leaving in their stead little rosy cicatrices. The swelling of the
region lasts sometimes very long ; exercise and massage accelerate
its decrease. The hair grows quickly and covers almost entirely the
hairless spots of the cauterization. This is one of the great advan-
tages of the method.
Whatever is the degree of firing or the mode used, a certain length
of time for rest must be allowed to the animal operated upon.
Generally after 8 or lodays it may resume exercise, walking daily for
20 or 30 minutes. A week or two later, it can resume work. A
longer rest is advantageous, however, for tendinous lesions, some
forms of spavin and other affections.
Accidents of firing are common. The straight cautery may cut
through the skin and give rise to a great separation between the
lips of the line ; capillary hemorrhages and excoriations of the skin
Fig. 44. â€” Subcutaneous cauterizing. (Lanzillotti Buonsanti.)
are not uncommon. These are easily avoided by careful attention
to the technic of the operation.
JNIore serious are the sloughs of skin and defective cicatrization,
which are the results of excessive cauterization. When firing is
followed by very severe inflammation, so that sloughing is threatened,
care must be immedi-
ately taken to prevent
it. A fine cold spray,
repeated often, is one of
the best methods to
use ; it cleans the region
and removes the irrita-
ting exudation, which
increases the inflam-
Astringent lotions and
lotion, alum water) have
their advocates. Tepid
antiseptic irrigation, the
use of powders of io-
doform, alone or mixed
with tannin, are preferable. Nocard gives preference to atomization
of iodoform ether : " They stop the itching and prevent the microbic
infection of the wounds." Let us also mention, but proscribe
entirely, the practice which some have of applying a blistering
preparation to the inflamed surface. Hemorrhages following the
puncture of a vein or artery with the heated needle are not danger-
ous ; they stop of themselves, by pressure or the introduction of a
small hemostatic, a piece of cotton. Other lesions, such as tendinous
or cartilaginous quittors, arthritis, and synovitis, we have already
shown how they are to be avoided.
Subcutaneous cauterization, recommended for a long standing
lameness of the shoulder or of the hip, has two principal steps.
1. Incisio?i a?id detachf?ient. â€” After the hair has been shaved over
the region to be operated upon, a vertical incision is made, 8 or 10
centimeters long. Both cutaneous edges are loosened from the
tissues underneath for a certain distance, and then separated from
each other with spreaders, after being covered, for protection, with
a wet cloth.
2. Application of firing. Upon the exposed parts, a certain number
of points, superficial, or more or less deep, is applied, following the
same rules as for ordinary modes of cauterization. For a superficial
92 VETERINARY SURGICAL THERAPEUTICS.
firing, 5 or 6 applications of the points are sufficient. With the
special buttoned cautery (fig. 45), Lanzilloti Buonsanti scarifies
a thiri layer of tissue.
Brambilia makes sev-
eral small incisions
through the skin and,
in each of them, applies
a firing point.
The care afterwards
is that required by all
Fig. 45. â€” Bead firing irons. (Lanzillotti Buonsanti.) Sunnuntino- SlirflCPS
Generally only a linear mark is left after the operation. At times,
however, there is an irregular callous cicatrix. (Peuch. )
CAUTERIZATION OF BOVINES.
Firing is used less for those animals than for horses. But the good
results that may be obtained have been made familiar by the writ-
ings of Cruzel, Roche-Lubin, Festal and Lafosse.
The technique differs little from that followed for horses. The
skin, thick and "rich in serosity," can longer endure without ac-
cidents the application of the cautery. But the thickness of the
dermis is very different according to the region ; it varies in the
proportion of one to four. From this point of view, Bouley had
made a progressive scale of the principal regions upon which opera-
tions are generally performed : ist, Degree, Inguinal region ;
2d, internal face of the hock, canon, and posterior face of the knee ;
3d, point of the shoulder, and outside of the stifle ; 4th, external
face of the hocks, fetlock, and coronets ; 5th, front, back, and
loins; 6th, hip joint ; 7th, anterior face of the knee.
Lafosse says : " It is necessary to submit the steer, before the
operation, to a strict diet of at least 12 hours, and to be sure that his
rumination was perfect before his last meal, so as to avoid tympani-
tis, which even then may take place, although these precautions
have been taken â€” especially when the firing is to last some time."
