mulation of food and saliva in the alveolar cavity. Some oesophageal
fistulae are obstinate and require surgical interference. As to the recto-
vaginal and the vesico-vaginal fistulas, attempts sofar made with animals
to bring about cicatrization have only proved unsuccessful.

There are fistulae of excretory canals which naturally have a ten-
dency towards cicatrization : those of the perineum after urethrotomy,
for instance. But almost all of them require a special treatment.
There are three principal methods to be used : i. Restore the normal
course of the flow ; 2. Create an artificial one ; 3. Dry its source.

If the fistula is recent, one may resort to the first method ; applica-
tion on the fistulous orifice of a closing bandage, vesicating frictions,
light and repeated cauterization of its edges, dilatation of the canal by
injections or by repeated uses of the sounds and the like. Occlusion,
vesication, and suture have often been used for recent salivary or urethral
fistulae. The second method is applicable only to a small number of
cases ; it is especially advised for a fistula of steno duct, open on the
cheek. To make a new way and dry the cutaneous fistula, the deep'
layers of the cheek, including the buccal membrane, are perforated on
a level with the wound, which is then closed by suture or a pitch plaster ;
the saliva escapes then into the mouth and transforms the newly-made
tract into a fistula. Success is still more certain if the new tract is.
drained while the old one is obliterated. The last method brings on
recovery in cases of fistula by producing the atrophy of the gland. For
certain salivary fistulae, irritating injections made in the parotid gland
and the ligature of the excretory duct have been successfully employed..

Purulent, stercoral, and vesical fistulae are quickly followed by-
erythema of the parts soiled by the substances escaping from them..
In their neighborhood, the skin ought to be washed several times a
day with a weak, tepid, antiseptic solution, and covered with boricated
vaseline or glycerine.

For some subjects, it may be useful to institute an appropriate general
treatment. Good food and tonics are always advantageous for debilitated
animals, weakened by an abundant suppuration of long standing.
For certain fistulas of the dog, an internal medication is advised (Fowler
solution, Cod Liver Oil).

VI.

FOREIGN BODIES.

Among the foreign bodies to be found in animals, some are formed'
in the organism under the influence of morbid processes (splinters,,
sequestra, calculi, pedunculated tumors of the peritoneum), but most
of them have come from outside, having penetrated the organism either



FOREIGN BODIES. 121

through natural passages or through the skin or a mucous membrane.
The last are those which we shall specially consider.

The phenomena produced by foreign bodies vary considerably
according to the degree of tolerance of the tissues with which they are in
contact, and especially according to their more or less irritating
properties, and their septic or aseptic constitution.

The digestive canal is the principal way for the introduction of
foreign bodies, and its mucous membrane is one of the most hospitable.
Among the substances which enter the mouth, some stay in it, implant
themselves on the gums, the cheeks, or the tongue, and give rise to
abscesses (Huchne, Dehaye). Others perforate the walls of that cavity :
in an abscess of the hollow of the right eye, Lapousse'e found a mass of
beards of wheat ; in a similar spot, Klintmann saw small pieces of straw.
The nervous centers have sometimes been reached by those emigrating
substances which run through the walls of the mouth and of the
pharynx : at the post mortem examination of a horse, Rodez and
Kenard found the cranium perforated by a stalk of grass ; in a pig,
Durrechou observed an intra-cranial abscess caused by a needle ; at the
autopsy of a dog having died from meningo-encephalitis, we have seen,,
with the lesions of that disease, a deep, suppurative otitis due to a
metallic piece, which, after perforating the soft palate, had entered the
Eustachian tube. Larvce of cestre' can produce similar disorders.
(Megnin).

Most foreign bodies introduced into the mouth pass into the pha-
rynx and the oesophagus ; sometimes they remain there : Me'tivet
treated a horse whose throat was closed by a piece of wood ; the
cesophageal obstruction of cattle is well known. Some of these bodies
drop into the trachea (Degive, Bournay). Those which reach the
stomach have varied fortune. They may remain there without producing
visible trouble : this fact, very ordinary in ruminants, is known in all
species of animals : at the post mortem examination of a mare which
had died suddenly, Garde found in the stomach seventy-five little stones
weighing altogether 4 kilogrammes (8 pounds) ; Nichoux found in a dog
a five-franc piece and one two-cent piece, which had remained in the
stomach twelve years without apparent trouble to the dog; in an
animal of the same species, we found two tops which had been in the
stomach eleven months. Some of these bodies give rise to dyspeptic
symptoms: in ruminants, to meteorizations ; in dogs, vomiting followed
by anorexia and loss of flesh. Ordinarily the dog succeeds in throwing
up the foreign body accidentally swallowed. Weber has related the
case of a dog thus rendering one morning " a gold piece of twenty
francs and two silver fifty centimes." When the substance swallowed
is not too big, it may pass through the pylorus, travel through the
intestines and be eliminated : the horse of our Belgian confrere Andre,



