In consequence of repeated attacks of acute catarrh, or "cold in the head," as it is usually termed, the mucous membranes of the nose and the air-passages of the head become permanently thickened, the mucous follicles or glands diseased, and their functions either destroyed or very much deranged. Although chronic catarrh is most commonly brought on in the manner above stated, it sometimes makes its appearance as a sequel of typhoid fever, scarlet fever, measles, or other eruptive fevers, or shows itself as a local manifestation of scrofulous or syphilitic taints in the system.

Injury to the nose may result in a displacement of one or more of the bony structures, setting up a chronic inflammation with catarrh at that point. In the early stages of the disease, the patient may be annoyed with "only a slight dropping into the throat," as many express it, the amount of the discharges from the air-passages of the head at this stage of the disease being only slightly in excess of health. In some cases the discharge is thick, ropy, and tough, requiring frequent and strong efforts in the way of blowing and spitting, to remove it from the throat, in which it frequently lodges. In other cases, or in other stages of the same case, the discharge is thin, watery, acrid, irritating, and profuse. The nose may be "stopped up" from the swollen and thickened condition of the lining mucous membrane, so as to necessitate respiration through the mouth, giving to the voice a disagreeable nasal twang. From the nature of the obstruction in this condition, it is useless for the sufferer to endeavor to clear the passage by blowing the nose; this only tends to render a bad matter worse, by increasing the irritation and swelling of the already thickened lining membrane. The swelling of the mucous membrane does not in all cases become so great as to cause obstruction to respiration through [pg 475]the affected passages. In some cases, the patient suffers from head ache a great portion of the time, or experiences a dull, heavy, disagreeable fullness or pressure in the head, with a confusion of his ideas, which renders him quite unfit for business, especially such as requires deep thought and mental labor. Memory may be more or less affected, and the disposition of those who are otherwise amiable is often rendered irritable or morose and despondent. The mental faculties suffer to such an extent in some cases as to result in insanity. The sense of smell is in many cases impaired, and sometimes entirely lost, and the senses of taste and hearing are not unfrequently more or less affected.

OzÆna. The ulcerous or more aggravated stage of the disease, from the offensive odor that frequently attends it, is denominated OzÆna.

The secretion which is thrown out in the more advanced stages of chronic catarrh becomes so acrid, unhealthy, and poisonous, that it produces severe irritation and inflammation, which are followed by excoriation and ulceration of the delicate membrane which lines the air-passages in the head. Although commencing in this membrane, the ulceration is not confined to it, but gradually extends in depth, until it frequently involves all the component structures of the nose—cartilage and bone, as well as fibrous tissues. As the ulceration extends up among the small bones, the discharge generally becomes profuse and often excessively fetid, requires the frequent use of the handkerchief, and renders the poor sufferer disagreeable to both himself and those with whom he associates. Thick, tough, brownish incrustations, or hardened lumps, are many times formed in the head, by the evaporation of the watery portion of the discharge. These lumps are sometimes so large and tough that it is with great difficulty that they can be removed. They are usually discharged every second, fourth, or fifth day, but only to be succeeded by another crop. Portions of cartilage and bone, or even entire bones, often die, slough away, and are discharged, either in large flakes, or blackened, half-decayed, and crumbly pieces; or, as is much more commonly the case, in the form of numerous minute particles, that escape with the discharge and are unobserved. It is painfully unpleasant to witness the ravages of this terrible disease, and observe the extent to which it sometimes progresses. Holes are eaten through the roof of the mouth, and great cavities excavated into the solid bones of the face; in such cases only the best and most through treatment will check the progress and fatal termination of the disease.

COMPLICATIONS.

Catarrh, or OzÆna, is liable to be complicated, not only by the system, blood, and fluids, suffering from scrofulous or other taints, as has already been pointed out, but also by an extension of the diseased conditions to other parts beyond the air-passages of the head.

Occasionally deformities of the septum or other internal structures [pg 476]also polypi or tumors, are sources of constant irritation and accelerate catarrhal disease.

