ECTASIA, DIVERTICULA, AND RUPTURES OF THE (ESOPHAGUS. 175 
sepsis, as Laurent’s and Graf’s observations show. Giaf s case was 
caused by a kick from another horse. Schleg’s case in a cow shows 
that spontaneous recovery is nevertheless possible. Krebs records 
dilatation and rupture of the oesophagus in a horse in consequence of 
fatty degeneration of the muscular coat. 
Should the oesophagus become ruptured in the thorax or abdomen, 
death soon follows from septic pleuritis or peritonitis. Kehm and 
Grunwald report such cases in the horse. The condition is, however, 
seldom recognised before death. Accumulation of food may cause 
inflammation and destruction of the mucous membrane, especially during 
the earlier stages and before it becomes gradually thickened and more 
resistant. 
Prognosis in these cases is usually unfavourable. If ectasia does not 
endanger life, it seriously interferes with nutrition and the use of the 
animal, and is usually incurable. By regulating the diet it may be possible 
to keep the animals at work ; fat cattle should be prepared for slaughter. 
Treatment. In ectasia, which sometimes extends over large areas, 
therapeutic treatment scarcely promises any good result, but in diverticula 
in the cervical portion of the oesophagus something may be done, both in 
horses and cattle, by operation, as is shown by the cases related by 
Beinemann, Schwerdtfeger, Moisant, Beichel, and others. The dilated 
portion of the mucosa may be replaced or removed altogether, and the 
rupture in the muscles brought together by sutures. With antiseptic 
precautions, the operation is not attended with much danger. This is 
the most promising treatment in animals, but in chronic cases is moie 
easily described than carried out, especially if the rupture in the muscular 
coat is already cicatrised and fixed to the neighbouring parts by much 
cicatricial tissue. The operation can, however, be tried. 
Procedure is similar to that of incising the oesophagus. After returning 
the mucosa, the muscular coat is, where practicable, carefully sutured 
with catgut or silk ligatures inserted close together ; bad results naturally 
follow if the stitches tear out. Where this course is impossible, the 
diverticulum must be opened, a piece of the dilated mucous membrane 
excised, -and the parts brought together in the above fashion. Moisant 
applied a sort of clamp during eating and drinking, and attained good 
results in a horse, and afterwards in two cows. Caieful stitching of the 
muscular and mucous coats is, however, not only simpler, but equally 
successful. Beinemann effected a cure, although the stitches tore out in 
two days, owing to inappropriate feeding. Granulations gradually close 
the opening. Beichel operated on oxen in the standing position. lo 
prevent the stitches tearing out, nothing more than water should be given 
during the ensuing twenty-four hours, and during the next few days only 
fluid nourishment. In complete rupture of the cervical portion of the 
