740 GENEEAL THERAPEUTIC MEASURES 



tion and flatulence are shown by colic, distention in tlie 

 region of the stomach, difficulty in thoracic breathing and 

 eructations of gas by the mouth, or- attempts at retching 

 and vomiting. 



To pass the tube, the horse may be backed into a stall. 

 The operator stands to the animal's left and an assistant, 

 holding up the horse's head and the distal end of the tube, 

 to the patient's right. 



The tube is placed in warm water and the surface is 

 dusted with powdered slippery elm or smeared with vase- 

 line. The left nostril of the horse is also lubricated in the 

 same way. 



The operator pushes the tube gently along the floor of 

 the left nasal fossa with the left hand, while guiding its 

 direction with the right hand. 



The first obstruction is likely to be met, when the tube 

 has been entered about a foot, by its contact with the tur- 

 binates. The point of the tube should then be held down- 

 wards, by the pressure of the right forefinger pushed as far 

 as possible into the nostril, while the outer part of the tube 

 is lifted upward to force the point down into the pharynx. 

 When the tube enters the pharynx attempts at swallowing 

 are likely to occur and these are just what are needed to 

 close the epiglottis over the larynx and to force the tube 

 into the gullet. If swallowing is not evident it may be 

 brought on by pushing the end of the tube gently backward 

 and forward into the pharynx, and, when an attempt at 

 deglutition occurs, the tube should be thrust forward. If 

 the tube goes into the trachea instead of the cesophagus, it 

 will meet with little resistance and expired air may be felt 

 coming from it, while coughing often results. If it is in the 

 gullet, the tube will be held more firmly by its walls and 

 only fetid gas may escape with stomach contents. It should 

 by these means be definitely established then that the tube 

 is in the gullet before introducing it farther. 



The tube should be made with white marks on the 

 rubber to show when it may be expected to have reached 

 the gullet and again the stomach. 



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