the tube mouth. (Gastrojejunostomy done by Dr. George L. Hays.) B,
Carcinoma of the lesser curvature. (Patient afterward surgically
explored and diagnosis verified by Dr. John J. Buchanan.) C, Healed
perforated ulcer. (Patient referred by Dr. John W. Boyce.)

Drawn from a case of postdiphtheric subglottic stenosis cured by the
author's method of direct galvanocauterization of the hypertrophies.
A, Immediately after removal of the intubation tube; hypertrophies
like turbinals are seen projecting into the subglottic lumen. B, Five
minutes later; the masses have now closed the lumen almost completely.
The patient became so cyanotic that a bronchoscope was at once
introduced to prevent asphyxia. C, The left mass has been cauterized
by a vertical application of the incandescent knife. D, Completely and
permanently cured after repeated cauterizations. Direct view;
recumbent patient.

PHOTOPROCESS REPRODUCTIONS OF THE AUTHOR'S OIL-COLOR DRAWINGS FROM
LIFE]

[273] CHAPTER XXXV--GASTROSCOPY

The stomach of any individual having a normal esophagus and normal
spine can be explored with an open-tube gastroscope. The adult size
esophagoscope being 53 cm. long will reach the stomach of the average
individual. Longer gastroscopes are used, when necessary, to explore a
ptosed stomach. Various lens-system gastroscopes have been devised,
which afford an excellent view of the walls of the air-inflated
stomach. The optical system, however, interferes with the insertion of
instruments, so that the open-tube gastroscope is required for the
removal of gastric foreign bodies, the palpation of, or sponging
secretions from, gastric lesions. The open-tube gastroscope may be
closed with a window plug (Fig. 6) having a rubber diaphragm with a
central perforation for forceps, when it is desired to inflate the
stomach.

_Technic_.--Relaxation by general anesthesia permits lateral
displacement of the dome of the diaphragm along with the esophagus,
and thus makes possible a wider range of motion of the distal end of
the gastroscope. All of the recent gastroscopies in the Bronchoscopic
Clinic, however, have been performed without anesthesia. The method of
introduction of the gastroscope through the esophagus is precisely the
same as the introduction of the esophagoscope (q.v.). It should be
emphasized that with the lens-system gastroscopes, the tube should be
introduced into the stomach under direct ocular guidance, without a
mandrin, and th