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LARYNGITIS

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Originally appearing in Volume V16, Page 230 of the 1911 Encyclopedia Britannica.
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LARYNGITIS, an inflammation of the mucus of the larynx. There are three chief varieties: acute, chronic, and oedematous. The larynx is also liable to attacks of inflammation in connexion with tubercle or syphilis. Acute Laryngitis may be produced by an independent catarrh, or by one extending either from the nasal or the bronchial mucous membrane into that of the larynx. The causes are various, " catching cold " being the most common. Excessive use of the voice either in speaking or singing sometimes gives rise to it. The inhalation of irritating particles, vapours, &c., and swallowing very hot fluids or corrosive poisons are well-recognized causes. It may also occur in connexion with diseases, notably measles and influenza. As a result of the inflammation there is a general swelling of the parts about the larynx and the epiglottis, the result being a narrowing of the channel for the entrance of the air, and to this the chief dangers are due. The symptoms vary with the intensity of the attack; there is first a sense of tickling, then of heat, dryness, and pain in the throat, with some difficulty in swallowing. There is a dry cough, with expectoration later; phonation becomes painful, while the voice is husky, and may be completely lost. In children there is some dyspnoea. In favourable cases, which form the majority, the attack tends to abate in a few days, but the inflammation may become of the oedematous variety, and death may occur suddenly from an asphyxial paroxysm. Many cases of acute laryngitis are so slight as to make themselves known only by hoarseness and the character of the cough, nevertheless in every instance the attack demands serious attention. The diagnosis is not, in adults, a matter of much difficulty, especially if an examination is made with the laryngoscope; in children, however,. it is more difficult, and the question of diphtheria must not be lost sight of. The treatment is, first and foremost, rest; no talking must be allowed. The patient should be kept in bed, in a room at an even temperature, and the air saturated with moisture. An ice-bag round the throat gives much relief, while internally diaphoretics may be given, and a full dose of Dover's powder if there be much pain or cough. Chronic Laryngitis usually occurs as a result of repeated attacks of the acute form. It is extremely common in people who habitually over-use the voice, and is the cause of the hoarse voice one associates with street sellers. The constant inhalation of irritating vapours, such as tobacco smoke, may also cause it. There is usually little or no pain, only the unpleasant sensation of tickling in the larynx, with a constant desire to cough. The changes in the mucous membrane are more permanent than in the acute variety, and there nearly always accompanies this a chronic alteration of the membrane of the pharynx (granular pharyngitis). The treatment consists in stopping the cause, where known, e.g. the smoking or shouting. Careful examination should be made to see if there is any nasal obstruction, and the larynx should be treated locally with suitable astringents, by means of a brush, spray or insufflation. Overheated and ill-ventilated rooms must be avoided, as entrance into them immediately aggravates the trouble and causes a paroxysm of coughing. Oedematous Laryngitis is a very fatal condition, which may occur, though rarely, as a sequence of acute laryngitis. It is far more commonly seen in syphilitic and tubercular conditions of the larynx, in kidney disease, in certain fevers, and in cases of cellulitis of the neck. The larynx is also one of the sites of Angeioneurotic oedema. In this form of laryngitis there are all the symptoms of acute laryngitis, but on a very much exaggerated scale. The dyspnoea, accompanied by marked stridor, may arise and reach a dangerous condition within the space of an hour, and demand the most prompt treatment. On examination the mucous membrane round the epiglottis is seen to be enormously swollen. The treatment is ice round the throat and internally, scarification of the swollen parts, and should that not relieve the asphyxial symptoms, tracheotomy must be performed immediately. Tubercular Laryngitis is practically always associated with phthisis. The mucous membrane is invaded by the tubercles, which first form small masses. These later break down and ulcerate; the ulceration then spreads up and down, causing an immense amount of destruction. The first indication is hoarseness, or, in certain forms, pain on swallowing. The cough is, as a rule, a late symptom. A sudden oedema may bring about a rapid fatal termination. The general treatment is the same as that advised for phthisis; locally, the affected parts may be removed by one or a series of operations, generally under local anaesthesia, or they may be treated with some destructive agent such as lactic acid. The pain on swallowing can be best alleviated by painting with a weak solution of cocaine. The condition is a very grave one; the prognosis depends largely on the associated pulmonary infection—if that be extensive, a very small amount of laryngeal mischief resists treatment, while, if the case be. the contrary, a very extensive mischief may be successfully dealt with. Syphilitic Laryngitis.