The practice of veterinary surgery, the basis of a series of lectures delivered to the seniors of the Grand Rapids Veterinary College

Table of Contents

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CHAPTER I — Diseases of The Eye 9-32 Diseases of The Orbit — Retro-Bulbary Phlegmon

Wounds of The Eyelids Blepharitis — Inflammation

of the Eyelids; Prosis; Entropium; Ectropium

Diseases of The Conjunctiva — Catarrhal Conjunctivitis; Purulent Conjunctivitis; Parenchymatous Conjunctivitis; Follicular Conjunctivitis Diseases of The

Lachrymal Apparatus Diseases of The Cornea —

Keratitis; Superficial Keratitis; Pannus Keratitis; Parenchymatous Keratitis; Wounds of the Cornea; Ulceration of the Cornea; Leukoma; Iritis; Cyclitis

Diseases of The Crystalline Lens — Cataract

"Diseases of The Retina and Optic Nerve Amauro-

tis Periodical Opthalmia — Moon- Eye; Chronic

Changes Due to Recurrency.

CHAPTER II— Diseases of The Head 33-86 Diseases of The Skin and Subcutaneous Tissues of The

Head — Wounds Wound Infectious Diseases —

Phlegmon; Malignant Oedema Dermititis — Superficial Dermatitis; Suppurative Folliculitis Diseases

of The Muscles and Nerves of The Head — Facial

Paralysis; Paralysis of the Trigeminal; Trismus

Diseases of The Nasal Cavities and Sinuses — Chronic Nasal Catarrh; Necrosis of the Turbinated Bones; New Formations in the Nasal Cavity; Foreign Bodies

in the Nasal Cavity; Fracture of the Nasal Bones

Diseases of The Sinuses — Hydrops; Empyema; New Formations of the Sinuses; Diseases of the Teeth; Shear Mouth; Step Mouth Diseases of The Individual Teeth — Caries; Alveolar Periostitis; Tooth Fistula; False Tooth Fistula; Extracting Teeth; Fracture of the Lower Jaw; Actinomycosis in the Region

of the Lower Jaw Diseases of The Tongue — Acute

Glossitis Actinomycosis of The Tongue — Wooden

Tongue; Fracture of the Hyoid Bone; Paralysis of the Tongue Diseases of The Pharynx — Pharyngitis; New Formations in the Pharynx Diseases

of The Guttural Pouches — Catarrh of the Guttural vi Table of Contents

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Pouches Diseases of The Ear — Ulceration of the

Ear Otitis Externa — Canker; Otitis Media

Diseases of The Parotid Gland — Salivary Fistula; Salivary Concrements; Fistula of the Ear; P'racture of

the Skull Diseases of The Neck — Wounds; Jugular

Fistula; Goiter; Poll Evil; Fracture of the Cervical

Vertebrae Diseases of The Larynx and Trachea —

Roaring; New Formations in the Larynx; Stenosis of

the Trachea Diseases of The Oesophagus — Choke

or Stenosis Dilatation of The Oesophagus — Diverticulum Perforation of The Oesophagus — Rupture;

Paralysis of the Oesophagus.

CHAPTER III — ^DiSEASES of The Shoulder 87-127

Shoulder Lameness — Acute Omarthritis; Chronic Omarthritis; Chronic Changes in the Joint; Traumatic Myositis of the Shoulder Muscles; Rheumatic Myositis; Bursitis Inter tubercularis; Fracture of the Scapula and Humerus; Paralysis of the Suprascapular Nerve; Radial Paralysis; Thrombosis o^ the Axillary and

Humeral Arteries Diseases of The Elbow and

Forearm — Shoe Boil; Inflammation of the Radio- Humeral Articulation; Fracture of the Radius and

Ulna; Fracture of the Ulna Diseases of The Carpus

— Wounds; Knee Boil; Acute Arthritis of the Carpus; Chronic Arthritis of the Carpus; Hygroma Formation

on the Corpal Joint Diseases of The Metacarpus —

Splints; Tendonitis; Stiltfoot; Stiltfoot in Foals; Rupture of the Flexor Tendons; Fracture of the Metacarpus; Scratches; Foot Rot in Sheep and Cattle; Fracture of the First Phalanx; Periostitis on the Dorsal Surface of the Os Suffraginis; Osteomyelitis of the Os Suffraginis; Diseases of the Coronary Band; Sub-Coronary Phlegmon; Distortion of the Coffin Joint; Ring-Bone; Fracture of the Second Phalanx; Podoarthritis; Podo-trochlitis; Suppurative Inflammation and Necrosis of the Third Phalanx and the Navicular Bone.

