A text-book of diseases of the nose and throat / by D. Braden Kyle ; with 175 illustrations, 23 of them in colors.

  • Kyle, D. Braden (David Braden), 1863-1916.
Date:
1900
Catalogue details

Licence: Public Domain Mark

Credit: A text-book of diseases of the nose and throat / by D. Braden Kyle ; with 175 illustrations, 23 of them in colors. 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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    nation and anterior rhinoscopy outline the parts fairly well. If the mirror be now turned somewhat to one side, there will be seen the eminence surrounding the Eustachian tube, which is separated from the posterior wall of the vault of the pharynx by the fossa of Rosenmtiller, the orifice of the tube showing as a grayish funnel- shaped depression. By elevating the handle of the rhinoscope, causing the mirror to incline nearer the horizontal, there is brought into view the half- dome-like cavity of the vault of the pharynx, which presents a rather irregular outline, its glandular tissue (pharyngeal tonsil) rendering its surface irregular and furrowed. This irregularity depends largely on the age of the patient. Usually in adult life the pharyngeal tonsil has atrophied, the irregularities then depend- ing on the amount of atrophy. In some cases very little atrophy lias taken place, while in others no evidence of the tonsil can be seen. In children the pharyngeal tonsil is always present, some- times rudimentary, and again enormously enlarged. This enlarge- ment may be mere swelling or actual tissue-proliferation. The color of the tissue seen by this view varies with the age of the patient, often in the young showing a deep-red color, while in the adult more of a pinkish-gray. The parts appear much smoother as the view passes down, until there is seen the smooth, shining, dark-red surface of the lower pharynx. With children it is often difficult to obtain a good view of the postnasal tissue, but an ap- proximate idea may be formed by introducing the index finger back of the soft palate and quickly sweeping it over the tissues. It must also be borne in mind, in examining the mucous mem- brane of the upper air-passages, that the long exposure of such a delicate membrane to the reflected rays of light, and the changes produced by the action of underlying muscles, alter the color of the membrane in a very short time. The first view obtained gives the true color, and therefore the examination should not be pro- longed. This is especially true of the pharyngeal and the laryn- geal membrane. Instruments Needed for Office Work.—A brief descrip- tion of the instruments necessary in treatment of the anterior and posterior nasal cavities may not be amiss here, leaving those required in special treatment to be described under the special conditions demanding them. In local treatment of the mucous membrane1 of the upper air- passages, the essential element is cleanliness, and for this purpose various forms of cotton applicators, douches, atomizers, etc., have been devised. To reach the diseased area with medicating fluids depends on our ability to cleanse the membrane thoroughly, and this can best be accomplished by reducing the cleansing fluid to a state of minute atomization or by tin- employment of the douche. Atomizer.—Many atomizers have been placed on the market