A manual of diseases of the nose, throat, and ear

Front matter

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Preface To The Third Edition

THE second edition has been carefully revised and all that seemed obsolete, or likely to become so, eliminated to make room for the numerous additions necessary to bring the book up to date without increasing its size. A book on one of the specialties in medicine designed for the use of students and general practitioners cannot be too concise, provided that the subject is efficiently covered and descriptions lose nothing in clearness by brevity. As in the previous editions of this little book, an effort has been made to eliminate all surplus words.

More space has been given to diagnosis and treatment than to rare and difficult operations that the beginner should not do. However these operations are described with sufficient minuteness for the student to practice them upon the cadaver. This method of study cannot be too highly indorsed because it produces a practical knowledge of the anatomy and topography of the respiratory tract and ear and skill in the handling of instruments that cannot otherwise be readily obtained. It is true that the trend of opinion has lately been toward conservative intranasal operations on the accessory sinuses rather than radical external operations, for example, like that of Killian, but such operations while rarely required upon the living are excellent practice for students upon the cadaver. The same is true of operations upon the internal ear.

Considerable attention has been given to directions for the preparation and preservation of anatomical specimens and sections through the nose and ear. The preparation of such specimens helps to fix the anatomy and relationship of the parts in the mind of the beginner, and hence specimens prepared by the student himself are more valuable for future reference and study than similar preparations purchased in the shops.

In the commoner operations like tonsillectomy and submucous resection of the nasal septum, when the methods of

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12 PREFACE TO THE THIRD EDITION operating are almost as numerous as the operators, a technique is given which, in the experience of the author, is simplest, quickest, easiest, most free from unnecessary traumatism and risk, and yields the largest proportion of good results. The author has never had a death from tonsillectomy nor a case of severe sepsis; yet he feels that other methods of operating may be equally as good as that described. However, the beginner should acquire as soon as possible the technique best suited to him for the commoner operations and not abandon it without good reason; because operators who have no established techniqne but are constantly shifting from one method to another, usually have the largest number of fatalities and unsatisfactory results.

The chapter on tonsils and adenoids although entirely rewritten for the second edition has again been carefully revised. Comparatively much space has been given to the consideration of diseases of the nasal accessory sinuses. While radical operations designed to obliterate these cavities have . been advocated when indicated, the fact is clearly stated that the majority of acute inflammations recover as the result of comparatively simple treatment, and that in the chronic suppurations no operation should be done that will leave the patients in a worse condition than before.

The chapter on diseases of the internal ear has been rewritten and considerable new material added to bring this part of the book completely up to date. The same is true of the intracranial complications of aural suppuration.

The formule at the end of the book have been carefully revised and only those retained which have not been superseded by better remedies. The various methods of employing cocain, adrenalin, etc., have received careful attention and considerable new material added to this section of the book.

E. B. GLEASON.

2033 CHESTNUT STREET,

PHILADELPHIA, PA., October, 1914.

Preface

TuIs manual was written to supply students and general practitioners with the essential facts of Rhinology, Laryngology, and Otology in as concise a form as possible.

~The more important facts of the anatomy, physiology,

and pathology of the upper respiratory tract and ear have received careful consideration, so that the volume might prove sufficiently complete for study or reference by undergraduates during their college years and for practitioners taking a post-graduate course in laryngology and otology.

The details of inspection, examination, and diagnosis of the nose, throat, and ear conditions and the use of the commoner instruments of diagnosis and for the making of applications have received very careful and comparatively lengthy detailed description. The same may be said of minor operations. Methods of treatment have been simplified as much as possible, so that in most instances only those methods, drugs, and operations have been advised which, by the actual experience of the author, have proved essential to the accomplishment of the desired result. At the end of the book is a collection of Formulas designed to represent more than a mere catalogue of prescriptions. Hence a detailed description of the better methods of use of each of the more.important drugs has been interpolated, which it is hoped the reader will find useful and suggestive.

i4 PREFACE

The history of the gradual development of some of the more important instruments, methods of treatment, and, more especially, operations has been considered of sufficient practical importance to be briefly outlined. In some instances the prognosis in cases not operated on has been accentuated by quotations from the writings of standard authors of the period before such operations were practised.

The book contains 262 engravings, a considerable proportion being original or drawn from dissections made by the author. The value of carefully made sections through the upper respiratory tract and ear for purposes of study and reference is stated and a method of preparing and preserving such specimens described.

E. B. GLEASON.