LARYNX. (MORBID ANATOMY AND PATH LOGY.)—The importance of this organ to lif and even when existence is not actually ei dangered, to the comfort and well-being of tl individual, must render any deviation from i healthy and normal condition in the highestd gree interesting to the pathologist : nor wi that interest be diminished by reflecting on t paramount value of a knowledge of these d viations to every practical physician. Small i size and composed of few and apparently sii pie structures—its functions so obvious th any imperfection in their performance could quickly perceived and readily understood— would appear only reasonable to suppose t its various pathological conditions should I been observed, and the symptoms con with them long since collected and a Yet, such is not the history of the pathol the larynx : on the contrary, it presents to us with all the interest of a new dis and whatever is known on the subject result of investigations made within the 1 years. We have the opinion of the lat Cheyne, (no mean authority on the subjec that in the year 1800, " perhaps there was n in Britain more than one individual, nam Monro, who was acquainted with the tr lure of the disease of which General ington died—acute laryngitis ; " and the sa writer goes on to shew that in ten years sub quent to that general's death, Dr. Baillie, th at the head of the medical profession in E land, admitted that he was ignorant of tl nature of the same malady. But witho reverting so far back, I may be permitted state, that within a comparatively recent peri I can personally remember the lack of know. ledge that obtained amongst medical practi tioners in this particular, and the deplorable results that too frequently ensued : and al• though it may be gratifying to reflect on the altered condition of things at present, )et it must be obvious that a subject so short a tin under investigation cannot be expected to hail been thoroughly worked out. Much as haz been brought forward—perhaps more remain behind, and any person now attempting to givi an exact and adequate description of the pa thology of this organ, may probably find it ne cessary to bespeak a very considerable degree of indulgence.
Accustomed to consider laryngeal disease practically, and more particularly with refe rence to operation, I find it difficult to bind myself down to mere pathological arrangement, or to attempt a satisfactory classification. True,
like other organs, the larynx is composed of different structures, in each of which disease will assume the character peculiar to itself, and exhibit the appropriate'appearances in an exa mination after death, but it rarely happens that morbid actions are so limited in extent, as to exist and produce their proper results in one tissue without the participation more or less of the others. This will produce confusion, and render it a matter of difficulty to connect symp toms with the existing pathological conditions that occasion them, and may be adduced as an objection to any attempt at arrangement founded upon structure alone: yet there really can be no classification altogether exempt from the same or a similar observation, and there fore I shall adopt this one as having the merit of the greatest simplicity. Following this view then, I find the larynx to be composed of the following structures, viz.:— 1. Mucous membrane, exhibiting all the va rieties of inflammation that are observed in that tissue when situated in other organs. Thus inflammation here may be acute or chronic, phlegmonous or erysipelatous, idiopathic or symptomatic, and attended by fever of a ty phoid or an inflammatory type. And these varieties producing different effects or results. Thus we have examples of acute idiopathic in flammation with fever of a sthenic kind in the croup of children, producing the adventitious membrane, and in the laryngitis of adults, that terminates so frequently in oedema; and of the same local disease with asthenic fever in the diphtherite and in erysipelas: whilst accident furnishes numerous instances of the results of symptomatic inflammation in the consequences of burns, scalds, penetrating wounds, and the swallowing of caustic poisons. As happens so constantly in other structures, chronic in flammation is here best known by the changes it induces, and furnishes us with abundant specimens of hypertrophy or thickening of the membrane, and of the different forms of ul ceration.