Exercises in equine surgery

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UNITED STATES OF AMERICA.

HXNXEHRCISES

IN

EQUINE SURGERY

IBS

P. J. CADIOT

PROFESSOR AT THE ALFORT VETERINARY SCHOOL

‘TRANSLATED BY
A. W. BITTING, D.V.M.

FORMERLY VETERINARIAN IN THE FLORIDA AGRICULTURAL COLLEGE AND
EXPERIMENT STATION, VETERINARIAN TO PURDUE UNIVERSITY
AND AGRICULTURAL EXPERIMENT STATION

EDITED BY
A. LIAUTARD, M.D., V.M.

PRINCIPAL, AND PROFESSOR OF ANATOMY, SURGERY, SANITARY MEDICINE
AND JURISPRUDENCE, OF THE AMERICAN VETERINARY COLLEGE,
NEW YORK, ETC., ETC.

WITH FIFTY-SIX ILLUSTRATIONS

AUTHORIZED EDITION

NEW YORK u 15
WILLIAM R. JENKINS
VETERINARY PUBLISHER AND BOOKSELLER
851 AND 853 SrxTH AVENUE

~

CopyRIGHT, 1897, BY Winuram R. JENKINS.
‘ All Rights Reserved,

PRINTED BY THE ;
PRESS OF WILLIAM R. JENKINS,

New York. /

AUTHOR'S PREFACE.

At the Alfort Veterinary School, the exercises in
equine surgery are given during the scholastic year,
on Monday of each week from half past six in the
morning to five in the evening. All operations are
made upon the cadaver except those made upon the
animal while in a state of anzesthesia secured by an in-
travenous injection of chloral hydrate. Nevertheless,
in order to broaden the field of application of the rules
here presented, we have looked upon a great many as
if they were being effected for a therapeutic object
and upon the horse as being able to give those reac-
tions which are to be met with in practice.

Most of the figures are from the crayon of M. G.
Nicolet and taken from the Traité de Thérapeutique chir-
urgicale des animaux domestiques, which we are publishing
with M. Almny, assistant professor at the Alfort Vet-
erinary School, and have been drawn from the collec-
tion of photographs gathered by the pupils connected
with the laboratory of clinical surgery.

Pp. J. Capror.

PREFACE.

When “‘ Exercices de Chirurgie Hippique” was published
I obtained, while abroad last summer, authorization
from Prof. P. J. Captor to render it into English.

Upon my return to the United States, however, I
was informed a translation had already been prepared
by Prof. A. W. Birrine, as the subject of his thesis
previous to his graduation from the Veterinary Depart-
ment of the Iowa State College (Ames, Iowa).

To Prof. Birtrna, therefore, belongs the principal
credit of the work, to which I have only contributed
some corrections and additions, as suggested by the
French author.

Though many of the subjects treated already have
their places in the various works on operative surgery,
it is hoped that the special processes used for some
operations at the world-renowned French School of
Veterinary Medicine, as presented in this little work,
will not fail to prove of some value and advantage to
American and English veterinary students, as well as
to practitioners.

AS iA AED:

EXERCISES

IN

EQUINE SURGERY.

RESTRAINT.
1.—Restraint of the Horse in a Standing Position.

Pass the lead strap through the mouth, and around the
lower jaw; apply a twitch to the superior lip; raise a foot

é eS
Fig. 1—Posterior limb raised and carried forward by means of a rope.

or bring a posterior member forward by means of a rope
(fig. 1). Hobble both posterior limbs; pass the line between the

4 EXERCISES IN EQUINE SURGERY,

fore limbs, in front of the right shoulder over the withers,
and to the left side; cross it and have it drawn forward by
an assistant (fig. 2). With Le Goff's hobbles secure three

Fig. 2—Restraint of the posterior limbs.

limbs, the two anterior and a posterior, if you operate upon
the anterior part of the body, the neck, or the head; the tw
posterior and an anterior if you operate upon the hind
quarters. .

Il.—Restraint of the Horse in the Recumbent
Position.

To cast the animal, prepare a bed of straw upon the floor
and have an assistant hold the head. Twitch or pass a strap
through the mouth, and around the lower jaw. Raise a fore
foot, and apply the hobbles to all the limbs, the buckles out-

RESTRAINT. 5

side, the rings of the two anterior turned backward, those
of the posterior turned forward, and the line lock on the
anterior limb on the side opposite to that on which you wish
him to lie. Pass the line through the ring of the hobble
on the posterior limb corresponding to the raised foot, then

Fig.3.—Casting the horse. Ordinary procedure.

successively through that on the other posterior limb, the
opposite anterior limb, and finally through that to which it is
fixed, and have it drawn moderately by the assistants. Throw
a rope over the trunk, back of the withers, which is to be held
by two assistants on the side on which the horse should fall.
Another assistant seizes the tail, and is to act in the same
manner as those holding the rope. Diminish as much as
possible the base of support; bring the limbs together by
making the horse back, or successively carry the two posterior
limbs forward; when in this condition the hobble line should
be gradually drawn (fig. 3). At a convenient signal there
should be common action; the extremities are brought

6 EXERCISES IN EQUINE SURGERY.

together; the animal, feeling his danger, immediately bends

V8
‘yh

/ oe

Fig. 4.—The right anterior limb is carried above the corresponding posterior.

the joints of the limbs, the traction exercised upon the trunk,
tail, and head overcomes the equilibrium of the body. The

B

SSF
TS

Fig. 5.—The right posterior limb is carried above the corresponding anterior.

horse should fall upon the bed, or rather lie on it, from hind

RESTRAINT. a

to front quarters, or in the reverse direction. Secure the line
by a double knot, or by the hobble lock.

If you wish to displace an anterior limb and earry it over
the superficial posterior limb, fix a rope to the canon of the
first, pass it from above to below on the inferior part of the
leg, then continue from the rear forward, from below to
above the forearm of the displaced limb, and hold the rope in
the direction of the withers after having unhobbled the limb
(fig. 4). Gecure it to the posterior by two turns crossed as
an X, one turn horizontal and a circular turn.

If a posterior limb is to be secured above the anterior
superficial, fasten a rope upon the canon of the first, pass
it around the fore limb from above downward, at the inferior
third of the forearm, then bring it back under the posterior
limb, and draw perpendicular to the vertebral column, after
having disengaged the extremity of the limb to be displaced
(fig. 5). Another rope fixed above the knee will prevent the
first from slipping.

GENERAL OPERATIONS.

I.—PHLEBOTOMY.

General Directions.—To puncture a vein, take a fleam,
a straight bistoury, or a lance; assure yourself that the point
of the instrument is in proper condition, well sharpened; if
you bleed with a fleam, a bleeding stick is needed. Moisten
and smooth the hair, or cut it with the scissors at the point
where you wish to open the vessel. ‘To arrest the hemorrhage,
use a pin and some British thread; make a common ligature,
the thread being preferable to a lock of hair.

Secure in a manner convenient for the operation; take the
most favorable position to secure enlargement of the vein and
protection from the animal’s actions. The bleeding requires

8 EXERCISES IN EQUINE SURGERY.

only one essential step—the opening of the vessel. If there is
failure the first time, give a second cut at the same point
as the first, for the fleam may not have penetrated to the
vein.

When the vessel is opened and in condition so that the blood
flows, avoid displacement of the skin; if the two orifices,
veinous and cutaneous, do not correspond, the bleeding will
be irregular; ycu would have a thrombus. To close the vein,
bring together the two cutaneous lips of the puncture, by
exercising traction upon the skin, with the thumb and finger
of the left hand, pierce them in the middle with a pin, make
one ligature of thread with a straight knot, or of hair with the
bleeding knot; cut the thread or hair a centimeter from the
knot, and bend over the point of the pin.

1.

Restraint.—Hold the head in line with the axis of the
body, and cover the eye on the corresponding side.

Bleeding from the Angularis.

TECHNIQUE.—The vein descends from the internal angle of
the eye towards the extremity of the zygomatic spine; it is
plainly noticed on a level of the fleshy portion of the supero-
maxillo-labialis; it is there that one may puncture with a
lance or straight bistoury.

When bleeding on the left side, compress the vein with the
thumb of the left hand a little below the point to be opened;
puncture from below upward with the other. On the right
side, make the compression with the right thumb, and the
puncture with the left hand.

2.—Bleeding from the Jugular.

Restraint.—Pass the lead strap through the mouth and
around the lower jaw; extend the head and carefully carry it
to the side opposite to that on which you wish to bleed; the
assistant should cover the eye on the side corresponding with
one of his hands.

TECHNIQUE.—Puncture the jugular at the union of the
middle third with the superior third of the neck, using a fleam.
When bleeding on the left side, place yourself a little in
front of the corresponding anterior member outside of the

PHLEBOTOMY. )

limit of its movement; carry the left hand, armed with a
fleam, in the jugular groove a little above the middle of the
neck, compress the vein to provoke its distention by stasis; it
is necessary to make slight movements with the hand parallel
with the vessel, in order to clearly distinguish the sanguinous
column by its undulations; the point of the fleam is placed
exactly over the vessel; puncture it with the right hand by a
stroke of the bleeding stick upon the instrument. When
bleeding from the right side, hold the fleam with the right
hand, and strike with the left. At the flow of blood, with-
draw the instrument.

During the time of bleeding, continue the compression, in
order to prevent the admission of air into the vein.

To arrest the hemorrhage, remove the pressure, and at the
same time bring the lips of the wound together with the
thumb and index finger; place one pin in their middle, a
half-centimeter from the edges, after which complete the
ligature.

3.—Bleeding from the Cephalic Vein.

Restraint.—Hold the head slightly to one side of the axis of
the body; raise the anterior member on the opposite side to
that on which you operate.

TECHNIQUE.—Search for the cephalic vein in the interstice
which separates the arm from the forearm; it passes from the
rear forward, over the superficial band of the coraco-radialis.
An exploration of the region permits one to easily recognize
the situation of the vessel, even when it is not very apparent.
It is useless to try to provoke distention, as the blood will
pass by way of the basilic vein.

With the fleam puncture the vein over the region of the
superficial band of the radialis or immediately within it.
When operating on the left side, take a position near the
corresponding anterior member; the right hand holds the
fleam; it finds a point of support upon the inferior part of
the mastoido-huineralis, towards the middle of the antero-
external face of the arm; the point of the instrument is
placed over the axis of the vessel, or a little obliquely; the
left hand strikes a light blow upon the handle. When

10 EXERCISES IN EQUINE SURGERY.

operating upon the right side, hold the fleam with the feft
hand, and strike with the other.

Arrest hemorrhage as in the jugular operation.

If the blow with the bleeding stick has been given strongly,

and the vein transpierced, ea voluminous thrombus is the
result.

4.

g from the Subcutaneous of the Forearm.

Restraint.—The same directions as for phlebotomy of the
cephalic vein. :

TECHNIQUE.—Open the vessel with the lance or straight
bistoury. When operating upon the left, place yourself
facing the member; provoke distention of the vein by com-
pression a little above the point where you wish to operate,
using the thumb of the left hand, the other fingers being
applied upon the.extensors of the foot; puncture quickly from
below upwards with the left hand. If you operate on the
right, compress the vessel with the left hand and open it with
the other.

Arrest hemorrhage as in the jugular.

5.—Bleeding from the Subcutaneous Thoracic Vein.

Restraint.—Hold the head in line with the axis of the body,
raise the fore foot on the side opposite to that on which the
vessel is to be opened.

TECHNIQUE.—The subcutaneous vein of the thorax is easily
seen in its anterior portion, to the rear and a little above the
elbow. Puncture it at a hand’s-breadth from the elbow,
opposite an inter-costal space.

When bleeding from the left, place yourself against the cor-

responding anterior limb, back turned toward the head, the.

right hand armed with a fleam held horizontally ; compress the
vessel immediately back of the extensors of the forearm; the
left hand earried vertically gives a slight blow upon the
instrument with the bleeding stick. To puncture the right
vein, hold the fleam with the left hand and strike with the
other.

If the bleeding is performed over a rib, the blade of the
instrument is nearly always broken on the bone; the vein is
transpierced; a large thrombus is the result.

PHLEBOTOMY. 11

6.—Bleeding from the Saphena.

Restraint.—The head is maintained nearly upon the median
line; take a position in the rear or in front of the posterior
limb opposite to the one on which phlebotomy is to be
practiced.

TECHNIQUE.—With the fleam, puncture the vein over the
flat side of the thigh. There are two methoas:

Bleeding at the Left Saphena.—1. Hold the right posterior
limb backward; instruct the assistant to hold firmly as for an
operation in shoeing; take a position below the right flank,
the knees flexed; the left hand, which holds the handle by its
extremity, takes the superior part of the internal face of the
leg as a point of support; avoid compressing the vein; the
blade of the instrument is placed over the axis of the vessel,
the right hand gives the stroke with the bleeding stick.

2. Hold the right posterior limb forward with a rope; take
a position back of the left limb near the median line; the left
hand holding the fleam (handle downward), take as a point of
support the superior part of the flat side of the thigh (the
region uncovered by the displacement of the right leg), and
compress the vein; the right hand gives the stroke with the
bleeding stick.

Bleeding at the Right Saphena.-—The left posterior limb
minay be held securely backward; take a position under the left
flank, hold the fleam in the right hand and strike with the
other. If the limb is carried forward, take a position in the
rear, hold the fleam in the right hand and strike with the left.

Arrest hemorrhage as in the preceding operations.

7.—Bleeding from the Toe.

Restraint.—Raise the foot on which you wish to operate.
If the subject is irritable, apply a twitch to the upper lip.

TECHNIQUE.—Pare the plantar region, thinning the sole
thoroughly at the anterior part; hollow out the toe, and
cut a groove in the commisural zone; then, either with the
point of a sage knife, or of a bistoury—the back of the
instrument turned towards the heel—or a narrow drawing
knife, section the tegumentary membrane and the arch of the
vascular circumflex at the bottom of the groove.

If the hemorrhage persists too long, arrest by a compress
bandage.

12 EXERCISES IN EQUINE SURGERY.

8.—Bleeding from the Palate.

Restraint.—Open the jaws with a speculum, apply a twitch,
or simply hold the head moderately elevated.

TECHNIQUE.—Be sure to puncture the network of sub-
mnucous veins opposite the fifth or sixth palatine groove. (The
anastomosis of the palatine artery corresponds very nearly to
the third groove. )

With the left hand the tongue is seized and drawn out of the
mouth through the interdental space, and is held immovable.
With the bistoury carried into the mouth, point upward,
cutting edge forward, make a deep incision of half a centi-
meter in the median line of the palate; prolong the incision to
a centimeter in length.

If the hemorrhage does not cease spontaneously, take a
splint fifteen centimeters long, roll linen about it in such
# mInanner as to form a mat compress, apply this transversely
upon the palate, on a level with the wound, then fix it in
position by two bands tied to the extremities of the cross
piece and to the nose-band of the halter. :

II.—_ANAESTHESIA.
Intravenous Injection of Chloral Hydrate.

Restraint. —Cast the animal on the side opposite to that on
which you operate; hold the head extended upon the neck.

Instruments.—Scissois, capillary trocar, apparatus of
Dieulafoy, solution of chloral of one to three (1: 3).

TECHNIQUE.— Operate at the point where bleeding is usually
practiced; take a position in front of the neck; clip the hair.
An assistant should compress the vein at the inferior portion
of the neck. The skin is stretched by exercising a little
traction towards the head; with the left hand, if operating on
the left side, with the other if operating on the right, puncture
the vein with a single thrust of the trocar held obliquely down-
ward and backwards, the point exactly placed on the vessel.
The puncture may also be made by two steps: first penetrate
the skin, then the wall of the vein. The trocar is withdrawn
from the canula; the blood flows in a jet from the ecanula, if
its extremity is well in the vein. Cease exercising compression

SETONS. 13

upon the vessel at the inferior part of the neck. An assistant
holds the canula inclined upon the neck well secured. :

Introduce into the canula the adjustment connecting the
rubber tube, work the cock corresponding, and slowly push
into the vein the quantity of chloral necessary for anesthesia
(80 to 40 grams, depending upon the size of the subject).
(Noeard. )

Remove the canula, wash off the small quantity of blood
that proceeds from the opening; after withdrawing, avoid
raising the skin.

IlIl._SETONS.

Tape setons and rowel setons are used. For the first, a sub-
cutaneous course of variable length is made, in which is
_ passed a band orribbon. In the other, a ring, or a piece of
leather made into a circle, is introduced beneath the bare
~ skin.

The majority of the operations are very painful, provoke a
lively resistance and necessitate a careful restraint (hobbles,
ropes) if the animal is not given an anaesthetic.

A.—Setons of Tape.

General Rules.—Use the seton needle, scissors and convex
bistoury and the tape. Take a tape 60 to 80 centimeters in
length; at one of its extremities fold it several times in such a
manner as to make a knot of five centimeters. The course for
the seton should be made in the subcutaneous connective
tissue, in general following the direction of the hair. The
length determined, at its extremities, make two incisions of
two and half to three centimeters in the body of the seton.
Afterwards take the needle, seize it near the blade, the index
along one of its faces, preferably the coneave; introduce it
into the first incision, engage it in the connective tissue, push
it forward, holding the instrument in the full hand, the index
always extended upon the handle near the cutaneous opening ;
with the free hand raise the skin in front of the point of the
instrument, either in folds or by exercising traction upon the
hair.

14 EXERCISES IN EQUINE SURGERY.

Avoid puncturing the skin or the muscles beneath. Direct
the instrument toward the second incision. Arriving at this
point, direct the blade outward, engage the end of the tape in
the eye, and withdraw the instrument; the seton is in place.
It only remains to disengage the end of the tape from the eye
of the needle and make a knot resembling that on the other
end. Do not tie the two extremities of the tape; it is bad
practice.

The operation can be made with the seton needle alone.
Hold it as has already been directed; the needle is introduced
at the base of a cutaneous fold, which is held transversely to
its direction by the thumb and index finger of the free hand.
By an energetic thrust, cause it to penetrate the skin and
implant it in the subcutaneous connective tissue, where you
make the course afterward. 'Che course is completed and the
needle brought out by a quick movement after having inclined
it in such a way that its point is directed towards the skin,
using the scissors as a point of support in front of and below
the point of the needle. The manner of passing and fixing the
tape is the same as in the first procedure.

More often a single incision is made—that which permits
the introduction of the needle—and, the hollow course, the
opening from it being made in passing towards the skin.

With the seton needle, having an eye in the heel, one can
pass the tape introduced in that orifice and draw out the
needle by its blade; but the other method is preferable.

is

Restraint.—Twitech the superior lip; raise the posterior
limb on the same side on which you wish to operate, or
hobble the anterior limb of the same side, or apply the hobbles
of LeGoff.

TTECHNIQUE.—If only one seton is to be inserted, pass it over
the median line from the anterior part of the sternum to the
region of the passage of the girth.

If two are used, pass them on each side of that line, within
the cephalic vein, at some distance from the limbs, over the
median portion of the enlargement of the sterno-humeral
muscle, even to the passage of the girth, and cause them to
slightly converge backward.

Seton in the Breast.

SETONS. 15

Place yourself a little in front of the right fore limb
(hobbled). Instead of implanting the needle in the skin
at first, it is preferable to make a short incision parallel to the
seton. Take the needle in the right hand; with the other lift
the skin to favor the progression of the instrument; arriving
at the point where it is to come out, the blade is passed
toward the skin, while the scissors, held in the left hand, are
applied strongly against it. Always proceed in this manner if
only one seton is placed. If two are used, you may pass each
without changing position, remaining in front of the right
limb; you may also, in order to pass the seton on the left side,
take a position in front of the corresponding member, after
having hobbled it.

2.—Seton in the Neck,

Restraint.—Twitch; hobble both fore limbs.

TECHNIQUE.—-Insert at the anterior part of the neck, ina
vertical direction or slightly oblique upward and forward, two
parallel setons at a distance of about ten centimeters from
each other. Make two small incisions through the hair on
the side of the neck, over the enlargement formed by the
mastoido-humeral muscle, and a little above the jugular
groove. If operating upon the left side, hold the needle in the
right hand, pass it from below upward in the direction which
has been indicated, and make the opening three fingers’
breadth from the mane; press over the skin in front of the
point with the scissors; pass the tape and withdraw the
instrument.

When operating upon the right side, manipulate the needle
with the left hand.

o.—Seton in the Jaw.

Restraint.—Twitch; raise an anterior limb.

TECHNIQUE.—Upon the flat side of the jaw, at a hand’s
breadth from the posterior border of the maxilla and from
the zygomatic crest, make a short incision in the direction of
the hair. If operating upon the left side, hold the needle
in the right hand, pass it parallel to the crest and make the

16 EXERCISES IN EQUINE SURGERY.

opening several centimeters in front of its extremity. Pass.
the tape and withdraw the instrument.

If the operation is made upon the right, manipulate the
needle with the left hand.

4.—Seton in the Shoulder.

Restraint.—Twitch the upper lip; hobble both fore limbs,
or raise the anterior limb on the side opposite that on which
you wish to operate.

TECHNIQUE.—Apply two setons, the one in front of the
seapulo-humeral articulation, the other on the external side
of the joint. Place yourself in profile near the limb, back
turned toward the rear.

If the seton is to be placed in the left shoulder, manipulate
the needle with the right hand. Pass the anterior seton in
two steps. Make an incision of three centimeters through the
the skin in front of the articulation; introduce the needle,
passing downward and backward, in the subcutaneous con-
nective tissue of the arm, along its anterior face, and bring
the blade out with the assistance of the scissors at fifteen
centimeters from the incision. Insert the tape and withdraw
the instrument. Then, at the limit of the inferior third and
of the middle third of the cervical border of the shoulder,
make a new incision; introduce the blade of the instrument
and pass it downward and forward towards the first incision ;
bring the blade out, insert in its eye the superior end of the
tape and withdraw the needle.

The posterior seton requires only one step. Ten centimeters.
above the articulation, and a little back of the first seton,
make one incision; introduce the needle, make it traverse
vertically to just ten centimeters below the joint; perforate
the skin at this point with the assistance of the scissors, insert
the tape in the needle, and withdraw it.

In the operation upon the right shoulder, manipulate the
needle with the left hand.

5.—Seton over the Ribs.

- Restraint.—Twitch the upper lip; hobble both anterior
limbs, or hobble the one on the side opposite that on which
you operate.

SETONS. 17

TECHNIQUE.—Pass two setons upon each of the thoracic
walls, one ten to fifteen centimeters behind the posterior
border of the extensor muscles of the forearm, the other eight
to ten centimeters posterior to the first; they should extend
from above to a little below the middle third of the thorax.
Do not prolong them beyond the spur vein. Give them a
vertical disposition over the fleshy portion; pass them along
an intercostal space over the lean flesh.

If you operate on the left side, place yourself on a line with
the anterior limb, the back turned toward the animal’s head ;
make two small vertical incisions in the skin at the superior
part of the costal region near the border of the ilio-spinalis, one
for each seton.

Hold the needle in the left hand, insert it in the first
incision, and make it penetrate under the skin of the costal
wall, point outward, to within a few centimeters of the spur
vein; with the assistance of the scissors make an opening at
this point; insert the tape in the eye of the blade, and pass it
through the course by withdrawing the instrument. Manipu-
late in like manner for the seton in the other side.

When operating on the right side, assume a position on a
line of the corresponding anterior limb, and hold the needle in
the right hand.

6.—Seton in the Haunch.

Restraint.—Twitch the superior lip; hobble both posterior
limbs.

TECHNIQUE.— Pass two setons vertically on a level with the
eoxo-femoral articulation from eight to ten centimeters from
each other—one in front, the other behind the joint. Give
them a length of about thirty centimeters.

Take a position a little in front of the limb, and make two
short vertical incisions at the same height and ten to fifteen
centimeters above the articulation. If operating upon the
left, hold the needle in the left hand; introduce it into the
first incision, pass it vertically or a little obliquely backward,
and pierce the skin ten to fifteen centimeters below the
articulation. Insert the tape and withdraw the instrument.
Proceed in the same manner for the other side.

18 EXERCISES IN EQUINE SURGERY.

To operate upon the right haunch, manipulate the needle
with the right hand.

In case the deep muscles are badly atrophied and the
enlargement of the articulation very pronounced, make the
incisions on a level with the articulation, and operate by two
steps, as for the anterior seton of the shoulder.

7.—Seton in the Buttock.

Restraint.—Twitch the upper lip; hobble both posterior
limbs; the line is passed between the anterior limb, continued.
over the withers, crossed and held by an assistant.

