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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    shortened image of the nasal fossre, with the turbinated bones, the septum, and the orifices of the Eustachian tubes. As a rule, a smaller mirror is used in rhinoscopy than in laryngoscopy, a No. 2 or 3 being the usual size. It should also be bent at a sharper angle with the shaft, the angle being about TOO0—110°. Obstacles to Rhinoscopy.—The main obstacle to the exami- nation is an irritable throat, as in laryngoscopy, with the only difference that it is less easily surmounted. For its management the same remark may be made as was made concerning the lar- yngeal examination ; the greatest patience must be exercised in teaching the patient to relax his throat, and allow of the in- troduction of the mirror without gagging. As a rule, this is only accomplished by the persistent, but patient, slow and gentle introduction of the spatula and mirror, carrying the Fig. 38 —Duplay's rhinoscope. operation to the point of tolerance, but arresting it always be- fore retching is excited. An obstinate tongue which arches itself up in the mouth, and cuts off the view, often accompanies an over-sensitive throat, and is overcome by a similar exercise of patience. Enlarged tonsils, if sufficient to interfere with an inspec- tion, should be removed. A narrow palato-pliaryngeal space is sometimes a trouble- some obstacle in rhinoscopy, as it affords but scant room for the examination. In order to overcome this difficulty, various hooks, dilators, and retractors have been devised. A simple rounded hook may be passed around the palate for drawing it forward, but it requires the use of one hand, and is also not usually well tolerated by the patient. Fig. 38 represents Duplay's rhinoscope, which is designed to overcome this diffi- culty somewhat. None of these devices, however, are of much service, as the palate is so sensitive that even when an exami-