. Diseases of the nose and throat . shallow ulcerations, resembling the mucous patches observedin the pharynx, but distributed with less regularity. These occur fromsix months to two years after the development of the primary sore insome other part of the bodv, and are onlv found in the vocal cords. (415) 416 DISEASES OF THE LARYNX. The ulcerations occurring in this stage are gray in color, surroundedby an hypersemic red zone. Secondary syphilis rarely occurs in thelarynx until several weeks or months after the appearance of thecutaneous eruption. The tertiary stage is also marked by hyperemia
. Diseases of the nose and throat . shallow ulcerations, resembling the mucous patches observedin the pharynx, but distributed with less regularity. These occur fromsix months to two years after the development of the primary sore insome other part of the bodv, and are onlv found in the vocal cords. (415) 416 DISEASES OF THE LARYNX. The ulcerations occurring in this stage are gray in color, surroundedby an hypersemic red zone. Secondary syphilis rarely occurs in thelarynx until several weeks or months after the appearance of thecutaneous eruption. The tertiary stage is also marked by hyperemia. This may hefollowed by deep and rapid ulceration, destroying cartilage and sur-rounding tissue. Efforts to repair by Nature produce severe contrac-tion from cicatrization, impeding respiration and producing extensive destruction of the epiglottis and other cartilages of thelarynx, arising from tertiary disease, may end in gross deformity aswell (Fig. 126). Gummy tumors are probably the most frequent pathological for-. Fig. 127.—Cicatricial stenosis of larynx, the result of syphiliticulceration. (From Bos worth.) mation found in the larynx during the course of this disease. Theydo not occur, however, until years after the primary infection. Theinterval may be over one and even two decades, the larynx during allthis long interval being practically free from disease. Sometimes thegummatous tumor involving one of the vocal cords may break downby ulceration, with extensive destruction of the tissues. In others itmay continue as a dark, nodular enlargement impeding the functionsof deglutition and respiration. The process of cure after destructionof cartilage is aided by formation of connective tissue; but this rapidlycontracts, resulting in the deformities of cicatrization already referredto (Fig. 127). Etiology.—Syphilis of the larynx is usually a tertiary, sometimes SYPHILIS. 417 a secondary, manifestation of acquired disease. As a primary affection,the case repo
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