TECHNIQUE.—Pass a single seton in the rear of the buttock.
Take a position against the member, the back turned towards
the animal’s head; make a short vertical incision in the
superior part of that region, immediately below the enlarge-
ment formed by the ischiatic tuberosity. If you operate on
the left side, hold the needle in the left hand, pass it in a
slightly oblique direction downward and inward, just to the
superior part of the leg; bring out the blade at this point,
insert the tape and withdraw the instrument.

When operating on the right side, take a position against
the corresponding member, and hold the needle in the right
hand.

8.—Seton in the Stifle.

Restraint.—Cast the animal upon the side opposite to that
on which it is desired to operate. Carry the limb forward in
extension with a rope fixed above the hoof or upon the canon.

TECHNIQUE.—The seton, which should be twenty or thirty
centimeters in length, is passed in front of the stifle. The
great mobility of the skin which covers the patellar articula-
tion renders it necessary, if one would place the seton exactly
on a level with it, to mark the limits before the animal is east,
in order to make the two incisions for the entrance and exit of
the needle; the first, ten to fifteen centimeters above the
center of the joint; the second, ten to fifteen centimeters
below the joint. If you operate upon the left limb, hold the
needle in the right hand, point towards the skin; insert it into
the superior incision and direct it towards the other, and be

LIGATIONS 19

careful to avoid wounding the synovial capsule. If you
operate upon the right stifle, hold the needle in the left hand.

9.—Ventral Seton.

Restraint.—Twitch; hobble both posterior limbs; raise the
left fore limb. If the subject is very irritable, operate upon
the animal cast upon the right side.

TECHNIQUE.—If the operation is made in the standing
position, place yourself in the rear of the right fore limb, the
Knees bent. Even with the the xiphoid appendix and upon
the median line, make a transverse fold of skin, incise it, hold
the needle solidly in the right hand, point owtwards, intro-
duce it in the connective tissue and pass it along the linea
alba to ten centimeters of the sheath in the horse, or to the
mamimae of the mare: make it come through at this point with
the assistance of the scissors; insert the tape and withdraw
the instrument.

If you operate upon the animal lying upon the right side,
manipulate the needle with the right hand.

B.—Rowel Seton.

The rowel seton is applied on a level with the superior
articulation of the limbs, notably those of the shoulder and
haunch.

TInstruments.—Convex bistoury, curved scissors, ring of
hair or rubber six to seven centimeters in diameter.

TECHNIQUE.—With the convex bistoury make an incision
of three or four centimeters on a level with the articulation;
with the curved scissors detach the skin from a circular
surface, within the incision from the inferior radius. Intro-
duce the leather or rubber ring, after having folded it twice.
Unfold it within the cavity.

IV.—LIGATION OF VESSELS.

Instruments.—Scissors, convex and straight bistouries, dis-
secting and hemostatic forceps, director, British silk thread,
eat-gut or linen tape, Deschamp or Cooper needles, and a
needle to suture.

20 EXERCISES IN EQUINE SURGERY.

General Directions.—The operation consists of three steps:
Ist, incision of the tissue which covers the vessel; 2nd, isola-
tion of the vessel for a centimeter by use of the dissecting
forceps, bistoury, and probe director; 3rd, application of the
band.

If the thread is absorbable (cat-gut), the ends are cut near
the knot; if linen or silk thread is used, one of the ends
should be cut near the knot, the other remaining outside of
the wound, serving to remove the ligature when it becomes
free. In general, wounds of the veins require only one
ligature; they should be made beyond the wound or upon the
periphery. For arteries, two ligatures are ordinarily applied;
one above the wound, the other below.

1.—Ligation of the Jugular.

Restraint.—Cast the animal on the side opposite to that on
which you wish to operate; extend the head upon the neck;
twitch the upper lip.

TECHNIQUE.—Operate at the superior part of the jugular
groove, a little below the point where the vein receives the
glosso-facial. Clip the hair, make a cutaneous incision of four
or five centimeters over the axis of the vessel and dissect the
underlying connective and muscular tissues. With the point
of the director lacerate the perivenous cellular tissue along the
line of incision; make the exposure of the vein, detaching it
from the adjacent tissue by always moving the point of the
director parallel with the vessel.

Pass a double British thread or linen tape under the vein;
draw the ligature tightly and secure it by a straight knot.
Cut one of the ends close to the knot, preserve several centi-
meters of the other and let it extend outside.

Unite the lips of the cutaneous wound at two points by
sutures.

ae

Ligature of the Glosso-facial Artery.

Restraint.—Twitch; raise the anterior limb on the side
opposite to that on which you operate.

TECHNIQUE.—It is easy to see the artery upon the cheek
along the anterior border of the masseter, in front of the vein

—— = .hUlh

LIGATIONS. al

and Steno’s duct. Make an incision of three centimeters along
the line of the vessel; divide the skin, cutaneous muscle and.
cellular tissue; with the director isolate the artery, slip a
thread under it and tie.

3.

Restraint.—Twitch; raise the fore limb on the side opposite
to that on which you wish to operate, or hobble both limbs.

TECHNIQUE.—Clip the hair; make an incision of six centi-
meters intersecting the skin, adjacent muscular, connective
and subcutaneous tissues, in the jugular groove immediately
above the vein. With the thumb of the left hand introduced
into the wound, push aside the anterior lip, and at the same
time displace the jugular vein; afterwards section the sub-seap-
ulohyoidean muscle, and lay down the bistoury. With the
index finger lacerate the pericarotidean connective tissue,
seize the artery (fig. 19), and compress it on a level with the
opening, separate the inferior laryngeal nerve which is joined
to it in front, then the cord formed by the great sympathetic
and pneumogastric which lies upon its posterior face.

If the artery is simply opened, have it held by an assistant,
who compresses it between the thumb and index finger on a
level with the perforation; apply the first ligature below the
wound and the other above.

When the vessel has been completely sectioned, prolong the
incision above and below, exposing the two ends and ligate
successively.

Ligature of the Carotid.

4,—Ligature of the Intercostal Arteries.

Restraint.—Twitch; raise the anterior member on the side
opposite to that on which you wish to operate.

TECHNIQUE.—The intercostal arteries lie at full length in
the fissure along the posterior border of the ribs, and are in
front of the corresponding nerves. When arterial blood
escapes from a wound in the intercostal space, it is the artery
of the anterior rib that is wounded.

Make a cutaneous incision fyom three to four centimeters in
length along the posterior border of the rib, divide the sub-
cutaneous layers and the external intercostal muscle; with

22 EXERCISES IN EQUINE SURGERY.

the point of the director or of a bistoury, separate the artery
from the connective tissue, which surrounds it, pass the
thread under it and bind tightly. If the vessel is cut, seize
the superior end and ligate it.

5.—Ligature of the Saphena Artery.

Restraint.—As for phlebotomy of the saphena vein; or
throw the animal on the same side as the leg to be operated
upon, carrying and securing the opposite hind leg forward
with a rope.

TECHNIQUE.—With a cut of the bistoury, divide the skin
parallel to the saphena vein. Isolate the artery with the
director, slip a thread below it and tie. If it is severed,
prolong the incision upward, seize the end with the forceps
and afterwards make the ligature.

6.—Ligature of the Plantar Artery.

Restraint.—The same situation as for plantar neurotomies,
high or low, according as it is practiced above or below the
fetlock. (Figs. 49 and 50.)

TECHNIQUE. —Make a cutaneous incision of three centi-
meters on a line with the-vessel. Divide with precaution the
subcutaneous connective tissue, the sheath or aponeurosis of
the plantar cushion, according to the place at which you
operate. The artery is exposed; isolate with the director and
make an ordinary ligature.

V.—SUTURES.

General Directions.—Clip the hair upon the lips of the
wound, cleanse it, bring the edges together with the fingers,
and use that suture which is most convenient.

In incised wounds in which the tissue is not destroyed and
the edges are clean, union is easy; where the wound is of
irregular nature, sutures should only be taken with certain
precautions. In general, such incised wounds may be cor-
rected; if the flaps are stretched, the first suture should be
near the center of the lips.

When the wound is irregular, sinuous or angular, begin by
taking the stitches on a line with the most elevated part, or
the angles. Penetrate the lip obliquely, supporting it with

SUTURES. 23

the foreeps where the needle penetrates from without to
within, pressing upon the other with the thumb and index
finger of the free hand on each side of the point where the
needle should come through. The stitches should be placed
at regular intervals; those which pass through the lips at the
same depth should penetrate at an equal distance from ths
edge of the wound; if you employ deep sutures, make the
points of entrance and exit of the needle farther from the
edges of the lips. Pass all the threads first, afterwards com-
menece by tying those in the middle or those at the angles,
and place the knots as far as possible from the wound over
the upper lip. In tieing the threads avoid equally insufficient
tension which permits the lips to gape, or an excessive tension
which provokes tearing.

1.—Interrupted Suture.

Ordinary curved needles or Reverdin needles; linen or silk
thread.

TECHNIQUE.—Prepare as many threads as you wish to make
points of suture. If you use an ordinary needle, pass the
first thread through its eye, pierce one of the edges of the
wound from without to within, and the other from within to
without. Use the same procedure with the other threads.
You may also use only one needle and a long thread. Pass it
in the lips of the wound, cut it with the scissors, leaving
sufficient ends to make the first suture. Proceed in like
manner for the other sutures.

If you use a Reverdin needle, penetrate one of the lips from
without to within, the other from within to without; slip the
thread in the eye and pass it through the lips of the wound in
withdrawing the needle.

2.—Continuous Suture.

Ordinary curved needle and linen or silk thread.

TECHNIQUE.—Thread the needle with a thread sufficiently
long to make all the stitches, and terminate with a rosette
knot. Pass through the lips a little obliquely at one of the
extremities of the wound, the first lip from without to within,
and the other from within to without; implant the needle

24 EXERCISES IN EQUINE SURGERY.

again into the first lip at the same distance from its edge as
the first stitch, and about a centimeter from it; make the exit
in the opposite lip on a line in an oblique course parallel to
the first. Continue this to the other end of the wound.
Secure the thread by a rosette knot.

Figs. 6 and 7.—Bayer’s Suture.*

S, suture; C, traumatic cavity; F, deep thread; DD, quills; G, gauze;
O, wadding; PP, skin; HE, splint.

3.—Twisted Suture.

Long steel pins with flat heads, linen thread.
TECHNIQUE.—The lips are brought face to face, insert a pin
perpendicular to the wound three millimeters from the edges,

* Bayer, Lelrbruch der Veterindr Chirurgie. Wien, 1890.

SUTURES. 25

through the first lip from without to within, and through the
other from within to without. In the same manner pass other
pins at intervals of about a centimeter. Engage a loop of the
. thread under both ends of the first pin; carry the ends of
the thread toward opposite ends of the pin, crossing it above
the wound; pass it again under the pin in such a manner as
to form a figure 8; repeat three or four times, then unite the
ends by a straight knot or a rosette.

Apply a similar ligature to all the pins. Cut them near the
stitches.

4.—Quilled Suture.

Ordinary curved needle with large eye, silk or linen thread;
wooden pins, red rubber tube or small gauze cylinder.

TECHNIQUE.—With a needle and double thread pierce the
lips of the wound as in the discontinuous suture. Repeat for
the other stitches. Upon one of the lips of the wound their
extremities are disposed as loops. Slip the wooden pin, rubber
tube or roll of gauze in these loops, draw the other ends of the
thread to fix the first end; after having divided them, tie them
against a similar pin until they are firm.

5.

(a) First Procedure.—A curved needle with a thread having
a ball of wadding or a small roll of tape or gauze attached to
one end is needed.

TECHNIQUE.—With a needle and double thread pass from
without to within through one of the lips of the wound at
about a centimeter from its free edge; draw the thread so that
the dossil is just against the skin. Pass a thread in the same
manner at a point corresponding on the other lip. In this
way make a certain number of stitches. Afterwards unite the
the corresponding threads quite firmly. |

(b) Second Procedure.—Heilister needle, dossils of fifteen
centimeters cut obliquely at one end, and bearing a knot at
the other.

TECHNIQUE.—Pierce one of the lips of the wound from
within to without with the needle, insert an end of the dossil
in its eye and pass it by withdrawing the instrument. In the
Same manner pass the dossil in the other side at a point

Dossil Suture.

e

26 EXERCISES IN EQUINE SURGERY.

corresponding to the first. Dispose four, six or eight in this
manner, draw them tightly and tie over a roll of gauze. |

G.—Bayer’s Suture.

This is convenient for those wounds with uncovering of the
skin where there is disruption of the subcutaneous tissue.

Instruments.—Needles and thread, drain, quills, gauze,
wadding and splints.

TECHNIQUE.-—Unite the lips of the wound by separate sik
stitches, being careful to take a sufficiency of the skin along
adjoining edges to bring the deeper structures together in
such a manner as to produce a crest a centimeter and a half
high (fig. 6). Fix a rubber drain at the inferior angle of the
wound. On a level with its limits pass, deeply perpendicular
to the cut, three double threads, and make a quilled suture.
Cover the region of the operation with a layer of gauze, then
a layer of wadding, and compress the whole by;means of
splints, the extremities being secured under the quills; the
skin is then exactly secured on the subcutaneous tissue; there
is no dead space (fig. 7).

VI.—_CAUTERIZATION.

Instruments.—Ordinary cautery for lines or points, heated
by charcoal, coke, or by means of a blast lamp; Paquelin’s
thermo-cautery, cautery of Paquelin de Place, or zodcautery.

Restraint.—To cauterize the various regions of the trunk,
and the external face of the limbs, the animal is restrained in
the standing position, if not too irritable, by employing the
twitch, raising a limb, or using the hobbles. To cauterize the
two faces of one or more members, operate upon the ani-
mal while cast. If the cautery is applied to only one member,
always begin on the internal face. If two limbs are to be
operated upon, cauterize the internal face of one and the
external face of the other. If two limbs are cauterized,
operate upon the internal face of one and the external face
of the other. When the horse is turned, it is important to
take precautions to prevent bruising the external region
already cauterized.

The limb to be operated upon should be immovable, well
secured, and the region of the operation well exposed.

CAUTERIZATION. 27

1.—Line Cauterization.

TECHNIQUE.—Use cauteries having the inferior edge regular,
thin, not sharp; very gradually convex the greater part of its
extent, curved most at its extremities (angles blunt). Before
placing the hot cautery upon the part, brush with a file, or
rub it upon a brick to remove the scales to prevent them
attaching themselves by their sharp edges. After having
clipped the hair, trace the lines with the cautery at a dull red
heat. The lines should be a centimeter and a half apart,
parallel, obliquely, or perpendicular to the direction of the
hair. The surface cauterized should always be of greater
extent than the diseased part.

If it permits of a series of lines in diverse directions and
unequal extent, the lines should neither cross nor unite; all
those of the same series should commence aud stop a half
centimeter from the first line of the neighboring series. The
series of lines in different directions should not be uselessly
multiplied; two or three are sufficient in all cases.

To complete the firing, use cauteries of a cherry red, never
to a white heat; pass successively in all the lines of the same
series, holding the instrument perpendicular to the skin, exer-
cise only a gentle pressure upon the handle, and never go
against the direction of the hair. When you take a hot
cautery, pass it rapidly in the first series of lines, slacken the
movement little by little as the instrument cools. Do not pass
it twice successively in the same line with only a very brief
interval; before reapplying the hot iron let the heat you have
deposited radiate for a time in the subcutaneous tissue.

The three degrees of cauterization are characterized by the
following signs:

First degree or light firing : Superficial grooves of yellowish
brown color, and at the bottom may be seen several drops of
serosity. Second degree or ordinary firing : Deeper grooves of
yellowish gilt color, abundant serosity at the bottom and
softening of the adjoining epidermis. Third deyree or severe
jiring: Furrows are deep and the walls are of a pale yellow
color; serosity is very abundant in the lines and drops upon
the cutaneous bands which separate them.

28 EXERCISES IN EQUINE SURGERY.

For light firing, to proceed methodically, pass five or six
times in the lines; for ordinary firing, eight to ten times, and
for severe jiring, twelve to fifteen times.

Fig. 8.—Cautery for lines.—Cautery for points.—Cautery for fine points.

2.—Cauterization in Superficial Points.

The operation may nearly always be made upon the animal
while standing, with a twitch applied to the upper lip.

TECHNIQUE.—NSelect an olivary or conic blunt point cautery
about three millimeters in diameter (fig. 8); heat to a sombre
red to mark the points, and to a cherry red to effect the
cauterization.

Dispose the points in quincunx (fig. 9), that is, those of
one row corresponding to the intervals of those of the adjacent
row, at equal distance of a centimeter to a centimeter and a
half from each other. Nevertheless, they may be brought
closer together toward the center of the lesion to concentrate

CAUTERIZATION. 29

the calorie, and increase the space towards the periphery.
Pass successively over the different rows of points, avoiding
passing twice in succession in the same line. One gradually
augments the duration of the application of the cautery to the
same degree as it cools.

Ye )'
YZ \
Wf 77 Z

r >

oe MW
RY .

nF

ANT

Fig. 9.—The principal regions where the cautery is ordinarily applied.
Canon, fetlock, pastern, and coronet of the left posterior limb; fired in
superficial points ; pastern and coronet of the left anterior limb fired in
fine points; tendon and stifle of the right limbs fired with the needle.

For the degree of firing the same signs are present as in line
firing.

Apply the cautery five or six times for light firing, eight to
ten for ordinary firing, and twelve to fifteen for severe firing.

30 EXERCISES IN EQUINE SURGERY.

3.—Firing in Fine Penetrating Points.

TECHNIQUE.—Use a cautery with a slender point two milli-
meters in diameter. (Fig. 8).. The points are disposed
alternately, having interspaces of eight to ten millimeters.
Pass the cautery successively in the different rows of points,
and exercise sufficient pressure upon the handle to penetrate
the skin with two or three cuts of the cautery. The iron
should not pass the deep subcutaneous tissue.

4.—Firing with Needles.

TECHNIQUE.—Use a cautery with a slender point two
millimeters or more in diameter, or one of the instruments
especially constructed for the purpose.

The points disposed alternately, should have interspaces of
five to ten millimeters, depending upon the extent of the
surface to be cauterized and the degree of firing. At the first
cut, pierce the skin and make the instrument penetrate into
the diseased tissue; fibrous, synovial, tendonous or osseous
tissue. Pass one, two, or three times successively in the
different rows of points. For the synovial, give only one
application of the instrument.

5.—Sub-cutaneous Cauterization.

Instruments. — Convex bistoury, forceps, retractors, and
point or button cautery. (Fig. 10.)

Fig. 10.—Button Cauteries.

TECHNIQUE.—First step: Incision and laying back the skin.
‘Clip the hair with the scissors or destroy it on the surface with
.a cautery, make an incision:of eight to ten centimeters in the

CAUTERIZATION. 31

skin in a vertical direction, or in the direction of the hair.
Dissect the skin on each side, exposing the underlying tissue
for a sufficient extent; apply wet clothes over each of the lips
and hold to one side by means of the retractors. (Fig. 11).

Fig. 11.—Subcutaneous Cauterization. (After Lanzillotti Buonsanti.)*

Second step: Application of the Cautery. Apply a certain
number of superficial points of greater or less depth upon the
naked subcutaneous tissue.

If you employ the button cautery (fig. 10), cauterize a thin
layer of the tissue.

* Lanzillotti Buonsanti, Tratlato di Tecnica e Therapeutica cnirurgica-
Milano, 1389.

NECK.—THORAX.—ABDOMEN.

I.—_HYOVERTEBROTOMY.

Restraint.—-Cast the subject on the side opposite to that on
which the operation is to be performed. Hold the head
moderately extended upon the neck after having removed the:
halter. (The operation may be practiced upon the animal
standing, after placing a twitch upon the lower lip.)

Instruments.—Scissors, curved and straight bistouries, for-
ceps, retractor, S sound, tape and drain.

TECHNIQUE.---First step : Incision of the skin and dissection
of the tissues which cover the guttural pouch.—After having
clipped the hair, make a cutaneous incision of three or four
centimeters immediately in front of the atlas, at the middle
third of the border of that bone.

The skin is gently drawn forward and downward in such
manner that the superior angle of the incision corresponds to
the tendon of the complexus minor; divide within the extent
of the cutaneous wound, the sub-parotidean aponeurosis, and
avoid wounding the gland and the auricular vein; if you come
upon the branches of the first and second pair of cervical
nerves, remove or divide them with the bistoury.

With a retractor, an assistant draws the anterior lip of the
incision forward (skin, gland and aponeurosis). Insert the
index, dorsal face outwards, under the aponeurosis, detach it
from the subjacent planes (small oblique of the head, stylo-
hyoidean muscle), execute lateral movements with the finger,
pushing it forward.

As soon as the exposure is sufficient, the index perceives this
point—in front, the enlarged portion of the great branch of
the hyoid; in the rear, the styloid apophysis of the occipital;
between the two, the muscular plane formed by the stylo-
hyoidean and the digastric. (Fig. 12.)

Second step: Puncture.—Exercise sufficient traction upon

the retractors to enlarge the wound and permit seeing to the
32

HYOVERTEBROTOMY. Bi

Fig. 12.—Hyovertebrotomy. Parotid Region.

P, parotid; T, tendon of the complexus minor; A, atlas; P, O, small
oblique of the head; A,8,styloid process of the occipital; H, great
branch of the hyoid; S, H, stylo-hyoidean muscle (occipito styloidean
of Chauveau and Arloing, great kerato-hyoidean of Girard); D, diga-
stric muscle; C, C, carotid artery; M, H, external maxillary artery:
A, A, posterior auricular artery.

34 EXERCISES IN EQUINE SURGERY.

depth of the field of operation, particularly the fibers of the
stylo-hyoidean, obliquely directed downward and forward.
The deep face of this small muscle is covered by the mucous
of the guttural pouch. Its center is a little above the postero-
inferior angle of the branch of the hyoid, where the puncture
should be made. Hold the bistoury in an oblique direction
downward and forward, the cutting edge turned toward the
commissure of the lips; carry it in the wound, the point applied
to the center of the stylo-hyoidean muscle, the blade parallel
to the fibers of that muscle; puncture it, make the blade
penetrate a centimeter into the pouch and withdraw the in-
strument immediately. If the puncture is made too deep, one
may strike the internal carotid or the branches of the neigh-
boring nerves (spinal, pneumogastric, or superior cervical
ganglion of the great sympathetic). If the cutting edge of the
bistoury is directed upward, there is danger of wounding the
facial nerve and posterior auricular artery; if turned down-
ward, the external carotid is menaced. Engage the index
finger in the puncture and enlarge it.

Third step: Counter Opening.—Introduce in the pouch one
extremity of the 8 sound; carry the other extemity toward the
ear in such manner as to give the instrument a direction nearly
parallel with the parotid; then push it under the gland towards
the inferior border; also make it penetrate the bottom of the
guttural pouch, the sub-parotidean connective tissue, and
carry the extremity to the inferior borcer of the gland, in the
angle formed by the jugular and glosso-facial. When the
extremity of the sound appears at this point, give it issue by
making a short ifcision parallel to the inferior border of the
parotid, in the skin and sub-cutaneous aponeurosis, raised by
the instrument. In the same manner, gradually. prolong it
forward and pass the tape or the drain by withdrawing the
instrument.

Il.—TRACHAEOTOMY.

Restraint.—Avoid injury by the front feet. Twitch the
upper lip; hobble both fore limbs (ordinary hobbles or Le-

TRACHAEOTOMY. 35 °

Goff’s hobbles), or restrain the animal in the travis and fix the
anterior members against the posts. :

Instruments.—Curved scissors, convex and straight bis-
touries or sage knife (right) with a thin blade; anatomical
forceps, three tenaculums, one of which is pointed, and a
trachaeotomy tube.

TECHNIQUE.—First step: Incision and dissection of the
tissues which cover the trachea.—The head is held much ele-
vated. Take a position in front of the subject; clip the hair
for a length of ten centimeters over the anterior aspect of the
neck at the limit of the middle and superior thirds. With the
convex bistoury make a vertical incision of five or six centi-
meters in the skin. With a second cut of the bistoury separate
the sterno-hyoidean and sterno-thyroidean muscles upon the
median line; these muscles and the cutaneous lips should be
divided by means of the tenaculums held by two assistants;
the connective tissue which covers the anterior face of the
trachea is raised with the forceps; divide it upon the median
line, follow by two cuts with the bistoury given flatways, the
one to the right, and the other to the left, detaching it from
the trachea over the prominence of two rings; the connec-
tive laminae are included in the retractors and the rings to be
cut are bare.

