WOUNDS AND AFFECTIONS OF THE THRO4T. 69 



dyspnoja, when a conical curved tube should be introduced for the 

 patient to breathe through. 



Wounds of the Throat. — Are extremely dangerous, on account 

 of the important .parts injured, and are usually the results of at- 

 tempted suicide. 



The treatment consists in arresting hemorrhage, obviating diffi- 

 culty of breathing, and preventing inflammation. The arteries must 

 be rapidly yet carefully tied, and the hemorrhage of the large veins 

 restrained by pressure. If the larynx or trachea should be wounded, 

 subsequent inconvenience may result from the introduction of cold 

 air, clots of blood, &c. ; if the pharynx or oesophagus is wounded, 

 the use of a tube becomes necessary, in order to convey nourish- 

 ment to the stomach. This tube must be introduced through the 

 mouth, and not through the wound, as often as it may be necessary 

 to supply the patient with food. The edges of the wound should be 

 carefully drawn together, and dressed in the most simple manner, 

 and should be protected from unfavourable atmospheric influences 

 by a covering of loose gauze, or of woollen texture thrown lightly 

 over the neck. The patient should be carefully watched, to prevent 

 a recurrence of the injury. A fistulous opening sometimes remains 

 in the trachea or larynx, which is extremely difficult to heal. 



Bronckocele^ or Goitre. — Is a sw^elling of the thyroid gland, 

 depending for the most part upon hypertrophy, although a cyst 

 may be formed, or calcareous matter deposited. In certain localities, 

 it is an endemic disorder, and often asso- 

 ciated with cretinism. It occurs most fre- I'^ig- ^9. 

 quently in females after the age of puberty. 

 It grows gradually, and without pain, occa- 

 sioning inconvenience merely by its deformity 

 and bulk. — Respiration is sometimes affected, 

 and the venous blood being prevented from 

 returning from the head, produces cerebral 

 disorder. The cause of the disease, is ob- 

 scure, but probably connected with climate. 



The treatment will consist in the use of 

 iodine, internally and externally, with atten- 

 tion to the general health ; or . it may be 

 necessary under the threatening of suffoca- 

 tion, to perform an operation. The removal 



of the gland is extremely dangerous, on account of hemorrhage, and 

 does not always produce a cure. 



Torticollis., or Wryneck. — This is a distortion of the neck to one 

 side, generally the result of spasm of. the sterno-cleido-mastoid 

 muscle, or by a paralysis of the muscle of the opposite side. It may 

 also result from tumours, caries of the spine, and cicatrices, espe- 

 cially those from burns. 



6* 



