The best means of inserting these sutures is with a curved needle fixed into a handle. The handle is wanted to obtain the necessary power, and the needle's point should be sharp to penetrate the hide of the horse, which in places is of considerable thickness. The needle is thrust through the integument about one inch and a half from one margin of the incision; it is brought out about the same distance within the divided soft parts. It enters the opposite side of the sundered flesh even with the place whence it came forth, and afterward it appears through the skin about equally distant from the opposite edge of the wound. There is a hole near the point of the needle; through this opening a piece of strong twine or narrow tape is threaded; when, the instrument being withdrawn, the twine or tape is pulled into the puncture which has been made. The needle is then released, the suture being left in.

So many sutures as may be necessary are thus inserted—in small wounds, these being about two inches asunder, but in larger injuries, three inches apart. All are duly placed before any are tied; the whole being ready, the wound is forced together by an assistant, while the strings are fastened—care being exercised not to bring any of them actually tight, lest the motion of the body or the swelling of the part should drag the sutures through the flesh and thereby tear them out.

A wound thus united may possibly heal by first intention, or the divided parts, when brought together, may join, and give no further trouble to the surgical attendant.

Union by first intention is, however, somewhat rare in the horse; and should not that take place, suppuration will be established. So soon as the pus flows freely forth, and the sutures appear to tighten or drag, cut them out by snipping the twine; but allow the strings to loosen before you attempt their withdrawal.

If this is not done, the sutures will speedily find an exit for themselves by causing the flesh against which the tension acts to be absorbed; thus the original injury will be rendered more complicated, and the ultimate blemish must be altogether greater.

All that is required after the establishment of suppuration is to bathe the part with the solution of chloride of zinc, one grain to the ounce of water. This lotion will suppress any fetor, and gently stimulate the healing process, as well as prevent the sprouting of fungoid granulations; it is necessary also to attend strictly to the directions laid down for feeding during the curing of wounds.

The treatment of an abraded wound chiefly consists in cleansing the surface with plenty of cold water, which should be allowed by its own weight to wash off any loose particles of dirt. No cloth or other aid should be employed to scrub the living flesh as though it were an insensitive board. The matter which cannot be removed by simply sluicing, had better remain to be expelled by the secretion of pus. The horse, especially when terrified, endures pain very badly; indeed, the animal is so timid and so delicately framed that it is always good surgery to spare all unnecessary suffering.

Support the body with laudanum and ether drinks, one ounce of each to the pint of water, as often as they may be needed. Let the food be generous, unless fever should arise, when the directions already given must be attended to.

Punctured wounds require only one kind of treatment, whether a nail be driven into the flesh of the foot, or the shaft of a cart be forced into the substance of the thigh. Here the knife must be employed; and, unless the animal shows evident symptoms of excessive weakness, it is better, perhaps, to operate while the parts are partially numbed by the shock, than to wait until a morbid sensibility is provoked. Always enlarge the opening; do this in the foot by cutting away the horn of the sole around the small puncture left by the nail. When the soft parts are penetrated, probe the wound first; then, if possible, insert a knife to the bottom of the puncture, and, with the edge downward, draw it forth. By this means a wound resembling a subverted < will be instituted. It will be narrowest toward the extremity, and widest at the mouth. A free opening affords a ready egress for all sloughs and pus. It materially aids the healing process, and effectually prevents the establishment of sinuses; while the clean incision left by the knife is of small import, when taken into consideration with the other consequences of a punctured wound.

Support the animal if necessary, or regulate the food by the symptoms.

A contused wound, when slight, may be rubbed with the iodide of lead ointment, one drachm of the active agent to the ounce of lard; when all enlargement will sometimes subside, and the effused blood may be absorbed. However, the horse commonly receives injuries of magnitude. In the last case, take a sharp knife and draw it along the entire length of the swelling. Make a long gash, only through the integument, at every eighth inch, and be careful to carry the knife through the integument, or to the lowest portion of the detached skin. Any sac that may be left is certain to retain corruption, and may produce fearful after-consequences. The attendant measures consist in bathing the contusion with a lotion composed of chloride of zinc, one grain, water, one ounce, and diminishing the food or supporting the body as nature demands such treatment.

