Laryngeal hemorrhage / by J.W. Gleitsmann.

  • Gleitsmann, Joseph William, 1840-1914.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: Laryngeal hemorrhage / by J.W. Gleitsmann. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    patient who had acquired severe stomatitis by excessive use of mercurial ointment, on account of parasites. On the third day after his reception into the hospital, symptoms of laryngeal stenosis set in, and lie died from suffocation five hours afterwards. The post-mortem revealed a submucous effusion of blood of one square inch extension below the right ventricle. Ruehle1 remarks that similar effusions have been observed in scurvy, and Immermann2 says that the mucous membrane of the bronchi and larynx in this disease almost always shows extended and numerous ecchymoses, and is covered with bloody mucus. Poisoning with phosphorus produces like conditions, according to Gottstein.3 Bogros4 relates two cases of hemorrhagic variola with exitus lethalis, both of which had sanguineous infiltration of the ary-epiglottic folds. In one of them they attained the thickness of two centimetres, and com- pletely occluded the aditus laryngis. The glosso-epiglottic folds pre- sented the same aspect, and interfered thereby with the mobility of the epiglottis. Suicidal attempts also contribute their share to this subject. Probably the oldest two on record are by Bobillier.5 A workman cut himself with a razor, and inflicted a horizontal wound about six centi- metres long between the hyoid bone and the thyroid cartilage. After it was dressed he felt well till the fifth day, when symptoms of laryngeal stenosis appeared, to which the patient succumbed. The post-mortem showed severance of the upper and anterior part of the thyroid cartilage and of the hyo-thyroid membrane, bloody infiltration of the right ary-epiglottic fold, and oedema of the laryngeal aperture. The second patient was a soldier who set a triangular wound of an inch and a half in length on the right side of the throat, which did not bleed until after four hours. A tampon stopped the bleeding towards the surface, but a soft bluish tumor formed on the left lower maxilla, and although the bandage was removed again, the patient died from suffocation. Dissection showed that the wound did not penetrate into the larynx, but that the entire cellu- lar tissue of the anterior part of the throat was filled with blood, and the infiltration of the mucous membrane of the arytenoid cartilage was so great that the entrance to the larynx was obstructed. Another case belonging to this category is described by Otto6 under the title : Hema- toma of the Aryepiglottic Fold. It occurred in an insane man who cut himself in the throat with a pocket-knife, which wound was followed by a 1 Ruehle, H., die Kehlkopfkrankheiten, Berlin, Hirschwald, 1861, p. 172. 2 Immermann,H., in Ziemssen’s Handbuch der speciellen Pathologic und Therapie, Leipzig, Vogel, 1876, Band XIII. part 2, p. 608. 3 Gottstein, J., Krankheiten des Kehlkolpfs, etc., Wien, Toeplitz und Deutike, 1884. * Bogros, M., Bulletin de la Soci4te anatomique de Paris, 1847, p. 141; also in Sestier’s Traite de l’angine laryngee oedemateuse, Paris, 1852, pp. 63 and 114. 5 Bobillier, M., Reeueil de memoirs de medecine, de chirurgie et de pharmacie mili- taire, tom. viii. 1820, pp. 140, 143 ; also in Sestier 1. c. pp. 137, 138. 6 Otto, A., Deutsches Archiv fur klinische Medizin, vol. xxvii. 1880, p. 580.