Part 17

In operating the animal is kept standing with the head as nearly as possible in the natural position. The hair is removed from the skin beneath the windpipe between the middle and upper thirds of the neck. The skin having been rendered tense, (without displacement) by the fingers and thumb of the left hand, an incision is made in the median line from above downwards, for about two inches and is carried through the muscles so as to expose two rings of the trachea. The needle and thread are passed through the membrane connecting the two rings, and with the knife a semi-circular piece of cartilage is cut from each of the two adjacent rings. The thread in the connecting membrane prevents them from being drawn in by the rush of air. It only remains to introduce the tube and fix it in position.

Not only does tracheotomy obviate immediate danger of suffocation, but by removing the source of irritation in the continuous and forcible rush of air through the narrowed and inflamed tube, and in securing for the blood a freer æration and a purer constitution it often induces a rapid change for the better in the character of the inflammatory action. The wound may be daily cleansed and dressed with sodium hyposulphite.

Some veterinarians following the example of Bretonneau and Trousseau have treated sore throat from the first by what is called the abortive treatment. For this purpose a long whalebone prob with a pledget of tow firmly attached to its end and covered with powdered alum is introduced through the mouth into the pharynx and larynx even. Violent paroxysms of coughing are induced, but cures are affected in from two to five days. Under Delafond’s treatment calves and foals recovered in twenty-four hours. A more modern method is to inject a solution by means of a hypodermic syringe inserted between the upper rings of the trachea.

Milder treatment such as the inhalation for an hour several times a day, of the fumes of burning sulphur and water vapor will be found generally successful. The air should be impregnated with sulphur fumes only so far as can be breathed without inducing coughing on the part of the patient. Such measures should not divert attention from the necessity for general care, a control of diet, clothing, air, the state of the bowels, nor from local external applications to the throat.

=Treatment of Chronic Laryngitis.= The patient should have a loose airy box with an equable temperature. The avoidance of work and exposure must be sought for the time. Green food, cut roots, boiled grain, or bran mashes, with little or no hay, or other dry food, must be given. The bowels must be regulated. An electuary compound of linseed meal, molasses, and a drachm of belladonna extract to every tablespoonful of the mixture, may be given to the extent of a tablespoonful smeared on the inner side of the cheek twice daily. A mustard poultice to the throat has often a good effect. Light firing over the larynx is sometimes beneficial.

If secretion is defective and cough hard and dry chloride of ammonium, carbonates or bicarbonates of soda, potash or ammonium or borax, in solution or in gaseous form, may be given, the various bitters being at the same time drawn upon as tonics. If secretion is excessive, with a loose gurgling cough, astringents are indicated like ferric sulphate or chloride, (½ dr.), or they may be applied as spray: alum or iron alum five grains to the ounce, zinc sulphate or sulphocarbolate two grains to the ounce, silver nitrate one-half grain to the ounce. These may be introduced through the nose with the head elevated, or in small genera through the fauces. Tar, oil of turpentine, creosote, carbolic acid or eucalyptol may be inhaled from hot water.

PHARYNGO-LARYNGITIS IN CATTLE.

Susceptibility. Causes, symptoms, cough, salivation, wheezing, lachrymation, muzzle dry, tender throat, dysphagia, disturbed innervation and circulation, hyperthermia. Duration. Abscess. Treatment, laxative, local treatment, lancing.

Cattle are less subject to sore throat than horses. The skin appears less sensitive to the influences of cold and heat. The ox is not subjected to the same severe exertions. It is rarely seen to sweat, the moisture passing off from the surface as insensible perspiration only. The disease, however, recognizes the same causes as in the horse, though these are manifestly less injurious.

Symptoms. The disease usually affects at once the larynx and pharynx so that the symptoms are somewhat modified. In the simplest form there is only a small, hacking cough, a flow of saliva from the mouth and some loss of appetite but no fever. In more acute cases the breathing is loud and wheezing, the cough, soft and rattling, is followed by a free discharge of mucous from the mouth, the nostrils and eyes are red, the muzzle dry, the pulse accelerated and full, the throat tender to the touch, and swallowing difficult, part of the food and drink being rejected through the nose. If the larynx is chiefly involved the loud noise in breathing is the predominant symptom and sometimes almost the only one.

Course, etc. The cough and other symptoms are usually moderated with the access of the abundant secretion on the second or third day, and recovery is perfect on the eighth to the fifteenth. If abscess results, to which there is a far greater liability than in the horse, it may not burst till the twentieth day and the case is correspondingly protracted. This should be carefully distinguished from the deposits of tubercle which take place around the throat in cattle. In rare cases the disease becomes chronic.

Treatment does not differ from that advised for the horse except in the greater safety of purgatives which must in this case be saline (Epsom or glauber salts one to two pounds), and in the greater ease with which local treatment can be applied owing to the shortness of the soft palate. When abscess forms it must be encouraged by poulticing and opened with the knife or lancet as soon as it points.

LARYNGITIS IN SHEEP.

Infrequency. Causes, damp lands, storms, close buildings, clipping. Symptoms, cough, sneezing, discharge, snuffling, oral breathing, tender throat. Treatment, ventilation, warm water vapor, sulphur dioxide, salines.

