A frequent but usually unrecognized complication of many of the conditions that the internist and general practitioner meet in their daily practice is obstruction of the airway by accumulating tracheobronchial secretions. The resultant asphyxia is the direct but insidious cause of many of the grave symptoms—and many of the deaths—commonly but mistakenly attributed to the underlying disease. When such secretions are being retained, their removal is valuable as an adjunct to supportive and specific therapy and often is lifesaving. Numerous writers1in recent years have discussed obstruction of the tracheobronchial tree as an anesthetic, postoperative, post-traumatic or neonatal problem. A few2have stressed the importance of prevention and treatment of asphyxia in infectious diseases in which the mechanisms that normally keep the airway cleared are impaired, as in bulbar poliomyelitis, tetanus and whooping cough. But the common occurrence of retention of tracheobronchial secretions as a medical problem is