enlarge wounds with incisions or counter-openings.
Generally wounds from bites bleed little. They may, however, be ac-
companied with abundant venous or arterial hemorrhage, which then
necessitates the enlarging of the wound and the application of ligatures.
Latulle treated a horse which, having been bitten (probably by his
mate) on the right side of the neck, near the jugular, had on that point
a ragged wound from which red blood escaped. The jugular and the
carotid had been opened so that ligature was required, (i)
POISONED WOUNDSâ€” VIRULENT WOUNDS.
Whatever may be the causes and the mode of their production,
whether due to the action of a wounding body or a bite, these wounds
are essentially characterized by the deposit, in the injured tissues, of a
deleterious substance â€” poison, venom or virus. What makes thenx
(i) Latulle, Journ. of Milit. Vet. Med. 1S67-6S, p. 413.
144 VETERINARY SURGICAL THERAPEUTICS.
serious, is the introduction of this injurious substance into the traumatic
center ; if, however, the extent and the depth of the lesions are suffi-
cient to influence the accidents that may follow, by opening a more or
less wide entrance to absorption, they have only a secondary impor-
For a long time it was believed that there was a rapid and complete
absorption of the soluble poisons, venoms and virus ; but experiments
have shown that if most of these agents diffuse easily, the absorption
of them is influenced by numerous circumstances, and, during a certain
time, a part remains on the wound, as well as in the superficial layers of
the wounded tissues. Among these agents, there are those which spread
quietly in the tissues, and are absorbed without producing any local
reaction ; others, possessed of very active phlogogenous properties,
â– which gave rise all round the traumas to intense inflammatory mani-
festations ; and also others, caustic in character, which produce the
scarification of a peritraumatic zone more or less extensive.
Poisoned Wounds Proper â€” and under this name we include those in
which are deposited vegetable poisons (alkaloids), mineral (mercurial,
-arsenical, carbolic acid, iodoform) or putrid poisons (ptomaines) â€” carry
with them a requirement of the first importance : immediately and pro-
fusely irrigate the wound with water or an antiseptic solution, thus freeing
it from the toxic matter which has not yet penetrated the surrounding
structures ; remove either by ablation or cauterization (according to the
nature of the case and the toxicity of the substance), the superficial layer
of the trauma or keep soaking the affected part in a tepid antiseptic
bath ; and administer internally an emetic, stimulants or tonics, or
agents with special therapeutic properties (antidotes).
The venomous wounds that we have to treat in France are made by
adders, the viperc aspic and the vipcre pcliade (Kauffmann). The former
is the more dangerous ; its venom often proves fatal to small animals
(dogs, sheep, goats) ; it may kill large animals also, as is recorded in
many instances. The second makes wounds more superficial and less
'dangerous : it frequently, however, causes the death of small animals
when they have not been properly treated. Out of sixty ewes of a
flock, bitten by adders, fourteen died (Roche). Channel (from Bourg)
has recorded that a br6od mare which was bitten on the udder, died
five days afterwards. Krebschmar also treated, without success, a dog
bitten on the lip. Cases of this kind are not rare.
The therapeutics consists: i. In arresting the circulation in the
wounded region, to prevent or to stop the penetration of the venom into
the system. 2. In removing that which may remain in the wound.
3. In contending against local and general accidents.
First, if the region permit it, a ligature should be applied, and tied
somewhat strongly above the wound, to arrest the circulation. An
POISONED WOUNDS. I45
elastic cord is preferable to all others ; if one is not at hand, a tourniquet
may be improvised with a piece of cord or a twisted handkerchief
which is tied and twisted with a piece of stick, a key or the handle of a
pocket knife. This ligature in place, attention should be directed
towards the wound. It should be carefully washed with cold water ;
often it may be enlarged advantageously ; its edges should be compressed
to expel the venom which may be infiltrated in the tissues and which
may be removed with another washing ; if the fang of the adder has
remained in the wound, it must be extracted. Hemorrhage is beneficial ;
the blood washes the wound and removes a certain quantity of the
venom. Suction of the wound might be made without bad results ; the
venom has no toxic action on mucous membranes. This, however, is
seldom used for animals. The local treatment is completed by
cauterization with a strong caustic (chromic, sulphuric, or nitric acid,
chloride of zinc) or with the red hot iron. Light caustics (ammonia,
nitrate of silver) are useless.
