Treatment. 



37 



kneading, while the discharge from the nose increases. The 

 percussion sound is dull either over the whole of the parotid 

 region or only over its inferior portion. If much gas has been 

 formed the parotid region has an elastic, tense consistency and 

 the percussion sound may be partly tympanitic. The rhino- 

 laryngoscope shows in severe cases a protrusion towards the 

 buccal cavity, variable in size, situated laterally to or in front 

 of the arythenoid cartileges. 



In a horse with catarrh of the guttural pouch and perforation of the membrane 

 tympani of the ear of the same side Durante noticed a mucopurulent discharge 

 from this ear which could be brought about at will by pressure on the diseased 

 air sac. 



The enlarged guttural pouch pushes aside and compresses 

 the neighboring organs. It may particularly press the arythe- 

 noid cartilage np- 

 ward or inward and 

 in this manner 

 cause laryngeal 

 whistling. Pressure 

 may increase to 

 such an extent 

 and may bring 

 about such a degree 

 of stenosis of the 

 larynx that attacks 

 of suffocation m a y 

 come on even at 

 rest, especially if 

 the amount of air in 

 the guttural pouch 

 becomes tempora- 

 rily increased. The 

 swelling also press- 

 es the wall of the 

 pharynx inward 

 and in this manner 

 produces difficulties 

 in deglutition. 



Zschokke saw in one case paralysis of the pharynx due to a 

 spreading of the inflammatory process along the neighboring 

 nerve trunks. In case of ulceration, unilateral epistaxis, and 

 after erosion of neighboring larger vessels fatal hemorrhage 

 may occur. Difficulties in deglutition may cause aspiration 

 pneumonia and pulmonary gangrene. Such complications as 

 will often occur after a longer duration of the affection make 

 it one of serious importance. 



Treatment. Recent cases can be cured by opening of the 

 guttural pouch followed by repeated irrigation. If, however, 



Fig. 4. Catarrh and meteori.sm of the guttural pouch of 

 the horse. Intense swelling of the parotid region. 



