1ST. SIMPLE NASAL CATARRH. NASAL GLEET. OZŒNA.
In long standing coryza the nasal mucous membrane becomes relaxed, fails to acquire its lost tone and continues to pour out a muco-purulent product. This is really a persistence of inflammation of a low type, under the influence of which the membrane secretes pus in place of its normal mucus. The discharge is white, thick, creamy, has little tenacity, and flows uninterruptedly. There may be slight enlargement of the submaxillary glands, and if the case is of long standing and the patient in low condition sores may appear on the mucous membrane. These ulcers are distinguished from those of glanders by the absence of the unhealthy angry aspect and excavated borders of the latter, by the absence of the small nodular deposits on the mucosa, by the less viscid nature of the secretion, and by the absence of submaxillary swellings, or if these exist, by their being less nodular, less indurated and less firmly attached to surrounding parts. The coincidence of ulcers and submaxillary swellings is always, however, matter for the gravest suspicion, and such cases should, as a rule, be subjected to the mallein test. (See Glanders and Farcy).
Treatment. In simple nasal catarrh, due alone to the relaxation of the mucous membrane, the internal use of tonics and the local application of astringent solutions to the nose rapidly restore the parts to a healthy state.
Among stimulants, cubebs, cayenne pepper and copaiba have a stimulating and styptic effect on the mucous membrane and each of these has been successfully used in such cases. Cantharides, in five grain doses, have proved even more successful, (Vines, Percivall). Sulphate of Copper in drachm doses in mucilage night and morning has proved very efficient (Sewell, Percivall). Arsenious Acid has been employed with still better results. The dose, of five grains may be intimately mixed with a scruple of bicarbonate of soda and given daily in food.[[1]]
[1]. In giving this agent, any redness or watering of the eyes, or colicy pain should be carefully watched for, and when these premonitory symptoms of poisoning are noticed the medicine should be at once suspended to be commenced a few days later in smaller doses.
But the most efficient tonic in these cases is arseniate of strychnia. Its good effects may be secured by combining with the above mentioned powders of arsenious acid and bicarbonate of soda, half a drachm of powdered nux vomica for each dose.[[2]] These powders will usually be taken in food, and may be continued for a month, or until the discharge ceases.
[2]. Whenever nux vomica or its alkaloids, strychnia or brucia, are given, increased irritability and nervousness should be carefully watched for and especially any involuntary twitching of the muscles. On their appearance the agent must be suspended and commenced a few days later in half the former doses.
In all cases the general health must be carefully attended to. Keep the patient in a dry, clean, airy building without draughts of cold air; give moderate exercise in the open air; and good grooming; and allow nutritious food of mildly laxative properties,—as occasional bran mashes and roots in winter and succulent grasses in summer.
Local Applications. These are the most important remedial measures and usually of themselves succeed in reestablishing a healthy condition.
The agents proving most useful are of an astringent nature and in obstinate cases one may be substituted for another as the last appears to lose its effect. Sulphate of Zinc or Sulphate of Copper in the proportion of half a drachm of either to a quart of water, may be used, or if there is much fœtor, a solution containing a drachm each of carbolic acid and carbonate of potash in a quart of water is to be preferred. In either case the addition of an ounce of pure glycerine renders the lotion at once more soothing and more efficient. The solution must be rendered tepid before injecting it, to obviate the irritation attending on the contact of a cold fluid with the delicate membrane of the nose. Among other agents may be named creolin, creosol, creosote, acetate of lead, potassium permanganate, and silver nitrate. Peroxide of hydrogen may be used either as injection or in spray.
The mode of injection is a matter of no small moment. It has been done in some instances by means of a large syringe but the irritation attendant on such a process is an insuperable objection to its use. A better instrument is that introduced by Professor Rey of Lyons. It consists in a tube bent on itself at an angle of 35° so as to form two arms of unequal lengths. The longer fifteen inches in length, one and a half in diameter and widening into a funnel at its free end;—the shorter about five inches long and tapering towards its free end where its aperture is only two-thirds of an inch across. The instrument is made of block tin or extemporaneously of gutta percha. Over the shorter arm is placed a tightly fitting leather ring four and a half inches in diameter on which is applied some wet tow to adapt it to the nostril and effectually close it. The nose having been drawn in so as to place the head in a vertical position, the short arm of the instrument is introduced into the affected nostril, and the liquid being gently poured into the long arm rises slowly in the nose until it is filled and the liquid flows from the nostril on the opposite side. In introducing the tube care must be taken that it may not irritate the inner wall of the nose on the one hand, nor pass into the blind pouch, known as the false nostril, on the other.
The greatest gentleness and tact are requisite in thus injecting the nostrils, though in troublesome animals it is sometimes necessary to resort to blindfolding or even to the application of a twitch on the ear, or finally to strapping the animal (head included) to a smooth firm vertical surface (operating table).