Jonathan Wright.

A history of laryngology and rhinology online

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Entered according to the Act of Congress, in tlic j'car 1914, by

in the Odice of the Librarian of Congress. All rights reserved.




A FEW words may not be amiss in the way of preface to this
history of the development of our knowledge of the nose and

An attempt has been made to link together the story of the
records of the nose and throat in medicine with the general drift of
medical history, with the salient features in the early history of
the civilization of mankind and with the general literature which
has a bearing upon the central subject of the work; for, as Huxley
has said: "Science and literature are not two things, but two sides
of one thing." This has been done in constant fear of rendering
the story too verbose and pedantic, but with the earnest hope
of riveting the attention of the reader in a way which can not
be attained in the routine preparation of an encyclopedia or a
dictionary. The author has also ventured to hope that the informa-
tion thus laboriously offered will not, on account of its form, prove
less accurate or extended because an attempt has been made to
make it more attractive. If he has failed in realizing these ideals —
and who ever fully succeeds? — he may comfort himself with the
reflection that the labor expended in an attempt to attain them
has been fully repaid by his pleasure in the work itself.

In the preparation of this work the author has taken his notes
chiefly from the original sources. In addition he has made use of
many historical works both of medicine and of general literature.
Among the former those of Sprengel (the Frencli edition of his
history). Baas (in English translation), Whittington, and especially
Gordon Holmes' "History of the Progress of Laryngology,"^ and
Heyman's "Geschichte der Laryngologie und Rhinologie" in his
"Handbuch;" among the latter those of Buckle, Ciuizot, Freeman,
Draper, Lecky, Gibbon, Grote, Ranke, Prescott, Kenan, and
many others have been systematically read during the course of
the work.

* Med. Press and Circular, London, 188.5, xci (n. s. XL), p. 49, spq.


In revising his book for a second edition the author cannot tail
to acknowledge his indebtedness to The Laryngoscope and to its
editor, Dr. Max A. Goldstein, for publishing the text of the first
edition in their columns. Through an oversight this was not
explicitly stated when it was first published in book form. As it
was not a part of the author's ambition in preparing the first draft
of the work that it should eventually appear in })ermanent form,
and inasmuch as the text was furnished from the columns of that
journal without emendation, naturally that care was not given to
various matters in its preparation which is essential to its existence
as a book.

There is in press at this time a valuable and exhaustive history
of laryngology in Germany. Its author, Dr. Karl Ivassel, of Posen,
has with the greatest courtesy furnished advance proof-sheets,
which show that it enters more into detail than this work, but
differs somewhat from it as to references to contemporaneous
events in the general history of civilization.

The author desires to acknowledge his indebtedness to Semon's
Centralblatt fur Laryngologie und Rhinologie. Without it the task
of collecting such data as have been added would have been too
great. He desires also to acknowledge a personal debt of long
standing to Sir Felix Semon, who urged him years ago to under-
take the present task and whose appreciative words in regard to
the first edition are still gratefully remembered.

The author desires to express his appreciation of the work of
Mr. Frank Place, of the librarv staff of the New York Academ\' of
Medicine, who has undertaken to confirm and revise the references.

J. W.

New York City, 1914.


Introduction 17

Physiognomy of the No«e.

Etymology of the Nose.
Egyptian Medicine 21

Specialists in Egypt.

Herodotus' Account of Them.

The Breath of Life.

The Papyros Ebers.

The Exodus of the Jews.

Penalties for Malpractice.
Chaldean Medicine 24

The Records of Magic.

Their Introduction in Rome.

The Medicine of the Market Place.

Stercoraceous Drugs.

^Yitch Medicine.

Pliny and the Therapy of the Magi.

Its Contact with Greek Medicine.

The Zend Avesta and the Medicine of the Parsees.
The Medicine of the Talmud 27

Diphtheria Among the Babylonian Jews.

The Relation to the Zend Avesta.


Nasal Polyp and Ozjena.
Hindu Medicine 28

Its Puzzling Chronology.

Its Relation to Greek Medicine.

