All blood vessels are abnormal from capillaries to arteries, their walls are all defective and usually unduly dilated.
Peculiar carrion-like odour from these aural abscesses very characteristic.
Often discharges cheesy or curdled. If free from ear troubles these children invariably suffer from throat affections, especially tonsils, They appear well in the daytime and free from pain but at night their sufferings begin, and they often scream with ear-ache. They may begin as early as the first year and go on until puberty. The least exposure to cold or slightest draught brings on an attack. Occasionally we have prolonged febrile attacks with great suffering, suddenly better for the breaking of an abscess. Quite often their general health is better even when the ear is discharging copiously of this tubercular foul smelling pus.
Ears look pale, white, often cold, and in the blood vessels enlarged bluish in colour traceable in the tissues.
Eczematous eruptions about the ears and especially the humid eruptions, pustules, fissures and incrustations behind the ear.
NOSE AND SMELL.
Nose haemorrhages are profuse, bright red, difficult to arrest and are better cold applications. Over heating, over exercise will often bring them on.
The tubercular child will have a haemorrhage from the nose on the slightest provocation-blowing the nose, a slight blow, or washing the face even will produce it in some people.
Headaches, vertigo and congestions to the brain and head are often ameliorated by nose-bleeds.
In worst form of hay fever where there is much sneezing and with much local trouble it often depends on the tubercular taint with an acquired latent SYCOSIS ingrafted. Discharge soon becomes thick, purulent and sometimes bloody.
Hay fever is an expression of SYPHILIS and LATENT SYCOSIS very often with a PSORIC taint (R)
Rush of blood to surface inducing great heat.
Acne Rosacea.
Catarrhal discharge is thick, usually yellow and of the odour of old cheese or sulphate of hydrogen, and is constantly dropping down the throat.
In lupus of the nose the three miasms are usually present.
FACE
Eyes sunken with blue rings.
Circumscribed red spots on cheeks, usually appearing afternoon or evening.
Flashes of heat to face, head and chest.
Red lips where blood is almost ready to ooze out.
Reddish millet-sized papules on nose, cheeks, chin and ulcers in corners of mouth.
Deep fissures in lips.
In tubercular fever face is pale or with circumscribed red spots on cheeks.
Paleness of face on rising and even after eating. One cheek red, the other pale; one cheek hot, the other cold.
Tubercular face is round, skin fair, smooth and clear, with that waxy smoothness and complexion; eyes bright and sparkling, eyebrows and eye-lashes soft, glossy, long and silken, thin lips.
or
We have the high cheek-bones, thick lips, almost like a African, in some cases the skin of the face is rough, voice coarse, deep, often hollow, eyelids red, in flamed, scaly crusty lashes, broken, in stubby, irregularly curved & imperfect In these cases the SYPHILITIC or Tubercular element predominates in latent from.
The face and head is often seen to be in the shape of a pyramid, with apex at the chin. The nose may be well shaped, the features sharp, eyes unusually bright and sparkling, nostrils small, opening narrow and the least obstruction in the nose induces them to breathe through the mouth, which causes an imperfect expansion and filling of the lungs.
We may not see the flashes of heat or circulatory expressions we see in the other expressions of the tubercular face; indeed the face looks fairly well, even in the last stages of disease, when other parts of the body become emaciated and show marked signs of the disease.
CAVITY OF THE MOUTH, TEETH AND GUMS.
Tree ulcers.
Swelling and induration of glands and such pathological changes as we see taking place in the teeth or dental arches are if a SYPHILITIC or TUBERCULAR diathesis.
Haemorrhage of mouth, excessive bleeding of gums (unless Syphilis is actually present) — often they will bleed at slightest touch.
Gums recede from teeth or they are soft and spongy. The dental arch is imperfect, irregular, or teeth are imperfect in form, club shaped, or they come in an imperfect or irregular order, often decaying or becoming carious before they are entirely through the gums. They appear often with much pain and suffering, accompanied with constitutional disturbances, often, a marked degree, such as diarrhoea, dysentery, spasms, convulsions, febrile states, abscesses of the middle ear, disturbance of digestion, meningeal congestion, and meningeal inflammation. These children cannot endure EXTREMES or heat or cold.
