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| author | Roger Frank <rfrank@pglaf.org> | 2025-10-15 02:05:02 -0700 |
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| committer | Roger Frank <rfrank@pglaf.org> | 2025-10-15 02:05:02 -0700 |
| commit | b98d79fa40094f7d9e087b3009313dc364f285e9 (patch) | |
| tree | 6f6698c111d466f3feb6b0b49f938ad281e8b6a5 /23403-h | |
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diff --git a/23403-h/23403-h.htm b/23403-h/23403-h.htm new file mode 100644 index 0000000..9484e0b --- /dev/null +++ b/23403-h/23403-h.htm @@ -0,0 +1,31571 @@ +<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN" + "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd"> + +<html xmlns="http://www.w3.org/1999/xhtml"> + <head> + <meta http-equiv="Content-Type" content="text/html;charset=iso-8859-1" /> + <title> + The Project Gutenberg eBook of Special Report on Diseases of the Horse, by Drs. Pearson, et al. + </title> + <style type="text/css"> +/*<![CDATA[ XML blockout */ +<!-- + p { margin-top: .75em; + text-align: justify; + margin-bottom: .75em; + } + h1,h2,h3,h4,h5,h6 { + text-align: center; /* all headings centered */ + clear: both; + } + hr { width: 33%; + margin-top: 2em; + margin-bottom: 2em; + margin-left: auto; + margin-right: auto; + clear: both; + } + + table {margin-left: auto; margin-right: auto;} + + body{margin-left: 10%; + margin-right: 10%; + } + + .pagenum { /* uncomment the next line for invisible page numbers */ + /* visibility: hidden; */ + position: absolute; + left: 92%; + font-size: smaller; + text-align: right; + } /* page numbers */ + + .linenum {position: absolute; top: auto; left: 4%;} /* poetry number */ + .blockquot{margin-left: 5%; margin-right: 10%;} + .sidenote {width: 20%; padding-bottom: .5em; padding-top: .5em; + padding-left: .5em; padding-right: .5em; margin-left: 1em; + float: right; clear: right; margin-top: 1em; + font-size: smaller; color: black; background: #eeeeee; border: dashed 1px;} + + .bb {border-bottom: solid 2px;} + .bl {border-left: solid 2px;} + .bt {border-top: solid 2px;} + .br {border-right: solid 2px;} + .bbox {border: solid 2px;} + + .right {text-align: right;} + .notes {background-color: #eeeeee; color: #000; padding: .5em; + margin-left: 10%; margin-right: 10%;} + + .center {text-align: center;} + .smcap {font-variant: small-caps;} + .u {text-decoration: underline;} + + .caption {font-weight: bold;} + + .figcenter {margin: auto; text-align: center;} + + .figleft {float: left; clear: left; margin-left: 0; margin-bottom: 1em; margin-top: + 1em; margin-right: 1em; padding: 0; text-align: center;} + + .figright {float: right; clear: right; margin-left: 1em; margin-bottom: 1em; + margin-top: 1em; margin-right: 0; padding: 0; text-align: center;} + + .footnotes {border: dashed 1px;} + .footnote {margin-left: 10%; margin-right: 10%; font-size: 0.9em;} + .footnote .label {position: absolute; right: 84%; text-align: right;} + .fnanchor {vertical-align: super; font-size: .8em; text-decoration: none;} + + .poem {margin-left:10%; margin-right:10%; text-align: left;} + .poem br {display: none;} + .poem .stanza {margin: 1em 0em 1em 0em;} + .poem span.i0 {display: block; margin-left: 0em; padding-left: 3em; text-indent: -3em;} + .poem span.i2 {display: block; margin-left: 1em; padding-left: 3em; text-indent: -3em;} + .poem span.i4 {display: block; margin-left: 2em; padding-left: 3em; text-indent: -3em;} + .poem span.i24 {display: block; margin-left: 12em; padding-left: 3em; text-indent: -3em;} + .poem span.i40 {display: block; margin-left: 20em; padding-left: 3em; text-indent: -3em;} + .poem span.i43 {display: block; margin-left: 21.5em; padding-left: 3em; text-indent: -3em;} + .poem span.i44 {display: block; margin-left: 22em; padding-left: 3em; text-indent: -3em;} + // --> + /* XML end ]]>*/ + </style> + </head> +<body> + + +<pre> + +The Project Gutenberg EBook of Special Report on Diseases of the Horse, by +United States Department of Agriculture and Leonard Pearson and Rush Shippen Huidekoper and Ch. B. Michener and W. H. Harbaugh + +This eBook is for the use of anyone anywhere at no cost and with +almost no restrictions whatsoever. You may copy it, give it away or +re-use it under the terms of the Project Gutenberg License included +with this eBook or online at www.gutenberg.org + + +Title: Special Report on Diseases of the Horse + +Author: United States Department of Agriculture + Leonard Pearson + Rush Shippen Huidekoper + Ch. B. Michener + W. H. Harbaugh + +Release Date: November 7, 2007 [EBook #23403] + +Language: English + +Character set encoding: ISO-8859-1 + +*** START OF THIS PROJECT GUTENBERG EBOOK DISEASES OF THE HORSE *** + + + + +Produced by Audrey Longhurst, Kevin Handy, Josephine +Paolucci and the Online Distributed Proofreading Team at +http://www.pgdp.net + + + + + + +</pre> + + +<p><span class='pagenum'><a name="Page_1" id="Page_1">[Pg 1]</a></span></p> + + + + +<h2>U. S. DEPARTMENT OF AGRICULTURE,</h2> <h3>BUREAU OF ANIMAL INDUSTRY.</h3> + +<h3><span class="smcap">A. D. MELVIN, Chief of Bureau.</span></h3> + +<hr style='width: 45%;' /> + +<h3>SPECIAL REPORT</h3> + +<h4>ON</h4> + +<h1>DISEASES OF THE HORSE.</h1> + +<h3>BY</h3> + +<h2>Drs. PEARSON, MICHENER, LAW, HARBAUGH, TRUMBOWER, LIAUTARD, HOLCOMBE, +HUIDEKOPER, MOHLER, EICHHORN, HALL, AND ADAMS.</h2> + +<hr style='width: 45%;' /> + +<h4>REVISED EDITION, 1916.</h4> + +<div class="figcenter" style="width: 150px;"> +<img src="images/image001.jpg" width="150" height="149" alt="" title="" /> +</div> + +<p class="center"> +WASHINGTON:<br /> +GOVERNMENT PRINTING OFFICE.<br /> +1916.<br /></p> +<hr style="width: 65%;" /> +<p><span class='pagenum'><a name="Page_2" id="Page_2">[Pg 2]</a></span></p> + +<p class="notes">Transcriber's note: Minor typos have been corrected and footnotes +moved to the end of the sections. The images for the plates are thumbnails +that take you to a larger version of the image.</p> + +<p class="right"> +<span class="smcap">Department of Agriculture</span>,<br /> +<br /> +<i>Washington, March 30, 1916.</i><br /> +</p> + +<p>This edition of the Special Report on Diseases of the Horse has been +prepared in compliance with House Concurrent Resolution No. 13, passed +February 3, 1916, as follows:</p> + +<div class="blockquot"><p><i>Resolved by the House of Representatives (the Senate +concurring)</i>, That there be printed and bound in cloth one +hundred thousand copies of the Special Report on the Diseases +of the Horse, the same to be first revised and brought to date, +under the supervision of the Secretary of Agriculture; seventy +thousand copies for the use of the House of Representatives and +thirty thousand for use of the Senate.</p></div> + +<p>Since the original edition issued by the Department in 1890 several +editions have been printed by order of Congress. The work was reprinted +in 1896, and revised and reprinted in 1903, 1908, and 1911. In +accordance with the foregoing resolution it again has been revised so as +to embody the latest practical development of knowledge of the subject.</p> + +<p class="right"> +<span class="smcap">D. F. Houston</span>,<br /> +<i>Secretary.</i> +</p> + + + +<hr style="width: 65%;" /> + +<p><span class='pagenum'><a name="Page_3" id="Page_3">[Pg 3]</a></span></p> +<h2>CONTENTS.</h2> + + + + +<div class='center'> +<table border="0" cellpadding="4" cellspacing="0" summary=""> +<tr><td align='left'></td><td align='right'>Page.</td></tr> +<tr><td align='left'>The examination of a sick horse. By Leonard Pearson</td><td align='right'><a href='#Page_7'>7</a></td></tr> +<tr><td align='left'>Fundamental principles of disease. By Rush Shippen Huidekoper</td><td align='right'><a href='#Page_27'>27</a></td></tr> +<tr><td align='left'>Methods of administering medicines. By Ch. B. Michener</td><td align='right'><a href='#Page_44'>44</a></td></tr> +<tr><td align='left'>Diseases of the digestive organs. By Ch. B. Michener</td><td align='right'><a href='#Page_49'>49</a></td></tr> +<tr><td align='left'>Diseases of the respiratory organs. By W. H. Harbaugh</td><td align='right'><a href='#Page_95'>95</a></td></tr> +<tr><td align='left'>Diseases of the urinary organs. By James Law</td><td align='right'><a href='#Page_134'>134</a></td></tr> +<tr><td align='left'>Diseases of the generative organs. By James Law</td><td align='right'><a href='#Page_164'>164</a></td></tr> +<tr><td align='left'>Diseases of the nervous system. By M. R. Trumbower</td><td align='right'><a href='#Page_210'>210</a></td></tr> +<tr><td align='left'>Diseases of the heart, blood vessels, and lymphatics. By M. R. Trumbower</td><td align='right'><a href='#Page_247'>247</a></td></tr> +<tr><td align='left'>Diseases of the eye. By James Law</td><td align='right'><a href='#Page_274'>274</a></td></tr> +<tr><td align='left'>Lameness. By A. Liautard</td><td align='right'><a href='#Page_298'>298</a></td></tr> +<tr><td align='left'>Diseases of the fetlock, ankle, and foot. By A. A. Holcombe</td><td align='right'><a href='#Page_395'>395</a></td></tr> +<tr><td align='left'>Diseases of the skin. By James Law</td><td align='right'><a href='#Page_458'>458</a></td></tr> +<tr><td align='left'>Wounds and their treatment. By Ch. B. Michener</td><td align='right'><a href='#Page_484'>484</a></td></tr> +<tr><td align='left'>Infectious diseases. By Rush Shippen Huidekoper</td><td align='right'><a href='#Page_507'>507</a></td></tr> +<tr><td align='left'>Shoeing. By John W. Adams</td><td align='right'><a href='#Page_583'>583</a></td></tr> +<tr><td align='left'>Index</td><td align='right'><a href='#Page_607'>607</a></td></tr> +</table></div> + +<hr style="width: 65%;" /> +<p><span class='pagenum'><a name="Page_5" id="Page_5">[Pg 5]</a></span></p> + +<h2>ILLUSTRATIONS.</h2> + + +<h4>PLATES.</h4> + + +<div class='center'> +<table border="0" cellpadding="4" cellspacing="0" summary=""> +<tr><td align='left'></td><td align='left'></td><td align='right'>Page.</td></tr> +<tr><td align='left'>Plate</td><td align='left'>I. Inflammation</td><td align='right'><a href="#PLATE_I">32</a></td></tr> +<tr><td align='left'></td><td align='left'>II. Inflammation</td><td align='right'><a href="#PLATE_II">32</a></td></tr> +<tr><td align='left'></td><td align='left'>III. Digestive apparatus</td><td align='right'><a href="#PLATE_III">48</a></td></tr> +<tr><td align='left'></td><td align='left'>IV. Age of horses as indicated by teeth</td><td align='right'><a href="#PLATE_IV">58</a></td></tr> +<tr><td align='left'></td><td align='left'>V. Intestinal worms</td><td align='right'><a href="#PLATE_V">92</a></td></tr> +<tr><td align='left'></td><td align='left'>VI. Bots</td><td align='right'><a href="#PLATE_VI">92</a></td></tr> +<tr><td align='left'></td><td align='left'>VII. Position of the left lung</td><td align='right'><a href="#PLATE_VII">112</a></td></tr> +<tr><td align='left'></td><td align='left'>VIII. Longitudinal section through kidney</td><td align='right'><a href="#PLATE_VIII">136</a></td></tr> +<tr><td align='left'></td><td align='left'>IX. Microscopic anatomy of kidney</td><td align='right'><a href="#PLATE_IX">136</a></td></tr> +<tr><td align='left'></td><td align='left'>X. Microscopic anatomy of kidney</td><td align='right'><a href="#PLATE_X">136</a></td></tr> +<tr><td align='left'></td><td align='left'>XI. Calculi and instrument for removal</td><td align='right'><a href="#PLATE_XI">152</a></td></tr> +<tr><td align='left'></td><td align='left'>XII. Normal presentation</td><td align='right'><a href="#PLATE_XII">192</a></td></tr> +<tr><td align='left'></td><td align='left'>XIII. Some factors in difficult labor</td><td align='right'><a href="#PLATE_XIII">192</a></td></tr> +<tr><td align='left'></td><td align='left'>XIV. Instruments used in difficult labor</td><td align='right'><a href="#PLATE_XIV">192</a></td></tr> +<tr><td align='left'></td><td align='left'>XV. Abnormal presentations</td><td align='right'><a href="#PLATE_XV">200</a></td></tr> +<tr><td align='left'></td><td align='left'>XVI. Abnormal presentations</td><td align='right'><a href="#PLATE_XVI">200</a></td></tr> +<tr><td align='left'></td><td align='left'>XVII. Abnormal presentations</td><td align='right'><a href="#PLATE_XVII">200</a></td></tr> +<tr><td align='left'></td><td align='left'>XVIII. Abnormal presentations</td><td align='right'><a href="#PLATE_XVIII">200</a></td></tr> +<tr><td align='left'></td><td align='left'>XIX. The nervous system</td><td align='right'><a href="#PLATE_XIX">216</a></td></tr> +<tr><td align='left'></td><td align='left'>XX. Interior of chest, showing position of heart and diaphragm</td><td align='right'><a href="#PLATE_XX">248</a></td></tr> +<tr><td align='left'></td><td align='left'>XXI. Circulatory apparatus</td><td align='right'><a href="#PLATE_XXI">248</a></td></tr> +<tr><td align='left'></td><td align='left'>XXII. Diagrammatic vertical section through horse's eye</td><td align='right'><a href="#PLATE_XXII">277</a></td></tr> +<tr><td align='left'></td><td align='left'>XXIII. Skeleton of horse</td><td align='right'><a href="#PLATE_XXIII">304</a></td></tr> +<tr><td align='left'></td><td align='left'>XXIV. Superficial layer of muscles</td><td align='right'><a href="#PLATE_XXIV">304</a></td></tr> +<tr><td align='left'></td><td align='left'>XXV. Splint</td><td align='right'><a href="#PLATE_XXV">312</a></td></tr> +<tr><td align='left'></td><td align='left'>XXVI. Ringbone</td><td align='right'><a href="#PLATE_XXVI">312</a></td></tr> +<tr><td align='left'></td><td align='left'>XXVII. Various types of spavin</td><td align='right'><a href="#PLATE_XXVII">312</a></td></tr> +<tr><td align='left'></td><td align='left'>XXVIII. Bone spavin</td><td align='right'><a href="#PLATE_XXVIII">312</a></td></tr> +<tr><td align='left'></td><td align='left'>XXIX. Bone spavin</td><td align='right'><a href="#PLATE_XXIX">312</a></td></tr> +<tr><td align='left'></td><td align='left'>XXX. Dislocation of shoulder and elbow, Bourgelat's apparatus</td><td align='right'><a href="#PLATE_XXX">360</a></td></tr> +<tr><td align='left'></td><td align='left'>XXXI. The sling in use</td><td align='right'><a href="#PLATE_XXXI">360</a></td></tr> +<tr><td align='left'></td><td align='left'>XXXII. Anatomy of foot</td><td align='right'><a href="#PLATE_XXXII">400</a></td></tr> +<tr><td align='left'></td><td align='left'>XXXIII. Anatomy of foot</td><td align='right'><a href="#PLATE_XXXIII">400</a></td></tr> +<tr><td align='left'></td><td align='left'>XXXIV. Anatomy and diseases of foot</td><td align='right'><a href="#PLATE_XXXIV">400</a></td></tr> +<tr><td align='left'></td><td align='left'>XXXV. Sound and contracted feet</td><td align='right'><a href="#PLATE_XXXV">400</a></td></tr> +<tr><td align='left'></td><td align='left'>XXXVI. Quarter crack and remedies</td><td align='right'><a href="#PLATE_XXXVI">432</a></td></tr> +<tr><td align='left'></td><td align='left'>XXXVII. Foundered feet</td><td align='right'><a href="#PLATE_XXXVII">432</a></td></tr> +<tr><td align='left'></td><td align='left'>XXXVIII. The skin and its diseases</td><td align='right'><a href="#PLATE_XXXVIII">458</a></td></tr> +<tr><td align='left'></td><td align='left'>XXXIX. Mites that infest the horse</td><td align='right'><a href="#PLATE_XXXIX">480</a></td></tr> +<tr><td align='left'></td><td align='left'>XL. Glanders</td><td align='right'><a href="#PLATE_XL">544</a></td></tr> +<tr><td align='left'></td><td align='left'>XLI. Glanders</td><td align='right'><a href="#PLATE_XLI">544</a></td></tr> +<tr><td align='left'></td><td align='left'>XLII. Glanders</td><td align='right'><a href="#PLATE_XLII">544</a></td></tr> +</table></div> + + +<p><span class='pagenum'><a name="Page_6" id="Page_6">[Pg 6]</a></span></p> + + +<h4>TEXT FIGURES.</h4> + + +<div class='center'> +<table border="0" cellpadding="4" cellspacing="0" summary=""> +<tr><td align='left'></td><td align='left'></td><td align='right'>Page.</td></tr> +<tr><td align='left'>Fig.</td><td align='left'>1. Ground surface of a right fore hoof of the "regular" form</td><td align='right'><a href='#Page_590'>590</a></td></tr> +<tr><td align='left'></td><td align='left'>2. Pair of fore feet of regular form in regular standing position</td><td align='right'><a href='#Page_591'>591</a></td></tr> +<tr><td align='left'></td><td align='left'>3. Pair of fore feet of base-wide form in toe-wide standing position</td><td align='right'><a href='#Page_591'>591</a></td></tr> +<tr><td align='left'></td><td align='left'>4. Pair of fore feet of base-narrow form in toe-narrow standing position</td><td align='right'><a href='#Page_592'>592</a></td></tr> +<tr><td align='left'></td><td align='left'>5. Side view of an acute-angled fore foot, of a regular fore foot, and of a stumpy fore foot</td><td align='right'><a href='#Page_592'>592</a></td></tr> +<tr><td align='left'></td><td align='left'>6. Side view of foot with the foot-axis broken backward as a result of too long a toe</td><td align='right'><a href='#Page_595'>595</a></td></tr> +<tr><td align='left'></td><td align='left'>7. Left fore hoof of a regular form, shod with a plain fullered shoe</td><td align='right'><a href='#Page_599'>599</a></td></tr> +<tr><td align='left'></td><td align='left'>8. Side view of hoof and fullered shoe</td><td align='right'><a href='#Page_599'>599</a></td></tr> +<tr><td align='left'></td><td align='left'>9. An acute-angled left fore hoof shod with a bar shoe</td><td align='right'><a href='#Page_601'>601</a></td></tr> +<tr><td align='left'></td><td align='left'>10. A fairly formed right fore ice shoe for a roadster</td><td align='right'><a href='#Page_601'>601</a></td></tr> +<tr><td align='left'></td><td align='left'>11. Left fore hoof of regular form shod with a rubber pad and "three-quarter" shoe</td><td align='right'><a href='#Page_602'>602</a></td></tr> +<tr><td align='left'></td><td align='left'>12. A narrow right fore hoof of the base-wide standing position shod with a plain "dropped crease" shoe</td><td align='right'><a href='#Page_602'>602</a></td></tr> +<tr><td align='left'></td><td align='left'>13. Hoof surface of a right hind shoe to prevent interfering</td><td align='right'><a href='#Page_603'>603</a></td></tr> +<tr><td align='left'></td><td align='left'>14. Ground surface of shoe shown in fig. 13</td><td align='right'><a href='#Page_603'>603</a></td></tr> +<tr><td align='left'></td><td align='left'>15. Side view of a fore hoof shod so as to quicken the "breaking over" in a "forger"</td><td align='right'><a href='#Page_604'>604</a></td></tr> +<tr><td align='left'></td><td align='left'>16. Side view of a short-toed hind hoof of a forger</td><td align='right'><a href='#Page_604'>604</a></td></tr> +<tr><td align='left'></td><td align='left'>17. A toe-weight shoe to increase the length of stride of fore feet</td><td align='right'><a href='#Page_605'>605</a></td></tr> +<tr><td align='left'></td><td align='left'>18. Most common form of punched heel-weight shoe to induce high action in fore feet</td><td align='right'><a href='#Page_605'>605</a></td></tr> +</table></div> + + +<hr style="width: 65%;" /> +<p><span class='pagenum'><a name="Page_7" id="Page_7">[Pg 7]</a></span></p> +<h2>SPECIAL REPORT ON DISEASES OF THE HORSE.</h2> + + + +<hr style="width: 65%;" /> +<h2>THE EXAMINATION OF A SICK HORSE.</h2> + +<h3>By Leonard Pearson, B. S., V. M. D.</h3> + + +<p>In the examination of a sick horse it is important to have a method or +system. If a definite plan of examination is followed one may feel +reasonably sure, when the examination is finished, that no important +point has been overlooked and that the examiner is in a position to +arrive at an opinion that is as accurate as is possible for him. Of +course, an experienced eye can see, and a trained hand can feel, slight +alterations or variations from the normal that are not perceptible to +the unskilled observer. A thorough knowledge of the conditions that +exist in health is of the highest importance, because it is only by a +knowledge of what is right that one can surely detect a wrong condition. +A knowledge of anatomy, or of the structure of the body, and of +physiology, or the functions and activities of the body, lie at the +bottom of accuracy of diagnosis. It is important to remember that +animals of different races or families deport themselves differently +under the influence of the same disease or pathological process. The +sensitive and highly organized thoroughbred resists cerebral depression +more than does the lymphatic draft horse. Hence a degree of fever that +does not produce marked dullness in a thoroughbred may cause the most +abject dejection in a coarsely bred, heavy draft horse. This and similar +facts are of vast importance in the diagnosis of disease and in the +recognition of its significance.</p> + +<p>The order of examination, as given hereafter, is one that has proved to +be comparatively easy of application and sufficiently thorough for the +purpose of the readers of this work, and is recommended by several +writers.<span class='pagenum'><a name="Page_8" id="Page_8">[Pg 8]</a></span></p> + + +<h4>HISTORY.</h4> + +<p>It is important to know, first of all, something of the origin and +development of the disease; therefore the cause should be looked for. +The cause of a disease is important, not only in connection with +diagnosis, but also in connection with treatment. The character of feed +that the horse has had, the use to which he has been put, and the kind +of care he has received should all be closely inquired into. It may be +found by this investigation that the horse has been fed on damaged feed, +such as brewers' grains or moldy silage, and this may be sufficient to +explain the profound depression and weakness that are characteristic of +forage poisoning. If it is learned that the horse has been kept in the +stable without exercise for several days and upon full rations, and that +he became suddenly lame in his back and hind legs, and finally fell to +the ground from what appeared to be partial paralysis, this knowledge, +taken in connection with a few evident symptoms, will be enough to +establish a diagnosis of azoturia (excess of nitrogen in the urine). If +it is learned that the horse has been recently shipped in the cars or +has been through a dealer's stable, we have knowledge of significance in +connection with the causation of a possible febrile disease, which is, +under these conditions, likely to prove to be influenza, or edematous +pneumonia.</p> + +<p>It is also important to know whether the particular horse under +examination is the only one in the stable, or on the premises, that is +similarly afflicted. If it is found that several horses are afflicted +much in the same way, we have evidence of a common cause of disease +which may prove to be of an infectious nature.</p> + +<p>Another item of importance in connection with the history of the case +relates to the treatment that the horse may have had before he is +examined. It sometimes happens that medicine given in excessive +quantities produces symptoms resembling those of disease, so it is +important that the examiner be fully informed as to the medication that +has been employed.</p> + + +<h4>ATTITUDE AND GENERAL CONDITION.</h4> + +<p>Before beginning the special examination, attention should be paid to +the attitude and general condition of the animal. Sometimes horses +assume positions that are characteristic of a certain disease. For +example, in tetanus (lockjaw) the muscles of the face, neck, and +shoulders are stiff and rigid, as well as the muscles of the jaw. This +condition produces a peculiar attitude, that once seen is subsequently +recognized as rather characteristic of the disease. A horse with tetanus +stands with his muscles tense and his legs in a somewhat bracing +position, as though he were gathered to repel a shock. The neck is stiff +and hard, the head is slightly extended upon it, and the<span class='pagenum'><a name="Page_9" id="Page_9">[Pg 9]</a></span> face is drawn, +and the nostrils are dilated. The tail is usually held up a little, and +when pressed down against the thighs it springs back to its previous +position. In inflammation of the throat, as in pharyngolaryngitis, the +head is extended upon the neck and the angle between the jaw and the +lower border of the neck is opened as far as possible to relieve the +pressure that otherwise would fall upon the throat. In dumminess, or +immobility, the hanging position of the head and the stupid expression +are rather characteristic. In pleurisy, peritonitis, and some other +painful diseases of the internal organs, the rigid position of the body +denotes an effort of the animal to avoid pressure upon and to protect +the inflamed sensitive region.</p> + +<p>The horse may be down in the stall and unable to rise. This condition +may result from paraplegia (paralysis), from azoturia, from forage +poisoning, from tetanus, or from painful conditions of the bones or +feet, such as osteoporosis or founder. Lying down at unusual times or in +unusual positions may indicate disease. The first symptom of colic may +be a desire on the part of the horse to lie down at an unusual or +inappropriate time or place. Sometimes disinclination to lie down is an +indication of disease. When there is difficulty in breathing, the horse +knows that he can manage himself better upon his feet than upon his +breast or his side. It happens, therefore, that in nearly all serious +diseases of the respiratory tract he stands persistently, day and night, +until recovery has commenced and breathing is easier, or until the +animal falls from sheer exhaustion. If there is stiffness and soreness +of the muscles, as in rheumatism, inflammation of the muscles from +overwork, or of the bones in osteoporosis, or of the feet in founder, or +if the muscles are stiff and beyond control of the animal, as in +tetanus, a standing position is maintained, because the horse seems to +realize that when he lies down he will be unable to rise.</p> + +<p>Abnormal attitudes are assumed in painful diseases of the digestive +organs (colic). A horse with colic may sit upon his haunches, like a +dog, or may stand upon his hind feet and rest upon his knees in front, +or he may endeavor to balance himself upon his back, with all four feet +in the air. These positions are assumed because they give relief from +pain by lessening pressure or tension upon the sensitive structures.</p> + +<p>Under the general condition of the animal it is necessary to observe the +condition or state of nutrition, the conformation, so far as it may +indicate the constitution, and the temperament. By observing the +condition of nutrition one may be able to determine to a certain extent +the effect that the disease has already had upon the animal and to +estimate the amount of strength that remains and that will be available +for the repair of the diseased tissues. A good condition of nutrition is +shown by the rotundity of the body, the pliability and<span class='pagenum'><a name="Page_10" id="Page_10">[Pg 10]</a></span> softness of the +skin, and the tone of the hair. If the subcutaneous fat has disappeared +and the muscles are wasted, allowing the bony prominences to stand out; +if the skin is tight and inelastic and the coat dry and harsh, we have +evidence of a low state of nutrition. This may have resulted from a +severe and long-continued disease or from lack of proper feed and care. +When an animal is emaciated—that is, becomes thin—there is first a +loss of fat and later the muscles shrink. By observing the amount of +shrinkage in the muscles one has some indication as to the duration of +the unfavorable conditions under which the animal has lived.</p> + +<p>By constitution we understand the innate ability of the animal to +withstand disease or unfavorable conditions of life. The constitution +depends largely upon the conformation. The type of construction that +usually accompanies the best constitution is deep, broad chest, allowing +plenty of room for the lungs and heart, indicating that these vital +organs are well developed; capacious abdomen, allowing sufficient space +for well-developed organs of digestion; the loins should be short—that +is, the space should be short between the last rib and the point of the +hip; the head and neck should be well molded, without superfluous or +useless tissue; this gives a clear-cut throat. The ears, eyes, and face +should have an expression of alertness and good breeding. The muscular +development should be good; the shoulders, forearms, croup, and thighs +must have the appearance of strength. The withers are sharp, which means +that they are not loaded with useless, superfluous tissue; the legs are +straight and their axes are parallel; the knees and hocks are low, which +means that the forearms and thighs are long and the cannons relatively +short. The cannons are broad from in front to behind and relatively thin +from side to side. This means that the bony and tendinous structures of +the legs are well developed and well placed. The hoofs are compact, +tense, firm structures, and their soles are concave and frogs large. +Such a horse is likely to have a good constitution and to be able to +resist hard work, fatigue, and disease to a maximum degree. On the other +hand, a poor constitution is indicated by a shallow, narrow chest, small +bones, long loins, coarse neck and head, with thick throat, small, bony, +and muscular development, short thighs and forearms, small joints, long, +round cannons, and hoofs of open texture with flat soles.</p> + +<p>The temperament is indicated by the manner in which the horse responds +to external stimuli. When the horse is spoken to, or when he sees or +feels anything that stimulates or gives alarm, if he responds actively, +quickly, and intelligently, he is said to be of lively, or nervous, +temperament. On the other hand, if he responds in a slow, sluggish +manner, he is said to have a sluggish, or lymphatic,<span class='pagenum'><a name="Page_11" id="Page_11">[Pg 11]</a></span> temperament. The +temperament is indicated by the gait, by the expression of the face, and +by the carriage of the head and ears. The nature of the temperament +should be taken into consideration in an endeavor to ascertain the +severity of a given case of illness, because the general expression of +an animal in disease as well as in health depends to a large extent on +the temperament.</p> + + +<h4>THE SKIN AND THE VISIBLE MUCOUS MEMBRANES.</h4> + +<p>The condition of the skin is a fair index to the condition of the +animal. The effect of disease and emaciation upon the pliability of the +skin have been referred to above. There is no part of the body that +loses its elasticity and tone as a result of disease sooner than the +skin. The practical herdsman or flockmaster can gain a great deal of +information as to the condition, of an animal merely by grasping the +coat and looking at and feeling the skin. Similarly, the condition of +the animal is shown to a certain extent by the appearance of the mucous +membranes. For example, when the horse is anemic as a result of disease +or of inappropriate feed the mucous membranes become pale. This change +in the mucous membranes can be seen most readily in the lining of the +eyelids and in the lining of the nostril. For convenience of examination +the eyelids can readily be everted. Paleness means weak circulation or +poor blood. Increased redness occurs physiologically in painful +conditions, excitement, and following severe exertion. Under such +conditions the increase of circulation is transitory. In fevers there is +an increased redness in the mucous membrane, and this continues so long +as the fever lasts. In some diseases red spots or streaks form in the +mucous membrane. This usually indicates an infectious disease of +considerable severity, and occurs in blood poisoning, purpura +hemorrhagica, hemorrhagic septicemia, and in urticaria. When the liver +is deranged and does not operate, or when the red-blood corpuscles are +broken down, as in serious cases of influenza, there is a yellowish +discoloration of the mucous membrane. The mucous membranes become bluish +or blue when the blood is imperfectly oxidized and contains an excess of +carbon dioxid. This condition exists in any serious disease of the +respiratory tract, as pneumonia, and in heart failure.</p> + +<p>The temperature of the skin varies with the temperature of the body. If +there is fever the temperature of the skin is likely to be increased. +Sometimes, however, as a result of poor circulation and irregular +distribution of the blood, the body may be warmer than normal, while the +extremities (the legs and ears) may be cold. Where the general surface +of the body becomes cold it is evident that the small blood vessels in +the skin have contracted and are keeping the blood away, as during a +chill, or that the heart is weak and is<span class='pagenum'><a name="Page_12" id="Page_12">[Pg 12]</a></span> unable to pump the blood to the +surface, and that the animal is on the verge of collapse.</p> + +<p>The skin is moist, to a certain degree, at all times in a healthy horse. +This moisture is not in the form of a perceptible sweat, but it is +enough to keep the skin pliable and to cause the hair to have a soft, +healthy feel. In some chronic diseased conditions and in fever, the skin +becomes dry. In this case the hair has a harsh feel that is quite +different from the condition observed in health, and from the fact of +its being so dry the individual hairs do not adhere to one another, they +stand apart, and the animal has what is known as "a staring coat." When, +during a fever, sweating occurs, it is usually an indication that the +crisis is passed. Sometimes sweating is an indication of pain. A horse +with tetanus or azoturia sweats profusely. Horses sweat freely when +there is a serious impediment to respiration; they sweat under +excitement, and, of course, from the well-known physiological causes of +heat and work. Local sweating, or sweating of a restricted area of the +body, denotes some kind of nerve interference.</p> + +<p>Swellings of the skin usually come from wounds or other external causes +and have no special connection with the diagnosis of internal diseases. +There are, however, a number of conditions in which the swelling of the +skin is a symptom of a derangement of some other part of the body. For +example, there is the well-known "stocking," or swelling of the legs +about the fetlock joints, in influenza. There is the soft swelling of +the hind legs that occurs so often in draft horses when standing still +and that comes from previous inflammation (lymphangitis) or from +insufficient heart power. Dropsy, or edema of the skin, may occur +beneath the chest or abdomen from heart insufficiency or from chronic +collection of fluid in the chest or abdomen (hydrothorax, ascites, or +anemia). In anasarca or purpura hemorrhagica large soft swellings appear +on any part of the skin, but usually on the legs, side of the body, and +about the head.</p> + +<p>Gas collects under the skin in some instances. This comes from a local +inoculation with an organism which produces a fermentation beneath the +skin and causes the liberation of gas which inflates the skin, or the +gas may be air that enters through a wound penetrating some +air-containing organ, as the lungs. The condition here described is +known as emphysema. Emphysema may follow the fracture of a rib when the +end of a bone is forced inward and caused to penetrate the lung, or it +may occur when, as a result of an ulcerating process, an organ +containing air is perforated. This accident is more common in cattle +than it is in horses. Emphysema is recognized by the fact that the +swelling that it causes is not hot or sensitive on pressure. It emits a +peculiar crackling sound when it is stroked or pressed upon.<span class='pagenum'><a name="Page_13" id="Page_13">[Pg 13]</a></span></p> + +<p>Wounds of the skin may be of importance in the diagnosis of internal +disease. Wounds over the bony prominence, as the point of the hip, the +point of the shoulder, and the greatest convexity of the ribs, occur +when a horse is unable to stand for a long time and, through continually +lying upon his side, has shut off the circulation to the portion of the +skin that covers parts of the body that carry the greatest weight, and +in this way has caused them to mortify. Little, round, soft, doughlike +swellings occur on the skin and may be scattered freely over the surface +of the body when the horse is afflicted with urticaria. Similar +eruptions, but distributed less generally, about the size of a silver +dollar, may occur as a symptom of dourine, or colt distemper. Hard +lumps, from which radiate welt-like swellings of the lymphatics, occur +in glanders, and blisterlike eruptions occur around the mouth and +pasterns in horsepox.</p> + + +<h4>THE ORGANS OF CIRCULATION.</h4> + +<p>The first item in this portion of the examination consists in taking the +pulse. The pulse may be counted and its character may be determined at +any point where a large artery occupies a situation close to the skin +and above a hard tissue, such as a bone, cartilage, or tendon. The most +convenient place for taking the pulse of the horse is at the jaw. The +external maxillary artery runs from between the jaws, around the lower +border of the jawbone, and up on the outside of the jawbone to the face. +It is located immediately in front of the heavy muscles of the cheek. +Its throb can be felt most distinctly just before it turns around the +lower border of the jawbone. The balls of the first and second or of the +second and third fingers should be pressed lightly on the skin over this +artery when its pulsations are to be studied.</p> + +<p>The normal pulse of the healthy horse varies in frequency as follows:</p> + +<div class='center'> +<table border="0" cellpadding="4" cellspacing="20" summary=""> +<tr><td align='left'>Stallion</td><td align='left'>28 to 32 beats per minute.</td></tr> +<tr><td align='left'>Gelding</td><td align='left'>33 to 38 beats per minute.</td></tr> +<tr><td align='left'>Mare</td><td align='left'>34 to 40 beats per minute.</td></tr> +<tr><td align='left'>Foal 2 to 3 years old</td><td align='left'>40 to 50 beats per minute.</td></tr> +<tr><td align='left'>Foal 6 to 12 months old</td><td align='left'>45 to 60 beats per minute.</td></tr> +<tr><td align='left'>Foal 2 to 4 weeks old</td><td align='left'>70 to 90 beats per minute.</td></tr> +</table></div> + +<p>The pulse is accelerated by the digestion of rich food, by hot weather, +exercise, excitement, and alarm. It is slightly more rapid in the +evening than it is in the morning. Well-bred horses have a slightly more +rapid pulse than sluggish, cold-blooded horses. The pulse should be +regular; that is, the separate beats should follow each other after +intervals of equal length, and the beats should be of equal fullness, or +volume.<span class='pagenum'><a name="Page_14" id="Page_14">[Pg 14]</a></span></p> + +<p>In disease, the pulse may become slower or more rapid than in health. +Slowing of the pulse may be caused by old age, great exhaustion, or +excessive cold. It may be due to depression of the central nervous +system, as in dumminess, or be the result of the administration of +drugs, such as digitalis or strophantus. A rapid pulse is almost always +found in fever, and the more severe the infection and the weaker the +heart the more rapid is the pulse. Under these conditions, the beats may +rise to 80, 90, or even 120 per minute. When the pulse is above 100 per +minute the outlook for recovery is not promising, and especially if this +symptom accompanies high temperature or occurs late in an infectious +disease. In nearly all of the diseases of the heart and in anemia the +pulse becomes rapid.</p> + +<p>The pulse is irregular in diseases of the heart, and especially where +the valves are affected. The irregularity may consist in varying +intervals between the beats or the dropping of one or more beats at +regular or irregular intervals. The latter condition sometimes occurs in +chronic diseases of the brain. The pulse is said to be weak, or soft, +when the beats are indistinct, because little blood is forced through +the artery by each contraction of the heart. This condition occurs when +there is a constriction of the vessels leading from the heart and it +occurs in certain infectious and febrile diseases, and is an indication +of heart weakness.</p> + +<p>In examining the heart itself it is necessary to recall that it lies in +the anterior portion of the chest slightly to the left of the median +line and that it extends from the third to the sixth rib. It extends +almost to the breastbone, and a little more than half of the distance +between the breastbone and the backbone. In contracting, it rotates +slightly on its axis, so that the point of the heart, which lies below, +is pressed against the left chest wall at a place immediately above the +point of the elbow. The heart has in it four chambers—two in the left +and two in the right side. The upper chamber of the left side (left +auricle) receives the blood as it comes from the lungs, passes it to the +lower chamber of the left side (left ventricle), and from here it is +sent with great force (for this chamber has very strong, thick walls) +through the aorta and its branches (the arteries) to all parts of the +body. The blood returns through the veins to the upper chamber of the +right side (right auricle), passes then to the lower chamber of the +right side (right ventricle), and from this chamber is forced into the +lungs to be oxidized. The openings between the chambers of each side and +into the aorta are guarded by valves.</p> + +<p>If the horse is not too fat, one may feel the impact of the apex of the +heart against the chest wall with each contraction of the heart by +placing the hand on the left side back of the fifth rib and above the +point of the elbow. The thinner and the better bred the horse is the +more distinctly this impact is felt. If the animal is excited, or if he<span class='pagenum'><a name="Page_15" id="Page_15">[Pg 15]</a></span> +has just been exercised, the impact is stronger than when the horse is +at rest. If the horse is weak, the impact is reduced in force.</p> + +<p>The examination of the heart with the ear is an important matter in this +connection. Certain sounds are produced by each contraction of the +normal heart. It is customary to divide these into two, and to call them +the first and second sounds. These two sounds are heard during each +pulsation, and any deviation of the normal indicates some alteration in +the structure or the functions of the heart. In making this examination, +one may apply the left ear over the heavy muscles of the shoulder back +of the shoulder joint, and just above the point of the elbow, or, if the +sounds are not heard distinctly, the left fore leg may be drawn forward +by an assistant and the right ear placed against the lower portion of +the chest wall that is exposed in this manner.</p> + +<p>The first sound of the heart occurs while the heart muscle is +contracting and while the blood is being forced from the heart and the +valves are rendered taut to prevent the return of the blood from the +lower to the upper chambers. The second sound follows quickly after the +first and occurs during rebound of blood in the arteries, causing +pressure in the aorta and tensions of the valves guarding its opening +into the left ventricle. The first sound is of a high pitch and is +longer and more distinct than the second. Under the influence of disease +these sounds may be altered in various ways. It is not profitable, in a +work such as this, to describe the details of these alterations. Those +who are interested will find this subject fully discussed in the +veterinary textbooks.</p> + + +<h4>TEMPERATURE.</h4> + +<p>The temperature of the horse is determined roughly by placing the +fingers in the mouth or between the thighs or by allowing the horse to +exhale against the cheek or back of the hand. In accurate examination, +however, these means of determining temperature are not relied upon, but +recourse is had to the use of the thermometer. The thermometer used for +taking the temperature of a horse is a self-registering clinical +thermometer, similar to that used by physicians, but larger, being from +5 to 6 inches long. The temperature of the animal is measured in the +rectum.</p> + +<p>The normal temperature of the horse varies somewhat under different +conditions. It is higher in the young animal than in the old, and is +higher in hot weather than in cold. The weather and exercise decidedly +influence the temperature physiologically. The normal temperature varies +from 99.5° to 101° F. If the temperature rises to 102.5° the horse is +said to have a low fever; if the temperature reaches 104° the fever is +moderate; if it reaches 106° it is high,<span class='pagenum'><a name="Page_16" id="Page_16">[Pg 16]</a></span> and above this point it is +regarded as very high. In some diseases, such as tetanus or sunstroke, +the temperature goes as high as 108° or 110°. In the ordinary infectious +diseases it does not often exceed 106°. A temperature of 107.5° and +above is very dangerous and must be reduced promptly if the horse is to +be saved.</p> + + +<h4>THE ORGANS OF RESPIRATION.</h4> + +<p>In examining this system of organs and their functions it is customary +to begin by noting the frequency of the respiratory movements. This +point can be determined by observing the motions of the nostrils or of +the flanks; on a cold day one can see the condensation of the moisture +of the warm air as it comes from the lungs. The normal rate of +respiration for a healthy horse at rest is from 8 to 16 per minute. The +rate is faster in young animals than in old, and is increased by work, +hot weather, overfilling of the stomach, pregnancy, lying upon the side, +etc. Acceleration of the respiratory rate where no physiological cause +operates is due to a variety of conditions. Among these is fever; +restricted area of active lung tissue, from filling of portions of the +lungs with inflammatory exudate, as in pneumonia; compression of the +lungs or loss of elasticity; pain in the muscles controlling the +respiratory movements; excess of carbon dioxid in the blood; and +constriction of the air passages leading to the lungs.</p> + +<p>Difficult or labored respiration is known as dyspnea. It occurs when it +is difficult, for any reason, for the animal to obtain the amount of +oxygen that it requires. This may be due to filling of the lungs, as in +pneumonia; to painful movements of the chest, as in rheumatism or +pleurisy; to tumors of the nose and paralysis of the throat, swellings +of the throat, foreign bodies, or weakness of the respiratory passages, +fluid in the chest cavity, adhesions between the lungs and chest walls, +loss of elasticity of the lungs, etc. Where the difficulty is great the +accessory muscles of respiration are brought into play. In great dyspnea +the horse stands with his front feet apart, with his neck straight out, +and his head extended upon his neck. The nostrils are widely dilated, +the face has an anxious expression, the eyeballs protrude, the +up-and-down motion of the larynx is aggravated, the amplitude of the +movement of the chest walls increased, and the flanks heave.</p> + +<p>The expired air is of about the temperature of the body. It contains +considerable moisture, and it should come with equal force from each +nostril and should not have an unpleasant odor. If the stream of air +from one nostril is stronger than from the other, there is an indication +of an obstruction in a nasal chamber. If the air possesses a bad odor, +it is usually an indication of putrefaction of a tissue or<span class='pagenum'><a name="Page_17" id="Page_17">[Pg 17]</a></span> secretion in +some part of the respiratory tract. A bad odor is found where there is +necrosis of the bone in the nasal passages or in chronic catarrh. An +ulcerating tumor of the nose or throat may cause the breath to have an +offensive odor. The most offensive breath occurs where there is +necrosis, or gangrene, of the lungs.</p> + +<p>In some diseases there is a discharge from the nose. In order to +determine the significance of the discharge it should be examined +closely. One should ascertain whether it comes from one or both +nostrils. If but from one nostril, it probably originates in the head. +The color should be noted. A thin, watery discharge may be composed of +serum, and it occurs in the earlier stages of coryza, or nasal catarrh. +An opalescent, slightly tinted discharge is composed of mucus and +indicates a little more severe irritation. If the discharge is sticky +and puslike, a deeper difficulty or more advanced irritation is +indicated. If the discharge contains flakes and clumps of more or less +dried, agglutinated particles, it is probable that it originates within +a cavity of the head, as the sinuses or guttural pouches. The discharge +of glanders is of a peculiar sticky nature and adheres tenaciously to +the wings of the nostrils. The discharge of pneumonia is of a somewhat +red or reddish brown color and, on this account has been described as a +prune-juice discharge. The discharge may contain blood. If the blood +appears as clots or as streaks in the discharge, it probably originates +at some point in the upper part of the respiratory tract. If the blood +is in the form of a fine froth, it comes from the lungs.</p> + +<p>In examining the interior of the nasal passage one should remember that +the normal color of the mucous membrane is a rosy pink and that its +surface is smooth. If ulcers, nodules, swellings, or tumors are found, +these indicate disease. The ulcer that is characteristic of glanders is +described fully in connection with the discussion of that disease.</p> + +<p>Between the lower jaws there are several clusters of lymphatic glands. +These glands are so small and so soft that it is difficult to find them +by feeling through the skin, but when a suppurative disease exists in +the upper part of the respiratory tract these glands become swollen and +easy to feel. They may become soft and break down and discharge as +abscesses; this is seen constantly in strangles. On the other hand, they +may become indurated and hard from the proliferation of connective +tissue and attach themselves to the jawbone, to the tongue, or to the +skin. This is seen in chronic glanders. If the glands are swollen and +tender to pressure, it indicates that the disease causing the +enlargement is acute; if they are hard and insensitive, the disease +causing the enlargement is chronic.<span class='pagenum'><a name="Page_18" id="Page_18">[Pg 18]</a></span></p> + +<p>The manner in which the horse coughs is of importance in diagnosis. The +cough is a forced expiration, following immediately upon a forcible +separation of the vocal cords. The purpose of the cough is to remove +some irritant substance from the respiratory passages, and it occurs +when irritant gases, such as smoke, ammonia, sulphur vapor, or dust, +have been inhaled. It occurs from inhalation of cold air if the +respiratory passages are sensitive from disease. In laryngitis, +bronchitis, and pneumonia, cough is very easily excited and occurs +merely from accumulation of mucus and inflammatory product upon the +irritated respiratory mucous membrane. If one wishes to determine the +character of the cough, it can easily be excited by pressing upon the +larynx with the thumb and finger. The larynx should be pressed from side +to side and the pressure removed the moment the horse commences to +cough. A painful cough occurs in pleurisy, also in laryngitis, +bronchitis, and bronchial pneumonia. Pain is shown by the effort the +animal exerts to repress the cough. The cough is not painful, as a rule, +in the chronic diseases of the respiratory tract. The force of the cough +is considerable when it is not especially painful and when the lungs are +not seriously involved. When the lungs are so diseased that they can not +be filled with a large volume of air, and in heaves, the cough is weak, +as it is also in weak, debilitated animals. If mucus or pus is coughed +out, or if the cough is accompanied by a gurgling sound, it is said to +be moist; it is dry when these characteristics are not present—that is, +when the air in passing out passes over surface not loaded with +secretion.</p> + +<p>In the examination of the chest we resort to percussion and +auscultation. When a cask or other structure containing air is tapped +upon, or percussed, a hollow sound is given forth. If the cask contains +fluid, the sound is of a dull and of quite a different character. +Similarly, the amount of air contained in the lungs can be estimated by +tapping upon, or percussing, the walls of the chest. Percussion is +practiced with the fingers alone or with the aid of a special percussion +hammer and an object to strike upon known as a pleximeter. If the +fingers are used, the middle finger of the left hand should be pressed +firmly against the side of the horse and should be struck with the ends +of the fingers of the right hand bent at a right angle so as to form a +hammer. The percussion hammer sold by instrument makers is made of +rubber or has a rubber tip, so that when the pleximeter, which is placed +against the side, is struck the impact will not be accompanied by a +noise. After experience in this method of examination one can determine +with a considerable degree of accuracy whether the lung contains a +normal amount of air or not. If, as in pneumonia, air has been displaced +by inflammatory product occupying the air space, or if fluid collects in +the lower part of the chest, the percussion sound becomes dull. If, as +in emphysema, or in pneumothorax,<span class='pagenum'><a name="Page_19" id="Page_19">[Pg 19]</a></span> there is an excess of air in the +chest cavity, the percussion sound becomes abnormally loud and clear.</p> + +<p>Auscultation consists in the examination of the lungs with the ear +applied closely to the chest wall. As the air goes in and out of the +lungs a certain soft sound is made which can be heard distinctly, +especially upon inspiration. This sound is intensified by anything that +accelerates the rate of respiration, such as exercise. This soft, +rustling sound is known as vesicular murmur, and wherever it is heard it +signifies that the lung contains air and is functionally active. The +vesicular murmur is weakened when there is an inflammatory infiltration +of the lung tissue or when the lungs are compressed by fluid in the +chest cavity. The vesicular murmur disappears when air is excluded by +the accumulation, of inflammatory product, as in pneumonia, and when the +lungs are compressed by fluid in the chest cavity. The vesicular murmur +becomes rough and harsh in the early stages of inflammation of the +lungs, and this is often the first sign of the beginning of pneumonia.</p> + +<p>By applying the ear over the lower part of the windpipe in front of the +breastbone a somewhat harsh, blowing sound may be heard. This is known +as the bronchial murmur and is heard in normal conditions near the lower +part of the trachea and to a limited extent in the anterior portions of +the lungs after sharp exercise. When the bronchial murmur is heard over +other portions of the lungs, it may signify that the lungs are more or +less solidified by disease and the blowing bronchial murmur is +transmitted through this solid lung to the ear from a distant part of +the chest. The bronchial murmur in an abnormal place signifies that +there exists pneumonia or that the lungs are compressed by fluid in the +chest cavity.</p> + +<p>Additional sounds are heard in the lungs in some diseased conditions. +For example, when fluid collects in the air passages and the air is +forced through it or is caused to pass through tubes containing +secretions or pus. Such sounds are of a gurgling or bubbling nature and +are known as mucous râles. Mucous râles are spoken of as being large or +small as they are distinct or indistinct, depending upon the quantity of +fluid that is present and the size of the tube in which this sound is +produced. Mucous râles occur in pneumonia after the solidified parts +begin to break down at the end of the disease. They occur in bronchitis +and in tuberculosis, where there is an excess of secretion.</p> + +<p>Sometimes a shrill sound is heard, like the note of a whistle, fife, or +flute. This is due to a dry constriction of the bronchial tubes and it +is heard in chronic bronchitis and in tuberculosis.</p> + +<p>A friction sound is heard in pleurisy. This is due to the rubbing +together of roughened surfaces, and the sound produced is similar to a +dry rubbing sound that is caused by rubbing the hands together or by +rubbing upon each other two dry, rough pieces of leather.<span class='pagenum'><a name="Page_20" id="Page_20">[Pg 20]</a></span></p> + + +<h4>THE EXAMINATION OF THE DIGESTIVE TRACT.</h4> + +<p>The first point in connection with the examination of the organs of +digestion is the appetite and the manner of taking food and drink. A +healthy animal has a good appetite. Loss of appetite does not point to a +special diseased condition, but comes from a variety of causes. Some of +these causes, indeed, may be looked upon as being physiological. +Excitement, strange surroundings, fatigue, and hot weather may all cause +loss of appetite. Where there is cerebral depression, fever, profound +weakness, disorder of the stomach, or mechanical difficulty in chewing +or swallowing, the appetite is diminished or destroyed. Sometimes there +is an appetite or desire to eat abnormal things, such as dirty bedding, +roots of grass, soil, etc. This desire usually comes from a chronic +disturbance of nutrition.</p> + +<p>Thirst is diminished in a good many mild diseases unaccompanied by +distinct fever. It is seen where there is great exhaustion or depression +or profound brain disturbance. Thirst is increased after profuse +sweating, in diabetes, diarrhea, in fever, at the crises of infectious +diseases, and when the mouth is dry and hot.</p> + +<p>Some diseases of the mouth or throat make it difficult for the horse to +chew or swallow his feed. Where difficulty in this respect is +experienced, the following named conditions should be borne in mind and +carefully looked for: Diseases of the teeth, consisting in decay, +fracture, abscess formation, or overgrowth; inflammatory conditions, or +wounds or tumors of the tongue, cheeks, or lips; paralysis of the +muscles of chewing or swallowing; foreign bodies in upper part of the +mouth between the molar teeth; inflammation of throat. Difficulty in +swallowing is sometimes shown by the symptom known as "quidding." +Quidding consists in dropping from the mouth well-chewed and insalivated +boluses of feed. A mouthful of hay, for example, after being ground and +masticated, is carried to the back part of the mouth. The horse then +finds that from tenderness of the throat, or from some other cause, +swallowing is difficult or painful, and the bolus is then dropped from +the mouth. Another quantity of hay is similarly prepared, only to be +dropped in turn. Sometimes quidding is due to a painful tooth, the bolus +being dropped from the mouth when the tooth is struck and during the +pang that follows. Quidding may be practiced so persistently that a +considerable pile of boluses of feed accumulate in the manger or on the +floor of the stall. In pharyngitis one of the symptoms is a return +through the nose of fluid that the horse attempts to swallow.</p> + +<p>In some brain diseases, and particularly in chronic internal +hydrocephalus, the horse has a most peculiar manner of swallowing and of +taking feed. A similar condition is seen in hyperemia of the brain. In +eating the horse will sink his muzzle into the grain in<span class='pagenum'><a name="Page_21" id="Page_21">[Pg 21]</a></span> the feed box +and eat for a while without raising the head. Long pauses are made while +the feed is in the mouth. Sometimes the horse will eat very rapidly for +a little while and then slowly; the jaws may be brought together so +forcibly that the teeth gnash. In eating hay the horse will stop at +times with hay protruding from the mouth and stand stupidly, as though +he has forgotten what he was about.</p> + +<p>In examining the mouth one should first look for swellings or for +evidence of abnormal conditions upon the exterior; that is, the front +and sides of the face, the jaws, and about the muzzle. By this means +wounds, fractures, tumors, abscesses, and disease accompanied by +eruptions about the muzzle may be detected. The interior of the mouth is +examined by holding the head up and inserting the fingers through the +interdental space in such a way as to cause the mouth to open. The +mucous membrane should be clean and of a light-pink color, excepting on +the back of the tongue, where the color is a yellowish gray. As +abnormalities of this region, the chief are diffuse inflammation, +characterized by redness and catarrhal discharge; local inflammation, as +from eruptions, ulcers, or wounds; necrosis of the lower jawbone in +front of the first back tooth; and swellings. Foreign bodies are +sometimes found embedded in the mucous membrane lining of the mouth or +lodged between the teeth.</p> + +<p>The examination of the pharynx and of the esophagus is made chiefly by +pressing upon the skin covering these organs in the region of the throat +and along the left side of the neck in the jugular gutter. Sometimes, +when a more careful examination is necessary, an esophageal tube or +probang is passed through the nose or mouth down the esophagus to the +stomach.</p> + +<p>Vomiting is an act consisting in the expulsion of all or part of the +contents of the stomach through the mouth or nose. This act is more +difficult for the horse than for most of the other domestic animals, +because the stomach of the horse is small and does not lie on the floor +of the abdominal cavity, so that the abdominal walls in contracting do +not bring pressure to bear upon it so directly and forcibly, as is the +case in many other animals. Beside this, there is a loose fold of mucous +membrane at the point where the esophagus enters the stomach, and this +forms a sort of valve which does not interfere with the passage of food +into the stomach, but does interfere with the exit of food through the +esophageal opening. Still, vomiting is a symptom that is occasionally +seen in the horse. It occurs when the stomach is very much distended +with food or with gas. Distention stretches the mucous membrane and +eradicates the valvular fold referred to, and also makes it possible for +more pressure to be exerted upon the stomach through the contraction of +the abdominal muscles. Since the<span class='pagenum'><a name="Page_22" id="Page_22">[Pg 22]</a></span> distention to permit vomiting must be +extreme, it not infrequently happens that it leads to rupture of the +stomach walls. This has caused the impression in the minds of some that +vomiting can not occur in the horse without rupture of the stomach, but +this is incorrect, since many horses vomit and afterwards become +entirely sound. After rupture of the stomach has occurred vomiting is +impossible.</p> + +<p>In examination of the abdomen one should remember that its size depends +largely upon the breed, sex, and conformation of the animal, and also +upon the manner in which the animal has been fed and the use to which it +has been put. A pendulous abdomen may be the result of an abdominal +tumor or of an accumulation of fluid in the abdominal cavity; or, on the +other hand, it may merely be an indication of pregnancy, or of the fact +that the horse has been fed for a long time on bulky and innutritious +food. Pendulous abdomen occurring in a work horse kept on a concentrated +diet is an abnormal condition. The abdomen may increase suddenly in +volume from accumulation of gas in tympanic colic. The abdomen becomes +small and the horse is said to be "tucked up" from long-continued poor +appetite, as in diseases of the digestive tract and in fever. This +condition also occurs in tetanus from the contraction of the abdominal +walls and in diarrhea from emptiness.</p> + +<p>In applying the ear to the flank, on either the right or left side, +certain bubbling sounds may be heard that are known as peristaltic +sounds, because they are produced by peristalsis, or wormlike +contraction of the intestines. These sounds are a little louder on the +right side than on the left on account of the fact that the large +intestines lie in the right flank. Absence of peristaltic sounds is +always an indication of disease, and suggests exhaustion or paralysis of +the intestines. This may occur in certain kinds of colic and is an +unfavorable symptom. Increased sounds are heard where the intestines are +contracted more violently than in health, as in spasmodic colic, and +also where there is an excess of fluid or gas in the intestinal canal.</p> + +<p>The feces show, to a certain extent, the thoroughness of digestion. They +should show that the feed has been well ground, and should, in the +horse, be free from offensive odor or coatings of mucus. A coating of +mucus shows intestinal catarrh. Blood on the feces indicates severe +inflammation. Very light color and bad odor may come from inactive +liver. Parasites are sometimes in the dung.</p> + +<p>Rectal examination consists in examination of the organs of the pelvic +cavity and posterior portion of the abdominal cavity by the hand +inserted into the rectum. This examination should be attempted by a +veterinarian only, and is useless except to one who has a good knowledge +of the anatomy of the parts concerned.<span class='pagenum'><a name="Page_23" id="Page_23">[Pg 23]</a></span></p> + + +<h4>THE EXAMINATION OF THE NERVOUS SYSTEM.</h4> + +<p>The great brain, or cerebrum, is the seat of intelligence, and it +contains the centers that control motion in many parts of the body. The +front portion of the brain is believed to be the region that is most +important in governing the intelligence. The central and posterior +portions of the cerebrum contain the centers for the voluntary motions +of the face and of the front and hind legs. The growth of a tumor or an +inflammatory change in the region of a center governing the motion of a +certain part of the body has the effect of disturbing motion in that +part by causing excessive contraction known as cramps, or inability of +the muscles to contract, constituting the condition known as paralysis. +The nerve paths from the cerebrum, and hence from these centers to the +spinal cord and thence to the muscles, pass beneath the small brain, or +the cerebellum, and through the medulla oblongata to the spinal cord. +Interference with these paths has the effect of disturbing motion of the +parts reached by them. If all of the paths on one side are interfered +with, the result is paralysis of one side of the body.</p> + +<p>The small brain, or cerebellum, governs the regularity, or coordination, +of movements. Disturbances of the cerebellum cause a tottering, +uncertain gait. In the medulla oblongata, which lies between the spinal +cord and the cerebellum, are the centers governing the circulation and +breathing.</p> + +<p>The spinal cord carries sensory messages to the brain and motor +impressions from the brain. The anterior portions of the cord contain +the motor paths, and the posterior portions of the cord contain the +sensory paths.</p> + +<p>Paralysis of a single member or a single group of muscles is known as +monoplegia and results from injury to the motor center or to a nerve +trunk leading to the part that is involved. Paralysis of one-half of the +body is known as hemiplegia and results from destruction or severe +disturbances of the cerebral hemisphere of the opposite side of the body +or from interference with nerve paths between the cerebellum, or small +brain, and the spinal cord. Paralysis of the posterior half of the body +is known as paraplegia and results from derangement of the spinal cord. +If the cord is pressed upon, cut, or injured, messages can not be +transmitted beyond that point, and so the posterior part becomes +paralyzed. This is seen when the back is fractured.</p> + +<p>Abnormal mental excitement may be due to congestion of the brain or to +inflammation. The animal so afflicted becomes vicious, pays no attention +to commands, cries, runs about in a circle, stamps with the feet, +strikes, kicks, etc. This condition is usually followed by a dull, +stupid state, in which the animal stands with his head down, dull and<span class='pagenum'><a name="Page_24" id="Page_24">[Pg 24]</a></span> +irresponsive to external stimuli. Cerebral depression also occurs in the +severe febrile infectious diseases, in chronic hydrocephalus, in chronic +diseases of the liver, in poisoning with a narcotic substance, and with +chronic catarrh of the stomach and intestines.</p> + +<p>Fainting is a symptom that is not often seen in horses. When it occurs +it is shown by unsteadiness of gait, tottering, and, finally, inability +to stand. The cause usually lies in a defect of the small brain, or +cerebellum. This defect may be merely in respect of the blood supply, to +congestion, or to anemia, and in this case it is likely to pass away and +may never return, or it may be due to some permanent cause, as a tumor +or an abscess, or it may result from a hemorrhage, from a defect of the +valves of the heart, or from poisoning.</p> + +<p>Loss of consciousness is known as coma. It is caused by hemorrhage in +the brain, by profound exhaustion, or may result from a saturation of +the system with the poison of some disease. Coma may follow upon +cerebral depression, which occurs as a secondary state of inflammation +of the brain.</p> + +<p>Where the sensibility of a part is increased the condition is known as +hyperesthesia, and where it is lost—that is, where there is no feeling +or knowledge of pain—the condition is known as anesthesia. The former +usually accompanies some chronic disease of the spinal cord or the +earlier stages of irritation of a nerve trunk. Hyperesthesia is +difficult to detect in a nervous, irritable animal, and sometimes even +in a horse of less sensitive temperament. An irritable, sensitive spot +may be found surrounded by skin that is not sensitive to pressure. This +is sometimes a symptom of beginning of inflammation of the brain. +Anesthesia occurs in connection with cerebral and spinal paralysis, +section of a nerve trunk leading to a part, in severe mental depression, +and in narcotic poisoning.</p> + + +<h4>URINARY AND SEXUAL ORGANS.</h4> + +<p>In considering the examination of the urinary and sexual organs we may +consider, at the beginning, a false impression that prevails to an +astonishing extent. Many horsemen are in the habit of pressings upon the +back of a horse over the loins or of sliding the ends of the fingers +along on either side of the median line of this region. If the horse +depresses his back it is at once said "his kidneys are weak." Nothing +could be more absurd or further from the truth. Any healthy horse—any +horse with normal sensation and with a normally flexible back—will +cause it to sink when manipulated in this way. If the kidneys are +inflamed and sensitive, the back is held more rigidly and is not +depressed under this pressure.</p> + +<p>To examine the kidneys by pressure the pressure should be brought to +bear over these organs. The kidneys lie beneath the ends of the<span class='pagenum'><a name="Page_25" id="Page_25">[Pg 25]</a></span> +transverse processes of the vertebræ of the loins and beneath the +hind-most ribs. If the kidneys are actually inflamed and especially +sensitive, pressure or light blows applied here may cause the horse to +shrink.</p> + +<p>The physical examination of the sexual and generative organs is made in +large part through the rectum, and this portion of the examination +should be carried out by a veterinarian only. By this means it is +possible to discover or locate cysts of the kidneys, urinary calculi in +the ureters, bladder, or upper urethra, malformations, and acute +inflammations accompanied by pain. The external genital organs are +swollen, discolored, or show a discharge as a result of local disease or +from disease higher in the tract.</p> + +<p>The manner of urinating is sometimes of considerable diagnostic +importance. Painful urination is shown by frequent attempts, during +which but a small quantity of urine is passed; by groaning, by +constrained attitude, etc. This condition comes from inflammation of the +bladder or urethra, urinary calculi (stones of the bladder or urethra), +hemorrhage, tumors, bruises, etc. The urine is retained from spasms of +the muscle at the neck of the bladder, from calculi, inflammatory +growths, tumors, and paralysis of the bladder.</p> + +<p>The urine dribbles without control when the neck of the bladder is +weakened or paralyzed. This condition is seen after the bladder is +weakened from long-continued retention and where there is a partial +paralysis of the hind quarters.</p> + +<p>Horses usually void urine five to seven times a day, and pass from 4 to +7 quarts. Disease may be shown by increase in the number of voidings or +of the quantity. Frequent urination indicates an irritable or painful +condition of the bladder or urethra or that the quantity is excessive. +In one form of chronic inflammation of the kidneys (interstitial +nephritis) and in polyuria the quantity may be increased to 20 or 30 +quarts daily. Diminution in the quantity of urine comes from profuse +sweating, diarrhea, high fever, weak heart, diseased and nonsecreting +kidneys, or an obstruction to the flow.