A system of surgery : theoretical and practical . etic, when with a little management the gi^eater part of thenostrils can be explored, and the position of a polypus or portion of necrosed bone oftenexactly determined. RhinosGOfy.—The cavities of the nostrils may be inspected from the front eitherby direct or reflected light. If the patient is placed facing the sunlight, and the tip of the nose is pressed up-wards by the thumb, the nostrils will be dilated so as to bring a good deal of theircavity into view. But for more complete examination some kind of speculum isneedful, and it is more conv
A system of surgery : theoretical and practical . etic, when with a little management the gi^eater part of thenostrils can be explored, and the position of a polypus or portion of necrosed bone oftenexactly determined. RhinosGOfy.—The cavities of the nostrils may be inspected from the front eitherby direct or reflected light. If the patient is placed facing the sunlight, and the tip of the nose is pressed up-wards by the thumb, the nostrils will be dilated so as to bring a good deal of theircavity into view. But for more complete examination some kind of speculum isneedful, and it is more convenient to reflect the light into the nostril by an appro-priate mirror. When sunlight cannot be obtained, an Argand burner with a con-densing lens can be substituted, or some of the various forms of the oxyhydrogen or ^ Medical Times and Gazette, March 28, 1863. 2 Billroth, Clinical Surgery. Translated by C. T. Dent, p. 54. ^ Fraenkel, in Ziemssens Cyclojicedia of the Practice of Medicine, vol. iv. p. 113, 632 DISEASES OF THE NOSE. Fig. 140. L. the electric light. The reflecting mirror can be fixed to a forehead-band or a spectacle-frame, or it may be held in the hand. The speculum is best made of bent wire, sothat it covers as little as possible of the surface to be inspected; and it shouldbe self-retaining, so that the operator has both his hands at liberty. A very useful form is that known as Fraenkels Nasal Speculum represented infig. 140. The blades being introduced, one intoeach nostril, they are separated by meansof the screw which forms the handle of theinstrument. The nostrils are thus widelydilated, and the instrument remains inposition without extraneous support. Itmay be used in a similar manner fordilating one nostril only. Another dilatorwhich I have found extremely convenientis that invented by Mr. Cresswell Baber (see figs. 141, 142). It consists of two hooksof silvered wire (curved, as seen in fig. 141)united by an elastic band,passing obliquely round thehead
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