Bronchoscopic Aids in Medical Conditions Within the Chest

¹ Washington, D.C.

Bronchoscopy has advanced far beyond the original indication for its use, the removal of foreign bodies from the bronchi, and is now recognized as a procedure that is, in experienced hands, neither difficult nor dangerous. In such conditions as atelectasis, bronchiectasis, bronchial stenosis, asthma, lung abscess, malignancy, unexplained hemoptysis and tuberculosis, bronchoscopy serves a definite purpose both in diagnosis and treatment. The specific functions of the bronchoscope in the management of these diseases are discussed. In the suppurative diseases its purpose of aspiration is stressed, keeping in mind that an obstructed bronchus might be the causative factor of the suppuration. In neoplastic disease its function is the early establishment of the diagnosis in order that the lung may be resected before metastases develop.

The indications for bronchoscopy in tuberculosis are the same as those in the diagnosis and treatment of other diseases of the chest: In establishing the diagnosis, in the bronchial obstruction produced by a ruptured tuberculous lymph gland, in the atelectases which occur with endobronchial tuberculosis, and in the exploration of the trachea and large bronchi in the dyspneic tuberculous patient to rule out the possible pressure of obstructing masses of granulation tissue.

In view of the many applications of bronchoscopy to medical conditions within the chest it is hoped that elementary instruction in bronchoscopy will at least be included eventually as a regular part of undergraduate medical education. Through this addition to the curriculum, the young physician will be prepared to avail himself forthwith of the opportunity for the acquisition of the technical training and skill in the employment of bronchoscopy, obtainable either from a post-graduate course or during the internship in a hospital.