The many papers appearing in the literature on the etiology of nasal polypi for the most part are divided into two main schools of thought, one holding that allergic disorder is the primary factor and infection is a secondary factor in the production of polypi, and the other maintaining that the hyperplastic changes are due to a primary bacterial infection. Many earlier investigators thought that a general constitutional predisposition, either acquired or inherited, is responsible for the formation of nasal polypi. The latter view coincides with the more recent observations, which hinge on the allergic origin of edematous polypi. Accepting for the moment that all edematous mucous nasal polypi are of allergic origin and that histamine is involved in the allergic phenomenon, it would appear reasonable to assume that histamine plays a part in the production of polypoid tissue. It was in an attempt to solve this point that this work was undertaken. A comparative analysis of nasal polypi and normal nasal mucous membrane was undertaken in order to ascertain whether histamine appears in greater quantities in polypoid tissue than in normal mucous membrane. The search for histamine was extended to include allergic nasal secretions in order to determine whether the nasal discharge is a true secretion, an exudate or a transudate. Since there is histamine in the blood, as has been demonstrated, if nasal secretion is largely a transudate, then the nasal discharge should contain histamine provided histaminase, an enzyme which destroys histamine, is not present.In his studies on the architecture of the blood vascular network in the erectile and secreting tissue of the nasal passages of the reindeer and the kangaroo Swindle1 stated that when the veinlike arteries and the This investigation was made possible by the Frank E. Ball Research Fund.
The study of the hydrogen ion concentration of nasal secretions in various diseases of the respiratory tract was continued throughout the years 1934 and 1935. In all, 350 determinations were made on 125 subjects. The conditions presented were as follows : Six patients had atrophic rhinitis, 11 came for bronchoscopic treatment, 25 had colds and 83 had allergic rhinitis or allergic rhinitis with superimposed infection.The hydrogen ion concentration was determined with the glass microelectrode. The description of the method and the precautions taken in its manipulation and in the handling of the secretion were given in an earlier paper.1 Tables 1 and 2 show the pH for tracheobronchial secretions and atrophic rhinitis, respectively. The number of cases for each condition is too small to be used as a basis for definite conclusions, but the trend of the pH is indicated. The secretions are primarily purulent and mucopurulent, and in consequence the hydrogen ion concentration is normal or on the acid side. The normal pH of blood (7.4) is taken as the normal for the tissue. In general, the results substantiate the reports in the literature2 that the pH of a secretion decreases in value as the secretion changes from opalescent mucus to whitish mucopus to pale yellow through deep yellow and greenish yellow fetid pus. It is interesting to note in table 1 the occurrence of the pathogenic organism, Haemophilus influenzae, in 5 of the cases. The secretion from 3 persons showed no culturable bacteria ; 2 of these did not have any bacteria in the stained smear.The microscopic examination of secretions from the third patient, G. J., showed many bacteria, but no growth was obtained. This lack of viability of the micro-organisms might be attributed to the high From the
Mucin, an important constituent of many body secretions and tissues, is a glucoprotein containing a complex carbohydrate radical or polysaccharide combined with a protein. This complex polysaccharide, mucoitin sulphuric acid, is made up of four constituents, glucosamine, glucuronic acid, sulphuric acid and acetic acid.' Mucins are not identical, as their elementary analyses show, their solubilities are not the same and the degree of viscosity of their aqueous solutions differ. It is thought that these differences probably lie in the protein portion of the molecule, rather than in the carbohydrate complex.
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