of cleaning the body is relatively new in the history of mankind. Until
supplies were made safe in the last century water was known to be the
carrier of deadly diseases like cholera. Our current ideas about washing
began with Ignaz Semmelweis.
the 1840’s Semmelweis found out that women in labor were less
likely to get "childbed fever" if the doctors washed their hands
in a solution of chloride and lime before they examined the women.
Childbed fever, or Puerperal sepsis, was caused by bacteria that the
doctors carried on their hands from the dissecting room to their patients in labor.
Many people died from infections in that day and the doctors picked up the
bacteria as they were dissecting – without gloves – and introduced
them to the women they then examined. Fifteen percent of women giving
birth in hospitals were dying because of these infections. The hand-washing
in Vienna, but Semmelweis could not persuade his colleagues elsewhere that
they were causing their patients illness. Twenty years later Pasteur, and
his germ theory, showed that Semmelweis was right, but even then most physicians
would not even accept Pasteur’s findings. Hand-washing, and what doctors
call aseptic technique, was not accepted until the 1880’s. Even
the stubborn could not refute what they were seeing under the lenses of
their ever more common microscopes. The CDC tells us "Hand-washing
is the single most important means of preventing the spread of infection."
It is easy to see the benefit of hand
washing before surgery or any hands-on-exam that may introduce bacteria
into the body. It is harder to see the benefit of regular hand washing in
the absence of this invasive exposure – but we invade ourselves. The
bacteria that make us sick don’t get into our bodies through our hands,
but we put our hands to our own faces and the bacteria invade through
eyes, nose and to a lesser extent the mouth.
The unstated purpose of hand washing is to protect the face and especially
the nose, because that is where most infections enter. An excellent review of the history of hand-washing is
found at the web site for access excellence.
web site also tells the story of some New York pediatricians who complained
to the city's health board that the boards promotion and teaching of
good hygiene, which included hand washing, to the city's mothers was adversely
practices. A system that pays physicians, who are supposed to keep us
well, only when we are sick can, at times, lead to problems – and some
of them may still be with us. For more about this see the story of Sara
Baker at commonsensemedicine.org
washing the nose?
Saline nasal sprays have been available for
a long time.
- They actually
became popular to counter the dryness that went with the use of antihistamines
- Regular use
decreases inflammatory markers in the nose and improves quality of life.
while they loosen the mucus they don't help to clean the cells under the mucus.
- Hypertonic solutions using saline are
These solutions are more concentrated than the fluid
in the tissues of the nose.
They speed the clearance of the nasal mucus by pulling
the cells to help with the washing.
To learn more about
this commercially available solution this link
will take you to their web site.
saline is easy to make and expensive to buy.
The problem with making it is that many people think
that more is better. This is not the
case with saline.
Isotonic saline is made
by adding a half teaspoon of salt to a cup of water.
slows the cilia.
A little more than three teaspoons of salt in the same amount of water
paralyses the cilia temporarily, and twice that paralyses
doctors recommend regular irrigation of the nose with lots of these fluids.
more likely to remove the mucus than sprays, but the mucus is the stuff
that catches the bacteria—some
of it is good.
- If you could look
into the back of the nose with a microscope you would see the bacteria
in the mucus, not on the cells.
Removing the mucus allows the bacteria to attach to the cells where they can
problem with saline, especially hypertonic saline, is that the body's own
antibacterial defenses, that are present in the fluids coating the airways,
underneath the mucus (they're called defensins), work
better when the saline concentration is lower. This concept is covered in the
section on saline and defensins.
does this because the small xylitol molecule acts osmotically to pull fluid,
water, to itself. This water reduces the saline concentration allowing the
defensins to be more effective.
- Hyperosmolar solutions
have more small molecules like sugars or proteins in a solution than the
body's fluid have. By osmosis they pull water into these
we breathe cold dry air the water in our nose evaporates to moisten the air
and the solutions remaining become hyperosmolar. This stimulates more blood
flow and our normal
- Researchers at
Johns Hopkins University
duplicated this condition by putting a solution of mannitol in the nose that was about three times more concentrated
than the fluids in the body. They found that when they put about a teaspoon
of this solution into the nose and let it sit for only ten seconds that
it does two things.
stimulates the release of histamine.
