Purulent Infection of the Navel 1017 



Prognosis. The prognosis is very grave in all cases of 

 omphalo-phlebitis, that is, in all patients suffering from unibilic 

 infection in which the infection gains the hepatic and general 

 circulation. It is most hopeless in the foal, in which animal the 

 mortality exceeds 95%. Of the few which ultimately sur- 

 vive, the vast majority are comparatively valueless because 

 of permanent changes in the articulations or in other parts of 

 the body. In the calf the prognosis is somewhat more favor- 

 able, but is still exceedingly grave. The greater the age of the 

 young animal when the symptoms of the disease appear, the 

 -more vigor and strength it has acquired ; the better the progno- 

 sis. If the infection is so mild that the first evidences appear 

 only after the young patient is 2 or 3 weeks old, the prognosis 

 is fair. 



When simple omphalitis is present and severe, and the local 

 swelling and inflammation indicate that the entrance of the in- 

 fection into the general system is barred by a resistant embolus 

 in the umbilic vein, the prognosis is. good. 



Handling, The handling of the localized infection of the 

 nave\ consists essentially of local disinfection. The navel should 

 be thoroughly cleansed ,and if a portion of the cord is still present 

 and undergoing decomposition it should be cautiously removed, 

 and any necrotic tissues should be excised or curetted away as 

 far as is practicable. Abscesses in the navel should be opened 

 promptly, under strict antiseptic precautions. It is highly essen- 

 tial, also, that, before attempting to operate, one should care- 

 fully differentiate between inflammation of the navel and 

 umbilic hernia. In some cases the two conditions coexist, and 

 become highly confusing, so that the hernia may be mistaken 

 for an abscess, or vice versa ; or a fistula may exist along with 

 hernia. When attempting to lay open a fistula, the surgeon 

 may open the peritoneal cavity and invite intra-peritoneal infec- 

 tion, or a protrusion of the omentum or the intestine. Sup- 

 purating fistulse about the navel should usually be treated by 

 the injection of antiseptics, such as tincture of iodine, rather 

 than by opening, unless the more conservative method fails to 

 produce the desired results. 



The .selection of a disinfectant is not so important as the thor- 

 oughness of its application, except that it should be one which 

 will penetrate the tis.sues freely, We prefer the application of 



