Diseases of the nose and its accessory cavities.

  • Watson, W. Spencer (William Spencer), 1836-1906.
Date:
1875
Catalogue details

Licence: Public Domain Mark

Credit: Diseases of the nose and its accessory cavities. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    adaptation of the parts, due to the great superficial swelling so often accompanying this affection. The relief to the pain and discomfort by an early opening of an abscess of the sac is very marked, and hence an early incision is always to be advised, provided the diagnosis is clear and there are no contra-indications of another kind. If the abscess is allowed to break, it often leaves a ragged opening on the cheek, which takes a long time to heal, and perhaps forms a permanent fistulous opening. (Cases LXIII and LXIY in Appendix.) As soon as the acute sym]3toms and swelling of the parts have subsided, means must be employed for restoring the per- viousness of the natural passages. The canaliculus must be laid open freely and kept patulous by passing a probe, and as soon as the extreme tenderness of the region of the sac has sub- sided, the lachrymal probe should be passed into the nose through the sac and nasal duct. A small probe only will pass in the first instance, and the passage must be dilated by gTadually increasing the size of the probe employed. It is generally found that as soon as the natural passage becomes pervious, the opening on the cheek gradually closes up, but in some cases a permanent fistula remains, which will have to be dealt with by subsequent treatment. Subsection 5. Laclirymal fistula is generally the result of a neglected or imperfectly-cured lachrymal abscess. If this be so, the first step in the treatment will be to ascertain the conditions of the sac as regards perviousness or the reverse. The constant overfiow of tears on the cheek, and the regurgitation of pus or mucus on making pressure over the sac, will be the best evidence of obstruction in the nasal duct, short of actual probing. The treatment then consists in the various proceedings already described in the treatment of mucocele. It is especially necessary to make use of the style in the treatment of fistula lachrymalis, and to continue its use until the fistulous opening has closed. It may be necessary to keep