DISEASES OF THE FACIAL SINUSES. 621 



with the necessary ablutions, and the aperture does not close up 

 so soon. 



I see no advantage in using probes ; they are calculated to 

 wound and irritate the mucous membrane, and the contained 

 material can be removed without them. 



With Professor Varnell, I condemn the use of setons ; they are 

 calculated to do harm by keeping up irritation in a part where 

 it is almost sure to lead to organic changes in the bones, and 

 thus render what may be a curable into an incurable disease. 

 Their insertion must originally have arisen from a defective 

 knowlege of anatomy and physiology. 



The opening into the cavity having been made, the practi- 

 tioner will be able to judge as to the nature of its contents. If 

 it contains pus, washing with water will remove the greater 

 part of it. Inspissated pus, however, is very difficult to remove, 

 and it is not advisable to exercise too great a force in washing 

 out the sinuses, as the inspissated contents wiU be floated away 

 in a few days by the formation of new pus. Large flakes will thus 

 be carried off both by the nostril and the opening. In washing 

 out the sinuses, if the horse be cast and the nose elevated, there 

 is great danger of suffocating liim, as the fluid will, in aU pro- 

 bability, find its way into the larynx, and finally into the lungs. 

 Care must therefore be exercised, the water must be injected 

 slowly — the elastic syphon is the best instrument for tliis pur- 

 pose — and the nose kept depressed. There is but little danger 

 of this accident if the patient be standing. 



If the sinus contain anything abnormal it must be removed. 

 In one case that I operated upon, there was a large clot of blood, 

 in a very foetid condition, filling up the whole cavity. The horse 

 had been discharging from the nostril for months ; removal of the 

 clot, however, was followed by a most rapid recovery. In other 

 cases calcareous deposits will be found studding the mucous 

 membrane, as if originally the tumours had been tubercular, 

 and most probably these concretions are calcareous tubercular 

 degenerations. 



The treatment of the case after the operation must depend 

 in a great measure upon the cause of the disease, and the state 

 of the animal's health. If the cause be local, such as a diseased 

 tooth, blood-clot, or imprisonment of pus, and the general 

 health good, but little need be done, except washing out the 



