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In order to make possible extensive intrathoracic operations, the negative pressure cabinet was devised and successfully employed for that purpose. This method was essential in cases of double thoracotomy and valuable in single thoracotomy when adhesions had not formed to prevent the collapse of the lung, as in the case of bullet wounds.
The difficulty of operative procedures under the conditions imposed by the cabinet, coupled with the high cost of installation, led to the work of Meltzer and Auer. The experiments of these investigators brought out the following facts:
The proper exchange of air in the lungs can be accomplished by an almost continuous stream of air passing in one direction. To produce this exchange of air, the stream should be delivered intratracheally through a catheter directed just above the bifurcation of the trachea. The catheter should be less than one-half the size of the glottis, so that obstruction
FLAGG PJ. INTRATRACHEAL INHALATION: PRELIMINARY REPORT OF A SIMPLIFIED METHOD OF INTRATRACHEAL ANESTHESIA DEVELOPED UNDER THE SUPERVISION OF DR. CHEVALIER JACKSON. Arch Otolaryngol. 1927;5(5):394–399. doi:10.1001/archotol.1927.00600010420002
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