</p> + +<p>The urine of the healthy horse is a pale or at times a slightly reddish +yellow. The color is less intense when the quantity is large, and is +more intense when the quantity is diminished. Dark-brown urine is seen +in azoturia and in severe acute muscular rheumatism. A brownish-green +color is seen in jaundice. Red color indicates admixture of blood from a +bleeding point at some part of the urinary tract, usually in the +kidneys.</p> + +<p>The urine of the healthy horse is not clear and transparent. It contains +mucus, which causes it to be slightly thick and stringy, and a certain +amount of undissolved carbonates, causing it to be cloudy. A sediment +collects when the urine is allowed to stand. The urine of the horse is +normally alkaline. If it becomes acid the bodies in suspension<span class='pagenum'><a name="Page_26" id="Page_26">[Pg 26]</a></span> are +dissolved and the urine is made clear. The urine may be unusually cloudy +from the addition of abnormal constituents, but to determine their +character a chemical or microscopic examination is necessary. Red or +reddish flakes or clumps in the urine are always abnormal, and denote a +hemorrhage or suppuration in the urinary tract.</p> + +<p>The normal specific gravity of the urine of the horse is about 1.040. It +is increased when the urine is scanty and decreased when the quantity is +excessive.</p> + +<p>Acid reaction of the urine occurs in chronic intestinal catarrh, in high +fever, and during starvation. Chemical and microscopic tests and +examinations are often of great importance in diagnosis, but require +special apparatus and skill.</p> + +<p>Other points in the examination of a sick horse require more discussion +than can be afforded in this connection, and require special training on +the part of the examiner. Among such points may be mentioned the +examination of the organs of special sense, the examination of the +blood, the microscopic examination of the secretions and excretions, +bacteriological examinations of the secretions, excretions, and tissues, +specific reaction tests, and diagnostic inoculation.</p> + + + +<hr style="width: 65%;" /> +<p><span class='pagenum'><a name="Page_27" id="Page_27">[Pg 27]</a></span></p> +<h2>FUNDAMENTAL PRINCIPLES OF DISEASE.</h2> + +<h3>By <span class="smcap">Rush Shippen Huidekoper</span>, M. D., <span class="smcap">Vet</span>.</h3> + +<h4>[Revised by Leonard Pearson, B. S., V. M. D.]</h4> + + +<h4>ANIMAL TISSUES.</h4> + +<p>The nonprofessional reader may regard the animal tissues, which are +subject to inflammation, as excessively simple structures, as similar, +simple, and fixed in their organization as the joists and boards which +frame a house, the bricks and iron coils of pipe which build a furnace, +or the stones and mortar which make the support of a great railroad +bridge. Yet while the principles of structure are thus simple, for the +general understanding by the student who begins their study the complete +appreciation of the shades of variation, which differentiate one tissue +from another, which define a sound tendon or a ligament from a fibrous +band—the result of disease filling in an old lesion and tying one organ +with another—is as complicated as the nicest jointing of Chinese +woodwork, the building of a furnace for the most difficult chemical +analysis, or the construction of a bridge which will stand for ages and +resist any force or weight.</p> + +<p>All tissues are composed of certain fundamental and similar elements +which are governed by the same rules of life, though at first glance +they may appear to be widely different. These are (<i>a</i>) amorphous +substances, (<i>b</i>) fibers, and (<i>c</i>) cells.</p> + +<p>(<i>a</i>) Amorphous substances may be in liquid form, as in the fluid of the +blood, which holds a vast amount of salts and nutritive matter in +solution; or they may be in a semiliquid condition, as the plasma which +infiltrates the loose meshes of connective tissue and lubricates the +surface of some membranes; or they may be in the form of a glue or +cement, fastening one structure to another, as a tendon or muscle end to +a bone; or, again, they hold similar elements firmly together, as in +bone, where they form a stiff matrix which becomes impregnated with lime +salts. Amorphous substances, again, form the protoplasm or nutritive +element of cells or the elements of life.</p> + +<p>(<i>b</i>) Fibers are formed of elements of organic matter which have only a +passive function. They can be assimilated to little strings, or cords, +tangled one with another like a mass of waste yarn, woven regularly like +a cloth, or bound together like a rope. They are of two<span class='pagenum'><a name="Page_28" id="Page_28">[Pg 28]</a></span> kinds—white +connective tissue fibers, only slightly extensible, pliable, and very +strong, and yellow elastic fibers, elastic, curly, ramified, and very +dense. These fibers once created require the constant presence of fluids +around them in order to retain their functional condition, as a piece of +harness leather demands continual oiling to keep its strength, but they +undergo no change or alteration in their form until destroyed by death.</p> + +<p>(<i>c</i>) Cells, which may even be regarded as low forms of life, are masses +of protoplasm or amorphous living matter, with a nucleus and frequently +a nucleolus, which are capable of assimilating nutriment or food, +propagating themselves either into others of the same form or into fixed +cells of another outward appearance and different function but of the +same constitution. It is simply in the mode of the grouping of these +elements that we have the variation in tissues, as (1) loose connective +tissue, (2) aponeurosis and tendons, (3) muscles, (4) cartilage, (5) +bones, (6) epithelia and endothelia, (7) nerves.</p> + +<p>(1) Loose connective tissue forms the great framework, or scaffolding, +of the body, and is found under the skin, between the muscles +surrounding the bones and blood vessels, and entering into the +structures of almost all the organs. In this the fibers are loosely +meshed together like a sponge, leaving spaces in which the nutrient +fluid and cells are irregularly distributed. This tissue we find in the +skin, in the spaces between the organs of the body where fat +accumulates, and as the framework of all glands.</p> + +<p>(2) Aponeurosis and tendons are structures which serve for the +termination of muscles and for their contention, and for the attachment +of bones together. In these the fibers are more frequent and dense, and +are arranged with regularity, either crossing each other or lying +parallel, and here the cells are found in minimum quantity.</p> + +<p>(3) In the muscles the cells lie end to end, forming long fibers which +have the power of contraction, and the connective tissue is in small +quantity, serving the passive purpose of a band around the contractile +elements.</p> + +<p>(4) In cartilage a mass of firm amorphous substance, with no vascularity +and little vitality, forms the bed for the chondroplasts, or cells of +this tissue.</p> + +<p>(5) Bone differs from the above in having the amorphous matter +impregnated with lime salts, which gives it its rigidity and firmness.</p> + +<p>(6) Epithelia and endothelia, or the membranes which cover the body and +line all its cavities and glands, are made up of single or stratified +and multiple layers of cells bound together by a glue of amorphous +substance and resting on a layer composed of fibers.<span class='pagenum'><a name="Page_29" id="Page_29">[Pg 29]</a></span> When the membrane +serves for secreting or excreting purposes, as in the salivary glands or +the kidneys, it is usually simple; when it serves the mechanical purpose +of protecting a part, as over the tongue or skin, it is invariably +multiple and stratified, the surface wearing away while new cells +replace it from beneath.</p> + +<p>(7) In nerves, stellate cells are connected by their rays to each other, +or to fibers which conduct the nerve impressions, or they act as +receptacles, storehouses, and transmitters for them, as the switch-board +of a telephone system serves to connect the various wires.</p> + +<p>All these tissues are supplied with blood in greater or less quantity. +The vascularity depends upon the function which the tissue is called +upon to perform. If this is great, as in the tongue, the lungs, or the +sensitive part of the hoof, a large quantity of blood is required; if +the labor is a passive one, as in cartilage, the membrane over the +withers, or the tendons of the legs, the vessels only reach the +periphery, and nutrition is furnished by imbibition of the fluids +brought to their surface by the blood vessels.</p> + +<p>Blood is brought to the tissues by arterioles, or the small terminations +of the arteries, and is carried off from them by the veinlets, or the +commencement of the veins. Between these two systems are small, delicate +networks of vessels called capillaries, which subdivide into a veritable +lacework so as to reach the neighborhood of every element.</p> + +<p>In health the blood passes through these capillaries with a regular +current, the red cells or corpuscles floating rapidly in the fluid in +the center of the channel, while the white or ameboid cells are +attracted to the walls of the vessels and move very slowly. The supply +of blood is regulated by the condition of repose or activity of the +tissue, and under normal conditions the outflow exactly compensates the +supply. The caliber of the blood vessels, and consequently the quantity +of blood which they carry, is governed by nerves of the sympathetic +system in a healthy body with unerring regularity, but in a diseased +organ the flow may cease or be greatly augmented. In health a tissue or +organ receives its proper quantity of blood; the nutritive elements are +extracted for the support of the tissue and for the product, which the +function of the organ forms. The force required in the achievement of +this is furnished by combustion of the hydrocarbons and oxygen brought +by the arterial blood, then by the veins this same fluid passes off, +less its oxygen, loaded with the waste products, which are the result of +the worn-out and disintegrated tissues, and of those which have +undergone combustion. The foregoing brief outline indicates the process +of nutrition of the tissues.</p> + +<p>Hypernutrition, or excessive nutrition of a tissue, may be normal or +morbid. If the latter, the tissue becomes congested or inflamed.<span class='pagenum'><a name="Page_30" id="Page_30">[Pg 30]</a></span></p> + + +<h4>CONGESTION.</h4> + +<p>Congestion is an unnatural accumulation of blood in a part. Excessive +accumulation of blood may be normal, as in blushing or in the red face +which temporarily follows a violent muscular effort, or, as in the +stomach or liver during digestion, or in the lungs after severe work, +from which, in the latter case, it is shortly relieved by a little rapid +breathing. The term congestion, however, usually indicates a morbid +condition, with more or less lasting effects. Congestion is active or +passive. The former is produced by an increased supply of blood to the +part, the latter by an obstacle preventing the escape of blood from the +tissue. In either case there is an increased supply of blood, and as a +result increased combustion and augmented nutrition.</p> + + +<h4>ACTIVE CONGESTION.</h4> + +<p>Active congestion is caused by—</p> + +<p>(1) <i>Functional activity.</i>—Any organ which is constantly or excessively +used is habituated to hold an unusual quantity of blood; the vessels +become dilated; if overstrained the walls become weakened, lose their +elasticity, and any sudden additional quantity of blood engorges the +tissues so that they can not contract, and congestion results. Example: +The lungs of a race horse, after an unusual burst of speed or severe +work, in damp weather.</p> + +<p>(2) <i>Irritants.</i>—Heat and cold, chemical or mechanical. Any of these, +by threatening the vitality of a tissue, induce immediately an augmented +flow of blood to the part to furnish the means of repair—a hot iron, +frostbites, acids, or a blow.</p> + +<p>(3) <i>Nerve influence.</i>—This may produce congestion either by acting on +the part reflexly or as the result of some central nerve disturbance +affecting the branch which supplies a given organ.</p> + +<p>(4) <i>Plethora and sanguinary temperament.</i>—Full-blooded animals are +much more predisposed to congestive diseases than those of a lymphatic +character or those in an anemic condition. The circulation in them is +forced to all parts with much greater force and in large quantities. A +well-bred, full-blooded horse is much more subject to congestive +diseases than a common, coarse, or old, worn-out animal.</p> + +<p>(5) <i>Fevers.</i>—In fever the heart works more actively and forces the +current of blood more rapidly; the tissues are weakened, and it requires +but a slight local cause at any part to congest the structures already +overloaded with blood. Again, in certain fevers, we find alteration of +the blood itself, rendering it less or more fluid, which interferes with +its free passage through the vessels and induces a local predisposition +to congestion.<span class='pagenum'><a name="Page_31" id="Page_31">[Pg 31]</a></span></p> + +<p>(6) <i>Warm climate and summer heat.</i>—Warmth of the atmosphere relaxes +the tissues; it demands of the animals less blood to keep up their own +body temperature, and the extra quantity accumulates in the blood-vessel +system. It causes sluggishness in the performance of the organic +functions, and in this way it induces congestion, especially of the +internal organs. So we find founders, congestive colics, and staggers +more frequent in summer than in winter.</p> + +<p>(7) <i>Previous congestion.</i>—Whether the previous congestion of any organ +has been a continuous normal one—that is, a repeated functional +activity—or has been a morbid temporary overloading, it always leaves +the walls of the vessels weakened and more predisposed to recurrent +attacks from accidental causes than are perfectly healthy tissues. Thus +a horse which has had a congestion of the lungs from a severe drive is +liable to have another attack from even a lesser cause.</p> + +<p>The alterations of congestion are distention of the blood vessels, +accumulation of the cellular elements of the blood in them, and effusion +of a portion of the liquid of the blood into the fibrous tissues which +surround the vessels. When the changes produced by congestion are +visible, as in the eye, the nostril, the mouth, the genital organs, and +on the surface of the body in white or unpigmented animals, the part +appears red from the increase of blood; it becomes swollen from the +effusion of liquid into the spongelike connective tissues; it is at +times more or less hot from the increased combustion; the part is +frequently painful to the animal from pressure of the effusion on the +nerves, and the function of the tissue is interfered with. The secretion +or excretion of glands may be augmented or diminished. Muscles may be +affected with spasms or may be unable to contract. The eyes and ears may +be affected with imaginary sights and sounds.</p> + + +<h4>PASSIVE CONGESTION.</h4> + +<p>Passive congestion is caused by interference with the return of the +current of blood from a part.</p> + +<p>Old age and debility weaken the tissues and the force of the +circulation, especially in the veins, and retard the movement of the +blood. We then see horses of this class with stocked legs, swelling of +the sheath of the penis or of the milk glands, and of the under surface +of the belly. We find them also with effusions of the liquid parts of +the blood into the lymph spaces of the posterior extremities and organs +of the pelvic cavity.</p> + +<p>Tumors or other mechanical obstructions, by pressing on the veins, +retard the flow of blood and cause it to back up in distal parts of the +body causing passive congestion.</p> + +<p>The alterations of passive congestion, as in active congestion, consist +of an increased quantity of blood in the vessels and an exudation<span class='pagenum'><a name="Page_32" id="Page_32">[Pg 32]</a></span> of +its fluid into the tissues surrounding them, but in passive congestion +we have a dark, thick blood which has lost its oxygen, instead of the +rich, combustible blood rich in oxygen which is found in active +congestion.</p> + +<p>The termination of congestion is by resolution or inflammation. In the +first case, the choked-up blood vessels find an outlet for the excessive +quantity of blood and are relieved; the transuded serum or fluid of the +blood is reabsorbed, and the part returns almost to its normal +condition, with, however, a tendency to weakness predisposing to future +trouble of the same kind. In the other case further alterations take +place, and we have inflammation.</p> + + +<h4>INFLAMMATION.</h4> + +<h5>(Plates I and II.)</h5> + +<p>Inflammation is a hypernutrition of a tissue. It is described by Dr. +Agnew, the surgeon, as "a double-edged sword, cutting either way for +good or for evil." The increased nutrition may be moderate and cause a +growth of new tissue, a simple increase of quantity at first; or it may +produce a new growth differing in quality; or it may be so great that, +like luxuriant, overgrown weeds, the elements die from their very haste +of growth, and we have immediate destruction of the part. According to +the rapidity and intensity of the process of structural changes which +takes place in an inflamed tissue, inflammation is described as acute or +chronic, with a vast number of intermediate forms. When the phenomena +are marked it is termed sthenic; when less distinct, as the result of a +broken-down and feeble constitution in the animal, it is called +asthenic. Certain inflammations are specific, as in strangles, the +horsepox, glanders, etc., where a characteristic or specific cause or +condition is added to the origin, character of phenomena, or alterations +which result from an ordinary inflammation. An inflammation may be +circumscribed or limited, as in the abscess on the neck caused by the +pressure of a collar, in pneumonia, in glanders, in the small tumors of +a splint or a jack; or it may be diffuse, as in severe fistulas of the +withers, in an extensive lung fever, in the legs in a case of grease, or +in the spavins which affect horses with poorly nourished bones. The +causes of inflammation are practically the same as those of congestion, +which is the initial step of all inflammation.</p> + +<p>The temperament of a horse predisposes the animal to inflammation of +certain organs. A full-blooded animal, whose veins show on the surface +of the body, and which has a strong, bounding heart pumping large +quantities of blood into the vascular organs like the lungs, the +intestines, and the laminæ of the feet, is more liable to have +pneumonia, congestive colics, and founder, than lymphatic, cold-blooded +animals which have pleurisies, inflammation of the bones, spavins, +ringbones, inflammation of the glands of the less vascular skin of the +extremities, greasy heels, thrush, etc.</p> + +<p><a name="PLATE_I" id="PLATE_I"></a></p> + +<div class="figcenter" style="width: 163px;"> +<a href="images/plate1.jpg"><img src="images/plate1t.jpg" width="163" height="450" alt="PLATE I." title="" /></a> +<span class="caption">PLATE I.<br />INFLAMMATION.</span> +</div> + +<p><a name="PLATE_II" id="PLATE_II"></a></p> + +<div class="figcenter" style="width: 267px;"> +<a href="images/plate2.jpg"><img src="images/plate2t.jpg" width="267" height="450" alt="PLATE II." title="" /></a> +<span class="caption">PLATE II.<br />INFLAMMATION.</span> +</div> + + +<p><span class='pagenum'><a name="Page_33" id="Page_33">[Pg 33]</a></span>Young horses have inflammation of the membranes lining the air passages +and digestive tract, while older animals are more subject to troubles in +the closed serous sacs and in the bones.</p> + +<p>The work to which a horse is put (saddle or harness, speed or draft) +will influence the predisposition of an animal to inflammatory diseases. +As in congestion, the functional activity of a part is an important +factor in localizing this form of disease. Given a group of horses +exposed to the same draft of cold air or other exciting cause of +inflammation, the one which has just been eating will be attacked with +an inflammation of the bowels; the one that has just been working so as +to increase its respiration will have an inflammation of the throat, +bronchi, or lungs; the one that has just been using its feet excessively +will have a founder or inflammation of the laminæ of the feet.</p> + +<p>The direct cause of inflammation is usually an irritant of some form. +This may be a pathogenic organism—a disease germ—or it may be +mechanical or chemical, external or internal. Cuts, bruises, injuries of +any kind, parasites, acids, blisters, heat, cold, secretions, such as an +excess of tears over the cheek or urine on the legs, all cause +inflammation by direct injury to the part. Strains or wrenches of +joints, ligaments, and tendons cause trouble by laceration of the +tissue.</p> + +<p>Inflammations of the internal organs are caused by irritants as above, +and by sudden cooling of the surface of the animal, which drives the +blood to that organ which at the moment is most actively supplied with +blood. This is called repercussion. A horse which has been worked at +speed and is breathing rapidly is liable to have pneumonia if suddenly +chilled, while an animal which has just been fed is more liable to have +a congestive colic if exposed to the same influence, the blood in this +case being driven from the exterior to the intestines, while in the +former it was driven to the lungs.</p> + +<p><i>Symptoms.</i>—The symptoms of inflammation are, as in congestion, change +of color, due to an increased supply of blood; swelling, from the same +cause, with the addition of an effusion into the surrounding tissues; +heat, owing to the increased combustion in the part; pain, due to +pressure on the nerves, and altered function. This latter may be +augmented or diminished, or first one and then the other. In addition to +the local symptoms, inflammation always produces more or less +constitutional disturbance or fever. A splint or small spavin will cause +so little fever that it is not appreciable, while a severe spavin, an +inflamed joint, or a pneumonia may give rise to a marked fever.<span class='pagenum'><a name="Page_34" id="Page_34">[Pg 34]</a></span></p> + +<p>The alterations in an inflamed tissue are first those of congestion, +distention of the blood vessels, and exudation of the fluid of the blood +into the surrounding fibers, with, however, a more nearly complete +stagnation of the blood; fibrin, or lymph, a plastic substance, is +thrown out as well, and the cells, which we have seen to be living +organisms in themselves, no longer carried in the current of the blood, +migrate from the vessels and, finding proper nutriment, proliferate or +multiply with greater or lesser rapidity. The cells which lie dormant in +the meshes of the surrounding fibers are awakened into activity by the +nutritious lymph which surrounds them, and they also multiply.</p> + +<p>Whether the cell in an inflamed part is the white ameboid cell of the +blood or the fixed connective tissue embedded in the fibers, it +multiplies in the same way. The nucleus in the center is divided into +two, and then each again into two, ad infinitum. If the process is slow, +each new cell may assimilate nourishment and become, like its ancestor, +an aid in the formation of new tissues; if, however, the changing takes +place rapidly, the brood of young cells have not time to grow or use up +the surrounding nourishment, and, but half developed, they die, and we +then have destruction of tissue, and pus or matter is formed, a material +made up of the imperfect dead elements and the broken-down tissue. +Between the two there is an intermediate form, where we have imperfectly +formed tissues, as in "proud flesh," large, soft splints; fungous +growths, greasy heels, and thrush.</p> + +<p>Whether the inflamed tissue is one like the skin, lungs, or intestines, +very loose in their texture, or a tendon or bone, dense in structure, +and comparatively poor in blood vessels, the principle of the process is +the same. The effects, however, and the appearance may be widely +different. After a cut on the face or an exudation into the lungs, the +loose tissues and multiple vessels allow the proliferating cells to +obtain rich nourishment; absorption can take place readily, and the part +regains its normal condition entirely, while a bruise at the heel or at +the withers finds a dense, inextensible tissue where the multiplying +elements and exuded fluids choke up all communication, and the parts die +(necrose) from want of blood and cause a serious quittor, or fistula.</p> + +<p>This effect of structure of a part on the same process shows the +importance of a perfect knowledge in the study of a local trouble, and +the indispensable part which such knowledge plays in judging of the +gravity of an inflammatory disease, and in formulating a prognosis or +opinion of the final termination of it. It is this which allows the +veterinarian, through his knowledge of the intimate structure of a part +and the relations of its elements, to judge of the severity of a +disease, and to prescribe different modes of treatment in two animals +for troubles<span class='pagenum'><a name="Page_35" id="Page_35">[Pg 35]</a></span> which, to the less experienced observer, appear to be +absolutely identical.</p> + +<p><i>Termination of inflammation.</i>—Like congestion, inflammation may +terminate by resolution. In this case the exuded lymph undergoes +chemical change, and the products are absorbed and carried off by the +blood vessels and lymphatics, to be thrown out of the body by the +kidneys, liver, the glands of the skin, and the other excretory organs. +The cells, which have wandered into the neighboring tissues from the +blood vessels, gradually disappear or become transformed into fixed +cells. Those which are the result of the tissue cells, wakened into +active life, follow the same course. The vessels themselves contract, +and, having resumed their normal caliber, the part apparently reassumes +its normal condition; but it is always weakened, and a new inflammation +is more liable to reappear in a previously inflamed part than in a sound +one. The alternate termination is necrosis, or mortification. If the +necrosis, or death of a part, is gradual, by small stages, each cell +losing its vitality after the other in more or less rapid succession, it +takes the name of ulceration. If it occurs in a considerable part at +once, it is called gangrene. If this death of the tissues occurs deep in +the organism, and the destroyed elements and proliferated and dead cells +are inclosed in a cavity, the result of the process is called an +abscess. When it occurs on a surface, it is an ulcer, and an abscess by +breaking on the exterior becomes then also an ulcer. Proliferating and +dying cells, and the fluid which exudes from an ulcerating surface and +the débris of broken-down tissue is known as pus, and the process by +which this is formed is known as suppuration. A mass of dead tissue in a +soft part is termed a slough, while the same in bone is called a +sequestrum. Such changes are especially liable to occur when the part +becomes infected with microorganisms that have the property of +destroying tissue and thus causing the production of pus. These are +known as pyogenic microorganisms. There are also bacilli that are +capable of multiplying in tissues and so irritating them as to cause +them to die (necrose) without forming pus.</p> + +<p><i>Treatment of inflammation.</i>—The study of the causes and pathological +alterations of inflammation has shown the process to be one of +hypernutrition, attended by excessive blood supply, so this study will +indicate the primary factor to be employed in the treatment of it. Any +agent which will reduce the blood supply and prevent the excessive +nutrition of the elements of the part will serve as a remedy. The means +employed may be used locally to the part, or they may be constitutional +remedies, which act indirectly.</p> + +<p><i>Local treatment.</i>—Removal of the cause will frequently allow the part +to heal at once. Among causes of inflammation may be mentioned a stone +in the frog, causing a traumatic thrush; a badly fitting<span class='pagenum'><a name="Page_36" id="Page_36">[Pg 36]</a></span> harness or +saddle, causing ulcers of the skin; decomposing manure and urine in a +stable, which, by their vapors, irritate the air tubes and lungs and +cause a cough.</p> + +<p>Motion stimulates the action of the blood, and thus feeds an inflamed +tissue. This is alike applicable to a diseased point irritated by +movement to an inflamed pair of lungs surcharged with blood by the use +demanded of them in a working animal, or to an inflamed eye exposed to +light, or an inflamed stomach and intestines still further fatigued by +feed. Rest, absolute quiet, a dark stable, and small quantities of +easily digested feed will often cure serious inflammatory troubles +without further treatment.</p> + +<p>The application of ice bags or cold water by bandages, douching with a +hose, or irrigation with dripping water, contracts the blood vessels, +acts as a sedative to the nerves, and lessens the vitality of a part; it +consequently prevents the tissue change which inflammation produces.</p> + +<p>Either dry or moist heat acts as a derivative. It quickens the +circulation and renders the chemical changes more active in the +surrounding parts; it softens the tissues and attracts the current of +blood from the inflamed organ; it also promotes the absorption of the +effusion and hastens the elimination of the waste products in the part. +Heat may be applied by hand rubbing or active friction and the +application of warm coverings (bandages) or by cloths wrung out of warm +water; or steaming with warm, moist vapor, medicated or not, will answer +the same purpose. The latter is especially applicable to inflammatory +troubles in the air passages.</p> + +<p>Local bleeding frequently affords immediate relief by carrying off the +excessive blood and draining the effusion which has already occurred. It +affords direct mechanical relief, and, by a stimulation of the part, +promotes the chemical changes necessary for bringing the diseased +tissues to a healthy condition. Local blood-letting can be done by +scarifying, or making small punctures into the inflamed part, as in the +eyelid of an inflamed eye, or into the sheath of the penis, or into the +skin of the latter organ when congested, or the leg when acutely +swelled.</p> + +<p>Counterirritants are used for deep inflammations. They act by bringing +the blood to the surface and consequently lessening the blood pressure +within. The derivation of the blood to the exterior diminishes the +amount in the internal organs and is often very rapid in its action in +relieving a congested lung or liver. The most common counterirritant is +mustard flour. It is applied as a soft paste mixed with warm water to +the under surface of the belly and to the sides, where the skin is +comparatively soft and vascular. Colds in the throat or inflammations at +any point demand the treatment applied in the same manner to the belly +and sides and not to the throat<span class='pagenum'><a name="Page_37" id="Page_37">[Pg 37]</a></span> or on the legs, as so often used. +Blisters, iodin, and many other irritants are used in a similar way.</p> + +<p><i>Constitutional treatment</i> in inflammation is designed to reduce the +current of blood, which is the fuel for the inflammation in the diseased +part, to quiet the patient, and to combat the fever or general effects +of the trouble in the system, and to favor the neutralization or +elimination of the products of the inflammation.</p> + +<p>Reduction of blood is obtained in various ways. The diminution of the +quantity of the blood lessens the amount of pressure on the vessels, +and, as a sequel, the volume of it which is carried to the point of +inflammation; it diminishes the body temperature or fever; it numbs the +nervous system, which plays an important part as a conductor of +irritation in diseases.</p> + +<p>Blood-letting is the most rapid means, and frequently acts like a charm +in relieving a commencing inflammatory trouble. One must remember, +however, that the strength of the body and repair depend on the blood; +hence blood-letting should be practiced only in full-blooded, +well-nourished animals and in the early stages of the disease.</p> + +<p>Cathartics act by drawing off a large quantity of fluid from the blood +through the intestines, and have the advantage over the last remedy of +removing only the watery and not the formed elements from the +circulation. The blood cells remain, leaving the blood as rich as it was +before. Again, the glands of the intestines are stimulated to excrete +much waste matter and other deleterious material which may be acting as +a poison in the blood.</p> + +<p>Diuretics operate through the kidneys in the same way.</p> + +<p>Diaphoretics aid depletion of the blood by pouring water in the form of +sweat from the surface of the skin and stimulating the discharge of +waste material out of its glands, which has the same effect on the blood +pressure.</p> + +<p>Antipyretics are remedies to reduce the temperature. This may be +accomplished by depressing the center in the brain that controls heat +production. Some coal-tar products are very effective in this way, but +they have the disadvantage of depressing the heart, which should always +be kept as strong as possible. If they are used it must be with +knowledge of this fact, and it is well to give heart tonics or +stimulants with them. The temperature of the body may be lowered by cold +packs or by showering with cold water. This is a most useful procedure +in many diseases.</p> + +<p>Depressants are drugs which act on the heart. They slow or weaken the +action of this organ and reduce the quantity and force of the current of +the blood which is carried to the point of local disease; they lessen +the vitality of the animal, and for this reason are now used much less +than formerly.<span class='pagenum'><a name="Page_38" id="Page_38">[Pg 38]</a></span></p> + +<p>Anodynes quiet the nervous system. Pain in the horse, as in the man, is +one of the important factors in the production of fever, and the dulling +of the former often prevents, or at least reduces, the latter. Anodynes +produce sleep, so as to rest the patient and allow recuperation for the +succeeding struggle of the vitality of the animal against the exhausting +drain of the disease.</p> + +<p>The diet of an animal suffering from acute inflammation is a factor of +the greatest importance. An overloaded circulation can be starved to a +reduced quantity and to a less rich quality of blood by reducing the +quantity of feed given to the patient. Feeds of easy digestion do not +tire the already fatigued organs of an animal with a torpid digestive +system. Nourishment will be taken by a suffering brute in the form of +slops and cooling drinks when it would be totally refused if offered in +its ordinary form, as hard oats or dry hay, requiring the labor of +grinding between the teeth and swallowing by the weakened muscles of the +jaws and throat.</p> + +<p>Tonics and stimulants are remedies which are used to meet special +indications, as in the case of a feeble heart, and which enter into the +after treatment of inflammatory troubles as well as into the acute +stages of them. They brace up weakened and torpid glands; they stimulate +the secretion of the necessary fluids of the body, and hasten the +excretion of the waste material produced by the inflammatory process; +they regulate the action of a weakened heart; they promote healthy +vitality of diseased parts, and aid the chemical changes needed for +returning the altered tissues to their normal condition.</p> + + +<h4>FEVERS.</h4> + +<p>Fever is a general condition of the animal body in which there is an +elevation of the animal body temperature, which may be only a degree or +two or may be 10° F. The elevation of the body temperature, which +represents tissue change or combustion, is accompanied with an +acceleration of the heart's action, a quickening of the respiration, and +an aberration in the functional activity of the various organs of the +body. These organs may be stimulated to the performance of excessive +work, or they may be incapacitated from carrying out their allotted +tasks, or, in the course of a fever, the two conditions may both exist, +the one succeeding the other. Fever as a disease is usually preceded by +chills as an essential symptom.</p> + +<p>Fevers are divided into essential fevers and symptomatic fevers. In +symptomatic fever some local disease, usually of an inflammatory +character, develops first, and the constitutional febrile phenomena are +the result of the primary point of combustion irritating the whole body, +either through the nervous system or directly by means of the waste +material which is carried into the circulation and through the<span class='pagenum'><a name="Page_39" id="Page_39">[Pg 39]</a></span> blood +vessels, and is distributed to distal parts. Essential fevers are those +in which there is from the outset a general disturbance of the whole +economy. This may consist of an elementary alteration in the blood or a +general change in the constitution of the tissues. Fevers of the latter +class are usually due to some infecting agent and belong, therefore, to +the class of infectious diseases.</p> + +<p>Essential fevers are subdivided into ephemeral fevers, which last but a +short time and terminate by critical phenomena; intermittent fevers, in +which there are alterations of exacerbations of the febrile symptoms and +remissions, in which the body returns to its normal condition or +sometimes to a depressed condition, in which the functions of life are +but badly performed; and continued fevers, which include contagious +diseases, such as glanders, influenza, etc., the septic diseases, such +as pyemia, septicemia, etc., and the eruptive fevers, such as variola, +etc.</p> + +<p>Whether the cause of the fever has been an injury to the tissues, such +as a severe bruise, a broken bone, an inflamed lung, or excessive work, +which has surcharged the blood with the waste products of the combustion +of the tissues, which were destroyed to produce force, or the toxins of +influenza in the blood, or the presence of irritating material, either +in the form of living organisms or of their products, as in glanders or +tuberculosis—the general train of symptoms are much the same, varying +as the amount of the irritant differs in quantity, or when some special +quality in them has a specific action on one or another tissue.</p> + +<p>There is in fever at first a relaxation of the small blood vessels, +which may have been preceded by a contraction of the same if there was a +chill, and as a consequence there is an acceleration of the current of +the blood. There is, then, an elevation of the peripheral temperature, +followed by a lowering of tension in the arteries and an acceleration in +the movement of the heart. These conditions may be produced by a primary +irritation of the nerve centers of the brain from the effects of heat, +as is seen in thermic fever, or sunstroke, or by the entrance into the +blood stream of disease-producing organisms or their chemical products, +as in anthrax, rinderpest, influenza, etc.</p> + +<p>There are times when it is difficult to distinguish between the +existence of fever as a disease and a temporary feverish condition which +is the result of excessive work. Like the condition of congestion of the +lungs, which is normal up to a certain degree in the lungs of a race +horse after a severe race, and morbid when it produces more than +temporary phenomena or when it causes distinct lesions, the temperature +may rise from physiological causes as much as four degrees, so fever, +or, as it is better termed, a feverish condition, may follow any work or +other employment of energy in which excessive tissue<span class='pagenum'><a name="Page_40" id="Page_40">[Pg 40]</a></span> change has taken +place; but if the consequences are ephemeral, and no recognizable lesion +is apparent, it is not considered morbid. This condition, however, may +predispose to severe organic disturbance and local inflammations which +will cause disease, as an animal in this condition is liable to take +cold and develop lung fever or a severe enteritis, if chilled or +otherwise exposed.</p> + +<p>Fever in all animals is characterized by the same general phenomena, but +we find the intensity of the symptoms modified by the species of animals +affected, by the races which subdivide the species, by the families +which form groups of the races, and by certain conditions in individuals +themselves. For example, a pricked foot in a Thoroughbred may cause +intense fever, while the same injury in the foot of a Clydesdale may +scarcely cause a visible general symptom. In the horse, fever produces +the following symptoms:</p> + +<p>The normal body temperature, which varies from 99° to 100° F., is +elevated from 1° to 9°. A temperature of 102° or 103° F. is moderate +fever, 104° to 105° F. is high, and 106° F. and over is excessive. The +temperature is accurately measured by means of a clinical thermometer +inserted in the rectum.</p> + +<p>This elevation of temperature can readily be felt by the hand placed in +the mouth of the animal, or in the rectum, and in the cleft between the +hind legs. It is usually appreciable at any point over the surface of +the body and in the expired air emitted from the nostrils. The ears and +cannons are often as hot as the rest of the body, but are sometimes +cold, which denotes a debility in the circulation and irregular +distribution of the blood. The pulse, which in a healthy horse is felt +beating about 42 to 48 times in the minute, is increased to 60, 70, 90, +or even 100. The respirations are increased from 14 or 16 to 24, 30, 36, +or even more. With the commencement of a fever the horse usually has +diminished appetite, or it may have total loss of appetite if the fever +is excessive. There is, however, a vast difference among horses in this +regard. With the same degree of elevation of temperature one horse may +lose its appetite entirely, while another, usually of the more common +sort, will eat at hay throughout the course of the fever, and will even +continue to eat oats or other grains. Thirst is usually increased, but +the animal desires only a small quantity of water at a time, and in most +cases of fever a bucket of water should be kept standing before the +patient, which may be allowed to drink ad libitum. The skin becomes dry +and the hairs stand on end. Sweating is almost unknown in the early +stage of fevers, but frequently occurs later in their course, when an +outbreak of warm sweat is often a most favorable symptom. The mucous +membranes, which are most easily examined in the conjunctivæ of the eyes +and inside of the mouth, change color if the fever is an<span class='pagenum'><a name="Page_41" id="Page_41">[Pg 41]</a></span> acute one; +without alteration of blood the mucous membranes become of a rosy or +deep-red color at the outset; if the fever is attended with distinct +alteration of the blood, as in influenza, and at the end of two or three +days in severe cases of pneumonia or other extensive inflammatory +troubles the mucous membranes are tinged with yellow, which may even +become a deep ocher in color, the result of the decomposition of the +blood corpuscles and the freeing of their coloring matter, which acts as +a stain. At the outset of a fever the various glands are checked in +their secretions, the salivary glands fail to secrete the saliva, and we +find the surface of the tongue and inside of the cheeks dry and covered +with a brownish, bad-smelling deposit. The excretion from the liver and +intestinal glands is diminished and produces an inactivity of the +digestive organs which causes a constipation. If this is not remedied at +an early period, the undigested material acts as an irritant, and later +we may have it followed by an inflammatory process, producing a severe +diarrhea.</p> + +<p>The excretion from the kidneys is sometimes at first entirely +suppressed. It is always considerably diminished, and what urine is +passed is dark in color, undergoes ammoniacal change rapidly, and +deposits quantities of salts. At a later period the diminished excretion +may be replaced by an excessive excretion, which aids in carrying off +waste products and usually indicates an amelioration of the fever.</p> + +<p>While the ears, cannons, and hoofs of a horse suffering from fever are +usually found hot, they may frequently alternate from hot to cold, or be +much cooler than they normally are. This latter condition usually +indicates great weakness on the part of the circulatory system.</p> + +<p>It is of the greatest importance, as an aid in diagnosing the gravity of +an attack of fever and as an indication in the selection of its mode of +treatment, to recognize the exact cause of a febrile condition in the +horse. In certain cases, in very nervous animals, in which fever is the +result of nerve influence, a simple anodyne, or even only quiet with +continued care and nursing, will sometimes be sufficient to diminish it. +When fever is the result of local injury, the cure of the cause produces +a cessation in the constitutional symptoms. When it is the result of a +pneumonia or other severe parenchymatous inflammation, it usually lasts +for a definite time, and subsides with the first improvement of the +local trouble, but in these cases we constantly have exacerbations of +fever due to secondary inflammatory processes, such as the formation of +small abscesses, the development of secondary bronchitis, or the death +of a limited quantity of tissue (gangrene).</p> + +<p>In specific cases, such as influenza, strangles, and septicemia, there +is a definite poison in the blood-vessel system and carried to the heart +and to the nervous system, which produces a peculiar irritation, usually +lasting for a specific period, during which the temperature can be but +slightly diminished by any remedy.<span class='pagenum'><a name="Page_42" id="Page_42">[Pg 42]</a></span></p> + +<p>In cases attended with complications, the diagnosis at times becomes +still more difficult, as at the end of a case of influenza which becomes +complicated with pneumonia. The high temperature of the simple +inflammatory disease may be grafted on that of the specific trouble, and +the determination of the cause of the fever, as between the two, is +therefore frequently a difficult matter but an important one, as upon it +depends the mode of treatment.</p> + +<p>Any animal suffering from fever, whatever the cause, is much more +susceptible to attacks of local inflammation, which become complications +of the original disease, than are animals in sound health. In fever we +have the tissues and the walls of the blood vessels weakened, we have an +increased current of more or less altered blood flowing through the +vessels and stagnating in the capillaries, which need but an exciting +cause to transform the passive congestion of fever into an active +congestion and acute inflammation. These conditions become still more +distinct when the fever is accompanied with a decided deterioration in +the blood itself, as is seen in influenza, septicemia, and at the +termination of severe pneumonias.</p> + +<p>Fever, with its symptoms of increased temperature, acceleration of the +pulse, acceleration of respiration, dry skin, diminished secretions, +etc., must be considered as an indication of organic disturbance. This +organic disturbance may be the result of local inflammation or other +irritants acting through the nerves on nerve centers, alterations of the +blood, in which a poison is carried to the nerve centers, or direct +irritants to the nerve centers themselves, as in cases of heat stroke, +injury to the brain, etc.</p> + +<p>The treatment of fever depends upon its cause. One of the important +factors in treatment is absolute quiet. This may be obtained by placing +a sick horse in a box stall, away from other animals and extraneous +noises and sheltered from excessive light and drafts of air. Anodynes, +belladonna, hyoscyamus, and opium act as antipyretics simply by quieting +the nervous system. As an irritant exists in the blood in most cases of +fever, any remedy which will favor the excretion of foreign elements +from it will diminish this cause. We therefore use diaphoretics to +stimulate the sweat and excretions from the skin; diuretics to favor the +elimination of matter by the kidneys; cholagogues and laxatives to +increase the action of the liver and intestines, and to drain from these +important organs all the waste material which is aiding to choke up and +congest their rich plexuses of blood vessels. The heart becomes +stimulated to increased action at the outset of a fever, but this does +not indicate increased strength; on the contrary, it indicates the +action of an irritant to the heart that will soon weaken it. It is, +therefore, irrational further to depress the heart by the use of such +drugs as aconite. It is better to strengthen it and to favor the +elimination of the substance that is<span class='pagenum'><a name="Page_43" id="Page_43">[Pg 43]</a></span> irritating it. The increased blood +pressure throughout the body may be diminished by lessening the quantity +of blood. This is obtained in some cases with advantage when the disease +is but starting and the animal is plethoric by direct abstraction of +blood, as in bleeding from the jugular or other veins; or by +derivatives, such as mustard, turpentine, or blisters applied to the +skin; or by setons, which draw to the surface the fluid of the blood, +thereby lessening its volume without having the disadvantage of +impoverishing the elements of the blood found in bleeding. In many cases +antipyretics given by the mouth and cold applied to the skin are most +useful.</p> + +<p>When the irritation which is the cause of fever is a specific one, +either in the form of bacteria (living organisms), as in glanders, +tuberculosis, influenza, septicemia, etc., or in the form of a foreign +element, as in rheumatism, gout, hemaglobinuria, and other so-called +diseases of nutrition, we employ remedies which have been found to have +a direct specific action on them. Among the specific remedies for +various diseases are counted quinin, carbolic acid, salicylic acid, +antipyrene, mercury, iodin, the empyreumatic oils, tars, resins, +aromatics, sulphur, and a host of other drugs, some of which are of +known effect and others of which are theoretical in action. Certain +remedies, like simple aromatic teas, vegetable acids, such as vinegar, +lemon juice, etc., alkalines in the form of salts, sweet spirits of +niter, etc., which are household remedies, are always useful, because +they act on the excreting organs and ameliorate the effects of fever. +Other remedies, which are to be used to influence the cause of fever, +must be selected with judgment and from a thorough knowledge of the +nature of the disease.</p> + + + +<hr style="width: 65%;" /> +<p><span class='pagenum'><a name="Page_44" id="Page_44">[Pg 44]</a></span></p> +<h2>METHODS OF ADMINISTERING MEDICINES.</h2> + +<h3>By <span class="smcap">Ch. B. Michener</span>, V. S.</h3> + +<h4>[Revised by Leonard Pearson, B. S., V. M. D.]</h4> + + +<p>Medicine may enter the body through any of the following designated +channels: First, by the mouth; second, by the air passages; third, by +the skin; fourth, by the tissue beneath the skin (hypodermic methods); +fifth, by the rectum; sixth, by the genito-urinary passages; and, +seventh, by the blood (intravenous injections).</p> + +<p><span class="smcap">By the mouth.</span>—Medicines can be given by the mouth in the form of +solids, as powders or pills; liquids, and pastes, or electuaries.</p> + +<p><i>Powders.</i>—Solids administered as powders should be as finely +pulverized as possible, in order to obtain rapid solution and +absorption. Their action is in this way facilitated and intensified. +Powders must be free from any irritant or caustic action upon the mouth. +Those that are without any disagreeable taste or smell are readily eaten +with the feed or taken in the drinking water. When placed with the feed +they should first be dissolved or suspended in water and thus sprinkled +on the feed. If mixed dry the horse will often leave the medicine in the +bottom of his manger. Nonirritant powders may be given in capsules, as +balls are given.</p> + +<p><i>Pills, or "balls"</i> when properly made, are cylindrical in shape, 2 +inches in length and about three-fourths of an inch in diameter. They +should be fresh, but if necessary to keep them some time they should be +made up with glycerin, or some such agent, to prevent their becoming too +hard. Very old, hard balls are sometimes passed whole with the manure +without being acted upon at all. Paper is sometimes wrapped around balls +when given, if they are so sticky as to adhere to the fingers or the +balling gun. Paper used for this purpose should be thin but firm, as the +tougher tissue papers. Balls are preferred to drenches when the medicine +is extremely disagreeable or nauseating; when the dose is not too large; +when the horse is difficult to drench; or when the medicine is intended +to act slowly. Certain medicines can not or should not be made into +balls, as medicines requiring to be given in large doses, oils, caustic +substances, unless in small dose and diluted and thoroughly mixed with +the vehicle, deliquescent, or efflorescent salts. Substances suitable +for balls can be made up by the addition of honey, sirup, soap, etc., +when required for immediate use. Gelatin capsules of different sizes are +now obtainable and are a convenient means of giving medicines in ball +form.<span class='pagenum'><a name="Page_45" id="Page_45">[Pg 45]</a></span></p> + +<p>When balls are to be given we should observe the following directions: +In shape they should be cylindrical, of the size above mentioned, and +soft enough to be easily compressed by the fingers. If made round or +egg-shaped, if too long or too hard, they are liable to become fixed in +the gullet and cause choking. Balls may be given with the "balling gun" +(obtainable at any veterinary instrument maker's) or by the hand. If +given by the hand a mouth speculum or gag may be used to prevent the +animal from biting the hand or crushing the ball. Always loosen the +horse before attempting to give a ball; if tied he may break his halter +and injure himself or the one giving the ball. With a little practice it +is much easier to give a ball without the mouth gag, as the horse always +fights more or less against having his mouth forced open. The tongue +must be firmly grasped with the left hand and gently pulled forward; the +ball, slightly moistened, is then to be placed with the tips of the +fingers of the right hand as far back into the mouth as possible; as the +tongue is loosened it is drawn back into the mouth and carries the ball +backward with it. The mouth should be kept closed for a minute or two. +We should always have a pail of water at hand to offer the horse after +balling. This precaution will often prevent him from coughing out the +ball or its becoming lodged in the gullet.</p> + +<p><i>Pastes or electuaries</i> are medicines mixed with licorice-root powder, +ground flaxseed, molasses, or sirup to the consistency of honey, or a +"soft solid." They are intended, chiefly, to act locally upon the mouth +and throat. They are given by being spread upon the tongue, gums, or +teeth with a wooden paddle or strong, long-handled spoon.</p> + +<p><i>Liquids.</i>—It is, very often, impossible to get balls properly made, or +to induce owners or attendants to attempt to give them, and for these +reasons medicines by the mouth are mostly given in the form of liquids. +Liquids may be given as drenches when the dose is large, or they may, +when but a small quantity is administered, be injected into the mouth +with a hard-rubber syringe or be poured upon the tongue from a small +vial.</p> + +<p>When medicine is to be given as a drench we must be careful to use water +or oil enough to dissolve or dilute it thoroughly; more than this Wakes +the drench bulky and is unnecessary. Insoluble medicines, if not +irritant or corrosive, may be given simply suspended in water, the +bottle to be well shaken immediately before giving the drench. The +bottle used for drenching purposes should be clean, strong, and smooth +about its neck; it should be without shoulders, tapering, and of a size +to suit the amount to be given. A horn or tin bottle may be better, +because it is not so easily broken by the teeth. If the dose is a small +one the horse's head may be held up by the left hand, while the medicine +is poured into the mouth by the right. The left thumb is to be placed in +the angle of the lower jaw, and the fingers spread<span class='pagenum'><a name="Page_46" id="Page_46">[Pg 46]</a></span> out in such manner +as to support the lower lip. Should the dose be large, the horse ugly, +or the attendant unable to support the head as directed above, the head +is then to be held up by running the tines of a long-handled wooden fork +under the noseband of the halter or the halter strap or a rope may be +fastened to the noseband and thrown over a limb, beam, or through a +pulley suspended from the ceiling. Another way of supporting the head is +to place a loop in the end of a rope, and introduce this loop into the +mouth just behind the upper front teeth or tusks of the upper jaw, the +free end to be run through a pulley, as before described, and held by an +assistant. It is never to be fastened, as the horse might in that case +do himself serious injury. The head is to be elevated just enough to +prevent the horse from throwing the liquid out of his mouth. The line of +the face should be horizontal, or only the least bit higher. If the head +is drawn too high the animal can not swallow with ease or even with +safety. (If this is doubted, just fill your mouth with water, throw-back +the head as far as possible, and then try to swallow.) The person giving +the drench should stand on some object in order to reach the horse's +mouth—on a level, or a little above it. The bottle or horn is then to +be introduced at the side of the mouth, in front of the molar teeth, in +an upward direction. This will cause the horse to open his mouth, when +the base of the bottle is to be elevated, and about 4 ounces of the +liquid allowed to escape on the tongue as far back as possible, care +being taken not to get the neck of the bottle between the back teeth. +The bottle is to be immediately removed, and if the horse does not +swallow this can be encouraged by rubbing the fingers or neck of the +bottle against the roof of the mouth, occasionally removing them. As +soon as this is swallowed repeat the operation until he has taken all +the drench. If coughing occurs, or if, by any mishap, the bottle should +be crushed in the mouth, lower the head immediately.</p> + +<p>Do not rub, pinch, or pound the throat nor draw out the tongue when +giving a drench. These processes in no way aid the horse to swallow and +oftener do harm than good. In drenching, swallowing may be hastened by +pouring into the nose of the horse, while the head is high, a few +teaspoonfuls of clean water, but <i>drenches must never be given through +the nose</i>. Large quantities of medicine given by pouring into the nose +are liable to strangle the animal, or, if the medicine is irritating, it +sets up an inflammation of the nose, fauces, windpipe, and sometimes the +lungs.</p> + +<p><span class="smcap">By the air passages.</span>—Medicines are administered to the lungs and upper +air passages by insufflation, inhalation, injection, and nasal douche.</p> + +<p><i>Insufflation</i> consists in blowing an impalpable powder directly into +the nose. It is but rarely resorted to.<span class='pagenum'><a name="Page_47" id="Page_47">[Pg 47]</a></span></p> + +<p><i>Inhalation.</i>—Gaseous and volatile medicines are given by inhalation, +as is also medicated steam or vapor. Of the gases used there may be +mentioned, as the chief ones, sulphurous acid gas and, occasionally, +chlorin. The animal or animals are to be placed in a tight room, where +these gases are generated until the atmosphere is sufficiently +impregnated with them. Volatile medicines—as the anesthetics (ether, +chloroform, etc.)—are to be given by the attending surgeon only. +Medicated vapors are to be inhaled by placing a bucket containing hot +water, vinegar and water, scalded hay or bran, to which carbolic acid, +iodin, compound tincture of benzoin, or other medicines have been added, +in the bottom of a long grain bag. The horse's nose is to be inserted +into the top of the bag, and he thus inhales the "medicated steam." Care +must be taken not to have it hot enough to scald the animal. The vapor +from scalding bran or hay is often thus inhaled to favor discharges in +sore throat or "distemper."</p> + +<p><i>Injections</i> are made into the trachea by means of a hypodermic syringe. +This method of medication is used for the purpose of treating local +diseases of the trachea and upper bronchial tubes. It has also been used +as a mode of administering remedies for their constitutional effect, but +is now rarely used for this purpose.</p> + +<p><i>The nasal douche</i> is employed by the veterinarian in treating some +local diseases of the nasal chambers. Special appliances and +professional knowledge are necessary when using liquid medicines by this +method. It is not often resorted to, even by veterinary surgeons, since, +as a rule, the horse objects very strongly to this mode of medication.</p> + +<p><span class="smcap">By the skin.</span>—Medicines are often administered to our hair-covered +animals by the skin, yet care must be taken in applying some +medicines—as tobacco water, carbolic-acid solutions, strong creolin +solutions, mercurial ointment, etc.—over the entire body, as poisoning +and death follow in some instances from absorption through the skin. For +the same reasons care must also be exercised and poisonous medicines not +applied over very large raw or abraded surfaces. With domestic animals +medicines are only to be applied by the skin to allay local pain or cure +local disease.</p> + +<p><span class="smcap">By the tissue beneath the skin (hypodermatic method).</span>—Medicines are +frequently given by the hypodermic syringe under the skin. It is not +safe for any but medical or veterinary practitioners to use this form of +medication, since the medicines thus given are powerful poisons. There +are many precautions to be observed, and a knowledge of anatomy is +indispensable. One of the chief precautions has to do with the +sterilization of the syringe. If it is not sterile an abscess may be +produced.</p> + +<p><span class="smcap">By the rectum.</span>—Medicines may be given by the rectum when they can not +be given by the mouth, or when they are not retained in<span class='pagenum'><a name="Page_48" id="Page_48">[Pg 48]</a></span> the stomach; +when we want a local action on the last gut; when it is desired to +destroy the small worms infesting the large bowels or to stimulate the +peristaltic motion of the intestines and cause evacuation. Medicines are +in such cases given in the form of suppositories or as liquid injections +(enemas.) Foods may also be given in this way.</p> + +<p><i>Suppositories</i> are conical bodies made up of oil of theobroma and opium +(or whatever medicine is indicated in special cases), and are introduced +into the rectum or vagina to allay irritation and pain of these parts. +They are not much used in treating horses.</p> + +<p><i>Enemas</i>, when given for absorption, should be small in quantity, +neutral or slightly acid in reaction, and of a temperature of from 90° +to 100° F. These, like feeds given by the rectum, should be introduced +only after the last bowel has been emptied by the hand or by copious +injections of tepid water. Enemas, or clysters, if to aid the action of +physics, should be in quantities sufficient to distend the bowel and +cause the animal to eject them. Simple water, salt and water, or soap +and water, in quantities of a gallon or more, may be given every half +hour. It is best that the horse retain them for some little time, as the +liquid serves to moisten the dung and favors a passage. Stimulating +enemas, as glycerin, should be administered after those already +mentioned have emptied the last bowel, with the purpose of still further +increasing the natural motion of the intestines and aiding the purging +medicine.</p> + +<p>Liquids may be thrown into the rectum by the means of a large syringe or +a pump. A very good "irrigator" can be bought of any tinsmith at a +trifling cost, and should be constantly at hand on every stock farm. It +consists of a funnel about 6 inches deep and 7 inches in diameter, which +is to be furnished with a prolongation to which a piece of rubber hose, +such as small garden hose, 4 feet long may be attached. The hose, well +oiled, is to be inserted gently into the rectum about 2 feet. The liquid +to be injected may then be poured in the funnel and the pressure of the +atmosphere will force it into the bowels. This appliance is better than +the more complicated and expensive ones.</p> + +<p>Ordinary cold water or even ice-cold water is highly recommended by many +as a rectal injection for horses overcome by the excessive heat of +summer, and may be given by this simple pipe.</p> + +<p><span class="smcap">By the genito-urinary passages.</span>—This method of medication is especially +useful in treating local diseases of the genito-urinary organs. It finds +its chief application in the injection and cleansing of the uterus and +vagina. For this purpose a large syringe or the irrigator described +above may be used.</p> + +<p><span class="smcap">By the blood.</span>—Injections directly into veins are to be practiced by +medical or veterinary practitioners only, as are probably some other +means of giving medicines—intratracheal injections, etc.</p> + +<p><a name="PLATE_III" id="PLATE_III"></a></p> +<div class="figcenter" style="width: 450px;"> +<a href="images/plate3.jpg"><img src="images/plate3t.jpg" width="450" height="317" alt="PLATE III." title="" /></a> +<span class="caption">PLATE III.<br />DIGESTIVE APPARATUS.</span> +</div> + + + +<hr style="width: 65%;" /> +<p><span class='pagenum'><a name="Page_49" id="Page_49">[Pg 49]</a></span></p> +<h2>DISEASES OF THE DIGESTIVE ORGANS.</h2> + +<h3>By <span class="smcap">Ch. B. Michener</span>, V. S.</h3> + +<h4>[Revised by John R. Mohler, V. M. D.]</h4> + + +<p>It is not an easy task to write "a plain account of the common diseases, +with directions for preventive measures, hygienic care, and the simpler +forms of medical treatment," of the digestive organs of the horse. Being +limited as to space, the endeavor has been made to give simply an +outline—to state the most important facts—leaving many gaps, and +continually checking the disposition to write anything like a full +description as to cause, prevention, and modes of treatment of diseases.</p> + + +<h4>WATER.</h4> + +<p>It is generally held, at least in practice, that any water that stock +can be induced to drink is sufficiently pure for their use. This +practice occasions losses that would startle us if statistics were at +hand. Water that is impure from the presence of decomposing organic +matter, such as is found in wells and ponds in close proximity to manure +heaps and cesspools, is frequently the cause of diarrhea, dysentery, and +many other diseases of stock, while water that is impregnated with +different poisons and contaminated in very many instances with specific +media of contagion produces death.</p> + +<p>Considering first the quantity of water required by the horse, it may be +stated that when our animals have access to water continually they never +drink to excess. Were the horse subjected to ship voyages or any other +circumstances where he must depend upon his attendant for the supply of +water, it may be roughly stated that he requires a daily average of +about 8 gallons of water. This varies somewhat upon the character of his +feed; if upon green feed, less water will be needed than when fed upon +dry hay and grain.</p> + +<p>The time of giving water should be carefully studied. At rest, the horse +should receive it at least three times a day; when at work, more +frequently. The rule should be to give it in small quantities and often. +There is a popular fallacy that if a horse is warm he should not be +allowed to drink, many asserting that the first swallow of water +"founders" the animal or produces colic. This is erroneous. No matter +how warm a horse may be, it is always entirely safe to allow him from +six to ten swallows of water. If this is given on<span class='pagenum'><a name="Page_50" id="Page_50">[Pg 50]</a></span> going into the +stable, he should have at once a pound or two of hay and allowed to rest +about an hour before feeding. If water is now offered him it will in +many cases be refused, or at least he will drink but sparingly. The +danger, then, is not in the "first swallow" of water, but is due to the +excessive quantity that the animal will take when warm if he is not +restrained.</p> + +<p>Ice-cold water should never be given to horses. It may not be necessary +to add hot water, but we should be careful in placing water troughs +about our barns to have them in such position that the sun may shine +upon the water during the winter mornings. Water, even though it is thus +cold, seldom produces serious trouble if the horse has not been deprived +for a too great length of time.</p> + +<p>In reference to the purity of water, Smith, in his "Veterinary Hygiene," +classes spring water, deep-well water, and upland surface water as +wholesome; stored rain water and surface water from cultivated land as +suspicious; river water to which sewage gains access and shallow-well +water as dangerous. The water that is used so largely for drinking +purposes for stock throughout some States can not but be impure. I refer +to those sections where there is an impervious clay subsoil. It is the +custom to scoop, or hollow out, a large basin in the pastures. During +rains these basins become filled with water. The clay subsoil, being +almost impervious, acts as a jug, and there is no escape for the water +except by evaporation. Such water is stagnant, but would be kept +comparatively fresh by subsequent rains were it not for the fact that +much organic matter is carried into it by surface drainage during each +succeeding storm. This organic matter soon undergoes decomposition, and, +as the result, we find diseases of different kinds much more prevalent +where this water is drunk than where the water supply is wholesome. +Again, it must not be lost sight of that stagnant surface water is much +more certainly contaminated than is running water by one diseased animal +of the herd, thus endangering the remainder.</p> + +<p>The chief impurities of water may be classified as organic and +inorganic. The organic impurities are either animal or vegetable +substances. The salts of the metals are the inorganic impurities. Lime +causes hardness of water, and occasion will be taken to speak of this +when describing intestinal concretions. Salts of lead, iron, and copper +are also frequently found in water; they also will be referred to.</p> + +<p>About the only examination of water that can be made by the average +stock raiser is to observe its taste, color, smell, and clearness. Pure +water is clear and is without taste or smell.</p> + +<p>Chemical and microscopic examination will frequently be necessary in +order to detect the presence of certain poisons, bacteria, etc., and +can, of course, be conducted by experts only.<span class='pagenum'><a name="Page_51" id="Page_51">[Pg 51]</a></span></p> + + +<h4>FEEDS AND FEEDING.</h4> + +<p>In this place one can not attempt anything like a comprehensive +discussion of the subject of feeds and feeding, and I must content +myself with merely giving a few facts as to the different kinds of feed, +preparation, digestibility, proper time of feeding, quality, and +quantity. Improper feeding and watering will doubtless account for more +than one-half the digestive disorders met with in the horse, and hence +the reader can not fail to see how very important it is to have some +proper ideas concerning these subjects.</p> + + +<h4>KINDS OF FEED.