A system of practical medicine. By American authors. Vol. 3 : $b Diseases of the respiratory, circulatory, and hæmatopoietic systems
Science
A system of practical medicine. By American authors. Vol. 3 : $b Diseases of the respiratory, circulatory, and hæmatopoietic systems
Medicine -- Practice
A variety of devices for fastening the reflector on the head of the
observer is in use, among which the head band, introduced by Cramer,
will be found the most serviceable. It consists of a broad strap of
some strong material which passes around the head and is fastened at
the back by a buckle. To the part of the band or strap resting on the
forehead is attached a padded plate, to which the reflector is fastened
with its ball-and-socket joint (Fig. 2). The reflector usually either
has a small hole in the centre or a small space in the centre is left
unsilvered. This opening is intended to be brought before the pupil of
one or the other eye of the observer in such a manner that the line of
vision and that of light have exactly the same direction. Using the
reflector in this way like the reflector of the ophthalmoscope, it is
easier to obtain the image of the larynx well illuminated, but with the
great disadvantage of {23} monocular vision, which makes all objects
appear on the same plane and prevents a correct interpretation of
distances--a very important point in laryngoscopy. It will therefore be
found more advantageous to place the reflector on the forehead, and
from thence reflect the light into the patient's larynx. Both eyes may
thus be employed in viewing the laryngeal image, and a correct idea of
the relations of parts in regard to distance may be formed.
[Illustration: FIG. 2. Head Reflector.]
The line of vision and the path of the beam of light in order to obtain
the best results should be in the same plane as though the light
emanated from the pupil of the observer; but practically the position
of the reflector upon the forehead is nearly as good as when the hole
in it is brought before the eye, because a line drawn from the pupil of
the eye to the laryngeal mirror, and a line from the reflector upon the
forehead to the mirror, do not form an angle sufficient to make any
very great difference in the reflection of the light downward, and very
little difficulty will be experienced in obtaining the desired image.
The head reflector should be concave when artificial light or ordinary
daylight is used, but be plane when direct sunlight is employed, for
the concentration of the sun's rays by a concave reflector produces so
much heat as to become painful to the patient.
THE SOURCE OF LIGHT.--As an artificial source of light a candle, coal
oil lamp, gas-flame, or incandescent electric lamp suffices for
ordinary purposes. But frequently it is desirable to have a much
stronger light than can be obtained without concentration, and several
forms of apparatus for concentrating artificial light have been
constructed and are in use. Among these, Tobold's lamp and Mackenzie's
light concentrator are the most convenient and most universally used.
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