Clinical Lecture on Laryngeal Phthisis

singers, but not less so to most other cases. I make some exceptions in my own use of nasal sprays, as in spraying cocaine, resorcin, the bichloride, etc., etc., which are sparingly soluble in any of the neutral oils. But even in these exceptions the aqueous solution is placed in a spray bowl containing a warm, oily excipicnt, and water being the heavier, it is first exhausted, when the oil spray follows. I ani sure that this paper has from its beginning subordinated sprays in voice treatment, particularly when it is possible to reach the nasal defect by any surgical means, and yet I consider their necessity, when intelligently used, only secondary to surgery. It is always soothing, and many times otherwise beneficial to the nasal mucous membrane, to leave it covered with a warm spray of vaseline at the end of a treatment. Proper hygienic instructions should be given these patients to lessen their liability to colds; on the other hand, all "coddling" should be interdicted, especially in the use of wraps, or other extra appliances about the neck. If " coddling " of any part of the body is ever admissible, it would be of the feet, since improperly protected feet will much more probably result in a throat or nasal inflammation than an unprotected neck. Some nervous persons exhibit a great anxiety about catching cold ; this mental fear should be made light of, since it no doubt in many instances exerts a potent influence in producing the very result that is most feared. All attempts at using the voice must be prohibited during an acute recurring stage of any chronic throat inflammation, and mild treatment should always be instituted immediately. Soothing sprays or cotton probe applications should be used appropriately, chosen according to the situation and character of the recurring attack, together with the usual hygienic and constitutional measures resorted to in acute catarrhal inflammations.