Causes: nervous lesions and disorders; arytenectomy; over distension;
stricture; parasites. Symptoms: dysphagia; regurgitation; cough;
dyspnœa; hard packed gullet. Inhalation pneumonia. Lesions. Treatment:
remove cause; liquid food; dilatation; nerve sedatives and stimulants;
electricity; counter-irritants.
_Causes._ This has been noticed in a number of cases in solipeds, and
attributed to central nervous lesions, cerebral concussion (Straub),
encephalitis (Hering, Bornhauser), paralysis of the fore extremities
(Meier), pharyngeal paralysis (Puschmann). Möller has seen it several
times consequent on arytenectomy, while Dieckerhoff and Graf have seen
it occur without any clearly defined cause. In a case referred to above,
the present writer found it connected with the attachment of larvæ of
œstri in the lower end of the gullet. Stricture and impaction may be a
further cause.
_Symptoms and lesions._ There is more or less interference with
deglutition, culminating in complete inability to swallow, and the
rejection of morsels of masticated food by the nose. Cough may also
occur from the descent of food toward the lungs, with more or less
dyspnœa and oppression of the breathing. Manipulation along the left
jugular furrow, detects the œsophagus as a prominent hard, rope-like
mass which fills up the groove unduly. When death occurs rapidly the
gullet is found gorged with masticated food throughout its entire
length. In certain instances gangrenous pneumonia is found, the result
of the penetration of food into the bronchia. In other cases there are
lesions of the medulla oblongata, or of the vagus or glossopharyngeal
nerves or their œsophagean branches.
Death usually results from obstruction, inanition, or, in case the
paralysis is partial, from pneumonia or exhaustion.
_Treatment._ First remove or correct the existing cause of the disease.
Impaction may be broken up by the use of the wire loop, or pincer
probang; parasites may be expelled by passing a cupped probang; the
impactions following arytenectomy can be obviated by feeding gruels,
milk and other liquid foods only, and from a bucket set on the ground;
stricture may be dilated by the use of graduated sounds; and nervous
diseases may be dealt with according to their specific nature in each
several case. When any definite cause of this kind has been overcome the
persistent use of strychnia, subcutem, or by the mouth, may be effectual
in overcoming the paresis of the gullet. Hypodermic injections are best
made along the left jugular groove, and frictions, stimulating
embrocations, and galvanic currents may be employed with excellent
effect.