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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    was the proceeding attended with much difficulty, and the patients recovered.1 We have, however, high authority for stating that, in some cases, serious and insurmountable obstacles do present themselves to the completion of the operation. In the uase recorded by Sir Benjamin Brodie, in the 26th volume of the Transactions of this Society, though attempts were made on two separate occasions to extract a coin from the right bronchus, through an opening in the trachea, the convulsive cough was so great on the introduction of the forceps, that it could not be felt, and it became necessary to desist. The same occurred in a case lately published by Mr. Solly, and a similar one is mentioned by Mr. Porter, as having occurred in the person of a boy 5 years of age, in whose right bronchus a bean had lodged. Several attempts were made to remove it, but without success. The presence of the forceps in the trachea produced the most intense distress, and the operation was abandoned. The bean was after¬ wards moved by a probe, and coughed out through the wound.3 Another argument which may be brought forward against the operation, is the difficulty of determining the exact position of the foreign body. This is undoubtedly attended with much uncertainty, and it becomes a matter of great moment to decide the question as to the nature of the evidence upon which the attempt to extract it would be justified. The auscultatory signs, though open to fallacy from the existence of previous disease in the lungs, are the chief guides. In the case now to be related, a persistent expiratory sound, at first a “cooing rhonchus,” and degene¬ rating into a peculiar “ whiff” or “ puff,” heard most clearly over the right bronchus, together with the pain experienced in that situation, and the consequent voluntary efforts made by the patient to expel it from thence, were the symptoms J Liston’s Practical Surgery, 4tli edit., chap. xi. 2 Medical Times, vol. xix, p. 557. 3 Porter on the Surgical Pathology of the Larynx and Trachea, 1837, p. 218.