Bronchotomy : a paper read by appointment before the Covington Medical Society, January 3, 1853 / by Asbury Evans.

  • Evans, Asbury.
Date:
1853
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Licence: Public Domain Mark

Credit: Bronchotomy : a paper read by appointment before the Covington Medical Society, January 3, 1853 / by Asbury Evans. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    Mr. President: I propose to-night to call the attention of the Society to the sub- ject of Bronchotomy, so called from bronchos, the wind-pipe, and teneo, to cut. The operation, according to Galen, was first pro- posed by Asclepiades, and is, therefore, of great antiquity. It has ~, been practiced ever since his time in some of the affections of the throat threatening suffocation. Of late years it has had a much more extended applicatien — only proportionate, however, to the broader and more exact views of modern physiology and pathology. In bronchotomy either the larynx or trachea may be opened. Formerly the French and many of the English surgeons gave the preference to laryngotomy. Now, tracheotomy is more esteemed —although the former operation is still done by many surgeons. Fergusson, in one place, says it is scarcely possible to name an in- stance in which laryngotomy possesses any advantage over trache- otomy; but in another he remarks, that, where a foreign substance is lodged in the larynx, or on account of the shortness of the neck, as in an infant, the crico-thyroid membrane should be divided. (Fergusson, p. 433.) Liston, in his Practical Surgery, says: The existence of a foreign substance being clearly ascertained, an opening must be! made into the trachea; and further, If fixed in the larynx, entan- gled in the lima, or lodged in one of the ventricles, the foreign body can be felt by the introduction of an instrument upwards; it can then be seized, or it can be displaced, either upwards into the fauces, or brought down through the opening in the neck. And again he repeats, Under all circumstances, tracheotomy is to be preferred to laryngotomy. But Liston was not always impartial in judging of surgical pro- ceedings. He was often a partisan in the advocacy of his pet operation. Bichat thought laryngotomy always answered as well tracheotomy, and in some cases better. Samuel Cooper (Surgery* vol. II, p. 30) thinks laryngotomy evidently preferable if the sub- i ^ stance is lodged between the edges of the glottis, or in the ventri- cles. He relates a case which was in the Hotel Dieu, under Fer- rand. A stone had fallen into the glottis; tracheotomy was per- formed, but only a little blood and mucus escaped. The patient