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lent catarrh. If we trace back the historv of any L.ise
of atrophic catarrh, we shall always find the history of
the "snotty-nosed child." The period of purulent
catarrh, when unaccompanied by proper treatment.
lasts from five to twelve years. That of hyperplasia
from eight to' ten years before the atrophic Stag
in. I have never found a case of atrophic catarrh
that I did not believe came from a case of purulent
catarrh, through its hyperplastic stage. We may not
always be able to trace their history through all the
-. yet it is a fact, notwithstanding, that the three
Diagnosis. — An anterior examination of the 1
« ill reveal the presence of more or less greenish-yellow
crusts. Thi 'resent an appearance which is
absolutely characteristic of atrophic catarrh, differ-
ing from th( nd in ulceration and ne<
which are mingled with blood, unhealthy pus. and ne-
t issue. These crusts are formed from the evap-
oration of the water of the thin secretion from the
atrophic membrane. If these crusts are not removed
but are allowed to remain they become very thick, anil
sometimes till up the entire nasal cavity. After re- rain dance slot free
maining in contact with the membrane for son*
1 the crusts and
membrance, which becomes very offensive. If the
ii or come off, and the cavity is thor-
oughly cleaned, the odor ceases, while in ozana from
tiarge is always offensive; also in
syphilitic ozaena. The mucous membrane is
January 2, 1S97]
ulcerated in atrophic catarrh. The appearance of the
nasal mucous membrane depends upon the length of
time that the atrophic stage has existed. In the early
period it is almost normal in appearance ; in the latter
periods its membrane rain dance slot presents almost a bloodless
appearance and adheres closely to the bone. The
bone sometimes appears -shrunken and the nasal cavi-
ties appear large and roomy.
Treatment. — The first thing in treatment of atro-
phic catarrh is to clean the nasal cavities of all crusts
and to see that they do not re-form. Without thorough
cleanliness nothing can be done to cure atrophic
["here seems to be a prevailing opinion among
physicians that atrophic catarrh cannot be cured: that
all that can be done is to keep the nose free from
crusts and give the patient temporary relief. Our
books and teachers tell us that this is all that can be
After a number of years' experience in the treatment
of atrophic catarrh I am prepared to say that not only
can it be relieved but it can be cured in almost every
case It will take long and persistent daily treat-
ment, extending over from one to three years. It is
not necessary for the physician to make the treatment
during all this time. With proper appliances the
patient will be able to do most of the work, calling
on the physician only once a week or once in two or
three weeks. For the first play rain dance slots few weeks the physician
should free rain dance slot machine make the treatments.
The crusts should not be removed by force. An
atomizer should be used with an antiseptic and alka-
line solution. Dobell's solution or some of its modi-
fications can be used for this purpose. Seller's tablets
answer a good purpose, but I prefer the following:
B kesorcin \ --.
Sodium bicarbonate gr. w.
Sodium biborate g
Glycerin § i.
Aqueous extract of hamamelis J ij.
Water enough to make half a pint.
This should be warmed and the nose thoroughlv
sprayed with it every day. I have a tablet made con-
taining five grains of resorcin and two grains each of
bicarbonate of sodium and biborate of sodium. ( Ine
of these tablets is dissolved in one ounce of water, or,
still better, in a saturated solution of hydronaphthol.
One of the foregoing solutions should be warmed
and the nasal cavities thoroughly sprayed with it at
least once rain dance slots free online every day. After the solution has been
I horoughly, the parts should be sprayed with
warm vaseline containing ten drops of campho-men-
thol and five drops of eucalyptol to the ounce. This
treatment should be persisted in till all the crusts
come away and are prevented from re-forming. Then
the patient is ready to play rain dance slot for free commence active treatment. If
the case is a mild one and not too far advanced, resor-
cin is one of the best app 1 use. The
resorcin wash should be used and then the nasal cav-
ity thoroughly sprayed with vaseline and resorcin (one
per cent.). As resorcin is insoluble in vaseline, it is
first dissolved in hot glycerin and then mixed with
the vaseline: in some cases thymol is also added in
the proportion of five grains to the ounce. This treat-
ment will clean the cavities thoroughly, ait as a 'lis
infectant, and promote the growth of healthy rain dance slot machine ti
In old advanced eases, in which the membrane has
atrophied to such an extent as to appear like parch-
ment, with little or no secretion, I get better results
with judicious use of trichloracetic acid.
I know of no remedy in the entire materia medica
that is SO useful in the treatment of all nose and
throat troubles as trichloracetic acid. Dr. Stein, of
Moscow, s.ivs that in solution of 1 to 500-2.000 it
will keep all suppurativa - in abeyance for
a week. In weak solutions it is one of the best anti-
septic remedies that I ever employed, and it also causes
stimulation to atrophic membrane to a greater extent
than any other application with which I am acquainted.
Dr. Stein says: "Weak solutiuns of trichloracetic
acid used in the nose in simple atrophic rhinitis for a
considerable time sometimes produce such a decided
hypertrophy of the turbinated membranes that it may
become necessary to cauterize diem in order rain dance slot review to secure
free breathing. No other medicine of which I am
cognizant produces such a remarkable effect, and thus
this agent is particularly applicable in the treatment
of ozena. In true ozena I now apply stronger solu-
tions than I did at first, i.e., one-half to ten per cent.
The odor is not so rain dance slots download quickly nor so thoroughly abol-
by any other medicinal agent as by the acid.
Here it is certainly a specific."
From my use of* trichloracetic acid during the past
six years I agree with Dr. Stein in every particular. I
keep a number of solutions of the acid on hand, vary-
ing from one to fifty per cent. After the nose is thor-
oughly cleansed with the resorcin solution, the part is
dried with absorbent cotton, and then a two-per-cent.
solution is applied on a probe with cotton to the
diseased membrane: the strength is increased as the
effect becomes less active, spraying afterward with
the vaseline and resorcin.
We sometimes find a portion of the mucous mem-
brane entirely denuded of epithelium and in which the
glands are all destroyed, leaving a thin dry layer of
membrane covering the bone. In these cases the
treatment mentioned will not stimulate the part nor
cause new epithelium to cover the atrophic part. In
such cases it is necessary to stimulate the edges of the
diseased part and cause the mobile leucoevtes to rain dance slot game col-