Elementary practical treatise on diseases of the pharynx and larynx / by E. J. Moure ; translated and adapted by J. Malcolm Farquharson.

  • Moure, E. J. (Émile Jean), 1855-1941.
Date:
1909
Catalogue details

Licence: Public Domain Mark

Credit: Elementary practical treatise on diseases of the pharynx and larynx / by E. J. Moure ; translated and adapted by J. Malcolm Farquharson. 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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    lying tissues, and cannot be confused with malignant tumours, except for a very short time at the very beginning. In some very rare cases, however, where the lupoid lesion is so well limited to the operculum, especially if the patient is old or otherwise healthy, histological examination alone can dispel all doubts. Lupus] is painless, whereas cancer is usually painful, spontaneously or otherwise. Syphilis during the secondary stage presents no analogy with cancer, but in the tertiary stage it is difficult some- times to be certain of the diagnosis. It should be kept in mind, that gummata generally have their seat on the epiglottis, one of the ventricular bands, the ventricular mucosa, or the subglottic region. The evolution of the affection should be taken into account, besides its history. Gumma produces within two or three months first vocal, then respiratory disturbances, if specific treatment has not been applied. The course of cancer, on the contrary, is much slower; moreover, the localization is different. The gumma appears as a diffuse infiltration, red, it is true, but without protuberances or hypersecretion. Neither spon- taneous pain nor blood-streaked expectoration is present. At the stage of ulceration the syphilitic loss of substance is crateriform, serpiginous, and deeply penetrates into the tissues ; its surface is greyish and dirty, suppurative, and is accompanied by reddish budding, peripheral infiltration, sometimes with perichondritis. In spite of extensive lesions, the vocal cords often remain mobile. Finally, the ulcer spreads upwards, gradually reaching the base of the tongue, the tonsils and the lateral walls of the pharynx deforming and destroying the affected parts. Tertiary manifestations are often found on the soft palate, the palatine vault, or in the naso-pharynx, and diagnosis is thereby facilitated. Finally, all doubt is dispelled by specific treatment, which is rapidly efficacious in syphilis (a week or even two days), whereas in cancer its effects are usually absent, or at least very slight and transitory. Hybrid forms sometimes occur. In those cases diffuse.