Throat ailments : more especially the enlarged tonsil and elongated uvula in connexion with defects of voice, speech, hearing, deglutition, respiration, cough, nasal obstruction, and the imperfect development of health, strength, and growth, in young persons / by James Yearsley.

  • Yearsley, James, 1805-1869.
Date:
1867
    EXPLANATION OF THE PLATES. PLATE I. Fir/. 1. Natural appearance of the Soft Palate, Uvula, Anterior and Posterior Arches. Fiq. 2. Uvula elongated in the case of a gentleman, which for many years had produced cough, supposed and treated as of pulmonary origin. Fig. 3. Tonsils enlarged, filling up the sides of the Pharynx, and materially diminishing the area of the Fauces. The voice, speech, hearing, deglutition, and respiration are all usually more or less affected in such a case. Although the tongue is depressed, the extent of the enlargements is but imper- fectly shown. PLATE II. Section of the Nose, Mouth, Soft Palate, Uvula, Tonsil, Pharynx, upper part of the (Esophagus and Trachea, showing the route taken by the Eustachian Tube Catheter along the inferior meatus and floor of the nostril into the orifice of the Eustachian Tube ; showing, also, the perfect facility and safety with which the most timid patient may introduce the Naso-guttural Probe to the back of the Throat, or wash the throat by the Naso-guttural Tube and Bottle. PLATE III. Sketch of the Author's Elastic Naso-guttural Probe for the re- moval of obstructions of the nasal passages, and the Elastic Naso- guttural Tube and P>ottle, fir washing and gargling the posterior
    nares and nasal passages generally, the upper portions of the throat, and mouths of the Eustachian Tubes. Fig. 1. Patient introducing the Naso-guttural Probe; showing, also, the horizontal direction which it takes to the back of the throat. Fig. 2. Patient injecting the Throat through the Nose, by means of the Naso-guttural Tube and Bottle. Fig. 3. Elastic Naso-guttural Probe.
    INTRODUCTION". Twenty-five years ago, my views on the subject of en- larged, that is to say, diseased tonsils were first submitted to the profession. It appeared to me that up to that date sufficient attention bad never been directed to the subject of morbid conditions of tbe throat in connexion with the health and strength, and consequently, the growth and de- velopment of young persons, nor had it been shown how dependent the harmony of various functions is on a healthy state of the throat. The chief points insisted on in my book on the subject, were :— 1. The extreme prevalence of tonsillary enlargements, and other morbid conditions of the throat, in this country. 2. The variety of effects these morbid conditions pro- duce, and the important functions they embarrass or seriously injure. 3. The different positions taken up in the throat by enlarged tonsils and the regular dependence of certain forms of disorder in relation thereto. 4. The facility, safety, and almost painlessness with which morbid growths may be removed from the tonsils—• B
    a subject upon which much doubt and difference of opinion had previously prevailed. My experience in the treatment of several thousand cases of Diseases of the Throat, extending over a period of five-and-twenty years, justifies me in saying, that in the whole range of surgery, no operation is so uniformly suc- cessful in its result as that for the removal of enlarged tonsils, or rather, strictly speaking, the removal of morbid growths from the tonsils, for the tonsils themselves, as has been erroneously supposed, are never removed; or, at least, there is always sufficient of the gland left, to perform the function for which it was originally destined, namely, the secretion of mucus to lubricate the food in its passage to the stomach. Among the most marked effects of enlarged tonsils may be noted the derangement of health and the arrest of the growth of young persons. I have observed the fact in numerous instances, and it is probably to be accounted for: 1. By the enlargements exerting more or less pressure on the carotid artery, thus, imposing an obstacle to the ready flow of blood to the brain by which the nervous energy of the body is dimim'shed, and corporeal deve- lopment is retarded. Any impediment to the due trans- mission of blood to the brain must exercise a prejudicial effect upon the nervous system. 2. By the food in its passage to the stomach becoming imbued with the foul secretions poured out from these diseased glands; for, if the food does not reach the stomach in a state of purity, that viscus becomes disor- dered, and the general health suffers. From the lacunae of enlarged tonsils issue foul secretions, which taint the food in its passage down the throat to the stomach ; the
    body therefore must be deprived of its due supply of pure and wholesome nourishment. 3. By the air which the patient breathes becoming" tainted on its passage to the lungs, and thus pro- ducing an effect identical with that of living in an impure atmosphere. The air which the sufferer from enlarged tonsils takes into the lungs in the act of breathing, is vitiated by having to pass over a diseased condition of the throat; consequently it is tantamount to the patient living in an unwholesome atmosphere, or an unhealthy and unsuitable climate. It has frequently happened that a parent has brought a child to me with enlarged tonsils; and, on my asking if any other child was similarly affected, the answer has been " Oh, no ; my next child (it may be one, two, three or even four years younger) is a fine healthy child, taller and stouter than this one, which is always delicate." In illustration of these effects I will quote a case. A medical gentleman, in large practice at Pinilico, consulted me on behalf of his child. She was one of several children, and had suffered the usual ailments resulting from the presence of enlarged tonsils, but her dwarfish appear- ance particularly arrested my attention. The father listened to my observations on this, as being among the prejudicial effects of the condition of her throat, incredulously ; but I begged him to note the result of their removal on her growth. As it was a girl, and apparently a favourite child, my pre- diction was looked forward to with no little anxiety and interest, for it was a question of permanent dwarfishness or the arrival at ordinary stature. She was fourteen years of age; but her sisters, aged twelve and even ten, had both outstripped her in height. The operation was, as is inva- riably the case, followed by effectual relief, and I saw no b 2