THE VETERINARIAN.

New Zealand Mail, Issue 934, 24 January 1890, Page 18

THE VETERINARIAN.

OPES AXION FOB THE CUBE OF UOA RING(The FfjjfiD.i A few months ago the atten 4 * on .°f hr norwas attracted to what seemed to ® fcant discovery—the cure, or at least, u. of roaring by an operation which previously been looked upon as formidable, if not imminently dangerous. It has long been recognised that roaring is, in most cases, caused by loss of power of certain muscles on the left side of the larynx generally, which muscles, by their tonicity, keep up the cartilages, and thus preserve a free opening into the breathing tubes. Paralysis of the muscles is followed by immobility of the cartilages to which they are attached, and consequently, while the cartilages on the one side are regularly kept open by the action of the healthy muscle, those on the diseased side remain in a fixed condition, cutting off about half the space which should be preserved for free breathing. A defect so obvious as that described could hardly escape the notice of surgeons, and it would follow naturally that some attempt would be made to afford relief by the obvious method of cutting away a portion of the whole of the diseased parts, so as to leave the opening into the larnyx free, at the cost of tho loss of an important structure, Operations on the larnyx which were first attempted were rather roughly done, and the success did not seem to be sufficiently pronounced to warrant the adaption, and the amount of damage which was done to the windpipe in making the opening for the removal of the diseased parts itself constituted a serious objection' to the operation. The revival of the operation on the larnyx which occurred recently was attended with great amelioration of the surgical incision. In place of cutting freely into the windpipe, it was found possible to move the vocal cord and its process through a small opening cut through the thyroid ligament, and Dr Fleming operated on several horses in that way. Later on, the whole of the arytenoid cartilage was taken out -through the thyroid ligament; but the operation was found to be difficult, on account of the want of space for manipulation ; and the next step was to extend the incision through the cricoid cartilage, which gave ample room for the operator to use his eyes and hands, and left a wound which healed quickly and left little blemish. Several horses were operated on at the Royal

Veterinary College. Some of them were sent by readers of The Field, who were disposed to try the new operation. One of the best cases at the beginning ended in a very unsatisfactory manner. The operation was performed without. any trouble, and the wound healed well. The roaring was materially diminished, but the horse always experienced a difficulty in swallowing ; water was constantly returned through the nostrils, a constant irritating rough was present,* and t.lie horse became emaciated. After some months the horse was returned to the college, and the larynx was again opened while the animal, was under chloroform, with the object of finding what deposit had occurred to disturb the causeo, the c:-re. To everyone’s surprise, the wound in the larynx was fou d to have healed in a manner that could only be described as perfect, and the opening was sufficiently large to admit of fiee breathing. From the state of the organ on which the operation had been performed, it was evident that something beyond the reach of surgery was the matter, and it was deemed expedient to destroy the horse by continuing the action of the cblnrof Tin until respiration ceased. Post-mortem examination of the respiratory orgin did not contribute any additional facts of importance., and the precise cause of failure remained undiscovered ; but it may be imagined that a nervous and sensitive animal might be kept in a state of constant trepidation from the peculiar condition of the larynx after the operation, and the feeling of suffocation which must be experienced when an attempt is made to swallow solids or liquids, particularly the latter. ivhich always to some extent pass down the unguarded opening of the larynx and excite couching - to some extent, and sometimes to a degree which must be extremely distressing to the animal. Many of the horses which were operated on at the Royal Veterinary College experienced considerable relief, and although they emitted some noise when galloped, they could not be called roarers. Whas became of these apparently successful cases we have no means of knowing. The horses were returned to their owners, and in the most instances nothing more was heard of them. If some of .our readers can supply the facts which are required to complete the history of these cases, they will add some valuable information to the literature of roaring. Commenting on the operation, for roaring and i s probable results, some time back, we suggested that, if the operation became as popular as it promised to become, and. was as successful as its supporters anticipated it would be, the future veterinary inspector of thoroughbred stock would have to look critically at the lower part of the larynx of every horse whic.i came under his notice, to find whether or not the.re was a clear eschar over the seat of a former wound made by the knife of. the operator; and we note, in the Veterinary Record a report of a case which bears on this point in a somewhat remarkable way. The report is by Professor Walley, and is introduced under the sounding title .of ‘ Arytenoidiictomy,’ which only means cutting away the arytenoid cartilage. Professor Walley writes.: — On the 16th inst. I received from a friend in the midland counties the larynx of a horse—with the following history : The horse was bought in the early part of the summer at Tattersall’s. He was a reader, and some two months prior to the date of his deivth the respiration became so very much impeded as to necessitate the performance of tracheotomy, which operation was performed by my friend. On the 12th inst., as the eanula was being cleansed, the animal’s breathing became very difficult, and he died iu the space of a few minutes. From the date on which tracheotomy was performed to the day of death the h or ° e did ordinary work with perfect ease. On making the post mortem examination my friend discovered that one arytenoid carfilarge was wanting. Briefly, I found the condition of the larynx as fellows : Left arytenoid cartilage absent. . Left aryteno-epiglottidean fold diminished in size and contracted. The submucous tissue and muepous membrane on left side, greatly thickened. The right arytenoid cartilage had fallen inwards towards tjie left side, owing, doubtless, to the removal of thp support ot the left cartilage. When the epiglottis y/as depressed a considerable aperture was left un.x. "d on the left side of the glottis. Ifeo cover.. '=h S 0 had been cut through, and t-lie ciicoid earn. *-—« of an inch) formed by tlie space (three-quarts. ends was filled up retraction of the with new connective tissue. *