Second step: Hatirpation of part of two tracheal rings.—
Implant the sharp pointed tenaculum from left to right in the
inter-annular ligament; hold it with the left hand. To the
left of the hook and near to it, make a puncture with the
straight bistoury or the sage knife; with the cutting edge, near
the point, by a saw-like movement, divide from left to right
the superior ring, making the incision semi-elliptical; follow
by an incision in the inferior ring, dividing it in the same man-
ner from right to left. Return to the starting point; the
instrument has excised the elliptical bit of trachea which rests
upon the point of the tenaculum. You may also cut each
portion of the circle in two steps; implant the blade of the
bistoury horizontally in the middle of the superior ring, and
divide it by making successively two curved incisions, the one
to the left and the other to the right. The same manipulation
for the inferior ring. (Fig. 13 )

36 EXERCISES IN EQUINE SURGERY.

Third step: Introduction of the tube.—First introduce the
inferior portion of the trachaeotomy tube and follow by insert-

Fig. 13.—Trachaeotomy.

The incision is prolonged above and below. Tracheal opening made
by an incision parallel to the two rings.

ing the ascending portion; secure it by turning the pin. If
the tube moves, secure immobility by rolling a little tow upon
the external tube between the opening and the skin.

LARYNGEAL TRACHAEOTOMY. BY 6

Ill.—LARYNGEAL TRACHAEOTOMY.

This consists in the introduction of a tube at the origin of
the trachea by an opening made in the crico-tracheal ligament.

Restraint.—The same as for trachaeotomy.

Instruments. —Scissors, bistouries, forceps, retractors and
special trachaeotomy tube, having a light, short canula.

TECHNIQUE.—This comprises three steps:

First step: Incision of the skin and muscles.—The head is
held elevated by an assistant; take a position in front of the
neck and explore the region of the larynx. Discover the ecrico-
tracheal ligament; clip the hair over the region; then make a
cutaneous incision on the median line, from in front of the
anterior border of the criccid to the third tracheal ring; divide
the layer formed by the sternal and subscapulo hyoidean
muscles, apply the blunt tenaculums or retractors, and turn
aside the lips of the wound,

Second step: Incision of the crico-tracheal ligament.—With
the bistoury held horizontally, section the crico-tracheal from
left to right to the extent of five centimeters.

Third step: Application of the twbe.—In the large gaping
opening, insert the tube as in ordinary trachaeotomy.

IV.—ARYTENECTOMY.

Restraint.— Hold the animal upon its back by means of a
solid erosspiece passed between the hobbles of the anterior
and posterior limbs. The head should be extended upon the
neck in the same axis.

Instruments.—Straight, curved and knee bent scissors,
convex blunt pointed bistouries, speculum, long rat-tooth
forceps, tampon canula, curved needle fixed to a handle, and
catgut.

TECHNIQUE.—It comprises four steps:

First step: Incision of the skin and muscles which cover the
trachea.—Clip the hair over the region of the larynx and
superior part of the trachea. With the convex bistoury incise ‘
the skin, the muscles which cover the larynx and prelaryngeal
connective tissue, upon the median line to the thyroid body
and third tracheal ring.

38 EXERCISES IN EQUINE SURGERY,

Cold applications are sufficient to arrest ordinary hemor-
rhage.

Fig. 14.—Arytenectomy.

The second step is accomplished, the crico-thyroidean ligament, the
ericoid cartilage, the crico-tracheal ligament and the first two rings of
the trachea are sectioned. The tampon canula and speculum are in
position. CC, cricoid; ist A, first annular ring of the trachea.

If one or more arterioles are sectioned, use torsion on the
ends.

Second step: Incision of the larynx and the first rings of the
trachea. Introduction and fixation of the tampon canula.—

ARYTENECTOMY. 39

Implant in the crico-thyroidean ligament, upon the median line
and immediately in front of the cricoid, the convex bistoury
held vertically with the cutting edge to the rear; cut upon the
median line, from front to back, the cricoid cartilage, the crico-

Fig. 15.

Third step: (a) Incision of the mucous membrane, along the superior
and posterior borders of the arytenoid. For clearness of demonstration,
the incision of the second step is prolonged in front just to the middle
of the epiglottis, and back just to the fourth annular ring of the trachea.

tracheal ligament and the first two rings of the trachea; after-
wards complete the division of the crico-thyroidean ligament
from back to front and avoid wounding the voeal cords; apply
the speculum, include the mucous membrane on a level with
the crico-tracheal ligament; insert the tampon canula and hold

it backward by means of a band passed under the pavilion.
(Fig. 14.)

40 EXERCISES IN EQUINE SURGERY.

Third step: Excision of the left arytenoid cartilage.—With
the blunt-pointed bistoury incise the mucous membrane along
the superior and posterior borders of the arytenoid (fig. 15);
with the straight scissors cut the vocal cord at its insertion to

Fig. 16,
Third step: (b) Dissection of the arytenoid at its inferior border and
external face.

the cartilage, dissect it by small cuts from back forward, see-
tioning the mucous membrane along its inferior border, and
the muscular fibers inserted upon its external face (fig. 16);
then, with the scissors held vertically, divide from above to
below, the mucous membrane which forms the anterior border,

ARYTENECTOMY. 41

The arytenoid is held immovable with the forceps; section it
from without to within near its articular angle by using the
blunt bistoury held in a gently oblique direction downward

Fig. 17.

Third step: (c) Section of the arytenoid near its articular angle.
A, laryngeal branch of the thyroid artery.

and forward (fig. 17); afterward lift the cartilage with the
forceps, hold the curved scissors vertically, pass them under
the posterior part, the flat face upward, and detach the fibers
inserted to it; (fig. 18); finally cut the mucous membrane on
a level with the arytenoid beak. (Fig. 15.)

42 EXERCISES IN EQUINE SURGERY.

Suture.—Use a thread of catgut thirty-five to forty centime-
ters long; the needle is carried over the anterior lip of the
wound, a centimeter and a half from the median line; then
make it pierce the mucous membrane from front to back, then

—

Fig. 18.
Third step: (d) Excision of the cartilage by means of the curved scissors.

to a corresponding point on the posterior border; with a forcep
seize the thread and bring one of the ends out; withdraw the
needle, its eye being furnished with the other end of the
thread. Unite the two ends of the thread with a straight knot
without exercising traction upon the mucous membrane.

Apply one or two other stitches in a similar manner (Moller).
Figs. 16 and 17.

CATHETERIZATION OF THE G@SOPHAGUS. 43

Dressing.—Place within the laryngeal cavity two rectanguiar
tampons of gauze marked by threads; remove the dilator;
suture the deep pre-laryngeal muscles, using care to pass any
of the threads in the tampon near their border, in order to
secure them solidly; then suture the skin. (Fig. 18.)

Wi

CATHETERIZATION OF THE G&SOPHAGUS.

Restraint.—If it is desired to operate on the animal stand-
ing, hobble both fore limbs, apply a twitch to the superior lip
and hold the head in extension in order to efface the angle
which is formed on the axis of the bucco-pharyngeal cavity,
and the cervical portion of the esophagus.

The operation is simple when the animal is cast. In that
attitude the head should also be extended upon the neck.

Instruments.—Mouth speculum and long catheter of small
calibre, terminated by an olivary enlargement.

TECHNIQUE.—The tongue is brought out of the mouth and
held to the right or left by an assistant; put on the speculum
and have it maintained in position by another assistant. The
probang, covered with vaseline or oil, isheld in both hands. It
is engaged in the opening of the jaws, and made to penetrate
to the depth of the bucal cavity and to the veil of the palate.
Avoid displacements which provoke movements of the
tongue. Arriving at the bottom of the mouth, the probang is
arrested by the veil of the palate——a resistance easily overcome
by a gentle effort. At the entrance of the oesophagus there is
another resistance; if the instrument is carefully held upon the
median line, it suffices to push carefully to clear the wsopha-
geal orifice. Then the probang, passed with the right hand,
slips through the left and descends rapidly along the csopha-
gus. At the last portion of the conduit, where the muscles lie
very thick, the progression of the instrument is often slack-
ened a little, but’ without exerting violent movements one
arrives at the cardiac orifice; a sensation of overcoming resist-
ance indicates the entrance of the probang into the stomach;
the stylet is withdrawn and an escape of gas is the result.

44 EXERCISES IN EQUINE SURGERY.

VI._OESOPHAGOTOMY.

Restraint.—Apply a twitch, hobble the fore feet, or use
LeGoff’s hobbles on both hind feet and the left fore foot.

Instruments.—Straight and -curved scissors, straight and
convex bistouries, director, dissecting forceps, fine needle and
thread.

TECHNIQUE.—First step: Incision of the layers which cover
the oesophagus.—Make the operation on the left side at the infe-
rior third of the neck, where the oesophagus is applied to the
left face of the trachea. Clip the hair in the guttural groove
for a length of fifteen centimeters. Make an incision of ten
centimeters in the skin immediately above the jugular; follow
with division of the cutaneous muscles and of the anterior part.
of the mastoido humeral. With the left thumb introduced in
the wound, separate the anterior lip of the incision from the
jugular, then from the carotid when dissecting the connective
tissue on a level with that artery. Incise the laminae of cel-
lular tissue which sheaths the oesophagus with a bistoury; do.
not tear the tissue with the fingers, and above all, avoid
detaching it below the inferior angle of the wound.

Second step: Isolation of the Oesophagus. The oesophagus
has not the firm consistence which it presents in the cadaver;
in the living animal it is weak, soft, very mobile; often the
fingers manipulate it without recognizing it. When the con-
nective tissue layers, which envelop it, are entirely divided,
its anatomical situation is almost invariably upon the left side
of the trachea, permitting of immediate recognition. Seize it
between the thumb and index of the right hand, bring it out
and pass the curved scissors under it, point forwards.

Third step: Puneture and removal of constriction. The
thumb of the left hand compresses the oesophagus upon the
scissors; with the point of a bistoury held in the right hand,
make a short incision of the muscular and mucous coats;
through that opening insert a director with groove turned
outward, in the superior part of the oesophagus; hold the
director with the left hand, slip in the groove the back of the
bistoury, relieve the constriction of the oesophagus,—mucous
and muscular—for the length of several centimeters. When

CSOPHAGOTOMY. 45

the esophagus is compressed over the scissors the deglutition

T, trachea; O. E, cesophagus; C, carotid.

caused by alittle saliva or a draught of liquid permits of
making, by a single cut of the bistoury, the puncture and

46 EXERCISES IN EQUINE SURGERY.

relief of constriction, without any danger of piercing the oppo-
site mucous wall.

Fourth step: Suture.—With the oesophagus lying upon the
scissors, by means of the forceps and fine needles, suture the
mucous coat alone. The ordinary overcast suture is sufficient.
(Colin). ‘

If fluids collect in the inferior part of the wound, incise the
skin and adjacent layers to the bottom of the cul-de-sac.

VII.—CERVICAL DESMOTOMY.

Restraint.—Cast the animal; twitch the upper lip; hold the
head extended.

Instruments.—Scissors and tenotomy knives.

TECHNIQUE.—Make the operation at any point whatever at
the superior part of the neck, along the cervical ligament.
Clip the hair, implant the blade of the straight tenotome in
the deep part of the neck, immediately in front of the inferior
border of the cervical cord; introduce into the wound the
curved tenotome, turn the cutting edge toward the ligament
and cut it after having flexed the head.

VIII.—RE-SECTION OF PART OF THE SPINOUS
PROCESSES OF THE WITHERS.

Restraint.—Cast the animal; twitch the superior lip.
Instruments.—-Scissors, bistouries, sequestrum forceps, scis-
sors bent on the flat, rubber drain, wadding, needles and
thread. -
TECHNIQUE.—Clip the mane and hair over the withers and
posterior part of the neck. At the summit of the withers
make a median cutaneous incision fifteen to twenty centi-
meters long. Separate from each side the layers of musculo-
aponeurosis that are attached to the superior part of the
spinous apophysis (the aponeurosis of the cervical and dorsal
trapezins, rhomboideus, aponeurosis common to the splenius,
the complexus minor and the anterior serratus.) Take up
with the forceps, and ligate the principal vessels that bleed.
With the bistoury or a sage knife, cut the supra-spinous
ligament transversely in front and rear of the apophysis to be

THORACENTISIS. 47

excised. With the chisel and hammer make the resection two
or three centimeters from the top of the isolated segments.
At the bottom of the wound and anteriorly make a lateral
counter opening; insert a drain and attach it to the skin,
Bandage with wadding. Make a dossil suture.

IX.—THORACENTISIS.

Restraint.—Twitch; raise the anterior limb on the side
opposite that on which you wish to operate.

Instruments.—Convex bistoury and capillary trocar.

TECHNIQUE.—With the horse, the effusion in the pleura is
nearly always double, for, with very rare exceptions, the two
pleural cavities communicate; one limits himself to the punc-
ture of the right pleura.

Place yourself on a line with the hypochondriac region,
Clip the hair near the seventh intercostal space a little above
the spur vein, and make a short vertical slit (button-hole) with
the bistoury. Take the trocar and canula, hold it in the right
hand, fix it solidly against the palm with the thumb and index
finger guided along the canula, the point passing two centi-
meters beyond the ends of the fingers; within the lips of the
wound, make it penetrate perpendicularly into the thorax by
a double movement of pressure and torsion. Afterwards with-
draw the trocar from the canula.

If you puncture the left side, operate within the eighth in-
tercostal space and hold the troear in an oblique direction
from front to rear.

X.—PARACENTISIS.

Restraint.—-T witch; raise the left posterior limb.

Instruments.—Convex bistoury and capillary trocar.

TECHNIQUE.—Puncture of the abdomen may be made on the
median line at equal distance from the pubis and xiphoid
appendix of the sternum, or at the dependent portion of the
left flank.

After having clipped the hair over the region selected for
operation, make a small incision in the skin. Take the capil-
lary trocar and canula, hold it as directed for thoracentisis

48 EXERCISES IN EQUINE SURGERY.

and take a position on a line with the left hypochondriac
region, the knees bent; make the penetration into the abdo-
men by a double movement or pressure and rotation. Seize
the canula with the thumb and index of the left hand; with-
draw the trocar with the other.

XI.—ENTEROTOMY.

Restraint.—Twitch; raise the right fore limb.

Instruments.—Convex bistoury and trocar of small calibre
(nested trocar).

TECHNIQUE.—To puncture the caecum, the place to be
selected is the hollow of the right flank at equal distances
from the angle of the haunch, the last rib and the transverse
processes of the lumbar vertebrie, or a little above this point.

Take a position facing the flank, clip the hair over the point
where you wish to operate, and make a small incision with the
bistoury. Hold the trocar in the left hand perpendicular to
the surface of the flank, the point carried into the incision;
with one stroke given upon the handle with the palm of the
right hand, make the instrument penetrate into the flexure of
the caecum. Hold the canula in the left hand, withdraw the
trocar with the other.

XII.—CATHETERIZATION OF THE URETHRA
IN THE HORSE.

Restraint.—Apply a twitch to the upper lip, hobble the
posterior limbs, pass the line between the anterior limbs, cross
it and have it held by an assistant.

Instruments.—Long catheter of gum-elastic or of rubber,
furnished with a stylet and coated with vaseline.

TECHNIQUE.—After having emptied the rectum, take a posi-
tion even with the right flank, engage the right hand in the
sheath, seize the head of the penis; by gentle and continued
traction bring that organ out, and have it held by an assistant.
Take the catheter provided with a stylet, introduce the slender
extremity into the urethral tube and pass the instrument
slowly into the urethra to the level of the ischial curve; to
make the passage more easy in that region, withdraw the

ee —

URETHROTOMY. 49

stylet for a length of fifteen centimeters; the canula curves
inward and becomes engaged within the pelvic portion of the
urethra; repass the stylet and continue the catheterization
until the catheter arrives in the bladder. If the catheter is
too rigid to eurve inward at the ischial curvature, exert very
gentle pressure upon its extremity while an assistant passes it;
or, perhaps engage the hand in the rectum and guide the
catheter to the bladder. The stylet is withdrawn, the urine
flows. It is rarely necessary to effect pressure upon the blad-
der by the hand introduced in the rectum.

The retraction of the catheter offers no difficulty; it is suffi-
cient to exercise gentle traction associated with semi-rotary
movements. The re-introduction of the stylet is useless.

In practice the operation should always be made aseptic.

XITI.

Restraint.—The same preparatory measures as for catheteri-
zation. Hold the tail elevated on the median line.

URETHROTOMY.

Instruments.—Straight bistoury, director, lithotomy forceps,
and a syringe provided with a slender canula.

TECHNIQUE.—The operation is performed at the superior
part of the perineum on a level with the urethral curvature.

Empty the rectum; an assistant secures the penis; fill the
syringe, engage the canula in the inferior. part of the urethra,
direct the assistant to compress the head of the penis upon the
base of the canvla, but permitting the orifice of the syringe to
be free. The operation consists of two steps.

Ist. Large puncture of the urethra.—While the assistant is
injecting the liquid in the urethra, place yourself behind the
horse and watch the distention of the canal (fig. 20). When
the part where you wish to operate appears well in relief,
discontinue the injection. The assistant who holds the penis
continues the compression, and, by occluding the urethral
opening, prevents the escape of the liquid. The operatory act
essential to urethrotomy is one of extreme simplicity. It con-
sists in the puncture with division of the urethral wall. It
should be accomplished at a single step. With the left hand
exercise gentle traction below upon the skin of the perineum,

50 EXERCISES IN EQUINE SURGERY.

The straight bistoury is held as a reversed fiddle bow in a
slightly oblique direction upward and forward; it is implanted
dezply upon the median line, immediately above the ischial
arch, in the axis of the enlargement formed by the distended
urethra. The penetration of the canal is made known by the

Fig. 20.—Perineal and Caudal Region.

O, Suspensory ligament of the penis; C B, bulbo-cavernosus muscle; SC,
inferior sacro-coccygeal muscle; IC, ischio-coccygeal muscle.

escape of a jet of liquid. Whether the animal retracts or not,
do not withdraw the instrument quickly in the direction which
you have given it at the time of the puncture. Bring the
hand upward, divide the superior wall of the canal and the
tissues which cover it for a length of two or three centimeters

If the puncture is too small, introduce a director, groove
upward, upon the index of the left hand, and with the straight
bistoury effect the division. The hemorrhage is not profuse

INGUINAL KELOTOMY. 51

except in case the bulbar artery is cut. In that case, tam-
ponize or make a mediate ligature at the superior extremity.

Second step: Introduction of the lithotomy forceps in the
bladder.—Apply the radial border of the left hand palmar sur-
face upward, upon the perineum, immediately below the punc-
ture. The lithotomy forceps are held in the right hand, with the
concave edge of the spoon turned down, introduce it into the
wound and slip over the palmar surface of the left hand, then
engage it in the intra-pelvie portion of the urethra and in the
bladder. You may also guide the instrument upon the index
introduced in the canal.

XIV.—INGUINAL KELOTOMY.

Restraint.—Cast the animal on the side opposite to that on
which you wish to operate. Afterwards place it in the same
position as for effecting perforation of the inguinal canal, the
posterior superficial limb maintained upon the corresponding
shoulder or brought into a state of abduction by two ropes,
one fixed in the direction of the neck, the other perpendicular
to the vertebral column.

Instrwments.—Scissors, coneave and straight bistouries, S
sound, director, blunt pointed bistoury, catgut or clamp and
castration forceps. ;

TECHNIQUE.— Introduce an intestinal loop into the vaginal
sheath, in the following manner: Effect laparotomy ona line
with the left flank; draw a loop of small intestine out of the
abdominal cavity; tie it to the S sound with a dossil, which is
passed around it and through the eye of the sound; introduce
the other extremity of the sound in the abdomen; pass it into
the vaginal sheath until it arrives at the bottom; puncture the
serotum when it comes in contact with the wall and draw it
out at this point; it carries the intestinal loop to which it is
attached with it; an artificial intestinal hernia is thus pro-
duced. Cut the tape and unite the two ends with a string;
afterwards the loop may be re-introduced into the sheath if it
should get out.

First step: Incision of the scrotum and enucleation.-—Accom-
plish the incision and enucleation as in castration by the use
of clamp in the covered operation.

52 EXERCISES IN EQUINE SURGERY.

Second step: Incision of the vaginal sheath.—With the-

Fig. 21.—Strangulated inguinal hernia. _ The external wall and the
vaginal sheath are incised.

AC, erural arch; PO, small oblique muscle of the abdomen; CG,
incision of the sheath (external face); I, intestine; C, testicular cord.

point of a convex bistoury make a straight incision in the

INGUINAL KELOTOMY. 53

three deep layers of the scrotum towards the posterior ex-
tremity of the testicle; engage the director in the incision par-
allel to the inferior border of the gland; the groove should be
turned toward the envelopes; divide it from within outward.
by slipping a straight bistoury in the director. The testicle
and intestine are thus exposed.

Third step: Dividing the neck of the sheath.—Towards the
middle of each of the lips, resulting from the division of the
deep envelopes of the scrotum, or upon the double lips of the
scroto-dartois layers, apply artery forceps having large jaws,
and have an assistant spread themapart. If you operate upon
the left, carry the index of the left hand, pulp upwara, to the
bottom of the sheath and engage it in the ring; afterwards
slip the flat side of a blunt-pointed bistoury upon the palmar
face; when its point passes through the ring, execute a quarter
of a revolution on the axis of the instrument in such manner
as to turn the cutting edge outward against the serous mem-
brane; by a gentle sawing movement, divide the ring.

Fourth step: Reduction.—The lips of the sheath are always
held apart and the testicular cord moderately stretched;
return the intestinal loop into the abdomen by gentle pressure
frequently repeated, beginning at its superior part.

Fifth step: Ligature or application of a clamp.—Bring
down the lips of the sheath against the cord, tie it, or fix the
clamp high upon the cord and covering, and cut off the testi-
cle two centimeters below.

If you wish to use torsion upon the sheath,—an excellent
operation to efface the opening just at the ring and avoid a
recurrence in the case of chronic inguinal hernia,—modify the
second and fifth steps as follows: 1st, enucleate the scroto-
dartois as high as possible; 2d, cover the cords with the deep
envelopes and execute two or three turns upon its axis before
applying the clamp.

54 EXERCISES IN EQUINE SURGERY,

XV.—CASTRATION OF THE HORSE.

Restraint.—Cast the animal upon his left side; apply the
twitch to the upper lip; attach a rope to the canon of the right
posterior limb, pass it from above downward under the neck,
then from before backward over the adjacent part of the loop
and under the limb to be displaced; unhobble the limb and by
drawing upon the rope, perpendicular to the vertebral column,
bring the foot on a line with the shoulder of the corresponding
fore limb; slip the rope toward the fetlock and pass it around
the canon. Two assistants should be instructed to maintain
the line in that position.

General Directions.—Be assured that there is no chronic
inguinal hernia. Except while proceeding with the torsion,
the operation should be rapidly executed. Begin with the
inferior testicle.

1.—Castration with Clamps.

Instruments.—Convex bistoury, scissors, clamps, cord or
metallic rings, forceps, ete.

First step: Castration with the Testicles Covered.

TECHNIQUE.—JSirst step: Prehension of the Testicle. The
left hand, with the fingers extended, the thumb separated from
the index, the palmar face applied to the skin, is placed in
front of the enlargement formed by the gland; the right hand,
with the fingers disposed in the same manner, is placed behind.
Bring the hands together, engaging them deeply under the
testicle. With the left hand enclose the cord at its superior
part. When the testicle is well down the cord should be
immediately seized. If the gland makes a half turn upon the
cord, return it to the normal position before securing it.

Second step: Incision of the scrotum, the dartois and the
sub-dartois connective tissue.—With the convex bistoury held
as a fiddle bow, incise the scrotum and dartois the full length
of the inferior border of the testicle by a single act.

The compression exercised by the fingers of the left hand
should bring out the testicle covered by the deep envelopes.
With a gentle hand incise the sub-dartois connective layers;
the aponeurosis of the cremaster muscle appears with its nar-

CASTRATION OF THE HORSE. 55

cous color; the action of the bistoury is marked upon its
superficial fibers.

Fig. 22.—Testicle and cords.

TC, covered testicle; T D, exposed testicle; P VY, vascular portion of
the cord; CD, vas deferens,

Third step: Enucleation of the testicle.—Lay aside the
bistoury; with the fingers of the right hand introduced in the

56 EXERCISES IN EQUINE SURGERY.

wound, the thumb on the same side as the left, by a double
pressing and spreading movement engage them between the
sub-dartois connective tissue and the fourth layer, which is
formed without by the cremaster and within by the fibrous
tunic. :

Seize the testicle with the right hand, the thumb applied
upon the superior face and the fingers upon the inferior; with
the thumb and index of the left hand, liberate the cord high
in front and laterally, from the incised tissues. Take the cord
in the left hand, the thumb applied upon the cremaster; with
the index or the thumb of the right hand, perforate and tear
the dense connective tissue which tightly unites the epididymis
to the dartois in the rear of the testicle.

