e performed at once, and the edges of the tracheal
wound held widely open with retractors, the patient being inverted, or
coughing induced by tickling the mucous membrane with a feather. The
foreign body is usually expelled, but it may be inhaled into one of
the bronchi. One of Killian's tracheal tubes may be introduced
through the tracheotomy wound and the body extracted by means of
suitable forceps.

_Foreign Bodies in the Bronchi._--Rounded objects, which pass through
the larynx, usually drop into one or other of the bronchi, usually the
right, which is the more vertical and slightly the larger. The body
may act as a ball-valve, permitting the escape of air with expiration,
but preventing its entrance on inspiration, with the result that the
portion of lung supplied by the bronchus becomes collapsed. The
physical signs of collapse of a portion or of the whole lung may be
recognised on examination of the chest. In some cases the body is
dislodged and driven up into the larynx, causing severe dyspnoeic
attacks and spasms of coughing. The irritation caused by the foreign
body in the bronchus may set up bronchitis or pneumonia, and abscess
of the lung may supervene. This has frequently followed the entrance
of an extracted tooth into the air-passage, and it may be a
considerable time before pulmonary symptoms arise. Sometimes the tooth
is ultimately coughed up and the symptoms disappear. In some cases the
physical signs closely simulate those of pulmonary phthisis.

The _treatment_ consists in removing the body by the aid of Killian's
or Jackson's tube passed through the mouth. If this is not successful,
low tracheotomy is performed and the tube is passed through the
tracheotomy opening.

INDEX

Abducens nerve, 400

Abductor paralysis, 404, 639
splint, 221

Abscess. _See_ Individual Organs and Regions

Accessory nasal sinuses. _See_ Individual Sinuses
nerve, 404

Acetabulum, fracture of, 125
tuberculous disease of, 210
wandering, 210, 227

Achillo-bursitis, 294

Acoustic nerve, 579

Acromion process, fracture of, 69

Actinomycosis. _See_ Individual Organs and Regions

Adenoids, 578

Alveolar abscess, 507
process, fracture of, 519
tumours of, 513

Ambulant splint for ankle, 189
treatment of hip disease, 222

Amputation in compound fracture, 26

Anatomy. _See_ Surgical Anatomy

Angina Ludovici, 548, 597

Ankle, deformities o