Course and Prognosis. 41 



away from the hand of the examiner. In some cases the head 

 is seen to be stretched out and bent sideways. 



Difficulty of respiration exists only when the mucosa is 

 swollen more markedly. In such cases one also hears whistling 

 and rattling noises during inspiration. These symptoms may 

 finally lead to the clinical picture of edema of the larynx. An 

 increased laryngeal sound may, however, be heard on ausculta- 

 tion of the larynx even in such cases where there are no other 

 noises which can be heard at a distance. One also hears fre- 

 quently rattling over the larynx and the windpipe. In horses 

 and dogs one may observe hoarseness and an indistinct noise. 



Fever exists only in the initial stage of simple laryngeal 

 catarrh. The elevation of temperature, however, as a rule, 

 amounts only to a few decimals of one degree (C._°). Catarrh 

 of the larynx occurring during the course of infectious diseases 

 is associated with moderate or even high fever. A scanty, 

 serous, mucous or mucopurulent nasal discharge exists only 

 rarely; also a moderately acute swelling of the submaxillary 

 and peripharyngeal lymph glands. 



Chronic laryngeal catarrh either remains after an acute 

 attack or develops from the start as a slow process. The 

 symptoms are on the whole similar to those of the acute form. 

 As a rule, however, the cough is less painful, rough, crowing 

 and dry ; rarely somewhat moist and accompanied by a peculiar 

 explosive sound. The inspiration following cough is occa- 

 sionally characterized by an audible noise. During the day 

 cough IS usually infrequent ; the secretions which collect during 

 the night cause long-continued attacks of cough in the morning. 

 The sensibility of the larynx is likewise increased, but the 

 animals do not try to get away from pressure as energetically 

 as they do in acute laryngitis. 



The respiration usually remains unchanged; exceptionally 

 only is the cleft between the vocal cords narrowed to such an 

 extent that respiration is difficult, even at rest, still more 

 during exercise, and that it eventually becomes whistling. The 

 respiratory difficulties are still greater if the catarrh has de- 

 veloped in connection with a neoplasm. Symptoms of fever 

 are observed only in the presence of acute exacerbations. 



Course and Prognosis. Primary acute catarrh of the larynx 

 lasts from a few days to one to two weeks. The cough is at 

 first rough and painful, but gradually it becomes more moist 

 and less convulsive, and finally disappears entirely. The dis- 

 ease rarely assumes a chronic character and then persists like 

 a primary chronic laryngitis for weeks and months. If the 

 duration is very long the mucosa undergoes changes which 

 exclude the possibility of complete recovery. The conditions 

 under Avhich the patients live have an important bearing on 

 the course; in secondary laryngitis the nature of the primary 



