200 DIGESTION. 



.report that they were continued after sufficient time had 

 elapsed for the parts to cicatrize. At all events, it is neces- 

 sary, in this instance, to confirm the results of experiments 

 on animals by observations on the human subject. 



Several cases of loss of the epiglottis in the human sub- 

 ject are quoted by Longet in support of his view that this 

 part is necessary to the complete protection of the air-pas- 

 sages, particularly in the deglutition of liquids. Two of the 

 most striking of these cases were observed by Larrey in 

 Egypt. One of these was the case of General Murat, who 

 was wounded by a ball passing through the neck from one 

 angle of the jaw to the other, cutting off the epiglottis, which 

 was expelled by the mouth. In this instance, the difficulty 

 in the deglutition of liquids was so great, that it became 

 necessary to introduce them through a tube passed into the 

 oesophagus. In the other case, the epiglottis was likewise en- 

 tirely removed by a wound and was preserved and presented to 

 the surgeon. In this instance, the difficulty in the deglutition 

 of liquids was even greater than in the former ; each effort at 

 swallowing being followed by convulsive and suffocating 

 cough. This difficulty persisted after the parts had become 

 completely cicatrized. In these cases it is possible that 

 the injury to muscles and other parts from such severe 

 wounds might interfere with the movements of the lar- 

 ynx or the closure of the glottis, and thus disturb deg- 

 lutition. In a case in which the epiglottis had entirely 

 sloughed away as a consequence of syphilitic disease, 

 which has already been referred to in the previous vol- 

 ume, 1 the difficulty in swallowing liquids, though suffi- 

 ciently well marked, was by no means as great as in the 

 cases mentioned above. The difficulty in swallowing was 

 noted as not great, but the patient swallowed liquids more 

 easily than solids. The difficulty consisted of cough and loss 

 of breath, as the patient described it. It was less when arti- 

 cles were swallowed while the patient was in the recumbent 



' ' See vol. i., p. 359. 



