A few only, and the most important, may be mentioned: menthol, Eucalyptol, Calendula, Tar, Thuja, Carbolic acid, Aceto- tartrate of aluminum. By various means, liquid Petroleum will take into solution the drugs mentioned and act as a better medium than water, with the exception of the Aluminum-aceto-tartrate, which should be used in an aqueous solution.
Some specialists have seen quoted as using Menthol with Petroleum in the proportion of sixty grains to the ounce, and oil of Eucalyptus, one drachm to the ounce. This proportion I consider far too strong, as it is not only painful but irritating to the membrane. Menthol should not be used in a proportion to exceed ten grains to the ounce, and sometimes five grains will suffice.
Menthol is indicated in painful inflammatory affections, and where there is frequent erection of the mucous membrane, especially of that covering the turbinated bodies.
Eucalyptol (Sanders) should not be used stronger than half a drachm to the ounce, and, in some cases, ten drops are sufficient. It is indicated in inflammatory swellings of the mucous membrane, accompanied by excessive secretions.
Thuja, combined with Petroleum, has not been mentioned by Old-School specialists, yet it is one of the best local remedies we have. It is useful after operations to assist the healing process, and is also indicated where there is a discharge of offensive purulent mucus and ulceration and scabs in the nostril. It has also given satisfactory results, when not too strong, in dry coryza.
The Aceto-tartrate of aluminum may be used either in solution, in the proportion of one drachm to the ounce, or in combination with Boric acid; equal parts. It has styptic and antiseptic qualities, and is, therefore, used chiefly to arrest haemorrhage after operations and for its antiseptic qualities. It is, however, also useful in hypertrophic rhinitis, a rapid subsidence of the swelling being brought about by insufflations of this drug with Boric acid; equal parts, or one to two.
Hypertrophy of the mucous membrane, the turbinated bodies, may be reduced either by the galvano-cautery or some strong acid. I know of no acid that answers the purpose so well as the Trichloracetic. It has an advantage over all other acids of which I have any knowledge. The pain produced by the cauterization is insignificant; the eschar which is formed is uniformly thick, is almost inodorous, produces no unsatisfactory action, and leaves no unpleasant after-effects. Immediately after the application of the acid a bright ivory-white scab is formed, which remains localized to the point of application. This latter quality is of great advantage, as it does not spread to other parts, as do many delinquescent caustics; for instance, Chromic acid.
Special attention should be paid to keeping spray tubes and instruments clean, for back of the unclean instrument is an unclean and careless operator.
Having journeyed thus far with the Old-School specialist, operating possibly in the same manner and with the same kind of instruments, yet with different objects in view, come we to the place where we must part company.
The Old-School specialist, having finished the operation, and the healing process being completed, if the case is not entirely cured, has nothing else to resort to but local remedies. These, to often, fail to complete the cure.
On the other hand, the Homoeopathic specialist, having prepared his case for future Homoeopathic treatment, looks forward with confidence, knowing that he has a host of remedies which, if carefully selected and applied according to the principle of similia similibus curantur, will effect a permanent cure.
There is no branch of medicine in which greater laurels could be won for Homoeopathy, if we were not too conservative, than in this branch of rhinology.
After the obstructions have been removed, the remedies that will be found to give the best results are as follows:.
Belladonna-Throbbing headache; worse fro motion and leaning forward; tip of the nose red, with burning in the nose; discharge of mucus mixed with blood. Especially useful in the first and second work after operation.
Kali Bichromicum.-Frontal headache; formation of hard plugs in the nostrils; dryness of the nose; with a feeling of pressure at the root of the nose; tenacious, ropy discharge from the posterior nares, adhering to the pharynx and removed with difficulty.
Kali Iodatum.-Acts similarly to Kali bichromicum, except that the Kali iodatum patient has more hypertrophy of the mucous membrane of the nose; the threat is dry; the glands enlarged, or presenting some evidence of scrofulous or syphilitic taint.
