SOKE THROAT, OR LARYNGITIS. 115 



not hesitate. Your purpose is to make a hole in the windpipe suffi- 

 ciently large to admit the tracheotomy tube. It is quickly manifested 

 when the windpipe is severed; the hot air rushes out, and when air 

 is taken in it is sucked in with a noise. A slight hemorrhage may 

 result (it never amounts to much) , which is easily controlled by wash- 

 ing the wound with a sponge and cold water, but use care not to get 

 any water in the Avindpipe. Do not neglect to instruct your assistant 

 to hold the head down immediately after the operation, so that the 

 neck will be in a horizontal line. This will prevent the blood getting 

 into the windpipe and allow it to drop directly on the ground. If 

 you have the self -adjustable tube, it retains its place in the wound 

 without further trouble after it is inserted. The other kind requires 

 to be secured in position by means of two tapes or strings tied around 

 the neck. After the hemorrhage is somewhat abated, sponge the 

 blood away and see that the tube is thoroughly clean, then insert it, 

 directing the tube downward toward the lungs. 



The immediate relief this operation affords is gratifying to behold. 

 The animal, a few minutes before on the verge of death from suffoca- 

 tion, emitting a loud wheezing sound with every breath, with haggard 

 countenance, body swaying, pawing, gasping, fighting for breath, 

 now breaths tranquilly, and may be in search of something to eat. 



The tube should be removed once a day and cleaned with the car- 

 bolic acid solution (1 to 20), and the discharge washed away from the 

 wound with a solution of carbolic acid, 1 part to 40 parts water. 

 Several times a day the hand should be held over the opening in the 

 tube to test the animal's ability to breathe through the nostrils, and as 

 soon as it is demonstrated that breathing can be performed in the 

 natural way the tube should be removed, the wound thoroughly 

 cleansed with the carbolic acid solution (1 to 40), and closed by in- 

 serting four or five stitches through the skin and Trvuscle. Do not 

 include the cartilages of the windpipe in the stitches. Apply the 

 carbolic acid solution to the wound three or four times a day until 

 healed. When the tube is removed to clean it the lips of the wound 

 may be pressed together to ascertain whether or not the horse can 

 breathe through the larynx. The use of the tube should be discon- 

 tinued as soon as possible. 



It is true that tracheotomy tubes are seldom to be found on farms, 

 and especially when most urgently required. In such instances there 

 is nothing left to be done but, with a strong needle, pass a wax end 

 or other strong string through each side of the wound, including the 

 cartilage of the windpipe, and keep the wound open by tying the 

 strings over the neck. 



During the time the tube is used the other treatment advised must 

 not be neglected. After a few days the discharge from the nostrils 



