Remarks on the operation of bronchotomy / by William Martin, Esq. (Bengal Medical Service).

  • Martin, William, Bengal Medical Service
Date:
1853
Catalogue details

Licence: Public Domain Mark

Credit: Remarks on the operation of bronchotomy / by William Martin, Esq. (Bengal Medical Service). Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    canula in Broncliotomy is not a new proposition. The Guy's Hospital Reports, Vol. VII., contain a paper by Mr. Hilton, in which he describes the use of a curved trocar and canula, which are figured in the accompanying illustration, and various curved trocars and instruments called Tracheotomes have been sometimes brought into use, particularly by the French. It seems to have been almost invai-iably the prac- tice to use these means as secondary, to succeed the primary dissections, &c.; but I am of opinion, that in the large majori- ty of cases, no dissection is necessary, and no instrument is required, but a shortened straight trocar with its canula, and the only considerations requisite are, as to the calibre of the instrument and whether it would be best to use a cylin- drical or a flattened trocar. I am convinced, that in a large number of cases, particularly in children, a curved instru- ment, such as is above alluded to, if not quite impracticable, would not be so manageable, nor so completely under the command of the operator, as a short straight instrument; the latter may be completely guarded from doing the slight- est injury by placing the fingers round and immediately pos- terior to the point and edges, whereas, when the larynx is, as is frequently the case with children, at any rate, in constant and convulsive movement, much harm might pos- sibly be done by plunging in a long instrument with a considerable curve, which must be worked by medi- um of the handle, at a considerable distance from the part to be entered into the air passage. There would be the greatest danger, I conceive, of its point and sharp angles going too far, either anteriorly or posteriorly, so as to transfix the walls of the canal either way, or to either side ; with a restless patient, it would be almost beyond the control of the operator. In some cases, in which we might find, or have reason to suspect, that important blood-vessels are in the way, or we cannot exactly discern the shape of the trachea, from its being