1897 Journal of the American Medical Association (JAMA)  
in the roof of the vault, because it is impossible to get a curette to conform to the curves of both the roof and the posterior walls. For that purpose I have designed a second pair shown in Fig. 2 . This curette may be used for general use, and all adenoids may be removed with it except those that have become hard. It will be observed that the cutting edge of this instrument is set at an angle of about 45 degrees from the handle and when introduced its edge strikes the mucous membrane on its
more » ... s membrane on its posterior walls at about the same angle ; but if the curette is pushed far up and the ring brought well forward against the post-nasal septum at the same time lowering the handle, the blade rests flat against the roof and as the sweep is made over the vault the curette engages the tumors within its rings and brings them away. Figure 1. Any instrument which is not so adapted fails in its purpose to remove the tumors from the roof and simply scrapes those from the posterior walls. It is well to add here that the tumors in the roof around the post-nasal nares do considerably more damage than those on the posterior walls, and it is therefore much more important to remove them. Tumors within the posterior nares can not be reached with these curettes and are best removed with a Bosworth snare. I claim considerable excellence for these curettes, not because they bear my name but because of my practical experience in operating with them, which has been very satisfactory. Figure 2. For removing granulations from the vault and stimulating the mucous membrane, I only use the second pair, Fig 2. The granulations come away readily with moderate force and without much injury to the membrane. For stimulating the membrane in cases of chronic nasopharyngeal catarrh I have used this curette with very happy results. The curettes are made by Chas. Truax, Green & Co., Chicago, 111. The greatest objection to the use of adhesive straps over wounds arises mainly from a collection of crusts or dried secretion under them, and from the difficulty of inspecting and changing the underlying dressings. This difficulty can be easily remedied by taking common dress hooks, A, bend the circular parts of the shank at a right angle, B, and fix them on the end of an inch strap of Meads, a similar adhesive plaster, C. The straps with the hooked ends may be placed one inch or more from the border of the wound, D, on either side and tension made with small rubber bands over any desired dressing, which will thus be comfortably retained in place. By unhooking the bands, the dressing may be removed without disturbing the straps, wound or patient. These hooks thus made were originated by me. I have used them over twenty years with satisfaction. There is no patent on them and the profession is welcome to the idea. I present herewith a photograph of a vaginal speculum which I have recently invented. The instrument is similar to Graves' in the mechanism for the vertical expansion of the blades, but has the following improved features. Instead of the screw used in most similar instruments to keep the distal ends of the blades expanded, I have adopted a ratchet and pawl mechanism, which permits the operator to expose the cervix uteri very quickly, and adjust the instrument with one hand, and to release the blades as quickly when he desires to remove the instrument. Another improvement is a funnel-shaped opening at the rear portion of the lower blade leading into a hollow shank on same, to which a piece of rubber tubing is affixed, thus providing a ready outlet for fluids while using the speculum. The instrument is aseptible, and the lower blade can[ill]be detached and used as a Sims speculum. Automatic Adjusting Thermometer. [ill]Thestrain and inconvenience of the ordinary thermometer in severe prostration is avoided by the contrivance of Prof. Cornet, which holds the thermometer automatically in the armpit, by means of a broad spring which passes over the shoulder. The thermometer is curved to fit and can be read without removing.-Deutsche med. Woch., June 3. Downloaded From: http://jama.jamanetwork.com/ by a UQ Library User on 06/15/2015
doi:10.1001/jama.1897.02440290037021b fatcat:cjjph4ardnexblyjsag63yw77q