1 8 TREPHINING OF THE FACIAL SINUSES. 



dissection of the skin from the bone in the European 

 operation. The pain caused in dressing must be greater in 

 the European method because the detached, overhanging 

 skin must be moved and disturbed each time causing pain 

 and inviting infection. The question of pain in dressing 

 must always be seriously considered as it not only affects 

 the time required for dressing and its efficacy, but has an 

 important relation to the docility of the animal after re- 

 covery, some horses having their dispositions permanently 

 ruined by the irritation due to the oft repeated painful 

 dressing of wounds. 



The cicatricial contraction of the tissues of the horse is 

 so great that the removal of a circular disk of skin J^ to 1)4 

 in. in diameter on the face does not leave a visible scar 

 so that the question of blemish falls back upon that of 

 infection, which, as we have asserted above is far more 

 probable by the continental European method. 



The rapidity and certainty of recovery are dependent 

 upon the considerations above discussed. The removal of 

 the cutaneous disk is certainly easier and quicker than the 

 other method. The convenience for dressing is evidently 

 superior by the English and American method. 



The opening of the sinuses into the nostrils is based upon 

 the surgical principle that suppurating cavities should be 

 provided with ample drainage from the most dependent 

 part. The direction to leave the external wound open, at 

 first thought seems antagonistic to general surgical princi- 

 ples but it should be remembered that the wound consists 

 only of the incision through the skin, connective tissue 

 and bone penetrating a suppurating cavity, and that any 

 object which we can place in this opening can only serve 

 to dam back the secretions of the cavity and can not prevent 

 them from coming in contact with the wounded surface. 

 It must further be regarded that the respiratory mucosa of 

 the upper air passages are not irritated or injured in any 



