ELEMORRHAGE FROM THE NASAL MUCOUS MEMBRANE. 305 



to clear their nostrils, it is necessary to free them of the obstructing 

 secretion by syringing out the nose with lukewarm water, and to feed 

 them by the bottle, or with a teaspoon, as long as the obstacles to 

 sucking continue. 



In the treatment of chronic nasal catarrh, particular attention must 

 be paid to any constitutional defect which may exist. The exhibition of 

 cod-liver oil is indicated where there seems to be a scrofulous condition 

 (presently to be described). In bloated, flabby subjects, with an over- 

 tendency to obesity, a depletive treatment by the systematic exhibition 

 of laxatives, as well as the cold-water cure, is suitable. Local treat- 

 ment is of the utmost importance in the cure of chronic coryza. The 

 most effective measure is pencilling the swollen mucous membrane 

 with a solution of nitrate of silver (gr. iv 3 ss to j), or cauteriza- 

 tion with the lunar caustic in substance, repeated from time to time. 

 The local employment of mercurials, in the form of snuffs, is in great 

 repute in such cases (calomel, hyd. precip. rub., aa gr. xij, sacch. alb. 

 ss), as are also dilute solutions of corrosive sublimate injected into 

 the nostrils. The preparations of alum, zinc, lead, tannin, etc., are less 

 to be recommended. When the discharge is offensive, and should this 

 condition not be corrected by the treatment above suggested, we may 

 try whether the injection of weak solutions of chlorine, or of iodine or 

 creasote (iodini puri, gr. ij iv, potas. iodid. gr. iv viij, aqua vj), 

 will not give more satisfactory results. 



Catarrhal ulcers require essentially the same treatment as chronic 

 catarrh. Local treatment, however, especially the touching of the 

 ulcers with caustic, is demanded where there is ulceration, even still 

 more imperatively than in simple catarrh. 



The management of polypous growths belongs to the province of 

 the surgeon. 



CHAPTER II. 



HAEMORRHAGE FROM THE NASAL MUCOUS MEMBRANE BLEEDING AT 

 THE NOSE EPISTAXIS. 



ETIOLOGY. Rupture of the capillaries of the nasal mucous mem- 

 brane, from internal pressure, is of far more common occurrence than 

 rupture of the capillaries of other mucous membranes, or of othei 

 Drgans. 



Most people have never suffered from any spontaneous bleeding, 

 save bleeding at the nose. One person may be more liable than 

 another is to such haemorrhage ; but few have never suffered from it at 

 all. Hence, as bleeding at the nose is the most common of all forms 

 of spontaneous haemonnage, it is not surprising that, when a morbid 

 21 