Susruta and Hippocrates.

Reference in the Rig Veda to Tracheotomy.

Charaka Samhita.

The Trace of Humoral Pathology.

Uvulotomy and Tonsillotomy.


Vaporizations and Fumigations and the Intranasal Use of Oil.


Foreign Bodies in the Throat.

Fracture of the Nose.

The Physiognomy of Death.
Pre-Hippocratic Medicine in Greece 35

Its Oriental Derivation.

Its Occidental Transformation.

Civilization in Greece.

Ancestry of Hippocrates.

Greek Medicine at the Siege of Troy.

The Nose and Throat in Homer.

Etymology of Greek Words for Throat.

Pharynx, Larynx.

Drink in the Larynx.

Early Greek Superstition.

The Early Philosophers and Their Ideas of Anatomy of the and
Throat and tlie Eustachian Tube.

Goats Breathing through their Ears.

The Atomic Theory and its Relation to Voice Production and Hearing.


The HippocRATir Treatises 43

Hippocrates as a Specialist Among Philosophers.

Oriental and Occidental Mentality.

The Era of Hipijocrates.

The Jilsclepiadae.

The Destination of Fluids.

The Origin of Catarrhs.

"Cor.\za" in a Double Meaning.

Coryza in Old People.

Acute Throat Inflammation.



Cynanche and Parac^'iianchc.

Uvulotomy and Evulsion of the Tonsils.

Fractures of the Nose.

Shceps' Lung as an Intranasal Splint.

Bandages on the Nose.


Nasal Polypi and the Methods of Their Removal.


Vicarious Menstruation.

From Hippocrates to Celsus 59

Tlie Schools and Libraries of Pergamos and Alexandria.

Anatomy of Aristotle, Praxagoras, Herophilus, Eudemis.
Roman Medicine 64

Cato, the Censor, and Nasal Polypus.

The Introduction of Greek Learning into Rome.

Anatomy and Physiology in the Time of Cicero.


His Opinion of Synanche and of Laryngotomy.
Celsus and the Pre-galenic Writers 66

Celsus on Coryza, Angina, Diphtheria, Oza;na, Nasal Polypi, the
Tonsils, and the Uvula.

The Therapy of Plin\-.

Aretaeus on the Uvula, Syphilis.

Cynanche, Laryngotomy, Syriac Ulcer or Diijhtheria, and the Manner
of Death from It.

Rufus of Ephesus and the Tonsils.

The Tracheotomy' of Aiityllus.

Coelius Aurelianus on Synanche and its Treatment.

His Reference to tlie Intubation of Hippocrates.
Galen 76

His Era.

His Anatomy.

The Intermaxillary Bone.

The Internal Nose and its Functions.

The Voice.

The Larj'nx as the Instrument of the Voice: Its Structure.

The Origin of the Voice.

Drink to the Larynx.


The Glands.

The Recurrent Nerves.

Hmnoral Pathology.


P(jlypi, Ozu'iia and its Therapy.

\'arieties of Cynanche.



The Tonsils, the Uvula, and Their Amputation.
The Greek Writers ok the Eastern Empire 87

Incantations, .Vmulets, and Charms.

Constantinople and its Warring Sects.

Cassius Felix and Dijjhtheria.


The Greek Writers of the Eastern Empire:

Nemesius and the Circulation of the Blood.

Marcellus Empiricus.

The Swallow Prescription.

Amputation of the Tongue.

Aetius, His Invocation to Jesus Christ.

Alexander Trallianus.

Theophilus on the Olfactory Nerves and the Cribriform Plate of the

Paulus Aegineta on the Operations of Tonsillotomy and Laryngotomy
and His Use of the Knotted String for Nasal Polypi.
The Arabians 96

The Transfer of Civilization to Them and Their Cultivation of It.

Their Conquests.

Destructions of the Alexandrian Libraries.

The Arabian Renaissance of Learning.

The Inferior Maxilla.


The Cautery.


Nasal Speculimi.

Stercoraceous Therapy.

A Postnasal Tumor.

