Causes: Alimentary and therapeutic; parasitic and accidental
traumatisms; mechanical irritants; acrids; caustics;
parasites—gongylonema, coccidia, spiroptera. Extension inflammations.
Lesions: hyperæmia; epithelial degeneration and desquamation; erosion;
petechiæ; suppuration; fibroid contraction; sacculation; polypi.
Symptoms: dysphagia, difficult deglutition; eructation; cough; upward
wave motion in jugular furrow; colicy pains; probang arrested; fever.
Treatment: liquid or semi-liquid food; for caustics, antidotes; cold
water; ice; antiseptics; derivatives; open abscess; potassium iodide.
_Causes._ This usually arises from injury to the mucous membrane and in
the milder forms remains confined to this structure. In the more severe,
it extends to the muscular coat and even to the periœsophagean tissues.
The causes may be divided into alimentary and therapeutic irritants;
parasitic or accidental traumatisms; and extension of inflammation from
the pharynx or other adjacent part.
Among _irritants_ taken as food, may be named hot mashes, bolted by a
hungry and gluttonous horse, and temporarily arrested in the gullet by
reason of the resulting irritation of the mucous membrane. In other
cases, coarse fibrous fodder is bolted without previous mastication, and
scratches and abrades the œsophagean mucosa leading to transient or
progressive inflammation. In other instances diseases of the teeth,
jaws, temporo-maxillary joint, or salivary glands prevent the necessary
trituration of the food, and it is swallowed in a rough, fibrous, or
even a dry condition. Again the impaction of a solid body (turnip,
apple, potatoe, egg) or of a quantity of finely divided grain or fodder
so as to obstruct the lumen of the gullet, is an occasional cause. The
density of the epithelium reduces these dangers to the minimum, yet a
too rough morsel, or an undue detention of the less irritating material
will determine hyperæmia and even inflammation and infective invasion.
Acrid and irritant vegetables in the food are less injurious when
thoroughly insalivated, as their contact with the œsophagean walls is
then very slight and transient.
_Irritant and caustic chemical agents_ given for therapeutic purposes,
attack the mouth, pharynx and stomach, more severely than the gullet
through which they are passed with great rapidity. In some cases,
however, the agent will adhere by reason of its powdery, gummy or
balsamic character and will then act as a direct irritant. Solutions of
caustic alkalies (weak lye) given to correct acid gastric indigestion in
the horse, and ammonia to remedy tympany in cattle, when insufficiently
diluted, will dangerously attack the œsophagean mucosa.
_Parasitic irritation_ is not so common here as in other parts of the
intestinal canal where the contents are longer delayed and are passed
with less friction, yet certain parasites are found in this region and
may even produce considerable irritation. The gongylonema of the
thoracic œsophagean mucosa of ruminants and swine are apparently
harmless. The psorospermia of the œsophagean muscles of the same animals
are alleged to cause œdema of the glottis, asphyxia and epilepsy. The
spiroptera microstoma of the horse has in one instance known to us
caused extensive denudation of the muscular coat within a foot of the
cardiac end of the gullet. Finally we have found bots hooked on to the
œsophagean mucosa close to the cardia, causing much irritation and
spasm. The spiroptera sanguinolenta is often present in chambers
hollowed in the œsophagean mucosa of the dog.
_Traumatic causes_ appear in the form of contusions and bruises from
without, but much more frequently from foreign bodies, and probangs
operating from within. The use of a whip or of a rope without a
cup-shaped end for the relief of a choked animal. Short of the
occurrence of laceration this often produces contusion and abrasion
which results in local inflammation. Even the too forcible dislodgment
of a solid body by a probang of approved pattern, may bruise and scratch
the gullet when the seat of violent spasm. Pins, needles, wire, thorns
and other sharp bodies are liable to do serious damage during their
passage in an ordinary bolus and when they transfix the mucosa violent
infective inflammation may ensue.
_Extension inflammations_ from the throat, and from phlegmous,
abscesses, tumors, etc., in the jugular furrow need only be mentioned in
this connection, as the primary disease will be clearly in evidence.