These precautions are not necessary when the animal is operated
upon standing ^ip. As p. general thing, all that is required is to
place him in stocks or under the yoke ; he is seldom thrown down.
The hair is cut short upon the region. It is better to use instru-
ments of which the point or cutting part does not widen out too
rapidly ; for, as the cautery goes deeper, it would generally leave
large external wounds.
For superficial lined or dotted firing, the rules followed with horses
are applicable to cattle, increasing one-third the number of applica-
tions of the instrument ; of course, taking note of the region where
the operation is performed. The signs of the three degrees of cau-
terization remain the same. One must bear in mind, however, that
' ' seldom are the eschars thrown off by suppuration ; when they drop,
cicatrization is already complete underneath, and the hair growing. "
(Lafosse. ) Since animals may do some mischief with their tongues,
some precaution should be taken to prevent this.
Deep and needle firing also give excellent results in the case of
Faulon prefers the simple top-shaped cautery to that of Bourguet,
though this or the Zoocautery work well. With one stroke, the
needle, heated to a clear red, is pushed to a depth of 2 centimeters
and a half, and may be inserted eight or ten times in each perfora-
tion, when the firing is done for tendinous or bony lesions. One
stroke is sufificient for synovial.
After the firing, Faulon recommends the application of the oint-
ment of iodide of lead with free iodine, made of:
Iodide of Lead lo gram mes
Iodine 2 do
Lard 30 do
In synovial dilatations, tendinous or articular swellings, especially
if the firing has been light, he paints the region with one of the
Laurel Oil 30 grammes
Croton Oil o gram 05
Oil of Turpentine )_,
Laurel Oil ) *^
During the first days, the patients are kept in the barn, on clean
bedding ; the crusts and scabs fall off from the loth to the 15th day ;
the eschar after 20 or 25 days.
Cauterization is little used in the treatment of small domestic
animals. Firing, however, might be efficacious for bony and artic-
ular lesions and paralysis met with in dogs ; but often its action is-
imperfect against chronic articular diseases, especially the dry
femoro-tibio-patellar arthritis so common among those animals.
Superficial firing has given, according to some authors, recovery
from lamenesses due to exostosis. Superficial points or lines are
applied with light instruments. Four to six applications are suffi-
cient. We use for our patients the penetrating needle of the Zoo-
cautery, and for bones, tendons, or synovial membranes we make
but one stroke. We place a wadded dressing over the part with a
protective bandage. The muzzle has often to be put on.
DISEASES COMMON TO ALL TISSUES.
INFLAMMATIONSâ€” GANGRENEâ€” FOREIGN BODIES
Whatever conception one may have of inflammation, â€” so varied may
be its forms and causes, â€” it has never ceased to be a process that is met
with in many of the very frequent diseases ; and as it is yet " the
principal phenomenon of pathology," as in the past, it is proper to con-
sider the general precepts for successfully overcoming it.
The removal of the cause or the attenuation of its effects is the first
thing to be considered in all cases of phlegmasia. If the inflammation
is due to a foreign body implanted in the tissues, it should be extracted
as soon as possible ; if mechanical irritations keep it up â€” the collar in
the case of a dog, the harness in the case of draught animals, the shoe
in some lesions of the foot â€” they must be removed ; and again, if, as
observed in some skin diseases (eczema), or those of other tissues
(rheumatism), the inflammation is due to a dyscrasical or infectious
cause, an internal treatment must be instituted.
Another precaution, which should be taken in all cases of inflammation
in the beginning, is to insure the immobilization of the diseased part,
and to keep it in a state of rest as complete as possible.
Aseptic traumatk inflammations may be seen with various degrees of
intensity, but they are seldom violent, and they naturally have a ten-
dency towards resolution. Even the most severe do not resist for any
length of time a well directed treatment. In their first stage, they are
ordinarily treated with cold applications, with which one tries to control
them, to moderate the congestive tendency, and to prevent the intersti-
tial hemorrhages. Cold (water, ice, snow) produces a constriction of
the tissues, a contraction of the blood vessels, and diminishes the hyper-
a^mia of the inflamed parts ; under its influence, the heat, swelling and
redness diminish. But its application must be long or continuous : if
it is often interrupted, a reaction will follow the ease temporarily pro-
98 VETERINARY SURGICAL THERAPEUTICS.
duced, and the benefit of the treatment will be lost. It is especially
true in a limited phlegmasia that refrigerants are useful. Where cold
water is applied in afifusions or fomentations often repeated, or by long
immersions or continued irrigation, its action is almost always benefi-
cial, and in many cases will be sufficient for simple phlegmasia. Cool-
ing mixtures, much used in days past, are now abandoned, as is also
refrigeration obtained with atomized liquids (ether).
