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Full text of "Diseases Of The Nose Throat And Ear"


In this chapter will be discussed a group of inflammatory conditions of the
nasal mucous membrane comprising acute rhinitis, fibrinous rhinitis, chronic
hypertrophic rhinitis, atrophic rhinitis and rhinitis sicca.


Acute rhinitis, or coryza, is a condition familar to all as the common cold. It
is especially prevalent in the spring and autumn, and is liable to occur after
exposure to wet and cold, or to others suffering from the infection. Coryza is
more apt to occur in those affected bx&tigue or vitamin deficiency or in those
with nasaljabstruction or chronic sjnus infection. It is met with in the course
of the exanthemata, especially measles, and it occurs in epidemic form as
influenza. Acute rhinitis is a virus disease, but it is thought that complications
arise from invasion by secondary^ organisms, such as the streptococcus,
M. catarrhalis and H. influenzae.

SYMPTOMS. The attack is ushered in by a fit of sneezing, and the nose
becomes blocked, usually unilaterally at first. Loss of the sense of smell,
headache ancfa feeling of chilliness accompany the obstruction, wfiile there is
i profuse nasal discharge at first T^aiery and kter becoming mucogurulent and
inally purulent. The discharge subsides in a few days, but by this time the
nfection may have spread to the pharynx, larynx and bronchi. Hearing may
>e impaired from a temporary obstruction of the auditory tube. In infants the
>bstructioniof a coryza may interfere with feeding and sleeping.

CLINICAL FEATURES. The nasal nfScqsa is red and swollen while the cavity
•-ontains mncoid or mucopurulent^secretion. The nasopharynx and pfiarynx
re similarly congested. The tympanic membranes may bejEtushed and

TREATMENT. There is no specific treatment, and the cold usually runs its
ormal course whatever therapy is adopted. In the early stages a hot bath at
edtime followed by O6_g of aspirin is helpful. Nasal obstruction may be
Deviated by a nasal spray of 1 per cent ephedrine hydrochloride irT normal
iline or by a steam inhalation. Sho"uI3the ostia of the maxillary sinuses
ecome blocked by oedema with consequent infra-orbital pain, relief may be
btained by an ep^drinfi. spray followed in 5 minutes by a steam inhalation,
s secondary effects are due to the invasion of other organSmsTmost of which
•e antibiotic-sensitive, a course of a wide-spectrum antibiotic may help to
•event the development of sinusitis or bronchitis. Vigorous nose blowing may
ad to otitis media and should be discouraged.

The prevention of colds consists in avoiding infections and building up
neral resistance. During epidemics, ~pu61ic transport, schools, offices,