Laryngology : stricture of the larynx : clinical lecture delivered at the Jefferson Medical College / by J. Solis-Cohen.

  • Solis-Cohen, Jacob da Silva, 1838-1927.
Date:
[between 1890 and 1899]
Catalogue details

Licence: Public Domain Mark

Credit: Laryngology : stricture of the larynx : clinical lecture delivered at the Jefferson Medical College / by J. Solis-Cohen. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    to him the day before. He got perfectly well. A few weeks after- wards, on account of a recurrence of these growths, I split open the larynx a third time. A few months afterwards I was compelled to open the trachea below the tube and remove some growths there. I think I performed the last of these operations some six years ago. Since then there has been no occasion for a major operation; but there has been a great disposition to repullulations in the parts originally implicated, and I have taken out several masses through the mouth upon various occasions and at varying intervals. The result of these repeated proliferations of tissue and removal by evulsion and by elec- tric cauterization has been to produce an irregular stricture of the larynx at the glottis, so that the lad has been compelled to wear his tracheotomy-tube as a permanent fixture. I made repeated attempts at dilating this stricture as opportunities presented in the very irregular intervals of the patient's attendance, but without much progress. The methods pursued will be described to you a little later, in connection with some general observations on the treatment of stricture of the larynx. Some two years ago I thought I would attempt to relieve the boy of his tube, and sent him to the Children's Hospital and put in an intubation-tube, which he wore for several weeks. I did not see that it did any good. After removing the tube I thought the parts were more constricted and the passage for air smaller, and I replaced the tracheotomy-tube. Shortly afterwards I removed the tracheotomy-tube and had the child carefully watched, thinking perhaps he might be able to do without it; but a few days later he was brought to my office in the arms of a nurse, black in the face and unconscious,—in fact, almost asphyxiated. I seized an ordinary trocar and canula that was lying on my table and plunged it into the trachea at the seat of the original orifice, withdrew the trocar and left in the canula; and a few minutes later, after respiration had become re-established, I enlarged the wound and put in a tracheotomy-tube. He has worn a trache- otomy-tube ever since, though not the same tube all the time. I determined to defer further efforts at relief until the period of puberty should be reached, and which is now approaching. For the last few months the boy has been able to breathe with the orifice of the tube closed with a cork. And now I propose to have him stay in this hospital a while where he can be watched, while we make another attempt to see whether he can do without the tube. You know that after puberty the larynx in the male grows very rapidly. Before that period the larynx of the male and that of the
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