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 |   Related post: growing further witliin the nose they are rare. I can recall only two cases of this kind in my experience. I think the re- mark of Dr. .Jarvis very well founded and appropriate. Where we find a papillary growth with a broad base and a tendency to bleed Buy Ethionamide we should he on the lookout for carcinoma. I think that Hopmann mistook for papilloma the changes that occur in the ordinary transition from the secondary to the tertiary form of chronic rhinitis. Cross-sections of these bodies under the microscope resemble papillomatous tissue, whereas they actu- ally consist of tarhinated erectile tissue. I think that Hop- mann, in some cases at least, mistook these outgrowths for papillomata. I desire to call attention to an important clini- cal point : Sometimes patients complain for a long time of a sense of fullness of the nostril and other symptoms of hyper- trophic catarrh, and after a while expel little pieces of flesh, as they term them, from the nose. Afterward they find that they can breathe better, and that the obstrnetion in the nose has disappeared. The reason is, that under the influence of the atrophic process these little bodies are separated and slough ofi. It does not mean that the patient has gotten well, but simply that the hypertrophic process has gone on to atrophy. Under the microscope, sections of these bodies resemble papillomatous growths in structure, and may be mistaken for them, while they are really the results of hypertrophic degeneration. Dr. Ingals : I think that this mulberry-like appearance of the turbinated body is probably the reason that Hopmann, and probably some others, have found so many so-called cases of papilloma of the nose, as a mistake might easily be made. I have often seen this condition, which is not that of a true papil- loma, but 1 have never seen but the one reported in which the growths had the appearance of warts. In this |)articular case the growths, which recurred many times, did not resemble papillomatous tumors in the larynx in any way. They grew first from the septum, and afterward from the turbinated body, and had all the appearance of warty growths as we commonly see them upon the hands. As to the thuja occidentalis : 1 did not wish to try to prove that it had any special value, though this has been alleged for it; but I must say that the patient did much better after using it than he had been doing before. It is possible that it may make some difference whether a fresh tincture is used or not. The preparation I employed was prepared at the time from the fresh leaves of the arbor vitfe. Hoarseness and Loss of Voice caused by Wrong Vocal Methods. — Dr. S. W. Lanommd, of Boston, read a paper on this subject. (To be published.) Dr. Delavan : It will be generally conceded that no higher authority than Dr. Langmaid could discuss the questions pre- sented in this paper. To it we can only add the testimony of our own experience. From the statements of noted singers who have been trained under the system which the reader of tlie paper describes, as well as from my own i)ersonal experience in practical vocalization, I am able to confirm the views which he has expressed. Not infrequently cases have come to me com- plaining of some laryngeal difficulty in which a diagnosis from simple inspection of the larynx was impossible, and a correct solution of the matter only arrived at by a careful study of the vocal methods of the patient and the discovery of its defects. In many instances faulty voice-production will be found to be the true explanation of an otherwise inexplicable difficulty. Of course it is of great importance for us to understand our cases in order that we may properly treat them, and, understanding them, to see that the treatment employed be not confined to local applications, but that the faulty methods of vocalization be corrected under the training of a competent teacher. Again, the services of the vocal instructor are of great value in the treatment of certain chronic conditions of laryngeal disease. I am in the habit of referring patients to a skillful teacher for the purpose of obtaining systematic exercise of the laryngeal muscles, just as in appropriate cases the surgeon resorts to pas- sive motion. It is to be hoped that Dr. Langmaid will continue to offer us such studies as this through his work. Aided by that of Dr. French, we should be in a position to recognize and successfully treat many cases which now are wholly misunder- stood. Dr. Hinkel: I am reminded by the i)aper of a class of cases in which I have taken much interest — cases in which there is vocal disability due to some structural defect in the nasal pas- sages or naso-pharynx. Such patients sufler injury to the throat and voice from the demands made upon the vocal orgau beyond what is customary in speech, even though there he nothing faulty in the vocal method. It is of importance to recognize this defective condition, for many teachers and pupils are puz- zled to account for the failure of promising voices in which the defect is due to a lack of co-ordination, as it were, between the primary tone-organ and the resonating apparatus. The re- moval of a septal ridge or of adenoids not infrequently restores the power and quality to the voice. I recall a tenor who gained a minor third in his compass after the removal of a sep- tal ridge from which he had sufi'ered no inflammation or ob- struction of which he was aware. Dr. Muliiall: The matter which the last speaker refers to is hardly germain to the subject of the paper. If we were to go into the discussion of the effects of abnormities of the air- passages upon the formation of tone we should hardly get Related links: Minomycin Antibiotic, Betnovate N For Acne, novo trazodone 50 mg, Cheap Hyaluronic Acid, Micardis Generic Equivalent, doxycycline hyclate usp 100 mg, Fluoxetine 5 Mg, buy prednisone, buy tamoxifen online no prescription, Clomid Or Serophene
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