434 TUMOURS IN THE PHARYNX AND (ESOPHAGUS. 



of hard sharp forage is easily infected. As the growths enlarge, 

 the following symptoms appear :— 



(1) Dyspnoea. The respiration is snoring and rattling, attended 

 with cough, and the dyspnoea occurs particularly during feeding, 

 and sometimes at every effort to swallow. When the head is bent, 

 this disturbance is more marked, a circumstance valuable in diagnosis. 

 (2) Difficulty in swallowing. The tumour, as it becomes larger, 

 interferes with deglutition. The head is extended, and food entering 

 the pharynx excites coughing. (3) Palpation from without some- 

 times discovers swelling in the region of the pharynx. In making 

 this examination, the head must be extended as much as possible, 

 and the two hands pushed upwards above the larynx. Harms once 

 found dislocation of the larynx. On introducing the hand into the 

 pharynx, the condition, size, character, and position of the new 

 growth can be fully determined. 



This examination is necessary to differentiate the condition in question 

 from diseases of the tongue, or from swelling of the retropharyngeal lymph 

 glands, though the latter is not very frequent in oxen. Nevertheless. 

 it has been several times observed, and Prietsch describes a case. A well- 

 nourished cow gradually developed snoring respiration four to five months 

 after the first calving. It was most marked when eating hay, and some- 

 times became so severe that chewing was interrupted, the head extended, 

 and the tongue thrust out of the mouth. The larynx was swollen and 

 enlarged. Post-mostem showed tuberculous changes in the lungs and 

 retropharyngeal lymph glands. 



According to Harms, the anterior pharyngeal swellings contain a greyish- 

 red material, sometimes calcined, in the interior of which actinomyces 

 can be detected. The posterior have a smooth fibrous form, and contain 

 a greenish decomposed material. They develop slowly. Harms states 

 that the swelling may exist for five months or more without producing 

 danger of suffocation, but the symptoms, and especially the respiratory 

 disturbance, generally increase. He further remarks that in the posterior 

 pharyngeal swellings arrest of growth may occur, so that clinical symptoms 

 remain stationary. 



Prognosis is unfavourable ; complete recovery improbable, 

 although improvement may be secured for a long time by operative 

 treatment. 



Treatment. Harms casts the animal, raises the neck, and makes 

 a longitudinal incision in the middle line under the larynx, through 

 which the hand is introduced, the connective tissue at the side of 

 the larynx is then divided, the tumour reached and removed by 

 breaking down the tissues around it. Meier casts the animal on the 

 right side, inserts a mouth gag, raises the head, introduces the right 

 hand into the mouth and pharynx with its volar surface towards 

 the palate, and grasps and tears off the anterior actinomycotic 



