SIGNIFICANCE OF THE pH OF NASAL SECRETIONS IN SITU: FURTHER STUDIES

Abstract

In a previous communication I1maintained that nasal vasoconstrictors with an unusually highpHvalue may (1) disturb the normalpHlevel of nasal secretions in situ in the clinically normal nose, (2) enhance irritation of the nasal mucous membrane and (3) postpone the return of the nasal mucosa from a pathologic alkaline status to a normal, slightly acid status. It has been suggested that during acute rhinitis, acute rhinosinusitis and the more active stages of allergic rhinitis the employment of a nasal vasoconstrictor which lowers the alkalinepHto a normal acid level, between 5.5 and 6.5, is most desirable. The fact that 1 per cent ephedrine hydrochloride in physiologic solution of sodium chloride—a nasal vasoconstrictor almost universally acceptable to rhinologists—has apH(5.9) that practically cleaves the midpoint between 5.5 and 6.5 furnishes adequate testimony to the truth of this concept. It has been suggested further that there