The forms, complications, causes, prevention and treatment of consumption and bronchitis : comprising also the causes and prevention of scrofula / by James Copland.

James Copland

Date:: 1861

Credit: The forms, complications, causes, prevention and treatment of consumption and bronchitis : comprising also the causes and prevention of scrofula / by James Copland. Source: Wellcome Collection.

337/448 (page 323)

$disecose wdtli it, even when the larynx has been the pai-t seemingly first attacked. There is no doubt that chronic laryngitis is in some cases first developed, and that the lungs become secondai-ily affected, particularly where a predisposition to pulmonary disease exists; and in these especially the susceptibility of the larynx to causes of irritation is much increased; but both maladies may commence simultaneously, and even proceed pan passu, that of the larynx only being manifest, owing to the nature of its organisation; and thus the pulmonary disease may seem to be consecutive, even whilst it is coetaneous wth the laryngeal, or even primary. The obscuration of the physical signs of pulmonary diseases by laryngeal affections is so great, that the former are generally masked by the latter from those who trust chiefly to these signs, to the neglect of those physiological and rational phenomena which generally ac- company even the early stages of pulmonary consumption, and in which the closely observing physician confides more surely than in the proofs furnished by the stethoscope. It is only in the far ad- vanced stages of pulmonary tubercles, that the physical signs are manifested, when they are complicated with chronic laiyngitis, as shown hereafter. It may, however, be concluded, that where there are laryngeal cough, muco-purulent or purulent expectoration, hoarseness or aphonia, semi-stridulous respiration, emaciation, and hectic fever, pulmonary tubercles exist in advanced stages, whether they-ai-e indicated by the physical signs or not; and this inference is strengthened by the occm-rence of night perspirations, irrita- bility of the bowels, incurvation of the finger-nails, and various other symptoms. 12. C. Syphilitic Chronic Lat^ngitis. — Syphilitic Laryngeal Phthisis.— Chronic laryngitis sometimes occm-s in the course of secondary syphilis, and it then assumes a specific form, soon passes into ulceration, the ulceration apparently extending from the tonsils and pharynx by continuity of surface to the lai-yngeal mucous membrane. Hence syphilitic chronic laryngitis is almost always associated with syphilitic inflammation of the tonsils, fauces, and pharynx. ]\Ir. CABiiiCHAEL considers venereal ulceration of the larynx as the consequence of the phagadenic venereal disease; and he beUeves that the ulceration always propagates itself at its edges by continuity of surface from the fauces to the phai-ynx, and thence to the larynx. Sj-philitic laryngeal consumption is generally consequent upon various symptoms of secondaiy or tertiary syphilis, although some$