Lobelia Cerulea.-Great depression of spirits; pain in the left side of the head and over the root of the nose; first, itching and tingling feeling in the left nostril, followed by frequent sneezing, with copious discharge of thick mucus from both nostrils; nostrils very sensitive, so that inhalation of air creates a slightly painful feeling. This remedy is especially adapted to such cases as are subject to catarrhal inflammation of the posterior nares and fauces, and in which there appear upon the posterior and lateral walls of the pharynx red elevated spots.
Passiflora Incarnata.-Distressing pain at the root of the nose; complete stoppage of one or both nostrils; discharge slight and thick; restless asleep.
Paris Quadrifolia.-Pain in the right temporal region, extending to the frontal sinus and root of the nose; discharge of red or greenish mucus on blowing the nose; stiffed condition and fulness at the root of the nose; constant hawking of tenacious mucus; fauces dry in the morning.
Hyoscyamus.-Buzzing and singing in the ears; sense of smell weak; jerking pain at the root of the nose; mucous membrane of the nose dry; this remedy is given by the Old-School when the secretions are excessive, and there is much restlessness- a few drops of the tincture being given; when the secretions are suppressed, especially after operations, it will give good results when given in the 3d or 6th potency.
Spigelia.-Pain in the temple or forehead, extending towards the eyes; discharge thin, copious, flows mostly through the posterior nares, causing choking at night, and when lying down; I have verified the latter symptoms in my practice repeatedly.
Senecio Aurens.-Inability to fix the mind on any one subject; dull, stupefying headache; secretions slight or suppressed; sneezing, burning and fulness in the nostrils-the burning being especially confined to the naso-pharynx; dryness of the mouth and pharynx; some pain in swallowing.
Thuja.-Pain at the root of the nose; ulceration and scabs in the nose; discharge of thick, sometimes offensive, green mucus, mixed with blood; red, itching eruption on the alae of the nose, which is frequently moist.
Wyethia.-Pain over the right eye; picking, dry sensation in posterior nares; sensation as if some foreign substance were in the nasal passages-an effort to clear them through the throat affords no relief; dryness of the fauces, with constant desire to clear the throat by hemming.
Besides these remedies, the following deserve due consideration: Arsenicum, Ars. iod., Calc. phos. Calc. carb. Calc. iod., Hepar., Hydrast. can.,, Hydrast. mur., Puls., Sepia, Bals. Peru.
As a general rule, the above remedies will be found sufficient. However, in particular cases, other remedies may have to be chosen.
In addition to the treatment given above, the nasal cavities should be cleansed once a day with some non-irritating solution, either with a douche, atomizer, or very small syringe.
I always advise the use of a small glass syringe, directing the patient, as the piston or rod is pushed in to gently snuff up the solution, propelling it along the nose to the naso-pharynx, cleansing this cavity, and allowing it to pass out through the mouth.
DISCUSSION.
GEORGE H. QUAY, M.D.: I like the ring of Dr. Teets’ paper. Would that every Homoeopathist in the land could read it and profit thereby.
There are two classes of men in our school: one, who thinks that every case he has demands an operation, and when he is unable to perform it must turn it over to and Old-School surgeon who will not even recognize him as a physician; the other class, who imagine that everything under the sun is amenable to internal medication-this is then class who, in the main, bring our school into disrepute. We accuse the Old-School of not investigating, when our won ranks are full of the same tribe.
The men in our school, possessing the largest experience in the treatment of catarrhal troubles of the upper respiratory track, are the ones who most readily acknowledge the need of surgical interference in these complaints. In fact, there is no rhinologist of extended experience but can adduce case after case of hypertrophic rhinitis that failed to obtain relief from internal prescribing alone, or combined with spray, until redundant tissue was removed. In the form of rhinitis just alluded to, the results following proper operative treatment are often little less than miraculous.
