T R A 



T R A 



in the event of the trocar flipping. This riflt may be avoided 

 by fixing the trachea well, and particularly by ufing fome 

 inftruments, which were invented by Bauchot, an old furgeon- 

 maior of the French navy. They confift of a cutting blade 

 mounted on a handle, to which is adapted a flat cannula, the 

 openin'i- of which has a rim furniflied with two fmall rings, 

 and of a kind of ileel crefcent, which ferved to fix the tra- 

 chea, and as a conduftor to the firll inllrument, which was 

 called the bronchotome. Bauchot employed thefe inftruments 

 fuccefsfully upon two perfons attacked with quinfey, and 

 threatened with fuffocation. 



It may be concluded from all which has been faid, that 

 the operation of tracheotomy, which is alfo named broncho- 

 tomy , and laryngotomy, may be fuccefsfully pradlifed, when 

 patients are in danger of lufFocation in cafes of inflammatory 

 quinfey ; when refpiration is obftrufted by the lodgment of 

 a foreign body in the ocfophagus, which body can neither be 

 extrafted, nor pufhed down into the ftomach ; and when 

 an extraneous fubftance has fallen into the wind-pipe. In 

 quinfies, and in cafes of foreign bodies lodged in the oefopha- 

 gus, the operation confifts in making an opening, through 

 which the air can enter to the lungs. In the cafe of a foreign 

 body in the trachea, an incifion is required, which divides 

 longitudinally feveral of the cartilaginous rings of this tube, 

 which is of a fize proportioned to that of the fubfl;ance to 

 be extrafted. 



When merely an opening is required for the pafFage of 

 the air, the furgeon may proceed in feveral different ways. 

 In the oldeft method, the patient was placed in the recum- 

 bent pofture, with his head fupported on pillows, fo that 

 the flcin of the front and lower part of the neck could be 

 pinched up into a tranfverfe fold, of which one end was held 

 by an afliftant, the other by the furgeon himfelf with his left 

 hand. This fold was divided from above downwards, and 

 the incifion was continued from the lower part of the larynx 

 to the front of the upper edge of the fternum. The cellular 

 fubftance between the fterno-hyoidei and fterno-thyroidei 

 mufcles, was next divided down to the fore-partof the thyroid 

 gland and trachea. This canal being expofed, the furgeon 

 puts his left-hand index -finger between two of the cartilagi- 

 nous rings, and then pafling along his nail the inftrument of 

 which he has made choice, he makes a tranfverfe incifion in 

 it. When he judges a cannula indifpenfable, Bauchot's in- 

 ftrument is the beft, the perforating part of which fliould 

 be [taken out immediately the trachea is divided, fo as to 

 leave only the tube, which is to be fixed in its place with fuit- 

 able ribbands paffed through the httle rings. In this manner, 

 there is no rifli of blood falling into the trachea, becaufe the 

 wound is filled by the inftrument with which it is made. If, 

 on the contrary, the tube be confidered ufelefs, the furgeon 

 (hoold ufe a lancet with rather a long point. 



Inftead of praftifing tracheotomy, or bronchotomy, fur- 

 geons have been recommended to perform the operation of 

 laryngotomy, as more fafe and eafy. The lower edge of the 

 thyroid cartilage, and the upper edge of the cricoid cartilage, 

 are connefted together by a thick ligamentous membrane, 

 covered in front merely by the integuments. This anterior 

 part of the crico-thyroid membrane is alfo immediately 

 oppofite the higheft and broadeft portion of the cavity 

 of the larynx, direftly below the glottis, fo that it is not 

 only eafy to bring it into view by a fuperficial fmall cut 

 through the flcin and cellular fubftance, but the incifion may 

 be made longitudinally, by which its union will be facilitated, 

 and there can be no rifk of hurting the oppofite fide of the 

 larynx. In Prance, this mode of operating has had feveral 

 diftmguiftied advocate», and the celebrated Vie-d'Azyr com- 



municated to the Societe de Medecine fome obfervations con- 

 cerning it. 