Fourth step: Application of the clamps.—The testicle is
held in the right hand, thumb above, and the superficial
envelopes removed for four or five centimeters beyond the
epididymis; put on the clamp with the left hand; proceed from
before backward upon the inferior part of the cord, and
pinching the epididymis and also the scrotum; that hand
‘ should also bring the two parts of the clamp together behind
the cord. An assistant slips a loop of cord, having a knot as
for phlebotomy, over the branches of the clamp; the right
hand holds the ends. The assistant applies the clamp forceps
and brings them together with considerable force. To direct
the movements and to avoid pulling on the cords, place the
right hand upon the forceps and draw the twine tightly with
the left. Tie with a straight knot. Remove the forceps and
cut the twine a centimeter from the knot. Instead of using
twine to bind the clamp you may use clamps having conic
branches; bring them together with the forceps and secure
them by slipping on metallic rings.

The same manipulation for the other testicle.

2.—Castration with Uncovered Testicles.
TECHNIQUE.—The first step is effected in the same manner
as in castration with covered testicles.

Second step: Incision of the envelopes.—With the convex
bistoury held like a fiddle bow, make a long incision through

CASTRATION OF THE HORSE, 57

all the envelopes that comprise the parietal layers of the
vaginal sheath. One or two cuts with the bistoury should be
sufficient to effect this division. ;

Third step: Enucleation.—Hold the testicle in the right
hand, remove the envelopes with the left; then the thumb and
index seizes the cord at its inferior part. The right hand
makes a liberal thrust at the cord on a level of the white mus-
cle, a little beyond the epididymis, with the straight bistoury,
the cutting edge turned backward, and section the posterior
part of the cord.

Fourth step: Application of the clamp.—Place it a little
higher on the cord than in the covered operation.

Fifth step: Excision of the testicle—Amputate the gland
by cutting the cord immediately above the epididymis. The
same manipulation for the other testicle.

3.—Castration with the Cords Covered.

TECHNIQUE.—The first step is effected in the sane manner
as in the castration with uncovered testicle.

Second step: Incision of the envelopes.—First divide the
serotum and the dartois over the middle or posterior third of
the testicle; afterwards make an incision in the deep envelopes
of a little less extent.

Third step: Hnucleation of the testicle.—Exercise pressure
with the fingers of the left hand upon the two faces of the
gland; this pressure, little by little, causes the testicle to pro-
ject between the lips of the incision, at the same time the
envelopes return unequally upon the cords; the scrotum and
dartois are easily separated from the deep envelopes, which
surround the front and sides of the testicle—the fibrous tunic
covered by the cremaster and the sub-dartois layers.

Continue exercising pressure with the left hand; soon the
incision in the fibrous and serous tunics enlarge; the testicle
comes out.

Fourth step: Application of the clamp.—The clamp should
be placed over the cord covered with the inferior part of the
deep envelopes (serous and fibrous tunic, and cremaster). The
scrotum and dartois are folded above, the left hand seizes the

58 EXERCISES IN EQUINE SURGERY.

extvemity of the epididymis and exercises traction behind upon
the deep envelopes; the thumb is earried into the anterior
vaginal cul-de-sac, draws downward and forward in the same
manner near to the epididymis. An assistant places the clamp
from before backward upon the cord thus covered.*

There is nothing particular as to the mode of securing the
clamps.

Fourth step: Removal of the testicle.—Amputate by cutting
the cord two centimeters above the testicle.

2,.—Castration by Limited Torsion.

Instruments.—Convex and_ straight bistouries, forceps,
artery forceps, catgut or silk.

(a).—Torsion by Two Incisions.

TECHNIQUE.—Effect the jirst, second and third steps as in
castration with clamps, with testicles uncovered.

Fourth step: Torsion and rupture of the cords.—The testi-
cle is supported with the left hand; apply the stationary for-
ceps below over the vascular portion of the cord four centime-
ters above the epididymis; seize that part between the jaws of
the forceps, secure its limbs by a hook with which it should
be provided, and have it held by an assistant.

Then take the movable forceps, grasp the cord a centimeter
below the stationary forceps; bring the branches together
tightly and secure them. ‘Twist the cord from left to right,
making a pivot upon the fixed forcep. Ten to fifteen turns,
depending upon the size of the cord, will be sufficient to com-
pletely rupture the cord. Ifthe torsion has been effectual,
there will be no hemorrhage. If the blood flows, apply the
artery forceps upon the testicular artery or ligate it.

(6).—Torsion by only One Incision.

TECHNIQUE.—VFirst step: Prehension of the left testicle.—
The testicle is grasped with the left hand and brought near the
center of the scrotal pouch.

* DEGIVE, Castration par le procédé a cordous couverts. Annal. de
med. vet., 1889, p. 30.

CASTRATION OF THE HORSE. 59

Second step: Incision of the scrotum and dartois.—Make
an iucision in these membranes, upon the median line, at the
posterior part of the scrotum, sufficiently large to permit the
eventration of the testicle.

Third step: Incision of the deep envelopes.—Incise these
membranes backward towards the posterior extremity of the
testicle by making a straight incision corresponding to that in
the scrotum and dartois. Lay aside the bistoury, and cause
the eventration of the testicle by pressing upon it with the left
hand and seizing it with the right.

Torsion is made either upon the whole cord or only upon the
vascular portion.

The same manipulation for the other testicle.*

3.—Aseptic Castration.t+

Instruments.—Convex bistoury, silk or large catgut, and
suture needle. Observe all precautions that are necessary for
asepsis.

TECHNIQUE.-—First method.—Effect the first, second and
third steps, as in the castration, by means of clamps, with testi-
cles uncovered.

Fourth step: Ligate.—At two or three centimeters above
the epididymis, bind the cord and draw tightly.

Fifth step: Removal of the testicle.—Cut the cord a centi-
meter below the ligature.

Sixth step: Sutwre.—Unite the scroto-dartois lips by inter-
rupted sutures, and cover the cut by a layer of collodian and
iodoform.

The same manipulation for the right testicle.

Second method.—Make a median line incision of the superfi-
cial envelopes and apply the ligature upon the covered cords.
Suture and close.

Third method.—Divide all the envelopes and ligate the
uncovered cords. Suture and close.

* JACOULET, Castration par torsion bornée. Bull. de la Soe. cent. de
med. vet., 1893, p. 45.

+ Bayer, Castration unter antiseptischen Cautelen und Heilung per
primam intentionem. Monatsschr. des Vereines der Thierarzte in
‘Oesterreich, 1881, p. 163.

60 EXERCISES IN EQUINE SURGERY.

XVI.—CASTRATION OF THE CRYPTORCHID.

(a).—By Perforating the Inguinal Canal.

Restraint.—Cast the animal on the side opposite to that on
which you wish to operate; by means of a rope carry the pos-
terior superficial member forward over the corresponding
shoulder, or hold it in abduction as for inguinal hernia by

Fig. 23.—Section of the wal!s of the left inguinal canal madeinaline from
the middle of the inferior inguinal ring to the external angle of the
ilium. Inner segment.

P A, skin; C D, dartois tunic; F S D, sub-dartoid connective tissue;
AGO, aponeurosis of the external oblique; L A, posterior margin of
that ring; II, inguinal canal filled with connective tissue; PO, inter-
nal oblique muscle; A T, aponeurosis of the transverse muscle; P, peri-
toneum; A RC, crural arch; A PC, crural facia; A I, external angle of
the ilium; A V D, section of the muscles covered by the crural arch.

means of two ropes, one drawn in the direction of the neck
and the other perpendicular to the vertebral column.

CASTRATION OF THE CRYPTORCHID. 61

1st.
Instruments.—Convex bistoury and artery forceps.

TECHNIQUE.—VFirst step: Incision of the scrotum and dar-

tois and dissection of the sub-dartoid twnic.—With the convex

Belgian Operation,

CI AS Ch

Fig. 24.—Inguinal interstice seen from the flank. The external commis-
sure of the inferior ineuinal ring is sectioned. The great aponeurosis is
divided a little in front of the line where it is doubled. The small

oblique is removed from the crural arch just at the internal commissure
of the interstice,

A RC, Crural arch; P O,Small oblique muscle; CT, Internal commissure
of the inguinal passage; A G O,Aponeurosis of the great oblique incised,
its edges senarated: CI, Internal commissure of the inferior inguinal
ring; C EH. External commissure sectioned; L A, Anterior lin; L P, Pos-
terior lip: A S. Dotted line indicating the situation of the superior
inguinal ring; L, Dotted line showing the height at which the opening
should be made in the oneration on the abdominal eryptorchid; A H,
Angle of the haunch; M P, Posterior limb held in abduction.

bistoury make an incision of twelve to fifteen centimeters
from before backward in the skin and dartois. Then, near the

62 “EXERCISES IN TQUINE SU&GERY.

center of that ring and following the saine line, make a small

VAP
Fig. 25.—Transverse vertical section of the posterior abdominal region,

showing part of the sub-lumbar ilial and pre-pubie regions (normal
stallion).

P, peritoneum; A A P, posterior abdominal artery; V A P, posterior
abdominal vein; A S, superior annular ring; C T,testicularcord; CD,
vas deferens; A O P, tissue layer enclosing the superior border of
Poupart’s ligament, the posterior border of the internal oblique, the
cremaster, the sub-peritoneal layer and peritoneum; A ©, Poupart’s
ligament turned downward; its deep face; L AJ, long abductor of the
leg; A LI, lumbo-iliae aponeurosis; PI, iliaeus; G P, psoas-magnus;
T P P, tendon of the psoas parvus; B, pelvic cavity; R, section of the

rectum; V, bladder; LL, lateral ligaments of the bladder with obliter-
ated umblical ligaments.

incision in the sab-dartoid connective fascia; introduce the

CASTRATION OF THE CRYPTORCHID. 63

thumbs back to back and enlarge it by spreading. In this
manner divide it throughout its extent to the inferior inguinal

GD.

Fig. 26.—A vertical transverse section of the posterior abdominal region,
showing the superior insertion and disposition of the internal oblique
and cremaster muscles as seenfrom in front. The peritoneum, the
sub-peritoneal layers and the transverse muscle are removed.

PO, internal oblique muscle; BPO, its posterior border; OC, superior
part of the cremaster (that muscle is cut within a few centimeters of
its origin); GD, great straight abdominal muscle; AJ, dotted line,
indicating the position of theinferior inguinal ring; A 8, dotted line
corresponding to the superior inguinal ring; L, dotted line traced at the
height where the hand reaches the peritoneum in operating upon the
abdominal eryptorchid; B, pelvis; V, bladder; R, rectum.

Second step: Penetration of the deep layers of the abdom-
tinal wall.—Use the right hand if you operate upon the right

~ 64 EXERCISES IN EQUINE SURGERY.

side, and the left if you operate upon the left. The fingers
are arranged as a cone, the hand is introduced into the

Fig. 27.—Prepubian and inguinal regions as seen from below. The figure
shows on each of the median line, the inferior inguinal ring and the
entrance to the inguinal canal.

CI, inner commissure of the inferior inguinal ring; C HE, external com-
missure of the same ring; LI, internal lip; L E, external lip; PO,
internal oblique muscle; T, testicle covered by the vaginal tunic, and
descended as far as the inferior inguinal ring (inguinal eryptorehid);
G, fibrous band, representing a remnant of the gubernaculum; L,
dotted line, showing the situation and direction of the opening made in

os) the internal oblique in the Danish method, as described by Bang and

Moller; T A, common tendon of the abdominal muscle; C P, section.

ofthe penis; P, skin; L M, dotted line traced upon the median line.

inguinal canal within the ring, the elbow directed toward the
pubie symphsis, and the extremities of the fingers in contact.

4
4

CASTRATION OF THE CRYPTORCHID. 65

with the crural arch. Direct them outwards toward the exter-
nal angle of the ilium, straight to the lumbar arch, or a little
to the rear. In passing through the canal, make progression
by executing a double movement of propulsion and semi-rota-
tion, with gradual spreading of the fingers, andavoid injury to
the internal commissure of the canal. Separate in this way
Poupart’s ligament and. the small oblique muscle to the bottom
of the inguinal canal. On arriving there the peritoneum is
recognized and the intestinal loops are felt through that mem-
brane.

Penetrate the serous membrane by pushing strongly upon
the end of the index or tearing it between the thumb and
finger. Enlarge the opening in the same manner as used for
penetrating the canal, until two fingers or the whole hand can
be introduced into the peritoneal cavity.

2.—Danish Method.

Instruments.—Convex bistoury, director, curved needles
and silk thread.

TECHNIQUE.—The first step is the same as in the Belgian
method.

Second step: Perforation of the internal oblique muscle.—
Tear the connective tissue at the inguinal opening as in the
Belgian method. Expose the small oblique muscle toward the
external commissure of the canal and at a certain height.
When the muscle is well stretched toward the end of an inspir-
ation, perforate it with the spatulate end of the director by
making a simple button-hole-like incision parallel to the fibres;
enlarge it, always using the director, sufficiently large for the |
introduction of two fingers. If you operate upon the left,
introduce the index and great finger of the left hand in the
muscle wound. When the abdominal wall is stretched at the
close of an inspiration, perforate and pass through the perito-
neum by active pressure upon the fingers. Enlarge the wound
parallel to the muscle fibers if you wish to introduce the hand
into the abdominal cavity. If the intestine tends to escape
apply a very wet tampon.

66 EXERCISES IN EQUINE SURGERY.

If you operate upon the right side perforate the abdominal
wall with the index and large fingers of the hand correspond-
ing.

(6)—Laparotomy. (See page 72.)

XVII.—AMPUTATION OF THE PENIS.

Restraint.—Cast the animal upon the left side; the right
posterior limb is carried on a line with the corresponding

7

Fig, 23—Amputation of the penis.

P, penis; C P, cut portion of the penis, corpus-cavernosum; M U, mucous.
eoat; M Pe, mucous and skin sutured; 8, catheter introduced into the
urethra.

shoulder as for castration, and held in that position by two
assistants.

Instruments.—Bistouries, ordinary forceps, artery forceps,
fine needles and thread, and director.

TECHNIQUE. —An assistant seizes the head of the penis, and
draws it moderately; another exercises gentle traction upon
the skin towards the base of the organ. Make a cireular in-
cision upon the superior and lateral faces of the penis, limiting
it at the line of incision between the lateral and inferior faces.

CATHETERIZATION OF THE URETHRA IN THE MARE. 67

This incision is completed by two others which start at its ex-
tremities, converge backward and unite upon the median line
five centimeters further. Within the area of the triangular
strip thus limited, excise the tissues which cover the urethra.
Expose it, dissect it a little beyond the circular incision and cut
it transversely one to two centimeters in front of that incision.
Introduce a director into the exposed portion, with its groove
turned toward the inferior wall, and with a bistoury guided by
the director, divide that wall upon the median line. Unite the
mucous lips to the corresponding skin by discontinuous stitches.
(Fig. 28). Cut the body of the corpus-cavernosum transversely
with the circular incision, tie the dorsal artery, bring down the
skin in front of the stump, bring their lateral edges together
upon the median line and take two or three stitches.

You may also make the section of the corpus-cavernosum
first, then dissect the urethra, split it, and suture to the skin.
The dissection of the urethra is facilitated by the introduction
of a catheter in the canal.*

XVIII.—_CATHETERIZATION OF THE URETHRA

IN THE MARE.

Restraint._-The same general directions as for passing the
catheter in the horse.

Instruments.—Metallic or gum elastic catheter about twenty
centimeters long.

TECHNIQUE.—The urethral opening is situated ten to fifteen
centimeters from the entrance of the vulva, below a large
valve stretched transversely across the inferior wall of that
cavity at its entrance into the vagina. Conduct the index of
the left hand to the opening by spreading the lips of the vulva;
slip a catheter along the finger; engage it in the urethral canal

*This method, described in human surgery, is superior to all others; if
well executed it avoids stricture of the urethra. Prior to us HARRISON
had recommended it upon the horse. (The Veterinary Jowrnal, 1885, p. 1.)
Prof. A. Liautard has been performing it also since 1879-80.

68 EXERCISES IN EQUINE SURGERY.

and pass it into the bladder. There is no folding of mucous
membrane to arrest the instrument in the 1inare as in the cow.

Fig. 29.—Vertical median antero-posterior section of the uro-genital or-

gans of the mare,

O, ovary; C G, left cornua; U, uterus; L L, broad ligament; V A, vagina;
V, bladder; R, rectum. C R. recto-vaginal cul-de-sac; C V, vesico-va-
ginal cul-de-sac; C8, superior cul-de-sac; C I, inferior cul-de-sac; C B,
section of the pelvis; P A, abdominal wall.

XIX.—OVARIOTOMY.

Restraint.—To operate upon the animal while lying down,
secure the limbs in the hobbles. (The manipulations are ex-
ecuted perhaps with greater ease when the animal is controlled
while standing, in the post travis, the posterior limbs being
fixed to the posts by ropes, the tail held elevated on the median
line or tied to a rope which passes over the cross-bar of the
travis back of the quarter, )

Instruments.—Bistoury cache and ecrasure (fig. 31).

OVARIOTOMY. 69

TECHNIQUE.—First step: Puncture of the vagina and enlarge-

Fig. 30.—Transverse section of the posterior abdominal region, made in
front of the first lumbar vertebrae, showing the position of the uterus,
its superior face, and insertion of the ovaries to the broad ligament as
they occur in the mare.

O, ovary; C, cornua; U, uterus; L L, broad ligament; R, section of the
rectum; B, pelvis; PA, abdominal wall; ist V L, first lumbar vertebrae.

ment of the opening with the fingers.---Explore the vagina and
cause its dilation. When the walls are stretched withdraw the

mm

70 EXERCISES IN EQUINE SURGERY.

hand; take the bistoury with the blade returned and carry it
to the bottom of the vagina.

7s

Fig 31.—Bistoury cache.
A, bistoury with movable blade; B, bistoury with guard.

At one or two fingers’ width from the os uteri make a short
puncture on the median line of the vaginal wall. To accom-
plish this, hold the bistuury in the full hand in a nearly Kori-

OVARIOTOMY. Hl

zontal or slightly oblique direction, point forward; project the
blade for its whole length with the thumb, follow with a brisk
arm action, carrying the blade forward; return the blade and
explore the wound; if the perforation is complete, withdraw

“Come

Fig. 32.—Antero-posterior section of the abdominal cavity and pelvis,
made on the median line, showing the genital organs in the mare.
Ovariotomy. Second step: Removing the left ovary; the instrument is
in position, the chain surrounds the ovarian ligament; the gland is held
in the right hand.

O, ovary; U, uterus; V A, vagina; C D, section of the right cornua; CG,
left cornua; L L, broad ligament; H, eerasure; R, rectum; C R, recto-

vaginal enl-de-sac; CS, superior cul-de-sac; P A, abdominal wall; C B,
section of the pelvic bone.

the instrument; if the peritoneum is not pierced, give it a
second cut with the bistoury.

After having laid the instrument aside enlarge the opening
with the fingers until it will permit the entrance of the whole
hand into the peritoneal cavity. To arrive at the ovary on one
side or the other, follow the uterus and the corresponding cor-
nua; at its extremity you will find the gland.

CG
cD

}
72 EXERCISES IN EQUINE SURGERY.

Second step: Seizing, and removal of the ovary.—The hand is
maintained in a line with the vaginal perforation; pass the
ecrasure along the forearm and guided by the hand to the ovary.
With the fingers dispose the chain in the form of a loop, enclos-
ing the ovary. Seize the ovary below the chain and eut the
pedicle by a slow movement of the ecrasure (fig. 32). Remove
it from below and bring the gland out in the hand.

The same manipulations for the other ovary.

XX.--LAPAROTOMY.

Restraint.—Cast the animal upon the right side, draw the
left posterior limb backward.

Instruments.—Scissors, bistouries, artery forceps, director,
drain, needles and thread to suture.

TECHNIQUE.—Clip the hair and shave the skin on the flank.
Cover the region with a wet, aseptic towel. Make an incision
of about ten centimeters, dividing the skin and sub-cutaneous
aponeurosis, in the region a little in front and below the angle
of the ilium. Give it the direction of the fibers of the ilio-ab-
dominal muscle. With the fingers or spatulate end of the
bistoury, perforate the small oblique, the transversalis and
peritoneum. Enlarge the opening in the same manner already
indicated for the castration of eryptorchids by the Danish
method. (See Cryptorchid.)

Effect those manipulations in the abdominal cavity proper
to the operation you wish to practise. Ba

Make the muscular sutures of catgut and skin sutures of silk,
securing the drain in the inferior angle of the wound.

XXI.—INTESTINAL SUTURES.
For these sutures use fine curved needles, or Reverdin
needles, which are curved to the left, and zero silk thread.
1.—Jobert’s Sutures.

TECHNIQUK.—Place the threads transversely to the lips of
the wound at intervals-of six millimeters, by proceeding in the

INTESTINAL SUTURES. 73

following manner :—--Make the needle perforate the intestinal
coats from without to within a centimeter from the edge of the
wound; make the needle come out again through the same lip
four or five millimeters from the edge; pierce the other lip from
without to within at four or five millimeters from the edge and
bring the needle out a half centimeter further. One repeats
this with all the threads, ties them successively and cuts the
ends near the knots. The edges of the wound are turned in-

Fig. 33.—Jobert’s Suture.

The thread passes through the three intestinal walls; the ends are curved;
the lips of the wound are brought together by their serous faces. (Af-
ter Chaput.)

ward and the lips are brought closely together by their serous.
face. (Fig. 33.)

2 —Lembert’s Suture.

TECHNIQUE.—The needle is inserted about eight millimeters
from the edge and only penetrates the serous membrane; it is
then passed perpendicularly to the axis of the wound within
the muscular layer and brought out two to four centimeters
further by piercing the serous coat from within to without.

Take the stitch in the other lip by beginning two to four

74 EXERCISES IN EQUINE SURGERY.

millimeters from its free edge, traverse it in the same manner
and bring it out 2s many millimeters further.

Take all the stitches that are necessary in this way, after-
wards tie the threads in succession.

Fig. 34.—Lembert’s Suture.

The thread is passed through the serous into the muscular coat; the ends
are crossed; the lips of the wound are brought together by their serous
faces. (Chaput.)

This suture is preferable to that of Jobert; the threads do
not penetrate the mucous and it is not infected. (Fig. 34.)

3.—Gely’s Suture.

TECHNIQUE.—Take a long silk thread and put a fine needle
on each end. With one of the needles penetrate the intestinal
wall from without to within a little outside of and back of one
of the angles of the wound; make the return from within to
without parallel with the wound and five or six centimeters
further ahead. Execute the sane manipulations on the other
side with the other needle; cross the threads. The left is pas-
sed over to the right, and vice versa. (Fig. 35.) Each needle
is introduced into the hole made by the returning needle or a
little in front. This manipulation is continued to the other
end of the wound. The stitches should be closed to a proper
degree in the order in which they are made. The serous faces

INTESTINAL SUTURES. {9

will exactly come back to back if the suture is correct. Tie the
two ends and cut near the knot,

Fig. 35.—Gely’s Suture.

4.—Czerny’s Suture.
TECHNIQUE.—It is Lembert’s suture modified by making two
rows of stitehes one above the other. Make the first row of
stitches traverse the serous and muscular layers at their edges

Fig. 36.—Czerny’s Suture.

1, Sero-muscular row, the threads passing across the muscular or cellu-
lar layers; 2, sero-serous row. (Chaput).

(fig. 35). Make the second row eight to ten millimeters from
the first. The two lips are maintained in contact for at least a
centimeter by the non-perforating sutures.

76 EXERCISES IN EQUINE SURGERY,

5.—Chaput’s Sutures.

TECHNIQUE.—Throughout the extent of each lip separate
the inucous and muscular layers for a centimeter from the

Fig. 37.—Suture for Abrasion. First method.

1, Muco-mucous suture; 2, Suture for abrasion.

edge. Place the first system of non-perforating sutures in the
mucous coat after excising or turning into the intestine the
detached part (muco-mucous suture). ‘The second line of

Fig. 38.—Suture for Abrasion. Second method.

1, Muco-mucous suture by infection; 2, Suture for abrasion

sutures perforate the serous and mucous coats (musculo-mus-
cular sutures). (Figs. 37 and 38.)
This suture should be employed in case of complete section

INTESTINAL SUTURES. 16

of the intestine. For the posterior semi-cireumference of the
intestine, the threads for the mucous sutures are knotted
inside; for the anterior semi-circumference they are knotted
outside. Above the muscular row of stitches one should make

Fig. 39.—Simple Intestinal Graft.