The above facts need no comment; the changes noted are exactly such as might be expected to follow the ablation of such an important organ as the arytenoid cartilage. The case proves that an animal which has been deprived of an important part of the larynx may be purchased without. any suspicion, and the subsequent history indicates that the ooeration may not only fail to afford relief to the roarer, but may be followed by complications, which ultimately prevent the passage of air into the larynx and cause death by suffocation. Recent operators have been more successful than the earlier experimenters were. Gunther, of tl mover, in 1834 began operations on the larnyx, and advanced from the removal of the vocal cords t > the cutting away of the whole of the arytenoid cartilage; but they were either unsuccessful in relieving roaring, or their patients died from the entrance of food and water into the trachea. Gerlach was equally unsuccessful, and the operation fell into bad odour. Quite recently, as Dr Fleming records in his work on roaring, Professor Moller, of the Berlin Veterinary School, tried several forms of operation on the larynx without success, until he extirpated the arytenoid cartilage with fair success; he claims, indeed, to have cured twenty roarers out of thirtb-five operated on. 'I Rncc»'Rsea encouraged operators in this country to persevere, but the p blic are left in doubt as to the results which liave.been gained. It is reported that the operation is to be discontinued in the army by order of the Commander-in-Chief, and it is certainly true that very little has been said or written about the cure of roaring laf.elv. Professor Walley’s case has revived the subject, but in a manner that does not suggest any hi.g I ke vitality of long duration,

SINGULAR ACCIDENT TO A HORSEIn reply to Mr Collins, M.R.C.S., of Dulverton, I was requested to attend on Mr 1L V. Gostling’s bay huntress after the accident. I found an oblique and complete fracture of the right humerus, extending the greater part of the shaft of that bone.. The field wherein the accident occurred was wheat stubble, and the ground was quite level and moist; no places could be found where the animal might have sunk her foot in the soil, nor where there any rabbit-holes. The horse scarcely moved from the spot after the accident, but a little before this the rider noticed the animal cross its forelegs. This horse had not suffered from any illness or lameness. But this occurrence is eclipsed by an accident which took place in my presence at Calcutta in the year 1863. I had been attending, in the premises of the establishment in Dharrumtollah-street, a grey Arab horse, lame of both forelegs, the nature of which was most obscure. Other V.S. opinions were sought, but no light was thrown on the subject. After I had been doing wliat 1 thought necessary for some weeks there appeared to be some decided improvement, and about this time the owner (a Frenchman) came to see his horse. I reported, accordingly, and then ordered the groom to bring the horse from the box to the ride (used for exercising), and requested, the man to trot the horse steadily in hand. Alter gob g .to and fro a distance cf sixty to seventy yards, steadily, suddenly ail the sesamoid bones of. both forelegs snapped asunder, the horse coming do-vn on his fetlocks, and having to be des roved on the spot. Ibe owner being an eve-witness relieved me of becoming the butt of what might have resulted in unpleasant remarks. —H. CiioftS, V.S.