On congenital fistulae of the trachea : A pathologico-therapeutic commentary ... / Translated ... by R. Knox.

  • Dzondi, Carl Heinrich, 1770-1835
Date:
1848
Catalogue details

Licence: Public Domain Mark

Credit: On congenital fistulae of the trachea : A pathologico-therapeutic commentary ... / Translated ... by R. Knox. Source: Wellcome Collection.

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    a 4 DZONDI ON CONGENITAL known to surgeons ; that it had been often present hut mistaken for an ulcer of a different nature, appears very probable to me, because the same thing occurred to myself at the beginning, and only after long and repeated observations in the first about to be related, did I at length learn to under¬ stand the true nature of the case. Be the thing as it may, however, I delay no longer, as I consider it my duty to communicate those facts to the learned which I have collected by experience, respecting the cure and diagnosis of congenital fistula of the trachea, this opportunity of writing being afforded ; and also respectfully to invite those who have observed any cases mentioned by their contemporaries, or read of such in the works of our ancestors, kindly to publish them or communicate them to me. The following will be the plan of the pamphlet:—I shall first relate some cases, from which I de¬ rived certain knowledge of this anomaly ; I shall then proceed to make some observations concerning the cause of the fatal termination of a case and finally, I shall explain the symptoms of the anomaly, with a proper method of cure. Case 1st._C. Schwarz, a woman, set. 28, the wife of a tailor at Halle, of delicate constitution, came to me in 1821, to request medical advice for a fistulous ulcer of the neck, under which she had laboured for some time. The ulcer was situated in the anterior and left part of the neck, about an inch from the centre of the trachea. Luring her childhood this swelling had been entirely overlooked, or perchance taken for an incipient sci ofulous affection ; afterwards, when it sensibly increased in bulk and extended across, it u as stimulated by external applications, rubbing with the grey ointment of mer¬ cury and plaisters, and was at length opened by a surgeon. Eiom that time a cure was in vain attempted by various remedies, such as injections, oint¬ ments, plaisters, caustic, &c. Eor this reason she requested my aid, and was for some weeks under my care. After various caustics had been tried to no purpose, the fistuke was at last healed by injecting ‘ liquor nitrici hydrargyri. After some weeks, however, the same swelling appeared in the middle or lower part of the trachea, about the size of a pea, in the region of the thyroid cartilage, and sensibly increased in size. Having made an incision, I examined more carefully the nature and tendency of the abscess, and I now found a narrow fistulous canal, deeper in the region of the incisura of the tlijroid cartilage, entering the trachea. I suspected its true nature, though not yet its congenital anomaly. The liquor nitrici hydrargyri, being again injected, effected a closure of the fistulous orifice, but after some days a passage again disclosed itself and the flow of mucous continued. When I was preparing to attempt a cure by substituting another remedy and method of treatment, the woman did not return, and I, being about to visit I ranee and England, neg¬ lected to attend the case. From this period I ascertained nothing concerning her; but I was lately informed that the woman lived till 1827, and was afflicted with fistula until the day of her death. A post-mortem examination was made, and the fistula found ; it was examined by the medical man, but not so carefully as to make him certain, respecting the thread-like canal, as these sinuses are wont to be very narrow. From this case I first became acquainted with fistula; of the larynx and trachea, but I did not yet suspect that they were congenital.