Definition

A lasting discharge from the nasal chambers, of varying quantity and character. When accompanied by an offensive odour it is known as ozoena.

Causes

Chronic discharges from the nostrils are usually the sequel of catarrh, in some cases resulting from cold, in others from influenza or strangles, from which the patient has been brought low in condition and made but a tardy recovery.

The membranes high up in the facial cavities have entered upon a chronic low form of inflammatory action, by which an unhealthy secretion is formed, which, when retained, appears to aggravate the condition. If the disease is confined to the nasal chambers only, the prospect of restoration to a healthy state is much greater than when the sinuses of the face which communicate with them are the seat of unhealthy action. When this is the case, the matter may accumulate and become so thick as to make removal only possible by a surgical operation. In coal-mines the habitual inhalation of dust and unwholesome air is said to cause nasal gleet, as does also the foul conditions found on shipboard. Quite a large proportion of seaborn horses suffer from catarrh, and a greater proportion of cases of chronic nasal discharge are found anions; these horses than result from catarrh con-tracted in the usual way. In addition to the causes stated, nasal gleet not unfrequently arises out of a diseased condition of the fangs of the teeth and of the bones of the facial region.

Symptoms

When of recent date the discharge is thick and opaque, as in the later stages of catarrh or common cold, but as it becomes a settled condition it is subject to great variations, not only in respect of its consistence and character, but also as to the amount discharged. In the former connection it undergoes some remarkable changes, being at one time a thin, transparent, glutinous fluid, and at another thick, white, or even curdy-looking matter. Where structural changes have taken place in the diseased membrane, the discharge may be streaked with blood, and in some instances largely mingled with it. The outflow is much greater at some times than at others, and especially when the head is depressed or lowered to the ground. Where the matter is long pent up in the cavities of the face it acquires an offensive odour, which may continue or pass away, to return from time to time at varying intervals. More or less constitutional disturbance is remarked in cases of some standing, and where a disagreeable odour is attached to the discharge. The coat becomes unthrifty and staring, there is general loss of condition, and the animal is easily fatigued. The submaxillary glands may become enlarged and hardened, and the membrane lining the nostril assumes a leaden hue, symptoms which are also associated with glanders, and sometimes give rise to much anxiety and indecision in the matter of diagnosis, even among experts.

Treatment

It will prove a safe plan in every case of nasal discharge and glandular swelling of a chronic kind to isolate the patient and keep for his particular use one set of stable utensils, harness, etc. Both local and constitutional measures of treatment should be adopted. Good sound food and a liberal allowance of it, exercise but not work, and good sanitary surroundings. Internal agents of the astringent tonic class are found to be very beneficial, and the salts of different metals may be administered and changed from time to time, the one for the other, with advantage. A course of arsenic and iron may be tried first, and should it not prove successful, then a change to the copper salts may be made. It is probable that all tonics are helpful, having regard to the relaxed state of the affected membrane. If it is decided to give arsenic, Fowler's solution should be chosen and given in the food in doses of from 1 to 2 ounces twice a day.

Local treatment of various kinds is recommended, and the agents employed are both wet and dry. The injection up the nostrils of astringent or styptic lotions with the aid of a syringe is not to be recommended, but the insufflation of iodoform by an instrument made for the purpose, and known as an insufflator (fig. 202), may be tried for a short period. It consists of an india-rubber ball, with a long vulcanite nozzle.

The lotions most favoured are those in which the sulphates of zinc, copper, and iron form the principal part, and in some severe cases a solution of chloride of zinc is used in the shape of Burnett's fluid. The patient is naturally alarmed by the use of nasal injections, and the success of the treatment depends largely upon the efficiency of the operator. There are cases that defy all treatment of this kind, owing to the inaccessibility of curative agents to the seat of disease; here the sinuses of the face may have to be trephined and the semi-solid matter removed (see "Operations"), after which the cavities will require to be repeatedly washed out with astringent and antiseptic solutions.

Fumigation of the nostrils (fig. 203) with warm vapour impregnated with volatilized carbolic acid or turpentine should be tried. This may be done by means of a nose-bag containing warm, moist bran or sawdust, over which a little of one or the other or both the agents named has been sprinkled. The application should be made three times a day for not less than an hour on each occasion. In all cases of this kind the patient should be made to eat hay from the ground, so as to encourage the downward now of matter from the cavities of the face. Where no benefit is derived from these several methods of treatment it may be desirable to wash out the sinuses of the face, but before this can be done one or more openings will require to be made into them by removing portions of bone, or, as it is termed, trepanning.

Insufflator.

Fig. 202. - Insufflator.