The laryngoscope : illustrations of its practical application, and description of its mechanism / by George Duncan Gibb.

  • Gibb, G. Duncan (George Duncan), Sir, 1821-1876.
Date:
1863
Catalogue details

Licence: Public Domain Mark

Credit: The laryngoscope : illustrations of its practical application, and description of its mechanism / by George Duncan Gibb. Source: Wellcome Collection.

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    ho came under my care in Jane last at the Westminster Hospital. The uvula and other parts of the throat were destroyed, there was ulcer- ation leading up to tlie pharyngo~nasal arch, as shown by the rhino- scope ; and the epiglottis completely covered up the larynx, so that it was utterly impossible \vith all the devices at my command to see the interior of the latter. This patient had been subject to fearful tertiary ravages, luider the care of my colleagues Mr. Holt and Dr. Fincham, aud was comparatively well, but liable at any moment to attacks of serious laryngeal disease, and pulmonary mischief from the position of the epi- glottis. It has fallen to my lot to encounter six instances of destruction of the free portion of the epiglottis; three of them occurred in 1862, and were brought before the Pathological Society; a fourth was lately sent to me by Mr. Brace, of Bath, and Dr. Guthrie of Brechin. A fifth I lately examined for Mr. Nunn, and Mr. J. W. Mason; and a sixth was recently under the care of my colleague, Mr. Holt, at the Westminster Hospital, wherein I diagnosed this condition. The symptoms in all were very distressing and painful to witness, in one there was ulceration of the left arytenoid cartilage, and the poor patient's sufferings were described as actually horrible. The an- nexed sketch affords a view of the parts laryngoscopically; the root of the epi- glottis seems as if it had been cut off by three incisions; my belief is that it was detached by thi-ee separate lacera- tions. The particulars appear in the fourteenth volume of the Pathological Transactions. Two of the other cases are as follows, the appearances they pre- sented were such as to excite the deepest commiseration in my mind for the un- fortunate sufferers. The first was truly a case of laryngeal phthisis, for the patient underwent all the suffering and symptoms as if he was iu the third stage of the pulmonary disease. I showed the subject of it to the Fellows of the Medical Society of London, and pointed it out as an example of laryngeal consimiption, in which the limgs remain comparatively somid, and yet the structures at the upper larynx were wholly chaotic, or to use a geological expression, had undergone a cataclysm, wherein they had been swept away without leaving scarcely a trace behind. Destruction of the epiglottis, aryteno-epiglottidean folds, arytenoid cartilages and vocal cords; incurable aphonia. A. Stoneham, a;t. 24, called on me the 7th of November, 1862, with a a, The base of the epiglottis, b, The back of the tongue. The black space in the centre is bounded on either side by the vocal cords, at the base of which are seen the arytenoid cartilages. The position of right and left, anterior and posterior, is reversed in the laryngeal mirror.