CASES OF SINUS DISEASE


In health the sinuses are sterile, being able to expel or destroy germs, but if the body resistance is lowered by cold or if neighboring tissues are inflamed, the sinus mucous membrane may become infected. Occasionally also infection is due to traumatism or the presence of a foreign body.


[ Read before I.H.A., Bureau of Clinical Medicine, June, 1944.].

One of the most trying affections to endure or to treat is that of sinus infection, a condition too often met with nowadays. It is especially prevalent in a damp climate like that in which I live. The Connecticut River Valley is full of sinus cases.

Next to climate the most important predisposing cause is probably lack of proper diet. Lack of vitamin A as found in carrots, squash, greens, and liver tends to produce the trouble.

Another very important cause of this affection is faulty dressing. The lack of protective covering for the body shown in the dressing of children and young women is a serious menace to health.

Among the local causes for sinus diseases may be listed:.

First: Lack of drainage and ventilation, due to adenoids, septic deviation, or the presence of foreign bodies; second, any condition causing stasis or congestion in the mucous membrane. This may be due to poor hygiene, poor ventilation, irritation from gases, vapors, or dust or ill-advised home or drug store remedies; third, the extension of some infection as from an acute coryza, tonsillitis, bronchitis, hay fever, etc.

In health the sinuses are sterile, being able to expel or destroy germs, but if the body resistance is lowered by cold or if neighboring tissues are inflamed, the sinus mucous membrane may become infected. Occasionally also infection is due to traumatism or the presence of a foreign body.

The presence of sinus disease is too often overlooked by general practitioners. Careful taking of history and symptoms and a clinical examination should lead to a correct diagnosis.

Some of the symptoms which point strongly to this condition are:.

1. Cessation of pain in the head with the onset of free nasal discharge.

2. Marginal blepharitis with corneal ulcers, excoriated upper lip and nasal discharge.

3. OEdema of eyelid from vascular pressure.

4. Localized headache.

a. Maxillary sinus, over antrum, over mastoid or superciliary ridge.

b. Frontal, forehead or, in more acute stage, the superciliary ridge.

c. Ethmoid, coronal or parietal.

d. Sphenoid, coronal, parietal or occipital.

5. Tenderness over the sinuses.

6. Purulent secretions from the nose.

7. Clear, jelly-like masses from the nose either anterior or posterior.

8. Swelling of glands of the neck.

Certain diseases call for sinus investigation, as arthritis, neuritis, asthma, deafness.

The treatment of sinus disease should consist first in the removal of the source of infection if it may be, and the use of proper hygiene and diet. Proper clothing, warm footwear for winter, good ventilation of rooms and sufficient sleep and exercise are most important. The diet should consist of plenty of butter, milk and eggs, fresh vegetables, fruit, especially oranges and not too much starch. In cold weather, it may be wise to add cold liver oil.

The medical treatment should be the prescription of the indicated remedy chosen from the totality of symptoms. Local treatment, especially surgical measures, should be avoided.

A few cases from my practice illustrate the variety of remedies used.

1. Mr. J. F., a lawyer, about 35, Now. 30, 1932. Has had sinus affection off and on for years. Coryza for 24 hours < right side. Acrid, watery discharge, sneezing from tickling < right, < in warm room. Feels better and discharge less in cool open air. Treatment: Ars. iod. 200. The remedy cleared up the case at once.

Another cold two months letter disappeared under the same remedy.

1934. Sept. 12. A year and a half after this he developed a right-sided cold from getting wet. Sneezing and lachrymation or right eye, > cool air. This improved at once on treatment: Sang. can. 1M.

Dec. 13, 1636. Two years and three months later he had a right- sided coryza, acrid, watery nasal discharge and right-sided lachrymation, tickling of the soft palate and sneezing. Treatment: Ars. iod. 200 in a.m. At 3 p.m., a severe pain began over the right frontal sinus. I gave him treatment: Sang. can. 1M. which improved conditions, but the next morning he seemed to need further help and Sang. can. 45M. finished the case.

Some months later after getting chilled he again had right-sided sinus pain and lachrymation. This time Sanguinaria did not relieve altogether. The pain was in a very small spot and Kali bi. 1M. helped promptly.

1940. May 3. Pain in small spot over right eye. Watery discharge from eye and nose. Treatment: Kali bi. 1M. This was not the similimum and in the afternoon I gave treatment: Sang. can. 45M. which improved matters for the following day, till evening. Then after being up for a time he developed an acrid discharge from the left eye with a bland nasal discharge. Treatment: Euphrasia 1 M. > at once.

The last time I treated him for sinus trouble was in January, 1941. He had pain over the right eye < hot bath. This disappeared under treatment: Ars. iod. 200.

II. G.P.H. Man in the forties, large and stout, referred by his physician in Boston. Earlier had local treatment for sinus but was converted to homoeopathy by its beneficent action. Now has a cold, postnasal discharge, very hard to remove. Treatment: Kali bi. 1 M. > this phase, but four days later he had a very severe throbbing pain in his left temple, extending through the eye. Pain began at 10 a.m. > pressure < cold air. Treatment: Nat. mur. 1 M. removed the pain promptly.

Eight months later he again had the pain after sleeping out-of- doors with uncovered head and Nat. mur. relieved again. In the nearly twenty years hence then, he has had a good many colds, but I think they have not affected the sinuses.

