CHAPTER X. 



OPERATIONS ON THE THROAT. 



Passing the Probang. — The probang is passed whenever a 

 foreign body is suspected in the throat or oesophagus out of 

 reach of the forceps. The mouth is fixed open with a speculum, 

 whilst the probang, after being carefully lubricated and the 

 stilette twisted a little so as to compress and stiffen the horse- 

 hair portion, is passed lightly and carefully down the oesophagus, 

 care being taken that it does not enter the trachea and so 

 cause asphyxia. If the foreign body is a large one, such as a 

 piece of bone or gristle, gentle and continuous pressure must 

 be applied ; on no account must undue force be exerted,, or 

 laceration and rupture of the oesophagus may result as a sequel. 

 If the obstruction is a small one it may either be forced on- 

 wards or withdrawn with the probang ; needles and fish bones 

 are often removed in this latter way, becoming fixed either in 

 the sponge at the extremity or in the horsehair brush portion. 



Before being withdrawn the handle of the stilette is pulled 

 upwards out of its socket and, if thought necessary to stiffen 

 it, slightly twisted ; it is then taken out and examined, or it 

 may be passed gently up and down the oesophagus for a few 

 times. Probangs are made of different sizes, and especial care 

 must be taken to use a sufficiently small one, as otherwise the 

 oesophagus is apt to become injured when violent pressure is 

 put upon it. In inserting it, too, there is occasionally difficulty 

 in guiding it past the larynx. 



CBsophagotomy. — When a foreign body becomes so firmly 

 lodged in the oesophagus that it cannot be moved by forceps 



