On the Practical Uses of the Laryngoscope and the Rhinoscope

Ephraim Cutter
1866 Boston Medical and Surgical Journal  
Professor Wilson has collected ninety cases, of which forty-four were females and thirty-throe males ; of the remainder the sex is not mentioned. Of this number, forty-eight were seated on the head, four on the face, four on the nose, eleven on the thigh, tln'ec on the leg and foot, six on the back, five on the glans penis, and nine on the trunk of the body. The most remarkable case on record is that of a Mexican porter, who had a horn situated on tho upper and lateral part of the head,
more » ... f the head, fourteen inches in circumference around its shaft, and divided above that point into three branches. In Diagnosis. Laryngoscopy.-Laryngoscopic diagnosis is positive and negative. Negative laryngoscopic diagnosis occurs where the symptoms point to the larynx and no appreciable lesion appears to explain them. Negative evidence, when true, is quite as useful as positive, and sometimes more so. It is valuable by way of exclusion. It directs attention to other than topical causes of disease. It decides questions of interference, whether medicinal or surgical. It is considerably important to know when to treat and when not to treat. Physicians should not labor to accomplish unattainable objects. It AArastcs their time and the patient's resources, and leads to an unpleasant termination of the affair in an opprobrium medici. Case I.-A middle-aged Man with Aphonia-, caused by no discoveracomplexioned man of 45 years, complaining of aphonia of several months' duration. Unassisted physical exploration revealed no lesion sufficient to explain the difficulty. On inspection by lar}iigoscopy, the epiglottis appeared normal in its body, Avings, cushion, tip and edges. The arytenoid cartilages and their connecting band were natural. The color, conformation and physical appearances of the walls of the larynx, the vocal cords, and the mucous membrane of the trachea, were also normal. (The idea of normal was gained by previous inspection of healthy laryngés.) A negative diagnosis was given, and the attending physician was directed to other iirvisible causes. Pressure upon the recurrent la-
doi:10.1056/nejm186602010740102 fatcat:k3oljdzcjrfwlicb44upzwxgpu