TEACHEOTOMY. 



689 



windpipe. (1) It should be on a spot where the muscles covering 

 the windpipe are not thick. (2) It should be sufficiently high, so 

 as to allow of a second opening being made, in the event of changes 

 (narrowing of the windpipe from distortion, ossification, etc.) 

 occurring in the neighbourhood of the first opening which would 

 interfere with the breathing. (3) It should be sufficiently low 

 down to prevent the horse disturbing the tube in any way by 

 drawing in his head (flexing his head on his neck). These condi- 

 tions will generally be fulfilled if the opening be made at a distance 

 of about 5 inches (Fig. 178) from the larynx. Mr. Jones advises 



Fig. 178. — Position of tracheotomy tube. 



that the operator should always see the horse ridden with the 

 bridle he regularly wears, so as to observe the position in which 

 the animal carries his head, and to find out if he is accustomed 

 to arch his neck a good deal; for in that case the tube must be 

 inserted lower down than otherwise. 



In temporary tracheotomy, it is best to make the opening about 

 half-way down the neck (that is, about half-way between the larynx 

 and the breast) ; for, at that spot, the windpipe occupies a more 

 superficial position than higher up, or lower down. 



THE OPERATION FOR PERMANENT TRACHEOTOMY.— 



After having selected the spot on which to operate, secure the horr,:: 



U 



