POLL EVIL OPERATION. 57 



portion of the ligament in the area indicated and all calca- 

 reous deposits or other diseased tissues. 



With lyuer's forceps groove a channel about 2 cm. wide 

 from behind to before directly upon the median line, through 

 the occipital protuberance to the depth of about 2 cm. mak- 

 ing the bottom as near as possible on a level with the wound 

 in the soft tissues as indicated by the dotted line, AA. 

 Using Luer's forceps as a curette detach all vestiges of the 

 neck ligament from the base of the occiput and leave the 

 bone bare and smooth. If the Luer or ronguer forceps are 

 not available the grooving of the occiput may be accom- 

 plished with a strong curved bone gouge. Or the grooving 

 of the occiput and curetting away of the attachments of the 

 neck ligament to the base of the occiput may be very 

 effectually accomplished with a hoof knife. Be careful to 

 avoid penetrating the cranial cavity or the occipito-atloid 

 articidation . If the operator is not perfectly clear regarding 

 the anatomy of the parts he would do well to have before 

 him a sagittal section of the head of a horse which may 

 serve as a guide. In curetting the ligamentous attachments 

 from the occiput the operator should keep the index finger 

 of the left hand at the bottom of the wound, against the 

 occipito-atloid ligament in order to protect it from injury. 

 The operation is rendered safer also by rigid control of the 

 hemorrhage to which end he needs an ample number of 

 compression artery forceps. 



Control the hemorrhage, cleanse and disinfect the wound, 

 pack with iodoform gauze and suture for its entire length 

 except the anterior part, where the tampon should slightly 

 protrude, and dust the margin of the wound with iodoform 

 and tannin. Remove the tampon after foity-eight hours 

 and dress antiseptically daily. The sutures may or may 

 not be removed according to conditions. In carrying out 

 this operation our chief aim should be to remove all diseased 

 parts, to afford perfect drainage anteriorly, to secure and 

 maintain antisepsis, and to keep the wound directly on the 

 median line from which no visible scar will result. 



