REPORTS OF CASES. 
'918 
the trachea it was found almost filled up for a distance of 3 or 
4 in. from granulations growing from the wound area. The 
swelling was very hard, indurated and partook of the general * 
features of the so-called botryomycosis. It was accordingly 
treated with tincture of iodine locally and potassium iodide in¬ 
ternally, responding very promptly, the swelling disappearing, 
and the induration softening. 
It appeared, however, that the trachea would again close 
unless some mechanical obstacle to atresia were permanently 
fixed in it, and to meet this requirement we had made a silver 
tube 1 ^ in. in diameter and 4 in. long. On the inferior face 
of the tube two silver strips in. wide and 4 in. long were 
soldered at right angles to the tube, the two strips being 1 in. 
apart equidistant on either side of the middle of the tube. These 
strips were attached as a precaution to avoid the possible slip¬ 
ping of the tube up or down the trachea. The silver used was 
925-1000 fine. This tube was inserted in the trachea after mak¬ 
ing a sufficient longitudinal incision, some retaining sutures 
taken across the tube and the two strips were bent at right 
angles beyond the indurated tissues. The operative wound 
closed with moderate rapidity and the horse returned to work 
on May 25. 
On June third the patient was again presented at the clinic, 
the cough and bronchial discharge had almost wholly disap¬ 
peared, the swelling at the seat of the tracheal wound had 
largely vanished, and there was only slight suppuration about 
the silver bands attached to the tracheal tube. The latter, 
which were 4 in. long at first, were now cut off close to the 
skin, about ^ in. from the tube. The horse was not seen by 
us after this date, but continued to work and kept in good con¬ 
dition for a time. 
The owner related that some weeks subsequently the bron¬ 
chial discharge and cough returned, and with it a very foetid 
odor. Again he was traded, and the discharge and odor creating 
alarm he was destroyed because of suspicion of glanders. 
The case presents many interesting features. The presence 
of the tumor between the tongue and epiglottis, with its neces¬ 
sary interference with the functions of the soft palate and with 
deglutition doubtless induced the inhalation of substances 
which led to the chronic muco-purulent bronchitis. The re¬ 
sort to longitudinal division of the soft palate prior to the re¬ 
moval of the tumor demonstrated quite clearly to the operator 
(Dr. Stone) the value of staphylotomy as a preparatory op- 
