114 



ABNORMAL ANATOMY OF THE LARYNX. 



Asphyxia is often delayed by the posterior 

 chink of the glottis being retained partially 

 open, in consequence of the coincident para- 

 lysed force of the arytenoid muscles, and by the 

 great inclination of the crico-arytenoid articu- 

 lating axis, with respect to its vertical section, 

 preventing the approximation of the arytenoid 

 cartilages by which the posterior part only of 

 the chink can be closed. When any irritation 

 is produced on the exquisitely sensitive mucous 

 membrane of the larynx, it transmits a reflex 

 action to the motor filaments of the recurrent, 

 and the glottis is spasmodically closed, without 

 any such morbid condition of the recurrent 

 nerve as Dr. Ley supposed necessary. 



The larynx, when dissected out, and cleared 

 of its extrinsic structures, presents on its ante- 

 rior aspect the free margin of the epiglottis, the 

 notch of the thyroid, the pomum Adami, its 

 mesial line, the crico-thyroid space, and liga- 

 ment, and the anterior border of the cricoid 

 cartilage. 



On each side of the larynx are observable a 

 portion of the wings of the thyroid, the crico- 

 thyroid muscle, the great and lesser cornu, the 

 superior and inferior tubercles, the oblique 

 ridge, the superior and inferior margins of the 

 thyroid, the side of the cricoid, with a portion 

 of the lateral crico-thyroid ligament, and the 

 superior, inferior, and posterior margins of the 

 cricoid. 



On the posterior aspect are observable, the 

 posterior free surface of the epiglottis, the ary- 

 tenoid cartilages and muscles, the aryteno- 

 epiglottic mucous folds, the crico-arytenoidei 

 postici muscles, the vertical ridge of the cricoid, 

 the posterior margins of the thyroid, and the 

 posterior surface of the cricoid cartilages. 



In the internal surface, from above, we ob- 

 serve the superior margin of the thyroid carti- 

 lage and great cornua, forming the superior 

 boundary of the larynx, the superior margin 

 and notch of the epiglottis, the cornicula la- 

 ryngis, the arytenoid and cuneiform cartilages, 

 the aryteno-epiglottic mucous folds, the supe- 

 rior and inferior vocal ligaments, the ventricles, 

 the rima glottidis, and the mucous membrane. 



Looking from below upwards, we perceive 

 the inferior circular margin of the cricoid, the 

 membrane lining its internal surface, the infe- 

 rior aspect of the thyro-arytenoid ligaments, 

 and the rima glottidis. 



The preceding outline of the general anatomy 

 of the larynx will give the reader an idea of its 

 manifold structures, its exquisite sensibility, 

 its complex motions, its connection with the 

 process of deglutition, and its admirable adapt- 

 ation for the production of sound, and may 

 serve to impress a conviction that it is one of 

 the most elaborate and perfect specimens of 

 mechanism in the human body.* 



BIBLIOGRAPHY. Galeni Opera, de locis affectis, 

 lib. i. cap. 6, p. 6. Vesalius, De corp. humani 

 fabrica, Basiliae, fol. 1555. J. Casserius, de org. vocis 

 et auditu, Ferrara, 1600. Riolamts, Opera. Anat. 

 Paris, fol. 1649. Bidloo, Anat. Humani Corp. 



* For the description of the vocal functions, see 

 the Article VOICE. 



Amstel. fol. 1685. Malpighi, Opera omnia, Lond. 

 fol. 1687. Cowper, Myotomia reformats, Lond. 

 8vo. 1694, p. 80. Dodart, Mem. de 1' Acad. Roy. 

 des Sciences, 1700. Morgagni, Advers. Anat. 

 omnia, Lugd. 1718. Santorini, Observations 

 Anat. Venice, 4to. 1724. Albinus, Hist. Muscul. 

 Hominis, Leidz Batavorum, 4to., 1734. Ferrein, 

 Mem. de 1'Acad. Royale, 1741, p. 400. Pic- 

 colomini, Anat. Int. Veronse, fol. 1754, p. 15, 

 45, 53. Duverney, Onvres Anat. Paris, 8vo. 1761, 

 p. 91. Winslow, Anat. Edinb. 8vo. 1763. Vicq d'Azyr, 

 Mem. de 1'Acad. Royale. 1779. Haller, El. Physiol. 

 Soemmering, De corp. humani struct.. vol. vi. Tra- 

 jecti ad Moenum, 8vo. 1801. Savart, Ann. de 

 Chimie et de Physique, Paris, 8vo. 1825. Ben- 

 nati, Recherches sur la Mechanisme de la Voix, 

 8vo. Pans, 1832. Willis, Camb. Phil. Trans, 

 vol. iv. p. 323, Camb. 1832. Cloquet, Traite 

 d'Anat. descrip. Paris, 8vo. 1834. Lauth, Mem. 

 de 1'Acad. Royale de Med. 1835. P. Broc, Traite 

 d'Anat. descrip. Paris, 1837, p. 527. The prin- 

 cipal systems of anatomy. 



(J. Bishop.) 



LARYNX. (MORBID ANATOMY AND PATHO- 

 LOGY.) The importance of this organ to life, 

 and even when existence is not actually en- 

 dangered, to the comfort and well-being of the 

 individual, must render any deviation from its 

 healthy and normal condition in the highest de- 

 gree interesting to the pathologist : nor will 

 that interest be diminished by reflecting on the 

 paramount value of a knowledge of these de- 

 viations to every practical physician. Small in 

 size and composed of few and apparently sim- 

 ple structures its functions so obvious that 

 any imperfection in their performance could be 

 quickly perceived and readily understood it 

 would appear only reasonable to suppose that 

 its various pathological conditions should have 

 been observed, and the symptoms connected 

 with them long since collected and arranged. 

 Yet, such is not the history of the pathology of 

 the larynx : on the contrary, it presents itself 

 to us with all the interest of a new discovery, 

 and whatever is known on the subject is the 

 result of investigations made within the last few 

 years. We have the opinion of the late Dr. 

 Cheyne, (no mean authority on the subject,) 

 that in the year 1800, " perhaps there was not 

 in Britain more than one individual, namely 

 Monro, who was acquainted with the true na- 

 ture of the disease of which. General Wash- 

 ington died acute laryngitis ; " and the same 

 writer goes on to shew that in ten years subse- 

 quent to that general's death, Dr. Baillie, then 

 at the head of the medical profession in Eng- 

 land, admitted that he was ignorant of the 

 nature of the same malady. But without 

 reverting so far back, I may be permitted 1o 

 state, that within a comparatively recent period 

 I can personally remember the lack of know- 

 ledge that obtained amongst medical practi- 

 tioners in this particular, and the deplorable 

 results that too frequently ensued : and al- 

 though it may be gratifying to reflect on the 

 altered condition of things at present, yet it 

 must be obvious that a subject so short a time 

 under investigation cannot be expected to have 

 been thoroughly worked out. Much as has 

 been brought forward perhaps more remains 

 behind, and any person now attempting to give 