CHAPTER IV— Diseases of The Thorax and Abdomen 128-180

Wounds — Rupture of the Seratus Magnus; Shoulder Abscesses Shoulder Fistula — J'istula of the Withers; Fracture of the Ribs; Fistula of the Ribs; Sternal Fistula Diseases of The Abdomen— Wounds; Per-

Table of Contents vii

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forating Abdominal Wounds; Intestinal Fistula; Umbilical Hernia; Inguinal and Scrotal Hernia; Hernia Ventralis; Diseases of the Rectum; Proctitis; Prolapsus Recti; Fistula of the Rectum; Stenosis of the Rectum; Paralysis of the Rectum; Calculi in the Bladder and Urethea; Cryptorchidy; Operation for

Cryptorchidy; Orchitis Diseases of The Spermatic

Cord — Fistula of the Spermatic Cord or Schirrus Cord; Hydrocele; Diseases of the Scrotum and Sheath; Balanitis; Inflammation of the Prepuce in the

Ox; Phimosis and Paraphimosis Diseases of The

Penis — Paralysis of the Penis; Diseases of the Female Genital Organs; Vaginitis; Prolapse of the Vagina;

New Formations in the Vagina; Hermaphrodism

Occlusion of The Vagina Injuries to The Uterus —

Metritis; Catarrhal Endo Metritis; Septic Metritis; Prolapsus Uteri; Torrio Uteri; Retention of the Placenta Diseases of The Mammary Gland — Mastitis; Oedema and Phlegmon of the Udder; Abscess of the Udder; Catarrhal Mastitis; Parenchymatous •Mastitis; Septic Mastitis; Gangrenous Dermatitis of the Udder; Infectious Gangrenous Mastitis; Stenosis and Obliteration of the Teat Canals; Milk Fistula; New Formation in the Udder.

CHAPTER V — Diseases of The Vertebrae, Tail AND Pelvis 181-190

Crural Paralysis — Ante Partum Paresis; Post Partum Paresis; Fracture of a Dorsal or Lumbar Vertebrse; Fracture of the Pelvis; Fracture of the Sacrum; Luxation of the Sacrum Lumbago — Myositis of the

Croup-Muscles; Thrombosis of the Iliac and Femoral Arteries.

CHAPTER VI — Diseases of The Hip 191-224

The So-Called Hip Lameness — Coxitis; Luxation of the Femur; Fracture of the Femur; Myositis of the Femoral Muscle; Paralysis of the Quadriceps Femoris;

Bursitis Trochanterica Diseases of The Stifle —

Acute Gonitis; Chronic Deforming Gonitis; Luxation ■ of the Patella; Luxation of the Patella Upward; Bursitis Subpatellaris Diseases of The Lower Portion

of The Hind Leg — Wounds and Phlegmon; Subfascial Phlegmon; Contusions of the Tibia; Fracture of the Tibia; Rupture of the Tendon of Achilles viii Table of Contents

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Diseases of The Hock Joint — Spavin; Injuries to the Joint and Surrounding Synovial Membranes; Inflammation of the Tendon .Sheaths in the Region of the Hock; Peri Arthritis of the Hock; Galls in the Region of the Joint; Capped Hock; Curb; Stringhalt Diseases of The Hoof — Podo-dermatitis; Suppurative Podo-dermatitis; Laminitis; Nail Puncture; Nail Prick; Corns; Quittor; Side Bones; Thrush.

