Influenza.—The laryngeal complica tions of influenza generally occur in the cases in which symptoms affecting the upper respiratory tract are observed. There is the tendency to hfemorrhage; ulceration is also occasionally observed. Spasmodic cough is also present, causing considerable distress to the patient by greatly increasing the intensity of the frontal cephalalgia. (Edema of the larynx is occasionally inet with, but, as a rule, it does not assume grave propor tions.
Laryngeal manifestations are frequent in influenza. Generally there is simply a catarrhal inflammation, but serious com plications may occur,—ulcers, erosions, paralysis, (edema. Two cases of (edema -witnessed in the Necker TIospital. The cederna affected the arytenoids and ven tricular bands, and dyspncea was marked, but not so great as to neeessitate trache otomy. Naticr had seen two eases of influenza complicated with laryngeal cedema of the cords, which disappeared upon applications of nitrate of silver. Cartaz (Journal of Laryn., June, '93).
Typhus l'ever.—In this disease the manifestations are similar to those in typhoid fever and the complications are also liability to -ulceration, cedema, or pseudodiphtheria.
Schech includes under the name of "laryngitis exudativa" a series of affec tions of the laryngeal mucous membrane in which there is exudation with more or less fluid contained in vesicles or bnlhe, or hypertemia with swelling. In miliaria there are vesicles on the epiglottis and aryepiglottic folds, giving rise to the sen sation of a foreign body. Herpes very seldom occurs alone in the larynx; there is usually an implication of skin or of mucous membrane.
Acute inflammation of the tongue, floor of the mouth, and larynx may be due to herpes. Two eases clinically in distinguishable from angina Ludovici, which affer death were found to be asso ciated with, if not due to, trichina spiralis and miliary tuberculosis, respec tively. S, Mackenzie Writ. Med. Jour., 'May IS, '94).
I ferpes of the larynx only occurs as one of the localizations of herpctic fever; its tifo,t itequetit seat is on the posterior ,urface of the epiglottis. and the region of the The herpetie vesicles are surrounded by an inflammatory 7011e. There is odynpleagia, dysplionia. possibly ,pleca. I trinih•l Rex ue de Laryn.,
irOtol., et de Rhin., :Mar. 15, '95).
Si.heeit ai3O group.: under the same hcad /tot-and-mouth disease (stomatitis epidemica) accompanied by more or less constitutional disturbance and by vesicles in the larynN. which break down into ulcers; aphtha., which sometimes occur in the larynx in association with aplitIne of the mouth or vulva; pemphigus, which occasionally forms exudative swellings in the larynx, but the disease is rare in this orffan. Urticaria also occasionally affects the laryngeal mucous membrane, and the symptoms depend upon its extent. Lichen ruber platzus is more usually ob served in the mouth and fauces than in the larynx. Inzpeligo herpetiformis, ery thema nodosum, and erythema multi forma are rarely observed in the larynx.
Pathology.—Symptomatic laryngitis is ascribed to the penetration into the laryn geal tissues of micro-organisms, espe cially the streptococcus pyogenes, staphy lococci, the pneumococcus, and bacteria coli communal. The germs are thought to penetrate the deeper structures through minute abrasions of the surface or by way of the lymph-channels, the blood, etc. Neighboring inflammatory foci are especially prone to cause infec tious disorders of the larynx.
,ymptoms are marked from the on,et of the disease. They develop very rapidly and are of the greatest severity. Frequently in a few hours after the earliest manife,tation of the di,ease a hard swelling will be found between the arch of the lower jaw and the hyoid bone. The swelling spread, rapidly, soon involving the »eek and face in a hard, dark-red, brawny induration. Re,piration i, soon impeded by involve ment of the deep connective ti,,ne of the I lie !duly:. ifx and be imulxv(1, nu,1 attael:s of acute tly,pfura v.ith crano,i, superNeue. The sIvelling may spread dotvnWard 0 Ole anleri0r intim :Ind 011 LO the che-t-riall. lit-Teeth))) of the mouth, al though mi,ati,faetory, due to fixation of the jinx. will disclose the sublingual lw wdematou, a, to push the tomme against he roof of the mouth. lit the early tile swelling unilateral. loft ,00n both sides become involNed. and deglutition become, diffi cult or impo,sibh•. l-:tipervening the local condition a marked general ,epsis. occur,. G. Ros, (_11inals dune. 1901).