468 OTOLOGY AND LARYNGOLOGY 



mists, physiologists, and pathologists as Luschka, Sappey, Zucker- 

 kandl, Exner, Hermann Munk, Richard Ewald, Risien Russell, 

 Bechterew, and others. And yet these are, I particularly wish to 

 state, a few names only taken at random from one's recollection of 

 those who have enormously improved our knowledge of the anatomy, 

 physiology, and morbid histology of the throat, nose, and ear, within 

 the last twenty years. 



Bacteriology. From pathological anatomy in general, there is but 

 one step to the latest development of that science, bacteriology. 

 Here again the close relationship of our specialties to this new science 

 is evident everywhere. We learn from the bacteriological examin- 

 ation of the sputum in cases in which the clinical examination of the 

 nose, pharynx, larynx, or ear leaves it doubtful whether we have to 

 do with tuberculosis the true nature of the process that engages our 

 attention ; we differentiate with the help of bacteriological examina- 

 tion between true diphtheria, Vincent's angina, and other forms of 

 septic inflammations of the cavities of the mouth and throat; the 

 employment of antitoxin enables us to deal infinitely more effect- 

 ively than at any previous state of our knowledge with that scourge 

 of humanity, diphtheria; we ascertain in those terrible although 

 fortunately rare cases, which I have grouped together under the 

 name of "Acute Septic Inflammations of the Throat and Neck," the 

 nature of the particular pathogenic microorganism that is causing 

 the disease in a given case, and although as yet by no means masters 

 of the situation, we succeed in a certain number of these cases, 

 namely, in those in which the streptococcus is producing the septic 

 inflammation in warding off by the employment of antistreptococcus 

 serum the otherwise unavoidable fatal issue. As a matter of fact, an 

 almost unlimited vista of further progress has dawned for our spe- 

 cialties in a number of previously most intractable affections from 

 the rise and progress of bacteriology. 



Internal Medicine. On the connection of laryngology, rhinology, 

 and otology with internal medicine it is practically unnecessary to 

 dwell. Whilst there is, needless to say, a number of local diseases of 

 these organs strictly limited to them, in another large and important 

 number the affection for which the aid of the specialist is sought is 

 only part and parcel of a systemic disease, and as I have endeav- 

 ored to show on another occasion, it would seem high time that 

 not only the public, which has rushed to the conclusion that all 

 affections of the throat, nose, and ear ought to be treated locally, but 

 also some enthusiastic specialists should come to understand that in 

 such cases not so much local as constitutional treatment is indicated. 

 There are numbers of cases of general anemia, of periodical disturb- 

 ance of the circulation, of general plethora, of nervous irritability, 

 of gout, in which, without any actual changes existing in the throat, 



