Good Health and Bad Medicine:
Colds - Part 1
Colds - Part 2
Colds - Part 3
Mouth Washes And Bad Breath
Sinuses And Sinusitis
Asthma And Hay Fever
Read More Articles About: Good Health and Bad Medicine
( Originally Published 1940 )
THERE are two facts that one should bear in mind with respect to the use of medicines in the treatment of nasal disorders. The first is that the mucous membrane of the nose is a structure of great complexity which no solution, vapor, liquid, drops, spray or salve can disinfect. The second is that in a "cold" the congestion of the nose is simply one symptom, though a troublesome one, of a general, systemic infection and that the most effective treatment for a general infection is rest.
That the nose cannot be disinfected has been long known. Doctors never attempt to disinfect the nose in the treatment of nasal disorders because disinfectants which are strong enough to be efficient will paralyze and burn, or otherwise injure the nasal lining. In weaker concentrations these disinfectants are inefficient and therefore useless. Doctors also know that the tissues of the body will overcome an infection if the general health is good. The most that they expect from any medicine for such disorders is that it may provide a slight protection to a raw surface or diminish a patch of congestion. It is known, too, that the indiscriminate use of salves and drugs in treatment of nasal disorders can be responsible for the spread of infection to sinuses, ears, mastoids and throat.
We have already emphasized the danger of "lipoid pneumonia" following the use of oily preparations in the nose, especially in young children (see Colds, page 42). This is a real danger, recognized now by every up-to-date doctor and public health official.
Besides the danger of lipoid pneumonia, there is also the danger that oils will carry into the lungs the germs which are normally so abundant in the nasal passages. Although one is not normally conscious that the oil is dropping into the lungs, it has been demonstrated time and again that any solution dropped into the nose has a tendency to settle into the lungs. And since bacteria are present in great numbers during an infection, the solution carries, many germs with it. This tendency to carry germs into the lungs is true not only of oils but also of other solutions containing Neo-Silvol, Argyrol and other so-called antiseptics.
There is then a double hazard in the instillation of drops into the nose. Preparations containing mineral oil may cause either lipoid pneumonia or infection of the lungs, or both. Preparations made up of watery solution of "antiseptics," such as Neo-Silvol and Argyrol, may cause infection and irritation of the lungs.
The safest medicaments for administration into the nose are "isotonic" solutions of drugs known as vaso-constrictors. These drugs tend to diminish congestion and swelling, and thus permit drainage of secretions and nasal breathing. A good vaso-constrictor is neo-synephrin in watery solution. It has a prolonged effect, and it appears to interfere little with protective activity of the hairlike cilia in the nose. A 1/2 % isotonic solution is sufficient. Ephedrine in ½% to 1% isotonic solution ranks next in effectiveness and safety. Propadrine i % in watery solution, and Benzedrine are the newest of the vaso-constrictor drugs. The Benzedrine inhaler is convenient to use. However, it can produce toxic reactions even in small doses and should, therefore, be used with caution. The oily solution of Benzedrine for dropping into the nose is not as safe as the isotonic solutions of neo-synephrin, ephedrine and propadrine.
All vaso-constrictor fluids should be purchased as isotonic solutions. An isotonic solution means a solution equal in concentration of salt to that of the tissue fluids. An isotonic solution will have the least irritating effect upon the mucous membrane.
The mode of administration of these solutions was de-scribed in the chapter on "Colds." They may be used as drops or sprays. It should be remembered, however, that with all their virtues, the most these solutions can do is to provide temporary relief of congestion. And frequently they will irritate and increase the congestion. They will never prevent or cure a cold or a nasal infection.
A word about swimming. Most swimming water, especially in pools, contains the washings of the mouths and nasal pas-sages of the persons in the water. Infectious material from one's own nose, mouth or gums may be washed or forced into lungs or middle ear. Forceful blowing of the nose after emerging from the water will also facilitate the development of infections of the nose, ears, sinuses and throat. This tendency to infection can be avoided somewhat by refraining from blowing of the nose while in the water or immediately after emerging from the water. Simply allow the water to drain from the nose.