PRINCIPLES OF VETERINARY SURGERY 363 



eration is often dangerous on account of the proximity of 

 the jugular and carotid artery. 



Chronic, soft abscesses should be opened, like hot ones, 

 in the most dependent point, and the cavity disinfected by 

 some antiseptic solution. 



ANNOTATION. 



Special Treatment. — Abcesses in any part of the muscular system, ac- 

 companied with a thick wall of degenerated muscular tissue (muscle scler- 

 osis), but especially the common example, developing in the mastoido- 

 humeralis at the point of the shoulder, very often prove obstinately per- 

 sistent and refractory. Extirpation of the entire tumefied area is the most 

 efifectual cure, but it often necessitates- almost impossible transgression into 

 structures supplied with large vessels which render the operation rather 

 hazardous. This i'? particularly the case with the cold abscess of the 

 shoulder that is closely related to the carotid artery and jugular vein. And 

 besides, being a tumefaction without any well defined limits, and deeply 

 rooted into the muscle tissue, it is absolutely impossible to locate its nutrient 

 vessels until they have been cut in the course of the dissection. Then, often 

 the flow of blood is so copious and the location of the vessel so hidden, that 

 its arrest is extremely difficult. Ligation is usually impossible and grasping 

 with the haemostatic forcep is seldom successful. Compression by packing 

 the wound taut with wadding and then suturing it is the only method re- 

 maining that will save the patient's life. This emergency recourse is not 

 without danger. The blood may still flow inwardly and dissect its way up- 

 ward along the loose areolar tissue of the jugular groove, or else into the 



thorax. One case operated upon by Dr. ( ) died six hours after 



operation from haemorrhage into the thoracic cavity after the wound had 

 been hurriedly packed to save the patient's life. Kragness reports two similar 

 cases answering the same description, in which the life was saved only by 

 the timely administration of salt solution. 



Now, in view of these possible accidents, it is evident that total ablation 

 of all of these tumors is not advisable. Only those having more or less well 

 defined limits and located at a safe distance from the jugular groove should 

 be submitted to the radical operation of total extirpation. The others, which 

 are in the majority, may be successfully eliminated by combined incision, 

 enucleation and cauterization. After the tumor is shaved and disinfected 

 it is divided in two equal halves by a vertical incision through its sclerotic 

 walls. The incision, which in addition liberates the pus, is made across the 

 entire tumor and into its pus cavity, but no farther. A considerable portion 

 of the sclerotic wall, between the skin and the pus sac, is then cut away 

 by sectional enucleation on each side of the incision, so as to hollow out a 

 cavity of considerable size. This done, a hot iron, (or a number of them 

 consecutively) is plunged into the hollow cavity until the remaining part of 

 the tumor (its periphery) is literally cooked. In a few days the, eschar 

 sloughs out and cicatrization promptly terminates the condition. This opera- 

 tion may be performed without any haemorrhage at all if the hot iron is 

 applied to the wound as fast as the incision and the subsequent enucleation 