A Relaxed Palate.

Haly Abbas.




The Pre-Renaissance Period 104

Learning in the Middle Ages.

Gregory the Great.

The Schools.

Ignorance and its Beginning Modifications by the Influence of Arabian
Science, of the Church, of the Crusades, of the Fall of Constantinople.

Italian Science.

The School of Salerno.



Operation for Nasal Polypi.




Constantine, the African.

Arnold di Villanova.

Henry of Amondeville.

Gui di Cauliac.

Their Dependence on Arabian Science.
The Renaissance 115

The Influence of Maritime Commerce.


The Gothic Cathedrals.

The Hospitals of Saint Louis.

The School of Bologna.

Revival of the Study of Anatomy.

Mondino di Luzzi.

Subservience to Galen.

Berengar del Carpi.

The Cartilages of the Larynx.

The Sphenoidal Sinus.

Vesalius and the Revolt from the Authority of Galen.

His Anatomical Plates.

Human Dissection.

The Olfactory Nerves.

The Iiiterniaxillar\- Bone.


The Renaissance:

"Glands" of the Throat.

The Puhnonary Circulation.

The Turhiiuitcd Bones.

Anatomy of the Larj-nx.

The Works of Fabricius ab Acquapendente and Casscrius on the Struc-
ture and Function of the Larynx.
The Reformation anu the Diffusiom of Knowledge 126

The InciuisitioM and tlio Index Expurgatorius.

The Aid of the Church in the Acciuisition of Knowledge and its Later
Restraint of its Spread.

Decline of Commerce, Arts, and Sciences in Italy.

The Diffusion of Knowledge through Wars and the Founding of Uni-
versities and Learned Societies.

The Beginnings of Physiology.

The Circulation of the Blood.

The Olfactory Nerves and the Theory of Willis.

The Vascular Theory of the Nasal Glands and Other pre-Schneiderian

The "de Catarrhis" of Schneider.

The Correction of Errors as to Catarrhs and the Evolution of the
Knowledge of Mucous Glands.

The Chyliferous and Lymphatic Systems.

The Microscope.

The Pharyngeal Tonsil.

The latrophysical and latrochemical and other Seventeenth Century

The Disappearance of Chaldean Therapy.
The Results of the Renaissance 141

Sixteenth Century Views as to Diseases of the Nose and Throat.

The Treatment of Oza^na and Tonsillar Hypertroi)hy.

Instruments for Operations on the Uvula.

Tobacco and Tea Therapy.



Rhinoplasty of Tagliacozzi.

Epidemics of Influenza, Pertussis, Diphtheria, Scarlet Fever, and
their Differentiation.

The Tracheotomy of Fabricius and the Tubes of Guido-Guidi.

Laryngocentesis and its Application in Cases of Drowning.

The Modern 0])eration of Tracheotomy and Laryngotomy.

Their Em()loyni('nt in Diphtheria.
Intranasal Sukgery and Pathology of the Seventeenth and

Eighteenth Centuries 161

Operations for Nasal Polypi.

The Forceps of Aranzi and Fabricius ab Acquapendente and the Harpsi-
chord Wire Snare of Fallopius.

The Instruments of Levret and of Benjamin Bell and Belloc's Sound.

The Pathogenesis of Nasal Polypi.

The Anatomy of the Accessory Nasal Sinuses and Speculations as to
their P^unctions.

Wounds of the Frontal Sinus.

Worms in the Sinuses.

Description of the Maxillary Sinus by Highmore ami the Operation ot
Cowper, his Predecessors and Followers on It.

Normal and Pathological Anatomy of the Nose and Throat.

Deviations and Sjjurs of the Nasal Septum.

The Ccrebrosiiinal Fluid.

The Prelaryngoscopic Era 178

The Intermaxillary Bone.

Bichat and the DifTerentiation of the Tissues.

Special Treatises.


Jacobson's Organ.


The Prelaryngoscopic Era:

The First Separate Treatises on the Diseases of the Nasal Fossae and
their Sinuses.

The Sj'stems of Medicine.

