692 
CASES OF TRACHEOTOMY. 
in the night with an alarming difficulty of breathing, and gene¬ 
rally excited state of the system ; so much so that, when called to 
the case, I doubted whether it was violent inflammation of the 
lungs themselves, or only an impediment in the air passages. 
The symptoms, however, were urgent; she was wheezing loudly, 
the pulse quick and hurried, the extremities cold, and a most 
profuse discharge of frothy mucus from the mouth. To relieve 
the lungs was the direct indication, and I accordingly took two 
quarts of blood ; but still the breathing remained difficult, and in 
less than an hour I was aw T akened with news that the mare was 
dying. Before I reached the stable she had fallen down, and was 
suffering the extremity of suffocation. 
As no time was to be lost, I divided two rings of the trachea 
with my knife, when a volume of air burst forth, and immediate 
relief ensued ; the tin canula was then put in requisition, and re¬ 
tained by stitches as in the former case. Convinced that there 
existed an impediment in the glottis, and determined to lose no 
chance of preventing the formation of a permanent stricture, I 
directly blistered her sides, throat, and under the jaw, exten¬ 
sively; that is, as soon as she rallied from the point of death as 
it were, at which she lay, and from the excitement of which na¬ 
ture did not revive for some hours. Gradually the warmth of the 
extremities returned, and was kept up by friction and bandages; 
the violent action of the lungs slowly subsided, youth and a 
strong constitution being greatly in her favour. 
The next day I found her suffering from inflammation of the 
bladder and kidneys, the effect of blistering so large a surface ; this 
I relieved by diluents and injections into the rectum and vagina. 
Her appetite was good, but for several days she respired only 
through the canula. There never was any apparent or palpable 
swelling under the jaw, or of the adjacent glands; yet after some 
days an opening was observed in the skin under the onset of the 
head, and a considerable discharge of pus took place, but none 
at any time appeared by the nostrils. Soon after this she began 
to breathe naturally: the canula has now been discontinued above 
a week ; the orifice in the trachea is nearly healed : she is gay, 
and bears trotting exercise, and has every sign of complete re¬ 
covery. 
The proximate cause of the impediment I cannot discover, 
nor account for its very sudden appearance, and decidedly local 
character ; but the case proves that tracheotomy maybe useful in 
some instances, when no other resource is available. 
