Foreign bodies in the air-passages : the substance of two clinical lectures delivered in the Western Infirmary, Glasgow / by Hector C. Cameron.

  • Cameron, Hector Clare, 1843-1928.
Date:
[between 1890 and 1899]
Catalogue details

Licence: Public Domain Mark

Credit: Foreign bodies in the air-passages : the substance of two clinical lectures delivered in the Western Infirmary, Glasgow / by Hector C. Cameron. 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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    thirst inclined her for. She never seemed to dread its entrance intcj ' the larynx, and quite unconcernedly aided its escape into the saucer hy a gentle gurgling cough, while at the same time she continued to drink from the vessel at her mouth. In this way she seemed to be able to ju’event any of it from passing into the chest. She ultimately made a complete recovery, although she suffered for a time from marked jiaralysis of the ciliary muscles and some slight paralysis of the lower limbs. Many explanations have been offered of this peculiar complication in the after-treatment of tracheotomy cases. It is never observed until some days after the operation, and is not unfrequently supposed by the medical atteudant to be due to ulceration into the oesophagus by the pressure of the end of the tube. But that this is not .so is proved by the fact that all difficulties connected with swallowing cease as soon as the tube has been removed, and the circular granulating Avouud has contracted sufficiently to bring its sides into apposition, and so put a stop to breathing in the neck. Nor is the occurrence due to the presence of the tube preventing the trachea from rising during deglutition (Holmes, “Surgical Diseases of Children”), because, if one removes the tube, milk will still escape with equal freedom by the patent wound ; and I have seen it occur freely in a gaping suici- dal wound in the neck, in which a poi’tion of the thyroid cartilage had actually been cut out. In this case the oesophagus was entire, and the escape of liquids did not occur for more than a week after the inflic- tion of the wound. Once more, it is not to be accounted for by a diph- theritic paralysis of the muscles concerned in swallowing (Spence, Buchanan, and others), since it occurs in cases other than those of dijih- theria. Mr. Bryant has recorded an instance in which it proved a troublesome complication, where the tracheotomy was undertaken for oedema of the glottis in a child who had shortly before swallowed a quantity of hot liquid (Guy’s Hosjntal Reports, vol. vi., 3d series). Besides, I am not aware that jiaralysis of deglutition in diphtheria over leads to the entrance of fluids into the larynx, as it is more liable to occasion their return by the anterior nares. All that need be said at ]iresent (for I 'will not pause to attempt any phvsiological exjilanation of the occurrence) is that in these esises the larynx has lo.st for the time that extreme sensitiveness and alertness of muscular spasm which usually succeed in ju’cvcnting the ingress of anvthinfr foreign. But wliat concerns us mo.st at in’e.sent is the fact that it also lo.ses, after breathing has been fairly established through the neck, the tendency to prevent the escape through the glottis, by the