. Un traité pratique sur le diagnostic médical pour les étudiants et les médecins . ion. Après cela, les parties agrandies devraient être touchées par la cocaïne et le résultat observé. Contraction de l'enflure sous son influence prouve son origine vasculaire. 256 RHINOSCOPY POSTÉRIEUR. 257 2. Rhinoscopie postérieure. C'est l'art le plus difficile de l'exami-nation et exige beaucoup de pratique de la part de l'examinateur. Les instruments nécessaires sont un tenon, un dépresseur uc, un réflecteur liead, deux tailles de miroirs de gorge, un crochet en pahite ou des cordes plates pour maintenir le softpalate vers l'avant, et un applicateur incurvé pour la cocaïne, ou un

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. A practical treatise on medical diagnosis for students and physicians . ion. After this the enlarged partsshould be touched with cocaine and the result observed. Contraction ofa swelling under its influence proves its vascular origin. 256 POSTERIOR RHINOSCOPY. 257 2. Posterior Rhinoscopy. This is the most difficult ])art of the exami-nation and requires much practice on the part of the examiner. Theinstruments needed are a tong;uc-depressor, liead-reflector, two sizes ofthroat-mirrors, a pahite-hook or flat strings for holding forward the softpalate, and a curved applicator for cocaine, or a spray bottle with tipturned upward. The patient is seated as before, the tongue held down with the tongue-depressor, and the ])atient is told to breathe freely through both mouthand nose. The light is directed into the pharynx and a mirror of thelargest possible size inserted carefully behind the soft palate. The properangle and the movement necessary to bring all parts into view can onlvbe learned by practice. As a rule, it is best to hold the handle well up Fig. 42.. Anteroposterior section of the nose, showing the outer wall of the right nasal cavity. (Zucker-kandl.) L, inferior turbinate: M, middle turbinate; A, anterior end of middle turbinate; JJ, superior turbinate; P. 5., frontal sinus; S.-?., sphenoidal sinus; E, Eustachian tube; T, vestibule. at first, and note the condition of the vault of the pharynx, then gradu-ally depress it, examining the choanse from above downward. Do notkeep the mirror too long in the throat. It is better to insert it severaltimes than to weary the patient by attempting to see everything the firsttime. After the choanae have been examined, a turn of the mirror toeither side will bring into view the orifices of the Eustachian tubes, andthe examination is complete. If, after repeated attempts, it is found tobe impossible to see the posterior nares, one must first seek to accustomthe patient to the presence of the instruments ; if this fails, it

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