The chromic acid, fused by heat to the end of a covered probe, such as MacCoy's, immediately before the anmsthetie, is then applied to the surface of one of the vocal bands, while the patient, having been told to make a sound, brings both bands into apposition. This enables the operator to avoid cauterization of their edges—an important point in the preser vation of the voice, especially in women. But little if any disturbance follows, and after a few days hardly a trace remains of the cauterization, except a spot present ing less redness than the surrounding parts. The applications should be made twice a week- until all traces of localized congestion or bosselated areas have dis appeared.
When laryngitis is aggravated by gas tric, hepatic, or intestinal disorder, espe cially in drinkers and smokers, attention to these conditions should, of course, form an important part of the treatment. In patients who smoke considerably the congestion is often maintained simply by the irritating action of the air con taminated with smoke. Sitting in a
smoking-car or in a room in which others are smoking is. therefore, as bad as if the patient himself were smoking.
In dry laryngitis. attention to the naso-pharyng.-_,eal disorder also forms an important part of the treatment. Deter gent and disinfecting sprays are of great use, but must be employed for a consider able time. Chlorate of potassium in the form of a saturated solution, and per manganate of potassium, 3 grains to the ounce, are effective agents, while listerin and water, equal parts, may also be recommended, to alternate with either. Iodide of potassium, administered inter nally, 5 grains three times a day in half a glassful of water, tends to increase the laryngeal secretions, as it does those of the nasal cavities, especially in persons who are sensitive to its physiological effects. When a gouty or rheumatic diathesis can be traced, colchicine or sa licylate of • sodium are indicated. (See GOUT and RHEUMATISM.)