CHRONIC LARYNGITIS 31 



(b) The discharge contains bacteria, leukocytes, red cor- 

 puscles and epithelial cells. 



Symptoms.— Hoarseness, change of voice, frequent 

 attempts at deglutition, a harsh, dry cough which later 

 becomes softer and moist as the secretions are increased. 

 The mucous membranes are congested and swollen. Pressure 

 on the larynx, exercise, excitement or drinking cold water 

 induces coughing. General symptoms are rare. 



Diagnosis.— The presence of the harsh, dry cough which is 

 aggravated by exercise and excitement and the absence of 

 general disturbance are characteristic of laryngitis. 



Prognosis.— Favorable. Recovery usually follows in eight 

 to ten days, unless when secondary to rabies, distemper, etc. 



Treatment.— Hygienic— Keep warm; supply plenty of 

 fresh air. 



Dietetic— Give warm milk and warm liquid foods. 



Medical.— Direct application of medicinal preparations to 

 the mucous membrane is unpracticable and of little value. 

 The following formula should be used to allay irritation and 

 stop the coughing: 



R — Morphini hydrochlorati . 0.1 



Aquae amygdalae amarae 30.0 



Misoe et fiat solutio. 

 Sig. — Give teaspoonful three times daily. 



Surgical.— Apply Priesnitz compress or hot antiphlogistin 

 pack over the larynx. Renew twice daily. 



Chronic Laryngitis.— Definition.— A chronic catarrhal in- 

 flammation of the mucosa and submucosa of the larynx. 



Etiology.— This is usually the result of frequent acute 

 attacks, and therefore the causes enumerated under acute 

 laryngitis are applicable to the chronic form. Chronic laryn- 

 gitis is often the result of the extension of chronic nasal and 

 pharyngeal catarrh; the presence of papillomata and poly- 

 poid fibromata within the larynx; as a sequel to distemper; 

 may be caused by pressure on the vagus nerve (enlarged 

 mediastinal lymph glands, sarcomas, carcinomas, etc.); 

 to direct irritation of the mucosa by malignant growths; 

 enlarged thyroids. 



