several distinct micro-organisms. Of these the most important is the
micrococcus catarrhalis described by Martin Kirchner in 1890, but
Friedlander’s pneumo-bacillus has also been found. In ordinary
cases of coryza, sneezing, congestion of the nasal mucous membrane
and a profuse watery discharge usher in the attack, and the inflammation
may extend to the pharynx, larynx and trachea, blocking
of the Eustachian tube producing a temporary deafness. Later the
discharge may become muco-purulent. One attack of coryza
conveys no immunity from subsequent attacks, and some persons
seem particularly susceptible. The treatment is directed towards
increasing the action of the kidneys, skin and bowels. A brisk
mercurial purgative is indicated, and salicin and aspirin are useful
in many cases. Considerable relief may be obtained by washing
out the nasal cavities several times a day with a warm lotion containing
boric acid. Those who are unusually prone to catch cold
should habituate themselves to an open air life by day and an open
window by night, adenoids or enlarged tonsils should be removed,
and the diet should be modified so as not to contain an excess of
starchy foods. An acute croupous inflammation occasionally attacks
the nasal mucous membrane when the Klebs-Loffler bacillus is not
present, but the nasal membrane often shares in true diphtheria,
or it may be the only organ to be infected thereby. The diagnosis is
of course bacteriological.
As a result of frequent catarrhal attacks the nasal mucous membrane may become the seat of a chronic rhinitis in which the turbinals become swollen with oedema, and congested and finally thickened by increase in the fibrous tissue. There is an excessive muco-purulent discharge, and the patient is unable to breathe through the nose; deafness and adenoid vegetations may be the result. In the early stages the nasal cavity should be washed out night and morning with an alkaline lotion, such as bicarbonate of soda, or a caustic, such as chromic acid, should be used in swabbing over the affected part. The application of the galvano-cautery here is useful, but when the areas are much hypertrophied the hypertrophied portion of the inferior turbinals may have to be removed under cocaine. A special form of recurrent hypertrophic rhinitis is hay fever (q.v.).
Rhinitis Sicca is a form of chronic rhinitis in which there is but little discharge, crusts or scabs which may be difficult to remove forming in the nasal cavities; the pharynx may be also affected.
Atrophic rhinitis or ozaena usually attacks children and young adults, following on measles or scarlet fever. Crusts form, and favour the retention of the purulent discharge. The disease may extend to the nasal sinuses and septic absorption take place. The treatment is to keep the nasal cavity clean by irrigation with solution of permanganate of potash or carbolic acid lotion, the nose then being wiped and smeared with lanolin or partially plugged with a tampon of cotton-wool, the process being repeated at frequent intervals, the general treatment being that for anaemia. Disease of the middle turbinated bone is also a cause of an offensive nasal discharge, and rhinitis occurring in infants gives rise to the obstructed respiration known as “the snuffles.”
Three forms of nasal polypi are described, the mucous, the fibrous and the malignant. The general symptoms of nasal polypus are a feeling of stuffiness in one or both nostrils, inability to breathe down the nose and a thin watery discharge. A nasal tone of voice, together with cough and asthma, may be present, or there may be partial or complete loss of the sense of smell (anosmia). The treatment of mucous polypi is their removal by the forceps or the snare, the base of the growth being afterwards carefully examined and cauterized with the galvano-cautery.
Fibrous polypi are usually very vascular, and may be a cause of severe epistaxis as well as of obstruction of breathing, “dead voice,” sleepiness and deafness. The increasing growth may lead to expansion of the bridge of the nose and deformity of the facial bones, known as “frog-face.” The tendency of fibrous polypi to take on malignant sarcomatous characters is specially noticeable. Extirpation of the growth as soon as its nature is recognized is therefore urgently demanded.
The chief diseases of the nasal septum are abscesses, due to the breaking down of haematomata, syphilitic gummata (leading to deep excavation and bony destruction), tuberculous disease in which a small yellowish grey ulcer forms and what is known as perforating ulcer of the septum, which is met with just within the nostril. The latter tends to run a chronic course, and the detachment of one of its crusts may cause epistaxis. Rhinoscleroma was first described by F. Hebra in 1870, and is endemic in Russian Poland, Galicia and Hungary, but is unknown in England, except amongst alien immigrants. The infecting organism is a specific bacillus, and the disease starts as a chronic smooth painless obstruction with the formation of dense plate-like masses of tissue of stony hardness. Treatment other than that of excision of the masses has proved useless, though the recent plan of introduction of the injection of a vaccine of the bacillus may in future modify the progress of the disease.
