AN EXTEMPORIZED HOOK TO RELIEVE HIGH CHOKING.
The balling-iron, after tracheotomy is accomplished, should be fixed in the mouth and the hand then introduced. Sometimes the impacted substance can be felt, but cannot be grasped. In this last case, a rough hook is to be extemporized out of any wire which may be at hand. It should be of the shape indicated in the preceding engraving, and of sufficient length to reach behind the obstruction. The hook is to be gently worked into its situation, and, with a sudden jerk, the foreign body is to be removed from the œsophagus.
Occasionally, the substance is so firmly embraced as not to permit any instrument to pass beside it. Sulphuric ether must then be inhaled, in the hope of thus overcoming the spasm. The ether, however, does not in every instance prove successful; and, as an egg, probably, alone could be of sufficient size to resist all the measures adopted for its removal, a large darning-needle must then be procured. That, being first armed with a piece of strong twine, must be driven through the skin and made to enter the globular impactment. There is no danger of injuring nerves or arteries while doing this; all vessels are pushed on one side by the enlargement, caused by the choking substance. The integrity of the shell being destroyed, the egg may easily be broken by external pressure. Another plan proposed, is to insert a fine trocar, and draw off the contents of the egg. Either method would answer, but it is always well to wound the lining membrane of the œsophagus as little as may be possible.
The employment of the cow probang has been advocated; the egg to be broken, if this recommendation is adopted, by the employment of the whalebone stilet. The œsophagus of the cow and horse, however, are of such different construction, that he must be a very bold or a very ignorant person who dare employ an instrument made for the first, to remove an obstruction within the gullet of the last.
THE COW PROBANG, USED TO BREAK AN EGG.
An old and hardened ball may provoke this accident; but then the impactment is not complete, because such substances are seldom of a perfect round. The sides are opened, and the obstruction is, therefore, more easily removed. Horses are not like the bovine race, so greedy as to swallow potatoes or small turnips, without mastication. Besides, man's favorite is more under domestication, and, therefore, less exposed to such accidents.
When the choking occurs low down, or within the thoracic portion of the œsophagus, the symptoms are less urgent. The animal ceases to feed. If water is attempted to be swallowed, it returns by the nostrils. The countenance expresses anguish; but the head is not held erect, neither are the muscles of the neck spasmodically contracted. Saliva flows from the mouth, and a copious discharge runs from the nose. The breathing is labored; but it is seldom noisy. The back is roached, the flanks tucked up, and the horse often stands as if desirous of elevating the quarters.
After two or three days, (for the low choke may continue such a period,) the accumulation of wind within the abdomen becomes excessive; the breathing quickens; the pulse fails, and the animal (if not relieved) perishes from suffocation, induced by tympanitis.
