. Virginia medical monthly . s, mucouspatches, ulcerations, oedemata, hyperplasias, gommata, chon-dritis and perichondritis may occur, necessitating a differen-tiation between syphilis, phthisis and cancer. At this point, I am forced to differ from those authors,who regard certain local symptoms as pathognomonic ofsyphilitic laryngeal disease, of laryngeal cancer or phthisis;and adhere to the more liberal views of Krishaber, Heinze,Ziemssen, Schnitzler, Sechtem, Cohen and Mandl. There is no clear local sign of distinction between syphi-litic, cancerous or tuberculous growths; the diagnosis mus
. Virginia medical monthly . s, mucouspatches, ulcerations, oedemata, hyperplasias, gommata, chon-dritis and perichondritis may occur, necessitating a differen-tiation between syphilis, phthisis and cancer. At this point, I am forced to differ from those authors,who regard certain local symptoms as pathognomonic ofsyphilitic laryngeal disease, of laryngeal cancer or phthisis;and adhere to the more liberal views of Krishaber, Heinze,Ziemssen, Schnitzler, Sechtem, Cohen and Mandl. There is no clear local sign of distinction between syphi-litic, cancerous or tuberculous growths; the diagnosis mustbe made from other facts connected with the case. (Kris-haber.*) The attempts made to establish anatomical peculiaritiescannot be said to have succeeded, * * * * * and the differ-ential diagnosis between syphilitic and phthisical ulcers maypresent great difficulties. () It is not possible to conclude from the laryngoscopic ap- *Annates d Mai. de V Oreille et du Larynx, Cyclopedia, Vol. VII, p. -)22 ORIGINAL COMMUNICATIONS—MORGAN. pearance of an ulcer alone, whether its nature is tubercularor not. (Heinze.*) Hence, in many cases it will be very difficult and evenimpossible to say which lesions are caused by syphilis andwhich not. * * * * * The diagnosis of many syphiliticaffections belongs to the most difficult category of laryngo-scopy. (Sechtem and ) There is nothing absolutely characteristic in the appear-ance of syphilitic disease in the larynx, whether of the simpleerythematous form or of the ulcerative variety. An obstinate chronic laryngitis in a constitution un-doubtedly free from tubercu-lous disease of the lungs isalmost presumptive evidenceof its syphilitic nature. AndmliPUl HJUHflf the same may be said of the ulcerative form if it can betraced to no other actual Fig. 6.—Sub-glottic gumma, Turck. cailSC. () kk The differential diagnosis cannot be accurately estab-lished without the anamnestics, or by the discove
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Keywords: ., bookcentury1800, bookdecade1870, booksubjectmedicine, bookyear187
