ON CATARRH. 351 



affected with the syphilis, and what is known as strumous disease, which 

 sometimes appears in the nose. 



As a matter of observation,! have noticed that people who have Catarrh 

 are prone to tie a knot in the corner of the handkerchief, or roll it around 

 the end of the little finger and poke it up the nose for the purpose of remov- 

 ing incrusted matter, and in that waj^ they abrade the surface, which creates 

 a greater disposition upon the part of the secretion to adhere to this part 

 and become dry and inspissated, and so the attempt to remove is repeated, 

 and what was originally an abrasion gets to be a complete destruction of the 

 whole membrane, with exposure of the bone, and exposure is likely to be 

 followed by death of the bone, and in that wa}'- loss of the septum of the nose 

 frequently results in ordinary cases of catarrh. In cases of syphilitic dis- 

 ease of the nose, attended with loss of the septum, or a portion of it, there is 

 always great tumefaction of the surrounding parts. The marginal outlines 

 are intensely red and considerably swollen, and this with the offensive char- 

 acter of the discharge, distinguishes the syphilitic from the traumatic soreS' 



Another form, called dry Catarrh, a proliferous inflammation with greatly 

 diminished secretion, attacks persons given to excessive smoking. There 

 is another form of Catarrh which is attended, not by dryness nor by an}^ 

 great moisture, but by swelling of the nasal membrane, with loss of the sense 

 of smell, which is common to persons given to the habit of snuflflng. There 

 is the smoker's catarrh, the snuffer's catarrh, and epidemic catarrh. 



In 1868, a German by the name of William Dumeyer, who kept a grocery 

 at Market and Fourteenth streets, had a sore throat, and I wished to exam- 

 ine his larynx with the laryngoscope, but the fauces were so very sensitive 

 to the approach of the mirror that I was obliged to use a solution of brom- 

 ide of potassium, which I had learned was an efficient local ansesthetic. I 

 gave Mr. Dumeyer a twenty-grain solution of bromide of potassium to be 

 used as a gargle ; that is the strength of the solution called the standard 

 solution. It diminished the morbid sensibility of the fauces, and when I 

 saw him again he said he did not need anything, he was well, and he wanted 

 to settle his bill ,• he thought he was cured. I relate this to show you that 

 the bromide destroys the sensibility of the membrane, and that suggested 

 the application of it in the treatment of nasal catarrh. I formerly used this 

 twenty-grain solution, which was regarded as the standard solution, for di- 

 minishing the morbid sensibility of the fauces, but I afterwards got into the 

 habit of using a much stronger solution, even to saturation. I now some- 

 times, but rarely, use the saturated solution. Experience has convinced me 

 that the weaker solution is better for general use with the atomizer. In 

 many cases the catarrh is attended with the disagreeable symptom of the 

 continued presence of mucus lying upon the soft palate and manifesting a 

 disposition to find its way down into the throat. That class of cases is 

 more common, and they are very troublesome sometimes. They may be 

 prolonged indefinitely by the use of too strong applications — by too harsh a 

 plan of treatment. 



