SOME GENERAL REMARKS CONCERNING THE EXAMINATION AND MENT OF THE LARYNGEAL DISEASES OF CHILDHOOD Laryngoscopy, the universal method of examining the adult larynx, cannot be frequently employed in the laryngeal diseases of childhood.
This is so, partly because of the type of disease, and partly because of the patient to be examined. The symptoms are often so alarming, that the physician must give relief without much of an examination. The symptoms are usually those caused by stenosis, and attempts to examine the larynx will only make them worse. Stenoses of the larynx play a very important role in childhood. Slowly developing diseases of the larynx, permitting a laryngeal examination are fairly rare in children.
It is niost difficult to make a laryngeal examination in children between the fourth and tenth years. The child struggles, and shuts the teeth tightly, making the use of an assistant and a mouth gag necessary. After the child is wrapped in a blanket it should be firmly held 111 the upright position in the lap of an assistant, the head being pressed back against the assistant's chest. Even then, the child's cries and the excessive mucus secretions IR the throat, will often make the examination impossible. In older children, the examination is more
easily accomplished. Forcible examination should not be attempted. The larynx may be often inspected by Kirstein's autoscopy. If the tongue is depressed in front, the epiglottis may be seen easily, and it is not necessary to carry the head of the child well forward as in the case of adults. An inspection of the epiglottis is valuable, because many diseases are located in this region. An examination ‘‘th the finger, and external palpation should not be neglected. In cases of foreign body, the X-ray examination will be valuable, if the child does not struggle too mttch.
is similar to that in adults, except that the symptoms are usually more severe, and may rapidly become dan gerous. When inhalation methods of treatment are employed, the air of the room should be saturated with the remedies. For this purpose either steam alone, or combined with oil of eucalyptus, oil of turpen tine or menthol, may be employed.