y known and that is
the fact that the germs of diphtheria may remain in the throat of a
patient for weeks, and even months, after all signs in the throat have
disappeared and the patient seems well. In such cases, however, the
disease can still be communicated in its most severe form to others.
Therefore, in all cases of diphtheria, examination of the secretion in
the throat must show the absence of diphtheria germs before the
patient can rightfully mix with other people.

Gargling and swabbing the throat with the (poisonous) solution of
bichloride of mercury, 1 part to 10,000 parts of water (none of which
must be swallowed), should be employed every three or four hours each
day till the germs are no longer found in the mucus of the tonsils.

=HOARSENESS= (_Acute Laryngitis_).--This is an acute inflammation of
the mucous membrane of the larynx. The larynx is that part of the
throat, in the region of the Adam's apple, which incloses the vocal
cords and other structures used in speaking. Hoarseness is commonly
due to extension of catarrh from the nose in cold in the head and
_grippe_. It also follows overuse of the voice in public speakers and
singers, and is seen after exposure to dust, tobacco, or other smoke,
and very commonly in those addicted to alcohol.

=Symptoms.=--Hoarseness is the first symptom noticed, and perhaps
slight chilliness, together with a prickling or tickling sensation in
the throat. There is a hacking cough and expectoration of a small
amount of thick secretion. There may be slight difficulty in breathing
and some pain in swallowing. The patient feels generally pretty well,
and is troubled chiefly by impairment of the voice, which is either
husky, reduced to a mere whisper, or entirely lost. This condition
lasts for some days or, rarely, even weeks. There may be a mild degree
of fever at the outset (100 deg. to 101 deg. F.). Very uncommonly the
breathing becomes hurried and embarrassed, and swallowing painful,
owing to excessive swelling and inflammation of the throat, so much so
that a surgeon's services become imperative to intube the throat or to
open the windpipe, in order to avoid suffocation. This serious form of
laryngitis may follow colds, but more often is brought about by
swallowing very hot or irritating liquids, or through exposure to fire
or steam. In children, after slight hoarseness for a day or two, if
the breathing becomes difficult and is accompanied by a crowing or
whistling