=Etiology.=—This disease is of frequent occurrence, due to inherited
syphilis, or to the secondary or tertiary stages of the acquired form.
=Symptoms.=—There is a hoarseness of the voice, a hacking cough,
difficulty in swallowing and the various symptoms of catarrhal
laryngitis. The secondary form may present superficial, whitish ulcers
on the cords or ventricular bands, while in a tertiary stage the
lesions are extensive and serious. Deep ulcers with raised edges are
present, gummata develop on the submucous coat of the epiglottis and
there may be necrosis and exfoliation of the cartilages. Deformity is
produced by the cicatrices following the healing of the ulcers and
sclerosis of the gummata. Edema of the larynx may suddenly prove fatal.
=Diagnosis.=—The history of the case, the presence of other symptoms of
the disease, the deep, symmetrical ulcers, the absence of tuberculosis
elsewhere and the absence of marked pain, will usually make a diagnosis
easy.
=Prognosis.=—Is somewhat favorable, more so at least than the
tubercular form of laryngitis. There is great danger of deformity and
permanent impairment of the voice.
=Treatment.=—The treatment should be both constitutional and local.
Active measures must be taken to rid the system of the virus of
syphilis, and thorough, direct treatment should be applied to the
larynx and to its innervation. If the cicatricial stenosis has
progressed so far that there is little hope from manipulative
treatment, tracheotomy or gradual dilatation should be performed. The
ulcerated portion is always to be kept clean.