A handbook of local therapeutics / edited by Harrison Allen.

Date:
1893
Catalogue details

Licence: Public Domain Mark

Credit: A handbook of local therapeutics / edited by Harrison Allen. Source: Wellcome Collection.

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    forms in which the parts are atrophied are often distended in parts with venous blood. However we may explain the fact, the conclusion is tern- perate that in both of the above-named forms of chronic nasal disease the local loss of blood not infrequently is followed by marked benefit to the patient. In Hypertrophic Catarrh the blood is removed by pricking here and there the distended surfaces. This ordinarily is best accomplished at the anterior end of the inferior or of the middle turbinated bone, as well as the region which answers to the line of junction of the triangular cartilage with the perpendicular plate of the ethmoid bone. In Atrophic Catarrh the points to be selected for depletion are almost uniformly on the septum, pretty well up and directly in front of the middle turbinated bone. In order to obtain relief the parts must bleed rather freely, that is to say, from two drachms to a half ounce or even an ounce. The hemor- rhage generally stops spontaneously. If the parts are depleted a second or third time—in intervals let us say of a week—the amount of blood lost is never so large as at the first bleeding. In lithgemic persons, particularly in high livers, it is remarkable how prompt and permanent is the relief which is sometimes obtained by single bleeding. So far as we have observed subjects of the class named generally exhibit the signs of catarrh of the congested hypertrophic type. Some forms of Tinnitus Aurium accompanied with congested states of the ears are best treated by local depletion from the middle turbinal at its posterior part. The parts selected should be thoroughly cocainized and the knife carried well back to the end of the turbinal as seen from in front. The temporary character of the benefit in this way secured indi- cates that a tinnitus due to structural changes in the middle ear is greatly intensified by the condition of the associated vessels. We are led to believe that a great deal of the relief which is obtained by intra-nasal operation, especially in conditions where the amount of interference seems to be out of proportion to the results obtained, can be attributed to the free loss of blood which accompanies the operation. W. C. Glasgow {Trans. A.^Laryng. Ass'n, 1887, 150) recommends systematic depletion of the nasal mucous membrane for Frontal Head- ache of congested type, associated with nasal disease. A simple bleed- ing may serve to relieve the headache, or the bleeding may have to be repeated in a week or a month. Dr. Glasgow has seen few cases which were not relieved by such local extraction of blood. The amount lost at each sitting rarely exceeded one ounce. W. H. Daly {Trans. Am. Laryng. Ass'n, 1888, p. 192) resorts to systematic depletion of the nasal mucous membrane in Chronic Nasal Catarrh, extracting from one-half to three ounces of blood at a sitting. He reports by this unaided treat- ment results of reduction of tissues, restoring normal nasal respiration. Scarification is often resorted to for relief of tension and pain in Acute