70 FISTULA AND POLL-EVIL 
cause severe pain, prolonged discomfort and 
permanent blemish. Often large patches of 
integument slough away (Fig. 4). 
The only beneficial effect of caustics is the 
widening of the aperture and tract for drain- 
age and since this can be accomplished better 
and without discomfort by other means the one 
argument in their favor loses force. 
The treatment of fistula of the withers which 
in our hands has given the best results is 
prompt, thorough, surgical intervention. Our 
operation of choice and which is hereinafter de- 
scribed consists of a median line incision ex- 
tending from the crest of the withers forwards 
six to twelve inches and downward through the 
skin, the pad of the mane and then between the 
two halves of the ligamentum nuche into the 
space beneath lving over the summits of the 
second and third thoracic vertebra. This is 
followed by a resection of such parts of the 
ligamentum nuche as are thought to be harm- 
ful and then by making lateral drainage 
apertures from the bottom of the cavity to the 
surface of the cervical region into which a 
perforated drainage tube is inserted. 
Radical Operation for Fistula of the Withers 
Preparation—As the procedure is one of 
some magnitude, attended with all of the dan- 
