Rhinology laryngology and otology : and their significance in general medicine / by E. P. Friedrich ; edited by H. Holbrook Curtis.

  • Friedrich, Ernst Paul.
Date:
[1900], ©1900
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Credit: Rhinology laryngology and otology : and their significance in general medicine / by E. P. Friedrich ; edited by H. Holbrook Curtis. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    A form of ascending catarrh of the air-passages has been described, beginning with bronchitis and terminating in acute laryngitis and pharyngitis. Emphysematous in- dividuals suffer from congestive catarrh, and are prone to have hemorrhages. According to Heinze ^ and Landgraf,^ croupous pneu- monia is sometimes followed by laryngeal complications. Among fifty cases of laryngeal ulceration, Heinze found one in which the vocal cords were ulcerated in the course of croupous pneumonia, and he states that the ulcerations were not tuberculous. Landgraf analyzed eighty cases of croupous pneumonia, and found two cases of ulceration in the larynx. In both cases the primary disease was severe,—one being a bilious form and the other being accompanied by severe sensory phenomena,—and he attributes the ulcers to the dyspnea, interpreting them as decubital ulcers analogous to typhoid ulcers : The closure of the glottis which precedes the cough—in other words, the pressure on the vocal processes and free borders of the vocal cords—led to the formation of ulcers in these situations. The most frequent complications of lung diseases in the larynx consist in paralysis, the occurrence of which after disease of the lungs and pleura is explained by the course of the recurrent laryngeal nerve. The plications ^ which form in the pleura over the apices in chronic inflammations are very apt to include the nerve, especially on the right side, where such a complication is favored by the relation of the nerve to the subclavian artery ; and, on the other hand, indurations of the apex may during cicatrization exert traction on the nerve. Paralyses of the right or left recurrent are most frequent in chronic indurative pleuritis, and produce permanent alterations in an acute left pleuritis. Schrotter once observed a paralysis, which disappeared after ten days, and infers that it was a case of inflamma- tory edematous infiltration of the pleura. Paralysis rarely develops in pleural exudations. Moeser ^ claims to have observed that patients with pleural exudations, particu- larly when there is a copious effusion of fluid, and oftener 1 Die Kehlkopfschwindsucht, p. 87. 2 Charile Ann.. xil, p. 244 et seq. 3 Comp. Gerhardt, Virch. Arch., xx^^I, p. 76. * Die Krankheiten des Kehlkopfes, p. 414. 5 Arch. f. klin. Med., xxxvn, p. 570 et seq.