There are two opposite causes of unconsciousness. One is conge...
Symptoms Of Laryngeal Foreign Body
1. Initial laryngeal spasm followed by wheezing respiration...
The Surgical Dissection Of The Bend Of The Elbow And The Forearm Showing The Relative Position Of The Arteries Veins And Nerves
The farther the surgical region happens to be removed from th...
Health And Money
It will be noticed that the remedies we recommend are in almos...
If the disease be general in the system, moving from place to...
Bandage Four-ply Flannel
The four-ply flannel bandage is simply what its name implies--...
Plate V Laryngeal And Tracheal Stenoses:
1, Indirect view, sitting position; postdiphtheric cicatricia...
On The Unadherent Eschar
The eschar is generally adherent in cases of recent injuries,...
Cases Beyond The Remedy Of Fasting
Occasionally, very ill people have a liver that has become so...
Bruises Case Xvi
J. Jennings, bricklayer, aged 26, fell through the roof of a ...
Various affections of the eyeball muscles cause this. To cure ...
A Healthy Colon
From my point of view the most amazing part of this whole exp...
If the operator has no refractive error he will need two pai...
Direct Laryngoscopy Adult Patient
Before starting, every detail in regard to instrumental equi...
Introduction Of The Esophagoscope
The esophagoscope is to be passed only with ocular guidance, ...
MICHEL DE NOTREDAME, or NOSTRADAMUS, a celebrated French phys...
Strangulation Or Hanging
Often accidentally caused in children or intoxicated persons. ...
Diffuse Dilatation Of The Esophagus
This is practically always due to stagnation ectasia, which i...
Angina Pectoris Management
While a number of causes of true cardiac pain may be eliminat...
This is one of the most difficult of diseases to control by a...
Category: ACQUIRING SKILL
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Endoscopic ability cannot be bought with the instruments. As with all
mechanical procedures, facility can be obtained only by educating the
eye and the fingers in repeated exercise of a particular series of
maneuvers. As with learning to play a musical instrument, a
fundamental knowledge of technic, positions, and landmarks is
necessary, after which only continued manual practice makes for
proficiency. For instance, efficient use of forceps requires that they
be so familiar to the grasp that their use is automatic. Endoscopy is
a purely manual procedure, hence to know how is not enough: manual
practice is necessary. Even in the handling of the electrical
equipment, practice in quickly locating trouble is as essential as
theoretic knowledge. There is no mystery about electric lighting. No
source of illumination other than electricity is possible for
endoscopy. Therefore a small amount of electrical knowledge, rendered
practical by practice, is essential to maintain the simple lighting
system in working order. It is an insult to the intelligence of the
physician to say that he cannot master a simple problem of electric
testing involving the locating of one or more of five possibilities.
It is simply a matter of memorizing five tests. It is repeated for
emphasis that a commercial current reduced by means of a rheostat
should never be used as a source of current for endoscopy with any
kind of instrument, because of the danger to the patient of a possible
grounding of the circuit during the extensive moist contact of a
metallic endoscopic tube in the mediastinum. The battery shown in Fig.
8 should be used. The most frequent cause of trouble is the mistake of
over-illuminating the lamps. The lamp should not be over-illuminated
to the dazzling whiteness usually used in flash lights. Excessive
illumination alters the proper perception of the coloring of the
mucosa, besides shortening the life of the lamps. The proper degree of
brightness is obtained when, as the current is increased, the first
change from yellow to white light is obtained. Never turn up the
rheostat without watching the lamp.
Next: Testing For Electric Defects
Previous: Retrograde Esophagoscopy