352 ON CATARRH. 



It has been, unfortunately, the practice of too many physicians to intro- 

 duce brushes and mops, with caustic solutions, and in that way perpetuate 

 the disease. I believe that the only true plan for the relief of catarrhal af- 

 fections, like all other localized diseases, is to to search out the locality that 

 that is chiefly affected, and direct the topical application to that point. In 

 the class of cases under my consideration, where there are general symp- 

 toms of distress depending upon the presence of too much mucus lying upon 

 the soft palate, and manifesting a disposition to flow down the throat, ad- 

 hering to the uvula, a weak solution of bromide of potassium of five or ten- 

 grains is to be used. I employ what is known as Holmes' Boston Perfumer, 

 held in such a manner that the fluid will find its way to the naso-pharyngeal 

 space ; and then snuflSng it up the nose and hawking it out clears the sur- 

 face entirely. Having cleansed both nostrils in this way, and having cleared 

 the naso-pharyngeal space, a decoction of ordinary green tea, or a solution 

 of five grains of carbolic acid and tannin to an ounce of water, or, as I gen- 

 erally prefer it, a mixture of equal parts of glycerine and water, is to be 

 used immediately afterward, with the atomizer. This may be done three 

 times every day ; that is quite often enough. Cleanse the passages first witb 

 the bromide of potassium, which acts as a local ana38thetic, diminishing the 

 morbid sensibility, and at the same time dissolving the fibrinous matter. 

 li'ollow that with the decoction of green tea, or the solution of carbolic acid 

 and^'tannin. (A favorite prescription is this : half a drachm each of carbolic 

 acid and tannin, to be dissolved in three ounces each of glycerine and water. 

 That is a mixture that I am in the habit of prescribing every day). It be- 

 comes necessary in many cases to make applications to the covering of the 

 superior turbinated bones. These may consist of a half-drachm solution of 

 carbolic acid to one ounce of water, or a half-drachm solution of iodine in 

 glycerine, or a half-drachm solution of nitrate of silver to the ounce of water.. 

 These are the more common applications, and they are to be made with a 

 brush or a little cotton-wool rolled upon the end of a probe, and the appli- 

 cation is not to be repeated oftener than every other day. Catarrhal affec- 

 tions of the larynx generally call for local treatment. They are generally- 

 associated with bronchial Catarrh, which requires, in addition to local treat- 

 ment, some constitutional measures. In the chronic forms of naso-j)haryn- 

 geal Catarrh, constitutional measures are also required in a majority of 

 instances. "Where the affection invades the Eustachian tubes, creating an 

 unpleasant noise in the ears that has been compared to the singing of grass- 

 hoppers, crickets, and steam escaping from a tea-kettle, the application 

 should be made to the ear itself, and consist in filling the ear full of very 

 warm water, and then have the head turned in a favorable position for the 

 retention of the fluid, putting in a plug of cotton-wool to prevent the water 

 escaping. Introduction of the Eustachain catheter maybe practiced where 

 there are evidently fluids in the tympanic cavity, or where the supply of air 

 is deficient, and the patient cannot practice Yalsalva's method, which con- 

 sists in holding the mouth and nose shut, and blowing forcibly into the ears,. 



