. Rhinoscopy and laryngoscopy, their value in practical medicine . e with the reflex image in the mirror. I can recommend these instruments from my own experience,and I believe that with these the operator would be quite wellprovided for all cases. Case IT.—The case here recorded may indeed be consideredas one of the most difficult for laryngoscopic operation. A lady (her age I did not ask), a governess, came to me lastautumn to be examined and to ask my advice. She had sufferedfor five years from complete aphonia, which had been graduallydeveloped. On a careful examination, I discovered three
. Rhinoscopy and laryngoscopy, their value in practical medicine . e with the reflex image in the mirror. I can recommend these instruments from my own experience,and I believe that with these the operator would be quite wellprovided for all cases. Case IT.—The case here recorded may indeed be consideredas one of the most difficult for laryngoscopic operation. A lady (her age I did not ask), a governess, came to me lastautumn to be examined and to ask my advice. She had sufferedfor five years from complete aphonia, which had been graduallydeveloped. On a careful examination, I discovered three forma-tions of various sizes, as in Fig. 13. The largest of these was 186 translators appendix. spherical and was seated in the vicinity of the left vocal chord;a second, smaller and club-shaped, projected from the anteriorangle of the glottis, and lay with its free extremity upon thefirst; the third and smallest protruded from the anterior surfaceof the right arytenoid cartilage, at about the level of the vocalchord, and extended into this latter structure.*. Fig. 18. I stated to her that I was inclined to operate; that I couldnot insure success, so far as the restoration of the Voice was con-cerned ; but that by the operation, even as regarded the voice,nothing was to be lost, since she was already voiceless, a circum-stance sufficiently unfortunate for a governess. To my amaze-ment, I must confess, there was no dyspnoea, not even anabnormal murmur to be heard on auscultation. [The author goes on to state that the patient had been exa-mined by two laryngoscopists, one of whom made the diagnosis,but at a time when the formation was not so large, and consi-dered an operation impracticable; the other, however, lookedforward to an operation at a later date. The lady had also beenadvised by another physician to go at once to London or Paris,where he thought she might long ago have been freed from herpolyp ; while in point of fact, up to that time, no laryngoscopicoperation had
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