500 HEALTH AND DISEASE 



ened, and the membrane lining the nostril assumes a leaden hue, symptoms 

 which are also associated with glanders, and sometimes give rise to much 

 anxiety and indecision in the matter of diagnosis, even among experts. 



Treatment. — It will prove a safe plan in every case of nasal discharge 

 and glandular swelling of a chronic kind to isolate the patient and keep for 

 his particular use one set of stable utensils, harness, &c. Both local and 

 constitutional measures of treatment should be adopted. Good sound food 

 and a liberal allowance of it, exercise but not work, and good sanitary 

 surroundings. Internal agents of the astringent tonic class are found to 

 be very beneficial, and the salts of different metals may be administered 

 and changed from time to time, the one for the other, with advantage. 

 A course of arsenic and iron may be tried first, and should it not prove 

 successful, then a change to the copper salts may be made. It is probable 

 ^^^^ that all tonics are help- 



Fig. 202. -Insufflator it is decided to give 



arsenic, Fowler's solu- 

 tion should be chosen and given in the food in doses of from 1 to 2 ounces 

 twice a day. 



Local treatment of various kinds is recommended, and the agents 

 employed are both wet and dry. The injection up the nostrils of astringent 

 or styptic lotions with the aid of a syringe is not to be recommended, but 

 the insufflation of iodoform by an instrument made for the purpose, and 

 known as an insuffiator (fig. 202), may be tried for a short period. It 

 consists of an india-rubber ball, with a long vulcanite nozzle. 



The lotions most favoured are those in which the sulphates of zinc, 

 copper, and iron form the principal part, and in some severe cases a solu- 

 tion of chloride of zinc is used in the shape of Burnett's fluid. The 

 patient is naturally alarmed by the use of nasal injections, and the success 

 of the treatment depends largely upon the efficiency of the operator. 

 There are cases that defy all treatment of this kind, owing to the in- 

 accessibility of curative agents to the seat of disease; here the sinuses of 

 the face may have to be trephined and the semi-solid matter removed 

 (see "Operations"), after which the cavities will require to be repeatedly 

 washed out with astringent and antiseptic solutions. 



Fumigation of the nostrils (fig. 203) with warm vapour impregnated 

 with volatilized carbolic acid or turpentine should be tried. This may 

 be done by means of a nose-bag containing warm, moist bran or saw- 

 dust, over which a little of one or the other or both the agents named has 



