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Nitric Acid Acidum

nose, bleeding, skin, nose-bleeding, blood and sometimes

NITRIC ACID (ACIDUM NITRICUM).—An exceedingly corrosive acid, pale yellowish in colour, and giving off white fumes when exposed to the air. It is a powerful caustic to animal fibres, and is often used in the treatment of warts, corns, or other callosities. In cancerous or syphilitic ulcers it is likewise of service as a local application. Internally, nitric acid is some times used, greatly diluted, as an intestinal astringent and antiseptic. The dose for this purpose is from five to ten drops, given in a tumblerful of water. The accidental or intentional swallowing of nitric acid results in burning sensations in the gullet and stomach, excessive nausea and vomiting, great pain, cold extremities, small and weak pulse, contortions, and (almost invariably) death. Alkaline solutions should be given as antidotes, and copious quantities of olive-oil and mucilaginous drinks administered.

NOSE, ARTIFICIAL.—The formation of an artificial nose becomes necessary when a considerable portion of the nose has been destroyed by disease, such as lupus, cancer, or syphilis ; or when a portion of the nose has been lost by injury. If the tip of the nose has been off accidentally, it may often grow on again if it be replaced at once and sutured on under medical care. Since cutting off the nose was a customary penalty in India, a method for replacing the same first developed there. A V-shaped incision was made in the forehead, and the flap lifted clown to make up for the loss of the nose. A later Italian method consists in partly severing a strip of skin from the upper arm, which is then tied fast to the head, and the skin-flap sutured to the nose. Not until this skin has grown fast to the nose is it completely severed from the arm. Skin from the cheeks may also be used for the formation of a nose. Unfortunately, however, the final result is not always perfect, for the new nose has a tendency to shrink. After a year it may become insignificantly small. Of late it has become

customary to use artificial noses made of celluloid. These preserve their shape and, used in conjunction with eye-glasses, can be so artfully contrived that the deformity is difficult to recognise.

NOSE-BLEEDING.--In this affection it is important to determine in which nostril the bleeding began. In profuse bleeding this may often be difficult, since the blood runs from one side of the nose into the other. The first remedy used to stop the flow should be pure antiseptic cotton, which is packed firmly into the bleeding nostril. Then the patient should press externally upon the wing of the nose, forcing it against the dividing wall, the front part of which is usually the seat of the hxmorrhage. The application of cold plates or of cold compresses to the neck, drawing water through the nose, hand-baths, etc., are very unreliable remedies ; on the other hand, it is advisable to hold the head very erect, and rather swallow a little blood than have the hmnorrhage continue with the head bent. Profuse lmmor rhages require the aid of a physician, who will look for the location of the bleeding, and also treat it after the cessation of the flow.

Nose-bleeding in children is generally caused by injuries, foreign bodies, or eruptions of the skin at the entrance of the nose ; in adults it may result from heart-defects, from congestions, or from diseases of the interior of the nose. Nose-bleeding is sometimes a forerunner of some febrile diseases, such as measles, diphtheria and typhoid fever. Old persons with calcification of veins and arteries may suffer from severe losses of blood, which endanger life. Although nose-bleeding may occasionally afford relief to a patient, it is never a sign of good health, as the laity sometimes believe. Frequently recurring nose-bleeding may lead to chlorosis and loss of strength, as can sometimes be noted in the numerous haemorrhages of children affected by whooping-cough.