. Annals of surgery . foundthat there was nofistula leadingfrom the fragment of slull to the wound cavity. In consultations with theCommanding Officer, Dr. Kaymcmd Spears and Dr. J. Chalmers DaCosfa if wasdecided that the fragment should be removed, for which the patient was referredto the Bronchoscopic Clinic, by bronchoscopic bismuth subnitrateinsufflation by the authors methodt showed (Fig. 2) that the fragment wasinaccessible by peroral bronchoscopy because of its location too far around thecorner, froin the main bronchus, in the upper left lobe; whereas it would bereadily ac
. Annals of surgery . foundthat there was nofistula leadingfrom the fragment of slull to the wound cavity. In consultations with theCommanding Officer, Dr. Kaymcmd Spears and Dr. J. Chalmers DaCosfa if wasdecided that the fragment should be removed, for which the patient was referredto the Bronchoscopic Clinic, by bronchoscopic bismuth subnitrateinsufflation by the authors methodt showed (Fig. 2) that the fragment wasinaccessible by peroral bronchoscopy because of its location too far around thecorner, froin the main bronchus, in the upper left lobe; whereas it would bereadily accessible through the peripheral lung-tissue at a depth of about 4 cm. The lung-mapping gave us the location of the large vessels which bearmore or less constant relation to the tracheobronchial tree. In collaboration with Dr. Willis F. Manges the thoracopenetrator (Fig. 3) t Jackson, Chevalier. The Bronchial Tree, Its study by Insufflation of Opaque Substances in the jLiving. Amer. Journ. Ront., October, 1918. p. IXTERCOSTAL THORACOlUXCTUKE was devised. The parallel sides were designed to prevent leakage of air or bloodpast the instrument at least before the cornpletion of the seizure and withdrawalof the foreign body. The point was designed to push aside rather than penetratelarge vessels. As suggested by Dr. Thomas Shallow, if the pleura should provetoo thick for penetration a puncture with a very slender tenotome would give thepenetrator a start. The possible dangers considered were: i, open pneumo-thorax : 2, hemorrhage with its associated risks of shock, h^, infected hemothorax, intrabronchial leakage and from the pulmonary artery, which Dr. J. Parsons SchafFer determined tobe w i t h i n onecentimetre of thesliell fragment: into theexternal suppu-rating cavityw h i c h did notpreviously com-municate with theiiircign body; of thepericardiumwhich lay closeposteriorly. A 11of these dangerswere cons
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Keywords: ., bookcentury1800, bookdecade1880, booksubjectsurgery, bookyear1885
