144 



chea, when it was found that respiration through the larynx could 

 be performed with considerable facility, showing clearly that the 

 swelling of the glottis had already diminished very much. Replaced 

 the tube as before. 



Second day. — Progress favourable; the epiglottis is free from 

 swelling, and of its natural dimensions. 



After cleansing the tube and replacing it, the patient was able to 

 breathe with natural facility through the larynx, with the tube closed 

 at its external orifice, showing conclusively, inasmuch as the tube 

 accurately filled up the opening in the trachea, that the swelling in 

 the glottis had already disappeared. 



Third day. — Left out the trachea tube altogether. 



March 20th. — Air no longer passes through the opening in the 

 trachea. The wound has filled up with granulations — the surface 

 only remaining to cicatrize. No auxiliary treatment was employed 

 in this case. 



April 1. — Patient was this day discharged, with the wound healed, 

 and his voice restored. 



The other three cases that occurred terminated fatally, and with- 

 out scarifications being resorted to. 



They, however, possessed peculiar interest, as furnishing illustra- 

 tions of the anatomical characters of the disease, and, happening as 

 two of them did, after the first trial of the new method of treatment, 

 they served to strengthen confidence in its adaptation and practica- 

 bility. 



Plates III. and IV. are faithful representations of the diseased 

 parts removed from two of these cases, and show that the oedematous 

 swelling affected both edges of the glottis in one (PI. III.), and only 

 one edge in the other specimen (PI. IV.). 



In the third case, not represented, the swelling also occupied only 

 one edge of the glottis, and in all the three cases the swelling de- 

 scended to the vocal chords, and encroached very much on the cavity 

 of the larynx. 



In one of the three cases (PI. III.), the epiglottis is represented 

 as free frpm swelling, though doubt existed on this point from the 

 tongue having been cut across at its base, and twenty-four hours 

 having elapsed after its removal before the specimen came into my 

 possession, thus allowing the effused fluid, which constitutes the swell- 

 ing, to ooze out, had it existed. 



In the other two cases, the epiglottis participated largely in the 

 oedema. 



