284 OPEEATIONS ON BONES. 



any signs of inconvenience, the indication of trephining only 

 becomes absolute when serious nervous manifestations are ex- 

 hibited. In simple contusions, or even with complete fracture of 

 the bone, trephining is not indicated unless brain lesions are 

 unmistakably present. 



It is indicated in soUpeds in cases of chronic discharges pro- 

 ceeding from suppurative collection in the sinuses, characterized 

 by a yellowish, grumous, and often offensive, running at the nose, 

 usually from but one side, and not uncommonly accompanied by 

 a deformity of the face, caused by a bulging of the bones, and 

 associated vidth it a dullness on percussion over their surface. 



Jessen & Unterburger have also recommended it in cases of 

 suppuration in the cavities of the nasal turbinated bones. In the 

 treatment of chronic catarrhal inflammation of the horns or of the 

 portions of the frontal sinuses which extend into the appendix of 

 the head, in ruminants, it has given excellent results. 



It is also indicated for the removal of foreign bodies, either of 

 a pathological nature or the product of wounds, entering the 

 cranium from the outside. It is available for the removal of 

 polypi or any kind of neoplasm, of migrating dental cysts, of 

 odontomse, or as one of the first steps in the operation for the 

 removal of diseased teeth from their alveolar cavity; in aU these 

 cases it is the first indication. It is also of common application in 

 extracting parasites, the coenurus especially, from the cranial cav- 

 ity of small ruminants, when their location has been first positively 

 ascertained. In some severe cases of diseased withers accom- 

 panied with abundant suppuration, which may filtrate under the 

 internal surface of the scapulae, and accumulate between that bone 

 and the thorax, it has been claimed that, performed upon the 

 scapula, it would furnish an eligible means of reaching the bottom 

 of the collection, and providing suitable drainage and consequent 

 reUef. 



Trephining the waU of the foot in special cases of laminitis, 

 to assist the escape of the effused blood from between the 

 laminoe has also been tried, but with what results we are not 

 informed. It has even been performed in the treatment of immo- 

 biUty, but so far as we have learned, has never been foUowed by 

 satisfactory results. It is also referred to in connection with the 

 cranial moculation of rabies, as performed by Pasteur. 



The special instrument employed in the operation is the 



