Diseases of the throat : a guide to the diagnosis and treatment of affections of the pharynx, oesophagus, trachea, larynx, and nares / By J. Solis Cohen.

  • Cohen, J. Solis (Jacob Solis), 1838-1927.
Date:
1872
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the throat : a guide to the diagnosis and treatment of affections of the pharynx, oesophagus, trachea, larynx, and nares / By J. Solis Cohen. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    considerable importance. A laryngoscopic mirror sliould afford a perfect image. Its qnality may be tested by holding it over a piece of white paper. The reflection should be perfectly white; if it be bluish or yellowish, the laryngeal image will be sure to lose in distinctness in proportion to the departure from a pure white, and thus to vary somewhat from the normal color of the parts. Laryngoscopic mirrors have been constructed from steel which has then been highly polished, and from other metals with sur- faces of great lustre. These are very serviceable while new and unscratched, though presenting a violetish tinge to the reflec- tion of white paper; but they soon become tarnished by usage, and are kept in order with difticulty. They are applicable only to special cases in which but a very small mirror can be em- ployed, and when it is a matter of some moment to avoid the loss of reflecting surface which even the narrowest setting would sacrifice in the glass mirror. Such a case occurs when it is necessary to make an examination through an artificial opening in the trachea. Introduction of the Mirror.—The position of the mirror in the pharynx of the patient, its manner of introduction, and the character of the image which is seen upon it when in position, is depicted in Fig. 7. The mirror is represented as having been placed at an angle of about 45° with the plane of the larynx; but its position in practice will vary in different individuals, in consequence of peculiarities of conformation. Much, too, will depend upon the degree of flexion given to the patient's head, the position of the observer's eye, and other contingencies which will become aj3parent as we proceed in the discussion of the subject. The manner in which the laryngoscopic mirror is most conve- niently used is as follows:— The patient is seated in a chair in such position that a strong light shall illumine the pharynx, and especially the lower por- tion of the soft palate. This examination may be made in the open air, before a window, or in front of a lamp or other artificial light. The observer seats himself in front of his patient, at such distance as to obtain distinct and clear vision of the soft palate and the posterior wall of the pharynx. The head of the patient should be kept erect, or very