The diagnosis and treatment of chronic nasal catarrh : three clinical lectures delivered at the College of Physicians and Surgeons, New York / by George Morewood Lefferts.

  • Lefferts, George Morewood, 1846-1920.
Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: The diagnosis and treatment of chronic nasal catarrh : three clinical lectures delivered at the College of Physicians and Surgeons, New York / by George Morewood Lefferts. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    the why and wherefore of their application — the general practitioner may overcome such difficulties as stand in the way of their successful employment, and this with the simplest aids in the way of apparatus.* If he will do this—and I hope to show you how he can most easily-I accomplish it —I assure him that the results which will be afforded,! their importance and interest, and his satisfaction at having mastered the use of an invaluable diagnostic means and therapeutic aid, which to-day are beginning to be considered a very necessary part of medical £ practice, will most richly repay him for the time and labor which he has expended. Certain instruments are essential for the practice of rhinoscopy,! but they are few, simple, and not necessarily of great cost. They are:l i, a good artificial illumination; 2, a concave forehead reflector, and,£ in addition, for anterior rhinoscopy; 3, a nasal speculum, and for pos-1 terior rhinoscopy; 4, tongue spatula; and, 5, a rhinoscopic mirror. 1 For ordinary purposes there is no better nor more convenient light than S that which is furnished by the argand gas burner, mounted upon a drop® light, which permits of the flame being lowered or elevated at will.9 Such a light is certainly easily procurable, and at a slight cost, if gas is M obtainable; if not, as in the country, then the ordinary student lamp, which burns petroleum or oil, forms a very efficient substitute. TcS either of these lamps it is no difficult matter to attach a single piano 2 convex lens two and one-half inches in diameter, which fits into the^ metallic chimney or tube known as Mackenzie’s, if you deem it desirrB able to intensify their illuminating powrers. Such an apparatus is shown in both of the accompanying illustrations (figs. 1 and 7). Our next essential is the forehead mirror or reflector (fig. 2). ThisSj is a slightly concave mirror, either three and one-half or four inches in diameter, with a focal distance of about twelve inches. The glass may ; be perforated at its center, or simply left unsilvered at that point, both , plans having their advocates; the latter, I think, you will find most sat- isfactory, and the only objection that I have ever heard urged against it — the liability of a coating of dust gathering upon the uncovered por- tion and obscuring the view through it—is one that is certainly very ; easily obviated. How this mirror shall be worn, and how it shall be attached to the operator’s head, are also points upon which there is some difference of opinion. Bruns, for instance, says that it should ■,