DIAGNOSIS.--The inflammatory stage may be suspected, rather than positively recognized, from the peculiar pain if the laryngoscope (or, in the rare case of thyroid perichondritis, palpation) reveals enlargement of a part of the cartilaginous structure without much injection of the mucous membrane. The presence of other symptoms mentioned, and in the case of cricoid perichondritis the localized pharyngeal reddening, make the diagnosis more probable. During the suppurating and necrotic stages the diagnosis becomes certain from the symptoms I have described, especially expectoration of fragments of necrosed cartilage, together with direct examination. The laryngoscope may show the abscess; sometimes the finger or a probe can detect fluctuation, and frequently through an opening the probe detects the necrosis. The movement of one or both vocal bands may be affected either mechanically from purulent accumulation, or from articular ankylosis, or from interference with muscular attachments or action, or with innervation. In my hand, and in that of others, a probe introduced through an external fistula has been seen in the larynx; others have been able to inject colored fluid and find it in the interior. PROGNOSIS.--Except in slight cases death is more apt to take place than recovery. If tracheotomy has saved the patient from impending death, ultimate prognosis is still unfavorable in severe cases. In idiopathic, traumatic, and syphilitic cases the prognosis is of course better than in others in which we have to face grave dangers of the underlying disease as well. The {121} remaining laryngeal stenosis after recovery makes the prognosis bad as to the doing away with the tracheotomy-tube, although it is far more favorable at the present day than it was previous to Schrötter's success with dilating measures. TREATMENT.--Throughout the disease the patient's general health and strength must be carefully attended to, tonics and stimulants used according to circumstances, and the underlying condition of secondary perichondritis, such as syphilis, etc., treated secundum artem. Locally, the treatment during the first stage must be antiphlogistic, by leeches, ice, etc., and soothing, especially by inhalations. Afterward, abscesses must, if accessible by means of the laryngoscope, be opened. Artificial feeding, through either an oesophageal or a rectal tube, may become necessary. Schrötter's hard-rubber tubes may be inserted to conduct air to the lungs, but tracheotomy, not laryngotomy, must be performed if, in spite of this tubage, suffocation threatens. The methodical dilatation of post-perichondritic laryngeal stenosis requires special bougies, catheters, hard-rubber tubes, pewter plugs, and dilators which are not to be found in the ordinary armamentarium of a medical practitioner; but the proper and frequently successful use of these can be acquired with patience and perseverance when a case of the kind presents itself for treatment.