122 VETERINARY SURGICAL THERAPEUTICS.

passed a curb-chain which he had swallowed ; the dog of which a report
was made by Leblanc, passed a stone of large dimensions ; that of
INIathis, after violent fits of colic expelled " the cork of a champagne
bottle.'' When the dimensions are too great, the foreign body is
arrested, and may give rise to rabid symptoms ; the phenomena,
however, of deep depression generally predominate. If the body
become encysted, it soon produces severe inflammation and sphacel of
the intestinal walls, if it is not removed by laparotomy. (Noirit,
Felizet, Degive, Frohner).*

Sharp bodies, when introduced into the digestive canal, end by
implanting themselves in its walls and pass through them more or less
rapidly. Passing through the oesophagus, they may injure the anterior
aorta (Olivier) or the posterior (Daigney), give rise to an aneurism
(Olivier), or to a fatal hemorrhage. In ruminants, they pass through
the rumen or the reticulum, and, according to the direction they take,
reach the liver, the spleen, the abdominal walls, the diaphragm, heart,
lungs, muscles of the shoulder or of the arm, the vertebral column, and
even the spinal cord. A foreign body is the common cause of traumatic
pericarditis of cattle. Guillaumin, Robinson, Aubry, Mottet, Lanusse,
Berger, Bru, Morot, Lucet have recorded abscesses of the thorax or of
the abdomen, due to the presence of foreign bodies which have been
swallowed. The cow which served Mottet for a subject of observation
swallowed two long needles ; the eighteenth day, the point of one
appeared under the skin of the middle of the right flank ; a week later,
the other showed itself near the last left rib ; the animal seemed scarcely
disturbed by them and the wounds healed rapidly. Rupture of the
intestine (Clerc and Jacotin), abscesses of the omentum (Salle), or of
the liver (Thierry), and peritonitis, also represent possible complications
of foreign bodies passing through the digestive canal. An autopsy of a
horse, made by Salle, revealed an epiploic tumor ; and in the center was
a cavity filled with pus, in which floated a "string 25 centimeters
long."

The 7'aginal mucous membrane possesses a certain amount of tolerance ;
the mucous membranes of the uterus, bladder and urethra are more
irritable ; metallic substances, however, introduced into the uterus to
overcome nymphomany (filoire) are perfectly supported. As to the
ocular and respiratory mucous membranes, they always react strongly

* From records of the Hospital Department of the American Veterinary College,
Drs. Huehne, and Morrison report the case of a dog in which the foreign body was
imbedded into the pyloric opening of the stomach. It consisted of a ball of brown
paper tightly rolled. (Americ. Veter. Review. Vol. 13 — p. 175). (T)

At X\ie. post mortem examination of a cat that had been ailing for some time without
manifest symptoms, a piece of the cob of an ear of corn was found imbedded into
the pyloric opening of the stomach by the translator.



FOREIGN BODIES. 1 23

against irritating contacts. At \\\q, post mortem examination of a dog
affected with severe wheezing, and short and repeated coughs,
Bournay found under the vocal cords "a small, oval, flattened piece of
gravel, which completely closed the trachea."

Cellular, fibrous, muscular, and glandular tissues react little against
the contact of foreign aseptic bodies. Frequently shots, bullets and
ether bodies of some size produce only the phenomena of encystment.
Projectiles of small caliber may thus remain in the tissues for years with-
out producing any trouble ; then again they may give rise to accidents
after remaining innocuous for some time. A ball encysted in the hand
of the man wounded at Waterloo, mentioned by Harland, after fifty-
nine years of perfect tolerance, gave rise to disorders (Terrier). In-
fected inorganic substances (wood, leather, etc.) ordinarily bring on
severe inflammation.

