prognosis and Treatment ot thoracic injuries. 483 



hemothorax, or pleurisy is unfavourable. Moderate fever from 

 wound infection does not necessarily prevent recovery, but symptoms 

 of pleurisy generally forebode death. 



Numerous recorded cases testify that such injuries in animals 

 sometimes take an unexpectedly favourable course. Jacobin records 

 the satisfactory recovery of a horse from a penetrating wound caused 

 by a spur, which hatl perforated the thoracic wall and injured a rib. 

 Recovery is not impossible even in cases in which the finger can 

 be introduced into the pleural cavity, and the movement of the 

 lung distinctly felt. Thus Thierry describes a case of shot-wound, 

 with prolapse of the lung through the thoracic opening, in a sporting 

 dog. Recovery occurred in three days. Esvelt saw a horse whose 

 chest had been penetrated by a carriage pole between the 11th and 

 12th ribs. There was prolapse of the lung. After reducing this and 

 applying an antiseptic dressing the parts gradually healed. 



Noguies, called to see a mare which had been " horned " by a 

 cow, found a mass of lung protruding from a thoracic wound three 

 inches long. The mare was cast, the torn mass of lung ligatured, 

 and a piece, weighing 20 ounces, was removed with a single sweep 

 of the knife. The ligature was afterwards removed, the parts were 

 disinfected, the hair was clipped away, the wound sutured, and a 

 blister applied over all. Recovery occurred without complications. 



On the other hand, apparently slight wounds may prove rapidly 

 fatal. This is especially true of insignificant-looking penetrating 

 wounds, like those produced by manure-forks, in which danger of 

 infection occurs during the first three or four days. When pus forms, 

 if meanwhile no threatening symptoms have appeared, the prognosis 

 becomes more favourable. 



The principles of treatment are clearly apparent, the first and 

 most important being thorough antisepsis. After checking the 

 flow of blood by ligaturing the injured vessels with sterilised material, 

 the wound is carefully disinfected, and closed. Where much discharge 

 is to be expected, drains must be inserted and counter-incisions 

 made. Over the ordinary dressings an air-tight bandage should be 

 applied. For the larger animals moss wadding is suitable, but where 

 this is not obtainable a cloth folded several times can be substituted, 

 and the compress kept in place with a roller. In small animals, 

 bandages are usually serviceable, but must be renewed immediately 

 they become moist with wound discharge. 



Where proper dressings cannot be provided, arrangements 

 may be made for continuous irrigation with disinfectants ; but if 

 a penetrating wound exist, care must be taken that fluid and air 



