Lectures on nasal obstruction / by A. Marmaduke Sheild.

Date:
1900
Catalogue details

Licence: In copyright

Credit: Lectures on nasal obstruction / by A. Marmaduke Sheild. 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.

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    membrane with the growths, unless it be for “show” in the basin afterwards. To use the forceps properly, the bits of growth should correspond in size to the ring of the forceps, and be definitely cut off. Violent tearing with forceps has led to all sorts of disasters : the Eustachian tube has been damaged, and large blood vessels have been injured, leading to alarming and •even fatal haemorrhage. Large abnormal vessels are sometimes found in the walls of the pharynx, and the internal carotid itself, before entering the temporal bone, may give curious bends and twists which may bring it into close proximity with the pharyngeal walls. I mention this not to engender undue nervousness, but only to inculcate caution and avoidance of violence. The haemorrhage from bad cases of adenoids may be very profuse, especially in vascular and plethoric individuals. You must expect it, and not be surpri.sed or alarmed. It ceases spontaneously. All instruments used must be boiled and placed in carbolic solution, and you cannot be too careful that }’Our forefinger has not been immersed in septic fluids just before the •operations.^ It may not be generally known that it is easy to dislocate the jaw of a young person with a powerful Ferguson’s gag, and, if this be not recognised at the time, a very awkward and serious after-complication may arise. I have experienced this accident on two occasions. It was recognised, and the bone promptly replaced before sensibility returned. Trcatuiciii of Cases ivhere other Local Conditions are associated ivith Adenoids. I have told you that before operating for adenoids you must be very careful to estimate any other conditions which may be E'\rter having operated upon gangrenous appendicitis, for instance, I i]ia\e postponed an operation for adenoids, finding it impossible to rid my finger of the unpleasant and characteristic odour which may hang about the skin of the hands for some hours after this proceeding.
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