</h4> + +<p>In this country horses are fed chiefly upon hay, grass, corn fodder, +roots, oats, corn, wheat, and rye. Many think that they could be fed on +nothing else. Stewart, in "The Stable Book," gives the following extract +from Loudon's Encyclopedia of Agriculture, which is of interest at this +point:</p> + +<div class="blockquot"><p>In some sterile countries they [horses] are forced to subsist +on dried fish, and even on vegetable mold; in Arabia, on milk, +flesh balls, eggs, broth. In India horses are variously fed. +The native grasses are judged very nutritious. Few, perhaps no, +oats are grown; barley is rare, and not commonly given to +horses. In Bengal a vetch, something like the tare, is used. On +the western side of India a sort of pigeon pea, called gram +(<i>Cicer arietinum</i>), forms the ordinary food, with grass while +in season, and hay all the year round. Indian corn or rice is +seldom given. In the West Indies maize, guinea corn, sugar-corn +tops, and sometimes molasses are given. In the Mahratta country +salt, pepper, and other spices are made into balls, with flour +and butter, and these are supposed to produce animation and to +fine the coat. Broth made from sheep's head is sometimes given. +In France, Spain, and Italy, besides the grasses, the leaves of +limes, vines, the tops of acacia, and the seeds of the carob +tree are given to horses.</p></div> + +<p>We can not, however, leave aside entirely here a consideration of the +digestibility of feeds; and by this we mean the readiness with which +they undergo those changes in the digestive canal that fit them for +absorption and deposition as integral parts of the animal economy.</p> + +<p>The age and health of the animal will, of course, modify the +digestibility of feeds, as will also the manner and time of harvesting, +preserving, and preparing.</p> + +<p>In the horse digestion takes place principally in the intestines, and +here, as in all other animals and with all feeds, it is found that a +certain part only of the provender is digested; another portion is +undigested. This proportion of digested and undigested feed must claim +passing notice at least, for if the horse receives too much feed, or +bulky feed containing much indigestible waste, a large portion of it +must pass out unused, entailing not only the loss of this unused feed, +but also calling for an unnecessary expenditure of vital force on<span class='pagenum'><a name="Page_52" id="Page_52">[Pg 52]</a></span> the +part of the digestive organs of the horse. It is thus that, in fact, too +much feed may make an animal poor.</p> + +<p>In selecting feed for the horse we should remember the anatomical +arrangement of the digestive organs, as well as the physiological +functions performed by each one of them. Feeds must be wholesome, clean, +and sweet, the hours of feeding regular, the mode of preparation found +by practical experience to be the best must be adhered to, and +cleanliness in preparation and administration must be observed.</p> + +<p>The length of time occupied by stomach digestion in the horse varies +with the different feeds. Hay and straw pass out of the stomach more +rapidly than oats. It would seem to follow, then, that oats should be +given after hay, for if reversed the hay would cause the oats to be sent +onward into the intestines before being fully acted upon by the stomach, +and as a result produce indigestion. Experience confirms this. There is +another good reason why hay should be given first, particularly if the +horse is very hungry or if exhausted from overwork, namely, it requires +more time in mastication (insuring proper admixture of saliva) and can +not be bolted, as are the grains. In either instance water must not be +given soon after feeding, as it washes or sluices the feed from the +stomach before it is fitted for intestinal digestion.</p> + +<p>The stomach begins to empty itself very soon after the commencement of +feeding, and continues rapidly while eating. Afterwards the passage is +slower, and several hours are required before the stomach is entirely +empty. The nature of the work required of the horse must guide us in the +selection of his feed. Rapid or severe labor can not be performed on a +full stomach. For such labor feed must be given in small quantity and +about two hours before going to work. Even horses intended for slow work +must never be engorged with bulky, innutritious feed immediately before +going to labor. The small stomach of the horse would seem to lead us to +the conclusion that he should be fed in small quantities and often, +which, in reality, should be done. The disproportion between the size of +the stomach and the quantity of water drunk tells us plainly that the +horse should always be watered before feeding. One of the common errors +of feeding, and the one that produces more digestive disorders than any +other, is <i>to feed too soon after a hard day's work</i>. This must never be +done. If a horse is completely jaded, it will be found beneficial to +give him an alcoholic stimulant on going into the stable. A small +quantity of hay may then be given, but his grain should be withheld for +one or two hours. These same remarks will apply with equal force to the +horse that for any reason has been fasting for a long time. After a +fast, feed less than the horse would eat, for if allowed too much the +stomach becomes engorged, its walls paralyzed, and "colic" is almost +sure to follow. The horse should be fed<span class='pagenum'><a name="Page_53" id="Page_53">[Pg 53]</a></span> three or four times a day. It +will not do to feed him entirely upon concentrated feed. Bulky feed must +be given to detain the grains in their passage through the intestinal +tract; bulk also favors distention, and thus mechanically aids +absorption. For horses that do slow work the greater part of the time, +chopped or cut hay fed with crushed oats, ground corn, etc., is the best +manner of feeding, as it gives the required bulk, saves time, and half +the labor of feeding.</p> + +<p>Sudden changes of diet are always dangerous. When desirous of changing, +do so very gradually. If a horse is accustomed to oats, a sudden change +to a full meal of corn will almost always sicken him. If we merely +intend to increase the quantity of the <i>usual</i> feed, this also must be +done gradually. The quantity of feed given must always be in proportion +to the amount of labor to be performed. If a horse is to do a small +amount of work, or rest entirely from work for a few days, he should +receive a proportionate quantity of feed. If this should be observed +even on Saturday night and Sunday, there would be fewer cases of "Monday +morning sickness," such as colics and lymphangitis.</p> + +<p>Feeds should also be of a more laxative nature when the horse is to +stand for several days.</p> + +<p><span class="smcap">Musty or moldy feeds.</span>—Above all things, avoid feeding musty or moldy +feeds. They are very frequent causes of disease of different kinds. Lung +trouble, such as bronchitis and "heaves," often follows their use. The +digestive organs always suffer from moldy or musty feeds. Musty hay is +generally considered to produce disorder of the kidneys, and all know of +the danger from feeding pregnant animals upon ergotized grasses or +grains. It has often been said to produce that peculiar disease known +variously as cerebrospinal meningitis, putrid sore throat, or choking +distemper.</p> + +<p><span class="smcap">Hay.</span>—The best hay for horses is timothy. It should be about one year +old, of a greenish color, crisp, clean, fresh, and possessing a sweet, +pleasant aroma. Even this good hay, if kept too long, loses part of its +nourishment, and, while it may not be positively injurious, it is hard, +dry, and indigestible. New hay is difficult to digest, produces much +salivation (slobbering), and occasional purging and irritation of the +skin. If fed at all it should be mixed with old hay.</p> + +<p><i>Second crop, or aftermath.</i>—This is not considered good hay for +horses, but it is prized by some farmers as good for milch cows, the +claim being made that it increases the flow of milk. The value of hay +depends upon the time of cutting, as well as care in the curing. Hay +should be cut when in full flower, but before the seeds fall; if left +longer it becomes dry, woody, and lacks in nutrition.<span class='pagenum'><a name="Page_54" id="Page_54">[Pg 54]</a></span> An essential +point in making hay is that when the crop is cut it should remain in the +field as short a time as possible. If left too long in the sun it loses +color, flavor, and dries or wastes. Smith asserts that one hour more +than is necessary in the sun causes a loss of 15 to 20 per cent in the +feeding value of hay. It is impossible to state any fixed time that hay +must have to cure, this depending, of course, upon the weather, +thickness of the crop, and many other circumstances; but it is well +known that in order to preserve the color and aroma of hay it should be +turned or tedded frequently and cured as quickly as possible. On the +other hand, hay spoils in the mow if harvested too green or when not +sufficiently dried. Mow-burnt hay produces disorder of the kidneys and +bowels and causes the horse to fall off in condition.</p> + +<p>The average horse on grain should be allowed from 10 to 12 pounds of +good hay a day. It is a mistake of many to think that horses at light +work can be kept entirely on hay. Such horses soon become potbellied, +fall off in flesh, and do not thrive. The same is true of colts; unless +the latter are fed with some grain they grow up to be long, lean, gawky +creatures, and never make so good horses as those accustomed to grain +with, or in addition to, their hay.</p> + +<p><span class="smcap">Straw.</span>—The straws are not extensively fed in this country, and when +used at all they should be cut and mixed with hay and ground or crushed +grain. Wheat, rye, and oat straw are the ones most used; of these, oat +straw is most easily digested and contains the most nourishment. Pea and +bean straw are occasionally fed to horses, the pea being preferable, +according to most writers.</p> + +<p><span class="smcap">Chaff.</span>—Wheat and rye chaff should never be used as a feed for horses. +The beards frequently become lodged in the mouth or throat and are +productive of more or less serious trouble. In the stomach and +intestines they often serve as the nucleus of the "soft concretions," +which are to be described when treating of obstructions of the digestive +tract.</p> + +<p>Oat chaff, if fed in small quantities and mixed with cut hay or corn +fodder, is very much relished by horses. It is not to be given in large +quantities, as I have repeatedly witnessed a troublesome and sometimes +fatal diarrhea following the practice of allowing horses or cattle free +access to a pile of oat chaff.</p> + +<p><span class="smcap">Grains.</span>—Oats take precedence of all grains as a feed for horses, as the +ingredients necessary for the complete nutrition of the body exist in +them in the best proportions. Oats are, besides, more easily digested +and a larger proportion absorbed and converted into the various tissues +of the body. Care must be taken in selecting oats. According to Stewart, +the best oats are one year old, plump, short, hard, clean, bright, and +sweet. New oats are indigestible. Kiln-dried<span class='pagenum'><a name="Page_55" id="Page_55">[Pg 55]</a></span> oats are to be refused, as +a rule, for even though originally good this drying process injures +them. Oats that have sprouted or fermented are injurious and should +never be fed. Oats are to be given either whole or crushed—whole in the +majority of instances; crushed to old horses and those having defective +teeth. Horses that bolt their feed are also best fed upon crushed oats +and out of a manger large enough to permit of spreading the grain in a +thin layer.</p> + +<p>In addition to the allowance of hay above mentioned, the average horse +requires about 12 quarts of good oats daily. The best oats are those cut +about one week before they are fully ripe. Not only is the grain richer +in nutritive materials at this time, but there is also less waste from +"scattering" than if left to become dead ripe. Moldy oats, like hay and +straw, not only produce serious digestive disorders but have been the +undoubted cause of outbreaks of that dread disease in horses, already +referred to, characterized by inability to eat or drink, sudden +paralysis, and death.</p> + +<p><span class="smcap">Wheat and rye.</span>—These grains are not to be used for horses except in +small quantities, bruised or crushed, and fed mixed with other grains or +hay. If fed alone, in any considerable quantities, they are almost +certain to produce digestive disorders, laminitis (founder), and similar +troubles. They should never constitute more than one-fourth the grain +allowance, and should always be ground or crushed.</p> + +<p><span class="smcap">Bran.</span>—The bran of wheat is the one most used, and its value as a +feeding stuff is variously estimated. It is not to be depended upon if +given alone, but may be fed with other grains. It serves to keep the +bowels open. Sour bran is not to be given, for it disorders the stomach +and intestines and may even produce serious results.</p> + +<p><span class="smcap">Maize (corn).</span>—This grain is not suitable as an exclusive feed for young +horses, as it is deficient in salts. It is fed whole or ground. Corn on +the cob is commonly used for horses affected with "lampas." If the corn +is old and is to be fed in this manner it should be soaked in pure, +clean water for 10 or 12 hours. Corn is better given ground, and fed in +quantities of from 1 to 2 quarts at a meal, mixed with crushed oats or +wheat bran. Great care should be taken in giving corn to a horse that is +not accustomed to its use. It must be commenced in small quantities and +very gradually increased. I know of no grain more liable to produce what +is called acute indigestion than corn if these directions are not +observed.</p> + +<p><span class="smcap">Linseed.</span>—Ground linseed is occasionally fed with other feeds to keep +the bowels open and to improve the condition of the skin. It is of +particular service during convalescence, when the bowels are sluggish in +their action. Linseed tea is very often given in irritable or inflamed +conditions of the digestive organs.<span class='pagenum'><a name="Page_56" id="Page_56">[Pg 56]</a></span></p> + +<p><span class="smcap">Potatoes.</span>—These are used as an article of feed for the horse in many +sections. If fed raw and in large quantities they often produce +indigestion. Their digestibility is increased by steaming or boiling. +They possess, in common with other roots, slight laxative properties.</p> + +<p><span class="smcap">Beets.</span>—These are not much used as feed for horses.</p> + +<p><span class="smcap">Carrots.</span>—These make a most excellent feed, particularly during +sickness. They improve the appetite and slightly increase the action of +the bowels and kidneys. They possess also certain alterative properties, +making the coat smooth and glossy. Some veterinary writers assert that +chronic cough is cured by giving carrots for some time. The roots may be +considered, then, as an adjunct to the regular regimen, and if fed in +small quantities are highly beneficial.</p> + +<p><span class="smcap">Grasses.</span>—Grass is the natural food of horses. It is composed of a great +variety of plants, differing widely as to the amount of nourishment +contained, some being almost entirely without value and only eaten when +nothing else is obtainable, while others are positively injurious, or +even poisonous. None of the grasses are sufficient to keep the horse in +condition for work. Horses thus fed are "soft," sweat easily, purge, and +soon tire on the road or when at hard work. Grass is indispensable to +growing stock, and there is little or no doubt that it acts as an +alterative when given to horses accustomed to grain and hay. It must be +given to such horses in small quantities at first. The stomach and +intestines undergo rest, and recuperate if the horse is turned to grass +for a time each year. It is also certain that during febrile diseases +grass acts almost as a medicine, lessening the fever and favoring +recovery. Wounds heal more rapidly than when the horse is on grain, and +some chronic disorders (chronic cough, for instance) disappear entirely +when at grass. In my experience, grass does more good when the horse +crops it himself. This may be due to the sense of freedom he enjoys at +pasture, to the rest to his feet and limbs, and for many other similar +reasons. When cut for him it should be fed fresh or when but slightly +wilted.</p> + +<p><span class="smcap">Silage.</span>—Regarding silage as a feed for horses, Rommel in Farmers' +Bulletin 578 writes as follows:</p> + +<div class="blockquot"><p>Silage has not been generally fed to horses, partly on account +of a certain amount of danger which attends its use for this +purpose, but still more, perhaps, on account of prejudice. In +many cases horses have been killed by eating moldy silage, and +the careless person who fed it at once blamed the silage +itself, rather than his own carelessness and the mold which +really was the cause of the trouble. Horses are peculiarly +susceptible to the effects of molds, and under certain +conditions certain molds grow on silage which are deadly +poisons to both horses and mules. Molds must have air to grow, +and therefore silage which is packed air-tight and fed out +rapidly will not become moldy. If the feeder watches the silage +carefully as the weather warms up he can soon detect the +presence of mold. When mold appears, feeding to horses or mules +should stop immediately.<span class='pagenum'><a name="Page_57" id="Page_57">[Pg 57]</a></span></p> + +<p>It is also unsafe to feed horses frozen silage on account of +the danger of colic. * * *</p> + +<p>To summarize, silage is safe to feed to horses and mules only +when it is made from fairly mature corn, properly stored in the +silo. When it is properly stored and is not allowed to mold, no +feed exceeds it as a cheap winter ration. It is most valuable +for horses and mules which are not at heavy work, such as brood +mares and work horses during the slack season. With plenty of +grain on the cornstalks, horses will keep in good condition on +a ration of 20 pounds of silage and 10 pounds of hay for each +1,000 pounds of live weight.</p></div> + + +<h4>PREPARATION OF FEEDS.</h4> + +<p>Feed is prepared for any of the following reasons: To render it more +easily eaten; to make it more digestible; to economize in amount; to +give it some new property; and to preserve it. We have already spoken of +the preparation of drying, and need not revert to this again, as it only +serves to preserve the different feeds. Drying does, however, change +some of the properties of feed, <i>i. e.</i>, removes the laxative tendency +of most of them.</p> + +<p>The different grains are more easily eaten when ground, crushed, or even +boiled. Rye or wheat should never be given whole, and even of corn it is +found that there is less waste when ground, and, in common with all +other grains, it is more easily digested than when fed whole.</p> + +<p>Hay and fodder are economized when cut in short pieces. Not only will +the horse eat the necessary quantity in a shorter time, but it will be +found that there is less waste, and the mastication of the grains (whole +or crushed) fed with them is insured.</p> + +<p>Reference has already been made to those horses that bolt their feed, +and we need only remark here that the consequences of such ravenous +eating may be prevented if the grains are fed with cut hay, straw, or +fodder. Long or uncut hay should also be fed, even though a certain +quantity of hay or straw is cut and fed mixed with grain.</p> + +<p>One objection to feeding cut hay mixed with ground or crushed grains, +and wetted, must not be overlooked during the hot months. Such feed is +liable to undergo fermentation if not fed directly after it is mixed; +even the mixing trough, unless frequently scalded and cleaned, becomes +sour and enough of its scrapings are given with the feed to produce +flatulent (wind) colic. A small quantity of salt should always be mixed +with such feed. Bad hay should never be cut simply because it insures a +greater consumption of it; bad feeds are dear at any price, and should +never be fed.</p> + +<p>The advantage of boiling roots has been mentioned. Not only does this +render them less liable to produce digestive disorders, but it also +makes them clean. Boiling or steaming grains is to be recommended when +the teeth are poor, or when the digestive organs are weak.<span class='pagenum'><a name="Page_58" id="Page_58">[Pg 58]</a></span></p> + + +<h4>DISEASES OF THE TEETH.</h4> + +<p><i>Dentition.</i>—This covers the period during which the young horse is +cutting his teeth—from birth to the age of 5 years. With the horse more +difficulty is experienced in cutting the second or permanent teeth than +with the first or milk teeth. There is a tendency among farmers and many +veterinarians to pay too little attention to the teeth of young horses. +Percivall relates an instance illustrative of this that is best told in +his own words:</p> + +<div class="blockquot"><p>I was requested to give my opinion concerning a horse, then in +his fifth year, who had fed so sparingly for the last +fortnight, and so rapidly declined in condition in consequence, +that his owner, a veterinary surgeon, was under no light +apprehensions about his life. He had himself examined his mouth +without having discovered any defect or disease, though another +veterinary surgeon was of opinion that the difficulty or +inability manifested in mastication, and the consequent +cudding, arose from preternatural bluntness of the surfaces of +the molar teeth, which were, in consequence, filed, but without +beneficial result. It was after this that I saw the horse, and +I confess I was, at my first examination, quite as much at a +loss to offer any satisfactory interpretation as others had +been. While meditating, however, after my inspection, on the +apparently extraordinary nature of the case, it struck me that +I had not seen the tusks. I went back into the stable and +discovered two little tumors, red and hard, in the situation of +the inferior tusks, which, when pressed, gave the animal +insufferable pain. I instantly took out my pocketknife and made +crucial incisions through them both, down to the coming teeth, +from which moment the horse recovered his appetite and, by +degrees, his wonted condition.</p></div> + +<p>The mouths of young horses should be examined from time to time to see +whether one or more of the milk teeth are not remaining too long, +causing the second teeth to grow in crooked, in which case the first +teeth should be removed with the forceps.</p> + +<p><i>Irregularities of teeth.</i>—There is a fashion of late years, especially +in large cities, to have horses' teeth regularly "floated," or "rasped," +by "veterinary dentists." In some instances this is very beneficial, +while in most cases it is entirely unnecessary. From the character of +the feed, the rubbing, or grinding, surface of the horse's teeth should +be rough. Still, we must remember that the upper jaw is somewhat wider +than the lower, and that, from the fact of the teeth not being perfectly +apposed, a sharp ridge is left unworn on the inside of the lower molars +and on the outside of the upper, which may excoriate the tongue or +cheeks to a considerable extent. This condition may readily be felt by +the hand, and these sharp ridges when found should be rasped down by a +guarded rasp. In some instances the first or last molar tooth is +unnaturally long, owing to the fact that its fellow in the opposite jaw +has been lost or does not close perfectly against it. Should it be the +last molar that is thus elongated, it will require the aid of the +veterinary surgeon, who has the necessary forceps or chisel for cutting +it. The front molar may be rasped down, if much patience is taken. In +decay of the teeth it is quite common to find the tooth corresponding to +the decayed one on the opposite jaw very much elongated, sometimes to +such an extent that the mouth can not be perfectly closed. Such teeth +must also be shortened by the tooth forceps, chisel, tooth saw, or rasp. +In all instances in which horses "quid" their feed, if they are +slobbering, or evince pain in mastication, shown by holding the head to +one side while chewing, the teeth should be carefully examined. Horses +whose teeth have unduly sharp edges are liable to drive badly; they pull +to one side, do not bear on the bit, or bear on too hard and "big," toss +the head, and start suddenly when a tender spot is touched. If, as is +mostly the case, all the symptoms are referable to sharp corners or +projections, these must be removed by the rasp. If decayed teeth ere +found, or other serious difficulty detected, or if the cause of the +annoying symptoms is not discovered, an expert should be called.</p> + +<p><a name="PLATE_IV" id="PLATE_IV"></a></p> +<div class="figcenter" style="width: 448px;"> +<a href="images/plate4.jpg"><img src="images/plate4t.jpg" width="448" height="450" alt="PLATE IV." title="" /></a> +<span class="caption">PLATE IV.<br /> + +Age of Horses as Indicated by Teeth.<br /><br /> + +Longitudinal section of left central lower incisor and cross sections of +same tooth showing table surfaces as they appear at the ages of 3, 5, 7, +9, 15, 20 and 25 years. C, Cement; D, Dentine; E, Enamel; I, +Infundibulum; K, Cup; P, Pulp Cavity; S, Star.</span> +</div> + +<p><span class='pagenum'><a name="Page_59" id="Page_59">[Pg59]</a></span><i>Toothache.</i>—This is rare in the horse and is mostly witnessed when +there is decay of a tooth or inflammation about its root. Toothache is +to be discovered in the horse by the pain expressed by him while feeding +or drinking cold water. I have seen horses, affected with toothache, +that would suddenly stop chewing, throw the head to one side, and +slightly open the mouth. They behave as though some sharp body had +punctured the mouth. If upon examination, no foreign body is found, we +must then carefully examine each tooth. If this can not be done with the +hand in the mouth, we can, in most instances, discover the aching tooth +by pressing each tooth from without. By tapping the teeth in succession +with a hard object, such as a small hammer, the one that is tender may +be identified. The horse will flinch when the sore tooth is pressed or +tapped upon. In most cases there is nothing to be done but extract the +decayed tooth, and this, of course, is to be attempted by the +veterinarian only.</p> + +<p><i>Deformity.</i>—There is a deformity, known as parrot-mouth, that +interferes with prehension, mastication, and, indirectly, with +digestion. The upper incisors project in front of and beyond the lower +ones. The teeth of both jaws become unusually long, as they are not worn +down by friction. Such horses experience much difficulty in grazing. +Little can be done except to examine the teeth occasionally, and if +those of the lower jaw become so long that they bruise the "bars" of the +upper jaw, they must be shortened by the rasp or saw. Horses with this +deformity should never be left entirely at pasture.</p> + +<p>The method of determining the age of a horse by the teeth is illustrated +in Plate IV.<span class='pagenum'><a name="Page_60" id="Page_60">[Pg 60]</a></span></p> + + +<h4>DISEASES OF THE MOUTH.</h4> + + +<h5>LAMPAS.</h5> + +<p>Lampas is the name given to a swelling of the mucous membrane covering +the hard palate and projecting in a more or less prominent ridge +immediately behind the upper incisors. The hard palate is composed of +spongy tissue that fills with blood when the horse is feeding, which +causes the ridges to become prominent, and they then help to keep feed +from dropping from the mouth. This swelling is entirely natural and +occurs in every healthy horse. Where there is some irritation in the +mouth, as in stomatitis or during teething, the prominence of the hard +palate may persist, owing to the increased blood supply. In such cases +the cause of the irritation should be nought for and removed. By way of +direct treatment, slight scarification is the most that will be +required. Burning the lampas is barbarous and injurious, and it should +never be tolerated.</p> + +<p>It is a quite common opinion among owners of horses and stablemen that +lampas is a disease that very frequently exists. In fact whenever a +horse fails to eat, and if he does not exhibit very marked symptoms of a +severe illness, they say at once "he has the lampas." It is almost +impossible to convince them to the contrary; yet it is not the case. It +may be put down, then, as an affliction of the stable-man's imagination +rather than of the horse's mouth.</p> + + +<h5>STOMATITIS.</h5> + +<p>Stomatitis is an inflammation of the mucous membrane lining the mouth +and is produced by irritating medicines, feeds, or other substances. The +symptoms are swelling of the mouth, which is also hot and painful to the +touch; there is a copious discharge of saliva; the mucous membrane is +reddened, and in some cases vesicles or ulcers in the mouth are +observed. The treatment is simple, soft feed alone often being all that +is necessary. A bucket of fresh, cold water should be kept constantly in +the manger so that the horse may drink or rinse his mouth at will. In +some instances, it may be advisable to use a wash of chlorate of potash, +borax, or alum, about one-half ounce to a pint of water. Hay, straw, or +oats should not be fed unless steamed or boiled. A form of contagious +stomatitis, characterized by the formation within the mouth of small +vesicles, or blisters, sometimes occurs. In this disease the horse +should be isolated from other horses, and his stall, especially the feed +box, and his bit should be disinfected.</p> + + +<h5>GLOSSITIS (INFLAMMATION OF THE TONGUE).</h5> + +<p>Glossitis, or inflammation of the tongue, is very similar to stomatitis, +and mostly exists with it and is due to the same causes. Injuries to the +tongue may produce this simple inflammation of its covering<span class='pagenum'><a name="Page_61" id="Page_61">[Pg 61]</a></span> membrane, +or, if severe, may produce lesions much more extensive, such as +lacerations, abscesses, etc. These latter would require surgical +treatment, but for the simpler forms of inflammation of the tongue the +treatment recommended for stomatitis should be followed.</p> + + +<h5>SALIVATION (PTYALISM).</h5> + +<p>Ptyalism, or salivation, consists in an abnormal and excessive secretion +of saliva. This is often seen as a symptom of irregular teeth; +inflammation of the mouth or tongue, or of the use of such medicines as +lobelia, mercury, and many others. Some feeds, such as clover, and +particularly second crop, produce it; foreign bodies, such as nails, +wheat chaff, and corncobs becoming lodged in the mouth, also are causes. +If the cause is removed no further attention is necessary, as a rule. +Astringent washes may be applied to the mouth as a gargle or by means of +a sponge.</p> + + +<h5>PHARYNGITIS.</h5> + +<p>Pharyngitis is an inflammation of the mucous membrane lining of the +pharynx or throat. It rarely exists unless accompanied with stomatitis +or laryngitis, especially the latter. In those rare instances in which +the inflammation is mostly confined to the pharynx are noticed febrile +symptoms—difficulty of swallowing either liquids or solids; there is +but little cough except when trying to swallow; there is no soreness on +pressure over larynx (head of the windpipe). Increased flow of saliva, +difficulty of swallowing liquids in particular, and cough only when +attempting to swallow, are the symptoms best marked in pharyngitis. In +some cases the throat becomes gangrenous and the disease ends in death. +For treatment a wet sheet should be wrapped around the throat and +covered with rubber sheeting and a warm blanket. This should be changed +three times daily; or the region of the throat may be rubbed with +mercurial ointment twice daily until the skin becomes irritated, but no +longer; chlorate of potash may be given in 2-dram doses four times +daily, mixed with flaxseed meal or licorice-root powder and honey, as an +electuary. Soft feeds should be given, and fresh water should be +constantly before the horse.</p> + + +<h5>PARALYSIS OF THE PHARYNX.</h5> + +<p>Paralysis of the pharynx, or, as it is commonly called, "paralysis of +the throat," is a rare but very serious disease. The symptoms are as +follows: The horse will constantly try to eat or drink, but will be +unable to do so; if water is offered him from a pail he will apparently +drink with avidity, but the quantity of water in the pail will remain +about the same; he will continue by the hour to try to drink; if he can +get any fluid into the back part of the mouth it will come out at once +through the nose. Feeds also return through the<span class='pagenum'><a name="Page_62" id="Page_62">[Pg 62]</a></span> nose, or are dropped +from the mouth, quidded. An examination of the mouth by inserting the +hand fails to find any obstruction or any abnormal condition. These +cases go on from bad to worse; the horse constantly and rapidly loses in +condition, becomes very much emaciated, the eyes are hollow and +lusterless, and death occurs from inanition.</p> + +<p>Treatment is very unsatisfactory. A severe blister should be applied +behind and under the jaw; the mouth is to be frequently swabbed out with +alum or chlorate of potash, 1 ounce to a pint of water, by means of a +sponge fastened to the end of a stick. Strychnia may be given in 1-grain +doses two or three times a day.</p> + +<p>This disease may be mistaken at times for foreign bodies in the mouth or +for the so-called cerebrospinal meningitis. It is to be distinguished +from the former, upon a careful examination of the mouth, by the absence +of any offending body and by the flabby feel of the mouth, and from the +latter by the animal appearing in perfect health in every particular +except this inability to eat or drink.</p> + + +<h5>ABSCESSES.</h5> + +<p>Abscesses sometimes form back of the pharynx and give rise to symptoms +resembling those of laryngitis or distemper. Interference with breathing +that is of recent origin and progression, without any observable +swelling or soreness about the throat, will make one suspect the +formation of an abscess in this location. But little can be done in the +way of treatment, save to hurry the ripening of the abscess and its +discharge by steaming with hops, hay, or similar substances and by +poulticing the throat. The operation for opening an abscess in this +region necessitates an intimate knowledge of the complex anatomy of the +throat region.</p> + + +<h4>DISEASES OF THE ESOPHAGUS OR GULLET.</h4> + +<p>It is rare to find diseases of this organ, except as a result of the +introduction of foreign bodies too large to pass or to the administering +of irritating medicines. In the administration of irritant or caustic +medicines great care should be taken that they be thoroughly diluted. If +this is not done, erosions and ulcerations of the throat ensue, and this +again is prone to be followed by constriction (narrowing) of the gullet.</p> + + +<h5>CHOKING.</h5> + +<p>The mechanical trouble of choking is quite common. It may occur when the +animal is suddenly startled while eating apples or roots, and we should +be careful never to approach suddenly or put a dog after horses or cows +that are feeding upon such substances. If left alone these animals very +rarely attempt to swallow the object until it is sufficiently +masticated.<span class='pagenum'><a name="Page_63" id="Page_63">[Pg 63]</a></span></p> + +<p>Choking also arises from feeding oats in a deep, narrow manger to such +horses as eat very greedily or bolt their feed. Wheat chaff is also a +frequent cause of choke. This accident may result from the attempts to +force eggs down without breaking or from giving balls that are too large +or not of the proper shape.</p> + +<p>Whatever object causes the choking, it may lodge in the upper part of +the esophagus, at its middle portion, or close to the stomach, giving +rise to the designations of pharyngeal, cervical, and thoracic choke. In +some cases where the original obstruction is low we find all that part +of the gullet above it to be distended with feed.</p> + +<p><i>Symptoms.</i>—The symptoms vary somewhat according to the position of the +body causing choke. In pharyngeal choke the object is lodged in the +upper portion of the esophagus. The horse will present symptoms of great +distress, hurried breathing, frequent cough, excessive flow of saliva, +sweating, trembling, or stamping with the fore feet. The abdomen rapidly +distends with gas. The diagnosis is completed by manipulating the upper +part of the throat from without and by the introduction of the hand into +the back part of the mouth, finding the body lodged here. In cervical +choke (where the obstruction is situated at any point between the +throatlatch and the shoulder) the protrusion caused by the object can be +seen and the object can be felt. The symptoms here are not so severe; +the horse will be seen occasionally to draw himself up, arch his neck, +and make retching movements as though he wished to vomit. The abdomen +may be tympanitic. Should there be any question as to the trouble, a +conclusion may be reached by pouring water into the throat from a +bottle. If the obstruction is complete, by standing on the left side of +the horse and watching the course of the esophagus, you can see the +gullet, just above the windpipe, become distended with each bottle of +water. This is not always a sure test, as the obstruction may be an +angular body, in which case liquids would pass it. Solids taken would +show in these cases; solids should not, however, be given, as they serve +to increase the trouble by rendering the removal of the body more +difficult.</p> + +<p>In thoracic choke the symptoms are less severe. Feed or water may be +ejected through the nose or mouth after the animal has taken a few +swallows. There will be some symptoms of distress, fullness of the +abdomen, cough, and occasionally retching movements. Sometimes a choking +horse is heard to emit groans. The facial expression always denotes +great anxiety and the eyes are bloodshot. The diagnosis is complete if, +upon passing the probang (a flexible tube made for this purpose), an +obstruction is encountered.</p> + +<p><i>Treatment.</i>—If the choke is at the beginning of the gullet +(pharyngeal) an effort must be made to remove the obstacle through the +mouth. A mouthgag, or speculum, is to be introduced into the<span class='pagenum'><a name="Page_64" id="Page_64">[Pg 64]</a></span> mouth to +protect the hand and arm of the operator. Then, while an assistant, with +his hands grasped tightly <i>behind</i> the object, presses it upward and +forward with all his force, the operator must pass his hand into the +mouth until he can seize the obstruction and draw it outward. This mode +of procedure must not be abandoned with the first failure, as by +continued efforts we may get the obstacle farther toward the mouth. If +we fail with the hand, forceps may be introduced through the mouth and +the object seized when it is just beyond the reach of the fingers. +Should our efforts entirely fail, we must then endeavor to force the +obstruction downward by means of the probang. This instrument, which is +of such signal service in removing choke in cattle, is decidedly more +dangerous to use for the horse, and I can not pass this point without a +word of caution to those who have been known to introduce into the +horse's throat such objects as whipstalks, shovel handles, etc. These +are always dangerous, and more than one horse has been killed by such +barbarous treatment.</p> + +<p>In cervical as well as in thoracic choke we must first of all endeavor +to soften or lubricate the obstruction by pouring oil or mucilaginous +drinks down the gullet. After this has been done endeavor to move the +object by gentle manipulations with the hands. If choked with oats or +chaff (and these are the objects that most frequently produce choke in +the horse), begin by gently squeezing the lower portion of the impacted +mass and endeavor to work it loose a little at a time. This is greatly +favored at times if we apply hot fomentations immediately about the +obstruction. Persist in these efforts for at least an hour before +deciding to resort to other and more dangerous modes of treatment. If +unsuccessful, however, the probang may be used. In the absence of the +regular instrument, a piece of inch hose 6 feet long or a piece of new +three-quarter-inch manila rope well wrapped at the end with cotton twine +and thoroughly greased with tallow should be used. The mouth is to be +kept open by a gag of wood or iron and the head slightly raised and +extended. The probang is then to be carefully guided by the hand into +the upper part of the gullet and gently forced downward until the +obstruction is reached. Pressure must then be gradual and firm. At first +too much force should not be used, or the esophagus will be ruptured. +Firm, gentle pressure should be kept up until the object is felt to +move, after which it should be followed rapidly to the stomach. If this +mode of treatment is unsuccessful, a veterinarian or a physician should +be called, who can remove the object by cutting down upon it. This +should scarcely be attempted by a novice, as a knowledge of the anatomy +of the parts is essential to avoid cutting the large artery, vein, and +nerve that are closely related to the esophagus in its cervical +portion.<span class='pagenum'><a name="Page_65" id="Page_65">[Pg 65]</a></span></p> + +<p>Thoracic choke can be treated only by means of the introduction of oils +and mucilaginous drinks and the careful use of the probang.</p> + + +<h5>STRICTURE OF THE ESOPHAGUS.</h5> + +<p>This is due to corrosive medicines, previous choking (accompanied with +lacerations, which, in healing, narrow the passage), or pressure on the +gullet by tumors. In the majority of cases of stricture, dilatation of +the gullet in front of the constricted portion soon occurs. This +dilatation is the result of the frequent accumulation of solid feed +above the constriction. Little can be done in either of these instances +except to give sloppy or liquid feed.</p> + + +<h5>SACULAR DILATATION OF THE ESOPHAGUS.</h5> + +<p>This follows choking, and is due to stretching or rupture of the +muscular coat of the gullet, allowing the internal, or mucous, coat to +protrude through the lacerated muscular walls. Such a dilatation, or +pouch, may gradually enlarge from the frequent imprisonment of feed. +When liquids are taken, the solid materials are partially washed out of +the pouch.</p> + +<p>The symptoms are as follows: The horse is able to swallow a few +mouthfuls without apparent difficulty; then he will stop feeding, paw, +contract the muscles of his neck, and eject a portion of the feed +through his nose or mouth, or it will gradually work down to the +stomach. As the dilatation thus empties itself the symptoms gradually +subside, only to reappear when he has again taken solid feed. Liquids +pass without any, or but little, inconvenience. Should this dilatation +exist in the cervical region, surgical interference may sometimes prove +effectual; if in the thoracic portion, nothing can be done, and the +patient rapidly passes from hand to hand by "swapping," until, at no +distant date, the contents of the sac become too firm to be dislodged as +heretofore, and the animal succumbs.</p> + + +<h4>DISEASES OF THE STOMACH AND INTESTINES.</h4> + +<p>As a rule it is most difficult to distinguish between diseases of the +stomach and of the intestines of the horse. The reason for this is that +the stomach is relatively small. It lies away from the abdominal wall, +and so pressure from without can not be brought to bear upon it to +reveal sensitiveness or pain. Nor does enlargement, or distention, of +the stomach produce visible alteration in the form of the abdomen of the +horse. Moreover, it is a rule to which there are few exceptions, that an +irritant or cause of disease of the stomach acts likewise upon the +intestines, so that it is customary to find them similarly deranged. For +these reasons it is logical to discuss together<span class='pagenum'><a name="Page_66" id="Page_66">[Pg 66]</a></span> the diseases of the +stomach and intestines and to point out such localizations in one organ +or another as are of importance in recognizing and treating the diseases +of the digestive organs of the horse.</p> + +<p>It should be understood that gastritis signifies an inflammation of the +stomach and enteritis an inflammation of the intestines. The two terms +may be used together to signify a disease of the stomach and intestines, +as gastro-enteritis.</p> + + +<h5>COLIC.</h5> + +<p>The disease of the horse that is most frequently met with is what is +termed "colic," and many are the remedies that are reputed to be "sure +cures" for this disease. Let us discover, then, what the word "colic" +means. This term is applied loosely to almost all diseases of the organs +of the abdomen that are accompanied with pain. If the horse evinces +abdominal pain, he probably will be considered as suffering with colic, +no matter whether the difficulty is a cramp of the bowel, an internal +hernia, overloading of the stomach, or a painful disease of the bladder +or liver. Since these conditions differ so much in their causation and +their nature, it is manifestly absurd to treat them alike and to expect +the same drugs or procedures to relieve them all. Therefore, it is +important that, so far as possible, the various diseased states that are +so roughly classed together as colic shall be separated and +individualized in order that appropriate treatments may be prescribed. +With this object in view, colics will be considered under the following +headings: (1) Engorgement colic, (2) obstruction colic, (3) flatulent or +tympanitic colic, (4) spasmodic colic. Worm colic is discussed under the +heading "Gastrointestinal parasites," page 90.</p> + +<p>The general symptoms of abdominal pain, and therefore of colic, are +restlessness, cessation of whatever the horse is about, lying down, +looking around toward the flank, kicking with the hind feet upward and +forward toward the belly, jerky switching of the tail, stretching as +though to urinate, frequent change of position, and groaning. In the +more intense forms the horse plunges about, throws himself, rolls, +assumes unnatural positions, as sitting on the haunches, and grunts +loudly. Usually the pain is not constant, and during the intermissions +the horse may eat and appear normal. During the period of pain sweat is +poured out freely. Sometimes the horse moves constantly in a circle. The +respirations are accelerated, and usually there is no fever.</p> + +<p><span class="smcap">Engorgement colic.</span>—This form of colic consists in an overloading of the +stomach with feed. The horse may have been overfed or the feed may have +collected in the stomach through failure of this organ to digest it and +pass it backward into the intestines. Even a normal quantity of feed +that the horse is unaccustomed to may cause<span class='pagenum'><a name="Page_67" id="Page_67">[Pg 67]</a></span> disease. Hence a sudden +change of feed may produce engorgement colic. Continued full rations +while the horse is resting for a day or two or working too soon after +feeding may serve as a cause. New oats, corn, or hay, damaged feed, or +that which is difficult of digestion, such as barley or beans, may +incite engorgement colic. This disease may result from having fed the +horse twice by error or from its having escaped and taken an +unrestricted meal from the grain bin. Ground feeds that pack together, +making a sort of dough, may cause engorgement colic if they are not +mixed with cut hay. Greedy eaters are predisposed to this disease.</p> + +<p><i>Symptoms.</i>—The horse shows the general signs of abdominal pain, which +may be long continued or of short duration. Retching or vomiting +movements are made; these are shown by labored breathing, upturned upper +lip, contraction of the flank, active motion at the throat, and drawing +in of the nose toward the breast, causing high arching of the neck. The +horse may assume a sitting position like a dog. At times the pain is +very great and the horse makes the most violent movements, as though +mad. At other times there is profound mental depression, the horse +standing in a sleepy, or dazed, way, with the head down, the eyes +closed, and leaning his head against the manger or wall. There is, +during the struggles, profuse perspiration. Following retching, gas may +escape from the mouth, and this may be followed by a sour froth and some +stomach contents. The horse can not vomit except when the stomach is +violently stretched, and, if the accumulation of feed or gas is great +enough to stretch the stomach so that vomiting is possible, it may be +great enough to rupture that organ. So it happens not infrequently that +a horse dies from ruptured stomach after vomiting. After the stomach +ruptures, however, vomiting is impossible. The death rate in this form +of colic is high.</p> + +<p><i>Treatment.</i>—The bowels should be stimulated to contraction by the use +of clysters of large quantities of water and of glycerin. Veterinarians +use hypodermic injections of eserin or arecolin or intravenous +injections of barium chlorid, but they must be employed with great +caution. It is not profitable to give remedies by the stomach, for they +can not be absorbed. But small doses of morphin (5 grains) or of the +fluid extract of Indian hemp (2 drams) may be placed in the mouth and +are absorbed in part, at least, without passing to the stomach. These +drugs lessen pain and thus help to overcome the violent movements that +are dangerous, because they may be the means of causing rupture of the +diaphragm or stomach. If facilities are available, relief may be +afforded by passing an esophageal tube through which some of the gaseous +and liquid contents of the stomach may escape.<span class='pagenum'><a name="Page_68" id="Page_68">[Pg 68]</a></span></p> + +<p><i>Rupture of the stomach.</i>—This mostly occurs as a result of engorged or +tympanitic stomach (engorgement colic) and from the horse violently +throwing himself when so affected. It may result from disease of the +coats of the stomach, gastritis, stones (calculi), tumors, or anything +that closes the opening of the stomach into the intestines, and very +violent pulling or jumping immediately after the animal has eaten +heartily of bulky feed. These or similar causes may lead this accident.</p> + +<p>The symptoms of rupture of the stomach are not constant or always +reliable. Always make inquiry as to what and how much the horse has been +fed at the last meal. Vomiting may precede rupture of this organ, as +stated above. This accident appears to be most liable to occur in heavy +draft horses. A prominent symptom observed (though it may also occur in +diaphragmatic hernia) is when the horse, if possible, gets the front +feet on higher ground than the hind ones or sits on his haunches, like a +dog. This position affords relief to some extent, and it will be +maintained for several minutes; it is also quickly regained when the +horse has changed it for some other. Colicky symptoms, of course, are +present, which vary much and present no diagnostic value. As the case +progresses the horse will often stretch forward the fore legs, lean +backward and downward until the belly nearly touches the ground, and +then rise up again with a groan, after which the fluid from his nostrils +is issued in increased quantity. The pulse is fast and weak, breathing +hurried, body bathed in a clammy sweat, limbs tremble violently, the +horse reels or staggers from side to side, and death quickly ends the +scene.</p> + +<p>In the absence of any pathognomonic symptom we must consider the history +of the case; the symptoms of colic that cease suddenly and are succeeded +by cold sweats and tremors; the pulse quick and small and thready, +growing weak and more frequent, and at length running down and becoming +altogether imperceptible; looking back at the flank and groaning; +sometimes crouching with the hind quarters; with or without eructation +and vomiting.</p> + +<p>There is no treatment that can be of any use whatever. Could we be sure +of our diagnosis it would be better to destroy the animal at once. +Since, however, there is always the possibility of a mistake in +diagnosis, we may give powdered opium in 1-dram doses every two or three +hours, with the object of keeping the stomach as quiet as possible.</p> + +<p><span class="smcap">Obstruction colic.</span>—The stomach or bowels may be obstructed by +accumulations of partly digested feed (fecal matter), by foreign bodies, +by displacements, by paralysis, or by abnormal growths.</p> + +<p><i>Impaction of the large intestines.</i>—This is a very common bowel +trouble and one which, if not promptly recognized and properly<span class='pagenum'><a name="Page_69" id="Page_69">[Pg 69]</a></span> treated, +results in death. It is caused by overfeeding, especially of bulky feed +containing an excess of indigestible residue; old, dry, hard hay, or +stalks when largely fed; deficiency of secretions of the intestinal +tracts; lack of water; want of exercise, medicines, etc.</p> + +<p>Impaction of the large bowels is to be diagnosed by a slight abdominal +pain, which may disappear for a day or two to reappear with more +violence. The feces are passed somewhat more frequently, but in smaller +quantities and drier; the abdomen is full, but not distended with gas; +the horse at first is noticed to paw and soon begins to look back at his +sides. Probably one of the most characteristic symptoms is the position +assumed when down. He lies flat on his side, head and legs extended, +occasionally raising his head to look toward his flank; he remains on +his side for from five to fifteen minutes at a time. Evidently this +position is the one giving the most freedom from pain. He rises at +times, walks about the stall, paws, looks at his sides, backs up against +the stall, which he presses with his tail, and soon lies down again, +assuming his favored position. The intestinal sounds, as heard by +applying the ear to the flank, are diminished, or there is no sound, +indicating absence of motion of the bowels. The bowels may cease +entirely to move. The pressure of the distended intestine upon the +bladder may cause the horse to make frequent attempts to urinate. The +pulse is but little changed at first, being full and sluggish; later, if +this condition is not overcome, it becomes rapid and feeble. Horses may +suffer from impaction of the bowels for a week, yet eventually recover, +and cases extending two or even three weeks have ended favorably. As a +rule, however, they seldom last more than four or five days, many, in +fact, dying sooner than this.</p> + +<p>The treatment consists of efforts to produce movement of the bowels and +to prevent inflammation of the same from arising. A large cathartic is +to be given as early as possible. Either of the following is +recommended: Powdered Barbados aloes 1 ounce, calomel 2 drams, and +powdered nux vomica 1 dram; or linseed oil 1 pint and croton oil 15 +drops; or from 1 pint to 1 quart of castor oil may be given. Some favor +the administration of Epsom or Glauber's salt, 1 pound, with one-quarter +pound of common salt, claiming that this causes the horse to drink +largely of water, thus mechanically softening the impacted mass and +favoring its expulsion. Whichever physic is selected, it is essential +that a full dose be given. This is much better than small and repeated +doses. It must be borne in mind that horses require about twenty-four +hours in which to respond to a physic, and under no circumstances is it +to be repeated sooner. If aloes has been given and has failed to operate +at the proper time, oil or some different cathartic should then be +administered. Allow<span class='pagenum'><a name="Page_70" id="Page_70">[Pg 70]</a></span> the horse all the water he will drink. Calomel may +be administered in half-dram doses, the powder being placed on the +tongue, one dose every two hours until four doses are given.</p> + +<p>Enemas of glycerin, 2 to 4 ounces, are often beneficial. Rubbing or +kneading of the abdominal walls and the application of stimulating +liniments or strong mustard water also, at times, favor the expulsion of +this mass. Walking exercise must occasionally be given. If this +treatment is faithfully carried out from the start the majority of cases +will terminate favorably. When relief is not obtained inflammation of +the bowels may ensue and cause death.</p> + +<p><i>Constipation, or costiveness.</i>—This is often witnessed in the horse, +and particularly in the foal. Many colts die every year from failure on +the part of the attendant to note the condition of the bowels soon after +birth. Whenever the foal fails to pass any feces, and in particular if +it presents any signs of colicky pains—straining, etc.—immediate +attention must be given it. As a rule, it will be necessary only to give +a few injections of soapy water in the rectum and to introduce the +finger through the anus to break down any hardened mass of dung found +there. If this is not effective a purgative must be given. Oils are the +best for these young animals, and preferably castor oil, giving from 2 +to 4 ounces. The foal should always get the first of the mother's milk, +which, for a few days, possesses decidedly laxative properties. If a +mare, while suckling, is taking laudanum, morphin, atropia, or similar +medicines, the foal during this time should be fed by hand and the mare +milked upon the ground. Constipation in adult horses is often the result +of long feeding on dry, innutritious feed, deficiency of intestinal +secretions, scanty water supply, or lack of exercise. If the case is not +complicated with colicky symptoms a change to light, sloppy diet, +linseed gruel or tea, with plenty of exercise, is all that is required. +If colic exists a cathartic is needed. In very many instances the +constipated condition of the bowels is due to lack of intestinal +secretions, and when so caused may be treated by giving fluid extract of +belladonna in 2-dram doses three times a day and handful doses of Epsom +salt daily in the feed. It is always best, when possible, to overcome +this trouble by a change of diet rather than by the use of medicines. +For the relief of constipation such succulent feeds as roots, grass, or +green forage are recommended. Silage, however, should be fed sparingly, +and not at all unless it is in the very best condition. Moldy silage may +cause fatal disease.</p> + +<p><i>Foreign bodies (calculi, stones) in the stomach.</i>—There are probably +but few symptoms exhibited by the horse that will lead one to suspect +the presence of gastric calculi, and possibly none by which we can +unmistakably assert their presence. They have been found most frequently +in millers' horses fed sweepings from the mills. A depraved<span class='pagenum'><a name="Page_71" id="Page_71">[Pg 71]</a></span> and +capricious appetite is common in horses that have a stone forming in the +stomachs. There is a disposition to eat the woodwork of the stable, +earth, and, in fact, almost any substance within their reach. This +symptom must not, however, be considered as pathognomonic, since it is +observed when calculi are not present. Occasional colics may result from +these "stomach stones," and when the latter lodge at the outlet of the +stomach they may give rise to symptoms of engorged stomach, already +described. There is, of course, no treatment that will prove effective. +Remedies to move the bowels, to relieve pain, and to combat inflammation +should be given.</p> + +<p><i>Intestinal concretions (calculi or stones in the intestines).</i>—These +concretions are usually found in the large bowels, though they are +occasionally seen in the small intestines. They are of various sizes, +weighing from 1 ounce to 25 pounds; they may be single or multiple, and +differ in composition and appearance, some being soft (composed mostly +of animal or vegetable matter), while others are porous, or honeycombed +(consisting of animal and mineral matter), and others are entirely hard +and stonelike. The hair balls, so common to the stomach and intestines +of cattle, are very rare in horses. Intestinal calculi form around some +foreign body, as a rule—a nail or piece of wood—whose shape they may +assume to a certain extent. Layers are arranged concentrically around +such nucleus until the sizes above spoken of are attained. These stones +are also often found in millers' horses, as well also as in horses in +limestone districts, where the water is hard. When the calculi attain a +sufficient size and become lodged or blocked in some part of the +intestines, they cause obstruction, inflammation of the bowels, colicky +symptoms, and death. There are no certain signs or symptoms that reveal +them. Recurring colics of the type of impaction colic, but more severe, +may lead one to suspect the existence of this condition. Examination +through the rectum may reveal the calculus.</p> + +<p>The symptoms will be those of obstruction of the bowels. Upon +post-mortem examinations these stones will be discovered mostly in the +large bowels; the intestines will be inflamed or gangrenous about the +point of obstruction. Sometimes calculi have been expelled by the action +of a physic, or they may be removed by the hand when found to occupy the +rectum.</p> + +<p>As in concretions of the stomach, but little can be done in the way of +treatment more than to overcome spasm (if any exists), and to give +physics with the hope of dislodging the stone or stones and carrying +them on and outward.</p> + +<p><i>Intussusception, or invagination.</i>—This is the slipping of a portion +of the intestine into another portion immediately adjoining, like a +partially turned glove finger. This may occur at any part of the bowels, +but is most frequent in the small guts. The invaginated portion<span class='pagenum'><a name="Page_72" id="Page_72">[Pg 72]</a></span> may be +slight—2 or 3 inches only—or extensive, measuring as many feet. In +intussusception, the inturned bowel is in the direction of the anus. +There are adhesions of the intestines at this point, congestion, +inflammation, or even gangrene. This accident is most liable to occur in +horses that are suffering from spasm of the bowel, or in those in which +a small portion of the gut is paralyzed. The natural wormlike or +ringlike contraction of the gut favors the passage of the contracted or +paralyzed portion into that immediately behind it. It may occur during +the existence of almost any abdominal trouble, as diarrhea, inflammation +of the bowels, or from injuries, exposure to cold, etc. A fall or +leaping may give the initial maldirection. Foals are most likely to be +thus afflicted.</p> + +<p>Unless the invaginated portion of the gut becomes strangulated, probably +no symptoms except constipation will be appreciable. Strangulation of +the bowel may take place suddenly, and the horse die within 24 hours, or +it may occur after several days—a week even—and death then follow. +There are no symptoms positively diagnostic. Colicky pains, more or less +severe and continuous, are observed, and at first there may be diarrhea, +followed by constipation. Severe straining occurs in some instances of +intussusception, and when this occurs it should receive due credit. As +death approaches, the horse sweats profusely, sighs, presents an anxious +countenance, the legs and ears become cold, and there is often freedom +from pain immediately before death. In some rare instances he recovers, +even though the invaginated portion of the gut has become strangulated. +In this case the imprisoned portion sloughs away so gradually that a +union has taken place between the intestines at the point where one +portion has slipped into that behind it. The piece sloughing off is +found passed with the manure. Such cases are exceedingly rare. +Nonirritating laxatives, such as castor oil, sweet oil, or calomel in +small doses, should be given. Soft feed and mucilaginous and nourishing +drinks should be given during these attacks. E. Mayhew Michener has +operated successfully on a foal with intussusception by opening the +abdomen and releasing the imprisoned gut.</p> + +<p><i>Volvulus, gut tie, or twisting of the bowels.</i>—These are the terms +applied to the bowels when twisted or knotted. This accident is rather a +common one, and frequently results from the violent manner in which a +horse throws himself about when attacked by spasmodic colic. The +symptoms are the same as those of intussusception and obstructions of +the bowels; the same directions as to treatment are therefore to be +observed.</p> + +<p><i>Paralysis of the intestine.</i>—This occurs in old, debilitated animals +that have been fed on coarse, innutritious fodder. This produces a +condition of dilatation so pronounced as to make it impossible for the +intestine to advance its contents, and so obstruction results. The<span class='pagenum'><a name="Page_73" id="Page_73">[Pg 73]</a></span> +symptoms are as in other forms of obstruction colic. The history of the +case is of much service in diagnosing the trouble. The treatment +consists in the administration of laxatives. One may give 1 quart of raw +linseed oil and follow it the next day with 1 pound of Glauber's salt +dissolved in a quart of warm water. Strychnia may be given in doses of 1 +grain two or three times daily. If the stagnant mass of feces is in the +rectum, it must be removed with the hand.</p> + +<p><i>Abnormal growths</i>, such as tumors or fibrous tissue, producing +contraction or stricture, may be causes of obstruction. The colic caused +by these conditions is chronic. The attacks occur at gradually +shortening intervals and become progressively more severe. Relief is +afforded by the use of purgatives that render the feces soft and thin +and thus enable them to pass the obstruction, but in time the contracted +place is liable to close so far that passage is impossible and the horse +will die.</p> + +<p><span class="smcap">Flatulent colic (tympanitic colic, wind colic, or bloat).</span>—Among the +most frequent causes of this form of colic are to be mentioned sudden +changes of feed, too long fasting and feed then given while the animal +is exhausted, new hay or grain, large quantities of feed that is green +or that has lain in the manger for some time and become sour, +indigestible feed, irregular teeth, crib biting, and, in fact, anything +that produces indigestion may produce flatulent colic.</p> + +<p><i>Symptoms.</i>—The symptoms of wind colic are not so suddenly developed +nor so severe as those of cramp colic. At first the horse is noticed to +be dull, paws slightly, and may or may not lie down. The pains from the +start are continuous. The belly enlarges, and by striking it in front of +the haunches a drumlike sound results. If not soon relieved the above +symptoms are aggravated, and in addition difficult breathing, bloodshot +eyes, and red mucous membranes, loud tumultuous heart beat, profuse +perspiration, trembling of front legs, sighing respiration, staggering +from side to side are noticed, and, finally, plunging forward dead. The +diagnostic symptom of flatulent colic is the distention of the bowels +with gas, detected by the bloated appearance and resonance on +percussion.</p> + +<p><i>Treatment.</i>—The treatment for wind colic differs very greatly from +that of cramp colic. Absorbents are of some service, and charcoal may be +given in any quantity. Relaxants and antispasmodics are also beneficial +in this form of colic. Chloral hydrate not only possesses these +qualities, but it also is an antiferment and a pain reliever. It is, +then, particularly well adapted to the treatment of wind colic, and +should be given in the same-sized doses and in the manner directed for +spasmodic colic. Diluted alcohol or whisky may be given, or aromatic +spirits of ammonia in 1-ounce doses at short intervals.<span class='pagenum'><a name="Page_74" id="Page_74">[Pg 74]</a></span></p> + +<p>A physic should always be given as early as possible in flatulent colic, +the best being Barbados aloes in the dose already mentioned. Injections, +per rectum, of turpentine 1 to 2 ounces, linseed oil 8 ounces, may be +given frequently to stimulate the peristaltic motion of the bowels and +to favor the escape of wind. Blankets wrung out of hot water do much to +afford relief; they should be renewed every 5 or 10 minutes and covered +with a dry woolen blanket. This form of colic is much more fatal than +cramp colic, and requires prompt and persistent treatment. It is +entirely unsafe to predict the result, some apparently mild attacks +going on to speedy death, while others that at the onset appear to be +very severe yielding rapidly to treatment. No efforts should be spared +until the animal is known to be dead. In these severe cases puncturing +of the bowels in the most prominent (distended) part by means of a small +trocar and cannula or with a needle of a hypodermic syringe, thus +allowing the escape of gas, has often saved life, and such punctures, if +made with a clean, sharp instrument that is not allowed to remain in the +horse too long, are accompanied with little danger and do more to +relieve the patient quickly than any other treatment.</p> + +<p><span class="smcap">Spasmodic or cramp colic.</span>—This is the name given to that form of colic +produced by contraction, or spasm, of a portion of the small intestines. +It is produced by indigestible feed; large drinks of cold water when the +animal is warm; driving a heated horse through deep streams; cold rains; +drafts of cold air, etc. Unequal distribution of or interference with +the nervous supply here produces cramp of the bowels, the same as +external cramps are produced. Spasmodic colic is much more frequently +met with in high-bred, nervous horses than in coarse, lymphatic ones.</p> + +<p><i>Symptoms.</i>—These should be carefully studied in order to diagnose this +from other forms of colic requiring quite different treatment. Spasmodic +colic always begins suddenly. If feeding, the horse is seen to stop +abruptly, stamp impatiently, and probably look back. He soon evinces +more acute pain, shown by pawing, suddenly lying down, rolling, and +getting up. During the period of pain the intestinal sounds, as heard by +applying the ear over the flank, are louder than in health. There is +then an interval of ease; he will resume feeding and appear to be +entirely well. In a little while, however, the pains return and are +increased in severity, only to pass off again for a time. As the attack +progresses these intervals of ease become shorter and shorter, and pain +may be continuous, though even then there are exacerbations of pain. +Animals suffering from this form of colic evince the most intense pain; +they throw themselves, roll over and over, jump up, whirl about, drop +down again, paw, or strike rather, with the front feet, steam and sweat, +and make frequent attempts to pass their urine. Only a small quantity of +water<span class='pagenum'><a name="Page_75" id="Page_75">[Pg 75]</a></span> is passed at a time; this is due to the bladder being so +frequently emptied. These attempts to urinate are often regarded by +horsemen as symptoms of trouble of the kidneys or bladder. In reality +they are only one of the many ways in which the horse expresses the +presence of pain. As a matter of fact, diseases of the bladder or +kidneys of the horse are exceedingly rare.</p> + +<p>To recapitulate the symptoms of spasmodic colic: The history of the +case, the type of horse, the suddenness of the attack, the increased +intestinal sounds, the intervals of ease (which become of shorter +duration as the case progresses), the violent pain, the normal +temperature and pulse during the intervals of ease, the frequent +attempts to urinate, etc., should be kept in mind, and there is then but +little danger of confounding this with other forms of colic.</p> + +<p><i>Treatment.</i>—Since the pain is due to spasm or cramp of the bowels, +medicines that overcome spasms—antispasmodics—are the ones indicated. +Chloral hydrate may be used. This is to be given in a dose of 1 ounce in +a pint of water as a drench. As this drug is irritant to the throat and +stomach, it has to be well diluted. A common and good remedy is +sulphuric ether and laudanum, of each 2 ounces, in a half pint of +linseed oil. Another drench may be composed of 2 ounces each of +sulphuric ether and alcohol in 8 ounces of water. If nothing else is at +hand give whisky, one-half pint in hot water. Jamaica ginger is useful. +If relief is not obtained in one hour from any of the above doses, they +may then be repeated. The body should be warmly clothed and perspiration +induced. Blankets dipped in very hot water to which a small quantity of +turpentine has been added should be placed around the belly and covered +with dry blankets or the abdomen may be rubbed with stimulating +liniments or mustard water. The difficulty, however, of applying hot +blankets and keeping them in place forces us in most instances to +dispense with them. If the cramp is due to irritants in the bowels, a +cure is not complete until a cathartic of 1 ounce of aloes or 1 pint of +linseed oil is given. Injections of warm, soapy water or salt and water +into the rectum aid the cure.