On laryngitis from local causes / by J.A. Kingdon.

  • Kingdon, J.A.
Date:
[1851]
Catalogue details

Licence: Public Domain Mark

Credit: On laryngitis from local causes / by J.A. Kingdon. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    when the tube became loaded with mu- cus. In the middle of the night she had another severe fit of coughing: a spoonful of warm milk was given, but as it seemed to be coughed through the tube no more was administered: she soon slept again, and passed a quiet night. Oct. 3rd, 6 a.m.—She had some diffi- culty of breathing in consequence of the tube being plugged with thick mu- cus: it was therefore removed and cleansed; but as respiration through the glottis was still accompanied with noise and effort, it was reintroduced. The lips and tongue were less swollen, but viscid saliva still dribbled from the mouth : she was still sleepy. Towards the afternoon, as the cough was trouble some, and there was a good deal of expectoration, three leeches were applied over the top of the sternum; their ap- plication was followed with marked benefit; the cough was relieved, and her breathing consequently was more free. On the following day, October 4, the canula was removed: her mouth had by this time regained its natural appearance, and she could swallow fluid in small quantities without difficulty. On the 6th of October (fourth day after the operation) a considerable quantity of mucus was expelled from the wound; the cough had again become trouble- some : two leeches were applied to the sternum: she was able to speak. On the 11th of October (the ninth day after the operation) she had perfectly reco- vered her voice, and could swallow solid food. The cough, however, was fre- quent, and prevented the closing of the wound. A small blister was applied to the chest. The note of the loth of October is,—The blister rose well, and has been followed by an almost entire cessation of cough : the wound is closed, though not yet cicatrized. She was dis- charged after a few days. This case very closely resembles those that were first reported in the Medico- Chirurgioal Transactions by Dr. M. Hall, and in the Dublin Hospital Re- ports by Mr. Burgess, and by itself would certainly lead to the same conclu- sion that those gentlemen have deduced from their cases—namely, that early bronchotomy is advisable. But it must be remembered that such cases are rare in comparison with the frequency of the milder forms of the complaint,—at least, if the experience of so large an hospital as St. Bartholomew’s is a fair test, or any evidence can be drawn from the paucity' of recorded cases: so that we must be careful, in framing the guiding principles of our treatment, to analyse the materials at hand, lest in avoiding severe measures we fall into the oppo- site extreme, and, as some have done, treat an important subject slightingly. Akin to the cases now under oiu’ con- sideration—indeed they almost belong to the same category—are laryngeal ob- structions produced by the local action of corrosive and irritating fluids: and before drawing your attention to some points of treatment, l think the narra- tion of the following case will be found interesting, and applicable to our pre sent subject; for the particulars of which, though the patient was under my close observation, I am indebted to my friend Mr. Wood. Case IY.—William Henry Shirwell, two years of age, a plump child, by no means of delicate appearance, wasplay- ing, on Feb. 26, 1850, about five o’clock in the evening, with a ginger-beer bottle which contained sulphuric acid. Having removed the cork, he attempted to drink, but was immediately seized with vomit- ing, and began to cough violently. The retching continued for about two hours, and about ten o’clock p.m. he was ob- served to breathe very quickly, and with a harsh, croupy sound: he slept, how- ever, at intervals, and was brought to the hospital on the following morning, Feb. 27, at half-past ten o’clock. At that time the child’s respirations were upwards of sixty in the minute, accom- panied with a harsh, hoarse, ringing sound with the inspiration: there was constant cough, and loss of voice, the attempt at crying giving rise to a rough, barking kind of noise; there was most urgent dyspnoea; the face, lips, and ears were livid,—in fact, were almost blue; the depressions above the clavi- cles at each inspiration were consider- able ; there was constant desire to sleep; the skin of the trunk and upper extre- mities was hot and dry, with the excep- tion of the face, which was covered with perspiration, while that of the lower extremities was cold. The child had swallowed some liquid soon after drink- ing the vitriol; but at the time of ad- mission he refused to drink. Three leeches were applied to the front of the chest, and an emetic forced down his