Observations on the surgical pathology of the larynx and trachea, chiefly with a view to illustrate the affections of those organs which may require the operation of bronchotomy: including remarks on croup, cynanche laryngea, injuries by swallowing acids and boiling water, foreign bodies in the windpipe, asphyxia, wounds, etc / [William Henry Porter].

  • Porter, William Henry, 1790-1861.
Date:
1837
Catalogue details

Licence: Public Domain Mark

Credit: Observations on the surgical pathology of the larynx and trachea, chiefly with a view to illustrate the affections of those organs which may require the operation of bronchotomy: including remarks on croup, cynanche laryngea, injuries by swallowing acids and boiling water, foreign bodies in the windpipe, asphyxia, wounds, etc / [William Henry Porter]. Source: Wellcome Collection.

    263/296 (page 251)
    there should be no hesitation in undertaking its removal where- ever such operation is practicable. 2. Hemorrhage into the trachea I have already mentioned as an extremely distressing symptom, and one which may possibly prove embarrassing to the surgeon. In order, however, to ap- preciate the danger likely to arise from this accident, several circumstances must be taken into consideration, amongst which are the size and situation of the wounded vessels, the size of the wound in the trachea, and the possibility of the vessel being secured either by ligature or otherwise. If there is a wound of a large vessel, and consequent profuse hemorrhage accompa- nied by an extensive injury of the larynx or trachea, there is seldom much time to apply for professional aid, and in such a case, and thus circumstanced, the patient must be singularly fortunate if he escapes at all. In most cases of attempted sui- cide the wound is situated between the thyroid cartilage and the os hyoides, and fortunately there are no vessels in that space likely to give rise to a fatal hemorrhage: here, however, some branches of the superior thyroid artery may be wounded, or in some circumstances even of the lingual, and these will pour forth a sufficient quantity of blood to render the patient’s situation both distressing and alarming. It is easy for a prac- titioner to talk of tying the bleeding vessel, and thus restrain- ing the hemorrhage; but it is sometimes a difficult matter to do it, and the young surgeon should be prepared to encounter cases of the most teasing and perplexing nature. The patient is anxious, agitated, and restless; perhaps he is tossing about in the frenzy of delirium; the blood is flowing freely into the larynx, and there is incessant cough, and sometimes convulsive struggling to maintain respiration: every plunge of the needle or tenaculum causes the patient to start away, and thus it be-