Disease of the Throat. The acrid, irritating and poisonous discharge, which, in some stages of disease, almost constantly runs down over the delicate lining membrane of the pharynx (throat), is liable to produce in this sensitive membrane a diseased condition similar to that existing in the air-passages of the head. The throat may feel dry, husky, and at times slightly sore or raw; or, from the muco-purulent discharge that is almost constantly dropping down over its surface, the patient may feel very little inconvenience from the disease of the throat until it is far advanced—the moistening and lubricating effect of the matter that drops on the surface tending to blunt the sensibility of the parts. (See pharyngitis for symptoms and treatment.)

The Extension of the Disease to the Larynx. The larynx, situated directly below the pharynx (throat), is subjected to the influence of the same irritation from acrid and poisonous discharges dropping into the throat from the head. More or less of it is removed by hawking and spitting, but some remains and is drawn into the larynx, or still lower into the trachea (windpipe), with the inspired air. Thus the disease creeps along the continuous mucous surfaces of the air-passages, the acrid poisonous discharge arousing in its track the irritation, inflammation, ulceration, and thickening of the lining membrane which characterize the disease in other portions of the air-passages. The symptoms and treatment of laryngitis will be found under its appropriate classification.

Bronchitis and Consumption. We have already detailed the manner in which the throat, larynx, and trachea, in succession, become affected from catarrh, or OzÆna. By the same process of extension, the bronchial tubes, and lastly, the parenchyma, or substance of the lungs, in their turn, become diseased, and bronchitis and consumption are firmly established. Tightness in the chest, with difficulty of breathing; soreness; darting, sharp, or dull, heavy pain, or a prickly, distressing sensation, accompanied with more or less cough and expectoration—are evidences that the bronchial tubes have become affected, and they should admonish the sufferer that he is now standing on the stepping-stone to CONSUMPTION, over which thousands annually tread, in their slow journey to the grave.

Illustration: Fig. 8. Internal and external ear.
Fig. 8. Internal and external ear. 1, External ear. 2, Internal auditory meatus. 3, Tympanum. 4, Labyrinth. 5, Eustachian tube.

Deafness. By means of a small canal, called the eustachian tube, an air-passage and communication between the throat and middle ear is formed. (See Fig. 8.) This passage is lined by a continuation of the mucous membrane which covers the throat and nasal passages. The catarrhal inflammatory process, by continuity of surface, follows the mucous membrane, thickening its structure, until the eustachian tube is closed, and the beautiful mechanism of the internal ear is rendered useless. While the thickening of the mucous membrane is going on, and the passage is gradually becoming closed (and [pg 477]the process sometimes extends through several years), the patient will occasionally, while blowing the nose, experience a crackling in one or both ears, and hearing becomes dull, but returns suddenly, accompanied with a snapping sound. This may be repeated many times, until, finally, hearing does not return, but remains permanently injured. In other cases the hearing is lost so gradually that a considerable degree of deafness may exist before the person is really aware of the fact. Either condition is often accompanied with noises in the head of every conceivable description, increasing the distress of the sufferer. The delicate bones of the ear are sometimes detached from their articulations, the drum is ulcerated and perforated, and through the orifice thus made, the bones or small spiculÆ may escape with the thick, purulent, and offensive discharge.

Closure of the Tear Duct. The lachrymal duct, or passage (tear duct), which, when in a healthy condition, serves to convey the tears from the eye into the nose, may be closed by the same inflammatory and thickening process which we have already explained. This condition is usually attended with watery and weak eyes, the tears escaping over the cheeks, and sometimes producing irritation and excoriation. The nasal branch of the ophthalmic nerve sometimes participates in the ulceration going on in the head, so that the eyes are sympathetically affected. They sometimes become congested or inflamed, and sharp pain in the eyeballs may be experienced.

Indigestion, Dyspepsia, Etc. A large portion of the acrid, poisonous, purulent discharge, which drops into the throat during sleep, is swallowed. This disturbs the functions of the stomach, causing weakness of that organ, and producing indigestion, dyspepsia, nausea, and loss of appetite. Many sufferers complain of a very distressing "gnawing sensation" in the stomach, or an "all gone," or "faint feelings," as they often express it.