Bones will stand metallic substances of small size without perceptible
reaction. Encystment, however, is more commonly observed in long
than in flat or short bones ; and in the former, more in the epiphysis
than in the diaphysis. When there are other bodies than projectiles
or metallic points, then often the bone becomes inflamed, suppurates,
and serious consequences are to be feared.

The disturbances produced in viscera by foreign bodies depend also
on the properties of the bodies and the degree of irritability of these
organs. If certain regions of the brain (hemispheres, white commis-
sural portions) are remarkable for their tolerance, in general the ence-
phalon, the marrow, and the nerves do not support the contact of
foreign bodies. The patients of Renard and of Durrechou died from
a cerebral abscess. Encystment is possible in the spleen and the liver ;
it is quite frequent in the lung, where, as in all viscera, one may, how-
ever, observe primitive or secondary accidents very serious.

Serous membranes possess a remarkable tolerance towards bodies
formed spontaneously in their cavity (intra-articular movable bodies,
pedunculated tumors of the peritoneum) ; they support equally well the
contact of aseptic foreign bodies, but they are extremely susceptible to
those that are soiled, and more or less septic ; and the action of the
latter invariably gives rise to an inflammation rapidly generalized.
Although the peritoneum may ordinarily be run through by free needles
without accident, it becomes the seat of an infectious diffused phlegmasia
in contact with a needle carrying a soiled thread. There is the same
order of phenomena and the same differences for wounding bodies
(septic or aseptic) which, after divisions of the abdominal or tlioracic
walls, reach the peritoneum or the pleura. Kolb has found in the right
ventricle of the heart of a cow, a lancet blade three and a half centime-
ters long by two in width, which had become loose during a bleeding
of the jugular and had been carried away by the current of the blood.



124 VETERINARY SURGICAL THERAPEUTICS.

This blade had remained in the heart without giving rise to the slightest
trouble. Articular or tendinous synovial membranes behave like the
serous membranes of splanchnic cavities.

The tolerance of the media of the eye is also especially related to the
aseptic or infecting condition of the body which has penetrated them ;
the iris, vitreous humor, and the retina, however, are more susceptible
than the crystalline lens and the serous membrane of the anterior
chamber.

In the foot of the horse, foreign bodies produce, almost always
rapidly, serious troubles, on account of the complex structure of that
organ, of the ordinarily infectious character of the traumatism, and of
the compression to which the injured parts are submitted.

Animate foreign bodies produce very different effects, according to the
species, the number, their properties and the tissues upon which they are
fixed. How many intermediate degrees can be observed between the
weak reaction of the stomachal mucous membrane of the horse from
cestri, and the intolerance of the nervous centers towards the parasites
which are carried to them by the blood.

To liquid foreign bodies the susceptibility of the organs is no less
variable. No serious troubles result, ordinarily, from the introduction
of serosity poured into closed traumatic lesions. Liquids, aseptic and
not toxic, injected under the skin, into muscles, serous membranes or
blood-vessels, are also well supported. But the tissues are very suscep-
tible to the contact of some organic liquids obtained from their natural
canals (urine, bile, saliva). The escape of bile, or of urine, into the
peritoneum is often fatal. Medicamental solutions injected without
sufficient aseptic care, ordinarily bring on suppuration or other infec^
tious accidents. The contents of hydatic cysts and of all morbid secre-
tions, generally speaking, are badly tolerated.

Gases, considered as foreign bodies, offer little interest. All are
harmless, except those that possess toxic properties, and are tolerated
by the tissues without trouble. The benignity of traumatic emphysema,
even when it is more or less generalized, is well known. Phenomena
of intolerance are observed only when gases hold infectious agents in
suspension.

