Part 21

Another obvious line of treatment is by the use of electricity locally and of strychnine internally. A weak current kept up for fifteen minutes may be sent from the positive pole in the left jugular furrow to the negative pole over the left side of the larnyx. Strychnia in the dose of two grains may be given daily in the food or in half that amount hypodermically over the left side of the larnyx. This would be useful only in the early stages with little or no fatty degeneration of the muscles.

ŒDEMA GLOTTIDIS.

Diseases Complicated by this. Seat, Abundance. Duration, Sequels, Symptoms, sudden dyspnœa, swelling of throat, pits on pressure, differentiation from croup. Treatment, cold, ice, astringents, scarification, tracheotomy.

This is usually a complication of acute laryngitis, but it may be a manifestation of other forms of local disease—tuberculosis, glanders, purpura hemorrhagica, pseudo-membranous inflammation,—or it may be a result of a more distant affection, like disease of the heart, lungs, or kidneys. As a complication of local inflammation it consists in an excessive serous exudation into the submucosa, around the base of the epiglottis and extending to the whole larnyx and pharnyx. It may thicken the parts by half an inch, causing complete closure of the glottis. In favorable cases it may subside as rapidly as it rose, while in others it may result in ulceration or abscess. The infiltration has usually a clear watery aspect, but is sometimes a dull red. When incised an abundance of serum escapes mixed in certain cases with pus.

Symptoms. In the course of one of the above named affections there comes on suddenly extreme dyspnœa, with stertorous breathing, a suffocative cough, and intense anxiety. The stridor is first with inspiration and later with expiration as well. The eyes are bloodshot and protruding, the pulse small and rapid, the movements uncertain, and the skin moist with sweat. There is manifest swelling of the throat and manipulation leaves the imprint of the finger.

When symptomatic of some distant affection it is at once slower in its result and more persistent.

The local pasty swelling and the absence of any false membrane suffice usually to distinguish it from croup which it so closely resembles in the suddenness of its onset, and the violence of its manifestations.

The less urgent cases may be treated by application of cold water or ice to the throat, and the injection of solutions of chloride of iron or alum into the fauces. Or the throat may be painted with tincture of iodine and rubbed with the palm to favor distribution and absorption of the exudate. In dogs the mouth may be opened widely and the dropsical membrane pricked at intervals to drain off the liquid. In the most acute cases the prompt adoption of tracheotomy is the only means of saving life.

LARYNGEAL HYPERÆSTHESIA. CONVULSIVE COUGH.

Convulsive cough with visible lesions—without. Excitants, cold air, or water, rough or dusty food, irritant agents inhaled or swallowed. Treatment, hygienic, nerve sedative, expectorant, tonics, Muriate of ammonia, Sulphur dioxide, silver solution, ferric chloride, alum, derivatives, elimination, aromatic, dietetic.

The chronic or paroxysmal cough may often be traced to the presence of tumor, ulcer, local inflammation, or parasite, but in some instances no local trouble is recognizable, the general health remains good, and yet the throat is abnormally sensitive and a cough or fit of coughing may be roused by passing into the cold air from a warm stable, by cold water in drinking, by inhaling irritant gas, by the passage of rough or fibrous food, or by handling the larnyx. There is undoubtedly a hyperæsthesia of the larnyx and the horse and dog as being more exposed to severe demands on the physical and nervous systems are especially liable to suffer.

Treatment must be adapted to the conditions. Over-work, damp unhealthy buildings, and all appreciable health depressing causes must be corrected, and a course of iron and nux vomica may be tried. Borax, bromide of potassium, and extract of hyoscyamus, made into an electuary with molasses or honey may be smeared upon the molars four or five times a day. In obstinate cases the inhalation of the fumes of burning salammoniac or sulphur, or the direct application to the larnyx of dilute solutions of silver nitrate, ferric chloride, or alum may benefit. The throat may be blistered by cantharides or mustard. Care should be taken to keep the functions of bowels and kidneys normally active, to protect the patient against cold and damp, and to give nutritive but non-stimulating and easily digested food, as for the horse, bran mashes, roots, grass or scalded hay, and for the dog pulped flesh, soup and mush. Sometimes benefit can be obtained from the vegetable aromatics and stimulants as eucalyptol, tar, turpentine, balsams of Tolu and Peru, tincture of anise, fennel, etc.

