. Modern surgery, general and operative. problem of the button or other disk-like object witha sharp point. If withdrawn with a plain forceps applied as at A, the point, B, will rip openthe esophageal wall. If grasped at C, the point, D, will rotate in the direction of F and willtrail harmlessly behind. To permit rotation, the authors rotation forceps are used as at U. mountable obstruction. This is the constriction made in the esophagus by thecontraction of the diaphragmatic musculature. To overcome this, moderatebut continuous pressure in the right place is necessary. The proper place is aro
. Modern surgery, general and operative. problem of the button or other disk-like object witha sharp point. If withdrawn with a plain forceps applied as at A, the point, B, will rip openthe esophageal wall. If grasped at C, the point, D, will rotate in the direction of F and willtrail harmlessly behind. To permit rotation, the authors rotation forceps are used as at U. mountable obstruction. This is the constriction made in the esophagus by thecontraction of the diaphragmatic musculature. To overcome this, moderatebut continuous pressure in the right place is necessary. The proper place is arosette-like sUt to be found by aiming the tube in the direction of the left an-terior superior spine of the ileum. As soon as the hiatus yields the tube-mouthtraverses the abdominal esophagus (about 3 cm. in length in the adult) soquickly that the tube seems at once to enter the stomach. So deceptive isthis that until demonstrated by the author, esophagoscopists mistook the Chevalier Jacksons Direct , Bronchoscopy, etc. loii. Fig. 650.—Foreign bodies removed from the esophagus by peroral esophagoscopj without anesthesia and without mortalit)^ lOI 2 Surgery of the- Rcsi)iratory Organs hiatal constriction for the cardia. The so-called cardiospasm is really anexaggeration of the normal spasmodic contraction, not at or of the cardiabut of the diaphragmatic musculature at the hiatus esophageus. Throughoutan esophagoscopy the aspirator, I, F, K, Fig. 627, is kept going by a nurseThis is efficient with the usually thin secretions encountered. Sponges oncarriers as described under bronchoscopy arc used as adjuncts. Esophagoscopy and Gastroscopy for Surgical Diagnosis.—The ease andcertainty with which diagnoses can be made in a few minutes without anes-thesia and without pain in cases of esophageal disease, have resulted fromdevelopment of a perfected technic. Endo-esophageal lues, tuberculosis and
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