• ACCIDENTS AND OPERATIONS. 355 



has been cleansed and the haemorrhage has ceased, the lips 

 are brought into direct apposition (taking care no hairs get 

 between), and so maintained by sutures or plaster ; the 

 latter will necessitate the shaving off the hair before it can 

 be applied. 



The animal must then be so secured that it cannot inter- 

 fere with the part. For though the dog's tongue is un- 

 doubtedly a great cleanser, it is neither a healer nor aid to 

 apposition, and the sooner siuch an idea is exploded the better. 

 Omit this precaution, and the surgeon's work will speedily 

 be undone ; the animal will persistently lick the wound, and 

 keep it gaping open. It then heals by granulation, for it 

 cannot do so by any other method. The result is a broad 

 unsightly cicatrix, instead of the fine and, in time, almost 

 imperceptible seam left from union in the first instance by 

 direct apposition, with or without the first intention. 



I say, with or without the first intention, because it is not 

 unusual for a patient to be brought some four or five days 

 after the wound has been closed, with the sutures out and 

 the lips apart, and we are asked to reclose it. This I seldom 

 do, finding in the treatment of wounds in the lower animals 

 that if the lips can be kept in apposition for the fifst four or 

 five days, they will, if they then break away, resume in the 

 final healing process the position they were originally placed 

 in, and each suture mark will reveal the nicety or otherwise 

 of adjustment. 



The same remarks will apply to healing^ by adhesive in- 

 flammation,* which may be considered a kind of, if not really, 

 first intention. 



The sutures commonly used are soft wire, pins, and silk. 



I prefer the latter for dogs, and if dipped in a weak solution 



of carbolic acid they maintain their position longer, and add 



to the healthiness of the wound. 



. Granulation and scabbing are, however, the most common 



* It is to my mind doubtful if healing ever takes place without an ex- 

 udation of lymph, at all events in the lower animals. 



