Practitioner's handbook of diseases of the ear and naso-pharynx / by H. Macnaughton-Jones.

  • Macnaughton-Jones, Henry, 1844-1918.
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Practitioner's handbook of diseases of the ear and naso-pharynx / by H. Macnaughton-Jones. Source: Wellcome Collection.

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

    77/204 (page 61)
    properly made, for auto-inflation and also for the surgeon's use. To add iodine vapour we must place in the Kerr's inhaler some vapor iodi; in like manner both oil of turpentine and chloroform may be used, or these may be con- veyed on the chloride of ammonia vapour. This bag is well made by Messrs Maw, Son, & Thompson. There is a small chloride of ammonium inhaler ( the Amuriagen), which is of a very convenient size and port- able. The aural bag can be filled from it, and several other va- pours may be inflated. Messrs Allen Hanbury have rather improved the bag by substi- tuting conical FiS. 54.-S, Sponge; A, pumice ;„„x J f 11 (instead of asbestos origin-'^'^^'^^ ally used). (Messrs Allen Han- valves. Perhaps i*^-^ the best chlor- ide of ammonium inhaler for the sur- geon's study is that of Messrs Burroughs and Welcome, as it furnishes a continuous supply of the vapour, and is always ready for use. It is better that the surgeon for a few occasions should freely Politzerise a patient. He will often be surprised at the marvellous improvement in the hear- ing, and the decrease in the intensity of the tinnitus, which follow from this simple step. He should remember the position and direction of the Eustachian orifice. The nozzle of the ordinary bag when inserted in the nostril (and for very forcible inflation I prefer the rubber tubing which can pass about an inch along the floor of the nostril) should be directed horizontally ; the patient is placed sitting; the act of compression should occur just as the hyoid bone is rising in preparation for the second act of deglutition. The patient can most effectually sustain the good eff'ect by using my bag at home. This he can do once daily at first, and at less fre- quent intervals subsequently. He will find that much of the magic of the aurist's art rests in this simple but successful trick of inflation, the sugges- tion of which we owe to Politzer. Fig. 55.—Keeue's Inflating Bag. EUSTACHIAN CATHETER. It is essential that all who would treat aural cases successfully should become dexterous in the use of the catheter. Catheterisation is essential in therapeutical application to the middle ear, in overcoming Eustachian obstruc- tion to inflation. In the diagnosis and prognosis of middle ear affections, stu- dents should not neglect to learn the method of using the instrument any more than they do that of the urethral one. Awkwardness is as hurtful, and gentleness combined with delicacy of touch as indispensable, in the urethral operation as in that on the Eustachian tube. Indeed, so far as the passage of the instrument is concerned, I believe more injury and pain are likely to be inflicted on the delicate and sensitive urethra than on the nose and naso- pharynx. On one occasion, and that comparatively recently, the beak of a small catheter caught in the cartila- ginous portion of the Eustachian tube, and I had some difficulty in removing it. I frightened my patient, rather a fidgety one, away. After a use, almost daily, of the Eustachian catheter for seventeen