A CASK OF BRONCHOTOMY. 
215 
suffering from the difficulty of respiration, that, although no re¬ 
straint was used on her, except that a man held her by the fore¬ 
lock with one hand with the other under the chin, yet she did not 
flinch, or in any way evince the slightest pain from the opera¬ 
tion. When the opening in the trachea was completed, it was 
found that the divided edges of the sterno-thyo-hoideus muscle 
projected over part of the wound, so as considerably to prevent 
the free ingress and egress of the air: two small portions were 
therefore excised, sufficient to leave the aperture into the windpipe 
cpiite free. In a few minutes the mare appeared greatly relieved, 
and breathed through the opening with freedom : a quantity of 
mucus, and several clots of blood, were discharged from the tra¬ 
chea ; the latter probably coming from the larynx. Conceiving, 
from the sudden manner in which the swellings of the throat 
arose, and which were still getting larger, that some small vessel 
or vessels were ruptured, and pouring their contents into the cel¬ 
lular membrane, a person was directed continually to bathe the 
parts from a bucket of cold salt and water. At the end of an 
hour, no extension of the swelling having taken place, the man 
was desired to desist from applying the salt and water for the 
present. More clots of blood, and some of them large ones, were 
discharged from the trachea. These clots coming most likely 
from the larynx and glottis, had, I should think, a great share in 
producing the very sudden difficulty of breathing that existed in 
this case. She now respired freely through the opening, and 
appeared easy; was bled to four quarts ; and the salt and water 
bathing was repeated every two hours. 
7 p.m. —She was breathing with difficulty, and a great wheezing 
noise. Upon examination, it was discovered that, in consequence 
of swelling about the wound, the lips of the incision had sepa¬ 
rated considerably, and drawn up the skin of the neck from below 
the wound, so as to cover one half of the original opening. I 
slit down the skin about an inch, with a common bleeding lan¬ 
cet, which entirely freed the opening in the windpipe, and the 
mare was instantly relieved. A thin bran mash was now allowed, 
which she ate greedily. 
14 th .—Swelling of the throat as yesterday ; a good deal of tu¬ 
mefaction round the wound, but the aperture quite free, through 
which she breathed with ease. The whole neck was fomented 
three times a-day with warm water ; she was allowed mashes and 
a little hay; and ate all that was given to her with avidity. In 
the evening I put my thumb into the opening of the windpipe, so 
as to stop it up ; immediately the mare became greatly distressed, 
and could not breathe through the regular passages. 
15 th .—Swelling of the throat rather less: to be rubbed night and 
