SUPPOSED RUPTURE OF THE OESOPHAGUS. 15 
did so, and the sac was reached at a depth of about two 
inches. A small quantity of colourless fluid escaped through 
the groove of the needle, which smelt of hay. The general 
impression arrived at was, that there was a rupture of the 
oesophagus at about the point indicated by the * in the 
sketch, and that there was a stricture also at the lower part 
of that tube before it enters the chest (b). No one, however, 
spoke very positively on the matter. Five days afterwards I 
summoned the medical gentlemen again for another con¬ 
sultation, a marked change having taken place. The pre¬ 
viously fluctuating mass had become a solid, compact sub¬ 
stance ; the part was tense and much more swollen, and 
pressure on it gave great pain. The swelling in the front of 
the chest partook more of the ordinary character of oedema 
than that at the upper part of the swelling. There was 
general stiffness of the head and neck, and the horse could 
neither drink from the ground nor eat hay out of the rack; 
his food had therefore to be placed on a level with his head, 
to enable him to partake of it, while his general appearance 
was that of a horse suffering from tetanus. It was now 
thought that pus was being formed, and it was suggested 
by Mr. Jackson that the passing of the exploring needle 
might have set up this new inflammation. It occurred to 
me, however, that if this were so, it would to some extent 
have been confined to the part adjacent to the puncture, 
whereas the increased swelling was general. In the course 
of a week or ten days, however, this nearly altogether sub¬ 
sided, leaving the lower part of the original swelling the 
only prominent portion. This maintained the same cha¬ 
racter, and was hard and painful on pressure. It was at 
this point, it will be remembered, that the puncture was 
made. A few days later, the hitherto hardened tumour 
began to yield, and shortly afterwards suppurated. The 
discharge was that of healthy pus, but the amount was 
trifling. 
So far I have preferred to leave the case to nature. Till 
now I have not seen in what the necessity for my inter¬ 
ference has been indicated. This new inflammatory action, 
it is supposed, is an effort on her part to obliterate the 
rupture; and, lest this should terminate in a fistulous 
opening into the sac, it may now be advisable to apply to 
the surface of the tumour some stimulant to bring about 
absorption. With this view I shall employ the Ung. Hyd. 
Biniod., with what effect you shall learn in due course. 