The wound is united by two series of non-perforating sero-serous
sutures.

a third row of stitches in the serous layer (surety sero-serous
suture).

When the wound is accompanied by a loss of substance the
intestinal graft gives excellent results. With regard to the
perforation, place the wounded loop against a part about
twenty centimeters above or below. Unite the lips of the
wound to the portion which is to serve as a graft by two
series of sero-serous non-puncturing stitches. (Fig. 39.)

78 EXERCISES IN EQUINE SURGERY.

HEAD.

I._EXAMINATION OF THE EYE.

Kestraint.—Hold the head immovable with or without the
use of a twitch.

Place yourself a little in front of the subject, on the same
side as the eye to be examined.

1.—Test of the Pupil.

Bring the animal into a well lighted place. During the
whole operation an assistant should cover the unexamined eye
with his hand. Lower the upper eyelid over the eye to be in-
spected; hold it down, keeping the globe covered for some
time, also exercise a little friction over it, then uncover quickly
by withdrawing the hand. If the iris possesses its mobility,
the pupil dilates when obscured and contracts rapidly on
exposure to light. Ifthe movements are not accomplished, or
very slowly, the iris is altered.

Examination with the Ophthalmoscope.

”
ae
Place a mydriatic substance in the eye (sulphate of atropine
1:100).
Tnstrauments.—Ophthalmoscope and lens, speculum, candle
or oil lamp.

a.—Exanmiination of the Eye by direct Dlumination.

Proceed in full day light, by reflecting the sun’s rays upon the
eye by means of a concave mirror (Follin’s ophthalmoscope) ;
or, it is preferable to operate in a dark box-stall, and employ
artificial light from an ordinary paraffin candle, or oil lamp.
An assistant holds the lamp in front and to the right of the
head if the left eye is to be examined; to the left, if the right
eye is to be examined. When the mydriatic effect is obtained,
inspect the eye after having put the speculum in place; you
should distinguish alterations of Decement’s membrane, the
iris, crystalline lens, and of the deep portion of the eye.. If it
has been attacked by periodic ophthalmia you detect posterior
synechsia or traces of synechia.

PUNCTURE OF THE CORNEA. 79

b.—Examination by Oblique Light.

Operate in a dark box. Have an assistant hold the lamp on
the side corresponding to the operation, on a line with the
anterior part of the neck. With the lens interposed between
the lamp and the eye, concentrate the rays upon it. By gra-
dually changing the position of the lamp and lens alterations
of the cornea, Decement’s membrane, the iris and crystalline
Jens can be readily distinguished and synechsia or its vestiges
recognized.

IIl.—PUNCTURE OF THE CORNEA.

Restraint.—Apply a twitch to the upper lip; raise the ante-
rior foot on the side opposite that on which you operate.

Instruments.—Speculum, lanceolate needles mounted in a
handle, or ordinary suture needles.

TECHNIQUE.—Render the eye insensible by the use of co-
caine; apply the speculum and fix the globe. Puncture the
cornea obliquely near its periphery, by introducing a needle
parallel with the iris; separate the lips of the wound by turn-
ing the needle a quarter of a revolution upon its axis.

After removing as much of the fluid as desired, return the
needle to its first position and withdraw it.

With the keratome or the trocar, ete., it is sufficient to make
an oblique puncture of the cornea; the fluid flows through the
groove of the keratome or the canula while in place.

II.—_OPERATION FOR CATARACT.

It is necessary that the animal be held in a couching or
recumbent position.

Restraint.—Cast the animal on the side opposite that on
which the operation is to be made. Secure general anesthesia.
Dilate the pupil by instillation of a solution of atropine.

Instruments. —Eye speculum, needle with a fine handle and
terminated by a lance-like point (Dupuytren or Scarpa needles).

TECHNIQUE.—A. When couching. The lids are separ-
ated and the eye fixed. The needle is held as a pen in writing,
in an oblique direction from below upward, and slightly back

80 EXERCISES IN EQUINE SURGERY.

to front, the point horizontal, the convexity turned upward;
implant it in the sclera five millimeters from the cornea and a .
little below the transverse diameter of the eye. At the time
all the curved portion of the needle has been introduced, exe-
cute a quarter of a turn of the instrument upon its axis in such
manner that its convexity turns toward the cornea. Carry its
extremity towards the superior part of the erystalline lens and
avoid wounding the iris; apply the concavity against the sum-
init of the lens, and, by a see-sawing movement, bring it down
in the field, force it downward and backward below the visual
axis, and into the vitreous body. Retain it there for some
time to prevent it ascending again and withdraw the instru-
ment after returning it to the horizontal position. When the
operation is well executed the anterior face of the crystalline
lens is turned downward.

B. When reclining. Introduce the needle in the eye
and carry it to the crystalline lens as directed when the animal
is couching. Instead of displacing the lens directly from above
downward, make the sea-sawing motion backward in the
vitreous humor; lay it upon the floor of the eye in such man-
ner that its anterior face will be turned upward.

Hold it there for a few moments to prevent it returning and
withdraw the needle after returning it to the horizontal posi-
tion.

IV.—_EXTIRPATION OF THE EYE.

Restrain the animal as in the operation for cataract. (In
practice general anesthesia is not necessary ; it suffices to make
five or six injections of a solution of cocaine of 1-100 around
the globe in the connective tissue).

Instruments.—Foreeps, straight bistoury, and curved scis-
sors.

TECHNIQUE.—VFirst step: Incision of the Conjunctiva.—In-
cise the conjunctiva along the entire periphery of the eye;
separate it from the winking bodies, the lids, and turn them
outwards. If the globe is very large divide the external angle.

Second step: Removal of the Eye.—Plunge the straight bis-

EXTIRPATION OF THE EYE. 81

toury, held me a pen and cutting edge out, between the ocular
globe and the orbit near the internal angle. Make the

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penetration to the bottom of the eavity; detach the inferior
part of the ocular globe by shaving from within to without to
the external angle of the eye, along the inferior semi-cireum-

ia

82 EXERCISES IN EQUINE SURGERY.

ference of the orbit. Carry the bistoury back to the internal
angle by shaving the superior semi-cireumference. The eye is
now only attached by the optic nerve and straight muscles.
Introduce the curved scissors, concavity turned toward the
ball, to the bottom of the cavity at the external angle, and
with one cut section the nerve and muscles.

V.—_LIGATURE OF STENO’S DUCT.

Restraint.—Cast the animal on the side opposite to that on
which you wish to operate. Hold the head extended upon the
neck by means of a halter.

Instruments.—RBistoury, forceps, director, needle and thread.

TECHNIQUE. —Ligature upon the jaw.—After turning from
within to the outside of the inferior border of the maxillary,
Steno’s duct rises along the anterior aspect of the masseter
behind the glosso-facial vein, there passes under it and the
artery to the opening within the bueal cavity. (Fig. 40.)

Make a short incision at two fingers’ width from the maxil-
lary border and a centimeter behind the glosso-facial artery;
divide the skin, the cutaneous muscle and use precaution in
dissecting the adjacent connecting tissue layers. The duct
appears below as a narrow flat white cord. It has only to
be isolated and tied; at the same time avoid wounding the
vein.

Ligation behind the maxilla.—At one to two centimeters
behind the ascending branch of the maxillary, near the inferior
angle of the parotid and on a line with the sterno-maxillaris,
make an incision of three or four centimeters through the skin
and cutaneous muscle in a gradually oblique direction down-
ward and forward; continue cautiously by dividing the cellular
layer in which the duct is located; lay it bare, isolate, and
ligate.

VI.—_TREPHINING.

Restraint.—Cast the animal on the side opposite to that on
which you wish to operate. Hold the head in extension upon
the neck. Twitch the upper lip. Remove the bridle or halter.

—— Te er ee ee

TREPHINING. 83

Instruments.—Bistoury, forceps, raspitory, trephine, long ox
paring knife.

Fig. 41.—Head, anterior face; SF, frontal sinus.

1.—Trephining the Frontal Sinuses.

Trephine the frontal sinuses between the internal angle of
the eye and the median line at equal distances from these two
points.

84 EXERCISES IN EQUINE SURGERY.

TECHNIQUE.—First step: A V-shaped incision and dissection
of the narrow cutaneous strip.—Make two oblique incisions
downward and forward. They should converge and unite at
their inferior extremity. With the forceps and straight bis-
toury, dissect the narrow cutaneous strip and also its bound-

Fig. 42.—Trephining. Large opening ofthe Sinus. Repulsion ofthe Molars.

A, Trephination of the inferior maxillary sinus; B, trephination of the
frontal sinus; E DU, line tor ineision for opening the large maxillary
sinus; f ¢ h, line of incision for opening the large frontal sinus; ab,
line of incision for the repulsion of the first molar teeth.

aries. Scrape the osseous surface over an area corresponding
to the diameter of the trephine to be used.

Second step: Trephining.—Prepare the trephine, the point
of the pyramid lowered some millimeters below the crown and
the guard set at one centimeter; the strip of skin is seized with
the forceps and held by an assistant. The point of the pyra-
iid is placed in the center of the uncovered bone. Impart a

TREPHINING. 8d

boring or rotary movement which causes the pyramid and saw
to successively penetrate the bone. In a few moments the
bone is divided. If the crown does not carry a guard, exercise
only moderate pressure upon the instrument when the section
is about complete. Frequently the round osseous section
remains attached in the crown; if it escapes into the sinus,
withdraw it with the forceps. Remove the long roughened
particles of bone that project into the opening, with a long
blade or paring knife.

2._-Trephining the Superior Maxillary Sinuses.

Operate in the angle formed by the inferior eyelid and the
zygomatic crest, at equal distance from these points.

The V-shaped incision has its summit corresponding to the

angle formed by the inferior orbicular muscle and the zygo-
matic crest.

oD.

Trephining of the Inferior Maxillary Sinus.

Make this a little in front of the zygomatic crest; in the old
horse, nearly on a level with the inferior extremity of that
erest; in the young (where the sinus is larger and descends
further), a little higher and farther beyond the crest.

The technique is the same as for the preceding operations.

Introduce the curved scissors into the opening of the inferior
maxillary sinus, and make communication with the superior
by tearing down the delicate osseous structure which separates
them.

4.—Large opening of the Sinuses for the removal
of Benign Tumors.

Lay bare the greater portion of the frontal sinus by detach-
ing a flap of skin which is limited within by an incision
made from above Cownward near the median line, and parallel
to it, and by another drawn from the internal angle of the eye
in an oblique direction from back forward to the first. Un-
cover the maxillary sinuses in the same manner by prolonging
along the zygoimatie crest and in front of the inferior eyelid,
the two incisions made for trephining the superior maxillary
sinus. (Fig. 42.) With a large sized trephine make three,

2)

E SURGERY.

N EQUIN

ERCISES I

EX

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REPULSION OF THE MOLARS. 87

four or five overlaping openings over the bare bone; re-
move the projecting osseous inter-arches to make the outline
regular.

Viil._REPULSION OF THE MOLARS.

Restraint.—The same as for trephining.

Instruments.—Sceissors, bistoury, forceps, trephine, chisel or
paring knife, gouge and repulsor.

TECHNIQUE.—A.—Repulsion of a superior molar.— First
step :—Incision and laying bare of the skin.—Make a large V-
shaped incision through the skin over the jaw on a level with
the deep extremity of the tooth you wish to remove. Free the
small strip of skin and also the edges and rasp the bony surface
thus exposed.

Second step :-—Trephining of the superior maxillary.—Make
three tangent openings in the external bony wall, two parallel
to the maxillary opening and the third in front of the first.
Trim the opening with the chisel or paring knife.

Third step :—Repulsion of the tooth.—Spread the jaws with
a speculuin and have it retained in position by an assistant.
The repulsor is placed on the root of the tooth to be removed,
parallel to its direction. The assistant gives light blows to the
repulsor with a hammer. Seek to discover the effect produced
with the free hand. Ordinarily a few blows suffice to loosen
the tooth and drive it from its alveolus. Seize it with the
long forceps or with the hand introduced into the mouth
between the branches of the speculum.

B.—Repulsion of an inferior molar.—The technique is the
same as for the superior molars ; but because of the danger of
fracturing the inferior maxillary bone the assistant should
strike very lightly upon the repulsor.

When operating upon one or the other jaw, and you do not
wish to expose a tooth to blows other than the one which
should be acted upon, it should be remembered that the voots
of three anterior molars of each jaw are directed slightly for-
ward; that those of the other three are directed slightly back-
ward. (Fig. 44.)

88 EXERCISES IN EQUINE SURGERY.

VIL.

AMPUTATION OF THE EAR.

Restraint.—Cast the animal on the side opposite that on

Fig. 44.—Position of tho Molar Teeth,

AMPUTATION. 89

which you wish to operate. Hold the head extended upon the
neck.

Instruments.—Scissors, bistouries, dissecting forceps, artery
forceps, needles and thread.

TECHNIQUE.—After having clipped the hair over the base of
the ear and periauricular region, make a circular incision, only
dividing the skin, two centimeters from the base of the conchal
cartilage. While an assistant draws the ear successively,
backward, downward and forward, dissect out the concha,
detaching it from the parotid gland and the seutiform carti-
lage cutting the parotido-seuto and cervico auricularis muscles ;
take up the posterior and anterior arteries with the artery for-
ceps. The concha is isolated to its base, excise it by a cut of

the bistoury through the fibrous ligament which attaches it to

the annular cartilage. Tie the auricular arteries and remove
the forceps. Introduce a small tampon of wadding in the
auditory conduit and suture the lips of the wound.

TAIL.

I.—AMPUTATION.

Restraint.—Twitech the upper lip; hobble both posterior
limbs; the line is passed forward between the two fore limbs
over the withers and side is crossed and held by an assistant.

Instruments.—Docking knife or a well sharpened paring '
knife, block and mallet, tail burner or rubber cord.

TECHNIQUE.-—One ordinarily sections the tail ten to fifteen
centimeters from its free extremity. The hair is combed and
eut circular about five centimeters from the point where the
incision is to be made ; unite in two lateral plaits that on the
superior part of the tail and fasten them upon the base of the
organ ; towards their extremity knot the hairs of the inferior
part. When that is done, prevent hemostasis by applying the
rubber cord a little above the line of section.

Take a position to the left of the subject, a little behind the ,
corresponding posterior limb. An assistant holds the taii

90 EXERCISES IN EQUINE SURGERY.

horizontally. If the docking instrument is used, hold the
female branch in the left hand, and in such a manner that the
portion to be cut lies in the concavity of the armature. Cut
the tail a little below the ligature with a single cut, by bring-
ing the two branches of the instrument together quickly and
forcibly. If the rubber cord is sufficiently tight there will be
no hemorrhage. ;

When the ligature is not applied, the blood escapes in jets
from the gaping orifice of the coceygeal arteries. Arrest
the hemorrhage by cauterizing with the tail burner heated to
a cherry red. Hold the caudal stump in the left hand and
apply the cautery for several minutes against the tail, the ori-
fice in the instrument corresponding to the vertebre; imprint
it there by several movements of semi-rotation (Peuch).

In default of a docking instrument, place a block under the
tail, at the point where you wish to section it. Apply the
sharp cutting edge of a paring knife or analogous instrument
and divide it'by one stroke of the'mallet. °

IIl._CAUDAL MYOTOMY.

Restraint.—Twitch; hold the head elevated ; hobble the pos-
terior limbs, the line is passed forward between the fore limbs
over the withers to the side, crossed and held by an assistant.

Instraments.— Convex bistoury and rat-tooth forceps or
tenotomes.

TECHNIQUE.—METHOD BY LONGITUDINAL INCISIONS.—Hold
the tail well elevated upon the median line, turning it over the
croup. Take a position behind the subject. Two longitudinal
enlargements formed by the depressor muscles are visible upon
the inferior face of the tail (See fig. 20). With the convex
bistoury make an incision of six or eight centimeters from
above downward exactly.in the axis of the muscles, being
careful to begin high enough to leave a space of three fingers’
width between their extremities and the base of the appendix.
You may also make two short transverse incisions wholly on
the outside of and on a line with the limits of the muscular
portion that is to be excised. These are united to the longi-
tudinal incision. (Trasbot.) The skin and the coceygeal

CAUDAL MYOTOMY. 91

aponeurosis is divided, the enlargements of the two depressor
muscles are between the edges of the incisions.

Seize one of the muscles with the forceps held in the left
hand; with the convex bistoury separate the deep layer out-
wardly, cut it transversely near the inferior angle of the inci-
sion, dissect its internal side, avoid wounding the median
coecygeal artery, finally remove the section at the superior
part of the incision by a cut of the bistoury given from below
upward.

Excise the other muscle by essentially the same inanipu-
lations.

The preceding operation is simple, easily executed and gives
good results.

SuBcurANEOUS METHOD. — first step :—Puncture.— The
place selected is at a hand’s breadth from the base of the tail.
Clip the hair upon the lateral faces, at the points of operation.
To section the depressor muscle on the right side hold the
straight tenotome in the right hand; upen the side of the tail
at the limit of the enlargement formed by that muscle, it is
said on a level with its deep layer, apply the point of the in-
strument; puncture the skin and coccygeal aponeurosis, and
make the blade of the tenotome penetrate flatwise under the
muscle.

Second step :—Section.—Withdraw the instrument and intro-
duce the curved tenotome into the wound; pass it under the
muscle until you reach the median line with its blunt point,
then execute a quarter revolution, turning its sharp edge to-
wards the muscle, seize the muscle with a full hand, apply the
thumb over the enlargement formed by the depressor, cuttiug
it from within to without in respect to the skin.

To section the depressor muscle on the left side operate with
the left hand.

If there is hemorrhage apply a bandage with moderate com-
pression. Fix the layers of wadding by turns of a band ap-
plied near the base of the tail.

92 EXERCISES IN EQUINE SURGERY,

LIMBS.

I.—TENOTOMY.

General Rules.—Make all tenotomies upon the animal while
east. Place the limb in the most favorable attitude for the
most rapid section of the tendon to be cut. If it is desired to
have the limb extended, this may be accomplished by
means of a rope. Except for the section of the cunean branch,
always employ the subcutaneous procedure, and make only a
short incision in the skin.

1.—Supracarpal Tenotomy.

Restraint.—Cast the animal upon the side opposite that
on which you wish to operate. Apply a twitch to the upper
lip. Hold the limb by means of two ropes, one placed at the
superior part of the forearm and held backward, the other
secured to the canon or fetlock and drawn forward.

Instruments.—Curved scissors and tenotomes.

TECHNIQUE.—1. Section of the tendon of the oblique flexor of
the metacarpus.—Take a position with the knees upon the
ground in front of the limb and ona line with the forearm.
The tendon is very apparent towards its inferior extremity, a
little above the knee. Clip the hair in that region. With the
straight tenotome make a short incision through the skin and
aponeurosis on a line with the anterior border of the tendon,
three or four centimeters above the supracarpal bone. Pass
the curved tenotome into the puncture flatwise, from before
backwards under the tendon, until its blunt point will have
proceeded to the posterior border of the cord. Execute a
quarter of a turn of the instrument upon its axis in such a
manner as to bring its cutting edge against the deep face of
the tendon; grasp it with a full hand, press with the thumb
against the point under the skin and a little behind the
tendon. Draw upon the ropes. By a gentle see-saw move-
ment cut the tendon and antibrachial aponeurosis from
within to without.

2. Section of the tendon of the external metacarpus—By
means of the straight tenotome, make a short puncture in the

TENOTOMY. 93

skin and adjacent aponeurosis four or five centimeters above
the supracarpal bone and immediately in front of the tendon.
By means of this opening engage the curved tenotome flatwise
under the tendon. Draw upon the ropes. Cut the tendon
and the aponeurosis in the same manner as in section of the
oblique flexor. (Fig. 45).

Fig. 45.—Inferior part of the forearm, knee and superior part of the
metacarpus (posterior face).

F o, oblique flexor of the metacarpus; F e, external flexor.

22

When practicing section of the perforans or the perforatus,
or of the double tenotomy, the place to be selected in the fore-
limbs is one to two centimeters below the middle part of the
canon; for the posterior members it is exactly at the middle
of the canon (the inferior cul-de-sac of the carpal sheath is
situated a little further down than that of the tarsal sheath).

Plantar Tenotomy.

94 EXERCISES IN EQUINE SURGERY.

In the anterior limbs the lateral artery of the canon passes
along the internal border of the tendons, and may be
wounded, In the posterior limbs, in the superior two-thirds
of the sheath it is situated on the posterior face of the canon
immediately in front of the external metatarsal; there is no
danger attending it.

Restraint.—In the anterior as well as the posterior limbs—
operate upon the external face. Cast the animal upon the
opposite side; leave the limb in the hobble; secure it by two
ropes, one at the inferior part of the forearm or the leg,
depending whether you operate upon an anterior or posterior
limb; the other upon the fetlock; the first held backward and
the second forward.

Instruments.—Scissors and tenotomes. !

TECHNIQUE. —1. Section of the Perforans. — First step:
Puncture.—Take a position with the knees upon the ground
in front of the fore-limb on a line with the fore-arm, or in the
rear of the posterior member on a line with the hough.
Prepare the region; implant the blade of the straight bistoury
between the two tendons, or, if they are altered and con-
founded, at the posterior third of the indurated mass which
they constitute. Avoid perforating the skin on the opposite
side.

Second step: Section.—Withdraw the straight tenotome and
slip the blade of the curved tenotome in its place. Execute a
quarter of a turn upon the axis of the instrument to permit
its cutting edge to come in contact with the perforans; seize it
with a full hand, press with the thumb against the canon as a
point of support; draw upon the rope, and cut the tendon
from the rear forward by a double see-sawing movement. A
slight noise and the separation of the tendon indicates that
the section is complete.

2. Section of the Perforatus.—Make a short incision in the
skin at the same point as for section ef the perforans. Intro-
duce the curved tenotome flatwise behind the tendon in the
subcutaneous connective tissue, direct the cutting edge against
the tendon and cut it from the back forward.

If you make a double tenotomy, cut the perforans first and

-

TENOTOMY . 95

then the perforatus, proceeding in the manner already ex-
plained.
Apply a light compress bandage upon the canon.

Fig. 46.—Metacarpal region.
Suspensor ligament of the fet]ock, carpal check, perforans and perforatus.

3.—Cunean Tenotomy.

Restraint.—Cast the animal upon the side upon which you ,
wish to operate; secure the posterior superficial member upon
the corresponding fore limb above or below the knee.

96 EXERCISES IN EQUINE SURGERY.

Instruments.—Curved scissors, convex bistoury, rat-tooth
forceps, suture needle furnished with a thread, or a tenotome.

TECHNIQUE.—The cunean branch is disposed obliquely from
before backward, and above downward on the internal face of
the hough, a little above the prominence which marks the
inferior limit of that region (fig. 47); it is easily detected as it
passes under the skin. In the case of spavin it is very
voluminous, but never entirely covered by the osseous neo-
formation, which is hollowed into a canal-like depression, at
the bottom of which is situated the tendon.

Fig. 47.—Internal fice of the hough.
BC, cunean branch.

Old Method.—After having clipped the hair over the inferior
portion of the internal face of the hough, make an incision
in the skin of three or four centimeters over the axis and
perpendicular to the tendon; follow by incising the sub-
cutaneous connective tissue; introduce the point of the curved
scissors (disposed on the flat surface, concave face outward)
from above downward under the tendon, which you find thus
disposed, and cut it with the bistoury.

Unite the cutaneous wound by two stitches.

DESMOTOMY. 97

Subcutaneous Method.—Make a short transverse puncture
through the skin over the axis of the internal face of the
hough on a level with the mferior border of the tendon. If
you make the section with a tenotome having.a concave
cutting edge, introduce the blade flatwise under the tendon
and eut it from within outward, and avoid incising the skin;
if you operate with a tenotome having a convex cutting edge,
engage the blade flatwise between the skin and tendon, and
eut it from without to within.

4.—_Tenotomy of the Lateral Extensor of the

Phalanges.

Restraint.—Cast the animal upon the side opposite the
member on which you wish to operate; leave the limbs in the
hobble.

Instruments.—Curved scissors and tenotomes.

TECHNIQUE.—In the posterior limb the tendon of the lateral
extensor of the phalanges is united with that of the anterior
extensor toward the middle of the metatarsi. In the superior
part of that region the two tendons as they pass under the
skin are easily detected.

