NASAL CAVITIES, DISEASES OF. Acute Rhinitis (Acute Coryza).
\ ti, is divisible into acute I, is anti the more unusual .• ent and croupous rhi 4Vis Acute Catarrhal Rhinitis.
Symptoms.– The onset of a cold is riotrz. toeal sy niptonis and a general w hien does not differ in kind lits-t which accompanies local in in general. embracing lassi !101.r. myalgia, and more or r. The local symptoms comprise J L.r dryness accompanied by sneez it,- 4i.,1 followed by a profuse discharge, a: first watery and later muco-purulent.
(ollattral symptoms there are: nasal ,:ee. impairment of the sense of smell, • i-peeially obstruction of one or both • t.1 the nose, this latter phenome r .1. in!. due to the turgescence of the .1r* ez.le tissue of the turbinated bodies.
If the nostrils are examined during an attaek of acute catarrhal inflammation 11.0 en:ire 'uncoils surface will present a vivid red appearance; the inferior tur 1 inatcd structures are engorged with 1.lood and in contact with the swelled •-eptum. conges.tion is usually- not =o intense in the posterior part of the oit,,.1 ie.-sages. The secretions are at • serous., later mucous, and finallv - 11'11(.9-purulent .
Etiology and Pathology.—Acute catar r.lal rhinitis, or coryza, may be excited y expesure to cold and draughts, h.:. various: inhaled substances which may al ci•her chemically or mechanically, by certain ingested substances which are eliminated through the nasal mucosa (i,.fne). and finally by specific bacterial rois ns: in the course of general infec tines processes, s-uch a:.s. measles, scarlet fever. influenza, etc. With the exception ci this: latter subdivision there is no class of cases of catarrhal rhinitis in which the likelihood of bacteriological causation can be demonstrated.
The coryza which accompanies specific fevers is undoubtedly in some cases purulent. however, and due to the usual exciters of suppuration.
With regard to the part played by various fumes, forms of dust, and the like, the subject encroaches upon the domain of hay fever, which is separately considered in this work.
A predisposition to cold in the head is furnished by a variety of local condi tions, such as deformity of the septum, adenoids and other chronic affections of the nasal and pharyngeal passages, and perhaps by certain general dyscrasic con ditions, such as syphilis and tubercle. Children are more commonly affected than adults; and women than men.
Catarrhal rhinitis is naturally prone to spread by continuity of tissue, and may or may not extend into the sinuses, naso-pharynx, middle ear,- nasal duct, etc., producing added sy,-mptoms refer able to the organs secondarily implicated.
Treatment. —The treatment is general and local. Much can be accomplished in the first twenty-four hours of a cold by active cathartics, prohibition of alco hol and tobacco, and a plain diet. In addition to this, sedatives—such as salol and phenacetin, 2 grains each every hour for four doses, or 15 grains of bro mide of potassium repeated every two or three honrs—are of marked benefit. One of the best ways of shortening the duration of cold in the head is to pro hibit the constant desire to blow the nose. Although it is uncomfortable, if the patient will allow the serum to re main in the nose, it prevents by pressure further transudation and allows the glandular structure to become quiet. Saline washes should not be used during the serous stage of the disease, certainly not before the secretions become thick ened.
Powders are of benefit, and I prefer the compound stearate of zinc and boric acid, to which may be added 72 of 1 per cent. of cocaine. This may be used at least four or five times in the twenty four hours.
If oily sprays are used they should be exceedingly mild in combination, not adding more than a grain or two to the ounce of such remedies as thymol or eucalyptol. Stronger solutions can only be of benefit by increasing the irritation, exciting the serous transudations and so eventually exhausting the glandular structures.