Notwithstanding the trivial importance usually attached to this disease, we believe it to be one of much greater gravity than might be supposed from the immediate results. Many people suffer from the disease for years, failing to give the matter sufficient attention to secure recovery. When of very long standing, the disease is somewhat obstinate to cure, and yet we have been able to demonstrate many times in the course of our experience that it is really curable. The measures to be employed are chiefly the following:Careful regulation of the diet, all articles of food being avoided which have a tendency to diminish the activity of the liver. As in nearly all cases of catarrh there is chronic torpidity of the liver, it is important that the patient should carefully follow all the directions given for the treatment of that disease with reference to diet as well as other particulars. Butter, sugar, fats, condiments, excess of animal food, and excess of food of any kind, should be particularly avoided. The patient should drink freely of pure water, and live in the open air and sunshine as much as possible, taking an abundance of out-of-door exercise every day. Especial attention should be given to the clothing, which should be carefully adapted to changes in the weather from day to day. The body should always be clothed warmly. Care should be taken to prevent exposure to drafts or any other means which will produce liability to cold. Baths should be employed for the purpose of exciting activity of the skin. Packs, vapor baths, Turkish baths, wet-sheet rubs, and in fact almost every form of general bath may be employed for this purpose. The application of fomentations over the liver and alternate hot and cold applications to the spine are indicated in connection with general treatment.

These measures are essential when a radical cure is expected, and the employment of local measures alone will accomplish very little unless the predisposing causes of the affection are removed by general treatment. Much good can be accomplished, however, by the use of local measures, among the most useful of which may be mentioned the following:The employment of saline solutions in the form of the nasal douche or in some other way. A solution which answers as well as any for this purpose consists of a teaspoonful of salt to a pint of soft water. This solution, as well as others which are employed for the same purpose, may be applied to the affected membrane in any one of three different ways: by injecting it into the nasal cavity through the nostrils by means of the syphon syringe; by washing out the nasal cavity in a similar manner, only injecting the fluid into the back part of the cavity allowing it to pass out through the nostrils. These methods of treatment have been already fully described elsewhere. The solution may also be applied to the mucous membrane by snuffing it up into the cavity. A little of the solution is taken up in the hollow of the hand, which is placed to the nostrils, and by forced inhalations a portion can be drawn up in contact with the affected parts.

When there is an offensive odor to the breath arising from the decomposition of catarrhal discharges in the nose or from injury to the bones, a little carbolic acid in the proportion of 20 to 30 drops to a pint of water may be added with advantage. In very bad cases in which there is a large amount of secretion, which hardens, forming large scabs in various parts of the nasal cavity, it is often necessary to employ, at least at the beginning of treatment, by means of the postnasal douche, a large amount of an alkaline solution, the object of which is to dissolve or wash away the hardened secretion. It is generally necessary to use from one to three gallons of the alkaline solution, according to the severity of the case. Ordinary soda or saleratus, in the proportion of a teaspoonful to a quart of water, answers as well for this purpose as anything which can be employed. After the nasal cavity has been thoroughly treated with alkaline washes by means of the syphon syringe, applications should be made of a small quantity of fluid, from half a pint to a pint, containing salt and carbolic acid, or a very small proportion of sulphate of zinc. The proportion of the latter should be about five grams to the pint. Chlorine water, a dram to a pint, permanganate of potash in the proportion of ten grains to a pint of soft water, and other mild disinfectant lotions, may also be employed with benefit. When the catarrh has begun to invade the throat, the inhalation of hot steam by means of the steam inhaler (Figs. 273, 274) will do much to check the progress of the disease.

The extension of the disease to the ear and other parts must of course be treated as may be demanded by the particular case in hand. In some cases no method of treatment seems to work successfully, and the patient apparently derives no benefit from anything except change of climate; but we have never yet met with a case so bad that it could not be benefited by a strict compliance with the rules laid down and a thorough employment of the measures mentioned.