ON PHOTOGRAPHING THE LARYNX. 
BY 
THOMAS R. FRENCH, M.D., 
BROOKLYN, 
[Reprinted from the Archives of Laryngology, Vol. iv, No, 4, Oct., 1853.J Ti £) | 
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Tuj 6 ON PHOTOGRAPHING THE LARYNX* 
THOMAS R. FRENCH, M.D., 
BROOKLYN. 
(With plate and two wood-cuts.) 
AT the last session of this Association, I presented 
several photographs of the larynx taken with the 
assistance of Mr. George B. Brainerd, of Brooklyn, only a 
few days before the meeting. 
Since then we have made numerous experiments with 
various forms of apparatus, all of which have been con- 
structed by Mr. Brainerd. 
This gentleman’s assistance has been simply invaluable. 
He is a civil engineer by profession, and became interested 
in the larynx and laryngoscopy immediately after I had 
incised an abscess in his larynx, which had begun to inter- 
fere with respiration. I soon succeeded in teaching him 
to examine his own larynx, and seeing that he was much 
interested in the study of its movements, and knowing him 
to be an expert amateur photographer, I broached the 
subject of photographing the laryngoscopic image. He 
entered into the solution of the question with the spirit 
of scientific inquiry, and, because of his untiring in- 
dustry and great ingenuity, has been mainly instrumental 
in enabling me to present to-day these photographic pict- 
ures of the interior of the larynx. 
We demonstrated last year that the larynx could be 
photographed, but with that process the throat-mirror and 
camera were in fixed positions, and the head of the patient 
had to be drawn up to the mirror and arranged to suit its 
position, which of course necessitated very tolerant fauces 
in order to succeed. We realized that photographs taken 
* Read before the American Laryngological Association, session 1883. 
Reprinted from the Archives of Laryngology, Vol. iv, No. 4, Oct., 1883. 2 
Thomas R. French. 
in this way could have but a limited value in the study and 
demonstration of diseases of the larynx, and, therefore, our 
objects this year have been : 
I. To simplify the procedure, and so convert that 
which before was only an interesting experiment into an 
operation of practical utility. 
2. To take a better photograph. 
In the fulfilment of both of these objects we believe 
that we have been successful, for, as I shall show farther 
on, we have adapted a hand-camera, with which the larynx 
of persons having only fairly tolerant fauces can, in the 
majority of instances, be photographed by any laryngo- 
scopist; and I have for presentation to-day a number of 
photographs taken with the stationary apparatus, which are 
an improvement on the results of last year. 
The hand-camera will not produce as large or as satisfac- 
tory pictures as the stationary apparatus, but, as the results 
of some of the work done with it will show, they are clear 
enough to make out the various structures of the normal 
larynx, or diseased conditions if they exist. 
The photographs shown last year were taken with a 
camera about the size of a segar box placed upon a tripod, 
and with the throat-mirror attached by a flexible rod to the 
camera. Unaided sunlight alone was used for illumination. 
The best photograph taken with that apparatus is probably 
familiar to all the Fellows of the Association. The sources 
of illumination used in the experiments made this year 
were unaided sunlight, condensed sunlight, oxyhydrogen, 
magnesium, and electric lights. 
With unaided sunlight plane reflectors were used. In 
order to increase the power of illumination from sunlight, 
and at the same time to avoid material increase of heat, 
Mr. Brainerd devised and constructed a condenser, which 
answers the purpose so well that it deserves a description. 
It consists of a box 10 inches long, in one end of which is 
placed a double convex lens 5 inches in diameter, which 
has a focal distance of 13 inches. At the outer end of a 
short tube fitted into the other end of the box is a plano- 
concave lens if inches in diameter. This is placed an inch On Photographing the Larynx. 
3 
or so inside of the point of focus of the double convex lens, 
and in that position intercepts the converging rays, and 
makes them parallel or divergent, according to its distance 
from the first lens. 
When sunlight is made to pass through these lenses the 
result is one of the most beautiful and powerful lights, 
without material heat, that I have ever seen. Both light 
and heat can be controlled by diaphragms of varying size, 
to be introduced between the lenses when the sun is very 
bright. 
With this condenser both the plane and concave reflect- 
ors were used. The electric-light used was produced by 
one of Wood’s 6,000 candle-power focussing lamps, which 
the Fuller Electric Light Co. courteously placed at our 
disposal for our experiments. A 2,000 candle-power Fuller 
lamp, such as is used for street illumination, was suspended 
from the ceiling by a rope and pulleys for our use, but the 
light produced by it was found to be too small and weak to 
illuminate all of the larynx at the same time. It was 
therefore discarded without experiment, and Wood’s power- 
ful focussing lamp without the reflector substituted. 
