Foreign Bodies in the Nasal Cavities.
FOREIGN bodies of various descriptions have been met with in the nasal cavities, particularly of children. They set up suppuration and give rise to a unilateral discharge, which is often offensive in character.
No attempt should be made to remove a foreign body from the nose by syringing. A fine hook should be passed behind the body and traction made upon it. Care must be taken that the body is not pushed farther into the cavity.
A condition characterised by atrophy of the nasal mucous membrane and accompanied by a purulent discharge and the formation of crusts having a very offensive odour which is not recognised by the patient.
CAUSES.- Uncured Catarrh; fevers; syphilis; mechanical injury; foreign bodies in the nostrils; or it may arise from an unknown cause. General ill-health no doubt predisposes to the disease.
TREATMENT.-The disease, especially if chronic, is not easily cured; but in most cases it may be greatly benefited.
Aurum.-Pain above the nose; heat and soreness of the nostrils; discharge of yellowish-green foetid pus.
Kali-Bich.-Thick, tenacious, sometimes bloody, discharge, in the form of elastic plugs (2x dil. sometimes required).
Iodium.-Great foetor, the Schneiderian membrane undergoing putrid Ulceration.
Mercurius Biniod.-Sanious discharge; destruction of the septum and bony structure of the nose.
Acid-Nit.-Syphilitic Ozaena; and when the patient has been drugged by large doses of Mercury.
Arsenicum.-Ichorous, foetid, and malignant discharge, particularly if the constitution is much shattered.
Sanguinaria and Hamamelis are said to be good remedies.
Zincum met.Met.-The nose swells, and is sore; loss of smell dryness, and lachrymation.
Cyclamen (frequent sneezing); Gels (watery flow); Phyto (mucous flow); Sticta (dryness).
ACCESSORY MEASURES.-Perfect cleanliness of the nasal passages is imperative; the nose may be irrigated by snuffing up a solution of common salt in warm water (a teaspoonful to the pint), several times a day. The fluid passes through the nasal cavities and is then spat out. At least half a pint should be used at a time.
131. Epistaxis-Bleeding from the Nose.
Although this is ordinarily a trifling affection, it requires some discrimination to decide when to interfere and when to let it alone; for it may be a symptom of the most diverse conditions of the constitution, and due either to local or general cause.
In simple, cases, when the discharge is trifling, no treatment is necessary; that suggested as follows is for cases in which the bleeding is excessive, long continued, oft-recurring, or in which it arises from a debilitated state of the constitution; for then the loss may be serious, and indicate a grave systemic condition.
SYMPTOMS.-Giddiness, weight, or oppression in the forehead often precede the Haemorrhage. Generally only one nostril bleeds. Sometimes the blood, instead of escaping in front, passes through the posterior nares into the fauces, and thence into the larynx or stomach. In the latter case, without careful investigation it might be mistaken for Haemorrhage from the lungs or stomach.
CAUSES.-Injuries, as a blow on the nose or some part of the head; Congestion of the head, from passion, over-exertion, coughing, etc; ulceration syphilitic, tuberculous, malignant-Apoplexy, old age, etc. The plethoric seem to be liable to Epistaxis from an excess of blood, the anaemic from an altered condition of this fluid, and the diseased from degenerative changes in the blood- vessels. Sometimes it takes place in women, from absent, scanty, or irregular period (see Lady’s Manual of Homoeopathic Treatment) In the latter instance it is said to be vicarious of menstruation. The predisposing cause is the extreme vascularity of the Schneiderian membrane-the mucous lining of the nasal cavities thus, it is well-known to be readily susceptible to cold, Syphilis and other influences. As a consequence of this congestive tendency, the capillaries become distended, and Haemorrhage may result.
TREATMENT.-Hamamelis.-Venous Haemorrhage, where the blood oozes or drops from the lining of the nose; Epistaxis from the Haemorrhagic diathesis; also when the degenerative changes in the blood-vessels, as in old age, favour the discharge.
Aconitum.-Haemorrhage from arterial excitement, or from passion. It is especially suited to plethoric persons.
Belladonna.-Cerebral Congestion; Epistaxis preceded by throbbing headache and fulness in the forehead and temples.
Arnica.-From a blow, fall, or physical exertion; Secale-during fevers, etc; Podoph. or Pulsatilla-when the Haemorrhage is vicarious of the monthly period; China, after the bleeding, when it has been excessive.
ACCESSORY MEANS.-The application of cold water or ice to the forehead, neck, or back, raising the arms above the head, and holding them so for a short time, generally arrests the Haemorrhage promptly. If, in spite of these means, the bleeding continues, a piece of lint should be rolled into the shape of the nostril, saturated with the tincture of Hamamelis, and twisted into the bleeding nostril, or into each, if the bleeding comes from both, or a lotion of Hamamelis O twenty drops to four tablespoonfuls of water, may be snuffed up the nostril of the affected side. Before inserting the plugs any clots of blood should be removed. The patient should be placed in the recumbent posture, and the temperature of the room reduced.
