Atlas and abstract of the diseases of the larynx / L. Grünwald ; edited by Charles P. Grayson.

  • Grünwald, L.
Date:
1898
Catalogue details

Licence: Public Domain Mark

Credit: Atlas and abstract of the diseases of the larynx / L. Grünwald ; edited by Charles P. Grayson. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    (2) DIRECT LARYNGOSCOPY. This method was introduced by Kirstein, and has the advantage that the larynx is viewed directly. A specially constructed, grooved compressor is used to press the tongue forward and exclude it from the field of vision, the patient holding his head as high and as far back as possible. When the method can be used at all, it has the advan- tage of showing more of the anterior surface of the pos- terior wall than is the case with the mirror. It is also free from the objection of having the image partly ob- scured by mucus and foreign material, a factor of some importance in the examination of children and uncon- scious patients; indeed, for the latter the method will probably always be indispensable. For the rest, its indi- cation and its application are still in the experimental stage. Whatever method of examination be used, reflected light is preferable to direct light, which is always more or less cut off by the head of the operator; we therefore use a reflector which is fastened either to the operator's fore- head or to a stand constructed for the purpose. Any strong light will do for the source ; the choice will therefore depend on the conveniences at hand. One dis- advantage which is common to all is the color; it is least in the electric arc light or in Aner's gas-burner.1 The latter was used for all the laryngeal images illustrated in this work. If it is especially desirable to obtain the nat- ural color in any particular case, or if, in general, sunlight is easily obtainable, it will be found to be decidedly the best light. In order, however, to minimize the changes incident to the different times of the day, and at the same time to diminish the glare, it will be best to let the sun- light fall first on a large reflector, after it has passed through the window, and from that by the ordinary re- flector into the larynx. 1 [The Welsbach light, the mantle being pure white, used in con- junction with a condensing lens, is certainly unexcelled, if not un- equalled, in its color and illuminating power, by any other artificial source of light.—Ed.]