The shift in the indications for the tracheotomy between 1940 and 1955: anhistorical review

In the period between 1940 and 1955 the indications for tracheotomy were ex tended, For centuries tracheotomies were performed to treat obstructive dis eases of the upper airway (hypopharynx, larynx, trachea). With th, end of t he second World War tracheotomy was indicated more and more for the therapy of lower airway disturbances. Medical empiricism is thought to be responsible for the gradual shift in th e indications during that period from upper to lower airway disturbances. K nowledge about the underlying principles of respiratory physiology was, how ever, already present at the end of the 19th century, but the shift in the indications did not occur until relatively recently. For many victims of Wo rld War II the discovery of the beneficial effect of a tracheotomy in a var iety of traumatic disorders may have come too late.