Early diagnosis of cancer of the esophagus : a new technic of X-ray examination / Anthony Bassler.

  • Bassler, Anthony, 1874-
Date:
1913
Catalogue details

Licence: In copyright

Credit: Early diagnosis of cancer of the esophagus : a new technic of X-ray examination / Anthony Bassler. 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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    in shape and measures about 10 cm. in its circumfer- ence. The tube is lubricated with glycerin and passed in the usual manner of a stomach-tube, or a mandrin may be employed to assist in its introduction. It is allowed to go down to beyond a mark made on the tube about 40 cm. (T.5% inches) from the upper end of the bag. The bag is then in the stomach, after which it is filled with water by means of the syringe. When this is done, the cock is closed and the tube is pulled on so that the bag is drawn tightly into the funnel-shaped cardiac orifice of the stomach. The patient is now told to exhale completely so as to raise the dome of the dia- phragm to a high level, and the external tube is held tightly at this point. It is then fastened about the fore- head of the patient, a double knot being employed to hold it, or in some instances it may be fastened around the neck. This is decided according to whether the patients have an opening in the teeth line, because it is desirable to have the tube rest on the gum rather than over the sharp edges of the teeth. In most instances, for comfort and quick work, an external weight may be employed to hold the bag tightly against the cardia (this is now my preference). Any weight of from one-half to one pound answers for the purpose. There is no dan- ger of the tube breaking because there is a silk string inside the tube to keep it from stretching too far. At the same time, the length of the string within the tube is such as to permit the first 40 cm. to stretch 2 inches, this being made so as to allow for the excursion of the diaphragm in ordinary respiration which is about 2 inches at this part of it. When this has been accom- plished, a mixture of bismuth, acacia and water is run into the gullet from an irrigating jar by means of an ordinary urethral catheter, preference being given to one of large size in order to have a stiffness for ready intro- duction. A study of a number of cardiospasm plates wherein there is only a slight degree of dilatation of the esopha- gus shows that the diameter of the gullet throughout its entire course runs about 3 cm., and the length of the normal gullet is about 23 cm. This capacity may be taken as a high standard for size, and represents about 160 c.c. It is wise to fill the gullet for an examination. Therefore 150 c.c. of suspension are placed in the irri- gating jar and allowed to flow in until the bismuth mix-