[Diagnosis and therapy of diseases of the larynx in the history of medicine].
BACKGROUND
FIRST CLINICAL APPROACHES. Bozzini in Frankfurt, Germany, in 1806 constructed the first endoscope, by which cavities of the human body could be inspected through a tube, but he was hardly able to demonstrate the larynx. His attempts were continued by Avery in London in 1840 with special view to the larynx but were not successful. Babington in London in 1829 constructed a glottiscope combining an angled mirror with a depressor for the tongue. He will probably have been able to inspect the larynx in some cases, but he did not continue these studies. Liston in London in 1837 reported that he had seen pathological findings of the larynx in a few cases by means of an angled mirror.
PHYSIOLOGY OF THE VOICE. Ferrein in Paris in 1741 was the first to carry out experiments on human larynges. These were continued in a systematic way by the physiologist Johannes Müller in Berlin in 1837 analysing the movements of the vocal cords. Manuel Garcia, a Spanish singing teacher, first in Paris, later in London, had studied the anatomy of the larynx very carefully, especially the muscle fibres. In 1855 he succeeded in inspecting his own larynx by means of an angled mirror and observed and described the movements of the vocal cords in great detail. At first his discovery did not arouse great attention, but later he was honoured very much as the inventor of laryngoscopy. SYNTHESIS OF PHYSIOLOGY AND CLINIC: Vienna 1857/58: The physiologist Carl Ludwig was preparing the second edition of his textbook on physiology, in which he extensively referred to Garcia's technique of laryngoscopy. His collegue Ernst Brücke was working on the physiological basis of phonetics. Johann Nepomuk Czermak, also a physiologist, was a guest of Brücke's and Ludwig's in Vienna during the winter 1857/58 and was inspired by the research work of his hosts. The neurologist Ludwig Türck had made experiments to visualize the human larynx in bodies and patients without knowing of Garcia's achievements. Since he used sun light only he had interrupted his studies in autumn 1857 and had lent his instrument, a mirror similar to that used by Garcia, to Czermak. Czermak used artificial light and the perforated concave mirror that had recently been introduced into ophthalmology. He was at once successful in inspecting his own larynx. He reported on this as early as March 1858 without informing Türck, although he mentioned him and the mirror that he had lent him. There was a public dispute about the priority between Türck and Czermak which drew wide attention to the invention of laryngoscopy which now was readily introduced in practical medicine forming the new discipline of laryngology. This development is delineated with many anecdotal details.
Feldmann
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HNO-Klinik, Universität Münster, Germany.
D005060:Europe; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D007818:Laryngeal Diseases / Q000175:diagnosis / Q000266:history*; D020704:Laryngoscopes / Q000266:history*; D007830:Larynx / Q000033:anatomy & histology