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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    The marked inflammatory appearances in the submu- cosa and perichondrium have no specific character. Typhoid fever affects the larynx l)y direct deposition of the specific bacilli. Catarrh develops in the infiltra- tion stage; the epithelium is attacked and readily sepa- rates, exposing the surface to superficial ulceration and slight hemorrhages. The specific character shows itself in the cirGumscribed nature of the invasions, particularly at the aperture and at the vocal processes. The erosions preferably select the sharp edge of the epiglottis. In analogy with the intestinal process we further get diffuse or circumscribed ^' marrow infiltrations and secondary infiltration resembling the intestinal form. Ulceration is occasionally preceded by a definite scaly stage, in the form of diphtheritic membranes. If the ulceration extends to the perichondrium, perichondritis with all its evil conse- quences ensues. According to the degree of intensity, the parts either heal completely, or grave defects, tightly drawn scars, membranous and other stenoses, remain (Plate 17, Fig. 2). In exanthematous typhoid the phe- nomena are similar, but milder. In the treatment we must always take the laryngeal complications into account. By keeping the upper parts of the alimentary and respiratory passages clean we may hope to influence the process favorably. Local treatment accomplishes nothing. Stenoses demand early trache- otomy, as the unexpected ajjpearance of secondary edema is particularly common in this complication. Influenija attacks every part of the respiratory tract. In the larynx the interarytenoidal mucous membrane is often found to be inflamed, and therefore (sec p. 19) we have barking, dry, convulsive cough, resembling and sometimes mistaken for whooping-cough. There is a marked tendency to hemorrhage, and su])erficial epithelial necrosis appears in the form of white spots on the true vocal cords ; these result in small erosions. In rare cases interstitial inflammations running on to abscess-formation have been observed. The predilection of influenza for
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