Bretonneau and Diphtheria.

The Epiglottis.

Innervation of the Larynx.

Modern Theories of Voice Production.

Photography of the Larynx.
Laryngeal Phthisis 193

Morgagni, Lieutaud, Petit, Portal, Sauve, Saignelet.

Tubercle as Named by Baillie.

Laryngeal Tubercle as seen by Broussais.

Lack of Differentiation.

Catarrhal, Syphilitic, Cancerous, and Tubercular Laryngeal Phthisis.

Catarrhal L^lcers.

Louis, Trousseau, and Belloc.

Histology and Pathology of the Mucous Membranes 199

The Cell.

The Epithelium.

The Tonsils.

Schleiden, Schwann, Yirchow, Henle, Bowman, KoUiker, Sappey, His,
Prelaryngoscopic Ther.'VPy 201


Galvanocautery Snare.

Horace Green and His Intralaryngeal Applications.

The Attempts of Bretonneau, Trousseau, and Belloc.

The Intubation of Desault, Loiseau, and Bouchut.
The Lary'ngoscope 203

Bozzini, Babington, Cagniard de la Tour, Senn, Liston, Baumes,
Selligue, Warden, Avery, Manuel Garcia.

The Difficulties of Techniciue.

The Introduction of it in Clinical Work by Turck and Czermak.

Their Rivalry.


Artificial Illumination by Czermak.

The Spread of the Art of Laryngoscopy to other Countries.

The Beginning of Special Clinics, Teaching, Societies, Journals, Text-
books of Laryngology, and the Enormous Growth of its Current

The Sequel of Laryngoscopy.

Laryngeal Tumors.

Intralarj-ngeal Operations Before and After the Invention of Laryngo-
The Tonsils 217

The Pharyngeal Bursa and Tonsil.

Tornwaldt's Disease.

Embryology and Histology of the Pharynx.

Leukocyte Emigration.

Their Origin and the Controversy in Regard to It.

Their Relation to the Epithelium.

The Accessory Tonsil.

The Lymphoid Cells.

Wilhelm Meyer and the Discovery of "Adenoids."

The Physiology of the Tonsils.

Their Absorptive Power.

The Fat Contents.

Their Relation to Dust.

Internal Secretion.

Bacteriology of the Tonsil.



Follicular Tonsillitis.


The Tonsils:

Vincent's Angina.

Tuberculosis of the Tonsil.

Their Relation to Systemic Infection.

Tonsillar Syphilis.

Operations on Tonsils and Adenoids.

Indications for it.

Anesthesia and Position in It.

Hemorrhage and Other Sequoke after It.

Ignipuncture and Galvanocautery Snare.

Bone and Cartilage in the Tonsils.

Nasal Anatomy, Physiology, and Pathology 238

Nasal Specula.

Neglect of Nasal Disease after the Introduction of Laryngoscopy.

Reflex Neuroses.

Gross Anatomy.

Relation of Nasal to Cranial INIorphology.

The Erectile Tissue.

The Glands.

Intra-epithelial Glands.

Smooth Muscle Cells.

Vascular Mechanism and Sexual Development.

Elastic Fibers.

Olfactory Epithelium.

Nasal Embryology.

Nasal Lymphatics.

Pathogenesis of (Edematous Nasal Polypi, Papillomata, Adenomata,

and Papillarj- Hypertrophies.
Bleeding Septal Polypi.
Kiesselbach's Area.

Protozoal CJranuloma.
Malignant Neoplasms.
Nasal Bougies.

Dental Engine.
Chronic Intranasal Diseask and its Modern Treatment .... 259

Reflex Neuroses.

Septal Spurs and Deviations.

Their Etiology and Operations for Their Relief.

Submucous Septal Operation.

Nasal Snares.




Inhalations and Detergents.

The Compressed Air Spray.

Improved Illumination.
The Accessory Nasal Sinuses -69

The Beginnings of Interest in Disease of Them.


Latent Suppuration.

Necrosing ]']thni()iditis.

Postmortem Examinations.




Teeth in the Nose.


