We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......


Elmer L. Kenyon, A.B., M.D.
JAMA. 1914;LXII(18):1398. doi:10.1001/jama.1914.25610430001015.
Text Size: A A A
Published online


The danger inherent in the commercially advertised douches is so evident as to warrant their general condemnation. The objection to them lies in the turned-back position of the head required in their use, since that position encourages entrance of infective fluids not only into the eustachian tubes but also into the sphenoidal, and to a lesser extent, into the anterior ethmoidal, frontal and antral sinuses. Not only that, but the flooding of the nasal cavity and the nasopharyngeal space by the sudden pouring in of a large amount of fluid makes the flow of some of this liquid into these sinuses almost inevitable. And even more, the influx of a large amount of fluid into the nasopharynx almost inevitably sets up a coughing and hawking and swallowing which is likely to throw the eustachian tube open just at the dangerous moment. Nasal douches requiring the tipping back of the head,


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.