A CASE OF PHARYNGITIS DUE TO STRANGLES. 223 



developed during strangles. Among the complications of this disease 

 pharyngitis is one of the commonest and least dangerous. It is indi- 

 cated, like other forms of sore throat, by loss of appetite, discharge 

 from the nostrils of fluid mixed with food and of part of the drinking- 

 water, by swelling and abnormal sensibility of the throat region. In 

 pharyngitis resulting from strangles the lymphatic glands in the poste- 

 rior portion of the intermaxillary space become inflamed, causing 

 cedematous swelling, which is soon followed by abscess formation. In 

 the majority of cases the only surgical treatment necessary is puncture 

 of the abscess, recovery occurring in from a fortnight to a month. 



The grave forms of pharyngitis due to strangles are those in which 

 abscesses develop deep in the guttural region near the subparotid or 

 retro-pharyngeal lymphatic glands. Functional symptoms are then 

 more marked and often alarming, swelling of the throat and of the 

 parotid region being sometimes enormous. To prevent rapidly fatal 

 complications the pus must, as soon as possible, be evacuated. 



Provided free drainage is secured, the swelling which accompanies 

 these abscesses usually disappears rapidly. U nless expectant treatment 

 is too long pursued, respiration seldom becomes so embarrassed as to 

 necessitate tracheotomy. In any case, if dyspnoea become intense and 

 the pus cannot be discovered even after several exploratory punctures, 

 no hesitation need be felt in operating, as in the horse the method is 

 very simple, never proves harmful, gives immediate relief, and removes 

 one cause of aggravation of the pharyngitis. 



[Operation is as follows: — A twitch having been applied, and the 

 seat of operation cleansed and disinfected, an incision is made through 

 the skin over the highest part of the swelling, and if possible below the 

 edge of the parotid, the underlying fascia divided, and the forefinger 

 inserted. The thick connective tissue or gland structure is now broken 

 down, the free hand meanwhile pressing on the swelling and guiding 

 the inserted finger towards the abscess, which, on being localised, is 

 broken by a sharp, powerful thrust. A stream of pus escapes, often 

 spurting to a distance of several yards. The opening may afterwards 

 be enlarged, and a gauze or rubber drain inserted. — Jno. A. W. D.] 



In our patient the pharyngeal inflammation was never really 

 menacing. We could scarcely discover any swelling or pain on pres- 

 sure over the throat region. The abscess beneath the jaw was the only 

 complication in that neighbourhood. 



The persistence of functional disturbance after the fifteenth day, 

 and the absence of local lesions capable of explaining it, caused me to 



