Barbour County index. [volume] (Medicine Lodge, Kan.) 1880-current, 1888-07-04
ABOUT TRACHEoTOMY.
An Operation Frequently Resorted
To in Throat Diseases.
The Surgical Treatment TO which, the
Crown Prince OF Germany Was Re-
Gently SubJected-Its Effects Said
20 BE Not Curative.

Grown Prince OF Germany Was Re-
Gently Subjected-Its Effects Said
TO De Not Curative.
One Of the most prominent physicians
and surgeons in the city gave Cincinnati
Enquirer reporter a description of the oper-
alton TO which the Crown Prince was re-
Gently subjected. Said the dOctor:I
"Tracheotomy is an operation resorted TO
when from any cause there is an obstruc-
ton 10 the free entrance Of AIR to the lungs
through the upper part Of the air passages.
These air passages consist of tube about
four and One-half inches in length and a little
less than an inch in diameter. The upper
part Of this channel is peculiarly arranged
and narrowed; this is called the larynx. 1t
is in the larynx that by the vibration of two
slender chords sounds are produced. The
framework Of the trachea and larynx con-
sists of rings OF cartilage or gristle, clothed
upon the inside by a delicate skin, or
mucous membrane Since the trachea is Of
larger caliber than the larynx that Is above
It, the difficulty in breathing, which would
follow an obstruction Of any kind in the
larynx above, can be remedicd at least
temporarily by opening the trachea or wind
pipe below the seat of obstruction. This
operation is called tracheotomy, and the
conditions calling for il may be a foreign
body, a tumOr, an inflammation of the
gristle, or the presence Of q membrane in
the larynx. The latter is the condition in
diphtheritic Group, the disease most frequent
ly calling for this operation. Probably
ninety per cent. of all tracheotomies are
made in children and for this disease, which
so often appears in epidemic form. In the
case Of the Crown Prince the condition
calling for tracheotomy has been either
cancerous tumor or an inflammation Of the
cartilages Of the larynx, with thickening OF
its lining membrane TO degree greatly in
terfering with the free entrance of air to
the lungs. Which of the cond tons exists
has not been positively determined, although
from the opinions of Sir Morel Mackenzie
aud Virchow, the disease is prob
ably a pericondritis with thickening
liberation of the mucous membrane. What
ever be the disease, tracheotomy was indi-
Gated 10 alleviate the most pronounced and
dangerous symptom, the difficulty in breath
ing When made for this purpose, trache-
otOmy is not a dangerous operation Indeed,
it was known and practiced a hundred
years before the Christian era. The opera
ton itself will not be fatal in more than ten
per cent. Of cases, and when the fatality is
greater it depends upon the condition for
which the operation is made. If, for ex-
moval of a foreign body only twenty per
cent. Of the cases operated upon will die,
whereas, when the operation is made in
cases of diphtherihc Group only thirty per
cent recover. This fatality must be ascribed,
not to the operation, but to the disease,
which extends down the lungs or kills the
patient by affecting his blood In the case
Of the Crown Prince the tracheotomy may
be but preliminary operation, to be event
ually followed by one contemplating the
removal Of more or less of the diseased
larynx above the tracheotomy wound.
The operation is sufficiently simple in the
hands Of a cool surgeon. The patient is
placed upon his back, with pillow placed
under the neck, and anRsthetized. A fold
of skin is raised and transfixed with
knife, aud a wound from one to two inches
in length is thus made in the central line
of the neck from the prominent portion of
the larynx toward the upper portion of the
breastplate. The knife is then laid aside,
and with a small pair of forceps the soft
parts are slowly torn asunder until the
windpipe is reached. The bleeding, which
is generally most feared, can be entirely
obviated by tearing through the soft parts
after the SKIN has been divided. When the
trachea is reached it is opened in the cen
trial line by an incision half an inch or less
in length. Through this incision in the
trachea a silver, aluminium or hard rubber
tube is inserted through which the patient
breathes. The operation itself does not take
long, and usually the tube can be placed in
the trachea within two minutes of the time
tho cut is first made. This tube remains in
the trachea until the obstruction TO breath
ing disappears Sometimes in cases of can
Ger or Of Inflammation Of the cartilages of
the larynx, the tube must be worn during
the remainder of life. Where the opera
ton has been made successfully for the re-
moval Of foreign bodies. or in cases of
diphthcritc Group it can often be removed
after the lapse of from one day 20 a week
"And what effect will this operation have
upon the Crown Princem
"The operation is not curative 1t will
probably prolong life, and that is all. Here,
as in other cases, tracheotomy is merely in
tended TO relieve one symptom, the diff
Guilty in breathing
HAS the operation been often performed
in this cityl'
"Very frequently and almost always for
the relief Of Group. For this disease the
operation is a comparatively recent one, and
has been established particularly by the
French physicians, BrettOneau and Trous-
seau, who were the leading lights Of Paris
during the first half Of the present century.
There is among the laity an adherence for
tracheotomy in Group, because seventy per
cent. died notwithstanding the operation.
Without it, however, for its more recent
substitute, intubation, all thus afflicted sue
cumb. In intubation the tube is inserted
into the larynx through the mouth without
an incision, This in the case Of the Crown
Prince was in no way applicable. do not
think he has much chance for recovery in
case it is necessary to remove the diseased
larynx."