RESPIRATORY APPARATUS. IQl 



1. Where stagnant masses of putrefying exudate are in 

 the turbinated bones, sinuses, gutteral pouches, or even on the 

 mucous membrane of the upper air passages and bronchi. 



2. In putrid decomposition of tumors in the air passages. 



3. In suppuration or necrosis of the bones of the h*^ad 

 bordering on the air passages: Suppuration in the tooth 

 alveoh. dental caries, necrosis of the turbinated bones. 



4. In gangrene of the hmgs. 



It is always important to determine where the odor 

 originates. At first we should be clear as to whether it 

 really comes from the nose or from the mouth. When the 

 mouth is closed, this is usually not difficult ; in doubtful cases 

 the odor of the saliva can be tested. The safest way is to 

 make an examination of the buccal cavity, especially 'of the 

 teeth. Wlien the alveoli of the upper molars are diseased, a 

 carious smell is emitted from both the mouth and nose. (See 

 Examination of the Mouth). 



If the offensive odor has been found to come from the 

 expiredair,itis then necessary to locate the part of the 

 respiratory apparatus at which the decomposition is taking 

 place. For this purpose we should first determine whether or 

 not the odor is equally offensive from both nostrils. When 

 the odor from one nostril is more prevalent than from the 

 other, the process of decomposition has its seat in the nasal 

 cavity of that side, and usually it is accompanied by a unilat- 

 eral nasal discharge, bulging of the facial bones and swelling 

 of the submaxillary lymph glands. 



The examination of the upper molar teeth of that side 

 should never be neglected. 



When the odor is equally oft'ensive from either nostril, 

 the putrid focus is as a rule contained in the lung, more rarely 

 in the pharynx, larynx or trachea. 



Putrid decomposition in the lung is not 

 always to be ascribed to pulmonary gan- 

 grene, for not infrequently adecomposi- 



