Atlas and abstract of the diseases of the larynx / by L. Grünwald ; authorized translation from the German edition by Charles P. Grayson.

  • Grünwald, L. (Ludwig), 1863-1927.
Date:
1898
Catalogue details

Licence: Public Domain Mark

Credit: Atlas and abstract of the diseases of the larynx / by L. Grünwald ; authorized translation from the German edition by Charles P. Grayson. Source: Wellcome Collection.

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    edges and dirty-yell(j\v Hoor; the one lying near the middle line has taken part in the destruction of the free edge of the overhanging plate. A deej) ragged cleft separates this entire mass from a smaller fragment on the left, which evidently represents the remains of the left half of the epiglottis. Owing to the swollen ventricular hand the vocal cord on the right side appears to be narrowed, injected, and rough (at the free edge); on the left side it is entirely hidden by the ventric- ular band, which is very red and swollen. All that ai)parently remains of the true cord is a spur projecting from under a similar ulcer to the one just described, and pei'haps the re- mains of the processus vocalis. Both aryepiglottidean liga- ments are likewise red and swollen; the right one has a yel- lowish hue. From under the latter a blunt red pyramid about half as large as a pea is seen to project into the lumen. The appearance of these sliarply circumscribed ulcers, even without the ananinesia, gives tlie diagnosis of Tertiary Infiltrative and Destructive Syphilis. Fig. 3. A man, 40 years old, was infected with syphilis seventeen years ago; since then he has had manifestations of the disease in tlie skin of the back, on the shins, in the nose, and finally, six years ago, in the larynx. Although the laryngeal affection was relieved by general treatment, as far as the pain wäs concerned, he now begins to suffer more and more from dyspnea. The entire larynx is deformed. The epiglottis consists of a swollen band, thicker on the right side than on the left and approaching the turban-shape. The surface is smooth and red. The ventricular bands are replaced by thick pale-red shreds of tissue; only one little corner of the vocal cord is seen on the left side, the right does not appear at all (not even in phona- tion). The entire posterior wall is converted into a massive horseshoe, on the anterior surface of which are two broad elevations, the left one marked with a notch. A number of smaller convolutions, resembling a chain of hills, spring from the anterior surface of the cricoid cartilage. The mucous membrane appears to be intact everywhere. The voice is feeble and of a deep, grunting quality (false vocal cord Phonation). . . , , ,. The whole picture may be explained as the remams of destructive gummata, although the hypertrophy of the posterior wall is very re- markable. The proliferation of the tumors must be restricted m order to reheve the dyspnea: microscopic examination of the extirpated portions reveals only harmless connective tissue and epithelial proliferation. (See PI.