230 Obstruction of the Esophagus. 



always indicated if the foreign body has already been pushed to the pharynx 

 and is to be pressed into the pharynx or mouth. If the hand is to be introduced 

 into the mouth, the head must be elevated. Moeller maintains that the head of 

 the animal should not be held at all. 



Some cases can be treated successfully hy the subcutaneous 

 injection of certain medicines. Hogs and dogs may receive an 

 emetic subcutaneously (liogs, 0.02-0.03 gm. veratrine or 0.05 

 gm. liydrocblorate of apomorpliine [Moulis], dogs, 0.01-0.02 .gm. 

 apomorpbine). Tbese emetics sometimes cause tbe expulsion 

 of tbe foreign body after a few minutes. In otber ani- 

 mals likewise, tbe following subcutaneous injections may ac- 

 complisb tbe oliject, even after unsuccessful attempts at extrac- 

 tion, by causing energetic muscular contractions and powerful 

 attempts at deglutition wliicli move tbe foreign body into tbe 

 stomacb, viz: Strychnine (Maury), eserine (Clerc), veratrine 

 (Micbalski), arecoline (Frobner). 



In eases where he did not succeed in removing the foreign body, Schaak 

 proceeded as follows : He pouied one quart of mucilaginous fluid into the animal 

 and then made it run uphill; in this manner horses and cattle often swallowed the 

 foreign body. 



If tbe methods described are unsuccessful, tbe further pro- 

 cedure depends upon the nature of the wedged-in body. Fruit, 

 bulbs, morsels of food, etc., in tbe course of time become soft- 

 ened in the esophagus and are finally swallowed. Since obstruc- 

 tion of tbe esophagus in cattle soon leads to bloating, one may 

 leave tbe foreign body undisturbed only if meteorism has been 

 relieved in the meantime. It is therefore necessary to per- 

 forate the rumen and it is best to leave the shield of the trocbar 

 in the wound, closing its outer opening with a cork, and to open 

 it from time to time in order to let out the accumulating gases. 

 It is also necessary, in the further course of the disease, to at- 

 tend to the artificial feeding of the patient per rectum. 



If the wedged-in body is too bard, or if its nature is un- 

 known, if one wants to accomplish removal when other means 

 have failed, displacement towards the stomach may be attempted 

 by the aid of an esophageal sound, a catheter, and in an emer- 

 gency, with a carefully wrapped elastic stick (stick of a whip, 

 piece of rattan), or a piece of moistened and oiled rope with a 

 knot at one end. The foreign body must, however, be pushed 

 without much force and very gradually. The extraction of for- 

 eign bodies with special armed extraction forceps or the crush- 

 ing of the foreign body is not to be recommended. 



The propulsion of the foreign body towards the stomach succeeds rapidly, 

 although in some cases this procedure requires great care and dexterity. Tf the 

 sound is introduced without care or with sudden force, injuries and tearing of 

 the esophageal wall and even lacerations of the neighboring vessel occur easily, 

 particularly in restless animals. Such cases are particularly frequent if the operation 

 is performed by non-professional attendants who are often too ready to step in. 



If the removal of tbe foreign body in the cervical portion 

 of tbe esophagus is impossible by any method above described. 



