90 
ACTINOMYCOSIS. 
the same time any infectious material that may have remained. The 
wound is washed out with carbolic solution, filled with some aseptic 
material (salicylic wadding, Esser), and the skin sewn up. When the 
stitches are removed next day, the parts are washed out with a disin¬ 
fectant solution, and treated as an open wound. Should the condition 
return, repetition of the operation is seldom of any use. 
Injections of iodine tincture and 1 per cent, sublimate solution have 
been recommended, but are tedious and unreliable. In some cases deeply 
incising the swelling and daily painting the surfaces with iodine tincture 
(not solution) is useful. Destruction of the fibrous tissue of the growth 
with arsenic has been highly spoken of. Arsenic, however, can only be 
used advantageously in the parotid region and in cases where the growth 
does not extend to the larynx or pharynx. Small solid fragments of 
arsenious acid weighing from 8 to 7 grains are thrust into the midst of 
the growth in the direction of the hard cord which can be felt extending 
into the depth. A passage can first be made with round-pointed scissors, 
and the fragment of arsenic inserted with slender forceps. Another 
method consists in incising the skin, passing a fairly wide trochar and 
canula to the base of the growth, removing the trochar, inserting the 
fragment of arsenic into the canula, and thrusting it to the bottom by 
replacing the trochar. The entire instrument is then withdrawn. In 
from six to twelve weeks the diseased tissue sloughs away, leaving a wound 
which heals by granulation. W orking oxen may be used throughout the 
treatment. Arsenic has also been used in the form of an ointment. 
Within recent years the internal use of potassium iodide has been 
warmly recommended. One and a half to drachms of the salt, 
dissolved in water, are given daily. Under this treatment the swellings 
diminish, but it must often be continued for many weeks before recovery 
is complete. Moreover, success is not invariable, though the real value 
of the treatment cannot be called in question. The other methods can 
always he tried in case of failure. 
Edgar used the red iodide of mercury dissolved in water by the 
addition of potassium iodide, in place of the latter salt alone. 
DISEASES OF THE FACE AND LOWER JAW. 
The face is here regarded as comprising that section of the head 
whose base is formed by the upper jaw and the malar and lachrymal 
bones. 
(1.) FRACTURES OF BONES OF THE FACE. 
On account of its sheltered position, the upper jaw is seldom fractured. 
In horses fracture is often due to dental operations, and in dogs to bites; 
less frequently to such external violence as kicks, or collision with fixed 
