464 AFFECTIONS OF THE PHARYNX. 



catarrh induced by spirituous liquors depends on their direct action, 



2. In other cases, the catarrh undoubtedly depends on catching cold. 



3. Not unfrequently it is propagated from neighboring parts to the 

 pharyngeal mucous membrane. In this class belong the catarrhs oc- 

 curring in mercurial stomatitis, and those difficulties of swallowing 

 which accompany the later stages of laryngeal catarrh. Sometimes it 

 accompanies catarrh of the stomach ; but every angina is not, as was 

 formerly supposed, of gastric origin. Not unfrequently catarrhal an- 

 gina must be regarded as the result of a blood-disorder. It is not a 

 complication, but a symptom of scarlatina, which is just as constant as 

 the exanthema. More rarely in exanthematous typhus, or measles, 

 which are always accompanied by catarrh of the respiratory organs, 

 there is also pharyngeal catarrh. Among the chronic infectious dis- 

 eases, constitutional syphilis often makes its appearance as pharyngeal 

 catarrh ; but other changes in the tissues of the pharynx usually occur 

 soon, which will be spoken of hereafter. 5. Sometimes catarrhal angi- 

 na is epidemic. A large number of persons are taken sick without our 

 knowing the influences inducing the affection. In many other cases, 

 also, the exciting causes are unknown. 



ANATOMICAL APPEARANCES. In acute catarrhal angina, the mu- 

 cous membrane, especially that of the soft palate, appears dark red. 

 The swelling of the mucous and sub-mucous tissue is most evident at 

 the uvula, which has plenty of relaxed sub-mucous tissue. The uvula 

 is thicker, but especially longer, and often rests on the root of the 

 tongue ("the palate is down"). The tonsils also are more or less 

 swollen. At first the mucous membrane is dry ; later, it is covered 

 with cloudy secretion, particularly about the tonsils and posterior wall 

 of the pharynx. 



In chronic catarrh of the fauces, the membrane does not appear 

 regularly reddened ; it is traversed by varicose veins, and is darker-col- 

 ored. The swelling is greater and more irregular than hi the preced- 

 ing variety. The diseased mucous membrane sometimes appears dry 

 and glistening, sometimes covered with a cloudy secretion. On the 

 soft palate and uvula the swollen and closed glands often appear as 

 small granules, or they form small yellow vesicles, which soon rupture, 

 and leave round (folh'cular) ulcers. In the dilated openings of the 

 tonsils there are occasionally found cheesy, badly-smelling plugs or 

 stony concretions, which are the putrefied or petrified contents of the 

 follicles. 



Recently, chronic pharyngeal catarrh has received a great deal of 

 attention in the journals and treatises on baths, but it has not been 

 sufficiently considered in the text-books on pathology. Occasionally 

 it is limited to the pharyngeal mucous membrane ; again, it extends to 



