y of the rima glottidis or glottic chink. Above each true cord,
and parallel with it, the ventricular fold or false cord is evident as
a pink fold of mucous membrane. Between the ventricular fold and the
vocal fold on each side is a linear interval, which indicates the
entrance to the ventricle of the larynx.

_Direct Laryngoscopy._--The larynx may also be examined by the direct
method by means of Jackson's or Killian's spatulae. After cocainisation
of the base of the tongue, the soft palate, and the posterior surface
of the epiglottis, the patient is seated upon a low stool and his head
supported by an assistant. The light is obtained from a small lamp in
the handle of the instrument or reflected from a forehead mirror. The
spatula is warmed and introduced under the guidance of the eye, its
end being passed over the epiglottis, and pressure exerted so as to
draw the latter structure forward. In children a general anaesthetic is
required, and the examination is made with the head hanging over the
end of the table. Killian's "suspension laryngoscopy" affords the best
method of examining the larynx in young children.

_Tracheoscopy and Bronchoscopy._--Direct examination of the trachea
and larger bronchi may be carried out in a similar way, by passing
through the mouth and larynx metal tubes, after the method devised by
Killian. This procedure is described as direct upper tracheoscopy and
bronchoscopy. The examination may also be made through a tracheotomy
wound--direct lower tracheoscopy. These procedures have proved of
great service in the recognition of foreign bodies in the lower
air-passages, and in their extraction; in the diagnosis of stenosis of
the trachea, and of aneurysm pressing on the trachea.

CARDINAL SYMPTOMS OF LARYNGEAL AFFECTIONS

The cardinal symptoms of laryngeal affections are interference with
the voice and with respiration, and pain on swallowing. Laryngeal
cough of a croupy or barking character may be present, and is usually
associated with a lesion of the posterior wall or inter-arytenoid
fold. Haemoptysis is seldom of laryngeal origin, and unless the
bleeding spot is visible in the mirror, the source of the bleeding is
much more likely to be in the bronchi or lungs.

#Interference with the Voice.#--_Hoarseness_ results from some
affection of the vocal cords: it may be simple laryngitis, some
specific cause such as tuberculosis or syphilis, or some condition
which prevents the proper approx