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Moments in Surgical History
July 2002

Frank Waxham and Charles Truax's Intubation of the Larynx

Arch Surg. 2002;137(7):870. doi:10.1001/archsurg.137.7.870

FRANK WAXHAM'S (1853-1911) Intubation of the Larynx (1888) is a most unusual medical monograph: the publisher, Charles Truax (1852-1918), was a surgical instrument maker. More important, this was the first treatise written in the United States on what surgeons hoped would be a new, lifesaving technique. The invention of a method for intubation of the larynx in cases of severe croup in children is properly credited to Joseph O'Dwyer (1841-1898), a physician at the New York Foundling Asylum. In treating suffocating croup, most physicians used the old-line operation of tracheotomy, but the results were so far from satisfactory that O'Dwyer sought a substitute technique. In the mid-1880s, he developed a set of metal intubation tubes that were graduated in size and meant to be inserted and extracted by physicians specifically trained in the procedure. Because membranous croup was such a common cause of childhood mortality, O'Dwyer wrote and spoke extensively about his tubes, urging their widespread use while acknowledging that the technique required considerable practice and a large amount of moxie on the part of the physician.

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