AFFECTIONS OF THE TURBINATED BONES IN THE HORSE. 19 



aroused suspicion of pus formation in the sinuses, or turbinated bones- 

 The temperature was ioi'i°F., the pulse 60, and the respirations 36 

 per minute. I first explored the naso-pharyngeal cavity with a 

 catheter, and afterwards trephined the nasal bone. The right nasal 

 cavity was clear, not diminished in size, and the sinuses of that side 

 contained no pus. I considered it probable that the ethmoid cells 

 were necrotic, a condition complicated by meningo-encephalitis. I 

 prescribed warm boric irrigations of the nasal cavity, and put off until 

 next day examination with the rhino-laryngoscope, by which I hoped 

 to coniirm the diagnosis. 



During the night the temperature fell i*8°F.,the mucous mem- 

 branes became reddish-violet, and the coma was interrupted by an 

 attack of convulsions with spasmodic contraction of the limbs. The 

 patient died next morning. 



At the post-inovteui examination we found secondary lesions of 

 purulent inflammation, marked especially by the presence of large 

 numbers of metastatic pulmonary abscesses. The primary changes 

 were very extensive, affecting the turbinated bones, ethmoid, and 

 the antero-inferior parts of the cranium. In the posterior portion of 

 the right nasal cavity the pituitary membrane was extremely hyper- 

 gemic and infiltrated. Near its base the maxillary turbinated bone 

 was destroyed over an oval space, about an inch to an inch and a 

 quarter in its longer diameter, which corresponded with the long axis 

 of the nose. Around this point the mucous membrane was thickened 

 and blackish, except towards the back, where it was covered with 

 necrotic suppurating points. In front, the turbinated bone was full of 

 caseous putrid pus. Opposite the lesion of the maxillary turbinated 

 bone, the ethmoidal turbinated bone showed a necrotic area where the 

 mucous membrane was thinned, greyish-yellow, and covered with 

 blood-stained pus. The ethmoid cells of the right side were deep red 

 in colour, and in places ecchymosed ; towards their base, the mucous 

 membrane appeared partially necrotic. The ethmoid cells and sphe- 

 noidal sinus contained foetid pus. In the region between the posterior 

 border of the sphenoid, and the superior border of the cribriform plate 

 of the ethmoid, the dura mater was thickened, yellowish or greenish- 

 grey, and everywhere soaked in pus ; the arachnoid cavity contained a 

 fibrinous exudate, especially thick near the sella turcica. Immersed 

 in pus, the pituitary gland had become softened and partly destroyed. 



Bacteriologically examined, pus collected from the necrotic portions 

 of the turbinated bones was found to contain various micro-organisms, 

 but especially streptococci, in longer or shorter chains — the greater 

 number in short chains — staphylococci, and a small bacillus strongly 



