242 OZENA. 



experience on the part of the practitioner. The symptoms of 

 the disease, if considered singly, are not of a nature directly 

 indicative of the malady. The question can more easily be 

 determined by reference to the symptoms and facts of the 

 case, considered in combination. Of what duration is the 

 disease ? and can its existence, in the first instance, be dated 

 from a severe attach of Catarrh, either in its common or epidemic 

 forms ? Are the lymphatic submaxillary glands enlarged or 

 not ? And, if so, are tliey loose, or adlierent to the jaws ? 

 When adherent to the jaws, the fact is more indicative of the 

 disease being Glanders than Ozena. Does the discharge issue 

 from one nostril or both ? and does it occasionally cease, or 

 diminish in quantity ? These and other matters, which I have 

 directly or indirectly treated upon, should be closely regarded 

 before a satisfactory conclusion can be drawn. 



Treatment. — Having satisfactorily determined the nature 

 of the disease, the next and most important consideration is 

 that of its proper treatment and its cause ; to secure which, 

 not only is medicine necessary, but, in numerous cases of the 

 kind, aids from Surgery also. 



The best remedies, in general, are — Calcarea Carbonica 5, 

 Arsenicum 3, Aurum 4, Tinct. China ; also. Sulphate of Copper, 

 Biniodide of Copper, Sulphate of Iron, Iodide of Iron, and 

 Muriatic Acid. 



The surgical remedies are— Trephining, and Syringing the 

 nostrils and the cavities of the head. 



I have, on several occasions, cured Ozena with two or more 

 of the first-named four remedies given in alternation. Some- 

 times, however, they are not productive of the least good ; but, 

 when mild remedies and methods fail, we are certainly justified 

 in having recourse to others of a more severe character. 



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