It pulls fluid from the tissues of the
other words this hyperosmolar solution turns on the washing machine and makes it more
effective by pulling the water from the tissues— more water is added for the
washing. And it pulls this water from underneath the mucus in a way that is
virtually identical to our own normal nasal cleaning—the fluid lifts the
mucus up off the cilia. And the histamine helps this process.
Xylitol is a sugar alcohol with osmotic properties similar
to mannitol. The osmolality of the xylitol in the spray I use is about 2 1/2
times the normal body osmolality—high enough to reproduce this effect.
Iowa researchers, mentioned earlier and covered in a different page, used
5% (near normal
osmolality) of xylitol in a nasal
spray. They found several important benefits of xylitol:
use four times a day for four days reduced bacterial colonization
is not absorbed by nasal cells so it stays in the mucus and ends up in
the stomach when the mucus is swallowed.
bacteria cannot use xylitol for food so they can't grow as rapidly as they normally
researchers referred to the work
of the Finns with xylitol, but gave little credit to the effects of xylitol
on particular bacteria demonstrated by
the Finnish studies. I believe these effects are very significant.
Physiologic and hypertonic saline solutions impair
ciliary activity in vitro.
Boek WM, Keles N, Graamans K, Huizing EH
Department of Otorhinolaryngology, University Hospital Utrecht, The
OBJECTIVE/HYPOTHESIS: Physiologic saline (NaCl 0.9%) is commonly used
in treating acute and chronic rhinosinusitis. Moreover, physiologic
saline is used as a control medium, vehicle, or solvent in studies on
ciliary beat frequency (CBF). Hypertonic saline (NaCl 7% and 14.4%)
has been applied in attempts to enhance mucociliary transport in
patients with cystic fibrosis or asthma and in healthy subjects.
Therefore the objective of this study is to document in vitro effects
of saline solutions in different concentrations on CBF. STUDY DESIGN:
Experimental, in vitro. METHODS: The effects on CBF of cryopreserved
mucosa of the sphenoidal sinus was measured by a photoelectrical
method. Initial frequencies, measured in Locke-Ringer's solution (LR),
were compared with CBF after exposure to NaCl in concentrations of
0.9%, 7.0%, and 14.4% (w/v). RESULTS: NaCl 0.9% has a moderately
negative effect on CBF. The 7% solution leads to a complete
ciliostasis within 5 minutes, although this effect turns out to be
reversible after rinsing with LR. A hypertonic solution of 14.4% has
an irreversible ciliostatic effect. CONCLUSION: LR is an isotonic
solution that has no effect on CBF. Therefore it is probable that this
solution is more appropriate than saline for nasal irrigation and
nebulization or antral lavage. Moreover, the results of this study
suggest that mucolytic effects induced by hyperosmolarity should be
attained preferably with hypertonic saline 7% in patients with cystic
fibrosis or asthma. At this concentration, the ciliostatic effect is
reversible, whereas irreversible changes are to be expected at higher
- [A free full text of this article is available at www.ncbi.nlm.nih.gov:80/entrez/utils/fref.fcgi?http://www.pnas.org/cgi/pmidlookup?view=full&pmid=11027360]
The osmolyte xylitol reduces the salt concentration
of airway surface liquid and may enhance bacterial killing.
Zabner J, Seiler MP, Launspach JL, Karp PH, Kearney WR, Look DC,
Smith JJ, Welsh MJ
Howard Hughes Medical Institute, Departments of Internal Medicine,
Pediatrics, and Physiology and Biophysics, and Nuclear Magnetic
Resonance Facility, University of Iowa College of Medicine, Iowa City,
IA 52242, USA. firstname.lastname@example.org
The thin layer of airway surface liquid (ASL) contains antimicrobial
substances that kill the small numbers of bacteria that are constantly
being deposited in the lungs. An increase in ASL salt concentration
inhibits the activity of airway antimicrobial factors and may
partially explain the pathogenesis of cystic fibrosis (CF). We tested
the hypothesis that an osmolyte with a low transepithelial
permeability may lower the ASL salt concentration, thereby enhancing
innate immunity. We found that the five-carbon sugar xylitol has a low
transepithelial permeability, is poorly metabolized by several
bacteria, and can lower the ASL salt concentration in both CF and
non-CF airway epithelia in vitro. Furthermore, in a double-blind,
randomized, crossover study, xylitol sprayed for 4 days into each
nostril of normal volunteers significantly decreased the number of
nasal coagulase-negative Staphylococcus compared with saline control.
