On the treatment of new formations of benign character in the larynx / by Lennox Browne.

  • Browne, Lennox (Isaac Lennox), 1841-1902.
Date:
1875
Catalogue details

Licence: Public Domain Mark

Credit: On the treatment of new formations of benign character in the larynx / by Lennox Browne. Source: Wellcome Collection.

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    met with much professional favour for these cases in this country. As a curious evidence that even in Germany, where operative procedures are most boldly adopted, a feeling is dawning that it is possible to in¬ trude too rudely into the larynx, it may be noted that Eyselle has recently suggested transfixing the growth by a needle passed through the thyroid cartilage from without: a procedure more easy in imagina¬ tion than performance, and of little practical value. Dr. Jelenffy of Pesth has also, on the well founded belief that one does not see much of the larynx after the instrument has entered it, invented a very safe guarded icraseur, by which, as he states, first one side and then the other can be freely and safely swept of excrescences. Un¬ doubtedly, the safest instrument is the guarded ring-guillotine of Stoerk, which combines strength, cutting power, and the maximum of safety against wounding healthy parts. I think I have good reason for stating that, since instruments were used unguarded, injury to healthy structures, and consequent perichondritis, have occurred more fre¬ quently than was formerly the case. 7. The cardinal law, that “ an extralaryngeal method ought never to be adopted unless there be danger to life from suffocation or dysphagia”, should be applied with equal force to intralaryngeal operations; and it is a subject worthy of consideration whether, in many cases, tracheotomy alone might not be more frequently performed—a. With a view of placing the patient in safety when dangerous symptoms are present; b. In order that the larynx may have complete functional rest; and c. As a preliminary step to further treatment, radical or palliative. If I have succeeded in proving the truth of my previous propositions, there is not much necessity for enlarging on this. I would simply beg once more to impress the importance of a more general study of the laryngo¬ scope, and of its use at an early stage in every case of alteration of voice; of the early treating of hypersemia of the larynx, remembering that it is the most general forerunner of growths; of the early and active local treatment of such new formations by topical astringent applications; of the administration of suitable medicinal remedies when there is evidence or presumption of any constitutional cause or com¬ plication ; and of the non-instrumental interference with these forma¬ tions for mere symptoms of inconvenience, having always in view the dangers that may occur to healthy structures, and the fear that irritation of the growth may only make the disease worse, rather than better. I have not discussed the question of thyrotomy, or division of the external cartilage of the larynx. Many of these operations have been done for
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