Digital examination and treatment of certain morbid conditions of the nasal chamber ; Age and sex in diseases of the upper respiratory tract / by Harrison Allen.

  • Allen, Harrison, 1841-1897.
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: Digital examination and treatment of certain morbid conditions of the nasal chamber ; Age and sex in diseases of the upper respiratory tract / by Harrison Allen. 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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    diagnosis of inflammation of the frontal sinus was made. The parts were leeched (two drachms of blood being drawn) and hot fomenta- tions applied to the skin on the brow. The symptoms subsided in a few days and the patient made a satisfactory recovery. The condition of the parts within a week after the operation was very satisfactorjy much more so than I had anticipated ; the dis- charge diminished ; the degree of comfort increased. A feeling of congestion about the head had persisted for so many years that he had accepted it as a condition scarcely worth mentioning, but now the relief was gladly acknowledged. In a very short time after the operation the patient returned to his home in Minneapolis, and was not seen until April 9, 1885, when he returned for a second treat- ment. He complained now only of a discharge which passed into his throat. This, while moderate in quantity, was muco-purulent. Since the date of the treatment in September, I had concluded that some forms of catarrh are due to the pressure of the middle tur- binated bone against the septum, and I sugge.sted that he be ether- ized, and this probability made the subject of special inquiry. On April 12 I etherized the patient, and passing the fifth finger in the right nasal chamber determined that the middle turbinated bone was, indeed, not only resting against the septum, but was in union there- with. Owing to the extreme hardness of the parts no attempt was made to separate them. In other respects the condition of the parts in the nose was much improved from the time of operation. Even after this manipulation which I had concluded led to no practical conclusion, the amount of discharge diminished, a fact which might be explained by the moderate amount of depletion of the blood-vessels of the mucous membrane. The patient soon after- ward returned to his home. I have .since heard from him on several occasions. The discharge is almost entirely cured and the general health greatly improved. Remarks.—This case illustrates the amount of relief which may be secured under conditions somewhat unfavorable. The age of the patient, the chronic character of the disease, the inability to reach all the affected structures, lead me to give a guarded opinion of the results of treatment. Nevertheless the amount of good accomplished was decided. The attack of acute inflammation of the frontal sinus was the only one of the kind which I have seen. It proved to be of short duration and did not interfere with prompt recovery. Ca.se XII.—M. H. C., aged ten years, reported July 17, 1887. As a sequel of pneumonia at the eighth year a chronic catarrh was established. The fetor was extreme, and the discharge was of a crust-like character. The nasal chamber would become filled with this material and at irregular intervals be forcibly dislodged with pain and bleeding. The general condition of the child was excellent. The father was a physician of prominence in a neighboring city, and had exhausted all the usual means resorted to for the relief of nasal catarrh before reporting. I immediately proposed that the child be examined under ether. This was done July 19. I found the anterior portion of the left middle turbinal enormou.sly enlarged, feeling to the sense of touch as though fully one-half inch wide. The bone was exceedingly hard and covered with a number of horn-like spicules.