FRACTURES OF THE FACIAL BONES. 97 



wound, if necessary. It is found, since the introduction of 

 antiseptic surgery, that the wound often remains dry, and that 

 it heals by the adhesive inflammation. If such be the case, 

 the dressing must on no account be interfered with, and means 

 must be taken to keep it in its place, either by the applica- 

 tion of collodion, stjrp tic-colloid, or gutta-percha paste. Wlien 

 a loose portion of bone remains, its presence may be detected 

 by the continued foetor of the discharge, and by an ulcer in the 

 skin communicating by means of a sinus with the bone 

 within. In all cases where a loose piece of bone is found in 

 the part some time after the accident, it will be advisable, if its 

 removal is not easily accomplished, to allow some weeks to 

 elapse before forcibly extracting it, in order that the union and 

 consolidation of the fracture may be complete. The opening in 

 the skin may then be enlarged, and the necrosed bone removed 

 by the forceps or tenaculum. 



No alarm need be felt at the foetor of the discharge during the 

 first few days after the accident, for as a rule this is always pre- 

 sent. The discharge is at first thin, dark-coloured, and foetid ; 

 but if not too profuse, it does not indicate any serious results, for 

 it very shortly becomes lighter in colour, less offensive in odour, 

 and partakes more of the nature of laudable pus. Every facility 

 must be given for the discharge to drain away, and the wound 

 may be injected with a weak solution of hydrochloric acid, I 

 recommend this in preference to all other dressings in such 

 cases, as it dissolves the earthy matters of the necrosed sur- 

 faces of the bones, and thus facilitates the formation of a healthy 

 healing surface. I have used it for years, and can speak most 

 highly of it. Much pain is manifested by the animal in some 

 cases of this kind of fracture, from the inferior dental division 

 of the posterior maxillary branch of the fifth nerve being in- 

 volved in the injury. In such, much relief will be given by 

 dressing the wound with a solution of morphia, or by the ad- 

 minstration of opium : the local application is the better practice, 

 and as little medicine as possible should 1)6 given after the 

 first dose of physic, for fear of causing displacement. If the 

 bowels are constipated, enemas ought to be administered, and 

 the food should be of a laxative nature — linseed, bran, boiled 

 turnips, or carrots ; or w^hat Mr, Anderson, V.S., Glasgow, 

 recommends — linseed oil in a warm bran-mash. The patient, 

 H 



