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Few things have so great and distressing effect as the fear of...
Papillomata Of The Larynx In Children
Of all benign growths in the larynx papilloma is the most fre...
In its most powerful form this is a solid stream of water dire...
Inflammation Of The Finger Case Xxxi
A young man, aged 18, came to me with a painful swelling of t...
Breast Swelling In
A blow on the breast, or the drain of nursing a child, along w...
This is a slow, smouldering kind of fever. For treatment, pack...
A most effective preventive and cure for this is the inhaling ...
Breast With Corded Muscles
Often a slight hardness shows itself in a woman's breast, when...
Punctures Case Iii
A female servant punctured the end of the finger by a pin; th...
Auricular Fibrillation Occurrence
This condition of auricular fibrillation occurs occasionally ...
Priessnitz's Method The Wet-sheet-pack
a remedy which, alone, is worth the whole antiphlogistic, dia...
How Alcohol is Made. The most dangerous addition that man has...
acts very beneficially when applied to the surface where ther...
Throat Sore (clergyman's)
Those who are in the habit of using their voice much should be...
Varieties Of Forms Of Scarlatina
The above is the description of scarlet-fever, as it most fre...
The proper cooking of this root is so important for health, ow...
The symptoms are increased tension, which means, sooner or la...
The Surgical Dissection Of The Superficial Structures Of The Male Perinaeum
The median line of the body is marked as the situation where ...
Felon - Whitlow
For this disease, in the early stage, when the sensation is t...
The spatular end of the laryngoscope should now be tipped ba...
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Independent aspirating tubes involve delay in
their use as compared to aspirating canals in the wall of the
endoscopic tube; but there are special cases in which an independent
tube is invaluable. Three forms are used by the author. The velvet
eye cannot traumatize the mucosa (Fig. 9). To hold a foreign body by
suction, a squarely cut off end is necessary. For use through the
tracheotomic wound without a bronchoscope a malleable tube (Fig. 10)
[FIG. 9.--The author's protected-aperture endoscopic aspirating tube
for aspiration of pharyngeal secretions during direct laryngoscopy and
endotracheobronchial secretions at bronchoscopy, also for draining
retropharyngeal abscesses. The laryngoscopes are obtainable with
drainage canals, but for most purposes the independent aspirating tube
shown above is more satisfactory. The tubes are made in 20 30, 40, and
60 cm. lengths. An aperture on both sides prevents drawing in the
mucosa. It can be used for insufflation of ether if desired. An
aspirating tube of the same design, but having a squarely cut off end,
is sometimes useful for removing secretions lying close to a foreign
body; for removing papillomata; and even for withdrawing foreign
bodies of a soft surface consistency. It is not often that the foreign
bodies can be thus withdrawn through the glottis, but closely fitting
foreign bodies can at least be withdrawn to a higher level at which
ample forceps spaces will permit application of forceps. Such
aspirating tubes, however, are not so safe to use as the protected,
double aperture tubes.]
[FIG. 10.--The author's malleable tracheotomic aspirating tube for
removal of secretions, exudates, crusts, etc., from the
tracheobronchial tree through the tracheotomic wound without a
bronchoscope. The tube is made of copper so that it can be bent to any
curve, and the copper wire stylet prevents kinking. The stylet is
removed before using the tube for aspiration.]
 Aspirators.--The various electric aspirators so universally
used in throat operations should be utilized to withdraw secretions in
the tubes fitted with drainage canals. They, however, have the
disadvantages of not being easily transported, and of occasionally
being out of order. The hand aspirator shown in Fig. 11 is, therefore,
a necessary part of the instrumental equipment. It never fails to
work, is portable, and affords both positive and negative pressures.
The positive pressure is sometimes useful in clearing the drainage
canal of any particles of food, tissue, clots, or secretion which may
obstruct it; and it also serves to fill the stomach or esophagus with
air when the ballooning procedure is used. The mechanical aspirator
(Fig. 12) is highly efficient and is the one used in the Bronchoscopic
Clinic. The positive pressure will quickly clear obstructed drainage
canals, and may be used while the esophagoscope is in situ, by simply
detaching the minus pressure tube and attaching the plus pressure. In
the lungs, however, high plus pressures are so dangerous that the
pressure valve must be lowered.
[Fig. 11--Portable aspirator for endoscopy with additional tube
connected with the plus pressure side for use in case of occlusion of
the drainage canal. This aspirator has the advantage of great power
with portability. Where portability is not required the electrically
operated aspirator is better.]
[FIG. 12.--Robinson mechanical aspirator adapted for bronchoscopic and
esophagoscopic aspiration by the author. The positive pressure is used
for clearing obstructed drainage canals and tubes.]
[FIG. 13.--Apparatus for insufflation of ether or chloroform during
bronchoscopy, for those who may desire to use general anesthesia. The
mechanical methods of intratracheal insufflation anesthesia
subsequently developed by Meltzer and Auer, Elsberg, Geo. P. Muller
and others have rightly superseded this apparatus for all general