, and are treated in the same way. The
stone, which is usually single, may be so large and so hard that it is
necessary to crush it before it can be removed.

#Ozaena#, or #foetid atrophic rhinitis#, is characterised by atrophy of
the nasal mucous membrane, and sometimes even of the turbinated bones,
and is accompanied by a muco-purulent discharge and the formation of
crusts having a characteristic offensive odour, which is not
recognised by the patient. It is usually bilateral, and the nasal
chambers, owing to the atrophy, are very roomy. It may be
differentiated from a tertiary syphilitic condition by the absence of
ulceration and necrosis of bone, by the odour, and by the fact that it
is not influenced by anti-syphilitic treatment.

Various methods of treatment are in vogue, but thorough cleanliness is
the most essential factor, and this is best secured by regular
syringing. Plugging of the nostrils with cotton-wool for half an hour
before washing out the nose greatly facilitates the detachment of the
crusts. A pint of lukewarm solution containing a teaspoonful of
bicarbonate of soda or of common salt, is then used with a Higginson's
syringe, the patient leaning over a basin and breathing in and out
quickly through the open mouth. The patient should then forcibly blow
down each nostril in turn, the other being occluded with the finger,
so that the infective material may thus be blown out without risk of
it entering the Eustachian tubes, as may happen when the handkerchief
is used in the ordinary way. Antiseptic sprays, such as peroxide of
hydrogen, and ointments may be applied to the mucous membrane after
cleansing.

#Epistaxis.#--Bleeding from the nose may be due either to local or to
general causes. Among the former may be cited injuries such as result
from the introduction of foreign bodies, blows on the face, and
fractures of the anterior fossa of the skull, and the ulceration of
syphilitic, tuberculous, or malignant disease. Amongst the general
conditions in which nasal haemorrhage may occur are typhoid fever,
anaemia, and purpura cardiac and renal disease, cirrhosis of the liver,
and whooping-cough. Prolonged oozing of blood may be an evidence of
haemophilia. Nasal haemorrhage usually takes place from one or more
dilated capillaries situated at the anterior inferior part of the
septum close to the vestibule, and in such cases the bleeding point is
readily detected. Occasionally bleeding occurs from one of th