Malignant Tumors.

Choanal Polypi.

Sinus Tuberculosis.


The Accessory Nasal Sinuses:

Rhinitis Caseosa.

Sinus Ozsena.

Embryogeny and Anatomy of the Sinuses.

Rontgenology, Transillumination, Irrigation, the Endoscope, and
Negative Pressure in Diagnosis.

Development of Operative Technique on the Different Sinuses and the

Complications of Sinus Disease.

Sequelse of Operations and Trend to Conservatism.

Local Anesthesia.

Bacteriology of the Nose and Throat 296

Mycosis Pharyngis or Leptothrix Buccalis.


Nasal Bacteria.
Atrophic Rhinitis 300




Tuberculosis of the Upper Air Passages 308

Infection, its Portals and Paths.

Primary Laryngeal Tuberculosis.

Treatment of Laryngeal Tuberculosis.
Rhinoscleroma 317



The Bacillus of Frisch.



AuToscoPY 319

Lary'Ngeal Paraly'sis 320

First Reports.

"Cadaveric Position" of the Cords.

Rosenbach-Semon "Law" or the Greater Proclivity of Abductors to

The Contracture Theory.

Central Innervation and Cerebral Localization.

Toxic Paralysis.

Double Posticus Paralysis.
Laryngeal Cancer and its Extirpation 327




Intralaryngeal Operation.

The Emperor Frederick.

Microscope in Diagnosis.

Supposed Transformations of Benign into Malignant Growths.

Semon's Statistics.


Pachydermia Laryngis.
Epilogue 333

Index of Personal Names 335

Index of Subjects 3-15


In every age there have been attempts to draw from the appear-
ance of the countenance, especially from the shape and size of the
nose, prognostications as to the mental and physical attributes of
men; but although many are the rules laid down for the guidance
of observers, they are of little value; for while doubtless the features
tell their story to us occasionally, if we are close observers, in
spite even of the modern and scientific treatises of Bell and of
Darwin, the expressions are too fugacious and elusive to allow us
to gather from them any reliable data as to the characteristics of
the individual. The extensive disquisitions on character drawn
from the aspect of the features are largely flights of a foolish and
puerile fancy.

Physiognomy of the Nose. — Xo longer ago than 1820 we find it
stated in a scientific work^ that "a long and pointed nose passes
for a sign of sagacity. A short and blunt nose marks a simplicity
of mind, easy to deceive and with very little foresight. A little
nose, thin and movable, denotes a natural mocker. Large noses
are an indication of heaviness, for they bespeak the lymphatic
nature of the complexion. Twisted noses, they say, are a sign of
an obliquit}' of mind; but an aquiline nose, large and muscular,
announces force and courage; a flattened nose an inclination to
luxury; in fact, it is thought there is a correspondence between
the sexual organs and that part of the countenance."

"Noscitur ex labiis quantum sit virginis antrum
Noscitur ex naso quanta sit hasta viri."

This is a quotation drawn from a literature stimulated by the
recent excursions of Lavater into the realms of uncontrolled and
uncritical observation.

On the testimony of Plutarch we learn that the Persians most
admired the hawk-nosed type of man as resembling Cyrus, their
best beloved king. This saying we find echoed in the sixteenth
century by Riolan- and Laurentius,^ the latter declaring, with how

1 Diet, des Sciences Medicales, Paris, 1820, Vol. XXXXII, p. 220.
- Opera Omnia, Paris, IGIO, Anatome, Cap., LIII, De Naso.
^ L'Historie Anatomique traduit par Size, Paris, 1610, p. 1374.



much truth I do not know, that the Egyptians in tlieir liieroulyphs
use the figure of a nose to designate a man. We may plainl\' see
the tyi)e of Cyrus in Bellini's jiortrait of the Sultan ]\Iohammed.*
We learn from the Old Testament (Levit. XXI, IS) that there was
a prejudice among the Patriarchs against flat-nosed people.

