Volume 1

A manual of surgical treatment / by W. Watson Cheyne and F.F. Burghard.

Date:
1912-1913
Catalogue details

Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: A manual of surgical treatment / by W. Watson Cheyne and F.F. Burghard. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

    503/606 (page 475)
    nothing more is required. If tlie breathing be not restored by these means the next step is— (2) Open the mouth, by means of the gag which should always be at hand (Fig. 216), if necessary, seize the tip of the tongue in the forceps (Fig. 217), and pull the tongue forcibly forwards. This does not move forward the base of the tongue to any appreciable extent, but mainly acts reflexly, and causes the re- traction of the soft tissues in front of the glottis, and is, therefore, of particular service in the condition described by Lord Lister (see p. 462). (3) Should the above manceuvres have no effect, the next proceeding is to explore and clear out the air-way. The finger is passed to the back of the throat, and used as a hook to draw forward the epiglottis and base of the tongue, and this has often a very marked effect, and should on no account be neglected. At the same time, anything in the shape of a foreign body can be felt for, and, if found, attempts may be made to remove it with the finger, or by means of the laryngeal forceps. The throat must be sponged to get rid of the mucus and blood, and, if this be excessive, the patient may very gently be turned on one side. Fig. 217.—Tongue Forceps. If a foreign body or definite obstruction can be felt, but cannot be removed witli the finger or by means of the forceps, and if the asphyxia is becoming more intense, the question of tracheotomy may now arise but mere feeble breathing, without definite signs of obstruction, is no indication for opening the trachea. It is absolutely essential to commence with the abo^'e three proceedings as preliminary to anything else that may be done ; it is useless to attempt to force air into the chest, by artificial respiration or other means, unless we first assure ourselves that the air-passages are clear. Violent