III. S.H.F. Daughter of II, brought up on homoeopathy, but after graduation from college entered a school for nurses and married an O. S. physician. During her training and since her marriage, she has had many attacks of coryza with inflammation extending to the sinuses.

Dec. 30, 1943. Got chilled yesterday. Cold began with stinging in posterior nares < right. Stinging in right eye < cold air < afternoon.

Now eyes hot, dull headache behind eyes, slight dropping in back of throat, treatment: Bell. 200.

Dec. 31. Head and eyes better, postnasal discharge yellow, right nostril stuffy with sneezing and tickling. Throat dry. Fullness over the antra. Treatment: Calc. carb. 200.

1944, Jan. 3. Three days later, postnasal discharge white, sneezing >, antra >. Throat dry and tingling with cough < talking. Treatment: Sac. lac.

Jan. 4. Next day. Much better. Condition cleared up.

Mar. 30. Reported continued improvement till five days ago, when she had sore throat followed by burning in posterior nares and sneezing, pain in sinuses < stooping. Thin acrid nasal discharge. Treatment: Bell. 200, which improved.

June 1. Reports a cold “off and on” for four weeks. A week of scratchy throat in the morning, then a paroxysmal cough from the throat < lying with postnasal drip; next congestion to the right ear with pain, better after a few hours but followed by stinging in the nose with acrid discharge. Now has pain on vertex and behind eyes, < stooping. Cough with greenish, sweetish expectoration, more on waking. Smell and taste diminished. Treatment: Calc. carb. 1 M.

June 3. Reports that she feels well. Is amazed at the change. She had been several times to the doctors at her hospital clinic and had been told that there was nothing to do — that she must just be patient. I think I made a mistake in not giving the 1 M. of calc. carb. at first.

IV. C. R. a Scotch woman in the sixties. Sinus trouble for many years. Has severe frontal pain > for free discharge of thick, purulent mucus. Treatment: kali bi. in potencies from 200th to 50 M. has kept her very comfortable.

V. Mrs. D., age 50, English. Menses now irregular. Hot flashes < night. Has two children — six and thirteen — and had four miscarriages between them. For twenty years has had infection of the left antrum < damp weather, warm or cold.

Dull pain extends to left ear and over left eye > warm applications < going in open air with uncovered head.

Discharge, thick, yellow or white, drops into throat and causes cough which is < deep breathing and dampness.

Wheezing respiration. Sleep only about four hours.

Treatment: Sepia 1M.

A week later the patient reported better sleep, no pain over sinuses and sense of pressure relieved. Wheezing >.

This is a case not easily cured because the patient does not trouble to report as long as she feels better, but I can truly say that she did improve locally and in general under Sepia. NORTHAMPTON, MASS.

DISCUSSION.

Dr. CARR: I fell into the sinus business unexpectedly, although being at a mental institution; but I find my greatest hope in a case of sinus to be sure of a strong general. Invariably a chronic case of sinus trouble of any duration is either sensitive to the heat or cold or some weather condition that affects the patient generally, so invariably I ask the question: Are you warm-blooded or cold-blooded, and in almost every case they say, “I am hot-blooded, excessively sensitive to the heat,” or else, ” I am very chilly and cool.”.

Right there I start my elimination and go right down the line to the particulars.

Dr. JACKSON: Regarding sinus conditions, we find in the majority of cases in the West, they are allergic; in other words, they are of a hayfever type. There are many of them, the majority of them perhaps, even complicated with asthmatic complications. Continuing with the absorption of the substance which is the aggravating factor, without a desensitization, hinders the action of the homoeopathic remedy very severely.

Desensitization in many of those cases is a very difficult problem because it isnt a single allergy; it is a multiple allergy and usually covers many, many fields.

DR. DIXON: I feel like rising to my feet again on this sinus affection. I have had lots of experience in it and Dr. Carr, I think, put his finger on the way of clearing them up, curing the patient of the sinus infections that are repeating over years — it is a pretty poor advertisement for the science of homoeopathy, I think. It should be cured. Oftentimes the background is tubercular. As I tell my new patients, a builder has to have a foundation. If you take a little time with the deep-acting remedies, the predisposing causes of aggravation, aggravated infections, you will clear up the cases and they dont repeat.

Tuberculinum is wonderfully good. Medorrhinum will come in so often you will be surprised, and Thuja is another one in the acute symptoms.

Dr. Stevens didnt mention one of my pets which might not be the one for the Connecticut Valley, but certainly is for Akron, Ohio, Spigelia.

Dr. MOORE: In those cold ones it is a good idea to keep Psorinum in mind. Sometimes that does very good work, and case management means quite a little. Take the youngsters off the candy, when they are eating a lot of candy. If you have them take cold bathing in the morning, starting in the summer and carrying it through to the winter. That will take care of the colds.

Dr. Stevens case of headache relieved by lying — that is also case management. Have them stop their lying.

Dr. STEVENS: Dr. Moore has a way of manufacturing interesting things, I think. I dont remember having said anything about headache was better lying.

DR. MOORE: Worse lying.

DR. STEVENS: I said worse stooping.

Dr. Dixon spoke of Spigelia. That is one of my favorite remedies for one-sided facial neuralgia. That may be often due to some sinus infection.

Grace Stevens