Patients with this form of catarrh are frequently mistaken in diagnosing their own cases. I have had them to come in my office asking me to make a prescription for biliousness. They get that idea because they have a dry and coated tongue and a very bitter taste in mouth. After an examination is made you fail to find symptoms to corroborate the patient’s diagnosis, but will soon find the real cause. With the reflected light and nasal speculum it takes but a short time to satisfy your mind from conditions of nose that have all the symptoms of ozena. There is a discharge made up of mucus which is very thick, therefore not very easily expelled, and as a result finds its way into all the fossæ and crevices in the nose. It is not long until this is dried into crusts which obstruct the passages of air, and being retained, decompose, throwing off a peculiar, penetrating stench. These crusts adhere very firmly to the membranes. The patients will remove them by artificial means, owing to the uncomfortable feeling produced by them. When the scabs are torn away there may be an oozing of blood. A stuffed up and oppressed fullness in the superior and posterior portion of the nasal passages is present. In the first stages of the disease the mucus will fall down from the palate in small slugs or masses, which as the disease goes on become more and more tenacious and more of a muco-purulent nature. In the beginning this discharge can be “hawked up,” but soon it becomes too thick and dry. While the membranes may be so irritated that there will be a free discharge of blood, still there is no real ulcerative process. The septum in some cases is perforated, but this is caused more by tearing away the dried-up discharge than anything else. The sufferers from ozena are never the strong and vigorous people. They are generally anæmic and having family histories which would make a physician think that the diseases were hereditary. These discharges being retained so long the poison may be absorbed into the blood, and soon the whole system will show the effects of the poison. In children the nostrils are so filled up that they can scarcely breathe at night, and it will not be far in the future when the child will be weak, nervous, irritable, and unable to sleep well. The stomach raises a disturbance as the disease gets older, which is accompanied by an occipital headache. The food which is eaten goes for naught, because the system does not seem to get the desired nourishment. Taste is destroyed, appetite gone, loss of energy for everything is apparent.