NOSTRILS, DISEASES OF THE. Acute inflammation of the nasal mucous membrane is a very common and well-known affection, which has been already described under the title of catarrh (q.v.), or cold in the head; while the chronic form of inflammation is described in the article OZCENA. Hemorrhage from the nostrils, or Epistaxis (Gr. a drop ping), is by far the commonest form of bleeding from a mucous membrane. It may be produced (1) by direct injury, as by a blow on the nose, or a scratch in the interior of the nostrils; or (2) it may be an active hemorrhage, in which case it is often preceded by a feeling of tension and heat in the nostrils, pain in the forehead, giddiness, buzzing in the ears, and flushing of the face (these symptoms are, however, seldom all present in the same case, and not unfrequently the flow of blood is preceded by no apparent dis order>: or (3) it may be of a passive character, and may be due either to a morbid condi tion of the blood, as in malignant scarlatina, typhoid and typhus fevers, scurvy, purpura, etc., or to obstruction of the circulation by disease of the liver and heart.
If the hemorrhage occur in a flushed plethoric subject, and is obviously of an active character, it may be regarded as a salutary effort of nature, and may be left. alone till it ceases spontaneously; but if it continues so long as materially to weaken the patient, or if it be of the passive character, or if it arise from injury, then means should be taken to stop it with as little delay as possible. The patient should be placed in the sitting pos ture at an open window, with the head erect or slightly inclined, backwards, and amongst the simpler means to be first tried, are compression of the nostrils by the fingers, the application of a key or other piece of cold metal to the back of the neck, and the occa sional immersion of the face or whole head in cold water, especially if accompanied by draiving-up of the water into the nostrils; or Dr. Negrier's plan of causing the patient, in a standing position, suddenly to raise his arms straight upwards, and to retain them for a short time in this position—a remedy which lie states to have always succeeded, even in very-bad cases, when other means had failed. Should these means fail, recourse
must be had to astringent injections (for example, twenty grains of alum dissolved in an ounce of water) thrown up the nostrils by a syringe, or to astringent powders (as finely powdered galls, kind, matico, alum, etc.), blown up the nostrils by means of a quill or other tube, or snuffed up by the patient. As a final resource, direct compression must be applied, Abernethy never failed in stopping the bleeding by winding a piece of moistened lint around a probe, so as to form a cylindrical plug, passing this along the floor of the nose for its entire length, then carefully withdrawing the probe, and allow ing the lint to remain for three or four days. Cases occasionally occur in which it is necessary also to plug the posterior orifices of the nostrils by an operation, into the details of which it is not necessary to enter.
Po!flints, which is an old term employed to signify any sort of peduncnlated tumor firmly adhering (literally, " by many feet") to a mucous surface, is of common occur rence in the nostrils; its most usual seat of attachment being one of the turbinated bones. The ordinary kind is of the consistence of jelly, yellowish, streaked with blood-vessels. aid of a pear-shaped form. The patient has a constant feeling of fullness in the nostril as if he had a cold in the head); he cannot effectually blow his nose; and his voice is ..ometimes rendered more or less thick and indistinct. If lie force his breath strongly through the affected nostril, and at the same time compress the other, and close the mouth, the polypus may generally be brought in view. The best treatment is to seize the neck or pedicle with the forceps, and twist it off. The consequent hemorrhage may he readily checked by the means already described.
Foreign bodies are often inserted into the nostrils by children, and become impacted. They may usually be extracted by a small scoop or a bent probe. If they cannot be removed by these means, they must he pushed back into the throat through the nares. „ Children are,oceasibnally born with iniperforated nostril's. This congenital malfor mation may, however, usually be remedied by surgical assistance.