The after-treatment of all injuries consists in keeping any external orifices open till all sloughs and pus have disappeared. In surgery, a large and depending opening, by means of which the interior may drain, is always to be preserved, and the knife, to this end, may be employed so often as the healing process threatens to prematurely close the wound.

Formerly it was the practice to bleed after every injury; this was done to prevent fever. However, observation has shown that the vital powers are more often weakened than increased by the shock attendant on severe accidents. Whenever the contrary happens, it is far better to lower the pulse by repeated doses of aconite, than to abstract that which will subsequently be necessary to repair injury.

It was also once the custom to fill wounds with tents or lumps of tow, and to bandage every injured part. These habits only served to confine that which nature was striving to cast out. They consequently did much harm, and are now happily discarded.

A piece of loose rag, saturated in the oil or the solution of tar, should, during summer, be suspended over the mouth of every wound, to keep off the flies. The only tent which the author approves of is when an incised wound happens where assistance is far away, and difficult to procure. Then, to arrest the hemorrhage, let the horse rug, a man's coat, or anything else be violently thrust into the gash, and forcibly held there until proper assistance can be obtained.

Such is the present method of treating wounds; this to the reader may appear very cruel; but could he have walked through and have inhaled the atmosphere of the wards in hospitals appropriated to such injuries as they existed in former times, he would thoroughly understand that apparent want of feeling is, in reality, the height of charity.

To conclude this part, the author lays before his readers the following bandage, intended to meet an inconvenience hitherto experienced when a horse has the walls of the abdomen punctured. The constant motion of the part renders ordinary sutures of no avail, and for that reason bandages, unless so tight as to check circulation, are of little use. The annexed is made like a broad belt, and is buckled round the body. The bars are composed of vulcanized India-rubber; they will yield to the movements of the abdomen, and yet serve as sutures supporting any pendant flap, while at the same time they will allow the wound to be dressed without disturbing the bandage. They also offer the advantage of permitting the attendant to pull one support aside without removing the whole.

Every part in the horse subjected to much motion when wounded, should have an adhesive plaster placed over it, and retained there until the suppurative action is confirmed. By this means is excluded the atmosphere, which, when this precaution was neglected, has entered the wound, penetrated between the muscles, and by distending the body increased the suffering, as well as led to the worst of consequences.

Wounds in veterinary surgery rank among the most formidable cases with which the practitioner has to contend. They are not so because the flesh of the horse is slower to heal than that of the human being. Indeed, the scale in this respect inclines toward the animal; but they are rendered slow to heal and difficult to cure by two causes. The horse is always impatient of restraint; any effort to confine the creature is more likely to provoke dangerous resistance than to induce the slightest symptom of amendment. The quadruped naturally delights in motion. It was formed for activity. Even when in its stall the body is never absolutely still; the position is being changed; the legs are frequently stamped; the head, eyes, ears, and tail are never quiet. This innate quality retards the union of sundered flesh. It favors the gravitation of pus between the muscles, and thus generates sinuses. These are the torments of veterinary surgery. Could the sinus be anticipated, or in all cases eradicated, the principal difficulty would be removed; but intelligent as the horse is, it proves impossible to make the animal comprehend the necessity for quietude. Hence any trivial accident may lead to injuries of so extensive a character and so malignant a nature as will set the best endeavors or the most consummate skill at defiance.

CHAPTER XV.
OPERATIONS.

There are few operations in veterinary surgery which a person of moderate nerve and average intelligence might not himself perform. The author has seen gentlemen with titles, and others holding high rank in the army, indulge in the strange pleasure of singeing living flesh with the heated iron. But he has never beheld horsemen handling the knife. The latter would better become their hands than the first severe and disfiguring instrument, which, however useful it may have been found in certain cases met with in human surgery, nevertheless would be well abolished from veterinary practice, because of its indiscriminate abuse. Firing is employed for every and for no reason. Now recourse is had to it because the joints are weak. Then it is adopted because a gentleman is fond of seeing his horses scored. Next, it is used to gain time, and thus prolong the treatment. Generally it is brought forward because the practitioner does not know what else to do. Lastly, it is esteemed the crowning measure of routine practice.

