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
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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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    common among heavy drinkers, and the hawking it occa- sions acts very injuriously on the larynx ; some cases are aggravated })y excessive smoking, the usual concomitant of alcoholic abuse. The piditre of the secondary affec- tion may be very similar to, or identical with, that of primary catarrh, the only feature which is at all charac- teristic being the accompanying nasal affection. This is usually so much in evidence tliat attem])ts have been made to class it as a special disease, forgetting tliat both forms are due to a common cause. In one case we may see a pale, slightly granular mucous membrane after closely adherent crusts of pus have been removed by coughing, or, when necessary on account of dyspnea, by direct interference; the true and false vocal cords narrowed and evidently atrophic, the surface of the former a dirty yellow or dotted over with greenish spots (Plate 10, Fig. 3)—the picture of so-called laryngitis sicca. In another case the prominent feature may be hypertrophy of the mucous membrane, especially of the epithelium, giving rise to wart-like eminences (Plate 22, Fig. 3); again, wheals ap])ear on one or both true vocal cords, presenting by certain indentations, which corre- spond in i)osition to the points where they are firmly at- tached to the cartilage below, and by the formation of ridges from the reciprocal pressure, a clinical picture which has been described as ^^ pachydermia verrucosa, and, with small show of reason, classed as a special dis- ease (Plate 10, Fig. 1). In addition to hyperplasia and the maceration already referred to, the reaction of the epithelium to the constant irritation may sliow itself in hemorrhages, brought about by laceration of the mucous membrane as the secretion is coughed up; these hemor- rhages are characteristically foimd associated with liyper- trophies (Plate 10, Fig. 1). The prognosis may be epitomized in the maxim : Tin- manente causa non cessahit effectus. The fundamental principle in the treatment is, therefore, removal of the nose and throat disease. This in itself often suffices to
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