IV.— ABDOMEN AND TAIL. 



NECROSIS OF APONEUROTIC TISSUES IN THE FLANK. 

 77. A twelve-year-old gelding, left in hospital the 5th February, 



Two months before this horse had suffered from colic and intestinal 

 indigestion, for which the caecum was punctured. During the follow- 

 ing days a warm, painful, oedematous swelling developed around the 

 wound, but nevertheless the horse continued to work for some time. 

 As the wound became sinuous, suppurated freely, and resisted treat- 

 ment by antiseptic injections, the animal was sent to Alfort. 



The centre of the right flank displayed a granulating wound, nearly 

 an inch in diameter, surrounded by induration which extended as far 

 as the last rib. The pus was abundant, liquid, and offensive. 



Diagnosis. — Necrosis of aponeurotic tissues in the flank. 



The horse was cast on the table. The sinus was found to be about 

 six inches in length, penetrated deeply, and ended in a large blind 

 pouch. It was exposed, a counter-opening made at the lowest point, 

 and a rubber drainage-tube inserted. The sinus was frequenth' washed 

 out with creolin and sublimate solution. 



By the 20th February swelling and suppuration had markedly 

 diminished, and the animal seemed in a fair way to recovery. A week 

 later, however, swelling extended below the lower wound, from which 

 pus escaped freely. Fresh operation was decided on. On probing 

 the lower wound a sinus, four inches in length, was found running 

 obliquely downwards and slightly backwards, along the last rib. A 

 counter-opening was made, and this second sinus drained like the 

 former. The injections were continued, though the liquids used and 

 the degree of concentration were varied. Among others, carbolic acid, 

 sublimate, chloride of zinc, Villate's solution, and tincture of iodine 

 were tried. A 20 to 30 per cent, solution of tincture of iodine and 

 iodide of potassium was found most useful. 



Recovery was not complete until towards the 15th Jime, though had 

 the animal not been used in a carriage it might long before have been 

 returned to work. 



Remark. — Although the disease was remarkabl}- obstinate we did 

 not think it advisable to perform a radical operation, as this would 

 have necessitated too great destruction of tissue and would not have 

 been without danger, on account of the depth to which the sinus 

 extended into the abdominal wall. We therefore preferred to confine 

 ourselves to counter-openings, drainage, and antiseptic injections. 



