PHARYNGO-FAUCIAL INFILTRATION.— About the time the roseola appears, times shortly before or after it, there is a development of inflammatory engorge ment of the tonsils, pharynx, and soft palate, involving usually the whole fan cial surface. The explanation of the volvement of the lances and pharynx characteristic of secondary syphilis, upon the ground of lymphatic engorgement, the primary cause of which is the abun dance and superficial character of the lymphatic capillaries of the affected parts, is quite plausible. That vasodilation due to the action of syphilotoxins upon the sympathetic is an associate factor is pos sible.
Among 2500 consecutive cases treated in the ear department of the Pennsyl vania Hospital, 7 were distinctly of syphilitic origin. Bulkley, in an anal ysis of 905S extragenital chancres, found 27 cases in which the sore was located on the external ear. Secondary and ter tiary manifestations are met with much more frequently. Hereditary syphilis of the ear manifests itself most frequently in the middle and inner ear. Syphilitic disease of the middle ear originates usually from infection through the Eustachian tube. Lesions of the inter nal car occur very late in the course of syphilis. The symptoms of this condi
tion are tinnitus and deafness coining on suddenly in either one or both ears, and not infrequently accompanied by unilateral facial pal•. Packard (Jour. Amer. Aled. Assoc., Feb. 2, 1901).
Several cases of secondary syphilis of the throat witnessed in which itchiness of the flumes was present. This was not a mere tickling, but a definite itchiness in every way comparable to the ordi nary feeling experienced in the skin, and accompanied by a similar desire for counter-irritation by scratching. In two cases this symptom was most marked. In both the itchiness had appeared very shortly after the onset of the sore throat, namely: about eight weeks after the appearance of the chancre.
That itchiness should occasionally be a fairly marked symptom in syphilitic affections of the mucous membrane is the more remarkable, since, with the ex ception of small papillar syphilides, spe cific cutaneous eruptions seldom itch much, often, indeed, not at all. A. A. Scot Skirving (Brit. Jour., May 4, 1901).