Complete Text (Part 27)

pyaemia or tetanus. Where the bleeding surface can be seen the application of chromic acid or the galvano-cautery has been found useful. DEVIATIONS OF THE SEPTUM. Give the etiology. Many suppositions have been advanced as to the cause of deviations of the septum. Besides traumatism, sleeping on a certain side and cleansing the nose with the same hand have been assigned as probable causes. The hypothesis most generally accepted is that a deviated sep- tum is the result of overgrowth ; i. e. if the septum grows faster than the remaining portions of the skull, it is wedged in between the crista nasalis, the vomer, and lamina perpendicularis. and therefore is deviated to the side. That deviations are congenital in their nature is not be- lieved, as the septum is usually straight until after the seventh year of life. What are the symptoms? If the deviation be of moderate extent, there may be no signs, except perhaps a slight deviation of the tip of the nose from the middle line. Where the deviation is considerable the whole nose may be deflected to one side. By examination with the rhinoscope the slightest deviation EXOSTOSES. 221 can of course be detected. Where the deviation is marked, all the signs of obstruction to nasal breathing are present, such as changed voice, impaired taste, smell, and hearing, with headache. What is the diagnosis? The diagnosis is easy. By aid of the rhinoscope the deviation can be easily seen, presenting on one side a convexity, on the other a concavity. Give the treatment of deviations of the septum. When the deviation is slight Michels has recommended pressure on the convex portion of the deviation with the finger 50 to 100 times daily. Adams recommends fracturing the septum, and supporting it in position by means of intranasal splints or bougies. Partial resection of the sep- tum has been recommended by Hartman and Petersen. In this operation the patient is placed under narcosis, an incision made in the mucous membrane, and the same pushed aside. The portion projecting is then resected by bone scissors, and the mucous membrane pushed back over the opening. A rubber tube is then introduced for the purpose of re- taining the septum in place. Many operations have been devised and recommended. NASAL EXOSTOSES. What are exostoses? Exostoses are bony growths which project usually from the septum. If large, they can give rise to troublesome symptoms, such as pain, due Fig. 85. Electro-motor. 222 THE NOSE. Fig. 86. Dental Engine. EXOSTOSES. 223 Fig. 87. Burrs for Dental Engine. Fig. 89. Drills for Dental Engine. Burr with Shield. 224 THE NOSE. to pressure, and which shows itself in the course of the fifth pair of nerves. If the exostoses are small, they seldom cause any inconveni- ence. On rhinoscopic examination their presence is easily made out, and by means of the probe their hardness detected. When they cause in- convenience, they are best removed. This can be effected by means of the saw or the electro-motor dental engine. (See Figs. 85, 86, 87, 88, and 89.) HEMATOMA OF THE SEPTUM. Describe hsematoma of the septum. Hsematoma of the septum is usually the result of injury, and consists in an extravasation of blood between the mucous membrane and the frame- work of the septum. When small it generally disappears of itself; when large it should be aspirated. Describe abscess of the septum. Abscess of the septum may be the result of hematoma or trauma- tism. It may occur as a result of syphilis preceding perforation. An early incision should be made and the pus evacuated. ANOSMIA AND PAROSMIA. What is anosmia. Anosmia is the loss of the sense of smell, and may be present as a symptom of various affections of the nose. Lesions of the olfactory bulb, tract, and of other portions of the brain may cause anosmia. The use of tobacco, snuff, and inhalations of tobacco-smoke may give rise to it. The treatment consists in the administration of tonics, such as strych- nine, arsenic, etc. Electricity should be used, the negative pole being- placed at the root of the nose and the positive at the occiput, Sajous recommends the insufflation of ^V gr. strjTchnin< thoroughly triturated with 2 grains of sugar. What is parosmia? Parosmia is a perverted sensation of smell, and is associated with lead- poisoning, locomotor ataxia, and epilepsy. INDEX. A. Abscess of brain, 156 Accommodation, 103, 104 Acuteness of vision, 102 Adenoid vegetations, 171, 172 Amaurosis, 83 Amblyopia, 83 Ametropia, 104 Ankyloblepharon, 26 Anosmia, 224 Astigmatism, 108 diagnosis, 109 treatment, 109 varieties, 108 Auricle, diseases and affections, 137, 138 eczema, 137 hsematoma, 137 new growths, 137 B. Blepharitis, 18 Blepharospasm, 23 C. Cataract, flap