The accessory sinuses of the nose are also prone to disease. The maxillary antrum may become filled with muco-pus, forming an empyema, pus escaping intermittently by way of the nose. The condition causes pain and swelling, and may require the irrigation and drainage of the antrum. The frontal sinuses may become filled with mucous, owing to the swelling of the nasal mucous membrane over the middle turbinated bone, or an acute inflammation may spread to the frontal sinuses, giving rise to an empyema in that locality. There is severe frontal pain, and in some cases a fulness on the forehead over the affected side, the pus often pointing in this site, or there may be a discharge of pus through the nose. The treatment is that of incision and irrigation of the sinus (in some cases scraping out of the sinus) and the re-establishment of communication with the nose, with free drainage. The ethmoidal and sphenoidal sinuses are also frequently the site of empyemata, giving rise to pain in the orbit and the back of the nose, and a discharge into the nasopharynx. In the case of the ethmoidal sinus it may give rise to exophthalmus and to strabismus (squint), with the formation of a tumour at the inner wall of the orbit and fever and delirium at night. In the young the condition may become rapidly fatal. Suppuration in the sphenoidal sinus may lead to blindness from involvement of the sheath of the optic nerve, and dangerous complications such as septic basal meningitis and thrombosis of the cavernous sinus may occur. Acute ethmoiditis and sphenoiditis are serious conditions demanding immediate surgical intervention. (H. L. H.)
OLGA, wife of Igor, prince of Kiev, and afterwards (from 945) regent for Sviatoslav her son, was baptized at Constantinople
about 955 and died about 969. She was afterwards canonized in
the Russian church, and is now commemorated on the 11th of July.
OLGIERD (d. 1377), grand-duke of Lithuania, was one of the
seven sons of Gedymin, grand-duke of Lithuania, among whom
on his death in 1341 he divided his domains, leaving the youngest,
Yavnuty, in possession of the capital, Wilna, with a nominal
priority. With the aid of his brother Kiejstut, Olgierd in 1345
drove out the incapable Yavnuty and declared himself grand-duke.
The two and thirty years of his reign (1345–1377) were
devoted to the development and extension of Lithuania, and he
lived to make it one of the greatest states in Europe. Two
factors contributed to produce this result, the extraordinary
political sagacity of Olgierd and the life-long devotion of his
brother Kiejstut. The Teutonic knights in the north and the
Tatar hordes in the south were equally bent on the subjection
of Lithuania, while Olgierd’s eastern and western neighbours,
Muscovy and Poland, were far more frequently hostile competitors
than serviceable allies. Nevertheless, Olgierd not only succeeded
in holding his own, but acquired influence and territory at the
expense of both Muscovy and the Tatars, and extended the
borders of Lithuania to the shores of the Black Sea. The principal
efforts of this eminent empire-maker were directed to securing
those of the Russian lands which had formed part of the ancient
grand-duchy of Kiev. He procured the election of his son
Andrew as prince of Pskov, and a powerful minority of the citizens
of the republic of Novgorod held the balance in his favour against
the Muscovite influence, but his ascendancy in both these
commercial centres was at the best precarious. On the other
hand he acquired permanently the important principalities of
Smolensk and Bryansk in central Russia. His relations with
the grand-dukes of Muscovy were friendly on the whole, and
twice he married orthodox Russian princesses; but this did not
prevent him from besieging Moscow in 1368 and again in 1372,
both times unsuccessfully. Olgierd’s most memorable feat was
his great victory over the Tatars at Siniya Vodui on the Bug in
1362, which practically broke up the great Kipchak horde and
compelled the khan to migrate still farther south and establish his
headquarters for the future in the Crimea. Indeed, but for the
unceasing simultaneous struggle with the Teutonic knights,
the burden of which was heroically borne by Kiejstut, Russian
historians frankly admit that Lithuania, not Muscovy, must have
become the dominant power of eastern Europe. Olgierd died
in 1377, accepting both Christianity and the tonsure shortly
before his death. His son Jagiello ultimately ascended the
Polish throne, and was the founder of the dynasty which ruled
Poland for nearly 200 years.
See Kazimierz Stadnicki, The Sons of Gedymin (Pol.) (Lemberg, 1849–1853); Vladimir Bonifatevich Antonovich, Monograph on the History of Western Russia (Rus.), vol. i. (Kiev, 1885). (R. N. B.)
OLHÃO, a seaport of southern Portugal, in the district of Faro; 5 m. E. of Faro, on the Atlantic coast. Pop. (1900) 10,009. Olhão has a good harbour at the head of the Barra Nova, a deep channel among the sandy islands which fringe the coast. Wine, fruit, cork, baskets and sumach are exported in small coasting
