File:A practical treatise on medical diagnosis for students and physicians (1904) (14755852004).jpg

Identifier: practicaltreatis1904muss (find matches)
Title: A practical treatise on medical diagnosis for students and physicians
Year: 1904 (1900s)
Authors: Musser, John Herr, 1856-1912 Pancoast, Henry
Subjects: Diagnosis Diagnosis, Radioscopic Diagnosis
Publisher: Philadelphia and New York : Lea
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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ated attempts, it is found tobe impossible to see the posterior nares, one must first seek to accustomthe patient to the presence of the instruments ; if this fails, it may benecessary to resort to the palate-hook or the cords to hold the uvula for-ward. The best hook is Whites. It is necessary to apply cocaine to thesoft palate before inserting the hook. Another plan, which is preferredby some, is to take the flat cords used for corset-laces, soak them in17 258 EXAMINATION OF THE NOSE AND THE LARYNX. mucilage and dry them. These are then stiff enough to pass through thenostril, yet flexible enough to pull down and out through the mouth withforceps. Then by drawing forward both ends the soft palate is pulled outof the way. Sometimes a view of the posterior nares may be obtained by makingthe patient breathe in short, quick gasps, by which the uvula is released.In ordinary breathing it is often tightly pressed against the posterior wallof the pharynx. Fig. 43. £;=l%^ t- ■>■ i^sx
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Rhinoscopic mirror in position, (Bosworth.) By the above methods the appearance and nutrition of the mucous mem-brane, relative size of the cavities, the nature of the discharge, and thepresence of ulceration or perforation of the septum are determined.Deviations of septum, enlargement or contraction of turbinated bones, thesize of the cavities, and the presence of foreign bodies or abnormal growthsare also detected. Appearance of the Mucous Membrane. The observer may find itunusually pale. This is seen in tuberculosis and in atrophic rhinitis. If aprotuberant mass is observed to be transparent and shining, as well aspale, it is a polypus. If the mucous membrane is bright red, it maybe due to acute inflammation, to glanders, or to syphilis. It is dull APPEAEAyCE OE THE MUCOUS MEMBRANE. 259 red in chronic catarrhs and cascou,^ rhi)iitis. The coatings of the mucousmembrane are of significance. If a dry mucus covers the part, there isdrt/ catarrh; on the other hand, a dirty-gray membrane

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