686 OPEKATIONS. 



well-known steeple-chase horse, The Continental, may be cited as 

 a comparative exception; though even in his case, the tube failed 

 to render the breathing normal. 



DISADVANTAGES OF AND CONSEQUENCES EllOM TEK- 

 MANENT TKACHEOTOMY.— The wound must of necessity set up 

 to a greater or less extent, diseased changes in the bronchial tubes 

 and lungs on account of the j^utrid discharge which drops from it 

 into the windpipe. The presence of the tube, especially if the 

 instrument be unduly heavy and its branches inordinately long, 

 is liable to irritate and inflame the windpipe, with consequent 

 ulceration of the mucous membrane, diminution of the calibre of 

 the windpipe from thickening of the mucous membrane and under- 

 lying tissues, ossification of the rings of the windpipe in the neigh- 

 bourhood of the opening, and formation of tumours. The air that 

 goes through the tube, lacking the natural preparation afforded 

 by a transit through the air-passages in front of the opening, is 

 apt to have an irritating effect on the bronchial tubes and lungs, 

 especially during cold weather, and when the organs of breathing 

 are violently called into play. The presence of an open tube 

 affords a ready means of entrance, into the bronchial tubes, of dust 

 and other irritating matters. A horse which wears a tube will always 

 be exposed to the danger of injury from his rubbing the tube, or 

 from its catching on some object. The special precautions which 

 have to be taken with such an animal, militate against the value 

 of the operation in inverse proportion to the amount of attention 

 which can be bestowed on the patient. We must not forget that 

 the relief in breathing from tracheotomy experienced by the roarer, 

 in no way cures his nervous complaint, which in many cases appears 

 to injuriously affect the general nutrition of the body, as well as 

 the implicated muscle or muscles of the larynx. 



INDICATIONS FOR PERMANENT TRACHEOTOMY.— As a 



rule, permanent tracheotomy answers fairly well for a time with 

 " noisy " race-horses and chasers ; provided that their " class," in- 

 dependently of their infirmity, was considerably higher than that 

 in w^hich they are intended to compete. As a gTeat rule, tube- 

 boarers can succeed only among selling platers. I would not re- 

 commend the operation for ordinary horses which are roarers, 

 unless their infirmity seriously impairs their efiiciency. Owing 

 to the nature of the work, the season of the year during w^hich it 

 is performed, and the danger of foreign bodies getting into the 

 windpipe via the tube, when out with hounds for several hours ; 

 permanent tracheotomy does not always answer well with hunters, 

 which, being animals of luxury, cannot with any degree of propriety 



