The principles of surgery Author:John Burns Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: will also make us very scrupulous in employing the caustic bougie. "Were the disease strictly local, and not very extensive, the portion could, without dividing ... more »any nerve or vessel, except the oesophageal branches, be cut out, and fluids afterwards injected into the stomach, bya tube inserted into the oesophagus, from the external wound. But the difficulty of ascertaining the extent and connexion of the disease, and the hazard arising from the effect of the wound on the system, must be considered as discouraging. Making an aperture in the oesophagus below the stricture, and introducing a tube, by which fluids could be injected into the stomach, is not immediately hazardous, and may be the mean of prolonging life for some time. The operation of simple oesophagotomy is less dangerous than the excision of even a small portion, for there is only an opening made in the tube, which is still left a continuous canal, that may be expected to heal over a flexible tube inserted from the nostril. This operation, or rather pharyngotomy, may be required, on account of substances impacted in the end of the pharynx, and where, from the inflammation and suppuration likely to be produced by them, and the necessity of inserting a tube from the nostril into the larynx, or opening, and preserving open, the larynx by laryngotomy, we calculate on more certain evil, than may follow extracting the substance. The first steps of the operation are similar to those for exposing the common carotid artery, and therefore I will not detail them here. The incision, if we have our choice, should be on the left side, as the tube rather inclines in that direction, but we must be regulated by the projection of the substance. We carry the incision from the side of the thyroid to some way below the cricoid cartilage, an...« less