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The management prescribed by physicians for patients complaining of snoring as a severe physical and mental nuisance has always been more or less unsatisfactory, and there is a marked paucity of literature to which one may turn to enlist aid in their behalf. Modern textbooks are curiously barren on this subject, and a search of recent periodic literature discloses but two references to scientific papers published in the last fifteen years. The fact is that this seriocomic symptom is often treated far more lightly than it deserves, as will be attested by many whose domestic tranquility may be strained to the breaking point by it. From certain developments in other fields of medicine which can be applied to the present problem, I feel that it is possible to attack this symptom with a fair measure of confidence by therapeutic methods entirely and constantly under the control of the physician and with perfect safety favorably influence the distressing affliction. DEFINITION For an intelligent attack a proper interpretation and definition of snoring is essential. If noisy respiration, inspiratory and expiratory, of a sleeping person is considered as the act of snoring, many varied sources of sound would have to be identified. Since the passing of air through a tube in which there are constrictions offering interference to the air column will readily produce sound, audible breathing can be produced in the human airway by the respiratory air as it passes through the nasal pharyngeal sphincter or over the base of the tongue and epiglottis, as it enters the aditus laryngis or as it passes between the vocal cords. In addition to these sites, relaxed cheeks and lips offer additional sources of vibration. Hence, if the definition had no orderly limitations, snoring would have to include laryngeal stridors, the habitual nocturnal groans of certain sleepers, the wheeze of persons with asthma and the coarse rales of sufferers from severe bronchitis.For the present purpose all adventitious and accessory respiratory sounds must be eliminated, and true snoring must be limited to and defined as a coarse lowpitched noise produced by vibrating soft tissues in the nasopharynx of a sleeping person. ETIOLOGY Classification.\p=m-\It is assumed that modifications of the upper air passages by adenoids, an elongated uvula, a tumor of the nasopharynx, a deflection of the septum, polyps and/or nasal allergy produce snoring in many persons. These are organic snorers, and for this group, of course, the standard measures of treatment are indicated and in many instances will prove to be all in the way of management that is required.
The management prescribed by physicians for patients complaining of snoring as a severe physical and mental nuisance has always been more or less unsatisfactory, and there is a marked paucity of literature to which one may turn to enlist aid in their behalf. Modern textbooks are curiously barren on this subject, and a search of recent periodic literature discloses but two references to scientific papers published in the last fifteen years. The fact is that this seriocomic symptom is often treated far more lightly than it deserves, as will be attested by many whose domestic tranquility may be strained to the breaking point by it. From certain developments in other fields of medicine which can be applied to the present problem, I feel that it is possible to attack this symptom with a fair measure of confidence by therapeutic methods entirely and constantly under the control of the physician and with perfect safety favorably influence the distressing affliction. DEFINITION For an intelligent attack a proper interpretation and definition of snoring is essential. If noisy respiration, inspiratory and expiratory, of a sleeping person is considered as the act of snoring, many varied sources of sound would have to be identified. Since the passing of air through a tube in which there are constrictions offering interference to the air column will readily produce sound, audible breathing can be produced in the human airway by the respiratory air as it passes through the nasal pharyngeal sphincter or over the base of the tongue and epiglottis, as it enters the aditus laryngis or as it passes between the vocal cords. In addition to these sites, relaxed cheeks and lips offer additional sources of vibration. Hence, if the definition had no orderly limitations, snoring would have to include laryngeal stridors, the habitual nocturnal groans of certain sleepers, the wheeze of persons with asthma and the coarse rales of sufferers from severe bronchitis.For the present purpose all adventitious and accessory respiratory sounds must be eliminated, and true snoring must be limited to and defined as a coarse lowpitched noise produced by vibrating soft tissues in the nasopharynx of a sleeping person. ETIOLOGY Classification.\p=m-\It is assumed that modifications of the upper air passages by adenoids, an elongated uvula, a tumor of the nasopharynx, a deflection of the septum, polyps and/or nasal allergy produce snoring in many persons. These are organic snorers, and for this group, of course, the standard measures of treatment are indicated and in many instances will prove to be all in the way of management that is required.
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