Part 16

Treatment. In many cases the passage of a probang or sound, will, by the mere distension of the gullet, overcome the local spasm, though it may be necessary to repeat the operation several times. In case the sound causes much pain the end of the instrument may be well smeared with solid extract of belladonna, and after passing this as far as the obstruction a short time may be allowed, before its passage is again attempted. In case obstruction by soft solids has taken place, the passage of the wire loop will serve to break up the mass and even to draw it up toward the mouth.

The administration of antispasmodics is the next indication. Chloroform or ether by inhalation or in solution in water, chloral hydrate as an enema, morphia or atropia hypodermically may be used according to convenience. Bromide of potassium and other antispasmodics given by the mouth, too often fail to pass the obstruction and thus prove useless, except in the intervals of the spasms.

Fomentations of the lower border of the neck with warm water, and frictions over the region of the gullet with camphorated spirit, essential oils, ammonia, or in calves with oil of turpentine, often contribute to relieve the spasm.

Finally after the severity of the attack has passed, a course of bitter tonics and above all of nux vomica will fortify the system against a relapse.

PARALYSIS OF THE ŒSOPHAGUS.

Causes: nervous lesions and disorders; arytenectomy; over distension; stricture; parasites. Symptoms: dysphagia; regurgitation; cough; dyspnœa; hard packed gullet. Inhalation pneumonia. Lesions. Treatment: remove cause; liquid food; dilatation; nerve sedatives and stimulants; electricity; counter-irritants.

Causes. This has been noticed in a number of cases in solipeds, and attributed to central nervous lesions, cerebral concussion (Straub), encephalitis (Hering, Bornhauser), paralysis of the fore extremities (Meier), pharyngeal paralysis (Puschmann). Möller has seen it several times consequent on arytenectomy, while Dieckerhoff and Graf have seen it occur without any clearly defined cause. In a case referred to above, the present writer found it connected with the attachment of larvæ of œstri in the lower end of the gullet. Stricture and impaction may be a further cause.

Symptoms and lesions. There is more or less interference with deglutition, culminating in complete inability to swallow, and the rejection of morsels of masticated food by the nose. Cough may also occur from the descent of food toward the lungs, with more or less dyspnœa and oppression of the breathing. Manipulation along the left jugular furrow, detects the œsophagus as a prominent hard, rope-like mass which fills up the groove unduly. When death occurs rapidly the gullet is found gorged with masticated food throughout its entire length. In certain instances gangrenous pneumonia is found, the result of the penetration of food into the bronchia. In other cases there are lesions of the medulla oblongata, or of the vagus or glossopharyngeal nerves or their œsophagean branches.

Death usually results from obstruction, inanition, or, in case the paralysis is partial, from pneumonia or exhaustion.

Treatment. First remove or correct the existing cause of the disease. Impaction may be broken up by the use of the wire loop, or pincer probang; parasites may be expelled by passing a cupped probang; the impactions following arytenectomy can be obviated by feeding gruels, milk and other liquid foods only, and from a bucket set on the ground; stricture may be dilated by the use of graduated sounds; and nervous diseases may be dealt with according to their specific nature in each several case. When any definite cause of this kind has been overcome the persistent use of strychnia, subcutem, or by the mouth, may be effectual in overcoming the paresis of the gullet. Hypodermic injections are best made along the left jugular groove, and frictions, stimulating embrocations, and galvanic currents may be employed with excellent effect.

ŒSOPHAGEAN TUMORS.

Forms of neoplasm in gullet of horse, ox, sheep, pig, dog. Symptoms: dysphagia; eructation; vomiting; bloating; cough; dyspnœa; stertor; fœtor; palpitation. Treatment.

These have been often noticed in the lower animals. In the horse have been noticed melanoma (Olivier, Röll, Kopp, Besnard, Pouleau), fibroma (Dandrieu, Dieckerhoff), Carcinoma (Chouard, Lorenz, Cadeac, Laurent), epithelioma (Blanc, Lorenz), Leiomyoma (Lucet, Lothes), cystoma (Caillau, Legrand), mucous cysts (Lucet).

In =cattle papilloma= is especially common, having been noted by Johne, Mons, Fessler, Schütz, Lusckar, Gratia, Beck, Cadeac and Kitt. =Tubercles=, and =fibroid masses= with cystic purulent centres are not uncommon. =Actinomycosis= is also frequent, sometimes hard and warty and at others soft and vascular.

In the =Sheep=, Dandrieu found between the muscular and mucous coats a hard tumor as large as a hen’s egg, the removal of which put a stop to a persistent choking. In both =cattle= and =sheep=, swellings from =coccidiosis= are common; in =cattle= and =swine= from =gongylonema=, and in =sheep= from =filaria= (Harms) or =spiroptera= (Zurn).

In =pigs=, =fibroma= is met with in the walls of the gullet (Raveski) and in =dogs= =fibroma=, =papilloma=, and the tumors of spiroptera.

Symptoms. The coccidia and spiroptera usually cause few symptoms or none, but neoplasms usually develop symptoms of obstruction, dysphagia, eructation, vomiting, and all the indications of choking according to their seat. These do not come on suddenly and recover as in simple choking, but even though there may be periodic obstructions, spasms and paroxysms, there is a slow, progressive advance as the neoplasms increase. Stertorous or mucous breathing, cough, dyspnœa and fœtid exhalations are common, the symptoms may be aggravated when the head is bent, and the tumor may even be felt on palpation of the throat or left jugular furrow. In ruminants tympany occurs after feeding.