—Invasion of the larynx in syphilis is very common. It may occur in both stages of the disease and in the inherited form. In the secondary stage the damage is superficial, and the symptoms those of a slight acute laryngitis. The injury in the tertiary stage is much more serious, the deeper structures are invaded with the formation of deep ulcers, which may when they heal form strong cicatrices, which produce a narrowing of the air-passage which may eventually require surgical interference. Occasionally a fatal oedema may arise. The treatment consists of administering constitutional remedies, local treatment being of comparatively slight importance. Paroxysmal Laryngitis, or Laryngismus stridulus, is a nervous affection of the larynx that occurs in infants. It appears to be associated with adenoids. The disease consists of a reflex spasm of the glottis, which causes a complete blocking of the air-passages. The attacks, which are recurrent, cause acute asphyxiation. They may cease for no obvious reason, or one may prove fatal. The whole attack is of such short duration that the infant has either recovered or succumbed before assistance can be called. After an attack, careful examination should be made, and the adenoids, if present, removed by operation. LA SABLIERE, MARGUERITE DE (c. 164o-1693), friend and patron of La Fontaine, was the wife of Antoine Rambouillet, sieur de la Sabliere (1624-1679), a Protestant financier entrusted with the administration of the royal estates, her maiden name being Marguerite Hessein. She received an excellent education in Latin, mathematics, physics and anatomy from the best scholars of her time, and her house became a meeting-place for poets, scientists and men of letters, no less than for brilliant members of the court of Louis XIV. About 1673 Mme de la Sabliere received into her house La Fontaine, whom for twenty years she relieved of every kind of material anxiety. Another friend and inmate of the house was the traveller and physician Francois Bernier, whose abridgment of the works of Gassendi was written for Mme de la Sabliere. The abbe Chaulieu and his fellow-poet, Charles Auguste, marquis de La Fare, were among her most intimate associates. La Fare sold his commission in the army to be able to spend his time with her. This liaison, which seems to have been the only serious passion of her life, was broken in 1679. La Fare was seduced from his allegiance, according to Mme de Sevigne by his love of play, but to this must be added a new passion for the actress La Champmesle. Mme de la Sabliere thenceforward gave more and more attention to good works, much of her time being spent in the hospital for incurables. Her husband's death in the same year increased her serious tendencies, and she was presently converted to Roman Catholicism. She died in Paris on the 8th of January 1693. LA SALE (or LA SALLE), ANTOINE DE (c. 1388-1462?), French writer, was born in Provence, probably at Arles. He was a natural son of Bernard de la Salle,' a famous soldier of fortune, who served many masters, among others the Angevin dukes. In 1402 Antoine entered the court of Anjou, probably as a page, and in 1407 he was at Messina with Duke Louis II., who had gone there to enforce his claim to the kingdom of Sicily. The next years he perhaps spent in Brabant, for he was present at two tournaments given at Brussels and Ghent, With other gentlemen from Brabant, whose names he has preserved, he took part in the expedition of 1415 against the Moors, organized by John I. of Portugal. In 1420 he accompanied Louis III. on another expedition to Naples, making in that year an excursion from Norcia to the Monte della Sibilla, and the neighbouring Lake of Pilate. The story of his adventures on this occasion, and an account, with some sceptical comments, of the local legends regarding Pilate, and the Sibyl's grotto,' form the most interesting chapter of La Salade, which is further adorned with a map of the ascent from Montemonaco. La Sale probably returned with Louis III. of Anjou, who was also comte de Provence, in 1426 to Provence, where he was acting as viguier of Arles in 1429. In 1434 Rene, Louis's successor, made La Sale tutor to his son Jean d'Anjou, duc de Calabre, to whom he dedicated, between the years 1438 and 1447, his La Salade, which is a text-book of the studies necessary for a prince. The primary intention of the title is no doubt the play on his own name, but he explains it on the ground of the miscellaneous character of the hook—a salad is composed " of many good herbs." In 1439 he was again in Italy in charge of