Symptoms. Dull, heavy headaches through the temples and above [pg 478]the eyes; indisposition to exercise; difficulty of thinking or reasoning, or concentrating the mind upon any subject; lassitude; indifference respecting business, lack of ambition or energy; obstruction of nasal passages; discharges voluntarily falling into the throat, sometimes profuse, watery, acrid, thick and tenacious, mucous, purulent, muco-purulent, bloody, concrete blood and pus, putrid, offensive, etc. In others, a dryness of the nasal passages: dry, watery, weak, or inflamed eyes; ringing in the ears, deafness, discharge from the ears, hawking and coughing to clear the throat, ulcerations, death and decay of bones, expectoration of putrid matter, spiculÆ of bones, scabs from ulcers leaving surface raw, constant desire to clear the nose and throat, voice altered, nasal twang, offensive breath, impairment or total deprivation of the sense of smell and taste, dizziness, mental depression, loss of appetite, nausea, indigestion, dyspepsia, enlarged tonsils, raw throat, tickling cough, difficulty in speaking plainly, general debility, idiocy, and insanity.

All the above symptoms, as well as some others which have been previously given, and which it is not necessary here to repeat, are common to this disease in some of its stages or complications; yet thousands of cases annually terminate in consumption or chronic bronchitis, and end in the grave, without ever having manifested one-half of the symptoms enumerated.

Varieties. People often suppose that there are a great many varieties or species of catarrh. This is an error. The nature of the disease is the same in all cases, the symptoms only varying with the different stages of the disorder, and the various complicated conditions which are liable to arise, and which have already been pointed out.

Causes. Anything which debilitates the system, or diminishes its powers of evolving animal heat and withstanding cold or sudden changes of atmospheric temperature, and other disease-producing agencies, renders the individual thus enfeebled very liable to catarrh. Among the most common debilitating agencies are a scrofulous condition of the system, or other impurities of the blood, exhaustive fevers, and other prostrating acute diseases, or those badly treated; exhaustive and unnatural discharges, intemperance, excessive study, self-abuse, adversity, grief, want of sleep, syphilitic taints of the system, which may have been contracted unknowingly, or may have been inherited, having perhaps been handed down even unto the third or fourth generation, to an innocent posterity from infected progenitors; too sudden rest after great and fatiguing exercise, and living in poorly-ventilated apartments. These are among the most fruitful causes of those feeble, deranged, or impure conditions of the system to which catarrh so frequently owes its origin. Although the immediate or exciting cause is generally repeated attacks of "cold in the head," which, being neglected or improperly treated; "go on from bad to worse," yet the predisposing or real cause of the disease is in the majority of cases, [pg 479]an enfeebled, impure, or otherwise faulty condition of the system, which invites the disease, and needs only the irritation produced in the nasal passages by an attack of cold, to kindle the flame and establish the loathsome malady. Some people are convinced with difficulty that there exists in their system a weakness, impurity, or derangement of any kind, which permitted the disease to fasten itself upon them. They may not feel any great weakness, may not have any pimples, blotches, eruptions, swellings, or ulcers, upon their whole person; in fact, nothing about them that would, except to the skilled eye of the practical and experienced physician, indicate that their system is weakened or deranged with bad humors; and yet such a fault may, and generally does, exist. As an ulcer upon the leg, or a "fever-sore," or an eruption upon the skin, may be the only outward sign of a fault in the system, so frequently chronic catarrh is the only sign by which a bad condition of the system manifests itself in a manner that is perceptible to the sufferer himself, or to the non-professional observer. The finely-skilled physician, whose constant practice makes his perceptive faculties perfect in this direction, would detect the constitutional fault, as an experienced banker detects a finely-executed and dangerous bank-note which the unpracticed eye would pronounce genuine.

