Gross Anatomy 

I am an unemployed layabout with a nasty head cold. Recently, however, I have noticed that when I blow my nose, tear-liquid actually SQUIRTS out of my right eye. Does this mean that I'm blowing too hard? Has my head sprung a leak? Can I do damage to my brain? Is there a possibility that my eyeball might pop out?

--Drippy in Silver City

Now, that's what I call a party trick. Work on your aim a bit, and master, say, shooting houseflies out of the air, and you're a cinch for The David Letterman Show. Instant fame, I must caution, may be fleeting; you'll need more than a single gag to go professional. So, stay committed to the task. It would certainly be a shame to see you waste your considerable talent by using it merely to keep the cat off the countertop.

A flash-in-the-pan fate is not as unlikely as you may think; a similarly talented man appears in vintage footage on the video site YouTube, smoking a pipe through the inner part of his eye and blowing smoke out of his mouth. Your matching, yet disturbing feats are made possible by our ingenious anatomy, which I will explain in a moment. But first, I'd like to ask Eye-Smoking Guy exactly how many other bodily openings he tried before stumbling upon his eyeball?

The tears in our eyes are created by a gland about the size and shape of an almond, which lies just behind the outer edge of the eyebrow. Protected by bone, the lacrimal gland secretes tears into the eye through about a dozen ducts located nearby. Without some sort of drain, the overflow would leave us weeping harder than Richard Simmons watching Titanic. A set of drainage holes are located above and below the little pink spot best known for production of "eye goop" at the inner corner of the eye. Your tears drain through these holes into a tube, called the nasolacrimal duct, which leads directly into the empty space behind the nose.

According to Gray's Anatomy (the book, not the television show), the nasolacrimal duct ends in an "imperfect valve," which is the likely reason you can magically extinguish candles with little more than a glance. By blowing your nose too strongly, you probably increase pressure enough to force the usually one-way, drain-only valve to invert, sending a stream of liquid out your eyeball. Fun, sure, but blowing your nose too hard can lead to some unwanted consequences--like nosebleeds or sinusitis.

Those loud, satisfying honks familiar to library patrons can easily break many of the blood vessels that trace the thin mucosal lining of the nose. Perhaps more seriously, vigorous blowing may launch bacteria and viruses into the sinuses, resulting in either simple inflammation or a full-fledged sinus infection. A recently reported, but seemingly unpublished study demonstrates this well. Ten volunteers allowed a dye to be placed in the back of their nasal cavities; three were instructed to cough, three were induced to sneeze, and four were told to blow their noses (not necessarily forcefully). No dye was found in any of the sinuses of the cough or sneeze groups, but it was clearly present in three of the four blowers.

So how does one learn to blow properly? Certainly not from the runners and cyclists well known for one-fingered, side-leaning, tissue-free, snot rockets. The proper technique is to use a paper tissue, rather than a cloth hanky (we should all be thankful the days of demonstrating compassion by handing a tearful stranger a mucus-covered rag are over). Closing one nostril at a time, with a finger to the side, is generally agreed to be more effective and gentler on the nose than a double-barreled discharge. By starting slow, and building up to a constant moderate pressure, you also avoid the abrupt horsepower that can send germs up into the sinuses, instead of out into the Kleenex. And since the typical cold-sufferer blows their nose more than three dozen times each sick day, there will be no shortage of practice opportunities.

As for show-biz opportunities, I know much less. But what I do know is that if blowing too hard is capable of sending germs into the sinuses, it would be equally capable of catapulting them into your eye during your performances. A standing order for prescription antibiotic eye drops may seem like just a part of your overhead, but it's a bad long-term business plan. Thus, I might recommend a different career direction; have you ever considered editing a newsweekly?

Dr. Ed Rabin is a chiropractor practicing at Life Chiropractic Center in Boise. Send 36 Kleenexes and health-related questions to theantidote@edrabin.com (on the Web at www.edrabin.com).

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