r opening the
windpipe is that part which is found, upon examination, to be least
covered with muscles, about 5 or 6 inches below the throat. Right here,
then, is the place to cut through. Have an assistant hold the animal's
head still. Grasp your knife firmly in the right hand, select the spot
and make the cut from above to below directly on the median line on the
anterior surface of the windpipe. Make the cut about 2 inches long in
the windpipe; this necessitates cutting three or four rings. One bold
stroke is usually sufficient, but if it is necessary to make several
other cuts to finish the operation, do not hesitate. Your purpose is to
make a hole in the windpipe sufficiently large to admit the tracheotomy
tube. It is quickly manifested when the windpipe is severed; the hot air
rushes out, and when air is taken in it is sucked in with a noise. A
slight hemorrhage may result (it never amounts to much), which is easily
controlled by washing the wound with a sponge and cold water, but use
care not to get any water in the windpipe. Do not neglect to instruct
your assistant to hold the head down immediately after the operation, so
that the neck will be in a horizontal line. This will prevent the blood
from getting into the windpipe and will allow it to drop directly on the
ground. If you have the self-adjustable tube, it retains its place in
the wound without further trouble after it is inserted. The other kind
requires to be secured in position by means of two tapes or strings tied
around the neck. After the hemorrhage is somewhat abated, sponge the
blood away and see that the tube is thoroughly clean, then insert it,
directing the tube downward toward the lungs.

The immediate relief this operation affords is gratifying to behold. The
animal, a few minutes before on the verge of death from suffocation,
emitting a loud wheezing sound with every breath, with haggard
countenance, body swaying, pawing, gasping, fighting for breath, now
breathes tranquilly, and may be in search of something to eat.

The tube should be removed once a day and cleaned with carbolic-acid
solution (1 to 20), and the discharge washed away from the wound with a
solution of carbolic acid, 1 part to 40 parts water. Several times a day
the hand should be held over the opening in the tube to test the
animal's ability to breathe through the nostrils, and as soon as it is
demonstrated that breathing can be performed in the natural way the tube
should