Text book of veterinary medicine, Volume 1 (of 5)

by James Law

The agents proving most useful are of an astringent nature and in obstinate cases one may be substituted for another as the last appears to lose its effect. Sulphate of Zinc or Sulphate of Copper in the proportion of half a drachm of either to a quart of water, may be used, or if there is much fœtor, a solution containing a drachm each of carbolic acid and carbonate of potash in a quart of water is to be preferred. In either case the addition of an ounce of pure glycerine renders the lotion at once more soothing and more efficient. The solution must be rendered tepid before injecting it, to obviate the irritation attending on the contact of a cold fluid with the delicate membrane of the nose. Among other agents may be named creolin, creosol, creosote, acetate of lead, potassium permanganate, and silver nitrate. Peroxide of hydrogen may be used either as injection or in spray.

The mode of injection is a matter of no small moment. It has been done in some instances by means of a large syringe but the irritation attendant on such a process is an insuperable objection to its use. A better instrument is that introduced by Professor Rey of Lyons. It consists in a tube bent on itself at an angle of 35° so as to form two arms of unequal lengths. The longer fifteen inches in length, one and a half in diameter and widening into a funnel at its free end;—the shorter about five inches long and tapering towards its free end where its aperture is only two-thirds of an inch across. The instrument is made of block tin or extemporaneously of gutta percha. Over the shorter arm is placed a tightly fitting leather ring four and a half inches in diameter on which is applied some wet tow to adapt it to the nostril and effectually close it. The nose having been drawn in so as to place the head in a vertical position, the short arm of the instrument is introduced into the affected nostril, and the liquid being gently poured into the long arm rises slowly in the nose until it is filled and the liquid flows from the nostril on the opposite side. In introducing the tube care must be taken that it may not irritate the inner wall of the nose on the one hand, nor pass into the blind pouch, known as the false nostril, on the other.

The greatest gentleness and tact are requisite in thus injecting the nostrils, though in troublesome animals it is sometimes necessary to resort to blindfolding or even to the application of a twitch on the ear, or finally to strapping the animal (head included) to a smooth firm vertical surface (operating table).

COLLECTION OF PUS IN THE NASAL SINUSES.

Nasal Sinuses, position, orifice, suppuration, symptoms, treatment, tonics, astringents, antiseptics, trephining, significance of the fœtor, mode of recovery.

In severe coryza the nasal sinuses become implicated as shown by the intensity of the symptoms, the prostration, the hanging head, and the heat and sometimes tenderness between the eyes and immediately beneath them on the side of the upper jaw. These sinuses are large spaces filled with air, situated between the superficial and deep plates of the bones of the face and opening into the nostrils by a narrow orifice in the upper part of the nasal chambers. When pus is largely formed in these it fails to flow out as rapidly as produced, parts with a portion of its liquid elements, increases in consistency and sometimes even undergoes decomposition, so that the discharge from the nostril has a putrid odor.

The most distinctive symptoms of this form of nasal gleet are obtained by percussing the sinuses, and in those cases in particular in which the accumulation is confined to one side of the head, the contrast between the two sides is unmistakable. By gently tapping the forehead with the middle finger from one eye to the other the flat solid sound on the diseased side is easily distinguished from the clear drum-like resonance on the healthy one. By tapping on the bone beneath each eye and just above the ridge on the side of the upper jaw, the difference between the two sides will be recognized in the same way. In some old standing cases increased tenderness and slight bulging of the bones over the affected sinuses are often superadded to the other symptoms. The eye on the affected side is usually retracted so as to seem smaller.

Treatment. In some cases the use of tonics and astringent injections as recommended for the treatment of ozœna will prove successful, but more usually it is needful to open and inject the sinuses.

For this the following articles are required: scissors, a knife, forceps, a trephine or circular saw from half to three-fourths of an inch in diameter and a whalebone or metallic prob.

The horse is thrown and made fast with the diseased side of the head uppermost. A point is then selected on a line drawn between the centres of the two eyeballs and an inch to one side the median line of the forehead; the hair is closely removed with the scissors, and a semi-circular flap of skin over an inch in diameter is dissected from the bone and turned back toward the poll. The trephine is next applied on the bone and a circular portion, having been cut through, is pulled out by the forceps, when the imprisoned pus will commonly ooze from the opening. A second point is chosen just above the lower end of the bony ridge of the upper jaw already referred to and opposite the third molar tooth, counting from before; the hair is removed as before, a flap of the skin raised upward and backward and the bone trephined to open the second sinuse. The point of election for this orifice is more important than that of the first. If it is too near the eye the lower part of the sinus, which is separated from the upper by an imperforate bony plate, is not opened and may continue to keep up the discharge from the nose. If on the contrary it is made too low down, the lower sinuse only is opened and the upper being imperfectly washed out from the wound in the forehead will keep up the discharge. Either then this plate must be struck with the trephine or it must be afterward perforated to secure a favorable result. The prob introduced by the wound in the forehead should further appear at the lower orifice.