Rhinology, laryngology and otology and their significance in general medicine.

  • Friedrich, Ernst Paul.
Date:
1900
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Licence: Public Domain Mark

Credit: Rhinology, laryngology and otology and their significance in general medicine. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    small numbers penetrate into the deeper portions of the nose. The question whether the nose contains germs under normal conditions has a practical bearing. There have been found the staphylococcus pyogenes aureus, the pneu- mococcus of Friedlander, the streptococcus, the diplococ- cus of Frankel-Weichselbaum, diphtheria bacilli, and count- less other bacteria of less importance, and Straus has shown that tubercle bacilli are frequently present in the noses of healthy individuals living among phthisical patients. But it is a matter of everyday observation that injuries or operative wounds in the nose usually heal without causing any, or at any rate very little, general disturbance, in spite of the apparent danger from infection which should result from the presence of such large numbers of bacteria. The explanation of this want of virulence on the part of the germs in the nasal cavities has been sought in a bactericidal quality of the mucous secretions. This was assumed by Wurtz and Lermoyez,^ but Thomson and Hewlett found that the^nasal mucus is not directly bactericidal, although it arrests the growth of germs to a certain extent. It is idle, in the absence of exact proofs, to discuss this question of the bactericidal powers of the secretion. The most that can be said is that it is not a favorable soil, and hinders the development of the microorganisms more or less. The conditions in this respect are evidently analogous to those found in the oral cavity, which contains even a greater abundance of bacteria. The mere presence of germs is not in itself injurious to the nose ; other factors must be taken into account: the number and virulence of the pathogenic germs which gain entrance ; the disposition of the individ- ual ; and the presence of other bacteria, which either assist or retard the growth of the pathogenic varieties. 2 and 3. Warming and Saturation of the Inspired Air. —It has been proved by the experiments of Aschenbrandt and of R. Kayser,^ that the temperature of the air-current during its passage through the narrow chambers of the nose is raised to from 25° to 35° C, depending on the external temperature. It would, however, be wrong to suppose that this function of the nose is indispensable for breathing ; Ka}'ser has shown that the inspired air is ^ Ann, des mal. de roreille, 1893, p. 661. 2 Pfliiger's Archiv, vol. XI.I.