NASAL POLYPUS. 
263 
“This was evidently a congenital anomaly inducing abnormal respira- 
tion, though it had not been observed, or had been hidden by the vendor 
at the time of sale. Had this membrane been cut across, or pierced by a 
trocar, the impediment to breathing would have been removed. At the 
commencement, however, it appeared that the evil existed on the left side, the 
discharge here being greater, a fact explained by the mucous secretion from 
the throat and trachea, issuing through the one, whereas usually it comes 
through both nasal cavities.” 
Polypus of the nose can, therefore, be confounded with 
other nasal obstructions. We have already noticed that it 
may give rise to symptoms similating glanders or chronic 
ozcena, and many other diseases, as has been shown, may be 
mistaken for it. Lastly, we may mention that obstructions 
in other parts of the aerial passages are likely to be confounded 
with nasal polypus. 
A correct diagnosis is then sometimes difficult, but always 
important. The prognosis is generally favorable, as may 
be inferred from the cases cited, and the methods of treat- 
ment, which we shall now enumerate. 
Treatment . — We can establish as an axiom that an opera- 
tion is always indispensable. Two operations may on some 
occasions be expedient, namely, tracheotomy and the extirpa- 
tion of the polypus. Tracheotomy is to be performed as 
usual. There are three different plans, however, resorted to 
to eradicate the tumour, they are: evulsion and twisting, 
ligature, and excision, with or without cauterization. 
Rychner and D’Arboval, among others, recommend 
evulsion. It will be seen above that M. Tears, surgeon to a 
regiment in France, had recourse to it as a last resource ; he 
first grasped the tumour with a bandage, and much damaged 
the pituitary membrane and turbinated bones ; the horse 
eventually did well — be it remembered, excision had been 
tried in this instance without effect. In human surgery the 
extraction of polypi by means of forceps is the usual mode. 
Miller, like others, says : “ Care is taken to apply the forceps 
accurately to the neck of the tumour, so as to ensure removal 
of the entire mass ; and gentleness is used, so as not to en- 
danger evulsion of bone. The forceps are well toothed, 
firmly jointed, and secured by a pin between the blades, so 
as to prevent them passing each other during the twisting 
movement Sometimes forceps 
considerably curved are useful in reaching small, soft 
polypi, which not unfrequently grow from the upper and 
front part of the nares, and which the ordinary instrument 
passes by.” 
Elsewhere Miller recommends what might be useful in 
animals as well as man. “ After the nostril has been finally 
