The laryngoscope : illustrations of its practical application, and description of its mechanism / by George Duncan Gibb.

  • Gibb, G. Duncan (George Duncan), Sir, 1821-1876.
Date:
1863
Catalogue details

Licence: Public Domain Mark

Credit: The laryngoscope : illustrations of its practical application, and description of its mechanism / by George Duncan Gibb. Source: Wellcome Collection.

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    assume, therefore, that it is the first instance wherein this new apphance was made use of for the diagnosis of an impacted substance. Through the kindness of Mr. J. W. Turner, of Lower rhilhmore Place, Kensington, I was requested to examine with the laryngoscope, a lad of 13, the son of Captain C, on tlie 19th of November, 1862. Some months before, when at dinner with the family, a piece of walnut- shell became lodged in his larynx, and after six weeks of occasional paroxysms of cough, he had a severe attack of laryngitis, which neces- sitated the operation of tracheotomy, which was skilfully performed by Mr. Paget. This at once relieved the urgency of the symptoms, yet did not effect the removal of the offending cause, which Mr. Turner believed must be still lodged in the sacculus of the larynx. I employed the laryngoscope with the patient sitting up in a chair near the fii-e, and had a good view of the parts, the mirror being very well borne against the uvula. At first there was spasm and resistance, but this wore off, and the larynx was found to be clear of obstruction above the vocal cords, which were mostly approximated. A cm-ved canula passed through the tracheal woimd from below upwards readily felt a foreign body, manifest both to Mr. Turner and myself. Its position was shifted, and another view was taken of the larynx, and this time one end of the walnut-shell could be distinctly seen below the vocal cords, projecting in the middle, across the rima from left to right, as represented in the engraving drawn at the time. Several efforts were made to dislodge it from below without success, but its position must have again become chang- ed, for it could not now be seen from above, chiefly owing, however, to closure of the glottis. It was apparently j ammed in the subglottic space, and could not be detached, even although the patient was under the influence of chloroform. We thought it prudent not to interfere further. The ashy-grey appearance of a, The epiglottis. 6, The vocal cords, the foreign body, bathed in secretion, with the piece of nutshell between, verv strildns'. projecting across the glottis from ^ \ • T\/r T)„™„+ left to right, c, The tongue. On a subsequent occasion Mr. Paget enlarged the woimd upwards, and passed his finger through the glottis from below and also from above, and felt no body then remaining. In conversing with liim about the case in the middle of January, he coincided with me in the opuiion that it had been coughed up before the second operation, and probably swallowed. I subsequently learnt that the wound had perfectly healed, and the young gentleman was never in better health in his whole Kfe. Congenital deformity' and arrest of development of the lart/nx, in an adult deaf-mute. A man, set. 54, born deaf and dumb; married three years—no