If the borders of the wound are already inflamed, the same method
should be pursued ; but it is good, besides, to make scarifications on
the tumefied zone and to introduce into them antiseptic mixtures.
The injections of carbolic acid, 3 p. c. (\\'aadt), 5 p. c. (Billroth), of
solutions of permanganate of potassium i p. c, or of chromic acid
(Kaufmann) may prevent local troubles or diminish them should they
already exist. The numerous specifics recommended here and in
foreign countries have not given what they promised ; it is better to
hold on to those which possess known properties. For general treatment,
one should have recourse to diffuse stimulants (wine, alcohol, ether,
acetate of ammonia). In South America, drinking of alcohol to
drunkenness is considered, for men, an excellent means to prevent
death. Hypodermic injections of strychnine (Muller) have also given
satisfactory results; the ligature or tourniquet should not remain
more than six or eight hours, if one would avoid gangrenous complica-
Venomous wounds of some arachnida (scorpions, tarantula) are
treated in the same way.
For bites of adders or snakes, as for injections, prophylaxis has been
studied. At first it was observed that the organism seems to accustom
itself to the action of the toxic : repeated injections of small doses
seemed to allow it to resist better large doses ; nevertheless, these still
had sufificient power to kill. (Kaufmann, Calmette, Phisalix and
Bertrand) ; later, from this it was found possible to confer on animals
immunity from the venom of snakes. The serum of animals thus
rendered proof against poison is antitoxic.
Stings made by bees^ ivasps, or hornels are accompanied with great
pains and a large diffuse swelling, at times quite extensive ; but in
146 VETERINARY SURGICAL THERAPEUTICS.
general these phenomena do not last long, and are not complicated with
serious accidents, except among small animals, where cases of death
are frequent, Lange tells us that out of seven geese attacked by a
swarm, six died within from seven to ten minutes ; the seventh remained
blind. H. D'Arboval has seen two dogs die from the stings of bees.
Other cases are recorded by Crepin and others. Sanitas treated a horse,
which after being stung by hornets, was taken with severe abdominal
pains. and with epistaxis. The horse whose case is published bySaint-
Cyr had been stung by bees on the head ; the entire lower part of the
face became the seat of a large tumefaction, warm, painful, especially
well marked on the lips, the nostrils, and the eyelids. The difificulty
of respiration due to the swelling of the nose had to be relieved by
When the stings are numerous, even large animals may succumb
rapidly. Guerin de Champneuf reports that a mare and her foal,
attacked by a swarm of bees, died after great sufferings. Herron has
treated a donkey which died under similar circumstances. Horses
have died in ten hours (Albrecht, Funfstiick), in six (Funsftiick), in five
(Clichy, Albrecht), in two (Clichy), in one (Guilleville.)* In xh^ Rccaeil
of 1853, Clichy reported the case of five horses, which, having been
attached to a wall, were attacked by an immense number of bees and
died, â€” two in two hours, the other three within from four to five hours, â€” â–
after having, every one, presented symptoms indicating violent pains
and a super excitation. Guilleville reports that five horses, closed in a
wagon, were killed in one hour by bees. In grave cases, the venomous
substance produces a severe inflammation of the skin and of most of
the mucous membranes, or patches of cutaneous gangrene, hyperaamia,
hemorrhages, oedema of the viscera, especially of the lungs, of the
brain, or of the meninges.
If one were called to help in a case where bees or hornets had attacked
animals and were still attached in large numbers, he must at first attend,
to removing the bees, carefully protecting himself, of course, with gloves,
cap, mask, etc. Since these insects " fear water," the best way to
make them go, is to throw some on their victims. Afterwards, the
treatment calls for simple cold water affusions, or lotions with alkaline,
ammoniacal, narcotic solutions or petroleum. Lang recommends the
following mixture: liq. ammoniae 15 parts; collodion, 5 ; salicylic acid
We shall not advise friction for the purpose of tearing out the stings
*C. Peabody relates the case of a horse, 12 years ago, which died in a little over
six hours. He records also an experiment made with an animal which he had stung-
with a swarm of bees and which he treated successfully by officinal solutions of
potassae internally and hypodermic injections of morphia. (Amer. Vet. Rev. vol. 22,
p. 613). (T).