CHAPTER VII— Surgical Diagnosis 225-260

History — Examination; The Age of the Animal; Sex; Color; Weight; Constitution; Inspection; Healing by First Intention; Healing b?'' Second Intention; Palpation; Temperature; Sensibility; Consistency; Crepitation; Abnormal Movement; Compressibility; Pulsation; Probing; Percussion; Ausculation Diagnostic

Operations — Puncture; Cocaine Injections; Trepanation; Extirpation; Resection; Special Diagnosis of the Eye; Eyelid; Conjunctiva; Bulb; Cornea; Anterior Chamber of the Eye; The Iris and the Pupil; Posterior Chamber of the Eye; Lens; Retina; Examination of the Pupil and Lens with the Mirror; Palpation of the

Eyeball Examination of The Sinuses and Nasal

Cavity — Inspection; Percussion; Ausculation; Examination of the Mouth Cavity; Examination of the Neck; Examination of the Thorax; Special Examination for Lameness; Diagnostic Cocaine Injection

Special Examination of The Shoulder — Shoulder Lameness; Examination of the Carpus; Examination of the Flexor Tendons; Examination of the Hoof; Examination of the Sole; Examination of the Frog; Examination of the Coronary Band; Palpation of the Hoof; Percussion of the Hoof; Mensuration; Examination of the Urinary Tract; Examination of the Croup or Hind Quarter; Rectal Examination; Examination for Prolapse of the Vagina; Examination of the Hock Joint Prescriptions.

Chapter I Diseases Of The Eye

DISEASES OF THE ORBIT

Retro-Bulbary Phlegmon

RETRO-BULBARY PHLEGMON is a condition in which the tissues surrounding the eyeball becomes ■ involved in the formation of a phlegmon, which frequently results in the formation of an abscess.

• Cause — The causes of this condition are either primary or secondary. The most important primary or direct cause is injuries or wounds, with or without infection. Secondary causes would be the spreading of an inflammatory condition, or an infectious process by continuity, from the surrounding tissues.

Forms — This condition appears in two forms depending upon the presence or absence of infection. The forms therefore would be septic and aseptic.

Symptoms — The sj^mptoms of both forms appear about the same clinically. The eyelids and the tissues surrounding the eyeball become swollen and oedematous. This swelling is hot, painful, and shows all of the symptoms of an acute inflammatory condition. This swollen condition frequently becomes so severe that the lids are nearly shut and the mucous membrane of the lid becomes inverted, so that it shows itself very distinctly between the edges of the lids. When this condition afifects the fatty cushion of the eye, it causes the eyeball to be protruded from the orbital lo The Practice of Veterinary Surgery

fossa. On examination of the conjunctiva it is found to be reddened, sensitive and swollen.

In the septic form of this disease, symptoms of abscess formation are noticed in this region. After a few days such general symptoms as rapid pulse, an elevation of temperature and the animal refusing food will be noted. All of the symptoms presented by the animal are more severe in this form.

Rarely does the abscess evacuate spontaneously without very severe symptoms. After the contents of the abscess are evacuated healing takes place by second intention and the symptoms gradually disappear. It may occur that the abscess points inwardly instead of pointing toward the outside of the body, in which case death results from meningitis and pyemia.

Course — The course of this condition is usually acute, but may run a course of several weeks.

Treatment — The treatment depends upon the form of the disease existing. In the aseptic form, moist warmth in the form of hot packs, antiphlogistics, or poultices, are the most effectual. If it is not practicable to apply moist warmth antiseptic ointments and lotions may be applied with massage; as boric acid ointment, ichthyol ointment, iodine ointment, etc.

In the septic form, open the abscess as early as possible. Give drainage and disinfect with some non-toxic, non-irritating antiseptic, as potassium permanganate, boric acid, etc. Internal treatment is of very little value.

WOUNDS OF THE EYELIDS

In the horse, lacerated wounds of the eyelid occur very frequently. This condition is seen in other animals but is less common. Other wounds seen on and in the region of

The Practice of Veterinary Surgery ii

the lid are bruises, contusions and decubitus as the result of traumatic injuries from being cast, etc. It is not uncommon to have septicaemia, following the last named injuries.

In treating lacerated wounds of the lids, great care must be exercised, for in suturing the act of puncturing the skin with the needle causes the animal to jerk or move the head, and if care is not exercised there is some danger of puncturing the eyeball.

It is not advisable to remove any apparent excessive tissue from flap wounds of the lids, as these wounds heal with remarkable rapidity and very rarely leave any unsightly eschar, owing to their great power of regeneration.

If these wounds give rise to a severe inflammation of the subcutaneous tissue they may be treated with a hot antiseptic pack, antiphlogistine, boric acid ointment, etc.

If the tissues in the region of the lids are contused the treatment should consist of antiseptic lotion as a two per cent boric acid solution, one per cent solution of alum, one-half per cent solution of acetic acid or a one per cent solution of potassium perm.anganate. These solutions seem to be more effective when applied warm, and from fifteen to twenty minutes at each application.

