Epistaxis.—This is a feature of the early stages of leprosy often associated with rhinitis, in particular the alternation of coryza-like conditions with others characterized by dryness of the nasal mucosa.
There is also a peculiar nasal tone to the voice of lepers.
In yellow fever and plague epistaxis is often the first sign of the degeneration of the endothelial linings of the capillaries.
Gangosa.—A disease of certain islands of the Pacific, especially Guam, characterized by naso-pharyngeal lesions and a nasal voice, is known as gangosa.
In goundou we have exostoses from the nasal processes of the superior maxillary bones.
CHAPTER XLIX
THE URINE AND THE GENITO-URINARY APPARATUS IN THE DIAGNOSIS OF TROPICAL DISEASE
The Urine
Of the chemical tests employed in the examination of urine that for the presence of sugar is rarely of value, as there is no tropical disease in which the presence or absence of sugar is of diagnostic importance.
The determination not only of the presence of albumin in the urine but, as well, of the variations quantitatively from day to day is, however, most necessary in many of the tropical diseases and particularly in yellow fever and blackwater fever.