The laryngoscope : illustrations of its practical application, and description of its mechanism / by George Duncan Gibb.

  • George Duncan Gibb
Date:
1863
Catalogue details

Licence: Public Domain Mark

Credit: The laryngoscope : illustrations of its practical application, and description of its mechanism / by George Duncan Gibb. Source: Wellcome Collection.

    16/58 (page 12)
    letter from Dr. Maxwell T. Masters, of Peckham, who kindly sent him to me. Always healthy until liis return from Australia, three years ago; consumi^tive on his mother's, and asthmatic on his father's side ; father alive, aged 70. All his brothers and sisters, six m number, are alive. Present ilhiess commenced with a cold on board ship when he had on one occasion to bale out water, and got very wet. The throat became sore, two years ago, when he could scarcely swallow even milk, and he was a patient in the Consumptive Hospital, Brompton, for six months; he was told he was not consumptive. Tlie throat gradually got worse; eight months ago a fit of coughing came on which was followed by hoarseness and gradual aphonia, which has continued to the present time. He has no pain, but in swallowing it tickles him at the back and roof of his mouth, which, if not carefully managed, suddenly regurgitates through the nose, imless his food is pultaceous. Large lumps of bread sometimes actually pass through the nose; fluids he cannot swallow, not even his saliva. Five months ago he was nearly gone, and has passed through attacks of terrible misery and suffering with his throat. Is not so much emaciated the last two months. He now breathes with a loud noise, somewhat of a snoring character, as if he was asleep ; has occasional croupy cough, no dyspncea, dysphagia nor pain; speaks in a loud whisper; pulse 116, weak; respiration 20 per minute. Laryngoscopy showed the most fearful ravages. Tlie uvula was almost gone, the velum was adherent posteriorly to the pharyngeal wall, and left a shallow passage towards the right side passing upwards to the nostrils behind. The epiglottis was wholly gone, and the aryteno- epiglottidean folds were mostly destroyed, their remains being trausfonned into fleshy tubercles surrounding the crescentic glottis, as represented in the woodcut. The arytenoid cartilages were gone. There were no vocal cords, but a sort of glottis remained, formed by folds or edges of the cicatrices of the destroyed mucous membrane, and expanding to a small degree with some slight movement dm-ing forcible inspiration. Everywhere great ravages were visible, and for fearful destruction of the parts it was one of the most terrible cases that has come under my notice. This patient had syphilis when a yoimger man, and although he denied it, I sus- pected a second attack from the occurrence of an eruption and other symptoms when on board sliip. Treatment was of course palhative, and he so improved that a more healthy state of the membrane of the larynx was brought about; heretofore it had been of a drab colom\ it now changed to a piiilv. The breathing contmued very noisy, Fis. 2. a, The root of the epiglottis, b, The tongue. The black, cre- scent-shaped glottis is surround- ed by the remains of the ary- teno-epiglottic folds.