The author, however, has never been necessitated to resort to so violent an agent. It is a most unseemly ornament in unprofessional hands; in this book, which is intended for the general public, the use of the firing-iron is altogether omitted.

The knife, especially to the animal, is the most humane of remedies. It often affords instant or immediate relief. The animal seems to suffer more from the restraint imposed than from the wounds inflicted. The chief sensation, with all forms of life, resides in the skin; so that the integument be quickly and effectually divided, the soft parts underneath have but little feeling. The interference with these last rather produces faintness or sickness than acute suffering; the knowledge of which fact will embolden many a humane person, though the writer trusts it will not be credited by all who are of an opposite character, since boldness, unrestrained by humanity, only renders the individual a savage without the savage's excuse.

Such operations as embriotomy, castration, and lithotomy are intentionally omitted, from a conviction that no gentleman would undertake them; and because, in every instance, they had better be intrusted to a regular veterinary surgeon.

Before undertaking any operation, always reflect on what you are about to do, and make up your mind how you design to do it. Irresolution causes more suffering than the most perverted determination can inflict. It is always well (however much in practice the operator may consider himself) to first perform the intended operation upon the dead subject. This is a custom which the writer invariably adopted; and frequently it has supplied his memory with a refresher which, in the hurry of practice, was found a most timely warning.

Never use small knives. Such things look pretty. The sight of a large blade may appear very ugly; but it does at one movement that work which an instrument of notching smallness would not in twenty hacks accomplish. Understand thoroughly that which you are about to perform, and always choose the tool likely to get through the business quickly. Periosteotomy cases were formerly sold by veterinary instrument makers which contained a knife of moderate doll's dimension. The writer, to accomplish the purpose which that little knife was specially made for, was accustomed to employ a bistoury larger than those in ordinary use among gentlemen of his profession.

Where you anticipate much bleeding, always endeavor, if possible, to divide the main artery with the first incision. This is by far the most humane, and therefore the safest practice. The vessel, being divided, can be taken up, and all further flow of blood thereby checked. But if the artery be left to the last, it remains to fill the smaller branches. These are of necessity frequently severed. Each, as it is cut, bleeds more or less freely; thus the hemorrhage is far greater, and the operation far more difficult, than if the main trunk had been secured at the earliest possible period.

Always tie both ends of an artery; because, though the main stream flows through that portion of the vessel nearest the heart, yet the other half, being fed by the smaller trunks, and the current having a tendency to regurgitate, a considerable quantity of the vital fluid may flow out of the mouth, which, in general opinion, has no medium of supply.

If, during an operation, you make an accidental incision into a vessel, either take it up, (which is the better way,) or cut it short off when there is a chance of its retracting and of the bleeding being thus arrested. Vessels of large size may, when requisite, be excised and tied; the vital current being afterward carried on by the dilatation of the lesser ducts.

To tie an artery it is imperative to secure the end of the vessel; this, if possible, should be accomplished with the forceps. When the mouth of the vessel is much retracted, it may be necessary to employ the knife; but that practice should be viewed only as the last resort of the proficient surgeon.

The end of the artery being fixed and drawn forth, a piece of strong silk, thrice twisted, (after the method represented in the inferior circle of the annexed illustration,) is passed over the vessel. The silk is then drawn tight, and will generally remain fixed. However, sad accidents have occurred by operators trusting to so doubtful a security; for that reason it is always advisable to make another twist, (as shown in the smaller circle of the illustration,) which will render the knot secure.

Even a vessel of the second magnitude may be obliterated, as the carotid artery or the jugular vein, without life being necessarily sacrificed. However, it is always well to spare these parts, or when either is lost to arrange so that the absence of them may entail the least possible inconvenience upon the animal. Thus, if the carotid artery be lost, place the food low down, and thereby aid the flow of blood to the head. If the jugular vein be destroyed, then put the fodder high up, that the current from the head may be facilitated.

