Chronic Catarrhal Laryngitis.
Synonyms:—Chronic endolaryngitis; simple chronic laryngitis; clergyman's sore throat.
Definition:—A chronic inflammation of the larynx, catarrhal in character, which involves its mucous structures, often quite persistent or stationary in character.
Etiology:—It occurs as an extension of an acute or subacute catarrhal inflammation of the post-nasal passages; also from persistent use of the voice, when there is weakness of the vocal structures. It occurs also, developing in an insidious and gradual manner, from any of the causes that will induce the acute form of the disease. It is common with alcoholics.
Symptomatology:—One of the first symptoms is dryness of the larynx, which causes a constant effort at hawking, as if clearing the throat of a tenacious mucus. The voice is thick and harsh; in fact, hoarseness is a most common and persistent symptom. The voice tires easily, the patient being unable to do any prolonged speaking, and huskiness soon occurs, with sometimes complete aphonia. Ultimately there is a cough, which becomes persistent. Usually it is short, harsh and hacking in character, but at other times it occurs in a spasmodic form, in paroxysms, and seems to be caused by a tickling in the throat. Again, it assumes a barking, or deep, hoarse, ringing character, and becomes very annoying to the patient. Usually expectoration is scanty, the cough being quite dry; at other times there is an outpour of thick mucus, or there may be a slight quantity of a mucopurulent expectoration. The pain is by no means as severe as in an acute form, but it may be annoying and persistent, becoming aggravated by efforts at prolonged speaking or singing.
Inspection of the throat reveals a mucosa, which, while somewhat tumefied, lacks the extreme swollen and reddened appearance of the acute form of the disease. The mucous glands are distended, and the mucous membrane presents in some cases a slightly ulcerated or eroded appearance.
Prognosis:—The prospect of a complete recovery in these cases is not good. The development of the disease is usually slow. Slight chronic structural changes in the mucous membranes are apt to occur, which render the condition more or less permanent in its character. If the patient be removed entirely from the exciting causes, and change his occupation, giving the voice complete rest and encouraging improved physical development, the condition may be relieved in time so as to be almost entirely unnoticed, or to produce but little discomfort.
Treatment:—It is obligatory upon the patient, if he obtain any improvement in this condition, that he desist from smoking entirely, and from the use of alcoholics; that the voice have a complete rest and that he be removed from any persistent atmospheric condition which, from the presence of dust, irritating odors or vapors, would induce irritation of the. mucous membranes of the throat. Physical exercise should be encouraged and a course of tonic treatment prescribed, which will improve every function of the muscular and nervous symptoms. The sea air and sea bathing have exercised very conspicuous beneficial results in many severe cases of this disorder.
There are but few specific measures that can be suggested in the medical treatment. We have depended upon the use of collinsonia in doses of from fifteen to thirty minims, every two or three hours, to relieve those cases in which there are no apparent structural changes, which will be found of benefit in all cases. Scudder classed it as a specific for this condition. We would be inclined to select other remedies which would meet other specific indications of the case with the expectation of inducing excellent results. The use of a spray of albolene or a chloretone inhalant, or other antiseptic, soothing, alkaline preparation, will be found of benefit. Where ulceration has occurred, the use of a saturated solution of boric acid, or a solution of potassium chlorate, will result beneficially.
