Bronchiectasis
Categories: BRONCHOSCOPY IN DISEASES OF THE TRACHEA AND BRONCHISources: A Manual Of Peroral Endoscopy And Laryngeal Surgery
In most cases of bronchiectasis there are strong
indications for a bronchoscopic diagnosis, to eliminate such
conditions as foreign body, cicatricial bronchial stenosis, or
endobronchial neoplasm as etiologic factors. In the idiopathic types
considerable benefit has resulted from the endobronchial lavage and
endobronchial oily injections mentioned under lung abscess. It is
probable that if bronchoscopic study were carr
definite causes for many so-called idiopathic cases would be
discovered. Lung-mapping as elsewhere herein explained is invaluable
in the study of bronchiectasis.
Bronchial asthma affords a large field for bronchoscopic study. As
yet, sufficient data to afford any definite conclusions even as to the
endoscopic picture of this disease have not been accumulated. Of the
cases seen in the Bronchoscopic Clinic some showed no abnormality of
the bronchi in the intervals between attacks, others a chronic
bronchitis. In cases studied bronchoscopically during an attack, the
bronchi were found filled with bubbling secretions and the mucosa was
somewhat cyanotic in color. The bronchial lumen was narrowed only as
much as it would be, with the same degree of cough, in any patient not
subject to asthma. The secretions were removed and the attack quickly
subsided; but no influence on the recurrence of attacks was observed.
It is essential that the bronchoscopic studies be made, as were these,
without anesthesia, local or general, for it is known that the
application of cocain or adrenalin to the larynx, or even in the nose,
will, with some patients, stop the attack. When done without local
anesthesia, allowance must be made for the reaction to the presence of
the tube. In those cases in which other means have failed to give
relief, the endobronchial application of novocain and adrenalin,
orthoform, propaesin or anesthesin emulsion may be tried. Cures have
been reported by this treatment. Argentic nitrate applied at weekly
intervals has proven very efficient in some cases. Associated
infective disease of the bronchial mucosa brings with it the questions
of immunity, allergy, anaphylaxis, and vaccine therapy; and the often
present defective metabolism has to be considered.
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Auricular Fibrillation Occurrence
This condition of auricular fibrillation occurs occasionally in valvular disease, and perhaps most frequently in mitral stenosis; but it can occur without valvular lesions, and with any valvular lesion. If it occurs in younger patients, valvular dis... Auricular Fibrillation Pathology
Schoenberg [Footnote: Schoenberg: Frankfurt. Ztschr. f. Pathol., 1909, ii, 4.] finds that in auricular fibrillation there are definite signs in the node, such as round cell infiltration, showing inflammation, a fibrosis of the tissue, and perhaps a ... Auricular Fibrillation Prognosis
The prognosis depends on the condition of the myocardium of the vagus. If this muscle is intact, and there is no pathologic condition in the sinus node (which can be proved by the successful results of treatment), the removal of all toxins that coul... Auricular Fibrillation Treatment
The condition may be stopped by relieving the heart and circulation of all possible toxins and irritants, and by the administration of digitalis. One attack is frequently followed by others, perhaps of longer duration. Occasionally, however, the pat... Autodrownage
Autodrownage is the name given by the author to the drowning of the patient in his own secretions. Tracheobronchial secretions in excess of the amount required to moisten the inspired air, become, in certain cases, a mechanical menace to life, unles... Ballooning Esophagoscopy
By inserting the window plug shown in Fig. 6 the esophagus may be inflated and studied in the distended state. The folds are thus smoothed out and constrictions rendered more marked. Ether anesthesia is advocated by Mosher. The danger of respirator... Balsamo
One of the most notorious charlatans of the eighteenth century was Giuseppe Balsamo, who was born at Palermo, Sicily, June 2, 1743. Though of humble origin, this arch-impostor assumed the title of Count Alessandro di Cagliostro, and styled himself G... Bathing
The surface of the body should be kept clean, as far as possible, and to this end, in summer, should be well bathed at least once a day. In winter, though useful, it is not so indispensable; still no one should neglect the bath more than a week, and... Baths
During rheumatism the peripheral blood vessels are generally dilated and the skin perspires profusely. This is caused not only by the rheumatism, but also by the salicylates. The surface of the body should be sponged with cold, lukewarm or hot water... Baths And Bathing
