PARALYSIS OF THE PHARYNX
From nervous bulbar lesion, or toxic from the pathogenic bacteria. Transient or permanent and fatal. Symptoms: dysphagia: liquids expelled by nose or enter lungs. Inhalation pneumonia. Facial palsy. Roaring, laryngeal thrill. Atrophy. Gangrene. Treatment: remove cause: combat bulbar hyperæmia and cephalic congestion: cold: derivatives, electricity: blisters: antiseptics.
This has been described as a rare affection, yet it is often a marked symptom of cerebro spinal meningitis, and has been observed in infectious pneumonia, and influenza of the horse (Cadeac, Palat) as well as in rabies, and traumatic injuries of the brain.
The existence of the condition usually implies disease of the bulb at the roots of the vagus and glossopharyngeal nerves, or swellings affecting these nerves or the sympathetic along its course. The morbid condition may be transient in which case a speedy recovery may follow, or it may be permanent and end fatally.
Symptoms. Swallowing is impossible and the animal refuses food and drink or if the latter is forced on him it is rejected by the nose or mouth when the head is lowered or still worse, it enters the larynx and descends into the lungs. The larynx innervated by the same trunks is usually involved and the alimentary solids and liquids determine gangrenous bronchitis and pneumonia, with labored breathing, fœtid breath and violent dyspnœa. In other cases the facial nerve is involved, the nostrils and lips are flaccid on one or both sides, and the eyelids and ears may droop. There may be snuffling breathing from the closure of the alæ nasi, or roaring from the approximation of the arytenoids and vocal cords. If the affection is unilateral the difficulty of breathing is greatly diminished and even deglutition may be effected with some effort. There is usually, however, the obvious unilateral paralysis of the face, and especially of the larynx, with the distinct thrill, during inspiration, conveyed to the finger placed on the larynx.
Complications in the form of gangrene and atrophy of parts supplied by the same nerves, or those adjoining the pharynx, have been recognized in different cases.
Treatment. This must depend on the obvious cause of the affection. If due to an infectious disease the first attention must be given to that. If due to tumors or abscesses pressing on the nerves they may be removed. If there is bulbar hyperæmia or effusion attention must be devoted to derivation and other means of combating that. Cephalic congestion and heat may be met by cold applications. Derivation toward the bowels may be secured by eserine, pilocarpin or physostigmine administered subcutem. Reabsorption of exudate may be sought by pilocarpin, or diuretics—the latter administered by the rectum. Electricity in weak current may be tried when the acute febrile symptoms have moderated, accompanied by hypodermic injection of strychnia (2 grs.). Frictions around the throat with essential oils or even a cantharides blister may be used to advantage. Antiseptic washes may be injected into the mouth,—vinegar, boric acid, borax, sulphite of soda. Finally the animal must be nourished by rich gruels and soups given by the rectum, or in the smaller animals by the stomach tube.