. Diseases of the nose and throat . and orthoform will have a wonderfully soothing effect, par-ticularly the latter, which is noted for its prolonged action. It is anon-toxic anodyne, producing anaesthesia of the parts for nearly twenty-four hours. The prognosis, under judicious treatment, is good underthe first two divisions, fairly good in some of the third and fourth varie-ties, and universally bad in the other two. 25a CHAPTER LXXVI. LUPUS OF THE LAEYNX. Primary lupus of the larynx is not so rare as primary tubercu-losis of the larynx, although both are believed to owe their origin tothe p
. Diseases of the nose and throat . and orthoform will have a wonderfully soothing effect, par-ticularly the latter, which is noted for its prolonged action. It is anon-toxic anodyne, producing anaesthesia of the parts for nearly twenty-four hours. The prognosis, under judicious treatment, is good underthe first two divisions, fairly good in some of the third and fourth varie-ties, and universally bad in the other two. 25a CHAPTER LXXVI. LUPUS OF THE LAEYNX. Primary lupus of the larynx is not so rare as primary tubercu-losis of the larynx, although both are believed to owe their origin tothe presence of tubercle bacilli. As a rule, however, it is secondaryin its origin, being derived from lupus of the pharynx, which itselfhad been an offshoot of lupus of the skin. In this, too, it differs fromtuberculosis of the larynx in being sequel to an external disease insteadof an internal one (Fig. 122). To the comparatively long list of cases of primary origin alreadypublished, Mayer, of New York, has recently added two more. On. Fig. 122.—Lupus. Laryngoscopic appearance.(After Lennox Browne.) examination of the report in the Journal of Laryngology in 1897,however, only one of these could be called purely laryngeal, and theother was a long-standing case under the care of Morris J. Aseh, andwas more pharyngeal than laryngeal. In this case the skin was foryears unaffected, and the patient lived for eighteen years, finally dyingof apical tuberculosis. For the pathology and etiology of laryngeal lupus, reference toits history as occurring in the pharynx will cover the points of chiefinterest. The only point that need be further mentioned here is theone brought out by Lefferts many years ago, that the first pathologicalelement of this disease is essential hypertrophy of tissue. This is fol-lowed by slow, but destructive, ulceration, to be succeeded by dense,(406) LUPUS OF THE LARYNX. 407 hard cicatrices. All three conditions may exist in the one larynx atthe same time. Symptoma
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