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Updated: May 27, 2025
A swelling is slowly and insidiously developed, but when the loose connective tissue of the neck becomes infiltrated, the spread is more rapid. The whole region becomes infiltrated and swollen, and the skin ultimately gives way and free suppuration occurs, resulting in the formation of sinuses.
The parasitic life of the bot-fly of sheep results in a severe catarrhal inflammation of the mucous membrane lining the sinuses of the head, and a discharge of a heavy, pus-like material from the nostrils. The irritation produced by the larvae may be so serious at times as to result in nervous symptoms and death.
The skulls of these people are always long and narrow, with a smaller development of the frontal sinuses than usually corresponds with such largely developed brow ridges. An Australian skull of a round form, or one the transverse diameter of which exceeds eight-tenths of its length, has never been seen.
Despite this danger, not eliminating surplus toxins carries with it the greater penalty of serious disability or death. Because of this liability, the body, in its wisdom, initially chooses secondary elimination routes as far from vital tissues and organs as possible. Almost inevitably the skin or skin-like mucus membranes such as the sinuses, or lung tissues become the first line of defense.
If no positive evidence of the disease exists, by means of careful exploration of sinuses with the probe, one may distinguish between true cartilaginous quittor and superficial abscess formation that is often accompanied by hyperplasia. Lameness depends upon the extent of the involvement as it affects the structures contiguous to the cartilage.
If two sinuses open on the surface, close one with cotton while filling the other so that if there is a connection the solution will come in contact with all tissues involved. Irrigate with the full pint of formaldehyd solution first, then follow with six or eight ounces of the bichlorid solution. Never probe the foot nor allow it to be tampered with except in the manner prescribed.
If a sinus passes through a muscle, the repeated contractions tend to prevent healing until the muscle is kept at rest by a splint, or put out of action by division of its fibres. The sinuses associated with empyema are prevented from healing by the rigidity of the chest wall, and will only close after an operation which admits of the cavity being obliterated.
Sinuses form, and the whole foot becomes greatly swollen and distorted by flattening of the sole and dorsiflexion of the toes. There is but little pain, and no glandular involvement or constitutional disturbance. The disease runs a prolonged course, sometimes lasting for twenty or thirty years. Spontaneous cure never takes place, and the risk to life is that of prolonged suppuration.
He still takes beef tea twice a day, and eggs and other food twice a day, making four meals a day; also, continues the quinine and whisky. Feb. 21st, 9:30 A. M., pulse 98, temp. 101. Feels more comfortable. Discharge of pus much less than yesterday. Wash out the sinuses and inject liquid vasaline. Feb. 23d, 9:30 A. M., pulse 98, temp. 101. Complains of being "very sick." Speaks English but poorly.
The individual glands attain a considerable size, and they fuse together to form a large tumour which fills up the axillary space. The disease progresses more rapidly than it does in the cervical glands, and almost always goes on to suppuration with the formation of sinuses. Conservative measures need not be considered, as the only satisfactory treatment is excision, and that without delay.
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