80 VETERINARY SUROldAL OPERATIONS 



moval of the pin some four or five days later. The wound 

 generally behaves well and requires no attention whatever. 



ACCIDENTS AND SEQUELiE.— A fleam blade in the 

 neck of a small, thin horse might reach the carotid artery, if 

 some judgment is not used in selecting an appropriate size, 

 or in striking the blow. The danger here, however, need not 

 be emphasized, as it is not very likely to occur. It is an im- 

 possible accident in a horse of ordinary flesh. Sometimes, 

 after the pin suture is adjusted, the blood will continue to 

 flow subcutaneously until a large sanguineous tumor devel- 

 ops around the seat cf operation. Occasionally it assumes 

 large proportions, extending as high as the larynx, as low as 

 the thorax and outward three to five inches. In this event, 

 if the flow is promptly discovered, a firm, continuous pressure 

 above the incision will limit the flow and sometimes promptly 

 arrest it. The patient must be kept quiet above all. If 

 excitable, it is preferable to leave the patient quiet and await 

 the spontaneous arrest of the bleeding. Under no circum- 

 stances must the incision be reopened with the intention of 

 effecting direct pressure to the vein, on account of the inevit- 

 able danger of infecting the blood clot and thus provoking 

 a serious abscess and possibly a serious phlebitis. Gener- 

 ally, the flow being rather trivial, non-interference is pre- 

 ferable. 



The most formidable sequelae of phlebotomy is septic 

 phlebitis. This sequel occurs in the form of a serious, threat- 

 ening inflammatory condition extending along the entire 

 vein, from its confluent to the throat arid even into its 

 cephalic and facial branches. The acute inflammation ter- 

 minates in the formation of multiple abscesses extending to- 

 ward the periphery but exerting their greatest effects about 

 the parotid region. The course of the disease is chronic, 

 and not infrequently the prognosis is grave. 



MODIFICATIONS.— Blood-letting from -other veins 

 besides the jugular is no longer regarded as a "modern veter- 

 inary method." The saphenic and radial veins were once 

 bled for local diseases of the feet and legs, and pedal arter- 

 iotomy (bleeding at the toe) was once given some attention 

 in the treatment of laminitis; but these expedients have 

 fallen into obscurity on account of their uselessness. 



In lieu of fleams the scalpel may be used to perform 

 jugular phlebotomy, and although it is a less satisfactory 

 instrument, the operation need not be abandoned simply be- 

 cause a fleam is not available. In performing the operation 

 with the scalpel, the skin is carefully shaved, disinfected and 



