Cases brought before the notice of the Pathological Society of London : see Transactions, vol. X / by Dr. John W. Ogle.

  • Ogle, John W. (John William), 1824-1905.
Date:
[1859]
Catalogue details

Licence: Public Domain Mark

Credit: Cases brought before the notice of the Pathological Society of London : see Transactions, vol. X / by Dr. John W. Ogle. Source: Wellcome Collection.

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

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    logy, of much interest and no slight difficulty, to decide upon the exact origin of the peculiar alteration of the voice or breathing under consideration. This leads me to speak of the modification of voice, whether respective of the strength, or timbre, or powers of modu- lation so often noticeable in cases of pulmonary phthisis. My impression has long been (and, indeed, according to my experience, post-mortem research has demonstrated it to be so) that the afi'ection of the voice in this disease is, by no means infrequently, quite «<«-connected with any altered condition of the mucous membrane of the parts forming the upper outlet of the larynx, such as we do very ft-equently meet with in this class of cases, and which, either alone or with an attendant affection of the vocal chords, completely accounts for the hoarseness, or other altered conditions of the voice, cough, &c. It is known that the peculiar arterial whiff or bruit, often audible within the upper part of the chest, apart from any intrinsic disease of the blood-vessels, has been supposed by some to be referrible in many cases to pressure upon, and consequent indentation of, some of the large intra-thoracic vessels by tubercular and consolidated lung-tissue. Should this supposition be correct, I see no impro- bability in conjecturing that the nervous structures abounding at the upper part of the chest (and among them the recurrent laryngeal, or the main trunk of the pneumo-gastric nerve) may in some cases become involved.* And this might, of course, also occur, not only from the pressure of the consolidated and distended lung, but also as a result of implication of the nerves by thicken- ing with puckering and induration of the neighbouring inflamed pleura, or by pressure from certain pleural exudations external to the lung-substance, consequent upon neighbouring inflamma- tory action. In this manner might the laryngeal muscles (on during life), proved to be a diniinisbed capacity of one of the nasal fossjo by- excessive enlargement of one of the turbinated bones, owing to extreme dilata- tion of its bony cells, seethe Veterinarian, Vol. X., 1837, as described minutely by Mr. James Turner. It is a curious fact that there are several instances on record proving the frequent hereditary character of roaring, • The relation of the recurrent laryngeal nerve to the lung and pleura on either side of the chest, ■whether, i. e., as hooking round the aortic arch on one side, or the first part of the subclavian artery on the other, would render the sup- position tenable.