\ 
BOTANIC PHYSICIAN. 
ough which a quantity of air may be transmitted, fully sufficient. 
for the purposes of respiration ; or, the perforation may be made, 
_ with an. instrument similar to a flat trocar; and which is perhaps 
the neatest way, as in using this, the blood is not so liable to get 
through the opening into the wit pipe, causing convulsive cough. 
Before introducing the tube, it should be passed through the 
tre of three or four thin compresses of linen; these not only 
serve to cover the pledget of emollient ointment with which the wound 
should he protected, but by taking off one.or more of them, which 
_ may be easily done by cutting up their sides with a pair of scissors, 
the length of the tube may be thus augmented at pleasure; and 
which in the event of the parts about the wound becoming. swelled, 
_ isa very important precaution; for when neglected, a very slight 
swelling on the sides of the sore will throw the tube out, For this 
purpose, too, the tube should never be less than two inches long + 
when first introduced, just as much of its extremity should be left 
_ uncovered by the compresses as admits of its passing easily into the 
windpipe. If any swelling takes place, one, two, or more plies of 
__ the linen being cut off, will still admit of the tube penetrating to the 
_ >A double tube, that is, one within the other, is preferred by many. 
‘When one tube only is used, it js apt to fill with mucus ; and as it 
must frequently be taken out for the removal of this, respiration in 
the meantime is apt to be impeded, but when a double tube is em- 
ployed, the inner one can be easily taken out, cleaned, and replaced, 
while the other is left in the opening. When, therefore, the outer 
canula of the tube is properly fixed, the inner one having been pre- 
viously adapted to it, and the opening in the canula covered with a 
piece of crape, or fine muslin, to prevent the admission of dust, the 
operation is in this manner completed. oes 
_ As the intention of this operation is to obviate the inconveni- 
ences atising from an obstructed respiration, it is evident that the 
canula should be continued in the wound as long as the cause that 
gave rise to it exists.. Ifa piece of bone or other substance has 
passed into the windpipe, and if this cannot be extracted at the 
opening newly made, a curved probe should be introduced at it in — 
order to ascertain the situation of the extraneous body: and this 
being done, another perforation must be made directly above it. In 
this manner, this cause of the disease may, in some instances, be re- 
_ moved, and when obstructions of a different kind are found to take” 
_ place, the means best adapted for their removal should be imme- — 
_ diately employed. But till the breathing becomes perfectly easy, 
‘the tube should be continued ;. and when, at last, it is judged proper 
to withdraw it, the skin should be immediately drawn over the ori- 
fice, and retained there with a piece of adhesive plaster, by which 
means a cure of the sore will soon be obtained, 
OPENING THE GULLET. 
Substances are frequently taken into the funnel, which in passing 
into the gullet, are too bulky to be forced down to the stomach by 
_ the muscular exertion of the parts at which they stop. When any 
