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When the nervous system is in a certain state, all impressions...
TO most people self-control means the control of appe...
Lues Of The Tracheobronchial Tree
Compared to laryngeal involvement, syphilis of the tracheobr...
In 1845-46 there was an epidemic in Dresden, a city of 100,00...
Ulcers Case Xxvii
Mrs. Wakefield, aged 36, had an extensive ulceration with exc...
Part of a raw turnip is grated down to a pulp. As much of this...
Sleep And Rest
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The remedy which has attracted and still attracts in a very h...
has great power as a local remedy in _Erysipelas_, to be appl...
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Acute Cardiac Symptoms Acute Heart Attack
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Quiet Vs Chronic Excitement
SOME women live in a chronic state of excitement all ...
Preparation Of The Patient For Peroral Endoscopy
The suggestions of the author in the earlier volumes in regar...
Affection Of The Brain
When the _brain_ is affected, the patient suddenly complains ...
Where cold is easily "taken," it is the skin which is defectiv...
See Towels, Cold Wet. ...
This peculiar burning and distressed feeling at the stomach d...
Cardiovascular Renal Disease
With the strennousness of this era, this disease or conditi...
Feet Giving Way
Where there is a great deal of standing to be done by any one,...
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
No dyspneic patient should be given a general
anesthetic; because any patient dyspneic enough to need a tracheotomy
for dyspnea is depending largely upon the action of the accessory
respiratory muscles. When this action is stopped by beginning
unconsciousness, respiration ceases. If the trachea is not immediately
opened, artificial respiration instituted, and oxygen insufflated, the
patient dies on the table. Skin infiltration along the line of
incision with a very weak cocaine solution (1/10 of 1 per cent),
apothesine (2 per cent), novocaine, Schleich's fluid or other local
anesthetic, suffices to render the operation painless. The deeper
structures have little sensation and do not require infiltration. It
has been advocated that an interannular injection of cocaine solution
with a hypodermic syringe be done just prior to incision of the
trachea for the purpose of preventing cough after the incision of the
trachea and the insertion of the cannula. It would seem, however, that
this introduces the risk of aspiration pneumonia and pulmonary
abscess, by permitting the aspiration and clotting of blood in small
bronchi, followed by subsequent breaking down of the clots. As the
author has so often said, The cough reflex is the watch dog of the
lungs, and if not drugged asleep by local or general anesthesia can
safely be relied upon to prevent all possibility of the blood or the
pus which nearly always is present in acute or chronic conditions
calling for tracheotomy, being aspirated into the deeper air-passages.
Cocaine in any form, by any method, and in any dosage, is dangerous in
very young children.