Case of a foreign body impacted in the orifice of the third branch of the right bronchus : with remarks / by John Gregory Forbes.

  • Forbes, John Gregory.
Date:
[1850]
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Licence: Public Domain Mark

Credit: Case of a foreign body impacted in the orifice of the third branch of the right bronchus : with remarks / by John Gregory Forbes. Source: Wellcome Collection.

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    to decide the question. For this purpose, more extended experience, derived from individual cases, is necessary, as the only means of determining whether the dangers resulting from the efforts made to extract the foreign body, are greater than those to which the patient is exposed if it is allowed to remain undisturbed in its position, and the powers of Nature are trusted to for its expulsion. It is with this view that I venture to bring before the Society a case which has recently occurred at the Western General Dispensary. The symptoms induced by the impaction of a foreign body in a bronchial tube differ materially from those which arise when it moves up and down in the air-passages during the act of respiration. In the latter case, the continued laryngeal irritation gives rise to repeated attacks of convulsive cough and threatened suffocation; in the former, these are not observed, but the symptoms are then referable to the impediment offered to the ingress and egress of the air on one side of the chest, to which succeed inflammation of the bronchial membrane, and of the parenchymatous tissue of the lung, entirely, or in part, and sometimes of the pleura itself.1 It is not my purpose, however, to enter into details of the symptoms occurring in such cases, which have been ably described in the writings of Porter, Stokes, and others; but I may briefly refer to the relative fatality which attends this accident when no surgical relief has been attempted, to the practicability of the operation, and to the success which has followed its accomplishment. The fatality which ensues from a foreign body remaining in the air-passages, led Mr. Porter to remark, “ that if not removed, it tends, sooner or later, to the one inevitable consequence—the destruction of the patient.^2 In looking over, however, the histories of published cases in which it was fixed in a bronchus, we find that in a small pro- 1 Craigie’s Pathological Anatomy, 2d edit., 1848, p. 589. 2 Porter on the Surgical Pathology of the Larynx and Trachea, 1887, p. 190.