Never, on any account, remove any portion of skin which is not involved in some fearful injury, or separated from its attachments by the action of disease.

Skin is the part of the body which is never reproduced, and even the place whence it is absent always heals slowly. However loose the skin may appear, however disproportioned it may seem after some tumor has been removed, respect every particle of it. Before the wound can heal, inflammation must set in. That process ended, the skin, under its action, will have contracted, and in the end there will be only sufficient integument to cover the part; whereas, if the slightest amount be excised, to such an extent there will for a long time remain a gaping sore.

Never spare the knife. Think well before you touch that tool; but, having it in hand, assure yourself its edge is sharp, and never do at two cuts that which might have been accomplished in one.

Always slit up a sinus where such a proceeding is possible. When the sinus is too long, supposing the pipe to take an internal direction, as from the withers to the chest, insert a seton with the guarded seton needle, a representation of which is given below.

The blade of this instrument is generally about two feet long. Before using it, the cutting head is always retracted by pulling back the nut at the extremity, and securing it in its place by means of the screw situated on the middle of the handle. The blade then reposes upon a blunt companion, and may with impunity be inserted down any sinus or false canal. Having reached the bottom of the pipe, and all important vessels being passed, the screw is loosened, and the projecting end of the blade at the extremity of the handle is struck forcibly, when the sharp point is driven forward, and this pierces the flesh.

Behind the cutting head there is a free space. Through that opening a long piece of tape is threaded, and the instrument is withdrawn, pulling the tape into the sinus, in which it remains. A knot is made at either end of the tape; thus a seton is with safety placed in situations where the depth to be penetrated would defy ordinary measures, and the vessels to be passed would render such measures more than doubly hazardous.

The use of a seton is to act as a drain, or to stimulate an unhealthy canal—to provoke a sinus to secrete healthy pus, instead of a thin and often a foul discharge—and thus to cause the diseased pipe to heal or to become obliterated.

When operating, always make your first incision through the skin rather too large than in the least too small; remember, the division from within outward occasions much less pain than the separation, made after the ordinary fashion, from without inward.

Never spare hair; the substance is readily reproduced. It can be wished to be spared only to conceal the fact of an operation having been performed. Always refuse to become a party to dishonesty. Do what is necessary for the proper performance of your office. The removal of hair, which may otherwise interfere with your sight, is essential: therefore cut it off, regardless of any wish to the contrary.

Instruct your assistants beforehand how to cast the horse; leave that business to them: never meddle yourself. The writer has seen veterinary surgeons, in their operating dresses, push and haul with the utmost energy. Such silly people have doubtless thought themselves exalted by this exhibition of violence. It would have been more to their credit had they devoted half the energy to teaching their people beforehand. But in what condition must their hands and temper be after having taken a lead in a struggle with a horse for mastery!

A surgeon should always be cool. His head should direct his hand; his knife should be held lightly; his eye should be quick, and his mind prepared to meet any accident. He should do his office neatly, and, if possible, without soiling his person. The ripping cut and the bloody hands alone distinguish the ignorant butcher from the scientific operator.

During every operation enjoin the strictest silence upon the spectators. The horse is never vicious, but it is always timid. Sounds have a powerful effect upon animals which cannot understand speech. Every word uttered, even in a whisper, should be of assurance to the sufferer; for the horse is only to be feared in its efforts to escape from some supposed peril. It becomes mad in its alarm. It then puts forth its strength and exerts it without regard to consequences. Man has everything to hope from the fortitude and noble forbearance of the creature. It responds to kindness with something more than submission; it answers sympathy by the most entire confidence and utter dependence. The life, the feeling, the natural powers are all subservient to the great love which is embodied in a horse's attachment. There is not among created beings one which has so large a sympathy; the horse must attach itself to something; to love seems essential to its being. The stable in which it is captive the patient prisoner learns to regard, as it were, a palace. The pace is always more willing when returning to captivity; freedom has no charm; the field has no allurement to the horse which has lived any time in the most crimped, confined, and uncomfortable of stalls. It will quit the spring grass to be fastened once more in the place to which it has been accustomed and has grown attached.

