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IN climbing a mountain, if we know the path and take it as a ...
Though not often fatal, this illness gives serious trouble. It...
Elsie was twenty. She came to see me because I had helped Els...
There are cases in which the outer skin has been taken off by ...
Palpitation Of The Heart
This is commonly a symptomatic or sympathetic affection--rare...
As in cholera morbus, keep the patient on his back, still as ...
This is a slow, smouldering kind of fever. For treatment, pack...
Burns Case Xxxiv
Mr. C. aged 51, scalded his leg ten days ago on the instep. H...
Nose Bleed - Epistaxis
If it arises from fullness of the vessels of the head, with t...
This should always be managed so as to soothe and not excite t...
No hook greater than a right angle should be used through en...
Treatment Of Scarlatina Anginosa Or Sore-throat Scarlet-fever
In _scarlatina anginosa_, or _sore-throat scarlet-fever_, whi...
Inflammation Of The Finger Case Xxxi
A young man, aged 18, came to me with a painful swelling of t...
The Lower Animals
It may, by some, be objected that, if we regard sensation as ...
Pericarditis Symptoms And Signs
If there is pain or much aching in the cardiac region, it ten...
Hepatization Of Lungs
Take A D current, pretty strong force. Treat in front, over t...
At Nauheim, under the direction of Dr. Theodore Schott, baths...
Pain Severe In Limbs
This is often not due to any trouble in the joint itself, but ...
In slight cases, where the patient simply cannot sleep for tos...
The Royal Touch
Malcolm. Well; more anon.--Comes the king forth, I pray ...
Endoscopy On The Human Being
Category: ACQUIRING SKILL
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Dog work offers but little practice
in laryngoscopy. Because of the slight angle at which the dog's head
joins his spine, the larynx is in a direct line with the open mouth;
hence little displacement of the anterior cervical tissues is
necessary. Moreover the interior of the larynx of the dog is quite
different from that of the human larynx. The technic of laryngoscopy
in the human subject is best perfected by a routine direct examination
of the larynx of anesthetized patients after such an operation as, for
instance, tonsillectomy, to see that the larynx and laryngopharynx are
free of clots. To perform a bronchoscopy or esophagoscopy under these
conditions would be reprehensible; but direct laryngoscopy for the
seeking and removal of clots serves a useful purpose as a preventative
of pulmonary abscess and similar complications.* Diagnosis of
laryngeal conditions in young children is possible only by direct
laryngoscopy and is neglected in almost all of the cases. No
anesthesia, general or local, is required. Much clinical material is
neglected. All cases of dyspnea or dysphagia should be studied
endoscopically if the cause of the condition cannot be definitely
found and treated by other means. Invaluable practice in esophagoscopy
is found in the treatment of strictures of the esophagus by weekly or
biweekly esophagoscopic bouginage.
* Dr. William Frederick Moore, of the Bronchoscopic Clinic, has
recently collected statistics of 202 cases of post-tonsillectomic
pulmonary abscess that point strongly to aspiration of infected clots
and other infective materials as the most frequent etiologic mechanism
(Moore, W. F., Pulmonary Abscess. Journ. Am. Med. Assn., April 29,
1922, Vol. 78, pp. 1279-1281).
In acquiring skill as an endoscopist the following paraphrased
aphorisms afford food for thought.
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