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Frank Waxham and Charles Truax's Intubation of the Larynx

Frank Waxham and Charles Truax's Intubation of the Larynx 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. View LargeDownload The various engravings in Intubation of the Larynx, including this one showing the "proper position of patient," allowed physicians to easily grasp all of the details necessary for a successful intubation (author's collection). After learning about O'Dwyer's successes, Waxham, who was professor of diseases of children at the College of Physicians and Surgeons of Chicago, became a leading voice for intubation. Modifying O'Dwyer's tubes, Waxham began to present his findings throughout the greater Chicago area. In slightly less than 5 years, he performed almost 300 intubations with a claimed success rate of 34%. In the process of perfecting his intubation technique, Waxham began to use tubes made according to his instructions by Charles Truax and Company. From this designer-manufacturer relationship emerged Intubation of the Larynx. Dedicating his book to O'Dwyer, Waxham provided explicit instructions for use of his tubes by graphically portraying the process of intubation. The 45 engravings poignantly captured the drama of this procedure. There was the resolute physician, the stern nurse, and the distraught child depicted in a desperate struggle for life. As noted in the preface, Waxham was an unabashed champion for his cause: Intubation has now become so thoroughly recognized as a practical and successful operation, that I believe it to be a duty the medical profession at large owe to the public, that at least one physician in every village, town and city throughout this great country, should possess the necessary instruments, pluck and skill to successfully perform this operation. Waxham's monograph met with critical acclaim while providing obvious financial benefits for its publisher. With the book editor of the Journal of the American Medical Association trumpeting the work as the "most complete and best description of the subject of intubation that has been placed before the public," the name Truax and Co was found on all of the illustrations of instruments. It was not long before Waxham's instruments were sold as a set containing 5 intubation tubes with obturators, an introducer, an extractor, a mouth gag, false membrane forceps, a mouth shield, and a scale to select the proper tube size. The public relations value was immense and came at an opportune time. Truax was correct in his business judgment: physicians and surgeons throughout the nation came to know his name and rely on his company's expertise in manufacturing all types of medical devices. By the turn of the century, Truax and Company occupied 6 floors of office space at 42-46 Wabash Ave in Chicago and employed almost 200 people. After authoring Intubation, Waxham spent several months in continuing medical education in Berlin and London. There he restricted his studies to diseases of the throat and nose. Returning to Chicago, he was nominated for a new professorial chair in laryngology and rhinology and subsequently became one of the country's earliest ear, nose, and throat specialists. In 1893, Waxham was named professor of laryngology and clinical medicine at Gross Medical College in Denver. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Frank Waxham and Charles Truax's Intubation of the Larynx

Archives of Surgery , Volume 137 (7) – Jul 1, 2002

Frank Waxham and Charles Truax's Intubation of the Larynx

Abstract

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...
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Publisher
American Medical Association
Copyright
Copyright © 2002 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.137.7.870
Publisher site
See Article on Publisher Site

Abstract

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. View LargeDownload The various engravings in Intubation of the Larynx, including this one showing the "proper position of patient," allowed physicians to easily grasp all of the details necessary for a successful intubation (author's collection). After learning about O'Dwyer's successes, Waxham, who was professor of diseases of children at the College of Physicians and Surgeons of Chicago, became a leading voice for intubation. Modifying O'Dwyer's tubes, Waxham began to present his findings throughout the greater Chicago area. In slightly less than 5 years, he performed almost 300 intubations with a claimed success rate of 34%. In the process of perfecting his intubation technique, Waxham began to use tubes made according to his instructions by Charles Truax and Company. From this designer-manufacturer relationship emerged Intubation of the Larynx. Dedicating his book to O'Dwyer, Waxham provided explicit instructions for use of his tubes by graphically portraying the process of intubation. The 45 engravings poignantly captured the drama of this procedure. There was the resolute physician, the stern nurse, and the distraught child depicted in a desperate struggle for life. As noted in the preface, Waxham was an unabashed champion for his cause: Intubation has now become so thoroughly recognized as a practical and successful operation, that I believe it to be a duty the medical profession at large owe to the public, that at least one physician in every village, town and city throughout this great country, should possess the necessary instruments, pluck and skill to successfully perform this operation. Waxham's monograph met with critical acclaim while providing obvious financial benefits for its publisher. With the book editor of the Journal of the American Medical Association trumpeting the work as the "most complete and best description of the subject of intubation that has been placed before the public," the name Truax and Co was found on all of the illustrations of instruments. It was not long before Waxham's instruments were sold as a set containing 5 intubation tubes with obturators, an introducer, an extractor, a mouth gag, false membrane forceps, a mouth shield, and a scale to select the proper tube size. The public relations value was immense and came at an opportune time. Truax was correct in his business judgment: physicians and surgeons throughout the nation came to know his name and rely on his company's expertise in manufacturing all types of medical devices. By the turn of the century, Truax and Company occupied 6 floors of office space at 42-46 Wabash Ave in Chicago and employed almost 200 people. After authoring Intubation, Waxham spent several months in continuing medical education in Berlin and London. There he restricted his studies to diseases of the throat and nose. Returning to Chicago, he was nominated for a new professorial chair in laryngology and rhinology and subsequently became one of the country's earliest ear, nose, and throat specialists. In 1893, Waxham was named professor of laryngology and clinical medicine at Gross Medical College in Denver.

Journal

Archives of SurgeryAmerican Medical Association

Published: Jul 1, 2002

Keywords: intubation,larynx

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