POISONED WOUNDS. I47
fixed in the skin (Clichy) ; such friction is painful, and does not loosen
liiese slings, since they are protected by the hair ; they can be pulled
away with nippers from the surface where they may be seen. Often
small abscesses form in the places where these were. Where the stings
are numerous the inflammation extensive and manifestations general,
stimulants (alcohol, ether, camphor, coffee) are the most efficacious
agents. If the swelling of the nose, pituitary or laryngeal mucous
membrane renders the respiration difficult and loud, and asphyxia is
threatened, tracheotomy should be performed.
To protect animals against certain winged insects (breeze fly, horse-
fly), which are very troublesome during warm weather, giving pain and
producing swellings on the skin, blankets, or nets, may be used.
Ordinarily, the skin is simply washed with solutions of strong odor
(tobacco, decoctions of walnut leaves, vinegar, cresyl, carbolic acid and
2-3 ^c tar, asafoetida). Inflammatory symptoms are treated by shower-
ing with water or washing with alkaline solutions.
Virulent luoiuids, due to the introduction into injured tissues of a
ferment that grows and multiplies indefinitely, present a gravity which
varies with the malignity of the ferment. Local phenomena and gen-
eral accidents depend exclusively on its properties : quantity is of little
importance, since on account of the faculty of the virus for pullulation,
the weakest doses are ordinarily sufficient to bring about infection.
Bacteriological researches of the last fifteen years have extended the
domain of virulent wounds : to glanders, rabies and anthrax, they have
added tuberculosis, tetanus and septicaemia, not to mention others of
â– less importance. All these infections have a period of incubation,,
which is of variable duration. Sometimes the lips of the wounds are
vapidly overrun by an intense phlegmasia produced by the local action
of the virus (anthrax, septicaemia); sometimes this phlegmasia appears
only after a few days (glanders), in other cases the wound acts as an
ordinary simple one, granulates and cicatrizes, and weeks or months
may pass before the first troubles, due to the infection, are manifested
Experimentation has proved that most virus is rapidly absorbed.
Some local conditions may retard the absorption, but generally tlie
blood that circulates through the wounded region has in a few minutes
retained and carried in its course a sufficient quantity of specific ele-
ments to produce infection. (Renault, Davanie, Rodet). Therefore,
a quick and rapid interference is imperative, if one wishes to prevent
surely the dreadful consequences of virulent inoculations.
As for venomous wounds, one must, when possible, arrest the circu-
lation with a ligature placed above the wound. This should be washed
freely with water, its borders squeezed, the extravasated blood and
the virulent matter which may have penetrated the tissues expelled.
]4^ VETERINARY SURGICAL THERAPEUTICS.
Hemorrhage thus stimulated by the water flow is advantageous ; the
blood oozing out cleans the wound and carries with it the noxious ele-
ments. It is evident that the chances of success depend very much
upon the length of time that has elapsed since the insertion of the
virus, ^^'hea this has had time to spread in the tissues, washing,
squeezing and hemorrhage are no longer to be trusted. The only safe
way â€” and it is sufficient, if the infectious elements are still in the parts
surrounding the wound, if the circulating blood has not already scat-
tered them in the organism, or if the lymphatic circulation has not car-
ried them further â€” is the free destruction of the peritraumatic zone
by caustics and the red-hot iron. It makes no difference what agent is
iised, providing it be powerful and applied immediately. Heated to a
white heat, the cautery " roasts " the Vv'ound, penetrates its borders,
reaches the anfructuosities, and goes on even to the healthy structures.
Liquid caustics â€” nitric, muriatic and sulphuric acid, chloride of zinc
and chloride of antimony â€” destroy also the entire infected layer and
the suspected zone. It is sometimes necessary to make several deep
eschars, and one should not hesitate, since success depends upon it.
Let us add that a late energetic interference is not always barren of re-
sults. Many times the red-hot iron, applied several hours after the
deposit of the virus, has prevented anthrax infection (Davanie, Rodet).
In the same way cauterization of a rabid wound, one hour after the
bite, has been beneficial. Ammonia, nitrate of silver and several other
light caustics, recommended in olden times, are absolutely useless. As
for the so-called specific antidotes, secret remedies and mystic prac-
tices, only ignoramuses have faith in them.
