Etiology and Pathology.—The cedema occurring as a result of simple catarrhal laryngitis is usually brought on by undue exposure to damp cold air while the body is overheated by violent exercise, such as dancing, fencing, etc. Decollete gowns and the luxury of sitting at an open win dow after dancing, and drinking of ice water, have thus caused many victims— sudden deaths credited to heart disease.
Two cases of cedematous laryngitis re quiring tracheotomy, both caused by drinking ice-water when the patients were in an overheated. condition. Vladi mir A. Padueeheff (Trans. Ural Med. Society, p. 26, '92).
Case of cedematous laryngitis follow ing cold, in a vigorous soldier. Trache otomy became necessary-. L. Dorange (Archives de MM. et de Pharma. Milit., July, '92).
(Edema of the larynx has also been ob served in cases treated with iodide of potassium, the connection between the disease and drug being shown by the re duction of the cedema when the drug is withdrawn. (See IODINE, in this vol ume.) TWO cases of (edema due to iodide of potassium. The first was a carcinoma of the larynx, in which an antisyphilitic treatment was instituted to eliminate the possibility of syphilis. After about 15 grains of iodide of potassium had been taken, laryngeal cederna developed to such an extent that a tracheotomy was required. In the second case, which was thought to be syphilitic, the epiglottis, arytenoids, and ventricular bands were (edematous, and the patient suffered from dyspncea. On administering iodide of potassium for a day or two, the cedema and dyspncea increased. After leaving off the iodide of potassium the cedema quickly improved in both cases. The remedy was administered later in the second case, without causing (edema. Schmiegelow (Archiv f. Laryn., vol. i, No. 1, '93).
It is probable that a latent disorder of the larynx is present in such cases. This may have existed before the use of the iodide or occur as a result of the disease —syphilis, for instance—for which the drug has been administered. Lesions of the kidney may mechanically induce laryngeal cedema by interfering with the free elimination of fluids.
Acute oedema of the larynx in two cases due to iodide of potassium: 1. Case of ligeal plithisis. e s after potassium was begun a siderable (edema of the left cilsil"Iliv 101.1 )%as noticed, IN 111c11 (1 isa p
(1' t Ile iodide was diseont blued.
14.
2. t ase in N1 hiell rat itAlt was given potas sic iodide for philitic manifestations. 1.tter two eeks there was coryza and spiwca and mileinatous swelling on the right side of the larynx. The iodide W a s 011111 ted. 1111(1 the swelling, disappeared.
The (-edema was unilateral in both eases. a feature not often met with in cases hitlicrto recorded. Staukowski (.M.tinch. med. Woelf., Mar. 23. '97).
Existence established of an early syphi litic (edema of the larynx, independent of all ulceration or erosion, and itself the solitary notification that the specific virus has attacked that organ. Lacroix (Archives de Laryng., Nov.-Dec.. '97).
As the cause of mdcma of the larynx is more thoroughly studied the cases that cannot bc aseribed to either some pre cxistinp. local affection in either the pharynx or the larynx or to some consti tutional disease or external irritation will be exceedingly rare. C. C. Rice IN. Y. Aled. Jour., Dee. 3. '98).
There are several types of idiopathic (edema of the larynx. First there are those cases in which there is no true inflammatory condition of the mucous membrane, but simply a, transudation of serum into the subrnucosa. This con dition is found in cases of far-advaneed nephritis with cardiac and vascular changes. Another type is that found ac companying acute catarrhal laryngitis. The condition may also be of an in fectious or septic origin. The latter class of cases is frequent during epi demics of influenza. J. S. Gibbs (Jour. Amer. „Med. Assoc., July 20, 1901).
Many of the cases of cedema of the larynx are thought to be of infectious origin. exposure of the parts to weakening influences of cold, etc., facilitating the entrance of micro-organisms of neighbor ing inflammatory processes, particularly of the naso-pharynx. The base of the tongue, the mouth, and the tonsils are known to be sources of infection.
Case of secondary oedema of the larynx, following suppuration of a deeply-seated gland in the region of the carotid artery: Extirpation of the lymphatic gland pro &iced immediate marked relief. Addeo Totti (Lo Sperimentale, Mar. 15, '92).