In long standing _coryza_ the nasal mucous membrane becomes relaxed,
fails to acquire its lost tone and continues to pour out a muco-purulent
product. This is really a persistence of inflammation of a low type,
under the influence of which the membrane secretes pus in place of its
normal mucus. The discharge is white, thick, creamy, has little
tenacity, and flows uninterruptedly. There may be slight enlargement of
the submaxillary glands, and if the case is of long standing and the
patient in low condition sores may appear on the mucous membrane. These
ulcers are distinguished from those of _glanders_ by the absence of the
unhealthy angry aspect and excavated borders of the latter, by the
absence of the small nodular deposits on the mucosa, by the less viscid
nature of the secretion, and by the absence of submaxillary swellings,
or if these exist, by their being less nodular, less indurated and less
firmly attached to surrounding parts. The coincidence of ulcers and
submaxillary swellings is always, however, matter for the gravest
suspicion, and such cases should, as a rule, be subjected to the mallein
test. (See Glanders and Farcy).
_Treatment._ In simple nasal catarrh, due alone to the relaxation of the
mucous membrane, the internal use of tonics and the local application of
astringent solutions to the nose rapidly restore the parts to a healthy
state.
Among _stimulants_, cubebs, cayenne pepper and copaiba have a
stimulating and styptic effect on the mucous membrane and each of these
has been successfully used in such cases. _Cantharides_, in five grain
doses, have proved even more successful, (Vines, Percivall). _Sulphate
of Copper_ in drachm doses in mucilage night and morning has proved very
efficient (Sewell, Percivall). _Arsenious Acid_ has been employed with
still better results. The dose, of five grains may be intimately mixed
with a scruple of bicarbonate of soda and given daily in food.[1]
Footnote 1:
In giving this agent, any redness or watering of the eyes, or colicy
pain should be carefully watched for, and when these premonitory
symptoms of poisoning are noticed the medicine should be at once
suspended to be commenced a few days later in smaller doses.
But the most efficient tonic in these cases is arseniate of strychnia.
Its good effects may be secured by combining with the above mentioned
powders of arsenious acid and bicarbonate of soda, half a drachm of
powdered nux vomica for each dose.[2] These powders will usually be
taken in food, and may be continued for a month, or until the discharge
ceases.
Footnote 2:
Whenever nux vomica or its alkaloids, strychnia or brucia, are given,
increased irritability and nervousness should be carefully watched for
and especially any involuntary twitching of the muscles. On their
appearance the agent must be suspended and commenced a few days later
in half the former doses.
In all cases the general health must be carefully attended to. Keep the
patient in a dry, clean, airy building without draughts of cold air;
give moderate exercise in the open air; and good grooming; and allow
nutritious food of mildly laxative properties,—as occasional bran mashes
and roots in winter and succulent grasses in summer.
_Local Applications._ These are the most important remedial measures and
usually of themselves succeed in reestablishing a healthy condition.
The agents proving most useful are of an astringent nature and in
obstinate cases one may be substituted for another as the last appears
to lose its effect. Sulphate of Zinc or Sulphate of Copper in the
proportion of half a drachm of either to a quart of water, may be used,
or if there is much fœtor, a solution containing a drachm each of
carbolic acid and carbonate of potash in a quart of water is to be
preferred. In either case the addition of an ounce of pure glycerine
renders the lotion at once more soothing and more efficient. The
solution must be rendered tepid before injecting it, to obviate the
irritation attending on the contact of a cold fluid with the delicate
membrane of the nose. Among other agents may be named creolin, creosol,
creosote, acetate of lead, potassium permanganate, and silver nitrate.
Peroxide of hydrogen may be used either as injection or in spray.
The mode of injection is a matter of no small moment. It has been done
in some instances by means of a large syringe but the irritation
attendant on such a process is an insuperable objection to its use. A
better instrument is that introduced by Professor Rey of Lyons. It
consists in a tube bent on itself at an angle of 35° so as to form two
arms of unequal lengths. The longer fifteen inches in length, one and a
half in diameter and widening into a funnel at its free end;—the shorter
about five inches long and tapering towards its free end where its
aperture is only two-thirds of an inch across. The instrument is made of
block tin or extemporaneously of gutta percha. Over the shorter arm is
placed a tightly fitting leather ring four and a half inches in diameter
on which is applied some wet tow to adapt it to the nostril and
effectually close it. The nose having been drawn in so as to place the
head in a vertical position, the short arm of the instrument is
introduced into the affected nostril, and the liquid being gently poured
into the long arm rises slowly in the nose until it is filled and the
liquid flows from the nostril on the opposite side. In introducing the
tube care must be taken that it may not irritate the inner wall of the
nose on the one hand, nor pass into the blind pouch, known as the _false
nostril_, on the other.
The greatest gentleness and tact are requisite in thus injecting the
nostrils, though in troublesome animals it is sometimes necessary to
resort to blindfolding or even to the application of a twitch on the
ear, or finally to strapping the animal (head included) to a smooth firm
vertical surface (operating table).