A guide to the study of ear disease / by P. Mcbride.

  • McBride, P. (Peter), 1854-1946.
Date:
[1884]
Catalogue details

Licence: Public Domain Mark

Credit: A guide to the study of ear disease / by P. Mcbride. Source: Wellcome Collection.

Provider: This material has been provided by University of Bristol Library. The original may be consulted at University of Bristol Library.

    41/238 (page 27)
    With the right hand the nozzle of the air-bag is inserted into its external extremity and air blown into it. In ascertaining whether the catheter is in proper position we are guided by the sensations of the patient and by auscultation; for if air be forced into the catheter when the point is in a patent Eustachian tube, the patient distinctly feels it enter the middle ear, and the surgeon hears it impinge upon the tympanic membrane with a full clear sound. The auscultatory phenomena may be modified as follows :— (1.) If the Eustachian tube be narrowed the air is heard to pass through it with difficulty, and to impinge but feebly on the tympanic membrane. (2.) If fluid be present either in the tube or tympanum, a bubbling or gurgling sound may be heard. (3.) If the tympanic membrane be perforated the air whistles through the perforation, or if the drumhead be in great part destroyed, blows right into the observer's ear. In attempting to pass the catheter one not un- frequently meets with patients whose inferior nasal passages are narrowed so as to refuse admission to even the smallest catheter. This state of matters may be congenital, traumatic, or caused by the presence of tumours {e.g. nasal polypi). Obstructions are not unfre- quently met with, especially in the left nostril, but as a rule turning the point of the instrument a little outwards enables it to glide past the obstacle. Occasionally the catheter has to be turned quite round before it can be got through the meatus. If one nostril be obstructed, the orifice of the Eustachian tube on that side may sometimes be entered by an instrument with an unusually large curve introduced through the opposite nostril, or by means of the doubly curved instrument invented by Dr. Noyes.