In the early s.tages of primary (edema cold applications externally, broken ice, and tannin; later on hot fomentation& should be applied to the neck. The re spiratory difficulty often yields to ether or sodium bromide with syrup of chloral. Insufnation of tannin solution is more valuable in serous than inflammatory cedema; in the latter pilocarpine injec tions are preferable. Scarification con demned. Tracheotomy preferred to in tubation, since the passage of the ean nula in the latter ease is often stopped by the cedema. Attention must be paid to the general condition. L. Bar (Allg. Wien. med.-Zeit., Aug. 11, 18, 25, '96).
When laryngitis is due to traumatism and the manifestations are not ciently marked to require operative meas ures, considerable pain is sometimes present; again, the lesion is so exposed that infection may occur, a benign ess thus being transformed into a severe one. The most satisfactory results are to be obtained by strict cleanliness through the use of a 5-grain solution of borax applied -with the atomizer, the laryn goscopical mirror being employed to properly locate the spray. TWO grains of pure iodoform are then applied with the insuftlator. This reduces the pain and curtails the infectious process in any form of laryngitis in which these ele ments prevail.
Symptomatic Laryngitis.
This term is sometimes applied to the laryngeal manifestations occurring in the course of general diseases, and involving, as a rule, the deeper structures. The symptoms vary with the intensity of the local manifestations, and ma3r range from those of a simple laryngeal catarrh to the most severe cedema calling for immediate tracheotomy. Complications of so dan gerous a nature are fortunately rarely witnessed.
Measles is usually attended by inflam matory involvement of the larynx. There is hoarseness and sometimes loss of voice, the symptoms, in fact, being quite those of acute laryngitis, including occasion ally slight tumefaction.
The laryngoscope reveals a condition similar to that of the skin, the exanthem showing itself more or less clearly. Red spots project from the surface, giving it an irregular appearance. The process of resolution usually progresses without .complication. Occasionally, however, cedema or ulceration occurs as a compli cation.
Case of acute laryngitis in measles in which the vocal bands became completely destroyed by ulceration, which had ex tended upward to the ventricles and downward for nearly V4 inch (6 milli metres), penetrating apparently down to the cartilages. L. Emmett Holt (Med. Record, June 22, '89).
Extreme importance of being always prepared for suffocating laryngitis in measles. It is usually at the beginning of the attack that the larynx is liable to become inflamed. Some of these cases may be mistaken for ordinary laryngis mus stridulus, but the latter does not present the constant character found in n3easles, and, even although there may be some relaxation in the severity- of the symptoms, the patient will still show aphonia or marked hoarseness. Suffo cating laryngitis usually- occurs in young patients, mostly under three years of age. Sevestre (Jour. de Med., Mar. 10, '99).
Variola and Varicella.—The laryngeal manifestations of variola are various. In some cases small pustules are observed; these may gradually develop into a ne crotic process, leading to perichondritis and even cedema. The symptoms are those of acute laryngitis. The intensity of the local disorders varies with the gravity of the general disease, but, as a rule, the course is a benign one.
In varicella laryngeal symptoms are not as frequently observed as in variola, but they sometimes a-ssume as serious proportions. Deglutition, phonation, and respiration may be seriously im paired, the latter restating mainly from the smallness of the larynx in children.
Auto' s) of a ease of ‘aricellon.; !aryl] gitiA in w h there was found gangrene I the cage of the epiglottis, a strip of slough n the free borders of the vocal ord-,. A erateriform erosion on the ‘,1.ttuentons pot Lion of the left vocal cord. .1 varicella spot on the mucous tmmbrane of the left pyriform fossa. lto,..7,r and Bayeux (1'resse Mr..4.1., Apr. 10, '97 .
III laryng,itis the symptoms are those of croup. 'The specific charac ter of the disease is very clear, there oeing small eiretzlar ulcerations on the vocal ords, and often on the epiglottis. Ilarlez 1.1onr. de 'MM., June 25, '97).
Searlet Ferer.—ln this disorder more or less marked involvement of larynx is frequent. In the vast majority of cases., however. the cause of the trouble is be nign, and resolution occurs along with the general malady. The exceptions in ferred may at least simulate various grave disorders, such as diphtheria and mem branous laryngitis. (Edematous infiltra tion is also occasionally witnessed, and likewise constitutes a grave complication. In all these disorders the tendency to ulceration is markedly increased, and, when this starts, it is checked with diffi culty. Perichondritis and hmmorrhage owed to destruction of blood-vessels are always to be feared in such cases.