Endoscopy On The Human Being
Categories: ACQUIRING SKILLSources: 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 routin
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.
More
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Disorders Of Muscles And Bones
The Muscles and Bones Have Few Diseases. Considering how complex it is, and the never-ceasing strain upon it, this moving apparatus of ours, the nerve-bone-muscle-machine, is surprisingly free from disease. The muscles, though they form nearly half ... Distinctive Use Of Each Pole
I have said that every disease is preternaturally either positive or negative. I have further said, that the application of either pole to a given part produces an effect the opposite of what would be produced in the same part by a reversal of the p... Disturbances Of The Heart In General
Of prime importance in the treatment of diseases of the heart is a determination of the exact, or at least approximately exact, condition of its structures and a determination of its ability to work. This is not the place to describe its anatom... Diverticulum Of The Esophagus
Diverticula may, and usually do, consist in a pouching by herniation, of the whole thickness of the esophageal wall; or they may be herniations of the mucosa between the muscular layers. They are classified according to their etiology, as traction a... Division Of The Process Of The Disease Into Periods
Its course is commonly divided into four distinct periods, viz.: the period of incubation, the period of eruption, the period of efflorescence, and the period of desquamation; to which may be added: the period of convalescence. ... Do Not Hurry
HOW can any one do anything well while in a constant state of rush? How can any one see anything clearly while in a constant state of rush? How can any one expect to keep healthy and strong while in a constant state of rush? But most of m... Don't Talk
THERE is more nervous energy wasted, more nervous strain generated, more real physical harm done by superfluous talking than any one knows, or than any one could possibly believe who had not studied it. I am not considering the harm done by ... Dr Jerome Kidder's Electro-magnetic Machine
On opening the machine-box, as it comes from the manufacturer, there will be found a glass bottle, intended to hold the battery fluid when not in use; a glass cup or jar, to serve as the battery cell; a pair of insulated metallic conducting cords; t... Dripping Sheet Substitute For The Half-bath
To apply the _dripping sheet_, a tin bathing hat or a large wash-tub is placed near the patient's bed, and a pail of water on the brim of the hat, or close by the tub. Dip a linen sheet into it, and leave it there till you wish to take the patient o... Dropsy
Use the A D current, moderate force. Give general tonic treatment; then place P. P. with the feet, in a vessel of warm water, or place the sponge-roll P. P. at the soles of the feet, and treat the affected parts a few minutes with N. P., to quicken ... Drugs In Hypertension
The drugs that are mostly used to lower blood pressure are nitrites or drugs which are like nitrites, and these are nitroglycerin, sodium nitrite, erythroltetra nitrate and amyl nitrite, and the frequency of their use is in the order named. Other dr... During And After Desquamation The Treatment Should Be Continued As
indicated in milder cases, except the throat continue troublesome, when more packs should be used. If the throat is well, the patient may leave his room by the sixteenth day, under the precautions given above. ... Dysentery
Treat exactly as in acute diarrh[oe]a, except that P. P. should be moved more over the colon and rectum than in diarrh[oe]a. ... Dysentery
This disease is caused by inflammation of the mucous membrane of the colon and rectum, (the large intestine) generally confined to the lower part of the bowel. It is always painful. There is griping and straining in the lower part of the abdomen, an... Dysmenorrhea Painful Menstruation
If the disease be occasioned by uterine displacement, obstructing the os uteri, the organ must be restored to its normal position. This can best be done by mechanical action. But it is most commonly occasioned by irritation of the mucus membrane lin... Dysmenorrhoea - Painful Menstruation
For this disorder, I know of no one remedy so valuable as the _Caulophyllin_, but _Pulsatilla_ in many cases is efficacious, and as they do not prevent each other's action, I prescribe them in alternation, giving a dose every half hour, for a short ... Dyspepsia
This is one of the most difficult of diseases to control by any of the ordinary modes of medical practice; and yet, under judicious electrical treatment, it is one of the surest to yield. The disease assumes various phases in different persons, and ... Dyspepsia
This term is applied so loosely and so indiscriminately to all chronic derangements of the stomach, that it is difficult to define it. I shall therefore point out some of the more common ailments of the stomach and their proper remedies. For sour... Earache - Otalgia
