OPENING OF THE GUTTURAL POUCHES. 57 



wound a drainage tube can be introduced into the pouch, 

 and fixed in its position by sutures. The opening can be 

 enlarged in an anter-posterior direction' to the extent of 5 to 

 8 cm. 



A far more common operation in veterinary practice 

 than the opening of the guttural pouches, is the opening of 

 abscesses of the sub-parotid lymph glands, lying between the 

 inner face of the parotid and the external face of the guttural 

 pouch. The operation here used is the same as Viborg's 

 for the guttural pouch but does not penetrate that cavity 

 because the inner wall of the abscess has pushed the ex- 

 ternal wall of the pouch inward so that the former largely 

 occupies the usual location of the guttural pouch. The 

 dyspnoea generally prohibits casting the animal and neces- 

 sitates operating in the standing position. In some cases 

 the d3'spnoea is so .severe as to demand tracheotomy before 

 the opening of the abscess can be undertaken because the ex- 

 citement aggravates the difficult respiration to the point of 

 suffocation. 



II. Chaberf s method. Secure the horse in the lateral re- 

 cumbent position, remove the hair and disinfect the skin 

 beneath the wing of the atlas. Make an incision about i 

 cm. in front of the lower half of the wing of the atlas and 

 parallel to it, about 6 cm. long extending through the skin 

 and .skin muscle down to the parotid gland. The incision 

 is facilitated by rendering the .skin tense with the left hand 

 and care is to be taken not to wound the auricular nerve 

 which pas.ses directly along the atlas. Tlien draw backward 

 the posterior lip of the wound and separate with blunt in- 

 .struments the posterior border of the parotid gland from the 

 atlas, to which it is bound by loose connective tissue, and 

 draw the gland forward with tenacula. At the bot- 

 tom of the opening thus formed there is seen the stylo- 

 maxillaris muscle, sm, Plate X, lying against the median 

 .side of the parotid gland covered only by the aponeurosis of 

 the ma.stoido-humeralis nuLScle. With the handle of the 



