Saint Louis chirurgica e medica ufficiale . premuto e non era in grado di pro- 226 comunicazioni originali. duce un tono al di sopra di un sussurro. L'aspetto generale di thepatient era quella di una persona nelle fasi successive di phthisis ;era molto emaciato, con i suoi poteri corporei grandemente im-abbinato con il minimo sforzo la produzione di grande angoscia e fa-tigue. Egli ha dichiarato che sette anni prima aveva notato un alter-zione nel tono della sua voce e da quel momento un graduallyincreasing raucedine o huskiness finché il tono era completamente dis-apparso. È stato soltanto di circa l'inizio dell'y

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Saint Louis Medical and Surgical Journal . pressed and he was unable to pro- 226 Original Communications. duce a tone above a whisper. The general appearance of thepatient was that of a person in the later stages of phthisis ;he was very much emaciated, with his bodily powers greatly im-paired—the slightest exertion producing great distress and fa-tigue. He stated, that seven years previously he had noticed an alter-ation in the tone of his voice, and since that time a graduallyincreasing hoarseness or huskiness until the tone had entirely dis-appeared. It was only about the beginning of the year 1875, that he commenced to experience marked difficulty of breathing, although for some time previous, there had been a certain im-pairment of the respiration, especially on any hurried movementor exertion. From that time, the dyspnoea had constantly in-creased, and he began to suffer from a difficulty in swallowing.He had undergone quite extended local and general treatmentunder a number of physicians, with no relief to his symptoms.. On deep inspirutioii. A laryngoscopic examination presented the picture as faith-fully given in the above wood-cut, which was drawn from theliving larynx, by Dr. Chas. A. Todd, of this city. On the firstnight the whole glottis seemed filled by a mass, which would en-tirely obstruct respiration, but on making the patient inspiredeeply, a small opening was seen at the cartilaginous extremityof the left vocal cord, perhaps a little longer than a goose-quill.On ordinary respiration, this opening was necessarily much^di- Case of Laryngeal Growth. 227 minished, as the tumor on the right cord overlapped in a meas-ure the left cord. A close examination showed the mass to con-sist of three distinct growths—one almost filling the right sideof the larynx and having its base on the right vocal cord ; a sec-ond with its base in the anterior angle of the thyroid cartilage ;and a third situated on the left cord, covering the anterior halfof the cord. They

Parole chiave associate all'immagine

• bookcentury1800
• bookdecade1880
• bookpublisherstlou
• bookyear1882