Illustration: Fig. 9. Examination of the Nasal Passages by means of the Rhinoscope and Head Mirror.
Fig. 9. Examination of the Nasal Passages by means of the Rhinoscope and Head Mirror.

Treatment. If you would remove an evil strike at its root. As the predisposing or real cause of catarrh is, in the majority of cases, some weakness, impurity, or otherwise faulty condition of the system, in attempting to cure the disease our chief aim must be directed to the removal of that cause. The more we see of this odious disease, the more so we the importance of combining; with the use of a local, soothing [pg 480]and healing application, a thorough and persistent internal use of blood-cleansing and tonic medicines.

As a local application for healing the diseased condition in the head, Dr. Sage's Catarrh Remedy is beyond all comparison the best preparation ever invented. It is mild and pleasant to use, producing no smarting or pain, and containing no strong, irritating, or caustic drug, or other poison. Its ingredients are simple and harmless, yet when scientifically and skillfully combined, in just the right proportions, they form a most wonderful and valuable healing medicine. Like gunpowder, which is formed of a combination of saltpeter, sulphur, and charcoal, the ingredients are simple, but the product of their combination is wonderful in its effects. The Remedy is a powerful antiseptic, and speedily destroys all bad smell which accompanies so many cases of catarrh, thus affording great comfort to those who suffer from this disease.

The reader's mind cannot be too strongly impressed with the importance of combining thorough constitutional with the local treatment of this disease. Not only will the cure be thus more surely, speedily, and permanently, effected, but you thereby guard against other forms of disease breaking out, as the result of humors in the blood or constitutional derangement or weakness.

In curing catarrh and all the various diseases with which it is so frequently complicated, as throat, bronchial, and lung diseases, weak stomach, catarrhal deafness, weak or inflamed eyes, impure blood, scrofulous and syphilitic taints, the wonderful powers and virtues of the "Golden Medical Discovery" cannot be too strongly extolled. It has a specific effect upon the lining mucous membranes of the nasal and other air passages, promoting the natural secretion of their follicles and glands, thereby softening the diseased and thickened membrane, and restoring it to its natural, thin, delicate, moist, healthy condition. As a blood-purifier, it is unsurpassed. As those diseases which complicate catarrh are diseases of the lining mucous membranes, or of the blood, it will readily be seen why this medicine is so well calculated to cure them.

The "Golden Medical Discovery" is the natural "helpmate" of Dr. Sage's Catarrh Remedy. It not only cleanses, purifies, regulates, and builds up the system to a healthy standard, and conquers throat, bronchial, and lung complications, when any such exist, but, from its specific effects upon the lining membrane of the nasal passages, it aids materially in restoring the diseased, thickened, or ulcerated membrane to a healthy condition, and thus eradicates the disease. When a cure is effected in this manner it is permanent. The system is so purified, regulated, and strengthened, as to be strongly fortified against the encroachments of catarrh and other diseases. The effects of the "Golden Medical Discovery" upon the system will be gradual, and the alterative changes of tissue and function generally somewhat slow. They are [pg 481]with however, less complete, radical, and lasting; and this constitutes its great merit. Under its influence all the secretions are aroused to carry the blood-poisons out of the system, the nutrition is promoted, and the patient finds himself gradually improving in flesh; his strength is built up, his lingering ailments dwindle away, and by and by he finds his whole person has been entirely renovated and repaired he feels like a new man—a perfect being.

Illustration: Fig. 10. Atomizer.
Fig. 10. Atomizer.

The Clothing. With most persons suffering from chronic nasal catarrh, there is a great disposition to take cold, even slight cause being sufficient to produce an acute attack, which greatly aggravates the chronic affection and operates to render it permanent. To obviate the bad effects that are liable to result from this predisposition, great attention should be paid to the clothing, that it thoroughly protects the person from sudden changes of temperature. For more particular and practical suggestions in regard to this matter, the reader is referred to the article on Clothing, in Part Two, Chapter II, of "The People's Common Sense Medical Adviser."

