Abstract
Since the middle of the 20th century, most discussions of spasmodic dysphonia (SD) reference a paper by Ludwig Traube published in1871 as the first historical citation, crediting him with priority for this clinical syndrome. However, our recent research has determined that the original observation by Traube was published in 1864 and does not in fact describe what is currently recognized as SD. It appears that many clinics throughout Europe and North America were investigating and publishing observations on a range of voice disorders. The wider context of work on laryngeal disorders in the 1860s-1870s is considered. One of Traube's contemporaries, Morell Mackenzie, made significant contributions to the understanding of laryngeal movement disorder and its consequences for the voice. These will be examined to gain a clearer focus on the characterization of this disorder. The clinical descriptions published by Morrell Mackenzie in the 1860s provide details that conform quite closely to our current-day understanding of SD. The citation of Traube's "hysterical" patient links to mid 20th-century views of the functional nature of SD and the utility of psychiatric treatment. The description presented by Mackenzie is consistent with current views of SD as a movement disorder.
Highlights
Spasmodic dysphonia (SD), referred to as Laryngeal Dystonia, is currently described as an idiopathic focal dystonia affecting the intrinsic muscles of the larynx
The National Institute of Health (NIH), USA classifies it as a Rare Disease with an occurrence of approximately 14 cases per 100,000
The typical citation for the original case of SD is Traube’s 1871 patient. This young girl who was suffering from typhoid fever was largely aphonic, producing some falsetto voice
Summary
Spasmodic dysphonia (SD), referred to as Laryngeal Dystonia, is currently described as an idiopathic focal dystonia affecting the intrinsic muscles of the larynx. One mid-19th century description captures the British view of quality of observation and interpretation of visualization afforded by the laryngoscope It comes from George Johnson (1818-1896) Professor of Medicine at Kings College, London in his lectures “The Laryngoscope directions for its use and practical illustrations of its value in the diagnosis and treatment of diseases of the throat and nose” delivered at the Royal College of Physicians. As the London clinician Morell Mackenzie said in 1863, “it was not, till quite recently, when the introduction of the laryngoscope enabled ‘the eye to direct the hand’, that it became possible to apply the galvanic current directly to the nerves and muscles of the larynx” 12 It appears that the development of the laryngoscope directly drove the growth in medical treatment for individuals with voice disorders and a deeper understanding of the function of the larynx in the production of the voice. He explicitly states that the difficulty in such patients does not arise from the cortico-spinal pathway, but rather what he refers to as the sympathetic ganglia
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