THE HOESE IN SICKNESS AND DISEASE 329 



Recollecting that the oesophagus, after proceeding down 

 one-third of the neck, inclines to the left of the trachea, 

 and before it reaches the chest gets quite round to the left 

 of that tube, we should select the left side of the neck, and 

 below the upper third of it, for the operation. Supposing 

 we take the middle of the neck, our first incision should 

 be three inches in length, and directed along the inferior 

 border of the jugular vein ; which vessel had better be 

 kept distended the while by pressure from the hand 

 of an assistant. The lips of the w^ound being kept 

 apart by the assistant, the operator carefully prosecutes 

 his dissection through the cellular tissue with which this 

 hollow abounds, keeping his knife from wounding the 

 jugular on his right, and guarding against the carotid 

 artery and nerves which lie enveloped in the cellular 

 substance contiguous to the windpipe, whose situation he 

 will best ascertain by feeling for the pulsations of the artery. 

 His object now is to get behind the carotid, and there feel 

 for the windpipe ; and this being found, will guide him to 

 a firm, cordiform, shining red substance, in close apposition 

 with it ; this is the oesophagus. In case any injection into 

 it be required, the oesophagus must be drawn forward with 

 a blunt hook, and opened by a longitudinal incision, and an 

 appropriate tube introduced. 



But where the extraction of a foreign body is our object 

 — a circumstance that will render the operation much more 

 facile, the tumour being our guide for incision — nothing 

 remains to be done after this but to liberate the enclosed 

 substance, and close the wound in the oesophagus with a 

 common suture of silk thread, and unite the lips of the 

 external wound with pins and tow twisted round them, in 

 the same manner as the wound after bleeding is closed. 

 Lastly, a compress upon the wound, confined by a roller 

 around the neck, will give support, and perhaps be found 

 serviceable. During the healing of the wound the animal's 

 diet must be liquid, or nearly so : gruel, thick and nutritive, 

 and boiled roots, and mashes of semi-fluid consistence. 

 Chopped green meat of any soft and succulent kind, and 

 short-cut grass, are also admissible. 