The experiments of Bayer have proved that irrigation and col'd bath;^.
are superior to all other modes. The mud of clay, with addition ot
common salt and vinegar, is irritating to the skin ; it may produce
cracked sores, especially on the side of the fiexion of joints.
Against some inflammations, astringent solutions are still much used
(alum, metallic sulphate, salts of lead, and a mixture of alum and lead).
Cold and astringents are not advised for any external inflammatory
affection in any stage. Not only are they useless in infectious phleg-
masia, but they may be injurious when there exist in the affected region
extensive disorders, when numerous vascular currents are obliterated,
and when tissues, bruised and ischaemated, seem threatened with
To assist the return of the circulation and stimulate the nutrition of
these tissues, other means are necessary, among which damp heat
comes in the first rank. Warm water (40-50 deg. C ) renders greatest
service in the treatment of external phlegmasia, especially when
situated in the inferior regions of the extremities. Warm affusions,
damp compresses, especially balneation, have a most favorable action
in the generality of cases where phlegmasia is recent, particularly when
the tension of the tissues is severe and the pain acute : the inflammatory
phenomena become circumscribed and diminish, the swelling and the
pain subside. When these are excessive, it is advantageous to bring
into action, upon the inflamed tissues, narcotic or analgesical sub-
stances. The ointments of the old pharmacopia should be ignored ta
give preference to the preparations with base of vaseline : vaseline, 100-
grammes ; cocaine, 2 grammes ; or, vaseline, 100 grammes ; boric acid,
to; antipyrine, 10; iodoform, 2. (Reclus.)
Subcutaneous or submucous tissues, when inflamed, become phleg-
monous, even when the surrounding tegument shows no apparent
interruption of the continuity. Warm water is again very advantage-
ous to conjure this complication.' It softens fatty matter dried on the
surface of the skin, loosens it, and produces a sligh*- antiseptic effect.
Irritants â€” revulsive or vesicatory agents â€” are at times used when one
wishes to accelerate a process or to substitute an artificial for a morbid
phlegmasia. It is thus that the reactionary inflammation is excited in
*' stickfasts," " scabs" of the skin, by the applications on their borders-
of a vesicating preparation ; it is also in this way that beneficial inter-
ference is obtained against some eczeniatous dermatitis by sliglit
cauterization of the diseased surfaces with solution of nitrate of silver or
nitric acid. At times, when the tissues are much swollen, scarifications
are useful ; blood and serosity escape from them, the tension of the
inflamed parts is diminished, the pain reduced ; but the objection to
them is that they expose the tissues to infection, if they are not made
aseptically, and the region covered afterwards with an antiseptic dressing
or damp compresses. Deep scarifications may bring on cartilaginous
quittor in cases of acute inflammation of the skin of the coronet, or dis-
ease of the withers or of the poll, if the phlegmasia exists in these
re-gions ; in both cases the complication exists on account of an inocu-
lation produced during or after the operation.
Almost all acute surgical phlogoses are infectious, brought on by
micro-organi'sms. Prophylaxy, for such as can be cured, is said in two
words : asepsis for the wou-nds of operations and antisepsis for acci-
dental wounds. As soon as a microbic phlegmasia exists, the agents
which have given rise to it must be destroyed by an antiseptic treatment,
or their pullulation must be arrested. One method consists in ap-
plying to the inflamed parts frequent warm lotions of corrosive subli-
mate, carbolic acid, or creolin solution : they are especially useful in
inflammatory diseases of the skin and of mucous membranes, as there
is danger of the extension of the process to the subcutaneous connective
layer. This treatment cleans off the surfaces, renders them aseptic and
protects them against complications.
When the region permits it, the application of compresses, dipped in
the same solutions and often changed, is to be resorted to. If poultices
are to be used, they must be prepared with phenic or creolin>ed water.
