Diseases of the larynx / by Dr. J. Gottstein ... trans. and added to by P. M'Bride.

  • Jacob Gottstein
Date:
[1883]
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the larynx / by Dr. J. Gottstein ... trans. and added to by P. M'Bride. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

    241/290 (page 229)
    LARYNGEAL DISEASE IN SYPHILIS. Etiology.—Syphilitic disease of the larynx is always a part symptom of general syphilis, and almost always combined with an affection of the pharynx.* In the order of frequency with which organs are attacked in syphilis, the larynx comes after the skin and pharynx. According to Lewin, whose statistics are based on the largest number of cases, about 575.(equal to 2*9 per cent.) out of 20,000 syphilitic persons who were taken into the Berlin Charite had the larynx affected; of those who were so attacked, about 500 (87 per cent.) showed slight laryngeal disease, and in about 75 (13 per cent.) the larynx was severely involved. The statistics of other authors, however, differ considerably from those of Lewin, and this may be due to various circumstances. Laryngo- logists must arrive at different results from syphilolographers, because the former are principally consulted in severe cases of laryngeal syphilis ; the result must also vary according, as in one hospital all secondary cases are examined, while in another only those who complain of throat symptoms, for the symptoms of laryngeal syphilis may be so slight that the condition gives rise to no discomfort. Views as to syphilitic con- gestion and catarrh, as Chiari and Dworak rightly remark, vary so much that in this way different results may be accounted for. At all events, Lewin's statistics seem to come nearest the truth, because they are drawn from a large material, and because all the syphilitic cases in the institution within a given time were examined with the laryngo- scope. According to these, the proportion of secondary or slight to tertiary or severe cases was 7:1. As to the relative frequency of syphilitic laryngeal disease compared with other affections, no observa- tions have been made. Mackenzie out of 10,000 cases of throat affection, i.e. of the pharynx and larynx found .'$0S examples of laryngeal syphilis (3'08 per cent.), and Schroetter out of 21,044 cases had 947 Of laryngeal syphilis (4*5 per cent.). In both instances the severe cases were more numerous than the mild, which is accounted lor by the fact that laryngologists see severe cases oftener than can be ex- plained on the grounds of their relative frequency. ■ This lasl statemenl has undoubtedly man] exceptions (Translator),