Diseases of the nose and throat, comprising affections of the trachea and oesophagus / by Sir St. Clair Thomson.
- Thomson, St. Clair, 1859-1943
- Date:
- 1912
Licence: In copyright
Credit: Diseases of the nose and throat, comprising affections of the trachea and oesophagus / by Sir St. Clair Thomson. Source: Wellcome Collection.
Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.
107/866 page 83
![CHAP. V] always recognized in good time, the subject deserves brief con- sideration. The nose is the natural and instinctive channel for carrying on respiration. The mouth is only used occasionally as a subsidiary route.* With rare exceptions all infants breathe entirely through the nose. If the nose of a sleeping child is gently closed he will continue to make increasingly violent efforts to draw tlirough it ; when these prove useless he will waken and gasp for breath, instead of simply opening and using the mouth as an air-way. Hence a baby with even partially obstructed nostrils is unable to suck the breast or the bottle, and after one or two draws is compelled to relax his hold in order to get a mouthful of air. When asleep, either because of this over- powering instinct (MacDonald and C. A. Parker), or because the tongue falls back and further obstructs the air-way (MacKeo^vn), or because vohtion is not at work to supplement the nasal with the buccal channel, a small child often persists in vain efforts to draw a sufficient supply of air through the nose. This results in snoring and noisy respiration, and indrawing of the sternum and lower ribs. Even when mouth- breathing is partially adopted to supplement the nasal air-way, the latter remains the route preferred by instinct, and as much air as possible is drawn tlirough it. Mouth-breathing is an acquired habit. Wlien it comes on in adults with fully developed frames, some of the results of nasal obstruction are not manifested. Nasal obstruction may be partial or complete, intermittent or constant. It may affect one side only, or it may vary from one side to the other. Sometimes it is unnoticed or denied by a patient, although, when observed, he is seen occasionally to draw a supplementary breath through the mouth, or the physical signs in the nose or throat may demonstrate his nasal insufficiency. The protective benefits of nasal respiration have already been referred to (p. 5), so that the symptoms and effects of nasal obstruc- tion can now be tabulated, and only a few of them will require further reference. Effects and Symptoms of Nasal Obstruction Direct effects on the nose: — Inactive alae nasi. Diminished ventilation of nose. Arrested development leading to narrow nasal passages. Arrested development leading to deviations of the septum. Arrested development leading to defective growth of the upper maxilla, with arching of the palate, V-shaped alveolar arch, and crowded teeth. Tendency to frequent and prolonged nasal catarrhs, and hypertrophic rhinitis. Postnasal catarrh, and increase of adenoid tissue. Catarrh of the Eustachian tubes, and acute or chronic otitis media. * Look to thy mouth, diseases enter there (George Herbert, The Church, stanza 22).](https://iiif.wellcomecollection.org/image/b23984478_0107.jp2/full/800%2C/0/default.jpg)
