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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    at inten^als of twice a week. The anterior ends of the middle tur- binals on each side were cauterized with a saturated solution of the nitrate of silver, or light applications were made with the galvano- cauter>\ Dobell’s solution and afterward a weak solution of carbolic acid were used in the form of sprays. The general health was excellent, and nothing appeared to be demanded in the way of general treatment. By November 24 he was compelled to report for duty at a Western post, scarcely, if at all, improved. When he could reasonably ask for a second leave of absence, the patient proposed to undergo a second treatment. On March 15, 1881, he committed suicide by shooting himself through the roof of the mouth with a pistol of the army pattern, having a ball of the calibre forty-five. It had been noted by the medical officers on duty at the post that the ofl&cer had been for some time before his death extremely melan- cholic. It, of course, remained entirely unknown what cause led to the suicidal act; but I could.not help making the reflection that the persistence of the distressing mental condition for which he had reported had in time unbalanced his judgment and developed a suicidal mania, the violent and sudden outbursts of which are well known. This case made a strong impression upon my mind. A valuable life had been sacrificed. If so gross a condition as a mass of dead bone in a child’s case had escaped my notice, wh5^ was it not possible in this patient’s also, for me to have failed to detect the existence of an essential morbid state. In cases of obstinate catarrh, where the symptoms were of a grave type, why could it not be profitable to explore the parts carefully ? I determined to act upon this impres- sion, and proposed to those patients who were at that time under my care, suffering from inveterate forms of nasal catarrh, that they per- mit me to etherize them and to determine by digital examination, as far as might be possible, the state of the nasal chambers. The following rules may be here given for conducting the exam- ination and divulsion : Carefully cleanse and disinfect the hands. Apply cosmoline or terraline to the little finger of the left hand. In- sert the finger in the nostril. The triangular cartilage will yield slightly. The parts touched convey different impressions since the variation in the component parts of the chamber is great. As a rule, the inferior turbinal can be defined at its side and the middle turbinal at its anterior portion. The parts which are be3»^ond reach of the finger are those which lie between its tip and the choana and are embraced within the region of the palatal bone. Of course, all structures of the normal,chambers which lie above the level of the middle turbinal are inaccessible. Should the anterior end of the middle turbinated bone be found covered with thick and softened tissue, which is readily pressed away, the posterior end of the semi- attached piece may lie beyond the finger-tip. The pedicle to the pendant mass may be readily removed by treating the whole as though it were a polypus. In this way, as recorded in the above summary, began a practice, which has since become a frequent one with me, of making digital examinations of the nasal passages in all obscure forms of nasal disease.