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SYMPATHY, in its best sense, is the ability to take another's...
Muscular Action Weak
The heart is the most important of all muscles. Sometimes the ...
Tartar Emetic Or Other Antimonial Poisons
If vomiting is not present, induce it by an emetic. Give doses...
Few vital processes are more remarkable than that by which foo...
(_Ague in the breast--Inflamed breast_.) This is a disease...
This is a very common trouble, especially in the young. To res...
There is no absolute contraindication to careful esophagosco...
Emetic; castor oil and enema. ...
Removal Of Foreign Bodies From The Larynx
Symptoms and Diagnosis.--The history of a sudden choking atta...
During an epidemic of scarlatina in 1836 two of my children w...
If pneumonia or gonorrhea is supposed to be the cause of the ...
Taking A Laryngeal Specimen For Diagnosis
The diagnosis of carcinoma, sarcoma, and some other conditio...
See Head, Soaping. ...
Clothes should be Loose and Comfortable. Man is the only anim...
(_Acetate of Copper Verdigris_) applied to _Cancerous_ ulcers...
Perversions In The Guidance Of The Body
SO evident are the various, the numberless perversion...
Throat Sore (clergyman's)
Those who are in the habit of using their voice much should be...
Other Sequels Dropsy &c
Beside the ulceration of glands and deafness, some of the seq...
Symptoms Of Prolonged Foreign Body Sojourn In The Bronchus
1. The time of inhalation of a foreign body may be unknown ...
This serious trouble in slighter forms affects one side of the...
Difficulties Of Esophagoscopy
Category: INTRODUCTION OF THE ESOPHAGOSCOPE
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
The beginner may find the
esophagoscope seemingly rigidly fixed, so that it can be neither
introduced nor withdrawn. This usually results from a wedging of the
tube in the dental angle, and is overcome by a wider opening of the
jaws, or perhaps by easing up of the bite block, but most often by
correcting the position of the patient's head. If the beginner cannot
start the tube into the pyriform sinus in an adult, it is a good plan
to expose the arytenoid eminence with the laryngoscope and then to
insert the 7 mm. esophagoscope into the right pyriform sinus by direct
vision. Passing the cricopharyngeal and hiatal spasmodically
contracted narrowings will prove the most trying part of
esophagoscopy; but with the head properly held, and the tube properly
placed and directed, patient waiting for relaxation of the spasm with
gentle continuous pressure will usually expose the lumen ahead. In his
first few esophagoscopies the novice had best use general anesthesia
to avoid these difficulties and to accustom himself to the esophageal
image. In the first favorable subject--an emaciated individual with no
teeth--esophagoscopy without anesthesia should be tried.
In cases of kyphosis it is a mistake to try to straighten the spine.
The head should be held correspondingly higher at the beginning, and
should be very slowly and cautiously lowered.
Once inserted, the esophagoscope should not be removed until the
completion of the procedure, unless respiratory arrest demands it.
Occasionally in stenotic conditions the light may become covered by
the upwelling of a flood of fluid, and it will be thought the light
has gone out. As soon as the fluid has been aspirated the light will
be found burning as brightly as before. If a lamp should fail it is
unnecessary to remove the tube, as the light carrier and light can be
withdrawn and quickly adjusted. A complete instrument equipment with
proper selection of instruments for the particular case are necessary
for smooth working.
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