Series of 10 eases in which interstitial injection of paraffin into the inferior turbinated bones were tried. Eckstein's paraffin with ft molting-point of 60' C. (140° F.) being. employed. 13y this means an artificial hypertrophy of the inferior turbinated bones was produced, and in the cases so treated the crusts disappeared in a few days and odor sub sided. Such reconstruction of the in ferior turbinates seems to have effected a complete cure in every instance, but further time should elapse before inter stitial injection of paraffin ean be de clared a radical cure for that most obsti nate affection. A. Brindel (Jour. de Med. de Bordeaux, July 27, 1902).
Series of eases in which paraffin injec tions were successfully employed to re store the inferior turbinate body in the treatment of atrophic rhinitis. A white paraffin with a melting-point of 105° F. (40.4° C.) was employed. Lake (Lan cet, Jan. 17, 1903).
Tumors of the Nasal Cavities.
Mucous Polypi.—Polypi, while usually classed under the head of new growths, are now generally believed to be of in flammatory origin. They are generally multiple and often bilateral. The great majOrity of them originate from the mucosa covering the middle turbinated bone. MacDonald describes polypi as ordinary inflammatory products pecul iarly modified by the physical condi tions in which they ex:st. The most striking feature of the polypus is its tendency to absorb and retain moisture, which gives to it its mdematous, trans parent, jelly-like character.
Symptoms.—The symptoms are pri marily those of obstructed nasal pas sages. Phinitis is present, the patient constantly taking fresh colds. During the day the patient sniffs or attempts to force air through the nose from be hind, while at night he usually snores loudly. Local reflexes are often present, such as cough or lactymation, while cerebral symptoms often occur, includ ing dizziness and aprosexia. The sense of smell is obtunded or lost. All of these symptoms are much aggravated during cold weather. In long.-standing eases asthmatic symptoms frequently occur. But whether they ore occasioned by a congestive bronchitis or are simply re flex phenomena referable to nasal dis turbances it is not always easy to de termine. Numerous cases of hay fever have been reported in which polypi were rt,,•,: t there was no bronchialth•tt rl ante. at, a rule, if the polypi +rt. f standing, pharyngeal and i runt _al L atarrhs are apt to be present.
Tilt amount of nasal discharge may I t copious, and it may be thinner than t le distliare of ordinary rhinitis; in t, the thin, profuse, watery discharge 1,1).)wil clinically as naso-hydrorrheea is Lasionally a symptom of polypus. Specch is peculiarly modified.
All the symptoms of polypi are ag .Jravatcd during wet weather on account f the capacity for absorbing moisture ssesstd by this variety of growth.
Polvpi may, under certain eircum :lances, cause obstructive symptoms of 11 e ostium maxillare, nasal duct, and liu,tachian tube. According to Griin %%ald, pus is present in about SG per ctrit. of all polypi, while the prcs.enee of a polypus usually implies sinus dis ease.
Diagnosis.—The existence of a mu cous polyp or polypi can be suspected by the symptoms of long-continued nasal ob=truction, the nasal discharge, the pe culiar hollowness of the voice, and the motion of these growths, which is easily appreciated by the patient. An exami nation of the nostrils, however, quickly shows a white, transparent, glistening enlarg.ement, which resembles no other wth, unless it is adenosarcoma. It is probably true that mucous polypi sometimes degenerate into a form of nas.al sarcoma. In some instances the appearance of the two growths resemble one another, and this is most apt to be true when mucous polypi have regrown several times, because congestion in- ; creases with each regrowth of the mu cons polypi and they contain more con nective tissue and blood-vessels at each regrowth.
Sarcoma of the nasal passages pre sents a granular surface, bleeds easily, crumbles away in pieces when attempts are made to remove it, and frequently involves the antrum and occasionally the orbit.
Etiology and Pathology.—While the inflammatory origin of polypus is gen erally conceded, it is impossible to state why they do not occur with equal readi ness in all cases of chronic rhinitis affect ing the middle turbinated. With regard to the relation of polypus to ethmoiditis, this association has often been recorded. There does not seem to be any radical distinction between the cedematous gran ulations which accompany ethmoidal dis ease and polypi which are unaccompanied by the latter malady. Polypi often con tain fragments of bone which would seem to show that the formations orig inate from the fungoid granulations asso ciated with ethmoidal disease.