Dyspnoea Laryngea. Roaring. Hemiplegia Laryngea. 139 



inches behind the anterior opening of the thorax. The recurrent 

 nerve between this and the larnyx was wasted so that its fibres 

 could scarcely be recognized, the laryngeal muscles on that side 

 were atrophied, and degenerated, and the glottis distorted and 

 partly closed. Fergusson has in his description made the mistake 

 of writing the right for the left ; it is evident that the right recur- 

 rent nerve could not possibly pass through a tumor in the situation 

 described. 



(d. ) Gamgee -furnishes a drawing of an immense tumor filling 

 up the anterior part of the chest, pressing on the vagi and recur- 

 rent nerves and causing roaring. 



(e.) The Clinique of the Alfort Veterinary School furnishes 

 the following among other cases of roaring consequent on inflam- 

 mation of the jugular vein. A well-bred and very fast English 

 thoroughbred had been used for two years by his owner who was a 

 hard rider. In June, 1857, he was bled as a preventive (saignee 

 de precaution), supurative phlebitis was induced and was only 

 cured at the end of six weeks. When again put to work he 

 proved a roarer and was still affected when seen six months later. 



In connection with this it may be noted that the swelling in 

 connection with the inflammation of the vein extends easily to 

 the sub-jacent vagus and recurrent nerves, leading to their inflam- 

 mation, functional inactivity and atrophy. Bleeding is usually 

 done on the left side of the neck so that the paralysis and wasting 

 would still be on the same side. Happily with a more humane 

 system of treatment, accidents of this kind are less frequent than 

 formerly. Glbckner furnishes a case which followed thrombosis 

 of the carotid. 



(f ) Reynal reports several cases in which roaring had occurred 

 as a sequel of inflammations and abscess about the throat, and in 

 which infiltrations or gray or yellow indurations had taken place 

 in the areolar tissue around the vagus nerve. As nothing is more 

 common than to find roaring resulting from severe sore throat, 

 parotitis, etc., this may explain its occurrence. 



Mandl first carefully examined the paralyzed muscles which pre- 

 sent to the naked eye a flattened and wasted appearance in marked 

 contrast to the full well-rounded forms or those on the opposite 

 side. They differ no less in color. In place of the deep red of 

 the healthy muscles those on the diseased side are of a yellowish 



