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Diseases Larynx

vocal, acute, cords, chronic, catarrh, disease and recovery

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LARYNX, DISEASES OF.—The vocal cords and their surrounding structures are subject to a large number of affections. Exposure to cold or to the action of irritating gases may cause simple catarrhal inflamma tion, which may terminate in early recovery or pass into a chronic condition.

The affection is often aggravated by excessive smoking (smoker's sore throat), or by prolonged use of the vocal cords, as in teachers, singers, ministers, etc. New growths may occur on the vocal cords, or they may become the seat of chronic inflammations clue to certain micro-organisms, tuberculosis, syphilis, etc. Some of the more common affections of the larynx are here considered.

Catarrh of the Larynx disease may be either acute or chronic. The acute form may be clue to cold and drenching, to affec tions of the nose and of the windpipe (especially if respiration is carried on habitually through the mouth), to over-exertion of the vocal cords, to inhalation of foul and dusty air, etc. Bicyclists are particularly liable to contract this disease. from inhaling large quantities of dust. The regular use of strong spices and of alcoholic drinks is a well-known cause of laryngeal catarrh. Sonic diseases, such as influenza, measles, and whooping-cough, often involve the larynx. are more frequently affected than women, owing to the more exposed nature of their occupations. Cases of acute catarrh of the larynx occur with greatest frequency during spring and autumn ; more rarely in summer.

Acute laryngitis begins with irritation and dryness of the throat, soon followed by more or less hoarseness. I f the voice he not used to excess, and no grave sins committed against the rules of hygiene, the process may pass within a week. Severe forms of the disease, however, may lead to super ficial ulcers on the vocal cords, or to thickening of the false vocal cords, which are located over the true ones (see Fig. 5I), and may require weeks to be cured. In the dry forms of laryngitis slight lifemorrhages may take place. Recovery is delayed by smoking, drinking, dancing, much talking, and singing ; it may even be entirely prevented, so that a chronic inflammation develops.

A mild catarrh heals spontaneously if properly cared for. In order to

assist Nature in bringing about recovery. it is advisable to remain indoors, to abstain from smoking, to speak as little as possible, to take inhalations of steam, to drink warm mineral waters with or without milk, and to place a cold compress around the neck at night, allowing it to become warm. The tendency to cough should be suppressed by soothing medicines.

In children an acute catarrh of the larynx often manifests itself in the form of a croupy cough. The children " bark " suddenly at night with a hoarse sound, and suffer from the signs of impaired respiration, which some times increases almost to suffocation. Such attacks, which may last an hour or two, may recur night after night for one or two weeks in succession. In certain cases, however, a recurrence may not take place until a fresh cold has been contracted. This disease, which constitutes the so-called " false croup," almost invariably terminates in recovery. Hot drinks may be given to loosen the viscid mucus.

Chronic catarrh of the larynx usually develops from the actute form. It is especially frequent in ministers, orators, military officers, minstrels. costermongers, stone-cutters, publicans. and workers in tobacco-factories. The disturbances comprise dryness, constant hoarseness, irritation, and hacking or coughing. The degree of hoarseness varies. Sometimes the voice is entirely absent, especially on awakening in the morning or after severe vocal exertions. If the disease runs a very protracted course it may cause paralysis of the vocal muscles and thickening of the cords.

The course of the affection is the more obstinate the less the patients heed the directions of the physician, or the less they are able to do so on ac count of their occupations. Acute attacks frequently recur. Above all, special attention should be paid to free breathing through the nose. If the nose be temporarily or constantly obstructed it should be cleared by a physician. The domestic remedies commonly used for the acute form of laryngitis are rarely efficacious in the chronic type of the affection. As a rule local treat ment is required ; often of the nose and pharynx also.

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