CAUDAL MYOTOMY 229 



the stitches have been removed in order to preserve the 

 apposition of the edges of the wound. 



When there is evidence of sepsis on the second, third or 

 fourth day the lower stitch is removed to facilitate the es- 

 cape of the wound secretions. In addition to the removal 

 of the stitch the wound at that point may be carefully 

 widened with a blunt instrument and submitted to a daily 

 injection of a limited amount of hydrogen peroxide, more 

 for the purpose of preserving the orifice than to disinfect the 

 whole area. Forcible irrigations are contraindicated. 



The cure is instantaneous. Patients which have never 

 been able to walk before are now able to move freely about 

 unincumbered. It is, however, advisable to first heal the 

 wound before any exercise is allowed, except in the case of 

 a suckling, in which such control is impossible. 



ACCIDENTS AND SEQUELS— During the operation 

 there is always danger of wounding the capsular ligament, 

 but this danger has been greatly magnified. If the division 

 is effected at the inferior end of the ligament as above rec- 

 ommended, the danger of this accident is practically nil. 

 When the accident does occur its gravity cannot be over- 

 estimated. It may prove fatal. Although the wound may, 

 at the time of the operation, be perfectly aseptic, the subse- 

 quent flow of synovia into it will surely promote a septic 

 state in spite of all preventive efforts. 



Septic arthritis may ensue even in the absence of the 

 above accident by the spread of an infective inflammation 

 from the surgical wound into the articulation. This accident 

 is rare after clean operations. 



Caudal Myotomy. 



SYNONYMS.— Pricking ; nicking. 



DEFINITION. — Caudal myotomy is a subcutaneous di- 

 vision of one or more of the coccygeal group of muscles for 

 the purpose of correcting defects in the carriage of the tail. 



INDICATIONS. — The principal indication for caudal 

 myotomy is habitual deflection of the tail of the horse. While 

 driving, or when trotted to the halter, the tail is deflected to 

 one side of the vertebral axis to the decided detriment of the 

 horse's appearance. The defect is regarded as a serious de- 

 formity by fanciers of good horses, either saddle horses or 

 harness horses, and its amelioration is always anxiously 

 sought. 



In the .past, when docking was extensively practiced 



