|The Line of Life is that line which runs round the base of the thumb and lies directly over a large blood-vessel called the great Palmer Arch. This blood-vessel is more directly connected with the heart, stomach, and vital organs which may hav... Read more of The Line Of Life And Its Variations at Palm Readings.org|| Informational|
Take the B D current, medium force. If the paralysis be in a ...
HEINRICH CORNELIUS AGRIPPA VON NETTESHEIM, a German alchemist...
Inflammation Of The Lungs - Pneumonia
This disease is often connected with Pleurisy, and consists o...
The Digestive Process
After we have eaten our four-color meal--often we do this in ...
Smoking, a Senseless Habit. Smoking is the curious act of dra...
This is usually a bodily illness, though often regarded as men...
Readily identified by smell of tar or carbolic. Wash mouth wel...
This seems a very simple thing to do, but is by no means easy ...
Ulcerative lesions in the larynx during typhoid fever are al...
This is a matter of great importance to the sick. Nor is anyth...
Suppression Of The Menses Amenorrhoea
For sudden suppression from taking cold, as by wetting the ...
Removal Of Double Pointed Tacks
If the tack or staple be small, and lodged in a relatively l...
Stage I Entering The Right Pyriform Sinus
The operator standing (as in Fig. 66), inserts the esophagos...
This is a severe pain in the lower back, shooting sharply down...
Foreign bodies that have penetrated the chest wall and lodge...
The Unrelenting Boredom Of Fasting
Then there's the unrelenting boredom of fasting. Most people ...
To understand the physiology, pathology and the best treatmen...
Bite Of The Rattlesnake
is _Alcohol_, in the ordinary form, or in common Whisky, Bran...
Conditions Causing Change In Blood Pressure
Woolley [Footnote: Woolley, P. G.: Factors Governing Vascular...
_Erysipelas_ being commonly the reflexion of an internal dise...
Practice On The Dog
Category: ACQUIRING SKILL
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Having mastered the technic of introduction on
the cadaver and trained the eye and fingers by practice work on the
rubber tube, experience should be had in the living lower air and food
passages with their pulsatory, respiratory, bechic and deglutitory
movements, and ever-present secretions. It is not only inhuman but
impossible to obtain this experience on children. Fortunately the dog
offers a most ready subject and need in no way be harmed nor pained by
this invaluable and life-saving practice. A small dog the size of a
terrier (say 6 to 10 pounds in weight) should be chosen and
anesthetized by the hypodermic injection of morphin sulphate in dosage
of approximately one-sixth of a grain per pound of body weight, given
about 45 minutes before the time of practice. Dogs stand large doses
of morphin without apparent ill effect, so that repeated injection may
be given in smaller dosage until the desired degree of relaxation
results. The first effect is vomiting which gives an empty stomach for
esophagoscopy and gastroscopy. Vomiting is soon followed by relaxation
and stupor. The dog is normal and hungry in a few hours. Dosage must
be governed in the clog as in the human being by the susceptibility to
the drug and by the temperament of the animal. Other forms of
anesthesia have been tried in my teaching, and none has proven so safe
and satisfactory. Phonation may be prevented during esophagoscopy by
preventing approximation of the cords, through inserting a silk-woven
cathether in the trachea. The larynx and trachea may be painted with
cocain solution if it is found necessary for bronchoscopy. A very
comfortable and safe mouth gag is shown in Fig. 73. Great gentleness
should be exercised, and no force should be used, for none is required
in endoscopic work; and the endoscopist will lose much of the value of
his dog practice if he fails to regard the dog as a child. He should
remember he is not learning how to do endoscopy on the dog; but
learning on the dog how safely to do bronchoscopy on a human being.
The degree of resistance during introduction can be gauged and the
color of the mucosa studied, while that interesting phenomenon, the
dilatation and lengthening of the bronchi during inspiration and their
contraction and shortening during expiration, is readily observed and
always forms subject for thought in its possible connection with
pathological conditions. Foreign body problems are now to be solved
under these living conditions, and it is my feeling that no one should
attempt the removal of a foreign body from the bronchus of a child
until he has removed at least 100 foreign bodies from the dog without
harming the animal. Dogs have the faculty of easily ridding their
air-passages of foreign objects, so that one need not be alarmed if a
foreign body is lost during practice removal. It is to be remembered
that dogs swallow very large objects with apparent ease. The dog's
esophagus is relatively much larger than that of human beings.
Therefore a small dog (of six to eight pounds' weight) must be used
for esophagoscopic practice, if practice is to be had with objects of
the size usually encountered in human beings. The bronchi of a dog of
this weight will be about the size of those of a child.
[FIG. 73.--Author's mouth gag for use on the dog. The thumb-nut serves
to prevent an uncomfortable degree of expansion of the gag. A bandage
may be wound around the dog's jaws to prevent undue spread of the
Next: Endoscopy On The Human Being
Previous: Practice On The Rubber-tube Manikin