Manual of diseases of the ear : including those of the nose and throat in relation to the ear : for the use of students and practitioners of medicine / by Thomas Barr and J. Stoddart Barr.

  • Barr, Thomas, 1846-1916
Date:
1909
Catalogue details

Licence: In copyright

Credit: Manual of diseases of the ear : including those of the nose and throat in relation to the ear : for the use of students and practitioners of medicine / by Thomas Barr and J. Stoddart Barr. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    '•] Facial Aspect. The facial aspect may yield information, especially if there be post-nasal adenoids, when the open mouth, the compressed nostrils, and the dull expression are characteristic (Fig. 2). Facial paralysis, generally unilateral, is not infrequently observed, and is generally associated with purulent ear disease, especially in children. In persons who are very deaf, the keen watchful eye, while striving to read the face of the speaker, is often noticeable. II. EXAMINATION OF THE TYMPANUM THROUGH THE EXTERNAL MEATUS. In order to survey in all their detail the deep parts of the external meatus, the tympanic membrane and the interior of the tympanum, we require, first, to remove or turn aside any obstructions in the canal of the ear; second, to straighten the curve of the canal; and third, to reflect light into the interior. During examination the patient should be seated on a revolving arm-chair of simple design, constructed of some plain polished wood, and having a straight back to which an adjustable sliding head rest can be attached. Such a chair is equally well suited for nose and throat work. Removal of Obstructions in the Meatus. The view of the deep parts of the ear is very frequently obstructed by hairs, particles of Fig. 3.—Cotton holder. cerumen, epidermic scales, purulent secretion, etc. The aural speculum suffices to push aside the hairs. The cotton holder (Fig. 3) is the safest instrument to employ in removing other substances. It consists of a piece of iron or steel wire, both ends of which are wrought into the form of a fine screw, round which, before use, a piece of cotton wool is firmly wound into a cylindrical shape. Metallic instruments, such as forceps or a probe, may be required to remove scales or particles of cerumen. The cautious use of the probe (Fig. 4) often yields valuable information as to the presence of granulation tissue, polypi, or furunculi. Such instruments should only be used when the inside of the ear is properly illuminated, so that the eye may guide the hand. A permanent difficulty is presented by an un- usually prominent antero-inferior meatal wall, which in certain cases