A guide to the examination of the nose : with remarks on the diagnosis of diseases of the nasal cavities / by E. Cresswell Baber.

Date:
1886
Catalogue details

Licence: Public Domain Mark

Credit: A guide to the examination of the nose : with remarks on the diagnosis of diseases of the nasal cavities / by E. Cresswell Baber. 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.

    145/200 page 129
    ch.vp. vi.] METHOD- OF PEEFOIxMAA CE. the impression of soft cushions. In this case they may be easily mistaken for polypi; which error may, how- ever, be avoided by a comparison of the sensation ex- perienced on the two sides. The situation of the Eustachian cushion and orifice, and the salpingo- pharyngeal fold can also be felt on either side and behind these, of course, Rosenmiiller’s fossae. The roof and posterior wall of the naso-pharynx should be care- fully examined, as it is in these 'situations that adenoid vegetations usually have their seat. Normally, owing to the presence of the pharyngeal tonsil, these parts have an uneven iri’egular surface, but when adenoid vegetations are present they are studded with more or less pedunculated growths of all sizes and shapes, which in well-marked cases completely fill the naso- pharynx giving to the finger the sensation of a bunch of worms. They are sometimes pressed together form- ing a soft cushion-like mass. The posterior margin of the septum instead of being nearly vertical, as shown in fig. 1, p. 4, often assumes an oblique direction, the upper part extending further backwards than the lower (see above, p. 22). This condition is soon recognised after a little practice. If the naso-pharynx be occupied by any other tumour, its shape and point of origin must be ascertained by coasting round it with the point of the finger. When palpation is practised merely as a means of diagnosis the observer's finger-nail should be short. But if used at the same time for treating adenoid vegetations by scraping, it is convenient to have it about an eighth of an inch in length. In either case it should be well-rounded. Some authors recommend the insertion first of one fore-finger, and then of the other K
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