BLEPHARITIS

Inflammation o£ the Eyelids

Blepharitis is an inflammation of the eyelids. Clinically it appears in two forms, superficial and deep. Superficial blepharitis occurs most commonly and is an inflammation of the skin covering the lid. It is due chiefly to dermatitis, eczema, and mild irritations. A deep blepharitis eflfects the deeper structures of the lid and is most commonly caused by phlegmons, which appear as a wound infectious disease, following bites, punctured wounds, necrosis and abscess formations. A necrotic condition of the lids may be caused by suppurative lachrymosis, decubitus, pressure necrosis from the halter or bridle, or from rubbing blisters on the lids.

In dogs, blepharitis usually occurs as the result of eczema appearing on the margin of the lids, or from furunculosis appearing in the form of small pustules or cysts.

Symptoms — The symptoms of blepharitis vary greatly and the symptoms of the cause predominate ; however, the lids become swollen, sensitive and reddened.

Course — The course of blepharitis is either acute or chronic.

Treatment — Eczematous blepharitis should be treated with antiseptic ointment applied freely with massage, as zinc ointment, ointment of balsam of Peru, ointment of yellow oxide of mercury, ichthyol ointment, etc. If the application of ointment is not practicable, solutions may be used to advantage, as ten per cent solution of calendula, ten per cent solution of balsam of Peru in alcohol, etc.

The treatment of necrosis of the lids consists in extirpating the necrotic area if possible. If this is not possible, cauterize with a five per cent solution of silver nitrate, followed by the application of a ten per cent solution of calendula or some non-irritating coal tar antiseptic.

In furuncolosis the pustules should be opened and cauterized with a ten per cent solution of silver nitrate.

Phlegmonous blepharitis should be treated with antiseptic ointments or moist heat applied in the form of hot packs, antiphlogistic preparations or ariol paste.

Ptosis

Ptosis is a condition in which there is persistent drooping of the upper eyelid. Ptosis very rarely occurs as a primary condition but is usually seen to occur secondarily to some other disease or as a symptom of a disease. It is most commonly due to swelling or paralysis.

Forms — Ptosis appears in two forms and these can be distinguished very readily. They are true and false.

In true ptosis there is a paralysis of the orbicularis oris muscle as well as the other muscles of the lids, while in false ptosis there is a drooping of the lid as a result of swelling.

True ptosis generally appears as a symptom of, or during the course of some other disease, as facial paralysis in the horse, or milk fever in the cow. It is also seen as a symptom of central facial paralysis in dourine.

False or pseudo ptosis consists in a severe swelling or an oedematous infiltration of the lids, causing a mechanical drooping. This is seen as the result of injuries or secondarily to some other disease.

Treatment — If ptosis appears as a symptom of or during the course of some other disease, treatment is not indicated, as it will disappear with the disease of which it is a symptom. However, it may occur that ptosis will assume a chronic form, in which case it requires surgical treatment. This consists in the removal of an elliptical piece of skin from the center of the upper lid under the strictest antiseptic conditions. Suture the free edges of the wound and the lid will return to its normal condition. The exact size of this piece of skin to be removed cannot be given, as it depends upon the individual case. It is best to hold up a given amount of skin and see how much is necessary to give results before it is removed. It is essential to have healing by first intention for a successful operation.

Entropium

Entropium is a change in the condition of the eyelid in which the outer border of the lid turns toward the cornea and the hairs on the free border of the lid come in direct contact with the cornea and conjunctiva. '

Occurrence — This condition is seen to occur most commonly in young animals, as the pup and colt. It may occur in animals of any age. One or both lids may be affected, although the upper lid is 'affected most frequently.

Cause — The most common cause producing this condition is chronic conjunctivitis. As the result of chronic irritation to the conjunctiva, during chronic conjunctivitis, new connective tissue is produced with an hypertrophy of the muscles of the lid. This new formed connective tissue is cicatricial in character. This eventually contracts with a resulting contortion of the lids. Entropium may also be caused by the muscles of the eye undergoing spasmodic contraction. This is not seen to occur commonly in the horse, but is the most common cause in the dog.

Entropium is also seen to occur at the removal of or following an atrophy of the eyeball. This condition has also been seen to occur as a congenital affection or defect.

