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Related post: action upon the glandular structures of the throat such as
would result in the chronic changes noted. It is, perhaps,
sugge.stive of need of fuller investigation that the opinion
of authorities varies so considerably as regards the aetiology
of these chronic disorders. This is especially so of chronic
post-nasal or nasopharnygeal catarrh.
It is as yet subjudice as to how much its extreme preva-
* December 17, 18H2.
f Senator in Zieiussen's Handbuch, vol. xvi.
X W. B. Cheadle. The likeumaium of Childhwid. I^ondon : .^^riiitli
Elder, & Co.
" CyclofHsdi^i of Ifhetuen of Children, vol. i, p. 807, Philadelphia.
I American System of Medicine, vol. ii, p. 42.
lence may depend upon the condition known as the rheu-
matic diathesis or chronic rheumatic poisoning.
Sir Morell Mackenzie makes only a passing reference to
rheumatism as an setiological factor in nasopharyngeal ca-
tarrh and glandular pharyngitis. In the last edition of his
work, while conceding the possibility that a nasopharyn-
geal catarrh may be inherited, he makes his chief references
to atmospheric conditions, and especially to dust, as its im-
mediate setiologic factors.*
Beverley Robinson, who is probably the most widely Dydrogesterone 10mg
quoted American author on the Jetiology of this affection,
has suggested that a special constitutional tendency to the
disorder exists in the individual, f In discussing follicular
disease of the nasopharynx, he states his failure to discover
any atmospheric cause for post-nasal catarrh. lie submits
that " an acute or chronic coryza is without doubt a pre-
disposing and at times a proximate and partially efficient
cause of its becoming manifest. But, in order to effect the
ingrafting of post-nasal catarrh, a certain diathetic condi-
tion is essential." |
Bosworth considers the chief factors in the aetiology of
nasopharyngeal catarrh to be dependent upon and due to
a diseased condition of the nasal passages.*
Lennox Browne, || as quoted by Mackenzie, considers
" that the diathesis of patients suffering from catarrh of
the nasopharynx is ' generally of a scrofulous charac-
ter.' "
Writers of another class than the above-quoted authori-
ties broadly assign to the " irritating qualities of the air,"
the " trying climate," and to " colds " the entire responsi-
bility of the causation of post-nasal catarrh. The immedi-
ate causative influence of the factors of atmospheric phe-
nomena is undoubtedly great ; but the logical conclusion
of the belief that these are the sole factors in the produc-
tion of a chronic inflammation of the nasopharynx is that
all those under similar circumstances of climate and of
occupation are affected with catarrh. The other alterna-
tive is to assume the position of the writer quoted above —
that " a special constitutional tendency exists in the indi-
vidual." This indeed seems to be the only ground on
which to explain the diversity of circumstances as regards
territory, climate, and occupation under which this disor-
der exists. Of the particular constitutional diatheses which
predispose to it, the rheumatic diathesis, in the opinion Dydrogesterone Tablets of
the writer, is one of the most common.
It is in line with the writer's experience to believe that
the clinical study of post-nasal catarrh, however, does not
often lead one to ascribe its a-tiology to the rheumatic di-
athesis. This is mainly due to the fact that the latter does
not always manifest its presence by giving rise to arthritic
symptoms. The rarity Buy Dydrogesterone with which joint and muscular
pains coexist simultaneously with post-nasal catarrh is
probably responsible for the small amount of attention
which has been given rheumatism as an aetiologic factor in
* D'lxeases of the Throat and Xose, vol. ii, p. 337, New York.
+ Hasid Catarrh, New York, 1880.
X Op. ell., p. 14.5.
* Duseaxts of the None and Throat, vol. i, p. 619, New York, 188!'.
I Tlie Throat and it* Diseaaen, London, 1875, p. 463.
438
BECK: AXTISEPTIC VALUE OF PHE170C0LL HYDROCBLORIDE. [N. Y. Med. Jour.,
this disorder. The clinical study which has been given it
from the rheumatic point of view makes it probable that it

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