CATAABH OF THE NOSE. 113 



bronchitis. When the fine bronchioles are involved it has a crack- 

 ing or crepitant sound and sibilant bruits ; this is only heard 

 during inspiration. This sound may sometimes be heard in the 

 alveolar passage and in the alveoli themselves when they are filled 

 with mucus or closed up, and where the air can only reach them 

 by strong inspiration. This is seen in the first and third stages 

 of croupal and catarrhal pneumonia, in cedema of the lungs, and 

 ill capillary bronchitis; in the last the crepitation is mixed with 

 an irregular rattling sound. We have also the friction-sound 

 of the pleura; this is not heard in the normal condition, but in 

 disease; it is either crepitating, scraping, or scratching. It is heard 

 in pleurisy; as a rule, it is louder on inspiration than expiration; 

 it is produced by collections of fibrinous accumulations on the 

 pleura. These sounds are not heard when the pleura is separated 

 by the presence of an exudate; the sound is plainest at the com- 

 mencement of the disease and when the exudate is being absorbed. 

 This sound is not altered by coughing, and in this way can be 

 distinguished from rattling sounds, which are heard when it is a 

 case of pleuro-pneumonia. The rubbing sound caused by the 

 broken ends of a fractured rib is indicated by the crepitation on 

 movement of the ends of the rib. 



DISEASES OP THE NASAL CAVITIES. 



Catarrh of the Nose. 

 (Cold in the Head; Coryza ; Rhinitis; Nasal Catarrh) 



Etiology. Catarrh of the nose (catarrhal inflammation of 

 the nasal raucous membranes) occurs very frequently and origi- 

 nates from local causes (dust, smoke, pentastomum tsenioides) or 

 by cold. Cold iu the head is also a symptom of distemper, and 

 may appear secondarily in any iaflammation of the other mucous 

 membranes of the head. 



Clinical Symptoms and Course. These are sneezing, wiping 

 the nose with the paws, or rubbing it against some object. Later, 

 a nasal discharge, which is watery and liquid at first, and later 

 becomes turbid, thicker and more tenacious; and it may become 

 purulent, according to the complications that may appear later on. 

 If the cavities in the upper chamber of the nose are affected, the 



