Case of a foreign body impacted in the orifice of the third branch of the right bronchus : with remarks / by John Gregory Forbes.

  • Forbes, John Gregory.
Date:
[1850]
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Licence: Public Domain Mark

Credit: Case of a foreign body impacted in the orifice of the third branch of the right bronchus : with remarks / by John Gregory Forbes. Source: Wellcome Collection.

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    upon which the chief reliance was placed as indicative of its presence. Supposing, then, the diagnosis to be as clearly established as it can be under such circumstances, and from the alleged nature of the foreign body, there is small probability of its being ejected, I cannot help feeling that an early attempt might be made to extract it by the usual mode. Although on the first trial it may not be possible to seize or even to feel it, a second may be more successful, and if it cannot be extracted, it may be displaced sufficiently to allow of its expulsion, as occurred in Mr. Porter’s case already quoted. But suppose, as has happened, every effort to remove it should fail, further experience is wanted to prove that the operation itself is attended with that amount of risk which would warrant the surgeon in depriving the patient of the prospect which it affords of immediate and, most probably, permanent relief. It is the opinion of Sir Benjamin Brodie, that under all circumstances the trachea should be opened,1 and Dr. Mason Warren, of Boston, states, “that if a case of the kind occurred to him, he should at once perform the operation of tracheotomy, and by a free use of ether, attempt to allay the irritability of the air-passages, so as to allow a more easy exploration by instruments than is generally afforded in the natural state.-” He admits at the same time, that the judgment of the surgeon must be determined by the circumstances of the particular case.3 I feel, however, considerable diffidence in advocating the operation in the presence of those so much better entitled to form a just opinion of its merits, and who, from the difficulties which attend the diagnosis, the irritation produced by the forceps, the injury which may be inflicted by them, and the uncertainty of being able to grasp and extract the foreign body, deem it more prudent to abstain from surgical interference. Case.—Mrs. W., set. 46, of pale complexion and thin 1 Med.-Chirurg. Transactions, vol. xxvi, p. 297. 2 Vide Boston Medical and Surgical Journal, Dec. 1847.