TREATMENT OF STERNAL SINUS. 
221 
sharp heels of a front shoe, or by the animal being run into. . It is eithei 
directly injured, purulent periostitis established, and necrosis ensues, 01 
it is indirectly affected from cellulitis extending to it from neighboui- 
ing textures. The thick muscular covering of the breast bone renders 
the removal of any necrotic portions difficult and tedious; pus mean¬ 
while burrows, and new necrotic points are formed, thus protracting the 
process for months or indefinitely. From time to time acute inflamma¬ 
tion sets in, and pus forms; the inflammation then either disappears or 
the substernal thickening becomes greater. 
Brill described a sternal sinus with two openings below and three at 
the height of the costal cartilages in a foal 2 J years old. Similar con¬ 
ditions have occasionally been seen in cattle. Belle mentions that a 
cow swallowed a splinter of glass, which perforated the rumen and lower 
wall of the chest, and produced sternal abscess and sinus. The glass 
was removed, and recovery occurred in five months. 
Symptoms. A semi-soft, slightly painful swelling appears between the 
forelimbs, sometimes exhibiting sinuous openings, from one or several 
of which ill-smelling bone pus discharges. A probe, introduced far 
enough strikes on the roughened surface of the necrotic bone. When 
the movements of the forelimbs are interfered with by the severe swelling, 
lameness may be noted, the animals straddling, while inflammatory 
action or acute pyrexia may exist. 
Treatment. The disease is always chronic, recovery rare. Laying the 
parts open, scraping necrotic portions of the sternum, careful washing 
out, followed by the use of iodoform and other materials, have usually 
been found useless. Gunther testifies to the inveteracy of the disease. 
It is seldom worth while to carry out a tiresome, costly, and rarely 
effectual treatment. Isolated recoveries may, however, occur. Marcoux 
reports a case which, after prolonged and fruitless treatment with liquor 
Villati and the actual cautery, was said to be healed by the use of 
opodeldoc. Landel tried opodeldoc without effect, but recovery followed 
the repeated use of the actual cautery, a farrier’s poker being heated 
white hot and thrust into the opening, which was then washed out with 
sprino- water ; the report does not indicate whether recovery was lasting. 
In a Tong-standing case treated by Lari, the inflammatory process at last 
extended to the pleura and pericardium. 
The prognosis is therefore unfavourable. If treatment is attempted, it 
can only be of an experimental character, and be based on general 
principles. Many practitioners confine themselves to dealing with the 
attacks of cellulitis. . . 
Treatment. Free exit for pus must be provided. W here it is necessaiy 
to lay open the lumen of the sinus, this should be effected as fai as 
possible in the longitudinal axis of the body. Disinfectant injections 
