94 ENTOZOA FOUND IN MAN. 



the respiratory passages is very uncertain, as oedema 

 of the glottis, croup, spasmodic laryngitis, and the 

 introduction of any foreign body give rise to ana- 

 logous symptoms. 



The paroxysms of suffocation occasioned by 

 oedema of the glottis and croup do not, however, 

 come on suddenly, and without having been pre- 

 ceded, or being accompanied, by the general symp- 

 toms of a disorder of the larynx ; those of spasmodic 

 laryngitis usually come on during the night, and 

 occur m very young cliildren ; the introduction of 

 foreign bodies into the larynx takes place only during 

 certain acts, such as that of swallowing food, of which 

 the patient has generally some knowledge ; whilst 

 the fits of coughing and of suffocation produced by 

 the introduction of a lumbricus into the larynx may 

 supervene at any moment, in individuals (especially 

 children) who present the appearance of the most 

 perfect state of health. 



An examination of the throat and of the upper 

 part of the larynx, either by the eye or by the finger, 

 may probably assist in the recognition of the real 

 course of the afiection, if the worm (as has happened 

 in nearly one-half of the recorded cases) be still partly 

 in the pharynx. 



It is scarcely necessary to observe that a lumbricus 

 which is situated partly in the larynx, and partly in 

 the pharynx, should be extracted as quickly as pos- 

 sible by the fingers, or by a forceps. When the 

 worm is beyond reach, sternutatories and prompt 

 emetics should be immediately administered, and if 

 these should fail to dislodge the worm, tracheotomy 

 should be performed. 