This may arise from various causes, but a common one is sudden cold. If it arises from cold, and there is general fever, or if the ear is red, or the side of the head and ear hot, _Bell._ and _Baptisia_ should be given in alternation, every hour, or... Early Symptoms Of Irritating Foreign Body Such As A Peanut Kernel In The Bronchus
1. Initial laryngeal spasm is almost invariably present with foreign bodies of organic nature, such as nut kernels, peas, beans, maize, etc. 2. A diffuse purulent laryngo-tracheo-bronchitis develops within 24 hours in children under 2 years. ... Edematous Tracheobronchitis
This is chiefly observed in children. The most frequently encountered form is the epidemic disease to which the name Influenza has been given (q.v. supra). The only noticeable difference between the epidemic and the sporadic cases is in the more ge... Electrical Classification Of Diseases
There are two, and only two, primary classes of disease--those in which the electro-vital force is abnormally positive, and those where it is preternaturally negative. The former class comprises every variety and phase of hypersthenia, and the latte... Emergencies
5. Cardiac Emergency Drugs.--Besides some of the drugs already mentioned (such as camphor hypodermically, nitroglycerin when indicated, strophanthin hypodermically or intravenously, caffein and strychnin), often ergot, suprarenal vasopressor princip... Emergency Tracheotomy
Stabbing of the cricothyroid membrane, or an attempted stabbing of the trachea, so long taught as an emergency tracheotomy, is a mistake. The author's two stage, finger guided method is safer, quicker, more efficient, and not likely to be followed ... Endocarditis
It should be understood that especially in acute conditions a positive separation of endocarditis from myocarditis is incorrect. Acute endocarditis can probably not occur without some inyocarditis, and myocarditis probably does not occur without s... Endocarditis A Secondary Affection
Mild endocarditis is rarely a primary affection, and is almost invariably secondary to one of the diseases named above. Nearly 75 percent of secondary endocarditis occurs as a complication of acute articular rheumatism and chorea, or subsequently. O... Endogastric Version
A very useful and comparatively safe method is illustrated in Figs. 94 and 95. In the execution of this maneuver the pin is seized by the spring with a rotation forceps, and thus passed along with the esophagoscope into the stomach where it is rotat... Endoscopic Operations For Laryngeal Stenosis
Web formations may be excised with sliding punch forceps, or if the web is due to contraction only, incision of the true band may allow its retraction. In some instances liberation of adhesions will favor the formation of adventitious vocal cords. ... Endoscopy In Malignant Disease Of The Larynx
The general surgical rule applying to individuals past middle life, that benign growths exposed to irritation should be removed, probably applies to the larynx as well as to any other epithelialized structure. The facility, accuracy and thoroughness... Endoscopy On The Human Being
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. M... Enemas Versus Colonics
People frequently wonder what is the difference between a colonic and an enema. First of all enemas are a lot cheaper because you give them to yourself; an enema bag usually costs about ten dollars, is available at any large drug store, and is in... Enlargement Of Liver
Take A D current, with medium force. Place N. P., some three to five minutes, on left side, over the spleen; and then as much longer at the coccyx. Manipulate with P. P. over the liver. Treat about three times a week. If the enlargement be recent, i... Enlargement Or Ossification Of The Heart
Treat these two affections in the same way. Take the A D current, moderate force. Place N. P. at the coccyx, or alternately there and, with long cord, on the spine opposite to the heart. Manipulate with P. P. over the heart. Treat five to eight minu... Entering The Bronchi
The lip of the bronchoscope should be turned in the direction of the bronchus to be explored, and the axis of the bronchoscope should be made to correspond as nearly as possible to the axis of this bronchus. The position of the lip is designated by ... Errors To Avoid In Suspected Foreign Body Cases
1. Do not reach for the foreign body with the fingers, lest the foreign body be thereby pushed into the larynx, or the larynx be thus traumatized. 2. Do not hold up the patient by the heels, lest a tracheally lodged foreign body be dislodged an... Eruptive Cutaneous Diseases
Take A D current, pretty vigorous force in acute cases; mild in chronic affections. If the eruption be inflamed and acute, use long cord with N. P.; if sluggish and chronic, use long cord with P. P. Move the two electrodes parallel to each other, up... Erysipelas
Take the A. D. current, medium force, in all forms of the diseases. 1. When acute, and characterized by high inflammation, with bright, smooth swelling, and spreading gradually and sometimes rapidly to surrounding parts; or when small vesicles app... Erysipelas
This is a disease of the skin, producing redness, burning and itching pains, appearing in patches, in adults, most apt to appear about the head and face, but in children, upon the limbs, or in very young children, beginning at the umbilicus. It some... Erysipelas