Sore throat is fortunately even more rare than in the larger ruminants. It occurs chiefly where this animal, constituted to feed on the dainty grasses of the dry mountain side, is kept on cold, marshy ground and exposed to frequent cold, wet blasts. Sheep suffer also from hot, close, filthy buildings in winter, and from unseasonable clipping.

The symptoms are frequent coughing and sneezing, running from the nose, working of the jaws, and breathing through the open mouth as being easier than through the plugged nostrils. The larynx is tender and may be swollen.

Treatment is usually confined to ventilation and cleansing of the fold, frequent fumigations with water vapor from the spout of a boiling kettle, and with sulphur fumes, and giving tepid farinaceous gruels or mashes containing sulphate of soda in the daily proportion of two pounds to each hundred head of sheep. Sal ammoniac may be given in food or drinking water.

LARYNGITIS IN PIG.

Frequency. Causes, wet, cold pens, exposure, withholding liquids. Symptoms, prostration, dullness, cough, fever, swollen throat and neck, dyspnœa, dark mucosa, sloughing of epithelium and epidermis, general petechiæ, fœtid breath, great prostration. Lesions, gangrenous patches on pharynx and fauces, ulcers, infiltrations. Treatment, hygienic, dietetic, emetic, laxative, poultice, bandages, locally, astringent, antiseptic, caustic, tonic.

Sore throat is common in some localities when pigs live in herds.

Causes. Chiefly faulty hygiene. Exposed, cold and wet piggeries, cold blasts for which the pig has an extraordinary aversion, and the deprivation of liquids in warm, dry seasons are frequent causes.

Symptoms. These have been described by M. Pradal, who divides the disease into three stages, evidently dealing with an infectious malady. The first stage is marked by loss of appetite, dullness, slow, listless movements, a tendency to hide under the litter; low, hoarse grunt and cough, the last aggravated by moving the animal; pain in swallowing; red, sunken eye, and constipation. If there is no improvement on the second or third day it merges into the second stage. This is characterized by a still hoarser grunt, painful, hard hacking cough, difficult breathing, especially in the sunshine, and a rapidly increasing swelling of the throat, soon extending to both ears and as far down as the breast bone. This engorgement feels soft and pasty though firm, tender lumps may be felt, indicating the approaching formation of abscess. It is so abundant that suffocation may ensue in the course of forty-eight hours. If the progress of the swelling is not arrested it soon passes into the third or gangrenous stage. The breathing is more hurried; the mouth open, the protruded tongue of a bluish black color, the cough followed by a continuous rattle, the head unsteady, swallowing impossible, and the swelling extends to the side of the face and beneath the chest. The swollen surface is cold and livid; the bristles easily detached; it is bedewed by a serosity which exudes from it, and portions of the dead skin tend to detach themselves. The mouth and throat participate in the gangrene, the breath, saliva and nasal discharge is fetid, and the epidermis peels off. The snout, ears and skin generally assume a bluish black hue, the prostration is extreme, the creature lying constantly on its side; the pain ceases and in one or two days death ensues, preceded by a state of comparative calmness.

On opening the throat after death the mucous membrane is engorged and thickened, bears various hues of black, blue, livid and green, and breaks down into a pulpy mass under slight pressure. The surrounding (pharyngeal) muscles even are implicated in this change. In the earlier stages there is only engorgement with blood of the tonsils and the mucous membrane of the pharynx and larynx; serous infiltration of the surrounding parts, and often the presence of inspissated mucus resembling false membranes or of ulcers on the surface.

Treatment. In the earlier stages, hygienic measures alone may suffice to check. A warm, dry, comfortable piggery, emollient and astringent drinks, such as sheep’s head broth, oatmeal and other gruels acidulated with vinegar or buttermilk, an emetic (six grains of tartar emetic); a dose of physic (four croton beans powdered and given in the food, or from two to three ounces of castor oil), and if the patient will permit it a flannel bandage or piece of sheepskin round the throat. If the symptoms are more threatening it is recommended to bleed from the ears and tail; to apply a linseed meal poultice round the throat to hasten the formation of abscess, or in the absence of such indications to employ a mustard poultice made with spirits of turpentine, or rugs wrung out of boiling water, to the same part. Local astringent and caustic applications to the throat are the most promising, applied by means of a whalebone prob as recommended for other animals, the mouth being held open by a noose round the upper jaw. Sodium sulphite, silver nitrate, potassium permanganate, hydrochloric acid diluted, and tincture of iodine, may be employed.

When the gangrenous stage has been reached all treatment is useless.

LARYNGITIS IN THE DOG.

Sore throat is chiefly seen in pampered pets and in hunting dogs, as the greyhound. In the latter class it is the result of chills, a cold ducking when heated, cold damp kennels, etc. It is sometimes almost the only manifestation of distemper.

Symptoms. Dullness, impaired appetite, a slight cough becoming more frequent and paroxysmal. These paroxysms give rise to accelerated and panting breathing, and if severe, to the ejection of a glairy yellow (bilious) material from the stomach. There is also running from the nose and frequent sneezing. The dull muffled bark has led to the supposition of rabies but it has no resemblance whatever to the characteristic cry of rabies while beginning like an impulsive bark merges into an agonized and baffled howl. Accelerated pulse, elevated temperature, reddened fauces and swollen tonsils are marked symptoms.