A text-book of medical diagnosis / by James M. Anders and L. Napoleon Boston ; with 418 illustrations in the text and 25 plates, 17 of them in colors.

  • Anders, James M. (James Meschter), 1854-1936.
Date:
1911
Catalogue details

Licence: In copyright

Credit: A text-book of medical diagnosis / by James M. Anders and L. Napoleon Boston ; with 418 illustrations in the text and 25 plates, 17 of them in colors. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    39/1276 (page 33)
    Suppurative inflammation of tlie accessory nasal sinuses is usually due to staphylococcus aureus, to streptococcus pyogenes, or to some other pus- producing organism. In the diagnosis of diphtheria little confidence is to be placed on the ex- amination of stained smears made from the pseudomembrane. DISEASES OF THE NOSE. ACUTE RHINITIS. Pathologic Definition.—An acute catarrh of the Schneiderian membrane. This inflammation sometimes tends to involve the adjacent sinuses and passages. It is known to the laity as cold in the head. Predisposing and Exciting Factors.—Exposure to drafts and the influence of atmospheric vicissitudes that are especially prevalent during the winter and spring seasons are the most potent factors. Inhalation of irritants (physical, chemical, and biologic) is also capable of exciting inflam- mation of the nasal mucous surface. At times the disease may display some evidence of an infectious nature, and at such times may occur in epidemics. Direct extension from other mucous surfaces may be accountable for acute rhinitis. General Complaint.—Sensations of chilliness, succeeded by fever- ishness, are common complaints. Frequent sneezing, headache, and malaise are prominent features, and there are apt to be experienced in unusually severe cases muscular pains in the back and extremities. Thirst is increased, anorexia complete, and constipation often attends. One of the most annoying features to the patient is that of a somewhat profuse watery discharge from the nose, which is later followed by reddening and at times excoriation of the alse nasi. Lacrimation is apparently in- creased, and is probably due to irritation of the mucous surface of the lacrimal canals. Adjacent mucous surfaces may also become involved, givdng rise to conjunctivitis, catarrhal phar3aigitis, laryngitis, and, in the severe forms, bronchitis. Nasolabial herpes may be present. Physical Signs.—The pulse is frequent, the skin dry and unduly warm. The nasal mucosa is reddened and swollen, thus interfering with the sense of smell and taste, and with breathing. The color of the mucous surface is deepened. At first it is covered with an opaque mucus, and later with a muco-purulent secretion. As the affection progresses the secretion becomes more abundant and turbid. Course.—In favorable cases all annoying symptoms begin to diminish from the third to the fifth days. The nasal discharge usually continues for a longer period unless controlled by medication. Complications.—^The nasal inflammatory process may extend to the pharynx, larynx, and at times to the trachea and bronchi, in which instance the signs and symptoms of involvement of these surfaces are conspicuous. CHRONIC RHINITIS (CHRONIC NASAL CATARRH). Pathologic Definition.—A chronic inflammatory process involving the nasal mucous membrane and consisting pathologically of two distinct forms: (a) Hypertrophic, in which there is enlargement of the lower turbin- ated bones, together with reddening and swelling of the nasal mucosa that may be general or limited either to the anterior or posterior nares. 3