_Erysipelas_ being commonly the reflexion of an internal disease with a peculiar tendency towards the skin, should not be treated locally alone, but with due regard for the original disease. If possible, the patient should perspire freely in long pa... Erythema
_Erythema_ may be considered an exceedingly mild form of erysipelas, and yields to gentle treatment, as it is given in measles. ... Esophageal Dilators
The dilatation of cicatricial stenosis of the esophagus can be done safely only by endoscopic methods. Blind esophageal bouginage is highly dangerous, for the lumen of the stricture is usually eccentric and the bougie is therefore apt to perforate ... Esophageal Foreign Body
After initial choking and gagging, or without these, there may be a subjective sense of a foreign body, constant or, more often, on swallowing. Odynphagia and dysphagia or aphagia may or may not be present. Pain, sub-sternal or extending to the bac... Esophageal Foreign Body Symptoms
1. There are no absolutely diagnostic symptoms. 2. Dysphagia, however, is the most constant complaint, varying with the size of the foreign body, and the degree of inflammatory or spasmodic reaction produced. 3. Pain may be caused by penetrat... Esophagoscopes
The esophagoscope, like the bronchoscope, is a hollow brass tube with beveled distal end containing a small electric light. It differs from the bronchoscope in that it has no perforations, and has a drainage canal on its upper surface, or next to ... Esophagoscopic Extraction Of Foreign Bodies
It is unwise to do an endoscopy in a foreign-body case for the sole purpose of taking a preliminary look. Everything likely to be needed for extraction of the intruder should be sterile and ready at hand. Furthermore, all required instruments for la... Esophagoscopy For Foreign Body
... Essentials Of A Successful, Safe Fast
1. Fast in a bright airy room, with exceptionally good ventilation, because fasters not only need a lot of fresh air; their bodies give off powerfully offensive odors. 2. Sun bathe if possible in warm climates for 10 to 20 minutes in the morning bef... Etiology
One of the most common causes of hypertension is clue to excess of eating and drinking. The products caused by maldigestion of proteins, and the toxins formed and absorbed especially from meat proteins, particularly when the excretions are insuffici... Etiology
Rheumatism is the cause of most instances of cardiac disease which date back to childhood or youth, while arteriosclerosis and chronic infection cause most cardiac diseases in the adult. In the former case it is the mitral valve which is the most fr... Etiology
The cause of an irregularly acting heart in an adult may be organic, as in the various forms of myocarditis, in broken compensation of valvular disease, Stokes-Adams disease, coronary disease, auricular fibrillation, auricular flutter, cerebral dise... Etiology
The lodgement of foreign bodies in the esophagus is influenced by: 1. The shape of the foreign body (disc-shaped, pointed, irregular). 2. Resiliency of the object (safety pins). 3. The size of the foreign body. 4. Narrowing of the esophagu... Etiology Pathology
If a chronic endocarditis has followed an acute condition, some slight permanent papillomas or warty growths may he left from the healed granulating or ulcerated surfaces. Sometimes these little elevations on the valves become inflamed and then adhe... Etiology Treatment
A subacute or a chronic infective endocarditis should be treated on the same plan as an acute endocarditis, which means rest in bed and whatever medication seems advisable, depending on the supposed cause of the condition. A chronic endocarditis ... Etiology Treatment
One has but to refer to the enumerated causes of irregular heart action to determine the treatment. In that caused by extrasystole, the treatment has just been suggested. In irregular heart caused by serious cardiac or other lesions the treatment ha... Examination Of The Trachea And Bronchi
All bronchial orifices must be identified seriatim; because this is the only way by which the bronchoscopist can know what part of the tree he is examining. Appearances alone are not enough. It is the order in which they are exposed that enables th... Exercise And Growth
Fatigue as a Danger Signal. The chief use of exercise in childhood, whether of body or mind, is to make us grow; but it can do this only by being kept within limits. Within these limits it will increase the vigor of the heart, expand the lungs, cl... Exercise While Fasting
The issue of how much activity is called for on a fast is controversial. Natural Hygienists in the Herbert Shelton tradition insist that all fasters absolutely must have complete bed rest, with no books, no TV, no visitors, no enemas, no exercise, n... Extent Of Electric Agency
When we have settled upon the position that the electricity of the heavens and of the artificial machine are identical, and that their identity is essentially one with galvanism, magnetism, the electro-vital fluid of animal and the life-force of the...