CAUTERIZATION 87 



vantage in the treatment of innumerable diseases and to 

 meet many conditions where radical surgical intervention 

 is inadvisable or inexpedient. For example, a quittor, a fis- 

 tula of the withers or a poll-evil, for various reasons may be 

 treated by the introduction of caustics into the fistulous 

 tracts in lieu of the more radical operations, and often with 

 exceptionally good results. In fact, in this day of modern 

 surgery there are still many of the foremost veterinarians 

 who prefer this method of treatment, to the modern opera- 

 tions, because of the facility with which such treatment can 

 be carried out as compared with the trouble of performing 

 a surgical operation, and on account of a prevailing aptitude" 

 of many practitioners to avoid "the knife" as much as possi- 

 ble. The veterinarian without surgical skill and the charla- 

 tan are, however, the chief adherents to the caustic methods 

 of treating chronic fistulous conditions, although the fore- 

 most surgeons sometimes adopt it as a convenient recourse. 



The benefits of such treatment, often very limited, are 

 sometimes excellent. The caustic substance introduced in a 

 ■tract destroys the layer of infected granulations, bringing 

 them out in the form of a burned tube — "the pipe" — some 

 few days later after they have separated from the surround- 

 ing living tissues. Thus the fistulous tract is widened to the 

 benefit of better drainage, and a healthy reaction is stimu- 

 lated in the surrounding tissues which bound the tract. But 

 the absolutely satisfactory results are only derived when the 

 necrotic center (the necrosed cartilage, bone or ligament) 

 already well separated from its surrounding tissues, is also 

 brought out with the cauterized granulations. Under such 

 circumstances the cauterization of a fistula is at once cura- 

 tive, — cicatrization then supervenes unmolested. 



If caustics were used with a full knowledge of the ele- 

 mental principle that fistulous tracts always direct their 

 course down to some underlying cause whose removal will 

 thereby, sooner or later be effected, their application might 

 then be defended as rational therapeutics. The removal of 

 this underlying cause as the initial or ultimate object of the 

 treatment, places cauterization of fistulous tracts amongst 

 scientific expedients, whilst its use to simply "burn out" 

 tracts stigmatizes it as the recourse of an empiric. 



As a haemostatic hot iron cauterization is par excellence 

 the best under many circumstances. In amputations of the 

 tail of any of the domestic animals, but especially of the 

 horse, there is no better nor safer method than the hot iron. 

 In the ablation of exuberant granulations on any part of the 



