Case of foreign body in the air-passages / by James Struthers, M.D.

  • Struthers, James.
Date:
[1852]
Catalogue details

Licence: Public Domain Mark

Credit: Case of foreign body in the air-passages / by James Struthers, M.D. 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.

    8/10 (page 6)
    The first opportunity I had of examining Neal, was in the latter end of 1848, four yeai's after the accident. The history of the case then was such as to excite a suspicion that a foreign body liad entered the air-passages at the time supposed by the patient, and had remained there ever since; while the physical examination of the chest established the existence of an open cavity of some extent near the middle of the lung. Such being the state of matters, all operative interference seemed to be contra-indicated ; as, even had all doubts of the presence of a foreign body been removed, the pi'obabiHty was^ I that it would be lying in the cavity, and therefore beyond the reach of instruments. I am not aware of any case of recoveiy, whether sjDontaneous or by operation, being on record in which more than two years had elapsed from the date of the accident. In those which have lasted longer, death took place sooner or later from dis- organisation of one or both limgs, either from tubei'culosis or gan- grene ; and the fatal issue would seem to have been equally certain^ whether the foreign body remained in the lung or was exjielled the efforts of nature. When the latter event has taken place, as it has done ten or even seventeen years after the accident, the case has either terminated suddenly, or the morbid process has gone on unchecked by the removal of its original cause, the disorganisation which had taken place before the expulsion ha-sdng been so great as' to prevent recovery. Had the bone been removed in this case, even fotu- years after the accident, there is good reason to believe that recovery would have taken place, as only a small portion of the' lung was seriously implicated, the general s^nnptoms mild, and the constitution of the patient but little affected. A point of considerable pathological interest in the case, is the] absence of all ulceration at the part where the foreign body was im-J pacted; the only change discovered, after carefiil examination, bein^ thickening of the mucous membrane. That the bone must have rea mained all along in the place whei'e it was found, is almost certaina otherwise, fi'om its comparatively small size and its sponge' textuPM it would have been frequently projected up to the larynx, giving rin to paroxysms of cough, none of which ever occvuTed ; besides, thesB was no thickening of the mucous membi*ane in any other pai't; ajM the cavity which was first formed opened directly into the tube M the mouth of which the bone lay. Another point of pathologicw interest, was the existence in the fluid from the gangi'enous absceaW at the apex of the lung of large quantities of me crystals of tbil triple phosphate and m'ate of ammonia, formed, no doubt, on thfl spot by the destruction and decomposition of the surrounding tissues Their form was exactly the same as that in which they exist in thi^ urine. ■ MURRAY AND OIDD, FRINTEItS, EDINBURGH.