470 AFFECTIONS OF THE PHARYNX. 



gina causes the same annoyances as severe catarrhal angina; we only 

 discover the form of the inflammation by inspecting the pharynx. On 

 careless examination, the gray patches may be mistaken for ulcers, 

 with fatty bases. 



The subjective symptoms of parenchymatous angina are not altered 

 by croup, so that, in this case also, the croup is first recognized on in-* 

 epecting the pharynx. 



Croupous angina, which usually occurs epidemically with croupous 

 laryngitis, is easily overlooked, as it causes proportionately little diffi- 

 culty, which, moreover, will probably be misunderstood, as it affects 

 children almost exclusively. If we examine the fauces of children sick 

 with croup, we often find them covered with croup membrane, although 

 the parents may not have noticed that the children had any difficulty 

 m swallowing. We have before said how important for diagnosis and 

 prognosis it is to examine the throat of every child affected with 

 hoarseness. 



TREATMENT. The treatment of croup occurring idiopathically, after 

 catching cold, etc., is the same as that for the severe forms of pharyn- 

 geal catarrh. 



Pharyngeal croup accompanying croupous laryngitis requires, as we 

 have already said, the prompt removal of the membrane, and energetic 

 cauterization of the affected mucous membrane, with a concentrated 

 solution of nitrate of silver. 



CHAPTER III. 



DIPHTHERITIC INFLAMMATION OP THE PHABYNGEAL MUCOUS MEM- 

 BRANE. 



DIPHTHERITIC inflammation, in which a fibrinous exudation is de- 

 posited in the tissue of the mucous membrane, and presses on its ves- 

 sels so as to cause it to slough, attacks the pharynx very frequently. 

 Diphtheritic pharyngitis, however, does not occur as a primary and in- 

 dependent affection, but in almost all cases depends on infection of 

 the blood from the poison of scarlatina, or of the disease we call epi- 

 demic diphtheria and class among the infectious diseases. (We speak of 

 croupous and diphtheritic inflammations of the different mucous mem- 

 branes ; but when we speak of " croup," or " diphtheria," we always 

 mean croupous inflammation of the laryngeal mucous membrane or 

 diphtheritic inflammation of the pharyngeal mucous membrane.) We 

 shall hereafter give a detailed account of diphtheria, when speaking 

 of scarlatina and epidemic diphtheria. 



