Pittsburg dispatch. [volume] (Pittsburg [Pa.]) 1880-1923, 1889-12-28

observe the inadequate manner OF teaching the
operative surgical treatment Of the naso-pharynx
FOR inner and middle ear disease they will proba-
bly, agree that there ought to be no apology for
bringing this subject before you in this manner.
and to the gentlemen ] see before me tonight.
NAV safely say. the day has passed wherein the
biologist can afford to ignore the teaching that
ant lesson of the needs Of informing ourselves Of
the latest methods of putting the naso-pharynx in
a propefanatomical condition, as prelude to
Psychological cure of the eoncomtant ear disease.
PROFESSIONAL ILLUSTRATION.
AS an example Of what does frequently occur,
let me mention very recent illustration in my
practice. Mrs. M. was brought to me by young
aurist, who desired me TO make an examination
with him. She had dizziness Of hearing and
sense of fulness, as the patient expressed it, in
the center Of her head. The doctor said privately
he had examined the case, and was sure there was
little or nothing the matter with her head, except
eustachian tubes were open, and he saw nothing
wrong in the naso-pharynx. l. however found
1t quite easy In this case to demonstrate large
sue. A cartilaginous ledge upon the septum with
broad base in the left nars that nearly 0ccluded
the nasal respiration, and general condition OF
septa chondritis high up in the right naris, sur
mounted by an ovofd base of mucous tissue. The
doctor saw it all plainly when pointed out buthad
not seen 1t before, and restoration of these parts
to normal anatomical condition will as surely
cure this woman as the proper exhibition of qui-
nine and calomel will cure an ague, and, may
You now ask me: How will you do this work?
Surgically, Of course, and in any manner you may
ters not about snybody's snare, or saw or cautery
blade, or drill or scissors; the best judgment
Of the surgeon In this case will have him remove
inserting saw into the fattened opening upon
the floor s., Of the nAris and saving upward, keep
ing naris as guide to prevent cutting the septum
too thin. or to avoid making fenestrum. After
the parts heal the thickening Of the cartilage and
bony septum high up in the right naris can be
drill; and, lastly. after that heals, the inferior
tST0nate1 can 0s 6esssGyse ade we
painless by the previous application Of cocaine,
eithepfn powder or solution, after cleansing and
drying the parts with absorbent cotton. The after
treatment Is strict aseptlc cleanliness locally.
JUDGMENT THE sUREsT GUIDE.
So you see, # is matter of personal as well
professional ju gment that is the safest guide for
you. You ask, how is one to know what is an abb
normal interior of nose or pharynx9 1t is not
difficult to recognize If you wish to and compe
tentto know when you it, but here preciselyis
the difficulty in the present and past, which is also
Illustrated BY case In point MIR; j.. OF Wells
vile, o., who had hay fever and dullness of hear
ing, consulted q medical man IN Buffalo who pro-
fesses to cure hay fever by medicines alone. Mr..
a nose and throat surgeon in Buffalo to have some
polyphs and other abnormal tissue removed then
cine that would cure. Mr.. J. heard incidentally
that there were several men in Pittsburg who
treated throatH and noses effectively, but didn't
to Pittsburg and was sent to a prom
inSIt Of Who vas % SeyeF aver
although competent man now engaged in gen.
eral surgery, he examined the interior Of Mr.. Us
nose and told him there was nothing the matter
with 1t, but thathe was probably looking for DIR.
DAILY. The man came to me and at one sitting, in
the presence ofmy assistant and two other med
Rnl a rr1Nr1 70 M NV m
polyps from the upper nasal fossae, aggregating
In size three large shellbark hickory nuts. do
that would not be true, but a rather common form
of carelessness or Indifference. But 1t is fact
that tis case @ Is not only cnrea OF MS inereshs
is cured of his hay asthma and constant tendency
to catch cold by the curing of his naso-pharynx:
These cases-anS there are many which Will
not burden you with-show brilliant and lasting
results and the biologist of o-day can, if he viii,
vanclng laryngoIogisE and rhinologist. Yes,
he can learn that TO cure his cases OF intfamma-
tory, internal and middle ear diseases, he must
look 20 the throat and mares, and endeavor to as
certain If there does not exist here the central
disease and If So consequently here are the parts
cure.
GOOD RESULTS CERTAIN.
You see, then, 1t is matter Of personal as well
professional judgment in each given case, which,
if properly carried out. whether by surgical
medical means, or both, that will more certain
De IOilOWeO Dy puyslOlORlcally BOOu EeSAlGS, OI
a permanent character than by any other method.
Is it not self-evident proposition that part or
organ that is anatomically wrong, will also be
physiologically wrong? Then is it not also self
evident that restoration of its proper
proper physiological function2 ought to mention
the valuable work OF my personal and excellent
friend Wilhelm Meyer, of Copenhagen, Denmark
''On Rdenoid Vegetations in the naso-pharyngeal
spaces. wherein he found "a per cent were hard Of
hearing. do not intend to diminish the import
an Of
treatment OF diseases of the ear, but do insist
that the nasopharyngeal structures shall not only
be examined as one of the routine measures, but
that they shall receive the proper surgically 0per
ative treatment that common surgical sense shall
dictate and IL the auraI surgeon is not prepared
is skilled in the operative surgery OF the naso-
pharynx.
In order to get the sense of the leading special
lists in laryngology and otolOgy upon the ques-
tions have tonight brought before you sent
out about 200 circulars in this country and abroad,
in which 1 submitted number of formulated
questions. The answers were many, and consti-
sideration of my questions, but a valuable SYM
pOsac of Inexperienced opinion and fact sufficient OF
themselves for valuable contribution to medical
science, but far too long for an occasion like this:
and consequently reserve it for future occasion
to present it to the profession.
The paper was discussed by Professors D.
D. St. John, Roosa, Bosworth, Pomeroy, and
others, of New York. Mackenzie, of Balti-
more; Roe, of Rochester, N. Y, and many
other eminent specialists present.
Archives fur Ohrenhelkinde 1873 and 1874.