Make the operation a few centimeters from the union of the
two tendons about three fingers’ width from the middle of the
canon. Puncture the skin even with the external border of
the canon and insert the straight tenotome under it. Intro-
duce the blade of the curved tenotome in the puncture,
directing the cutting edge of the instrument against the
tendon, and cutting it from within to without. Flexion of the
phalanges, secured by drawing backward upon the rope
attached to the pastern, favors section of the border.

IIl.—_ DESMOTOMY.

1.—Metacarpal Desmotomy.

Restraint.—Cast the animal upon the side opposite the limb
to be operated upon, leave it in the hobbles; attach a rope to
the inferior part of the forearm and another to the pastern.

Instruments.—Scissors and tenotomes.

98 EXERCISES IN EQUINE SURGERY.

TECHNIQUE.—Make the operation a little above the inferior
extremity of the small metacarpals or the metatarsals at a
point where the suspensor of the fetlock is well drawn (fig. 46),
and at some distance from the superior cul-de-sac of the
sessainoid sheath.

Implant the straight tenotome between the suspensory liga-
ment of the fetlock and the perforans; insert the blade of the
curved tenotome in the incision, turn the cutting edge against
the suspensory ligament and cut forward, after having drawn
the ropes as for plantar tenotomy.

2.

Patellar Desmotomy.

Restraint.—Cast the animal upon the same side as the limb
on which the operation is to be performed; fasten the super-
ficial posterior limb upon the inferior part of the corresponding
fore limb.

Instruments.—Scissors and tenotome.

TECHNIQUE.—The internal tibio patellar ligament (fig. 48) is
easily distinguished on exploration of the internal face of the
stifle. At one centimeter above the superior margin of the
tibia, immediately behind the ligament, puncture the skin
with the straight tenotome, and, holding it very obliquely,
make the blade penetrate under the ligament, to avoid wound-
ing the synovial capsule. At the same time the instrument is.
withdrawn pass the blade of the curved tenotome in the
puncture; turn the cutting edge against the ligament and eut
from within to without.

Ill. NEURECTOMY.

General Rules.—The diverse neurectomies are performed
upon the animal adjusted in the decubital position. If the
operation is made on the external side of the limb, the horse
is cast on the side opposite that member; if it is made on the
internal side, it should be cast on the side corresponding to
the member; if the operation is bilateral, the operation is first
made upon the inside.

Instruments.—Scissors, two bistouries, rat-tooth foreeps,
and needle furnished with thread are the only instruments

NEURECTOMY. 99

that are indispensable; but it is convenient to have a dilator
or retractor, a director and artery forceps.

The operation comprises four steps: Ist, incision of the skin; _
2nd, dissection of the subcutaneous tissues and isolation of the
nerve; 3rd, resection of a part of the nerve; 4th, suture.

Fig. 48.—Femoro-tibio-patellar articulation.

Lit, internal lip of the femoral trochlea; t ri, internal tibio-patellar
ligament; f r, femoro-patellar ligament.

1.—Plantar Neurectomy Below the Fetlock.
(Phalangeal Neurectomy.)

Restraint.—The operation should always be made upon both
plantar nerves. Begin with the internal. The horse should
be cast upon the same side as the limb to be operated upon.

100 EXERCISES IN EQUINE SURGERY.

If it is an anterior member, fix it above the hough of the
opposite posterior member; if upon a posterior member, carry
it above the knee on the opposite fore limb.

TECHNIQUE.—First step: Incision. —If the phalangeal
region is neither infiltrated nor indurated, it is sufficient to
explore the lateral face with the pulp of the thumb to find at
the posterior part the ligament of the plantar cushion and the
adjacent vasculo-nervous cord. There make the line of inci-
sion (fig. 49). If there is infiltration or induration, and these
organs cannot be found, the incision should be made at the
limit of the lateral and posterior faces of the pastern, follow-
ing the axis of the first phalanx and at the superior third of
that bone (above the ligament), or at the inferior third (below
the ligament).

With the hair clipped and the skin shaved, make a cuta-
neous incision of two and a half to three centimeters with the
convex bistoury ; divide the adjacent cellular tissue; if you come
upon the ligament, prolong the incision a little above or below.

Second step: Dissection and isolation of the nerve.—Seize the

the connective tissue layers, which form a kind of sheath’

common to the digital artery and plantar nerve, gather it in
folds transversely to these organs, and divide it with the point
of the bistoury. Isolate the nerve for a centimeter and a half,
always with the bistoury if you have a sure hand, and with
the director if you are afraid of wounding the artery. It is
situated immediately in front of the nerve and the vein about
a centimeter in front of the artery. The vein is exposed in the
wound when the incision is made too far forward,—an error
frequently committed by beginners.

The execution of this step is facilitated by the use of a
dilator or retractor. If the blood flows and soils the parts, an
assistant drains the field of operation.

Third step : Resection.—The nerve is seized with the forceps;
slip the blade of the bistoury under it flatwise, turn the cutting
edge upward, section it with one cut at the superior angle of
the wound. Afterwards cut it at the inferior angle of the
incision, removing from a centimeter to a centimeter and a
half of tissue.

NEURECTOMY. 101

Fourth step : Sutwre.—Unite the lips by one or two stitches,
according to the extent of the incision.

Cover with flannel, replace the limb in the hobble, turn the
animal, and after re-securing the member in a convenient
position make the operation upon the opposite side.

Fig. 49.—Plantar neurectomy below the fetlock.
b, ligament of the plantar cushion; a, digital artery; n, plantar nerve.

2.

Plantar Neurectomy above the Fetlock. (Meta-
_ carpal or Metatarsal Neurectomy.)

Restraint.—The limb should be shackled as for the preceding
operation, being careful nevertheless to attach the rope suffi-
ciently high upon the canon that the inferior part of that
region remains uncovered.

One may also unite the limb to be operated upon with its
congener with a rope in figure 8; unhobble the first and carry

102 EXERCISES IN EQUINE SURGERY.

it forward (anterior limb) or backward (posterior limb) by
means of ropes, the lines drawing on it in contrary directions.

TECHNIQUE.-— When the fetlock and the inferior part of the
eanon are clean (free from connective tissue or indurations),
the nerve is easily recognized on exploration with the pulp
of the thumb, on the lateral face of the tendons a little above

Fig. 50.—Piantar neurectomy above the fetlock.

V, collateral vein of the canon; A, collateral artery of the canon:
N, plantar nerve.

the fetlock. The plantar nerve passes along the border of the
perforans. On the internal side of the anterior leg the col-
lateral artery of the canon (continued by the digital) is
situated a little deeper; on the external side, the digital
arrives in the neighborhood of the nerve immediately above
the fetlock. (Fig. 50.)

NEURECTOMY. 1038

If the engorgement of the region does not permit the recog-
nition of the nerve, the line of incision should be determined
by the border of the cylindrical mass that forms the tendons.
As in phalangeal neurectomy, when the nerve is not recognized
the incision is often made too far forward.

When the synovial capsule of the fetlock is distended, per-
haps the nerve is displaced, carried more or less to the rear.
The operation in that case should be made above, or below
the distended cul-de-sac.

The same technique as for phalangeal neurectomy.

3.—Median Neurectomy (antibrachial neurectomy).

Restraint.—Cast the animal upon the same side as the mei-
ber to be operated upon. Carry it forward with a rope after
having engaged the other fore limb above the hough over the
corresponding posterior limb.

TECHNIQUE.—You ean easily perceive the median nerve on
the internal face of the elbow, directed downward and a little
backward; it crosses the artery at a very acute angle, towards
the posterior face of the radius, to become imbedded under
the mass of flexor muscles (fig. 54). The principal vein is
situated in front of the artery. Make the operation on a level
with the inferior part of the elbow joint, or immediately
behind the superior extremity of the radius, towards the
suinmit of the interstice which separates on that bone the
flexor muscles from those of the forearm.

Iirst step : Incision.—Clip the hair; divide successively the
skin, the subcutaneous connective tissue, and the sternal
aponeurosis for a length of five centimeters. Towards the
inferior angle of the wound make a short incision of the anti-
brachial aponeurosis; under this, engage the director, groove
outward, from below upward, parallel to the nerve; with the
tbistoury thus guided, incise the aponeurosis from within to
without (Peters). To effect that division the blunt-pointed
bistoury may also be used. Afterwards take away a semi-
elliptical part from each lip of the aponeurosis; the nerve is
very largely exposed (Moller). Separate the edges of the
wound by two retractors.

104 EXERCISES IN EQUINE SURGERY.

Second step: Dissection of the sub-aponeurotic layers and

ésolation of the nerve.—This step of the operation is somewhat ©

difficult. Avoid wounding the radial veins. If, under the
influence of the movements, the nerve has been displaced, it
will be brought upon the line of incision by gradually chang-
ing the position of the limb by carrying it backward or
forward. By means of the forceps and the bistoury, or with
the director, isolate the nerve and earry it above the director.

Fig. 51.—Median neurectomy,

N, median or enbito-plantar nerve; A, posterior radial artery ;
V, one of the posterior radial veins.

Third step: Resection.—Cut the nerve with the bistoury or
scissors at the superior angle of the wound, resect it about two

centimeters on the inferior part.
Fourth step: Sutwre.—Unite the lips of the wound by two

or three separate stitches.

4.—_Sciatic Neurectomy (tibial neurectomy).

Restraint.—Cast the animal upon the same side as the limb
upon which you wish to operate; leave the limb in the hobble;
fasten its congener upon the corresponding fore limb.

TECHNIQUE.—The great sciatic passes along the internal
side of the tendon of the hough. As one passes the hand
above the point of the caleaneum it is detected superficially
situated a little in front of the cord surrounded by fatty

AUTO-PLASTY OF THE KNEE. 105

connective tissue (fig. 52). It is there that the operation is
performed.

At two or three centimeters in front of the anterior border
of the tendon of the hough divide the skin and aponeurosis of
the leg for a length of four centimeters; dissect the cellulo-
adipose tissue which envelopes the nerve; isolate it, seize it
with the forceps, cut it above first, excise a portion about two
centimeters long from the inferior portion and unite the edges
of the wound by two stitches. (Rousseau.)

Fig. 52.—Neurectomy or the great sciatic (posterior tibial).
A, aponeurosis; C, cellulo-adipose layer; N, sciatic nerve.

IV.—AUTO-PLASTY OF THE KNEE.

Cast the animal on the side opposite to that on which you
wish to operate; hold the limb in extension.

Instruments.—Bistouries, forceps, needle with holder, and
Florence hair.

106 EXERCISES IN EQUINE SURGERY.

TECHNIQUE.—Shave the skin on the anterior face of the
knee; make two curvilinear incisions, limiting a narrow
elliptical strip parallel to the long axis of the limb (fig. 53).
Raise that strip, and do not go below the subcutaneous con-
nective tissue. Dissect the lips of the wound of the skin;
move them to a sufficient degree to permit their union. If the
loss of substance is very large, make an incision on each side
at a sufficient distance from the wound and parallel with its_
long axis to favor the slipping of the skin. Unite the lips of
the amputation by interrupted sutures with Florence thread.

Fig. 53.—Anto-plasty of the knee cap (after Cherry; figures reproduced
by W. Hunting).* Replacing the twisted suture by discontinuous
stitches of Florence hair.

In practice the operation only succeeds under the most
vigorous antiseptic precautions and the insurance of complete
immobility of the knee until the moment the cicatrix is solid.
(Deleambre and Vinsot.)

* CHERRY, “On Broken Knees,” The Farrier and Naturalist, 1829,
Vol. IL, p. 377. Huntine, “An Operation on Blemished Knees,” The
Veterinary Record, 1889, p. 474.

SAND-CRACKS. 107

FOOT.
I.—SAND-CRACKS.
1.-- Grooving.

Make a transverse groove five to six centimeters long and
one centimeter wide at the superior third of the wall. Use the
paring knife or rasp. Groove to the pellicle.

2.—Thinning in a V-shape.

Trace two oblique grooves on the wall, eonverging down-
ward. They should be at equal distance from the sand-crack
at the superior part and unite on a level with its inferior
extremity at a variable height upon the wall. Thin the nar-
row triangular strip of horn comprised between these grooves
to the bottom.

3.

Restvraint.—For sand-crack at the toe, cast the animal on
the side opposite to that on which you wish to operate.
Secure the posterior limb to the corresponding anterior above
the knee, or the anterior to the posterior above the hough.
For quarter-crack, the accident often occurs upon the inner
or outer quarter, cast the subject upon the same side as the
limb to be operated upon, or upon the opposite side and secure
as has already been indicated.

Instruments.—Drawing-knife, sage-knife, forceps, paring-
knife and farrier pincers; for dressing, shoe, wadding and
roller bandage.

TECHNIQUE.—A.—METHOD BY EXTIRPATION.—Jirst step:
Furrowing.—The foot is to be pared deeply in its anterior
region; take a drawing-knife with a large hollow, and make
two furrows in the horn five or six centimeters from the sand-
erack; they should be parallel or gradually converge towards
the plantar border; limit in this way a strip of wall in which
the fissure real or fictitious occupies the central part. Give the
grooves a breadth of a centimeter and a half; without making
arches, hollow them into the wall towards the plantar
border until the horn gives way to the pressure of the finger

Operation for Sand-crack.

108 EXERCISES IN EQUINE SURGERY.

nail. Unite these two furrows at their inferior part by a third
groove, equally deepened at the bottom, between the wall and
sole.

Second step: Incision of the horn.—With the sage-knife in ~

the full hand, the thumb pressing upon the wall as a point of
support, incise the horn at the bottum of the furrows, along
the edges of the strip that is to be extirpated in order to save
the thinned portion; make the incision with the point of the
sage-knife, and avoid a deep incision of the sub-horny integu-
ment.

Third step: Extirpation.—Hold the hoof-knife in the full
hand by its dull extremity, in a transverse direction to the
axis of the foot; carry the other extremity to the inferior part
of one of the grooves, and engage it under the strip of horn to
be forced out; give the instrument a point of support against.
the wall on the opposite side of the groove; detach the strip at
its inferior part by pressure ,upon the free extremity of the
instrument, which gives a lever of the first-class, As soon as
the narrow strip is partially loosened an assistant seizes it with
the pincers, and by giving it a see-sawing movement from
below upward, succeeds in detaching it from the podophyllous
tissue; a second movement in a lateral: direction releases it.
from the cutidura from one groove to the other. During the
execution of this last mmanoeuver, press upon the podophyllous.
layer with the thumbs to avoid tearing that organ.

Fourth step: Eacision.—With the forceps and sage: knife
lift the band of podophyllous tissue from the entire surface of
the third phalanx and scrape it. .

Dressing without a shoe.—Cover the wound with wadding
of turf, bind the foot, the digital region and adjust the layers
of wadding with the band. Make circles around the phalan-
ges and reverse upon the plantar region. Assure sufficient
pressure to prevent hemorrhage. Envelope the dressing in a
sheet of linen and furnish the whole with a double plait of
straw. (Fig. 56).

Dressing with a shoe.—Cover the wound with phlegdets
superposed to overflowing over the sides and above the gap.
Secure them with a roller bandage; passing the first, turn to

ee ee ee See eee Oe

REMOVAL OF THE SOLE. 109

the middle, the second above the third, and the balance suc-
eessively above and below, making as many reverses as may be
necessary, being careful that each turn of the bandage covers
‘the inferior two-thirds of that which preceded, and being
covered in its inferior two-thirds by the turn that follows.
Hold the ends upon the median line between the two branches
of the shoe perpendicular to the plantar region. All turns of
the bandage should be passed behind between the end and the
branches of the shoe.

B.—METHOD OF THINNING.—First step: Thinning a strip
of wall.—Trace two grooves upon the wall, converging down-
ward, the same as if practicing the extirpation method. Thin
the strip of wall with the drawing-knife until the horn res-
ponds at all points to the pressure of the nail. At the coronet,
the blood oozes upon the cut where it rests upon the cutidura
a half centimeter from the horn; also continue the thinning of
the pellicle by scraping with the sage or drawing knife.

Second step: Haxcision.— With the sage-knife excise the
middle part of the thinned region, removing the horn and
podophyllous structure for the width of a centimeter the
whole length of the thinned portion. Scrape the phalanx.

Dress the sae as for extirpation.

II._REMOVAL OF THE SOLE.

Restraint. —Cast the animal; hobble the member in a simple
position if the operation is made on a fore foot.

Instruments and bandage material.—Hoof-knife, farrier’s
pincers, shoeing hammer, drawing-knife, sage-knife, thin shoe
with four holes, splints, wadding and roller bandage.

TECHNIQUE.—First step: Furrowing.—Pare the foot, leav-
ing the sole and frog a half centimeter thick in order to avoid
their tearing with the pincers when employing traction.
Immediately inside of the white line at the periphery of the
sole, cut a large circular groove from a centimeter to a centi-
meter and a half wide, dividing the bars in the rear and to the
depth that the horn should be thinned.

Second step: Incision of the horn at the bottom of the
groove.—Hold the sage-knife in the right hand, stipporting the

110 EXERCISES IN EQUINE SURGERY.

thumb against a point on the sole; with the point incise the
thin layer at the bottom of the furrow, by beginning at
the inferior heel, and avoid cutting into the thick velvety
tissue.

Third step: Removal.—Detach the sole in the anterior
region with the hoof-knife or elevator by taking a point of sup-
port upon the inferior part of the wall, and avoid tearing the
velvety tissue. An assistant seizes the anterior part of the
sole with the pincers and tears it, and also the frog from
before backward by a see-sawing movement, while you con-
tinue to separate the parts as it continues to approach the
heels.

Dressing.—Attach the shoe, dispose layers of wadding over
the plantar region; begin by heaping the gap. Afterwards
put on the splints longitudinally and transversely. Cover the
heels with small phlegdets. Fasten the dressing by several
turns of the roller bandage, which in the rear passes over the
splints that are supported by the heels of the shoe.

The foot may also be bandaged as after the operation for
punctured wound of the foot.

Ill OPERATION FOR PUNCTURED WOUND
OF THE FOOT.

Restraint.—Secure the foot as for removal of the sole.
Place a bundle of straw under the member or hobble the limb
in the crossed position for the execution of the essential steps.

Instruments.— Drawing-knife, sage-knife, forceps, tenacu-
lum, scraper or curette. If the sole is removed, use the instru-
ments necessary for that operation.

THCHNIQUE.—A.—PARTIAL OPERATION.—Fi7st step: Un-
sole or thin the horn deeply in the plantar region—sole bars
and frog.

Second step: Hacision.--Hollow an infundibuliform cavity
in the middle zone of the plantar region; excise a part of the
cushion and aponeurosis. Make the removal with the forceps
and sage-knife.

B.—CoOMPLETE OPERATION.—Etfect the first step as for
partial operation.

eee

OPERATION FOR PUNCTURED FOOT. lil

Second step: Removal of the Plantar Cushion.—The foot
is held in extension by an assistant; section the cushion trans-
versely near its base with the double sage-knife; make the
section obliquely from back forward, from the surface of the
cushion towards the aponeurosis, to a point such that the pro-
longing of the incision in the aponeurosis would lead to the
posterior border of the os navieular. Seize the anterior part

Fig. 54.—Complete operation for punctured foot.

CP, plantar cushion; AP, transverse section of the plantar aponeurosis:
PS, small sessamoid; LS, sessamoido-phalangea!l ligament; AP,
oblique layer of the plantar aponeurosis, near to its insertion; SI,
surface for insertion of that aponeurosis.

of the cushion with the forceps or tenaculum and detach it by
giving two cuts flatwise with the sage-knife in the hollow of
the foot. Ordinarily the deep layers of the cushion rest upon
the aponeurosis; excise it with the sage-knife and forceps.

112 EXERCISES IN EQUINE SURGERY.

Third step: Removal of the Plantar A poneurosis.—With the

sage-knife, resting upon a solid point of support, section the

‘plantar aponeurosis transversely from one lateral lacune to
the other. At the deepest point the instrument should come
upon the os navicular near its posterior border. Follow
with a division upon the median line and behind the strip’
of aponeurosis to a level with the sessamoidean; excise each
‘portion successively and separate it with the tenaculum or
forceps, and cut it with the sage-knife. Be careful of the hand.
at the point of support; achieve first a transverse section of
the aponeurosis on one side; then make a curvilinear incision
toward the semi-lunar crest; afterwards detach it from the
phalanx by tearing it from the semi-lunar crest. The same
manipulation for the other portion. (Nocard.)

Fourth step: Scraping the Osseous Faces.—With a sealpel
blade, a drawing-knife or straight gouge, maneuvered flatwise,
lift the cartilaginous layer which covers the inferior face of the
navicular. Lift the terminal fibers of the plantar aponeurosis
uniformly and serape the semi-lunar crest, and avoid wound-
ing the inter-osseous ligament. When the operation is made
for its therapeutic action, do not scrape the semi-lunar crest,
lest the fibers which are attached are struck with necrosis.
In that case limit the large incision to the necrosis and scrape
the osseous face corresponding. (Fig. 54).

Dressing.—Cover the plantar region with layers of wadding
and bandage the foot or apply a dressing with a shoe as for
removal of the sole.

1V.—OPERATION FOR CARTILAGINOUS QUIT-
TOR.—COMPLETE REMOVAL OF THE
FIBRO-CARTILAGE OF THE
OS PEDIS.

Restraint.—The animal is cast; fix the limb in a simple
position, or crossed above or below the knee if it occurs in a
posterior limb, and above cr below the hough if it occurs in an
anterior member.

Instruments.—Rasp, drawing-knife, sage-knife, forceps,
retractor, pieces necessary for dressing. If the operation is

OPERATION FOR CARTILAGINOUS QUITTOR. 113

aimade by extirpation also provide the instruments necessary to
detach a part of the wall.

TECHNIQUE.—A.—METHOD BY THINNING.—First step: Thin-
ning of the quarter.—Pare the foot thin to the bottom over
the quarter where you wish to operate, the bar and the corres-
ponding portion of the sole. Afterward trace a groove upon
the wall obliquely from above downward, from before back-
ward, starting from the coronet on a line with the anterior
extremity of the cartilage, and limit the strip by walls twice
as far apart at the superior extremity asat the other. Thin
the horny pellicle over the entire extent of the narrow strip,
especially at the surface and neighborhood of the coronet. If
the superficial horny layer is very hard and difficult to cut,
use a rasp upon it or a cautery heated to a dull red.

Second step: Incision of the Keratogenous DMembrane.—
Separate the wall from the podophyllous tissue by incising the
integument between the two portions of the keratogenous
membrane along the inferior coronary zone. Make the
incision with the sage-knife held in the full hand, the thumb
taking a point of support over the thinned quarter; begin at
the anterior limit of the thinned portion, to prolong backward
just within the lateral lacune, turning round the heel between
the cutidural circle and podophyllous leaves. The blade of
the sage-knife held perpendicularly divides only the horny
pellicle and subjacent tegument. Avoid cutting the cartilage.

Third step: Laying bare of the Coronet and Skin.—Seize
the inferior border of the coronet with the forceps; by means
of a sage-knife detach that organ partially from the cartilage
for the full length of the incision; lay it bare for about a cen-
timeter in width. ‘Towards the middle of the incision follow
by introducing a double sage-knife, convex face outward,
between the coronet and the cartilage just above its superior
border. Lay bare the cutidura and skin in the rear first; hold
the instrument in the full hand; make it gradually pivot on
its axis backward and inward to bring the cutting edge upon
the surface of the cartilage, and by a series of slow movements
executed from in front backward, separate the cartilaginous
tegument; arriving on a level with its posterior border, turn it

114 EXERCISES IN EQUINE SURGERY.

and gradually withdraw the sage-knife in such a manner that
the coronet will not be found strongly held upon the cutting
edge of the instrument. Then follow by manipulating the
sage-knife from back forward to accomplish the separation on
a line with the anterior part of the body. During the execu-
tion of these acts, which are directed toward the complete
isolation of the whole external face and edges of the eartilage,
take a point of support over the thinned quarter. Avoid
equally the cutting of the coronet and the cartilage.

Fourth step: Extirpation of the Cartilage.—Engage a sim-
ple sage-knife (right or left, according to the quarter operated
upon) under the coronet; introduce it flatwise, the edge turned
upward and backward, turning the posterior border of the
body; execute a half turn of the instrument upon its axis, then
with a single cut excise the posterior part of the cartilage from
within to without, and make the exit of the knife above the
podophyllous leaves. To remove the remaining portion of the
scutiform plaque, the foot should be held in extension and the
coronet separated by the tenaculum. By successive attempts
excise first the inferior part, raising the cartilaginous lamine,
the thinner as you approach the fibrous layer, which should
be respected. Shortly the light color and the consistence of
the cartilaginous tissue give place to a yellowish gray hue, and
to the suppleness of the fibrous substance.

