RELATIONS TO OTHER SCIENCES 471 



important in our field, and the possibility of syphilis must be always 

 kept in view in the event of our meeting with any obscure affection. 

 On the other hand, eruptions on the mucous membranes of the 

 pharynx, nose, and larynx not only accompany in a number of cases 

 analogous skin affections, but may precede such external manifest- 

 ations or even remain for a long time limited to the mucous cover- 

 ings. Thus lupus, herpes, pemphigus, lichen, and a host of other 

 eruptions sometimes occur first in the parts intrusted to our care 

 and may baffle the specialist whose knowledge of skin diseases is 

 limited. 



Neurology and Mental Diseases. When discussing the relations 

 of our specialties with internal medicine I have already incidentally 

 mentioned the significance of laryngeal paralysis for the diagnosis of 

 some of the gravest intrathoracic diseases. It is, however, not only 

 in connection with these but with numerous affections of the central 

 nervous system that laryngology is of the greatest importance 

 for neurology. The discovery of a laryngeal paralysis may be for 

 a long time the first sign of the existence of organic central nervous 

 disease, and in no affection is this more clearly shown than in tabes 

 dorsalis. Again, neuroses of the olfactory nerve not rarely accom- 

 pany important intracranial affections. Thus anosmia may occur in 

 hysteria, basilar meningitis, and locomotor ataxy, and parosmia 

 may be met with in hysteria, epilepsy, hypochondriasis, or may 

 precede mental disturbances of an even graver character. Affections 

 of the inner ear and of the auditory nerve occur in. many diseases 

 of the central nervous system. Auditory hallucinations, such as the 

 hearing of voices, may accompany or even usher in different forms 

 of insanity, and symptoms of Meniere's disease probably come 

 as often under the observation of the neurologist as of that of the 

 aurist. 



I forbear from entering upon a further enumeration of the branches 

 of medicine with which our specialties have points of interest in 

 common. My list is by no means exhausted, and I may as a proof of 

 this remind you of the connection between them and dentistry, the 

 point of contact being the affections of the antrum of Highmore, but 

 in truth it may be said that there is hardly one single branch of medi- 

 cine which does not occasionally come into touch with laryngological, 

 rhinological, or otological interests. 



In conclusion I should have liked to dwell upon the relations of the 

 three specialties to one another, a question on which I hold views of 

 my own. But apart from the need of keeping my own observations 

 within the limits of the time specified, it would be out of place to 

 introduce controversial matters into an address of this kind; and 

 further I have on more than one previous occasion stated my 

 opinions on this most important topic as clearly as I could. 



