172 
INJURIES TO THE PHARYNX AND (ESOPHAGUS. 
threatening suffocation. Foreign bodies injuring the .mucous membrane 
of these regions sometimes produce extensive inflammation and the 
formation of abscesses, which may break externally and cause oesophageal 
fistula, or into the thorax or abdomen, inducing fatal septic pleuritis or 
peritonitis, and rapidly leading to death. Laser records, in a remount 
horse, the rare case of double rupture of the oesophagus—one in the neck 
portion, the second in the thorax; death ensued. External perforation 
is most frequently met with at the upper end of the oesophagus, close 
behind the pharynx ; Moller has several times seen this in horses. The 
abscess breaks and discharges an exceedingly offensive pus, often mixed 
with food, after which saliva, food, and water escape during swallowing, 
proving beyond question that the disease has originated in the oesophagus 
or pharynx. The wound closes gradually, but a small fistulous canal 
remains, discharging water and saliva, and healing often with the 
greatest difficulty. This constitutes oesophageal or pharyngeal fistula. 
Butters recently described such a case. The inflammatory processes and 
consequent swelling produce difficulty in swallowing, and not infrequently 
feverish symptoms (angina). A swelling develops on the left side, gradu¬ 
ally increases, becomes soft, and finally breaks, when the difficulty in 
swallowing and the fever disappear. Guilmot saw a case of abscess 
formation in the lumen of the oesophagus of a calf, causing difficulty in 
swallowing, vomiting, and tympanites; on introducing the oesophageal 
sound, about two pints of pus were discharged, the symptoms disappearing 
some days later. Haubold saw an oesophageal fistula produced in the 
horse by abscess formation in the retro-pharyngeal lymph glands; the 
animal recovered in three weeks. Stamm had a similar case following 
strangles. Injuries of the walls of the pharynx by balling-guns or tooth 
instruments, indicated by salivation and disturbance in swallowing, may 
heal, provided they do not take a fatal course from bleeding or inflamma¬ 
tion. In small animals their position and extent can be determined by 
direct inspection. 
Treatment. As already indicated, care must be exercised in the use of 
oesophageal and tooth instruments, and sharp balling-guns or sticks 
avoided. The course of abscess formation in the throat may be shortened 
by early and cautious opening, by washing out the abscess, and making- 
provision for regular discharge of the contents, inflammatory products, 
and saliva. CEsopliageal fistulse sometimes give much trouble. Definite 
closure may often be produced by passing a thread steeped in sublimate, 
or by applying the actual cautery, but is not always successful. In a 
horse under Moller’s treatment these and other measures were used 
without result. Widening the fistula and suturing the opening in the 
oesophagus generally produces healing, though the operation is by no 
means easy, and does not in every case produce the desired effect. In 
