Clinical Observations on the Introduction of Tracheal Tubes by the Mouth, Instead of Performing Tracheotomy or Laryngotomy

CASE IV.-In this case, the tracheal tube was intended to be used during -eradication of an epitheliomatous tumour, this intention being frustrated by the demise of the patient whilst under the influence of cbloroform, the tube, however, not being then used. The man was about sixty years of age, but looked older, probably in consequence of excessive alcoholic indulgence, which had been kept up for many years. He had chronic bronchitis with muco-purulent expectoration, in consideration of which considerable doubt was expressed to him about operating; but, as he was very anxious to have the rapidly extending disease era.dicated, it was determined to do so. Owing to the state of his lungs, it was deemed necessary to make a preliminary trial of the tube, in order to observe its behaviour under the profuse expectoration. The tracheal tube was passed, and, during -its retention, considerable quantities of muco-purulent secretion were expelled-onseveral occasions quiite clear of the tube, and even in some instances for a considerable distance beyond it-two, three, and even four feet beyond the nozzle of the tube. In order to lessen the secretion, a few days were allowed to elapse, during which remedial measures