A very small local iodoform dressing is applied, and, when healthy granulations appear, cicatrisation can be left to natural means.
Cases of actinomycosis of the jaw are much more troublesome. If, as usually happens, the lesion is ulcerated before the practitioner is called in, the external fungoid growth should be removed by means of an elliptical incision through the skin, the axis of the ellipse being parallel with the branch of the maxilla. The bony fistula is then exposed.
In following up this fistula care must be taken not to injure the facial artery, the facial vein, or Stenon’s duct. Once the bone is exposed the disease can be attacked in the depths. The diseased interior is cut away by means of a special curette, all affected portions being removed, and an iodine or iodoform dressing is then applied.
The operation is extremely troublesome, owing to the enormous bleeding, and sometimes it is impossible to carry out successfully, as in the case of old-standing and extensive lesions. To ensure recovery under such circumstances, it is necessary to remove a portion of the branch of the jaw, and this, though quite possible from the scientific standpoint, would not be worth while in an animal, the value of which is usually small.
Curettage of the bone is only of value in dealing with recent lesions, and even then should not be practised except in the case of animals which the owners particularly desire to keep.
In cases of actinomycosis of the upper jaw surgical treatment is just as difficult as in the lower jaw, and calls for similar precautions.
The diseased portions of bone having been removed, the cavity is plugged with iodoform or cotton wool, or a dressing saturated with boric acid and iodoform.
In all surgical operations it is important not to injure the dental arteries or nerves, or the alveolo-dental periosteum.
TUBERCULOSIS.
Tuberculosis is a contagious disease produced by the action of Koch’s bacillus. It is common to man and all domesticated animals, but it specially affects animals of the bovine species. Its existence has long been recognised, although in oxen it was formerly confounded with the lesions of peripneumonia and echinococcosis.