Then, however much removed from itself, it must pour the richest of its affections on some animal, should man, in pride, refuse to accept the offering. Creatures the most opposite have been the horse's favorite. How often do we hear of the liking formed between a goat, a dog, a cat, and the horse! Love has a strange freemasonry of its own; how else can we account for the larger creature being able to make its longing understood by the smaller life? There may, however, be between animals some substitute for language; but we can hardly suppose any recognized signs exist between birds and the equine species. Yet a famous animal-painter had a pony which formed a violent and lasting affection for a bantam cock. These two used to march side by side up and down the field in which the larger animal was confined; for so very expansive is the horse's love that it will embrace not only its abode, but some life, however distant apparently from its own.

The voice of the person who is accustomed to groom and feed the animal, if he has been only ordinarily humane in the performance of his office, will at all times reassure the beating heart of a prostrated horse. But vast injustice to the animal's better qualities is done by the mode of casting it. It is violently jerked off its legs; by a sudden pull it is thrown "with a burster" upon its side. There it struggles. If mastery sides with the animal, then let the men be speedy in their flight. The quadruped, in its fear, designs no harm to any person. It means only to escape from the terrible danger which encompasses it. Still, it is regardless in its alarm, and may do more injury than the most evil intention could accomplish. There is an engraving of the method of casting horses commencing this chapter. Let the capable reader imagine the effect produced upon the timid quadruped when it is violently flung upon the earth with a sound well denominated "a burster."

The horse is much better made to lie down gently, after the method adopted by Mr. Rarey. Half, and far more than half, the terror excited by an operation may thus be avoided. The confusion and bustle, conjoined with violence, which naturally attend "casting," must make a lasting impression upon the retentive mind of the animal, and, we may suppose, must aggravate the pain, thus materially endangering the result of an operation. The hobbles may be fixed quite as readily when the horse is down as when the animal is standing. Nay, they may be fixed more readily, as the horse, when down, has lost three-fourths of its power.

Mr. Rarey's method of throwing the most unruly animal is thus described by that gentleman:—

"Everything that we want to teach the horse must be commenced in some way to give him an idea of what you want him to do, and then be repeated till he learns it perfectly. To make a horse lie down, bend his left fore leg and slip a loop over it, so that he cannot get it down. Then put a surcingle around his body, and fasten one end of a long strap around the other fore leg just above the hoof. Place the other end under the surcingle, so as to keep the strap in the right direction; take a short hold of it with your right hand; stand on the left side of the horse, grasp the bit in your left hand, pull steadily on the strap with your right; bear against his shoulder till you cause him to move. As soon as he lifts his weight, your pulling will raise the other foot, and he will have to come on his knees. Keep the strap tight in your hand, so that he cannot straighten his leg if he rises up. Hold him in this position, and turn his head toward you; bear against his side with your shoulder—not hard, but with a steady, equal pressure—and in about ten minutes he will lie down. As soon as he lies down he will be completely conquered, and you can handle him as you please. Take off the straps, and straighten out his legs; rub him lightly about the face and neck with your hand the way the hair lies; handle all his legs; and, after he has lain ten or twenty minutes, let him get up again. After resting him a short time, make him lie down as before. Repeat the operation three or four times, which will be sufficient for one lesson. Give him two lessons a day; and when you have given him four lessons, he will lie down by taking hold of one foot. As soon as he is well broken to lie down in this way, tap him on the opposite leg with a stick when you take hold of his foot, and in a few days he will lie down from the mere motion of the stick."

What prevents the hobbles being buckled on? What prevents all necessary arrangements being carried out? What, indeed, but the stubbornness inseparable from ignorance! Veterinary surgeons, as a rule, are not an educated class. In proportion as their information is limited, so is their adherence to established custom likely to be intractable.

There are, besides the hobbles, two other inventions designed to limit the capability of resistance. One is the side line. A soft collar is put over the horse's head and a hobble is fastened to the foot it is desired to have elevated. From the collar is dependant a metal loop, ring, or other contrivance. By the side of this a strong rope is attached. The cord is then passed through the D of the hobble; afterward it is brought back and ran through the side ring or loop. A man then takes hold of the end of the rope, and, by gradual traction, causes the leg to be advanced. It is neither wise nor humane to drag the foot off the ground. A horse which will stand quiet with both feet resting on the earth, is rendered restless when one leg is fastened in the air.

