. A Reference handbook of the medical sciences embracing the entire range of scientific and practical medicine and allied science . s-sion of Dr. C. II. Knights paper. Transactions of theAmerican Larjngological Association, 1901) states that hehas had a few cases which have done well tinder treat-ment Avitli chromic acid, and he prefers this to the gal-vano-cautery. P.\CHYDERMi.\ —There is one form of pachy-dermia, of syphilitic origin, which I shall not touch upon,as it will be treated of in connection with syphilitic ]ieri-chondritis of the larynx. The form with which we haveto dea
. A Reference handbook of the medical sciences embracing the entire range of scientific and practical medicine and allied science . s-sion of Dr. C. II. Knights paper. Transactions of theAmerican Larjngological Association, 1901) states that hehas had a few cases which have done well tinder treat-ment Avitli chromic acid, and he prefers this to the gal-vano-cautery. P.\CHYDERMi.\ —There is one form of pachy-dermia, of syphilitic origin, which I shall not touch upon,as it will be treated of in connection with syphilitic ]ieri-chondritis of the larynx. The form with which we haveto deal here is probably of infianmiatory origin, accord-ing to Virchow; or is caused by friction, according toSchrotter. However, it is a form of chronic laryngitis,Vol. v.—27 and is seen in those cases in which laryngitis is eitherchronic or Iecurreut in form, and has beeupresent for along i^eriod of time. Cases which I have seen have been in persons who havefound it necessary to use the voice while suffering fromacute laryngitis, not necessarily straining the throat, bjpitching the voice too high, as in the case of chorditis. Fig. 3113.—Pacliydermia; Cen ral Vesetation witli Gray Plaiiues onEaih Side. tuberosa, but merely using the voice when it should at rest. The theor_v of the causation frictionhardly seems tenable, for the reason that the plaquesand enlargements seldom form on the free edges of thecords, but usually on the aryepiglottic folds, where fric-tion is very slight. This observation as regards locationis that held by E, Meyer and P. Bergengriin. On laryngoscopic examination the cords are seen to bethickened and there is a want of approximation in theirentire length, a condition which is largely due to thethickening in the posterior commissure, as well as to theirregular growths which may be seen there. These flat-tened and irregular nodules are not at all of the same sizeor shape as the singers nodes(which are small and roundlike large pinlieads)
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