ETIOLOGY.--Scrofulosis and syphilis seem to be the predisposing causes. Climate may have some influence. The reason of the special proclivity of the female is undetermined. Of 9 reported cases, records of which are before the writer, 8 were in females. PATHOLOGY AND MORBID ANATOMY.--Laryngeal lupus is usually an extension of the disease from the upper lip or the nose, extending along the nasal passages, pharynx, and palate. Destructive ulceration takes place, with irregular cicatrization and the formation of hard nodules of hyperplastic tissue of irregular conformation, varying from the size of hempseeds to that of small peas, similar to the cutaneous buccal and pharyngeal nodules. SYMPTOMS.--These include dysphonia, dyspnoea, dysphagia, and cough. Pain is exceptional. DIAGNOSIS.--Laryngoscopic inspection reveals the characteristic nodulation, the nature of which is inferred from the coexistence of external lupus. The disease may be confounded with lepra, syphilis, tuberculosis, or carcinoma. Discrimination from syphilis is the most difficult, and is predicated chiefly on its slow progress and on the absence of constitutional manifestations. PROGNOSIS.--This is unfavorable. The reported cures seem to have occurred only under the influence of antisyphilitic treatment. TREATMENT.--The prolonged use of cod-liver oil and of potassium iodide seems to be more beneficial than any other systemic treatment. Destruction of the nodules and ulcerated tissues is indicated when the diseased structures are sufficiently circumscribed and accessible. This may be done with the sharp spoon or with the electric cautery. Silver nitrate and iodine have been lauded as topical remedies. Lepra of the Larynx. Lepra is rare in the larynx. ETIOLOGY.--Its cause seems to be climatic. In Europe it is most frequent in Norway and Sweden, and in America in Cuba and the West Indies. PATHOLOGY AND MORBID ANATOMY.--It is always associated with cutaneous lepra, and usually with lepra of the nasal passages and the pharynx. According to Schroetter's observations, laryngeal lepra occurs as small connective-tissue nodules on the epiglottis or in the interior of the larynx, or as uniform thickenings, general or circumscribed. These may lead to stricture. Extensive ulceration may ensue. SYMPTOMS.--Dysphonia, aphonia, dyspnoea, cough, and local anæsthesia are the main symptoms. Pain is infrequent. DIAGNOSIS.--This depends upon the external manifestations of lepra and the laryngoscopic detection of the characteristic thickenings and nodulations. PROGNOSIS.--This is unfavorable. TREATMENT.--This must be conducted on general principles. Elsberg commended iodoform topically and gurgun oil internally. {133} DISEASES OF THE TRACHEA. BY LOUIS ELSBERG, A.M., M.D.