305 



establislied and the discovery of the wound becomes due to the promi. 

 nence caused by the prevseuce of the provisional callus which marks its 

 cure. When the fracture is complete it will be marked by local de- 

 formity, mobility of the fragments, and crepitation. Nasal hemor- 

 rhage, roaring, frequent sneezing, loosening or loss of teeth, difficulty 

 of mastication, and inflammation of the cavities of the sinuses are 

 varying complications of these accidents. The object of the treatment 

 should be the restoration of the depressed bones as nearly as possible 

 to their normal position, and their retention in place by protecting 

 splints, which should cover the entire facial region. And special pre- 

 cautious should be observed to prevent the patient from disturbing the 

 dressing by rubbing his head against surrounding objects, such as the 

 stall, the manger, the rack, etc. Clots of blood in the nasal passages 

 must be washed out, collections of pus must be removed from the 

 sinuses, and if the teeth are loosened and likely to fall out, they should 

 be removed. If roaring is threatened, tracheotomy is indicated. 



Fractures of the jjremaxillary bone. — These are mentioned by conti- 

 nental authors. They are usually encountered in connection with frac- 

 tures of the nasal bone, and may take place either in the width or the 

 length of the bone. 



The deformity of the upper lip, which is drawn sidewise in this lesion, 

 renders it easy of diagnosis. The abnormal mobility and the crepita- 

 tion, with the pain manifested by the patient when undergoing ex- 

 amination, are concurrent symptoms. Looseness of the teeth, abun- 

 dant salivation, and entire inability to grasp the food complete the 

 symptomatology of these accidents. In the treatment, splints of gutta 

 percba or leather are sometimes used, but they are of difficult applica- 

 tion. Our own judgment and practice are in favor of the union of the 

 bones by means of metallic sutures. 



The lower jaw.— A fracture here is not an injury of infrequent oc- 

 currence. It involves the body of the bone, at its symphysis, or back 

 of it, and includes one or both of its branches, either more or less for- 

 ward, or at the posterior part, near the temporo maxillary articulation, 

 at the coronoid ijrocess. 



Falls, bloNVS, or other external violence, or powerful muscular con- 

 tractions during the use of the speculum, may be mentioned among 

 the causes of this lesion. The fracture of the neck and of the branches 

 in front of the cheeks causes the lower jaw, the true dental arch, to 

 drop, without the ability to raise it again to the upper, and the result 

 is a peculiar and characteristic physiognomy. The prehension and 

 mastication of food become impossible ; there is an abundant escape oi 

 fetid and sometimes bloody saliva, especially if the gums have been 

 wounded ; there is excessive mobility of the lower end of the jawbone; 

 and there is crepitation, and frequently paralysis of the under lip. But 

 although the aspect of an animal suffering with a complete and often 

 compound and comminuted fracture of the submaxilla presents at times 

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