Bathing as a Means of Cleanliness. It has been said that one of the reasons why man lost his hairy coat was that he might be able to wash himself better and keep cleaner. However this may be, he has to wash a great deal oftener than other animals, m... Batteries
The simplest, best, and safest source of current is a double dry battery arranged in three groups of two cells each, connected in series (Fig. 8). Each set should have two binding posts and a rheostat. The binding posts should have double holes for ... Before Perspiration Comes On There Is A Little More Excitement For
a few minutes (41), which must not induce the friends of the patient to take him out of the pack; only when it continues to increase, instead of the perspiration breaking out and relieving the patient, it will be necessary to change the sheet, another... Belladonna
has great power as a local remedy in _Erysipelas_, to be applied with water in proportion of ten drops of the _tr._ to a gill of warm water. It is also of much value applied to the surface of inflamed breasts; also injected when there is inflammatio... Belladonna
The remedy which has attracted and still attracts in a very high degree the attention of physicians and parents, is _Belladonna_. This remedy was first introduced as a specific and prophylactic by Hahnemann, and soon recommended not only by his own ... Benign Growths In The Larynx
Benign growths in the larynx are easily and accurately removable by direct laryngoscopy; but perhaps no method has been more often misused and followed by most unfortunate results. It should always be remembered that benign growths are benign, and t... Benign Growths Primary In The Tracheobronchial Tree
Extension of papillomata from the larynx into the cervical trachea, especially about the tracheotomy wound, is of relatively common occurrence. True primary growths of the tracheobronchial tree, though not frequent, are by no means rare. These prima... Benign Neoplasms Of The Esophagus
As a result of prolonged inflammation edematous polypi and granulomata are not infrequently seen, but true benign tumors of the esophagus are rare affections. Keloidal changes in scar tissue may occur. Cases of retention, epithelial and dermoid cyst... Beverages
The Popularity of Beverages. For some curious reason, the habit has grown up of taking a large part of the six glasses of water that we require daily in the form of mixtures known as beverages. These beverages are always much more expensive than p... Biliary Calculi Gravel In Liver
Take A C current, strong as can be borne; and treat the inflamed and painful part with P. P., while N. P. is upon the right end of the duodenum. Treat eight to ten minutes, daily. ... Bilious Colic
This disease, in addition to the symptoms of cutting, cramping pains in the bowels, as in common colic, has great distress in the stomach, with nausea and vomiting, the bowels being costive, the feet and hands cold, sometimes cold sweats occur. Ther... Bilious Fever
This fever may be either intermittent, remitting, or continued, and typhoid. It is distinguished from common intermittent, by the great derangement of the stomach, as nausea and vomiting of bilious matter, yellow coated tongue, bitter taste in the m... Bite Of The Rattlesnake
is _Alcohol_, in the ordinary form, or in common Whisky, Brandy, Rum or Gin. Let the patient drink it freely, a gill or more at a time, once in fifteen to twenty minutes, until some symptoms of intoxication are experienced, then cease using it. The ... Blood Pressure
The study of the blood pressure has become a subject of great importance in the practice of medicine and surgery. No condition can be properly treated, no operation should be performed, and no prognosis is of value without a proper consideration o... Blood Pressure And Insurance
An epitome of the consensus of opinion of the risk of accepting persons for insurance as modified by the blood pressure is presented by Quackenbos. [Footnote: Quackenbos: New York Med. Jour., May 15, 1915, p. 999.] Some companies have ruled that at ... Blood Pressure In Children
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The first decision to be made is what constitutes a slow pulse or slow heart. A pulse below 58 or 60 beats per minute should be considered slow, and anything below 50 should be considered abnormally slow and a condition more or less suspicious. A pu... Bradycardia Symptoms
If a person has been long accustomed to a slow-acting heart, there are no symptoms. If the heart has become slowed from disease or from any acute condition, the patient is likely to feel more or less faint, perhaps have some dizzines, and often head... Brain Impressions
