SPASM OF THE MUSCLES OF THE GLOTTIS. ETC. 5} 



state of marasmus, in consequence of the continuance of the malady, 

 the suppuration, and the fever by which it is attended. 



TREATMENT. The treatment of laryngeal perichondritis can, of 

 course, be only a treatment of symptoms, seeing that the disease is not 

 generally recognizable until after the effusion has formed in the sub- 

 mucous tissue. There then remains nothing to do except to perform 

 tracheotomy, and this operation and the opening of any abscesses about 

 the neck are about the only measures at our disposal, and even they are 

 merely palliative. 



NEUROSES. NERVOUS AFFECTIONS OF THE LARYNX. 



Deranged sensibility of the larynx, excessively exalted excitability 

 of its sensory fibres (hyperaesthesia), and their abnormally diminished 

 sensibility (anaesthesia) are never observed as independent diseases. 

 We may count certain cases of globus hystericus and of spasmodic 

 cough, in hysterical persons, to the first of these forms. True, persons 

 suffering from the latter complaint do not complain of abnormal sensi- 

 bility in the larynx, but the coughing-fits to which they are subject are 

 to be regarded as reflex phenomena, independent of the morbid condi- 

 tion of the sensory nerve-fibres, whose excitability is increased. The 

 neuroses of the motor function in the larynx are divisible into hyperci- 

 nesis and acinesis / into spasm and palsy. We shall treat of each in 

 the following chapters. 



CHAPTER X. 



SPASM OF THE MUSCLES OF THE GLOTTIS SPASMTJS GLOTTIDIS ASTHMA 



LARYNGEUM ASTHMA ACUTTJM MILLARI ASTHMA THYMICUM LA- 



RYNGISMUS STRIDT7LUS. 



ETIOLOGY. [This disease depends mainly upon a spasmodic ex- 

 citement of the nerves whereby contraction of the glottis-muscles is 

 effected ; but the motor-nerves of the inspiratory and expiratory 

 muscles also seem to take part in the spasms, which indeed are often 

 accompanied by general eclamptic seizures. Hence Henoch infers 

 that the essential of this disorder is to be sought in the medulla and 

 central organs, and not in the vagus alone. Only by such a suppo- 

 sition can we account for the frequent connection of spasm of the 

 glottis with the most heterogeneous diseases swelling of the thy- 

 mus, cranio-tabes, teething, hydrocephalus, hypersemia and hyper- 

 trophy of the brain, disorders of the stomach or liver, dyscrasia or 

 constitutional anomalies, acting upon a subject having nerve-cen- 

 tres predisposed to excitement.] 