INFECTIOUS DISEASES OF THE THROAT.

Infectious throat diseases. Parasites, Leeches. Œstrus larva. Chronic sore throat. Mechanical removal.

Infections are in many respects the most serious affections of this region but their consideration must be sought under strangles, distemper, diphtheria, anthrax, actinomycosis, tuberculosis, glanders, etc.

PARASITES OF THE THROAT.

=Leeches.= These taken in with the water will sometimes fasten themselves on the walls of the pharnyx or even on the lips of the larnyx, producing cough, sore throat, difficulty of swallowing, bleeding from the nose (or mouth), or dyspnœa. They are to be removed as recommended above under parasites of the nasal chambers.

=Œstrus Larva.= =Bots.= In horses and mules the larva of the œstrus sometimes attaches itself to the mucous membrane of the pharynx or even of the larynx producing chronic irritation, cough and even dyspnœa. A chronic sore throat with nasal discharge, occurring in autumn or winter, in the absence of fever or constitutional disorder may be found to depend on these parasites and to recover when these have been removed by the hand.

GUTTUROMYCOSIS OF SOLIPEDES.

Aspergillus. Complications, ulceration, lesions of adjoining parts, food in lungs, hepatization, gangrene. Treatment, by incision, sulphur dioxide, iodine.

Rivolta and Bassi have found in the guttural pouches of horses and a mule, an advancing ulceration of the mucosa partially covered with crusts composed largely of the mycelium, conidia and spores of Aspergillus or a closely allied fungus. In the mule the ulcer had opened into the carotid artery causing a profuse epistaxis. In the three horses there was dysphagia, and the food, descending to the lungs, had caused pulmonary hepatization and gangrene. The description of the ulcers led Raillet to infer the existence of glanders and that the presence of the aspergillus was accidental, rather than a causative factor. In parallel cases the opening of the guttural pouch and injection with sulphurous acid solution or dilute solution of iodine would be appropriate treatment.

DISEASES OF THE CHEST.

Cough, its artificial production, precautions, character in different animals. Cough in disease, strong, full, ringing, weak, short, broken, abortive, dry, rasping, croupy, small, husky, soft, humid, rattling, mucous, paroxysmal, sympathetic, wheezing, roaring, whistling, grunt, moan. Expectoration, nasal in horse, also buccal in other animals. Morbid expectoration, watery, viscid, cloudy, flocculent, purulent, rusty, cretaceous, parasitic, fœtid, varicolored, microbic. Expired air, warm, cool, vegetable odor, acid, fœtid, heavy. Respiration, number in health, alteration in disease, rapid, slow, tardy, short, catching, quick, deep, labored. Position, standing, lying. Pleuritic breathing, broken winded.

Before describing specific diseases, it is needful to consider the methods of physical diagnosis which enable the practitioner to differentiate the diseases of the chest. Some of the following remarks will bear equally on diseases of the nose and throat as well.

COUGH.

The cough so varied in health and in disease deserves careful practical study. It can usually be excited in solipedes, sheep and dogs by pinching the first ring of the windpipe between the thumb and first two fingers. In oxen it is best produced by compressing the anterior part of the larynx. In old cattle it is difficult to produce coughing. In no animal should the attempt be made rudely nor unnecessarily repeated, as it may tend to excite or to aggravate already existing sore throat.

The cough of the healthy horse is sharp, loud and ringing, often repeated two or three times and followed by a snort (clearing of himself). It is weaker in young horses and shorter and drier in the aged.

The usual cough of the ox is weak, dry, slightly husky and prolonged.