A manual of diseases of the throat and nose : including the pharynx, larynx, trachea, oesophagus, nose and naso-pharynx . to in inFig. 104 ; 6, bolt, which prevents the smallsilver ball passing beyond the containingbox. Fig. 109.—Smiths valve, slightly modified:a, india-rubber valves, which can be drawnin, but not forced outward ; 6, bar by whichthe valves are secured. tion of a valve to its mouth, which admits the ingress of air, but closes the-tube when the patient expires. The primary object of these valves is to enable the patient to speak withoutstopping the mouth of the canula withhis fi
A manual of diseases of the throat and nose : including the pharynx, larynx, trachea, oesophagus, nose and naso-pharynx . to in inFig. 104 ; 6, bolt, which prevents the smallsilver ball passing beyond the containingbox. Fig. 109.—Smiths valve, slightly modified:a, india-rubber valves, which can be drawnin, but not forced outward ; 6, bar by whichthe valves are secured. tion of a valve to its mouth, which admits the ingress of air, but closes the-tube when the patient expires. The primary object of these valves is to enable the patient to speak withoutstopping the mouth of the canula withhis finger, but they also greatly facili-tate coughing and favor kinds of valves have been de-vised. The first was that of Luer (), in which a small chamber contain-ing a small ball is fitted into the mouthof the canula. When the patientspeaks the pea is driven forward andblocks up the anterior opening, whilston inspiration it falls into the cavity ofthe containing box, and allows the airto enter the windpipe. The noise ofthe pea rattling in its chamber is an-noying to some patients, and Thomas Smithl has ited a valve consisting of a little silver box with anindia-rubber flap, permitting inspira-tion but closing the canula on expira-tion and vocalization. In this instru-ment the india-rubber valve is apt to-be forcibly coughed out, and lately asomewhat similar valve (Fig. 109) hasbeen made in which the flap is sup-ported by a fine central bar which di-minishes the tendency to its forcibleeversion. It must not be forgottenthat all these mechanical contrivancesfor assisting in speaking diminish the supply of air, and hence they shouldnot be used during sleep or where any exertion has to be made. Artificial Vocal Apparatus.—When the greater part of the larynxhas been removed, vocalization can be assisted by the introduction of &vibrating-reed. The first instrument of this kind was devised by Gussen- Fig. 110.—Dr. Foulis Modification of Gussenbauer
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Keywords: ., bookcentury1800, bookdecade1880, bookpublisherne, booksubjectnose
