376 TREATMENT OF CRANIAL FRACTURES AND INJURIES. 



on the edge. The animal was able to travel more than two miles after 

 the accident, but then showed signs of coma, the temperature fell to 

 97'6° F., and the heart's action to twenty-four beats per minute. The 

 respiration was irregular. After some hours the horse died. Post-mortem 

 examination showed the entire base of the skull to be fractured. Extra- 

 meningeal bleeding had occurred and extended as far as the entrance to 

 the spinal canal. 



Fractures of the sphenoid and of the occipital, and even of the 

 other bones of the skull, usually produce death in a short time, often 

 after a few seconds. Fractures of other cranial bones may prove 

 fatal if attended with much bleeding into the brain cavity. Mariot 

 saw a horse, after falling, die with loss of consciousness and 

 advancing dyspnoea. Becker records that a horse, after having 

 struck its head against a wall, immediately died. Post-mortem 

 showed a comminuted fracture of the occipital, with severe extra- 

 vasation of blood on the medulla oblongata. 



Treatment. In subcutaneous fractures, without much dislocation, 

 rest alone is required. Cold applications, laxatives, and spare diet 

 tend to ward off brain symptoms, and may suffice in small fractures 

 where dislocation of the fragments is only slight, and the brain 

 functions are not disturbed. Replacement should be attempted 

 where it can be effected without making a wound, and thus 

 endangering aseptic healing. Strict antisepsis must be adopted 

 in compound or complicated fractures where the injury is still recent, 

 i.e., has not existed for more than twenty-four hours. The hair 

 is cut or shaved, the wound examined with a disinfected finger, 

 splinters of bone and foreign bodies as far as possible removed, and 

 the entire surface carefully washed out. Plenty of disinfecting 

 fluid must be used, preferably in the form of a strong stream. No 

 harm is done if the fluid penetrates the connective tissue and 

 produces oedema. Loose shreds of tissue are removed with the 

 scissors, the wound sutured with sterilised material (catgut or silk), 

 and a dressing applied, kept in place in the horse with the help of 

 the head collar, to which the turns of the bandage are fastened. The 

 horse should then be placed on the pillar reins, so that it cannot 

 rub off the bandage, as it frequently attempts to do. During the 

 first forty-eight hours the patient must be watched, and the usual 

 measures taken to ward off brain symptoms. 



