Tracheotomy in laryngeal diphtheria : after-treatment and complications / by Robert William Parker.

  • Parker, Robert William, -1913.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: Tracheotomy in laryngeal diphtheria : after-treatment and complications / by Robert William Parker. Source: Wellcome Collection.

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    rubber, flexible ivory ; but finally discarded tliem in favour of silver, recognising tbat tbe ulceration depended on the unsuitable shape of the tube, rather than on the fact of its being rigid : La forme des canules habituellement en usage n'est pas celle qui conviendrait le mieux (p. 180, op. cit.). After many unsuccessful trials, M. Roger finally adopted Ltjer^s tube with the movable collar. While admitting the immense improvement which was thus effected, as already stated I am inclined to think that much of the mischief was really due to the quarter- circle shape of the tube itself. I must refer the reader back to what has already been said on the subject of tubes. Since using the ' angular' tube, I have not had any cases of ulceration to report, CiCATEiciAL NARKOwiNa.—Narrowing of the trachea is occasionally met with. Its occurrence is possible after tracheotomy, where there has been much sloughing or destructive disease, either in the trachea or around the incision into it. I have seen one case where stridulous breathing, years after the operation, probably indicates this pathological condition. The treatment of such cases, to be of any avail, must commence early ; even then it is not very satisfactory. It should consist in the passing of graduated bougies, hollow, so that respiration can be carried on during the process of dilatation. Better still will be the adoption of such measures as will prevent its occurrence. These have been already referred to in the preceding paragraphs. (e) Accidental conditions.—Under this heading I shall include two cases, which, though not by any means unique instances, are nevertheless so rarely met with as to require separate consideration. They appear so purely accidental in their incidence that none but the most general precautions can be taken to guard against them.