536 DISEASES OF THE PHAEYNX, (ESOPHAGUS, ETC. 



patient, "being generally sufficient. Armatage's is the best form 

 of gag. 



In introducing the probang, it is essential — 1st, that the 

 animal's nose should be elevated, in order to make the mouth 

 and throat as near a straight line as possible ; 2d, that the neck 

 should be kept straight ; Sd, that the probang should be pushed 

 with care over the epiglottis ; 4tli, that the pressure brought to 

 bear upon the obstructing object should not be violent, but gentle 

 and intermitting, as firm and persistent pressure is apt to cause 

 rupture of the oesophagus ; for it must be remembered that 

 generally the tube is spasmodically closed beyond the obstacle, 

 and severe and continuous pushing increases this condition, 

 causes the obstacle to tear the cuticular coat, and finally to 

 penetrate the oesophagus altogether. If gentle taps with the 

 cup-end of the probang be insufficient, the "screw stillet" is to 

 be introduced, and an attempt made to transfix the obstacle with 

 the cork-screw termination of the stillet, and to withdraw it 

 through the mouth. The operation may be compared to that of 

 drawing a cork out of a bottle ; but should the operator fail in 

 removing the obstacle by this method, it will be good practice to 

 pierce it in several places by the screw, and thus break down its 

 integrity, and leave the completion of the operation to its gradual 

 softening, more particularly in those instances where the symp- 

 toms are not very urgent. In cases where the impaction is 

 witliin the thoracic portion of the oesophagus, nothing more can 

 be done ; but should it be witliin the reach of the operator, it may 

 be deemed necessary to perform " cesophagotomy." This opera- 

 tion is very easily performed. It should be adopted, however, 

 as a last resource, as wounds of the oesophagus are difficult to 

 manage, and tend to produce a stricture of the tube. 



If the foreign body can be distinctly made out by examination, 

 the operator should, in the first place, have a twitch put on the 

 horse's nose — in the cow, the " buU dogs ; " in the second place, 

 the head must be elevated and neck extended to throw the 

 muscles into a state of firmness and tension ; then an assistant 

 is made to press the off side of the neck upon the obstacle, so as to 

 cause it to bulge outwards as far as possible : these preliminaries 

 being completed, the surgeon must make a bold longitudinal 

 incision on to the object, cutting through the skin, muscles, ami 

 CESophagus at one stroke of the knife, but taking care not to 



