SURGICAL TREATMENT OF CHRONIC ROARING HEMIPLEGIA LARYNGIS. 35 1 



declared that the animal could not work at a trot, and on leaving it 

 with us insisted on my at once performing the same operation on it as 

 was practised on his other horse. 



External examination of the larynx and trachea revealed nothing 

 abnormal. After a few minutes' trotting the horse produced a roaring 

 sound, which rapidly became aggravated. This test was repeated each 

 morning for the following three days. On each occasion whistling 

 occurred after a couple of minutes, and soon became very loud, while 

 dyspnoea threatened. 



Operation on the 28th under chloroform anaesthesia. The larynx 

 was opened and paralysis of the left arytsenoid detected. I removed 

 the cartilage, leaving a small fragment of the articular angle in the 

 depths. The intra-laryngeal wound was not sutured. A gauze dress- 

 ing was inserted and fixed in position by two sutures passed through 

 the skin and muscle. The sutures also served to steady the cannula. 



The animal did not rise until ten minutes after the hobbles had 

 been removed. It was then returned to its box and kept without food 

 for twenty-four hours. Morning temperature 38° C. ; evening tempera- 

 ture 38-4° C. 



Next day the sutures were cut, the dressing and cannula removed, 

 and the superficial wound cleansed. The skin and muscular layers of 

 each lip were united by three interrupted sutures. To facilitate breath- 

 ing the lips of the wound were kept widely open for some days. The 

 patient was placed on ordinary diet, which it ate with good appetite. 

 A little saliva, water, and food escaped by the wound.. Temperature, 

 morning 38*8° C, evening 39'5° C 



During the following days treatment was confined to cleansing the 

 external wound night and morning with fragments of wadding held in 

 dressing forceps. 



From the 7th October food and liquid ceased to escape by the 

 larynx. From the loth to the 30th 2 to 2^ drachms of iodide of 

 potassium were given daily in the drinking-water. On the 23rd the 

 superficial wound had completely healed. 



On the 28th the horse was trotted and galloped in the riding school. 

 At the end of ten minutes at a trot, and of five minutes at a gallop, 

 slight abnormal breathing sounds were still audible. 



M. S — kept this horse for work. He reported on the 21st January, 

 1899: 



" During the months following its return to work the horse was 

 able to make long and rapid journeys without showing more than 

 slightly noisy breathing. On starting out it coughed and discharged 

 a little whitish mucus from the nose for the first mile. Even at the 

 present time there is a slight discharge on commencing work, but once 

 the animal warms to its work respiration becomes normal, even at a 

 rapid trot. In harness this horse has made continuous journeys of 

 fifteen miles without being distressed, and has often made the double 

 journey, amounting in all to thirty miles, with a rest of one hour half- 

 way. In the saddle it roars a little at rapid paces, but the sound 

 ceases when the horse has galloped rapidly for some distance or after 

 it has jumped. It is perfectly useful for all kinds of work." 



