438 VETERINARY SURGICAL OPERATIONS 



vena saphena above the internal malleolus of the tibia, 

 and one at the point where the vein traverses the cuneiform, 

 are clipped, shaved, cocainized subcutaneously and disin- 

 fected. At each of these points, beginning at the uppermost 

 one, an incision is made over the vein three-quarters of an 

 inch long, and after dissecting the skin loose from around the 

 vein a catgut ligature is slipped around it by means of the 

 aneurism netdle or the simple full curved needle. Before 

 tying the ligature the undermost point is treated in the same 

 manner; then both are tied with double surgeon's knots and 

 a crucial stitch placed in each of the cutaneous incisions, 

 which are then dusted with iodoform and coated with collo- 

 dion or clay dressing. 



AFTER-CARE. — The cutaneous stitches are removed 

 in eight days, which is the first interference the wounds, if 

 properly made, will require. The catgut absorbs and there- 

 fore requires no further attention. The horse is ready for 

 work in twenty days. 



SEQUELS AND ACCIDENTS.— There are no special 

 known sequelae of the operation, although it would only be 

 reasonable to suspect that embolic conditions might some- 

 times follow unexpectedly, as sometimes happens after the 

 ligation of large veins. Accidental incision of the vein while 

 dissecting it out may occur, but beyond delaying matters for 

 a few moments while adjusting the forceps no complications 

 result. 



Evacuation of the Guttural Pouches. 



The guttural pouches are sometimes, although rarely, the 

 seat of a purulent accumulation which manifests itself by 

 more or less dyspnoea and by a nasal discharge that becomes 

 conspicuous during mastication and during exertion. The 

 accumulated product, at first liquid, becomes desiccated by 

 its long sojourn in the dependent part of the pouch, and on 

 account of the constant churning to which it is subjected by 

 the movements of the jaws it becomes rolled into spherical 

 bodies resembling whitish marbles. Recently the author 

 found the right guttural pouch of a horse impacted with oats. 

 Its evacuation can be effected by two methods, hyo-vertebro- 

 tomy and staphylotomy, the former of which is the preferable 

 one. 



Hyo-vertebrotomy is performed in the lateral recumbent 

 position under general anaesthesia. The parotid region is 

 clipped, shaved and disinfected, and an incision made through 



