NASAL DIPHTHERIA. - Diphtheria of the nasal cavities is, in most eases, simple extension from the fauces, or larynx. It may, however, occur as a primary affection. It is characterized by more or less complete obstruction of the nares; a thin, muco-purulent, and often bloody discharge from the nostrils; and a more or less marked toxinia. Pseudo membrane may be developed and may be visible through the anterior nares, but, as a rule, we see no membrane. Tbe nasal discharge is usually very irritating and the nares become excoriated.
The degree of the toxmia varies markedly. Usually it is very moderate, the temperature is not high (100° or 101°), the prostration is not marked, and the chief danger of the cases seems to lie in an extension of the process by con tinuity of tissue, to the pharynx or larynx, or the development of pneu monia.
The affection is often protracted, the discharge from the nose and the obstruc tion persisting for weeks, despite careful treatment.
Lennox Browne reports a total mortal ity of 63.4 per cent. in a series of cases of diphtheria involving the nose, and at tributes to the nasal affection more im portance than to the laryngeal. Few writers or clinicians can agree with this opinion. In practically all the cases of the series reported other parts were in volved besides the nares, and the mor tality-record is a tribute to the gravity of extensive diphtheria rather than to the clanger of the nasal affection alone. In infants, however, nasal diphtheria fre quently proves fatal. It may readily be the origin of a pharyngeal or laryngeal process. It may, furthermore, be the means of communicating the disease to others.