TUMOURS IN THE PHARYNX AND (ESOPHAGUS. 
179 
cough, and the dyspnoea occurs particularly during feeding, and some¬ 
times at every effort to swallow. When the head is bent, this disturbance 
is more marked, a circumstance valuable in diagnosis. (2) Difficulty 
in swallowing. The tumour, as it becomes larger, interferes with degluti¬ 
tion. The head is extended, and food entering the pharynx excites 
coughing. (8) Palpation from without sometimes discovers swelling in 
the region of the pharynx. In making this examination, the head must 
be extended as much as possible, and the two hands pushed upwards 
above the larynx. Harms once found dislocation of the larynx. On in¬ 
troducing the hand into the pharynx, the condition, size, character, and 
position of the new growth can be fully determined. 
This examination is necessary to differentiate the condition in question from 
other diseases of the tongue like makroglossia, or from swelling of the retro¬ 
pharyngeal lymph glands, though the latter is not very frequent m oxen. 
Nevertheless, it has been several times observed, and Pnetsch describes a case. 
A well-nourished cow gradually developed snoring respiration tour to live 
months after the first calving. It was most marked when eating hay, and 
sometimes became so severe that chewing was interrupted, the head extende , 
and the tongue thrust out of the mouth. The larynx was swollen and enlarged 
Post-mortem showed tuberculous changes in the lungs and retropharyngeal 
lymph glands. n , . • , 
According to Harms, the anterior pharyngeal swellings contain a greyish- 
red material, sometimes calcified, in the interior of which actinomyces can be 
detected. The posterior have a smooth fibrous form, and contain a greenis 1 
decomposed material. They develop slowly. Harms states that the swelling 
mav exist for five months or more, without producing danger of suffocation, 
but the symptoms, and especially the respiratory disturbance, generally in¬ 
crease. He further remarks that in the posterior pharyngeal swellings arrest 
of growth may occur, so that clinical symptoms remain stationary. 
Prognosis is unfavourable ; complete recovery improbable, although 
improvement may be secured for a long time by operative treatment. 
Treatment. Harms casts the animal, raises the neck, and makes a 
longitudinal incision in the middle line under the larynx, through which 
the hand is introduced, the connective tissue at the side of the laiynx is 
then divided, the tumour reached and removed by breaking down the 
tissues around it. Meier casts the animal on the right side, inserts a 
mouth gag, raises the head, introduces the right hand into the mouth 
and pharynx with its volar surface towards the palate, and giasps and 
tears off the anterior actinomyces swellings. . The posterior growths, on 
account of their firm coating of connective tissue, cannot thus be dea 
with and, therefore, Meier pierces these with the finger, allowing the 
contents to escape. Harms prefers the former of these methods, and of 
the latter remarks that it is difficult to carry out, and does not always 
remove the dyspnoea. The “ ecraseur ” is often very useful. W ith it the 
entire tumour, under certain conditions, may doubtless be removed. 
Esser, after extensive experience, has come to the conclusion that the 
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