OCR Text |
Show 12 cus. or srmcrunn IN THE assorm to accomplish himself ing the foreign body. And he ought , and forceps, he may with what variety of probes, probangs act the body, or to think eventually necessary, either to extr push it out from the glottis. is this. The in: The operation recommended by Desault forceps. struments are a sharp pointed knife, spatula, and to the breast The patient is to be seated, and the head held over the thyof an assistant, who stands behind. The skin ion is now incis An e. roid cartilage, is to be a little drawn asid ce of inen to be made through the skin, laying bare the prom n the the thyroid cartilage and the cricoid cartilage. The asun- slit be to e are ilag two lateral parts of the thyroid cart d with acte der, and being held so, the foreign body can be extr JbUW mum USE on THE FLEXIBLE PIPE. 1" charge of mucus collected in the (esophagus. Sometimes there is a considerable general irritation, with fits of sufloeation ; the voice is remarkably weak. For this complaint, as in the stricture of the urethra, the bougie and caustic are used. We sound with the bougie to ascertain if there be a confirmed stricture, and not merely a spasm or paralysis. We are to endeavour to accommodate the form and size of the bougie so as gradually to stretch the contracted part ; and this failing,r of its eflect, or being attended with an increase of the mischief, we have still the use of the caustic in reserve. This practice is strongly recommended ‘ by Mr. Home. I cannot at present take the merit of making a single observation on the subject. forceps. OF THE USE OF THE FLEXIBLE PIPE, INTRODUCED INTO THE (ESOPIIAGUS- OP S'IRICTURES IN TIII‘. (ESOI'HAGUS. Wusn we consider that the msophagus is a powerful mus.cular tube, and that it is liberally bedewed with mucus, and consequently is of a glandular structure, we have a key to the knowledge of its diseases. It is not wonderful that a muscular tube, connected with, the stomach, (which is the source or the seat of so many strange and varying symptoms,) should frequently sufi‘er by the irregular action of its muscular fibresse. It is however the permanent stricture of the (esophagus I have to mention here. The stricture of the oesophagus is marked by a gradually increasing difficulty of swallowing, there occurs often irregu- lar pain in the stomach, and frequent reaching with the dis~ (:- . 4‘" a} -‘u..:.w.u.' " 5‘ " Spasmodic affections of the oesophagus, may be removed by rubbing camphor and opium, or aether, on the sides of the neck; or by swallowing a very little tincture of opium. Valerian and camphor may be given by the mouth or by injection. The irregularity of the uterine action, the general state of the system, and of the uterine discharges, must be attended to. When the spasm continues obstinate, the dexterous use of a bougie will sometimes relieve it. Ir is not long since, the only means suggested to us of nourishing a patient who had an obstruction of deglutition, was by clysters, or by forcing down solid food into the oesophagus by the probang. It was therefore a very happy invention of Mr. Hunter, in a case of impeded action of the throat, to cover the probang with an eel-skin, which, being introduced into the stomach, enabled him to inject nourishing soups. For the same pur~ pose we now use the flexible gum-tube, having adapted to it the nozzle of a syringe, or injecting-bag and pipe. In the introduction of the tube, we must be careful that we do not commit a blunder, which though not likely to happen, yet because it may happen and prove fatal, we must always consider; I mean the introduction of the tube into the wind- pipe, instead of the gullet. In the first place then it is wrong to make the patient open the mouth wide and push out the tongue, and at that instant to introduce the tube quickly, for by the projection of the tongue, the epiglottis is raised to the utmost ; and if the patient should have such a command over himself, as to persevere in keeping the tongue thus, while the \‘Urm umwmwrwrs t I l ' I .. ... |