of raw garlic on serum cholesterol level, clotting time and fibrinolytic activity in normal subjects. J Postgrad Med 1991; 37(3):128-31.

12. Ali M & Thompson M. Consumption of a garlic clove a day could be beneficial in preventing thrombosis. Prostag. Leukot Essent Fatty Acids 1995; 53(3):211-2.

13. Morris J et al., Effects of garlic extract on platelet aggregation: A randomized placebo-controlled double-blind study. Clin Exp Pharmacol Physiol 1995; 22:414-17.

14. Legnani C, et al., Effects of a dried garlic preparation on fibrinolysis and platelet aggregation in healthy subjects. Arzneim ForschIDrug Res 1993; 43(2).119-22.

15. Jung F et al., Effect of different garlic preparations on the fluidity of blood, fibrinolytic activity and peripheral microcirculation in comparison with placebo. Planta Med 1990; 56(6):668.

16. Srivastava KC. Aqueous extracts of onion, garlic and ginger inhibit platelet aggregation and alter arachidonic acid metabolism. J Biomed Biochim Acta 1984;43:S 335-46.

17. Srivastava KC. Effect of onion and ginger consumption on platelet thromboxane production in humans. Prostag. Leukot Ess. Fatty A. 1989;35:183-5.

18. Lumb AB. Effect of dried ginger on human platelet function. Thromb Haemost 1994;71(1):110-1.

19. Siegel RK. Ginseng abuse syndrome problems with the panacea. JAMA 1979;241(15):1614-5.

20. Teng CM et al. Antiplatelet actions of panaxynol and ginsenosides isolated from giniseng, Biochim. Biophysi. Acta 1989;990(3):315-20.

21. Greenspan EM. Ginseng and vaginal bleeding. Letter to the Editor. JAMA 1983;249(15):2018.

22. Hopkins MP et al., Ginseng face cream and unexplained vaginal bleeding. Am J Obstet Gynecol 1988; 159(5):1,121-2.

23. Hogan RP. Hemorrhagic diathesis caused by drinking an herbal tea. JAMA 1983;249(19):2,679-80.

24. Norcross WA et al., Accidental poisoning by warfarin-contaminated herbal tea. West J Med 1993; 159(l):80-2.

25. Blank

26. Tam LS et al., Warfarin interactions with Chinese traditional medicines: danshen and methyl salicylate medicated oil. Aust NZJ Med 1995; 25(3):258.

27. Yu CM, Chan JCN, Sanderson JE. Chinese herbs and warfarin potentiation by 'Danshen'. J Int Med 199-i';241,:337-9.

28. Zhou Q The effect of new breviscapine on the fibrinolysis and anticoagulation of human endothelial cells (Abstract). Thromb Haemost 1991:65(6):1224.

29. Wang Z et al., Effects of radix salviae miltorrhizae on antithrombotic activities of endothelial cells. Thrornb Haemost 1993:69(6):642.

30. Pansatiankul BJ et al., Dicumarol content in alcoholic herb elixirs: One of the factors at risk induced IVKD-1. Southeast Asian J Trop Med Public Health 1993;24(l):201-30.

31. Thomas 00. Anticoagulant and antifibrinolytic properties of Tanacetum cilicium. Fitoterapia 1989; 60(12):138-40.

32. Thomas 00. Anticoagulant and antifibrinolytic properties of Tanacetum corymbosum. Fitoterapia 1989; 60(3)231-3.

33. Thomas 00. Anticoagulant and antifibrinolytic properties of Tanacetum macrophyllum. Fitoterapicx 1989; 60(4):329-30.

34. Srivastava KC. Extracts from two frequently consumed spices-cumin (cuminum cyminum) and turmeric (curcuma longa) -inhibit platelet aggregation and alter eicosanoid biosynthesis in human blood platelets. Prostaglandins Leukot Essent Fatty Acids 1989; 37(l):57-64,

35. Kassler, WJ et al., The use of medicinal herbs by HIV infected patients. Arch. Intern. Med. 1991, 151:2,281-2,288.

36. Hokama, Y & Hokama, IL: In vitro inhibition of platelet aggregation with low dalton compounds from aqueous dialysates of edible fungi. Res Commun Chem Pathol Pharmacol 1981, 31:177-180.

37. Shimuzu, A et al., Isolation of an inhibitor of platelet aggregation from a fungus. Canoderma lucidum. Chem Pharm Bull. 1985, 33:3,012-3,013.

38. You, S et al., Anti-blood platelet aggregation constituents in the root of Isatis tinctoria L. Chung Yao Tung Pao. 1988, 13:31-32.

39. Ko, F et al., Inhibition of platelet thromboxane formation and phosphoinositides breakdown by osthole from Angelica pubescans. Trhromb. Haemost. 1989, 62:996-999.

40. Onitsuka, M et al., New platelet aggregation inhibitors from Tan-Shen: radix of Salvia miltiorrhiza. Chem. Pharm. Bull. 1983, 31:1,670-1,675.