THE mere idea of a brain clear from false impressions gives a sense of freedom which is refreshing. In a comic journal, some years ago, there was a picture of a man in a most self-important attitude, with two common mortals in the background gazi... Breast Cancer
I have worked with many young women with breast cancer; so many in fact, that their faces and cases tend to blur. But whenever I think about them, Kelly inevitably comes to mind because we became such good friends. Like me, Kelly was an independent-... Bromids And Chloral
If there is much restlessness and the circulation is good, that is, if myocarditis is probably not present, the bromids may be of great value, especially in children. The dose should be sufficient to quiet the nervous system. The drug may be discont... Bronchial Aspiration
As mentioned above, bronchial aspiration is often necessary. When the patient is unable to get up secretions, he will, as demonstrated by the author many years ago, drown in his own secretions. In some cases bronchoscopic aspiration is required (Pe... Bronchial Dilators
It is not uncommon to find a stricture of the bronchus superjacent to a foreign body that has been in situ for a period of months. In order to remove the foreign body, this stricture must be dilated, and for this the bronchial dilator shown in Fig. ... Bronchial Stenosis
Stenosis of one or more bronchi results at times from cicatricial contraction following secondary infection of leutic, tuberculous or traumatic lesions. The narrowing resulting from foreign body traumatism rarely requires secondary dilatation after ... Bronchiectasis
In most cases of bronchiectasis there are strong indications for a bronchoscopic diagnosis, to eliminate such conditions as foreign body, cicatricial bronchial stenosis, or endobronchial neoplasm as etiologic factors. In the idiopathic types consid... Bronchoscopes
The regular bronchoscope is a hollow brass tube slanted at its distal end, and having a handle at its proximal or ocular extremity. An auxiliary canal on its under surface contains the light carrier, the electric bulb of which is situated in a reces... Bronchoscopic And Esophagoscopic Grasping Forceps
are of the tubular type, that is, a stylet carrying the jaws works in a slender tube so that traction on the stylet draws the V of the open jaws into the lumen of the tube, thus causing the blades to approximate. They are very delicate and light, y... Bronchoscopic Appearances In Disease
The first look should note the color of the bronchial mucosa, due allowance being made for the pressure of tubal contact, secretions, and the engorgement incident to continued cough. The carina trachealis normally moves slowly forward as well as do... Bronchoscopic Oxygen Insufflation
Bronchoscopic oxygen insufflation is a life-saving measure equalled by no other method known to the science of medicine, in all cases of asphyxia, or apnea, present or impending. Its especial sphere of usefulness is in severe cases of electric shock... Bronchoscopy In Diseases Of The Trachea And Bronchi
The indications for bronchoscopy in disease are becoming increasingly numerous. Among the more important may be mentioned: 1. Bronchiectasis. 2. Chronic pulmonary abscess. 3. Unexplained dyspnea. 4. Dyspnea unrelieved by tracheotomy calls ... Bronchoscopy In Malignant Growths Of The Trachea
The trachea is often secondarily invaded by malignancy of the esophagus, thyroid gland, peritracheal or peribronchial glands. Primary malignant neoplasms of the trachea or bronchus have not infrequently been diagnosticated by bronchoscopy. Peritrach... Bruises Case Xiv
The first case of bruise which I shall detail was not severe, but will serve to illustrate the mode of treatment by the adherent eschar. Mr. Symons, aged 60, slipped off a chair and bruised the shin, last evening; the skin was removed to the exten... Bruises Case Xix
Robert Hill, aged 16, received a blow yesterday from a bone which was thrown at him, upon the outer condyle of the humerus. He complains of extreme pain and there are much redness and swelling. I applied the lunar caustic and directed the part to be... Bruises Case Xv
The following case was far more severe, but the mode of treatment was not less efficacious. Mr. Granger, aged 36, was exposed to a severe bruise by a great weight of stones which had been piled up, falling upon the outside of the leg; he was extr... Bruises Case Xvi
J. Jennings, bricklayer, aged 26, fell through the roof of a house and bruised and lacerated his shin rather severely to the extent of an inch and half in one part and in several other places in a less degree. I applied the lunar caustic to the woun... Bruises Case Xvii
An old man, aged 60, received a bruise upon the occiput from a fall; the skin was lacerated and removed to the extent of half-a-crown. I applied the lunar caustic soon after the accident. On the next day an adherent eschar was formed. There was ne... Bruises Case Xviii
