ate temperature, and pass this
through the nose in the same manner as directed for the salt water. The
salt water is not curative, but is milder than simple water, and is,
therefore, preferable for cleansing the passages.

On first commencing the use of the instrument, it is best to hang it
only a very little higher than the forehead, but after using it a few
times, put it up about as high as the length of the tube will admit.

Let no one entertain any feeling of timidity on commencing the use of
this instrument, as its operation is perfectly simple and harmless, and,
with the fluids which we recommend, is never attended with any
strangling, choking, pain, or other disagreeable sensations. The
medicine should be applied with the Douche at least twice a day, in the
morning and at night on retiring. There is no advantage in using the
medicine oftener than three times a day, when used with the instrument,
but a _sufficient_ quantity should be used each time to medicate all the
diseased parts. If any remains in the Douche it may be poured back into
the stock solution for subsequent use, but a liquid that has once passed
through the nasal cavity contains the germs of the disease and must not
be used a second time.

* * * * *

NASAL POLYPUS.

The term Nasal Polypus is usually given to a variety of growths which
are met with in the nasal passages far more frequently than any other
tumors. They are thus designated because of their fancied resemblance to
the aquatic polypus. They occur singly, or in clusters, as illustrated
in Fig. 13. In the early stages the mucous membrane is swollen and
irregularly dilated, presenting a rough and mottled appearance not
unlike chronic catarrh with which they are usually associated. Gradually
these mound-like tumors enlarge, usually becoming pendulant, and
presenting a grayish opaque glistening surface, similar to the pulp of a
grape. Occasionally they become massive at the point of attachment, and
assimilate a warty or cauliflower growth. The latter variety is better
supplied with blood vessels and presents a red or dark pink surface and
may bleed on slight irritation. The favorite location is beneath or
behind the middle or superior turbinated bodies, oftentimes nearly or
quite concealed. However, no portion of the mucous membrane lining the
upper air passages is exempt. Sometimes they grow from the roof of the
nostril and pharnyx in pendulous masse