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DISEASES OF THE THORACIC VISCERA. 



ANGINA LARYNGEA {Laryngitis), 

 (Inflammation of the lining membrane of the laryfix.) 



Symptoms. — Acute laryngitis may vary from the production of 

 but a slight hoarseness, without stridalous breathing, and with little 

 or no fever, to a violent irritation of the mucous membrane and sub- 

 jacent cellular tissue of the glottis, epiglottis, and upper portion of 

 the larynx, which, by inducing a3dema, may cause death by suffo- 

 cation. The developed stage of this disease is generally preceded by 

 a sensation of irritation, heat, and tickling in the throat, pain in the 

 region of the larynx, increased by pressure, and cough. General 

 febrile excitement comes on, the respiration is stridulous, the voice 

 becomes hoarse, sometimes descends into a whisper, and in extreme 

 cases there is complete aphonia. Violent coughing comes on in 

 paroxysms, during which the face becomes swollen and livid, the 

 eyes turgid and prominent, and there is more or less cerebral dis- 

 turbance. There is often dysphagia, and the drinks are returned 

 through the nose ; in some cases, the epiglottis may be felt swollen, 

 turgid, erect, and on inspection is seen red and shining. The cough, 

 which is at first dry, is afterwards attended with the expectoration 

 of a thin and acrid secretion, which, should the case proceed favour- 

 ably, becomes bland, viscous, and transparent, and gradually changes 

 to a yellow. 



Should the disease progress to a fatal termination, all the symp- 

 toms become aggravated ; the mucous membrane of the larynx be- 

 comes swollen, and the rima glottidis is so contracted as not to allow 

 sufficient atmospheric air to pass to the lungs ; hence, there is great 

 dyspnoea, with violent action of the respiratory muscles. As the 

 rima becomes more contracted, the difficulty of breathing increases, 

 the patient sits up in bed, tosses about his limbs, his eyes are promi- 

 nent and tearful ; and he dies apparently exhausted by his efforts ; 

 or, if a strong person, in a convulsive struggle. When the disease 

 terminates more slowly, it is supposed that death is produced by 

 blood which is not duly aerated circulating in the brain. 



This disease may be mistaken for foreign bodies in the larynx, 

 acute pneumonia, pleuritis, acute pericarditis, tumours pressing on 

 the larynx, hysteric spasm, &c. 



