Abstract
In 1922, Sicard and Forestier showed in Paris the first skiagrams of the “bronchial tree” outlined by lipiodol. Other workers had previously attempted to outline the bronchial tree with other opaque chemicals and powders. I am going to try to show you to-night some of the results we have obtained at the City of London Chest Hospital since we commenced this method of examination in 1924. Lipiodol is poppy-seed oil which is chemically combined with 40 per cent. of iodine. The iodine is not easily liberated when combined in this way, but is apparently set free should it enter the stomach. Several methods of injection are in use :— (1) The Trans-glottic Method. (2) The Bronchoscopic Method. (3) The Crico-thyroid Method. (4) The Oral Method, as demonstrated to me by Dr. Singer at St. Louis. The crico-thyroid method has been used almost exclusively in our cases. I will mention a few details of the technique used by Dr. Chandler. The patient is given a sub-cutaneous injection of morphia beforehand. A preliminary complete X-ray examination is essential, and it should be repeated just previous to the injection if many days have elapsed since it was made. Cases should be carefully selected and the injection reserved for those cases in which the diagnosis is still in doubt after thorough investigation. Injections should be made in the X-ray room, or in a room in close proximity to it.
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