Specular Esophagoscopy
Categories: INTRODUCTION OF THE ESOPHAGOSCOPESources: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Inspection of the hypopharynx and upper
esophagus is readily made with the esophageal speculum shown in Fig.
4. High lesions and foreign bodies lodged behind the larynx are thus
discovered with ease, and such a condition as a retropharyngeal
abscess which has burrowed downward is much less apt to be overlooked
than with the esophagoscope. High strictures of the esophagus may be
exposed and treated by direct visual bouginage until the lumen is
sufficiently dilated to allow the passage of the esophagoscope for
bouginage of the deeper strictures.
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Sentiment _versus_ Sentimentality
FREEDOM from sentimentality opens the way for true sentiment. An immense amount of time, thought, and nervous force is wasted in sentimentalizing about "being good." With many, the amount of talk about their evils and their desire to overcome them... Shock
The treatment of shock will probably always be unsatisfactory as the cause is so varied, and, although circulatory prostration and vasomotor paresis always constitute the acute condition, the physiologic health of the heart and blood vessels is so v... Signs Of Heart Weakness
It should be remembered that a normal heart may slow to about 60 during sleep, and all nervous acceleration of the pulse may be differentiated during sleep by the fact that if the heart does not markedly slow, there is cardiac weakness or some gener... Simple Dilatation
The term "simple dilatation" may be applied to the dilatation of one or both ventricles when there is no valvular lesion and when the condition may not be called broken compensation. The compensation has been sufficiently discussed. Dilatation of th... Simple Hypertrophy
Like any other muscular tissue, the heart hypertrophies when it has more work to do, provided this work is gradually increased and the heart is not strained by sudden exertion. To hypertrophy properly the heart must go into training. This training... Site Of Lodgement
Almost all foreign bodies are arrested in the cervical esophagus at the level of the superior aperture of the thorax. A physiologic narrowing is present at this level, produced in part by muscular contraction, and mainly by the crowding of the adja... Site Of Lodgment
The majority of foreign bodies in the air passages occur in children. The right bronchus is more frequently invaded than the left because of the following factors: I. Its greater diameter. 2. Its lesser angle of deviation from the tracheal axis. 3. ... Sitz-bath Anchor Of Safety
If there be much delirium, the sitz-bath may be required longer, and the pack shorter, as indicated above (81). In all such cases the packs and sitz-baths, alternately, ought to be continued, till the nervous symptoms disappear altogether, and shoul... Sleep And Rest
Why We Need Rest. A most important element in a life of healthful exercise, study, and play is rest. Even when we are hard at work, we need frequent breathing spells and changes of occupation and amusement to keep one part of our muscles, or our bra... Small Pox - Variola
This disease begins with pain in the head and back, chilly sensations, followed by a high fever, so similar in all respects to a severe attack of Bilious or "winter" fever, that it is difficult or impossible to distinguish it with certainty, as Smal... Small-pox
_Small-pox_, by far the most dangerous of them, has found a barrier in its destructive progress in Dr. Jenner's discovery. Vaccination is an almost sure prophylactic against it; but, notwithstanding, many, with whom the preservative was neglected or... Social/cultural/psychological Obstacles To Fasting
Numerous attitudes make it difficult to fast or to provide moral support to friends or loved ones that are fasting. Many people harbor fears of losing weight because they think that if times were really tough, if there was a famine or they became il... Sore Nipples
This affection of nursing women frequently comes on before the birth of the child, but generally does not make its appearance until after the suckling has continued for a week or more. It seems in some cases to be connected with the aphthae (sore mo... Spasmodic Stenosis Of The Esophagus
Etiology - The functional activity of the esophagus is dependent upon reflex action. The food is propulsed in a peristaltic wave by the same mechanism as, and through an innervation (Auerbach and Meissner plexus) similar to that which controls intes... Spatula-protected Method
