OPENING OF THE GUTTURAL POUCHES. 6i 



can be enlarged in an anter-posterior direction to the extent 

 of 5 to 8 cm. or large enough to admit the operator's hand. 



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 latter. The dyspnoea 

 generally prohibits casting the animal and necessitates 

 operating in the standing position. In some cases the 

 dyspnoea 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. Chabert'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 passes directly along the atlas. Then 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 it forward with tenacula. At the bottom of the 

 opening thus formed the'reTs^een the stylo-maxillaris 

 muscle, sm, Plate XI, lying against the median side of 

 the parotid gland covered only by the aponeurosis of the 

 mastoido-humeralis muscle. With the handle of the scalpel 

 inclined toward the wing of the atlas penetrate in the 



