488 TREATMENT OF SHOULDER ABSCESS. 



operators practise local anaesthesia by Schleich's method ; Malkmus 

 applies a twitch and the hippo-lasso. Bayer recommends strict- 

 antiseptic precautions, and after carefully curetting and disinfecting 

 the abscess cavity applies a dressing which is fixed to the button 

 sutures used to close the wound. Malkmus has shown that these 

 excessive precautions are unnecessary, and that by using interrupted 

 sutures, inserting a drainage-tube, and dressing with glutol, the 

 same end is attained. He also insists, however, on the importance 

 of curetting the cavity and of observing antiseptic precautions. 

 The horse is afterwards kept for a fortnight on the pillar reins, and 

 if great swelling occurs the parts are kept moist with 3 per cent, 

 solution of acetate of alumina. If the covering of glutol separates 

 from the surface of the wound it is renewed ; in a week the drainage- 

 tube is removed, and in eleven days the sutures. The operative 

 wound usually heals by primary intention in three weeks, and the 

 horse can resume work in one to two weeks later. This method can 

 be recommended as practical and efficacious. 



Before attempting total extirpation the horse should be cast 

 and anaesthetised, for even if quiet, bleeding or other complication 

 may ensue, which cannot be properly dealt with if he is standing 

 or struggling. The animal is laid on the healthy side, placed in a 

 good light, and the hair removed from the swelling. Scalpels, forci- 

 pressure forceps, needles, thick and thin ligatures, and aseptic cotton 

 wool, or gauze must be provided. An incision is made in the direction 

 of the neck over the tumour ; the skin on either side is separated or 

 drawn back, which, on account of the looseness of the subcutis, is 

 not difficult. In order to exert traction on the tumour, a piece of 

 tape is passed through it, and the loose connective tissue surrounding 

 it is separated with the fingers or scissors, beginning at the lower 

 and inner side in order to avoid the carotid and its branches, or in 

 case of injury, to facilitate their being ligatured. Profuse bleeding 

 may occur if the swelling is deeply incised, or a portion of it is allowed 

 to remain. Divided vessels sometimes retract into the masses of 

 connective tissue, their ligation becomes difficult or impossible ; 

 and as the actual cautery often belies its reputation, the operator 

 may see the animal bleed to death. This danger is avoided if the 

 operator carefully detaches the growth as far as possible with scissors 

 or the fingers, and in dividing the muscle at once ligatures the exposed 

 vessels in two places. The tumour secured, if necessary, with a 

 strong tape, is then cut away. After rinsing out the cavity with 

 a disinfecting fluid, and ligaturing any bleeding vessels, the surfaces 

 should be powdered with 1 part of iodoform to 3 of tannin, the cavity 



