A manual of diseases of the throat and nose : including the pharynx, larynx, trachea, œsophagus, nose and naso-pharynx / by Morell Mackenzie.

Mackenzie, Morell, 1837-1892.

Date:: 1884

Credit: A manual of diseases of the throat and nose : including the pharynx, larynx, trachea, œsophagus, nose and naso-pharynx / by Morell Mackenzie. Source: Wellcome Collection.

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$uiillimetres, and so on tlu'oughoiit the scale. Xos. 1 and are not made, as they are too small to be of any use. The ivory-knohhed hongies are .sometimes useful when the oh- ^ strnction is of a spasmodic charac- ter, the spasm occasionallyyieMing' 4 to a knoh whilst resisting a cylin- drical body. The knob at the end 5 of the whalebone stem reseml)les an olive in .sha]>e, the small end 6 being directed downwards. The same whalebone n^d can be used for several knobs of various sizes, t as they are made to unscrew. These in.struments have not 8 hitherto been made according to any scale, and I very seldom iLse them on account of the risk 9 there always is <jf the ivory knob b(!coming .se]iarated from the .stem. Althmuth in the ordi- nary course the little juiint would pa.ss into the stomach and do no harm, there is some danger of its being vcmiiteil or hawked 11 upwards, and timling its way into the air-pas.sage.s. It is obvious that the danger is much increased 12 where there is a stricture of the gullet, as under such circum- stances the knob cannot ]>ass downward.s, ami it will most 18 likely be thrown violently u]>- wards by suilden spasm of the- muscular walls of the (csojihagus. When a gum-(da.stic bougie bas 14 to be passi-d it should be warmeil aiid then dipped into water or glycerine (not oil, as that is often very disagna-able to the patiiuit), l'> and then slightly Ixuit at about an inch from its extremity, so that when introdma.'d into the throat the point of t.lie. bougie lU’esses slightly l>y its own elasticity against tlie jiosterioi' wall Fic;. 2.—The Ar'i'iioii’.s Scale fok Qisoi’H.40E.\L Bougies.$