41. Austin, F: Schistosoma mansoni chemoprophylaxis with dietary lapachol. Am. J. Trop. Hygien. 1974, 23:412-419.

42. Link, K: The discovery of dicumarol and its sequels. Circul., 1959, 19:97-107.

43. Lei, X & Chiou, G: Cardiovascular pharmacology of Panax notoginseng (Burk). FH Chen and Salvia miltiorrhiza. Am. J. Chin. Med. 1986, 14:145-152.

44. Hata, K et al., On the coumarins of the roots of Angelica polymorpha maxim (Umbelliferae). Yakugaku Zasshi. 1967, 87:464-465.

45. Hsu, H: Oriental Materia Medica. Long Beach, Calif. Oriental Healing Arts Institute, 1986.

46. Saxe. T: Toxicity of medicinal herbal preparations. Am. Fam. Phys. 1987, 35:135-142.

47. Makheja, A et al., Inhibition of platelet aggregation and thromboxane synthesis by onion and garlic. Lancet, 1979, 1:781.

48. Block, J et al., Early clinical studies with lapachol. Cancer Chemother. Rep. 1974, 4:27-28.




Aromatherapy - Essential Oils

Oils which are recommended for nosebleeds, include:

Lemon Essence,
Terebinth Essence.

Related Health Conditions

AnemiaMenstruation
AnxietyNosebleed
Blood clotPain
BruisePregnancy
CirrhosisThrombocytopenia
HemophiliaUlcers
HepatitisVaricose veins
InfectionVomiting



Abstracts

References

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Chasroff, I.J. & J.W. Ellis. 1983. Family Medical Guide, William Morrow and Company Inc., Pub. 594 pp.

Davies PS et al., Parents' and children's reactions to taking blood in a nutrition survey. Arch Dis Child, 1996 Oct, 75:4, 309-13.

Denke MA: Effects of continuous combined hormone-replacement therapy on lipid levels in hypercholesterolemic postmenopausal women. Am J Med, 1995 Jul, 99:1, 29-35.

Eagles, J.A. & M.N. Randall. 1980. Handbook of Normal and Therapeutic Nutrition. Raven Press, New York. 323 pp.

Freese R & Mutanen M: Alpha-linolenic acid and marine long-chain n-3 fatty acids differ only slightly in their effects on hemostatic factors in healthy subjects. Am J Clin Nutr, 1997 Sep, 66:3, 591-8.

Gutcher, G.R. & P.M. Farrell. An Evaluation of Vitamin E Status in Premature Infants. American Journal Clinical Nutrition, 40 1984.

Guyton, A.C. 1976. Textbook Of Medical Physiology 5th ed. Saunders Pub Co., Philadelphia. 1194 pp.

Harris WS: Dietary fish oil and blood lipids. Curr Opin Lipidol, 1996 Feb, 7:1, 3-7.

Hathaway, W. E.et al: Comparison of Oral and Parenteral Vitamin K Prophylaxis For The Prevention of Late Hemorrhage Diseases of the Newborn. The Journal of Pediatrics, September 1991;119(3):461-464.

Hochain P et al., Which patients taking non-aspirin non-steroidal anti-inflammatory drugs bleed? A case-control study. Eur J Gastroenterol Hepatol, 1995 May, 7:5, 419-26.

Howe, P.S. 1981. Basic Nutrition in Health and Disease, 7th ed. W.B. Saunders Co., Philadelphia.

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Kerber-CW; Liepsch-D.: Flow dynamics for radiologists. II. Practical considerations in the live human. AJNR-Am-J-Neuroradiol. 1994 Jun; 15(6): 1076-86.

Kunz, J.R.M. 1982. The American Medical Association Family Medical Guide. Random House Pub, New York. 832 pp.

Nelson, G. J. et al., The Effect of a Salmon Diet on Blood Clotting, Platelet Aggregation and Fatty Acids in Normal Adult Men. Lipids, 1991;26(2):87-96.

Nelson GJ et al., A human dietary arachidonic acid supplementation study conducted in a metabolic research unit: rationale and design. Lipids, 1997 Apr, 32:4, 415-20.

Nelson GJ et al., The effect of dietary arachidonic acid on platelet function, platelet fatty acid composition, and blood coagulation in humans. Lipids, 1997 Apr, 32:4, 421-5.

Pennington, J. 1978. Nutritional Diet Therapy. Bull Pbng Co., Palo Alto, Ca. 106 pp.

Petersdorf, R.G. & R.D. Adams. 1983. Harrison's Principles Of Internal Medicine. 10th ed. McGraw Hill Pub Co., New York. 2212

Shimada, K. & T. Matsuda. Bleeding Secondary to Vitamin K Deficiency in Patients Receiving Antibiotics. Journal Antimicrobial Chemotherapy, 14 1984.

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Wang-G et al: The application of traditional Chinese medicine (TCM) to the management of hepatic cancerous pain. J-Tradit-Chin-Med. 1994 Jun; 14(2): 132-8.

Yonehara-T et al: Detection of reverse flow by duplex ultrasonography in orthostatic hypotension. Stroke. 1994 Dec; 25(12): 2407-11.