Tracheotomy in laryngeal diphtheria : after-treatment and complications / by Robert William Parker.

  • Parker, Robert William.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: Tracheotomy in laryngeal diphtheria : after-treatment and complications / by Robert William Parker. Source: Wellcome Collection.

Provider: This material has been provided by University of Bristol Library. The original may be consulted at University of Bristol Library.

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    tube is removed: thus the whole calibre of the trachea is available for breathing purposes. Meanwhile, the habit of using the larynx is gradually restored ; its performance of the healthy functions tends little by little to restore the normal nerve mechanism, which was disturbed partly by the disease and partly by the operation. In judging how much is due to disordered nerve func- tion, and how much to some other (possibly mechanical cause), we may rely chiefly on the fellowing points : in the nervous cases the difficulty of breathing intermits, disappearing for hours together at times when the patient's attention is directed to some other subject, the voice is nearly always unaffected, and expiration is unimpeded; on. the other hand, when the voice is husky, the difficulty of breathing persistent, inspiration and expiration alike difficult, we may almost feel sure that there are local conditions to account for the symptoms. Miscellaneous Cases. Sudden death.—Apart from local conditions, there is a danger to which tracheotomy patients are liable : I mean the danger of sudden death. In my own experience not less than four such cases have occurred during the last ten years. It would seem as if this danger is asso- ciated with injury or disease of all the organs supplied by the pneumogastric nerves. Case 1 —A well-nourished sturdy little boy, aged eighteen months, came under observation on account of a ' croupy' cougb, which had commenced some four or five days earlier. He was found with symptoms of laryngeal catarrh—fever, dyspncea, huskiness of voice, with general restlessness and want of sleep. Tracheotomy had to be shortly performed, as the foregoing symptoms soon became greatly aggravated. In opening the trachea, the isthmus of the thyroid gland was found to be