In whatever manner the operation may have been prac- 

 tifed, fome attention muft be paid to the dreffing of the 

 wound. If the fole objeft has been to rcftore refpiration 

 during the fhort period of time necen"ary for die removal of 

 a foreign body lodged in the cefophagus, there is no reafon 

 why the wound fliould not be fpeedily healed. Suppofing 

 the trachea, or larynx, to have been opened by a tranf- 

 verfe incifion, the patient's head muft be inchned forwards, 

 and the edges of the longitudinal wound of the flcin brought 

 together. When the operation has been praftifed to reUeve 

 the fuffbcation caufed by quinfey, the paflage of the air 

 through the wound muft be promoted, until the diminution 

 of the inflammation of the parts about the throat allows the 

 air to pafs the natural way. The cannula which is ufed 

 muft be covered with gauze, in order to prevent the entrance 

 of extraneous fubftances in the atmofphere, or bits of the 

 dreffings. The wound ftiould be covered with pledgets and 

 comprefles, and the whole fupported with a fuitable bandage. 

 Such are at leaft the means recommended by methodical 

 writers ; but Sabatier obferves, that experience has not 

 confirmed their propriety. To fome praftitioners (he has 

 proved, that it is difficult to keep the cannula in its place ; 

 to others fhe has fliewn, that the tube becomes fiUed with 

 mucus, by which it is rendered ufelefs. Sabatier even 

 thinjcs, that it might be better to omit altogether the em- 

 ployment of the cannula, and nothing would be more eafy, 

 were laryngotomy performed as above explained. The fuper- 

 ficial fmall wound required in this operation, may be left 

 uncovered with dreffings, and no inconvenience will follow. 

 Sabatier's Medecine Operatoire, tom. iii. p. 25, Sec. 

 edit. 2. 



TRACHICHTHYS, in Ichthyology, a genus of fifties, 

 firft defcribed by Dr. Shaw in the " Naturalift's Mifcel- 

 lany," the charadters of which are as follow : head rounded 

 in front ; eye large, mouth wide, toothlefs, defcending. 

 Gill-membrane furnifhed with eight rays, of which the four 

 lowermoft are rough on the edges. Scales rough ; abdo- 

 men mailed with large carinated fcales. There is one 

 fpecies ; i>jz. 



T. AusTRALls, or Southern Tr. With mailed abdomen ; a 

 native of the coaft of New Holland. Its colour is a bright 

 pink-ferruginous, or fair reddifh-brown. The middle part 

 of all the fins of a deeper colour than the reft of the animaT, 

 and the edges lighter, or of a yellowifh tinge. 



TRACHIDNA, a name given by Jovius and fome others 

 to the draco marinus of the old authors, called by us the 

 •weeDcr. 



TRACHINIA, in Ancient Geography, a canton of 

 Theffaly, in the Phthiotide, near mount Oeta. It is alfo 

 called Melide. In this country was the town of Heraclea, 

 fince called Heraclea Trachinise. Thucydides. 



TRACHINItE Petr.«, high and inacceffible rocks 

 which bordered a plain near the Maliac gulf. They fur- 

 rounded the Melide. Between thefe rocks and the fea flowed 

 the river Melas, whence the territory had its name. 



TRACHINUS, in the Linnsean fyftem of Ichthyology, 

 the name of a genus of fifh of the order of the Jugulares : 

 the charafters are, that the head is compreffed and not fmooth : 

 the membrane of the gills has fix rays, and the lower lamina 

 of the opercula is ferrated : and the anus is near the breaft. 

 Linnaeus mentions one fpecies, inz. theDraco. Artedi refers 

 the Uranofcope alfo to this genus. 



The name is originally Greek, the w^rd ■r^ax"''''? fignify- 



ing rough, fharp, or prickly. It was given to this fifh from 



N 2 tlic 



