DELICATE DIAGNOSTIC SIGNS. 153 



"At the first appearance of this group of symptoms 

 one is apt to suspicion the existence of glanders, but a 

 careful examination will prove it to be unfounded. On 

 examining the nasal cavity, the lining membrane will 

 be seen to be smooth, polished, and uniformly rosy, 

 with its normal follicular. openings, and on unfolding 

 the superior wing of the nostril, the salient border of 

 the cartilage presen ts a neat and polished surface, with- 

 out any little pimples or morbid tint. Now, we know 

 that in glanders, even of the sinuses, which is often 

 unaccompanied by cankers or other ulcerations, it is 

 in those places certain specific morbid signs may be 

 recognized, which, although very superficial and with 

 difficulty seen by the eye, are nevertheless of great 

 value in the diagnosis. Such, for instance, are the 

 peculiar aspect of the salient border of the wing of the 

 nostril, with its vivid red tint, the small superficial 

 erosions of the lining membrane, entirely hidden under 

 the fold of the cartilage, and those small granular pro- 

 jections called tubercles. In the jettage from caries 

 nothing of this kind exists. There is a marked differ- 

 ence in the odor too; in caries the odor is exceedingly 

 fetid, while in glanders it is almost null. 



" If, after this attentive examination, the surgeon is 

 still in doubt as to the specific nature of the nasal dis- 



small opening, with the nasal passage also. This opening is 

 situated at the supero-posterior part of the middle meatus, and 

 is guarded by an imperfect valve, which, when pressed upon 

 from within, either partially or wholly closes it. It may also 

 be closed by the mucous membrane being thickened by disease. 

 Internally the sinuses are partially divided into compartments 

 by thin osseous plates, and are lined by a slightly vascular mem- 

 brane, which is continuous with that of the nasal passage, but 

 is, not so thick nor so vascular," 