The occasion which makes it imperative to apply the side line is, when the hocks or hinder parts are examined. Many unbroken horses, though quiet in other respects, will not allow these portions of the body to be touched. By causing one leg to be advanced, the other is deprived of all power as a weapon of offense. The horse would obviously fall, if he were to project the only free hind member; and the timidity of the creature indisposes it to incur so vast an indignity.

The other invention is the double side line. A rope is fixed to a loop on either side. The loop or ring is attached to a soft collar. The rope is afterward threaded through a hobble on each pastern. Both legs are then gently pulled forward, and the animal, having its posterior supports drawn from under it, comes to the earth. The ropes are held tight while the horse is turned upon its back. The instant it is in that position, somebody seats himself upon the head, while the body of the animal is propped up by numerous trusses of straw.

This last is but an imperfect method of casting. In general it is rendered still more cruel by the abuse to which it is subject. The ropes are commonly pulled with an utter disregard to the living body upon which they operate. The hind legs are often drawn to the shoulders, and frequently additional cords are employed to make the poor creatures more distorted and more fixed. Has man any cause to wonder at a horse being occasionally what is called "vicious," when the unreasoning creature is thus fearfully operated upon? Is it not rather a proof of the horse's intelligence that it can recognize the cause of its suffering, and study ever after to repel its tormentor?

Let the horse be thrown down after the admirable method introduced by Mr. Rarey. Let it then be hobbled, and never, during the operation, hear any sound but soothing accents. Animals do not understand words, but they are quick readers of characteristics. The language itself these creatures may not be able to literally interpret; but they comprehend all which the manner conveys. When kindness is expressed, the meaning is felt, though the verbiage be lost: it is astonishing how animals will enter into the intention of speech! How home kind language seems to go to the ignorant heart, and how true it is that a gentle word is never thrown away! It is surprising to observe the affection by which the human race is surrounded; they live and walk among animals eager for permission to adore them, anxious to love and to serve them; but it is lamentable to see how an evil spirit repels the feeling which pervades all nature.

There is another point upon which the writer presumes to offer advice. Veterinary surgeons display ignorance in nothing more than in being servile copyists. They do not view their sphere of science as a separate and distinct branch. They always will strive to follow the example of human practitioners even to particulars. There is no difference in the dissecting knives used at the King's College and the Royal Veterinary establishment, though bodies of different bulks are studied in each school. The operating knives of most veterinary surgeons are ridiculously small for such purposes. The consequence is, the animal is much longer down than is absolutely necessary. The author has known one hour employed in dressing a quittor; whereas six sinuses ought to be laid open and dressed in less than five minutes. A vast deal of time is thus wasted; although the opposition to Mr. Rarey's method of throwing will, doubtless, be the length of time it would occupy. However, granting the objection; which is the surgeon bound to consider—the welfare of his patient or his own convenience? It is not every day that the gentleman who enjoys the largest practice has to cast a horse. It is, in fact, a somewhat rare and an exceptional occurrence. Could not the most engaged man devote an occasional half hour to the benefit of his profession?

When operating upon living flesh, always have your knives rather too large than in any measure too small. The work is performed quicker; besides, the hands are kept at some distance from the wound, and the eyes thereby are enabled to direct their movements. The probability of mistakes is thus lessened, and no man, with a knife in his hand and bleeding flesh under his eyes, has a right to expose himself to the possibility of an error which, of course, is not to be erased or atoned for.

Should a horse, when under the knife, struggle, do not attempt to contend with the animal. Immediately leave hold of your instruments, and withdraw your person out of danger. Allow your knife, etc. to remain; it will seldom be displaced, or, if cast out of the wound, can be easily reintroduced; whereas, did you endeavor to snatch away or to retain your hold, the most lamentable consequences might be the result.