the castle of Capua, with the due de Calabre and his young wife, Marie de Bourbon, when the place was besieged by the king of Aragon. Rene abandoned Naples in 1442, and Antoine no doubt returned to France about the same time. His advice was sought at the tournaments which celebrated the marriage of the unfortunate Margaret of Anjou at Nancy in 1445; and in 1446, at a similar display at Saumur, he was one of the umpires. La Sale's pupil was now twenty years of age, and, after forty years' service of the house of Anjou, La Sale left it to become tutor to the sons of Louis de Luxembourg, comte de Saint Poi, who took him to Flanders and presented him at the court of Philippe le Bon, duke of Burgundy. For his new pupils he wrote at Chatelet-sur-Oise, in. 1451, a moral work entitled La Salle. He was nearly seventy years of age when he wrote the work that has made him famous, L'Hystoire et plaisante cronicque dal petit Jehan de Saintre et de la jeune dame des Belles-Cousines, Sans autre nom nommer, dedicated to his former pupil, Jean de Calabre. An envoi in MS. 10,057 (nouv. acq. fr.) in the Bibliotheque Nationale, Paris, states that it was completed at Chatelet on the 6th of March 1455 (i.e. 1456). La Sale also announces an intention, never fulfilled, apparently, of writing a romance of Paris et Vienne. The MSS. of Petit Jehan de Saintre usually contain in addition Floridam et Flvide, translated by Rasse de Brunhamel from the Latin of Nicolas de Clamange, ' For his career, see Paul Durrieu, Les Gascons en Italie (Auch, 1885, pp. 107-71). ' For the legend of the Sibyl current in Italy at the time, given by La Sale, and its interrelation with the Tannhauser story, see W. Soederhjelm, " A. de In Salle et la legende de Tannhauser " in Memoires de la soc. neo-philologique d'Helsingfors (1897, vol. ii.); and Gaston Paris, " Le Paradis de la Reine Sibylle," and " La Legende du Tannhauser," in the Revue de Paris (Dec. 1897 and March 1898).229 and dedicated to La Sale; also Addiction extraite des Cronicques de Flandres, of which only a few lines are original. Brunhamel says in his dedication that La Sale had delighted to write honour-able histories from the time of his " florie jeunesse," which confirms a reasonable inference from the style of Petit Jehan de Saintre that its author was no novice in the art of romance-writing. The Reconfort d Madame de Neufville, a consolatory epistle including two stories of parental fortitude, was written at Vendeuil-sur-Oise about 1458, and in 1459 La Sale produced his treatise Des anciens tournois et faictz d'armes and the Journee d'Onneur et de Prouesse. He followed his patron to Genappe in Brabant when the Dauphin (afterwards Louis XI.) took refuge at the Burgundian court. La Sale is generally accepted as the author of one of the most famous satires in the French language, Les Quinze Joyes de mariage, because his name has been disengaged from an acrostic at the end of the Rouen MS. He is also supposed to have been the " acteur " in the collection of licentious stories supposed to be narrated by various persons at the court of Philippe le Bon, and entitled the Cent Nouvelles Nouvelles. One only of the stories is given in his name, but he is credited with the compilation of the whole, for which Louis XI. was long held responsible. A completed copy of this was presented to the Duke of Burgundy at Dijon in 1462. If then La Sale was the author, he probably was still living; otherwise the last mention of him is in 1461. Petit Jehan de Saintre gives, at the point when the traditions of chivalry were fast disappearing, an account of the education of an ideal knight and rules for his conduct under many different circumstances. When Petit Jehan, aged thirteen, is persuaded by the Dame des Belles-Cousines to accept her as his lady, she gives him systematic instruction in religion, courtesy, chivalry and the arts of success. She materially advances his career until Saintre becomes an accomplished knight, the fame of whose prowess spreads through-out Europe. This section of the romance—apparently didactic in intention—fits in with the author's other works of edification. But in the second part this virtuous lady falls a victim to a vulgar intrigue with Damp Abbe. One of La Sale's commentators, M. Joseph Neve, ingeniously maintains that the last section is simply to show how the hero, after passing through the other grades of education, learns at last by experience to arm himself against coquetry. The book may, however, be fairly regarded as satirizing the whole theory of " courteous " love, by the simple method of fastening a repulsive conclusion on an ideal case. The contention that the fabliau-like ending of a romance begun in idyllic fashion was due to the corrupt influences of the Dauphin's exiled court, is inadmissible, for the last page was written when the prince arrived in Brabant in 1456. That it 1s an anti-clerical satire seems unlikely. The profession of the seducer is not necessarily chosen from that point of view. The language of the book is not disfigured by coarseness of any kind, but, if the brutal ending was the expression of the writer's real views, there is little difficulty in accepting him as the author of the Quinze Joyes .de mariage and the Cent Nouvelles Nouvelles.