Fistula of the Withers. 



This is a condition which requires the exercise of 

 the best surgical judgment on the part of the veter- 

 inarian. It is just as important for the operator to 

 recognize those cases which require a radical surgical 

 operation and the complete extirpation of the diseased 

 parts as it is to recognize the case in which ordinary 

 drainage will suffice to effect a cure. 



The guide in these cases is the amount of tume- 

 faction which is present and the nature of this tume- 

 faction. First, I desire to say that those cases which 

 require radical interference are rare. Seventy-^five 

 per cent of all cases of fistula of the withers are cur- 

 able through the establishment of proper drainage and 

 the application of remedies to terminate necrotic ten- 

 dencies. A possible addition is bacterin therapy but 

 this is reliable and of real value only if the bacterins 

 are autogenous. Many cases of fistula of the withers 

 are distinctly of pneumococcic origin. 



The treatment of fistulous withers consists of 

 either radical surgical removal of all necrotic tissue 

 or of the establishment of proper drainage only. 



The first class, those for radical operation, con- 

 sists of only those rare cases in which the withers 

 are immensely tumefied with little or no discharge. 

 In such cases incision is made on the median line and 

 the entire mass of necrotic tissue, down to the last 



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