TRACHEOTOMY, AS PERFORMED UNDER DIFFICULTIES—A COMMON OCCURRENCE.
The incision being made, the fingers are thrust into the wound to keep the division open. At first this may be difficult; but as time proceeds, the standing of the horse becomes firmer and the breathing less noisy. The veterinarian is, however, impatient at the delay and his enforced position. He is just beginning to despair, when the messenger returns, accompanied by a sleepy companion. Both are surprised at the condition of the horse, and, not observing the wound, imagine the animal has been cured by magic. However, to the demands of the equine medical attendant, nothing like a tracheotomy tube is to be invented. At last the spout of the tea kettle is thought of; and the good dame awakens in the morning to find her kettle demolished and its spout thrust into the "plaguy horse's throat."
It is the curse of veterinary surgery, that nobody appears to understand when an operation is required. The practitioner, therefore, is seldom prepared for its performance. The circumstances allow him little time to think, and none to return or to fetch the necessary instruments.
However, when he has proper time and choice, he should always make a free incision through the skin and panniculus carnosus. Make this opening about one-third up the neck, measuring from the chest. It is more general to open the windpipe at a similar distance from the jaw, and, assuredly, the superior incision has this advantage, that there is less to cut through. But where no important nerves or vessels are endangered, surgery cares little about the depth of a wound, the chief attention being given to the probable after-consequences.
The superior portion of the neck is especially the seat of motion; it varies with every turn and movement of the head. Hence the end of the tube is apt to be brought into constant contact with the lining membrane of the trachea, and horses have been slaughtered with huge tracheal abscesses, to all appearance produced solely by wearing the tracheotomy tube.
To avoid this danger the author chooses for incision a spot nearer to the chest, where the motion is less constant and not so varied. Even at this last place all danger is not entirely surmounted, in consequence of which a horse, while wearing a tracheotomy tube, should never be permitted to feed from the ground.
DIAGRAM, SHOWING THE STRUCTURES TO BE
INTERFERED WITH DURING THE PERFORMANCE
OF TRACHEOTOMY.
1. 1. The sterno-maxillares muscles—a pair—have to be separated,
being joined by fine cellular tissue.