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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    The requisites are an amperemeter and rheostat to measure the strength of the current and to introduce and remove it without causing pain. Ten to fifteen cells suffice for its generation. It is applied with the double needle, stabbing deeply after the parts have been well cocainized. It is best to screw the needle directly to the conducting wires. The treatment is used to remove secondary epithelial hyperplasias (warts, pachydermia\ and especially in small tuberculous infiltrations; sometimes also to melt out the base of a previously extirpated ulcer. Galvanocautery is still more heroic. The sharp-pointed stabbing cautery is a powerful tissue-destroyer. It is therefore properly used in nodular tuberculosis and in dee]) ulcers. As the reaction is more severe than in elec- trolysis, great care must be exercised in its application ; only the diseased parts must be touched, and one must be especially careful to avoid burning the surface. The loop may be successfully used to remove pedunculated, hard tumors or such as threaten hemorrhage. Sharp instruments arc used to separate or excise diseased parts. Operating-knives, either sharp-pointed or blunt, with a cutting-edge, are employed to make incisions in edematous or purulent swellings and to remove flat ulcers. Curets, single and double, Heryng's or Krause's, are used to remove diseased parts from healthy tissue, espe- cially in tuberculosis, and to expose deeper infiltrations so that they may be cast off more easily. If curettage is resorted to at all, it must be done thor- oughly, down to the healthy tissue ; it is, therefore, indi- cated only when there is reasonable hope of success. Furthermore, the operation should be exhaustive, and completed at one sitting, not split up into innumerable little pickings. Many failures are attributable to such senseless and ineffectual methods. The use of the numerous instruments devised for ex- tirpating tumors (loops, tonsillotomes, forceps, annular knives, etc.) can only be learnt by practice.