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.
Varieties of neoplasms. Malignant invade adjacent and distant parts. Symptoms: sore throat; stertor; dyspnœea; dysphagia. In cattle, lymphadenoma, tubercle, actinomycosis. Cause cough, ptyalism, discharge, fœtor, dysphagia. Dogs and pigs vomit. Treatment: medical; surgical.
Tumors of the pharynx are not common in the horse yet they occasionally appear as either primary or secondary neoplasms. They are of various kinds, as, epithelioma (Labat, Mathis), carcinoma (Casper, Dupuy, Mathis), sarcoma (Siedamgrotzky, Johne), lipoma (Fricker), cystoma (Degive) and melicerous (Lesbre). The malignant forms tend to invade the surrounding tissues and spread widely into the nose, palate, tongue, pharyngeal glands, and, secondarily, into the small intestines. The simple tumors like the lipomata and fibromata tend to detach themselves and hang by a pedicle (see pharyngeal polypi). The same is true of the melicerous cyst which originating in an obstructed mucous or salivary duct projects as a mass as large as a hen’s or pigeon’s egg into the fauces or pharynx.
Symptoms. There are symptoms of intense sore throat with stertor continuous or intermittent, increasing to dyspnœa at intervals or on exertion. In case of pediculated tumors these attacks correspond to the displacement of the tumor into the glottis. Deglutition is difficult or impossible, liquids or even solids returning through the nose, mixed with mucus and at times tinged with blood. Nasal discharge and ptyalism are present.
In cattle pharyngeal tumors may be of the same nature as mentioned for the horse, but they are far more frequently lymphadenoma, and above all tubercle or actinomycosis. Zimmer found that of seventy-three such tumors fifty-four were actinomycosis.
The symptoms are wheezing breathing, cough, nasal discharge, ptyalism, bleeding from the nose, fœtid breath, difficult deglutition attended by cough and rejection of the ingesta through the nose, and the presence of a solid body in or on the pharynx which may be manipulated from without or within and tends to increase in size.
In dogs there are the same general symptoms with vomiting. The vomited material is usually remasticated and swallowed. The swelling in the pharynx can be felt from without, or seen through the open mouth. The tonsils are usually enlarged. Pressure on the pharynx or gullet produces instant regurgitation.
Treatment consists in the removal of the tumor when possible. Malignant growths and multiple tumors are not favorable for treatment. Actinomycosis can be treated throughout by iodides, or these may supplement the surgical measures. In the short-faced animals an ecraseur, or a wire-snare passed through a tube may be employed. (See pharyngeal polypi).