The diseases of the stomach / by Dr. C.A. Ewald.

  • Carl Anton Ewald
Date:
1900, ©1897
Catalogue details

Licence: Public Domain Mark

Credit: The diseases of the stomach / by Dr. C.A. Ewald. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    protuberances or to a posterior displacement of the liyoid bone or nervous spasm of the oesophagus. In such cases it is necessary to use a more rigid tube, and, according to the resistance to be over- come, we may try either one of the above described silk tubes, or a so-called red English tube made of catgut varnished over. 1 no longer use the black French bougies, which were formerly so popu- lar, as they wear out too easily. The majority of the above instruments are Y5 ctm. [29^ inches] long, so that, having been introduced into the stomach, only a small piece is left projecting between the teeth, as we may usually reckon the distance from the incisor teeth to the lowest point of the greater curvature as being 60 to 65 ctm. [23| to 25|^ inches]. For further manipulations, this small projecting piece may be lengthened before or after its introduction by attaching a small piece of glass tubing with a suitable length of rubber tube of the same size; or, if the upper end of the stomach tube is funnel-shaped, we may insert a hard rubber stopcock, one side of which has a conical end with a screw thread, while the other side is a smooth tube over which soft rubber tubing may be slipped. For cases of dilatation of the stom- ach I have had extra long tubes made with a length of 95 ctm. [3Y^ inches].* All stiff instruments which are introduced into the oesophagus or stomach, as the sponge probang, bougies, etc., ought to be held in the right hand like a pen ; the left index finger is passed into the patient's mouth and depresses the tongue, the tip of the finger pass- ing to the epiglottis if possible ; the tube is then passed rapidly along the left index finger to the posterior pharyngeal wall, and then, and not before, by raising the right wrist the point of the in- strument is depressed into the oesophagus. The more quickly and boldly you manipulate the more easily will the tube pass, and the less will the patient be annoyed. The danger of entering the larynx is greatly exaggerated, and the detailed accounts given about it in * These tubes can be obtained at Miersch, Berlin W., Friedrichstrasse 66. [At ray request the Davidson Rubber Company have made Ewald stomach tubes with a graduated scale on the tube up to 25 inches ; a special mark is made at the 16th inch to show when the tube enters the cardia. These tubes may be had of J. Camp' bell, 328 Lezington Avenue, N. Y.—Ed.]