An American text-book of diseases of the eye, ear, nose and throat / edited by G.E. De Schweinitz and B. Alex. Randall.

Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: An American text-book of diseases of the eye, ear, nose and throat / edited by G.E. De Schweinitz and B. Alex. Randall. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    be aborted by holding an ice-bag behind and under the angle of the jaw. Acute laryngitis, even to the extent of inflammatory edema, may also be aborted or kept under by the ice-bag or by Leiter's coil (cold) around the front of the neck. The application of heat to the tonsils and throat, in the form of the poultice or coil, is often very grateful to the patient, and requires no comment. Powders.—The use of these agents in the nose is not physiological, be- cause of its function to get rid of foreign bodies by sneezing, hypersecretion, and the action of the ciliated epithelia. Hence, the general use of snuff's because they clear the head is calculated to entail congestion and hyper- nutrition, especially in the common form of catarrh of which patients com- plain, which is generally that of a slight hypertrophy or engorgement; they should be forbidden, since they tend to increase the evil. Bland antiseptic powders, however, can often be used to advantage after operations or in cases where there is superficial loss of substance in the nose, or even where only the cilia seem to be absent. Such substances as iodoform, dermatol, aristol, and their congeners, which have become so numerous of late, may be of value in these cases, either pure or diluted with starch or bismuth or even compound stearate of zinc. It must be borne in mind, however, that, as in the ear, an insoluble powder sometimes hinders the proliferation of the mucous mem- brane to cover a defect. In these cases, therefore, insoluble powders should not be used ; but they should be of such material that by the heat and moisture of the nose they will be melted into an oil or syrup. The use of powders in the larynx probably does not in most cases com- pensate for the discomfort which they cause; but the antiseptic powders and those having a specific action, such as iodoform and its congeners, are valuable in ulcerative conditions of this organ. The best powder-blower for the nose is one manufactured by the David- son Co., known as No. 192. Pigments.—The name of these substances is legion—and is continually being added to—-but the one substance which lias lasted through many periods of antagonism, and which is now probably the most universally used, especially in Germany, is the solution of nitrate of silver in various strengths ; this has a slightly astringent, strongly antiseptic, and somewhat stimulating action. It can be applied—except in the nose—to all the parts of the upper mucous membranes. It is best applied to the naso-pharynx and larynx in strength from 2 to 8 per cent. ; and may be used even to 12 per cent, in the larynx and on tiie tonsils. It is best, of course, to begin with mild solutions and work up. It is to be borne in mind that the nitrate of silver some- times produces ceruleanism ; and the writer has seen at least one case where a deep-brown pigmentation of the membranes and a dull coloration of the skin was attributed to the use of nitrate of silver in the throat; fortunately these cases are of extreme rarity. Where an astringent effect is sought for, as in pharyngitis, solutions of tannin, 60 grs. to the oz. of glycerin; of the subsulphate of iron, 40 grs. to the oz. of water; of sulphate of zinc, 10 to 30 grs. to the oz. of water (also used as a spray), may be mentioned among others as of considerable value. It is probable that the use of astringents in the nose, such as tannin or iron, even in their strong solutions, are productive of more discomfort to the patient than of benefit to his condition ; much better results may be obtained by the use of caustics. As stimulating pigments may be mentioned tincture of iodin from 10 to 50 per cent, in glycerin, which may be of value in various states of the