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coryza, nose, affection, ear, acute, nervous, treatment and secretion


CORYZA.—Cold in the head. This affection is of so frequent occur rence that everyone believes himself to be quite familiar with it, but it often leads to consequences which are difficult of recognition by the laity. Acute, chronic, and nervous coryzas are to be distinguished.

Acute coryza begins usually at night with a pricking irritation in the back of the naso-pharynx. There is an inclination to sneeze, and a sensation of fullness and heat in the nose. The secretion is sparse at first, and is often mixed with blood streaks. After six to eight hours it becomes looser and contains mucus ; later it turns yellowish-green, viscid, and resembling pus. Very frequently the secretion is watery. The duration of an attack of acute coryza varies from several days to weeks. After persisting for some time, it may lead to a profuse, yellowish, purulent, of ten malodorous, secretion ; when this occurs the accessory cavities of the nose (the maxil lary and frontal sinus) become involved. This suppuration within the accessory cavities, which is usually accompanied by daily headache lasting for hours, may heal spontaneously, but occasionally it requires operative treatment.

In the chronic form of coryza, which may last indefinitely, the outflowing pus leads to the formation of polypi (see NOSE, POLYPI IN) and to obstruc tion of the nose. If an acute coryza extends to the larynx and the bronchi, it will result in hoarseness and cough. This annoying complication is a regular occurrence in some persons, especially in winter. Coryza may spread also to the naso-lachrymal canal, leading to running of the eyes and to catarrh of the mucous membrane of the eyelids (conjunctivitis). Its transmission to the ear causes pressure and a sensation of dullness, ringing in the ears, and difficulty of hearing ; it may even lead to inflammation of the middle ear. An acute coryza occurring in the course of an influenza— and such is the usual history—may be complicated by an extension from the middle ear to the mastoid cells, and from there the infection may spread to the meninges, causing a purulent meningitis. Mastoid complications are not infrequent, and are often very serious. They frequently require operative treatment.

Coryza of infants, if congenital and persistent, may be a serious sign of an infection of gonorrhoea or of syphilis. In small children, owing to the narrowness of the naso-pharyngeal space and to the width of the opening of the Eustachian tube, catarrhal inflammation of the nose may extend to the middle ear, where it may give rise to a purulent inflammation, causing great earache, and perforation of the drum. See EAR, DISEASES or.

Coryza in small children and infants is always a very troublesome disease, as many do not attempt to breathe through the mouth. They suffer, there fore, from shortness of breath, even from attacks of suffocation, and their ability to swallow is so impaired that it becomes difficult to feed them.

Countless remedies are recommended for the cure of coryza, but they do not deserve recognition. Smelling-salts and snuffing-powders prepared with menthol and camphor may afford relief ; but injections of cold water, alum solutions, etc., are absolutely dangerous. A steam-bath (breathing steam from a tall pitcher), if used on the first day of the affection, is sometimes useful in suppressing a threatening coryza ; but at a later stage of the disease it is ineffectual. The dry air of rooms, especially of steam-heated rooms, acts injuriously ; whereas plenty of outdoor exercise in fresh, clear air is beneficial, even in the middle of a severe winter. If the disease is accompanied by severe headache, by profuse, persistent, and ill-smelling discharge, or by involvement of the ears, careful special treatment is required. The prevention of coryza, so far as it is an affection due to cold, may be accomplished by a general hardening of the body. See HARDENING. Stockings should be changed frequently, and wet foot-wear promptly removed, especially in the case of children.

Nervous coryza consists in an intense irritation accompanied by sneezing, and by a profuse watery (never viscid or purulent) secretion ; it begins abruptly and ceases as suddenly. During the intervals between the attacks, the state of health is usually normal. The affection generally begins early in the morning, as soon as a part of the body is uncovered, and lasts for from several minutes to two hours. The eyes are often watery. In some indi viduals the inclination to sneeze appears when they pass from one room into another with different temperature, or when they smell certain substances, as roses, or hay. See HAY-FEVER. Some persons are affected when travelling on railways (" railway coryza ") ; and others when in a crowd, or when looking into brilliant light. All persons suffering from nervous coryza, which is related to asthma, are themselves nervous ; and in order to be cured permanently of coryza they must undergo a general treatment calculated to improve their nervous tone. This will cause a diminution of the excessive sensibility of their mucous membranes. Morbid changes in the nose are present in some cases ; and the removal of these will cure the affection.