With this light reflected from both plane and concave 
reflectors, sixteen exposures were made with the small 
camera. The best results were obtained from the use 
of the plane reflector; but the photographs taken in this 
way were no better than those resulting from the use of un- 
aided sunlight, and not as satisfactory as those obtained 
when condensed sunlight was employed. 
The illuminating power of this light could certainly have 
been increased by the use of a condenser, but the experi- 
ment was not made, for the light as it was, proved to be 
very trying and dazzling to the eyes of both Mr. Brainerd, 
upon whom the experiments were made, and myself. 
The experiments with sunlight were made with a variety 
of cameras, all of which, with the exception of two, have 
been discarded. Of these, one is a stationary camera and 
the other is intended to be held in the hand while the 
photograph is being taken. 
The stationary apparatus consists of two tubes, one inch 4 
Thomas R. French. 
in diameter, moving one within the other. The lens, a 
plano-convex achromatic of five inches focus is set in the 
distal extremity of the outer tube, and an ordinary plane or 
concave reflector is suspended in front of it; upon the side 
of the tube an adjustable arm is fixed, which carries the 
throat-mirror ; at the other end of the inner tube is the 
exposing apparatus, consisting of a perforated drop shutter 
and a slide for the holders containing the sensitive plates. 
The whole is fixed to a flat wooden base. 
Here are a number of photographs (see plate -facing page 
■"g-ffi) of the larynx taken with this apparatus, which are pre- 
sented to show what can be done. While they are much 
better than those of last year, they are of no great practical 
value, for in order to secure them the patient and camera 
must be placed in fixed positions, which precludes the pos- 
sibility of using the apparatus upon a large majority of 
patients who come under observation. 
Fig. i. 
(Figs. I, 2, 3, and 4 of plate are artotype reproductions 
of the best photographs taken with the stationary camera 
exhibited at the meeting at which this paper was read. 
The reproductions are, of course, not as clear as the photo- 
graphs.) On Photographing the Larynx. 
5 
Fig. 2. 
The small camera (Fig. i) is intended to be held in the 
hand while the picture is being taken. It consists of a box 
4|-inches long, inches wide, and fof an inch in thickness. 
The back opens upon hinges, and admits of the intro- 
duction of either the ground glass or plate-holder. On the 
anterior face, a tube inches long is attached, in the outer 
end of which the lens is placed. This lens has a focus of 
i£ inches. 
At the side of the tube a part of the handle of a throat- 
mirror is fixed, and into that the shank of a throat-mirror is 
passed and fastened by a thumb-screw. The shank of the 
mirror is somewhat curved, and is attached to the side of 6 
Thomas R. French. 
the frame holding the mirror. The object of this is to 
allow of the lens being held opposite any part of the open- 
ing of the mouth, and also to prevent the possibility of a 
shadow being cast upon the mirror. 
In the front part of the box is a shutter made of lead, 
and perforated with a hole just the size of the lens. The 
shutter is held in position by a lever acting as a key, on the 
anterior face of the camera. 
The apparatus is used in the following manner: 
I have sketched upon this plate (Fig 2. shows the plate 
reduced) the relative positions of patient, observer, camera, 
and condenser in the procedure about to be described, a 
reference to which will, perhaps, aid you in understanding 
the description. 
A reflector, either plain or concave, attached to a head- 
band, is arranged over the left eye so that the pencil of sun- 
light from the solar condenser is received upon it and 
thrown into the mouth. The patient, with the head in- 
clined slightly backward, now protrudes the tongue and 
holds it well out between the forefinger and thumb of the 
right hand. 
The throat mirror with camera attached, held in the 
right hand of the observer, is placed in position in the 
fauces, and the light adjusted so that the larynx can be 
seen, with the observer’s left eye, to be well illuminated. 
If, now, the tongue does not mound up above the level 
of the lower edge of the lens, and the lower edge of the 
mirror, it may be taken for granted that, when the plate is 
exposed, the picture received upon it will be nearly the 
same as that seen with the left eye in the throat-mirror. 
The photograph is taken by pressing upon the key with the 
index finger; this releases the shutter which, in falling, 
makes an instantaneous exposure, amounting, perhaps, to 
one seventh of a second. 
In using condensed sunlight with the small camera, it is 
important to throw the circle of light from the inner side of 
the reflector—that nearest the nose,—for in this way a part 
of the larynx exposed to the lens of the camera may be 
illuminated, which cannot be seen with the eye. To insure On Photographing the Larynx. 
