A text-book on diseases of the ear, nose and throat . thestimulus of the cautery parts contract down to the bone which will notdo so for cocaine. Cocaine is therefore not an absolute means of diag-nosis between intumescent and hypertrophic rhinitis. In some cases one HYPERTEOPHIC AXD ATROPHIC 317 finds that not only tlie mucous surface but the turbinated bones them-selves have enlarged as a result of hypertrophic rhinitis. Hypertrophy of the middle turbinals is found less frequently than thatof the inferior, but it is not a rare condition. The anterior portion is thefavorite seat of
A text-book on diseases of the ear, nose and throat . thestimulus of the cautery parts contract down to the bone which will notdo so for cocaine. Cocaine is therefore not an absolute means of diag-nosis between intumescent and hypertrophic rhinitis. In some cases one HYPERTEOPHIC AXD ATROPHIC 317 finds that not only tlie mucous surface but the turbinated bones them-selves have enlarged as a result of hypertrophic rhinitis. Hypertrophy of the middle turbinals is found less frequently than thatof the inferior, but it is not a rare condition. The anterior portion is thefavorite seat of enlargements, and the smooth, translucent, often nodular,masses, of pale-pinkish hue, can be seen to press against the septum,closing the olfactory fissure and causing anosmia and neuralgic pains inthe forehead and eyes. It is especially the lower border of the middleturbinal that is found enlarged. Diagnosis.—The diseases to be distinguished from hyi:)ertrophic rhi-nitis are intumescent rhinitis, syphilis of the nose, and nasal mucous Fig. Left nasal fossa. (Bresgen.) H, polypoid thickeniugof anterior end of middle turbinal {M) ; thelatter and the lower turbinal ( V) present marked hj-pertrophy of the mucosa of the posterior ends :T, orifice of Eustachian tube ; P, polypus in the superior meatus. polyi)i. The readiness with which the probe will displace the swellingand press against the bone in intumescent rhinitis and the usual sub-sidence of the tumefaction under cocaine are the main points in hypertrophic rhinitis the tissues give an impression of solidity whenpressed upon, and their surface is irregular and uneven, while it is smoothin intumescent rhinitis. Diffuse gummatous infiltration of the nasal mu-cous membrane without ulceration may be hard to distinguish from hy-pertrophies of a non-syphilitic nature, and one must often await theresults of specific treatment for purposes of diagnosis. Xasal mucouspolypi hardly ever originate from the lower tur
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