The nose is the preferred entrance for air to enter the lungs. It is a longer route than breathing through the mouth and thereby the air is warmed and cleansed more effectively by the nasal hairs. The nasal membranes are sensitive to pollutants and produce mucus to trap foreign material and protect the delicate lung tissues. The sinuses -air spaces within the skull bones – are mucous membrane-lined cavities that drain fluid into the nasal passages.
CARE OF THE NOSE
The nose is very much self-repairing and provided that it is not damaged will look after itself. Damage can occur from trauma and, becoming more common, from the inhalation of drugs of abuse such as cocaine, heroin and amphetamines. Smoking is highly injurious to the nasal mucous membrane, hairs and sinuses.
Nasal washing techniques are popular in the East and little watering cans known as Neti Lota pots are used in a cleansing technique known as Jala Lota. These pots are available through outlets but the technique is best taught by a skilled yoga practitioner or complementary medical practitioner with experience. Techniques of inhaling water without these watering cans are commonly practised but definitely need to be taught .
At the top of each nostril is a yellow-brown epithelium, which contains millions of receptors that join together to form the olfactory nerve responsible for smell. This runs to a receptor area in the brain, which is able to differentiate an immeasurably large number of odours.
Unlike vision or taste, which have a variety of components made up from primary colours or taste , smells cannot be made up from a few components. Each olfactory receptor may have its own specific odour molecule to recognize and it may mean that thousands have to be activated before the brain recognizes a smell.
As an aside, smells may be unrecognized but nevertheless noticed. Insects in particular are known to give off pheromones that attract members of the opposite sex. It is probable that human beings recognize or pick up airborne chemicals from others without registering them consciously as a smell. The phenomenon whereby women placed in a dormitory or in close proximity will all eventually have their periods at the same time suggests a pheromone activity.
A loss of smell occurs due to any interference with the transmission of impulses from the receptor to, and including the olfactory centre in, the brain.
Transient or temporary loss is often noted with colds or inflammation of the nasal membranes. Conditions such as hay fever or nasal polyps, whereby the mucous membranes swell and may engulf the olfactory receptors may appear permanent until the season changes or the polyps are cured. A more permanent anosmia will occur if the olfactory receptors are damaged, as they are by pollution, smoking and the inhalation or ‘snorting’ of narcotics such as heroin, cocaine and amphetamines. Glue-sniffing is a sad and rapid cause of olfactory receptor damage. Trauma or infection such as meningitis or encephalitis can damage both the olfactory nerve and the brain centre, as can tumours.
A transient loss due to an obvious cause should be treated as per the recommendations in the appropriate section here.
A gradual or persistent loss of smell should be examined by a doctor with referral to a nose specialist or neurologist. Testing will be carried out by asking an individual to smell coffee, almond, tar and lemon, all of which are generally pungent and easily recognized. Foul-smelling compounds such as asafoetida, which possesses a smell so unpleasant that the nose will wrinkle uncontrollably, are used to determine whether anosmia is complete or not.
In chronic cases food allergy must be considered and blood testing to isolate culprits is recommended. Ingestion of allergens may create a permanent inflammation in the membranes, which envelop and block the olfactory receptors.
Homeopathic remedies may be of use and should be chosen based on the constitution of an individual by a homeopath.
The Eastern philosophies, especially Tibetan medicine, believe that the loss of one of our senses is an indication of a very deep disorder. It does not mean that it is particularly life-threatening but simply that treatment may be difficult and require much discipline and therapy. Referral to a Tibetan physician is recommended but if none are available then Chinese or Ayurvedic physicians may help.
A broken nose is a common injury, especially in people who play a lot of sport. It is a painful occurrence and very often the softer cartilage at the front of the nose is itself fractured or fractures away from the bone. The nasal bones may be broken and very often the swelling will hide any marked deformity. Radiographic examination is often required but, because little is done to treat a broken nose until the swelling has subsided, this may not take place for a couple of days. The nose is a highly vascular area and bleeding is often very profuse.
If a broken nose is suspected it should be reviewed by a GP or accident and emergency doctor.
Administer the homeopathic remedy Arnica 6 every lOmin for five doses and then every 2-3hr for 2-3 days. If the damage is severe, alternate the Arnica with Symphytum 6 every 3hr for one week.
Apply an Arnica-based cream around the damaged area.
