BEOKEN WIND. 375 



through the cheek bone, it should be subsequently broken through, 

 so as to secure efficient drainage. If the passage between the 

 inferior maxillary sinus and the riose be blocked up, if necessary, 

 bore, into the inferior maxillary sinus, another hole, lower down^ 

 on the cheek and clear the passage by means of syringing and the 

 use of a probe. To keep the holes in the bone from closing up 

 after syringing the cavities out, fit champagne corks into them 

 respectively ; those used for, the holes in either of the maxillary 

 sinuses, having a passage bored down their centre with a rat-tailed 

 file, for purposes of drainage. When the secretion of the mucous 

 membrane is healthy, which under ordinary circumstances it will 

 be in a fortnight or three weeks, take out the corks and allow 

 the wounds to heal up. If the cause of the nasal gleet is the 

 presence of the diseased fang of a tooth which projects into one 

 of the maxillary sinuses, remove the offending tooth, which is 

 an operation I need not describe here. It is well to feed the 

 patient off the ground, for the lower the head is held, the more 

 efficient will be the drainage. Probably, much of the good obtained 

 in this disease from turning the horse out to grass, is due to the 

 head being kept longer in a dependent position than if the animal 

 was in the stable. 



Broken Wind {Emphysema of the Lungs). 



The term " broken-wind " denotes a chronic condition of diffi- 

 culty of breathing in which the act of expiration is always longer 

 than that of inspiration. 



The difficulty of breathing in broken wind is almost always due to 

 emphysema of the lungs^ which consists of a dilated condition of the lungs, 

 owing to an excess of air in the air-cells or in the cellular tissue that sur- 

 rounds the lobules (p. 349). This continued dilatation prevents the lungs 

 from becoming exhausted of air, at the end of the act of expiration, to 

 their full extent, which causes the amount of air taken in to be less than it 

 would be, were the lungs capable of being properly emptied. In any case, 

 a certain amount (residual air) always remains in the lungs. When the 

 distension occurs in the air-cells — in which case, by the breakiijg down of 

 their walls, the cells of the affected lobule tend to run into each other — the 

 chief cause seems to be violent expiratory efforts made in the act of cough- 

 ing. In the case, however, of distension existing in the connective tissue 

 (intctr-lobular emphysema), the entrance of air appears to occur during 

 inspiration ; the primary cause being, probably, some slow and long-con- 

 tinued degenerative change in the lung tissue. As a full condition of the 

 stomach and intestines greatly interferes with the action of the lungs, it 

 is not surprising that violent work, when the animal is "blown out" with 

 food, and especially when his " condition " is not good, should be followed 

 by ejnjAysema of the lungs. 



Owing, probably, to improved stable management, broken wind 

 is now a rare disease. 



