Sodium Morrhuate Therapy for Chronic Simple, Vasomotor and Hypertrophic Forms of Rhinitis

Abstract

Chronic rhinitis with engorgement or congestion of the turbinates is a common disorder. Pathologically and clinically it has been classified as turgescent, intumescent, vasomotor, hyperesthetic, allergic, hypertrophic and hyperplastic rhinitis. The variations in nomenclature are somewhat confusing.These types of rhinitis cause nasal obstruction. The chronic simple form is characterized by chronic inflammation and swelling of the soft tissues with distention of the blood sinuses of the turbinates and with a varying degree of proliferation of connective tissue, from prolonged or frequent recurrences of acute inflammation, chronic sinal disease, anatomic defects and related disorders. The mucous membrane appears swollen, smooth and reddened. Patients with rhinitis of the intumescent form complain of nasal obstruction, particularly night and morning, with frequent headaches of varying intensity. Hypertrophic rhinitis can be considered as a later form, differing from the chronic simple form by its association with an enlargement of the cellular elements of the turbinates, with some increase in the fibroblastic tissue, thickening, and permanent dilatation and increase in the number of blood sinuses and glandular elements (serous and goblet cells). Since hypertrophy actually means an increase in the size of the cells that are present, the use of the term hypertrophic is somewhat misleading, for there is some hyperplasia, or increase in the number of cellular elements. As this form progresses, it eventually produces a true hyperplasia and frequently a granular lobulated structure on the posterior portion of the turbinates, spoken of as a "mulberry mass." The vasomotor type of rhinitis is also referred to as hyperesthetic rhinitis, rhinorrhea, turgescent rhinorrhea, nervous coryza, summer catarrh or perennial hay fever. It often simulates mild allergic rhinitis. In fact, as more is learned from the point of view of allergy, it is becoming apparent that many of the instances of rhinitis belong in this category. The usual symptoms are like those From the