Practical observations on organic obstructions of the oesophagus : preceded by a case which called for oesophagotomy and subsequent opening of the trachea / by John Watson.

  • Watson, John, 1807-1863.
Date:
[1844]
Catalogue details

Licence: Public Domain Mark

Credit: Practical observations on organic obstructions of the oesophagus : preceded by a case which called for oesophagotomy and subsequent opening of the trachea / by John Watson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Art. II.—Practical Observations on Organic Obstructions of the (Eso- phagus ; preceded by a case which called for (Esophagotomy and sub- sequent opening of the Trachea ; ivith accompanying illustrations. By John Watson, M.D., Surgeon to the New York Hospital. L* Mr. John Ames, of Easton, Massachusetts, aged 24, of tall and spare habit, previously in the enjoyment of moderate health, was seized in the latter part of October, 1843, with a cough, which lasted for a week or two, and left him, about the first of November, with marked difficulty of degluti- tion. Having always had what he called a narrow swallow, and being subject to frequent turns of choking, he did not at first pay much attention to the present difficulty. But it soon became more serious, obliging him frequently to leave the table while eating, and, at length, to eat by himself, and with the utmost caution. He consulted a surgeon of Boston, sometime during November, who recommended the occasional introduction of a probang, the application of a blister to the throat, and daily inunction with hydriodate of potassa ointment around the neck. This course was followed for a few weeks, without relief. About the 1st of January, 1844, the difficulty had so far increased, that he was obliged to relinquish the use of solid food, and to subsist wholly on soft and fluid substances. He came to New York about the middle of January, and the surgeon whom he first consulted here, thought he was enabled to pass an ordinary urethral catheter below the seat of obstruction in the throat. The patient came under my care on the 19th of January. At that date it was utterly impossible to pass an instrument of any size beyond the point of stricture. A gum-elastic catheter, introduced by the mouth, came in contact with the obstruction, at the distance of seven inches from the edge of the front teeth of the upper jaw. The patient was living entirely on fluids. He was free from cough, he had no pains of any sort, no soreness or ten- derness about the throat either from pressure or from attempting to swallow. He was evidently emaciated and enfeebled; he had a frequent and copious flow of saliva and mucus from the mouth, probably in consequence of the obstruction to the passage of these fluids downwards. The thyroid bodies were larger than usual, and one or two lymphatic glandular swellings existed on either side of the throat, just below the angles of the jaw. The fauces were free from inflammation, the tonsils were not enlarged. The epiglottis could be fairly brought into view by depressing the tongue; but every thing about the fauces, within the range of vision or within the reach of the finger, was perfectly healthy. The patient had never before suffered from any severe illness. He was one of a numerous family, none of whom were subject to any serious disorder. He had, however, always been rather delicate. His mother had for years supposed he was of a scrofulous diathesis. 27*