With these symptoms it may not require much time to make a correct diagnosis, but it may be some time ere the patient is entirely free from the trouble even if he does use good homeopathic treatment. Then it is the treatment which interests us most. The patient at the beginning will ask if you can cure him and how long it will require to do it. The physician necessarily must guard his prognosis, especially if it is a case of long standing. If there is much atrophy, which has extended over several years, a permanent cure is very doubtful. But even with these cases much can be done to make patients more comfortable. Correct the odor, the dryness, and the formation of scabs. If the case is not of too long standing, very likely you will be able to produce a healthy condition of the mucous membrane. If you are so fortunate as to produce a cure, the patient will always remember you for it, and you will or should feel proud of it yourself. Much will depend on occupation, age, and persistence with which the patient carries out treatment.
The treatment, to be beneficial, implies the discovery and removal of all predisposing and exciting causes. To do this will require both local and systemic treatment. No cure can result unless good constitutional treatment is persisted in. When taking the case it is wise to inform the patient that he must expect treatment through several months, and even then the case must be examined once in a while or there may be a recurrence of the disease.
Too much time cannot be spent in a careful examination of the patient. Be certain the cause of trouble is ferreted out. The course of treatment will depend upon the cause of the disease. After thorough examination a course of treatment is planned. As I have said before, each case must be studied. There are no specifics for the disease.
In the local treatment the important object is cleanliness. The mucous membrane must be kept in a perfectly clean condition all the time. This is the main object of all local treatment. In some cases I assist nature to heal parts by getting a slight stimulating effect of medicine.
It is not always an easy task to remove all the dry crusts, but where the scabs are very dry I use an application of peroxide of hydrogen on cotton, or with the atomizer, to soften them. When the atomizer or douches are used post-nasal injections must be given as well as through the anterior chambers of nose. Any application can be used which will soften up scabs. Can use “Dobell’s Solution,” solution of sea salt, listerine, or glycerine. After all the crusts have been removed, others must be prevented from forming. This I do by keeping on an application of glycerine. A very good formula to keep the nostrils free is calendula and glycerine, at 2 drams to ounce water, and used in nebulizer or directly applied on cotton. When the odor is present after removal of scabs, I use permanganate of potash, 10 grs. to ounce in spray, or aristol in lavolene used in nebulizer.
After the cleaning process has been gone through with and all the mucous membrane is perfectly clean, naturally it is ready for some healing application. A good one to use is calendula and hamamelis in lavolene. If there should be any ulceration of septum, apply an ointment of yellow oxide of mercury, 10 grs. to the ounce. This will heal ulcer in short time.
Where membranes need some stimulation a glycerite of tar, hydrastis, or eucalyptol in nebulizer will be found to be of service.
Many times patient will complain more of the deafness than anything else. When you have this complication it will be necessary to give attention to some special treatment for the pharynx and eustachian tubes. The latter must be kept open by Valsalva’s method or the Politzer air bag.
In selecting the internal remedy keep in mind the constitutional and local lesions. Often I use the internal remedy locally; say 5 to 20 drops of tincture to ounce water. Make yourself confident that you have the indicated remedy. There are many remedies which are of service. Some of the more common ones, which have syphilitic taint are, aurum, kali iod., mercury, nitric acid, argentum nitricum, and calc. iod. In scrofulous diathesis and ill-nourished patients such remedies as aurum mur., silicea, calc. phos., sulph., phosphorus, ars., hepar sulph., alumin., kali bich., cal. carb., and graphites are useful.
All through the treatment the physician should have perfect control of patient. Should be able to direct his diet and hygiene. Use all means that will recuperate the general health. If patient is laboring day by day in dust and dirt, he may be compelled to change his occupation.