336 DISEASES OF THE HORSE. 
be dispensed with. In the complete variety the danger to be com- 
bated is compression of the brain, and attention to this indication 
must not be delayed. The means to be employed are the trephining 
of the skull over the seat of the fracture and the elevation of the de- 
pressed bone or the removal of the portion which is causing the 
trouble. Fragments of bone in comminuted cases, bony exfoliations, 
collections of fluid, or even protruding portions of the brain sub- 
stance must be carefully cleansed away and a simple bandage so ap- 
plied as to facilitate the application of subsequent dressings. 
FRACTURES OF THE BONES OF THE FACE. 
In respect to their origin—usually traumatic—these injuries rank 
with the preceding, and are commonly of the incomplete variety. 
They may easily be overlooked, and may even sometimes escape rec- 
ognition until the reparative process has been well established and the 
wound is discovered owing to the prominence caused by the presence 
of the provisional callus which marks its cure. When the fracture is 
complete it will be marked by local deformity, mobility of the frag- 
ments, and crepitation. Nasal hemorrhage, roaring, frequent sneez- 
ing, loosening or loss of teeth, difficulty of mastication, and inflamma- 
tion of the cavities of the sinuses are varying complications of these 
accidents. The object of the treatment should be the restoration of 
the depressed bones as nearly as possible to their normal position and 
their retention in place by protecting splints, which should cover the 
entire facial region. Special precautions should be observed to pre- 
vent the patient from disturbing the dressing by rubbing his head 
against surrounding objects, such as the stall, manger, rack, etc. Clots 
of blood in the nasal passages must be washed out, collections of pus 
removed from the sinuses, and, if the teeth are loosened and liable to 
fall out, they should be removed. If roaring is threatened, trache- 
otomy is indicated. 
FRACTURES OF THE PREMAXILLARY BONE. 
These are mentioned by continental. authors and are usually en- 
countered in connection with fractures of the nasal bone, and may 
take place either in the width or the length of the bone. 
The deformity of the upper lip, which is drawn sidewise in this 
lesion, renders it easy of diagnosis. The abnormal mobility and the 
crepitation, with the pain manifested by the patient when under- 
going examination, are concurrent symptoms. Looseness of the 
teeth, abundant salivation, and entire inability to grasp the feed 
complete the symptomatology of these accidents. In the treatment 
splints of gutta-percha or leather are sometimes used, but they are 
of difficult application. Our own judgment and practice are in 
favor of the union of the bones by means of metallic sutures. 