But in spite of these predilections of the Caucasian race we find
among the native negroes and the Chinese dift'erent ideals as to the
beautv of the nose. "The ancient Huns during; the age of Attila
were accustomed to flatten the noses of their infants with bandages
for the sake of exaggerating a natural conformation. With the
Tahitians to be called long-nosed is an insult and they compress
the noses and foreheads of their children for the sake of beauty.
So it is with the ^Malays of Sumatra, the Hottentots, certain
negroes, and the natives of Brazil."-

In attempting to present an outline of the growth of our knowl-
edge of the nose and throat and of their diseases, it must be remem-
bered that a complete and intelligent review of the subject can-
not be obtained by beginning our study with the discovery or
rather with tlie introduction of the use of the laryngoscope. That
would be a consideration of the history of laryngoscopy and its
sequelse in the history of the diseases of the upper air tract, and
of the growth and development of technical skill. However great
may have been the revolution wrought by Tiirck and Czermak in
tliis field, the history of rhinology and laryngology begins not with
the invention of the speculum and the laryngeal mirror, but with
the earliest records of the civilization of man. In fact, it is reason-
able to conjecture that it is only the lack of records which prcAcnts
us from tracing knowledge of the diseases of the nose and throat
still farther back into prehistoric times. It must necessarily be
that any disease of the respiratory system causing obstructive
dyspnoea, or any affections causing deformity and discharge from
the nose, would have attracted the attention of the medicine men
of our primeval ancestors. Injuries to the head must, as freciuently
then as now, have involved the nasal organ. Indeed, we shall
find in the very earliest Hindu and Greek records evidences of the
care and attention devoted to the study of this branch of the
medical art. We shall also find that to some extent the nose and
nasal disease in the earliest times possessed proportionately a
larger interest for medical men than it did in more recent and
more enlightened times, until the beginning of the growth of what
we are pleased to call ^lodern lihinology. Exposed to accidental
and intentional injury in the sports and wars of the ancients,
mutilated bj^ the deliberate acts of a cruel justice before the days
of jails, or in the fierce outbursts of passion and revenge, traumatic

' Thi.s rimy be conveniontly rofcrrcd to in Mrs. Oliphant's Makers of Venice.
- Darwin's Descent of Man, Part III, Chap. XIX.



conditions of the nose have occupied necessarily not only a very
large place in the medical literature, but in the secular writings of
former civilizations:

"Atque hie Priamiden laniatum corpore toto
Deiphobum vidit, lacerum crudeliter ora,
Ora manusque ambas, populataqiie tempora raptis
Auribus et truncas inhonesto volnere naris."

— Virgil, Aeneis VI, 494.

Innumerable colloquial phrases in all known tongues still testify
to its importance as a symbolical figure of speech.

Etymology of Nose. — It would seem that the remarkable coinci-
dence, pointed out by Hvorka,^ that the word "nose" has the same
stem in all known European languages, might be explained, as he
suggests, on phonetic principles, and it is very likely that the
nasal resonance of the " n" followed by a vowel has had an influence
in preserving the stem from radical changes; but it is difficult to
see why, on this ground, the sibilant "s" should enter almost
universally into the word. The following is the list of languages
quoted by Hvorka in a little different sequence, with the accom-
panying word for nose:

Sanskrit .
Old Indian
Old Persian
Zendic .


Italian .
French .
Gothic .
Old Norse
Old German
Middle German
English .

Nas Danish Noesen

Nasa Netherland .... Neeus

Nana Modern German . . Nase

Naonha Old Slavonic .... Nosz

Nohar Old Bulgaric .... Nosii

/p'-r Old Prussian .... Nozy

\p/vo- Lithuanian .... Nosis

Nasus Lettic Nasis

Naso Bohemian Nos

Nariz Polish Nos

Nez Polabian Nus

Nasa Upper and Lower Sorbian Nos

Nos Russian Nos

Nasa Servian Nos

Nase Croatian Nos

Nose Slovenic Nos

Nose Swedish Niisan

It thus seems evident that there has been a direct transmission

Online LibraryJonathan WrightA history of laryngology and rhinology → online text (page 1 of 42)