Another caution, and this part of the writer's office is concluded. When you operate upon a leg, have that limb uppermost, unless your incision is made upon the inner side. Have the foot placed upon a pillow or sack stuffed with straw, and a strong webbing put around the hoof. The webbing give to a man who is to pull at it. The dragging sensation renders the horse inclined to retract the member; therefore place yourself in front of the limb, or on the same side as the man who holds the webbing. The fore leg, when advanced, cannot be readily employed as a weapon of offense, and the hind limb is always, when used in defense, projected backward.

OPERATIONS—TRACHEOTOMY.

This operation is, perhaps, the most humane recourse of veterinary surgery. Neurotomy may save the horse from greater and longer suffering; but tracheotomy is performed, unlike the former operation, upon an animal in an unconscious state. Difficult respiration, either from tumor pressing upon the larynx, infiltration upon the lining membrane of the larynx, or choking from various causes, produces imperfect oxygenation of the blood. The vital current being impure, of course the brain which it nurtures is not in a condition of health or activity. The consciousness is impaired or altogether destroyed; and immediate relief is experienced after the performance of the operation. The recovery is as rapid as the previous symptoms were alarming. The altered aspect of the animal is as though the body were resuscitated. In certain cases, where every breath is drawn in pain, the ease afforded by tracheotomy is most marked. It makes little difference to Nature, by what means the air is inhaled, so that a sufficiency of diluted oxygen come in contact with the absorbing membrane of the lungs. This, when the larynx is closed or diseased, tracheotomy permits to be accomplished. It is equally beneficial, safe, and humane. However ugly its description may read, it is in practice to be strongly recommended.

The general fault with veterinary surgeons is the delay which commonly pushes off the operation to the last moment. In this delay the proprietor is, perhaps, equally or even more at fault. Hope leads the owner on to the very last, and even then it is with reluctant horror that consent is given "to cut the horse's throat." Such is the term by which certain practitioners characterize tracheotomy; and though it is uttered merely as a joke, yet it creates an impression which acts against a harmless operation.

In agricultural districts, the veterinarian is frequently knocked up at night by a messenger, who announces "Farmer Hodges's horse be a dying." The farmer may live several miles off in the country; and the reluctant sleeper hurries on his clothes to obey the implied summons.

In due time the pair reach farmer Hodge's homestead. It needs no finger to point out the stable. The sound of laborious breathing effectually notifies it. However, the practitioner, upon entrance into the place, is horrified to find himself there with no better company than a boy and a rapidly-sinking animal. The circumstances demand other assistance. The horse doctor cannot help giving voice to his requirements. The lad hearing this, says hastily he will fetch somebody very soon—hangs up the lantern and vanishes into the darkness.

Minutes pass and no footfall greets the ear. The divisions of the hour are struck by the village church, and still no sound of returning steps. The animal becomes worse and worse. In its disabled state it fears to lie down, as that position impedes the breathing. In its efforts to stand, it reels about—now falling to one side and then to the other. Yet the departed messenger does not return. The veterinarian finds the limits of delay are passed: ten minutes more and the quadruped will be down. He takes out his lancet. One foot from the breast-bone, and as near the center of the neck as the rocking motion of the horse or the flickering light of the lantern will allow him to aim, he plunges the blade deeply into the flesh, if possible at one cut dividing the cartilages of the trachea. He has little control over the incision. Frequently a gash results from the tottering of the animal. Mostly he divides more than he would have done had daylight and assistance been afforded him.

The incision being made, the fingers are thrust into the wound to keep the division open. At first this may be difficult; but as time proceeds, the standing of the horse becomes firmer and the breathing less noisy. The veterinarian is, however, impatient at the delay and his enforced position. He is just beginning to despair, when the messenger returns, accompanied by a sleepy companion. Both are surprised at the condition of the horse, and, not observing the wound, imagine the animal has been cured by magic. However, to the demands of the equine medical attendant, nothing like a tracheotomy tube is to be invented. At last the spout of the tea kettle is thought of; and the good dame awakens in the morning to find her kettle demolished and its spout thrust into the "plaguy horse's throat."

