A detailed article on the art of the Nose Examination.

Examination of the Nose

Inspection of the nose sometimes reveals diseased conditions which concern the bony structure, and, therefore, belong to surgery : deformities, fistulas, ulcers, with deeply- seated destructive process at the root of the nose.

Only one of these conditions has interest for us as physicians : the so-called saddle nose, arising from necrosis and removal of a part of the bony framework of the nose, is an almost infallible sign of constitutional syphilis.

Swelling and redness of the nostrils indicate inflammation of the nasal mucous membrane.  Not infrequently we also see traces of a muco-purulent or purulent, sometimes an ill-looking bloody, serous secretion ; the latter is sometimes oifensive in odor.

Patients with obstructed nose (with severe catarrh or tumors) breathe through the mouth.  On the other hand, in severe dyspnoea there is likewise motion of the alee nasi.

Epistaxis shows itself most plainly by the flow of blood from the nose.  However, when persons are entirely unconscious or healthy persons are asleep upon the back, the blood flows backward into the pharynx or even into the stomach.  Then the hemorrhage may be overlooked, or the first symptom of epistaxis may be vomiting of blood.


In all important diseases of the nose it is necessary to make use of the nasal speculum or otoscope. Palpation of the interior of the nose may he necessary.

Acute muco-purulent and purulent catarrh of the nose is symp- tomatic in measles, diphtheria, and equinia.  Chronic catarrh is a common symptom of scrofula (in which disease the whole nose is often swollen) and of syphilis.  In the former disease there is sometimes an inflammatory thickening of the whole nose, particularly of its lower walls.  Inflammation of an acute form, with very foul-smelling and ill-looking secretion, most frequently indicates diphtheria of the nose and pharynx.

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