A i in 5o solution of Nitrate of Silver, r in i,000 Perchloride of Mercury, 5 to io per cent. Protargol, 5 to zo per cent. Argyrol and Resorcin 5 to io per cent. have all been advocated.
Preventive measures consist in the avoidance when possible of localities where pollen of grasses is abundant in the early summer or where ragweed luxuriates later on. City indoor life, a sea voyage, or residence in a high altitude, or a sojourn at a seaside spot, destitute of much vegetation, may enable the victim of hay fever to stave off the attacks. Respirators, goggles, veils and plugs of cotton-wool in the nostrils may mitigate the amount of coryza and sneezing by preventing the admission of pollen, but, as a rule, their use causes acute discomfort, and as preventive remedies they are generally unsuccessful, and the same may be said of inhalations.
The nasal douche is of value both as a preventive and palliative, and an adjunct to other treatment. By regular flushing out of the nasal cavity and the naso-pharynx the pollen grains are washed away and the irritative effect of their toxin prevented or minimised. Before the season when the grasses are flowering the douche when carefully used will relieve the chronic congestive condition of the nasal mucosa, which is such a strong factor in many cases. The best form for routine use is to prescribe
a powder of equal parts of Sodium Bicarbonate, Sodium Chloride and Borax, a saltspoonful of which dissolved in a wineglassful of tepid water may be used to cleanse the membrane. The writer in these cases abandons the usual nasal douche apparatus and directs the patient to fill the hollow of his hand with the liquid, which is strongly sniffed up through the nostrils and brought out by the mouth and expectorated, 2 or 3 oz. being used on each occasion 3 or 4 times a day.
Cocaine produces in the long-run an abnormally sensitive and relaxed condition of the mucosa, which perpetuates the mischief indefinitely, though in emergencies it may be safely used for a short period, as a whiff of Chloroform may be employed in the emergency of an acute attack. Some authorities employ a i in 5,00o Perchloride of Mercury solution for cleansing the nostrils, and Carbolic Acid i in ioo is decidedly valuable when used as above directed. Dry snuffs as those containing gum, bismuth, Sc., are always not only valueless, hut hurtful, as they cake upon the mucous membrane and act like crusts. Astringent powders like alum and tannin are still more objectionable.