684 OPEEATIONS. 



after the operation, when these appliances have been removed '* 

 (Cagny and Gohert). 



I have ah'eady pointed out that the application of a tourniquet 

 should be employed only for a short time ; because destructive 

 changes and finally death of the part will quickly ensue, if it be 

 long continued. 



'& 



Tracheotomy. 



GENERAL REMARKS.— Tracheotomy is the operation of 

 making an opening from the outside of the throat into the wind- 

 pipe with the object of relieving obstruction to breathing situated 

 above the opening; and may be temporary or permanent. The 

 former is employed for acute difficulty of breathing which threatens 

 the life of the animal; the latter, for chronic affections, such as 

 roaring. As the opening has a constant tendency to become closed, 

 we are obliged, in order to counteract this effort at repair by 

 the wounded tissues, to adopt some mechanical means, of which 

 the best is a tracheotomy tube (Figs. 177 and 178). The use of 

 a tube, which is a practical necessity in permanent tracheotomy, 

 is optional in the temporary operation. We find that the greater 

 the amount of damage (cutting through and removal of cartilage) 

 inflicted on the windpipe in making the opening, other things being 

 e(]ual ; the greater will be the probability of the wound causing 

 injurious alterations in the shape and the calibre of the windpipe. 

 Takino- this fact into consideration, and bearing- in mind that tem- 

 porary tracheotomy is employed, with extremely few exceptions, 

 only on horses which are at rest ; we may conclude that, as a great 

 rule, it demands a much smaller opening than permanent trache- 

 otomy. 



INDICATIONS FOR THE USE OF TEMPORARY TRACHE^ 

 OTOMY. — The usual cases which demand this form of operation 

 are those of laryngitis which produces swelling of the part (oedema 

 of the glottis) ; abscess in or near the larynx ; and choking. The 

 opening may generally be allowed to close after about three days. 



ADVANTAGES OF PERMANENT TRACHEOTOMY.— The relief 

 obtained from the operation is often great and long continued. 

 Leblanc kept a roarer at work by means of his tracheotomy tube 

 for eighteen years. " Since the year 1872, I have used my tube 

 with several roarers, among which were two that were employed 

 at fast paces. With this apparatus, which is very simiDle and light, 

 tliey were able to do their work as well as before they became 

 roarers, and have continued to do it for the past four years. Several 



