The laryngoscope : directions for its use, and practical illustrations of its value in the diagnosis and treatment of diseases of the throat and nose : two lectures delivered at the Royal College of Physicians / by George Johnson.
- Date:
- 1864
Licence: Public Domain Mark
Credit: The laryngoscope : directions for its use, and practical illustrations of its value in the diagnosis and treatment of diseases of the throat and nose : two lectures delivered at the Royal College of Physicians / by George Johnson. 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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![of the moutli; and they do this with a provoking pertinacity just as the mirror is being introduced be- tween the teeth. This position of the tongue offers a serious impediment to the introduction of the mirror, and the obstruction is greater in proportion to the size of the rebellious tongue. It is usually a result of ner- vousness on the part of the patient, and is sure to be made worse by any appearance of petulance in the operator. The better plan is to endeavour to reassure the patient. Sometimes the occupation of holding his own tongue between the thumb and finger has a good effect by diverting his attention, and occasionally, while he is holding the tip of his tongue, you may depress the dorsum with a spatula or with your forefinger. In some instances, after making one or two attempts, it is better to defer the examination to a future day. After two or three sittings, there is usually less ner- vousness, and the tongue comes moi'e under control. [Dr. Watson, after hearing this lecture, told me that in the case of patients who have this tendency to arch up the tongue, and so to prevent the examination of the fauces, he directs them to practise by sitting in front of a looking-glass with the mouth open. The inspection of the tongue, while they are endeavouring to acquire the power of controlling its movements, is found to be a great assistance.] Another impediment to the examination of the larynx results from unusual sensitiveness of the fauces, so that the touch of the mirror excites contraction of the pharynx and retching. This excessive sensibility is common when the fauces are in a state of inflam- matory congestion; so that, seeing the throat en- gorged and red, we may anticipate a difficulty in the](https://iiif.wellcomecollection.org/image/b21920321_0025.jp2/full/800%2C/0/default.jpg)
