A manual of diseases of the throat and nose : including the pharynx, larynx, trachea, œsophagus, nose and naso-pharynx / by Morell Mackenzie.

  • Mackenzie, Morell, 1837-1892.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: A manual of diseases of the throat and nose : including the pharynx, larynx, trachea, œsophagus, nose and naso-pharynx / by Morell Mackenzie. Source: Wellcome Collection.

    25/610 (page 13)
    obstruction—i.e., no organic stricture. An instrument lias lieen invented by Dr. Gaston Sainte-Marie/ by means of which it is jiroposed to measure the calibre of the gullet through- out its entire extent, or at any given point. It consists of a hollow sound, at the lower end of vdiich is a small olive-shaped bag made of india-rubber, so that its capacity is diminished by very slight jiressure. Into the upper extremity of the sound is fitted a graduated glass tube, about ten centimetres long, jirovided at its upper part with a stopcock and a metallic funnel, lly this means water, or some coloured liquid, can be poured into the instrument, thus ihstending the hag at the other end to the fullest extent. It is obvious that any pressure on the Avails of the hag will cause the fluid to rise above its original level in the glass tube, and the greater the pressure the higher Avill the contained fluid he forced. I am not aware that this instru- ment has ever been tried in actual practice, ami it is evident that it Avould be difficult to use in such a way as to obtain any trustworthy results. CEsiipha(josii(>pii.—This method consists in the visual examination of the interior of the gullet by means of suitable instruments. These must necessarily be in the form of tubes, and their use is always likely to he attended Avith consideralfle difficulty ; for, unlike the larynx and trachea, Avhich are nearly ahvays open to inspection, the orifice of the gullet is closed, and loAver doAvn the Avails of the canal are usually in more or less clo.se apposition. Further difficulty arises from the spa.smodic contraction, so easily set uj), of the muscular tunic of the oesophagus, ami also from the pharyngeal irritation Avhich almost unavoidably occurs in introducing instniments. The older surgeons do not appear to have endeavoured to OA'ercome these difficulties, and the first attempt to examine the gullet during life Avould seem to have been made by Semele<ler and 8toerk in 1866.^ This e.xperiment, hoAA'cver, yielded only negative results. The instrument enqiloyed appears to liaA'c con.sisted ojf a forceps Avith s[)Oon-sha])ed ^ “ Des (litfereiits inodes d’c-xploratiou de TOisopliage. ” i’ai is, 1875, p. 21. ■ Private letter from Profcs.sor Stoerk, November 13, 1880. Dr. Stoerk has since published an account of this experiment in the article in which his more recent invention is descrilied (“Wien. klin. Wochenschrift,” No. 8, February, 1881).