File:Interstate medical journal (1917) (14597055640).jpg

Identifier: interstatemedica2419unse (find matches)
Title: Interstate medical journal
Year: 1917 (1910s)
Authors:
Subjects: Medicine
Publisher: St. Louis, : Interstate Medical Journal
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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he vocal cords I had determined on apreliminary tracheotomy through which I could better meet orobviate this accident. Furthermore, I did not wish to repeat ageneral anesthetic. Under local anesthesia a low tracheotomy was made throughwhich a short (9 mm. Jackson bronchoscope was introduced andthe foreign body located. Dr. Merrick McCarthy, who was assistingme, then screwed the special extractor into the hole in the foreignbody which was easily withdrawn with the bronchoscope until thetracheal opening was reached, when it was stripped off. I imme-diately seized it with a forceps and extracted it. It proved to bea brass umbrella ferrule (Fig. 5, B) 15 mm. long and 10 mm. in itswidest diameter. Comment.—These cases illustrate certain features of foreignbodies in the bronchi. In the first place physicians and laymen 928 INTERSTATE MEDICAL JOURNAL realize that foreign bodies can readily be removed and patientsare no longer neglected, but are more frequently sent to clinics andhospitals.
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A. B. C. Fig-. 5.-—A, bullet, actual size, removed from bronchus (Figr. 1). B, umbrella ferrule, actual size, removed from bronchus (Fig. 3). C, upholstery tack,actual size, spontaneously expelled from bronchus. The physical findings and roentgenograms were characteristic inthe first case for complete obstruction of a bronchus, while in thesecond, although the foreign body was a large one, a by-pass forair could be diagnosticated. The necessity for improvising in-struments to meet unusual conditions is especially well demon-strated in Case II. I find that Richardson1 devised an instrumentresembling a cork-screw to remove a rubber eraser which pluggeda bronchus, while the instrument which I employed may be likenedto a bolt and nut. The use of a flexible forceps has some advantageswhen the tactile sense is employed in extraction, since there is butslight danger of traumatizing the tissues with such an instrument.Although Jacksons contention is correct, that foreign bodies shouldbe sei

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