It is the curse of veterinary surgery, that nobody appears to understand when an operation is required. The practitioner, therefore, is seldom prepared for its performance. The circumstances allow him little time to think, and none to return or to fetch the necessary instruments.

However, when he has proper time and choice, he should always make a free incision through the skin and panniculus carnosus. Make this opening about one-third up the neck, measuring from the chest. It is more general to open the windpipe at a similar distance from the jaw, and, assuredly, the superior incision has this advantage, that there is less to cut through. But where no important nerves or vessels are endangered, surgery cares little about the depth of a wound, the chief attention being given to the probable after-consequences.

The superior portion of the neck is especially the seat of motion; it varies with every turn and movement of the head. Hence the end of the tube is apt to be brought into constant contact with the lining membrane of the trachea, and horses have been slaughtered with huge tracheal abscesses, to all appearance produced solely by wearing the tracheotomy tube.

To avoid this danger the author chooses for incision a spot nearer to the chest, where the motion is less constant and not so varied. Even at this last place all danger is not entirely surmounted, in consequence of which a horse, while wearing a tracheotomy tube, should never be permitted to feed from the ground.

At the commencement, when the operator has leisure, he generally does not cut too deep. The first incision fairly divides the skin and panniculus carnosus quite in the middle of the neck, and is rather longer than a by-stander would deem to be absolutely necessary. The elasticity of the skin will somewhat shorten the opening, while the torture of repeated enlargements will be avoided, and the more important structures beneath the skin will be fairly brought into view.

In the center of your division will appear two long muscles, joined together by a fine cellular union; that union you are to separate; it consists only of cellular tissue, and will necessitate more care than exertion. Underneath the divided muscles will be found two others, smaller and paler, but also joined together by means of fine cellular tissue. These are also to be sundered, and then the trachea lies exposed. There is neither nerve, nor artery, nor vein to avoid, nor to take up in the performance of tracheotomy. All consists in making your primary incision large enough, and, subsequently, in not attempting more than the division of two pairs of muscles.

The commencement of the incision should be made at the spot already indicated. After the skin is cut through and the muscles are divided, two assistants should be obtained to hold them back, while a circular piece is excised from the cartilages of the exposed trachea.

The trachea is formed of numerous cartilaginous rings each half an inch wide, but so united by elastic tissue that the whole forms one continuous tube reaching from the head to the chest of a horse. If possible, only two of these rings are to be interfered with; that is, a half circle, should be cut out of each, which, with the elastic connecting medium, will make an opening of one inch in diameter. Both the rings, however, should be perfectly divided; but a half circle should be excised from one, leaving a portion of cartilage to keep the remainder in its place. This matter, probably, may be made more clear by the engraving on the opposite page.

After the first half circle is made, or when a portion is cut off the first cartilage, that piece should be bent outward. The elastic connecting substance will readily permit this to be done, and the current of fresh air admitted will considerably refresh the animal. The cartilage being bent outward, it should be leisurely transfixed by means of a sharp needle armed with strong twine. The string may be fastened to the button-hole of the operator's waistcoat, and afterward the circle be leisurely completed.

The twine is necessary because the spasmodic breathing has drawn the excised portion of cartilage upon the lungs, and thereby done as much mischief as the operator designed to do good. By bending the half circle outward, some relief is afforded to the breathing, and the character of the respiration partially benefited. The process is, however, rendered more safe by the employment of the loop; but care should be taken, when subsequently using the knife, not to cut the string. Therefore, before the circle is completed, the cartilage should be bent backward, as shown in the previous engraving, then laid hold of, and, when firmly grasped, the excision ought to be perfected.

A tube has to be worn afterward; this is put into the opening, and fastened in by means of a strap or tape passed round the neck. There are many tubes sold by the instrument makers for this purpose; the majority, however, are far too large. None should be beyond one inch in diameter. The horse only requires to inhale part of the air through the canula, the remainder coming, as before, through the larynx. A free space of one inch is, therefore, plenty to admit the deficient oxygen; for no animal could live through an operation, were air, previous to its commencement or during its continuance, altogether excluded.