Drugs are applied to the nose in the form of powder, which may be taken in the same way as snuff by putting a little on the top of the thumb, holding it in front of the nose and strongly inspiring; or the powder may be put on a small piece of cardboard in which a pinhole has been made just under the powder, or with a small perforated spoon like that used in Scotland for snuff. Sternutatories may be used in this way, and so may Ferrier's powder for soothing the mucous membrane in cases of commencing catarrh.

Fluids may be applied by insufflation, the nose being simply immersed in them and strong inspiration being made.

They may also be applied by the nasal douche. This consists simply of a long india-rubber tube to act as a syphon (Fig. 161). The upper end of it is placed in a vessel filled with the solution to be applied, and it is prevented from falling out by a hollow lead weight attached to its upper end. At the lower end is a conical nozzle, which completely plugs the nostril. The tube being filled with the fluid by suction so that it commences to act as a syphon, the nozzle is placed in one nostril, and the head is held with the mouth open over a basin. In this position the posterior nares are cut off by the soft palate from the pharynx, and the solution passes up one nostril and not through the other, so that the nasal cavity is washed out and its mucous membrane acted upon by the solution which is employed. By altering the position of the head, both in insufflation and in washing with the douche, the part of the nose reached by the fluid will be changed. Thus when the head is held much forward, the anterior and upper part of the nose will be chiefly cleansed, when the head is held upright, the posterior and lower, and when the position is intermediate, the middle part of the nose will be most affected.

Fig. 161.   Nasal douche.

Fig. 161. - Nasal douche.

The nose may also be washed out by using a large syringe (ear) with a piece of india-rubber tubing fitted on to the nozzle. If at the moment of injection the patient be directed to say 'anemone' (or some such word) and expectorate, the injection will come out of the mouth.

Pure water is irritating to sensitive mucous membranes like that of the nose, and so instead of employing pure water it is much better to use a 5 to 1 per cent, solution of common salt, which is a bland, non-irritating fluid. Such a solution may be made by adding a drachm of common salt to a pint of water.

Fluids may also be applied to the nose in the form of spray, either directed simply into the nostrils, or by means of a catheter perforated with a number of minute holes, and introduced along the floor of the nasal fossae. The former may be used for applying astringent and deodorising solutions, and the latter for the purpose of washing out the nose and removing hardened secretions.