972 WOUNDS AND INJURIES. 



A second difficulty in the healing of such wounds is the development 

 of subfascial cellulitis. It generally accompanies perforating wounds 

 caused by stable-forks. The symptoms are great pain when the 

 animal stands on the limb or attempts to move it, moderate swelling, 

 inflammation of the neighbouring lymph vessels and glands, and 

 fever. The skin is not excessively swollen, but at a later stage 

 infection extends and deep-seated abscesses break through the fascia, 

 becoming subcutaneous. The cellulitis may lead to extensive necrosis 

 and fatal septicaemia, a result favoured by the pent-up discharges 

 not readily escaping through the fascia. 



The treatment must be directed by general principles. Cold 

 applications are useful in relieving severe pain ; if merely bruised, 

 the parts maybe surrounded with cotton-wool, and kept continuously 

 irrigated. Wounds, especially those reaching to the bone, are best 

 treated by antiseptic measures. The periostitis may afterwards 

 be arrested by blisters. Sequestra must be removed as soon as they 

 appear to have separated. If only the skin is bruised or excoriated, 

 the parts should be cleansed, and dusted with iodoform, amyloform, 

 or boric acid, or smeared with lead or zinc ointment. 



The exuberant granulations produced by muscular hernia? are 

 removed with scissors, the cautery, or caustics. To prevent their 

 return, it is often necessary to still further divide the fascia ; some- 

 times a piece of it may be excised, and further strangulation thus 

 prevented. Though a pressure dressing is difficult to apply at this 

 point, benefit sometimes follows the use of a few strips of adhesive 

 plaster. A piece of leather or strong linen is smeared with resin 

 plaster (composed of two-thirds resin and one-third wax), and applied 

 over a pad of gauze covering both the exuberant granulations and 

 neighbouring parts. Absolute rest is indispensable. Subfascial 

 suppurating cellulitis calls for early incision and disinfection, and 

 if necessary, drainage. Deep-seated abscesses are to be opened 

 as soon as diagnosed. 



II.- FRACTURE OF THE TIBIA. 



In the horse, fractures of the tibia rank next in point of frequency 

 to those of the pelvis. Of 1,082 fractures occurring during four 

 years amongst army horses, 189 were in this bone. Such fracture 

 is oftenest caused by kicks from horses in neighbouring stalls, the 

 point struck being the internal face of the lower fourth of the tibia, 

 which lies directly under the skin. In most cases the bone is at 

 first only fissured, and the true fracture occurs later, during such 



