Volume 1

A text-book of practical medicine : with particular reference to physiology and pathological anatomy / by Felix von Niemeyer ; translated from the eighth German edition, by special permission of the author, by George H. Humphreys and Charles E. Hackley.

Date:
1873
Catalogue details

Licence: Public Domain Mark

Credit: A text-book of practical medicine : with particular reference to physiology and pathological anatomy / by Felix von Niemeyer ; translated from the eighth German edition, by special permission of the author, by George H. Humphreys and Charles E. Hackley. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    34/760 (page 12)
    den), wliich we usually make use of, like those of Obersaltzbmimen, and Seltzer, mixed with warm milk, or whey; the sulphur springs, also, of the Pyrenees, above all the Eaux-bonnes, are, with good reason, in repute, in the treatment of chronic laryngitis. Our conjectures as to the modus operandi of these waters are as yet vague and untenable—a matterf however, far less to be regretted than the fact that we have no criterion whereby to predetermine the cases in which relief may be ex- pected, and those in which they do no good. In obstinate and inveterate cases of chronic laryngitis, local treat- ment deserves an extended trial. The attempt to blow medicated powders into the larynx is an ancient practice. For this purpose, a long quiU, or a glass tube, eight or ten inches in length, and several lines in diameter, is employed. A few grains of the powder to be inhaled is laid within one end, the other end is introduced as far as possible into the mouth of the patient, who is then to close lus lips, and to draw a deep inspiration, or else we may blow into the external end of the tube. If this procedure should excite violent inclination to cough, we may assume that a part of the medicament, at least, has reached its destination, although, no doubt, the greater part remains clinging to the velum-palati and pharynx. The medicines most frequently used in this practice by Trousseau are arg. nitrat. (gr. j—^ij to sacc. alb. 3 j—ij), calomel (gr. x—xx to sacc. 3 j—ij), alumen. ( 3 ss— to sacc. alb. 3 ij). At present, by aid of the laryngoscope, and of a ciu'ved tube, inserted as far as the entrance of the larynx, we can blow into it almost the whole of the powder. Another procedure, which acts with tolerable certaint}', consists in expressing the contents of a small sponge, made fast to the end of a little rod of whalebone, and saturated with solution of arg. nit. (gr. xx to 1 j) over the entrance of the larynx. The result of this mode of treat- ment is often both instantaneous and brilliant, and finds a striking analogue in the efficient use of solution of nitrate of silver in the treat- ment of catarrhal conjunctivitis. An adept in the use of the laryngoscope enjoys the great advantage of being able to assure himself by direct ocular observation of his suo- cess in passing the sponge behind the epiglottis. The most recent and genei’aUy-employed method of producing the direct action of medicaments upon the mucous membrane of the larynx consists in causing the patient to inhale them in solution reduced to the condition of a spray or mist. The apparatus hitherto employed for this purpose consequently bear the names of n6phogene, pulverization, [nebulizer], inhalations apparatus. Of these there are two kinds. In one, the slender stream of liquid to be inhaled is driven forcibly against a small convex disk, and thus reduced to the condition of spray, as in the