Diseases of the nose and throat . e mirror is very deceptive and shouldnot be relied upon in estimating the quantity of adenoid vegetations ADENOIDS. 229 in a given case. An opinion as to treatment must be based upon thehistory of the case and the information gained by exploring withthe finger (Fig. 81). The prognosis is good provided the condition be recognized earlyand the adenoids thoroughly removed. If allowed to remain withthe hope of the occurrence of atrophy, associated derangements, asfor example in the ears, may progress to an irremediable the hard variety of adenoids there
Diseases of the nose and throat . e mirror is very deceptive and shouldnot be relied upon in estimating the quantity of adenoid vegetations ADENOIDS. 229 in a given case. An opinion as to treatment must be based upon thehistory of the case and the information gained by exploring withthe finger (Fig. 81). The prognosis is good provided the condition be recognized earlyand the adenoids thoroughly removed. If allowed to remain withthe hope of the occurrence of atrophy, associated derangements, asfor example in the ears, may progress to an irremediable the hard variety of adenoids there is no use in wasting time overlocal applications or in an endeavor to improve the general condi-tion of the patient. The depraved general state is so clearly aggra-vated by, if not the direct result of, the local condition that the lat-ter demands first attention. Engorgement of the adenoid mass dueto inflammatory or intestinal disturbance may be relieved by appro-priate treatment and does not require the radical interference de-. Fig. 82. Denhards Mouth-gag. manded in established disease. In the soft variety and in veryyoung children when the symptoms have not long existed removalof the mass by simply scraping with the index finger will frequentlysuffice. In infants of two years and under this may be readily donewithout an anesthetic, attention being paid as far as possible toasepticism by preliminary cleansing of the hands of the operator andof the nasopharynx with a saturated boric acid solution. In thesecases and when an anesthetic is used the jaws must be held apartwith a mouth gag (Fig. 82). In older children in whom obstructive symptoms are persistentit is a better plan to remove the growths thoroughly under ether orother anesthetic. Thus the shock of the operation is oppor-tunity is given for deliberate and careful exploration and, conse-quently, more thorough removal. 230 DISEASES OF THE NOSE AND THROAT. Contrary to the generally received opinion that chlorofo
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