</p> + +<p>Rectal injections, clysters, or enemas as a rule should be lukewarm, and +from 3 to 6 quarts are to be given at a time. They may be repeated every +half hour if necessary. Great care is to be taken not to injure the +rectum in giving such injections. A large syringe or a piece of rubber +hose 4 or 5 feet long, with a funnel attached at one end, affords the +best means by which to give them. The pipe of the syringe or the hose +introduced into the rectum must be blunt, rounded, and smooth; it is to +be thoroughly oiled and then carefully pushed through the anus in a +slightly upward direction. Much force must be avoided, for the rectum +may be lacerated and serious complications or even death result. +Exercise will aid the action of the bowels in this and similar colicky +troubles, but severe galloping or trotting is to be<span class='pagenum'><a name="Page_76" id="Page_76">[Pg 76]</a></span> avoided. If the +horse can have a loose box or paddock, it is the best, as he will then +take what exercise he wants. If the patient is extremely violent, it is +often wise to restrain him by leading him with a halter, since rupture +of the stomach or displacement of the bowels may result and complicate +the trouble.</p> + + +<h4>INDIGESTION OR GASTROINTESTINAL CATARRH.</h4> + +<p>From the facts that they merge insensibly into each other and usually +occur simultaneously, there is ample reason for considering these +conditions together. This condition may be acute—that is, of sudden +onset—or it may be chronic. The changes of structure produced by this +disease occur in the mucous membrane lining of the stomach and +intestines. This membrane becomes red from increased blood supply or +from hemorrhage into it, is swollen, and is covered by a coating of +slimy mucus. In some especially severe cases the membrane is destroyed +in spots, causing the appearance of ulcers or of erosions.</p> + +<p>The causes of indigestion are numerous, but nearly all are the result of +errors in feeding.</p> + +<p>Some horses are naturally endowed with weak digestive organs, and such +are predisposed to this condition. Anything that irritates the stomach +or intestines may cause this disease. Feeds that the animal is +unaccustomed to, sudden changes of diet, imperfectly cured, unripe, or +damaged feeds are all fruitful causes, and so are worms. In suckling +foals this condition may come from some disease of the dam that renders +her milk indigestible, or from overexertion or overheating of the mare. +Another prolific cause is bad teeth, making mastication imperfect, and +thus causing the horse to swallow his feed in a condition unfit for the +action of the digestive juices. Working a horse too soon or too hard +after feeding may cause either colic or indigestion. Any condition that +reduces the vitality, such as disease, overwork, poor feed, or lack of +care, may directly bring on indigestion by weakening the digestive +organs.</p> + +<p><i>Symptoms.</i>—Indigestion is characterized by irregular appetite; +refusing all feed at times, and at others eating ravenously; the +appetite is not only irregular, but is often depraved; there is a +disposition on the part of the horse to eat unusual substances, such as +wood, soiled bedding, or even his own feces; the bowels are irregular +to-day, loose and bad smelling, to-morrow bound; whole grain is often +passed in the feces, and the hay passed in balls or impacted masses, +undergoing but little change; the horse frequently passes considerable +quantities of sour-smelling wind. The animal loses flesh, the skin +presents a hard, dry appearance and seems very tight (hidebound). If the +stomach is very seriously involved, the horse may yawn by<span class='pagenum'><a name="Page_77" id="Page_77">[Pg 77]</a></span> stretching +the head forward and upward and by turning the upper lip outward. There +may be more or less colicky pain. In the chronic cases there is mental +depression; the horse is sluggish and dull. The abdomen gradually +becomes small, giving a "tucked up" appearance, or, on the other hand, +it becomes flaccid and pendulous.</p> + +<p><i>Treatment.</i>—One should commence with the feed—its quality, quantity, +and time of feeding; examine the water supply, and see, besides, that it +is given before feeding; then carefully observe the condition of the +mouth and teeth; and, continuing the observations as best we may, +endeavor to find the seat of the trouble. If the teeth are sharp or +irregular they must be rasped down; if any are decayed they must be +extracted; if indigestion is due to ravenous eating or bolting, the feed +must then be given from a large manger where the grain can be spread and +the horse thus compelled to eat slowly.</p> + +<p>Any irritation, such as worms, undigested feed, etc., that is operating +as a cause is to be removed by appropriate treatment, as advised +elsewhere. If there is a tendency to distention of the stomach and +bowels, with gas, during indigestion, the following may be used: Baking +soda, powdered ginger, and powdered gentian, equal parts. These are to +be thoroughly mixed and given in heaping tablespoonful doses, twice a +day, before feeding. This powder is best given by dissolving the +above-named quantity in a half pint of water and given as a drench.</p> + +<p>As a digestive tonic the following is good: Glauber's salt, 2 pounds; +common salt, 1 pound; baking soda, one-half pound. Of this a heaping +tablespoonful may be given in each feed. If diarrhea exists, the +treatment advised below may be used.</p> + + +<h4>DIARRHEA.</h4> + +<p>Diarrhea is due to indigestion or intestinal catarrh or to irritation of +the bowels from eating moldy or musty feed, drinking stagnant water, +diseased condition of the teeth, eating irritating substances, to being +kept on low, marshy pastures, and to exposure during cold nights, or in +low, damp stables. Some horses are predisposed to scour and are called +"washy" by horsemen; they are those with long bodies, long legs, and +narrow, flat sides. Horses of this build are almost sure to scour if fed +or watered immediately before being put to work. Fast or road work, of +course, aggravates this trouble. Diarrhea may exist as a complication of +other diseases, as pneumonia and influenza, for instance, and again +during the diseases of the liver.</p> + +<p>The symptoms are the frequent evacuations of liquid stools, with or +without pronounced abdominal pain, loss of appetite, emaciation, etc.</p> + +<p><i>Treatment</i> is at times very simple, but requires the utmost care and +judgment. If due to faulty feed or water it is sufficient to change +these. If it results from some irritant in the intestines this is best<span class='pagenum'><a name="Page_78" id="Page_78">[Pg 78]</a></span> +gotten rid of by the administration of an oleaginous purge, for which +nothing is better than castor oil, although raw linseed oil may be used +if the case is not severe. The diarrhea often disappears with the +cessation of the operation of the medicine. If, however, purging +continues it may be checked by giving wheat flour in water, starch +water, white-oak bark tea, chalk, opium, or half-dram doses of sulphuric +acid in one-half pint of water twice or thrice daily. Good results +follow the use of powdered opium 2 drams and subnitrate of bismuth 1 +ounce, repeated three times a day. In all cases it should be remembered +to look to the water and feed the horse is receiving. If either of these +is at fault it is at once to be discontinued. We should feed sparingly +of good, easily digested feeds. With that peculiar build of nervous +horses that scour on the road but little can be done as a rule. They +should be watered and fed as long as possible before going on a drive. +If there is much flatulency accompanying diarrhea baking soda or other +alkaline medicines may effect a cure, while if the discharges have a +very disagreeable odor it may be corrected by 1 ounce of sulphite of +soda or dram doses of creolin in water, repeated twice a day. Be slow to +resort to either the vegetable or mineral astringents, since the +majority of cases will yield to change of feed and water or the +administration of oils. Afterwards feed upon wheat-flour gruel or other +light feeds. The body should be warmly clothed.</p> + +<p><span class="smcap">Superpurgation.</span>—This is the designation of that diarrhea, or flux from +the bowels, that, at times, is induced by and follows the action of a +physic. It is accompanied with much irritation or even inflammation of +the bowels and is always of a serious character. Although in rare +instances it follows from a usual dose of physic and where every +precaution has been taken, it is most likely to result under the +following circumstances: Too large a dose of physic; giving physics to +horses suffering from pneumonia, influenza, or other debilitating +diseases; riding or driving a horse when purging; exposure or drafts of +cold air; or giving large quantities of cold water while the physic is +operating. There is always danger of superpurgation if a physic is given +to a horse suffering from diseases of the respiratory organs. Small and +often-repeated physics are also to be avoided, as they produce debility +and great depression of the system and predispose to this disorder. When +a physic is to be given one should rest the horse and give him sloppy +feed until the medicine begins to operate; clothe the body with a warm +blanket; keep out of drafts; give only warm water in small quantities. +After a horse has purged from twelve to twenty-four hours it can mostly +be stopped, or "set," as horsemen say, by feeding on dry oats and hay. +Should the purging continue, however, it is best treated by giving +demulcent drinks—linseed tea and oatmeal or wheat-flour<span class='pagenum'><a name="Page_79" id="Page_79">[Pg 79]</a></span> gruel. After +this the astringents spoken of for diarrhea may be given. Besides this +the horse is to receive brandy in doses of from 2 to 4 ounces, with milk +and eggs, four or five times a day.</p> + +<p>Laminitis ("founder") is a frequent sequel of superpurgation and is to +be guarded against by removing the shoes and standing the horse on moist +sawdust or some similar bedding.</p> + + +<h4>DYSENTERY.</h4> + +<p>This disease, sometimes called "bloody flux," is an intestinal disease +attended with fever, occasional abdominal pains, and fluid discharges +mingled with blood. Discharges in dysentery are coffee colored or +bloody, liquid, and very offensive in odor, and passed with much +straining. It is rare in the horse, but is sometimes quite prevalent +among foals.</p> + +<p><i>Causes.</i>—Probably the most common cause is keeping young horses in +particular for a long time on low, wet, marshy pastures, without other +feed (a diarrhea of long standing sometimes terminates in dysentery); +exposure during cold, wet weather; decomposed feeds; stagnant water that +contains large quantities of decomposing vegetable matter; low, damp, +and dark stables, particularly if crowded; the existence of some +disease, as tuberculosis of the abdominal form. In suckling foals it may +come from feeding the dam on irritant feeds or from disease of the +udder. In other foals it may be produced by exposure to cold and damp, +to irritant feed, or to worms.</p> + +<p><i>Symptoms.</i>—The initial symptom is a chill, which probably escapes +notice in the majority of instances. The discharges are offensive and +for the most part liquid, although it is common to find lumps of solid +fecal matter floating in this liquid portion; shreds of mucous membrane +and blood may be passed or the evacuations may be mucopurulent; there is +much straining, and, rarely, symptoms of abdominal pain; the subject +lies down a great deal; the pulse is quickened and the temperature +elevated. Thirst is a prominent symptom. In the adult, death rarely +follows under two to three weeks, but in foals the disease may end in +death after a few days.</p> + +<p><i>Treatment.</i>—This is most unsatisfactory, and I am inclined to place +more dependence upon the care and feed than any medication that may be +adopted. First of all the horse must be placed in a dry, warm, yet +well-ventilated stable; the skin is to receive attention by frequent +rubbings of the surface of the body, with blankets, and bandages to the +legs. The water must be pure and given in small quantities; the feed, +that which is light and easily digested. Medicinally, give at first a +light dose of castor oil, about one-half pint, to which has been added 2 +ounces of laudanum. The vegetable or mineral astringents are also to be +given. Starch injections containing laudanum often afford great relief. +The strength must be kept up<span class='pagenum'><a name="Page_80" id="Page_80">[Pg 80]</a></span> by milk punches, eggs, beef tea, oatmeal +gruel, etc. In spite of the best care and treatment, however, dysentery +is likely to prove fatal. In the case of nurslings, the dam should be +placed in a healthy condition or, failing in this, milk should be had +from another mare or from a cow.</p> + + +<h4>GASTROENTERITIS.</h4> + +<p>This condition consists in an inflammation of the stomach and +intestines. Instead of being confined to the mucous, or lining, +membrane, as in gastrointestinal catarrh, the inflammatory process +extends deeper and may even involve the entire thickness of the wall of +the organ.</p> + +<p>This disease may be caused by irritant feed, hot drinks, sudden +chilling, moldy or decayed feeds, foul water, parasites, or by chemical +poisons. It may also complicate some general diseases, especially +infectious diseases, as anthrax, influenza, rabies, or petechial fever. +Long-continued obstruction of the bowels or displacement resulting in +death are preceded by enteritis.</p> + +<p><i>Symptoms.</i>—The symptoms differ somewhat with the cause and depend +also, to some extent, upon the chief location of the inflammation. In +general the animal stops eating or eats but little; it shows colicky +pain; fever develops; the pulse and respiration become rapid; the mucous +membrane becomes red; the mouth is hot and dry. Pressure upon the +abdomen may cause pain. Intestinal sounds can not be heard at the flank. +There is constipation in the earlier stages that is, followed later by +diarrhea. The extremities become cold. Sometimes the feces are coated +with or contain shreds of fibrin, looking like scraps of dead membrane, +and they have an evil, putrid odor. If the disease is caused by moldy or +damaged feed there may be great muscular weakness, with partial +paralysis of the throat, as shown by inability to swallow. If chemical +poisons are the cause, this fact may be shown by the sudden onset of the +disease, the history of the administration of a poison or the entire +absence of known cause, the rapid development of threatening symptoms, +the involvement of a series of animals in the absence of a contagious +disease, and the special symptoms and alterations known to be produced +by certain poisons. To make this chain of evidence complete, the poison +may be discovered in the organs of the horse by chemical analysis. In +nearly all cases of gastro-enteritis there is nervous depression.</p> + +<p>The poisons that are most irritant to the digestive tract are arsenic, +corrosive sublimate, sugar of lead, sulphate of copper, sulphate or +chlorid of zinc, lye, or other strong alkalies, mineral acids, and, +among the vegetable poisons, tobacco, lobelia, and water hemlock.</p> + +<p><i>Treatment.</i>—The treatment will depend upon the cause, but if this can +not be detected, certain general indications may be observed. In all +cases feed should be given in small amounts and should be of the<span class='pagenum'><a name="Page_81" id="Page_81">[Pg 81]</a></span> most +soothing description, as oatmeal gruel, flaxseed tea, hay tea, fresh +grass, or rice water. The skin should be well rubbed with alcohol and +wisps of straw, to equalize the distribution of the blood; the legs, +after being rubbed until warm, should be bandaged in raw cotton or with +woolen bandages. The horse should be warmly blanketed. It is well to +apply to the abdomen blankets wrung out of hot water and frequently +changed; or mustard paste may be rubbed on the skin of the belly. +Internally, opium is of service to allay pain, check secretion, and +soothe the inflamed membrane. The dose is from 1 to 2 drams, given every +three of four hours. If there is constipation, the opium should be mixed +with 30 grains of calomel. Subnitrate of bismuth may be given with the +opium or separately in 2-dram doses. Stimulants, such as alcohol, +aromatic spirits of ammonia, or camphor may be given in 2-ounce doses, +mixed with warm water to make a drench.</p> + +<p>If putrid feed has been consumed, creolin may be administered in doses +of 2 drams, mixed with 1 pint of warm water or milk. If there is +obstinate constipation and if a laxative must be employed, it should be +sweet or castor oil, from 1 pint to 1 quart.</p> + +<p><i>Antidotes for poisons.</i>—For the various poisons the remedies are as +follows:</p> + +<p>Arsenic: Oxyhydrate of iron solution, 1 pint to 1 quart; or calcined +magnesia, one-half ounce in 1 pint of water.</p> + +<p>Corrosive sublimate (bichlorid of mercury): The whites of a dozen eggs, +or 2 ounces of flowers of sulphur.</p> + +<p>Sugar of lead: Glauber's salt, 1 pound in 1 quart of warm water; to be +followed with iodid of potash, 3 drams at a dose, in water, three times +daily for five days.</p> + +<p>Sulphate of copper: Milk, the whites of eggs, or reduced iron.</p> + +<p>Sulphate or chlorid of zinc: Milk, the whites of eggs, or calcined +magnesia.</p> + +<p>Lye or alkalies, as caustic potash or soda: Vinegar, dilute sulphuric +acid, and linseed tea, with opium, 3 drams.</p> + +<p>Mineral acids: Chalk, or calcined magnesia, or baking soda; later give +linseed tea and opium.</p> + + +<h4>HEMORRHOIDS, OR PILES.</h4> + +<p>These are rare, comparatively, in horses. They are diagnosed by the +appearance of bright-red irregular tumors after defecation, which may +remain visible at all times or be seen only when the horse is down or +after passing his manure. They are mostly due to constipation, +irritation, or injuries, or follow from the severe straining during +dysentery. I have observed them to follow from severe labor pains in the +mare.<span class='pagenum'><a name="Page_82" id="Page_82">[Pg 82]</a></span></p> + +<p><i>Treatment.</i>—Attention must be paid to the condition of the bowels; +they should be soft, but purging is to be avoided. The tumors should be +washed in warm water and thoroughly cleansed, after which scarify them +and gently but firmly squeeze out the liquid that will be seen to follow +the shallow incisions. After thus squeezing these tumors and before +replacing through the anus, bathe the parts with some anodyn wash. For +this purpose the glycerite of tannin and laudanum in equal parts is +good. Mucilaginous injections into the rectum may be of service for a +few days.</p> + + +<h4>HERNIA, OR RUPTURE.</h4> + +<p>There are several kinds or hernias that require notice, not all of +which, however, produce serious symptoms or results. Abdominal hernias, +or ruptures, are divided into reducible, irreducible, and strangulated, +according to condition; and into inguinal, scrotal, ventral, umbilical, +and diaphragmatic, according to their situation. A hernia is reducible +when the displaced organ can be returned to its natural location. It +consists of a soft swelling, without heat, pain, or any uneasiness, +generally larger on full feed, and decreases in size as the bowels +become empty. An irreducible hernia is one that can not be returned into +the abdomen, and yet does not cause any pain or uneasiness. Strangulated +hernia is one in which the contents of the sac are greatly distended, or +when from pressure upon the blood vessels of the imprisoned portion the +venous circulation is checked or stopped, thereby causing congestion, +swelling, inflammation, and, if not relieved, gangrene of the part and +death of the animal. According to the time or mode of origin, hernias +may be congenital or acquired.</p> + +<p><span class="smcap">Congenital scrotal hernia.</span>—Not a few foals are noticed from birth to +have an enlarged scrotum, which gradually increases in size until about +the sixth month, sometimes longer. Sometimes the scrotum of a +six-months-old colt is as large as that of an adult stallion, and +operative treatment is considered. This is unnecessary in the great +majority of cases, as the enlargement often disappears by the time the +colt has reached his second year. Any interference, medicinal or +surgical, is worse than useless. If the intestine contained within the +scrotum should at any time become strangulated, it must then be treated +the same as in an adult horse.</p> + +<p><span class="smcap">Scrotal hernia</span> is caused by dilatation of the sheath of the testicle, +combined with relaxation of the fibrous tissues surrounding the inguinal +ring, thus allowing the intestine to descend to the scrotum. At first +this is intermittent, appearing during work and returning when the horse +is at rest. For a long time this form of hernia may<span class='pagenum'><a name="Page_83" id="Page_83">[Pg 83]</a></span> not cause the least +uneasiness or distress. In course of time, however, the imprisoned gut +becomes filled with feces, its return into the abdominal cavity is +prevented, and it becomes strangulated. While the gut is thus filling +the horse often appears dull, is disinclined to move, appetite is +impaired, and there is rumbling and obstruction of the bowels. Colicky +symptoms now supervene. Strangulation and its consequent train of +symptoms do not always follow in scrotal hernia, for often horses have +this condition for years without suffering inconvenience.</p> + +<p><span class="smcap">Inguinal hernia</span> is but an incomplete scrotal hernia, and, like the +latter, may exist and cause no signs of distress, or, again, it may +become strangulated and cause death. Inguinal hernia is seen mostly in +stallions, next in geldings, and very rarely in the mare. Bearing in +mind that scrotal hernia is seen only in entire horses, we may proceed +to detail the symptoms of strangulated, inguinal, and scrotal hernia at +the same time. When, during the existence of colicky symptoms, we find a +horse kicking with his hind feet while standing or lying upon his back, +we should look to the inguinal region and scrotum. If scrotal hernia +exists, the scrotum will be enlarged and lobulated; by pressure we may +force a portion of the contents of the gut back into the abdomen, +eliciting a gurgling sound. If we take a gentle but firm hold upon the +enlarged scrotum and then have an assistant cause the horse to cough, +the swelling will be felt to expand and as quickly contract again.</p> + +<p>The history of these cases will materially aid us, as the owner can +often assure us of preceding attacks of "colic," more or less severe, +that have been instantaneously relieved in some (to him) unaccountable +manner. The colicky symptoms of these hernias are not diagnostic, but, +probably, more closely resemble those of enteritis than any other bowel +diseases. In many cases the diagnosis can be made only by a +veterinarian, when he has recourse to a rectal examination; the bowels +can here be felt entering the internal abdominal ring.</p> + +<p><i>Treatment of inguinal hernia.</i>—If the reader is sure of the existence +of hernia, he should secure the horse upon its back, and, with a hand in +the rectum, endeavor to catch hold of the wandering bowel and pull it +gently back into the cavity of the abdomen. Pressure should be made upon +the scrotum during this time. If this fails, a veterinarian must be +called to reduce the hernia by means of incising the inguinal ring, +replacing the intestines, and to castrate, using clamps and performing +the "covered operation."</p> + +<p><span class="smcap">Ventral hernia.</span>—In this form of hernia the protrusion is through some +accidental opening or rupture of the abdominal wall. It may occur at any +part of the belly except at the umbilicus, and is caused by kicks, +blows, hooks, severe jumping or pulling, etc. Ventral<span class='pagenum'><a name="Page_84" id="Page_84">[Pg 84]</a></span> hernia is most +common in pregnant mares, and is here due to the weight of the fetus or +to some degenerative changes taking place in the abdominal coats. It is +recognized by the appearance of a swelling, at the base of which can be +felt the opening or rent in the abdominal tunics, and from the fact that +the swelling containing the intestines can be made to disappear when the +animal is placed in a favorable position.</p> + +<p><i>Treatment of ventral hernia.</i>—In many instances there is no occasion +for treatment, and again, where the hernial sac is extensive, treatment +is of no avail. If the hernia is small, a cure may be attempted by the +methods to be described in treating of umbilical hernia. If one is +fortunate enough to be present when the hernia occurs, and particularly +if it is not too large, he may, by the proper application of a pad and +broad bandage, effect a perfect cure.</p> + +<p><span class="smcap">Umbilical hernia</span> is the passing of any portion of the bowel or omentum +("caul") through the navel, forming a "tumor" at this point. This is +often congenital in our animals, and is due to the imperfect closure of +the umbilicus and to the position of the body. Many cases of umbilical +hernia, like inguinal and scrotal of the congenital kind, disappear +entirely by the time the animal reaches its second or third year. +Advancing age favors cure in these cases from the fact that the omentum +(swinging support of the bowels) is proportionally shorter in adults +than in foals, thus lifting the intestines out of the hernial sac and +allowing the opening in the walls to close. Probably one of the most +frequent causes of umbilical hernia in foals is the practice of keeping +them too long from their dams, causing them to fret and worry, and to +neigh, or cry, by the hour. The contraction of the abdominal muscles and +pressure of the intestines during neighing seem to open the umbilicus +and induce hernia. Accidents may cause umbilical hernia in adults in the +same manner as ventral hernia is produced, though this is very rare.</p> + +<p><i>Treatment of umbilical hernia.</i>—In the treatment of umbilical hernia +it should be remembered that congenital hernias are often removed with +age, but probably congenital <i>umbilical hernias</i> less frequently than +others. Among the many plans of treatment are to be mentioned the +application of a pad over the tumor, the pad being held in place by a +broad, tight bandage placed around the animal's body. The chief +objection to this is the difficulty in keeping the pad in its place. +Blisters are often applied over the swelling, and, as the skin hardens +and contracts by the formation of scabs, an artificial bandage or +pressure is produced that at times is successful. Another treatment that +has gained considerable repute of late years consists in first clipping +off the hair over the swelling. Nitric acid is then applied with a small +brush, using only enough to moisten the skin.<span class='pagenum'><a name="Page_85" id="Page_85">[Pg 85]</a></span> This sets up a +deep-seated, adhesive inflammation, which, in very many cases, closes +the opening in the navel. Still another plan is to inject a solution of +common salt by means of the hypodermic syringe at three or four points +about the base of the swelling. This acts in the same manner as the +preceding, but may cause serious injury if the syringe or solution is +not sterile.</p> + +<p>Others, again, after keeping the animal fasting for a few hours, cast +and secure it upon its back; the bowel is then carefully returned into +the abdomen. The skin over the opening is pinched up and one or two +skewers are run through the skin from side to side as close as possible +to the umbilical opening. These skewers are kept in place by passing a +cord around the skin between them and the abdomen and securely tying it. +Great care must be taken not to draw these cords too tight, as this +would cause a speedy slough of the skin, the intestines would extrude, +and death result. If properly applied, an adhesion is established +between the skin and the umbilicus, which effectually closes the +orifice. Special clamps are provided for taking up the fold of the skin +covering the hernial sac and holding it until the adhesion is formed.</p> + +<p><span class="smcap">Diaphragmatic hernia.</span>—This consists of the passage of any of the +abdominal viscera through a rent in the diaphragm (midriff) into the +cavity of the thorax. It is a rather rare accident, and one often +impossible to diagnose during life. Colicky symptoms, accompanied with +great difficulty in breathing, and the peculiar position so often +assumed (that of sitting upon the haunches), are somewhat characteristic +of this trouble, though these symptoms, as we have already seen, may be +present during diseases of the stomach or anterior portion of the +bowels. Even could we diagnose with certainty this form of hernia, there +is little or nothing that can be done. Leading the horse up a very steep +gangway or causing him to rear up may possibly cause the hernial portion +to return to its natural position. This is not enough, however; it must +be kept there.</p> + + +<h4>PERITONITIS.</h4> + +<p>Peritonitis is an inflammation of the serous membrane lining the cavity +of and covering the viscera contained within the abdomen. It is very +rare to see a case of primary peritonitis. It is, however, somewhat +common as a secondary disease from extension of the inflammatory action +involving organs covered by the peritoneum. Peritonitis is often caused +by injuries, as punctured wounds of the abdomen, severe blows or kicks, +or, as is still more common, following the operation of castration. It +follows strangulated hernia, invagination, or rupture of the stomach, +intestines, liver, or womb.<span class='pagenum'><a name="Page_86" id="Page_86">[Pg 86]</a></span></p> + +<p><i>Symptoms.</i>—Peritonitis is mostly preceded by a chill; the horse is not +disposed to move, and, if compelled to do so, moves with a stiff or sore +gait; he paws with the front feet and may strike at his belly with the +hind ones; lies down very carefully; as the pain is increased while +down, he maintains the standing position during most of the time; he +walks uneasily about the stall. Constipation is usually present. +Pressure on the belly causes acute pain, and the horse will bite, +strike, or kick if so disturbed; the abdomen is tucked up; the +extremities are fine and cold. The temperature is higher than normal, +reaching from 102° to 104° F. The pulse in peritonitis is rather +characteristic; it is quickened, beating from 70 to 90 beats a minute, +and is hard and wiry. This peculiarity of the pulse occurs in +inflammation of the serous membrane, and if accompanied with colicky +symptoms, and, in particular, if following any injuries, accidental or +surgical, of the peritoneum, there is reason to think that peritonitis +is present. Peritonitis in the horse is mostly fatal when it is at all +extensive. If death does not occur in a short time, the inflammation +assumes a chronic form, in which there is an extensive effusion of water +in the cavity of the belly, constituting what is known as ascites, and +which, as a rule, results in death.</p> + +<p><i>Treatment.</i>—The treatment of peritonitis is somewhat like that of +enteritis. Opium in powder, 1 to 2 drams, with calomel, one-half dram, +is to be given every two, three, or four hours, and constitutes the main +dependence in this disease. Extensive counterirritants over the belly, +consisting of mustard plasters, applications of mercurial ointment, +turpentine stupes, or even mild blisters, are recommended. Purgatives +must never be given during this complaint. Should we desire to move the +bowels, it can be done by gentle enemas, though it is seldom necessary +to resort even to this.</p> + + +<h4>ASCITES, OR DROPSY OF THE ABDOMEN.</h4> + +<p>This is seen as a result of subacute or chronic peritonitis, but may be +due to diseases of the liver, kidneys, heart, or lungs. There will be +found, on opening the cavity of the belly, a large collection of +yellowish or reddish liquid; from a few quarts to several gallons may be +present. It may be clear in color, though generally it is yellowish or +of a red tint, and contains numerous loose flakes of coagulable lymph.</p> + +<p><i>Symptoms.</i>—There is slight tenderness on pressure; awkward gait of the +hind legs; the horse is dull, and may have occasional very slight +colicky pains, shown by looking back and striking at the belly with the +hind feet. Oftener, however, these colicky symptoms are absent. Diarrhea +often precedes death, but during the progress of<span class='pagenum'><a name="Page_87" id="Page_87">[Pg 87]</a></span> the disease the bowels +are alternately constipated and loose. On percussing the abdominal walls +we find that dullness exists to the same height on both sides of the +belly; by suddenly pushing or striking the abdomen we can hear the +rushing or flooding of water. If the case is an advanced one, the horse +is potbellied in the extreme, and dropsical swellings are seen under the +belly and upon the legs.</p> + +<p>Treatment is, as a rule, unsatisfactory. Saline cathartics, as Epsom or +Glauber's salt, and diuretics, ounce doses of saltpeter, may be given. +If a veterinarian is at hand he will withdraw the accumulation of water +by tapping and then endeavor to prevent its recurrence (though this is +almost sure to follow) by giving three times a day saltpeter 1 ounce and +iodid of potash 1 dram, and by the application of mustard or blisters +over the abdominal walls. Tonics, mineral and vegetable, are also +indicated. Probably the best tonic is one consisting of powdered +sulphate of iron, gentian, and ginger in equal parts; a heaping +tablespoonful of the mixture is given as a drench or mixed with the +feed, twice a day. Good nutritious feeds and gentle exercise complete +the treatment.</p> + + +<h4>DISEASES OF THE LIVER.</h4> + +<p>In the United States the liver of the horse is but rarely the seat of +disease, and when we consider how frequently the liver of man is +affected this can not but appear strange. The absence of the gall +bladder may account to a certain extent for his freedom from liver +diseases, as overdistention of this and the presence in it of calculi +(stones) in man is a frequent source of trouble. In domestic animals, as +in man, hot climates tend to produce diseases of the liver, just as in +cold climates lung diseases prevail. Not only are diseases of the liver +rare in horses in temperate climates, but they are also very obscure, +and in many cases pass totally unobserved until after death. There are +some symptoms, however, which, when present, should make us examine the +liver as carefully as possible. These are jaundice (yellowness of the +mucous membranes of the mouth, nose, and eyes) and the condition of the +dung, it being light in color and pasty in appearance.</p> + + +<h4>HEPATITIS, OR INFLAMMATION OF THE LIVER.</h4> + +<p>This disease may be general or local, and may assume an acute or chronic +form.</p> + +<p><i>Symptoms.</i>—The symptoms of acute hepatitis are: Dullness; the horse is +suffering from some internal pain, but not of a severe type; constipated +and clay-colored dung balls; scanty and high-colored urine; and general +febrile symptoms. If lying down, he is mostly<span class='pagenum'><a name="Page_88" id="Page_88">[Pg 88]</a></span> found on the left side; +looks occasionally toward the right side, which, upon close inspection, +may be found to be slightly enlarged over the posterior ribs, where pain +upon pressure is also evinced. Obscure lameness in front, of the right +leg mostly, may be a symptom of hepatitis. The horse, toward the last, +reels or staggers in his gait and falls backward in a fainting fit, +during one of which he finally succumbs. Death is sometimes due to +rupture of the enveloping coat of the liver or of some of its blood +vessels.</p> + +<p><i>Causes.</i>—Among the causes that lead to this disease we must mention +first the stimulating effect of overfeeding, particularly during hot +weather. Horses that are well fed and receive but little exercise are +the best subjects for diseases of this organ. We must add to these +causes the more mechanical ones, as injuries on the right side over the +liver, worms in the liver, gallstones in the biliary ducts, foreign +bodies—as needles or nails that have been swallowed and in their +wanderings have entered the liver—and, lastly, in some instances, the +extension of inflammation from neighboring parts, thus involving this +organ. Acute hepatitis may terminate in chronic inflammation, abscesses, +rupture of the liver, or may disappear, leaving behind no trace of +disease whatever.</p> + +<p><i>Treatment.</i>—This should consist, at first, of the administration of 1 +ounce of Barbados aloes or other physic. General blood-letting, if had +recourse to early, must prove of much benefit in acute inflammation of +the liver. The vein in the neck (jugular) must be opened, and from 4 to +6 quarts of blood may be drawn. Saline medicines, as Glauber's salt or +the artificial Carlsbad salt, are indicated. These may be given with the +feed in tablespoonful doses. The horse is to be fed sparingly on soft +feed, bran mashes chiefly. If treatment proves successful and recovery +takes place, see to it that the horse afterwards gets regular exercise +and that his feed is not of a too highly nutritious character and not +excessive.</p> + + +<h4>JAUNDICE, ICTERUS, OR THE YELLOWS.</h4> + +<p>This is a condition caused by the retention and absorption of bile into +the blood. It was formerly considered to be a disease of itself, but is +now regarded as a symptom of disorder of the liver. "The yellows" is +observed by looking at the eyes, nose, and mouth, when it will be seen +that these parts are yellowish instead of the pale-pink color of health. +In white or light-colored horses the skin even may show this yellow +tint. The urine is saffron colored, the dung is of a dirty-gray color, +and constipation is usually present. Jaundice may be present as a +symptom of almost any inflammatory disease. We know that when an animal +has fever the secretions are checked, the bile may be retained and +absorbed throughout the system, and<span class='pagenum'><a name="Page_89" id="Page_89">[Pg 89]</a></span> yellowness of the mucous membranes +follows. Jaundice may also exist during the presence of simple +constipation, hepatitis, biliary calculi, abscesses, hardening of the +liver, etc.</p> + +<p><i>Treatment.</i>—When jaundice exists we must endeavor to rid the system of +the excess of bile, and this is best accomplished by giving purgatives +that act upon the liver. Calomel, 2 drams, with aloes, 7 drams, should +be given. Glauber's salt in handful doses once or twice a day for a week +is also effective. May apple, rhubarb, castor oil, and other cathartics +that act upon the first or small bowels may be selected. We must be +careful to see that the bowels are kept open by avoiding hard, dry, +bulky feeds.</p> + + +<h4>RUPTURE OF THE LIVER.</h4> + +<p>This is known to occur at times in the horse, most frequently in old, +fat horses and those that get but little exercise. Horses that have +suffered from chronic liver disease for years eventually present +symptoms of colic and die quite suddenly. Upon post-mortem examination +we discover that the liver has ruptured. The cicatrices, or scars, that +are often found upon the liver indicate that this organ may suffer +<i>small</i> rupture and yet the horse may recover from it. This can not be +the result, however, if the rent or tear is extensive, since in such +cases death must quickly follow from hemorrhage, or, later, from +peritonitis. Enlarged liver is particularly liable to rupture.</p> + +<p>The immediate causes of rupture appear to be excessive muscular +exertion, as leaping a fence, a fall, a blow from a collision, a kick +from a horse, or sudden distention of the abdomen with gas.</p> + +<p>The symptoms of rupture of the liver will depend upon the extent of the +laceration. If slight, there will be simply the symptoms of abdominal +pain, looking back to the sides, lying down, etc.; if extensive, the +horse is dull and dejected, has no appetite, breathing becomes short and +catching, he sighs or sobs, visible mucous membranes are pale, +extremities cold, pulse fast, small, and weak or running down. +Countenance now shows much distress, he sweats profusely, totters in his +gait, props his legs wide apart, reels, staggers, and falls. He may get +up again, but soon falls dead. The rapid running-down pulse, paleness of +the eyes, nose, and mouth, sighing, stertorous breathing, tottering +gait, etc., are symptoms by which we know that the animal is dying from +internal hemorrhage.</p> + +<p><i>Treatment.</i>—But little can be done in the way of treatment. Opium in +powder, in doses of 2 drams every two or three hours, may be given, with +the idea of preventing as much as possible all movements of internal +organs. If there is reason to suspect internal bleeding,<span class='pagenum'><a name="Page_90" id="Page_90">[Pg 90]</a></span> we should give +large and frequent doses of white-oak bark tea, dram doses of tannic or +gallic acid, or the same quantity of sugar of lead, every half hour or +hour. Fluid extract of ergot or tincture of the chlorid of iron, in +ounce doses, may be selected. Cold water dashed upon the right side or +injected into the rectum is highly spoken of as a means of checking the +hemorrhage.</p> + + +<h4>BILIARY CALCULI, OR GALLSTONES.</h4> + +<p>These are rarely found in the horse, but may occupy the hepatic ducts, +giving rise to jaundice and to colicky pains. There are no absolutely +diagnostic symptoms, but should one find a horse that suffers from +repeated attacks of colic, accompanied with symptoms of violent pain, +and that during or following these attacks the animal is jaundiced, it +is possible that gallstones are present. There is little or nothing to +be done except to give medicines to overcome pain, trusting that these +concretions may pass on to the bowels, where, from their small size, +they will not occasion any inconvenience.</p> + + +<h4>DISEASES OF THE PANCREAS AND SPLEEN.</h4> + +<p>Diseases of the pancreas and spleen are so rare, or their symptoms so +little understood, that it is impossible to write anything concerning +either of these organs and their simple diseases that will convey to the +reader information of practical value.</p> + + +<h3>GASTROINTESTINAL PARASITES.</h3> + +<h4>[By Maurice C. Hall, Ph. D., D. V. M.]</h4> + +<p>Horses are subject to infestation by a number of species of worms, these +worms being especially numerous at certain points in the alimentary +canal.</p> + +<p>The tapeworms of the horse are relatively unimportant and not very +common. There are three species, the smallest about two inches long and +the largest about eight inches long. These two occur in the small +intestine; a form intermediate in size may also be found in the cecum +and colon. These are flat, segmented worms with the head at the smaller +end.</p> + +<p>Flukes occur in horses elsewhere, but have apparently never been +reported in the United States.</p> + +<p>Roundworms, or nematodes, constitute the most important group of +parasitic worms in the horse. The more important of these are as +follows:</p> + +<p><span class="smcap">Roundworm</span> (<i>Ascaris equorum</i>).—This is the common large, yellowish +roundworm (Pl. V, fig. 5), about the size of a lead pencil or larger, +which may be found in horses almost anywhere in the<span class='pagenum'><a name="Page_91" id="Page_91">[Pg 91]</a></span> United States. It +occurs in the intestine and probably occasions little damage as a rule, +except when present in large numbers, in which case it will probably be +found in the droppings. The symptoms occasioned by it are rather obscure +and are such as might arise from a number of other causes, namely, +colicky pains, depraved appetite, diarrhea or constipation, and general +unthriftiness. In a general way, the presence of parasites may be +suspected when an animal shows no fever but is unthrifty, debilitated, +and shows disordered bowel movements in cases where there is no evident +explanation in the way of feed, care, and surroundings.</p> + +<p><i>Treatment</i> for the removal of this worm consists in the use of +anthelmintics such as tartar emetic, turpentine, and carbon bisulphid, +but as these remedies are essentially poisons intended to kill the worm, +and as their use by persons unused to determining conditions unfavorable +for their use is dangerous and likely to result in the death of the +animal or in permanent injury to the kidneys or other organs, it is +advisable to call in a veterinarian in such cases.</p> + +<p><span class="smcap">Pinworm</span> (<i>Oxyuris equi</i>).—This is a rather large worm (Pl. V, fig. 1), +somewhat smaller than the foregoing and readily distinguishable from it +by the presence of a long, slender tail. It also occurs generally +throughout the United States, and except when present in large numbers +probably does very little damage. It inhabits the large intestine and +hence is difficult to reach with medicines administered by the mouth. +The use of a half ounce of gentian on the feed night and morning for a +week has been recommended, but the use of rectal enemas will give more +prompt and perhaps more certain results. These enemas may be made up +with one or two tablespoonfuls of salt to the pint, or infusions of +quassia chips, a half pound to the gallon of water, and injected into +the rectum once or twice a day.</p> + +<p><span class="smcap">Stomach worms of the horse</span> (<i>Habronema</i> spp.).—These worms (Pl. V, fig. +4) occur in nodules in the mucous lining of the horse's stomach and are +credited with doing more or less damage. Their presence is not likely to +be diagnosed in the present state of our knowledge, but in case their +presence is determined or suspected in connection with the summer sores +noted later, tartar emetic is recommended. At least one of these worms +has an intermediate stage in the ordinary housefly, the fly becoming +infested while it is a larva developing in horse manure. Obviously, +therefore, any measures looking toward the eradication of the fly or the +proper disposal of manure will aid in the control and eradication of +this worm. The United States Bureau of Entomology has shown that fly +maggots travel downward through a manure pile as it comes time for the +maggot to enter the ground and pupate, and an excellent maggot<span class='pagenum'><a name="Page_92" id="Page_92">[Pg 92]</a></span> trap, +consisting of an exposed manure platform raised on posts which are set +in a concrete basin extending under the platform and filled with three +or four inches of water, has been devised. As maggots work down they +come to the platform and escape through the spaces between the boards, +left open for the purpose, to the water in the concrete basin, where +they are drowned. In this way the exposed manure pile serves to attract +flies with a deceptive proffer of a breeding place.</p> + +<p>Apparently it is the young forms of these stomach worms which develop at +times on the skin, causing a cutaneous habronemiasis known as summer +sores. This is discussed under diseases of the skin.</p> + +<p><span class="smcap">Strongyles</span> (<i>Strongylus</i> spp. and <i>Cylicostomum</i> spp.).—These worms +(Pl. V, figs. 2 and 3) live in the large intestines of the horse as +adult worms and are often present in enormous numbers. Many of them are +very small, and the largest are less than two inches long. The adult +worms do considerable damage, but the immature or larval worms do even +more.</p> + +<p>The larva of <i>Strongylus vulgaris</i> enters the blood vessels of the +intestinal wall and finally attaches in the great mesenteric artery, +where it causes aneurisms; here it transforms to an adult without sexual +organs, which passes to the walls of the cecum and encysts, giving rise +to small cysts or abscesses; these cysts finally discharge to the +interior of the cecum, setting the worms, now mature, at liberty in the +lumen of the intestines.</p> + +<p>The larvæ of <i>Strongylus equinus</i> are found principally in the liver, +lungs, and pancreas.</p> + +<p>The larvæ of <i>Strongylus edentatus</i> may be met with almost anywhere, +especially under the serous membranes, the pleura and peritoneum.</p> + +<p>The embryos and larvæ of species of <i>Cylicostomum</i> are found in the +mucosa of the large intestine.</p> + +<p>Aneurisms impede the circulation of the blood, and may give rise to +intermittent lameness. The aneurism may rupture, since it constitutes a +weak place in the wall of the blood vessel, and the horse die of the +resulting hemorrhage. Particles of blood clots in the aneurisms may +break off and plug a blood vessel at the point where they lodge, thereby +causing the death of the part from which the blood is shut off and +occasioning a type of colic which often terminates fatally. The larvæ of +<i>Cylicostomum</i> form cysts in the walls of the large intestine, and when +these open they give rise to small sores; when they are numerous they +cause a thickening and hardening which impair the proper functioning of +the intestine. Abscesses sometimes perforate, causing death. The adult +worm attacks the intestinal wall, causing bleeding which results in +anemia. The numerous small sores thus caused allow bacteria to get into +the circulation, sometimes resulting in localized abscesses or in septic +arthritis or joint disease.</p> + +<p><a name="PLATE_V" id="PLATE_V"></a></p> +<div class="figcenter" style="width: 318px;"> +<a href="images/plate5.jpg"><img src="images/plate5t.jpg" width="318" height="450" alt="PLATE V." title="" /></a> +<span class="caption">PLATE V.<br /> + +INTESTINAL WORMS.</span> +</div> + + +<p><a name="PLATE_VI" id="PLATE_VI"></a></p> +<div class="figcenter" style="width: 309px;"> +<a href="images/plate6.jpg"><img src="images/plate6t.jpg" width="309" height="450" alt="PLATE VI." title="" /></a> +<span class="caption">PLATE VI.<br /> +BOTS<br /><br /> + +1. Bots in the stomach.<br /> + +2. Bots in the duodenum.</span> +</div> + +<p><span class='pagenum'><a name="Page_93" id="Page_93">[Pg 93]</a></span>The disease due to these worms is quite common. The worms enter the body +as immature forms in the spring, when the animal is turned out on +pasture. The first symptoms show in November or December, the disease +being in a latent stage during the development of the worms. The first +symptoms are diarrhea, loss of appetite, and emaciation. The animal +becomes anemic. Secondary symptoms are edema and such complications as +joint infection, colic due to embolism, and accidents from falls, +hemorrhage from ruptured aneurisms, or perforation at the site of +abscess. The animal may die, recover, or become a chronic sufferer, the +internal injuries failing to make a satisfactory recovery even with the +removal of the worms in chronic cases.</p> + +<p><i>Treatment</i> calls for the expulsion of the adult worms from the +intestine, the development of the body resistance to repair the damage +wrought by the developing worms, and the combating of complications. For +the expulsion of the worms the use of carbon bisulphid in gelatin +capsules, 2 to 5 grams, according to the size of the patient, for five +days, followed by magnesium sulphate the sixth day, has been +recommended. Owing to the difficulty and danger in the administration of +carbon bisulphid in capsule, it is advisable to call in a veterinarian. +Tonic treatment consists in the subcutaneous administration of +artificial serum and caffein. The various complications of bacterial +infection, colic, heart depression, etc., call for the attention of a +veterinarian. Preventive measures consist in avoiding reinfection with +worms so far as possible by using dry upland pasture in preference to +low, wet land, and by rotating pastures or rotation of the stock on a +given pasture. Horses may be alternated with cattle, sheep, or hogs to +advantage, so far as parasites are concerned. Another feature, always of +importance, is the provision of a pure, potable drinking water.</p> + +<p><span class="smcap">Bots</span> (<i>Gastrophilus</i> spp.).—Bots (Pl. VI) are quite common in the +stomach and upper part of the small intestine of the horse anywhere in +the United States, one kind being occasionally found in the rectum. They +attach to that portion of the mucous lining of the stomach nearest the +esophagus or sometimes around the pyloric opening to the intestine or +even in the upper intestine, and undoubtedly interfere with the proper +functioning of the stomach and the health of the animal to a certain +extent. The symptoms are rather vague as a rule, but the general result +is a condition of unthriftiness.</p> + +<p>A treatment which has been found effective consists in feeding lightly +on the day preceding treatment, withholding food in the evening and +giving an ounce of Barbados aloes or a pint of linseed<span class='pagenum'><a name="Page_94" id="Page_94">[Pg 94]</a></span> oil. The next +day give 3 drams of carbon bisulphid in a gelatin capsule at 6 o'clock, +repeat the dose at 7 o'clock, and again at 8 o'clock, making a total of +9 drams altogether for an adult horse; half that amount will be +sufficient for a yearling colt. As previously noted, there is some +little difficulty and danger of accident in the administration of +treatments of this character and it is advisable to call in a +veterinarian.</p> + +<p>Unless destroyed by treatment, the bots in the stomach of the horse pass +out in the manure in the spring and burrow down into the soil an inch or +two. Here they undergo a certain amount of development and finally +emerge as adult flies. These bot flies mate and during the summer the +eggs are deposited by the female on the forelegs and shoulders or around +the chin, mouth and nostrils of the horse, the location and appearance +of the eggs varying somewhat with different species of bot flies. These +eggs or the young maggots escaping from them are ingested by the horse +in licking the portions irritated by the movement of the escaping +maggots, and when swallowed develop to form bots in the stomach. Careful +currying, especially around the forequarters, is an aid in keeping down +bot infestation, but this is not commonly feasible with horses on +pasture, the ones most liable to become infested.</p> + + + +<hr style="width: 65%;" /> +<p><span class='pagenum'><a name="Page_95" id="Page_95">[Pg 95]</a></span></p> +<h2>DISEASES OF THE RESPIRATORY ORGANS.</h2> + +<h3>By <span class="smcap">W. S. Harbaugh</span>, V. S.</h3> + +<h4>[Revised by Leonard Pearson, B. S., V. M. D.]</h4> + + +<p>The organs pertaining to the respiratory function may be enumerated in +natural order as follows: The nasal openings, or nostrils; the nasal +chambers, through which the air passes in the head; the sinuses in the +head, communicating with the nasal chambers; the pharynx, common to the +functions of breathing and swallowing; the larynx, at the top of the +windpipe; the trachea, or windpipe; the bronchi (into which the windpipe +divides), two tubes leading from the windpipe to the right and left +lungs, respectively; the bronchial tubes, which penetrate and convey air +to all parts of the lungs; the lungs.</p> + +<p>The pleura is a thin membrane that envelops the lung and lines the walls +of the thoracic cavity. The diaphragm is a muscular structure, +completely separating the contents of the thoracic cavity from those of +the abdominal cavity. It is essentially a muscle of inspiration, and the +principal one. Other muscles aid in the mechanism of respiration, but +the diseases or injuries of them have nothing to do with the diseases +under consideration.</p> + +<p>Just within the nasal openings the skin becomes gradually but +perceptibly finer, until it is succeeded by the mucous membrane. Near +the junction of the skin and membrane is a small hole, presenting the +appearance of having been made with a punch; this is the opening of the +lachrymal duct, a canal that conveys the tears from the eyes. Within and +above the nasal openings are the cavities, or fissures, called the false +nostrils. The nasal chambers are completely separated, the right from +the left, by a cartilaginous partition, the nasal septum. Each nasal +chamber is divided into three continuous compartments by two thin, +scroll-like turbinated bones.</p> + +<p>The mucous membrane lining the nasal chambers, and, in fact, the entire +respiratory tract, is much more delicate and more frequently diseased +that the mucous membrane of any other part of the body. The sinuses of +the head are compartments which communicate with the nasal chambers and +are lined with a continuation of the same membrane that lines the nasal +chambers; their presence increases the volume and modifies the form of +the head without increasing its weight.</p> + +<p>The horse, in a normal condition, breathes exclusively through the +nostrils. The organs of respiration are quite liable to become +diseased,<span class='pagenum'><a name="Page_96" id="Page_96">[Pg 96]</a></span> and, as many of the causes which lead to these attacks can be +avoided, it is both important and profitable to know and study the +causes.</p> + + +<h4>CAUSES OF DISEASES OF RESPIRATORY ORGANS.</h4> + +<p>The causes of many of the diseases of these organs may be given under a +common head, because even a simple cold, if neglected or badly treated, +may run into the most complicated lung disease and terminate fatally. In +the spring and fall, when the animals are changing their coats, there is +a marked predisposition to contract disease, and consequently at those +periods care should be taken to prevent other exciting causes.</p> + +<p>Badly ventilated stables are a frequent source of disease. It is a +mistake to think that country stables necessarily have purer air than +city stables. Stables on some farms are so faultily constructed that it +is almost impossible for the foul air to gain an exit. All stables +should have a sufficient supply of pure air, and be so arranged that +strong drafts can not blow directly on the animals. In ventilating a +stable, it is best to arrange to remove air from near the floor and +admit it through numerous small openings near the ceiling. The reason +for this is that the coldest and most impure air in the stable is near +the floor, while that which is warmest and purest, and therefore can +least be spared, is near the top of the room. In summer, top exits and +cross currents should be provided to remove excessive heat. Hot stables +are almost always poorly ventilated, and the hot stable is a cause of +disease on account of the extreme change of temperature that a horse is +liable to when taken out, and extreme changes of temperature are to be +avoided as certain causes of disease.</p> + +<p>A cold, close stable is invariably damp, and is to be avoided as much as +the hot, close, and foul one. Horses changed from a cold to a warm +stable are more liable to contract cold than when changed from a warm to +a cold one. Pure air is more essential than warmth, and this fact should +be especially remembered when the stable is made close and foul to gain +the warmth. It is more economical to keep the horse warm with blankets +than to prevent the ingress of pure air in order to make the stable +warm.</p> + +<p>Stables should be well drained and kept clean. Some farmers allow large +quantities of manure to accumulate in the stable. This is a pernicious +practice, as the decomposing organic matter evolves gases that are +predisposing or exciting causes of disease. When a horse is overheated, +it is not safe to allow him to dry by evaporation; rubbing him dry and +gradually cooling him out is the wisest treatment. When a horse is +hot—covered with sweat—it is dangerous to allow him to stand in a +draft; it is the best plan to walk him until his<span class='pagenum'><a name="Page_97" id="Page_97">[Pg 97]</a></span> temperature moderates. +In such cases a light blanket thrown over the animal may prevent a cold. +Overwork or overexertion often causes the greater number of fatal cases +of congestion of the lungs. Avoid prolonged or fast work when the horse +is out of condition or unaccustomed to it. Animals that have been +working in cold rains should be dried and cooled out and not left to dry +by evaporation. When the temperature of the weather is at the extreme, +either of heat or cold, diseases of the organs of respiration are most +frequent.</p> + +<p>It is not to be supposed that farmers can give their horses the +particular attention given to valuable racing and pleasure horses, but +they can most assuredly give them common-sense care, and this may often +save the life of a valuable animal. If the owner properly considers his +interests, he will study the welfare of his horses so that he may be +able to instruct the servant in details of stable management.</p> + + +<h4>WOUNDS ABOUT THE NOSTRILS.</h4> + +<p>Wounds in this neighborhood are common, and are generally caused by +snagging on a nail or splinter or by the bite of another horse; or by +getting "run into," or by running against something. Occasionally the +nostril is so badly torn and lacerated that it is impossible to effect a +cure without leaving the animal blemished for life, but in the majority +of instances the blemish, or scar, is the result of want of conservative +treatment. As soon as possible after the accident the parts should be +brought together and held there by stitches. If too much time is allowed +to elapse, the swelling of the parts will considerably interfere. Never +cut away any skin that may be loose and hanging, or else a scar will +certainly remain. Bring the parts in direct apposition and place the +stitches from a quarter to a half-inch apart, as circumstances may +demand. It is not necessary to have special surgeons' silk and needles +for this operation; good linen thread or ordinary silk thread will +answer. The wound afterwards only requires to be kept clean. For this +purpose it should be cleansed and discharges washed away daily with a +solution made of carbolic acid 1 part in 40 parts of water. If on +account of the irritability the horse is inclined to rub the wound +against some object, his head should be tied by means of two halter +ropes attached to the opposite sides of the stall to prevent him from +opening the wound. Except when at work or eating, the head should be so +tied about 10 days.</p> + + +<h4>TUMORS WITHIN THE NOSTRILS.</h4> + +<p>A small, globular tumor is sometimes found within the false nostril, +under that part of the skin that is seen to puff or rise and fall when a +horse is exerted and breathing hard. These tumors contain matter of a +cheesy consistency.<span class='pagenum'><a name="Page_98" id="Page_98">[Pg 98]</a></span></p> + +<p><i>Treatment.</i>—If the tumor is well opened and the matter squeezed out, +nature will perform a cure. If the opening is made from the outside +through the skin, it should be at the most dependent part, but much the +best way to open the tumor is from the inside. Quiet the animal, gently +insert your finger up in the direction of the tumor, and you will soon +discover that it is much larger inside than it appears to be on the +outside. If necessary put a twitch on the ear of the horse to quiet him; +run the index finger of your left hand against the tumor; now, with the +right hand, carefully insert the knife by running the back of the blade +along the index finger of the left hand until the tumor is reached; with +the left index finger guide the point of the blade quickly and surely +into the tumor; make the opening large. A little blood may flow for a +while, but it is of no consequence. Squeeze out the matter and keep the +part clean.</p> + + +<h4>COLD IN THE HEAD, OR NASAL CATARRH.</h4> + +<p>Catarrh is an inflammation of a mucous membrane. It is accompanied with +excessive secretion. In nasal catarrh the inflammation may extend from +the membrane lining the nose to the throat, the inside of the sinuses, +and to the eyes. The causes are the general causes of respiratory +disease enumerated above. It is especially common in young horses and in +horses not acclimated.</p> + +<p><i>Symptoms.</i>—The membrane at the beginning of the attack is dry, +congested, and irritable; it is of a deeper hue than natural, pinkish +red or red. Soon a watery discharge from the nostrils makes its +appearance; the eyes may also be more or less affected and tears flow +over the cheeks. The animal has some fever, which may be easily detected +by means of a clinical thermometer inserted in the rectum or, roughly, +by placing the finger in the mouth, as the feeling of heat conveyed to +the finger will be greater than natural.</p> + +<p>To become somewhat expert in ascertaining the changes of temperature in +the horse it is only necessary to place the finger often in the mouths +of horses known to be healthy. After you have become accustomed to the +warmth of the mouth of the healthy animal you will have no difficulty in +detecting a marked increase of the temperature. The animal may be dull; +he sneezes or snorts, but does not cough unless the throat is affected; +he expels the air forcibly through his nostrils, very often in a manner +that may be aptly called "blowing his nose." A few days after the attack +begins the discharge from the nostrils changes from a watery to that of +a thick, mucilaginous state, of a yellowish-white color, and may be more +or less profuse. Often the appetite is lost and the animal becomes +debilitated.</p> + +<p><i>Treatment.</i>—This disease is not serious, but inasmuch as neglect or +bad treatment may cause it to lead to something worse or become chronic +it should receive proper attention. The animal should not<span class='pagenum'><a name="Page_99" id="Page_99">[Pg 99]</a></span> be worked for +a time. A few days of rest, with pure air and good feed, will be of +greater benefit than most medication. The value of pure air can not be +overestimated, but drafts must be avoided. The benefit derived from the +inhalation of steam is considerable. This is effected by holding the +horse's head over a bucketful of boiling water, so that the animal will +be compelled to inhale steam with every inhalation of air. Stirring the +hot water with a wisp of hay causes the steam to arise in greater +abundance. One may cause the horse to put his nose in a bag containing +cut hay upon which hot water has been poured, the bottom of the bag +being stood in a bucket, but the bag must be of loose texture, as gunny +sack, or, if of canvas, holes must be cut in the side to admit fresh +air.</p> + +<p>The horse may be made to inhale steam four or five times a day, about 15 +or 20 minutes each time.</p> + +<p>Particular attention should be paid to the diet. Give bran mashes, +scalded oats, linseed gruel, and grass, if in season. If the horse +evinces no desire for this soft diet, it is better to allow any kind of +feed he will eat, such as hay, oats, corn, etc., than to keep him on +short rations.</p> + +<p>If the animal is constipated, relieve this symptom by injections +(enemas) of warm water into the rectum three or four times a day, but do +not administer purgative medicines, except of a mild character.</p> + +<p>For simple cases the foregoing is all that is required, but if the +appetite is lost and the animal appears debilitated and dull, give 3 +ounces of the solution of acetate of ammonia and 2 drams of powdered +chlorate of potassium diluted with a pint of water three times a day as +a drench. Be careful when giving the drench; do not pound the horse on +the gullet to make him swallow; be patient, and take time, and do it +right.</p> + +<p>If the weather is cold, blanket the animal and keep him in a comfortable +stall. If the throat is sore, treat as advised for that ailment, to be +described hereafter.</p> + +<p>If, after 10 days or 2 weeks, the discharge from the nostrils continues, +give one-half dram of reduced iron three times a day. This may be mixed +with damp feed. Common cold should be thoroughly understood and +intelligently treated in order to prevent more dangerous diseases.</p> + + +<h4>CHRONIC CATARRH (OR NASAL GLEET, OR COLLECTION IN THE SINUSES).</h4> + +<p>This is a subacute or chronic inflammation of some part of the membrane +affected in common cold, the disease just described. It is manifested by +a persistent discharge of a thick white or yellowish-white matter from +one or both nostrils. The commonest cause is a neglected or badly +treated cold, and it usually follows those cases<span class='pagenum'><a name="Page_100" id="Page_100">[Pg 100]</a></span> where the horse has +suffered exposure, been overworked, or has not received proper feed, +and, as a consequence, has become debilitated. It may occur as a sequel +to influenza.</p> + +<p>Other but less frequent causes for this affection are: Fractures of the +bones that involve the membrane of the sinuses, and even blows on the +head over the sinuses. Diseased teeth often involve a sinus and cause a +fetid discharge from the nostril. Violent coughing is said to have +forced particles of feed into the sinus, which acted as a cause of the +disease. Tumors growing in the sinuses are known to have caused it. It +is also attributed to disease of the turbinated bones. Absorption of the +bones forming the walls of the sinuses has been caused by the pressure +of pus collecting in them and by tumors filling up the cavity.</p> + +<p><i>Symptoms.</i>—Great caution must be exercised when examining these cases, +for the horse may have glanders, while, on the other hand, horses have +been condemned as glandered when really there was nothing ailing them +but nasal gleet. This is not contagious, but may stubbornly resist +treatment and last for a long time. In most cases the discharge is from +one nostril only, which may signify that the sinuses on that side of the +head are affected. The discharge may be intermittent; that is, +quantities may be discharged at times and again little or none for a day +or so. Such an intermittent discharge usually signifies disease of the +sinuses. The glands under and between the bones of the lower jaw may be +enlarged. The peculiar ragged-edged ulcer of glanders is not to be found +on the membrane within the nostrils, but occasionally sores are to be +seen there. If there is any doubt about it, the symptoms of glanders +should be well studied in order that one may be competent to form a safe +opinion.</p> + +<p>The eye on the side of the discharging nostril may have a peculiar +appearance and look smaller than its fellow. There may be an +enlargement, having the appearance of a bulging out of the bone over the +part affected, between or below the eyes. The breath may be offensive, +which indicates decomposition of the matter or bones or disease of the +teeth. A diseased tooth is further indicated by the horse holding his +head to one side when eating, or by dropping the feed from the mouth +after partly chewing it. When the bones between the eyes, below the +eyes, and above the back teeth of the upper jaw are tapped on, a hollow, +drumlike sound is emitted, but if the sinus is filled with pus or +contains a large tumor the sound emitted will be the same as if a solid +substance were struck; by this means the sinus affected may be located +in some instances. The hair may be rough over the affected part, or even +the bone may be soft to the touch and the part give somewhat to pressure +or leave an impression where it is pressed upon with the finger.<span class='pagenum'><a name="Page_101" id="Page_101">[Pg 101]</a></span></p> + +<p><i>Treatment.</i>—The cause of the trouble must be ascertained before +treatment is commenced. In the many cases in which the animal is in poor +condition (in fact, in all cases) he should have the most nutritive feed +and regular exercise. The feed, or box containing it, should be placed +on the ground, as the dependent position of the head favors the +discharge.</p> + +<p>The cases that do not require a surgical operation must, as a rule, have +persistent medical treatment. Mineral tonics and local medication are of +the most value. For eight days give the following mixture: Reduced iron, +3 ounces; powdered nux vomica, 1 ounce. Mix and make into 16 powders; +one powder should be mixed with the feed twice a day. Arsenious acid +(white arsenic) in doses of from 3 to 6 grains three times daily is a +good tonic for such cases. Sulphur burnt in the stable while the animal +is there to inhale its fumes is also a valuable adjunct. Care should be +taken that the fumes of the burning sulphur are sufficiently diluted +with air so as not to suffocate the horse. Chlorid of lime sprinkled +around the stall is good. Also keep a quantity of it under the hay in +the manger so that the gases will be inhaled as the horse holds his head +over the hay while eating. Keep the nostrils washed and the discharge +cleaned away from the manger and stall. The horse may be caused to +inhale the vapor of compound tincture of benzoin by pouring 2 ounces of +this drug into hot water and fumigating in the usual way.