304 DISEASES OF THE NASAL CAVITIES. 



greatly impedes cicatrization. We shall speak of syphilitic ozcena in 

 our second volume, where destruction of the nose by lupus, often called 

 scrofulous ozaena, up to the point at which it passes into the province 

 of surgery, is also to be discussed. 



The question whether the nasal passages are obstructed by swelling 

 and hypertrophy of the mucous membrane, or by a polypous growth, 

 always remains doubtful until the polypus becomes accessible to 

 sight or touch. In patients suffering from obstructive catarrh (Stock- 

 schnupfen) of one or both nostrils, particularly when the secretion is 

 more or less covered by blood after violent blowing of the nose, we 

 should never neglect exploring the cavities of the nose, both in front 

 and rear, with the utmost care. 



The method of examining large polypi and the symptomatology 

 of such affections belong to the domain of surgery. I therefore pass 

 by this subject, as well as that of the other growths in the nose, and 

 the affections of its adjacent cavities, referring to the surgical text- 

 books, and, above all, to the classical work of my colleague, JBruns. 



TREATMENT. Various abortive methods of treatment for acute 

 nasal catarrh have been proposed, but none of them, neither swabbing 

 the nostrils with sponges or charpie, nor syringing, nor touching the 

 mucous membrane with a pencil dipped in solution of astringent or 

 narcotic medicament, nor the application of narcotics in the form of 

 powder, nor the inhalation of the vapor of vinegar, nor the so-called 

 dicta sicca, have obtained general approval. The production of active 

 diaphoresis, which has, indeed, in many instances, cut short acute nasal 

 catarrh, is the only procedure worthy of adoption. Where the oppor- 

 tunity offers for a Russian bath, direct a patient, who is beginning to 

 suffer from a cold in the head, to make use of one, observing all the 

 precautions, upon which the success of this somewhat heroic procedure 

 depends. 1 In most cases, we should confine ourselves to advising the 

 patient to keep his room for a day or two, and to swallow some hot 

 drink from time to time, to keep the head and feet warm, not to use 

 silken or cotton, but linen, pocket-handkerchiefs, and to change them 

 frequently ; to smear the upper lip with lip-salve, in order to protect it, 

 by means of a film of grease, from the irritating action of the acrid 

 secretion. The inhalation of warm vapor at the outset of a cold, while 

 the nose is still dry, is advised by many. The snuffing of cold water 

 into the nostril is not dangerous, as is vulgarly supposed, but it fails 

 to afford a lasting relief, and sometimes even appears to protract the 

 morbid process. In the latter stages of acute coryza, after the irrita- 

 bility of the mucous membrane has given place to a more torpid con- 

 dition, a long walk in the fresh air, or even an occasional pinch of snutt, 

 accelerates the cure. In infants at the breast, who are as yet unable 