The Diet has an important influence with this disease, as with consumption and many other chronic ailments. It should be largely composed of those articles rich in the non-nitrogenized or carbonaceous elements. Fat meats, rich, sweet cream, good butter, and other similar articles of food, should comprise a large part of the diet. These elements, which are prolific in the production of animal heat counteract the predisposition to take cold, and thus become most valuable remedial agents—not less essential than the medical treatment that has been advised. The patient, suffering from chronic catarrh, should study well the hygienic teachings to be found in Part Two of "The People's Common Sense Medical Adviser," and govern himself accordingly.

Treatment of Complications. There are various complications of this disease that require modifications of the treatment to meet them successfully. The rules cannot be made that would enable non-professional readers to vary the treatment to suit peculiarities of constitution, or complications of the disease. When consulted, either the person or by letter, we have been able to so modify the treatment as to be adopt it to peculiar individuals which rejected the ordinary treatment, [pg 482]and have thus cured hundreds who had otherwise failed to find relief.

In the abdomen the sympathetic centers are situated upon the coeliac artery, and are termed, collectively, the semilunar [pg 104]coeliac ganglion. Numerous inosculating branches radiate from this center and are called, from the method of their distribution, the solar plexus. From this, also, originate other plexi which are distributed to the stomach, liver, kidneys, intestines, spleen, pancreas, supra-renal glands, and to the organs of generation. Four other pairs of abdominal ganglia connected with, the lumbar branches are united by filaments to form the semilunar ganglion.

The sympathetic ganglia of the pelvis consist of five pairs, which are situated upon the surface of the sacrum. At the extremity of the spinal column this system terminates in a single knot, designated as the ganglion impar.

Owing to the position of the sympathetic ganglia, deeply imbedded in the tissues of the chest and abdomen, it is exceedingly difficult to subject them to any satisfactory experiments. A few isolated facts form the basis of all our knowledge concerning their functions. They give off both motor and sensory filaments. The contraction of the iris is one of the most familiar examples of the action of the sympathetic system.

In the reflex actions of the nerves of special sense, the sensation is transmitted through the cerebro-spinal system, and the motor impulse is sent to the deep-seated muscles by the sympathetic system. Physiologists enumerate three kinds of reflex actions, which are either purely sympathetic, or partially influenced by the cerebro-spinal system. Dr. Dalton describes them as follows:

First.—"Reflex actions taking place from the internal organs, through the sympathetic and cerebro-spinal systems, to the voluntary muscles and sensitive surfaces.—The convulsions of young children are often owing to the irritation of undigested food in the intestinal canal. Attacks of indigestion are also known to produce temporary amaurosis [blindness], double vision, strabismus, and even hemiplegia. Nausea, and a diminished or capricious appetite, are often prominent symptoms of early pregnancy, induced by the peculiar condition of the uterine mucous membrane."

Second.—"Reflex actions taking place from the sensitive surfaces, through the cerebro-spinal and sympathetic systems [pg 105]to the involuntary muscles and secreting organs.—Imprudent exposure of the integument to cold and wet, will often bring on a diarrhea. Mental and moral impressions, conveyed through the special senses, will affect the motions of the heart, and disturb the processes of digestion and secretion. Terror, or an absorbing interest of any kind, will produce a dilatation of the pupil, and communicate in this way a peculiarly wild and unusual expression to the eye. Disagreeable sights or odors, or even unpleasant occurrences, are capable of hastening or arresting the menstrual discharge, or of inducing premature delivery."

Third.—"Reflex actions taking place through the sympathetic system from one part of the body to another.—The contact of food with the mucous membrane of the small intestine excites a peristaltic movement in the muscular coat. The mutual action of the digestive, urinary, and internal generative organs upon each other takes place entirely through the medium of the sympathetic ganglia and their nerves. The variation of the capillary circulation in different abdominal viscera, corresponding with the state of activity or repose of their associated organs, are to be referred to a similar nervous influence. These phenomena are not accompanied by any consciousness on the part of the individual, nor by any apparent intervention of the cerebro-spinal system."

[pg 106]