To extirpate the superior part, take the other sage-knife and
work it from bottom to top; completely separate the antero-
supero angle of the body, where often the cartilaginous layer
is thickened. To excise the antero-inferior angle, which fills
the depression situated in front of the basilar apophysis, use
the curette or small paring-knife.

If the cartilage has undergone ossification in the region of
the basilar process, remove that osseous neoformation with the
paring-knife used asa little gouge. When the ossification of the
plaque is extensive, remove all. Detach it first from the
phalanx by making a furrow at its base with the paring-knife,
and achieving the operation with the hoof-knife and the ham-
mer. Afterwards separate it with the hoof-knife and witha
sage-knife detach it from adjoining tissues. All these manipu-

OPERATION FOR CARTILAGINOUS QUITTOR. 115

lations should be effected, taking the necessary care not to
wound the synovial membrane, nor the lateral ligaments at
their juncture with the foot. Nearly always in front of the
body there rests a cartilaginous portion of the scutiform
plaque. Remove it by thin layers as in the classic operation.

B.—METHOD BY EXTIRPATION.-—Lirst step: Furrowing.—
Pare the foot and the inferior face of the heel thin; groove the
wall from the edge of the coronet to the plantar border, mak-

ry

Fig. 55.—Complete operation for the removal of cartilaginous quittor.
(Method by thinning) The cartilaginous layer of the scutiform
plaque is removed.

ing the furrow a centimeter and a half wide obliquely down-
ward and backward, beginning at the anterior part of the
cartilage, the limits of the superior extremity of the strip
should be double the width of the inferior. Make another
groove in the plantar region from the inferior extremity of the
first to the heel.

Second step: Forcibly Removing the Strip of Wall.—Incise
the horny pellicle at the bottom of the groove, along the

116 EXERCISES IN EQUINE SURGERY.

border of the part to be removed in a manner to conserve a
thin band of a centimeter in front of the podophyllous tissue.
Follow by detaching that portion of the wall, proceeding in
the same manner as has been indicated for sand-crack.

Fig. 56.—Bandage of the Foot.

At the third step prolong the incision of the keratogenous
membrane upon this band.
After that effect the uncovering and extirpation as in the

first procedure.
Dressing with a Shoe.—Attach the shoe; place a tampon of

wadding in the depression under the podophyl and coronet,

OPERATION FOR CARTILAGINOUS QUITTOR. 11%

in order to conserve the disposition of the cutidural region;
heap up the parietal breach, dispose large layers of wadding
and secure it with the bandage. Pass the first cireular turn
at the middle of the dressing, reverse the bandage on a level
with the shoe heel on opposite sides and hold the end to the
point perpendicular to the plantar region; pass it from behind
forward, the second turn above, and the third below. Fix the
dressing solidly by associating the reverse circular turns
between the heel and the end and cover the part as in the
dressing of a sand crack. Secure the ends with a straight
knot.

Bandage without a Shoe.—After having placed a wadding
tampon under the coronet and heaped the gap at the quarter,
envelop the foot and digital region by layers of super-imposeG
wadding. Secure these by turns of bandage upon the phalan-
geal ray and by the reverses passed under the plantar region.

Cover the dressing with a linen sheet two or four-ply and
complete by a double braid of straw. (Fig. 56).

ALPHABETICAL INDEX.

PAGE
ANT OURO! ONS CEheag Sects Home OS Bass Dae ma Ones 0.0 TORS 88
/ATTD) DUNMORE OVEN OE EH na aedecmieas. yy Colic can OA prenminceorsats Macao 89
Amputation of the penis...... Ne ANA) artes ye Ucn Eee ~. 466
JNTASSUNETEH Ss 5500650660006 BRIE GS CIO OT AG Seo CNC eeepc hn 12
PNtrayit CNG GUO Iya algae si aiatare oe ccbese re Senay ee si ne saa ane ates Sate 6 sisi nal ware ere oF
PATUGOT ASH VOL THeRKMeCe ye) che Hel irene cece aos cms eee euis uOO
Hleedine sino! cheranoulaniscan mst coerce eens ocala a acice 8
Bleedinapirompuneycephalicnvernyyeeey ype scien: 9
Bleedinestrom" the jue ularsvyeiiasssec-eeesec a eeee ences ceeee 8
Isleccimestrommibe palates aac aeciaasto ccitencns dalete cis a eeceusie eleven 12
JSleSCliner WHOM WN SHON 6G oooobsonooDasooUh dads one COOURDE 11
Bleeding from the subcutaneous of the forearm..............-- 10
Bleeding from the subcutaneous thoracic vein................- 10
Seeding enon L MeL OC ae setae rae spies avcie sacs’ eli eis ojaiete, arekeeevawsistyee 11
CORTON Cit WINS GAY DUOKIMNC. cose soonsaoboxdorodagdasg aoedr 60
CHS RITOM ly; ealkarein OSes sd eogaussdooes condcudeusdBpoS 61
Castano bye amishmopelauloneeariari ii oii cle ce cea cre 65
Wasirabionvoithe horses’ peer we ae elke) ok uae 54
Castrationgwitiagclampsicm. pre ceecieseccic sere smteistale sin weenie ees 54
Casiation withythielcondsxcomeredean sla vance cienics cs nacre ce o7
Cagipno@m loy Ihntannacl WoOrmNOMN. . 6s6daGocepocdqdqadodaucoweousan 58
Casiration withthe testicles covered sya eee esac eae 54
Castration with the testicles uncovered.................... G 56
(CHISMANTOM, ARC ONWG > 500c0cccg000g5 000000 Hes opel stele ne ste teri, 40) cua 59
Catheterization of the oesophagus...........2.2.ee.e cee eeeeeee 43
Catheterization of the urethra in the horse..................6.. 48
Catheterization of the urethra in the mare.............. ...... 67
Caucaliimiyotomiyer wenaactes da srsie/s halides Waly sales xk coerce esta ese 90

119

120 . INDEX.

PAGE
Cauberization a's, 2 i's ss eis.9,010 26 setefaiesen era iadyele cheery teisto etter aetna 26
Cauterization, in: lines i/.0). «5 stots apeystotonts oe eis oie ee 27
Cauterization in fine penetrating points.....................-- 30
Canterization with needless. <). ac cci te wise el-h cles cto ie eee 30
Cauterization, SubcutameousS:.2-1. 5.115 of oe cleieiease 2 etre eee 30
Cauterization in superficial points’... ....:. 0... 20.0222 see 28
Desm otomy.ccicjcctoce vee sete sie cele ater dae reece «ee ee
Desmotomy, cervical. 5 5,00. i0<2 os050 descent oa) 46
Desmotomy, metacarpal 0.0022 22.0). 2000. co= cn eu) 97
Desmotomy, patellar, ..:22..:.e. 0). «cas seneleee aoe 98
Hinterotomy 2°. 0.6 cess a's see acelcbls ol bs eiviniele Gaye sone eee 48
Hye, examination of the’... oh) < 35 .1a-2 0-1 esc Se 78
Kye, examination by direct illumination ..........:-.-.-.seee 78
Kye, examination by oblique light..........:.0+..:+ss0s- sae 79
Eye, examination with the ophthalmoscope. .................-. 78
Hye, extirpation of the ss.) veg ais se. ois siete -1.8s oon ino 80
liye, operation for catarach.:s.i cis ncies occ sa «cic cece sone see 79
Eye, puneture of the corneas... «2... si. 0.25 4006 2> oie ee 79
Hye, tesb-of the pupil. «i... fe <0's + +n sistem Byala se <n ee 78
Ely overbeprotom ye. sive ca vs! «outs vias cs ome oui Selon 9 ae 32
Inguinal ketotomy, | ii) 3.) etext. 4 dette ss clos Be Pre 2 - - 51
Intravenous injection of chloral hydrate...........0-c0s+-.:2s- 12
Kelotomy, inguinal: |. . 2500 sd. << sciss b'e is eo sae eee 51
Laparotomy os Lies swansiedslaere sete pede o's «ue dala ue octet ee 2
Laryngeal tracheotomy @.\.2.)svije bess ce 0 oe srieee eee 37
lbigature ofthe carotid).< 3, .45..:aaecee pecan oe cee See 21
Ligature of the glosso facial. 21... 0.0: oe wie ecen woe ee 20
ligature of the intercostal arteries... ... 2...-).-+-2-2-. +92 eee 21
Ligature of the jugular. vein.i3 (0... ces ssige- soos oe ae eee 20
Ligatare of the plantar artery.'.... 2.25.02. 0s06++ sues cul saan 22
Ligature of the saphena artery ................+. sve 907 el eeoeleene 22
Ligature of Steno’s duct.......... sateen tives eear etal sistwleze aie letovee 82
Ligature of vessels ....... vials d eioiels\ elie visia dielsateloiereiel saline eae 19
Myotomy,; catidalvs..° catccuts seminars o suds wishes: iva ieate, Oe et etehe nee 90

BNCHECCLOMMYE oe 28 Sc cle Sey icioe arate er ciaie aoa Sei aicistae aisicinel oierote eisiein aes
wWenrectomy, above the) fetlocks.)c. 5 csscesse siete se tee wei etme
Wenrectomy: below, the fetlocks 45 Ss082 sens ga oe ve cee on cess
PMCMEC CLOWN. Me TAN) 5215 <c.tatnrc) sce ievevate grevct auch epsveraectaihs! ocmelele od aeheiers
INCMNCELONIY | SCIAGIC, 5 Aram Sa 1) Reins voc c carlo cic. neice aye ce nieve eee es
WesophavOloOmiyy <a ss vee ees ces oo elo ha MN Ne eeuteis ad se cunre ee Slee
OM ATLOLOMNY Aeregese ore aie ael ae sieevedive tect one feedetctey Sie) exe cae Mialsletareratevers
Operation ton cartilacimousiguibtoryas-ten os cece cielo sale
Operation for punctured wound of the foot................. ..
PRE ACEMUISIS Set Shares ay seer seers atelste lens ieie ste siereiaw ove lala’ a, win susyare ovanaatets
EM CO LOTIY A ere Merc rcle ete eteefoe misintemieteiiee aletetane Siulale’aaieaes Sous ee ieiess
SHIMON OR: CEEOL Gy eter tal ope tatatotcial ole] atcictetstaha'e' «| afeveve:» sie ahexa s/skarsieisls
VEScehlOngOlsG he SPIN OUS PEOCESSESHy eet. iaicieiteiseieleicioe) sy steleistcrers
FRGES GIT pres ter csoral shetev ore) fous tavoh Potteretat tata attelsletefarcfovetoteieveyeisie aveieeaverals
Restrain bamibhe standings Positioned. sees eos es = =
Restraint anpbhe recumbent MOSULTOM. ] eee ee -lotel ts erelse)te clare
fvepulstanvolgthermolars’s st vasl rien) soe wicte sissies side rss oe wate
SHUG! CRACKS HSS NER ARGS Ames BACB MCAS Be eae nS Rar ee eee Aes aer F
Sand cracks, grooving............... fovoce steel ais eteveioke iskeverateveiotepete
SaMdecracks + FHInnIM SIV] SHADE. 9.7.) -tafasc = a cies sees oie es ss eciate
AMC CLACKS AO PELAPLOM TOR re hceer rata totete iets 2c) tiel a Wiens ode wie tien}
DI CUOUS meres erate Se shel oro el cxotsretayot eroleveyaitae ei sieteicie a Sicisit is) secs erent

Setonsinguherbubhockaacper cee were eye ies oie aise Riotersre or cusiete ctl toate
SOM OAH OVE ENO Tse ats Be COL Ge ae OE ee ern ee enone
Se LOMBSI MI te) A Wess seven ere cae leley a pere cechere ote stain siee ia eset aus eaayebaes

SCOT TINE IIO Ree OH OOOO SIGITOn Re Oo any et One ene

DevoMmmebMerstill Owes wate creceeanan ere wise siecle aie a tege eis eve bounce ters
SIO TRO IELS RoSGoN bho tioe Hale CaS ae eee Oe meant Co a SroeOereeS
Setommavent rallye haya acerce testers ccervsict stern ove revcteverevare fereuohoxa tent tesc rouse

SHON TTURES er k Sa E e Ea Ba R oa Ae

PAGE
Suture, Chaput’s....... w'd ehohe'y Ww aval Se Tat cite aia baa tst elite ae ea

Suture, Continous: ..<.. c/c.s: 3 sisvarsjershaie #1 ep oleletald ceoleie = ejetenelete eee aE
Sature, Czerney’s. .6'.. [0.0 x oleic cyesereveici\stniocpelelnia’ soa) ole alata cele okt
Suture, COssilis 4 25. siecrafere cho eterecictel eateisste orotonetcietet eta anette
Suture, Gely’s.... ho0. 5 sais nc ototie e oluelejaine nists les stulinhenn etait
Suture, interrupted... eo... Fe ciate aiav one o/=:5,5/0teie,shel-;50)a erate
Suture, wtestimal: £4 .cic:.cjsas ysis etepeistalers + event stiar
Sucure, Jobertis. 2 seers ee - ; 72
Suture; Lembert’s. . 2.500 cecwen, nslele «'ateie) clgts clea +) 0sehs eet een
Suture, quilled) si: oo. omeseste at oer
Suture. *twisbedly.. sie 2 everie ore caenersisten yoke letatetehenstar ct harets
MTenotomy ... .)s:s:scic o's cies vic s/n sictere are] steletelere,gucte stats sieve! s/s atete teem aaa
NRNOLOMIY;, (CUNCAI se clelels trios tiets eievalatertaltneioe anton
Tenotomy, ‘plamiiar’. 2% {s/o ctevis'<coetects acters oreo
Tenotomy, supracarpal . ./5e!. Gs om «crecletsuritiee tates
Tenotomy of the lateral extensors of the phalanges............. 97
ME WOPAGETIDISIS;.101-1 4/0) aici aie fe orca chester alctelenstereyeherai vere siete
Tracheotomy maternal wider e\alalesbictele o/s ceiea) ore atoleislate ere: oie e akatete tant nee eammnES
Tracheotomy, laryngeal... of ..0 cess esse cle ee» wrnielnie solo /n's chee
Me pHiniN Pr , s.5, ies take s fe siesgisiele oversee o(aiey ce alates ayer e) cael svelere Ter eel ett eae mm
Trephining of the frontal sinuses. 5.5. i. 2.26.0 ss: « «+s eee
Trephining of the inferior maxillary sinuses........ APE oe
Trephining of the superior maxiiary sinuset........0+-eseceoes OO
Wrethrotomy: .. <3... weve. 30s ae taleamecda dee ioette aan

WILLIAM R. JENKINS’

Veterinary Books.

1897.

(*) Single asterisk designates New Books.
(**) Double asterisk designates Recent Publications.

ANDERSON. ‘“Viceinthe Horse” and other papers
on Horses and Riding. By H. L, Anderson. Demy,
CREO ONO Me na Bs aiciots & ANila ata on Se en GIO RE eee 2 00

— ‘ How to Ride and School a Horse.” With a System
of Horse Gymnastics. By Edward lL. Anderson.
(CSO Sadie ome admey Bemscct alae Grater a Rr eA oie 1 00

()BACH. “How to Judge a Horse.” A concise treatise
as to its Qualities and Soundness;. Including Bits and
Bitting—Saddles and Saddling, Stable Drainage, Driv-
ing One Horse, a Pair, Four-in-hand, or Tandem, etc.
By Captain F. W. Bach. 12mo, cloth, fully illustrated
SOO SA OMe eercroe ieee Seren raveralat eres oe a totare clare aie atcnench aus 50

BANHAM. “Tables of Veterinary Posology and
Therapeutics,’ with weights, measures, etc. By
George A. Banhan, F.R.C.V.S. 12mo, cloth....... 75

BAUCHER. ‘‘Method of Horsemanship.” Including
the Breaking and Training of Horses............ 1 00

2 Veterinary Catalogue of William R. Jenkins

BELL. ‘The Veterinarians Call Book (Perpetual).”
By Roscoe R. Bell, D.V.S., Profsssor of Materia
Medica, Therapeutics and Hygiene in the American
Veterinary College, New York; President of the Long

Island Veterinary Society; late U. 8S. Goverment
Veterinary Inspector, ete.

A visiting list, that can be commenced at any time
and used until full, containing much useful informa-
tion for the student and the busy practitioner.
Among contents are items concerning: Veterinary
Drugs; Poisons; Solubility of Drugs; Composition of
Milk, Bile, Blood, Gastric Juice, Urine, Saliva; Respi-
ration; Dentition; Temperature, ete., etc. Bound in
leather, with flap and pocket ............. 20s. ee 1 25

(“)BRADLEY. ‘** Outlines of Veterinary Anatomy.”
By O. Charnock Bradley, Member of the Royal Col-
lege of Veterinary Surgeons; Professor of Anatomy
in the New Veterinary College, Edinburgh.

The author presents the most important facts of
veterinary anatomy in as condensed a formas possible,
consistent with lucidity. 12mo, cloth.

Parr Ts: ~The: Tambss 22 segs. ee eee 125
PART TDi. Che Prink ieee. seks ee eee 1 25
PART IIL: The Head and Neck (25.52 4200 eeeee 125
THE SET COMPLETE. ))0. uoc«cen te. tee Cee 3 50

CLEMENT. * Veterinary Post Mortem Examina-
tions.’ By A. W. Clement, V.S. Records of
autopsies, to be of any value, should accurately
represent the appearances of the tissues and organs

so that a diagnosis might be made by the reader were
not the examiners conclusions stated. To make they
pathological conditions clear to the reader, some
definite system of dissection is necessary. The
absence in the English language, of any guide in
making autopsies upon the lower animals, induced
Dr. Clement to write this book, trusting that it
would prove of practical value to the profession.
12mo, cloth; illustrated’ 2.2... 0.6.0 2 see eee 75

851-853 Stath Avenue (cor. 48th St.), New York. 3

(*) CADIOT. ‘Roaring in Horses,” Its Pathology
and Treatment. This work represents the latest
development in operative methods for the alleviation
of roaring. Each step is most clearly defined by
excellent full-page illustrations. By P. J. Cadiot,
Professor at the Veterinary School, Alfort. Trans,
Thos. J. Watt Dollar, M.R.C.V.S., ete. Cloth..... 75

— ‘“ Exercises in Equine Surgery.” By P. J. Cadiot.
Translated by Prof. A. W. Bitting, M.D.V.S., edited

by Prof. A. Liautard, M.D.V.S. 8vo, cloth, illus-
(HEN LEG |) we ebas cate cee segre tae tench ons aR entslie ae BUN trac 2 50

CHAUVEAU. ‘The Comparative Anatomy of the
Domesticated Animals.” By A. Chauveau. New
edition, translated, enlarged and entirely revised hy
George Fleming, F.R.C.V.S. 8vo. cloth with 585
Illustrations ..... Bate eu aa cseW ote baie e cuales Svereta a RN eseiaes .0 75

CLARKE. ‘Horses’ Teeth.” A Treatise on their
Anatomy, Pathology, Dentistry, etc. Revised and

enlarged. By W. H. Clarke. 12mo, cloth........ 2 50
— “Chart of the Feet and Teeth of Fossil
EV OMSG Sareea orere ee errata eisai Sek ancpeceiniccs & ei create Reneiuloeas § 25
CLEAVELAND. ‘Pronouncing Medical Lexicon.”
Pocketiedition aim Clotintessarer erence om iala sersicle sieve site 15

COURTNEY. ‘Manual of Veterinary Medicine and

Surgery.” By Edward Courtney, V.S. Crown, 8vo,
CLO CI seer ee coin aise taco cre slctoeletinehn sisyeca-wtelents Gla 2 75

(**) COX. ‘Horses: In Accident and Disease.” The
sketches introduced embrace various attitudes which
have been observed, such as in choking; the disorders
and aceidents occurring to the stomach and intestines ;
affection of the brain ; and some special forms of lame-

ness, etc. By J. Roalfe Cox, F.R.C.V.S. 8vo, cloth,
futlliygillus trate chs. te ele ose eionnecorsilepacciatalciaeial see 1 50

4 Veterinary Catalogue of William R. Jenkins

CURTIS. ‘Horses, Cattle, Sheep and Swine.’ The
origin, history, improvement, description, characteris-
tics, merits, objections, ete. By Geo. W. Curtis,
M.S.A. Superbly illustrated. Cloth, $2 00; half
sheep, $2:75';) half MOroceO~ 7. <i. - ieee 1h ee 3 50

DALRYMPLE. “ Veterinary Obstetrics.” A com-
pendium for the use of advanced students and Practi-
tioners. By W. H. Dalrymple, M.R.C.V.S., late
principal of the Department of Veterinary Science in
the Louisiana State University and A. & M. College;
late Veterinarian to the Louisiana State Bureau of
Agriculture, and Agricultural Experiment Stations;
Member of the United States Veterinary Medical
Associations, ete. (In preparation.)

DALZIEL, “British Dogs.” Describing the History,
Characteristics, Points, and Club Standards, etc., ete.
With numerous colored plates and wood engravings.
By Hugh Dalziel. Vol. I., $4 00. Vol. II., 8vo.4 vu

— ‘*The Fox Terrier.” Illustrated. (Monographs on
British DOgs) ii.) jee. reccumemsien cc) hee 1 00

— **Fox Terrier Stud Book.”? Edited by Hugh Dalziel.

Vol. I. Containing Pedigrees of over 1,400 of the best-

known Dogs, traced to their most remote known an-
COSCOLS sisi e/a styelecatcerese oie sc tekeperess leh eLsteste core eretee eee 1 00

Vol. II. Pedigrees of 1,544 Dogs, Show Record, &c.1 00
Vol. III. Pedigrees of 1,214 Dogs,Show Record,&e.1 00
Vol. lV. Pedigrees of 1,168 Dogs,Show Record, &e.1 00
Vol. V. Pedigrees of 1,662 Dogs, Show Record, &¢.1 00

— “The St. Bernard.” Illustrated...............- 1 00

851-853 Sixth Avenue (cor. 48th St.), New York. 5

*¢St. Bernard Stud Book.” Edited by Hugh Dalziel.

Vol. I. Pedigrees of 1,278 of the best-known Dogs,
traced to their most remote known ancestors, Show
VE CORGM ACH errtepaetorn etree oraiat vole cheverne uate oles aide anaes 1 00

Vol. II. Pedigrees of 564 Dogs, Show Record, &c..1 00

— “The Diseases of Dogs.” Their Pathology, Diagnosis
and Treatment, with a dictionary of Canine Materia-
Medica. By Hugh Dalziel. 12mo, cloth............. 80

— ‘Diseases of Horses.” 12mo, cloth.............. 1 00

— “Breaking and Training Dogs.” Being concise
directions for the proper education of dogs, both
for the field and for companions. Second edi-
tion, revised and enlarged. Part I, by Pathfinder;

Part II, by Hugh Dalziel. 12mo, cloth, illus....2.60
— ‘The Collie.” Its History, Points, and Breeding. By
Hugh Dalziel. Illustrated, 8vo, cloth............ 1 00
— “The Greyhound.” 8vo, cloth, illus.............. 1 00

DANCE. “Veterinary Tablet.” Folded in cloth case.
The tablet of A. A. Dance is a synopsis of the diseases
of horses, cattle and dogs with the causes, symptoms
COOL CUIKES Matin dian car ORGABee Siege Shisha ove Staue ehonscey stator 75

DANA. ‘Tables in Comparative Physiology.” By
IB Olen C2eE Dan aa VLAD Ss eeiscrs on cieraie ce aieveve ni ctele cies oratories 25

DAY, ‘The Race-horse in Training,” By Wm. Day,

6 Veterinary Catalogue of William Rk. Jenkins

(*)DUN. ‘Veterinary Medicines, Their Actions and
Uses.” By Finlay Dun, V.S. Revised edition (almost
entirely re-written) 8vo, cloth.................-.. 3 50

DWYER. ‘Seats and Saddles.” Bits and Bitting,
Draught and Harness and the Prevention and Cure of
Restiveness in Horses. By Francis Dwyer. Illus-
trated. -1-vol., 12mo, cloth, gilt.-22 3-4-2 eerie 1 50

()FLEMING. ‘Veterinary Obstetrics.” Including the
Accidents and Diseases incident to Pregnancy, Parturi-
tion, and the early Age in Domesticated Animals.
By Geo. Fleming, F.R.C.V.S. With 212 illustrations.
New edition revised, 226 illustrations, 758 pages...6 25

773 pages, 8vo, cloth (old edition) ....... ........ 3 50
— “Rabies and Hydrophobia” History. Natural
Causes, Symptoms and _ Prevention. By Geo.
Fleming; M. R-C.V.S; “Sv, (clouhs.. sc o)-teeee 3 75
— ‘Propagation of Tuberculosis.” Stating Injurious

Effects from the consumption of the Flesh and
Milk of Tuberculous Animals. By Geo. Fleming,
M.D., M.R.C.V.S., and others. 8vo, cloth....... 1 50

— “A Treatise on Practical Horseshoeing.” By George
Fleming, M.R:C.V:S. (Cloth: 5.-2).. 1... «sees 75

— ‘Tuberculosis.” From a Sanitary and Pathological
PointiOl. VIEW s,2 6 hile ciciett’e Sloe aie ele oleefeiers Sere 25

— “The Contagious Diseases of Animals.” Their
influence on the wealth and health of nations.
L2MO; PAPOL oie eres eee asa sit ashes els) Bel 25

851-853 Sixth Avenue (cor. 48th St.), New York. 7

‘Operative Veterinary Surgery.” Part I, by Dr.
Geo. Fleming, M.R.C.V.S. This valuable work,
the most practical treatise yet issued on the
subject in the English language, is devoted to the
common operations of Veterinary Surgery; and the
concise descriptions and directions of the text are illus-
trated with numerous wood engravings. 8vo,cloth.2 75
Orders will now be received for the second volume.

