GANGRENOUS CORYZA. 321 



brown, soon acquires a very foetid smell, and is found to contain epithe- 

 lial debris and yellowish-green false membranes. After the least effort 

 to cough or the slightest touch on the membranes themselves — some- 

 times without any visible cause at all — epistaxis sets in, the blood being 

 mixed wdth the discharge or simply escaping in the form of reddish 

 strings, like that occasionally seen in glanders. 



The mucous membrane of the nasal cavities is red, turgid, apt to 

 bleed, and painful to the touch. 



Percussion of the nasal cavities, sinuses, and even of the horns reveals 

 everywhere exceptional sensibility. 



Sometimes, but only in certain subjects, the lower portions of the head, 

 including the muzzle, nostrils, lips and forehead, become infiltrated, as 

 though the case were one of purpura. Thoracic complications are rarely 

 absent, unless the disease is treated. Towards the end of the first week 

 the respiration, still painful and snoring, becomes more rapid ; and 

 auscultation reveals at various points in the lungs areas of bronchitis 

 and of broncho-pneumonia, indicated by bronchial i-ales, rattling breathing, 

 and tubal souffles, etc. These complications are accompanied by attacks 

 of coughing, which increase the discharge, and may threaten to end in 

 sufifocation. This happens when large masses of false membranes frpm 

 the bronchi are thrown into the larynx and cannot readily be ejected 

 through the .glottis, which has been reduced in size by cedematous 

 infiltration and inflammation. 



Percussion is generally useless. The appearance of the eyes is also very 

 significant. These symptoms develop simultaneously with the respiratory 

 disturbance, and are marked by infiltration of the eyelids, cedematous 

 conjunctivitis, and ophthalmia. The cornea becomes whitish, infiltrated, 

 opaque, and sometimes shows ulcerative keratitis ; or, on the other hand, 

 it remains simply semi-transparent, and through it the media of the 

 eye may be seen to have become oj)alescent. Ulcerative keratitis may 

 develop rapidly and end in perforation of the cornea. 



In certain rare instances examination with the ophthalmosco]3e has 

 revealed the existence of exudative iritis ; this condition may be com- 

 plicated with synechia, intra-ocular haemorrhage, and result in perma- 

 nent loss of vision. 



These ocular symptoms are accompanied by continuous, abundant 

 and prolonged discharge of tears, intense photophobia, and exceptional 

 sensitiveness to manual examination, etc. 



Digestive disturbance appears less important, and may be regarded as 

 consequent on the febrile reaction, the general disturbance, or the condi- 

 tion of the respiratory apparatus. But complete examination will show 

 that from the onset of the disease a special form of stomatitis occurs. 

 From the first the mouth is hot and dry : soon afterwards abundant 



D.C. Y 