</p> + +<p>If the nasal gleet is the result of a diseased tooth, the latter must be +removed. Trephining is the best possible way to remove it in such cases, +as the operation immediately opens the cavity, which can be attended to +direct. In all those cases of nasal gleet in which sinuses contain +either tumors or collections of pus the only relief is by the trephine; +and, no matter how thoroughly described, this is an operation that will +be seldom attempted by the nonprofessional. It would therefore be a +waste of time to give the modus operandi.</p> + +<p>An abscess involving the turbinated bones is similar to the collection +of pus in the sinuses and must be relieved by trephining.</p> + + +<h4>THICKENING OF THE NASAL MEMBRANE.</h4> + +<p>This is sometimes denoted by a chronic discharge, a snuffling in the +breathing, and a contraction of the nostril. It is a result of common +cold and requires the same treatment as prescribed for nasal gleet, +namely, the sulphate of iron, sulphate of copper, iodid of potassium, +etc. The membranes of both sides may be affected, but one side only is +the rule; the affected side may be easily detected by holding the hand +tightly over one nostril at a time. When the healthy side is closed in +this manner the breathing through the affected side will demonstrate a +decreased caliber or an obstruction.<span class='pagenum'><a name="Page_102" id="Page_102">[Pg 102]</a></span></p> + + +<h4>NASAL POLYPUS.</h4> + +<p>Tumors with narrow bases (somewhat pear-shaped) are occasionally found +attached to the membrane of the nasal chambers, and are obstructions to +breathing through the side in which they are located. They vary much in +size; some are so small that their presence is not manifested, while +others almost completely fill the chamber, thereby causing a serious +obstruction to the passage of air. The stem, or base, of the tumor is +generally attached high in the chamber, and usually the tumor can not be +seen, but occasionally it increases in size until it can be observed +within the nostril. Sometimes, instead of hanging down toward the nasal +opening, it falls back into the pharynx. It causes a discharge from the +nostril, a more or less noisy snuffling sound in breathing, according to +its size, a discharge of blood (if it is injured), and sneezing. The +side that it occupies can be detected in the same way as described for +the detection of the affected side when the breathing is obstructed by a +thickened membrane.</p> + +<p>The only relief is removal of the polypus, which, like all other +operations, should be done by an expert when it is possible to obtain +one. The operation is performed by grasping the base of the tumor with +suitable forceps and twisting it round and round until it is torn from +its attachment, or by cutting it off with a noose of wire. The resulting +hemorrhage is checked by the use of an astringent lotion, such as a +solution of the tincture of iron, or by packing the nostrils with +surgeon's gauze.</p> + + +<h4>PHARYNGEAL POLYPUS.</h4> + +<p>This is exactly the same kind of tumor described as nasal polypus, the +only difference being in the situation. Indeed, the stem of the tumor +may be attached to the membrane of the nasal chamber, as before +explained, or it may be attached in the fauces (opening of the back part +of the mouth), and the body of the tumor then falls into the pharynx. In +this situation it may seriously interfere with breathing. Sometimes it +drops into the larynx, causing the most alarming symptoms. The animal +coughs, or tries to cough, saliva flows from the mouth, the breathing is +performed with the greatest difficulty and accompanied with a loud +noise; the animal appears as if strangled and often falls exhausted. +When the tumor is coughed out of the larynx the animal regains quickly +and soon appears as if nothing were ailing. These sudden attacks and +quick recoveries point to the nature of the trouble. The examination +must be made by holding the animal's mouth open with a balling iron or +speculum and running the hand back into the mouth. If the tumor is +within reach, it must be removed in the same manner as though it were in +the nose.<span class='pagenum'><a name="Page_103" id="Page_103">[Pg 103]</a></span></p> + + +<h4>BLEEDING FROM THE NOSE.</h4> + +<p>This often occurs during the course of certain diseases, namely, +influenza, bronchitis, purpura hemorrhagica, glanders, etc. But it also +occurs independently of other affections and, as before mentioned, is a +symptom of polypus, or tumor, in the nose.</p> + +<p>Injuries to the head, exertion, violent sneezing—causing a rupture of a +small blood vessel—also induce it. The bleeding is almost invariably +from one nostril only, and is never very serious. The blood escapes in +drops (seldom in a stream) and is not frothy, as when the hemorrhage is +from the lungs. (See Bleeding from the lungs, p. 127.) In most cases +bathing the head and washing out the nostril with cold water are all +that is necessary. If the cause is known, you will be guided according +to circumstances. If the bleeding continues, pour ice-cold water over +the face, between the eyes and down over the nasal chambers. A bag +containing ice in small pieces applied to the head is often efficient. +If in spite of these measures the hemorrhage continues, plugging the +nostrils with cotton, tow, or oakum, should be tried. A string should be +tied around the plug before it is pushed up into the nostril, so that it +can be safely withdrawn after 4 or 5 hours. If both nostrils are +bleeding, only one nostril at a time should be plugged. If the +hemorrhage is profuse and persistent, a drench composed of 1 dram of +acetate of lead dissolved in 1 pint of water, or ergot, 1 ounce, should +be given.</p> + + +<h4>INFLAMMATION OF THE PHARYNX.</h4> + +<p>As already stated, the pharynx is common to the functions of both +respiration and alimentation. From this organ the air passes into the +larynx and thence onward to the lungs. In the posterior part of the +pharynx is the superior extremity of the gullet, the canal through which +the feed and water pass to the stomach. Inflammation of the pharynx is a +complication of other diseases—namely, influenza, strangles, etc.—and +is probably always more or less complicated with inflammation of the +larynx. That it may exist as an independent affection there is no reason +to doubt, and it is discussed as such with the diseases of the digestive +tract.</p> + + +<h4>SORE THROAT, OR LARYNGITIS.</h4> + +<p>The larynx is situated in the space between the lower jawbones just back +of the root of the tongue. It may be considered as a box (somewhat +depressed on each side), composed principally of cartilages and small +muscles, and lined on the inside with a continuation of the respiratory +mucous membrane. Posteriorly it opens into and is continuous with the +windpipe. It is the organ of the voice, the vocal cords being situated +within it; but in the horse this function is of<span class='pagenum'><a name="Page_104" id="Page_104">[Pg 104]</a></span> little consequence. It +dilates and contracts to a certain extent, thus regulating the volume of +air passing through it. The mucous membrane lining it internally is so +highly sensitive that if the smallest particle of feed happens to drop +into it from the pharynx violent coughing ensues instantly and is +continued until the source of irritation is ejected. This is a provision +of nature to prevent foreign substances gaining access to the lungs. +That projection called Adam's apple in the neck of man is the prominent +part of one of the cartilages forming the larynx.</p> + +<p>Inflammation of the larynx is a serious and sometimes fatal disease, +and, as before stated, is usually complicated with inflammation of the +pharynx, constituting what is popularly known as "sore throat." The +chief causes are chilling and exposure.</p> + +<p><i>Symptoms.</i>—About the first symptom noticed is cough, followed by +difficulty in swallowing, which may be due to soreness of the membrane +of the pharynx, over which the feed or water must pass, or from the pain +caused by the contraction of the muscles necessary to impel the feed or +water onward to the gullet; or this same contraction of the muscles may +cause a pressure on the larynx and produce pain. In many instances the +difficulty in swallowing is so great that water, and in some cases feed, +is returned through the nose. This, however, does not occur in +laryngitis alone, but only when the pharynx is involved in the +inflammation. The glands between the lower jawbones and below the ears +may be swollen. Pressure on the larynx induces coughing. The head is +more or less "poked out," and has the appearance of being stiffly +carried. The membrane in the nose becomes red. A discharge from the +nostrils soon appears. As the disease advances, the breathing may assume +a more or less noisy character; sometimes a harsh, rasping snore is +emitted with every respiration, the breathing becomes hurried, and +occasionally the animal seems threatened with suffocation.</p> + +<p><i>Treatment.</i>—In all cases steam the nostrils, as has been advised for +cold in the head. In bad cases cause the steam to be inhaled +continuously for hours—until relief is afforded. Have a bucketful of +fresh boiling water every fifteen or twenty minutes. In each bucketful +of water put a tablespoonful of oil of turpentine, or compound tincture +of benzoin, the vapor of which will be carried along with the steam to +the affected parts and have a beneficial effect. In mild cases steaming +the nostrils five, six, or seven times a day will suffice.</p> + +<p>The animal should be placed in a comfortable, dry stall (a box stall +preferred), and should have pure air to breathe. The body should be +blanketed, and bandages applied to the legs. The diet should consist of +soft feed—bran mashes, scalded oats, linseed gruel, and, best of all, +fresh grass, if in season. The manger, or trough, should neither be too +high nor too low, but a temporary one should be constructed<span class='pagenum'><a name="Page_105" id="Page_105">[Pg 105]</a></span> at about +the height he carries his head. Having to reach too high or too low may +cause so much pain that the animal would rather forego satisfying what +little appetite he may have than inflict pain by craning his head for +feed or water. A supply of fresh water should be before him all the +time; he will not drink too much, nor will the cold water hurt him. +Constipation (if present) must be relieved by enemas of warm water, +administered three or four times during the twenty-four hours.</p> + +<p>A liniment composed of 2 ounces of olive oil and 1 each of solution of +ammonia and tincture of cantharides, well shaken together, may be +thoroughly rubbed in about the throat from ear to ear, and about 6 +inches down over the windpipe, and in the space between the lower jaws. +This liniment should be applied once a day for two or three days.</p> + +<p>If the animal is breathing with great difficulty, persevere in steaming +the nostrils, and dissolve 2 drams of chlorate of potassium in every +gallon of water he will drink; even if he can not swallow much of it, +and even if it is returned through the nostrils, it will be of some +benefit to the pharynx as a gargle.</p> + +<p>An electuary of acetate of potash, 2 drams, honey, and licorice powder +may be spread on the teeth with a paddle every few hours. If the pain of +coughing is great, 2 or 3 grains of morphin may be added to the +electuary.</p> + +<p>When the breathing begins to be loud, relief is afforded in some cases +by giving a drench composed of 2 drams of fluid extract of jaborandi in +half a pint of water. If benefit is derived, this drench may be repeated +four or five hours after the first dose is given. It will cause a free +flow of saliva from the mouth.</p> + +<p>In urgent cases, when suffocation seems inevitable, the operation of +tracheotomy must be performed. To describe this operation in words that +would make it comprehensible to the general reader is a more difficult +task than performing the operation, which, in the hands of the expert, +is simple and attended with little danger.</p> + +<p>The operator should be provided with a tracheotomy tube (to be purchased +from any veterinary instrument maker) and a sharp knife, a sponge, and a +bucket of clean cold water. The place to be selected for opening the +windpipe is that part which is found, upon examination, to be least +covered with muscles, about 5 or 6 inches below the throat. Right here, +then, is the place to cut through. Have an assistant hold the animal's +head still. Grasp your knife firmly in the right hand, select the spot +and make the cut from above to below directly on the median line on the +anterior surface of the windpipe. Make the cut about 2 inches long in +the windpipe; this necessitates cutting three or four rings. One bold +stroke is usually sufficient, but if it is necessary to make several +other cuts to finish the operation, do<span class='pagenum'><a name="Page_106" id="Page_106">[Pg 106]</a></span> not hesitate. Your purpose is to +make a hole in the windpipe sufficiently large to admit the tracheotomy +tube. It is quickly manifested when the windpipe is severed; the hot air +rushes out, and when air is taken in it is sucked in with a noise. A +slight hemorrhage may result (it never amounts to much), which is easily +controlled by washing the wound with a sponge and cold water, but use +care not to get any water in the windpipe. Do not neglect to instruct +your assistant to hold the head down immediately after the operation, so +that the neck will be in a horizontal line. This will prevent the blood +from getting into the windpipe and will allow it to drop directly on the +ground. If you have the self-adjustable tube, it retains its place in +the wound without further trouble after it is inserted. The other kind +requires to be secured in position by means of two tapes or strings tied +around the neck. After the hemorrhage is somewhat abated, sponge the +blood away and see that the tube is thoroughly clean, then insert it, +directing the tube downward toward the lungs.</p> + +<p>The immediate relief this operation affords is gratifying to behold. The +animal, a few minutes before on the verge of death from suffocation, +emitting a loud wheezing sound with every breath, with haggard +countenance, body swaying, pawing, gasping, fighting for breath, now +breathes tranquilly, and may be in search of something to eat.</p> + +<p>The tube should be removed once a day and cleaned with carbolic-acid +solution (1 to 20), and the discharge washed away from the wound with a +solution of carbolic acid, 1 part to 40 parts water. Several times a day +the hand should be held over the opening in the tube to test the +animal's ability to breathe through the nostrils, and as soon as it is +demonstrated that breathing can be performed in the natural way the tube +should be removed, the wound thoroughly cleansed with carbolic-acid +solution (1 to 40), and closed by inserting four or five stitches +through the skin and muscle. Do not include the cartilages of the +windpipe in the stitches. Apply the solution to the wound three or four +times a day until healed. When the tube is removed to clean it the lips +of the wound may be pressed together to ascertain whether or not the +horse can breathe through the larynx. The use of the tube should be +discontinued as soon as possible.</p> + +<p>It is true that tracheotomy tubes are seldom to be found on farms, and +especially when most urgently required. In such instances there is +nothing left to be done but, with a strong needle, pass a waxed end or +other strong string through each side of the wound, including the +cartilage of the windpipe, and keep the wound open by tying the strings +over the neck.</p> + +<p>During the time the tube is used the other treatment advised must not be +neglected. After a few days the discharge from the nostrils<span class='pagenum'><a name="Page_107" id="Page_107">[Pg 107]</a></span> becomes +thicker and more profuse. This is a good symptom and signifies that the +acute stage has passed. At any time during the attack, if the horse +becomes weak, give whisky or aromatic spirits of ammonia, 2 ounces in +water. Do not be in a hurry to put the animal back to work, but give +plenty of time for a complete recovery. Gentle and gradually increasing +exercise may be given as soon as the horse is able to stand it. The feed +should be carefully selected and of good quality. Tonics, as iron or +arsenic, may be employed.</p> + +<p>If abscesses form in connection with the disease they must be opened to +allow the escape of pus, but do not rashly plunge a knife into swollen +glands; wait until you are certain the swelling contains pus. The +formation of pus may be encouraged by the constant application of +poultices for hours at a time. The best poultice for the purpose is made +of linseed meal, with sufficient hot water to make a thick paste. If the +glands remain swollen for some time after the attack, rub well over them +an application of the following: Biniodid of mercury, 1 dram; lard, 1 +ounce; mix well. This may be applied once every day until the part is +blistered.</p> + +<p>Sore throat is also a symptom of other diseases, such as influenza, +strangles, purpura hemorrhagica, etc., which diseases may be consulted +under their proper headings.</p> + +<p>After a severe attack of inflammation of the larynx the mucous membrane +may be left in a thickened condition, or an ulceration of the part may +ensue, either of which is liable to produce a chronic cough. For the +ulceration it is useless to prescribe, because it can neither be +diagnosed nor topically treated by the nonprofessional.</p> + +<p>If a chronic cough remains after all the other symptoms have +disappeared, it is advisable to give 1 dram of iodid of potassium +dissolved in a bucketful of drinking water, one hour before feeding, +three times a day for a month if necessary. Also rub in well the +preparation of iodid of mercury (as advised for the swollen glands) +about the throat, from ear to ear, and in the space between the lower +jawbones. The application may be repeated every third day until the part +is blistered.</p> + + +<h4>SPASM OF THE LARYNX.</h4> + +<p>The symptoms are as follows: Sudden seizure by a violent fit of +coughing; the horse may reel and fall, and after a few minutes recover +and be as well as ever. The treatment recommended is this: Three drams +of bromid of potassium three times a day, dissolved in the drinking +water, or give as a drench in about a half pint of water for a week. +Then give 1 dram of powdered nux vomica (either on the food or shaken +with water as a drench) once a day for a few weeks.<span class='pagenum'><a name="Page_108" id="Page_108">[Pg 108]</a></span></p> + + +<h4>CROUP AND DIPHTHERIA.</h4> + +<p>Neither of these diseases affects the horse, but these names are +sometimes wrongly applied to severe laryngitis or pharyngitis, or to +forage poisoning, in which the throat is paralyzed and becomes +excessively inflamed and gangrenous.</p> + + +<h4>THICK WIND AND ROARING.</h4> + +<p>Horses that are affected with chronic disease that causes a loud, +unnatural noise in breathing are said to have thick wind, or to be +roarers. This class does not include those affected with severe sore +throat, as in these cases the breathing is noisy only during the attack +of the acute disease.</p> + +<p>Thick wind is caused by an obstruction to the free passage of the air in +some part of the respiratory tract. Nasal polypi, thickening of the +membrane, pharyngeal polypi, deformed bones, paralysis of the wing of +the nostril, etc., are occasional causes. The noisy breathing of horses +after having been idle and put to sudden exertion is not due to any +disease and is only temporary. Very often a nervous, excitable horse +will make a noise for a short time when started off, generally caused by +the cramped position in which the head and neck are forced in order to +hold him back.</p> + +<p>Many other causes may occasion temporary, intermittent, or permanent +noisy respiration, but chronic roaring is caused by paralysis of the +muscles of the larynx; and almost invariably it is the muscles of the +left side of the larynx that are affected.</p> + +<p>In chronic roaring the noise is made when the air is drawn into the +lungs; only when the disease is far advanced is a sound produced when +the air is expelled, and even then it is not nearly so loud as during +inspiration.</p> + +<p>In a normal condition the muscles dilate the aperture of the larynx by +moving the cartilage and vocal cord outward, allowing a sufficient +volume of air to rush through. But when the muscles are paralyzed the +cartilage and vocal cord that are normally controlled by the affected +muscles lean into the tube of the larynx, so that when the air rushes in +it meets this obstruction and the noise is produced. When the air is +expelled from the lungs its very force pushes the cartilage and vocal +cords out, and consequently noise is not produced in the expiratory act.</p> + +<p>The paralysis of the muscles is due to derangement of the nerve that +supplies them with energy. The muscles of both sides are not supplied by +the same nerve; there is a right and a left nerve, each supplying its +respective side. The reason why the muscles on the left side are the +ones usually paralyzed is owing to the difference in the anatomical +arrangement of the nerves. The left nerve is much longer and more +exposed to interference than the right nerve.<span class='pagenum'><a name="Page_109" id="Page_109">[Pg 109]</a></span></p> + +<p>In chronic roaring there is no evidence of any disease of the larynx +other than the wasted condition of the muscles in question. The disease +of the nerve is generally far from the larynx. Disease of parts +contiguous to the nerve along any part of its course may interfere with +its proper function. Enlargement of lymphatic glands within the chest +through which the nerve passes on its way back to the larynx is the most +frequent interruption of nervous supply, and consequently roaring. When +roaring becomes confirmed, medical treatment is entirely useless, as it +is impossible to restore the wasted muscle and at the same time remove +the cause of the interruption of the nervous supply. Before roaring +becomes permanent the condition may be benefited by a course of iodid of +potassium, if caused by disease of the lymphatic glands. Electricity has +been used with indifferent success. Blistering or firing over the larynx +is, of course, not worthy of trial if the disease is due to interference +of the nerve supply. The administration of strychnia (nux vomica) on the +ground that it is a nerve tonic with the view of stimulating the +affected muscles is treating only the result of the disease without +considering the cause, and is therefore useless. The operation of +extirpating the collapsed cartilage and vocal cord is believed to be the +only relief, and, as this operation is critical and can be performed +only by the skillful veterinarian, it will not be described here.</p> + +<p>From the foregoing description of the disease it will be seen that the +name "roaring," by which the disease is generally known, is only a +symptom and not the disease. Chronic roaring is also in many cases +accompanied with a cough. The best way to test whether a horse is a +"roarer" is either to make him pull a load rapidly up a hill or over a +sandy road or soft ground; or, if he is a saddle horse, gallop him up a +hill or over soft ground. The object is to make him exert himself. Some +horses require a great deal more exertion than others before the +characteristic sound is emitted. The greater the distance he is forced, +the more he will appear exhausted if he is a roarer; in bad cases the +animal becomes utterly exhausted, the breathing is rapid and difficult, +the nostrils dilate to the fullest extent, and the animal appears as if +suffocation was imminent.</p> + +<p>An animal that is a roarer should not be used for breeding purposes. The +taint is transmissible in many instances.</p> + +<p><i>Grunting.</i>—A common test used by veterinarians when examining "the +wind" of a horse is to see if he is a "grunter." This is a sound emitted +during expiration when the animal is suddenly moved, or startled, or +struck at. If he grunts he is further tested for roaring. Grunters are +not always roarers, but, as it is a common thing for a roarer to grunt, +such an animal must be looked upon with suspicion until he is thoroughly +tried by pulling a load or galloped up a hill. The test should be a +severe one. Horses suffering with pleurisy,<span class='pagenum'><a name="Page_110" id="Page_110">[Pg 110]</a></span> pleurodynia, or rheumatism, +and other affections accompanied with much pain, will grunt when moved, +or when the pain is aggravated, but grunting under these circumstances +does not justify the term of "grunter" being applied to the horse, as +the grunting ceases when the animal recovers from the disease that +causes the pain.</p> + +<p><i>High blowing.</i>—This term is applied to a noisy breathing made by some +horses. It is distinctly a nasal sound, and must not be confounded with +"roaring." The sound is produced by the action of the nostrils. It is a +habit and not an unsoundness. Contrary to roaring, when the animal is +put to severe exertion the sound ceases. An animal that emits this sound +is called a "high blower." Some horses have naturally very narrow nasal +openings, and they may emit sounds louder than usual in their breathing +when exercised.</p> + +<p><i>Whistling</i> is only one of the variations of the sound emitted by a +horse called a "roarer," and therefore needs no further notice, except +to remind the reader that a whistling sound may be produced during an +attack of severe sore throat or inflammation of the larynx, which passes +away with the disease that causes it.</p> + + +<h4>CHRONIC BRONCHITIS.</h4> + +<p>This may be due to the same causes as acute bronchitis or it may follow +the latter disease. An attack of the chronic form is liable to be +converted into acute bronchitis by a very slight cause. This chronic +affection in most instances is associated with thickening of the walls +of the tubes. Its course is slower, it is less severe, and is not +accompanied with so much fever as the acute form. If the animal is +exerted, the breathing becomes quickened and he soon shows signs of +exhaustion. In many instances the animal keeps up strength and +appearances moderately well, but in other cases the appetite is lost, +flesh gradually disappears, and he becomes emaciated and debilitated. It +is accompanied with a persistent cough, which in some cases is husky, +smothered, or muffled, while in others it is hard and clear. A whitish +matter, which may be curdled, is discharged from the nose. If the ear is +placed against the chest behind the shoulder blade, the rattle of the +air passing through the mucus can be heard within.</p> + +<p><i>Treatment.</i>—Rest is necessary, as even under the most favorable +circumstances a cure is difficult to effect. The animal can not stand +exertion and should not be compelled to undergo it. It should have much +the same general care and medical treatment prescribed for the acute +form. Arsenious acid in tonic doses (3 to 7 grains) three times daily +may be given. As arsenic is irritant, it must be mixed with a +considerable bulk of moist feed and never given alone. Arsenic may be +given in the form of Fowler's solution, 1 ounce three times daily in the +drinking water. An application of mustard applied<span class='pagenum'><a name="Page_111" id="Page_111">[Pg 111]</a></span> to the breast is a +beneficial adjunct. The diet should be the most nourishing. Bulky feed +should not be given. Linseed mashes, scalded oats, and, if in season, +grass and green-blade fodder are the best diet.</p> + + +<h4>THE LUNGS.</h4> + +<p>The lungs (see Pl. VII) are the essential organs of respiration. They +consist of two (right and left) spongy masses, commonly called the +"lights," situated entirely within the thoracic cavity. On account of +the space taken up by the heart, the left lung is the smaller. +Externally, they are completely covered by the pleura. The structure of +the lung consists of a light, soft, but very strong and remarkably +elastic tissue, which can be torn only with difficulty. Each lung is +divided into a certain number of lobes, which are subdivided into +numberless lobules (little lobes). A little bronchial tube terminates in +every one of these lobules. The little tube then divides into minute +branches which open into the air cells (pulmonary vesicles) of the +lungs. The air cells are little sacs having a diameter varying from +one-seventieth to one two-hundredth of an inch; they have but one +opening, the communication with the branches of the little bronchial +tubes. Small blood vessels ramify in the walls of the air cells. The air +cells are the consummation of the intricate structures forming the +respiratory apparatus. They are of prime importance, all the rest being +complementary. It is here that the exchange of gases takes place. As +before stated, the walls of the cells are very thin; so, also, are the +walls of the blood vessels. Through these walls escapes from the blood +the carbonic acid gas that has been absorbed by the blood in its +circulation through the different parts of the body; through these walls +also the oxygen gas, which is the life-giving element of the atmosphere, +is absorbed by the blood from the air in the air cells.</p> + + +<h4>CONGESTION OF THE LUNGS.</h4> + +<p>Congestion is essentially an excess of blood in the vessels of the parts +affected. Congestion of the lungs in the horse, when it exists as an +independent affection, is generally caused by overexertion when the +animal is not in a fit condition to undergo more than moderate exercise. +Very often what is recognized as congestion of the lungs is but a +symptom of exhaustion or dilatation of the heart.</p> + +<p>The methods practiced by the trainers of running and trotting horses +will give an idea of what is termed "putting a horse in condition" to +stand severe exertion. The animal at first gets walking exercises, then +after some time he is made to go faster and farther each day; the amount +of work is daily increased until he is said to be "in condition." An +animal so prepared runs no risk of being<span class='pagenum'><a name="Page_112" id="Page_112">[Pg 112]</a></span> affected with congestion of +the lungs, if he is otherwise healthy. On the other hand, if the horse +is kept in the stable for the purpose of laying on fat or for want of +something to do, the muscular system becomes soft, and the horse is not +in condition to stand the severe exertion of going fast or far, no +matter how healthy he may be in other respects. If such a horse be given +a hard ride or drive, he may start off in high spirits, but soon becomes +exhausted, and if he is pushed he will slacken his pace, show a desire +to stop, and may stagger or even fall. Examination will show the +nostrils dilated, the flanks heaving, the countenance haggard, and the +appearance of suffocation. The heart and muscles were not accustomed to +the sudden and severe strain put upon them; the heart became unable to +perform its work; the blood accumulated in the vessels of the lungs, +which eventually became engorged with the stagnated blood, constituting +congestion of the lungs.</p> + +<p>The animal, after having undergone severe exertion, may not exhibit +alarming symptoms until returned to the stable; then he will be noticed +standing with his head down, legs spread out, the eyes wildly staring or +dull and sunken. The breathing is very rapid and almost gasping; in most +cases the body is covered with perspiration, which, however, may soon +evaporate, leaving the surface of the body and the legs and ears cold; +the breathing is both abdominal and thoracic; the chest rises and falls +and the flanks are powerfully brought into action. If the pulse can be +felt at all it will be found beating very frequently, one hundred or so +to a minute. The heart may be felt tumultuously thumping if the hand is +placed against the chest behind the left elbow, or it may be scarcely +perceptible. The animal may tremble all over. If the ear is placed +against the side of the chest a loud murmur will be heard and perhaps a +fine, crackling sound.</p> + +<p>One can scarcely fail to recognize a case of congestion of the lungs +when brought on by overexertion, as the history of the case indicates +the nature of the ailment. In all cases of suffocation the lungs are +congested. It is also seen in connection with other diseases.</p> + +<p><i>Treatment.</i>—If the animal is attacked by the disease while on the +road, stop him immediately. Do not attempt to return to the stables. If +he is in the stable, make arrangements at once to insure an unlimited +supply of pure air. If the weather is warm, out in the open air is the +best place, but if too cold let him stand with head to the door. Let him +stand still; he has all he can do, if he obtains sufficient pure air to +sustain life. If he is encumbered with harness or saddle, remove it at +once and rub the body with cloths or wisps of hay or straw. This +stimulates the circulation in the skin, and thus aids in relieving the +lungs of the extra quantity of blood that is stagnated there. If you +have three or four assistants, let them rub the body and legs well until +the skin feels natural; rub the legs until they are warm, if possible. +When the circulation is reestablished, put bandages on the legs from the +hoofs up as far as possible. Throw a blanket over the body and let the +rubbing be done under the blanket. Diffusible stimulants are the +medicines indicated—brandy, whisky (or even ale or beer if nothing else +is at hand), ether, and aromatic spirits of ammonia. A drench of 2 +ounces each of spirits of nitrous ether and alcohol, diluted with a pint +of water, every hour until relief is afforded, is among the best +remedies. Or, give a quarter of a pint of whisky in a pint of water +every hour, or the same quantity of brandy as often, or a quart of ale +every hour, or 1 ounce of tincture of arnica in a pint of water every +hour until five or six doses have been given. If none of these remedies +are at hand, 2 ounces of oil of turpentine, shaken with a half pint of +milk, may be given once, but not repeated. The animal may be bled from +the jugular vein. Do not take more than 5 or 6 quarts from the vein, and +do not repeat the bleeding. The blood thus drawn will have a tarry +appearance.</p> + + +<p><a name="PLATE_VII" id="PLATE_VII"></a></p> +<div class="figcenter" style="width: 450px;"> +<a href="images/plate7.jpg"><img src="images/plate7t.jpg" width="450" height="286" alt="PLATE VII." title="" /></a> +<span class="caption">PLATE VII.<br /> + +POSITION OF THE LEFT LUNG.</span> +</div> + +<p><span class='pagenum'><a name="Page_113" id="Page_113">[Pg 113]</a></span>When the alarming symptoms have subsided active measures may be stopped, +but care must be used in the general treatment of the animal for several +days, for it must be remembered that congestion may be followed by +pneumonia. The animal should have a comfortable stall, where he will not +be subjected to drafts or sudden changes of temperature; he should be +blanketed and the legs kept bandaged. The air should be pure, a +plentiful supply of fresh, cold water always in the stall; and a diet +composed principally of bran mashes, scalded oats, and, if in season, +grass. When ready for use again the horse should at first receive only +moderate exercise, which may be daily increased until he may safely be +put to regular work.</p> + + +<h4>PNEUMONIA, OR LUNG FEVER.</h4> + +<p>Pneumonia is inflammation of the lungs. The chief varieties of pneumonia +are catarrhal—later discussed in connection with bronchitis, under the +name of broncho-pneumonia—and the fibrinous or croupous variety. The +latter form receives its names from the fact that the air spaces are +choked with coagulated fibrin thrown out from the blood. This causes the +diseased portions of the lungs to become as firm as liver, in which +condition they are said to be hepatized. As air is excluded by the +inflammatory product, the diseased lung will not float in water.</p> + +<p>The inflammation usually begins in the lower part of the lung and +extends upward. The first stage of the disease consists of congestion, +or engorgement, of the blood vessels, followed by leakage of serum +containing fibrin from the blood vessels into the air passages.<span class='pagenum'><a name="Page_114" id="Page_114">[Pg 114]</a></span> The +fluids thus escaping into the air cells and in the minute branches of +the little bronchial tubes become coagulated.</p> + +<p>The pleura covering the affected parts may be more or less inflamed. A +continuance of the foregoing phenomena is marked by a further escape of +the constituents of the blood, and a change in the membrane of the +cells, which becomes swollen. The exudate that fills the air cells and +minute bronchial branches undergoes disintegration and softening when +healing commences.</p> + +<p>The favorable termination of pneumonia is in resolution that is, a +restoration to health. This is gradually brought about by the exuded +material contained in the air cells and lung tissues being broken down +and softened and absorbed or expectorated through the nostrils. The +blood vessels return to their natural state, and the blood circulates in +them as before. In the cases that do not terminate so happily the lung +may become gangrenous (or mortified), an abscess may form, or the +disease may be merged into the chronic variety.</p> + +<p>Pneumonia may be directly induced by any of the influences named as +general causes for diseases of the organs of respiration, but in many +instances it is from neglect. A common cold or sore throat may be +followed by pneumonia if neglected or improperly treated. An animal may +be debilitated by a cold, and when in this weakened state may be +compelled to undergo exertion beyond his strength; or he may be kept in +a badly ventilated stable, where the foul gases are shut in and the pure +air is shut out; or the stable may be so open that parts of the body are +exposed to drafts of cold air. An animal is predisposed to pneumonia +when debilitated by any constitutional disease, and especially during +convalescence if exposed to any of the exciting causes. Foreign bodies, +such as feed accidentally getting into the lungs by way of the windpipe, +as well as the inhalation of irritating gases and smoke, ofttimes +produce fatal attacks of inflammation of the lung and bronchial tubes. +Pneumonia is frequently seen in connection with other diseases, such as +influenza, purpura hemorrhagica, strangles, glanders, etc. Pneumonia and +pleurisy are most common during cold, damp weather, and especially +during the prevalence of the cold north or northeasterly winds. Wounds +puncturing the thoracic cavity may cause pneumonia.</p> + +<p><i>Symptoms.</i>—Pneumonia, when a primary disease, is ushered in by a +chill, more or less prolonged, which in many cases is seen neither by +the owner nor the attendant, but is overlooked. The breathing becomes +accelerated, and the animal hangs its head and has a very dull +appearance. The mouth is hot and has a sticky feeling to the touch; the +heat conveyed to the finger in the mouth demonstrates a fever; if the +thermometer is placed in the rectum the temperature will be found to +have risen to 103° F. or higher. The pulse is frequent,<span class='pagenum'><a name="Page_115" id="Page_115">[Pg 115]</a></span> beating from +fifty or sixty to eighty or more a minute. There is usually a dry cough +from the beginning, which, however, changes in character as the disease +advances; for instance, it may become moist, or if pleurisy sets in, the +cough will be peculiar to the latter affection; that is, cut short in +the endeavor to suppress it. In some cases the discharge from the +nostrils is tinged with blood, while in other cases it has the +appearance of muco-pus. The appetite is lost to a greater or less +extent, but the desire for water is increased, particularly during the +onset of the fever. The membrane within the nostrils is red and at first +dry, but sooner or later becomes moist. The legs are cold. The bowels +are more or less constipated, and what dung is passed is usually covered +with a slimy mucus. The urine is passed in smaller quantities than usual +and is of a darker color.</p> + +<p>The animal prefers to have the head where the freshest air can be +obtained. When affected with pneumonia a horse does not lie down, but +persists in standing from the beginning of the attack. If pneumonia is +complicated with pleurisy, however, the horse may appear restless and +lie down for a few moments to gain relief from the pleuritic pains, but +he soon rises. In pneumonia the breathing is rapid and difficult, but +when the pneumonia is complicated with pleurisy the ribs are kept as +still as possible and the breathing is abdominal; that is, the abdominal +muscles are now made to do as much of the work as they can perform. If +pleurisy is not present there is little pain. To the ordinary observer +the animal may not appear dangerously ill, as he does not show the +seriousness of the ailment by violence, as in colic, but a careful +observer will discover at a glance that the trouble is something more +serious than a cold. By percussion it will be shown that some portions +of the chest are less resonant than in health, indicating exclusion of +air. If the air is wholly excluded the percussion is quite dull, like +that elicited by percussion over the thigh.</p> + +<p>By auscultation important information may be gained. When the ear is +placed against the chest of a healthy horse, the respiratory murmur is +heard more or less distinctly, according to the part of the chest that +is beneath the ear. In the very first stage of pneumonia this murmur is +louder and hoarser; also, there is a fine, crackling sound something +similar to that produced when salt is thrown in a fire. After the +affected part becomes solid there is an absence of sound over that +particular part. After absorption begins one may again hear sounds that +are of a more or less moist character and resemble bubbling or gurgling, +which gradually change until the natural sound is heard announcing +return to health.</p> + +<p>When a fatal termination is approaching all the symptoms become +intensified. The breathing becomes still more rapid and difficult; the +flanks heave; the animal stares wildly about as if seeking<span class='pagenum'><a name="Page_116" id="Page_116">[Pg 116]</a></span> aid to drive +off the feeling of suffocation; the body is bathed with sweat; the horse +staggers, but quickly recovers his balance; he may now, for the first +time during the attack, lie down; he does so, however, in the hope of +relief, which he fails to find, and with difficulty struggles to his +feet; he pants; the nostrils flap; he staggers and sways from side to +side and backward and forward, but still tries to retain the standing +position, even by propping himself against the stall. It is no use, as +after an exhausting fight for breath he goes down; the limbs stretch out +and become rigid. In fatal cases death usually occurs in from 10 to 20 +days after the beginning of the attack. On the other hand, when the +disease is terminating favorably the signs are obvious. The fever abates +and the animal gradually improves in appetite; he takes more notice of +things around him; his spirits improve; he has a general appearance of +returning health, and he lies down and rests. In the majority of cases +pneumonia, if properly treated, terminates in recovery.</p> + +<p><i>Treatment.</i>—The comfort and surroundings of the patient must be +attended to first. The quarters should be the best that can be provided. +Pure air is essential. Avoid placing the animal in a stall where he may +be exposed to drafts of cold air and sudden changes of temperature. It +is much better for the animal if the air is cold and pure than if it is +warm and foul. It is better to make the animal comfortable with warm +clothing than to make the stable warm by shutting off the ventilation. +From the start the animal should have an unlimited supply of fresh, cold +drinking water. Blanket the body. Rub the legs until they are warm and +then put bandages on them from the hoofs up to the knees and hocks. If +warmth can not be reestablished in the legs by hand rubbing alone, apply +dry, ground mustard and rub well in. The bandages should be removed once +or twice every day, the legs well rubbed, and the bandages replaced. +Much harm is often done by clipping off hair and rubbing in powerful +blistering compounds. They do positive injury and retard recovery, and +should not be allowed. Much benefit may be derived from hot application +to the sides of the chest if the facilities are at hand to apply them. +If the weather is not too cold, and if the animal is in a comfortable +stable, the following method may be tried: Have a tub of hot water handy +to the stable door; soak a woolen blanket in the water, then quickly +wring as much water as possible out of it and wrap it around the chest. +See that it fits closely to the skin; do not allow it to sag so that air +may get between it and the skin. Now wrap a dry blanket over the wet hot +one and hold in place with three girths. The hot blanket should be +renewed every half hour, and while it is off being wetted and wrung the +dry one should remain over the wet part of the chest to prevent +reaction. The hot applications should be kept up for three or four +hours, and when stopped the skin should be<span class='pagenum'><a name="Page_117" id="Page_117">[Pg 117]</a></span> quickly rubbed as dry as +possible, an application of alcohol rubbed over the wet part, and a dry +blanket snugly fitted over the animal. If the hot applications appear to +benefit, they may be tried on three or four consecutive days. Unless +every facility and circumstance favors the application of heat in the +foregoing manner, it should not be attempted. If the weather is very +cold or any of the details are omitted, more harm than good may result. +Mustard may be applied by making a paste with a pound of freshly ground +mustard mixed with warm water. This is to be spread evenly over the +sides back of the shoulder blades and down to the median line below the +chest. Care should be taken to avoid rubbing the mustard upon the thin +skin immediately back of the elbow. The mustard-covered area should be +covered with a paper and this with a blanket passed up from below and +fastened over the back. The blanket and paper should be removed in from +one to two hours. When pneumonia follows another disease, the system is +always more of less debilitated and requires the careful use of +stimulants from the beginning. To weaken the animal still further by +bleeding him is one of the most effectual methods of retarding recovery, +even if it does not hasten a fatal termination.</p> + +<p>Another and oftentimes fatal mistake made by the nonprofessional is the +indiscriminate and reckless use of aconite. This drug is one of the most +active poisons, and should not be handled by anyone who does not +thoroughly understand its action and uses. It is only less active than +prussic acid in its poisonous effects. It is a common opinion, often +expressed by nonprofessionals, that aconite is a stimulant. Nothing +could be more erroneous; in fact, it is just the reverse. It is one of +the most powerful sedatives used in the practice of medicine. In fatal +doses it kills by paralyzing the very muscles used in breathing; it +weakens the action of the heart, and should not be used. Do not give +purgative medicines. If constipation exists, overcome it by an allowance +of laxative diet, such as scalded oats, bran, and linseed mashes; also, +grass, if in season. If the costiveness is not relieved by the laxative +diet, give an enema of about a quart of warm water three or four times a +day.</p> + +<p>A diet consisting principally of bran mashes, scalded oats, and, when in +season, grass or corn fodder is preferable if the animal retains an +appetite; but if no desire is evinced for feed of this particular +description, then the animal must be allowed to eat anything that will +be taken spontaneously. Hay tea, made by pouring boiling water over good +hay in a large bucket and allowing it to stand until cool, then +straining off the liquid, will sometimes create a desire for feed. The +animal may be allowed to drink as much of it as he desires. Corn on the +cob is often eaten when everything else is refused. Bread may be tried; +also apples or carrots. If the animal<span class='pagenum'><a name="Page_118" id="Page_118">[Pg 118]</a></span> can be persuaded to drink milk, +it may be supported by it for days. Three or four gallons of sweet milk +may be given during the day, in which may be stirred three or four fresh +eggs to each gallon. Some horses will drink milk, while others will +refuse to touch it. It should be borne in mind that all feed must be +taken by the horse as he desires it; none should be forced down him. If +he will not eat, you will only have to wait until a desire is shown for +feed. All kinds may be offered, first one thing and then another, but +feed should not be allowed to remain long in trough or manger; the very +fact of its constantly being before him will cause him to loathe it. +When the animal has no appetite for anything the stomach is not in a +proper state to digest food, and if it is poured or drenched into him it +will only cause indigestion and aggravate the case. It is a good +practice to do nothing when there is nothing to be done that will +benefit. This refers to medicine as well as feed. Nothing is well done +that is overdone.</p> + +<p>There are many valuable medicines used for the different stages and +different types of pneumonia, but in the opinion of the writer it is +useless to refer to them here, as this work is intended for the use of +those who are not sufficiently acquainted with the disease to recognize +its various types and stages; therefore they would only confuse. If you +can administer a ball or capsule, or have anyone at hand who is capable +of doing it, a dram of sulphate of quinin in a capsule, or made into a +ball, with sufficient linseed meal and molasses, given every three hours +during the height of the fever, will do good in many cases. The ball of +carbonate of ammonia, as advised in the treatment of bronchitis, may be +tried if the animal is hard to drench. The heart should be kept strong +by administering digitalis in doses of 2 drams of the tincture every +three hours, or strychnia 1 grain, made into a pill with licorice +powder, three times daily.</p> + +<p>If the horse becomes very much debilitated, stimulants of a more +pronounced character are required. The following drench is useful: +Rectified spirits, 3 ounces; spirits of nitrous ether, 2 ounces; water, +1 pint. This may be repeated every four or five hours if it seems to +benefit; or 6 ounces of good whisky diluted with a pint of water may be +given as often, instead of the foregoing.</p> + +<p>During the period of convalescence good nutritive feed should be allowed +in a moderate quantity. Tonic medicines should be substituted for those +used during the fever. The same medicines advised for the convalescing +period of bronchitis are equally efficient in this case, especially the +iodid of potash; likewise, the same general instructions apply here.</p> + +<p>The chief causes of death in pneumonia are heart failure from +exhaustion, suffocation, or blood poisoning from death (gangrene) of +lung tissue. The greater the area of lung tissue diseased the greater<span class='pagenum'><a name="Page_119" id="Page_119">[Pg 119]</a></span> +the danger; hence double pneumonia is more fatal than pneumonia of one +lung.</p> + + +<h4>THE WINDPIPE.</h4> + +<p>The windpipe, or trachea as it is technically called, is the flexible +tube that extends from, the larynx, which it succeeds at the throat, to +above the base of the heart in the chest, where it terminates by +dividing into the right and left bronchi—the tubes going to the right +and left lung, respectively. The windpipe is composed of about fifty +incomplete rings of cartilage united by ligaments. A muscular layer is +situated on the superior surface of the rings. Internally the tube is +lined with a continuation of the mucous membrane that lines the entire +respiratory tract, which here has very little sensibility in contrast to +that lining the larynx, which is endowed with exquisite sensitiveness.</p> + +<p>The windpipe is not subject to any special disease, but is more or less +affected during laryngitis (sore throat), influenza, bronchitis, etc., +and requires no special treatment. The membrane may be left in a +thickened condition after these attacks. One or more of the rings may be +accidentally fractured, or the tube may be distorted or malformed as the +result of violent injury. After the operation of tracheotomy it is not +uncommon to find a tumor or malformation as a result, or sequel, of the +operation. In passing over this section attention is merely called to +these defects, as they require no particular attention in the way of +treatment. It may be stated, however, that any one of the +before-mentioned conditions may constitute one of the causes of noisy +respiration described as "thick wind."</p> + + +<h4>GUTTURAL POUCHES.</h4> + +<p>These two sacs are situated above the throat, and communicate with the +pharynx, as well as with the cavity of the tympanum of the ear. They are +peculiar to solipeds. Normally, they contain air. Their function is +unknown.</p> + +<p>One or both guttural pouches may contain pus. The symptoms are as +follows: Swelling on the side below the ear and an intermittent +discharge of matter from one or both nostrils, especially when the head +is depressed.</p> + +<p>The swelling is soft, and, if pressed upon, matter will escape from the +nose if the head is depressed. As before mentioned, these pouches +communicate with the pharynx, and through this small opening matter may +escape. A recovery is probable if the animal is turned out to graze, or +if he is fed from the ground, as the dependent position of the head +favors the escape of matter from the pouches. In addition to this, give +the tonics recommended for nasal gleet. If this treatment fails, an +operation must be performed, which should not be attempted by any one +unacquainted with the anatomy of the part.<span class='pagenum'><a name="Page_120" id="Page_120">[Pg 120]</a></span></p> + + +<h4>BRONCHITIS AND BRONCHO-PNEUMONIA.</h4> + +<p>Bronchitis is an inflammation of the bronchial tubes. When this +inflammation extends to the air sacs at the termini of the smallest +branches of the bronchial tubes, the disease is broncho-pneumonia. +Bronchitis affecting the larger tubes is less serious than when the +smaller are involved. The disease may be either acute or chronic. The +causes are generally much the same as for other diseases of the +respiratory organs, noticed in the beginning of this article. The +special causes are these: The inhalation of irritating gases and smoke +and fluids or solids gaining access to the parts. Bronchitis is +occasionally associated with influenza and other specific fevers. It +also supervenes on common cold or sore throat.</p> + +<p><i>Symptoms.</i>—The animal appears dull; the appetite is partially or +wholly lost; the head hangs; the breathing is quickened; the cough, at +first dry, and having somewhat the character of a "barking cough," is +succeeded in a few days by a moist, rattling cough; the mouth is hot; +the visible membranes in the nose are red; the pulse is frequent, and +during the first stage is hard and quick, but as the disease advances +becomes smaller and more frequent. There is a discharge from the +nostrils that is at first whitish, but later becomes creamy or frothy, +still later it is sometimes tinged with blood, and occasionally it may +be of a brownish or rusty color. By auscultation, or placing the ear to +the sides of the chest, unnatural sounds can now be heard. The air +passing through the diseased tubes causes a wheezing sound when the +small tubes are affected, and a hoarse, cooing, or snoring sound when +the larger tubes are involved. After one or two days the dry stage of +the disease is succeeded by a moist state of the membrane. The ear now +detects a different sounds caused by the bursting of the bubbles as the +air passes through the fluid, which is the exudate of inflammation and +the augmented mucous secretions of the membrane. The mucus may be +secreted in great abundance, which, by blocking up the tubes, may cause +a collapse of a large extent of breathing surface. Usually the mucus is +expectorated; that is, discharged through the nose. The matter is +coughed up, and when it reaches the larynx much of it may be swallowed, +and some is discharged from the nostrils. The horse can not spit, like +the human being, nor does the matter coughed up gain access to the +mouth. If in serious cases all the symptoms become aggravated, the +breathing is labored, short, and quick, it usually indicates that the +inflammation has reached the breathing cells and that catarrhal +pneumonia is established. In this case the ribs rise and fall much more +than natural. This fact alone is enough to exclude the idea that the +animal may be affected with pleurisy, because in that disease the ribs +are as nearly fixed as it is in the power of the<span class='pagenum'><a name="Page_121" id="Page_121">[Pg 121]</a></span> animal to do so, and +the breathing is accomplished to a great extent by aid of the abdominal +muscles. The horse persists in standing throughout the attack. He +prefers to stand with head to a door or window to gain all the fresh air +possible, but if not tied may occasionally wander listlessly about the +stall. The bowels most likely are constipated; the dung is covered with +slimy mucus. The urine is decreased in quantity and darker in color than +usual. The animal shows more or less thirst; in some cases the mouth is +full of saliva. The discharge from the nose increases in quantity as the +disease advances and inflammation subsides. This is rather a good +symptom, as it shows that one stage has passed. The discharge then +gradually decreases, the cough becomes less rasping, but of more +frequent occurrence, until it gradually disappears with the return of +health.</p> + +<p>Bronchitis, affecting the smaller tubes, is one of the most fatal +diseases, while that of the larger tubes is never very serious. It must +be stated, however, that it is an exceedingly difficult matter for a +nonexpert to discriminate between the two forms, and, further, it may as +well be said here that he will have difficulty in discriminating between +bronchitis and pneumonia.</p> + +<p><i>Treatment.</i>—The matter of first importance is to insure pure air to +breathe, and next to make the patient's quarters as comfortable as +possible. A well-ventilated box stall serves best for all purposes. +Cover the body with a blanket, light or heavy, as the season of the year +demands. Hand-rub the legs until they are warm, then wrap them in cotton +and apply flannel or Derby bandages from the hoofs to the knees and +hocks. If the legs can not be made warm with hand rubbing alone, apply +dry mustard. Rub in thoroughly and then put the bandages on; also rub +mustard paste well over the side of the chest, covering the space +beginning immediately behind the shoulder blade and running back about +eighteen inches, and from the median line beneath the breast to within +ten inches of the ridge of the backbone. Repeat the application to the +side of the chest about three days after the first one is applied.</p> + +<p>Compel the animal to inhale steam from a bucketful of boiling water +containing a tablespoonful of oil of turpentine and spirits of camphor, +as advised for cold in the head. In serious cases the steam should be +inhaled every hour, and in any case the oftener it is done the greater +will be the beneficial results. Three times a day administer an +electuary containing acetate of potash (2 drams), with licorice and +molasses or honey. It is well to keep a bucketful of cold water before +the animal all the time. If the horse is prostrated and has no appetite, +give the following drench: Spirits of nitrous ether,<span class='pagenum'><a name="Page_122" id="Page_122">[Pg 122]</a></span> 2 ounces; +rectified spirits, 3 ounces; water, 1 pint. Repeat the dose every four +or five hours if it appears to benefit. When the horse is hard to +drench, give the following: Pulverized carbonate of ammonia, 3 drams; +linseed meal and molasses sufficient to make the whole into a stiff +mass; wrap it with a small piece of tissue paper and give as a ball. +This ball may be repeated every four or five hours. When giving the ball +care should be taken to prevent its breaking in the mouth, as in case of +such accident it will make the mouth sore and prevent the animal from +eating. If the bowels are constipated, give enemas of warm water. Do not +give purgative medicines. Do not bleed the animal.</p> + +<p>If the animal retains an appetite, a soft diet is preferable, such as +scalded oats, bran mashes, and grass, if in season. If he refuses cooked +feed, allow in small quantities anything he will eat. Hay, cob corn, +oats, bread, apples, and carrots may be tried in turn. Some horses will +drink sweet milk when they refuse all other kinds of feed, and +especially is this the case if the drinking water is withheld for a +while. One or 2 gallons at a time, four or five times a day, will +support life. Bear in mind that when the disease is established recovery +can not occur in less than two or three weeks, and more time may be +necessary. Good nursing and patience are required.</p> + +<p>When the symptoms have abated and nothing remains of the disease except +the cough and a white discharge from the nostrils, all other medicines +should be discontinued and a course of tonic treatment pursued. Give the +following mixture: Reduced iron, 3 ounces; powdered gentian, 8 ounces; +mix well together and divide into sixteen powders. Give a powder every +night and morning mixed with bran and oats, if the animal will eat it, +or shaken with about a pint of flaxseed tea and administered as a +drench.</p> + +<p>If the cough remains after the horse is apparently well, give 1 dram of +iodid of potassium dissolved in a bucketful of drinking water one hour +before each meal for two or three weeks if necessary. Do not put the +animal to work too soon after recovery. Allow ample time to regain +strength. This disease is prone to become chronic and may run into an +incurable case of thick wind.</p> + + +<h4>PLEURISY.</h4> + +<p>The thoracic cavity is divided into two lateral compartments, each +containing one lung and a part of the heart. Each lung has its separate +pleural membrane, or covering. The pleura is the thin, glistening +membrane that covers the lung and also completely covers the internal +walls of the chest. It is very thin, and to the ordinary observer +appears to be part of the lung, which, in fact, it is for all<span class='pagenum'><a name="Page_123" id="Page_123">[Pg 123]</a></span> practical +purposes. The smooth, shiny surface of the lung, as well as the smooth, +shiny surface so familiar on the rib, is the pleura. In health this +surface is always moist. A fluid is thrown off by the pleura, which +causes the surface to be constantly moist. This is to prevent the +effects of friction between the lungs and the walls of the chest and +other contiguous parts which come in contact. It must be remembered that +the lungs are dilating each time a breath is taken in, and contracting +each time a breath of air is expelled. It may be readily seen that if it +were not for the moistened state of the surface of the pleura the +continual dilatation and contraction and the consequent rubbing of the +parts against each other would cause serious friction.</p> + +<p>Inflammation of this membrane is called pleurisy. Being so closely +united with the lung, it can not always escape participation in the +disease when the latter is inflamed. Pleurisy may be due to the same +predisposing and exciting causes as mentioned in the beginning of this +work as general causes for diseases of the organs of respiration, such +as exposure to sudden changes of temperature, confinement in damp +stables, etc. It may be caused also by wounds that penetrate the chest, +for it must be remembered that such wounds must necessarily pierce the +pleura. A fractured rib may involve the pleura. The inflammation +following such wounds may be circumscribed; that is, confined to a small +area surrounding the wound, or it may spread from the wound and involve +a large portion of the pleura. The pleura may be involved secondarily +when the heart or its membrane is the primary seat of the disease. It +may occur in conjunction with bronchitis, influenza, and other diseases. +Diseased growths that interfere with the pleura may induce pleurisy. The +most frequent cause of pleurisy is an extension of inflammation from +adjacent diseased lung. It is a common complication of pneumonia. +Pleurisy will be described here as an independent affection, although it +should be remembered that it is very often associated with the foregoing +diseases.</p> + +<p>The first lesion of pleurisy is overfilling of the blood vessels that +ramify in this membrane and dryness of the surface. This is followed by +the formation of a coating of coagulated fibrin on the diseased pleura +and the transudation of serum which collects in the chest. This serum +may contain flakes of fibrin and it may be straw colored or red from an +admixture of blood. The quantity of this accumulation may amount to +several gallons.</p> + +<p><i>Symptoms.</i>—When the disease exists as an independent affection it is +ushered in by a chill, but this is usually overlooked. About the first +thing noticed is the disinclination of the animal to move or turn +around. When made to do so he grunts or groans with pain. He stands +stiff; the ribs are fixed—that is, they move very little in the<span class='pagenum'><a name="Page_124" id="Page_124">[Pg 124]</a></span> act of +breathing—but the abdomen works more than natural; both the fore feet +and elbows may be turned out; during the onset of the attack the animal +may be restless and act as if he had a slight colic; he may even lie +down, but does not remain long down, for when he finds no relief he soon +gets up. After effusion begins these signs of restlessness disappear. +Every movement of the chest causes pain; therefore the cough is +peculiar; it is short and suppressed and comes as near being no cough as +the animal can make it in his desire to suppress it. The breathing is +hurried, the mouth is hot, the temperature being elevated from 102° or +103° to 105° F. Symptoms that usually accompany fever are present, such +as costiveness, scanty, dark-colored urine, etc. The pulse is frequent, +perhaps 70 or more a minute, and is hard and wiry. The legs and ears are +cold.</p> + +<p>Percussion is of valuable service in this affection. After effusion +occurs the sound produced by percussing over the lower part of the chest +is dull. By striking different parts one may come to a spot of greater +or less extent where the blows cause much pain to be evinced. The animal +may grunt or groan every time it is struck. Another method of detecting +the affected part is to press the fingers between the ribs, each space +in succession, beginning behind the elbow, until a place where the +pressure causes more flinching than at any other part is reached. +Auscultation is also useful. In the first stage, when the surfaces are +dry and rough, one may hear, immediately under the ear, a distinct sound +very much like that produced by rubbing two pieces of coarse paper +together. No such friction sound occurs when the membrane is healthy, as +the natural moisture, heretofore mentioned, prevents the friction. In +many cases this friction is so pronounced that it may be felt by placing +the hand over the affected part. When the dry stage is succeeded by the +exudation of fluid this friction sound disappears. After the effusion +into the cavity takes place sometimes there is heard a tinkling or +metallic sound, due to dropping of the exudate from above into the +collected fluid in the bottom of the cavity, as the collected fluid more +of less separates the lung from the chest walls.</p> + +<p>Within two or three days the urgent symptoms may abate owing to the +exudation of the fluid, and the subsidence of the pain. The fluid may +now undergo absorption, and the case may terminate favorably within a +week or 10 days.</p> + +<p>If the quantity of the effusion is large its own volume retards the +process of absorption to a great extent, and consequently convalescence +is delayed. In severe cases the pulse becomes more frequent, the +breathing more hurried and labored, the flanks work like bellows, the +nostrils flap, the eyes stare wildly, the countenance expresses much +anxiety, and general signs of dissolution are plain. After a<span class='pagenum'><a name="Page_125" id="Page_125">[Pg 125]</a></span> time +swellings appear under the chest and abdomen and down the legs. The +accumulation in the chest is called hydrothorax, or dropsy of the chest. +When this fluid contains pus the case usually proves fatal. The +condition of pus within the cavity is called empyema.</p> + +<p>Pleurisy may affect only a small area of one side or it may affect both +sides. It is oftener confined to the right side.</p> + +<p><i>Treatment.</i>—The instructions in regard to the general management of +bronchitis and pneumonia must be adhered to in the treatment of +pleurisy. Comfortable quarters, pure air, warm clothing to the body and +bandages to the legs, a plentiful supply of pure cold water, the +laxative feed, etc., in this case are equally necessary and efficacious. +The hot applications applied to the chest, as directed in the treatment +of pneumonia, are very beneficial in pleurisy, and should be kept up +while the symptoms show the animal to be in pain.</p> + +<p>During the first few days, when pain is manifested by restlessness, +apply hot packs to the sides diligently. After four or five days, when +the symptoms show that the acute stage has somewhat subsided, mustard +may be applied as recommended for pneumonia. From the beginning the +following drench may be given every six hours, if the horse takes it +kindly: Solution of the acetate of ammonia, 3 ounces; spirits of nitrous +ether, 1 ounce; bicarbonate of potassium, 3 drams; water, 1 pint.</p> + +<p>If the patient becomes debilitated, the stimulants as prescribed for +pneumonia should be used according to the same directions. The same +attention should be given to the diet. If the animal will partake of the +bran mashes, scalded oats, and grass, it is the best; but if he refuses +the laxative diet, then he should be tried with different kinds of feed +and allowed whichever kind he desires.</p> + +<p>In the beginning of the attack, if the pain is severe, causing the +animal to lie down or paw, morphin may be given by the mouth in 5-grain +doses, or the fluid extract of <i>Cannabis indica</i> may be used in doses of +2 to 4 drams.</p> + +<p>If the case is not progressing favorable in ten or twelve days after the +beginning of the attack, convalescence is delayed by the fluid in the +chest failing to be absorbed. The animal becomes dull and weak and +evinces little or no desire for feed. The breathing becomes still more +rapid and difficult. An effort must now be made to excite the absorption +of the effusion. An application of liniment or mild blister should be +rubbed over the lower part of both sides and the bottom of the chest. +The following drench may be given three times a day, for seven or eight +days, if it is necessary and appears to benefit: Tincture of the +perchlorid of iron, 1 ounce; tincture of gentian, 2 ounces; water, 1 +pint. Also give 1 dram of iodid of potassium, dissolved in the drinking +water, an hour before feeding every night and morning for a week or +two.<span class='pagenum'><a name="Page_126" id="Page_126">[Pg 126]</a></span></p> + +<p><i>Hydrothorax</i> is sometimes difficult to overcome by means of the use of +medicines alone, when the operation of tapping the chest is performed to +allow an escape for the accumulated fluid. The operation is performed +with a combined instrument called the trocar and cannula. The puncture +is made in the lower part of the chest, in the space between the eighth +and ninth ribs. Wounding of the intercostal artery is avoided by +inserting the instrument as near as possible to the anterior edge of the +rib. If the operation is of benefit, it is only so when performed before +the strength is lowered beyond recovery. The operation merely receives a +passing notice here, as it is not presumed that the nonprofessional will +attempt it, although in the hands of the expert it is attended with +little danger or difficulty.