enlarged tonsils.

[RESPIRATORY DISEASES 9]

[Illustration: Adenoids]

Symptoms.--Children breathe chiefly or wholly through the mouth. They are
apt to breathe noisily, especially when they eat and drink. They sleep
with their mouth open, breathe hard and snore. They have attacks of slight
suffocation sometimes, especially seen in young children. There may be
difficulty in nursing in infants; they sleep poorly, toss about in bed,
moan, talk, and night terrors are common. They may also sweat very much
during sleep. A constant hacking or barking cough is a common symptom and
this cough is often troublesome for some hours before going to bed.
Troubles with the larynx and pharynx are common and spasmodic laryngitis
appears to be often dependent upon adenoids. Bronchial asthma and sneezing
in paroxysms are sometimes connected with them. The chest becomes
deformed. The prolonged mouth-breathing imparts to adenoid patients a
characteristic look in the face. The lower jaw is dropped and the lips are
kept constantly apart. In many cases the upper lip is short, showing some
part of the upper teeth. The dropping of the jaw draws upon the soft parts
and tends to obliterate the natural folds of the face about the nose,
lips, and cheeks. The face has an elongated appearance and the expression
is vacant, listless, or even stupid. The nose is narrow and pinched, from
long continued inaction of the wings of the nose (alae nasi). The root of
the nose may be flat and broad. When the disease sets in during early
childhood, the palate may become high arched. If the disease continues
beyond second teething, the arch of the palate becomes higher and the top
of the arch more pointed. The upper jaw elongates and this often causes
the front teeth to project far beyond the corresponding teeth in the lower