432 PARALYSIS OF THE PHARYNX AND (ESOPHAGUS. 



the presence of foreign bodies. No strict distinction can be made 

 between paralysis of the pharynx and oesophagus. Conditions 

 viewed as paralysis of the oesophagus must sometimes be referred 

 to the pharynx. In serious diseases, especially in brain disorders 

 and rabies, as well as towards the end of life, innervation of deglutition 

 often suffers, and food consequently remains fixed in the oesophagus. 

 Hence post-mortem examination of horses often discovers accumula- 

 tion of food in the oesophagus, without any apparent obstruction 

 in the lumen of the tube ; but these cases have no further clinical 

 interest. 



Moller treated a horse which showed difficulty in swallowing for a 

 long time ; no cause could be discovered, no other morbid symptoms 

 were present — even on post-mortem nothing abnormal could he detected. 

 In another horse, recovery from a laryngeal injury was followed by difficulty 

 in swallowing, and though food was chewed as usual, no attempt was made 

 to swallow it, but the horse allowed it to fall from the mouth again. 

 The tongue appeared normal, both in appearance and function. It, there- 

 fore, seems probable that paralysis of the pharynx existed, though the 

 strict proof was wanting. We have seen similar difficulty in deglutition 

 several times after resection of the arytenoid cartilage ; in one case caused 

 by great increase in the connective tissue about the larynx and pharynx ; 

 in another case the symptoms completely disappeared after some weeks. 

 Possibly this case depended on inflammatory swelling in the pharynx, 

 though the animal showed no other disturbance. Dieckerhoff saw a 

 similar case in a horse. That inability to swallow may be caused by 

 impaction of the oesophagus appears evident from Puschmann's record of 

 a horse which had the tube packed tightly with hay two inches from the 

 cardiac orifice. The cases described by Cadeac and others as oesophageal 

 cramp may probably be referred either to impaction of the oesophagus 

 or other hindrance to the passage of food (diverticulum stenosis). 

 Complete blocking of the oesophagus naturally prevents the possibility 

 of swallowing. This is easily explained if one adopts Kronecker and 

 Meltzer's view, that food is injected immediately into the stomach from 

 the pharynx. 



Kohne saw six otherwise healthy horses which appeared unable to 

 swallow, and in consequence very rapidly fell away in condition; they 

 showed some oedema under the chest. The autopsy revealed nothing 

 of a positive character. 



Stietenroth saw some similar cases ; the pupils of the eyes were 

 markedly dilated, and at a later stage there was loss of sensation over 

 almost the whole surface of the body, a condition which Stietenroth 

 interpreted as pointing to belladonna poisoning. This view seemed to be 

 supported by the fact that the disease attacked two horses in the same 

 stable within a short interval. 



Schmidt has indicated the possible occurrence of one-sided 

 paralysis of the pharynx and oesophagus. An old mare had a left- 

 sided nasal discharge; the left nostril was filled with food, and on 

 drinking a great part of the water flowed back through the nose. 



