DISEASES OF THE LARYNX, WINDPIPE, AND BRONCHIAL TUBES.
A description of catarrh, or "cold in the head," is given on p. 214, and it has there been pointed out how this condition, beginning in the nose, may extend to the throat and on to the windpipe and bronchial tubes, developing, that is to say, into "cold in the chest." In nasal catarrh the mucous membrane lining the nostrils becomes red and swollen, is easily irri tated--even cold air irritating it and causing sneezing,—and in a short time pours out a dis charge, at first watery and then thick. Now the mucous membrane of the throat is con tinuous with that of the nostrils, so also is that of the larynx, so also is that of the wind pipe. The bronchial tubes, down even to their finest branches and their ultimate endings, are lined with a mucous membrane continuous with that of the windpipe, larynx, and throat, and through them with that of the nose. The in flamed or catarrhal condition of the nostrils may thus extend, through mere continuity of the membrane which it affects, right down the windpipe and bronchial tubes. Moreover, any part of this continuous membrane may he sepa rately affected by a catarrhal condition. But in whatever part of the mucous membrane the catarrh appears, it exhibits essentially the same characters, any differences that may be observed being due, not to any change in the nature of the inflammation, but simply to the position which it occupies. Thus inflammation of the larynx, inflammation of the windpipe, and in flammation of the bronchial tubes are simply forms of catarrh in different situations.
Inflammation of the Larynx (Laryngitis).
—Here the changes already alluded to affect the mucous membrane of the larynx. The mem brane becomes red, swollen, and at first dry; later, the membrane secretes fluid which soon becomes thick and glairy, and contains pus. The inflammation passes off gradually, by the membrane becoming less engorged with blood, and less swollen, but a relaxed condition is apt to remain for some time.
The causes of the disease are usually expo sure to wet or cold. The inflammation may also be due to the direct action on the mem brane of some irritation. For example, the fumes emitted from some forms of galvanic cells—Bunsen's or Grove's cell, for instance— are extremely irritating to the throat, and if one incautiously works in the room where a battery of such cells is, inhaling the fumes is apt to provoke an attack of laryngitis. In
some diseases of the lung the matters that are brought up are irritating to the larynx and windpipe. Violent exertion in speaking or shouting may also be a cause. In various other diseases, small-pox, measles, scarlet fever, kidney disease, this affection may be a compli cation. Thus it is not uncommon to find children developing suddenly the signs of laryngitis, the hoarse barking cough, altered voice, &c., with fever, that make the parents believe croup to be coming on, and ,next day the cause is revealed by an abundant crop of the eruption of measles. The poison in the blood, that is to say, has inflamed the mucous membrane of the larynx as it has inflamed that of the eyes and nose, as the streaming eyes and sneezing testify.
Symptoms.—That the affection is the result of a cold is frequently evident by a previous "cold in the head,"—hoarseness, perhaps loss of voice, soreness referred to the larynx, and irritable cough, coining in spasms and easily excited by a deep breath or by breathing a cold atmosphere after a warm one being its chief signs. Such an attack passes off in a few days. In a more severe form, attended by fever and quick pulse, there is aching or actual pain, and perhaps even pain on pressure on the larynx (Adam's apple) from without. Swallowing in creases the pain. The person may at first think the pain is due to a fish-bone that has stuck deep down in the throat. Spasms of coughing occur, the cough being hoarse and rough. The voice is altered, perhaps lost. All this is due to the redness, dryness, and swelling of the membrane. But the swelling in very severe cases may seriously impede breathing by ob structing the passage, and then the breathing is wheezy and whistling. Perhaps the patient gasps for breath and has all the appearance .of one struggling against suffocation, the eyes being prominent and face livid and bathed in sweat. If not relieved, the patient becomes delirious and sinks into insensibility owing to the blood being charged with carbonic acid gas. Such acute cases are only found in adults, and generally take such a fatal form because of an enfeebled constitution.