458 



may become fistnlce. The pus burro vrs aDcl finds lodgment deep down 

 between the muscles, and only escapes when the sinus becomes sur- 

 charged or during motion of the parts, when the matter is squeezed 

 out. 



Symptoms. — These of course will vary according to the progress made 

 •by the fistula. Following an injury we may oiten notice soreness or 

 stiffness of the front legs, and upon careful examination of the withers 

 we will see small tortuous lines running from the point of irritation 

 downward and backward over the region of the shoulder. These are 

 superficial lymphatics, and are swollen and painful to the touch. In a 

 day or two a swelling is noticed on one or both sides of the dorsal ver- 

 tebraj, which is hot and painful and rapidly enlarging. The pain may 

 at this time subside somewhat, the stiffness disappear, but the swelling 

 continues and increases in size. It iiuctuates upon pressure, and either 

 opens or its contents become inspissated, dry uj), leaving a tumor 

 that gradually develops the common characteristics of a fibrous tumor. 

 When the enlargement has opened we should carefully examine its 

 cavity, as on its condition will wholly depend our treatment. 



In the earliest stage, when there is soreness, enlarged lymi>hatics, but 

 no well-marked swelling, the trouble may be frequently aborted. To 

 do this requires both general and local treatment. Ajjhysic should be 

 given, and the horse receive 1 ounce of powdered saltpeter three times 

 a day in his water or feed. If the fever runs high, 20-drop doses of 

 tincture of aconite root every two hours may be administered. Locally 

 we vvill find much relief by pouring cold water from a height upon the 

 inflamed spot for an hour at a time three or four times a day. Cooling 

 lotions, muriate of ammonia, or saltpeter and water, sedative washes, 

 as tincture of opium and aconite, chloroform liniment, or camphorated 

 oil are also to be frequently ai>plied. I have seen a number of cases 

 presenting these initial symptoms of fistula thus aborted that required 

 no other treatment than the avoidance of the original cause. When, 

 however, the formation of pus is inevitable, this must be hurried as 

 much as possible. Hot fomentations and poultices are to be constantly 

 used, and as soon as fluctuation can be plainly felt the abscess wall is to 

 be opened at its lowest point. In this procedure lies our hope of a 

 speedy cure. If the parts are so laid open by the knife that the pus 

 must escape as fast as it is formed, and where there is left no possibility 

 of its burrowing between the muscles, forming pockets or sinuses, the 

 parts rapidly and permanently heal without any mediation whatever, 

 as though we had been dealing with a simple abscess of the withers, and 

 not a true fistula at all. 



Attention is again called to the directions given above as to the neces- 

 sity of probing the cavity when opened. If upon a careful examination 

 "With the probe we find that there are no pockets, no sinuses, but a sim- 

 ple, regular abscess wall, the indication for treatment is to make an 

 opening from below so that the matter must all escape. Earely is any- 