Continued immersions or baths in a warm antiseptic solution are most
useful, and in the case of small animals nothing is easier. They can be
used for large animals when the inflammation is located in the foot or
in the lower part of a leg : a large basin, tub or pail, resting on a bed
of straw, and containing a weak solution of creolin (2 p. 100), carbolic
acid (2 p. 100), or of corrosive sublimate (i per 1000), answers the
purpose, the diseased part being soaked in it for 20 or 30 minutes.
Warm antiseptic compresses and irrigations or baths give the best results
in the treatment of phlegmasia; of the skin and of the mucous membranes
(vulva, vagina and rectum), in periarticular inflammations, ulcerated
lesions, diphtheritic lesions, and, in general, in all microbic affections.
The liquid, absorbed by the cutaneous pores, penetrates into the tissues
and into the lymphatics, and produces a most remarkable effect : the
swelling diminishes, the pains subside, the tension becomes less, the
phlegmasia is arrested and soon goes away. In numerous cases which
look threatening, where suppuration seems likely to be abundant, recov-
100 VETERINARY SURGICAL THERAPEUTICS.
ery takes place in a few days, and if an abscess is formed, it always has
small dimensions. In cases of lymphangitis of the extremities, so com-
mon among horses where there are wounds of the digital region, this
treatment renders the greatest service. During the intervals between
the baths, the diseased part must be covered with antiseptic compresses.
There are specific inflammations which require a very rapid interfer-
ence and more energetic means, such as the carbuncular and septicaemia
phlegmasia, when they are situated superficially and detected early.
With them, one must resort to the destruction of the inflamed parts, or
make in them deep scarifications or punctures with the hot cautery, and
introduce deeply into the tissues bactericide solutions. (See Anthrax
In inflammation of the subcutaneous tissues â€” connective layers, mus-
cles, tendons, articulations and periarticular structures â€” when the pain
is very slight or has been subdued, compression and massage constitute
an excellent treatment, of which we shall speak later. According to
the place of the diseased region and the degree of intensity of the in-
flammatory phenomena, compression should be made with a wadded
dressing or by the application of bands of flannel or linen, or of the
elastic bandage. When it is likely to be a little severe, as the case may
be with the elastic band, it must be used only at intervals, now and then,
as otherwise cutaneous necrosis by ischsemia might take place. Before
applying a compressive bandage, it is advantageous to submit the en-
gorged part to methodical massage. The technique of massage is simple :
The region is covered with vaseline, and rubbing or pressing is made
upon it with the full hand, or the palmar surface of the thumbs, 'J7iese
pressures, or 'â– ^passes" must always be 'â– 'â– ce7itripetal^^ made in the direc-
tion of the venous and lymphatic canals. In some regions, the extremi-
ties especially, it is necessary, in order not to be hindered by the hair,
to cover the skin with a smooth tissue or a band of parchment. Mas-
sage for five or ten minutes is sufficient. Light pressures are made
first to numb the swollen part, and are gradually increased in force.
These manipulations help the resolution by a mechanism easily under-
stood : the clots of blood of the connective lamella are crushed, the
exudations spread and are distributed into a wider cellular territory ;
the resorption of the sero-sanguineous infiltrations is made active, since
it takes place through more numerous channels.
Chronic inflammations are also treated by compression, massage and
alterative applications, exutories or cauterization. The last is the best
means for obtaining the destruction of indurations following old phleg-
Some chronic inflammations are brought on and kept up by special
parasites. To this group belong actinomycosis and botryomycosis. Up
to late years extirpation was the only treatment of the new formation
due to these mycosic processes. To-day we have recourse to a specific
medication : the administration of iodide of potassium internally, by
the use of tincture of iodine, applied externally by painting or by injec^
tions. (See Actynomycosis and Botryoinycosis.)
For the horse, iodine administered internally and injections of tinc-
ture of iodine, pure or diluted (tincture, 4 ; iodide of potassium, 5 ;
water, 20), have seemed to us to be a good treatment for some purulent
old phlegmasite which do not belong to botryomycosis.
