Nasal Polypi 121 



posterior ethmoidal branches of the ophthalmic ; and, in the case of a 

 fracture extending across the anterior fossa of the skull, these vessels 

 may be lacerated, and severe bleeding may occur from the nose. 

 The facial, and the spheno-palatine and the descending palatine of the 

 internal maxillary, also afford branches, and the superior coronary 

 sends a twig to the front of the septum. The veins correspond to the 

 arteries. 



Of the lymphatics, some pass with the olfactory filaments into. the 

 subdural space, and others enter the glands near the angle of the 

 jaw. 



Of the nerves, olfactory filaments are distributed to the roof and to 

 the inner and outer walls near the roof ; the nasal of the ophthalmic 

 gives sensory branches to the anterior part of the fossa, and the 

 anterior dental, Vidian, spheno-palatine, and descending palatine also 

 send in branches. 



Chronic purulent discharge from one nostril is very apt to be caused 

 by necrosis or by the presence of a bead or a bean in the meatus. 

 Discharge from both nostrils is more likely to be the result of consti- 

 tutional disease. It may be treated by sending a gentle stream of 

 tepid water from an irrigator up one nostril whilst the patient breathes 

 through the open mouth ; the soft palate and the palato-pharyngei 

 (p. 1 08) then keep the nasal part of the pharynx shut off from the 

 ouccal tract, so that the lotion, turning round the back of the vomer, 

 flows out through the other nostril. 



In two cases of necrosis high in the fossa I have successfully 

 performed Rouge's operation, which consists in incising the superior 

 labio-dental fold of membrane, and then detaching and everting the 

 lip and the soft parts of the nose. In this way exploration of, and 

 operation upon, the upper spongy bones can be most effectually carried 

 out. 



Mucous polypi generally hang from the superior and middle tur- 

 binated bones, and are usually covered 

 with ciliated epithelium. They grow 

 in crops, and, blocking the nostril, ob- 

 struct respiration. Pressing outwards, 

 they may widen the nose, and, com- 

 pressing the nasal duct, may cause the 

 eye to ' water.' In inveterate cases, 

 when crop succeeds crop of polypi, it 

 may be expedient to draw out by the 

 forceps the middle and superior spongy 

 bones taking care, of course, not to 

 damage the cribriform plate. 



Bleeding- from the nose, if not the 

 result of fracture of the base of the 

 skull (p. 81), or of other injury, may be a general oozing from the en- 



