A manual of diseases of the throat and nose / by Francke Huntington Bosworth.

  • Bosworth, F. H. (Francke Huntington), 1843-1925.
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: A manual of diseases of the throat and nose / by Francke Huntington Bosworth. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    The anterior examination reveals the condition of the mu- cous membrane of the nose, as far as seen, as to the character and degree of inflammation existing ; the amount and charac- ter of its secretion ; the existence of ulceration and necrosis ; the degree to which the passage is pervious ; the position of the septum as regards its deviation from the median line ; and fin- ally, the existence of any neoplasm in the cavity, by far the most frequent of these being mucous polypi. It is especially urged in this connection, that, whenever it is possible, sunlight should be used in preference to the artifi- cial light. By this means it will often be feasible to explore the whole nasal cavity from in front, and even bring into view the wall of the pharynx. The examination posteriorly is made by so'placing the small laryngeal mirror in the back part of the fauces that it will give a reflected view of the parts above and out of the line of direct vision. , The patient should be placed in the same position as that required for examination of the larynx, and the light thrown into the open mouth in such a manner that the rays are brought to a focus at or near the wall of the pha- rynx. The next step is so to depress the tongue that ample space will be afforded between its base and the free border of the soft palate for the passage of the mirror without its touching the parts. For depressing the tongue the same remarks apply as were made in reference to the examination of the pharynx. In order to obtain a successful observation it is absolutely ne- cessary that the throat should be completely relaxed, and es- pecially that the palate should be entirely at rest and hang free from the pharynx, as it is through the opening between these parts that the view is obtained. If the mirror on its in- troduction touches the uvula, soft palate, or the root of the tongue, it is extremely liable to cause so much irritation, for these parts are very sensitive in most patients, that contrac- tion of the faucial muscles will occur, and the palatopharyn- geal opening be completely closed, and of course the examina- tion prevented. Having then the tongue thoroughly depressed, while at the same time the faucial muscles are completely relaxed, it will be seen that there is a wide space afforded behind the soft palate and uvula for the introduction of the mirror. It may be here