344 LACKRATION OF THE LEFT JUGULAR VEIN. 
tereb. and sewed up the integument, and applied the puft-ball 
externally, but the blood continued flowing for a short time. 
I stopped the return of blood through the near side jugular vein 
with my finger, and the hemorrhage immediately ceased; but 
when the finger was withdrawn, the blood again flowed throuo-h 
the opening. When the current of blood on the off side was 
slopped, no effect whatever was produced. 
1 told the owner that the mare was in a very dangerous state, 
and that in all probability the case would terminate fatalh'’; and 
that there was only one chance left of saving her life, namely, 
by taking up the jugular vein. 
He immediately consented, and the operation w'as performed 
as follows:—The mare was thrown. The part of the vein I in¬ 
tended to tie was the usual place of bleeding, as I considered it 
useless to search for the vein at the chest; in fact, from the verv 
unhealthy and lacerated state of the wound, it would have been 
impossible to have found it. I made an incision an inch and 
a half long through the skin, and cut through the few muscular 
fibres of the panniculus carnosus and levator humeri muscles, and 
exposed the vein, which I detached from the surrounding parts. 
I then passed a blunt probe under the vein, and raised it. The 
probe was held by an assistant until I had passed two ligatures 
with a curved needle under the vein, and made it quite secure. 
I then brought the lips of the external wound together by sutures. 
After the mare got up I gave her some hay, which she ate, for 
the first time for a fortnight, without its producing hemorrhage. 
I then again cleansed out the wound in the chest, and applied 
the unguent, tereb., and watched her minutely until she had eaten 
a sieve full of hay chaff'. 
I ordered her head to be tied up, to prevent congestion of 
blood in the brain. This precaution was proved to be necessary, 
for the head, on the left side, began to swell exceedingly, and in 
the space of two or three hours the bifurcation of the jugular 
vein on the near side, and the submaxillary and facial veins, 
became distended almost to bursting; and all the veins on the 
near side felt as hard and unyielding as they possibly could feel. 
I quite expected the ligature would give way from the immense 
pressure of blood. 
I ordered her head to be well fomented wath warm water 
several times in the day. This had the effect of reducing the 
swelling, for in the space of a few hours it became greatly 
diminished. I considered it necessary to give her mild tonic 
and diuretic medicine for several successive days. 
Oct. 12f//.—The mare appeared more lively, and had eaten 
as well as when in health. iS'o more blood escaped from the 
