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Article
September 1951

PERORAL ENDOSCOPY

Author Affiliations

PHILADELPHIA

AMA Arch Otolaryngol. 1951;54(3):312-331. doi:10.1001/archotol.1951.03750090083009
Abstract

ANATOMIC and physiologic studies of the tracheobronchia[ill] tree and esophagus are necessary so that information gained may later be applied clinically. By these observations the clinician is guided in his search for the correct diagnosis and proper treatment, and new thoughts and interest in new fields of endeavor are stimulated.

PHYSIOLOGY OF TRACHEOBRONCHIAL TREE  Any addition to the knowledge of the underlying physiology of respiratory obstruction is a basic contribution to the understanding of this problem. Gray1 demonstrated that the first change resulting from respiratory obstruction was a reduction in the ventilation capacity of the pulmonary bellows, which if mild meant dyspnea on exertion and if severe meant dyspnea even at rest. The second respiratory change was hypoventilation, resulting in an increased oxygen consumption being necessary to support the extra respiratory effort. As hypoventilation became severer, it caused first a retention of carbon dioxide, second a fall in the

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