Course. Diagnosis. 211 



region is swollen moderately or not at all; it is not very 

 tender; the ingestion of food is frecjuently interrnpted by at- 

 tacks of congli and the anterior nares discharge a tenacious 

 mucoid or mucopurulent secretion. 



Course. Primary acute pharyngitis usually takes a favor- 

 able course, except in hogs, where the disease usually leads to a 

 fatal issue. The symptoms appear in rapid succession, so that 

 they are fully developed in two to three days ; they then remain 

 at their height for an equal period of time and recede gradually, 

 so that at the end of the first, or during the second week, coni- 

 jDlete recovery occurs. 



The course is more protracted when ulceration or suppura- 

 tion of the deeper tissues occurs. In these cases all symptoms 

 persist for a longer time or even increase in intensity. The 

 fever goes up, remains stationary or becomes remittent until 

 the shedding of the necrotic tissue occurs or the abscess opens 

 into the pharynx or into the outer w^orld. After opening of 

 the abscess and the discharge of pus, the condition of the patient 

 rapidly ameliorates and recovery takes place. A pharyngeal 

 fistula, which may have formed, generally closes only after a 

 long period of time. Occasionally a thickening in the pharyn- 

 geal wall may be formed, which may permanently disturb 

 deglutition and respiration, particularly during work (Wetzl). 

 A catarrh of the guttural pouch may occur in horses ; in hogs, 

 a tough, not painful, swelling may be formed after the opening 

 of a number of small subcutaneous abscesses, which permanently 

 interferes with deglutition and respiration. Paralysis of the 

 pharynx may also occur, but may again disappear after a pro- 

 longed period. 



A fatal issue is generally due to complications. Edema of 

 the larynx, in the absence of proper aid, may lead to suffoca- 

 tion. An occurrence, which is not infrequent in horses, is as- 

 piration pneumonia due to swallowing or inspiration of pus of 

 an abscess breaking into the pharynx. Inflammation may also 

 spread into the loose connective tissue in the mediastinum, and 

 then a pleuritis or pericarditis closes the chapter (Cadeac). 

 In phlegmonous pharyngitis septic material may be absorbed 

 from ulcerations and lead to general sepsis or a fatal hem- 

 orrhage may occur at the base of an open ulcer (Wakefield, De 

 Jong, Monod). 



Diagnosis. The clinical picture of pharyngitis is, as a rule, 

 quite characteristic, so that diagnosis offers no difficulties. For- 

 eign bodies which have become wedged in the pharynx, gener- 

 ally in carnivora and cattle (Fiebiger has seen two such cases 

 in horses), can liest l)e detected by inspection and internal man- 

 ual palpation. Tumors of the pharynx are usually not painful, 

 the signs of an acute affection are missing and internal palpa- 

 tion reveals the tumor. In paralysis of the pharynx there is no 



