108 CLINICAL DIAGNOSTICS. 



severe. In tuberculosis, notwithstanding the severity of the 

 case, there is little discharge because what little exudate 

 appears upon the surface of the mucous membranes is re- 

 moved by coughing and eventually swallowed. 



The discharge is copious in strangles and in diffuse 

 catarrhs of the upper air passages and bronchi. 



Unilateral nasal discharge is characteristic of disease of 

 one side of the anterior air passages as far back as the fauces. 

 A catarrh involving but one side of the soft palate or pharynx 

 may also show a discharge from only one nostril. 



Of especial importance is the variation in quantity of the 

 discharge. In some cases a copious amount of discharge is 

 ejected when the head is suddenly lowered [unreining after a 

 drive], while for a day or more there is present either no dis- 

 charge at all or only a very slight one. This symptom is 

 characteristic of catarrhs of the frontal and superiormaxil- 

 lary sinuses and of the guttural pouches. 



b. The color. The color of the nasal discharge de- 

 pends upon the character of the inflammation, and also the 

 presence of foreign mixtures. It will vary from colorless to 

 grey, zvhite, yellow, red, brown or green in all their different 

 tints. During the course of a disease the color of the nasal 

 discharge will change with the character of the inflamma- 

 tion. A serous or mucous discharge is usually colorless ; a 

 purulent discharge is grey or yellow or may be of a greenish 

 hue. 



A colorless and clear discharge is noted in serous and 

 mucous catarrhs. 



A gray discharge is due to the admixture of epithelial 

 cells ; if leucocytes appear in it the color is greyish-white ; if 

 red blood corpusc'es are present a greyish-yellow or even yellow 

 color is given to the discharge. 



A green discharge is usually due to an admixture of the 



