506 HEALTH AND DISEASE 



The presence of angular specimens shows them to have existed some 

 considerable time, and, by rubbing one against another, to have worn 

 down the original rounded surface into a number of facets. 



The disease may be confined to one pouch, or extend to both. The 

 affected side of the throat in the region of the parotid gland is full or 

 distinctly swollen. Pressure applied to this part induces pain, and if deep 

 pressure be made, matter is sometimes caused to flow from the nostrils in 

 large amount. If the escape of pus be prevented by partial or complete 

 closure of the escape holes in the eustachian tubes, the accumulation of 

 matter becomes so great as to interfere with swallowing, and pressure 

 on the larynx induces a noisy or roaring sound in breathing. Under these 

 circumstances the outward swelling would be very considerable and marked 

 by distinct fluctuation. 



Treatment. It is frequently the case that this abnormal condition of 

 the guttural pouches is in existence for a considerable time before it is 

 recognized. The continuous discharge from the nostrils following upon 

 strangles and influenza is generally regarded as the result of a catarrhal 

 state of the nasal membrane, and it is not until some interference with 

 swallowing, or breathing, or some enlargement in the region of the throat 

 takes place that the actual state of affairs becomes recognized. Before 

 proceeding to any heroic measures of treatment, it may be desirable to 

 try the effects of a run at grass and a blister to the throat. As the 

 downward position of the head assumed in grazing favours the discharge 

 of the matter, and the emptying of the sac, this may have the desired 

 effect. Should it not do so, then the distended pouch or pouches will 

 require to be punctured and their contents evacuated. This is an opera- 

 tion that calls for expert assistance, as there are numerous important 

 vessels and nerves in the region of the throat which it would be dangerous 

 to injure. 



The operation consists in cutting through the skin behind the posterior 

 edge of the parotid gland, about 4 to 5 inches below the ear, and over 

 the seat of the most fluctuating point. This having been done, a hole is 

 made into the pouch either by dissection or, what is safer, by carefully 

 thrusting a blunt-pointed instrument something like a pen-holder, but 

 having a wider base, through the tissues into the sac, and then cautiously 

 enlarging the opening upward and downward with the knife. When the 

 sac has been emptied, it should be thoroughly washed out with a weak 

 solution of carbolic acid. This should be done, if possible/while the horse's 

 head is inclined downwards, which position he may be made to assume by 

 feeding him on the ground. As a repetition of the injection will require to 

 be made on the two following days, the aperture should be kept open 



