Fistula of the withers and poll-evil . since this can be accomplished betterand without discomfort by other means the oneargument in their favor loses force. The treatment of fistula of the withers whichin our hands has given the best results isprompt, thorough, surgical intervention. Ouroperation of choice and which is hereinafter de-scribed consists of a median line incision ex-tending from the crest of the withers forwardssix to twelve inches and downward through theskin, the pad of the mane and then between thetwo halves of the ligamentum nuchas into thespace beneath lying over the summits
Fistula of the withers and poll-evil . since this can be accomplished betterand without discomfort by other means the oneargument in their favor loses force. The treatment of fistula of the withers whichin our hands has given the best results isprompt, thorough, surgical intervention. Ouroperation of choice and which is hereinafter de-scribed consists of a median line incision ex-tending from the crest of the withers forwardssix to twelve inches and downward through theskin, the pad of the mane and then between thetwo halves of the ligamentum nuchas into thespace beneath lying over the summits of thesecond and third thoracic vertebrse. This isfollowed by a resection of such parts of theligamentum nuchge as are thought to be harm-ful and then by making lateral drainageapertures from the bottom of the cavity to thesurface of the cervical region into which aperforated drainage tube is inserted. Radical Operation for Fistula of the Withers Prepai^ation.—As the procedure is one ofsome magnitude, attended with all of the dan-. Fig. 4.—Effects of the Use of mule was treated for a typica;! fistula of the withersby the injection of concentrated lye. Discharge from thewound occasioned sloughing of the skin over large areas. 72 FISTULA AND POLL-EVIL gers of major operations, it is essential to in-vestigate carefully into the patients physicalcondition. Weak, emaciated, enfeebled sub-jects should be given a preparatory treatmentthat will tend to build them up in strength andvigor. This may consist in evacuating andirrigating large abscesses, cleaning them upover the soiled shoulders, grooming the body,good feeding and any general good care thatwill improve the health» The week or two re-quired for such preparatory treatment is notlost, since the improved health before the op-eration will shorten the duration of the periodof post-operative convalescence, and will re-duce the rate of mortality which in enfeebledsubjects is bound to be high on account ofshock an
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