462 CATARRH. 



II. Chronic Nasal Catarrh. 



Definition. — A continuous, remittent, or intermittent dis- 

 charge of a varying cJiaracter from the nasal chambers, usu- 

 ally unassociated with local inflammatory action, cough, or 

 fever. 



Nature and Causation. — Considering the very great number 

 of cases of coryza, or simple catarrh, which are regularly en- 

 countered, the percentage of bad or indifferent recoveries, or 

 such as terminate in chronic nasal discharge, is exceedingly 

 small. After protracted and severe cases, and where debilitat- 

 ing influences, either extrinsic or intrinsic, have been in opera- 

 tion, it not unfrequentl}^ occurs as part of the general atony, 

 that the secreting membrane of the nasal chambers and upper 

 air-passages requires a longer time than usual to regain its 

 normal tonicity and healthy function, during this time ex- 

 hibiting as the most marked feature of the unhealthy condition 

 a continuous or intermittent nasal discharge. 



Clinically, succeeding the subsidence of the active symptoms 

 of ordinary catarrh, it is usual to regard all continuous dis- 

 charges from the nasal cavities as cases of chronic nasal catarrh 

 or nasal gleet. These discharges are often as dissimilar in 

 character as they are in the source of their origin. 



At the present, however, it is the intention only to speak of 

 such as may be traced to a previous attack of common cold, 

 not that this condition of nasal discharge may not originate 

 from other and, to us, inappreciable causes. 



By far the greater number of the cases of chronic nasal 

 catarrh which we encounter are associated with or owe their 

 origin — (1) To lesions of the nasal chambers proper ; (2) To 

 lesions of the mucous cavities connected with these chambers. 



The first of these classes of cases is, as a rule, the less 

 dangerous, and more likely to yield to medical treatment ; they 

 may also be only the earliest symptoms of, and may ultimately 

 terminate in, those of the other group. Although to both of 

 these classes of structural lesions there belongs the one common 

 feature of an abnormal nasal discharge, and all cases, to what- 

 ever class they may belong, have been indift'erently spoken of 

 as cases of chronic nasal catarrh or nasal gleet it is probably 



