SYMPTOMATOLOGY.--The diseases comprised under the collective name of chronic laryngitis give rise to various symptoms, of which the chief are {122} morbid sensations in the region of the larynx and alteration of the voice. Unless ulceration have occurred, the morbid sensations hardly amount to pain, except on acute exacerbation from catching cold or after long-continued use of the voice. They consist in a sense of dryness or of pressure, in a tickling or in an unnatural feeling that cannot be definitely described in words. Though not acute, they are sufficient to make the patient constantly conscious of their existence and to induce fruitless efforts at clearing the throat, etc. The alteration of the voice varies from occasional unsteadiness or veiling, or a loss of power or purity of tone, to different degrees of hoarseness, dysphonia, and even aphonia. In singers and public speakers the disease interferes sometimes with professional vocal efforts only, ordinary conversation not being affected. The voice is best, sometimes worst, after a night's rest, and in either instance changes after moderate use for worse or better as the case may be; but long-continued exercise is always harmful. The voice is comparatively easily fatigued, and then the vocal organ becomes positively painful. In addition to the two chief and constant symptoms there are others that may or may not be present, and which sometimes assume even greater prominence than the modification of the voice. Thus, secretion, which in most cases is very slight, glassy grayish, and viscid, is occasionally very abundant, yellowish, or darkish, or more rarely still mixed with streaks of blood and in clumps, though not sticky or dried into scabs, and is sometimes so fetid that the patient's breath is exceedingly malodorous. Cough, which in most cases is either absent or comparatively trifling, barking, or hacking, occasionally is the most troublesome of all the symptoms. Dysphagia is sometimes present even in simple or mild cases. In severer cases, in the later stages, especially in syphilitic and phthisical chronic laryngitis, swallowing becomes painful and difficult, or even impossible. Dyspnoea occurs only from accumulations of phlegm in the larynx, and is then lessened after expectoration, or it may depend upon the diminished lumen of the laryngeal cavity on account of thickening of the walls, as it is especially apt to do in subglottic chronic laryngitis, or on account of so-called polypoid hypertrophies in simple cases, gummata or cicatricial tissue in specific cases, etc. Dyspnoea may become so urgent as to require tracheotomy.