The great diversity of the clinical and anatomical characters presented
by purulent collections admits of the following classification : war7n or
acute and cold or chronic abscesses ; superficial and deep abscesses ; abscesses
by congestion, forming in dependent regions ; general abscesses, develop-
ing in the course of specific diseases (distemper, glanders) ; metastatic
abscesses, appearing secondary to a suppurating lesion, as the result of a
" metastasis " of the pus, and well characterizing pyohaemia ; critical
abscesses, occurring in the course of some internal diseases and coincid-
ing with an improvement in the general condition ; sudden abscesses^
which, in some animals exhausted by age, work, or previous diseases,
appear suddenly, without noticeable local reaction ; uri?iary or stcrcorous
abscesses, which follow the infiltration of urine or of foecal matter in the
substance of the tissues.
With the exception of some organs of obscure vitality (epidermis, hoof,
teeth and cartilages), all tissues may become the seat of abscesses.
These may therefore be seen almost in every part of the organism.
They are frequent in some regions (maxillary space, poll, neck,-withers,
point of the shoulder and inferior partÂ«of the legs), and again rare in
others (abdominal walls, croup, gluteal region and thigh). Venous and
lymphatic abscesses are a great deal more common than arterial.
Muscles and bones are less affected with suppuration than the skin and
connective tissue. Generally, it is in this last that absesses develop : it
is this which offers the greatest facility for pyogenesis.
Suppurative inflammation maybe the result of the effect of numerous
causes, but it is generally due to traumatic action. Some aljscsses,
consequent upon the extension of the inflammation, occur in the
neighborhood of the primitive lesion, or at some distance from it, in the
lymphatic vessels or their collecting glands. Our publications contain
a large number of curious observations about superficial abscesses, due
to foreign bodies which have travelled a distance more or less great,
102 VETERINARY SURGICAL THERAPEUTICS.
through tissues (projectiles, needles, nails and other sharp metallic
bodies swallowed by cattle, etc). The pathogeny of some varieties ot
abscesses (critical or sudden) is yet imperfectly known.
Suppuration does not establish itself Avith the same facility in the
various domestic species ; under the head of "pyogenic aptitude," or
the frequency of abscesses, these species are arranged in the following
order : horses, sheep, swine, dogs, cats and cattle.
Among horses, warm and cold abscesses of every size are very com-
mon. Among cattle, they are undoubtedly less frequent, less rapid in
their development, and ordinarily are surrounded by a thick, hardened
layer ; although among young animals principally acute diffuse abscesses
are also observed. Among dogs, diffused abscesses, " in sheets " (cv^
7iappe), with bloody pus and with copious oedema, are frequent.
The bacteriological researches of the last twenty years, especially those
of Rosenbach, Ogston, Strauss, Roser, Socin and Garre, have shown be-
yond a doubt the microbic origin of surgical suppurations. All phleg-
masias which bring on suppuration are the work of pyogenic microbes.
The staphylococcus albus and aurens, the streptococcus pyogenis, and
that of Schutz (microbe of distemper), are the most frequent. The
yellow staphylococcus of Babes, the citrinus, the foetid hacilhis pyogoiis
of Passet, the pyogenic microbe of Pasteur, bacillus coli, and several
others, whose presence has been detected in the pus of some abscesses,
have a less important part to play. According to Lucet, among cattle,
ordinary abscesses are due to special micro-organisms.
The pyogenic agents penetrate the tissues through the presence of a
wound or the interruption of the continuity of the epithelium or
epidermis ; often, also, they are carried into them by sharp substances.
Suppuration does not unavoidably follow in all cases where the animal
tissues are thus invaded by these microbes. Unless there is additional
help (local ansemia and alterations of anatomical elements), " positive
inoculations " ordinarily require a large number of microbes. Fehleisen
tells us that sometimes one cubic centimeter of a culture of staphy-
lococci or of streptococci is necessary to bring on suppuration. Wat-
son Cheyne estimates that for an abscess in the rabbit â€” an animal
whose "pyogenic aptitude" is well marked â€” 250 millions of cocci are
required to make the tissues react, and Bujwid, in order to reach the
same results, had to inject several millions of staphylococci.
Several authors (Ponfick, Gravitz, de Bary, de Christmas) have sue -
ceeded in bringing on suppuration in subjects from among certain
species of animals by injecting aseptically, under the skin or in the eye,
amicrobic irritating substances (nitrate of silver, mercury, or oil of
turpentine), or sterilized cultures of pyogenic microbes. It has beeru
Tecognized that the products of the secretions of the germs of pus are
themselves phlogogenic and pyogenic. Arloing has observed that the