OSTITIS OF THE INFERIOR MAXILLA — NECROSIS — (sEQUESTRUM). 327 



the jaw was seen to be pendent and blood to be running from the mouth. 

 It was immediately brought to the School for treatment. 



State on Examination. — The mouth was open, and discharged blood- 

 stained saliva. Manipulation caused pain, shown by the animal 

 yelping. Slight movement of the lower jaw produced crepitation ; the 

 bone was fractured through its neck. The left branch was also 

 fractured under the masseter muscle. The jaw was swollen and very 

 painful, and traumatic fever pronounced. The pulse was 120 ; respira- 

 tions 34 ; and temperature 39'8° C. 



Treatment. — A dressing formed of layers of linen smeared with 

 pitch was applied. This bandage covered the whole of the lower jaw, 

 and a few turns were passed behind the nape of the neck. The 

 fractured bone was also kept in position by a band of tarlatan rolled 

 round the jaws and neck, several of the turns crossing under the larynx. 

 The patient was spoon-fed with liquid food. The mouth was washed 

 out with boric lotion. 



The dressing had to be readjusted several times, and as the animal 

 continually tried to remove it a muzzle was used. 



On the loth May the bandage was removed. The maxilla had 

 united, and the fragments were solidly fixed together. The dog was 

 fed with bread and chopped meat (without bone). 



On the 15th it was able to take its usual food. The lower jaw was 

 slightly deformed by the presence of a callus, but showed no abnormal 

 tenderness. 



OSTITIS OF THE INFERIOR MAXILLA— NECROSIS— (SEQUESTRUM). 



31. Six-3^ear-old gelding, left in hospital on the 26th October, 1897. 



Disease had been caused by the bit. The mucous membrane of 

 the mouth had been seen to be wounded, and the lower margin of the 

 maxilla swollen. The injury was first treated by firing, but the swelling 

 increased. An operation was afterwards performed, but gave unsatis- 

 factory results, a fistula remaining. Six weeks later, as the animal was 

 difficult to handle, it was sent here. 



The outer margin of the left branch of the inferior maxilla, opposite 

 the bars, exhibited a bony tumour the size of a hen's egg, the centre 

 of which was pierced by a fistula about two inches in depth. In the 

 cavity of the mouth could be seen the cicatrix left by the incision made 

 two months before on first operating. 



On the 29th October the horse was cast on Daviau's table. The 

 fistula was enlarged with a gouge, revealing a sequestrum as large as a 

 hazel-nut in the depth of the bone. The inferior wall of the cavity 

 containing it being very thick and hard, we decided to operate through 

 the mouth. The jaws were opened with a gag, and the tush and 

 corner tooth of the corresponding side removed. Through the opening 

 thus made the sequestrum was easily removed. The margins of the 

 wound were lightly cauterised, and the wound itself plugged with gauze 

 through the cutaneous orifice. Each day the dressing was renewed and 

 the wound washed out with dilute iodine solution. Recovery occurred 

 in three weeks. 