Symptoms — The edge of the e3^elid seems to turn in so that the hairs on the border of the lid irritate the conjunctiva and cornea. As the result of this continual irritation, there appears lachrymosis, photophobia, conjunctivitis, and keratitis. Eventually, after the irritation has become chronic, ulceration of the cornea and chronic keratitis with leucoma formation appear.

Treatment — The treatment of this condition is operative and consists in removing an elliptical piece of skin from the center of the lid as in ptosis. If both lids are affected, the operation must be performed on both lids. The pieces of skin must be removed under the strictest antiseptic precautions. When the free edges of the wound are sutured, the lid will return to its normal condition.

After the operation the conjunctivitis and keratitis should be treated with yellow oxide of mercury ointment, ichthyol ointment, warm boric solution, four per cent, etc.

Ectropium

Ectropium is a condition in which the free border of the eyelid is turned outward. From a veterinary standpoint, this is a very unimportant condition as it very rarely occurs in practice. If it does occur it is seen in older animals and chiefly then in the dog, rarely in the horse.

Cause — Ectropium is sometimes congenital, but usually follows conjunctivitis in which the conjunctiva is left greatly thickened, or there is an increased amount causing mechanical ectropium.

Treatment — The treatment is operative in acquired cases and expectative in congenital cases. If the conjunctiva is greatly thickened or increased in amount, it may be excised and treated with warm boric acid solution. If this does not give the desired results, remove an elliptical piece of skin, about one-half an inch from the canthi. When the free edges of the skin are sutured, it will have a tendency to draw the lids to their normal condition. Healing by first intention is essential.

DISEASES OF THE CONJUNCTIVA

Catarrhal Conjunctivitis

Catarrhal conjunctivitis consists in a superficial inflammation of the conjunctiva, with the formation of a catarrhal or serous exude. This form of conjunctivitis appears in all animals. It may appear as a primary disease or as a symptom of some other disease.

Cause — The most common causes of catarrhal conjunctivitis appearing as a primary disease, are direct irritations by mechanical means, as splinters, briars, hayseed, hair, dust, grain, pollen, or by chemical agents as alcohol, bichloride, rubbing blisters, etc., or by thermic agents as burning, extremely liot weather, freezing, etc. While these are the most common causes, it may also be due to parasites. When it is parasitic in origin it is unilateral, otherwise it appears as a bilateral afifection.

Catarrhal conjunctivitis occurs as a symptom during the course of some contagious and infectious disease, as dog distemper, contagious pleuro-pneumonia, contagious corhyza, influenza, periodical opthalmia, malignant head catarrh, etc. In dogs, the disease sometimes appears in old age and does not seem to have any specific cause.

Symptoms — The symptoms of catarrhal conjunctivitis appear with a serous or watery discharge from the eyes, the animal keeps the lids closed as the presence of light seems to be very irritating. The conjunctiva is swollen, reddened and painful on pressure. The conjunctiva frequently becomes so greatly swollen that it is visible between the lids. As the disease progresses the discharge becomes admixed with mucus.

Treatment — The treatment consists in the application of mild astringent washes to the conjunctiva, as one per cent solution of alum, two per cent solution of boric acid, one per cent solution of zinc sulphate, or ichthyol. If the conjunctiva is hyper-sensitive, a few drops of a four per cent solution of cocaine may be dropped directly into the conjunctival sack. In the earlier stages of this disease a few drops of adrenalin solution (1/10,000) will be found very useful in allaying the congestion.

Purulent Conjunctivitis

Purulent conjunctivitis is a suppurative inflammation of the conjunctiva as the result of infection.

Cause — The most common cause of purulent conjunctivitis is an infection of the conjunctiva with ordinary pus cocci, or it may be due to a specific infection as in dog distemper, or malignant head catarrh.

The entrance of the infection to the conjunctiva may take place in various ways as by mechanical means, by rubbing, or by the entrance of a foreign body into the conjunctival sack, etc.

Purulent conjunctiA^tis may occur as the result of the entrance of a foreign body, but this is not common in practice. If due to a foreign body in the conjunctival sack, it appears as a unilateral affection.

