CHRONIC CATARRH OF THE GUTTURAL POUCHES. 365 



(5.) CHRONIC CATARRH OF THE GUTTURAL POUCHES. 



The guttural pouches, two in number, may be regarded as dila- 

 tations of the mucous membrane of the pharynx and Eustachian 

 tube, with which each pouch is in free communication. The 

 Eustachian tube is a fibrocartilaginous canal or gutter, about four 

 inches long, extending from the pharynx to the petrous temporal 

 bone, where the tube is prolonged into the middle ear. The pharyn- 

 geal portion of the gutter presents inferiorly a slit-like opening leading 

 into the guttural pouch. This orifice is protected by a fibro-carti- 

 laginous plate or clap-valve, an expansion of the outer wall of the 

 gutter. The pouches possess a considerable area, and are attached 

 to the neighbouring parts by connective tissue. From their protected 

 position they seldom suffer from inflammatory disorders ; but when 

 these do occur, they are generally of a chronic character. Exudate 

 is retained, becomes decomposed, and irritation of the membrane 

 continues. The fluid part escapes or is partly resorbed, while the 

 solids, from movement within the pouches, become fashioned 

 into chestnut-like bodies, which sometimes attain the size of a hen's 

 egg. Their surface appears yellowish-brown, their interior yellowish, 

 and on account of their cartilaginous consistency they have been 

 described as chondroids. They are in many instances of the nature 

 of inspissated pus. Uhlich counted 317 small chondroids weighing 

 collectively 17 ounces. Savarese removed 240 ; they weighed from 

 5 grains up to If drams. In other cases a turbid, porridge-like fluid, 

 containing great numbers of greyish-white grains, sometimes mixed 

 with food materials, occupy the diseased sac. Thomassen described 

 dropsy of the guttural pouch in a two months old foal ; Johow found 

 the pouch filled with thick mucus ; the entrance to the pharynx 

 was displaced by the swelling. The distended pouch presses on the 

 larynx and trachea, and causes dyspnoea ; thickenings or polypoid 

 growths are often seen on the surface of the mucous membrane. 

 Generally only one pouch is diseased, seldom both. 



The causes include inflammatory processes extending from the 

 mucous membrane of the pharynx through the Eustachian tube 

 during the course of sore throat and strangles, and foreign bodies 

 and food passing into the pouch. Whether in such cases congenital 

 defects exist in the Eustachian tube cannot be determined from 

 the reports of observers. Possibly defective action of the valve- 

 like plate at the Eustachian opening may permit the entrance 

 of food into the guttural pouch. Schlampp found 27 ounces of food 

 in the pouch of a horse. Ruprecht records injury to the sac from 



