459 



tiling more neeileel than to keep tlie orilice open and to bcatlie or injed 

 the parts with some simple antiseptic wash that is not irritant or caustic 

 A low opening and cleanliness constitute the essential and ratioua". 

 treatment. If caustics are inserted, they cause sloughing of healthj 

 tissues and favor the formation of sinuses by producing sloughs belo^ 

 the point of incision. If the abscess has existed for some time and has 

 not opened, its walls become thickened, the pus granular or inspissated, 

 then, after an opening has been made by the knife and the contents 

 washed and squeezed out as thoroughly as possible, the plan of treat 

 mentis materially different. There is enormous thickening of the walls, 

 which must be destroyed a^nd sloughed out by caustics. The best plar 

 here is to make the first incision inihe highest point of the swelling, intro- 

 duce a piece of caustic potash (fused) 1 to 2 inches in length, carefully 

 plug the opening with oakum or cotton, and secure the horse so that he 

 can not disturb the parts by rubbing or biting them. The skin of the 

 shoulder and entire leg must be thoroughly greased with lard or oil in 

 order to prevent the caustic (should it escape) from excoriating the skin 

 over which it flows. Twenty-four hours after the introduction of the 

 caustic the plug is to be removed and hot fomentations applied. As 

 soon as the discharge is again established wo must make another open- 

 ing with the knife or seton needle as low as possible, and keep this open 

 with a seton. The object of making the first incision on top is to insure 

 the retention of the caustic uutil it has attacked the entire inner sur- 

 face of the cavity. If this is done the caustic causes sloughing of every 

 portion of the diseased parts, leaving a healthy granulating surface 

 underneath, which only requires that the depending orifice be kept 

 open and the cavity washed out with a weak antiseptic solution once or 

 twice a week to effect a cure. In many cases of fistula there is more 

 than one sinus or pipe that must be explored, laid open with the 

 knife if possible, or opened through its bottom by means of a sharp 

 seton needle, passing a tape through the openings, and retaining it in 

 this position for some time. If the pipes are directed straight downward 

 between the shoulder blade and the spine it is difficult or impossible to 

 make a counter opening, and the case becomes serious or intractable. 

 Caustic sohitio7is must now be injected carefully into the sinuses with 

 the hope of reaching every diseased part. Probably the best is gran- 

 ular chloride of zinc, 1 ounce to a half pint of water. This should be 

 injected three times during one week, after which a weak solution of 

 the same, or sulphate of zinc, is to be occasionally injected. Pressure 

 must be applied //-owi hclow, and endeavors made in this manner to heal 

 the different pipes /ro»i the bottom. Should the bones of the withers or 

 the shoulder blade be diseased the complication is again serious, and 

 these must be scraped or jiortions of them removed, requiring the aid 

 of the veterinary surgeon. 



In those cases of fistula where the tumor is large and hard, yet not 

 sufficiently defined to admit of extirpation with the knife, we may often 