extraction, 91 Graefe's linear extraction, 92 needle operation, 91 operative treatment, 90-92 secondary, 95 simple extraction, 92 varieties, 88-90 Catheterization, Eustachian tube, 134 Cerumen, impacted, 138 Chalazion, 20 Choroid, 61 appearance, 66 coloboma, 70 inflammation, 67 15 Choroid, rupture, 69 -tubercle, 69 tumors, 70, 71 Choroiditis, varieties, 67, 68 Ciliary body, 60 Color-blindness, 81 Conjunctiva, 33 amyloid degeneration, 42 gonorrhoea, 35 hemorrhage, 43 tuberculosis, 43 Conjunctivitis, 33 varieties, 33-40 Cornea, 44 burns, 54 conical, 53 deposits, 52 diseases, 44-54 examination, 44, 45 foreign bodies, 54 leucoma, 51 staphyloma, 51 tattooing, 52 tumors, 53 ulcer, 49 wounds, 53 Cyclitis, 65 r>. Dacryo-adenitis, 28 Deafness, 149 Diplacusis, 157 Distichiasis, 24 Distinct vision, 102 Double images, 114 E. Ear, anatomy, 121 Ectropion, 25 Emmetropia, 105 -131 225 226 INDEX. Entropion, 24 Epicantbus, 26 Epiphora, 30 Episcleritis, 56 Epistaxis, 219 Examination, hearing, 132 external auditory canal, 133 middle ear, introduction of air, 134 tuning-fork, 132 voice, 132 watch; 132 Exophthalmic goitre, 122 External auditory canal, 138 examination, 133 foreign bodies, 138 inflammations, 139, 140 ostoses, 141 other affections, 141 Eye as an optical instrument, 102-110 F. Fixation, field of, 83 G. Glaucoma, 85 varieties, 85, 86 treatment, 87 operative, 87 H. Hemianopsia, 82, 83 Hemorrhage of the ear, Heterophoria, 116 varieties, 119 Hordeolum, 19 Hypermetropia, 107 Hypopyon keratitis, 50 I. Internal ear, 156 diseases of, 156, 157 Iridectomy, 51, 87 Iris, anatomy, 59 inflammations, 62-64 Iritis, varieties, 62-64 K. Keratitis, varieties, 45-50 156 Lachrymal apparatus, 26, 27 canals, diseases, 30 slitting, 31 gland, diseases, 28, 29 sac, anatomy, 28 diseases, 30-32 Laryngitis, varieties, 178-186 Laryngoscopy, 177, 178 Larynx, acute oedema, 181 anatomy, 173-177 diseases, differential diagnosis, 192, 193 foreign bodies, 191 inflammations, 178-186 neuroses, 187 paralysis, 187 varieties, 187, 188 syphilis, 186 tuberculosis, 184 tumors, 189 benign, 189 malignant, 190 Lens, 87, 88 dislocation, 95 Lenses, 98 classification, 101 curvature, 99 dioptric surface, 102 foci, 99, 100 images, 100 trial-glasses, 101 varieties, 99 Lids, anatomy, 17, 18 diseases., 18-26 M. Mastoid inflammation, 152, 153 diagnosis, 153 operation for, 154 Megalopsia, 83 Meniere's disease, 157 Metamorphopsia, 83 Micropsia, 83 Middle ear, 141 caries, 150 inflammations, 142 varieties, 142, 143, 146-149 necrosis, 151 polypi, 151 treatment, 151, 152 Muscular apparatus, eye, 113-120 INDEX. 227 Myopia, 105 varieties, 105, 106 N. Nasal catarrh, purulent, 204 fossse, 196-198 Near-point, 103 Nose, anatomy, 195 foreign bodies, 218 inflammations, 202-212 lupus, 215 polypi, 215-217 scrofula, 214 syphilis, 212 tuberculosis, 214 tumors, 215 benign, 215-218 malignant, 218 o. Ocular muscles, 113 action, 114 (Edenia of the larynx, 181 Onyx, 50 Ophthalmia, purulent, 35 sympathetic, 83 symptoms, 84 treatment, 84 Ophthalmometer, 112 Ophthalmoplegia, 121 Ophthalmoscope, 110 employment of, 110, 111 Optic nerve, 76 diseases, 76 atrophy, 78 hemorrhage, 78 neuritis, 76-78 principles, 96-102 Optical axis, 102 Orbit, contents, 121 cellulitis, 121 diseases, 121, 122 tumors, 122 Otitic meningitis, 155 Otitis media, varieties, 142-149 Palate, anatomy, 159,-160 Parosmia, 224 Perforation, membrana tvmpani, lAl 149 Pharyngeal tonsil, hypertrophv, 171, 172 Pharyngitis, varieties, 160-163 Pharynx, anatomy, 159 foreign bodies, 168 function, 159 inflammations, 160-163 neuroses, 167 varieties, 167 syphilis, 164 tuberculosis, 165, 166 tumors, 168 Pinguicula, 42 Prism, 98 Pterygium, 41 Ptosis, 23 Punctum, displacement, 30 Pupil, movements, 60 R. Refraction, 96, 97 Remedies and Formulae, eye, 123-126 anaesthetics, 125 antiseptics, 123 astringents, 123 mydriatics, 124 myotics, 125 ointments, 125 powders, 125 solids, 126 Retina, 71 appearance, 72 central artery, 78 thrombosis, 79 embolism, 79 congestion, 73 opaque nerve-fibres, 73 tumors, 75 Retropharyngeal abscess, 163 Rhinitis, 202 varieties, 73-75, 202-212 Rhinoscopy, 111, 199-202 anterior, 199 posterior, 200 S. Sclerotic, anatomy, 55, 56 inflammations, 56 wounds, 57 Scotomata, 81 Septum, deviations, 220 hgematonia, 224 228 INDEX. Septum, exostoses, 221 tumors, 218 Sinuses, phlebitis, 155 thrombosis, 155 Skioscopy, 111 Spring catarrh, 41 Squint, 115 Strabismus, 115 operations for, 117-119 tenotomy, 117 open operation , 117 paralytic, varieties, 115, 120 Stye, 19 Symblepharon, 26 Synchisis scintillans, 96 T. Tonsillitis, 168 varieties, 169 Tonsils, anatomy, 160 diseases, 168-170 Tonsils, hypertrophy, 170 Trichiasis, 24 u. 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