Before steps are taken to arrest the bleeding, the interior of the nose should, if possible, be inspected by a surgeon and the bleeding point sought for. As a rule it is readily detected on the septum of the nose just inside the nostril.
As a preliminary to the use of local applications, the nasal cavity should be irrigated with salt solution (tablespoonful of common salt to a pint of water), to remove all clots from cavity. In many cases this is all that is necessary to stop the bleeding. If the bleeding is not very copious it may be stopped by grasping the nose firmly between the finger and thumb.
Plethoric persons predisposed to Epistaxis, or to Congestions, should lead a temperate life, avoid stimulants, use frequent ablutions of cold water, and take moderate exercise daily in the open air. Immoderate exertion, fatigue, and much stopping are injurious. Delicate persons, of spare habit, are benefited by nourishing food. When bleeding from the nose frequently or periodically recurs, a change of air, and more or less complete change of habits, are generally necessary to overcome the predisposition. But such cases should always be under the care of a professional Homoeopath.
132. Polypus Nasi-Polypus of the Nose.
Nasal polypi spring from and consist of oedematous masses of mucous membrane. They are as a rule multiple, smooth, rounded in outline, of a translucent bluish-grey colour, soft in consistence, and freely movable. They may be associated with suppuration in one or more of the accessory nasal sinuses, and also in malignant disease. After removal they are apt to return.
SYMPTOMS OF NASAL POLYPI.- A nasal sound in the voice; the patient acquires the habit of keeping his mouth open to facilitate breathing; difficulty of swallowing liquids; the nose is enlarged externally on the affected side, and on looking up the nostril the Polypus may be seen. In consequence of the stuffy symptoms which a Polypus occasions, it may at first be mistaken for a Cold in the head, But on the nose being violently blown, the Polypus descends and appears near the orifice, causing obstruction, contrary to the usual result of such an operation.
TREATMENT.-Calc-C., Mercurius-Iodium, K. Bich., Phosphorus Teuc., Thuja, Sanguinaria (internally, and powder of it externally), and Opi. have proved the most successful remedies. Snuffing up salt solution, as described under Ozaena, is of service.
In the choice of one of the above remedies reference should be made to the general constitution of the patient and it should be used locally, in a more concentrated form, as well as internally.
In most cases, it is necessary to remove these growths by surgical means, and several sittings are usually necessary.
133. Loss or Perversion of the Sense of Smell.
This condition is generally consequent on some other affection, especially chronic Catarrh.
TREATMENT.- When recent, and dependent on a catarrhal Cold, or Rheumatism, Aconite in a low dilution will be readily curative. We have cured chronic cases from similar causes, with Pulsatilla or Mercurius, according to the condition present. Sulph. is also valuable in perverted smell.
Kali-Bich., Kali-iod., Gelsemium, Sepia., and Calc-c., are also recommended.
These are the most common cause of post-nasal obstruction, and are enlargements of the lymphoid tissue normally found in the naso-pharynx.
Adenoids form a soft velvety mass, which projects from the vault of the naso-pharynx, and are frequently associated with enlargement of the tonsils. The patient often suffers from granular pharyngitis, and nasal catarrh. They most commonly occur between the ages of five and fifteen, after which they tend to undergo atrophy. They may, however persist into adult life.
SYMPTOMS.-The most pronounced symptom in most cases is interference with nasal respiration, so that the patient is compelled to breathe through the mouth. As the respiratory difficulty is increased during sleep the patient snores loudly, and his sleep is frequently broken by sudden night-terrors. Owing to the disturbed sleep, to imperfect oxygenation of the blood, and to frequent attacks of nasal and bronchial catarrh, the child’s nutrition is interfered with, and he becomes languid and backward at his lessons. When the adenoids encroach upon the Eustachian tubes the patient suffers from deafness, frequent attacks of ear-ache, and sometimes from suppurative middle ear disease, with a discharge from the ear.
Among the rarer conditions attributed to adenoids, are asthma, inspiratory laryngeal stridor, persistent cough, chorea, and nocturnal enuresis.
TREATMENT.-When the child can breathe freely through the noise, the use of an elastic band (see Fig. 3), at night, over a period of six months, with appropriate general and medicinal treatment, may be sufficient.
The object of the elastic band is to hold the lower jaw up and to close the lips, so that the patient must breathe through the nose. If, however, the nose is so obstructed that insufficient passage is present for nasal respiration, or if the patient complain of ear-ache, the thorough removal of the adenoids by a surgeon is indicated. After the operation the elastic band must be worn for a time until nasal respiration is thoroughly established.
Of drugs that will be found useful are- Baryta, Carb., Calc- Carb., Phosphorus, Nat.-Mur., Psorinum. Sulph., Pulsatilla
The child’s general health must also be attended to in respect of good nourishing food, fresh air, and sunlight.