The Hawaiian gazette. [volume] (Honolulu [Oahu, Hawaii]) 1865-1918, 1878-05-15
Letter from DIR. TisdaIe.
NO..
THE NOSE

Few are aware how complex organ the nose is.
1t appears SO Simple, appendage to the face,
that its delicate mechanism is no. appreciated. Yet
fourteen bones and five cartilages combine to form
its skeleton, and these are covered with tissues
whose delicAcy is scarcely equaled by any in the
body. Il communicates with the throat, mouth,
eyes and brain. by distinct and separate passages.
1t opens into four cavities sinuses. Each nOstr
is divided into three meath or passages. by bones
which curl upon themselves and thus afford an
enormous surface for the ramifcations of the OIL
factory These bones being the superior, mid
die and inferior turbinated.
Nasal CatarEh.-No doubt repeated colds in the
heal frequently the cause Of catarrh. But we
would earnestly protest against the notion that
tarrh is ordinarily from this Catarrh de-
Ponds upon conditions, the appreciation of which
is understand in order the dis
ease successfully.
First it is 4 disorder of nutrition and often con-
nected with vitiated state Of the blood. Second it
is local arrangement of functional activity, in the
cells of the part affected. Hence, the which
lead to it very numerous, while local irritants
such impure air, dust, etc, frequent sources
Of the disorder, while arrangements of digestion
often provoke it, while it is often the out-growh Of
boil the lip abcess Of the gums more
frequently it is the result OF some systemic
stitutional disorder.
The consequences Of the disease serious both
locally aud remotely. Through the blood vessels
and lymphatics the poisonous matter is carried ntn
the circulation, and thus other surfaces
inhamed and diseased. BY contact the little mucous
folliees communicate the disorder their neghbors
aud thus the disease is prOpagated to the throat
bronchn and lungs; consumption is not unfre
queut issue. Locally it pain, heat and swell
ing of the fauces and palate, and thus difficulty Of
breathing and swallowing. The discharges "ay be
loose at first, but become hard and firmly attached
along the passage at last. Small ulcers form which
eat up the substance of the tissues. Deafness may
follow closure of the eusachian tubes by the foul
matter. And finally, it may the most viru-
lent form when the secretions become etid and pro-
fuse. They fall down into the stomach producing
nausea and vomiting. The alterations spread even
to softening and death Of the surrounding bones
The features become defprmed through the sinking
in Of the heshy parts of the face.
The condition Of the sufferer becomes revoltingy
offensive almost to isolate him from society, and
render him an object Of disgust to himself The dis
in this form is technically called " oZena"
Again, 1t may assume the form of heshy tumors
pEotruding from the sPongy bones Of the Which
are known as polYpi," or it may cause swelling
and induration of the tonsils called "tOnsilitis"
The Inflammation may extend into the neighburing
cavities, and closing them lead to dropsy and alb
cesses.
This is especially common with the sntrum, and
lastly, may produce neura gia of the face and dis
orders of the This catalogue of the immediate
sequences of chronic nasal catarrh is surely large
enough ana terrible enough to lead to an early at
tentiOn 10 its primary symptoms
The treatment of this disease has long been the
grouni of pure empiricsm The various snuifs and
lotions which have been sold for this purpose have,
however, had their day. Their absurdity rests upon
the anatomy of the organ, for they do not reach
at least but mperfecty, the upper and back part of
the passages where the disease really lies.
Through the aid Of the laryngO-scope, instru-
ment for examining the pOsterior parts Of the
and larynx, by means of rejecting mirrors, are
able to discover the particular spot of the trouble
and either by indicated vapors, the tonic effects of
electricity, the -pharyngea syringe the nasal
douche, to apply, directly the part the remedies
necessary But it should be borne in mind that the
local trouble is only symptom ordinarily of some
internal disorder. To prevent its and eff
feet permanent cure, the physician must employ
other than mere topical remedies 1t is through
neglect of this latter fact, attention being given
to the general health that few have derived per-
manent benefit FROM the treatment they have received.
1t seems almost Incredible that intelligent per-
will allow himself be afflicted with this oath-
disease, which Injuries his health and renders
him disgusting object to his friends, when most
can be radically and permanently cured.
Yours truly, L. P. TIsDALE, NJ. D.
Honolulu, May IL, l77S.