HEALTH COLUMN.

Otago Witness, Issue 3101, 20 August 1913, Page 68

HEALTH COLUMN.

Polypus. The term “polypus” originally meant “with many feet or roots,” but in modern surgical phraseology this meaning is lost sight of, and a polyp has, usually, but one root. As a rule the layman will associate tho term “polypus” with the nose; but polypi are not confined to that organ they aro a'so found in the car, the gums, the bladder, the uterus, and the rectum. Wherever found, a polyp is always a soft and pendulous growth from the mucous membrane. —Nasal Polypus.— This being the most common, it will be described first. The true mucous polpyus of the nose is a soft, moist, gelatinous tumour, of a greyish-yellow colour when lodged in the upper part of the nasal cavity; but when it descends into the lower part of the nose or beyond it, and is exposed to tho air, the polyp becomes of a reddish-brown or purple tint and somewhatshrivelled on the surface. It is usually lobulatcd, pedunculated, or bottle-shaped, and not very vascular, except at the root, where it is permeated by thinwalled vessels that bleed freely on the slightest touch. In structure it is soft and homogeneous to the naked eye. If cut across’ and squeezed a large quantity of sticky fluid flows from it, and the mass becomes reduced to a small proportion of its original bulk. . , Mucous polypi are covered completely by mucous membrane, with ciliated epithelium, the cilia (or fine hairs) of which may bo seen in active movement under the microscope after removal. Tho tissue which forms the bulk of the tumour is composed of delicate bands ot connective tissue separated from each other by an abundant mucous fluid. The whole mass is abundantly supplied with blood vessels. Situation. — The tumour may grow from any part of tho lining membrane of the nose excep„ the septum or partition which divides the nose into two portions. Most frequently tuo polypi grow from the middle portion of the. nostril. They are usually numerous and of all sizes; as they increase they commonly extend forwards into the lower nostril, but when large they may be seen to roach into tho pharynx, hanging down behind the palate. Symptoms.— The symptoms occasioned by the presence of nasal polypi depend on the interference with respiration and speech which they occasion. Respiration through the affected nostril is imoeded, the patient being unable to blow’ through it when directed to do so, and the speech is thick and nasal. There is snuffling with mucous discharge from the nostril, and all these symptoms arc worse in damp than in dry weather. On examining tho interior of the nose the lower end of the polyp may often bo distinctly seen, and if it is large it will descend to a level with, or even beyond, the nasal aperture, when the patient blows forcib'y By the introduction of a blunt probe the size and extent of the tumour, together with the position of its root, may be readily ascertained. . . As it grows the tumour impresses changes on tho shape of neighbouring bones, producing expansion and flattening of the nose. Arraun as it interferes with tho flow of tears down the nasal duct, it may occasion a watery state of the eyes. This, together with the change of shape in the features and the peculiar character of voice and respiration, often suffices in giving a clue to the nature of tho patient’s disease. Causation. — Polypi occur chiefly in young adults aftei the ago of puberty; but they are not infrequently mot with at later periods of life. Their causes are very obscure. Most commonly they are referred either to a blow or to a prolonged catarrh. They aic inoie common in women than in men. Treatment. — In very exceptional cases a nasal polypus may be separated and expelled of itself. This being the case, some means should be adopted for their removal. Special instillments are required for this purpose, and these need not bo described hero. The mucous membrane is first rendered insonsiblo by the application of a solution of cocaine! In this manner the slight operation is devoid of pain. The bleeding, which is often very free, stops on the application of cold water. It seems to be lessened by the use of cocaine. At about the end of a fortnight tho patient should he examined again, as it not infrequently happens that small polypi, which had' been prevented from descending into the nostril by the presence of the larger ones, now come down and require removal. These procedures must be had recourse to from time to time, until all tendency to fresh formations of this kind has ceased. —Other Polypi.— Polypi of the gums arc merely overgrowths of tho little tongue of gum between the teeth, and appear generally to depend on the presence of tartar or caries of tho teeth. The offending tooth should be scaled. stopped, or extracted, and the growth cut off. Polypoid growths are not infrequently found in the external ear. When small they cause but little inconvenience, but when a large a sensation of fullness is felt in the oar, with a sense of heaviness and giddiness in the head. In some eases they aro attended with considerable pain, and by a discharge of blood; in others they throw off an offensive secretion, and yet produce no serious symptoms of a nature to induce the patient to seek relief ; whilst in others, again, the head symptoms are so distressing as to cause serious a'arm. No treatment other than removal can be of avail. Polypi in the bladder or rectum may give rise to considerable hemorrhage and discomfort, and will, in most eases, require to bo excised. Psoriasis. Psoriasis is a very common skin disease, which may attack persons of a l l ages. It appears in tho form of separate spots

or patches of diseased skin, which are of a dull red colour, and have on their surface numerous white scales. It generally breaks out on the elbows and the fronts of the legs. Sometimes it attacks the scalp, then gives rise to much scaling, and is often one of the causes of dandruff. One difference between psoriasis and eczema is that the surfaces of the former are never moist only when greatly scratched and irritated, whilst in the latter they are moist. Psoriasis seldom itches, whilst eczema is generally unbearable in this respect. The cause of the skin disease is rather obscure; sometimes spring and autumn favour it; or it may come on after a nervous shock, mental emotion, or some depressing influences. It ma.j 7 also follow any injury of the skin r iho sufferer must not wear any irritating clothes, nor must the perspiration from the skin be checked, nor the surface chilled. Frequent tepid or alkaline baths, or the free use of hot water and soap will bo beneficial. There are certain internal remedies which can be taken, but these should only be administered under medical advice. The disease is curable, it is not contagious, nor is it due to a narasite.