Laryngology in the 1860s

“The extent of the treatment by laryngologists of diseases of the throat in the ‘sixties – and indeed for the next quarter of a century – was limited to the opening of abscesses, the removal of tonsils, and the endo-laryngeal removal of polypi and other small tumors from the larynx. Caustic, astringent, or sedative solutions were applied to the larynx with a camel’s-hair brush, or syringed or sprayed into it, or astringent or sedative powders were puffed in by an insufflator. Functional or hysterical loss of voice was treated by applying the galvanic current to the vocal cords with a special instrument. The diagnosis between simple chronic laryngitis, syphilis, tuberculosis of the larynx, and malignant disease . . . was always difficult and sometimes impossible, even for an experienced laryngologist. . . . Since the local anesthetic properties of cocaine were discovered only in 1884 the manual dexterity of the early laryngologists and especially of Morell Mackenzie – whose technical skill was outstanding – had to be well-nigh miraculous” (Stevenson[2], 38, 39).