His pupil Charles Battaille, to whom reference has been already made in an earlier chapter, was most enthusiastic over it, and, having been a medical student at one time, considered himself well qualified to demonstrate its virtues. Hearing that the Turkish Ambassador in Paris was going to give a dinner to the most prominent French inventors of that time, he obtained permission to show off the uses of the new exhibit during the evening. After pointing out that it would revolutionise the scientific study of the throat, he proceeded to force the instrument down the gullet of an unfortunate Court official who had barely finished dinner. The result was disastrous.
The other story was a comical experience of a well-known specialist.
Like all very sensitive areas of the human body, the organ of the voice is sometimes invaded by special symptoms, notably in hysterical patients.
When the laryngoscope became a speciality, a young lady who for two whole years had lost all power of articulation was brought up to London by her mother for advice and treatment. The experienced laryngologist to whom she was introduced placed her in proper position before his lamp, while the parent poured out the prolonged tale of affliction. Without taking any apparent notice of the latter, he placed the mirror in the girl's throat with the usual request, delivered in a cool and commanding tone, "Say 'aw,' please"; when the young lady snappishly drew back her head with, "How can I with that thing in my throat?"—followed by, "Oh, dear, I've spoken!" The specialist turned at once to the anxious parent, and told her she might take her daughter home cured,—as she proved to be.
In the present state of our knowledge of such matters, it is rather startling to remember that two and a half centuries ago the famous physician of Norwich, Sir Thomas Brown, thought it a part of his duty, as an advanced teacher of his contemporaries, to devote a chapter of one of his books to stating and proving that food and drink did not descend into the body by two separate tubes. It appears that at that date the majority of the British public actually believed that, as Nature had placed two pipes in the neck, solids were transmitted by one and fluids by the other during the ordinary act of swallowing.
Most people nowadays are aware that the vibrations of the elastic bands, of which there is one on each side beneath the membrane of the upper part of the larynx, produce the sounds of the voice by their effect on the air issuing from the lungs. Certain qualities of tone, and of course the pitch of a note, are determined by their length and tension, while the special characteristics which make the voice of each individual definitely recognisable are due to the varied forms of the several parts of the throat, nose, mouth, &c., above that level. Again, the "breaking" of the voice of a boy on reaching the threshold of adolescence is due to the mechanical effect of the elongation of the elastic bands above referred to—so-called "vocal cords,"—produced by the forward growth of the cartilages of the larynx which determine the formation of the "Adam's apple." All these simple facts were absolute mysteries previously to the enlightening device of Manuel Garcia.
Though Czermak took up the laryngoscope and added to its general feasibility by the introduction of artificial light, it still had many obstacles to overcome, but in this it only shared the common fate of all innovations. A number of the men who bore the heat of the day in the early time of storm and stress are still alive, and must rejoice in the fulness of recognition which their speciality has gained.
Intralaryngeal medication and surgery soon followed the discovery of the diagnostic properties, and its principles were extended to the elucidation and treatment of diseases of the parts situated between the nose and throat.
Professor Osler has told us that if we take the sum of human achievement in science and the arts, and subtract the work of those above forty, "while we should miss great treasures, even priceless treasures, we should practically be where we are to-day." The achievement of Garcia supplies a striking comment on these hasty words. He was ten years over the limit fixed by the professor when by his invention he opened up a new world to scientific exploration. Subtract the laryngoscope from medicine, and what a gap is left in modern methods of diagnosis and treatment! Before its invention threw light into places which had been dark since the birth of the human race, the larynx was an undiscovered country, and its diseases lay beyond the limits of medical art.
"Had Garcia's work ended when he was forty, we should still not improbably be powerless to deal with functional aphonia, with laryngeal growths, with tuberculosis of the larynx, and with many conditions in the upper air-passages which can now be treated satisfactorily, because they can be seen. What is more important, we should be without a means of diagnosis which has proved invaluable in the detection of unsuspected disease of the brain and in the elucidation of obscure mediastinal affections. Abductor paralysis of a vocal cord is often the only appreciable symptom in the early stage of tabes, and it may give the key to the situation of a growth in the fourth ventricle, the medulla, or the cerebellum. Faint appearances, discoverable only by laryngosocopy, may furnish the first indication of pulmonary tuberculosis before any physical signs are present. The state of the larynx, in fact, is often a danger-signal to those who can read its meaning. The laryngoscope may also reveal the presence of an aortic aneurism or a mediastinal tumour. Its value in medicine is greater than that of the ophthalmoscope, because its application is wider, and the indications which it supplies are often more definite."