The nature and treatment of ozaena / by Dr Loewenberg ; translated by Dr Kirk Duncanson.

  • Lœwenberg, B. (Benjamin), 1836-
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: The nature and treatment of ozaena / by Dr Loewenberg ; translated by Dr Kirk Duncanson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    that the nasal cavities are completely filled conformably to the law of communicating vessels. By means of these two processes, which I have just described, we remove the greater part of the cocci with the mucus containing them, and we vigorously attack the vitality of the remaining, but the action is only transitory. I therefore employ, conjointly with the preceding manipulations, a third process. 3rd, After the douche and the nasal bath, the daily treatment terminates with insufflations of impalpable boric acid powder. It is necessary to take much care to spread the powder equally upon all the interior of the nasal cavities and the upper pharynx (especially when there exists considerable deviation of the septum), and to reach only these cavities. In order thus to localize the in- sufflation, whilst it is going on I make the patient pronounce the vowel a that the velum may remain up, and prevent the powder from falling into the larynx. I recommend this method generally for the insufflations of powders into the nasal cavities ; it is speci- ally indispensable in the application of more active substances, such as nitrate of silver, the casual penetration of which into the larynx or its deglutition must be absolutely avoided. I do not know if other writers have thought of this precaution, which I consider important. The insufflations of boric acid powder are for the purpose of establishing on the walls of the cavities of the nose and naso- pharynx a reserve or supply of antiseptic material dissolving itself in the mucus in proportion as it is secreted. I have chosen boric acid because of its harmlessness, a quality so much appreciated in other diseases, such as those of the eye, and its excellent microbicidal action. In my estimation it is more energetic than appears from the tables prepared by Buch- holtz, Miquel, and other savants. I will now state, in addition to the excellent practical results which this substance has always given me, the argument which I use to explain its therapeutic action. We must not judge of the antiseptic power of a body exclusively according to the rank it holds in experiments in vitro, but also consider, when it is a question of application to the animal organ- ism, in what concentration it can be borne. From this evidently depends the dose in which, and the lapse of time during which it may be employed. Now, the tolerance of the tissues being very feeble for the substances which much excel boric acid in the tables of these savants, whilst it is, so to speak, infinite for this latter body, it follows that enormous quantities of it may be employed. You may even store it in fine powder in organs where the forma- tion permits, for example, the auditory canal, and, in cases of per- foration, the tympanum (I add, in passing, that I have found it advantageous to prescribe this same powder to combat other de- compositions, as, for example, fcetid perspirations of the feet or armpits).