_Lesions._ These are usually circumscribed when due to a traumatic
injury and extended when caused by caustics or irritants. The affected
section is swollen, and surrounded by some serous effusion. When the
muscular coat is involved it is often paler than normal, and
microscopically shows extensive granular and fatty degeneration. The
mucosa usually sloughs off its epithelial layer, sometimes over an
extensive area (thoracic portion, Renault; whole gullet, Bertheol), and
the exposed raw surface is of a deep red or violet. When the epithelium
is not shed, it is infiltrated, swollen and friable breaking down under
the slightest manipulation. Petechiæ and slight blood extravasations are
abundant, and diffuse suppuration is not uncommon. In traumatic injuries
necrosed areas are found in the muscular and mucous coats. Strictures,
dilatations, and polypoid growths are liable to follow as sequelæ.
_Symptoms._ These usually manifest themselves from two to four days
after the operation of the cause. There is much difficulty in
deglutition, the effort to swallow either solids or liquids causing
acute suffering, with extension of the head on the neck and strained
contraction of the facial muscles. If the liquid succeeds in passing the
pharynx, it is arrested at the seat of inflammation and regurgitated
through the nose and mouth, or in solipeds through the nose only. This
takes the appearance of emesis even if nothing actually comes from the
stomach. The animal shakes the head violently, breathes hurriedly, and
has fits of paroxysmal coughing. A wave extending from below upward
along the jugular furrow and followed by nasal discharge is a marked
symptom, as the violence of the inflammation increases. Uneasy movements
of the limbs, pawing and lying down and rising, indicate the existence
of colic, and this is aggravated by the administration of anodynes or
antispasmodics by the mouth. In cattle, rumination is arrested, froth
accumulates around the lips, the rumen becomes tympanitic, and colicy
movements appear. Oftentimes a swelling extends upward in the jugular
furrow, and even in its absence, pressure with the fingers along the
furrow will often detect an area of tenderness with or without local
swelling. Fever with more or less elevation of temperature, is a general
symptom. There may be wheezing breathing or loud stertor. The passage of
a probang is arrested by the swelling or spasm at the diseased part and
when withdrawn may be covered with pus or fœtid _debris_. In the horse a
small probang may be passed through the nose.
_Treatment._ In a slight congestion at the seat of a recent obstruction
and which tends to renewed obstruction, little more is necessary than to
restrict the feed for a few days to soft mashes so that irritation of
the sensitive surface, spasm and the arrest of the morsel may be
obviated. Plenty of pure water or of well boiled linseed or other gruel
should be allowed.
In cases in which the obstruction is still present in the gullet, its
removal by probang or looped wire is the first consideration, to be
followed by the measures mentioned above.
In case of the swallowing of a caustic agent, no time should be lost in
giving an antidote. For the mineral or caustic organic acids, lime
water, magnesia, or other bland basic agent is demanded. For caustic
alkalies or basic agents, bland acids, such as vinegar, citric acid, or
even a mineral acid very largely diluted will be in order. In both these
cases and in that of caustic salts, albuminous and mucilaginous agents,
eggs, linseed tea, slippery elm, gums, and well boiled gruels are
indicated. To these may be added small doses of laudanum when the
irritation is great. Iced drinking water, iced milk, or iced gruels are
often soothing to the suffering animal, and cold compresses, snow or ice
applied along the jugular furrow is often valuable. To counteract the
septic developments on the affected mucous membrane, chlorate of potash,
boric acid, salol, naphthalin, naphthol, pyoktannin, or even weak
solutions of phenic acid or creolin may be used. In the slighter forms
of inflammation or when the acute form threatens to persist, an active
counter-irritant of mustard or cantharides may be applied along the
jugular furrow.
In case of abscess, as manifested by fluctuation following a hard,
indurated, painful swelling, a free incision should be followed by
frequent injections of antiseptic lotions or by the packing of the
cavity with such bland antiseptics as salol, boric acid, or iodoform on
cotton.
As inflammation subsides, potassium iodide may be given, both as an
antiseptic and a resolvent, to counteract the tendency to fibroid
contraction and stricture of the gullet.