FISTULA. 
535 
five inches long - , extended from the common outlet, downward, 
forward and to the right, passing through the complexus 
magnus and splenius, and terminated between the cervical 
trapezius. Fourth, ten inches long, extended from the outlet, 
downward, forward and toward the left and terminated be¬ 
neath the cuticularis colli. The treatment of this case was 
quite simple. Sinuses 3 and 4 were given inferior drainage 
by very large incisions at the lowest point. Sinuses 1 and 
2 were drained by large setons passed from similar points to 
the surface in a downward direction. These sinuses were 
washed out daily with 1-3000 bichloride solution. The se¬ 
tons were left in place two weeks and daily moved up and 
down. Each week the patient was brought to town for ex¬ 
amination and treatment. The treatment usually consisted of 
a thorough flushing with cold water, after which each sinus 
received a small injection of a mild, white ligament. August 
10th an examination showed a sound horse, and there has 
been no recurrence during the three and a half years. The 
outlet and both drainage incisions were reopened by the 
knife every two or three weeks Criticism : (a) Later ex¬ 
perience has taught me that quicker results would have been 
obtained with less washing and irrigation, {b) The setons 
should have been left in place at least a month, {c) I should 
have insisted in having the horse under daily observation. 
Case D, iron gray filly, two years old, never had a collar 
on, sheds and doors all high, running in a woodland pasture 
with case C. Examination August 20th, 1890, showed merely 
a large hygroma on left side, two inches in front of cervical 
angle or scapula. Contents thin, serum-like fluid without 
offensive odor; free incisions were made above and below; 
the cavity cleansed and packed with bichloride cotton. Some¬ 
where at this point I made an error, for the case was on hand 
uncured all fall and winter. There was either an early-devel¬ 
oped and undiscovered sinus down beside the cervical lam¬ 
ina, or a piece of cotton was left in the large cavity. In this 
case I expected a rapid recovery, and gave very little treat¬ 
ment during the fall; was away from my practice all winter, 
and on my return in April found case D had developed into 