</p> + +<p>We have described here bronchitis, pneumonia, and pleurisy mainly as +they occur as independent diseases, but it should be remembered that +they merge into each other and may occur together at one time. While it +is true that much more might have been said in regard to the different +stages and types of the affections, and also in regard to the treatment +of each stage and each particular type, the plan adopted of advising +plain, conservative treatment is considered the wisest on account of +simplifying as much as possible a subject of which the reader is +supposed to know very little.</p> + + +<h4>PLEUROPNEUMONIA.</h4> + +<p>This is the state in which an animal is affected with pleurisy and +pneumonia combined, which is not infrequently the case. At the beginning +of the attack only one of the affections may be present, but the other +soon follows. It has already been stated that the pleura is closely +adherent to the lung. The pleura on this account is frequently more or +less affected by the spreading of the inflammation from the lung tissue. +There is a combination of the symptoms of both diseases, but to the +ordinary observer the symptoms of pleurisy are the most obvious. The +course of treatment to be pursued differs in no manner from that given +for the affections when they occur independently. The symptoms will be +the guide as to the advisability of giving oil and laudanum for the pain +if the pleurisy is very severe. It should not be resorted to unless it +is necessary to allay the pain.</p> + + +<h4>BRONCHO-PLEUROPNEUMONIA.</h4> + +<p>This is the term or terms applied when bronchitis, pleurisy, and +pneumonia all exist at once. It is impossible for one who is not an +expert to diagnose the state with certainty. The apparent symptoms are +the same as when the animal is affected with pleuropneumonia.<span class='pagenum'><a name="Page_127" id="Page_127">[Pg 127]</a></span></p> + + +<h4>SUPPURATION AND ABSCESS IN THE LUNG.</h4> + +<p>There are instances, and especially when the surroundings of the patient +have been bad or the disease is of an especially severe type, when +pneumonia terminates in an abscess in the lung. Sometimes, when the +inflammation has been extreme, suppuration in a large portion of the +lung takes place. Impure air, the result of improper ventilation, is +among the most frequent causes of this termination. The symptoms of +suppuration in the lung are chronic pneumonia, a solidified area of lung +tissue, continued low fever, and, in some cases, offensive smell of the +breath, and the discharge of the matter from the nostrils.</p> + + +<h4>MORTIFICATION.</h4> + +<p>Gangrene, or mortification, means the death of the part affected. +Occasionally, owing to the intensity of the inflammation or bad +treatment, pneumonia and pleuropneumonia terminate in mortification, +which is soon followed by the death of the animal. Perhaps the most +common cause of this complication is the presence of a foreign body in +the lung, as food particles or medicine. Rough drenching or drenching +through the nostrils may cause this serious condition.</p> + + +<h4>HEMOPTYSIS, OR BLEEDING FROM THE LUNGS.</h4> + +<p>Bleeding from the lungs may occur during the course of congestion of the +lungs, bronchitis, pneumonia, influenza, purpura hemorrhagica, or +glanders. An accident or exertion may cause a rupture of a vessel. +Plethora and hypertrophy of the heart predispose to it. Following the +rupture of a vessel the blood may escape into the lung tissue and cause +a serious attack of pneumonia, or it may fill up the bronchial tubes and +prove fatal by suffocating the animal. When the hemorrhage is from the +lung it is accompanied with coughing; the blood is frothy, of a bright +red color, and comes from both nostrils; whereas when the bleeding is +merely from a rupture of a vessel in some part of the head (heretofore +described as bleeding from the nose) the blood is most likely to issue +from one nostril only, and the discharge is not accompanied with +coughing. The ear may be placed against the windpipe along its course, +and if the blood is from the lungs a gurgling or rattling sound will be +heard. When it occurs in connection with another disease it seldom +requires special treatment. When caused by accident or overexertion the +animal should be kept quiet. If the hemorrhage is profuse and continues +for several hours, 1 dram of the acetate of lead dissolved in a pint of +water may be given as a drench, or 1 ounce of the tincture of the +perchlorid of iron, diluted with a pint of water, may be given instead +of the lead. It is rare<span class='pagenum'><a name="Page_128" id="Page_128">[Pg 128]</a></span> that the hemorrhage is so profuse as to require +internal remedies. But hemorrhage into the lung may occur and cause +death by suffocation without the least manifestation of it by the +discharge of blood from the nose.</p> + + +<h4>TUBERCULOSIS OF THE LUNGS.</h4> + +<p>Pulmonary consumption or tuberculosis has been recognized in the horse +in a number of instances. The symptoms are as of chronic pneumonia or +pleurisy. There is no treatment for the disease.</p> + + +<h4>HEAVES, BROKEN WIND, OR ASTHMA.</h4> + +<p>Much confusion exists in the popular mind in regard to the nature of +heaves. Many horsemen loosely apply the term to all ailments where the +breathing is difficult or noisy. Scientific veterinarians are well +acquainted with the phenomena and locality of the affection, but there +is a great diversity of opinion as regards the exact cause. Asthma is +generally thought to be caused by spasm of the small circular muscles +that surround the bronchial tubes. The continued existence of this +affection of the muscles leads to a paralysis of them, and the forced +breathing to emphysema, which always accompanies heaves.</p> + +<p>Heaves is usually associated with disorder of the function of digestion +or to an error in the choice of feed. Feeding on clover hay or damaged +hay or straw, too bulky and innutritious feed, and keeping the horse in +a dusty atmosphere or a badly ventilated stable produce or predispose to +heaves. Horses brought from a high to a low level are predisposed.</p> + +<p>In itself broken wind is not a fatal disease, but death is generally +caused by an affection closely connected with it. After death, if the +organs are examined, the lesions found depend much upon the length of +time broken wind has affected the animal. In recent cases very few +changes are noticeable, but in animals that have been broken-winded for +a long time the changes are well-marked. The lungs are paler than +natural, and of much less weight in proportion to the volume, as +evidenced by floating them in water. The walls of the small bronchial +tubes and the membrane of the larger tubes are thickened. The right side +of the heart is enlarged and its cavities dilated. The stomach is +enlarged and its walls stretched. The important change found in the +lungs is a condition technically called pulmonary emphysema. This is of +two varieties: First, what is termed "vesicular emphysema," which +consists of an enlargement of the capacity of the air cells (air +vesicles) by dilation of their walls. The second form is called +interlobular, or interstitial, emphysema, and follows the<span class='pagenum'><a name="Page_129" id="Page_129">[Pg 129]</a></span> first. In +this variety the air finds its way into the lung tissue between the air +cells or the tissue between the small lobules.</p> + +<p><i>Symptoms.</i>—Almost every experienced horseman is able to detect heaves. +The peculiar movement of the flanks and abdomen point out the ailment at +once. In recent cases, however, the affected animal does not always +exhibit the characteristic breathing unless exerted to a certain extent. +The cough which accompanies this disease is peculiar to it. It is +difficult to describe, but the sound is short and something like a +grunt. When air is inspired—that is, taken in—it appears to be done in +the same manner as in health; it may possibly be done a little quicker +than natural, but not enough to attract any notice. It is when the act +of expiration (or expelling the air from the lungs) is performed that +the great change in the breathing is perceptible. It must be remembered +that the lungs have lost much of their elasticity, and in consequence of +their power of contracting on account of the degeneration of the walls +of the air cells, and also on account of the paralysis of muscular +tissue before mentioned. The air passes into them freely, but the power +to expel it is lost to a great extent by the lungs; therefore the +abdominal muscles are brought into play. These muscles, especially in +the region of the flank, are seen to contract, then pause for a moment, +then complete the act of contracting, thus making a double bellowslike +movement at each expiration, a sort of jerky motion with every breath. +The double expiratory movement may also be detected by allowing the that +the expiratory current is not continuous, but is broken into two jets. +When the animal is exerted a wheezing noise accompanies the breathing. +This noise may be heard to a less extent when the animal is at rest if +the ear is applied to the chest.</p> + +<p>As before remarked, indigestion is often present in these cases. The +animal may have a depraved appetite, as shown by a desire to eat dirt +and soiled bedding, which he often devours in preference to the clean +feed in the trough or manger. The stomach is liable to be overloaded +with indigestible feed. The abdomen may assume that form called +"potbellied." The animal frequently passes wind of a very offensive +odor. When first put to work dung is passed frequently; the bowels are +often loose. The animal can not stand much work, as the muscular system +is soft. Round-chested horses are said to be predisposed to the disease, +and it is certain that in cases of long standing the chest usually +becomes rounder than natural.</p> + +<p>Certain individuals become very expert in managing a horse affected with +heaves in suppressing the symptoms for a short time. They take advantage +of the fact that the breathing is much easier when the stomach and +intestines are empty. They also resort to the<span class='pagenum'><a name="Page_130" id="Page_130">[Pg 130]</a></span> use of medicines that +have a depressing effect. When the veterinarian is examining a horse for +soundness, and he suspects that the animal has been "fixed," he usually +gives the horse as much water as he will drink and then has him ridden +or driven rapidly up a hill or on a heavy road. This will bring out the +characteristic breathing of heaves if the horse is so afflicted, but +will not cause the symptoms of heaves in a healthy horse. All +broken-winded horses have the cough peculiar to the affection, but it is +not regular. A considerable time may elapse before it is heard and then +it may come on in paroxysms, especially when first brought out of the +stable into the cold air, or when excited by work, or after a drink of +cold water. The cough is usually the first symptom of the disease.</p> + +<p><i>Treatment.</i>—When the disease is established there is no cure for it. +Proper attention paid to the diet will relieve the distressing symptoms +to a certain extent, but they will undoubtedly reappear in their +intensity the first time the animal overloads the stomach or is allowed +food of bad quality. Clover hay or bulky feed which contains but little +nutriment have much to do with the cause of the disease, and therefore +should be entirely omitted when the animal is affected, as well as +before. It has been asserted that the disease is unknown where clover +hay is never used. The diet should be confined to feed of the best +quality and in the smallest quantity. The bad effect of moldy or dusty +hay, fodder, or feed of any kind can not be overestimated. A small +quantity of the best hay once a day is sufficient. This should be cut +and dampened. The animal should invariably be watered before feeding; +never directly after a meal. The animal should not be worked immediately +after a meal. Exertion, when the stomach is full, invariably aggravates +the symptoms. Turning on pasture gives relief. Carrots, potatoes, or +turnips chopped and mixed with oats or corn are a good diet. Half a pint +to a pint of thick, dark molasses with each feed is useful.</p> + +<p>Arsenic is efficacious in palliating the symptoms. It is best +administered in the form of a solution of arsenic, as Fowler's solution +or as the white powdered arsenious acid. Of the former the dose is 1 +ounce to the drinking water three times daily; of the latter one may +give 3 grains in each feed. These quantities may be cautiously increased +as the animal becomes accustomed to the drug. If the bowels do not act +regularly, a pint of raw linseed oil may be given once or twice a month, +or a handful of Glauber's salt may be given in the feed twice daily, so +long as necessary. It must, however, be borne in mind that all medicinal +treatment is of secondary consideration; careful attention paid to the +diet is of greatest importance. Broken-winded animals should not be used +for breeding purposes. A predisposition to the disease may be +inherited.<span class='pagenum'><a name="Page_131" id="Page_131">[Pg 131]</a></span></p> + + +<h4>CHRONIC COUGH.</h4> + +<p>A chronic cough may succeed the acute disease of the respiratory organs, +such as pneumonia, bronchitis, laryngitis, etc. It accompanies chronic +roaring, chronic bronchitis, broken wind; it may succeed influenza. As +previously stated, cough is but a symptom and not a disease in itself. +Chronic cough is occasionally associated with diseases other than those +of the organs of respiration. It may be a symptom of chronic indigestion +or of worms. In such cases it is caused by a reflex nervous irritation. +The proper treatment in all cases of chronic cough is to ascertain the +nature of the disease of which it is a symptom, and then cure the +disease if possible and the cough will cease.</p> + +<p>The treatment of the affections will be found under their appropriate +heads, to which the reader is referred.</p> + + +<h4>PLEURODYNIA.</h4> + +<p>This is a form of rheumatism that affects the intercostal muscles; that +is, the muscles between the ribs. The apparent symptoms are very similar +to those of pleurisy. The animal is stiff and not inclined to turn +round; the ribs are kept in a fixed state as much as possible. If the +head is pulled round suddenly, or the affected side struck with the +hand, or if the spaces between the ribs are pressed with the fingers, +the animal will flinch and perhaps emit a grunt or groan expressive of +much pain. It is distinguished from pleurisy by the absence of fever, +cough, the friction sound, the effusion into the chest, and by the +existence of rheumatism in other parts. The treatment for this affection +is the same as for rheumatism affecting other parts.</p> + + +<h4>WOUNDS PENETRATING THE WALLS OF THE CHEST.</h4> + +<p>A wound penetrating the wall of the chest admits air into the thoracic +cavity outside the lung. This condition is known as pneumothorax and may +result in collapse of the lung. The wound may be so made that when the +walls of the chest are dilating a little air is sucked in, but during +the contraction of the wall the contained air presses against the torn +part in such manner as entirely to close the wound; thus a small +quantity of air gains access with each inspiration, while none is +allowed to escape until the lung is pressed into a very small compass +and forced into the anterior part of the chest. The same thing may occur +from a broken rib inflicting a wound in the lung. In this form the air +gains access from the lung, and there may not be even an opening in the +walls of the chest. In such cases the air may be absorbed, when a +spontaneous cure is the result, but<span class='pagenum'><a name="Page_132" id="Page_132">[Pg 132]</a></span> when the symptoms are urgent it is +recommended that the air be removed by a trocar and cannula or by an +aspirator.</p> + +<p>It is evident that the treatment of wounds that penetrate the thoracic +cavity should be prompt. It should be quickly ascertained whether or not +a foreign body remains in the wound; then it should be thoroughly +cleaned with a solution of carbolic acid, 1 part in 40 parts of water. +The wound should then be closed immediately. If it is an incised wound, +it should be closed with sutures or with adhesive plasters; if torn or +lacerated, adhesive plaster may be used or a bandage around the chest +over the dressing. At all events, air must be prevented from getting +into the chest as soon and as effectually as possible. The after +treatment of the wound should consist principally in keeping the parts +clean with a solution of carbolic acid, and applying fresh dressing as +often as required to keep the wound in a healthy condition. Care should +be taken that the discharges from the wound have an outlet in the most +dependent part. (See Wounds and their treatment, p. 484.) If pleurisy +supervenes, it should be treated as advised under that head.</p> + + +<h4>THUMPS, OR SPASM OF THE DIAPHRAGM.</h4> + +<p>"Thumps" is generally thought by the inexperienced to be a palpitation +of the heart. While it is true that palpitation of the heart is +sometimes called "thumps," it must not be confounded with the affection +under consideration.</p> + +<p>In the beginning of this article on the diseases of the organs of +respiration, the diaphragm was briefly referred to as the principal and +essential muscle of respiration. Spasmodic or irregular contractions of +it in man are manifested by what is familiarly known as hiccoughs. +Thumps in the horse is similar to hiccoughs in man although in all cases +the peculiar noise is not made in the throat of the horse.</p> + +<p>There should be no difficulty in distinguishing this affection from +palpitation of the heart. The jerky motion affects the whole body, and +is not confined to the region of the heart. If one hand is placed on the +body at about the middle of the last rib, while the other hand is placed +over the heart behind the left elbow, it will be easily demonstrated +that there is no connection between the thumping or jerking of the +diaphragm and the beating of the heart. In fact, when the animal is +affected with spasms of the diaphragm the beating of the heart is +usually much weaker and less perceptible than natural. Thumps is +produced by causes similar to those that produce congestion of the lungs +and dilatation or palpitation of the heart, and may occur in connection +with these conditions. If not relieved, death usually results from +congestion or edema of the lungs, as<span class='pagenum'><a name="Page_133" id="Page_133">[Pg 133]</a></span> the breathing is interfered with +by the inordinate action of this important muscle of inspiration so much +that proper aeration of the blood can not take place. The treatment +should be as prescribed for congestion of the lungs, and, in addition, +antispasmodics, such as 1 ounce of sulphuric ether in warm water or 3 +drams of asafetida.</p> + + +<h4>RUPTURE OF THE DIAPHRAGM.</h4> + +<p>Post-mortem examinations after colic or severe accident sometimes reveal +rupture of the diaphragm. This may take place after death, from the +generation of gases in the decomposing carcass, which distend the +intestines so that the diaphragm is ruptured by the great pressure +against it. The symptoms are intensely difficult respiration and great +depression. There is no treatment.</p> + + + +<hr style="width: 65%;" /> +<p><span class='pagenum'><a name="Page_134" id="Page_134">[Pg 134]</a></span></p> +<h2>DISEASES OF THE URINARY ORGANS.</h2> + +<h3><span class="smcap">By James Law, F. R. C. V. S.</span>,</h3> + +<h4><i>Formerly Professor of Veterinary Science, etc., in Cornell University.</i></h4> + + +<h4>USES OF THE URINARY ORGANS.</h4> + +<p>The urinary organs constitute the main channel through which are +excreted the nitrogenous or albuminoid principles, whether derived +directly from the feed or from the muscular and other nitrogenized +tissues of the body. They constitute, besides, the channel through which +are thrown out most of the poisons, whether taken in by the mouth or +skin or developed in connection with faulty or natural digestion, +blood-forming, nutrition, or tissue destruction; or, finally, poisons +that are developed within the body, as the result of normal cell life or +of the life of bacterial or other germs that have entered the body from +without. Bacteria themselves largely escape from the body through the +kidneys. To a large extent, therefore, these organs are the sanitary +scavengers and purifiers of the system, and when their functions are +impaired or arrested the retained poisons quickly show their presence in +resulting disorders of the skin and connective tissue beneath it, of the +nervous system, or other organs. Nor is this influence one-sided. +Scarcely an important organ of the body can suffer derangement without +entailing a corresponding disorder of the urinary system. Nothing can be +more striking than the mutual balance maintained between the liquid +secretions of the skin and kidneys during hot and cold weather. In +summer, when so much liquid exhales through the skin as sweat, +comparatively little urine is passed, whereas in winter, when the skin +is inactive, the urine is correspondingly increased. This vicarious +action of skin and kidneys is usually kept within the limits of health, +but at times the draining off of the water by the skin leaves too little +to keep the solids of the urine safely in solution, and these are liable +to crystallize out and form stone and gravel. Similarly the passage, in +the sweat, of some of the solids that normally leave the body, dissolved +in the urine, serves to irritate the skin and produce troublesome +eruptions.</p> + + +<h4>PROMINENT CAUSES OF URINARY DISORDERS.</h4> + +<p>A disordered liver contributes to the production under different +circumstances of an excess of biliary coloring matter which stains the +urine; of an excess of hippuric acid and allied products which, being +less soluble than urea (the normal product of tissue change),<span class='pagenum'><a name="Page_135" id="Page_135">[Pg 135]</a></span> favor the +formation of stone, of taurocholic acid, and other bodies that tend when +in excess to destroy the blood globules and to cause irritation of the +kidneys by the resulting hemoglobin excreted in the urine, and of +glycogen too abundant to be burned up in the system, which induces +saccharine urine (diabetes). Any disorder leading to impaired functional +activity of the lungs is causative of an excess of hippuric acid and +allied bodies, of oxalic acid, of sugar, etc., in the urine, which +irritate the kidneys, even if they do not produce solid deposits in the +urinary passages. Diseases of the nervous system, and notably of the +base of the brain and of the spinal cord, induce various urinary +disorders, prominent among which are diabetes, chylous urine, and +albuminuria. Certain affections, with imperfect nutrition or destructive +waste of the bony tissues, tend to charge the urine with phosphates of +lime and magnesia and endanger the formation of stone and gravel. In all +extensive inflammations and acute fevers the liquids of the urine are +diminished, while the solids (waste products), which should form the +urinary secretion, are increased, and the surcharged urine proves +irritant to the urinary organs or the retained waste products poison the +system at large.</p> + +<p>Diseases of the heart and lungs, by interfering with the free, onward +flow of the blood from the right side of the heart, tend to throw that +liquid back on the veins, and this backward pressure of venous blood +strongly tends to disorders of the kidneys. Certain poisons taken with +the feed and water, notably that found in magnesian limestone and those +found in irritant, diuretic plants, are especially injurious to the +kidneys, as are also various cryptogams, whether in musty hay or oats. +The kidneys may be irritated by feeding green vegetables covered with +hoar frost or by furnishing an excess of feed rich in phosphates (wheat +bran, beans, peas, vetches, lentils, rape cake, cottonseed cake) or by a +privation of water, which entails a concentrated condition and high +density of the urine. Exposure in cold rain or snow storms, cold drafts +of air, and damp beds are liable to further disorder an already +overworked or irritable kidney. Finally, sprains of the back and loins +may cause bleeding from the kidneys or inflammation.</p> + +<p>The right kidney, weighing 23-1/2 ounces, is shaped like a French bean, +and extends from the loins forward to beneath the heads of the last two +ribs. The left kidney (Pl. VIII) resembles a heart of cards, and extends +from the loins forward beneath the head of the last rib only. Each +consists of three distinct parts—(<i>a</i>) the external (cortical), or +vascular part, in which the blood vessels form elaborate capillary +networks within the dilated globular sacs which form the beginnings of +the secreting (uriniferous) tubes and on the surface of the sinuous, +secreting tubes leading from the sacs inward toward the second, or +medullary, part of the organ; (<i>b</i>) the internal<span class='pagenum'><a name="Page_136" id="Page_136">[Pg 136]</a></span> (medullary) part, made +up in the main of blood vessels, lymphatics, and nerves extending +between the notch on the inner border of the kidney to and from the +outer vascular portion, in which the secretion of urine is almost +exclusively carried on; and (<i>d</i>) a large, saccular reservoir in the +center of the kidney, into which all uriniferous tubes pour their +secretions and from which the urine is carried away through a tube <i>g</i> +(ureter), which passes out of the notch at the inner border of the +kidney and which opens by a valve-closed orifice into the roof of the +bladder just in front of its neck. The bladder is a dilatable reservoir +for the retention of the urine until the discomfort of its presence +causes its voluntary discharge. It is kept closed by circular, muscular +fibers surrounding its neck or orifice, and is emptied by looped, +muscular fibers extending in all directions forward from the neck around +the blind anterior end of the sac. From the bladder the urine escapes +through a dilatable tube (urethra) which extends from the neck of the +bladder backward on the floor of the pelvis, and in the male through the +penis to its free end, where it opens through a pink, conical papilla. +In the mare the urethra is not more than an inch in length, and is +surrounded by the circular, muscular fibers closing the neck of the +bladder. Its opening may be found directly in the median line of the +floor of the vulva, about 4-1/2 inches from its external opening.</p> + + +<h4>GENERAL SYMPTOMS OF DISEASE.</h4> + +<p>These apply especially to acute inflammations and the irritation caused +by stone. The animal moves stiffly on the hind limbs, straddles, and +makes frequent attempts to pass urine, which may be in excess, deficient +in amount, liable to sudden arrest in spite of the straining, passed in +driblets, or entirely suppressed. Again, it may be modified in density +or constituents. Difficulty in making a sharp turn, or in lying down and +rising with or without groaning, dropping the back when mounted or when +pinched on the loins is suggestive of kidney disease, and so to a less +extent are swelled legs, dropsy, and diseases of the skin and nervous +system. The oiled hand introduced through the rectum may feel the +bladder beneath and detect any overdistention, swelling, tenderness, or +stone. In ponies the kidneys even may be reached.</p> + + +<h4>EXAMINATION OF THE URINE.</h4> + +<p>In some cases the changes in the urine are the sole sign of disease. In +health the horse's urine is of a deep amber color and has a strong odor. +On a feed of grain and hay it may show a uniform transparency, while on +a green ration there in an abundant white deposit of carbonate of lime. +Of its morbid changes the following are to be looked for: (1) <i>Color</i>: +White from deposited salts of lime; brown or red from blood clots or +coloring matter; yellow or orange from bile or blood pigment; pale from +excess of water; or variously colored from vegetable ingredients +(santonin makes it red; rhubarb or senna, brown; tar or carbolic acid, +green). (2) <i>Density</i>: The horse's urine may be 1.030 or 1.050, but it +may greatly exceed this in diabetes and may sink to 1.007 in diuresis. +(3) <i>Chemical reaction</i>, as ascertained by blue litmus or red test +papers. The horse on vegetable diet has alkaline urine turning red test +papers blue, while in the sucking colt and the horse fed on flesh or on +his own tissue (in starvation or abstinence during disease) it is acid, +turning blue litmus red. (4) <i>Organic constituents</i>, as when glairy from +albumen coagulable by strong nitric acid and boiling, when charged with +microscopic casts of the uriniferous tubes, with the eggs or bodies of +worms, with sugar, blood, or bile. (5) <i>In its salts</i>, which may +crystallize out spontaneously, or on boiling, or on the addition of +chemical reagents.</p> + +<p><a name="PLATE_VIII" id="PLATE_VIII"></a></p> +<div class="figcenter" style="width: 450px;"> +<a href="images/plate8.jpg"><img src="images/plate8t.jpg" width="450" height="453" alt="PLATE VIII." title="" /></a> +<span class="caption">PLATE VIII.<br /> + +LONGITUDINAL SECTION THROUGH KIDNEY.</span> +</div> + +<p><a name="PLATE_IX" id="PLATE_IX"></a></p> +<div class="figcenter" style="width: 317px;"> +<a href="images/plate9.jpg"><img src="images/plate9t.jpg" width="317" height="450" alt="PLATE IX." title="" /></a> +<span class="caption">PLATE IX.<br /> + +MICROSCOPIC ANATOMY OF KIDNEY.</span> +</div> + +<p><a name="PLATE_X" id="PLATE_X"></a></p> +<div class="figcenter" style="width: 252px;"> +<a href="images/plate10.jpg"><img src="images/plate10t.jpg" width="252" height="450" alt="PLATE X." title="" /></a> +<span class="caption">PLATE X.<br /> + +MICROSCOPIC ANATOMY OF KIDNEY.</span> +</div> + +<p><span class='pagenum'><a name="Page_137" id="Page_137">[Pg 137]</a></span>Albuminous urine in the horse is usually glairy, so that it may be drawn +out in threads, but its presence can always be tested as follows: If the +liquid is opaque, it may be first passed through filter paper; if very +dense and already precipitating its salts, it may be diluted with +distilled water; add to the suspected liquid acetic acid drop by drop +until it reddens the blue litmus paper; then boil gently in a test tube; +if a precipitate is thrown down, set the tube aside to cool and then add +strong nitric acid. If the precipitate is not dissolved, it is albumen; +if dissolved it is probably urate or hippurate of ammonia. Albumen is +normally present in advanced gestation; abnormally it is seen in +diseases in which there occurs destruction of blood globules (anthrax, +low fevers, watery states of the blood, dropsies), in diseases of the +heart and liver which prevent the free escape of blood from the veins +and throw back venous pressure on the kidneys, in inflammation of the +lungs and pleuræ, and even tympany (bloating), doubtless from the same +cause, and in all congestive or inflammatory diseases of the kidneys, +acute or chronic.</p> + +<p>Casts of the uriniferous tubes can be seen only by placing the suspected +urine under the microscope. They are usually very elastic and mobile, +waving about in the liquid when the cover glass is touched, and showing +a uniform, clear transparency (waxy) or entangled circular epithelial +cells or opaque granules or flattened, red-blood globules or clear, +refrangent oil globules. They may be even densely opaque from crystals +of earthy salts.</p> + +<p>Pus cells may be found in the urine associated with albumen, and are +recognized by clearing up, when treated with acetic acid, so that each +cell shows two or three nuclei.<span class='pagenum'><a name="Page_138" id="Page_138">[Pg 138]</a></span></p> + + +<h3>DIURESIS (POLYURIA, DIABETES INSIPIDUS, OR EXCESSIVE SECRETION OF +URINE).</h3> + +<p>This consists in an excessive secretion of a clear, watery urine of a +low specific gravity (1.007) with a correspondingly ardent thirst, a +rapidly advancing emaciation, and great loss of strength and spirit.</p> + +<p><i>Causes.</i>—Its causes may be any agent—medicinal, alimentary, or +poisonous—which unduly stimulates the kidneys; the reckless +administration of diuretics, which form such a common constituent of +quack horse powders; acrid diuretic plants in grass or hay; new oats +still imperfectly cured; an excess of roots or other very watery feed; a +full allowance of salt to animals that have become inordinately fond of +it; but, above all, feeding on hay, grain, or bran which has not been +properly dried and has become musty and permeated by fungi. Thus hay, +straw, or oats obtained in wet seasons and heating in the rick or stack +is especially injurious. Hence this malady, like coma somnolentum +(sleepy staggers), is widespread in wet seasons, and especially in rainy +districts.</p> + +<p><i>Symptoms.</i>—The horse drinks deep at every opportunity and passes urine +on every occasion when stopped, the discharge being pale, watery, of a +low density, and inodorous; in short, it contains a great excess of +water and a deficiency of the solid excretions. So great is the quantity +passed, however, that the small amount of solids in any given specimen +amounts in 24 hours to far more than the normal—a fact in keeping with +the rapid wasting of the tissues and extreme emaciation. The flanks +become tucked up, the fat disappears, the bones and muscles stand out +prominently, the skin becomes tense and hidebound, and the hair erect, +scurfy, and deficient in luster. The eye becomes dull and sunken, the +spirits are depressed, the animal is weak and sluggish, sweats on the +slightest exertion, and can endure little. The subject may survive for +months, or may die early of exhaustion. In the slighter cases, or when +the cause ceases to operate, a somewhat tardy recovery may be made.</p> + +<p><i>Treatment</i> consists in stopping the ingestion of the faulty drugs, +poisons, or feed, and supplying sound hay and grain free from all taint +of heating or mustiness. A liberal supply of boiled flaxseed in the +drinking water at once serves to eliminate the poison and to sheathe and +protect the irritated kidneys. Tonics like sulphate or phosphate of iron +(2 drams morning and evening) and powdered gentian or Peruvian bark (4 +drams) help greatly by bracing the system and hastening repair. To these +may be added agents calculated to destroy the fungus and eliminate its +poisonous products. In that form which depends on musty food nothing +acts better than large doses of iodid of potassium (2 drams), while in +other cases creosote, carbolic acid (1 dram), or oil of turpentine (4 +drams), properly diluted, may be resorted to.<span class='pagenum'><a name="Page_139" id="Page_139">[Pg 139]</a></span></p> + + +<h4>SACCHARINE DIABETES (DIABETES MELLITUS, GLYCOSURIA, OR INOSURIA).</h4> + +<p>This is primarily a disease of the nervous system or liver rather than +of the kidneys, yet, as the most prominent symptom is the sweet urine, +it may be treated here.</p> + +<p><i>Causes.</i>—Its causes are varied, but resolve themselves largely into +disorder of the liver or disorder of the brain. One of the most +prominent functions of the liver is the formation of glycogen, a +principle allied to grape sugar, and passing into it by further +oxidation in the blood. This is a constant function of the liver, but in +health the resulting sugar is burned up in the circulation and does not +appear in the urine. On the contrary, when the supply of oxygen is +defective, as in certain diseases of the lungs, the whole of the sugar +does not undergo combustion and the excess is excreted by the kidneys. +Also in certain forms of enlarged liver the quantity of sugar produced +is more than can be disposed of in the natural way, and it appears in +the urine. A temporary sweetness of the urine often occurs after a +hearty meal on starchy feed, but this is due altogether to the +super-abundant supply of the sugar-forming feed, lasts for a few hours +only, and has no pathological significance. In many cases of fatal +glycosuria the liver is found to be enlarged, or at least congested, and +it is found that the disorder can be produced experimentally by agencies +which produce an increased circulation through the liver. Thus Bernard +produced glycosuria by pricking the oblong medulla at the base of the +brain close to the roots of the pneumogastric nerve, which happens to be +also the nerve center (vasomotor) which presides over the contractions +of the minute blood vessels. The pricking and irritation of this center +leads to congestion of the liver and the excessive production of sugar. +Irritation carried to this point through the pneumogastric nerve causes +saccharine urine, and, in keeping with this, disease of the pancreas has +been found in this malady. The complete removal of the pancreas, +however, determines glycosuria, the organ having in health an inhibitive +action on sugar production by the liver. The same result follows the +reflection of irritation from other sources, as from different ganglia +(corpora striata, optic thalami, pons, cerebellum, cerebrum) of the +brain. Similarly it is induced by interruption of the nervous control +along the vasomotor tracts, as in destruction of the upper or lower +cervical sympathetic ganglion, by cutting the nervous branch connecting +these two, in injury to the spinal marrow in the interval between the +brain and the second or fourth dorsal vertebra, or in disease of the +celiac plexus, which directly presides over the liver. Certain chemical +poisons also cause saccharine urine, notably woorara, strychnia, +morphia, phosphoric acid, alcohol, ether, quinia, chloroform, ammonia, +arsenic, and phlorizin.<span class='pagenum'><a name="Page_140" id="Page_140">[Pg 140]</a></span></p> + +<p><i>Symptoms.</i>—The symptoms are ardent thirst and profuse secretion of a +pale urine of a high density (1.060 and upward), rapid loss of +condition, scurfy, unthrifty skin, costiveness or irregularity of the +bowels, indigestion, and the presence, in the urine, of a sweet +principle—grape sugar or inosite, or both. This may be most promptly +detected by touching the tip of the tongue with a drop. Sugar may be +detected simply by adding a teaspoonful of liquid yeast to 4 ounces of +the urine and keeping it lightly stopped at a temperature of 70° to 80° +F. for 12 hours, when the sugar will be found to have been changed into +alcohol and carbon dioxid. The loss of density will give indication of +the quantity of sugar transformed; thus a density of 1.035 in a urine +which was formerly 1.060 would indicate about 15 grains of sugar to the +fluid ounce.</p> + +<p>Inosite, or muscle sugar, frequently present in the horse's urine, and +even replacing the glucose, is not fermentable. Its presence may be +indicated by its sweetness and the absence of fermentation or by +Gallois's test. Evaporate the suspected urine at a gentle heat almost to +dryness, then add a drop of a solution of mercuric nitrate and evaporate +carefully to dryness, when a yellowish residue is left that is changed +on further cautious heating to a deep rose color, which disappears on +cooling and reappears on heating.</p> + +<p>In advanced diabetes, dropsies in the limbs and under the chest and +belly, puffy, swollen eyelids, cataracts, catarrhal inflammation of the +lungs, weak, uncertain gait, and drowsiness may be noted.</p> + +<p><i>Treatment</i> is most satisfactory in cases dependent on some curable +disease of liver, pancreas, lungs, or brain. Thus, in liver diseases, a +run at pasture in warm weather, or in winter a warm, sunny, well-aired +stable, with sufficient clothing and laxatives (sulphate of soda, 1 +ounce daily) and alkalies (carbonate of potassium, one-fourth ounce) may +benefit. To this may be added mild blistering, cupping, or even leeching +over the last ribs. Diseases of the brain or pancreas may be treated +according to their indications. The diet should be mainly albuminous, +such as wheat bran or middlings, peas, beans, vetches, and milk. Indeed, +an exclusive milk diet is one of the very best remedial agencies. It may +be given as skimmed milk or butter-milk, and in the last case combines +an antidiabetic remedy in the lactic acid. Under such an exclusive diet +recent and mild cases are often entirely restored, though at the expense +of an attack of rheumatism. Codeia, one of the alkaloids of opium, is +strongly recommended by Tyson. The dose for the horse would be 10 to 15 +grains thrice daily. In cases in which there is manifest irritation of +the brain, bromid of potassium, 4 drams, or ergot one-half ounce, may be +resorted to. Salicylic acid and salicylate of sodium have proved useful +in certain cases; also phosphate of sodium. Bitter tonics (especially +nux vomica one-half dram) are useful in improving the digestion and +general health.<span class='pagenum'><a name="Page_141" id="Page_141">[Pg 141]</a></span></p> + + +<h4>HEMATURIA (BLOODY URINE).</h4> + +<p><i>Cause.</i>—As seen in the horse, bloody urine is usually the direct +result of mechanical injuries, as sprains and fractures of the loins, +lacerations of the sublumbar muscles (psoas), irritation caused by stone +in the kidney, ureter, bladder, or urethra. It may, however, occur with +acute congestion of the kidney, with tumors in its substance, or with +papilloma or other diseased growth in the bladder. Acrid diuretic plants +present in the feed may also lead to the escape of blood from the +kidney. The predisposition to this affection is, however, incomparably +less than in the case of the ox or the sheep, the difference being +attributed to the greater plasticity of the horse's blood in connection +with the larger quantity of fibrin.</p> + +<p>The blood may be present in small clots or in more or less intimate +admixture with the urine. Its condition may furnish some indication as +to its source; thus, if from the kidneys it is more liable to be +uniformly diffused through the urine, while as furnished by the bladder +or passages clots are more liable to be present. Again, in bleeding from +the kidney, minute, cylindrical clots inclosing blood globules and +formed in the uriniferous tubes can be detected under the microscope. +Precision also may be approximated by observing whether there is +coexisting fracture, sprain of the loins, or stone or tumor in the +bladder or urethra.</p> + +<p><i>Treatment.</i>—The disease being mainly due to direct injury, treatment +will consist, first, in removing such cause whenever possible, and then +in applying general and local styptics. Irritants in feed must be +avoided, sprains appropriately treated, and stone in bladder or urethra +removed. Then give mucilaginous drinks (slippery elm, linseed tea) +freely, and styptics (tincture of chlorid of iron 3 drams, acetate of +lead one-half dram, tannic acid one-half dram, or oil of turpentine 1 +ounce). If the discharge is abundant, apply cold water to the loins and +keep the animal perfectly still.</p> + + +<h4>HEMOGLOBINURIA (AZOTURIA, AZOTEMIA, POISONING BY ALBUMINOIDS).</h4> + +<p>Like diabetes, this is rather a disease of the liver and blood-forming +functions than of the kidney, but as prominent symptoms are loss of +control over the hind limbs and the passage of ropy and dark-colored +urine, the vulgar idea is that it is a disorder of the urinary organs. +It is a complex affection directly connected with a plethora in the +blood of nitrogenized constituents, with extreme nervous and muscular +disorder and the excretion of a dense reddish or brownish urine. It is +directly connected with high feeding, especially on highly nitrogenized +feed (oats, beans, peas, vetches, cottonseed meal), and with a period of +idleness in the stall under full rations. The disease is never seen at +pasture, rarely under constant daily work,<span class='pagenum'><a name="Page_142" id="Page_142">[Pg 142]</a></span> even though the feeding is +high, and the attack is usually precipitated by taking the horse from +the stable and subjecting it to exercise or work. The poisoning is not +present when taken from the stable, as the horse is likely to be +noticeably lively and spirited, but he will usually succumb under the +first hundred yards or half mile of exercise. It seems as if the +aspiratory power of the chest under the sudden exertion and accelerated +breathing speedily drew from the gorged liver and abdominal veins +(portal) the accumulated store of nitrogenous matter in an imperfectly +oxidized or elaborated condition, and as if the blood, surcharged with +these materials, were unable to maintain the healthy functions of the +nerve centers and muscles. It has been noticed rather more frequently in +mares than horses, attributable, perhaps, to the nervous excitement +attendant on heat, and to the fact that the unmutilated mare is +naturally more excitable than the docile gelding.</p> + +<p>Lignières has found in hemoglobinuria a streptococcus which produced +nephritis, bloody urine, and paraplegia in experimental animals, +including horses.</p> + +<p><i>Symptoms.</i>—In the milder forms this affection may appear as a lameness +in one limb, from indefinite cause, succeeding to some sudden exertion +and attended by a dusky-brown color of the membranes of the eye and nose +and some wincing when the last ribs are struck. The severe forms come on +after one or two days of rest on a full ration, when the animal has been +taken out and driven one hundred paces or more: The fire and life with +which he had left the stable suddenly give place to dullness and +oppression, as shown in heaving flanks, dilated nostrils, pinched face, +perspiring skin, and trembling body. The muscles of the loins or haunch +become swelled and rigid, the subject moves stiffly or unsteadily, +crouches behind, the limbs being carried semiflexed, and he soon drops, +unable to support himself. When down, the body and limbs are moved +convulsively, but there is no power of coordination of movement in the +muscles. The pulse and breathing are accelerated, the eyes red with a +tinge of brown, and the urine, if passed, is seen to be highly colored, +dark brown, red, or black, but it contains neither blood clots nor +globules. The color is mainly due to hemoglobin and other imperfectly +elaborated constituents of the blood.</p> + +<p>It may end fatally in a few hours or days, or a recovery may ensue, +which is usually more speedy and perfect if it has set in at an early +stage. In the late and tardy recoveries a partial paralysis of the hind +limbs may last for months. A frequent sequel of these tardy cases is an +extensive wasting of the muscles leading up from the front of the stifle +(those supplied by the crural nerve) and a complete inability to stand.<span class='pagenum'><a name="Page_143" id="Page_143">[Pg 143]</a></span></p> + +<p><i>Prevention.</i>—The prevention of this serious affection lies in +restricting the diet and giving daily exercise when the animal is not at +work. A horse that has had one attack should never be left idle for a +single day in the stall or barnyard. When a horse has been condemned to +absolute repose on good feeding he may have a laxative (one-half to 1 +pound Glauber's salt), and have graduated exercise, beginning with a +short walk and increasing day by day.</p> + +<p><i>Treatment.</i>—The treatment of the mild cases may consist in a laxative, +graduated daily exercise, and a daily dose of saltpeter (1 ounce). +Sudden attacks will sometimes promptly subside if taken on the instant +and the subject kept still and calmed by a dose of bromid of potassium +(4 drams) and sweet spirits of niter (1 ounce). The latter has the +advantage of increasing the secretion of the kidneys. Iodid of potassium +in one-half ounce doses every four hours has succeeded well in some +hands. In severe cases, as a rule, it is desirable to begin treatment by +a dose of aloes (4 to 6 drams) with the above-named dose of bromid of +potassium, and this latter may be continued at intervals of four or six +hours, as may be requisite to calm the nervous excitement. Fomentations +with warm water over the loins are always useful in calming the +excitable conditions of the spinal cord, muscles, liver, and kidneys, +and also in favoring secretion from the two latter. On the second day +diuretics may be resorted to, such as saltpeter one-half ounce, and +powdered colchicum, one-half dram, to be repeated twice daily. A +laxative may be repeated in three or four days should the bowels seem to +demand it, and as the nervous excitement disappears any remaining +muscular weakness or paralysis may be treated by one-half dram doses of +nux vomica twice a day and a stimulating liniment (aqua ammonia and +sweet oil in equal proportions) rubbed on the torpid muscles.</p> + +<p>During the course of the disease friction to the limbs is useful, and in +the advanced paralytic stage the application of electricity along the +line of the affected muscles. When the patient can not stand he must +have a thick, soft bed, and should be turned from side to side at least +every twelve hours. As soon as he can be made to stand he may be helped +up and even supported in a sling.</p> + + +<h4>ACUTE INFLAMMATION OF THE KIDNEYS, OR ACUTE NEPHRITIS.</h4> + +<p>Inflammations of the kidneys have been differentiated widely, according +as they were acute or chronic, parenchymatous or tubal, suppurative or +not, with increased or shrunken kidney, etc. In a work like the present, +however, utility will be consulted by classing all under acute or +chronic inflammation.</p> + +<p><i>Causes.</i>—The causes of inflammation of the kidneys are extremely +varied. Congestion occurs from the altered and irritant products passed +through these organs during recovery from inflammations of<span class='pagenum'><a name="Page_144" id="Page_144">[Pg 144]</a></span> other organs +and during fevers. This may last only during the existence of its cause, +or may persist and become aggravated. Heart disease, throwing the blood +pressure back on the veins and kidneys, is another cause. Disease of the +ureter or bladder, preventing the escape of urine from the kidney and +causing increased fullness and tension in its pelvis and tubes, will +determine inflammation. Decomposition of the detained urine in such +cases and the production of ammonia and other irritants must also be +named. In elimination of bacteria through the kidney, the latter is +liable to infection with consequent inflammation. The advance of +bacteria upward from the bladder to the kidneys is another cause. The +consumption in hay or other fodder of acrid or irritant plants, +including fungi, the absorption of cantharidine from a surface blistered +by Spanish flies, the reckless administration of diuretics, the presence +of stones in the kidney, exposure of the surface to cold and wet, and +the infliction of blows or sprains on the loins, may contribute to its +production. Liver disorders which throw on the kidneys the work of +excreting irritant products, diseases of the lungs and heart from which +clots are carried, to be arrested in the small blood vessels of the +kidney, and injuries and paralysis of the spinal cord, are additional +causes.</p> + +<p><i>Symptoms.</i>—The symptoms are more or less fever, manifest stiffness of +the back and straddling gait with the hind limbs, difficulty in lying +down and rising, or in walking in a circle, the animal sometimes +groaning under the effort, arching of the loins and tucking up of the +flank, looking back at the abdomen as if from colicky pain, and +tenderness of the loins to pinching, especially just beneath the bony +processes 6 inches to one side of the median line. Urine is passed +frequently, a small quantity at a time, of a high color, and sometimes +mixed with blood or even pus. Under the microscope it shows the +microscopic casts referred to under general symptoms. If treated by +acetic acid, boiling and subsequent addition of strong nitric acid, the +resulting and persistent precipitate indicates the amount of albumen. +The legs tend to swell from the foot up, also the dependent parts +beneath the belly and chest, and effusions of liquid may occur within +the chest or abdomen. In the male the alternate drawing up and +relaxation of the testicles in the scrotum are suggestive, and in small +horses the oiled hand introduced into the rectum may reach the kidney +and ascertain its sensitiveness.</p> + +<p><i>Treatment</i> demands, first, the removal of any recognized cause. Then, +if the suffering and fever are high, 2 to 4 quarts of blood may be +abstracted from the jugular vein; in weak subjects or unless in high +fever this should be omitted. Next relieve the kidneys so far as +possible by throwing their work on the bowels and skin. A pint of castor +oil is less likely than either aloes or salts to act on the kidneys. To +affect the skin a warm stall and heavy clothing may be<span class='pagenum'><a name="Page_145" id="Page_145">[Pg 145]</a></span> supplemented by +dram doses of Dover's powder. Pain may be soothed by dram doses of +bromid of potassium. Boiled flaxseed may be added to the drinking water, +also thrown into the rectum as an injection, and blankets saturated with +hot water should be persistently applied to the loins. This may be +followed by a very thin pulp of the best ground mustard made with tepid +water, rubbed in against the direction of the hair and covered with +paper and a blanket. This may be kept on for an hour, or until the skin +thickens and the hair stands erect. It may then be rubbed or sponged off +and the blanket reapplied. When the action of the bowels has been +started it may be kept up by a daily dose of 2 or 3 ounces of Glauber's +salt.</p> + +<p>During recovery a course of bitter tonics (nux vomica 1 scruple, ground +gentian root 4 drams) should be given. The patient should also be +guarded against cold, wet, and any active exertion for some time after +all active symptoms have subsided.</p> + + +<h4>CHRONIC INFLAMMATION OF THE KIDNEYS.</h4> + +<p><i>Causes.</i>—Chronic inflammation of the kidneys is more commonly +associated with albumen and casts in the urine than the acute form, find +in some instances these conditions of the urine may be the only +prominent symptoms of the disease. Though it may supervene on blow, +injuries, and exposures, it is much more commonly connected with faulty +conditions of the system—as indigestion, heart disease, lung or liver +disease, imperfect blood formation, or assimilation; in short, it is +rather the attendant on a constitutional infirmity than on a simple +local injury.</p> + +<p>It may be associated with various forms of diseased kidneys, as +shrinkage (atrophy), increase (hypertrophy), softening, red congestion, +white enlargement, etc., so that it forms a group of diseases rather +than a disease by itself.</p> + +<p><i>Symptoms.</i>—The symptoms may include stiffness, weakness, and increased +sensibility of the loins, and modified secretion of urine (increase or +suppression), or the flow may be natural. Usually it contains albumen, +the quantity furnishing a fair criterion of the gravity of the +affection, and microscopic casts, also most abundant in bad cases. +Dropsy, manifested in swelled legs, is a significant symptom, and if the +effusion takes place along the lower line of the body or in chest or +abdomen, the significance is increased. A scurfy, unthrifty skin, +lack-luster hair, inability to sustain severe or continued exertion, +poor or irregular appetite, loss of fat and flesh, softness of the +muscles, and pallor of the eyes and nose are equally suggestive. So are +skin eruptions of various kinds. Any one or more of these symptoms would +warrant an examination of the urine for albumen and casts, the finding +of which signifies renal inflammation.<span class='pagenum'><a name="Page_146" id="Page_146">[Pg 146]</a></span></p> + +<p><i>Treatment</i> of these cases is not always satisfactory, as the cause is +liable to be maintained in the disorders of important organs elsewhere. +If any such coincident disease of another organ or function can be +detected, that should be treated first or simultaneously with this +affection of the kidneys. In all cases the building up of the general +health is important. Hence a course of tonics may be given (phosphate of +iron 2 drams, nux vomica 20 grains, powdered gentian root 4 drams, +daily) or 60 drops of sulphuric acid or nitrohydrochloric acid may be +given daily in the drinking water. If there is any elevated temperature +of the body and tenderness of the loins, fomentations may be applied, +followed by a mustard pulp, as for acute inflammation, and even in the +absence of these indications the mustard may be resorted to with +advantage at intervals of a few days. In suppression of urine, +fomentations with warm water or with infusion of digitalis leaves is a +safer resort than diuretics, and cupping over the loins may also +benefit. To apply a cup, shave the skin and oil it; then take a +narrow-mouthed glass, rarify the air within it by introducing a taper in +full flame for a second, withdraw the taper and instantly apply the +mouth of the glass to the skin and hold it closely applied till the +cooling tends to form a vacuum in the glass and to draw up the skin, +like a sucker.</p> + +<p>As in the acute inflammation, every attention must be given to secure +warm clothing, a warm stall, and pure air.</p> + + +<h4>TUMORS OF THE KIDNEYS.</h4> + +<p>Tumors, whether malignant or simple, would give rise to symptoms +resembling some form of inflammation, and are not liable to be +recognized during life.</p> + + +<h4>PARASITES.</h4> + +<p>To parasites of the kidney belong the echinococcus, the larval, or +bladder worm, stage of the small echinococcus tapeworm of the dog. +<i>Dioctophyme renale</i>, the largest of roundworms, has been found in the +kidney of the horse. Its presence can be certified only by the passage +of its microscopic eggs or of the entire worm. Immature stages of +roundworms, either <i>Strongylus equinus</i> or a related species, may be +found in the renal artery or in the kidney itself.</p> + + +<h4>SPASM OF THE NECK OF THE BLADDER.</h4> + +<p>This affection consists in spasmodic closure of the outlet from the +bladder by tonic contraction of the circular muscular fibers. It may be +accompanied with a painful contraction of the muscles on the body of the +bladder; or, if the organ is already unduly distended, these will be +affected with temporary paralysis. It is most frequent in the horse, but +by no means unknown in the mare.<span class='pagenum'><a name="Page_147" id="Page_147">[Pg 147]</a></span></p> + +<p><i>Causes.</i>—The causes are usually hard and continuous driving without +opportunity for passing urine, cold rainstorms, drafts of cold air when +perspiring and fatigued, the administration of Spanish fly or the +application of extensive blisters of the same, abuse of diuretics, the +presence of acrid, diuretic plants in the fodder, and the presence of +stone in the bladder. As most mares refuse to urinate while in harness, +they should be unhitched at suitable times for urination. Spasms of the +bowels are always attended by spasm of the bladder, hence the free +passage of water is usually a symptom of relief.</p> + +<p><i>Symptoms.</i>—The symptoms are frequent stretching and straining to +urinate, with no result or a slight dribbling only. These vain efforts +are attended by pain and groaning. On resuming his natural position the +animal is not freed from the pain, but moves uneasily, paws, shakes the +tail, kicks at the abdomen with his hind feet, looks back to the flank, +lies down and rises, arches the back, and attempts to urinate as before. +If the oiled hand is introduced into the rectum the greatly distended +bladder may be felt beneath, and the patient will often shrink when it +is handled.</p> + +<p>It is important to notice that irritation of the urinary organs is often +present in impaction of the colon with solid matters, because the +impacted intestine under the straining of the patient is forced backward +into the pelvis and presses upon and irritates the bladder. In such +cases the horse stands with his fore limbs advanced and the hind ones +stretched back beyond the natural posture and makes frequent efforts to +urinate, with varying success. Unpracticed observers naturally conclude +that the secondary urinary trouble is the main and only one, and the +intestinal impaction and obstruction is too often neglected until it is +irremediable. In cases in which the irritation has caused spasm of the +neck of the bladder and overdistention of that organ, the mistake is +still more easily made; hence it is important in all cases to examine +for the impacted bowel, forming a bend or loop at the entrance of the +pelvis and usually toward the left side. The impacted intestine feels +soft and doughy and is easily indented with the knuckles, forming a +marked contrast with the tense, elastic, resilient, overdistended +bladder.</p> + +<p>It remains to be noted that similar symptoms may be determined by a +stone or sebaceous mass, or stricture obstructing the urethra, or in the +newborn by thickened mucus in that duct and by the pressure of hardened, +impacted feces in the rectum. In obstruction, the hard, impacted body +can usually be felt by tracing the urethra along the lower and posterior +surface of the penis and forward to the median line of the floor of the +pelvis to the neck of the bladder. That part of the urethra between the +seat of obstruction and the<span class='pagenum'><a name="Page_148" id="Page_148">[Pg 148]</a></span> bladder is usually distended with urine and +feels enlarged, elastic, and fluctuating.</p> + +<p><i>Treatment.</i>—Treatment may be begun by taking the animal out of +harness. This failing, spread clean litter beneath the belly or turn the +patient out on the dung heap. Some seek to establish sympathetic action +by pouring water from one vessel into another with dribbling noise. +Others soothe and distract the attention by slow whistling. Friction of +the abdomen with wisps of straw may succeed, or it may be rubbed with +ammonia and oil. These failing, an injection of 2 ounces of laudanum or +of an infusion of 1 ounce of tobacco in water may be tried. In the mare +the neck of the bladder is easily dilated by inserting two oiled fingers +and slightly parting them. In the horse the oiled hand introduced into +the rectum may press from before backward on the anterior or blind end +of the bladder. Finally, a well-oiled gum-elastic catheter may be +entered into the urethra through the papilla at the end of the penis and +pushed on carefully until it has entered the bladder. To effect this the +penis must first be withdrawn from its sheath, and when the advancing +end of the catheter has reached the bend of the urethra beneath the anus +it must be guided forward by pressure with the hand, which guidance must +be continued onward into the bladder, the oiled hand being introduced +into the rectum for this purpose. The horse catheter, 3-1/2 feet long +and one-third inch in diameter, may be bought of a surgical-instrument +maker.</p> + + +<h4>PARALYSIS OF THE BLADDER.</h4> + +<p>Paralysis of the body of the bladder with spasm of the neck has been +described under the last heading, and may occur in the same way from +overdistention in tetanus, acute rheumatism, paraplegia, and hemiplegia, +in which the animal can not stretch himself to urinate, and in cystitis, +affecting the body of the bladder but not the neck. In all these cases +the urine is suppressed. It also occurs as a result of disease of the +posterior end of the spinal marrow and with broken back, and is then +associated with palsy of the tail, and, it may be, of the hind limbs.</p> + +<p><i>Symptoms.</i>—The symptoms are a constant dribbling of urine when the +neck is involved, the liquid running down the inside of the thighs and +irritating the skin. When the neck is unaffected the urine is retained +until the bladder is greatly overdistended, when it may be expelled in a +gush by the active contraction of the muscular walls of the abdomen; +this never empties the bladder, however, and the oiled hand introduced +through the rectum may feel the soft, flabby organ still half full of +urine. This retained urine is liable to decompose and give off ammonia, +which dissolves the epithelial cells, exposing the raw, mucous membrane +and causing the worst type of cystitis.<span class='pagenum'><a name="Page_149" id="Page_149">[Pg 149]</a></span> Suppression and incontinence of +urine are common also to obstruction of the urethra by stone or +otherwise; hence this source of fallacy should be excluded by manual +examination along the whole course of that duct.</p> + +<p><i>Treatment.</i>—Treatment is only applicable in cases in which the +determining cause can be abated. In remedial sprains of the back or +disease of the spinal cord these must have appropriate treatment, and +the urine must be drawn off frequently with a catheter to prevent +overdistention and injury to the bladder. If the paralysis persists +after recovery of the spinal cord, or if it continues after relief of +spasm of the neck of the bladder, apply a pulp of mustard and water over +the back part of the belly in front of the udder, and cover with a rug +until the hair stands erect. In the male the mustard may be applied +between the thighs from near the anus downward. Daily doses of 2 drams +extract of belladonna or of 2 grains powdered Spanish fly may serve to +rouse the lost tone. These failing, a mild current of electricity daily +may succeed.</p> + + +<h4>INFLAMMATION OF THE BLADDER (CYSTITIS, OR UROCYSTITIS).</h4> + +<p>Cystitis may be slight or severe, acute or chronic, partial or general. +It may be caused by abuse of diuretics, especially such as are +irritating (cantharides, turpentine, copaiba, resin, etc.), by the +presence of a stone or gravel in the bladder, the irritation of a +catheter or other foreign body introduced from without, the septic +ferment (bacterium) introduced on a filthy catheter, the overdistention +of the bladder by retained urine, the extrication of ammonia from +retained decomposing urine, resulting in destruction of the epithelial +cells and irritation of the raw surface, and a too concentrated and +irritating urine. The application of Spanish flies or turpentine over a +too extensive surface, sudden exposure of a perspiring and tired horse +to cold or wet, and the presence of acrid plants in the fodder may cause +cystitis, as they may nephritis. Finally, inflammation may extend from a +diseased vagina or urethra to the bladder.</p> + +<p><i>Symptoms.</i>—The symptoms are slight or severe colicky pains; the animal +moves his hind feet uneasily or even kicks at the abdomen, looks around +at his flank, and may even lie down and rise frequently. More +characteristic are frequently repeated efforts to urinate, resulting in +the discharge of a little clear, or red, or more commonly flocculent +urine, always in jets, and accompanied with signs of pain, which persist +after the discharge, as shown in continued straining, groaning, and +perhaps in movements of the feet and tail. The penis hangs from the +sheath, or in the mare the vulva is frequently opened and closed, as +after urination. The animal winces when the abdomen<span class='pagenum'><a name="Page_150" id="Page_150">[Pg 150]</a></span> is pressed in the +region of the sheath or udder, and the bladder is found to be sensitive +and tender when pressed with the oiled hand introduced through the +rectum or vagina. In the mare the thickening of the walls of the bladder +may be felt by introducing one finger through the urethra. The +discharged urine, which may be turbid or even oily, contains an excess +of mucus, with flat shreds of membrane, with scaly epithelial cells, and +pus corpuscles, each showing two or more nuclei when treated with acetic +acid, but there are no microscopic tubular casts, as in nephritis. If +due to stone in the bladder, that will be found on examination through +rectum or vagina.</p> + +<p><i>Treatment</i> implies, first, the removal of the cause, whether poisons in +feed or as medicine, the removal of Spanish flies or other blistering +agents from the skin, or the extraction of stone or gravel. If the urine +has been retained and decomposed it must be completely evacuated through +a clean catheter, and the bladder thoroughly washed out with a solution +of 1 dram of borax in a quart of water. This must be repeated twice +daily until the urine no longer decomposes, because so long as ammonia +is developed in the bladder the protecting layer of epithelial cells +will be dissolved and the surface kept raw and irritable. The diet must +be light (bran mashes, roots, fresh grass), and the drink impregnated +with linseed tea, or solution of slippery elm or marsh mallow. The same +agents may be used to inject into the rectum, or they may even be used +along with borax and opium to inject into bladder (gum arabic 1 dram, +opium 1 dram, tepid water 1 pint). Fomentations over the loins are often +of great advantage, and these may be followed or alternated with the +application of mustard, as in paralysis; or the mustard may be applied +on the back part of the abdomen below or between the thighs from the +anus downward. Finally, when the acute symptoms have subsided, a daily +dose of buchu 1 dram and nux vomica one-half dram will serve to restore +lost tone.</p> + + +<h4>IRRITABLE BLADDER.</h4> + +<p>Some horses, and especially mares, show an irritability of the bladder +and nerve centers presiding over it by frequent urination in small +quantities, though the urine is not manifestly changed in character and +no more than the natural quantity is passed in the twenty-four hours. +The disorder appears to have its source quite as frequently in the +generative or nervous system as in the urinary. A troublesome and +dangerous form is seen in mares, which dash off and refuse all control +by the rein if driven with a full bladder, but usually prove docile if +the bladder has been emptied before hitching. In other cases the +excitement connected with getting the tail over the reins is<span class='pagenum'><a name="Page_151" id="Page_151">[Pg 151]</a></span> a powerful +determining cause. The condition is marked in many mares during the +period of heat.</p> + +<p>An oleaginous laxative (castor oil 1 pint) will serve to remove any +cause of irritation in the digestive organs, and a careful dieting will +avoid continued irritation by acrid vegetable agents. The bladder should +be examined to see that there is no stone or other cause of irritation, +and the sheath and penis should be washed with soapsuds, any sebaceous +matter removed from the bilocular cavity at the end of the penis, and +the whole lubricated with sweet oil. Irritable mares should be induced +to urinate before they are harnessed, and those that clutch the lines +under the tail may have the tail set high by cutting the cords on its +lower surface, or it may be prevented from getting over the reins by +having a strap carried from its free end to the breeching. Those proving +troublesome when "in heat" may have 4-dram doses of bromid of potassium, +or they may be served by the male or castrated. Sometimes irritability +may be lessened by daily doses of belladonna extract (1 dram), or a +better tone may be given to the parts by balsam copaiba (1 dram).</p> + + +<h4>DISEASED GROWTHS IN THE BLADDER.</h4> + +<p>These may be of various kinds, malignant or simple. In the horse I have +found villous growths from the mucous membrane especially troublesome. +They may be attached to the mucous membrane by a narrow neck or by a +broad base covering a great part of the organ.</p> + +<p><i>Symptoms.</i>—The symptoms are frequent straining, passing of urine and +blood with occasionally gravel. An examination of the bladder with the +hand in the rectum will detect the new growth, which may be +distinguished from a hard, resistant stone. In mares, in which the +finger can be inserted into the bladder, the recognition is still more +satisfactory. The polypi attached by narrow necks may be removed by +surgical operation, but for those with broad attachments treatment is +eminently unsatisfactory.</p> + + +<h4>DISCHARGE OF URINE BY THE NAVEL, OR PERSISTENT URACHUS.</h4> + +<p>This occurs only in the newborn, and consists in the nonclosure of the +natural channel (urachus), through which the urine is discharged into +the outer water bag (allantois) in fetal life. At that early stage of +the animal existence the bladder resembles a long tube, which is +prolonged through the navel string and opens into the outermost of the +two water bags in which the fetus floats. In this way the urine is +prevented from entering the inner water bag (amnion), where it would +mingle with the liquids, bathing the skin of the fetus and cause +irritation. At birth this channel closes up, and the urine takes<span class='pagenum'><a name="Page_152" id="Page_152">[Pg 152]</a></span> the +course normal to extra-uterine life. Imperfect closure is more frequent +in males than in females, because of the great length and small caliber +of the male urethra and its consequent tendency to obstruction. In the +female there may be a discharge of a few drops only at a time, while in +the male the urine will be expelled in strong jets coincidently with the +contractions of the bladder and walls of the abdomen.