—Both these are masterpieces in their way and exhibit a much greater dramatic power and grasp of dialogue than does Petit Jehan. Some light is thrown on the romance by the circumstances of the duc de Calabre, to whom it was dedicated. His wife, Marie de Bourbon, was one of the " Belles-Cousines " who contended for the favour of Jacques or Jacquet de Lalaing in the Livre des faits de Jacques Lalaing which forms the chief source of the early exploits of Petit Jehan. The incongruities of La Sale's aims appear in his method of construction. The hero is not imaginary. Jehan de Saintre flourished in the Hundred Years' War, was taken prisoner after Poitiers, with the elder Boucicaut, and was employed in negotiating the treaty of Bretigny. Froissart mentioned him as " le meilleur et le plus vaillant chevalier de France." His exploits as related in the romance are, however, founded on those of Jacques de Lalaing (c. 1422-1453), who was brought up at the Burgundian court, and became such a famous knight that he excited the rivalry of the " Belles-Cousines," Marie de Bourbon and Marie de Cleves, duchesse d'Orleans. Lalaing's exploits are related by more than one chronicler, but M. Gustave Raynaud thinks that the Livre des faits de Jacques de Lalaing, published among the works of Georges Chastelain, to which textual parallels may be found in Petit Jehan, should also be attributed to La Sale, who in that case undertook two accounts of the same hero, one historical and the other fictitious. To complicate matters, he drew, for the later exploits of Petit Jehan, on-the Livres des fails de Jean Boucicaut, which gives the history of the younger Boucicaut. The atmosphere of the book is not the rough realities of the English wars in which the real Saintre figured but that of the courts to which La Sale was accustomed. The title of Les Quinze Joyes de mariage is, with a profanity characteristic of the time, borrowed from a popular litany, Les Quinze Joies de Notre Dame, and each chapter terminates with a liturgical refrain voicing the miseries of marriage. Evidence in favour of La Sale's authorship is brought forward by M. E. Gossart (Bibliophile beige, 1871, pp. 83-7), who quotes from his didactic treatise of La Salle a passage paraphrased from St Jerome's treatise against Jovinian which contains the chief elements of the satire. Gaston Paris (Revue de Paris, Dec. 1897) expressed an opinion that to find anything like the malicious penetration by which La Sale divines the most intimate details of married life, and the painful exactness of the description, it is necessary to travel as far as Balzac. The theme itself was common enough in the middle ages in France, but the dialogue of the Quinze Joyes is unusually natural and pregnant. Each of the fifteen vignettes is perfect in its kind. There is no redundance. The diffuseness of romance is replaced by the methods of the writers of the fabliaux. In the Cent Nouvelles Nouvelles the Italian novella is naturalized in France. The book is modelled on the Decameron of Boccaccio, and owes something to the Latin Facetiae of the contemporary scholar Poggio; but the stories are rarely borrowed, and in cases where the Nouvelles have Italian parallels they appear to be independent variants. In most cases the general immorality of the conception is matched by the grossness of the details, but the ninety-eighth story narrates what appears to be a genuine tragedy, and is of an entirely different nature from the other contes. It is another version of the story of Floridam et Elvide already mentioned. Not content with allowing these achievements to La Sale, some critics have proposed to ascribe to him also the farce of Maitre Pathelin. The best editions of La Sale's undoubted and reputed works are:—Petit Jehan de Saintre by J. M. Guichard (1843) ; Les Cent Nouvelles Nouvelles by Thomas Wright (Bibl. elzeverienne, '858); Les Quinze Joyes de mariage by P. Jannet (Bibl. elzev., 1857). La Salade was printed more than once during the 16th century. La Salle was never printed. For its contents see E. Gossart in the Bibliophile beige (1871, pp. 77 et seq.). See also the authorities quoted above, and Joseph Ncve, Antoine de la Salle, sa vie et ses ouvrages . suivi du Reconfort de Madame de Fresne . et de fragments et documents inedits (1903), who argues for the rejection of Les Quinze Joyes and the Cent Nouvelles Nouvelles from La Sale's works; Pietro Toldo, Contributo allo studio della novella francese del XV e XVI secolo (1895), and a review of it by Gaston Paris in the Journal des Savants (May 1895) ; L. Stern, " Versuch fiber Antoine de la Salle," in Archiv fur das Studium der neueren Sprachen, vol. xlvi. ; and G. Raynaud, " Un Nouveau Manuscrit du Petit Jehan de Saintre," in Romania, vol. xxxi. (M. BR.)
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