Gfaniilar ivoiinds, also known as granular dcrmitis, smnmer ivoutids,
are frequent in warm climates, quite common in the meridional coun-
tries of Europe and the south of France, but rare in our latitude and
altogether exceptional in Northern regions. Sometimes they appear
suddenly and seem to bethe result of the action of nematodes (^\vo\\.2^
which reach the dermis, by ways still unknown, and, settling there, pro-
duce a vegetating dermatitis with peculiar characteristics; at others
they constitute a secondary affection, complicating exposed traumatic
lesions (wounds, sero-sanguineous collections, cysts, open abscesses).
Their principal attributes are, a protruding granulation, which covers
the entire diseased surface ; also caseous or cretaceous granulations,
round, angular or irregular and of a yellowish-gray color ; and a great
itching, which induces constant rubbing.
SUBCUTANEOUS WOUNDS. I49
They are very obstinate wounds to cure, generally resist all the
numerous remedies recommended : emollients, narcotics, astringents,
vesications, light caustics, cold affusions or continued irrigation. They
can only be healed by excision of the granulations and fungosities with
the bistoury, or by destroying them with energetic caustics, such as the
If the wound is superficial and spreading, the granulating surface
should be excised. Often, however, they are implanted so deeply that
the curette must be used in addition to the bistoury to remove them
completely. With the curette it is easy to clean the walls of the cavi-
ties where the layer of morbid tissue presents sometimes considerable
thickness. When the wound is once cleaned, it is covered with a dress-
ing, or treated with frequent applications of antiseptic vaseline.
When actual cauterization is used, all the morbid tissue must be de-
stroyed with cauteries in point, heated to sherry red or white heat and
pushed into the deepest layer of the diseased part. If the punctures
thus made with the cautery are very close, the entire granulating sur-
face is transformed into one eschar, which suppuration soon eliminates.
After cauterization, it is advantageous to have recourse to continued
There are granular wounds which, during the warm season, resist the
abrasions of the granulating layer, and cauterization. They go back to
their former condition and last until the end of fall or even until late in
In meridional countries, some of these wounds are seen to assume an
'ulcerous character, gradually spreading in width and depth, without
being any better during the cold season. When they have resisted
several successive operations, it is better to destroy the patient, if it is
'of little value, than to continue a treatment doubtful as to its results.
Whether from accident or from an operation, subcutaneous wounds
â– of like dimensions are much less serious than exposed wounds. The
traumatic center has a temporary continuity with the outside through
a small solution of continuity, but this soon becomes obliterated ; the
tissues are then protected against infectious agents, and if the wound-
ing body has not infected them, cicatrization takes place rapidly, as
with protected wounds. The inflammatory phenomena are slight,
diminish after a few days and soon disappear; and since the skin is
divided only for a short distance, the pain is moderate. Struck with
the benignity of accidental subcutaneous wounds and the rapidity of
150 VETERINARY SURGICAL THERAPEUTICS.
their cicatrization, J. Guerin, about the year 1S40, invented the sid> -
cntancoHS method, the value of which has been considerably diminished
by antisepsis. We use it, however, for some operations, especially in
plantar tenotomy, in cervical or patellar desmotomy and in caudal
Subcutaneous wounds, which are free from infection, and have a.
natural tendency to heal, require simple treatment. This consists
principally in closing the solution of continuity of the skin with a
collodion cover, after a thorough cleansing of the region. A light com-
pressive antiseptic dressing is sometimes useful. The wounded region
sliould be immobilized as much as possible, to avoid the rubbing of
tlie surfaces which are to unite the loosening of the exudation collected
between them, or the irritation of the newly-formed tissue. Sul)-
cutaneous wounds of operations made in healthy tissues are always
aseptic, and cicatrize by adhesive union when sufficient care has been
taken. Accidental subcutaneous wounds do not always act in sucli a
simple way ; they often suppurate and may be complicated with other
accidents ; they belong then to the series of exposed wounds.
