y Dr. Logan Turner.

#Examination of the Larynx.#--For this purpose the examiner requires a
laryngeal reflector with forehead attachment, one or two sizes of
laryngeal mirror, a tongue cloth, and the means of obtaining good
illumination. The source of light should be by preference placed
opposite to and on the same horizontal plane as the patient's left
ear. The forehead reflector is placed over the observer's right eye so
that he may look through the central aperture, while at the same time
he throws a good circle of light into the patient's mouth. The patient
should be seated with the head thrown slightly back; the tongue is
protruded and covered with the cloth, and held lightly but firmly
between the finger and thumb of the left hand. A full-sized mirror,
warmed so as to prevent the condensation of the breath upon it, is
inserted with the reflecting surface turned downwards, and pressed
gently against the soft palate so as to push that structure upwards.
The handle of the instrument is carried towards the left angle of the
mouth, and by slightly altering the plane of the reflecting surface of
the mirror the different parts of the larynx are in turn brought into
view. The movements of the vocal cords should be observed during both
respiration and phonation, and for the latter purpose the patient
should be directed to phonate the vowel sound "eh."

In the upper part of the mirror the epiglottis usually comes first
into view: it is of a pinkish yellow colour, and presents a thin,
sharply defined free margin. In front of the epiglottis are the median
and lateral glosso-epiglottic folds passing forwards to the base of
the tongue, and enclosing the two valleculae. Extending backwards and
downwards from the lateral margins of the epiglottis are the two
ary-epiglottic folds which reach the arytenoid cartilages posteriorly.
Between the two layers of mucous membrane of which the ary-epiglottic
folds are composed are the cartilages of Wrisberg and Santorini. In
the interval between the two arytenoid cartilages is the
inter-arytenoid fold of mucous membrane, which forms the upper margin
of the posterior wall of the larynx. The upper aperture of the larynx
is bounded by the epiglottis in front, the ary-epiglottic folds
laterally, and the inter-arytenoid fold behind. In the interior of the
larynx the vocal folds (true vocal cords) form the most prominent
features, being conspicuous as two flat white bands, which form the
boundar