Foreign bodies in the air passages / By J. Mason Warren.

  • Jonathan Mason Warren
Date:
[1847?]
Catalogue details

Licence: Public Domain Mark

Credit: Foreign bodies in the air passages / By J. Mason Warren. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

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    with more impunity. If flat, they naturally present an ecke to the tube, so as to permit the passage of air on either side. When lodged in the bronchus, such a substance becomes after a time enveloped in mu- cus, so as to obstruct the free act of respiration ; it is then forced upwards, and in the struggle which ensues the mucus is disengaged. The body then falls back, and remains quiescent until it again becomes covered with mucus, when the process of dislodgement is repeated. Sometimes in the violent cough, which occurs at the change of place of this body, it is. forced out into the mouth and swallowed, or ejected ; at others, by coming up suddenly, when the patient’s attention is distracted, it takes the larynx as it were by surprise, and easily escapes. interesting case of this latter class occurred in a little girl, a patient of Dr. Hale, in whom tracheotomy was performed by Dr. J. C. Warren, foi the removal of the wooden stopper of an inkstand, which had been sucked into the trachea. As soon as this passage was opened, all irrita- tion subsided, the foreign substance settled down into the bronchus, and although the wound was kept open a week, and attempts made to dis- lodge it, they were without avail. Some months afterwards, as the pa- tient was looking out of a window, very intently watching the passing of a military company, the substance came up without effort, into the mouth, and was at once expelled. 3d. If the substance is fixed in the bronchus, and the patient young, the prospect of seizing it by instruments introduced through the wound and carried down in the direction of the lungs, is extremely small. In fact I do not know of a single successful case upon record, with the ex- ception of one, in which Mr. Liston opened the trachea of an adult, and introducing the forceps with some difficulty, seized a bone, which had become engaged in the right bronchus. 4th. Some doubts will arise, however, as to the propriety of leaving in any case a foreign substance for a period of time in the lungs, without an effort to remove it. For although it may finally become detached and be ejected, as it frequently is, after remaining many months or years imbedded in the substance of the lungs, or stowed away in the bronchial tubes, yet fatal organic lesions are not uncommonly the result. The judgment of the surgeon must therefore be determined by the cir- cumstances of the particular case. It is remarkable in how great a number of these cases, which we find recorded as having occurred in children, the substance introduced was a common garden bean. Dr. Twitchell, of Keene, N. H., in the New England Quarterly Journal of Medicine and Surgery, mentions two instances, in which he operated with success. Many of a similar char- acter may be found, by looking through the different periodicals. Should another case of this kind occur to me, I should at once per- form the operation of tracheotomy, and by a free use of ether attempt to allay the irritability of the air-passages, so as to allow a more easy ex- ploration by instruments, than is generally afforded in the natural state. Boston, December 9, 1847.
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