Diseases of the nose, throat and ear / by Charles Huntoon Knight and W. Sohier Bryant.

  • Knight, Charles H. (Charles Huntoon), 1849-1913.
Date:
1909
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the nose, throat and ear / by Charles Huntoon Knight and W. Sohier Bryant. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    tension. The sense of smell is completely abolished for the time being. One of the most annoying symptoms is tinnitus aurium, frequently accompanied by impairment of hearing and a sense of fullness in the ears, dependent, no doubt, upon extension of the in- flammatory process to the naso-pharynx and the orifices of the Eustachian tubes. There may be a mild degree of pyrexia. In the course of a few hours the dryness of the membranes is succeeded by an effusion of watery secretion, more or less profuse, at first mucous and gradually becoming purulent. In the declining stage the dis- charges become thicker and dryer. If inspected in the prodromic stage the mucous membrane is seen to be excessively tumefied, dry and glazed, and very red. In the second stage the swelling and redness may persist, but the surfaces are bathed in mucus. In the final stage we find the congestion and swelling less, but the nasal pas- sages are apt to be obstructed by tenacious purulent and inspissated secretion. Usually in a week or ten days the patient is restored to health, but not without perceptible aggravation of a preexisting abnormality, or certain changes in the tissues which increase the tendency to recurrent attacks. Treatment.—An attack of acute rhinitis may be invariably miti- gated and sometimes aborted. At the outset it is customary to give to an adult ten grains of quinine with ten grains of Dover's powder, and proportionate doses to children, unless there is some known contra-indication. By many this course is strongly op- posed. Measures tending to encourage perspiration are often used with benefit, such as the hot foot bath and hot lemonade inter- nally. Some observers insist upon entire abstention from fluids internally, with the result, it would seem, of adding rather to the patient's discomfort. On the other hand, Cohen recommends copi- ous draughts of water. The less local meddling the better, but there seems to be no doubt that an application of cocaine, two per cent, to the inflamed nares, followed by an insufflation of Ferrier's snuff (morph. sulph. gr. i, bismuth, subnitr. 3iii> pulv. acacia 5i) is very soothing and contributes to the comfort of the patient (Fig. 14). Cocaine should never be entrusted to a patient except in extreme cases and unless we are quite sure of his capacity to resist the fasci- nations of the habit. The abuse of an agent, so energetic and decided in its action, may do permanent harm. There is no doubt about the comfort it gives by emptying the venous sinuses and thus restoring