NINTH ANNUAL YEAR BOOK— PART X 489 
burst and discharge. The opening, however, is usually small and may 
close prematurely, so that abscess after abscess is formed. It is distin- 
guished from hernia by the fact that it can not be returned into the 
abdomen, and from inflammation of the veins and urachus by the ab- 
sence of swellings forward and backward along the lines of these canals. 
Treatment. — Treatment consists in an early opening of the abscess by 
a free incision and the injection twice a day of an astringent antiseptic 
(chlorid of zinc i/. dram, water 1 pint). 
INFLAMMATION OF THE NAVEL VEINS (UMBILICAL PHLEBITIS). 
In this affection of the navel the inflammation may start directly from 
mechanical injury, as in either of the two forms just described, but on 
this are inoculated infective microbes, derived from a retained and putre- 
fying afterbirth, an abortion, a metritis, a fetid discharge from the womb, 
an unhealthy open sore, a case of erysipelas, from overcrowding, from 
filthy floor or bedding, or from an offensive accumulation of manure, 
solid or liquid. As the microbes vary in different cases, given outbreaks 
will differ materially in their nature. One is erysipelatoid; another puru- 
lent infection vAth. the tendency to secondary abscesses in the joints, liver, 
lungs, etc.; another is due to a septic germ and is associated with fetid 
discharge from the navel and general putrid blood poisoning. In estimat- 
ing the causes of the disease we must not omit debility of the calf when 
the mother has been underfed or badly housed or when either she or the 
fetus has been diseased. 
Symptorns. — The symptoms will vary. With the chain-form germs 
(streptococci) the navel becomes intensely red, with a very firm, painful 
swelling, ending abruptly at the edges in sound skin and extending for- 
ward along the umbilical veins. The secondary diseases are circum- 
scribed black engorgements (infarctions) or abscesses of the liver, lungs, 
kidneys, bowels, or other internal organs, and sometimes diseases of the 
joints. 
With the ordinary pus-producing germs (staphylococcus pyogenes 
aureus and streptoccoccus pyogenes) and local inflammation in the navel 
causes a hot, painful swelling, which rapidly advances to the formation 
of matter (pus), and the raw, exposed surface, at first bright red, be- 
comes dark red or black, soft, friable, and pultaceous. If the pus is 
white, creamy, and comparatively inoffensive in odor, the secondary for- 
mations in internal organs and joints are mainly of he same purculent 
character (secondary abscesses). 
If on the other hand, the discharge is very offensive and the pus more 
serous or watery or bloody, there is reason to suspect the presence of 
some of the septic bacteria, and the results on the general system are 
a high fever and softening of the liver and spleen and no tendency to 
abscesses of the internal organs. Diarrhea is a common symptom, and 
death ensues early, the blood after death being found unclotted. 
Complicated cases are common, and in all alike the umbilical veins 
usually remain open and can be explored by a probe passed at first up- 
ward and the forward toward the liver. 