Symptoms — The symptoms of purulent conjunctivitis appear with a purulent or suppurative discharge from the eyes, scabs, or crusts form on the edge of the lids, sometimes causing the lids to be pasted together. The conjunctiva is very pale. This constitutes a diagnostic symptom. After this disease has existed for some time, the suppurative process spreads to the lids and cornea, giving rise to eczema or furunculosis and keratitis.

Course — The course of this disease is usually long drawn out, assuming a chronic form.

Treatment — The treatment consists of applying antiseptic solutions and ointments to the conjunctival sack, as chinosol (1/1000), one per cent solution of ichthyol, one-half per cent solution of cresol, one per cent solution of copper sulphate or zinc sulphate, yellow oxide of mercury ointment, etc. Before treatment is administered it is very essential to examine the conjunctival sack for the presence of a foreign body. This is especially true of unilateral purulent conjunctivitis.

Parenchymatous Conjunctivitis

Parenchymatous conjunctivitis is an inflammation of the entire structure of the conjunctiva, especially the deeper layers. It consists in a severe traumatic or infectious inflammatory process.

Occurrence — It appears as a primary disease from the spreading of an inflammatory process by continuity, or as a symptom of some other disease.

If due to infection, the infection enters the deeper structures by way of the blood or lymph stream. In these cases it generally appears as the symptom of some other disease.

Symptoms — The chief and diagnostic symptom is a very firm, glassy swelling of the conjunctiva. After a few d/ays the inflammatory process spreads, involving the sclera. There is a serous or sero mucous discharge from the eye. In exceptional cases the discharge becomes purulent.

Course — The course of this disease is acute. If healing does not take place promptly the conjunctiva becomes necrotic.

Treatment — The treatment consists in the application of cooling antiseptic astringent washes, as one per cent solution of alum, etc. If the swelling of the conjunctiva becomes severe, it becomes necessary to scarify the superficial layers.

Follicular Conjunctivitis

Follicular conjunctivitis consists in a severe chronic swelling of the lymph follicles and connective tissue on the inner surface of the membrana nictitans.

This disease is seen to occur mostly in dogs, but mayappear in any animal.

Cause — The exact cause is unknown.

Symptoms — The membrana nictitans becomes red and swollen. By examining it after the disease has existed for some time, there will be found small dark red ulcerations on the inner surface. These ulcerations later on become confluent, forming distinct nodules. The membrane nicitans protrudes from the inner canthus, resembling somewhat a small turiiefaction. There is rarely any discharge from the eye afifected.

This condition may spread to the conjunctiva by continuity, in which case it leads to cicatrization with the formation of entropium.

Course — The course of this disease is chronic.

Treatment— The most satisfactory treatment consists in removing the entire membrana nictitans. Grasp the membrane with an artery forcep, or small vulsellum forcep, draw it out as far as possible and remove with the scissors. The entire membrane must be removed to give the desired results. Other forms of treatment consist in cauterization with a five per cent solution of silver nitrate, immediately followed with salme solution. This form of treatment is not very satisfactory, from a clinical point of view. After removing the membrana nictitans instill five to ten drops of warm boric acid solution into the eye three times daily. If the conjunctiva is involved, place a small amount of yellow oxide of mercury ointment directly between the lids.

DISEASES OF THE LACHRYMAL APPARATUS

The only disease of the lachrymal apparatus that is of clinical importance is a catarrhal condition of the lachrymal sack and duct. This consists in a chronic catarrhal inflammation, caused by a stricture or stoppage of the naso-lachrymal duct.

Symptoms — The symptoms of catarrh of the lachrymal sack consists in the flowing of tears over the face instead of through the naso-lachrymal duct. This irritates the conjunctiva, and after the disease exists some time, conjunctivitis appears, which is acute in character.

Course — The course of this disease is chronic.

Treatment — The treatment consists in irrigating the lachrymal sack, through the naso-lachrymal duct, with mild antiseptic astringents, as zinc sulphate one per cent, alum two per cent, etc. This irrigation can be carried out with a small syringe, or a bulb syringe, through the nasal opening of the naso-lachrymal duct.

DISEASES OF THE CORNEA

Keratitis

Diseases of the cornea are divided into suppurative and non-suppurative, from a clinical point of view; however, there may be another division according to the part of the cornea affected, that is superficial, parenchymatous and posterior keratitis.

Superficial Keratitis

Superficial keratitis is an inflammation of and involves the superficial portion of the cornea and the reflection of the conjunctiva over the cornea.