The therapeutics of foreign bodies presents very different require-
ments, according to their nature, their size and their aseptic or infectious-
state. The preceding considerations show the relative innocuity of
metallic bodies compared with organic substances, and the remarkable
tolerance of the tissues for the former, when they are small and aseptic.
The organism does not try to get rid of them ; it only defends itself
against contact with them ; it isolates them with a circular neoformation
resulting in an encysting membrane. No immediate interference is
necessary for those, unless they are so nearly on the surface that theic



FOREIGN BODIES. I25

extraction offers no serious difficulty. Leave the work of encystment
and watch the progress of the changes. It is in conformity to this rule,
that little projectiles and other metallic bodies are left in the tissues.
Penetrating wounds should not be explored with dirty instruments or
fingers. Cut the hair round the traumatism, disinfect it with free an-
tiseptic irrigation, cover it with iodoform, collodion, and, if possible,
with a wadding dressing. Such are the regulations to follow. Extrac-
tion is advised only for projectiles immediately under the surface of the-
skin, and requiring only slight incision. If the foreign bodies are pro-
truding from the surface of the skin, they must be removed immediately
with all necessary care, and the wound must be treated like those result-
ing from punctures. (See GuJi Shot Wounds zwA Wounds h^^^ Pricking In-
struments. )

More or less soiled foreign bodies, introduced into any region and
situated superficially, are extracted with forceps after the disinfection
and division of the tract which they have made. The interference is
the same for similar bodies lodged deeply in a muscular region — neck,
shoulder, croup, or thigh — where only important blood-vessels and
nerves are to be avoided. Abscesses produced by foreign bodies which
have run through the mucous membrane of the mouth, pharynx, oeso-
phagus, stomach, or intestines, and have migrated into the tissues, do
require special attention. Whether situated on the head, neck, thorax,
or abdomen, as soon as fluctuation is manifest, they must be punctured,
the injuring body extracted, and antiseptics applied. For those which
appear on the thoracic or abdominal walls, the diagnosis is sometimes
difficult.

Generally, the cicatrization of the tract made by the foreign body
takes place quickly. It may, however, leave a fistula. After extract-
ing a pair of scissors from an abdomina powders (those of coal, coal-tar,
camphor, tannin, alone or mixed with iodoform). But until these
wounds are entirely covered with a coat of granulations, infectious com-
plications are to be feared. The surest way to prevent them is to make
a free use of microbicide solutions.

II.

WOUNDS FROM PRICKING OBJECTS. (PUNCTURED

WOUNDS).

The gravity of these depends especially upon the tissues or organs
that are involved, and upon the size, form, and aseptic or infected state
of the injuring object. Pricking bodies with sharp points, fine and
smooth edges, penetrate while separating the anatomical elements,
which are destroyed in small number only, and the phenomena fol-
lowing are simple. The innocuity of exploring punctures made with
trocars or needles of small dimension is well known, there is a like
simplicity of phenomena following subcutaneous operation, wounds
which have decided analogies with pricks from two points of view — the
way they occur, and their character and mode of repair. Let us recall
again to memory the cases where people have implanted a number of
needles deeply in certain regions, without any accident following. It
is also known that needles, unthreaded, which are swallowed, can pass
through the walls of the digestive tube and travel through viscera with-
out doing any serious mischief ; in dogs and cats, it is not rare to find
encysted in viscera or in the tissues, needles whose presence was never
suspected on account of the absence of all pathological manifestations.
It is very different when the needle carries a thread, since it bears with
it infectious elements which give rise to septic complications.

If larger points, conical or prismatic, enter also the tissues and
separate their elements, they compress them more, and easily lacerate
them. Bodies with blunt or ragged points, those whose edges are
rough, bruise and lacerate the organs, and make a lesion with contused
walls and an irritated zone which may afterwards mortify. The wound-
ing agent may open a vein, an artery, a synovial sac, or one of the
great serous membranes, and may break into the tissues. Often it is
soiled and loaded with pblogogenous or septic germs, so much the more
serious as the tissues are more delicate. Infected pricks of aponeuroses,
ligaments, tendons or bones, ordinarily, are followed by limited necrosis



WOUNDS FROM PRICKING OBJECTS. 1 33

of those organs. Penetrating wounds of tendinous sheaths, of articular
synovial sacs, or of splanchnic cavities, are, ordinarily, accompanied
with diffused inflammation of those membranes. Complications of
tetanus and of septicaemia are likely to be fatal where the agents of
these serious infections are deposited in the punctures (wounds with
stable forks, with the tooth of a harrow, or with a nail).

