American practitioner and news . ade is in delay, the physician yielding to thenatural inertia of the family; in view of the fatal consequence,disregard of these vital signs deserves sharpest criticism. The expert intubator should have a competent understand-ing of the therapeutic effect of antitoxin so that when con-sulted he can by the degree of dyspnea, the amount of antitoxinalready given and the length of time since administrationjudiciously decide whether or not immediate intubation is Kahn: Intubation 213 demanded; be must consider also the age and strength of thepatienl and how promptl
American practitioner and news . ade is in delay, the physician yielding to thenatural inertia of the family; in view of the fatal consequence,disregard of these vital signs deserves sharpest criticism. The expert intubator should have a competent understand-ing of the therapeutic effect of antitoxin so that when con-sulted he can by the degree of dyspnea, the amount of antitoxinalready given and the length of time since administrationjudiciously decide whether or not immediate intubation is Kahn: Intubation 213 demanded; be must consider also the age and strength of thepatienl and how promptly he can Be summoned in ease delajis decided on. If after weighing these considerations there isdoubt -tlicii intubate! Indecision equally with unwarrantedinactivity is responsible for the high Eatality of acute Laryngealstenosis. This paper is offered as a plea for early intubation;the physician is not justified in assuming the rfels of hesitationthat under a cyanotic dloud robs the tube of its benefits, thechild of its Diphtheritic casts (A) bronchial (B) nasal(actual size) How to Intubate. Appreciating thai resl in bed and theavoidance of exercise arc essential in the proper treatmenl ofdiphtheria, I intubate with the patient in the dorsal recumbenlposture which, though rendering the op ration somewhal moredifficult, avoids the increased cardiac strain incidental to theusual uprighl position. Enveloping the child in a sheel orblanket, snugly pinned as a mummy dressing to prevenl itsstruggles, further conserves the weakened heart. The gag,placed on the left side, is opened and steadied bj a finger of 21U The American Practitioner and Nezvs. the assistant as he firmly holds the head in the median intubator at the patients right, having armed the in-troducer with the properly selected tube previously threaded,holds the instrument loosely in the right hand while his leftindex finger is passing into the open mouth and the epiglottishooked up—then with cautious
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