Xylitol may be of value in decreasing ASL salt concentration and
enhancing the innate antimicrobial defense at the airway surface.
In vivo release of inflammatory mediators by
Silber G, Proud D, Warner J, Naclerio R, Kagey-Sobotka A,
Lichtenstein L, Eggleston P
Department of Pediatrics, Johns Hopkins University School of Medicine,
Baltimore, Maryland 21205.
Hyperosmolar environments induce histamine release from mast cells and
basophils in vitro. To assess whether the same stimulus induces
mediator release in vivo, 15 healthy human volunteers underwent nasal
challenges with instilled solutions of differing osmolalities:
lactated Ringer's solution (257 +/- 3 mOsm/kg), isosmolar mannitol
(277 +/- 6 mOsm/kg), and hyperosmolar mannitol (869 +/- 8 mOsm/kg).
The effect of these challenges on the volume, osmolality, and
inflammatory mediator content of subsequent 5-ml isosmolar lavages was
determined. The volumes of lavages returned after hyperosmolar
challenges were significantly greater than those after isosmolar
challenges (5.5 +/- 0.2 ml versus 4.2 +/- 0.1 ml; p less than 0.01)
and these lavage solutions had higher osmolalities. Even when
corrected for increased volumes, the lavages after hyperosmolar
challenges contained significantly higher quantities of inflammatory
mediators such as histamine (29.0 versus 10.1 ng; p less than 0.01),
TAME-esterase activity (32.7 versus 11.1 cpm x 10(-3); p less than
0.01), and immunoreactive leukotrienes (9.9 versus 3.4 ng; p less than
0.01). The changes in mediators were dose dependent in that
incremental increase in challenge osmolality were associated with
incremental increases in histamine release. Therefore, when exposed to
hyperosmolar stimuli in vivo, the nasal respiratory airway releases
inflammatory mediators and fluid rapidly shifts into the airway lumen.
It has been suggested that the mediator release observed on breathing
cold and dry air is due to increased osmolality of airway secretions;
the present data confirm that osmotic variations at the airway surface
can provide an adequate stimulus for cell activation.
The spray described in these pages
is not a drug. This means that the people manufacturing this spray
cannot advertise what the spray does to prevent disease and illness.
The spray only helps to clean your nose. The benefits come from
a clean nose. The only way people will learn about this practical
and sensible way to help the immune system wash pollutants from
the back of the nose is by interested people, like you, sharing
If you have family or friends with any of these problems, they
may benefit greatly from your sharing this information with them.
Links in the other sections, referring to a person or study, will
take you to a Medline summary, from the National Library of Medicine,
of the article in question.
This spray is protected by United States and international patents.
While careful reading of these pages will tell you how to mix this
spray yourself we request that you do not sell such spray on the
open market. Such sales would be prohibited by the above mentioned
Disclaimer: All material provided in this web site is provided
for educational purposes in the hope of improving our general health.
Access of this web site does not create a doctor-patient relationship
nor should the information contained on this web site be considered
specific medical advice with respect to a specific patient and/or
a specific condition. Copy sections of this page and discuss them
with your physician to see if they apply to your own symptoms or
Dr. Jones specifically disclaims any liability, loss or risk, personal
or otherwise, that is or may be incurred as a consequence, directly
or indirectly, of use or application of any of the information
provided on this web site.
A. H. 'Lon' Jones D.O.
812 West 8th St. Suite 2A
Plainview, Texas 79072
Phone (806) 291-0700
Fax (806) 293-8229