</p> + +<p>The first care is to ascertain whether the urethra is pervious by +passing a human catheter. This determined, the open urachus may be +firmly closed by a stout, waxed thread, carried with a needle through +the tissues back of the opening and tied in front of it so as to inclose +as little skin as possible. If a portion of the naval string remains, +the tying of that may be all sufficient. It is important to tie as early +as possible so as to avoid inflammation of the navel from contact with +the urine. In summer a little carbolic-acid water or tar water may be +applied to keep the flies off.</p> + + +<h4>EVERSION OF THE BLADDER.</h4> + +<p>This can occur only in the female. It consists in the turning of the +organ outside in through the channel of the urethra, so that it appears +as a red, pear-shaped mass hanging from the floor of the vulva and +protruding externally between its lips. It may be a mass like the fist, +or it may swell up to the size of an infant's head. On examining its +upper surface the orifices of the urethra maybe seen, one on each side, +a short distance behind the neck, with the urine oozing from them drop +by drop.</p> + +<p>This displacement usually supervenes on a flaccid condition of the +bladder, the result of paralysis, overdistention, or severe compression +during a difficult parturition.</p> + +<p>The protruding organ may be washed with a solution of 1 ounce of +laudanum and a teaspoonful of carbolic acid in a quart of water, and +returned by pressing a smooth, rounded object into the fundus and +directing it into the urethra, while careful pressure is made on the +surrounding parts with the other hand. If too large and resistant it may +be wound tightly in a strip of bandage about 2 inches broad to express +the great mass of blood and exudate and diminish the bulk of the +protruded organ so that it can be easily pushed back. This method has +the additional advantage of protecting the organ against bruises and +lacerations in the effort made to return it. After the return, straining +may be kept in check by giving laudanum (1 to 2 ounces) and by applying +a truss to press upon the lips of the vulva. (See Eversion of the womb.) +The patient should be kept in a stall a few inches lower in front than +behind, so that the action of gravity will favor retention.</p> + +<p><a name="PLATE_XI" id="PLATE_XI"></a></p> +<hr style="width: 95%;" /><div class="figcenter" style="width: 330px;"> +<a href="images/plate11.jpg"><img src="images/plate11t.jpg" width="330" height="450" alt="PLATE XI." title="" /></a> +<span class="caption">PLATE XI.<br /> + +CALCULI AND INSTRUMENT FOR REMOVAL.</span> +</div> + +<p><span class='pagenum'><a name="Page_153" id="Page_153">[Pg 153]</a></span></p> +<h3>INFLAMMATION OF THE URETHRA (URETHRITIS, OR GLEET).</h3> + +<p>This affection belongs quite as much to the generative organs, yet it +can not be entirely overlooked in a treatise on urinary disorders. It +may be induced by the same causes as cystitis (which see); by the +passage and temporary arrest of small stones, or gravel; by the +irritation caused by foreign bodies introduced from without; by blows on +the penis by sticks, stones, or by the feet of a mare that kicks while +being served; by an infecting inflammation contracted from a mare served +in the first few days after parturition or one suffering from +leucorrhea; by infecting matter introduced on a dirty catheter, or by +the extension of inflammation from an irritated, bilocular cavity filled +with hardened sebaceous matter, or from an uncleansed sheath.</p> + +<p><i>Symptoms.</i>—The symptoms are swelling, heat, and tenderness of the +sheath and penis; difficulty, pain, and groaning in passing urine, which +is liable to sudden temporary arrests in the course of micturition, and +later a whitish, mucopurulent oozing from the papilla on the end of the +penis. There is a tendency to erection of the penis, and in cases +contracted from a mare the outer surface of that organ will show more or +less extensive sores and ulcers. Stallions suffering in this way will +refuse to mount or, having mounted, will fail to complete the act of +coition. If an entrance is effected, infection of the mare is liable to +follow.</p> + +<p><i>Treatment</i> in the early stages consists in a dose of physic (aloes 6 +drams) and fomentations of warm water to the sheath and penis. If there +is reason to suspect the presence of infection, inject the urethra twice +daily with borax 1 dram, tepid water 1 quart. When the mucopurulent +discharge indicates the supervention of the second stage a more +astringent injection may be used (nitrate of silver 20 grains, water 1 +quart), and the same may be applied to the surface of the penis and +inside the sheath. Balsam of copaiba (1 dram daily) may also be given +with advantage after the purulent discharge has appeared.</p> + +<p>Every stallion suffering from urethritis should be withheld from +service, as should mares with leucorrhea.</p> + + +<h4>STRICTURE OF THE URETHRA.</h4> + +<p>This is a permanent narrowing of the urethra at a given point, the +result of previous inflammation, caused by the passage or arrest of a +stone, or gravel, by strong astringent injections in the early +nonsecreting stage of urethritis, or by contraction of the lining +membrane occurring during the healing of ulcers in neglected +inflammations of that canal. The trouble is shown by the passage of +urine in a fine stream, with straining, pain, and groaning, and by +frequent painful<span class='pagenum'><a name="Page_154" id="Page_154">[Pg 154]</a></span> erections. It must be remedied by mechanical +dilatation, with catheters just large enough to pass with gentle force, +to be inserted once a day, and to be used of larger size as the passage +will admit them. The catheter should be kept perfectly clean and washed +in a borax solution and well oiled before it is introduced.</p> + + +<h4>URINARY CALCULI (STONE, OR GRAVEL).</h4> + +<p>These consist in some of the solids of the urine that have been +precipitated from the urine in the form of crystals, which remain apart +as a fine, powdery mass, or magma, or aggregate into calculi, or stones, +of varying size. (See Pl. XI.) Their composition is therefore determined +in different animals by the salts or other constituents found dissolved +in the healthy urine, and by the additional constituents which may be +thrown off in solution in the urine in disease. In this connection it is +important to observe the following analysis of the horse's urine in +health:</p> + + + +<div class='center'> +<table border="0" cellpadding="4" cellspacing="0" summary=""> +<tr><td align='left'>Water</td><td align='right'>918.5</td></tr> +<tr><td align='left'>Urea</td><td align='right'>13.4</td></tr> +<tr><td align='left'>Uric acid and urates</td><td align='right'>.1</td></tr> +<tr><td align='left'>Hippuric acid</td><td align='right'>26.4</td></tr> +<tr><td align='left'>Lactic acid and lactates</td><td align='right'>1.2</td></tr> +<tr><td align='left'>Mucus and organic matter</td><td align='right'>22.0</td></tr> +<tr><td align='left'>Sulphates (alkaline)</td><td align='right'>1.2</td></tr> +<tr><td align='left'>Phosphates (lime and soda)</td><td align='right'>.2</td></tr> +<tr><td align='left'>Chlorids (sodium)</td><td align='right'>1.0</td></tr> +<tr><td align='left'>Carbonates (potash, magnesia, lime)</td><td align='right'>16.0</td></tr> +<tr><td align='left'></td><td align='right'>———</td></tr> +<tr><td align='left'></td><td align='right'>1000.0</td></tr> +</table></div> + + +<p>The carbonate of lime, which is present in large quantity in the urine +of horses fed on green fodder, is practically insoluble, and therefore +forms in the passages after secretion, and its microscopic rounded +crystals give the urine of such horses a milky whiteness. It is this +material which constitutes the soft, white, pultaceous mass that +sometimes fills the bladder to repletion and requires to be washed out. +In hay-fed horses carbonates are still abundant, while in those mainly +grain-fed they are replaced by hippurates and phosphates—the products +of the wear of tissues—the carbonates being the result of oxidation of +the vegetable acids in the feed. Carbonate of lime, therefore, is a very +common constituent of urinary calculi in herbivora, and in many cases is +the most abundant constituent.</p> + +<p>Oxalate of lime, like carbonate of lime, is derived from the burning up +of the carbonaceous matter of the feed in the system, one important +factor being the less perfect oxidation of the carbon. Indeed, +Füstenberg and Schmidt have demonstrated on man, horse, ox, and rabbit +that under the full play of the breathing (oxidizing) forces oxalic +acid, like other organic acids, is resolved into carbonic acid.<span class='pagenum'><a name="Page_155" id="Page_155">[Pg 155]</a></span> In +keeping with this is the observation of Lehmann, that in all cases in +which man suffered from interference with the breathing oxalate of lime +appeared in the urine. An excess of oxalate of lime in the urine may, +however, claim a different origin. Uric and hippuric acids are found in +the urine of carnivora and herbivora, respectively, as the result of the +healthy wear (disassimilation) of nitrogenous tissues. If these products +are fully oxidized, however, they are thrown out in the form of the more +soluble urea rather than as these acids. When uric acid out of the body +is treated with peroxid of lead it is resolved into urea, allantoin, and +oxalic acid, and Wœhler and Frerrichs found that the administration +of uric acid not only increased the excretion of urea but also of oxalic +acid. It may therefore be inferred that oxalic acid is not produced from +the carbonaceous feed alone but also from the disintegration of the +nitrogenous tissues of the body. An important element of its production +is, however, the imperfect performance of the breathing functions, and +hence it is liable to result from diseases of the chest (heaves, chronic +bronchitis, etc.). This is, above all, liable to prove the case if the +subject is fed to excess on highly carbonaceous feeds (grass and green +feed generally, potatoes, etc.).</p> + +<p>Carbonate of magnesia, another almost constant ingredient of the urinary +calculi of the horse, is formed the same way as the carbonate of +lime—from the excess of carbonaceous feed (organic acids) becoming +oxidized into carbon dioxid, which unites with the magnesia derived from +the feed.</p> + +<p>The phosphates of lime and magnesia are not abundant in urinary calculi +of the horse, the phosphates being present to excess in the urine in +only two conditions—(<i>a</i>) when the ration is excessive and especially +rich in phosphorus (wheat, bran, beans, peas, vetches, rape cake, oil +cake, cottonseed cake); and (<i>b</i>) when, through the morbid, destructive +changes in the living tissues, and especially of the bones, a great +quantity of phosphorus is given off as a waste product. Under these +conditions, however, the phosphates may contribute to the formation of +calculi, and this, above all, is liable if the urine is retained in the +bladder until it has undergone decomposition and given off ammonia. The +ammonia at once unites with the phosphate of magnesia to form a double +salt—phosphate of ammonia and magnesia—which, being insoluble, is at +once precipitated. The precipitation of this salt is, however, rare in +the urine of the horse, though much more frequent in that of man and +sheep.</p> + +<p>These are the chief mineral constituents of the urine which form +ingredients in the horse's calculi, for though iron and manganese are +usually present it is only in minute quantities.<span class='pagenum'><a name="Page_156" id="Page_156">[Pg 156]</a></span></p> + +<p>The excess of mineral matter in a specimen of urine unquestionably +contributes to the formation of calculi, just as a solution of such +matters out of the body is increasingly disposed to throw them down in +the form of crystals as it becomes more concentrated and approaches +nearer to the condition of saturation. Hence, in considering the causes +of calculi we can not ignore the factor of an excessive ration, rich in +mineral matters and in carbonaceous matters (the source of carbonates +and much of the oxalates), nor can we overlook the concentration of the +urine that comes from dry feed and privation of water, or from the +existence of fever which causes suspension of the secretion of water. In +these cases, at least the usual quantity of solids is thrown off by the +kidneys, and as the water is diminished there is danger of its +approaching the point of supersaturation, when the dissolved solids must +necessarily be thrown down. Hence, calculi are more common in stable +horses fed on dry grain and hay, in those denied a sufficiency of water +or that have water supplied irregularly, in those subjected to profuse +perspiration (as in summer), and in those suffering from a watery +diarrhea. On the whole, calculi are most commonly found in winter, +because the horses are then on dry feeding, but such dry feeding is even +more conducive to them in summer when the condition is aggravated by the +abundant loss of water by the skin.</p> + +<p>In the same way the extreme hardness of the water in certain districts +must be looked upon as contributing to the concentration of the urine +and correspondingly to the production of stone. The carbonates, +sulphates, etc., of lime and magnesia taken in the water must be again +thrown out, and just in proportion as these add to the solids of the +urine they dispose it to precipitate its least soluble constituents. +Thus the horse is very subject to calculi on certain limestone soils, as +over the calcareous formations of central and western New York, +Pennsylvania, and Ohio, in America; of Norfolk, Suffolk, Derbyshire, +Shropshire, and Gloucestershire, in England; of Poitou and Landes, in +France; and Munich, in Bavaria.</p> + +<p>The saturation of the urine from any or all of these conditions can only +be looked on as an auxiliary cause, however, and not as in itself an +efficient one, except on the rarest occasions. For a more direct and +immediate cause we must look to the organic matter which forms a large +proportion of all urinary calculi. This consists of mucus, albumen, pus, +hyaline casts of the uriniferous tubes, epithelial cells, blood, etc., +mainly agents that belong to the class of colloid or noncrystalline +bodies. A horse may live for months and years with the urine habitually +of a high density and having the mineral constituents in excess without +the formation of stone or gravel; again, one with dilute urine of low +specific gravity will have a calculus.<span class='pagenum'><a name="Page_157" id="Page_157">[Pg 157]</a></span></p> + +<p>Rainey, Ord, and others furnish the explanation. They not only show that +a colloid body, like mucus, albumen, pus, or blood, determined the +precipitation or the crystalline salts in the solution, but they +determined the precipitation in the form of globules, or spheres, +capable of developing by further deposits into calculi. Heat intensifies +this action of the colloids, and a colloid in a state of decomposition +is specially active. The presence, therefore, of developing fungi and +bacteria must be looked upon as active factors in causing calculi.</p> + +<p>In looking, therefore, for the immediate causes of calculi we must +consider especially all those conditions which determine the presence of +albumen, blood, and excess of mucus, pus, etc., in the urine. Thus +diseases of distant organs leading to albuminuria, diseases of the +kidneys and urinary passages causing the escape of blood or the +formation of mucus or pus, become direct causes of calculi. Foreign +bodies of all kinds in the bladder or kidney have long been known as +determining causes of calculi and as forming the central nucleus. This +is now explained by the fact that these bodies are liable to carry +bacteria into the passages and thus determine decomposition, and they +are further liable to irritate the mucous membrane and become enveloped +in a coating of mucus, pus, and perhaps blood.</p> + +<p>The fact that horses, especially on the magnesian limestones, the same +districts in which they suffer from goiter, appear to suffer from +calculi may be similarly explained. The unknown poison which produces +goiter presumably leads to such changes in the blood and urine as will +furnish the colloid necessary for precipitation of the urinary salts in +the form of calculi.</p> + + +<h4>CLASSIFICATION OF URINARY CALCULI.</h4> + +<p>These have been named according to the place where they are found, renal +(kidney), ureteric (ureter), vesical (bladder), urethral (urethra), and +preputial (sheath, or prepuce). They have been otherwise named according +to their most abundant chemical constituent, carbonate of lime, oxalate +of lime, and phosphate of lime calculi. The stones formed of carbonates +or phosphates are usually smooth on the surface, though they may be +molded into the shape of the cavity in which they have been formed; thus +those in the pelvis of the kidney may have two or three short branchlike +prolongations, while those in the bladder are round, oval, or slightly +flattened upon each other. Calculi containing oxalate of lime, on the +other hand, have a rough, open, crystalline surface, which has gained +for them the name of mulberry calculi, from a supposed resemblance to +that fruit. These are usually covered with more or less mucus or blood, +produced by the irritation of the mucous membrane by their rough<span class='pagenum'><a name="Page_158" id="Page_158">[Pg 158]</a></span> +surfaces. The color of calculi varies from white to yellow and deep +brown, the shades depending mainly on the amount of the coloring matter +of blood, bile, or urine which they may contain.</p> + +<p><i>Renal calculi.</i>—These may consist of minute, almost microscopic, +deposits in the uriniferous tubes in the substance of the kidney, but +more commonly they are large masses and lodged in the pelvis. The larger +calculi, sometimes weighing 12 to 24 ounces, are molded in the pelvis of +the kidney into a cylindroid mass, with irregular rounded swellings at +intervals. Some have a deep brown, rough, crystalline surface of oxalate +of lime, while others have a smooth, pearly white aspect from carbonate +of lime. A smaller calculus, which has been called coralline, is also +cylindroid, with a number of brown, rough, crystalline oxalate of lime +branches and whitish depressions of carbonate. These vary in size from +15 grains to nearly 2 ounces. Less frequently are found masses of very +hard, brownish white, rounded, pealike calculi. These are smoother, but +on the surface crystals of oxalate of lime may be detected with a lens. +Some renal calculi are formed of more distinct layers, more loosely +adherent to one another, and contain an excess of mucus, but no oxalate +of lime. Finally, a loose aggregation of small masses, forming a very +friable calculus, is found of all sizes within the limits of the pelvis +of the kidney. These, too, are in the main carbonate of lime (84 to 88 +per cent) and without oxalate.</p> + +<p>Symptoms of renal calculi are violent, colicky, pains, appearing +suddenly, very often in connection with exhausting work or the drawing +of specially heavy loads, and in certain cases disappearing with equal +suddenness. The nature of the colic becomes more manifest if it is +associated with stiffness of the back and hind limbs, frequent passage +of urine, and, above all, the passage of gravel with the urine, +especially at the time of the access of relief. The passage of blood and +pus in the urine is equally significant. If the irritation of the kidney +goes on to active inflammation, then the symptoms of nephritis are +added.</p> + +<p><i>Ureteric calculi.</i>—These are so called because they are found in the +passage leading from the kidney to the bladder. They are simply small, +renal calculi which have escaped from the pelvis of the kidney and have +become arrested in the ureter. They give rise to symptoms almost +identical with those of renal calculi, with this difference, that the +colicky pains, caused by the obstruction of the ureter by the impacted +calculus, are more violent, and if the calculus passes on into the +bladder the relief is instantaneous and complete. If the ureter is +completely blocked for a length of time, the retained urine may give +rise to destructive inflammation in the kidney, which may end in the +entire absorption of that organ, leaving only a fibrous<span class='pagenum'><a name="Page_159" id="Page_159">[Pg 159]</a></span> capsule +containing an urinous fluid. If both the ureters are similarly blocked, +the animal will die of uremic poisoning.</p> + +<p><i>Treatment of renal and ureteric calculi.</i>—Treatment is unsatisfactory, +as it is only the small calculi that can pass through the ureters and +escape into the bladder. This may be favored by agents which will relax +the walls of the ureters by counteracting their spasm and even lessening +their tone, and by a liberal use of water and watery fluids to increase +the urine and the pressure upon the calculus from behind. One or two +ounces of laudanum, or 2 drams of extract of belladonna, may be given +and repeated as it may be necessary, the relief of the pain being a fair +criterion of the abating of the spasm. To the same end use warm +fomentations across the loins, and these should be kept up persistently +until relief is obtained. These act not only by soothing and relieving +the spasm and inflammation, but they also favor the freer secretion of a +more watery urine, and thus tend to carry off the smaller calculi. To +accomplish this object further give cool water freely, and let the feed +be only such as contains a large proportion of liquid, gruels, mashes, +turnips, beets, apples, pumpkins, ensilage, succulent grasses, etc. If +the acute stage has passed and the presence of the calculus is +manifested only by the frequent passage of urine with gritty particles, +by stiffness of the loins and hind limbs, and by tenderness to pressure, +the most promising resort is a long run at pasture where the grasses are +fresh and succulent. The long-continued secretion of a watery urine will +sometimes cause the breaking down of a calculus, as the imbibition of +the less dense fluid by the organic, spongelike framework of the +calculus causes it to swell and thus lessens its cohesion. The same end +is sought by the long-continued use of alkalies (carbonate of +potassium), and of acids (muriatic), each acting in a different way to +alter the density and cohesion of the stone. It is only exceptionally, +however, that any one of these methods is entirely satisfactory. If +inflammation of the kidneys develops, treat as advised under that head.</p> + +<p><i>Stone in the bladder (vesical calculus, or cystic calculus).</i>—These +may be of any size up to over a pound in weight. One variety is rough +and crystalline and has a yellowish-white or deep-brown color. These +contain about 87 per cent carbonate of lime, the remainder being +carbonate of magnesia, oxalate of lime, and organic matter. The +phosphatic calculi are smooth, white and formed of thin, concentric +layers of great hardness extending from the nucleus outward. Besides the +phosphate of lime they contain the carbonates of lime and magnesia and +organic matter. In some cases the bladder contains and may be even +distended by a soft, pultaceous mass made up of minute, round granules +of carbonates of lime and magnesia. This, when removed and dried, makes +a firm, white, and stony mass.<span class='pagenum'><a name="Page_160" id="Page_160">[Pg 160]</a></span> Sometimes this magma is condensed into a +solid mass in the bladder by reason of the binding action of the mucus +and other organic matter, and then forms a conglomerate stone of nearly +uniform consistency and without stratification.</p> + +<p><i>Symptoms of stone in the bladder.</i>—The symptoms of stone in the +bladder are more obvious than those of renal calculus. The rough, +mulberry calculi especially lead to irritation of the mucous membrane +and frequent passing of urine in small quantities and often mingled with +mucus or blood or containing minute, gritty particles. At times the flow +is suddenly arrested, though the animal continues to strain and the +bladder is not quite emptied. In the smooth, phosphatic variety the +irritation is much less marked and may even be altogether absent. With +the pultaceous deposit in the bladder there is incontinence of urine, +which dribbles away continually and keeps the hair on the inner side of +the thighs matted with soft magma. In all cases alike the calculus may +be felt by the examination of the bladder with the oiled hand in the +rectum. The pear-shaped outline of the bladder can be felt beneath, and +within it the solid, oval body. It is most easily recognized if the +organ is half full of liquid, as then it is not grasped by the +contracting walls of the bladder, but may be made to move from place to +place in the liquid. If a pultaceous mass is present it has a soft, +doughy feeling, and when pressed an indentation is left.</p> + +<p>In the mare the hard stone may be touched by the finger introduced +through the short urethra.</p> + +<p><i>Treatment of stone in the bladder.</i>—The treatment of stone in the +bladder consists in the removal of the offending body; in the mare this +is easily effected with the lithotomy forceps. These are slightly warmed +and oiled, and carried forward along the floor of the passage of the +vulva for 4 inches, when the orifice of the urethra will be felt exactly +in the median line. Through this the forceps are gradually pushed with +gentle, oscillating movement until they enter the bladder and strike +against the hard surface of the stone. The stone is now grasped between +the blades, care being taken to include no loose fold of the mucous +membrane, and it is gradually withdrawn with the same careful, +oscillating motions as before. Facility and safety in seizing the stone +will be greatly favored by having the bladder half full of liquid, and +if necessary one oiled hand may be introduced into the rectum or vagina +to assist. The resulting irritation may be treated by an injection of +laudanum, 1 ounce in a pint of tepid water.</p> + +<p>The removal of the stone in the horse is a much more difficult +proceeding. It consists in cutting into the urethra just beneath the +anus and introducing the lithotomy forceps from this forward into the +bladder, as in the mare. It is needful to distend the urethra with<span class='pagenum'><a name="Page_161" id="Page_161">[Pg 161]</a></span> +tepid water or to insert a sound or catheter to furnish a guide upon +which the incision may be made, and in case of a large stone it may be +needful to enlarge the passage by cutting in a direction upward and +outward with a probe-pointed knife, the back of which is slid along in +the groove of a director until it enters the bladder.</p> + +<p>The horse may be operated upon in the standing position, being simply +pressed against the wall by a pole passed from before backward along the +other side of the body. The tepid water is injected into the end of the +penis until it is felt to fluctuate under the pressure of the finger, in +the median line over the bone just beneath the anus. The incision is +then made into the center of the fluctuating canal, and from above +downward. When a sound or catheter is used as a guide it is inserted +through the penis until it can be felt through the skin at the point +where the incision is to be made beneath the anus. The skin is then +rendered tense by the thumb and fingers of the left hand pressing on the +two sides of the sound, while the right hand, armed with a scalpel, cuts +downward onto the catheter. This vertical incision into the canal should +escape wounding any important blood vessel. It is in making the +obliquely lateral incision in the subsequent dilatation of the urethra +and neck of the bladder that such danger is to be apprehended.</p> + +<p>If the stone is too large to be extracted through the urethra, it may be +broken down with the lithotrite and extracted piecemeal with the +forceps. The lithotrite is an instrument composed of a straight stem +bent for an inch or more to one side at its free end so as to form an +obtuse angle, and having on the same side a sliding bar moving in a +groove in the stem and operated by a screw so that the stone may be +seized between the two blades at its free extremity and crushed again +and again into pieces small enough to extract. Extra care is required to +avoid injury to the urethra in the extraction of the angular fragments, +and the gravel or powder that can not be removed in this way must be +washed out, as advised below.</p> + +<p>When a pultaceous magma of carbonate of lime accumulates in the bladder +it must be washed out by injecting water through a catheter by means of +a force pump or a funnel, shaking it up with the hand introduced through +the rectum and allowing the muddy liquid to flow out through the tube. +This is to be repeated until the bladder is empty and the water come +away, clear. A catheter with a double tube is sometimes used, the +injection passing in through the one tube and escaping through the +other. The advantage is more apparent than real, however, as the +retention of the water until the magma has been shaken up and mixed with +it hastens greatly its complete evacuation.<span class='pagenum'><a name="Page_162" id="Page_162">[Pg 162]</a></span></p> + +<p>To prevent the formation of a new deposit any fault in feeding (dry +grain and hay with privation of water, excess of beans, peas, wheat +bran, etc.) and disorders of stomach, liver, and lungs must be +corrected. Give abundance of soft drinking water, encouraging the animal +to drink by a handful of salt daily. Let the feed be laxative, +consisting largely of roots, apples, pumpkins, ensilage, and give daily +in the drinking water a dram of either carbonate of potash or soda. +Powdered gentian root (3 drams daily) will also serve to restore the +tone of the stomach and system at large.</p> + +<p><i>Urethral calculus (stone in the urethra).</i>—This is less frequent in +horses than in cattle and sheep, owing to the larger size of the urethra +in the horse and the absence of the <b>S</b>-shaped curve and vermiform +appendix. The calculi arrested in the urethra are never formed there, +but consist of cystic calculi which have been small enough to pass +through the neck of the bladder, but are too large to pass through the +whole length of the urethra and escape. Such calculi therefore are +primarily formed either in the bladder or kidney, and have the chemical +composition of the other calculi found in those organs. They may be +arrested at any point of the urethra, from the neck of the bladder back +to the bend of the tube beneath the anus, and from that point down to +the extremity of the penis. I have found them most frequently in the +papilla on the extreme end of the penis, and immediately behind this.</p> + +<p><i>Symptoms of urethral calculus.</i>—The symptoms are violent straining to +urinate, but without any discharge, or with the escape of water in drops +only. Examination of the end of the penis will detect the swelling of +the papilla or the urethra behind it, and the presence of a hard mass in +the center. A probe inserted into the urethra will strike against the +gritty calculus. If the stone has been arrested higher up, its position +may be detected as a small, hard, sensitive knot on the line of the +urethra, in the median line of the lower surface of the penis, or on the +floor of pelvis in the median line from the neck of the bladder back to +the bend of the urethra beneath the anus. In any case the urethra +between the neck of the bladder and the point of obstruction is liable +to be filled with fluid, and to feel like a distended tube, fluctuating +on pressure.</p> + +<p><i>Treatment of urethral calculus</i> may be begun by an attempt to extract +the calculi by manipulation of the papilla on the end of the penis. This +failing, the calculus may be seized with a pair of fine-pointed forceps +and withdrawn from the urethra; or, if necessary, a probe-pointed knife +may be inserted and the urethra slightly dilated, or even laid open, and +the stone removed. If the stone has been arrested higher up it must be +extracted by a direct incision through the walls of the urethra and down +upon the nodule. If in the free<span class='pagenum'><a name="Page_163" id="Page_163">[Pg 163]</a></span> (protractile) portion of the penis, +that organ is to be withdrawn from its sheath until the nodule is +exposed and can be incised. If behind the scrotum, the incision must be +made in the median line between the thighs and directly over the nodule, +the skin having been rendered tense by the fingers and thumb of the left +hand. If the stone has been arrested in the intrapelvic portion of the +urethra, the incision must be made beneath the anus and the calculus +extracted with forceps, as in stone in the bladder. The wound in the +urethra may be stitched up, and usually heals slowly but satisfactorily. +Healing will be favored by washing two or three times daily with a +solution of a teaspoonful of carbolic acid in a pint of water.</p> + +<p><i>Preputial calculus (calculus in the sheath, or bilocular +cavity).</i>—These are concretions in the sheath, though the term has been +also applied to the nodule of sebaceous matter which accumulates in the +blind pouches (bilocular cavity) by the sides of the papilla on the end +of the penis. Within the sheath the concretion may be a soft, +cheesy-like sebaceous matter, or a genuine calculus of carbonate, +oxalate, phosphate and sulphate of lime, carbonate of magnesia, and +organic matter. These are easily removed with the fingers, after which +the sheath should be washed out with castile soap and warm water and +smeared with sweet oil.</p> + + + +<hr style="width: 65%;" /> +<p><span class='pagenum'><a name="Page_164" id="Page_164">[Pg 164]</a></span></p> +<h2>DISEASES OF THE GENERATIVE ORGANS.</h2> + +<h3>By <span class="smcap">James Law, F. R. C. V. S.,</span></h3> + +<h4>Formerly Professor of Veterinary Science, etc., in Cornell University.</h4> + + +<h4>CONGESTION AND INFLAMMATION OF THE TESTICLES, OR ORCHITIS.</h4> + +<p>In the prime of life, in vigorous health, and on stimulating feed, +stallions are subject to congestion of the testicles, which become +swollen, hot, and tender, but without any active inflammation. A +reduction of the grain in the feed, the administration of 1 or 2 ounces +of Glauber's salt daily in the feed, and the bathing of the affected +organs daily with tepid water or alum water will usually restore them to +a healthy condition.</p> + +<p>When the factors producing congestion are extraordinarily potent, when +there has been frequent copulation and heavy grain feeding, when the +weather is warm and the animal has had little exercise, and when the +proximity of other horses or mares excites the generative instinct +without gratification, this congestion may grow to actual inflammation. +Among the other causes of orchitis are blows and penetrating wounds +implicating the testicles, abrasions of the scrotum by a chain or rope +passing inside the thigh, contusions and frictions on the gland under +rapid paces or heavy draft, compression of the blood vessels of the +spermatic cord by the inguinal ring under the same circumstances, and, +finally, sympathetic disturbance in cases of disease of the kidneys, +bladder, or urethra. Stimulants of the generative functions, like rue, +savin, tansy, cantharides, and damiana, may also be accessory causes of +congestion and inflammation. Finally, certain specific diseases, like +dourine, glanders, and tuberculosis, localized in the testicles, will +cause inflammation.</p> + +<p><i>Symptoms.</i>—Apart from actual wounds of the parts, the symptoms of +orchitis are swelling, heat, and tenderness of the testicles, straddling +with the hind legs alike in standing and walking, stiffness and dragging +of the hind limbs or of the limb on the affected side, arching of the +loins, abdominal pain, manifested by glancing back at the flank, more or +less fever, elevated body temperature, accelerated pulse and breathing, +lack of appetite, and dullness. In bad<span class='pagenum'><a name="Page_165" id="Page_165">[Pg 165]</a></span> cases the scanty urine may be +reddish and the swelling may extend to the skin and envelopes of the +testicle, which may become thickened and doughy, pitting on pressure. +The swelling may be so much greater in the convoluted excretory duct +along the upper border of the testicle as to suggest the presence of a +second stone. Even in the more violent attacks the intense suffering +abates somewhat on the second or third day. If it lasts longer, it is +liable to give rise to the formation of matter (abscess). In exceptional +cases the testicle is struck with gangrene, or death. Improvement may go +on slowly to complete recovery, or the malady may subside into a +subacute and chronic form with induration. Matter (abscess) may be +recognized by the presence of a soft spot, where pressure with two +fingers will detect fluctuation from one to the other. When there is +liquid exudation into the scrotum, or sac, fluctuation may also be felt, +but the liquid can be made out to be around the testicle and can be +pressed up into the abdomen through the inguinal canal. When abscess +occurs in the cord the matter may escape into the scrotal sac and cavity +of the abdomen and pyemia may follow.</p> + +<p><i>Treatment</i> consists in perfect rest and quietude, the administration of +a purgative (1 to 1-1/2 pounds Glauber's salt), and the local +application of an astringent lotion (acetate of lead 2 drams, extract of +belladonna 2 drams, and water 1 quart) upon soft rags or cotton wool, +kept in contact with the part by a suspensory bandage. This bandage, of +great value for support, may be made nearly triangular and tied to a +girth around the loins and to the upper part of the same surcingle by +two bands carried backward and upward between the thighs. In severe +cases scarifications one-fourth inch deep serve to relieve vascular +tension. When abscess is threatened its formation may be favored by warm +fomentations or poultices, and on the occurrence of fluctuation the +knife may be used to give free escape to the pus. The resulting cavity +may be injected daily with a weak carbolic-acid lotion, or salol may be +introduced. The same agents may be used on a gland threatened with +gangrene, but its prompt removal by castration is to be preferred, +antiseptics being applied freely to the resulting cavity.</p> + + +<h4>SARCOCELE.</h4> + +<p>This is an enlarged and indurated condition of the gland, resulting from +chronic inflammation, though it is often associated with a specific +deposit, like glanders. In this condition the natural structure of the +gland has given place to embryonal tissue (small, round cells, with a +few fibrous bundles), and its restoration to health is very improbable. +Apart from active inflammation, it may increase very slowly. The +diseased testicle is enlarged, firm, nonelastic, and comparatively<span class='pagenum'><a name="Page_166" id="Page_166">[Pg 166]</a></span> +insensible. The skin of the scrotum is tense, and it may be edematous +(pitting on pressure), as are the deeper envelopes and spermatic cord. +If liquid is present in the sac, the symptoms are masked somewhat. As it +increases it causes awkward, straddling, dragging movement of the hind +limbs, or lameness on the affected side. The spermatic cord often +increases at the same time with the testicle, and the inguinal ring +being thereby stretched and enlarged, a portion of intestine may escape +into the sac, complicating the disease with hernia.</p> + +<p>The only rational and effective treatment is castration, and when the +disease is specific (glanders, tuberculosis), even this may not succeed.</p> + + +<h4>HYDROCELE, OR DROPSY OF THE SCROTUM.</h4> + +<p>This may be merely an accompaniment of dropsy of the abdomen, the cavity +of which is continuous with that of the scrotum in horses. It may be the +result, however, of local disease in the testicle, spermatic cord, or +walls of the sac.</p> + +<p><i>Symptoms.</i>—The symptoms are enlargement of the scrotum, and +fluctuation under the fingers, the testicle being recognized as floating +in water. By pressure the liquid is forced, in a slow stream and with a +perceptible thrill, into the abdomen. Sometimes the cord or the scrotum +is thickened and pits on pressure.</p> + +<p><i>Treatment</i> may be the same as for ascites, yet when the effusion has +resulted from inflammation of the testicle or cord, astringent +applications (chalk and vinegar) may be applied to these. Then, if the +liquid is not reabsorbed under diuretics and tonics, it may be drawn off +through the nozzle of a hypodermic syringe which has been first passed +through carbolic acid. In geldings it is best to dissect out the sacs.</p> + + +<h4>VARICOCELE.</h4> + +<p>This is an enlargement of the venous network of the spermatic cord, and +gives rise to general thickening of the cord from the testicle up to the +ring. The same astringent dressings may be tried as in hydrocele, and, +this failing, castration may be resorted to.</p> + + +<h4>ABNORMAL NUMBER OF TESTICLES.</h4> + +<p>Sometimes one or both testicles are wanting; in most such cases, +however, they are merely partially developed, and retained in the +inguinal canal or abdomen (cryptorchid). In rare cases there may be a +third testicle, the animal becoming to this extent a double monster. +Teeth, hair, and other indications of a second fetus have likewise been +found in the testicle or scrotum.<span class='pagenum'><a name="Page_167" id="Page_167">[Pg 167]</a></span></p> + + +<h4>DEGENERATION OF THE TESTICLES.</h4> + +<p>The testicles may become the seat of fibrous, calcareous, fatty, +cartilaginous, or cystic degeneration, for all which the appropriate +treatment is castration. They also become the seat of cancer, glanders, +or tuberculosis, and castration is requisite, though with less hope of +arresting the disease. Finally, they may become infested with cystic +tapeworms or the agamic stage of a strongyle (<i>Strongylus edentatus</i>).</p> + + +<h4>WARTS ON THE PENIS.</h4> + +<p>These are best removed by twisting them off, using the thumb and +forefinger. They may also be cut off with scissors and the roots +cauterized with nitrate of silver.</p> + + +<h4>DEGENERATION OF PENIS (PAPILLOMA, OR EPITHELIOMA).</h4> + +<p>The penis of the horse is subject to great cauliflower-like growths on +its free end, which extend back into the substance of the organ, +obstruct the passage of urine, and cause very fetid discharges. The only +resort is to cut them off, together with whatever portion of the penis +has become diseased and indurated. The operation, which should be +performed by a veterinary surgeon, consists in cutting through the organ +from its upper to its lower aspect, twisting or tying the two dorsal +arteries, and leaving the urethra longer by half an inch to 1 inch than +the adjacent structures.</p> + + +<h4>EXTRAVASATION OF BLOOD IN THE PENIS.</h4> + +<p>As the result of kicks, blows, or of forcible striking of the penis on +the thighs of the mare which it has failed to enter, the penis may +become the seat of effusion of blood from one or more ruptured blood +vessels. This gives rise to a more or less extensive swelling on one or +more sides, followed by some heat and inflammation, and on recovery a +serious curving of the organ. The treatment in the early stages may be +the application of lotions, of alum, or other astringents, to limit the +effusion and favor absorption. The penis should be suspended in a sling.</p> + + +<h4>PARALYSIS OF THE PENIS.</h4> + +<p>This results from blows and other injuries, and also in some cases from +too frequent and exhausting service. The penis hangs from the sheath, +flaccid, pendulous, and often cold. The passage of urine occurs with +lessened force, and especially without the final jets. In cases of local +injury the inflammation should first be subdued by astringent and +emollient lotions, and in all cases the system should<span class='pagenum'><a name="Page_168" id="Page_168">[Pg 168]</a></span> be invigorated by +nourishing diet, while 30-grain doses of nux vomica are given twice a +day. Finally, a weak current of electricity sent through the penis from +just beneath the anus to the free portion of the penis, continued for 10 +or 15 minutes and repeated daily, may prove successful.</p> + + +<h4>SELF-ABUSE, OR MASTURBATION.</h4> + +<p>Some stallions acquire this vicious habit, stimulating the sexual +instinct to the discharge of semen by rubbing the penis against the +belly or between the fore limbs. The only remedy is a mechanical one, +the fixing of a net under the penis in such fashion as to prevent the +extension of the penis or so prick the organ as to compel the animal to +desist through pain.</p> + + +<h4>DOURINE.</h4> + +<p>This disease is discussed in the chapter on "Infectious Diseases."</p> + + +<h3>CASTRATION.</h3> + + +<h4>CASTRATION OF STALLIONS.</h4> + +<p>This is usually done at 1 year old, but may be accomplished at a few +weeks old at the expense of an imperfect development of the fore parts. +The simplicity and safety of the operation are greatest in the young. +The delay till 2, 3, or 4 years old will secure a better development and +carriage of the fore parts. The essential part of castration is the safe +removal or destruction of the testicle and the arrest or prevention of +bleeding from the spermatic artery round in the anterior part of the +cord. Into the many methods of accomplishing this limited space forbids +us to enter here, so that only the method most commonly adopted, +castration by clamps, will be noticed. The animal having been thrown on +his left side, and the right hind foot drawn up on the shoulder, the +exposed scrotum, penis, and sheath are washed with soap and water, any +concretion of sebum being carefully removed from the bilocular cavity in +the end of the penis. The left spermatic cord, just above the testicle, +is now seized in the left hand, so as to render the skin tense over the +stone, and the right hand, armed with the knife, makes an incision from +before backward, about three-fourths of an inch from and parallel to the +median line between the thighs, deep enough to expose the testicle and +long enough to allow that organ to start out through the skin. At the +moment of making this incision the left hand must grasp the cord very +firmly, otherwise the sudden retraction of the testicle by the cremaster +muscle may draw it out of the hand and upward through the canal and even +into the abdomen. In a few seconds,<span class='pagenum'><a name="Page_169" id="Page_169">[Pg 169]</a></span> when the struggle and retraction +have ceased, the knife is inserted through the cord, between its +anterior and posterior portions, and the latter, the one which the +muscle retracts, is cut completely through. The testicle will now hang +limp, and there is no longer any tendency to retraction. It should be +pulled down until it will no longer hang loose below the wound and the +clamps applied around the still attached portion of the cord, close up +to the skin. The clamps, which may be made of any tough wood, are +grooved along the center of the surfaces opposed to each other, thereby +fulfilling two important indications—(<i>a</i>) enabling the clamps to hold +more securely and (<i>b</i>) providing for the application of an antiseptic +to the cord. For this purpose a dram of sulphate of copper may be mixed +with an ounce of vaseline and pressed into the groove in the face of +each clamp. In applying the clamp over the cord it should be drawn so +close with pincers as to press out all blood from the compressed cord +and destroy its vitality, and the cord applied upon the compressing +clamps should be so hard-twined that it will not stretch later and +slacken the hold. When the clamp has been fixed the testicle is cut off +one-half to 1 inch below it, and the clamp may be left thus for 24 +hours; then, by cutting the cord around one end of the clamp, the latter +may be opened and the stump liberated without any danger of bleeding. +Should the stump hang out of the wound it should be pushed inside with +the finger and left there. The wound should begin to discharge white +matter on the second day in hot weather or the third in cold, and from +that time a good recovery may be expected.</p> + +<p>The young horse suffers less from castration than the old, and very +rarely perishes. Good health in the subject is all important. Castration +should never be attempted during the prevalence of strangles, influenza, +catarrhal fever, contagious pleurisy, bronchitis, pneumonia, purpura +hemorrhagica, or other specific disease, nor on subjects that have been +kept in close, ill-ventilated, filthy buildings, where the system is +liable to have been charged with putrid bacteria or other products. Warm +weather is to be preferred to cold, but the fly time should be avoided +or the flies kept at a distance by the application of a watery solution +of tar, carbolic acid, or camphor to the wound.</p> + + +<h4>CASTRATION OF CRYPTORCHIDS (RIDGLINGS).</h4> + +<p>This is the removal of a testicle or testicles that have failed to +descend into the scrotum, but have been detained in the inguinal canal +or inside the abdomen. The manipulation requires an accurate anatomical +knowledge of the parts, and special skill, experience, and manual +dexterity, and can not be made clear to the unprofessional mind in a +short description. It consists, however, in the discovery and removal of +the missing gland by exploring through the natural channel (the inguinal +canal), or, in case it is absent, through the inguinal<span class='pagenum'><a name="Page_170" id="Page_170">[Pg 170]</a></span> ring or through +an artificial opening made in front and above that channel between the +abdominal muscles and the strong fascia on the inner side of the thigh +(Poupart's ligament). Whatever method is used, the skin, hands, and +instruments should be rendered aseptic with a solution of mercuric +chlorid 1 part, water 2,000 parts (a carbolic-acid lotion for the +instruments), and the spermatic cord is best torn through by the +écraseur. In many such cases, too, it is desirable to sew up the +external wound and keep the animal still, to favor healing of the wound +by adhesion.</p> + + +<h4>CONDITIONS FOLLOWING CASTRATION.</h4> + +<p><i>Pain after castration.</i>—Some horses are pained and very restless for +several hours after castration, and this may extend to cramps of the +bowels and violent colic. This is best kept in check by carefully +rubbing the patient dry when he rises from the operation, and then +leading him in hand for some time. If the pain still persists a dose of +laudanum (1 ounce for an adult) may be given.</p> + +<p><i>Bleeding after castration.</i>—Bleeding from the wound in the scrotum and +from the little artery in the posterior portion of the spermatic cord +always occurs, and in warm weather may appear to be quite free. It +scarcely ever lasts, however, more than 15 minutes, and is easily +checked by dashing cold water against the part.</p> + +<p>Bleeding from the spermatic artery in the anterior part of the cord may +be dangerous when due precaution has not been taken to prevent it. In +such case the stump of the cord should be sought for and the artery +twisted with artery forceps or tied with a silk thread. If the stump can +not be found, pledgets of tow wet with tincture of muriate of iron may +be stuffed into the canal to favor the formation of clot and the closure +of the artery.</p> + +<p><i>Strangulated spermatic cord.</i>—If in castration the cord is left too +long, so as to hang out of the wound, the skin wound in contracting +grasps and strangles it, preventing the free return of blood and causing +a steadily advancing swelling. In addition the cord becomes adherent to +the lips of the wound in the skin, whence it derives an increased supply +of blood, and is thereby stimulated to more rapid swelling. The subject +walks stiffly, with a straddling gait, loses appetite, and has a rapid +pulse and high fever. Examination of the wound discloses the partial +closure of the skin wound and the protrusion, from its lips, of the end +of the cord, red, tense, and varying in size from a hazelnut upward. If +there is no material swell and little protrusion, the wound may be +enlarged with the knife and the end of the cord broken loose from any +connection with the skin and pushed up inside. If the swelling is +larger, the mass constitutes a tumor and must be removed. (See below.)<span class='pagenum'><a name="Page_171" id="Page_171">[Pg 171]</a></span></p> + +<p><i>Swelling of the sheath, penis, and abdomen.</i>—This occurs in certain +unhealthy states of the system, in unhealthful seasons, as the result of +operating without cleansing the sheath and penis, or of keeping the +subject in a filthy, impure building, as the result of infecting the +wound by hands or instruments bearing septic bacteria, or as the result +of premature closure of the wound, and imprisonment of matter.</p> + +<p>Pure air and cleanliness of groin and wound are to be obtained. +Antiseptics, like the mercuric-chlorid lotion (1 part to 2,000) are to +be applied to the parts; the wound, if closed, is to be opened anew, any +accumulated matter or blood washed out, and the antiseptic liquid freely +applied. The most tense or dependent parts of the swelling in sheath or +penis, or beneath the belly, should be pricked at intervals of 3 or 4 +inches to a depth of half an inch, and antiseptics freely applied to the +surface. Fomentations with warm water may also be used to favor oozing +from the incisions and to encourage the formation of white matter in the +original wounds, which must not be allowed to close again at once. A +free, creamlike discharge implies a healthy action in the sore, and is +the precursor of recovery.</p> + +<p><i>Phymosis and paraphymosis.</i>—In cases of swelling, as above, the penis +may be imprisoned within the sheath (phymosis) or protruded and swollen +so that it can not be retracted into it (paraphymosis). In these cases +the treatment indicated above, and especially the scarifications, will +prove a useful preliminary resort. The use of astringent lotions is +always desirable, and in case of the protruded penis the application of +an elastic or simple linen bandage, so as to press the blood and +accumulated fluid out, will enable the operator to return it.</p> + +<p><i>Tumors on the spermatic cord.</i>—These are due to rough handling or +dragging upon the cord in castration, to strangulation of unduly long +cords in the external wound, to adhesion of the end of the cord to the +skin, to inflammation of the cord succeeding exposure to cold or wet, or +to the presence of infection (<i>Staphylococcus botriomyces</i>). These +tumors give rise to a stiff, straddling gait, and may be felt as hard +masses in the groin connected above with the cord. They may continue to +grow slowly for many years until they reach a weight of 15 or 20 pounds, +and contract adhesions to all surrounding parts. If disconnected from +the skin and inguinal canal they may be removed in the same manner as +the testicle, while if larger and firmly adherent to the skin and +surrounding parts generally, they must be carefully dissected from the +parts, the arteries being tied as they are reached and the cord finally +torn through with an écraseur. When the cord has become swollen and +indurated up into the abdomen such removal is impossible, though a +partial destruction of the mass may still be attempted by passing +white-hot, pointed irons upward toward the inguinal ring in the center +of the thickened and indurated cord.<span class='pagenum'><a name="Page_172" id="Page_172">[Pg 172]</a></span></p> + + +<h4>CASTRATION BY THE COVERED OPERATION.</h4> + +<p>This is only required in case of hernia or protrusion of bowels or +omentum into the sac of the scrotum, and consists in the return of the +hernia and the application of the caustic clamps over the cord and inner +walls of the inguinal canal, so that the walls of the latter become +adherent above the clamps, the canal is obliterated, and further +protrusion is hindered. For the full description of this and of the +operation for hernia for geldings, see remarks on hernia.</p> + + +<h4>CASTRATION OF THE MARE.</h4> + +<p>Castration is a much more dangerous operation in the mare than in the +females of other domesticated quadrupeds and should never be resorted to +except in animals that become unmanageable on the recurrence of heat and +that will not breed or that are utterly unsuited to breeding. Formerly +the operation was extensively practiced in Europe, the incision being +made through the flank, and a large proportion of the subjects perished. +By operating through the vagina the risk can be largely obviated, as the +danger of unhealthy inflammation in the wound is greatly lessened. The +animal should be fixed in a trevis, with each foot fixed to a post and a +sling placed under the body, or it may be thrown and put under +chloroform. The manual operation demands special professional knowledge +and skill, but it consists essentially in making an opening through the +roof of the vagina just above the neck of the womb, then following with +the hand each horn of the womb until the ovary on that side is reached +and grasped between the lips of forceps and twisted off. It might be +torn off by an écraseur especially constructed for the purpose. The +straining that follows the operation may be checked by ounce doses of +laudanum, and any risk of protrusion of the bowels may be obviated by +applying the truss advised to prevent eversion of the womb. To further +prevent the pressure of the abdominal contents against the vaginal wound +the mare should be tied short and high for twenty-four or forty-eight +hours, after which I have found it best to remove the truss and allow +the privilege of lying down. Another important point is to give bran +mashes and other laxative diet only, and in moderate quantity, for a +fortnight, and to unload the rectum by copious injections of warm water +in case impaction is imminent.</p> + + +<h4>STERILITY.</h4> + +<p>Sterility may be in the male or in the female. If due to the stallion, +then all the mares put to him remain barren; if the fault is in the +mare, she alone fails to conceive, while other mares served by the same +stallion get in foal.</p> + +<p>In the stallion sterility may be due to the following causes: (<i>a</i>) +Imperfect development of the testicles, as in cases in which they are<span class='pagenum'><a name="Page_173" id="Page_173">[Pg 173]</a></span> +retained within the abdomen; (<i>b</i>) inflammation of the testicles, +resulting in induration; (<i>c</i>) fatty degeneration of the testicles, in +stallions liberally fed on starchy feed and not sufficiently exercised; +(<i>d</i>) fatty degeneration of the excretory ducts of the testicles (<i>vasa +deferentia</i>); (<i>e</i>) inflammation or ulceration of these ducts; (<i>f</i>) +inflammation or ulceration of the mucous membrane covering the penis; +(<i>g</i>) injuries to the penis from blows (often causing paralysis); (<i>h</i>) +warty growths on the end of the penis; (<i>i</i>) tumors of other kinds +(largely pigmentary), affecting the testicles or penis; (<i>j</i>) nervous +diseases which abolish the sexual appetite or that control the muscles +which are essential to the act of coition; (<i>k</i>) azoturia with resulting +weakness or paralysis of the muscles of the loins or the front of the +thigh (above the stifle); (<i>l</i>) ossification (<i>anchylosis</i>) of the +joints of the back or loins, which render the animal unable to rear or +mount; (<i>m</i>) spavins, ringbones, or other painful affections of the hind +limbs, the pain of which in mounting causes the animal to suddenly stop +short in the act. In the first three of these only (<i>a</i>, <i>b</i>, and <i>c</i>) +is there real sterility in the sense of the nondevelopment or imperfect +development of the male vivifying element (spermatozoa). In the other +examples the secretion may be imperfect in kind and amount, but as +copulation is prevented it can not reach and impregnate the ovum.</p> + +<p>In the mare barrenness is equally due to a variety of causes. In a +number of breeding studs the proportion of sterile mares has varied from +20 to 40 per cent. It may be due to: (<i>a</i>) Imperfect development of the +ovary and nonmaturation of ova; (<i>b</i>) cystic or other tumors of the +ovary; (<i>c</i>) fatty degeneration of the ovary in very obese, pampered +mares; (<i>d</i>) fatty degeneration of the excretory tubes of the ovaries +(Fallopian tubes); (<i>e</i>) catarrh of the womb, with mucopurulent +discharge; (<i>f</i>) irritable condition of the womb, with profuse +secretion, straining, and ejection of the semen; (<i>g</i>) nervous +irritability, leading to the same expulsion of the male element; (<i>h</i>) +high condition (plethora), with profuse secretion and excitement; (<i>i</i>) +low condition, with imperfect maturation of the ova and lack of sexual +desire; (<i>j</i>) poor feeding, overwork, and chronic debilitating diseases, +as leading to the condition just named; (<i>k</i>) closure of the neck of the +womb, temporarily by spasm or permanently by inflammation and +induration; (<i>l</i>) closure of the entrance to the vagina through +imperforate hymen, a rare, though not unknown, condition in the mare; +(<i>m</i>) acquired indisposition to breed, seen in old, hard-worked mares +which are first put to the stallion when aged; (<i>n</i>) change of climate +has repeatedly been followed by barrenness; (<i>o</i>) hybridity, which in +male and female alike usually entails sterility.<span class='pagenum'><a name="Page_174" id="Page_174">[Pg 174]</a></span></p> + +<p><i>Treatment.</i>—The treatment of the majority of these conditions will be +found dealt with in other parts of this work, so that it is only +necessary here to name them as causes. Some, however, must be specially +referred to in this place. Stallions with undescended testicles are +beyond the reach of medicine, and should be castrated and devoted to +other uses. Indurated testicles may sometimes be remedied in the early +stages by smearing with a weak iodin ointment daily for a length of +time, and at the same time invigorating the system by liberal feeding +and judicious work. Fatty degeneration is best met by an albuminoid diet +(wheat bran, cottonseed meal, rape cake) and constant, well-regulated +work. Saccharine, starchy, and fatty food (potatoes, wheat, corn, etc.) +are to be specially avoided. In the mare one diseased and irritable +ovary should be removed, to do away with the resulting excitability of +the remainder of the generative organs. An irritable womb, with frequent +straining and the ejection of a profuse secretion, may sometimes be +corrected by a restricted diet and full but well-regulated work. Even +fatigue will act beneficially in some such cases, hence the practice of +the Arab riding his mare to exhaustion just before service. The +perspiration in such case, like the action of a purgative or the +abstraction of blood just before service, benefits, by rendering the +blood vessels less full, by lessening secretion in the womb and +elsewhere, and thus counteracting the tendency to the ejection and loss +of semen. If these means are ineffectual, a full dose of camphor (2 +drams) or of salicin may at times assist. Low condition and anemia +demand just the opposite kind of treatment—rich, nourishing, albuminoid +feed, bitter tonics (gentian), sunshine, gentle exercise, liberal +grooming, and supporting treatment generally are here in order.</p> + +<p>Spasmodic closure of the neck of the womb is common and is easily +remedied in the mare by dilatation with the fingers. The hand, smeared +with belladonna ointment and with the fingers drawn into the form of a +cone, is introduced through the vagina until the projecting, rounded +neck of the womb is felt at its anterior end. This is opened by the +careful insertion of one finger at a time, until the fingers have been +passed through the constricted neck into the open cavity of the womb. +The introduction is made with a gentle, rotary motion, and all +precipitate violence is avoided, as abrasion, laceration, or other cause +of irritation is likely to interfere with the retention of the semen and +consequently with impregnation. If the neck of the womb is rigid and +unyielding from the induration which follows inflammation—a rare +condition in the mare, though common in the cow—more force will be +requisite, and it may even be needful to incise the neck to the depth of +one-sixth of an inch<span class='pagenum'><a name="Page_175" id="Page_175">[Pg 175]</a></span> in four or more opposite directions prior to +forcible dilatation. The incision may be made with a probe-pointed +knife, and should be done by a professional man if possible. The +subsequent dilatation may be best effected by the slow expansion of +sponge or seaweed tents inserted into the narrow canal. In such cases it +is best to let the wounds of the neck heal before putting to horse. An +imperforate hymen may be freely incised in a crucial manner until the +passage will admit the human hand. An ordinary knife may be used for +this purpose, and after the operation the stallion may be admitted at +once or only after the wounds have healed.</p> + + +<h3>PREGNANCY.</h3> + +<h4>INDICATIONS OF PREGNANCY.</h4> + +<p>As the mere fact of service by the stallion does not insure pregnancy, +it is important that the result should be determined to save the mare +from unnecessary and dangerous work or medication when actually in foal +and to obviate wasteful and needless precautions when she is not.</p> + +<p>The cessation and nonrecurrence of the symptoms of heat (horsing) are +most significant, though not an infallible, sign of conception. If the +sexual excitement speedily subsides and the mare persistently refuses +the stallion for a month, she is probably pregnant. In very exceptional +cases a mare, though pregnant, will accept a second or third service +after weeks or months, and some mares will refuse the horse +persistently, though conception has not taken place, and this in spite +of warm weather, good condition of the mare, and liberal feeding. The +recurrence of heat in the pregnant mare is most liable to take place in +hot weather. If heat merely persists an undue length of time after +service, or if it reappears shortly after, in warm weather and in a +comparatively idle mare, on good feeding, it is less significant, while +the persistent absence of heat under such conditions may be usually +accepted as proof of conception.</p> + +<p>An unwonted gentleness and docility on the part of a previously +irritable or vicious mare, and supervening on service, is an excellent +indication of pregnancy, the generative instinct which caused the +excitement having been satisfied.</p> + +<p>An increase of fat, with softness and flabbiness of muscle, a loss of +energy, indisposition for active work, a manifestation of laziness, +indeed, and of fatigue early and easily induced, when preceded by +service, will usually imply conception.</p> + +<p>Enlargement of the abdomen, especially in its lower third, with slight +falling in beneath the loins and hollowness of the back are significant +symptoms, though they may be entirely absent. Swelling<span class='pagenum'><a name="Page_176" id="Page_176">[Pg 176]</a></span> and firmness of +the udder, with the smoothing out of its wrinkles, is a suggestive sign, +even though it appears only at intervals during gestation.</p> + +<p>A steady increase in weight (1-1/2 pounds daily) about the fourth or +fifth month is a useful indication of pregnancy. So is a swollen and red +or bluish-red appearance of the vaginal mucous membrane.</p> + +<p>From the seventh or eighth month onward the foal may be felt by the hand +(palm or knuckles) pressed into the abdomen in front of the left stifle. +The sudden push displaces the foal toward the opposite side of the womb, +and as it floats back its hard body is felt to strike against the hand. +If the pressure is maintained the movements of the live foal are felt, +and especially in the morning and after a drink of cold water or during +feeding. A drink of cold water will often stimulate the fetus to +movements that may be seen by the eye, but an excess of iced water may +prove injurious, even to the causing of abortion. Cold water dashed on +the belly has a similar effect on the fetus and is equally provocative +of abortion.</p> + +<p>Examination of the uterus with the oiled hand introduced into the rectum +is still more satisfactory, and, if cautiously conducted, no more +dangerous. The rectum must be first emptied and then the hand carried +forward until it reaches the front edge of the pelvic bones below, and +pressed downward to ascertain the size and outline of the womb. In the +unimpregnated state the vagina and womb can be felt as a single rounded +tube, dividing in front to two smaller tubes (the horns of the womb). In +the pregnant mare not only the body of the womb is enlarged, but still +more so one of the horns (right or left), and on compression the latter +is found to contain a hard, nodular body, floating in a liquid, which in +the latter half of gestation may be stimulated by gentle pressure to +manifest spontaneous movements. By this method the presence of the fetus +may be determined as early as the third month. If the complete, natural +outline of the virgin womb can not be made out, careful examination +should always be made on the right and left side for the enlarged horn +and its living contents. Should there still be difficulty the mare +should be placed on an inclined plane, with her hind parts lowest, and +two assistants, standing on opposite sides of the body, should raise the +lower part of the abdomen by a sheet passed beneath it. Finally the ear +or stethoscope applied on the wall of the abdomen in front of the stifle +may detect the beating of the fetal heart (one hundred and twenty-five a +minute) and a blowing sound (the uterine sough), much less rapid and +corresponding to the number of the pulse of the dam. It is heard most +satisfactorily after the sixth or eighth month and in the absence of +active rumbling of the bowels of the dam.<span class='pagenum'><a name="Page_177" id="Page_177">[Pg 177]</a></span></p> + + +<h4>DURATION OF PREGNANCY.</h4> + +<p>Mares usually go about eleven months with young, though first +pregnancies often last a year. Foals have lived when born at the three +hundredth day, so with others carried till the four hundredth day. With +the longer pregnancies there is a greater probability of male offspring.</p> + + +<h4>HYGIENE OF THE PREGNANT MARE.</h4> + +<p>The pregnant mare should not be exposed to teasing by a young and ardent +stallion, nor should she be overworked or fatigued, particularly under +the saddle or on uneven ground. Yet exercise is beneficial to both +mother and offspring, and in the absence of moderate work the breeding +mare should be kept in a lot where she can take exercise at will.</p> + +<p>The feed should be liberal, but not fattening—oats, bran, sound hay, +and other feeds rich in the principles which form flesh and bone being +especially indicated. All aliments that tend to indigestion are to be +especially avoided. Thus rank, aqueous, rapidly growing grasses and +other green feed, partially ripe rye grass, millet, Hungarian grass, +vetches, peas, beans, or maize are objectionable, as is overripe, +fibrous, innutritious hay, or that which has been injured and rendered +musty by wet, or that which is infested with smut or ergot. Feed that +tends to costiveness should be avoided. Water given often, and at a +temperature considerable above freezing, will avoid the dangers of +indigestion and abortion which result from taking too much ice-cold +water at one time. Very cold or frozen feed is objectionable in the same +sense. Severe surgical operations and medicines that act violently on +the womb, bowels, or kidneys are to be avoided as being liable to cause +abortion. Constipation should be corrected, if possible, by bran mashes, +carrots, or beets, seconded by exercise, and if a medicinal laxative is +required it should be olive oil or other equally bland agent.