13S 
EDITORIAL. 
The Tracheal Insufflation of Meltzer. —If, in a curar- 
ized clog, whose trachea is open, a tube is introduced in the respir¬ 
atory tract as far as the tracheal bifurcation, and if through this 
tube is made to pass a continuous current of air under a given 
pressure, the heart keeps on beating regularly and the animal 
remains alive during several hours, without, however, making the 
slightest respiratory motion. To succeed all that is necessary is 
that the tube reaches nearly to the tracheal bifurcation and that 
its size should be smaller, half or two-thirds that of the trachea, 
so as to allow the easy return of the insufflated air. 
If, continues Mr. Lenormant, in the Presse Medic ale, the ani¬ 
mal is not curarized, the tracheal insufflation leaves the respira¬ 
tory movements to continue, but renders them slower (6 to 8 
minutes with a pressume of 12 mm. Hg.) ; with a higher pressure 
(20 to 25 mm. Hg.) apnea takes place and the cardiac beatings 
are slower, but still regular. Therefore, thanks to the continued 
insufflation of air in the trachea, gaseous exchanges in the lungs 
take place as in normal respiration and hematosis is perfect, and 
thus is realized a true artificial respiration, without active or 
passive respiratory movements of the thorax, without change in 
the size of the lungs. And this artificial respiration is not inter¬ 
fered with by the free opening of the thorax; both pleura can be 
freely incised, a large portion of the thoracic walls can be resected 
without collapsus of the lungs, without any trouble occurring; 
the lungs remain immobile, in a state of middle distension, and 
conserve their normal, rosy coloration. 
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* * 
These facts were established by two American physiologists, 
Aner and Meltzer, in 1909. From them interesting practical de¬ 
ductions were made and upon them were stablished new methods 
of narcosis and of artificial respiration. If the air, insufflated in 
the trachea carries anesthetic vapors, such as after passing in a 
bottle of ether, a regular and easy anesthesia will rapidly follow. 
The method was first applied in experimental surgery. 
Meltzer himself, then Elsberg and Neuhof used it with success 
in several hundreds of animals. It is by it that Carrel was enabled 