Mrs. C. aged 40, was detained on a journey by a bruised wound on her knee, received a fortnight before, which was healing very slowly under the usual mode of treatment. The inflammation was subsiding but the sore was extremely irritable and painful,... Bruises Case Xx
It frequently occurs to surgeons to receive slight wounds upon the hands which prove very troublesome. Of this kind is the following. Mr. L.C. had an irritable and inflamed sore on the ulnar side of the third finger, occasioned by a bruise a fortn... Burns And Scalds
No matter what the nature and extent of the burn may be, the very best of all medicines of which I have any knowledge, is _Soap_. If the parts affected, are immediately immersed or enveloped in Soft Soap, the pain will be greatly lessened, and the i... Burns Case Xxxiii
A little girl, aged 10, scalded her breast a week ago and has treated it with the ordinary remedies. There remained a superficial ulceration of the size of half-a-crown. I applied the lunar caustic lightly over the surface of the sore, and then the ... Burns Case Xxxiv
Mr. C. aged 51, scalded his leg ten days ago on the instep. He applied ointments and poultices. The surface remained ulcerated to the extent of three inches in length and an inch and a half in breadth, and presented a considerable thick slough in th... Burns Case Xxxv
The following case will present a specimen of my trials of the lunar caustic in larger ulcers. Anthony Knowles, aged 44, was kicked by a horse on the leg, above the inner ankle, two years ago. The part has never healed, but still remains in the s... Burns Case Xxxvi
The last case I have to give is one of great interest, as it clearly shows the influence of the lunar caustic in subduing the inflammation surrounding ulcerations, and in promoting the healing process, even in cases of phagedenic ulcer. In such case... Butter, Margarine And Fats In General
Recently, enormous propaganda has been generated against eating butter. Its been smeared in the health magazines as a saturated animal fat, one containing that evil substance, cholesterol. Many people are now avoiding it and instead, using margarine... Cadaver Practice
The fundamental principles of peroral endoscopy are best taught on the cadaver. It is necessary that a specially prepared subject be had, in order to obtain the required degree of flexibility. Injecting fluid of the following formula worked out by ... Caffein
Caffein can irritate the heart and cause irregularity and tachycardia, especially in certain persons. In fact, some can never take a single cup of coffee without having an attack of palpitation, and many times when coffee and tea have been unsuspect... Calendula
is applied to wounds, _incised_ and _lacerated_, promoting healing by the first intention. It is a valuable application for wounds in scrofulous persons, which tend to suppurate rather than heal by the first intention. It is also useful in old sores... Cancers
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It is so serious a thing for a woman with valvular lesion or other cardiac defect to become pregnant that no young woman with heart disease should be allowed to marry. Perhaps every normal heart during pregnancy hypertrophies somewhat to do the extr... Cardiac Drugs
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With the strennousness of this era, this disease or condition, which may be regarded as one of the accompaniments of normal old age, has become of grave importance, and nowadays frequently develops in early middle life. If it is diagnosed in its i... Cardiovascular Renal Disease Arrhythmia
While this terns really signifies irregularity and intermittence of the heart, it may also be broadly used to indicate a pulse which is abnormally slow or one which is abnormally fast, a rhythm which is trot correct for the age, condition and acti... Cardiovascular Renal Disease Treatment
While it is urged, in preventing the actual development of this disease, and in slowing its progress, that it is advisable to lower a high blood pressure, we must remember that this blood pressure mad be compensatory, and many times should not be mu... Care Of Instruments
The endoscopist must either personally care for his instruments, or have an instrument nurse in his own employ, for if they are intrusted to the general operating room routine he will find that small parts will be lost; blades of forceps bent, brok... Care Of The Nails
Importance of Clean Nails. On account of their constant use, your hands are brought in contact with dusty or dirty substances in your work and in your play; and it is very easy for some of this dirt, and such germs as it may contain, to lodge in the...