374 
CONTRIBUTIONS TO THE PATHOLOGY AND 
was first affected with epidemic catarrh, from which he was rapidly 
recovering, when at the period stated he was seized in the manner 
detailed—a state which I considered to arise from the retention of 
food in the pharynx or esophagus, and which one or two facts in 
some measure warranted; first, from the flow of ropy saliva from 
the mouth; and, secondly, from the extreme suddenness of the 
attack ; on the other hand, the absence of all attempts at vomiting, 
and my not being able to detect the lodgment of any foreign sub¬ 
stance in or around the organs where the obstruction to respiration 
evidently existed, made the question as to the real cause somewhat 
dubious. The obstruction I now regard, however, as having arisen 
from a spasmodic action of the muscles of the larynx, induced, 
without doubt, from the animal being attacked with cough at the 
moment the act of deglutition occurred, by which means a portion 
of food fell into the larynx, and produced the violent state of 
spasm—a state, the fatal effects of which were only counteracted 
by having recourse to tracheotomy*. The inflammation of the 
mucous tissues, with the consequent oedema and ulceration of the 
same, I regard as consecutive upon the irritation also. On the 
evening of the 5th, rheumatic lameness manifested itself in the 
left hind leg; on the evening of the 7th in the left fore limb; while 
at the same time I first observed a cramped state of the abdominal 
muscles in connexion with a short grunting noise, symptoms which 
indicated disease of the pleura, and which on the 9th became 
clearly evident from the subdued tone of the respiratory murmur 
through a portion of the right lung. On the evening of the 9th 
the dulness was increased, accompanied by a friction sound over 
the region of the heart. From the morning of the 10th until mid¬ 
day of the 13th no particular change was observable, when the 
symptoms generally became aggravated; the most prominent of 
which were, increase of the pulse and respirations, partial loss of 
consciousness ; abdominal muscles more cramped : loss of respira¬ 
tory murmur through a greater portion of the right lung, with simi- 
* “ There are three classes of cases in which the operation of tracheotomy 
may be required. The first of these is that of any disease of the larynx itself, 
or the immediately adjacent structures, by which its orifice or course may 
be obstructed physically or mechanically. 
“ The second is that of reflex action, or spasmodic closure of the glottis, 
induced through the irritation of the superior laryngeal, or some remoter 
incident nerve, and the recurrent, or the medulla oblongata ; spasmodic laryn¬ 
gismus. 
“ The third is Catalysis of the pneumogastric nerve, or, it may be, of the 
medulla oblongata—a condition attended by collapse, and partial closure of 
the glottis or larynx, paralytic or catalytic laryngismus." 
On the Operation and Application of Tracheotomy ,” 
by Dr. Marshall Hull , Lancet , April 7th , 1849. 
