Inflammation of the Larynx. Laryngitis.
Varieties. Several types of laryngitis or inflammation of the larynx are recognizable, acute laryngiti8, in which the membranes alone are commonly involved; edema of the larynx, in which the deeper tissues become inflamed and infiltrated; chronic laryngitis, in which the various types of inflammatory processes assume a chronic nature; and what is called symptomatic laryngitis, when the nature of the trouble partakes of the characteristics of the microbes with which the locality has become infected. Rheumatism sometimes predisposes to an affection simulating laryngitis but differing from it in that the local symptoms are somewhat less active, though the pain and soreness on pressure and on swallowing is more severe than that experienced in the commoner forms. The voice is used with difficulty and there is shortness of breath in most cases. This form is very serious, especially in singers; the joints between the small bones of the throat may become involved when permanent hoarseness results. In some cases the laryngeal symptoms will be the only signs of rheumatism for months.
General Treatment. The trachea is involved with the larynx; but it is rare for the former to be affected without the latter, so that it will suffice, in treating 'tracheitis, to confine our efforts to inflammation of the larynx.
Diseases of the windpipe may be divided into (1) acute, (2) sub acute and (3) chronic inflammations; (4) fibrinous secretions ~see Membranous Croup and Diphtheria); (5) secretions of serous fluid; (6) spasms of the muscles (see Spasm of the Glottis); (7) nervous cough; (8) paralysis of the vocal cords; and (9) new growths (cancer, etc.). In all affections of the throat, however, there are characteristics which are common to each, i.e., more or less complete loss of voice, dryness and redness of the membranes, more or less exudation of a thick, sticky material, and a dry rasping cough. In sub acute and chronic conditions, otherwise known as "sore throat," the inflammation is of a " low " order, and the treatment is oftener local than general. With the. .exceptions, however, the relief desired must be obtained through general tonic measures, or those directed towards reduction of, temperature if such there be; by means of proper local indication; and by restoring the " tone " of the mucous membranes.
Among the measures recommended for their general tonic effect upon the throat, those of hygiene are of the first importance. A change of climate or of occupation will sometimes effect a change when every medicine has failed. A sea voyage or a residence in a clear dry climate is admirable for this purpose. A nutritious diet, outdoor life, invigorating exercise are also indicated. Among the drugs, iron, quinine and strychnine may be mentioned as well as a good cod liver oil emulsion with hypophosphites. It is, however, by means of local measures that the greatest results are to be looked for in the treatment of diseases of the throat. These may be applied either in the form of sprays by means of suitable atomizers; through the medium of steam as generated by any one of the well known vaporizers or from an open pan of water which is kept at the boiling point; or better yet through the continual breathing of various healing oils from sponges or pledgets of cotton which have been saturated and placed in a mask and worn more or less constantly over the nose and mouth. Illustrations of one form of steam vaporizer, and also of a simple mask made of netting to be worn at night are given. Or one may charge the atmosphere of the room where he works or sleeps by setting free naturally, volatile substances of a chemical or vegetable nature. Instances of the latter method are the employment of chloride of ammonia in aggravated cases of acute inflammation of the throat and windpipe, or the use of menthol in croup. In the former method a soup plate is placed on the floor of the room and three or four ounces of sulphuric acid are placed in it. In another plate nearby are poured two ounces of strong ammonia, and then about a tablespoonful of ordinary salt is sprinkled on the acid. In less than a minute the room is filled with dense fumes of ammonium chloride which are of great efficacy in those cases where a large amount of offensive secretion collects in the throat. In the second method mentioned, place a few crystals of menthol in a large iron kitchen spoon and heat over the gas or lamp until evaporated. Creosote produces good effects in whooping cough, spasm of the glottis, and in chronic inflammations of the throat, if cloths wet with it are hung about the room. Turpentine and eucalyptol may be used in the same way in the place of creosote.
In cases where there is dryness of the throat it is better to set free the substances used by the aid of steam, allowing it to escape freely into the room or to enter a "bronchitis tent." Or the boiling water may be placed in a pitcher, medicated, and the head, pitcher and all enveloped in a blanket or towel. The "bronchitis tent" is made by lashing four broomsticks to the corners of the bed, and over this frame spreading two sheets pinned together in the middle, letting the side fall over the sides and ends of the bed, and making a canopy underneath which is introduced a tube from an "Arnold" or similar steam atomizer. From 2 to 5 drops or grains of any of the medicaments mentioned may be used in the water. Following are a few prescriptions for use with steam:
After using steam inhalations the patient should not breathe the outdoor air for several hours.
For use with the face mask the following is valuable in cases attended with excessive cough:
Chloroform 1/2 oz., Creosote 1/2 oz., Menthol 10 grains. Dose 10 drops in the inhaler every 3 hours. Any one of these ingredients may also be used alone. Sometimes when there is a large amount of thick, sticky mucous secretion 10 drops of tincture of iodine may be used to liquefy the secretion and stimulate the membranes.
There are many vaporizers or nebulizers on the market at the present time in which by means of compressed air the medicament is forced against the sides of the inhaler and broken up into a fine cloud or vapor. An oily fluid is usually employed in which to dissolve the medicine. The following will be found useful in acute cases of inflammation:
Paralysis of the laryngeal muscles or aphonia, and new growths when appearing in the throat are amenable to the same treatment as when the affections occur elsewhere in the body.
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