150 



bcred that the test of touch was applied, not only by myself, but by 

 one or more of my colleagues or assistants, and thus the diagnosis 

 of the disease was established beyond doubt. 



To those who have encountered this formidable disease, this sub- 

 ject will possess peculiar interest ; and the remedy proposed, per- 

 haps, may be hailed by them as a valuable improvement in the 

 healing art. 



Time and experience alone can determine this question. To this 

 test I desire to subject it after having, as I believe, faithfully re- 

 corded and made known the results of my own experience. 



In conclusion, I desire to express my grateful acknowledgements 

 to Drs. R. K. Hoffman and John A. Swett, my highly esteemed col- 

 leagues at the New York Hospital, for the opportunities they kindly 

 afforded me of applying the new treatment upon their patients, and 

 also to my pupil Mr. Moreau Morris, for the accurate and beautiful 

 drawings accompanying this paper, and so indispensable for its 

 illustration. 



Note. — Since this paper was laid before the American Medical 

 Association at its recent meeting, I have had access to Valleix's 

 work, entitled Guide du Medecin Praticien, tome i. p. 481, Paris 

 1842, giving a detailed account of M. Lisfranc's operation, respecting 

 which it seemed doubtful, from the very slight notice taken of it by 

 earlier authorities, especially Cruveilhier, whether it had ever been 

 performed. M. Valleix says, "M. Lisfranc (Mem. sur VAng. 

 Laryng. (Edem., Journ. Gen. de Med., tome lxxxiii., 1823,) first 

 conceived the idea of evacuating by means of incisions more or less 

 numerous, the serous or scro-purulent fluid engorging the submucous 

 tissue of the larynx. This surgeon cites five cases in which this 

 operation was followed by an immediate change, and subsequently 

 by a complete cure. In a sixth case, several similar operations at 

 variable intervals acted only as palliatives. Extensive lesions of 

 the larynx existed, which at length caused the death of the patient. 



"The following is M. Lisfranc's method of scarifying the larynx. 

 Take a long narrow-bladed slightly curved bistoury in a stiff handle, 

 protected with a strip of linen to within half an inch of the point. 

 Let the patient open his mouth wide, and have the jaws kept apart by 

 means of a cork placed far back between the molar teeth, one end of 

 the cork being held by an assistant. The patient being placed in 

 front of the operator with his head supported against the breast of an 

 assistant, pass the index and middle finger of the left hand into the 



