File:Cleveland medical gazette (1899) (14597620408).jpg

Identifier: clevelandmedical1518unse (find matches)
Title: Cleveland medical gazette
Year: 1900 (1900s)
Authors:
Subjects: Medicine
Publisher: Cleveland OH : William W. Williams
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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say that I have had a good deal of experience in the lastfew years with such cases, but vQry few of my cases have beenthose of adults—they have been mainly cases in children. All ofthem have resuHed from the drinking of lye and the strictureshave been so small that I have never been able to get such abougie as this through them. I think it important, however, inthese cases as in cases of stricture of the urethra to begm with aslarge a dilator as can be passed through, but in these cases which1 have mentioned I have frequently been able to use nothinglarger than a filiform bougie. I think we have in such cases anannular stricture which extends along the tract. In the case ofchildren I have found that when I had improved the conditionssufficiently to pass a Xo. 28 bougie the dilation was all that wasrequired. The passage of a No. 6 or 8 has always been enough togive temporary relief so far as swallowing fluids was concerned.This case seems to me to be a rather unusual one because the
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stricture dilates so readily and contracts so rapidly. I questionwhether cicatricial contraction could be responsible for a stric-ture which can be dilated so readily. Such a stricture might re-sult from something pressing upon the esophagus from without,and if such w^ere the case we could easily understand that press-ing the growth widely away, or whatever obstructs the passage,might give relief for a few days, and then the growth would comeback to its old position. I have devised a set of bougies for Society Proceedings. smaller strictures but not for one of this size. A No. 30 is prob-ably the smallest size that can be gotten at the stores here and Iwas obliged to have the ones made which I am using. After passing the filiform bougie I next pass a whalebonebougie about a No. 3 or 4, and when it is dilated to this extent 1am usually able to insert the first of my series of graded bougies,beginning with the No. 6. These dilators are so arranged thatall bougies have two olive form bul

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