46 
DEPARTMENT OF SURGERY. 
stitute the operation proper. Each of these steps should be 
completed on first treatment, with the exception of diseased 
bones and shreds of skin. It is frequently advisable to wait 
until the “ line of deinarkation ” is distinct before attempting to 
remove a bony segment, because waiting will obviate the re¬ 
moval of a second piece, which usually exfoliates from a cliis- 
seled or sawed surface. As regards the skin the finest shreds 
should be preserved. The amount of skin that will reproduce 
itself is not large, and as the integument is an important factor 
in determining the size of the cicatrix it must always be consid¬ 
ered poor surgery to thoughtlessly cut it away. And, again, 
shreds of skin carefully sutured will frequently serve as a pro¬ 
tection to the wound for a few days, even if they must be re¬ 
moved later, and frequently such shreds will take on new life 
over a much larger area than was at first expected. 
But aside from these two exceptions—bone and skin—the 
wound should at once be so perfectly “ trimmed ” that a second 
operation'will seldom be necessary. The surgeon who overlooks 
a piece of wood in a punctured wound, a necrosed spine in a 
fistula of the withers, a segment of diseased cartilage in a quit- 
tor, a sequestrum in gnathitis, or even the shreds of a lacer¬ 
ated wound, will soon suffer the consequences of a lost profes¬ 
sional reputation. 
Hcemostasis .—After completing the preceding step the sur¬ 
geon is then confronted with the task of arresting the 
haemorrhage, which may vary from slight capillary oozing to 
the spurting of a large vein or artery. In either case haemo¬ 
stasis is an important factor. If not in actually saving the 
patient’s life, nothing can have more influence in the healing 
of a w T ound. A wound that is filled with blood cannot heal 
with the desired promptness under any circumstances and is 
always a fit field for septic processes. The practical veterinarian 
is, however, too well aware of the difficulties in this connection. 
It is very nice to read about applying torsion or ligating vessels, 
but when the feat is undertaken it is not so easv. The trouble 
is we can seldom find the vessel in the recesses of a wound to 
apply such treatment. The only vessel that can be satisfactor¬ 
ily ligated or twisted is the superficial spurting artery. The 
others located in invisible recesses can not be ligated nor even 
twisted. The moderate, mysterious, venous haemorrhage that 
is just profuse enough to prove annoying and capillary oozing 
can be arrested by patient baling and compression, but when 
such bleeding is profuse no amount of ordinary patient efforts 