Cause — The chief causes are mechanical irritations from external sources, which either comes directly in contact with the cornea or lodges between the folds of the conjunctiva, thus irritating the cornea. This disease has been known to occur by metastasis, but is extremely rare, in which case it is suppurative in character.

Forms — Superficial keratitis appears in two forms, catarrhal and suppurative.

Symptoms — The symptoms of superficial catarrhal keratitis consist in swelling of the cornea with desquamation of the epithelium. The cornea is rough and opaque in appearance, and there is a catarrhal discharge from the eyes. This form of keratitis is most commonly seen in practice.

In superficial purulent keratitis the surface of the cornea is yellow and roughened. In some cases the entire cornea does not become yellowish in color, but yellow spots appear over the surface of the cornea. This form of keratitis very rarely appears primarily, but is seen either as the result of or during the course of some other disease.

Treatment — The treatment of superficial catarrhal keratitis consists in the use of yellow oxide of mercury ointment, ichthyol ointment or mild astringent antiseptic washes.

In superficial purulent keratitis, yellow oxide of mercury, one per cent solution of chinosol, or eucamphol should be instilled directly into the conjunctival sack.

Pannus Keratitis

Pannus keratitis is characterized by thickening and roughness of the cornea, with resulting vascularization. The cornea becomes covered with new formed blood vessels, leading from the border to the center, which are visible to the naked eye.

Cause — This condition generally results from purulent keratitis, accompanied by ulceration in which there is an attempt on the part of nature to repair by means of granulation. After healing there is left over a cicatrix (leucoma).

Symptoms — There are symptoms of photophobia and lachrymosis present in a marked degree. There is also a catarrhal or muco-purulent discharge from the eye. The cornea is rough and contains numerous small visible blood vessels.

Course — The course is chronic as a rule.

Treatment — The use of red oxide of mercury ointment is very valuable in the treatment of this disease. It should be placed directly into the conjunctival sack. Two per cent solution of quinine sulphate or yellow oxide of mercury ointment may also be used. The value of mild astringents is doubtful in these cases.

Parenchymatous Keratitis

This is an inflammation of the deeper or interstitial structures of the cornea and involving the true layers of the cornea itself. It consists in a thickening of the cornea from new formed connective tissue along with the entrance of pus cocci, or some specific infection into the cornea.

Cause — The cause of this disease is infection. The infection can gain entrance either directly from external sources or indirectly by metastasis.

Symptoms — The symptoms are divided into two classes, those that appear in the form of an infiltration and those leading to abscess formation.

In cases of very mild infection there is an infiltration of the cornea causing a diffused or circumscribed opaqueness. This condition is of very short duration, as absorption occurs or abscess formation exists.

An abscess is usually the result of direct infection. An abscess on the cornea presents a yellowish area about the size of a radish seed and very sharply defined. The course of this condition is about one week and terminates either in absorption with cicatricial formation, or it suppurates, discharges and leaves behind an ulcerating surface.

Treatment — The treatment of infiltration of the cornea as the result of infection, consists in using yellow oxide of mercury ointment, while abscesses should be punctured and cauterized with silver nitrate immediately followed by saline solution.

Wounds of the Cornea

Wounds of the cornea appear quite commonly in horses and dogs, but are rarely seen in other animals.

Cause — Wounds of the cornea are caused by the animals being injured or coming in contact with sharp objects. They may also be caused by burning or cauterization, but not commonly.

According to the location these wounds are classified as superficial, deep or completely perforating. Perforating wounds are usually found on the upper part of the cornea, near the sclera.

Symptoms — The symptoms of wounds of the cornea are photophobia, lachrymosis, pain on pressure, swelling and heat in the region of the affected eye. In perforating wounds it frequently occurs that the posterior chamber of the eye becomes infected and suppurates.

Wounds of the cornea that are not infected heal rapidly, leaving a small cicatrix. Those that are infected generally lead to ulceration. Perforating wounds sometimes lead to the formation of anterior synechia.

Treatment — The treatment of these wounds consists in instilling into the eye warm boric acid solutions. If there is great pain and photophobia present, use a few drops of cocaine solution. Any metallic preparation is strictly contra-indicated, because the metallic base in contact with the free surface of the wounds leads to the formation of an albuminate with a resulting leukoma.