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as seen. 4. The shape, size and position of a foreign body, and its relations to surrounding structures, should be studied before attempting to apply the forceps. (Exception cited in Rule 10.) 5. Preliminary study of a foreign body should be from a distance. 6. As the first grasp of the forceps is the best, it should be well planned beforehand so as to seize the proper part of the intruder. 7. With all long foreign bodies the motto should be "Search, not for the foreign body, but for its nearer end." With pins, needles, and the like, with point upward, _search always for the point_. Try to see it first. 8. Remember that a long foreign body grasped near the middle becomes, mechanically speaking, a "toggle and ring." 9. Remember that the mortality to follow failure to remove a foreign body does not justify probably fatal violence during its removal. 10. _Laryngeally lodged_ foreign bodies, because of the likelihood of dislodgment and loss, may be seized by any part first presented, and plan of withdrawal can be determined afterward. 11. For similar reasons, laryngeal cases should be dealt with only in the author's position (Fig. 53). 12. An esophagoscopy may be needed in a bronchoscopic case, or a bronchoscopy in an esophageal case. In every case both kinds of tubes should be sterile and ready before starting. It is the unexpected that happens in foreign body endoscopy. 13. Do not pull on a foreign body unless it is properly grasped to come away readily without trauma. Then do not pull hard. 14. Do no harm, if you cannot remove the foreign body. 15. Full-curved hooks are to be used in the bronchi with greatest caution, if used at all, lest they catch inextricably in branch bronchi. [176] 16. Don't force a foreign body downward. Coax it back. The deeper it gets the greater your difficulties. 17. The watchword of the bronchoscopist should be, "If I can do no good, I will at least do no harm." _Fluoroscopic bronchoscopy_ is so deceptively easy from a superficial, theoretical, point of view that it has been used unsuccessfully in cases easily handled in the regular endoscopic way with the eye at the proximal tube-mouth. In a collected series of cases by various operators the object was removed in 66.7 per cent with a mortality of 41.6 per cent. In the problem of a pin located out of the field of bronchoscopic vision, the fluoroscopist will yield invaluable aid. An extremely delicate forceps i
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