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most often due to Plendil Online some sensory disturbance, where the patient does not feel the air Buy Cheap Plendil either because of the involvement of the sensory nerve filaments or because of the wide passage the current of air does not exert Buy Plendil Online sufficient pressure on Plendil Mg the mucous mem- brane. This is well illustrated in those cases where the lumen in one side of the nostril is wider than in Amlodipine Felodipine the other, in which case the trouble is more often referred to Order Plendil Online the open side. It is doubtful whether a sinus affection by preventing ventilation and an interchange of air within the sinuses, an interchange which normally occurs, should by itself be respon- sible for this .symptom. In rarer cases the trouble will be found to be general rather than local. Due to a diminished alkalinity of the blood or to some other error in metabolism, there is Purchase Plendil Generic Plendil an increased demand for o.xygen, the lack of which may be referred to the nose. Occasionally, too, local and general conditions are both apparently normal and we are obliged to use such terms as nasal neurosis or nasal neurasthenia. Whatever opinion one may have Felodipine 10 Mg as to the causes of this symptom it is iinportant to remember that in this type the obstruction com- plained of is apparent and not real. \ more frequent condition is an obstruction due to the abnormal action of the nasal mucous mem- brane. To perform its function of warming, moistening, filtering, and Buy Plendil perhaps regulating the amount of the inspired air, this membrane expands' and contracts, thus varying constantly the lumen of the nose. The causes responsible for this varia- tion in dimension of the mucous membrane are often obscure, and to some extent depend on the function that is to be performed. Changes in the atmosphere, chemical and mechanical irritants, and mental emotions- — all affect this highly susceptible membrane and cause it to expand and contract. This expansion is due to an increase in the blood supply, which distends the venous sinuses not unlike the erectile tissue elsewhere in the body and with little or no inflammatory reaction. The Felodipine 5 Mg term func- tional obstruction is suggested for this type of cases. There are few individuals who have not occasionally experienced a sudden change from opening to closure and reversely occurring in both nostrils or more Order Plendil often alternating from one nostril to the other without any apparent cause. Inflammation of the nasal mucous Plendil Tablets membrane is another condition that is Felodipine Er frequently responsible for Cheap Plendil obstruction. Functional disturbance may occur in a normal mucous membrane ; more often it occurs in one that has undergone inflammatory changes. Clinically, a chronically inflamed mucous meinbrane is either hyperthrophied or atrophied or without change in size and it loses its moist pearl pink color which is characteristic of a normal mucous mem- brane. The hypertrophy or hyperplasia may be a conservative process, one of Nature's efforts to compensate for some loss of Felodipine 5mg function or for some local anatomical irregularity. Thus, large turbinates are found in roomy noses and on the concave side of a deviated septum. No such utilitarian purpose is evident in an atrophic or otherwise chronically inflamed membrane. One cannot but feel that here the underlying cause is some general systemic dis- turbance, such as syphilis, gout, rheumatism or intestinal intoxication. It may be, too, that a dis- turbed secretion of the ductless glands has some influence. The relation of the erectile tissue Felodipine Amlodipine of the nose to the gonadal glands has long been noticed. The f acies of those with atrophic rhinitis is not Plendil Price unlike those with a deficiency of the thyroid gland. The broad nose, dry skin, and its frequent occur- rence in women all suggest this, as well as the fact that the condition is less often seen in patients with hyperthyroidism. In the acute cases of inflamma- tion the individual immunity is an important element. A virulent Klebs-Loeffler may be innocuous Felodipine Tablets to some, while a bit of innocent dust will in a suscept- ible person excite the most violent inflammatory paroxysm. In the treatment of these forms of obstruction much can be accomplished by the correction of any general disturbance, which even a superficial exam- ination will in most cases disclose. Changes in the diet, the prevention of autointo.xication, the correc- tion of hygienic errors, and the treatment of any- indefinite gouty, rheumatic, glandular or syphilitic OctoK-r 30, I9J0.] RACHFORD: CONGENITAL UNDERDEVELOPMENT. 677 conditions do more good as a rule than local appli- cations. In this connection may be mentioned the favorable action of laxatives, potassium iodide, and

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