SUPPURATING MEDIAN OTITIS. 299 



though a fresh incision was not necessary. The wound having been dis- 

 infected a groove was cautiously excavated around the tooth by means 

 of a gouge and hammer, and unsuccessful attempts made to loosen it. 

 As, however, the tooth was very deeply implanted^ and extraction 

 might possibly have caused injury to the brain, the operation was 

 stopped. The wound was cleansed and plugged with iodoform 

 gauze, the skin brought together with a couple of sutures, and the 

 horse allowed to rise. Although every precaution had been observed 

 the animal showed grave symptoms. The head was held pendent, a 

 little inclined to the left ; movement was very difficult ; the fore-limbs 

 were planted wide apart, and yielded on movement, allowing the 

 animal to fall on its knees. It at once rose, but was unsteady on its 

 legs. A deep bed of straw having been spread around it, the patient 

 lay down. It rose in half an hour, and was then placed in its box. 

 During the evening it took some sloppy food. 



. Next day it was found standing but greatly depressed ; the head 

 was held low and still inclined to the left ; the fore-limbs were planted 

 widely apart. The animal was led out and moved a few steps ; the 

 gait was slow, uncertain, and vacillating. At certain moments rolling 

 of the eyes occurred. The wound was washed and plugged with 

 iodoform gauze. 



On returning to its box the animal attempted to eat. It took some 

 sloppy food and a little hay. At first we suspected intra-cranial 

 haemorrhage, but as the circulation and respiration became more rapid, 

 and the temperature rose to 40*3° C. (i04'5° F.),* we concluded that the 

 mechanical injury was complicated with meningo-encephalitis. Affu- 

 sions of cold boric solution were made to the head, the wound was 

 washed with 2 per cent, creolin solution, iodide of potassium was given, 

 and the food confined to mashes and milk. 



On the 4th February the respiration was rapid and short, 36 per 

 minute ; temperature 39*8° C. The pulse was very small and un- 

 countable. 



On the 5th the respiration was still rapid and the pulse feeble. The 

 animal was sleepy, had no appetite, and only seemed able to masticate 

 its hay. Although held very low the head was less inclined to the 

 left, and movement was less painful. Temperature 39*4° C. Treatment 

 as before. The evening temperature rose to 41° C. 



On the 6th the condition remained the same ; temperature 40° C. 

 Next day there was slight improvement ; temperature 39'6° to 

 39'9° C. Respiration was less rapid ; appetite fair ; difficulty existed 

 in swallowing. 



On the 8th the general condition was a little improved. The 

 patient left the corner of the box in which it had been standing, 

 moved about with some freedom, and ate its oats and mash. Ha}- 

 and straw were slowly chewed, the food dropped out of the mouth 

 and again picked up ; occasionally a little was swallowed, but with 



* As the Centigrade scale is now largely used, and the constant addition of the Fahren- 

 heit temperature would prove very cumbrous in these clinical records, I have printed in the 

 Appendix a comparative chart showing the exact equivalent on the Fahrenheit scale of any 

 given Centigrade temperature. To this readers are kindly referred. — Jxo. A. W. D. 



