Buy Meclizine Purchase Meclizine OnlineBuy Meclizine Purchase Meclizine Online
|
 |   Related post: aud sopranos, where, as we know, the highest tension and. the most rapid vibration of the bands are required durinij- singing. In writing the histories of these six cases, I paid some attention to the manner in which the voice had been used, and it seemed to me significant that two of the patients, young women of twenty years, were in the same class at a grand conservatory of music where only the true Italian method was taught. During vocalization in both of these cases, as the scale was ascended, the epiglottis was carried farther downward and backward with each note and the larynx was compressed more and more. One of these women could sing only a short time without becoming quite hoarse. After changing her teacher and using her voice in a different manner, she could sing and does sing every night at a theatre, and sings fairly Buy Meclizine Online well too, and there is still some nodular enlargement on one of the bands. One of my six patients — an operatic singer of great repu- 86 RIGE: THE CONDITION Order Meclizine Online KNOWN AS " GBORDITIS TUBEROSAr [N. Y. Mkd. Jour., tation — stated the patliology of the condition known as '•chorditis tuberosa" quite accurately when she said, after I had described to her the laryngoscopic appearances, " Why, I should say I had corns on my vocal bands." And Where To Buy Meclizine that I believe is the pathological condition which is present in these cases — a "dermoid metamorphosis," as Zietnssen * puts it, the trachomatous condition alluded to by Macken- zie, f Wedl, who examined a number of specimens micro- scopically, found only connective-tissue hypertrophy with heaps of nuclei. I have had sections from two nodules ex- amined, which were removed from the vocal band by a small snap guillotine, and the result, which was the same in both cases, was connective tissue and e])ithelial elements iu largely increased numbers. These nodular enlargements are produced by the friction of the free edge of one band against that of the other where the voice is used a great deal, and where the tension of the bands is unevenly controlled because of a faulty method of using the laryngeal muscles; just as the outer layers of Generic Meclizine the skin of the foot are hypertrophied by the friction of an ill- fitiing shoe. Contrary to the teaching of many writers, I believe that the nodular enlargement is the primary lesion ; and the pathological appearances of the bands which follow — such as congestion and general thickening, by reason of which these cases have been improperly classed among those of chronic laryngitis — these are secondary lesions and are directlv dependent upon Meclizine Online the nodular enlargement. "Chorditis tuberosa" should not be confounded with the uneven surface of the vocal bands seen in long-standing cases of simple chronic chorditis, where the vocal appara- tus has been abused for many years, and strong astringents or caustics have been so frequently applied to the larynx that little normal mucous covering remains. The terms " trachoma" and " scleroma" are more ap- propriately applied to the uneven, rough, granular condition of the vocal bands, as seen in the above cases, than to the condition known as "chorditis Meclizine Buy tuberosa." Chorditis tu- berosa may be the cause of a general trachomatous condi- tion. Chorditis tuberosa should also be differentiated from the cicatrices of tubercular and syphilitic ulcers or from granulation tissue springing therefrom, and also from be- nignant growths attached to the vocal Buy Cheap Meclizine bands. The nodular enlargements may be situated upon one or both bands. In five of the eight cases I have seen, the nodule was on the left band. It is usually located a trifle more anteriorly than midway between the vocal processes and the anterior insertions of the vocal bands. (Fig. 1.) And it is probable that at this point the friction between the bands is greatest. A nodular enlargement on one band, if the voice is persistently used in singing or speaking, in time produces some alteration in the tissue of the other band at the point of contact. Sometimes there is an ap- pearance of depression in the vocal band just opposite the nodule into whi'-h the protruding jioint fits. (Fig. 2.) If this depression is examined carefully, the covering will pre- sent a roughened appearance, a callous spot which has been * Zicmsscn, C)lilopieiHa Practice AM., vol. iv, p. 217. f Sir Morell Mackenzie, Di*. of Tltroat, vol. i, p. 294. Buy Meclizine produced by the protruding point on the opposite band. This callous depression Purchase Meclizine Online is really raised above Purchase Meclizine the normal surface of the vocal band ; but a concavity exists because the edges about the depression are elevated to a still greater degree. After the nodule has existed for some time the depression on the second band is sometimes filled, and later gives place to a second nodule. Two nodules are now seen striking against each other, and the bands are by just so much more prevented from approximating during phona- tion. If these nodules are not removed, and if the person is allowed to continue singing, the irritative friction and the increased effort of the intrinsic laryngeal muscles neces- sary to bring the bands together cause a congestion and thickening Order Meclizine of the entire substance of the bands, which it will be very difficult to dissipate by the most judicious of local treatment. If a very careful examination of one of Related links: Zofran Prices, Cheap Furosemide, Synthroid 0.175 Mg, order propecia no prescription, Purchase Hydroxyzine, Buy Enhance9 Online, lisinopril-hctz 10mg-12.5mg tablets, Buying Ventolin Online, Cyclogyl Eye Drops, Purchase Azithromycin Online
|