346 VETERINARY SURGICAL THERAPEUTICS. 
in those tissues, pressure by the aponeurosis ordinarily makes the pus 
migrate alongside the connective layers, until it finds a place for escape ; 
sometimes aponeurosis are perforated by the necrotic fluid; then, almost 
always the opening of communication of the sub and susaponeurotic infil- . 
trations is very small and it becomes necessary to make a free incision 
or a°counter opening. The incision of aponeurosis is. made as much‘as 
possible from inward outwards, with the bistouri guided with the grooved 
director, bearing in mind the presence of blood vessels and nerves. 
Sometimes the operation is not without danger; the tissues being indur- 
ated, the instrument must be introduced deep. In the region of the 
flank, the peritoneum is not the only danger; Blanc, in operating ona 
horse, had a mortal hemorrhage.’ 
Submitted to the long action of pus or injured by a soiled wounding 
object, the closed, little vascular tissue resists badly against infection ; 
often a more or less extensive part of it becomes mortified, and once 
established in the aponeurotic structure, necrosis spreads little by little, 
as it does in tendinous tissue, in the scutiform plate, giving rise some- 
times to very severe disorders, to numerous fistulas and abundant ‘sup- 
puration. This march is that of most necrosis affecting the aponeurosis 
of the withers, the back, croup, flank or lower abdominal wall. In a 
horse affected with necrosis of the aponeurosis of the flank, following 
a puncture of the cecum, we had to make three successive counter open- 
ings, the last one far away to the inferior part of the abdomen, and not- 
withstanding a most careful treatment, recovery did not take place for four 
months. The indications for all those necrosis are the same; free incis- 
ions or counter openings, introduction of tents or drains to insure the flow 
of pus, repeated injections of strong antiseptic solutions (phenic acid, 
creoline, chloride of zinc, Villate solution, tincture of iodine). 
1 Blanc, Bullet. Soc. Med. Vet. Prat., 1895, page 45. 
