Diagnosis. Treatment. Paralysis of the Est)pliagus. 223 



other hand, saw five attacks in five years; they always histed 

 five hours and were followed by respiratory difficnlties lasting 

 for twenty-four hours. The disease always ends in recovery. 



Diagnosis. On account of the disturbances of deglutition 

 and the subsequent vomiting, esophagism may be confounded 

 with inflammation, stenosis or obstruction of the esophagus. 

 However, the sudden appearance, the likewise rapid disappear- 

 ance of the attack, the perfectly normal condition of the animal 

 between the attacks furnish enough data to distinguish this 

 affection from stenosis or inflammation. Primary esophagism 

 may l)e distinguished from mild cases of obstruction of the gul- 

 let in the thoracic portion, which disappear spontaneously after 

 a short time, by the use of the sound (perhaps after the pre- 

 liminary application of narcotics). If no impediment is found 

 and if the attacks still persist, the diagnosis is, of course, pri- 

 mary esophagism. It is also possible that during very greedy 

 feeding, a morsel may become lodged in the caudal portion of 

 the esophagus, this subsequently may pass on, yet the described 

 s^anptoms may persist a while, and a veterinarian not knowing 

 the history of the case may think of primary spasm of the esoph- 

 agus (Cagny, Johne). Indeed, esophagism is, as a rule, due 

 to a temporary obstruction or to a superficial injury. 



Treatment. The disturbed condition of the nerves calls 

 for the use of narcotics, such as morphine subcutaneously (0.04- 

 0.6 gm. for horses; 0.01-0.1 gm. for smaller animals); chloral 

 hydrate per rectum (25-50 gm. for large animals; 0.05-0.5 gm. 

 for smaller animals) ; during the intervals between the attacks 

 bromide of potash internally (for horses, in daily doses of 20 

 gm.). This treatment is usually successful. 



Literature. Bournay, Eev. vet., 1898, 204.— Cadeae, J. vet., 1888, 618.— 

 Friedberger, Miinch., Jhb!, 1890-01, 60.— Frohiier, Monh., 1S97, YJII, 484, 1898, 

 IX, 345.— Johne, S. B., 1879, 45.— Eies, Eee., 1897, 228.— Eoy, Rev. vet., 1898, 286.— 

 Winkel, Holl. Z., 1905, XXXII, 56. 



3. Paralyis of the Esophagus. Paralysis oesophagi. 



{Laehmmifi des SchJundes [German].) 



Etiology. Paralysis of the esophagus occurs usually to- 

 gether with paralysis of the pharynx, and is due to the same 

 causes as the latter (see page 214). There have, however, been 

 described a few cases of primary paralysis of the esophagus in 

 horses, the nature of which has not been cleared up. Moeller 

 saw this affection a few times after resection of the arytenoid 

 cartilages, sometimes as a temporary, sometimes as a permanent 

 condition. He found marked proliferation of connective tissue 

 around the larynx in one case and thinks it may be possible that 



