304 



thickness of the dressing, opposite the wound, in order to permit the 

 escai)e of pus and to secure access to the points requiring the ai)phca- 

 tiou of treatment. 



FRACTURE OF DIFFERENT BONES. 



Of the cranial bones. — Fractures of this variety in large animals are 

 comparatively rare, though the records are not destitute of cases. 

 When they occur, it is as the result of external violence, the suiierers 

 being usually runaways which have come in collision with a wall or a 

 tree, or other obstruction; or it may occur in those which in pulling 

 upon the halter have broken it with a jerk and been thrown backwards, 

 as might occur in rearing too violently. Under these conditions we 

 have witnessed fractures of the parietal, of the frontal, and of the 

 sphenoid bones. These fractures may be of both the complete and the 

 incomplete kind, which indeed is usually the case with those of the flat 

 bones, and they are liable to be complicated with lacerations of the 

 skin, in consequence of which they are easily brought under observa- 

 tion. But when the fact is otherwise and the skin is intact, the diag- 

 nosis becomes diificult. The incomplete variety may be unaccompanied 

 by any special symptoms, but in the complete kind one of the bony 

 plates may be so far detached as to press upon the cerebral substance 

 with sufficient force to produce serious nervous complications. When 

 the injury occurs at the base of the cranium hemorrhage may be looked 

 for, with paralytic symptoms, and when these are present the usual ter^ 

 mination is death. It may still happen, however, that the symptoms 

 of an apparently very severe concussion may disappear, with the result 

 of an early and complete recovery, and the surgeon will therefore do 

 well to avoid undue precipitation in venturing upon a prognosis. In 

 fractures of the orbital or the zygomatic bones the danger is less press- 

 ing than with injuries otherwise located about the head. The treatment 

 of cranial fractures is simple, though involving the best skill of the 

 experienced surgeon. When incomplete, hardly any interference is 

 needed ; even plain bandaging may usually be dispensed with. In the 

 complete variety the danger to be combated is compression of the 

 brain, and attention to this indication must not be delayed. The means 

 to be employed are the trephining of the skull over the seat of the frac- 

 ture, and the elevation of the depressed bone or the removal of the 

 portion which is causing the trouble. Fragments of bone in comminu- 

 ted cases, bony exfoliations, collections of fluid, or even protruding 

 portions of the brain substance must be carefully cleansed away, and a 

 simple bandage so applied as to facilitate the application of subsequent 

 dressings. 



Fractures of the bones of the face. — In respect to their origin — usually 

 traumatic— these injuries rank with the preceding, and are commonly of 

 the incomplete variety. They may easily be overlooked and may even 

 sometimes escape recognition until the reparative process has been well 