Treatment is surgical and consists in the removal of the tumors by incision and ecraseur or otherwise. Thoracic œsophagean tumors are usually inoperable.

IMPACTION OF THE CROP. INGLUVIAL INDIGESTION.

Gallinaceæ and Palmipeds. Causes; Overfeeding after privation; fermentation; lack of water; green food in geese and chickens; food containing paralyzing element. Symptoms; dull; motionless; erect plumes; drooping wings and head; gapes; ejects liquid from bill; firm cervical swelling. Treatment; manipulation; incision; surgical precautions. Convalescent feeding.

The cervical dilatation of the œsophagus known as the crop is well developed in all granivorous birds, (Gallinaceæ, etc.;) and like the macerating cavities of the ox (first two stomachs) is subject to overdistension and paralysis. In the palmipeds (ducks, geese) there is no distinct crop but in its place the cervical portion of the gullet has a fusiform dilatation, and under given conditions this may be also the seat of impaction.

Causes. The impaction may result from overfeeding when the bird has been starved, or when it suddenly gains access to food of a specially appetizing kind and to which it has been unaccustomed. The crop like every other hollow viscus is rendered paretic by overdistension. Then the food undergoes fermentation still further distending the cavity, affecting the brain by reflex action, and paralyzing the vagus and its peripheral branches in the lungs, heart, stomach, liver, intestines, etc. When the food is dry as in the case of beans, peas, bran, farinas, it may be a simple firm impaction which the muscular walls of the crop are unable to break up or move onward. When green food is taken there is often superadded the additional evil of active fermentation from the great number and activity of the bacterial ferments contained in it and the soft aqueous fermentescible nature of the food (See tympany in ruminants). Dupont states that young geese led out to fresh spring grass may lose two-thirds of their number in a few hours from such overloading and that some species of Carex and cynodon dactylon are particularly injurious. Chickens also gorge the crop with clover, etc. In all such cases, plants that contain a paralyzing principle like lolium temulentum, ripening lolium perenne, chick vetch, etc., are to be specially dreaded. (See Trichosoma Contortum).

Symptoms. There are first dullness and sluggish movements, followed by indisposition to move, the bird standing in one place with ruffled feathers and drooping wings, and at intervals, projecting the head forward with open beak and in some cases a little liquid is rejected. If the bird is now caught and examined the crop is found to be firmly distended, and more or less compressible or indentable according to the nature of the food impacted. In most cases and especially if the food has been green or aqueous, there is a certain resiliency from the presence of gas outside the solid impacted mass.

Treatment. This must be in the line of seconding the physiological efforts of regurgitation which is a normal and common act in birds. The duck which has gulped a mouse half-way down the cervical part of the œsophagus will readily disgorge it when he finds it impossible to pass it further. The carnivorous birds often reject by vomiting the indigestible debris such as feathers and bones, after all the more soluble parts have been disposed of in the stomach. The pigeon even feeds its young by disgorging into their open bills, the semi-digested food and milk from its crop. Following these indications we must break up the contents of the crop by manipulation and force them in small masses upward into the bill and downward to the proventriculus. The rejection by the bill may be further stimulated by introducing the finger into the fauces to rouse the reflex active emesis. Usually the crop can be quickly and satisfactorily emptied in this way.

When this proves impossible there remains the operation of direct incision through the walls of the crop and the evacuation of its contents. This can be done by a pocket knife or even a pair of scissors. The crop is punctured in its lower part and the incision is continued upward as far as may be necessary to allow the escape of the contents. Usually half an inch will suffice. Then the crop is squeezed so as to press the contents through this opening and it is emptied by a process of enucleation. If the contents are fibrous it may be necessary to employ forceps to dislodge the material. The empty crop may be washed out with tepid water, any food attached to the raw edges of the wound must be removed and the skin stitched accurately together. The wound rarely fails to heal by first intention. To avoid stretching it, the food for a day or two should be restricted to milk, gruels, or a little soft mash.

Lerein notices jaundice as a sequel of impacted crop, and recommends treatment by sulphate of soda in the water.

TYMPANITIC INDIGESTION IN THE RUMEN. BLOATING.

Definition. Susceptible Genera. Causes; gastric paresis, overloading, cold, fear, exhaustion, poisons, fermentescible food,—new grain, leguminosæ, frosted vegetables, ruminitis, foreign bodies in rumen, microbian ferments. Symptoms, abdominal, general. Gases formed under different aliments—carbon dioxide, marsh gas, hydrogen sulphide, nitrogen, oxygen. Lesions, rupture of rumen or diaphragm, compression or rupture of liver or spleen, petechiæ, congestion of lungs and right heart, of cutaneous and cerebral vessels. Prevention, avoid indigestible and fermentescible aliments, correct adynamic conditions, tonics, avoid injurious ferments, make alimentary transitions slowly. Treatment, exercise, bath or douche of cold water, rubbing and kneading, rope round abdomen spirally, gag in mouth, dragging on tongue, movement of a rope in fauces, probang, stimulants, antiseptics, alkalies, ammonia, oil of turpentine, oil of peppermint, alcohol, ether, pepper, ginger, soda, potash, lime, muriatic acid, carbolic acid, creosote, creoline, sulphites, kerosene, chloride of lime, chlorine, tar, common salt, hypochlorite of soda, magnesia, eserine, pilocarpin, barium chloride, colchicum, lard, trochar, Epsom salts, rumenotomy. Treatment of diseased gullet, mediastinal glands, stomach or intestines.