An operative procedure may be necessary The cause of nose bleeds is often trauma such as a direct blow or persisting inflammation in the nasal passages caused by infection or irritants which may be as innocuous as pollen in hay fever sufferers.
Rarely is a nose bleed serious although it can be associated with diabetes and hypertension. Sinusitis and nasal polyps are less serious conditions but also need to be considered. Problems with the clotting system may often show up as more bleeds.
In children, ensure that there is no foreign body in the nose and do your best to stop any picking!
Sudden, unexpected, persistent or bright red bleeding should be examined by a physician since quarterisation may be necessary.
Remove any foreign object if necessary.
Keep the head tipped forward and apply pressure to the soft lower part of the nostril or nostrils.
Apply a cold compress on the bridge of the nose and the back of the neck. This may help to stem the flow by decreasing blood flow.
Avoid swallowing blood by spitting out.
The following homeopathic remedies can be employed and taken every ten minutes at potency 6. Bright red blood – Phosphorus, Bright blood with steady flow – Ferrum Phos, Following injury – Arnica
Recurrent nose bleeds, with no established serious cause, should be treated with treble the recommended dose of a multimineral and vitamin supplement. Beta-carotene 2 milligrams per foot of height should be taken in divided doses through the day. Recurrent nose bleeds should also be examined by an ear, nose and throat specialist to isolate any defective or weak blood vessels or other underlying health problem.
If no obvious cause is apparent consult a complementary medical practitioner and check for vitamin and mineral deficiencies.
The nose can be blocked by a foreign obje< inflammation, growths or polyps. Inflammation most commonly caused by pollutants, including smoking or drugs of abuse, or infections such as the common cold.
See the appropriate section when underlying cause of an obstruction.
A foreign body may be easily removed but if not see a doctor.
Nasal polyps are actually fluid-laden, mucous membrane ‘sponges’ usually created by persistent irritation from an external pollutant such as pollen, mechanical fumes or drugs of abuse. Smoking in particular is a major cause. There is a correlation with hay fever, asthma and other allergic responses and it may be triggered by food allergies. Hypoglycaemia encourages membrane :t, swelling and mucus production and is often an is overlooked reason for polyp production. There is
ADULT some hereditary predisposition. The nasal passages swell in response to tears and emotional suppression is another overlooked cause of polyp growth. Nasal polyps are most often protruding from the sinuses, especially the ethmoid and frontal sinuses. Their presence causes nasal obstruction, mucus excess and diminution in smell and taste.
Any persistent discharge or congestion should be examined by a GP.
Avoidance of any nasal pollutants, including smoking, should be encouraged.
Diets high in sugars and refined foods should be adjusted. Spicy foods and alcohol should also be avoided.
Specific food allergy testing should be undertaken to identify any negative response.
A nasal washing technique should be learnt .
Homeopathic remedies should be considered, in particular Calcarea carbonica and Teucrium. These should be taken at potency 30 twice a day for two weeks.
Herbal treatments may be of benefit but should be prescribed by a specialist. These include nasal sprays of herbal and homeopathic remedies. Try them, they may work.
The following supplements should be taken in divided doses throughout the day at the following levels per foot of height: beta-carotene , vitamin C , chromium and zinc, 5mg taken before going to sleep. These levels should be tried for one month in conjunction with homeopathic remedies.
Any repression of sadness or tears needs to be brought to light and neurolinguistic programming or hypnotherapy prior to counselling may be a curative.
Steroid drops prescribed by a GP and taken without fail four times a day for one month may be curative if the underlying cause is removed. At the very least steroids will be effective at relieving the congestive symptoms. Do not exceed the recommended two drops per nostril because some absorption will take place through the membranes and a considerable amount may be swallowed unless the head is in the correct position. This requires an individual to kneel and place the vertex of the skull on the floor and stay in that position for a couple of minutes. Do not sniff and swallow afterwards, instead preferably blow the nose gently.
Refined endoscopic techniques are now available for surgical polyp removal and should be insisted upon if other treatments do not work and surgery is required. Bear in mind that 40 per cent of polyps will recur and that the procedure is an uncomfortable one and should really be left until other avenues have failed.
Nasal washing is best done by the use of a Neti pot and the technique from yoga known as Jala Lota.
For Jala Lota prepare a saltwater solution using a teaspoonful of salt in a cup of warm water. Fill the Neti pot and, standing by a sink or a bath, place the top of the head pointing directly down. Breathe through an open mouth slowly and pour the water through the Neti nozzle up one nostril and out of the other. Ensure a continuation of breathing as this creates a negative pressure and may help to pull the fluid into the sinuses. Repeat this technique four times a day.
