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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    air-passage and the vexatious and mischievous delay it may cause. Besides it enables the operator to accomplish his purpose without the assistance of another person. The proposed alteration consists in substituting a curved silver tube for the straight cannula, and in having part of the shaft of the trocar formed of conjoined links. Sundry other tracheotomes—some very ingenious—have been pro- posed since, but none of them has ever been widely used. It seems probable that the earliest surgeons did not use any cannula after opening the trachea ; at all events, there is no account of them ; and I am unable to state by whom they were introduced. Fabricitjs used a short, straight tube. Casserius preferred them slightly curved. Habicot, somewhat later, returned to the straight tube. Perhaps the most important change as regards the tubes was the introduction of the double tube in 1730. This is due to Dr. George Martin, and is recorded in the thirty-sixth volume of the 1 Philosophical Transactions/ p. 448. The author is giving An account of the opera- tion of Bronchotome. The case seems to have been one of laryngeal diphtheria : the operation was completely successful, the cannula being removed on the fourth day. He says, I cannot but think it an ingenious proposal of one of our ministers here to make the pipe double, or one within another; that the innermost might safely and easily be taken out and cleaned when necessary without any molestation to the patient. . . Of hardly less importance was M. Koger's adoption of Luer's px'oposal to have the tube attached to a moveable collar, thus per- mitting it to follow the movements of the larynx. The great desideratum, of being able to dispense with a tube altogether seems as far from its realisation as when Walther,1 many years ago, decried the use of every kind 1 ' Graefe and Walther's Journal,' vol. ix, p. 204.