TYMPANITES OF THE GUTTURAL TOUCH. .'{7.'} 



The disease described by French authors, and especially by Vatel 

 and Gohier, as guttural tympanites, has been observed repeatedly 

 by others. Friebel and Kiihnert found this condition in foals soon 

 after birth. It consists in the accumulation of abnormal quantities 

 of air or gas in the guttural pouches, which become so dilated as 

 to cause severe dyspnoea. A swelling appears in the region of the 

 parotid which is resonant on percussion, and on strong pressure 

 sometimes produces a whistling sound in consequence of air 

 escaping from the Eustachian tube. It occasionally occurs in foals, 

 and affects both guttural pouches. If the sacs are opened the 

 gas escapes, but reaccumulates as soon as the openings close. 

 Reported cases show that tympany may be due to one of two 

 causes. 



(1) Atmospheric air enters through the Eustachian tubes and 

 gradually accumulates in the guttural pouches. This probably occurs 

 during deglutition, and is caused by some defect of the clap-valve 

 which guards the opening into the pouch, the valve allowing air to 

 enter but preventing its exit. Even in normal subjects, exit of air 

 appears to be difficult. Degive injected air through a cannula into 

 the guttural pouch of a dead animal, and noticed that it was retained 

 for a long time. Gerlach referred the condition to paralysis of the 

 elevators of the soft palate, which he considered should close the 

 Eustachian tube, because in one of his cases these muscles seemed 

 atrophied on the diseased side. K. Giinther also considered that the 

 pouch might become distended in this way. The air which has so 

 entered, according to Gerlach, is unable to return, because the tube 

 closes like a valve at its point of entry into the guttural pouch. 

 Investigations in the horse, carried out with the pharyngeal speculum, 

 do not, however, support this idea. 



(2) Other published observations ascribe the condition to the 

 development of gas during catarrhal disease of the guttural pouch 

 (Bassi, Degive, Moller). 



Treatment. Cases associated with disease of the mucous membrane 

 and the accumulation of fluid secretion are treated according to the 

 principles previously described. Where atmospheric air accumulates, 

 Gunther's catheter is used ; and if the condition recurs, the guttural 

 pouch is opened, and a drainage-tube inserted. Stockfleth employed 

 this method successfully. Friebel pierced the cavity with a trocar, and 

 injected astringents like 2 per cent, solution of sulphate of zinc. 

 Where such methods are unsuccessful, it is better to divide the opening 

 of the Eustachian tube, as was done by Niebuhr with good results. 

 Possibly the valve-like action of the tube is thus done away with. 



