Acute laryngitis comes on suddenly, and lasts about a week. It is a catarrh of the larynx, due to exposure to cold; and actors, speakers and clergymen who use their voices much are liable to such attacks. It sometimes comes on in association with general catarrh, which starts as a cold in the head; or it may occur with measles or influenza. The swallowing of very hot liquids or certain poisons will cause severe laryngitis, or inflammation of the larynx.
The symptoms begin by irritation and difficult breathing, with dry cough and alteration of the voice. It may be simply husky at first, then very hoarse, and finally the voice may be lost. This is due to swelling and inflammation of the local cords.
Children sometimes contract laryngitis, or what mothers call " croup." The child wakes up suddenly with crowing, followed by an attack of coughing. The attack is alarming, but is to be distinguished from true croup-which is really diphtheria-by the fact that in laryngitis the child's general health is good.
Treatment. In severe cases, the patient should be kept in bed in a room of an even temperature, with a warm, moist atmosphere. A bronchitis kettle may be used if the symptoms are bad. Medicated inhalations are very useful. Put a teaspoonful of Friar's Balsam in about a pint of boiling water in a jug, and inhale the steam. Hot fomentations may be applied to the neck in the form of flannel wrung out of very hot water. Warm gruel and milk are the best forms of nourishment whilst there is any pain and coughing. The voice should be rested.
Chronic laryngitis is sometimes very troublesome to people who have to use their voice a great deal. Clergymen, speakers and teachers are often subject to this affection, which may follow repeated acute attacks. The inhalation of irritating gases, a dusty atmosphere, and constant smoking also will cause it. Rheumatic and gouty people are liable to chronic laryngitis, and nasal obstruction encourages laryngitis if mouth breathing is associated with it, because the cold air is drawn in through the mouth instead of being filtered and warmed by the nose. Hoarseness, and the need of frequently clearing the throat, are the chief symptoms; but there is rarely any pain, although the discomfort may be considerable. Those who are subject to chronic laryngitis should avoid heated rooms, excessive use of the voice, and the muffling up of the throat, which only increases its delicacy. The neck and the chest should be sponged every morning with cold water; and gargling with cold water, to which half a teaspoonful of alum has been added, is a good thing. The throat may have to be painted with stringent remedies, which must be ordered by the doctor, as the strength of this depends upon the condition of the throat. Inhalations, two or three times a day, of steam medicated with iodine, menthol, etc., are useful, and the doctor will probably direct the patient to spray the throat twice daily.
Lead Poisoning. This disease, although not common in the general community, is very prevalent amongst lead-workers in the white-lead factories. Apart from this, however, lead poisoning may occur by drinking water which has been passed through lead pipes, or stored in cisterns lined with lead. In the same way lead colic and other symptoms of poisoning will be caused by drinking wines and spirits which have been contaminated by lead, probably from the vessels in which they are stored. The adulteration of certain foods and beverages has given rise to innumerable cases of accidental poisoning; whilst hair dyes, and the use of toilet cosmetics containing lead, will also cause lead poisoning.
When chronic lead poisoning occurs, the first signs are anaemia, debility and pallor. Colic is a very frequent symptom; whilst a blue line appears at the margin of the gums, due to the deposit of lead sulphide in that part. In severe cases, palsy or paralysis of muscles is found.
Acute lead poisoning may be the result of accidental poisoning, or it may occur after the existence of chronic poisoning for some time.
Apart from lead-workers, poisoning from other sources must be treated by a doctor, and the cause of the attack dealt with.
Lips. Sore lips are nearly always caused by external irritation, such as friction of a damp veil. This may cause an eruption of the lips and surrounding skin, which is very difficult to get rid of. The habit of biting and sucking the lips also will cause severe irritation. Herpes of the lips will sometimes persist for months. It is an eruption of little white vesicles, or blisters, which appear and disappear in crops. In general ill-health, anaemia, debility, the lips are pale and bloodless, and are more liable to become " sore."
The best treatment in all these instances is to avoid any source of irritation, such as sucking the lips in cold weather, which is the commonest cause of chafing and roughness. Zinc ointment should be applied every night at bedtime, well rubbed into the lips and surrounding skin, and left on all night. Before going out of doors in cold weather a little cream could again be rubbed into the lips. Any habit of biting the lips should be given up. The use of lip-salves and other cosmetics, unless they are of very good quality, will produce roughness and eruptions.
It is a great mistake to use ointments belonging to other people, as many skin affections are infectious, and the poison is left in the ointment by the finger which has touched the affected part. Acne, for instance, round about the mouth can easily be "caught" in this way, and is sometimes very difficult to get rid of. Simple sulphur ointment is the best application. A crack at the side of the lip is sometimes very persistent, and will not yield to the application of creams.
The best plan is to dry the part, and if it exists at the edge of the mouth, a handkerchief should be put inside the mouth to prevent the crack becoming moist. Then a little collodion should be painted on the crack with a camel's-hair brush, and allowed to dry. This forms a new skin, and prevents the little crack being irritated by moisture. The skin heals underneath the cover of collodion, and the crack thus disappears. The irritation of the side of the lip or tongue caused by a broken tooth should always be attended to. A dentist can generally file away any ragged edges, and in the case of elderly people, especially, this should always be done, as chronic irritation of the tongue by a tooth may be the starting point of swelling or "growth," which may prove serious. To be continued.