A postnasal drip may be recognized as a sensation of fluid at the back of the nose, but is often unrecognized. Whilst upright and awake a postnasal drip tends to be swallowed or coughed out, but at night when asleep or in a horizontal position, the trickle may descend into the lungs, causing a night-time cough. If the postnasal discharge is infected, then sore throats, loss of voice and bronchitis may be created. Most postnasal discharge comes from the sinuses.
See Sinusitis, but bear in mind that sinus discharge is not necessarily associated with infection and therefore may not be painful.
Adenoids may also become inflamed and create mucus as may the nasopharnyx mucous membrane. If sinuses are not a problem is most commonly used to free any blockages in the Eustachian tube, but can be used to open up the passages to the sinuses.
Sinus infection may be either acute or chronic. Pain is usual in chronic sinusitis but is not always present and the site is dependent upon which sinus is affected. Most commonly infection will trigger inflammation, viral and bacterial being more common than yeast or fungal, but the latter two are often overlooked. The maxillary sinuses may, one time in four, be inflamed because of inflammation in the upper teeth, gums or jaw.
Inhalation of noxious substances, which include smoking, inhaled drugs of abuse such as cocaine and amphetamine, strong industrial fumes, pollution and even the chlorine from swimming pools, may all trigger a non-infected inflammation. Fatigue, fever and discharge are associated and a yellow or green mucus is usually indicative of a bacterial infection.
Frontal sinus headaches have a peculiarity of developing midmorning. I am uncertain why this occurs but it seems that there must be some body clock mechanism. Nostrils tend to fluctuate in their patency due to vasoconstriction altering throughout the day and Ayurvedic philosophy suggests that more energy is absorbed through the left nostril than the right.
Rhinitis created by allergies is a frequent initiator of acute sinusitis and the chronic state may be
ADULT encouraged by food or airborne allergies. Low blood sugar levels trigger mucous membrane inflammation and mucus production so any factor affecting or causing hypoglycaemia must be taken into account. Toxic bowels can often induce sinus irritation.
The diagnosis of sinusitis is frequently clinical but investigations such as CT scans or fibre optic endoscopy can be utilized. Sinus X-rays are frequently useless and provide a dose of radiation that is not likely to be of benefit.
Attempt to soothe sinus inflammation with inhalations of lavender, chamomile or Olbas by putting two drops of the essential oil into a bowl of steaming water.
Attempt to keep the mucus thin and less viscid by ensuring good hydration by drinking plenty of water and avoiding dry atmospheres such as air conditioning.
Hot showers or hot compresses over the inflamed area will be beneficial.
Homeopathic remedies can be used in both acute and chronic conditions. Selection of a remedy should be based on the site and type of pain, type of discharge and other associated symptoms.
In acute infections, see Colds for treatment.
Chronic infections may benefit from using the following supplements in the following dosages per foot of height in divided doses throughout the day: beta-carotene , vitamin C , chromium and zinc .
The following may be used to thin mucus and act as anti-inflammatory agents: N-acetylcysteine and bromelaine, each at 400mg per foot of height in divided doses throughout the day.
Infectious causes may be benefited by taking Echinacea and Golden Seal at twice the recommended dose on a proprietary brand.
If problems continue, nasal washing techniques may be of use. Sniffing salt water by blocking one nostril and inhaling water until it reaches the back of the throat and blowing it out can clear the nasal passages but does not encourage the solution to enter the sinuses. It is better to use a small watering can device that is often available at healthfood stores known as a Neti pot. This technique is known as Jala Lota .
Establish any food allergies by exclusion diets or food allergy testing and avoid any allergens.
See Allergies and Postnasal drip.
Consider counselling and hypnotherapy to remove underlying or suppressed sorrow or grief.
The orthodox use of painkillers is sometimes necessary because sinus pain can be most debilitating. Steroid drops and sprays with or without antibiotics may be offered and are usually used if the sinusitis is related to polyps .
Persisting problems may result in an orthodox offer of an operative procedure. This may either be a sinus wash or mucous membrane removal performed through a small tube known as a sinus endoscope. The procedures are not pleasant and there is a 40 per cent chance of recurrence over the next two years. This procedure should only be used as a last resort.