6o6 



EXAMINATION OF THE LARYNX. 



EXAMINATION OF THE LARYNX. 

 LARYNGOSCOPY. EXAMINATION OF THE EXCISED LARYNX. 



After Bozzini, in 1807, had given the first impulse toward illuminating and 

 examining the internal cavities of the body by means of the mirror, and Babington, 

 in 1829, had viewed the glottis in this way, the singing- teacher, Manuel Garcia, 

 in 1854, made investigations, by means of the laryngoscopic mirror, on himself 

 and other singers, concerning the movements of the vocal bands during respiration 

 and phonation. Turck and Czermak rendered the greatest service in the applica- 



FIG. 212. Method of Making a Laryngoscopic Examination. 



tion of the laryngoscope to medical purposes, the latter being the first to use 

 artificial light for illumination. Rhinoscopy was first attempted by Baumes in 

 1838, and was systematically developed by Czermak. 



The laryngoscope consists of a small mirror, attached to a handle at an angle 

 (Fig. 211, B), the instrument being introduced with the mouth wide open and 

 the tongue drawn out (Fig. 211, A). The position of the mirror must be changed 



in accordance with the region to be reflected ; 

 and it may at times even be necessary to ele- 

 vate the soft palate by means of the mirror 

 (b) . The mirror receives the picture of the 

 larynx in the direction of the dotted line, and 

 reflects it at the same angle through the oral 

 cavity to the eye of the observer, which has 

 taken its position in the line of the reflected 

 rays. The illumination of the larynx is ac- 

 complished by collecting either sunlight or 

 light from an artificial source in a concave 

 mirror, and permitting the concentrated bun- 

 dle of rays to fall on the laryngoscopic mirror 

 held in the throat. The latter reflects the 

 light against the larynx, which is thus illumi- 

 nated. The observer looks in the same direc- 

 tion as the rays of light, either under the edge 

 of the illuminating mirror, or through a cen- 

 tral perforation in the latter. 

 The laryngoscope received an important improvement at the hands of Oertel, 

 who showed how the movements of the vocal bands could be followed directly 

 with the eye by means of rapidly intermittent illumination through the disc of 

 a stroboscope (laryngo-stroboscope) . By replacing the eye by a photographic 

 camera, Ssimanowsky was able to photograph the movements of the vocal bands 

 in an artificial larynx. 



FIG. 213. The Laryngoscopic Image During 

 Respiration. 