Contrary to what is. customary, we have separated avitusions froni
contused 7uounds. If both are made by a similar mechanism by the
action, upon tissues, of blunt, bruising bodies, and although since the
beginning of the era of antisepsis, the principal clinical characteristics,
which distinguish them â€” absence or presence of a solution of continuity
of the skin â€” is less important than in past days, among animals, they
still offer sufficiently great differences to justify this division, â€” also
taking into consideration their gravity, progress, mode of repair,
possible complications and the therapeutics that they require.
Constituted essentially by a traumatic lesion â€” laceration, bruise or
crushing of the subcutaneous tissues â€” without solutions of continuity
of the teguments, contusions are of very varied form and gravity.
Sometimes the disorders and the functional symptoms are exclusively
local ; at others, there ai-e distant troubles. It is for this reason that
contusions which are united on the lateral side of the head may give rise
to facial hemiplegia. Nervous branches (radial, sciatic, external
popliteal) ma}' be injured on the extremities, and paralysis will be
observed to follow, which lasts for a longer or shorter time.
Considered as lesions, they are divided into three classes : coiifiisioiis
of the first degree, with rupture of the capillaries of the skin or of the
subcutaneous tissue and W\\\\&Qc\\-)-v(\o'i\'s,\ contusiotis of the second degree,.
M'ith rupture of small blood-vessels, and formation of a bloody en-
largement ; contusions of the third degree, with destruction of the tissues
and more or less extensive mortification. The priitiitive effusions of
scrosity and of liquid greasy matters will be considered in the next
The contusions of the first degree, with or without excoriation of the
epidermis, heal by natural processes. Rest, only, is required for the
diseased part. One may, however, use with advantage, especially if
there is swelling, either antiphlogistics â€” cold epithems, compresses wet
witii cold water or an astringent solution (alum water, white lotion,
solution of metallic sulphates) â€” or slight resolutive topical remedies
If pain is severe, narcotics will allay it (poultices or opiate ointments),
or analgesics (cocained vaseline), and also fomentations or continued
immersion in warm water. Scarifications, recommended by some
French and other authors, must not be used.
For contusions of the second degree, more active interference is de-
manded. If they are recent, cold water, or salt water, applications
and simple white lotions (that of alum) are useful ; they hasten
hemostasis and arrest the growth of the bloody tumor. Later, one
should use resolutive lotions (various tinctures, camphorated alcohol),
and the tincture of iodine painted over the parts ; beside these, massage
Avhich spreads the extravasated liquid over a wider surface and stimu-
lates its absorption ; or also methodic pressure, made with an India
rubber band, or one of linen or of flannel, if the bloody swelling is
upon an extremity.
These means fail when the tumor is old and surrounded by fibrinous
strata and an organized membrane, â€” in a word, when it is encysted. It is
for such cases that sudden and rather strong compression has been
recommended to rupture the wall of the pseudo-cyst, or puncture or
incision of this wall, and irritant injections into the pouch after evacu-
ation of its contents. For bloody tumors with clots, one should
puncture with the larger trocar of Dieulafoy or that of Potain. The
liquid should be expelled by methodical pressures made upon the
swelling, followed by a washing of the pouch witli a strong solution of
carbolic acid, cresyl, or tincture of iodine ; a compressive bandage
should be applied, if the region permits it. When the walls of the
bloody collection are thickened, already doubled up by a neo membrane,
the effusion returns ; a new puncture and another antiseptic injection is
required. Some hematomas contain large clots, whose exit from the
cavity through a simple puncture is impossible. They must be opened
with an incision sufficiently extended to permit the removal of these
clots; afterwards, they are to be treated as other bloody collections. It
is rarely necessary to have recourse to curetting of the walls. If
suppuration occurs, the pouch must be freely opened, irrigated, and
152 VETERINARY SURGICAL THERAPEUTICS.
Independently of all surgical interference, contusions of the first and
second degrees may exceptionally present, at certain times, well
marked inflammatory phenomena and terminate in suppuration. The
specific agents of the latter have reached the traumatic center, either
through superficial excoriations that have denuded the papillar layer
of the tegument, or by vascular channels, when the blood is accident-
In contusions of the third degree, the lesions are often very serious.
The muscular layers are crushed, the interstices of connective structure
are extensively gorged with blood ; the skin soon becomes mortified,
the contusion is transformed into an open wound and exposed to all
the dangers of contused wounds. Recent contusions are, in general,