AFFECTIONS OF THE !MK.
The wounds of this part, inflicted in at tempts at suicide, often require the sur geon's assistance. After stopping any bleeding vessels, let the wound be ap proximated, by bringing the head for wards on the neck, and retaining it in that position. Sutures, placed in the trachea, cause great and very detrimental irritation : yet if the tube be cut com pletely through, and position alone will not bring the ends together, a suture should be placed, so as not to affect the lining of the tube. If the cesophagus be wounded, a hollow bougie should be in troduced through the nose, for the pur pose of conveying nourishment into the stomach ; and this may even be necessary when the trachea alone is injured. In flammation niay require bleeding, and the antiphlogistic plan. if there be cough, almond emulsion, with opium, will afford service. Foreign bodies, lodging in the cesophagus, may be either thrust down into the stomach, or drawn upwards through the mouth. The former plan may be pursued with those which can produce no harm when in the alimentary canal; the latter, with such as might prove hurtful from their hardness, indis solubility, pointed angular shape, &c. Indeed, bodies of the latter description, if very low down, must still be pushed on into the stomach, as they hardly ad mit of extraction. When the substance is near the throat, a curved pair of for ceps may remove it ; there is also an in strument made of strong flexible wire, doubled and twisted together, and bent at the end into a noose like a hook ; and other mechanical contrivances have been suggested. A common probary, probably, is the best instrument for pushing bodies onwards to the stomach, which must be done, whatever their nature is, when they cannot be got out, and produce trouble some symptoms. Often they are loosen ed, after a time, by suppuration, if small ; or they may be discharged by abscesses ; or, as pins and needles, may traverse parts of the body, and appear at a consi derable distance.
Bronchotomy is an operation in which an opening is made into the trachea or larynx, for the purpose of inflating the lungs, in cases of suspended animation ; for the continuance of respiration, when the natural passage is obstructed by dis ease ; or for the extraction of foreign bo dies from the trachea. In instances of
apparent death, from drowning, &c. it is our first object to restore respiration ; the suspension of that function has caus ed the stoppage of the other actions, and its restoration is essential to the putting of the animal machine again in motion. If this cannot be done by the means laid down in the article Daowszsa, the sim ple operation which we shall describe may be performed. Again, in diseases or tumours about the throat or trachea, and in cases where suffocation is threatened by a foreign body in the latter tube, the same remedy is necessary. A longitudi nal incision of two inches should be made in the middle of the neck, commencing just above the sternum, and continued upwards ; the parts should then be sepa rated with the finger and handle of the knife, so as to expose the trachea, which may be opened by a longitudinal cut of half an inch. Some have advised this operation to be performed by a trans verse cut between the thyroid and cri coid cartilages ; and others by a longitu dinal incision in the projecting part of the thyroid, called pomum Adam.
Wry Neck, is a deformity in which the head is drawn towards one of the shoul ders ; arising either from undue contrac tion of the sterno-cleido mastoideus, (whose fibres will be found in a very tense state) or from a relaxation, or pa ralytic condition of the opposite muscle. Perhaps cicatrices from wounds may sometimes be a cause. if it occurs in early life, sad continues long, the verte bra of the neck, and even of the back, may become deformed.
camphorated mercurial frictions, and other stimulating applica tions, electricity, blisters, issues, mecha nical means being at the same time em ployed: this plan is more particularly proper when there is Induration. Divi Zion of the clavicular portion of the mus cle, by a surgical operation, is most to be depended on.