Occasionally deformities of the septum or other internal structures also polypi or tumors, are sources of constant irritation and accelerate catarrhal disease.
Disease of the Throat. The acrid, irritating and poisonous discharge, which, in some stages of disease, almost constantly runs down over the delicate lining membrane of the pharynx (throat), is liable to produce in this sensitive membrane a diseased condition similar to that existing in the air-passages of the head. The throat may feel dry, husky, and at times slightly sore or raw; or, from the muco-purulent discharge that is almost constantly dropping down over its surface, the patient may feel very little inconvenience from the disease of the throat until it is far advanced—the moistening and lubricating effect of the matter that drops on the surface tending to blunt the sensibility of the parts. (See pharyngitis for symptoms and treatment.)
The Extension of the Disease to the Larynx. The larynx, situated directly below the pharynx (throat), is subjected to the influence of the same irritation from acrid and poisonous discharges dropping into the throat from the head. More or less of it is removed by hawking and spitting, but some remains and is drawn into the larynx, or still lower into the trachea (windpipe), with the inspired air. Thus the disease creeps along the continuous mucous surfaces of the air-passages, the acrid poisonous discharge arousing in its track the irritation, inflammation, ulceration, and thickening of the lining membrane which characterize the disease in other portions of the air-passages. The symptoms and treatment of laryngitis will be found under its appropriate classification.
Bronchitis and Consumption. We have already detailed the manner in which the throat, larynx, and trachea, in succession, become affected from catarrh, or Ozæna. By the same process of extension, the bronchial tubes, and lastly, the parenchyma, or substance of the lungs, in their turn, become diseased, and bronchitis and consumption are firmly established. Tightness in the chest, with difficulty of breathing; soreness; darting, sharp, or dull, heavy pain, or a prickly, distressing sensation, accompanied with more or less cough and expectoration—are evidences that the bronchial tubes have become affected, and they should admonish the sufferer that he is now standing on the stepping-stone to CONSUMPTION, over which thousands annually tread, in their slow journey to the grave.
Deafness. By means of a small canal, called the eustachian tube, an air-passage and communication between the throat and middle ear is formed. (See Fig. 8.) This passage is lined by a continuation of the mucous membrane which covers the throat and nasal passages. The catarrhal inflammatory process, by continuity of surface, follows the mucous membrane, thickening its structure, until the eustachian tube is closed, and the beautiful mechanism of the internal ear is rendered useless. While the thickening of the mucous membrane is going on, and the passage is gradually becoming closed (and the process sometimes extends through several years), the patient will occasionally, while blowing the nose, experience a crackling in one or both ears, and hearing becomes dull, but returns suddenly, accompanied with a snapping sound. This may be repeated many times, until, finally, hearing does not return, but remains permanently injured. In other cases the hearing is lost so gradually that a considerable degree of deafness may exist before the person is really aware of the fact. Either condition is often accompanied with noises in the head of every conceivable description, increasing the distress of the sufferer. The delicate bones of the ear are sometimes detached from their articulations, the drum is ulcerated and perforated, and through the orifice thus made, the bones or small spiculæ may escape with the thick, purulent, and offensive discharge.
Closure of the Tear Duct. The lachrymal duct, or passage (tear duct), which, when in a healthy condition, serves to convey the tears from the eye into the nose, may be closed by the same inflammatory and thickening process which we have already explained. This condition is usually attended with watery and weak eyes, the tears escaping over the cheeks, and sometimes producing irritation and excoriation. The nasal branch of the ophthalmic nerve sometimes participates in the ulceration going on in the head, so that the eyes are sympathetically affected. They sometimes become congested or inflamed, and sharp pain in the eyeballs may be experienced.
Indigestion, Dyspepsia, Etc. A large portion of the acrid, poisonous, purulent discharge, which drops into the throat during sleep, is swallowed. This disturbs the functions of the stomach, causing weakness of that organ, and producing indigestion, dyspepsia, nausea, and loss of appetite. Many sufferers complain of a very distressing "gnawing sensation" in the stomach, or an "all gone," or "faint feelings," as they often express it.
Symptoms. Dull, heavy headaches through the temples and above the eyes; indisposition to exercise; difficulty of thinking or reasoning, or concentrating the mind upon any subject; lassitude; indifference respecting business, lack of ambition or energy; obstruction of nasal passages; discharges voluntarily falling into the throat, sometimes profuse, watery, acrid, thick and tenacious, mucous, purulent, muco-purulent, bloody, concrete blood and pus, putrid, offensive, etc. In others, a dryness of the nasal passages: dry, watery, weak, or inflamed eyes; ringing in the ears, deafness, discharge from the ears, hawking and coughing to clear the throat, ulcerations, death and decay of bones, expectoration of putrid matter, spiculæ of bones, scabs from ulcers leaving surface raw, constant desire to clear the nose and throat, voice altered, nasal twang, offensive breath, impairment or total deprivation of the sense of smell and taste, dizziness, mental depression, loss of appetite, nausea, indigestion, dyspepsia, enlarged tonsils, raw throat, tickling cough, difficulty in speaking plainly, general debility, idiocy, and insanity.
All the above symptoms, as well as some others which have been previously given, and which it is not necessary here to repeat, are common to this disease in some of its stages or complications; yet thousands of cases annually terminate in consumption or chronic bronchitis, and end in the grave, without ever having manifested one-half of the symptoms enumerated.