“* Human and Animal Variole.” A Study in
Comparative Pathology. Paper........... ...... 25

‘‘Animal Plagues.” Their History, Nature, and
Prevention. By George Fleming, F. R. C. V.S., ete.

First Series. 8vo, cloth, $6.00; Second Series.
SOC Obipserwece cree Gen Ra LR cites Min alts 3 00

«Roaring in Horses.” By Dr. George Fleming,
F.RC.V.S. A treatise on this peculiar disorder
of the Horse, indicating its method of treatment
and curability. 8vo, cloth, with col. plates ...... 1 50

(*FLEMING-NEUMANN. ‘Parasites and Para-

sitic Diseases of the Domesticated Animals.” A
work which the students of human or veterinary medi-
cine, the sanitarian, agriculturist or breeder or rearer
of animals, may refer for full information regarding
the external and internal Parasites—vegetable and
animal—which attack various species of Domestic
Animals. A Treatise by L. G. Neumann, Professor
at the National Veterinary School of Toulouse,
Translated and edited by George Fleming, C. B., L.L.
'D.,F.R.C.V.S. 873 pages, 365 illustrations, cloth.7 50

FRIEDBERGER - FROHNER. us Pathology

and Therapeutics of the Domesticated Animals.”
Translated by Prof, L. Zuill, M. D., D. V. S.

8 Veterinary Catalogue of William R. Jenkins

GRESSWELL, ‘The Diseases and Disorders of the
Ox.” By George Gresswell, B.A. With Notes by
James B. Gresswell. Crown, 8vo, cloth, illus....3 50

— ‘* Diseases and Disorders of the Horse.”’ By Albert,
James B., and George Gresswell. Crown, 8vo, illus-
trated; clothes 2° 4 eee oe ne ee aes eee 1 75

GRESSWELE, Manual of ‘The Theory and Practice
of Equine Medicine.” By J. B. Gresswell, F.R.C.V.S.,
and Albert Gresswell, M.R.C.V.S., second edition,
enlarged, 8vo, cloth. -.s7.) Sesxceeco. 0 soe o eee 2 75

— ‘Veterinary Pharmacology and Therapeutics.” By
James B. Gresswell, F.R.C.V.S. 16mo, cloth ...1 5U

— ‘* The Bovine Prescriber.” For the use of Veterina-
rians and Veterinary Students. By James B. and
Albert Gresswell, M.R.C.V.S Cloth.............. 75

— ‘The Equine Hospital Prescriber.” Drawn up for the
use of Veterinary Practitioners and Students. By
Drs. James B. and Albert Gresswell, M.R.C.V.S.

— ‘Veterinary Pharmacopeia, Materia Medica and
Therapeutics.” By George and Charles Gresswell,
with descriptions and physiological actions of medi-
cines. By Albert Gresswell. Crown,8vo,cl........ 275

(“)\GOTTHEIL. ‘A Manual of General Aistology.”
By Wm. 8. Gottheil, M.D., Professor of Pathology in
the American Veterinary College, New York; etc., ete.

Histology isthe basis of the physician’s art, as
Anatomy is the foundation of the surgeon’s science.
Only by knowing the processes of life can we under-
stand the changes of disease and the action of remedies;
as the architect must know his building materials, so
must the practitioner of medicine know the intimate
structure ot the body. To present this knowledge in
an accessible and simple form has been the author's
task. 8vo., cloth, 148 pages, fully illustrated... 1 00

851-853 Siath Avenue (cor. 48th St.), New York. 9

(HASSLOCH, ‘A Compend of Veterinary Materia
Medica and Therapeutics.” By Dr. A. C. Hassloch,
V.S., Lecturer on Materia Medica and Therapeutics,
and Professor of Veterinary Dentistry at the NewYork
College of Veterinary Surgeons and School of Compa-
rative Medivine, N. Y. 12mo, cloth, 225 pages ..1 50

HAYES. ‘Veterinary Notes for Horse-Owners.” An
every day Horse Book. Jllustrated. By M. H. Hayes.
LINTOSCLOL Meee Garter ee rnc ere le Meret ome eee ations 5 00

— “Riding.” Onthe Flat and Across Country. A Guide
to Practical Horsemanship. By Captain M. H. Hayes.
Secondsedition6mos clothes ae ee aoe 45 4225

— ‘‘Iilustrated Horse Breaking.” By Captain M. H.
Hawes. -l2mo; cloths illustrated: . 2222. 5<.-.+-.- 8 40

— “The Horsewoman.” By Captain M. H. Hayes and
Mrs. Hayes. 12mo, cloth, illustrated.... ...... 4 26

(HEATLEY, ‘The Stock Owner’s Guide.” A
handy Medical Treatise for every man who owns an
ox orcow. By George 8. Heatley, M.R.C.V. 12mo,

— “The Horse Owner’s Safeguard.” A handy Medical

Guide for every Horse Owner. 12mo, cloth .....1 50
— ‘Practical Veterinary Remedies.” 12mo, cloth...1 00
HILL. ‘The Principles and Practice of Bovine Med-

icine and Surgery.” By J. Woodroffe Hill, F.R.C.V.S.
Cloth. (Tx. mporarily out of print).

10 Veterinary Catalogue of William R. Jenkins

HILL. ‘The Management and Diseases of the Dog.”
Containing full instructions for Breeding, Rearing and
Kenneling Dogs. Their Different Diseases. How to
detect and how to cure them. Their Medicines, and
the doses in which they can be safely administered.
By J. Woodroffe Hill, F.R.C.V.S. 12mo, cloth, extra
fully illustrated 5.1). .saees cone deen ee 2 00

HINEBAUCH. ‘Veterinary Dental Surgery.” For
the use of Students, Practitioners and Stockmen.

(“)HOARE. ‘A Manual of Veterinary Therapeutics
. and Pharmacology.” By E. Wallis Hoare, F.R.C.V.S.
12mo; cloth, 560 pares... aac susess-. eee eee 2 75

“Deserves a good place in the libraries of all veterina-
rians. * * * Cannothelp but be of the greatest assist-
ance tothe young veterinarian and the every day busy
practitioner.”—American Veterinary Review.

()KOBERT, ‘Practical Toxicology for Physicians
and Students,’? By Prof. Dr. Rudolph Kobert,
Director of the Pharmacological Institute, Dorpat,
Russia. Translated and edited by L. H. Friedburg,
Ph.D., of Dept. of Chemistry, College of City of New
York, Prof. of Chemistry and Toxicology at the Ame-
rican Veterinary College, New York, and New York
Homcepathic Medical College and Hospital. Author-
ized edition. (In preparation.)

KOCH. ‘* Etiology of Tuberculosis.» By Dr. R.
Koch. Translated by T. Saure. 8vo, cloth.....1 00

851-853 Siwth Avenue (cor. 48th St.), New York. 11

KEATING. “A New Unabridged Pronouncing
Dictionary of Medicine.” By John M. Keating, M D.,
LUL.D., Henry Hamilton and others. A voluminous
and exhaustive hand-book of Medical and scientific

_ terminology with Pnonetic Pronunciation, Accentu-
ation, Etymology, ete. With an appendix containing
important tables of Bacilli, Microcci Leucomaines,
Ptomaines; Drugs and Materials used in Antiseptic
Surgery; Poisons and their antidotes; Weights and
Measures; Themometer Scales; New Officinal and
Unofficinal Drugs, etec., etc. 8vo, 818 pages..... 5 00

LAMBERT. ‘**The Germ Theory of Disease.”
Bearing upon the health and welfare of man and the
domesticated animals. By James Lambert, F.R.C.V.S.
SMO MDE WC Tampere Worse erent et heros ars aie, srcsienne asleye ce a 25

LAW. °**¥Farmers’ Veterinary Adviser.”? A Guide to
the Prevention and Treatment of Di-ease in Domestic

EITAUTARD. “Median Neurotomy in the Treatmert

Chronic Tendinitis and Periostosis of the Fetlock.”
By C. Pellerin, late Repetitor of Clinic and Surgery to
the Alfort Veterinary School. Translated with addi-
tional facts relating to it, by Prof A. Liautard, M.D.,
V.M.

Having rendered good results when performed by
himself, the author believes the operation, which
consists in dividing he cubito-plantar nerve and in
excising a portion of the peripherical end, the means
of improving the conditions, and consequently the
values of many apparently doomed animals. Agricul-
ture in particular will be benefited,

The work is divided in‘o two parts. The first covers
the study of Median Neurotomy itself; the second,
the exact relations ofthe facts as observed by the
PUNO | eSVO! AWOATTSre een ea eee eer seer 1 00

12 Veterinary Cutalogue of William R. Jenkins

(LIAUTARD. ‘Manual of Operative Veterinary
Surgery” By A. Liautard, M.D., V.M., Principal
and Professor of Anatomy, Surgery, Sanitary Medicine
and Jurisprudence in the American Veterinary College;
Chevalier du Merite Agricole de France, Honoiary
Fellow of the Royal College of Veterinary Surgeons
(London), ete., ete. 8vo, cloth, 786 pages and nearly
600 illustrations ionic... 6s Sacer pacman eee 6 OU

— **Animal Castration.’? A concise and practical Treatise
on the Castration of the Domestic Animals. The
only work on the subject in the English language.
Iilustrated with forty-four cuts. 12mo, cloth...2 OU

(*) ** Vade Mecum of Equine Anatomy.” By A. Liautard,
M.D.V.S. Deaa of the American Veterinary College.
12mo, cloth. New edition, with illustrations. ...2 00

— ** Translation of Zundel on the Horse’s Foot.”
Cloub: 655-2 eek ee Bee eee oie ieee 2 VO

— ** How to Tell the Age of the Domestic Anima!.”? By

Di. A. Liautard, M.D., V.S. Profusely illustrated.
PO ns@s \GlObI stars. 6 se oxsactss Se weer oe tea ee 50

— **Qn the Lameness of Horses.’’? By A. LiautarJd,
NE DW ain. cece cant ters Spee nee ie eee ..2 50

LONG. “Book of the Pig.” Its selection, Breeding,
Feeding and Management. 8vo, Gloth.. ........ + 25
()LUPTON. ** Horses: Sound and-Unsound,” with
Law rclating to sales and Warranty. By J. Irvine
Lupton, F.R.C.V.S. 8vo, cloth, illustrated ..... 1 25
— **'The Horse.’? As he Was, as he Is, and as he
Ought to Be. By J. I. Lupton, F.R.C.V.S. ILlus-
trated... Crow); ENO. oc ce ldos sien cect ieee eee 1 40

851-853 Sixth Avenue (cor. 48th St.), New York. 138

MAGNER. ** Facts for Horse Owners.” By D.
Magner. Upwards of 1,000 pages, illustrated with 900
engravings. 8vo, cloth, $5.00; sheep, $6.00; full
PUN OEOC COM me roe oarn ha oe ee toa eo erate me TE gienoreie 7 50

MAGNER. ‘Veterinary Diagrams.” (1) The Struc-
ture of Horses Feet (in colors). The Structure of
Horses Feet (Effects of Bad Treatment of the ee

MountedsandsViarmiSned sc sei. sic neccveo clelsr= 6)
(2) The Shoeing of the Horse. The Education of ee
Horse. Mounted and: Varnishedls:. 22... <2 2 UU

MAYHEW. ‘The Illustrated Horse Doctor.”? An
accurate and detailed account of the Various Diseases
to which the Equine Race is subject; together with the
latest mode of Treatment, and all the Requisite Pre-
scriptions written in plain English. By E. Edward
Maynew, M.R.C.V.S. Illustrated. Entirely new

CUTMONES VO CLOLA a ceca cc so ieie eves ciayeisel Maer. e 2 75
McBRIDE. “Anatomical Outlines of the Horse.”
NWN, COUT Ser ans Oka SAD ee eS Oe a ae EP ets 2 50

McCOMBIE. ‘‘Cattle and Cattle Breeders.” Cloth.1 00

MWFADYEAN. ‘* Anatomy of the Horse.” A Dis-
section Guide. By J. M. M’Fadyean, M.38.C.V.S.
This book is intended for Veterinary students, and
offers to them in its 48 full-page colored plates numer-
ous other engravings and excellent text, the most
valuable and practical aid in the study of Veterinary

Anatomy, especially in the dissecting room. vo,
CLOUT aioe east eee ereer a vey nia ysusie hav ear iete wie evbyckererae 5 50

— ** Comparative Anatomy of the Domesticated Ani-
mals.’ By J. M’Fadyean. Profusely illustrated,
and to be issued in two parts. Pxrt I—Osteology,
PEBVOlyo, eyo SP} NS Clogs saudanabonddos bode 275

(Part IT. in preparation.)

14 Veterinary Catalogue of William R. Jenkins

MILLS. ‘*How to Keep a Dog in the City.’’ By
Wesley Mills, M.D, V.S. It tells how to choose
manage, house, feed, educate the pup, how to keep him
clean and teach him cleanliness. Paper........... 25

(**)MOLLER., ‘Operative Veterinary Surgery.” By
Professor Dr. H. Moller, Berlin. Translated and
edited from the 2d edition, enlarged and improved,
by John A, W. Dollar, M.R.C.8.

Prof. Moller’s work presents the most recent and
complete exposition of the Principles and Practice of
Veterinary Surgery, and is the standard text-book on the
subject throughout Germany.

Many subjects ignored in previous treatises on
Veterinary Surgery here receive full consideration,
while the better known are presented under new and
suggestive aspects.

As Prof. Moller’s work represents not only his
own opinions and practice, but those of the best
Veterinary Surgeons of various countries, the trans-
lation cannot fail to be of signal service to American
and British Veterinarians and to Students of Veter-
inary and Comparative Surgery.

1 vol., 8vo. 722 pages, 142 illustrations ........ 5 25

MORETON. ** On Horse-breaking.”? i2mo, cl...50

MOSSELMAN-LIENA UX, “Veterinary Microbio-
logy.” By Professors Mosselman and Liénaux, Nat-
ional Veterinary College, Cureghem, Belgium. Trans-
lated and edited by R. R. Dinwiddie, Professor of
Veterinary Science, College of Agriculture, Arkansas
State University. 12mo, cloth, 312 pages........ 2 00

851-853 Sixth Avenue (cor. 48th St.), New York. 15

*)NOCARD. “The Animal Tuberculoses, and their
Relation to Human Tuberculosis.” By Ed. Nocard,
Professor of the Alfort Veterinary College. ‘Trans-
lated by H. Sctarfield, M.D. Ed., Ph. Camb.

Perhaps the chief interest to doctors of human
medicine in Professor Nocard’s book lies in the
demonstration of the small part played by heredity,
and the great part played by contagion in the propa-
gation of bovine tuberculosis. It seems not unreason-
able to suppose that the same is the case for human
tuberculosis, and that, if the children of tuberculosis
parents were protected from infection by cohabitation
or ingestion, the importance of heredity as a cause of
the disease, or even of the predisposition to it, would

dwindle away into insignificance. 12mo, cloth 143
MEAS CS cy nieecvs eth siazcie wis roe mans aeayeis avstessioiul Sueraiets creas .1 00

PEGLER. ‘‘The Book of the Goat.”? 12mo, cloth.1 75

PELLERIN. ‘Median Neurotomy in the Treatment
of Chronic Tendinitis and Periostosis of the Fetlock.”’
By C. Pellerin, late repetitor of Clinic and Surgery to
the Alfort Veterinary School. Translated, with Addi-
tional Facts Relating to It, by Prof. A. Liautard, M.D.,
VEN Svomboards illustrate ds ace m nye eee 1 00

: See also under Liautard.

PROCTOR. ‘The Management and Treatment of
the Horse” in the Stable, Field and on the Road.
By William Proctor) 8VO0-.. 52-2550 56-e 42+ 2 40

PETERS. “A Tuberculous Herd—Test with Tuber-
culin.’ By Austin Peters, M.R.C.V.S., Chief
Inspector of Cattle for the New York State Board of
Health during the winter of 1892-93. Pamphlet....25

16 Veterinary Catalogue of William R Jenkins

REYNOLD. “Breeding and Management of Draught
Horses; Svo;cloth=eo.)..nreinceese eee 1 40

ROBERTSON. “The Practice of Equine Medicine.”
A text-book especially adapted for the use of Veter-
inary students and Veterinarians. By W. Robertson,
Principal and Professor of Hippopathology in the
Royal Veterinary College, London. 8vo. cloth, 806
pages, revised editions... 2) seresi<'s oiieyeiels ee eee 6 25

()ROBERGE. ‘The Foot of the Horse,” or Lame-
ness and all Diseases of the Feet traced to an Unbal-
anced Foot Bone, prevented or cured by balancing the
foot. By David Roberge. 8vo, cloth.........-. 5 00

(SMITH. ‘*A Manual of Veterinary Physiology.”
By Veterinary Captain F. Smith, M.R.C.V.S. Author
of ‘A Manual of Veterinary Hygiene.”

Throughout this manual the object has been to con-
dense the information as much as possible. The
broad facts of the sciences are stated so as to render
them of use to the student and practitioner. In this
second edition—rewritten—the whole of the Nervous
System has been revised, a new chapter dealing with
the Development of the Ovum has been added together
with many additional facts and illustrations. About
one hundred additional pages are given. Second
edition, revised and enlarged, with additional illus-
trations)... 28.5.2 steed comer ee ee enn ake ene 3 75

(*)SMITH. “Manual of VeterinaryHygiene.” 2nd
edition, revised. Crown, 8vo, cloth ............ 3 25

851-853 Sixth Avenue (cor. A8th St.), New York. 17

STORNMOUTH. ‘Manual of Scientific Terms.”
Especially referring to those in Botany, Natural

History, Medical and Veterinary Science. By Rev.
James SLOCMMOULN Ye escrito eerste secon OO)

C)STRANGEWAY. ‘Veterinary Anatomy.” New
edition, revised and edited by I. Vaughn, F.L.S.,

M.R.C.Y.S., with several hundred illustrations. 8vo.
GOWN SS oS ico conloo SE Oa SHAD Ose oui Serres 5 00

@SUSSDORF. Colored Plates specially for Lectures.
Size 40x27. By Professor Sussdorf, M.D. Translated
by Prof. W. Owen Williams, of the New Veterinary
College, Edinburgh.

Plate 1.—** Diagram of the Horse.”’ Left or near side
view.

Plate 2.—‘* Diagram of the Mare.” Right side view.

Plate 3. ‘Anatomy of the Cow,” showing the
position of the viscera in the large cavities of the body.

Plate 4. °** The Ox.’? Showing right side view of the

position of the viscera in the large cavities of the
body.
(Plates 5 and 6 in preparation.)

ePricesunmounbede reser so eco e. 1 75 each
‘¢ mounted on linen, with roller,..1 75 extra ‘

VETERINARY DIAGRAMS in Tabular Form.
Size, 284 in. x 22 inches. Purice per set of five... 4 75

No.1. ‘The External Form and Elementary Ana-
tomy of the Horse.” Eight coloured illustrations—
1. External regions; 2. Skeleton; 3. Muscles (Superior
Layer); 4. Muscles (Deep Layer); 5. Respiratory Ap-
paratus; 6. Digestive Apparatus; 7. Circulatory Ap-
paratus ; 8. Nerve Apparatus ; with letter-press descrip-
CLONE re ec aces eee ey oreo hehe cic ale, divi ictal onnieeee eos eee 1 25

18 Veterinary Catalogue of William R. Jenkins

No.2. ‘*The Age of Domestic Animals.” Forty-two
figures illustrating the structure of the teeth, indicat-
ing the Age of the Horse, Ox, Sheep, and Dog, with
full description’... ..%.6 266 ceaesc ee epee eee 75

No. 3. ‘*The Unsoundness and Defects of the Horse.”
Fifty figures illustrating—1l. The Defects of Confor-
mation; 2. Defects of Position ; 3. Infirmities or Signs
of Disease; 4. Unsoundnesses; 5. Defects of the Foot;
with full deseription: . T....... 226 snes soso eee 75

No. 4. ‘The Shoeing of the Horse, Mule and Ox.”
Fifty figures descriptive of the Anatomy and Physio-
logy of the Foot and of Horse-shoeing. ........... 75

No. 5. ‘The Elementary Anatomy, Points, and But-
cher’s Joints of the Ox.” Ten coloured illustrations
—1. Skeleton; 2. Nervous System: 3. Digestive
System (Right Side) ; 4. Respiratory System ; 5. Points
of a Fat Ox; 6. Muscular System; 7. Vascular System ;
8. Digestive System (Left Side); 9. Butcher’s Sections
of a Calf; 10. Butcher’s Sections of an Ox; with full
CeSCripblONy 3.5. 65:50:56 og: 0s scarves cre cues o alecel eee 1 25

WALLEY. “Hints on the Breeding and Rearing of
Farm Animals;” ~12mo; cloth... 3..-2.--- eee 80

— “Four Bovine Scourges.” (Pleuro - Pneumonia,
Foot and Mouth Disease, Cattle Plague and
Tubercle.) With an Appendix on the Inspection of
Live Animals and Meat. Illustrated, 4to, cloth. .6 40

851-853 Siath Avenue (cor. 48th St.), New York. 19

— “The Horse, Cow and Dog.” By Dr. Thomas
Walley. A poetical account of the ‘‘Troubl-
ous Life of the Horse”; ‘‘ The Life of a Dairy Cow,”
and ‘‘ The Life of a Dog”; with an article on Animal
Characteristics. 12mo, cloth. ........ Sec anos aise 80

C)WALLEY. ‘A Practical Guide to Meat Inspection.”
By Thomas Walley, M.R.C.V.S., formerly principal
of the Edinburgh Royal (Dick) Veterinary College;
Professor of Veterinary Medicine and Surgery, etc,
Third Edition, thoroughly revised, with forty-five
coloured illustrations, 12mo, cloth............... 3 00

An experience of over 30 years in his profession
and a long official connection (some sixteen years)
with Edinburgh Abattoirs have enabled the author to
gather a large store of information on the subject,
which he has embodied in his book. Dr. Walley’s opi-

nions are regarded as the highest authority on Meat
Inspection.

(*)WILLIAMS. “Principles and Practice of Veter-
inary Medicine.” New author’s edition, entirely
revised and illustrated with numerous plain and color-
ed plates. By W. Williams, M.R.C.V.S.8vo., cl..6 00

— (**) ‘Principles and Practice of Veterinary Surgery.”
New author’s edition, entirely revised and illustrated
with numerous plain and colored plates. By W.
Walliams>s VER: CAVES. ovo. Clothier. --en. sao 6 00

WYMAN. “The Clinical Diagnosis of Lameness
in the Horse.” By W. E. A. Wyman, V.S., Prof. of
Veterinary Science, Clemson A. & M. College, and
Veterinarian to the South Carolina Experiment Sta-
tion. (In preparation.)

20 Veterinary Catalogue of William R. Jinkins

ZUNDEL. ‘The Horse’s Foot and Its Diseases.” By
A. Zundel, Principal Veterinarian of Alsace Lorraine.
Translated by Dr. A. Liautard, V.S. 12mo, cloth
illustrated. oo. ase ease ee vee ele) flee hee aera 2 00

ZUILL. “Typhoid Fever; or Contagious Influenza

in the Horse.” By Prof. W. L. Zuill, M.D.,D.V.S.
Pamphlet 2 22:. sci Sakic ses nett anc. ee ae eee 25

Our Books are for sale by all booksellers,

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