7 
this, it is best to cover the outer half of,the reflector with 
black silk. 
On account of the parallax or displacement of the image 
due to the difference in point of view between the eye and 
the camera, some skill is necessary in managing the illumi- 
nation, so that the part which it is desired to bring out will 
be exposed to the lens if not to the eye. 
Here are a number of photographs taken with this, the 
small camera, showing normal and diseased larynges in vari_ 
ous positions. Some of them are so small—the pictures of 
the larynx themselves measuring only about or T3¥ of an 
inch in diameter—that they cannot be satisfactorily seen 
without the aid of a magnifying glass. In order to 
make them clear to the unaided eye it is necessary to 
enlarge them. On account of the short time which has 
elapsed since these photographs were taken, satisfactory en- 
largements could not be obtained. (Fig. 5 of plate is an 
artotype reproduction of one of the many photographs 
taken with the hand-camera exhibited at the meeting at 
which this paper was read. It does the photograph great 
injustice, but is shown because of the fact that it is the first 
photograph taken of the image of a diseased larynx. It rep- 
resents perichondritis in laryngeal phthisis. Fig. 6 of 
Frontispiece is a reproduction of a photograph of a portion 
of the rhinoscopic image taken with the hand-camera. It 
shows hypertrophied membrane, due to catarrh, on both sides 
of the septum, and portions of the middle and inferior tur- 
binated bones of the right side.) 
These photographs are not as large or clear as desirable, 
but allowance must be made for the fact that an ordinary 
plano-convex achromatic lens was used, which was not con- 
structed with any special reference to photography, and the 
pictures taken with it bear about the same relation to those 
that would be produced by a regularly constructed photo- 
graphic lens, that the tin-type of the itinerant photographer 
bears to the imperials of a Sarony or a Kurtz. 
It may be asked, Why have we not used the best lens 
that could be obtained ? to which we would answer that our 
plan from the first has been: first, to attain the result 8 
Thomas R. French. 
aimed at, and this has only just been reached ; and then to 
eliminate objectionable features and perfect the product. 
Any want of sharpness in the views must be attributed to 
the imperfection of the lens or inaccuracy in focussing, for 
the closest inspection will not show any duplication of lines, 
such as would result from a movement of the parts during 
exposure. 
Experience has shown that the apparatus may be im- 
proved in several ways. By adding a larger lens the size of 
the pictures could be doubled, without increasing the size 
and weight of the present camera more than one third. 
Mr Brainerd suggested the following, and had time al- 
lowed, the suggestions would have been carried out : 
The use of a wide-aperture combination lens to flatten 
the field and increase the sharpness of the image. The 
addition of a micrometer for more delicate focussing, and 
to contribute to the sharpness of the image. The use of an 
exposing drop to be actuated by a spring instead of by 
gravity, in order to shorten the exposure when the light 
will warrant it. This might be placed in front of the lens 
to protect it from the breath of the patient. Setting the 
lens on one side of the centre of the plate to give a more 
nearly coincident vision of eye and camera. 
The development of the plates is a very simple matter, and 
a knowledge of it can be readily acquired, so in taking pict- 
ures with the hand-camera the services of a photographer 
are not necessarily required. 
The results of the experiments made this year may be 
summed up as follows ; 
i. Better photographs have been taken with the station- 
ary apparatus than those of last year. 
2. A camera has been so adapted that it can be held in 
the hand and quickly placed in position. This makes it 
possible to photograph the larynx in patients wdiose fauces 
are only moderately tolerant. 
3. The photographs are taken instantaneously, by a drop 
shutter, thus making it possible to photograph the larynx, 
even if the parts are in motion. 
4. The parts reflected in the mirror are alone exposed, On Photographing the Larynx. 
9 
thus avoiding the confusion which arises when the mouth 
and lips are included and out of focus. 
5. As the apparatus is so small, and the exposure is made 
instantaneously, if desirable, photographs can be taken with- 
out the patients being aware of the object of the procedure. 
6. Several diseased conditions of the larynx have been 
photographed. This is an important step in advance, for 
we believe that it is the first time that it has been accom- 
plished. 
7. Portions of the rhinoscopic image have been photo- 
graphed. These photographs show, among other things, 
hypertrophy of the mucous membrane covering the poste- 
rior portion of the nasal septum. 
So far as we are aware, this is the first time that any por- 
tion of the posterior nares has been photographed. g. p. putnam’s sons, printers 
NEW YORK