Atlas and abstract of the diseases of the larynx / by L. Grünwald ; authorized translation from the German edited by Charles P. Grayson.

  • Ludwig Grünwald
Date:
1902
Catalogue details

Licence: Public Domain Mark

Credit: Atlas and abstract of the diseases of the larynx / by L. Grünwald ; authorized translation from the German edited by Charles P. Grayson. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    matter of routine, to take that possibility into considera- tion. Miraculous cures are sometimes ef!*ected by such perfunctory '^ reasoning and corresponding line of treat- ment. Under certain conditions palpation may play a promi- nent part by enabling one to determine paralyses which could not otherwise be recognized. In total paralysis of the recurrent nerve, or at least in complete phonatory paralysis, the normal vibration of the thyroid cartilage may be absent on the affected side; the value of palpa- tion is obvious in such cases, especially if laryngoscopy is impossible. In paralysis of the cricothyroid muscle the normal vibration of the cricothyroid membrane and the approxi- mation of the lower border of the thyroid and upper border of the cricoid cartilages, normally felt in phona- tion, are absent. If the posterior portion of the upper border of the thyroid is compressed and the entire organ moved about with the fingers, crepitation, produced by the rubbing of the posterior wall against the spinal column, is felt. This crepitation is distinguished from pathological crepitation by its disappearing if, during the movement, the entire larynx is drawn forward. The phenomenon occurs path- ologically, so that it can be both felt and heard, in arthritic ])rocesses affecting the crico-arytenoidean articulation. (For details see below.) It seems superfluous to say that sensitive spots must always be felt for; it is important, however, to warn against pronouncing as pathological the extreme sensitive- ness of the superior laryngeal nerves, which enter the larynx at the center of the upper lateral border of the cricoid cartilage. (5) AUSCULTATION nowadays is practically confined to the sounds heard by the unaided ear in respiration and in phonation. Respi-
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