TRACHEOTOMY IN A BAY MARE. 531 
once proposed tracheotomy, to which the owner immediately 
assented. 
Having no instruments with me except a lancet, I was obliged 
to operate with a sharp penknife, which I accordingly did, cutting 
through the common integument, carefully dissecting between the 
sterno-maxillaris and sterno-thyroideus muscles, thus exposing 
the trachea ; having done which, I waited until what little bleed- 
ing there was had subsided, and then opened the trachea, dividing- 
three of the cartilaginous rings. She experienced instant relief, 
and all distressing symptoms vanished. My next consideration 
was, how to keep the orifice open. Many practitioners cut a small 
portion from two of the rings, so as to avoid destroying the elasti- 
city of the air tube as little as possible : I, however, found my plan 
answer very well. I passed a suture through the integument on 
each side, and tied it at the back of the neck ; I then passed two 
others through each end of one of the rings, which I tied in a like 
manner, thus effecting my purpose very well. I may offer a slight 
remark , — experientia docet , — that, in tying the suture in the trachea, 
I would do it so as to leave a loop of about half an inch in length, 
that might be easily cut with a pair of scissors when it was 
wished to remove them. As I did not do so, in consequence of 
the swelling which took place, I experienced a little difficulty in 
their removal. 
In this state I left her until the following morning. She ap- 
peared in better spirits — the enlargement still increases in size, and 
eats no better. Support her with enemas of gruel, and let her 
have the same to drink. 
17 th . — In the course of the night an immense quantity of matter 
had been discharged, continually running out from the poultice, 
and she is decidedly in all respects better. 
18/A. — Breathes with no difficulty : when, therefore, we close the 
artificial opening, remove the sutures and dress the abscess under- 
neath the jaw with common digestive ointment. 
22c?. — A slight degree of respiration takes place through the 
opening in the trachea — no difficulty in swallowing — appetite 
daily improving — very much inclined to rub her neck upon the 
edge of the manger, therefore have her head tied up. 
August 1th . — The artificial opening perfectly healed, leaving a 
very slight cicatrix. Had daily walking exercise for the last week. 
Discharged from the sick list. 