Wounds from prickings when free from infection heal rapidly.
Immediately after the extraction of the wounding object, the sepa-
rated tissues return close to each other. The narrow solution of con-
tinuity is soon filled with plastic lymph, with leucocytes, and with pro-
liferating elements, and cicatrization is a matter of a few days. All
that is required is to assist the repairing process. Clip the hairs all
round the prick, disinfect the tegument and the edges of the wound,
close it with iodoform collodion ; such are the rules to be observed. The
same treatment should be used for pricks made with points of larger
dimensions, which contuse and bruise a thin layer of the tissues pierced,
but do not carry with them infectious elements. Rapid occlusion is
especially important with penetrating wounds which open an articular
serous membrane, the pleura, or the peritoneum. The old treatment,
■which consisted in finding out, by probing, the depth and direction of
those wounds, to enlarge them or enlarge their sides, is now condemned.
To wait for developments is the rule, even when the wounding object
has been broken and has left its point in the tissues: if it is aseptic,
only a light reaction will follow, and it will become encysted. Exam-
ples are common of pricks, which look serious at first, but heal with-
out complications. The same is true of the numerous penetrating
wounds of a horse's foot, although made by soiled substances, which,
however, in piercing the hoof, have been relieved of the impurities de-
posited on their surface.

Infected punctures are not slow to give rise to acute pains accom-
panied with great tumefaction of the wounded region. These manifes-
tations are treated with antiphlogistics, continued irrigations, especially
with antiseptic baths or nebulizations. If the lesion is on the extremity
of a leg, one will have recourse to repeated immersions in a carbolic
acid, a cresyl or a luke-warm corrosive sublimate solution. Some-
times the inflammatory manifestations subside, at others they remain
or increase, pain becomes excessive, and tumefaction diffuse ; then,
most commonly, either pus collects at the bottom of the wound, or tlie
inflamed tissues are compressed by an aponeurosis, or an irritating
foreign body remains there implanted. At this point one should inter-
fere at once. Without loss of time the first puncture should be freely
enlarged, in order to allow the pus to escape, if there is any, the
phlogosed tissues should be relieved, and the irrigations or the antisep-
tic baths should be continued. The enlarging: of the wound assists the



134 VETERINARY SURGICAL THERAPEUTICS.

resolution of the inflammatory process, and allows the elimination of
the foreign body which may have been retained. Even w'hen the
jDhlegmatic phenomena are intense, it is better to wait for this spon-
taneous elimination than to make with probes and forceps attempts and
explorations which are always very painful and without real usefulness.

In small animals, wounds are often observed which were made by
curved pricking objects (hooks of any kind) still implanted in the tis-
sues. These objects must be removed by enlarging the opening of
their entrance, or by pushing them through the tissues and extracting
them by their points.

Some voluminous pricking bodies produce deep wounds, with bruised
borders, which suppurate abundantly after a few days. These lesions
must be treated like contused wounds.

In exceptional cases, punctures may injure an artery and give rise to
abundant hemorrhage. This requires plugging and sometimes the en-
larging of the wound for the application of a ligature on the blood-
vessel.

III.

CONTUSED WOUNDS.

These, very unlike in their external aspect, extent, and depth, include-
numerous varieties, representing all the possible intermediate stages be-
tween simple excoriation and the most serious traumatisms with attri-
tion of the different tissues of a region and the bone which forms its
base. Most of them are extensive, badly defined, with thick ischsemic
surrounding, infiltrated with blood and threatened with slough.

From the therapeutic point of view, we will arrange them in three
classes : i. Superficial, having excoriation for type ; 2. Deep, with ischae-
miated zone of slight thickness ; 3. Deep, with wide contused zone,
bruised and doomed to have gangrene.

Superficial contused wounds heal quickly, almost always without
accidents of any kind. It is sufficient to cut the hair surrounding them,
disinfect them, and cover them with a coat of collodion or of powder of
pulverized coal, or tannin alone or mixed with iodoform (3 to 5 parts
to J.) Sometimes, though superficial, they are painful ; the animals
try all the time to rub it or bite it; opiated ointment or cocaine vase-
line may be of advantage in such cases. In some regions, especially
the legs, a strict disinfection and an antiseptic dressing will, very often^
bring on recovery without noticeable suppuration.

In deep contused wounds, whose inflamed zone is comparatively
limited, quick cicatrization, without slough, is possible. They must be
carefully washed, cleaned of all foreign bodies which may be deposited
upon them, and purified with a disinfecting solution (corrosive subli-



CONTUSED WOUNDS. 1 35

mate, carbolic acid, creolin, chloride of zinc, or permanganate of