Safety-pins in children, point upward, when lodged high in the cervical esophagus may be readily removed with the aid of the laryngoscope, or esophageal speculum. The keeper end is grasped with the alligator forceps, while the spatular tip of the l... Spectacles
If the operator has no refractive error he will need two pairs of plane protective spectacles with very large eyes. If ametropic, corrective lenses are necessary, and duplicate spectacles must be in charge of a nurse. For presbyopia two pairs of spe... Specular Esophagoscopy
Inspection of the hypopharynx and upper esophagus is readily made with the esophageal speculum shown in Fig. 4. High lesions and foreign bodies lodged behind the larynx are thus discovered with ease, and such a condition as a retropharyngeal absces... Spermatorrhea
The points to be gained are, to reduce the action of the amatorial organs of the brain and the secretion of the testes, and to contract and strengthen the tissue of the seminal vesicles and the prostrate gland. Take the B D current. First, treat ... Sponge-pumping
While the usually thin, watery esophageal and gastric secretions, if free from food, are readily aspirated through a drainage canal, the secretions of the bronchi are often thick and mucilaginous and aspirated with difficulty. Further-more, bronchia... Stage 2
Passing the cricopharyngeus is the most difficult part of esophagoscopy, especially if the patient is unanesthetized. Local anesthesia helps little, if at all. The handle of the esophagoscope is still pointing upward and consequently we are sure tha... Stage 3 Passing Through The Thoracic Esophagus
The thoracic esophagus will be seen to expand during inspiration and contract during expiration, due to the change in thoracic pressure. The esophagoscope usually glides easily through the thoracic esophagus if the patient's position is correct. Af... Stage 4 Passing Through The Hiatus Esophageus
When the head is dropped, it must at the same time be moved horizontally to the right in order that the axis of the tube shall correspond to the axis of the lower third of the esophagus, which deviates to the left and turns anteriorly. The head and... Stage I Entering The Right Pyriform Sinus
The operator standing (as in Fig. 66), inserts the esophagoscope along the right side of the tongue as far as and down the posterior pharyngeal wall. A lifting motion imparted to the tip of the esophagoscope by the left thumb will bring the rounded... Starches
Sources of Starch. The starches are valuable and wholesome foods. They form the largest part, both in bulk and in fuel value, of our diet, and have done so ever since man learned how to cultivate the soil and grow crops of grain. The reason is clear... Starvation
It is true that ethical medical doctors use the least-risky procedure they are allowed to use. But this does not mean there are no risks to allopathic treatment. The medical doctor justifies taking the risks by saying that the risk/reward ratio is t... Stings Of Insects
The effect produced by the sting of Bees, Wasps, and Hornets of all kinds, is so nearly, if not quite identical, that I shall make no distinction between them. There are very few, if any persons, who do not know the symptoms, at least the local effe... Stokes Adams Disease Heart Block
Stokes-Adams disease, or the Stokes-Adams syndrome, is a name applied to a combination of symptoms which was described by Stokes in 1846, and had been observed by Adams in 1827. The disease is characterized by bradycardia and cerebral attacks, eithe... Stokes Adams Treatment
The treatment of true Stokes-Adams disease is unsuccessful. If general arteriosclerosis is present, that condition should be treated. Digitalis would seem almost invariably contraindicated, although it is of value in extrasystoles without heartblock... Strabismus Discordance Of The Eyes
If neither of the rectus muscles have been cut and cicatrized, and if the deformity be not congenital, it may ordinarily be cured. Take B D current, with small pointed electrodes. If the eye be turned inward, insert P. P. in the outer angle of the... Strychnin
The question of the advisability of strychnin is a constant subject for discussion. Strychnin is overused in the cases of most patients who are seriously ill. In a patient in whom we are trying to cause nervous and muscular rest, strychnin is certai... Styptic Charms
Fancy can save or kill; it hath closed up wounds, when the balsam could not, and without the aid of salves, to think hath been a cure. CARTWRIGHT. With bandage firm Ulyss... Sudden Invasion Of The Nervous Centres
Of the different forms of scarlatina maligna the most dangerous is the sudden invasion of the nervous system, particularly the _brain_, the _cerebellum_ and the _spine_, by which the patient's life is sometimes extinguished in a few hours. In other ...