</p> + +<p>The stall of the pregnant mare should not be too narrow, so as to cramp +her when lying down or to entail violent effort in getting up, and it +should not slope too much from the front backward, as this throws the +weight of the uterus back on the pelvis and endangers protrusions and +even abortion. Violent mental impressions are to be avoided, for though +most mares are not affected thereby, yet a certain number are so +profoundly impressed that peculiarities and distortions are entailed on +the offspring; hence, there is wisdom shown in banishing particolored or +objectionably tinted animals, and those that show deformities or faulty +conformation. Hence, too, the importance of preventing prolonged, acute +suffering by the pregnant mare, as certain troubles of the eyes, feet, +and joints in the foals have<span class='pagenum'><a name="Page_178" id="Page_178">[Pg 178]</a></span> been clearly traced to the concentration +of the mother's mind on corresponding injured organs in herself. Sire +and dam alike tend to reproduce their individual defects which +predispose to disease, but the dam is far more liable to perpetuate the +evil in her progeny which was carried while she was individually +enduring severe suffering caused by such defects. Hence, an active bone +spavin or ringbone, causing lameness, is more objectionable than that in +which the inflammation and lameness have both passed, and an active +ophthalmia is more to be feared than even an old cataract. For this +reason all active diseases in the breeding mare should be soothed and +abated as early as possible.</p> + + +<h4>EXTRA-UTERINE GESTATION.</h4> + +<p>It is rare in the domestic animals to find the fetus developed elsewhere +than in the womb. The exceptional forms are those in which the sperm of +the male, making its way through the womb and Fallopian tubes, +impregnates the ovum prior to its escape, and in which the now vitalized +and growing ovum, by reason of its gradually increasing size, becomes +imprisoned and fails to escape into the womb. The arrest of the ovum may +be in the substance of the ovary itself (ovarian pregnancy), in the +Fallopian tube (tubal pregnancy), or when by its continuous enlargement +it has ruptured its envelopes so that it escapes into the cavity of the +abdomen, it may become attached to any part of the serous membrane and +draw its nourishment directly from that (abdominal pregnancy). In all +such cases there is an increase and enlargement of the capillary blood +vessels at the point to which the embryo has attached itself so as to +furnish the needful nutriment for the growing offspring.</p> + +<p>All appreciable symptoms are absent, unless from the death of the fetus, +or its interference with normal functions, general disorder and +indications of parturition supervene. If these occur later than the +natural time for parturition, they are the more significant. There may +be general malaise, loss of appetite, elevated temperature, accelerated +pulse, with or without distinct labor pains. Examination with the oiled +hand in the rectum will reveal the womb of the natural, unimpregnated +size and shape and with both horns of one size. Further exploration may +detect an elastic mass apart from the womb, in the interior of which may +be felt the characteristic solid body of the fetus. If the latter is +still alive and can be stimulated to move, the evidence is even more +perfect. The fetus may die and be carried for years, its soft structures +becoming absorbed so as to leave only the bones, or by pressure it may +form a fistulous opening through the abdominal walls, or less frequently +through the vagina or rectum. In the latter cases the best course is to +favor the expulsion of the foal and to wash out the resulting cavity +with a solution of carbolic acid 1 part<span class='pagenum'><a name="Page_179" id="Page_179">[Pg 179]</a></span> to water 50 parts. This may be +repeated daily. When there is no spontaneous opening it is injudicious +to interfere, as the danger from the retention of the fetus is less than +that from septic fermentation in the enormous fetal sac when that has +been opened to the air.</p> + + +<h4>MOLES, OR ANIDIAN MONSTERS.</h4> + +<p>These are evidently products of conception, in which the impregnated +ovum has failed to develop naturally, and presents only a chaotic mass +of skin, hair, bones, muscles, etc., attached to the inner surface of +the womb by an umbilical cord, which is itself often shriveled and +wasted. They are usually accompanied with a well-developed fetus, so +that the mole may be looked upon as a twin which has undergone arrest +and vitiation of development. They are expelled by the ordinary process +of parturition, and usually at the same time with the normally developed +offspring.</p> + + +<h4>CYSTIC DISEASE OF THE WALLS OF THE WOMB, OR VESICULAR MOLE.</h4> + +<p>This condition appears to be attributable to hypertrophy (enlargement) +of the villi on the inner surface of the womb, which become greatly +increased in number and hollowed out internally into a series of cysts, +or pouches, containing liquid. Unlike the true mole, therefore, they +appear to be disease of the maternal structure of the womb rather than +of the product of conception. Rodet, in a case of this kind, which had +produced active labor pains, quieted the disorder with anodynes and +effected a recovery. When this can not be done, attempts may be made to +remove the mass with the écraseur or otherwise, following it up with +antiseptic injections, as advised under the last heading.</p> + + +<h4>DROPSY OF THE WOMB.</h4> + +<p>This appears as a result of some disease of the walls of the womb, but +has been frequently observed as the result of infection after sexual +congress, and has, therefore, been confounded with pregnancy. The +symptoms are those of pregnancy, but without any movements of the fetus +and without the detection of any solid body in the womb when examined +with the oiled hand in the rectum. At the end of four or eight months +there are signs of parturition or of frequent straining to pass urine, +and after a time the liquid is discharged clear and watery, or muddy, +thick, and fetid. The hand introduced into the womb can detect neither +fetus nor fetal membrane. If the neck of the womb closes, the liquid may +accumulate a second time, or even a third, if no means are taken to +disinfect it or to correct the tendency. The best resort is to remove +any diseased product that may be found attached to the walls of the womb +and to inject it daily with a warm solution of carbolic acid 2 drams, +chlorid of zinc one-half<span class='pagenum'><a name="Page_180" id="Page_180">[Pg 180]</a></span> dram, water 1 quart. A course of bitter tonics +(gentian 2 drams, sulphate of iron 2 drams, daily) should be given, and +a nutritious, easily digested, and slightly laxative diet allowed.</p> + + +<h4>DROPSY OF THE AMNION.</h4> + +<p>This differs from simple dropsy of the womb in that the fluid collects +in the inner of the two water bags (that in which the foal floats) and +not in the otherwise void cavity of the womb. This affection can occur +only in the pregnant animal, while dropsy of the womb occurs in the +unimpregnated. The blood of the pregnant mare contains an excess of +water and a smaller proportion of albumen and red globules, and when +this condition is still further aggravated by poor feeding and other +unhygienic conditions there is developed the tendency to liquid +transudation from the vessels and dropsy. As the watery condition of the +blood increases with advancing pregnancy, so dropsy of the amnion is a +disease of the last four or five months of gestation. The abdomen is +large and pendulous, and the swelling fluctuates under pressure, though +the solid body of the fetus can still be felt to strike against the hand +pressed into the swelling. If the hand is introduced into the vagina, +the womb is found to be tense and round, with the projecting rounded +neck effaced, while the hand in the rectum will detect the rounded, +swollen mass of the womb so firm and tense that the body of the fetus +can not be felt within it. The mare moves weakly and unsteadily on her +limbs, having difficulty in supporting the great weight, and in bad +cases there may be loss of appetite, stocking (dropsy) of the hind +limbs, difficult breathing, and colicky pains. The tension may lead to +abortion, or a slow, laborious parturition may occur at the usual time.</p> + +<p><i>Treatment</i> consists in relieving the tension and accumulation by +puncturing the fetal membrane with a cannula and trocar introduced +through the neck of the womb and the withdrawal of the trocar so as to +leave the cannula in situ, or the membranes may be punctured with the +finger and the excess of liquid allowed to escape. This may bring on +abortion, or the womb may close and gestation continue to the full term. +A course of tonics (gentian root 2 drams, sulphate of iron 2 drams, +daily) will do much to fortify the system and counteract further +excessive effusion.</p> + + +<h4>DROPSY OF THE LIMBS, PERINEUM, AND ABDOMEN.</h4> + +<p>The disposition to dropsy often shows itself in the hind and even in the +fore limbs, around and beneath the vulva (perineum), and beneath the +abdomen and chest. The affected parts are swollen and pit on pressure, +but are not especially tender, and subside more or less perfectly under +exercise, hand rubbing, and bandages. In obstinate cases rubbing with +the following liniment may be resorted to:<span class='pagenum'><a name="Page_181" id="Page_181">[Pg 181]</a></span> Compound tincture of iodin, +2 ounces; tannic acid, one-half dram; water, 10 ounces. It does not last +more than a day or two after parturition.</p> + + +<h4>CRAMPS OF THE HIND LIMBS.</h4> + +<p>The pressure of the distended womb on the nerves and blood vessels of +the pelvis, besides conducing to dropsy, occasionally causes cramps of +the hind limbs. The limb is raised without flexing the joints, the front +of the hoof being directed toward the ground, or, the spasms occurring +intermittently, the foot is kicked violently against the ground several +times in rapid succession. The muscles are felt to be firm and rigid. +The cramp may be promptly relieved by active rubbing or by walking the +animal about, and it does not reappear after parturition.</p> + + +<h4>CONSTIPATION.</h4> + +<p>This may result from compression by gravid womb, and is best corrected +by a graduated allowance of boiled flaxseed.</p> + + +<h4>PARALYSIS.</h4> + +<p>The pressure on the nerves of the pelvis is liable to cause paralysis of +the hind limbs or of the nerve of sight. These are obstinate until after +parturition, when they recover spontaneously, or under a course of nux +vomica and (local) stimulating liniments.</p> + + +<h4>PROLONGED RETENTION OF THE FETUS (FOAL).</h4> + +<p>Though far less frequently than in the case of the cow, parturition may +not be completed at term, and the mare, to her serious and even fatal +injury, may carry the foal in the womb for a number of months. Hamon +records one case in which the mare died after carrying the fetus for 17 +months, and Caillier a similar result after it had been carried 22 +months. In these cases the fetus retained its natural form, but in one +reported by Gohier the bones only were left in the womb amid a mass of +apparently purulent matter.</p> + +<p><i>Cause.</i>—The cause may be any effective obstruction to the act of +parturition, such as lack of contractile power in the womb, unduly +strong (inflammatory) adhesions between the womb and the fetal +membranes, wrong presentation of the fetus, contracted pelvis (from +fracture or disease of the bones), or disease and induration of the neck +of the womb.</p> + +<p>The mere prolongation of gestation does not necessarily entail the death +of the foal; hence the latter has been born alive at the four hundredth +day. Even when the foal has perished putrefaction does not set in unless +the membranes (water bags) have been ruptured and septic bacteria have +been admitted to the interior of the womb. In the latter case a fetid +decomposition advances rapidly, and the mare usually perishes from +poisoning with the putrid matters absorbed.<span class='pagenum'><a name="Page_182" id="Page_182">[Pg 182]</a></span></p> + +<p>At the natural period of parturition preparations are apparently made +for that act. The vulva swells and discharges much mucus, the udder +enlarges, the belly becomes more pendent, and the animal strains more or +less. No progress is made, however; there is not even opening of the +neck of the womb, and after a time the symptoms subside. The mare +usually refuses the male, yet there are exceptions to this rule. If the +neck of the womb has been opened and putrefying changes in its contents +have set in, the mare loses appetite and condition, pines, discharges an +offensive matter from the generative passages, and dies of inflammation +of the womb and putrid infection. In other cases there is a slow wearing +out of the strength, and she finally dies of exhaustion.</p> + +<p>The treatment is such as will facilitate the expulsion of the fetus and +its membranes and the subsequent washing out of the womb with +disinfectants. So long as the mouth of the womb is closed time should be +allowed for its natural dilatation, but if this does not come about +after a day or two of straining, the opening may be smeared with extract +of belladonna, and the oiled hand, with the fingers and thumb drawn into +the form of a cone, may be inserted by slow oscillating movements into +the interior of the womb. The water bags may now be ruptured, any +malpresentation rectified (see "Difficult parturition"), and delivery +effected. After removal of the membranes wash out the womb first with +tepid water and then with a solution of 2 ounces of borax in half a +gallon of water.</p> + +<p>This injection may have to be repeated if a discharge sets in. The same +course may be pursued even after prolonged retention. If the soft parts +of the fetus have been absorbed and the bones only left, these must be +carefully sought for and removed, and subsequent daily injections will +be required for some time. In such cases, too, a course of iron tonics +(sulphate of iron, 2 drams daily) will be highly beneficial in restoring +health and vigor.</p> + + +<h4>ABORTION.</h4> + +<p>Abortion is, strictly speaking, the expulsion of the impregnated ovum at +any period from the date of impregnation until the foal can survive out +of the womb. If the foal is advanced enough to live, it is premature +parturition, and in the mare this may occur as early as the tenth month +(three hundredth day).</p> + +<p>The mare may abort by reason of almost any cause that very profoundly +disturbs the system; hence, very violent inflammations of important +internal organs (bowels, kidneys, bladder, lungs) may induce abortion. +Profuse diarrhea, whether occurring from the reckless use of purgatives, +the consumption of irritants in the feed, or a simple indigestion, is an +effective cause. No less so is acute indigestion with evolution of gas +in the intestines (bloating). The presence<span class='pagenum'><a name="Page_183" id="Page_183">[Pg 183]</a></span> of stone in the kidneys, +uterus, bladder, or urethra may induce so much sympathetic disorder in +the womb as to induce abortion. In exceptional cases wherein mares come +in heat during gestation, service by the stallion may cause abortion. +Blows or pressure on the abdomen, rapid driving or riding of the +pregnant mare, especially if she is soft and out of condition from +idleness, the brutal use of the spur or whip, and the jolting and +straining of travel by rail or boat are prolific causes. Bleeding the +pregnant mare, a painful surgical operation, and the throwing and +constraint resorted to for an operation are other causes. Traveling on +heavy, muddy roads, slips and falls on ice, and jumping must be added. +The stimulation of the abdominal organs by a full drink of iced water +may precipitate a miscarriage, as may exposure to a cold rainstorm or a +very cold night after a warm day. Irritant poisons that act on the +urinary or generative organs, such as Spanish flies, rue, savin, tansy, +cotton-root bark, ergot of rye or other grasses, the smut of maize and +other grain, and various fungi in musty fodder are additional causes. +Frosted or indigestible feed, and, above all, green succulent vegetables +in a frozen state, have proved effective factors, and filthy, stagnant +water is dangerous. Low condition in the dam and plethora have in +opposite ways caused abortion, and hot, relaxing stables and lack of +exercise strongly conduce to it. The exhaustion of the sire by too +frequent service, entailing debility of the offspring and disease of the +fetus or of its envelopes, must be recognized as a further cause.</p> + +<p>The symptoms vary mainly according as the abortion is early or late in +pregnancy. In the first month or two of pregnancy the mare may miscarry +without observable symptoms, and the fact appears only by her coming in +heat. If more closely observed a small clot of blood may be found behind +her, in which a careful search reveals the rudiments of the foal. If the +occurrence is somewhat later in gestation, there will be some general +disturbance, loss of appetite, neighing, and straining, and the small +body of the fetus is expelled, enveloped in its membranes. Abortions +during the later stages of pregnancy are attended with greater +constitutional disturbance, and the process resembles normal +parturition, with the aggravation that more effort and straining is +requisite to force the fetus through the comparatively undilatable mouth +of the womb. There is the swelling of the vulva, with mucus or even +bloody discharge; the abdomen droops, the flanks fall in, the udder +fills, the mare looks at her flanks, paws with the fore feet and kicks +with the hind, switches the tail, moves around uneasily, lies down and +rises, strains, and, as in natural foaling, expels first mucus and +blood, then the waters, and finally the fetus. This may occupy an hour +or two, or it may be prolonged for a day or more, the symptoms subsiding +for a time, only to reappear with renewed energy. If there is +malpresentation of the fetus it will<span class='pagenum'><a name="Page_184" id="Page_184">[Pg 184]</a></span> hinder progress until rectified, +as in difficult parturition. Abortion may also be followed by the same +accidents, as flooding, retention of the placenta, and leucorrhea.</p> + +<p>The most important object in an impending abortion is to recognize it at +as early a stage as possible, so that it may, if possible, be cut short +and prevented. Any general, indefinable illness in a pregnant mare +should lead to a close examination of the vulva as regards swelling, +vascularity of its mucous membrane, and profuse mucus secretion, and, +above all, any streak or staining of blood; also the condition of the +udder, if that is congested and swollen. Any such indication, with +colicky pains, straining, however little, and active movement of the +fetus or entire absence of movement, are suggestive symptoms and should +be duly counteracted.</p> + +<p>The changes in the vulva and udder, with a soiled and bloody condition +of the tail, may suggest an abortion already accomplished, and the +examination with the hand in the vagina may detect the mouth of the womb +soft and dilatable and the interior of the organ slightly filled with a +bloody liquid.</p> + +<p><i>Treatment</i> should be preventive if possible, and would embrace the +avoidance of all causes mentioned, and particularly of such as may seem +to be particularly operative in the particular case. If abortions have +already occurred in a stud, the especial cause in the matter of feed, +water, exposure to injuries, overwork, lack of exercise, etc., may often +be identified and removed. A most important point is to avoid all causes +of constipation, diarrhea, indigestion, bloating, violent purgatives, +diuretics or other potent medicines, painful operations, and slippery +roads, unless well frosted.</p> + +<p>When abortion is imminent, the mare should be placed alone in a roomy, +dark, quiet stall, and have the straining checked by some sedative. +Laudanum is usually at hand and may be given in doses of 1 or 2 ounces, +according to size, and repeated after two or three hours, and even daily +if necessary. Chloroform or chloral hydrate, 3 drams, may be substituted +if more convenient. These should be given in a pint or quart of water, +to avoid burning the mouth and throat. Or <i>Viburnum prunifolium</i> (black +haw), 1 ounce, may be given and repeated if necessary to prevent +straining.</p> + +<p>When all measures fail and miscarriage proceeds, all that can be done is +to assist in the removal of the fetus and its membranes, as in ordinary +parturition. As in the case of retention of the fetus, it may be +necessary after delivery to employ antiseptic injections into the womb +to counteract putrid fermentation. This, however, is less necessary in +the mare than in the cow, in which the prevalent contagious abortion +must be counteracted by the persistent local use of antiseptics. After +abortion a careful hygiene is demanded, especially in the matter of pure +air and easily digestible feed. The mare should not<span class='pagenum'><a name="Page_185" id="Page_185">[Pg 185]</a></span> be served again for +a month or longer, and in no case until after all discharge from the +vulva has ceased.</p> + + +<h4>INFECTIOUS ABORTION IN MARES.</h4> + +<p>This disease is discussed in the chapter on "Infectious Diseases."</p> + + +<h3>PARTURITION.</h3> + +<h4>SYMPTOMS OF PARTURITION.</h4> + +<p>As the period of parturition approaches, the swelling of the udder +bespeaks the coming event, the engorgement in exceptional cases +extending forward on the lower surface of the abdomen and even into the +hind limbs. For about a week a serous fluid oozes from the teat and +concretes as a yellow, waxlike mass around its orifice. About 24 hours +before the birth this gives place to a whitish, milky liquid, which +falls upon and mats the hairs on the inner sides of the legs. Another +symptom is enlargement of the vulva, with redness of its lining +membrane, and the escape of glairy mucus. The belly droops, the flanks +fall in, and the loins may even become depressed. Finally the mare +becomes uneasy, stops feeding, looks anxious, whisks her tail, and may +lie down and rise again. In many mares this is not repeated, but they +remain down; violent contractions of the abdominal muscles ensue; after +two or three pains the water bags appear and burst, followed by the fore +feet of the foal, with the nose between the knees, and by a few more +throes the fetus is expelled. In other cases the act is accomplished +standing. The whole act may not occupy more than 5 or 10 minutes. This, +together with the disposition of the mare to avoid observation, renders +the act one that is rarely seen by the attendants.</p> + +<p>The navel string, which connects the foal to the membranes, is ruptured +when the fetus falls to the ground, or when the mare rises, if she has +been down, and the membranes are expelled a few minutes later.</p> + + +<h4>NATURAL PRESENTATION.</h4> + +<p>When there is a single foal, the common and desirable presentation is +with the fore feet first, the nose between the knees, and with the front +of the hoofs and knees and the forehead directed upward toward the anus, +tail, and croup. (Plate XII, fig. 1.) In this way the natural curvature +of the body of the fetus corresponds to the curve of the womb and +genital passages, and particularly of the bony pelvis, and the foal +passes with much greater ease than if placed with its back downward +toward the udder. When there is a twin birth the second foal usually +comes with its hind feet first, and the backs of the legs, the points of +the hocks, and the tail and croup are turned upward toward the anus and +tail of the mare. (Plate XII,<span class='pagenum'><a name="Page_186" id="Page_186">[Pg 186]</a></span> fig. 2.) In this way, even with a +posterior presentation, the curvature of the body of the foal still +corresponds to that of the passages, and its expulsion may be quite as +easy as in anterior presentation. Any presentation aside from these two +may be said to be abnormal and will be considered under "Difficult +parturition."</p> + + +<h4>PREMATURE LABOR PAINS.</h4> + +<p>These may be brought on by, any violent exertion, use under the saddle, +or in heavy draft, or in rapid paces, or in travel by rail or sea, +blows, kicks, crushing by other animals in a doorway or gate. Excessive +action of purgative or diuretic agents, or of agents that irritate the +bowels or kidneys, like arsenic, paris green, all caustic salts and +acids, and acrid and narcotico-acrid vegetables, is equally injurious. +Finally, the ingestion of agents that stimulate the action of the gravid +womb (ergot of rye or of other grasses, smut, various fungi of fodders, +rue, savin, cotton root, etc.) may bring on labor pains prematurely.</p> + +<p>Besides the knowledge that parturition is not yet due, there will be +less enlargement, redness, and swelling of the vulva, less mucous +discharge, less filling of the udder, and fewer appearances of wax and +probably none of milk from the ends of the teats. The oiled hand +introduced into the vulva will not enter with the ease usual at full +term, and the neck of the womb will be felt not only closed, but with +its projecting papillæ, through which it is perforated, not yet +flattened down and effaced, as at full term. The symptoms are, indeed, +those of threatened abortion, but at such an advanced stage of gestation +as is compatible with the survival of the offspring.</p> + +<p><i>Treatment.</i>—The treatment consists in the separation of the mare, in a +quiet, dark, secluded place, from all other animals, and the free use of +antispasmodics and anodynes. Opium in dram doses every two hours, or +laudanum in ounce doses at similar intervals, will often suffice. When +the more urgent symptoms have subsided these doses may be repeated +thrice a day till all excitement passes off or until the passages have +become relaxed and prepared for parturition. <i>Viburnum prunifolium</i> +(black haw), in ounce doses, may be added if necessary. Should +parturition become inevitable, it may be favored and any necessary +assistance furnished.</p> + + +<h4>DIFFICULT PARTURITION.</h4> + +<p>With natural presentation this is a rare occurrence. The great length of +the fore limbs and face entail, in the anterior presentation, the +formation of a long cone, which dilates and glides through the passages +with comparative ease. Even with the hind feet first a similar conical +form is presented, and the process is rendered easy and<span class='pagenum'><a name="Page_187" id="Page_187">[Pg 187]</a></span> quick. +Difficulty and danger arise mainly from the act being brought on +prematurely before the passages are sufficiently dilated, from narrowing +of the pelvic bones or other mechanical obstruction in the passages, +from monstrous distortions or duplications in the fetus, or from the +turning back of one of the members so that the elongated conical or +wedge-shaped outline is done away with. Prompt as is the normal +parturition in the mare, however, difficult and delayed parturitions are +surrounded by special dangers and require unusual precautions and skill. +From the proclivity of the mare to unhealthy inflammations of the +peritoneum and other abdominal organs, penetrating wounds of the womb or +vagina are liable to prove fatal. The contractions of the womb and +abdominal walls are so powerful as to exhaust and benumb the arm of the +assistant and to endanger penetrating wounds of the genital organs. By +reason of the looser connection of the fetal membranes with the womb, as +compared with those of ruminants, the violent throes early detach these +membranes throughout their whole extent, and the foal, being thus +separated from the mother and thrown on its own resources, dies at an +early stage of any protracted parturition. The foal rarely survives four +hours after the onset of parturient throes. From the great length of the +limbs and neck of the foal it is extremely difficult to secure and bring +up limb or head which has been turned back when it should have been +presented. When assistance must be rendered, the operator should don a +thick woolen undershirt with the sleeves cut out at the shoulders. This +protects the body and leaves the whole arm free for manipulation. Before +inserting the arm it should be smeared with lard. This protects the skin +against septic infection and favors the introduction of the hand and +arm. The hand should be inserted with the thumb and fingers drawn +together like a cone. Whether standing or lying, the mare should be +turned with head downhill and hind parts raised as much as possible. The +contents of the abdomen gravitating forward leave much more room for +manipulation. Whatever part of the foal is presented (head, foot) should +be secured with a cord and running noose before it is pushed back to +search for the other missing parts. Even if a missing part is reached, +no attempt should be made to bring it up during a labor pain. Pinching +the back will sometimes check the pains and allow the operator to secure +and bring up the missing member. In intractable cases a large dose of +chloral hydrate (1 ounce in a quart of water) or the inhalation of +chloroform and air (equal proportions) to insensibility may secure a +respite, during which the missing members may be replaced. If the waters +have been discharged and the mucus dried up, the genital passages and +body of the fetus should be lubricated with lard or oil before any +attempt at extraction is made. When the missing member has been brought +up into<span class='pagenum'><a name="Page_188" id="Page_188">[Pg 188]</a></span> position and presentation has been rendered natural, traction +on the fetus must be made only during a labor pain. If a mare is +inclined to kick, it may be necessary to apply hobbles to protect the +operator.</p> + +<p><span class="smcap">Difficult parturition from narrow pelvis.</span>—A disproportion between the +fetus got by a large stallion and the pelvis of a small dam is a serious +obstacle to parturition, sometimes seen in the mare. This is not the +rule, however, as the foal up to birth usually accommodates itself to +the size of the dam, as illustrated in the successful crossing of +Percheron stallions on mustang mares. If the disproportion is too great +the only resort is embryotomy.</p> + +<p><span class="smcap">Fractured hip bones.</span>—More commonly the obstruction comes from +distortion and narrowing of the pelvis as the result of fractures. +(Plate XIII, fig. 2.) Fractures at any point of the lateral wall or +floor of the pelvis are repaired with the formation of an extensive bony +deposit bulging into the passage of the pelvis. The displacement of the +ends of the broken bone is another cause of constriction, and between +the two conditions the passage of the fetus may be rendered impossible +without embryotomy. Fracture of the sacrum (the continuation of the +backbone forming the croup) leads to the depression of the posterior +part of that bone in the roof of the pelvis and the narrowing of the +passage from above downward by a bony ridge presenting its sharp edge +forward.</p> + +<p>In all cases in which there has been injury to the bones of the pelvis +the obvious precaution is to withhold the mare from breeding and to use +her for work only.</p> + +<p>If a mare with a pelvis thus narrowed has got in foal inadvertently, +abortion may be induced in the early months of gestation by slowly +introducing the oiled finger through the neck of the womb and following +this by the other fingers until the whole hand has been introduced. Then +the water bags may be broken, and with the escape of the liquid the womb +will contract on the solid fetus and labor pains will ensue. The fetus +being small will pass easily.</p> + +<p><span class="smcap">Tumors in the vagina and pelvis.</span>—Tumors of various kinds may form in +the vagina or elsewhere within the pelvis, and when large enough will +obstruct or prevent the passage of the fetus. Gray mares, which are so +subject to black pigment tumors (melanosis) on the tail, anus, and +vulva, are the most liable to suffer from this. Still more rarely the +wall of the vagina becomes relaxed, and being pressed by a mass of +intestines will protrude through the lips of the vulva as a hernial sac, +containing a part of the bowels. If a tumor is small it may only retard +and not absolutely prevent parturition. A hernial protrusion of the wall +of the vagina may be pressed back and emptied, so that the body of the +fetus engaging in the passage may<span class='pagenum'><a name="Page_189" id="Page_189">[Pg 189]</a></span> find no further obstacle. When a +tumor is too large to allow delivery the only resort is to remove it, +but before proceeding it must be clearly made out that the obstruction +is a mass of diseased tissue, and not a sac containing intestines. If +the tumor hangs by a neck it can usually be most safely removed by the +écraseur, the chain being passed around the pedicel and gradually +tightened until that is torn through.</p> + +<p><span class="smcap">Hernia of the womb.</span>—The rupture of the musculo-fibrous floor of the +belly and the escape of the gravid womb into a sac formed by the +peritoneum and skin hanging toward the ground is described by all +veterinary obstetricians, yet it is very rarely seen in the mare. The +form of the fetus can be felt through the walls of the sac, so that it +is easy to recognize the condition. Its cause is usually external +violence, though it may start from an umbilical hernia. When the period +of parturition arrives, the first effort should be to return the fetus +within the proper abdominal cavity, and this can sometimes be +accomplished with the aid of a stout blanket gradually tightened around +the belly. This failing, the mare may be placed on her side or back and +gravitation brought to the aid of manipulation in effecting the return. +Even after the hernia has been reduced the relaxed state of the womb and +abdominal walls may serve to hinder parturition, in which case the oiled +hand must be introduced through the vagina, the fetus brought into +position, and traction coincident with the labor pains employed to +produce delivery.</p> + +<p><span class="smcap">Twisting of the neck of the womb.</span>—This condition is very uncommon in +the mare, though occasionally seen in the cow, owing to the greater +laxity of the broad ligaments of the womb in that animal. It consists in +a revolution of the womb on its own axis, so that its right or left side +will be turned upward (quarter revolution), or the lower surface may be +turned upward and the upper surface downward (half revolution). The +effect is to throw the narrow neck of the womb into a series of spiral +folds, turning in the direction in which the womb has revolved, closing +the neck and rendering distention and dilatation impossible.</p> + +<p>The period and pains of parturition arrive, but in spite of continued +efforts no progress is made, neither water bags nor liquids appearing. +The oiled hand introduced into the closed neck of the womb will readily +detect the spiral direction of the folds on its inner surface.</p> + +<p>The method of relief which I have successfully adopted in the cow may be +equally effective in the mare. The dam is placed (with her head uphill) +on her right side if the upper folds of the spiral turn toward the +right, and on her left side if they turn toward the left, and the oiled +hand is introduced through the neck of the womb and a limb or other part +of the body of the fetus is seized and<span class='pagenum'><a name="Page_190" id="Page_190">[Pg 190]</a></span> pressed against the wall of the +womb, while two or three assistants turn the animal over on her back +toward the other side. The object is to keep the womb stationary while +the animal is rolling. If success attends the effort, the constriction +around the arm is suddenly relaxed, the spiral folds are effaced, and +the water bags and fetus press forward into the passage. If the first +attempt does not succeed, it may be repeated again and again until +success crowns the effort. Among my occasional causes of failure have +been the prior death and decomposition of the fetus, with the +extrication of gas and overdistention of the womb, and the supervention +of inflammation and inflammatory exudation around the neck of the womb, +which hinders untwisting. The first of these conditions occurs early in +the horse from the detachment of the fetal membranes from the wall of +the womb; and as the mare is more subject to fatal peritonitis than the +cow, it may be concluded that both these sources of failure are more +probable in the former subject.</p> + +<p>When the case is intractable, though the hand may be easily introduced, +the instrument shown in Plate XIV, figure 7, may be used. Each hole at +the small end of the instrument has passed through it a stout cord with +a running noose, to be passed around two feet or other portion of the +fetus which it may be possible to reach. The cords are then drawn tight +and fixed around the handle of the instrument; then, by using the cross +handle as a lever, the fetus and womb may be rotated in a direction +opposite to that causing the obstruction. During this process the hand +must be introduced to feel when the twist has been undone. This method +may be supplemented, if necessary, by rolling the mare as described +above.</p> + +<p><span class="smcap">Effusion of blood in the vaginal walls.</span>—This is common as a result of +difficult parturition, but it may occur from local injury before that +act, and may seriously interfere with it. This condition is easily +recognized by the soft, doughy swelling so characteristic of blood +clots, and by the dark-red color of the mucous membrane. I have laid +open such swellings with the knife as late as 10 days before +parturition, evacuated the clots, and dressed the wound daily with an +astringent lotion (sulphate of zinc 1 dram, carbolic acid 1 dram, water +1 quart). A similar resort might be had, if necessary, during +parturition.</p> + +<p><span class="smcap">Calculus (stone) and tumor in the bladder.</span>—The pressure upon the +bladder containing a stone or a tumor may prove so painful that the mare +will voluntarily suppress the labor pains. Examination of the bladder +with the finger introduced through the urethra will detect the offending +agent. A stone should be extracted with forceps. (See "Lithotomy.") The +large papillary tumors which I have met with in the mare's bladder have +been invariably delicate in texture<span class='pagenum'><a name="Page_191" id="Page_191">[Pg 191]</a></span> and could be removed piecemeal by +forceps. Fortunately, mares affected in this way rarely breed.</p> + +<p><span class="smcap">Fecal impaction of the rectum.</span>—In some animals, with more or less +paralysis or weakness of the tail and rectum, the rectum may become so +impacted with solid feces that the mare is unable to discharge them, and +the accumulation both by reason of the mechanical obstruction and the +pain caused by pressure upon it will impel the animal to cut short all +labor pains. The rounded swelling surrounding the anus will at once +suggest the condition, when the obstruction may be removed by the +well-oiled or well-soaped hand.</p> + +<p><span class="smcap">Spasm of the neck of the womb.</span>—This occurs in the mare of specially +excitable temperament, or under particular causes of irritation, local +or general. Labor pains, though continuing for some time, produce no +dilatation of the neck of the womb, which will be found firmly closed so +as to admit but one or two fingers; this, although the projection at the +mouth of the womb may have been entirely effaced, so that a simple round +opening is left, with rigid margins.</p> + +<p>The simplest treatment consists in smearing this part with solid extract +of belladonna, and after an interval inserting the hand with fingers and +thumb drawn into the form of a cone, rupturing the membranes and +bringing the fetus into position for extraction, as advised under +"Prolonged retention of the fetus." Another mode is to insert through +the neck of the womb an ovoid rubber bag, empty, and furnished with an +elastic tube 12 feet long. Carry the free end of this tube upward to a +height of 8, 10, or 12 feet, insert a filler into it, and proceed to +distend the bag with tepid or warm water.</p> + +<p><span class="smcap">Fibrous bands constricting or crossing the neck of the womb.</span>—These, +occurring as the result of disease, have been several times observed in +the mare. They may exist in the cavity of the abdomen and compress and +obstruct the neck of the womb, or they may extend from side to side of +the vagina across and just behind the neck of the womb. In the latter +position they may be felt and quickly remedied by cutting them across. +In the abdomen they can be reached only by incision, and two +alternatives are presented: (1) To perform embryotomy and extract the +fetus piecemeal, and (2) to make an incision into the abdomen and +extract by the Cæsarean operation, or simply to cut the constricting +band and attempt delivery by the usual channel.</p> + +<p><span class="smcap">Fibrous constriction of vagina or vulva.</span>—This is probably always the +result of direct mechanical injury and the formation of rigid cicatrices +which fail to dilate with the remainder of the passages at the approach +of parturition. The presentation of the fetus in the natural way and the +occurrence of successive and active labor pains without any favorable +result will direct attention to the rigid and unyielding cicatrices +which may be incised at one, two, or more<span class='pagenum'><a name="Page_192" id="Page_192">[Pg 192]</a></span> points to a depth of half an +inch or more, after which the natural expulsive efforts will usually +prove effective. The resulting wounds may be washed frequently with a +solution of 1 part of carbolic acid to 50 parts of water, or of 1 part +of mercuric chlorid to 1,000 parts of water.</p> + +<p><span class="smcap">Fetus adherent to the walls of the womb.</span>—In inflammation of the mucous +membrane lining the cavity of the womb and implicating the fetal +membranes the resulting embryonic tissue sometimes establishes a medium +of direct continuity between the womb and fetal membranes; the blood +vessels of the one communicate freely with those of the other and the +fibers of the one are prolonged into the other. This causes retention of +the membranes after birth, and a special risk of bleeding from the womb, +and of septic poisoning. In exceptional cases the adhesion is more +extensive and binds a portion of the body of the foal firmly to the +womb. In such cases it has repeatedly been found impossible to extract +the foal until such adhesions were broken down. If they can be reached +with the hand and recognized, they may be torn through with the fingers +or with a blunt hook, after which delivery may be attempted with hope of +success.</p> + +<p><span class="smcap">Excessive size of fetus.</span>—It would seem that a small mare may usually be +safely bred to a large stallion, yet this is not always the case; and +when the small size is an individual rather than a racial characteristic +or the result of being very young, the rule can not be expected to hold. +There is always great danger in breeding the young, small, and +undeveloped female, and the dwarfed representative of a larger breed, as +the offspring tend to partake of the large race characteristics and to +show them even prior to birth. When impregnation has occurred in the +very young or in the dwarfed female there are two alternatives—to +induce abortion or to wait until there are attempts at parturition and +to extract by embryotomy if impracticable otherwise.</p> + +<p><span class="smcap">Constriction of a member by the navel string.</span>—In man and animals alike +the winding of the umbilical cord around a member of the fetus sometimes +leads to the amputation of the latter. It is also known to get wound +around the neck or a limb at birth, but in the mare this does not +seriously impede parturition, as the loosely attached membranes are +easily separated from the womb and no strangulation or retarding occurs. +The foal may, however, die from the cessation of the placental +circulation unless it is speedily delivered.</p> + +<p><span class="smcap">Water in the head (hydrocephalus) of the foal.</span>—This consists in the +excessive accumulation of liquid in the ventricles of the brain so that +the cranial cavity is enlarged and constitutes a great, projecting, +rounded mass occupying the space from the eyes upward. (See Plate XIII, +fig. 3.) With an anterior presentation (fore feet and nose) this +presents an insuperable obstacle to progress, as the diseased cranium is +too large to enter the pelvis at the same time with the fore arms. With +a posterior presentation (hind feet) all goes well until the body and +shoulders have passed out, when progress is suddenly arrested by the +great bulk of the head. In the first case, the oiled hand introduced +along the face detects the enormous size of the head, which may be +diminished by puncturing it with a knife or trocar and cannula in the +median line, evacuating the water and pressing in the thin, bony walls. +With a posterior presentation, the same course must be followed; the +hand passed along the neck will detect the cranial swelling, which may +be punctured with a knife or trocar. Oftentimes with an anterior +presentation the great size of the head leads to its displacement +backward, and thus the fore limbs alone engage in the passages. Here the +first object is to seek and bring up the missing head, and then puncture +it as above suggested.</p> + +<p><a name="PLATE_XII" id="PLATE_XII"></a></p> +<div class="figcenter" style="width: 306px;"> +<a href="images/plate12.jpg"><img src="images/plate12t.jpg" width="306" height="450" alt="PLATE XII." title="" /></a> +<span class="caption">PLATE XII.<br /> + +NORMAL PRESENTATIONS.</span> +</div> + +<p><a name="PLATE_XIII" id="PLATE_XIII"></a></p> +<div class="figcenter" style="width: 450px;"> +<a href="images/plate13.jpg"><img src="images/plate13t.jpg" width="450" height="279" alt="PLATE XIII." title="" /></a> +<span class="caption">PLATE XIII.<br /> + +SOME FACTORS IN DIFFICULT LABOR.</span> +</div> + +<p><a name="PLATE_XIV" id="PLATE_XIV"></a></p> +<div class="figcenter" style="width: 450px;"> +<a href="images/plate14.jpg"><img src="images/plate14t.jpg" width="450" height="285" alt="PLATE XIV." title="" /></a> +<span class="caption">PLATE XIV.<br /> + +INSTRUMENTS USED IN DIFFICULT LABOR.</span> +</div> + +<p><span class='pagenum'><a name="Page_193" id="Page_193">[Pg 193]</a></span><span class="smcap">Ascites, or dropsy of the abdomen in the foal.</span>—The accumulation of +liquid in the abdominal cavity of the fetus is less frequent, but when +present it may arrest parturition as completely as will hydrocephalus. +With an anterior presentation the foal may pass as far as the shoulders, +but behind this all efforts fail to effect a further advance. With a +posterior presentation the hind legs as far as the thighs may be +expelled, but at this point all progress ceases. In either case the +oiled hand, passed inward by the side of the foal, will detect the +enormous distension of the abdomen and its soft, fluctuating contents. +The only course is to puncture the cavity and evacuate the liquid. With +the anterior presentation this may be done with a long trocar and +cannula, introduced through the chest and diaphragm, or with a knife an +incision may be made between the first two ribs and the lungs and heart +cut or torn out, when the diaphragm will be felt projecting strongly +forward, and may be easily punctured. Should there not be room to +introduce the hand through the chest, the oiled hand may be passed along +beneath the breast bone and the abdomen punctured. With a posterior +presentation the abdomen must be punctured in the same way, the hand, +armed with a knife protected in its palm, being passed along the side of +the flank or between the hind limbs. It should be added that moderate +dropsy of the abdomen is not incompatible with natural delivery, the +liquid being at first crowded back into the portion of the belly still +engaged in the womb, and passing slowly from that into the advanced +portion as soon as that has cleared the narrow passage of the pelvis and +passed out where it can expand.</p> + +<p><span class="smcap">General dropsy of the fetus.</span>—In this case the tissues generally are +distended with liquid, and the skin is found at all points tense<span class='pagenum'><a name="Page_194" id="Page_194">[Pg 194]</a></span> and +rounded, and pitting on pressure with the fingers. In some such cases +delivery may be effected after the skin has been punctured at narrow +intervals to allow the escape of the fluid and then liberally smeared +with fresh lard. More commonly, however, it can not be reached at all +points to be so punctured nor sufficiently reduced to be extracted +whole, and resort must be had to embryotomy.</p> + +<p><span class="smcap">Emphysema, or swelling of the fetus with gas.</span>—This has been described +as occurring in a living fetus, but I have met with it only in the dead +and decomposing foal after futile efforts had been made for several days +to effect delivery. These cases are very difficult, as the foal is +inflated to such extent that it is impossible to advance it into the +passages, and the skin of the fetus and the walls of the womb and vagina +have become so dry that it is impracticable to cause the one to glide on +the other. The hair comes off any part that may be seized, and the case +is rendered the more offensive and dangerous by the very fetid liquids +and gases. The only resort is embryotomy, by which I have succeeded in +saving a valuable mare that had carried a colt in this condition for +four days.</p> + +<p><span class="smcap">Contractions of muscles.</span>—The foal is not always developed +symmetrically, but certain groups of muscles are liable to remain short, +or to shorten because of persistent spasmodic contraction, so that even +the bones become distorted and twisted. This is most common in the neck. +The bones of this part and even of the face are drawn to one side and +shortened, the head being held firmly to the flank and the jaws being +twisted to the right or left. In other cases the flexor muscles of the +fore limbs are contracted so that the latter are strongly bent at the +knee. In neither of these cases can the distorted part be extended and +straightened, so that body or limbs must necessarily present double, and +natural delivery is rendered impossible. The bent neck may sometimes be +straightened after the muscles have been cut on the side to which it is +turned, and the bent limbs after the tendons on the back of the shank +bone have been cut across. Failing to accomplish this, the next resort +is embryotomy.</p> + +<p><span class="smcap">Inclosed ovum, or tumors of the fetus.</span>—Tumors or diseased growths may +form on any part of the foal, internal or external, and by their size +impede or hinder parturition. In some cases what appears as a tumor is +an imprisoned and undeveloped ovum which has grafted itself on the +fetus. These are usually sacculated, and may contain skin, hair, muscle, +bone, and other natural tissues. The only course to be pursued in such +cases is to excise the tumor, or, if this is not feasible, to perform +embryotomy.</p> + +<p><span class="smcap">Monstrosities.</span>—Monstrosity in the foal is an occasional cause of +difficult parturition, especially such monsters as show excessive +development of some part of the body, a displacement or distortion of<span class='pagenum'><a name="Page_195" id="Page_195">[Pg 195]</a></span> +parts, or a redundancy of parts, as in double monsters. Monsters may be +divided into—</p> + +<p>(1) Monsters with absence of parts—absence of head, limb, or other +organ.</p> + +<p>(2) Monsters with some part abnormally small—dwarfed head, limb, trunk, +etc.</p> + +<p>(3) Monsters through unnatural division of parts—cleft head, trunk, +limbs, etc.</p> + +<p>(4) Monsters through absence of natural divisions—absence of mouth, +nose, eyes, anus, confluent digits, etc.</p> + +<p>(5) Monsters through fusion of parts—one central eye, one nasal +opening, etc.</p> + +<p>(6) Monsters through abnormal position or form of parts—curved spine, +face, limb, etc.</p> + +<p>(7) Monsters through excess of formation—enormous head, supernumerary +digits, etc.</p> + +<p>(8) Monsters through imperfect differentiation of sexual +organs—hermaphrodites.</p> + +<p>(9) Double monsters—double-headed, double-bodied, extra limbs, etc.</p> + +<p><i>Causes.</i>—The causes of monstrosities appear to be very varied. Some +monstrosities, like extra digits, absence of horns or tail, etc., run in +families and are produced almost as certainly as color or form. Others +are associated with too close breeding, the powers of symmetrical +development being interfered with, just as in other cases a sexual +incompatibility is developed, near relatives failing to breed with each +other. Mere arrest of development of a part may arise from accidental +disease of the embryo; hence vital organs are left out, or portions of +organs, like the dividing walls of the heart, are omitted. Sometimes an +older fetus is inclosed in the body of another, each having started +independently from a separate ovum, but the one having become embedded +in the semifluid mass of the other and having developed there +simultaneously with it, but not so largely nor perfectly. In many cases +of redundance of parts the extra part or member has manifestly developed +from the same ovum and nutrient center with the normal member to which +it remains adherent, just as a new tail will grow out in a newt when the +former has been cut off. In the early embryo, with its great powers of +development, this factor can operate to far greater purpose than in the +adult animal. Its influence is seen in the fact pointed out by St. +Hilaire that such redundant parts are nearly always connected with the +corresponding portions in the normal fetus. Thus superfluous legs or +digits are attached to the normal ones, double heads or tails are +connected to a common neck or rump, and double bodies are attached to +each other by corresponding points, navel to navel, breast to breast, +back to<span class='pagenum'><a name="Page_196" id="Page_196">[Pg 196]</a></span> back. All this suggests the development of extra parts from the +same primary layer of the impregnated and developing ovum. The effect of +disturbing conditions in giving such wrong directions to the +developmental forces is well shown in the experiments of St. Hilaire and +Valentine in varnishing, shaking, and otherwise breaking up the natural +connections in eggs, and thereby determining the formation of +monstrosities at will. So, in the mammal, blows and other injuries that +detach the fetal membranes from the walls of the womb or that modify +their circulation by inducing inflammation are at times followed by the +development of a monster. The excitement, mental and physical, attendant +on fright occasionally acts in a similar way, acting probably through +the same channels.</p> + +<p>The monstrous forms liable to interfere with parturition are such as, +from contracted or twisted limbs or spine, must be presented double; +where supernumerary limbs, head, or body must approach the passages with +the natural ones; where a head or other member has attained to an +unnatural size; where the body of one fetus has become inclosed in or +attached to another, etc.</p> + +<p>Extraction is sometimes possible by straightening the members and +obtaining such a presentation as will reduce the presenting mass to its +smallest and most wedgelike dimensions. To effect this it may be needful +to cut the flexor tendons of bent limbs or the muscles on the side of a +twisted neck or body; one or more of the manipulations necessary to +secure and bring up a missing member may be required. In most cases of +monstrosity by excess, however, it is needful to remove the superfluous +parts, in which case the general principles employed for embryotomy must +be followed. The Cæsarean section, by which the fetus is extracted +through an incision in the walls of the abdomen and womb, is +inadmissible, as it practically entails the sacrifice of the mare, which +should never be done for the sake of a monster. (See "Embryotomy," p. +202.)</p> + +<p><span class="smcap">Entrance of twins into the passage at once.</span>—Twins are rare in the mare, +and still more rare is the impaction of both at once into the pelvis. +The condition would be easily recognized by the fact that two fore limbs +and two hind would occupy the passage at once, the front of the hoofs of +the fore feet being turned upward and those of the hind feet downward. +If both belonged to one foal, they would be turned in the same +direction. Once recognized, the condition is easily remedied by passing +a rope with a running noose round each foot of the foal that is furthest +advanced or that promises to be most easily extracted, and to push the +members of the other fetus back into the depth of the womb. As soon as +the one fetus is fully engaged into the passage it will hold its place +and its delivery will proceed in the natural way.<span class='pagenum'><a name="Page_197" id="Page_197">[Pg 197]</a></span></p> + + +<h3>ABNORMAL PRESENTATIONS.</h3> + +<h4>(Pls. XV-XVIII.)</h4> + +<p>Abnormal presentations may be tabulated as follows:</p> + + + +<div class='center'> +<table border="1" cellpadding="4" cellspacing="0" summary=""> +<tr><td rowspan="11">Anterior presentations:</td><td rowspan="4">Fore limbs</td><td align='left'>Incompletely extended. Flexor tendons shortened.</td></tr> +<tr><td align='left'>Crossed over the neck.</td></tr> +<tr><td align='left'>Bent back at the knee.</td></tr> +<tr><td align='left'>Bent back from the shoulder.</td></tr> +<tr><td rowspan="4">Head</td><td align='left'>Bent downward on the neck.</td></tr> +<tr><td align='left'>Head and neck turned back beneath the breast.</td></tr> +<tr><td align='left'>Turned to one side.</td></tr> +<tr><td align='left'>Turned upward and backward on the back.</td></tr> +<tr><td align='left'>Hind limbs</td><td align='left'>Hind feet engaged in the pelvis.</td></tr> +<tr><td align='left'>Transverse</td><td align='left'>Back of foal to side of pelvis.</td></tr> +<tr><td align='left'>Inverted</td><td align='left'>Back of foal to floor of pelvis.</td></tr> +<tr><td rowspan="4">Posterior presentations</td><td rowspan="2">Hind limbs</td><td align='left'>Bent on itself at the hock.</td></tr> +<tr><td align='left'>Bent at the hip.</td></tr> +<tr><td align='left'>Transverse</td><td align='left'>Back of foal to side of pelvis.</td></tr> +<tr><td align='left'>Inverted</td><td align='left'>Back of foal to floor of pelvis.</td></tr> +<tr><td rowspan="2">Transverse presentation of body</td><td rowspan="2"> </td><td align='left'>With back and loins presented.</td></tr> +<tr><td align='left'>With breast and belly presented.</td></tr> +</table></div> + + +<p><span class="smcap">Fore limbs incompletely extended.</span>—In cases of this kind, not only are +the back tendons behind the knee and shank bone unduly short, but the +sinew extending from the front of the shoulder blade over the front of +the elbow and down to the head of the shank bone is also shortened. The +result is that the fore limb is bent at the knee and the elbow is also +rigidly bent. The condition obstructs parturition by the feet becoming +pressed against the floor of the pelvis or by the elbow pressing on its +anterior brim. Relief is to be obtained by forcible extension. A rope +with a running noose is passed around each fetlock and a repeller (see +Plate XIV) planted in the breast is pressed in a direction upward and +backward while active traction is made on the ropes. If the feet are not +thereby raised from the floor of the pelvis the palm of the hand may be +placed beneath them to protect the mucous membrane until they have +advanced sufficiently to obviate this danger. In the absence of a +repeller, a smooth rounded fork handle may be employed. If the +shortening is too great to allow of the extension of the limbs in this +way, the tense tendons may be cut across behind the shank bone and in +front of the elbow, and the limb will be easily straightened out. This +is most easily done with an embryotomy knife furnished with a ring for +the middle finger, so that the blade may be protected in the palm of the +hand. (See Plate XIII, fig. 4.)</p> + +<p><span class="smcap">Fore limb crossed over back of neck.</span>—With the long fore limbs of the +foal this readily occurs, and the resulting increase in thickness, both +at the head and shoulder, offers a serious obstacle to progress. (See +Plate XV, fig. 2.) The hand introduced into the passage detects the head +and one fore foot, and farther back on the same side of the head the +second foot, from which the limb may be traced obliquely across the back +of the neck.<span class='pagenum'><a name="Page_198" id="Page_198">[Pg 198]</a></span></p> + +<p>If parturition continues to make progress the displaced foot may bruise +and lacerate the vagina. By seizing the limb above the fetlock it may be +easily pushed over the head to the proper side, when parturition will +proceed normally.</p> + +<p><span class="smcap">Fore limb bent at knee.</span>—The nose and one fore foot present, and on +examination the knee of the missing fore limb is found farther back. +(Plate XV, fig. 1.) First place a noose each on the presenting pastern +and lower jaw, and push back the body of the fetus with a repeller, +while the operator seizing the shank of the bent limb extends it so as +to press back the knee and bring forward the fetlock and foot. As +progress is made little by little the hand is slid down from the region +of the knee to the fetlock, and finally that is secured and brought up +into the passage, when parturition will proceed without hindrance. If +both fore limbs are bent back the head must be noosed and the limbs +brought up as above, one after the other. It is usually best to employ +the left hand for the right fore limb, and the right hand for the left +fore limb.</p> + +<p><span class="smcap">Fore limb turned back from shoulders.</span>—In this case, on exploration by +the side of the head and presenting limb, the shoulder only can be +reached at first. (Plate XV, fig 4.) By noosing the head and presenting +fore limb, they may be drawn forward into the pelvis, and the oiled hand +being carried along the shoulder in the direction of the missing limb is +enabled to reach and seize the forearm just below the elbow. The body is +now pushed back by the assistants pressing on the head and presenting +limb or on a repeller planted in the breast until the knee can be +brought up into the pelvis, after which the procedure is the same as +described in the last paragraph.</p> + +<p><span class="smcap">Head bent down between fore limbs.</span>—This may be so that the poll or nape +of the neck, with the ears, can be felt far back between the fore limbs, +or so that only the upper border of the neck can be reached, head and +neck being bent back beneath the body. With the head only bent on the +neck, noose the two presenting limbs, then introduce the hand between +them until the nose can be seized in the palm of the hand. Next have the +assistants push back the presenting limbs, while the nose is strongly +lifted upward over the brim of the pelvis. This accomplished, it assumes +the natural position and parturition is easy.</p> + +<p>When both head and neck are bent downward it may be impossible to reach +the nose. If, however, the labor has only commenced, the limbs may be +drawn upon until the operator can reach the ear, by dragging on which +the head may be so far advanced that the fingers may reach the orbit; +traction upon this while the limbs are being pushed back may bring the +head up so that it bends on the neck only, and the further procedure +will be as described in the last paragraph.<span class='pagenum'><a name="Page_199" id="Page_199">[Pg 199]</a></span></p> + +<p>If the labor has been long in progress and the fetus is jammed into the +pelvis, the womb emptied of the waters, and firmly contracted on its +solid contents, the case is incomparably more difficult. The mare may be +chloroformed and turned on her back with hind parts elevated, and the +womb may be injected with sweet oil. Then, if the ear can be reached, +the correction of the malpresentation may be attempted as above +described. Should this fail, one or more sharp hooks may be inserted in +the neck as near the head as can be reached, and ropes attached to these +may be dragged on, while the body of the foal is pushed back by the fore +limbs or by a repeller. Such repulsion should be made in a direction +obliquely upward toward the loins of the mother, so as to rotate the +fetus in such a way as to bring the head up. As this is accomplished a +hold should be secured nearer and nearer to the nose, with hand or hook, +until the head can be straightened out on the neck.</p> + +<p>All means failing; it becomes necessary to remove the fore limbs +(embryotomy) so as to make more space for bringing up the head. If, even +then, this can not be accomplished, it may be possible to push the body +backward and upward with the repeller until the hind limbs are brought +to the passage, when they may be noosed and delivery effected with the +posterior presentation.</p> + +<p><span class="smcap">Head turned on shoulders.</span>—In this case the fore feet present, and the +oiled hand passed along the fore arms in search of the missing head +finds the side of the neck turned to one side, the head being perhaps +entirely out of reach. (Plate XVIII, fig. 1.) To bring the head forward +it may be desirable to lay the mare on the side opposite to that to +which the head is turned, and even to give chloroform or ether. Then the +feet being noosed, the body of the fetus is pushed by the hand or +repeller forward and to the side opposite to that occupied by the head +until the head comes within reach, near the entrance of the pelvis. If +such displacement of the fetus is difficult, it may be facilitated by a +free use of oil or lard. When the nose can be seized it can be brought +into the passage, as when the head is turned down. If it can not be +reached, the orbit may be availed of to draw the head forward until the +nose can be seized or the lower jaw noosed. In very difficult cases a +rope may be passed around the neck by the hand or with the aid of a +curved carrier (Plate XIV), and traction may be made upon this while the +body is being rotated to the other side. In the same way in bad cases a +hook may be fixed in the orbit or even between the bones of the lower +jaw to assist in bringing the head up into position. Should all fail, +the amputation of the fore limbs may be resorted to, as advised under +the last heading.</p> + +<p><span class="smcap">Head turned upward on back.</span>—This differs from the last malpresentation +only in the direction of the head, which has to be sought<span class='pagenum'><a name="Page_200" id="Page_200">[Pg 200]</a></span> above rather +than at one side, and is to be secured and brought forward in a similar +manner. (Plate XVIII, fig. 2.) If a rope can be passed around the neck +it will prove most effectual, as it naturally slides nearer to the head +as the neck is straightened and ends by bringing the head within easy +reach.</p> + +<p><span class="smcap">Hind feet engaged in pelvis.</span>—In this case fore limbs and head present +naturally, but the hind limbs bent forward from the hip and the loins +arched allow the hind feet also to enter the passages, and the further +labor advances the more firmly does the body of the foal become wedged +into the pelvis (Plate XVII, fig. 2.) The condition is to be recognized +by introducing the oiled hand along the belly of the fetus, when the +hind feet will be felt advancing. An attempt should at once be made to +push them back, one after the other, over the brim of the pelvis. +Failing in this, the mare may be turned on her back, head downhill, and +the attempt renewed. If it is possible to introduce a straight rope +carrier, a noose passed through this may be put on the fetlock and the +repulsion thereby made more effective. In case of continued failure the +anterior presenting part of the body may be skinned and cut off as far +back toward the pelvis as possible (see "Embryotomy"); then nooses are +placed on the hind fetlocks and traction is made upon these while the +quarters are pushed back into the womb. Then the remaining portion is +brought away by the posterior presentation.</p> + +<p><span class="smcap">Anterior presentation with back turned to one side.</span>—The diameter of the +axis of the foal, like that of the pelvic passages, is from above +downward, and when the fetus enters the pelvis with this greatest +diameter engaged transversely or in the narrow diameter of the pelvis, +parturition is rendered difficult or impossible. In such a case the +pasterns and head may be noosed, and the passages and engaged portion of +the foal freely lubricated with lard, the limbs may be crossed over each +other and the head, and a movement of rotation effected in the fetus +until its face and back are turned up toward the croup of the mother; +then parturition becomes natural.</p> + +<p><span class="smcap">Back of foal turned to floor of pelvis.</span>—In a roomy mare this is not an +insuperable obstacle to parturition, yet it may seriously impede it, by +reason of the curvature of the body of the foal being opposite to that +of the passages, and the head and withers being liable to arrest against +the border of the pelvis. Lubrication of the passage with lard and +traction of the limbs and head will usually suffice with or without the +turning of the mare on her back.</p> + +<p>In obstinate cases two other resorts are open: First, to turn the foal, +pushing back the fore parts and bringing up the hind so as to make a +posterior presentation, and, second, the amputation of the fore limbs, +after which extraction will usually be easy.</p> + +<p><a name="PLATE_XV" id="PLATE_XV"></a></p> +<div class="figcenter" style="width: 450px;"> +<a href="images/plate15.jpg"><img src="images/plate15t.jpg" width="450" height="268" alt="PLATE XV." title="" /></a> +<span class="caption">PLATE XV.<br />ABNORMAL PRESENTATIONS.</span> +</div> + +<p><a name="PLATE_XVI" id="PLATE_XVI"></a></p> +<div class="figcenter" style="width: 271px;"> +<a href="images/plate16.jpg"><img src="images/plate16t.jpg" width="271" height="450" alt="PLATE XVI." title="" /></a> +<span class="caption">PLATE XVI.<br /> + +ABNORMAL PRESENTATIONS.</span> +</div> + +<p><a name="PLATE_XVII" id="PLATE_XVII"></a></p> +<div class="figcenter" style="width: 282px;"> +<a href="images/plate17.jpg"><img src="images/plate17t.jpg" width="282" height="450" alt="PLATE XVII." title="" /></a> +<span class="caption">PLATE XVII.<br /> + +ABNORMAL PRESENTATIONS.</span> +</div> + +<p><a name="PLATE_XVIII" id="PLATE_XVIII"></a></p> +<div class="figcenter" style="width: 272px;"> +<a href="images/plate18.jpg"><img src="images/plate18t.jpg" width="272" height="450" alt="PLATE XVIII." title="" /></a> +<span class="caption">PLATE XVIII.<br /> + +ABNORMAL PRESENTATIONS.</span> +</div> + +<p><span class='pagenum'><a name="Page_201" id="Page_201">[Pg 201]</a></span><span class="smcap">Hind presentation with leg bent at hock.</span>—In this form the quarters of +the foal with the hind legs bent up beneath them present, but can not +advance through the pelvis by reason of their bulk. (Plate XV, fig. 3.) +The oiled hand introduced can recognize the outline of the buttocks, +with the tail and anus in the center and the sharp points of the hocks +beneath. First pass a rope around each limb at the hock, then with hand +or repeller push the buttocks backward and upward, until the feet can be +brought up into the passages. To this the great length of the shank and +pastern in the foal is a serious obstacle, and in all cases the foot +should be protected in the palm of the hand while being brought up over +the brim of the pelvis; otherwise the womb may be torn. When the pains +are too violent and constant to allow effective manipulation, some +respite may be obtained by the use of chloroform or morphin and by +turning the mare on her back, but too often the operator fails and the +foal must be sacrificed. Two courses are still open: First, to cut +through the cords behind and above the hock and extend the upper part of +the limb, leaving the hock bent, and extract in this way, and, second, +to amputate the hind limbs at the hip joint and remove them separately, +after which the body may be extracted.</p> + +<p><span class="smcap">Hind presentation with legs bent forward from hip.</span>—This is merely an +aggravated form of the presentation last described. (Plate XVII, fig. +1.) If the mare is roomy, a rope may be passed around each thigh and the +body pushed upward and forward, so as to bring the hocks and heels +upward. If this can be accomplished, nooses are placed on the limb +further and further down until the fetlock is reached and brought into +position. If failure is met with, then amputation at the hips is the +last resort.</p> + +<p><span class="smcap">Hind presentations with back turned sideways or downward.</span>—These are the +counterparts of similar anterior presentations and are to be managed in +the same way.</p> + +<p><span class="smcap">Presentation of the back.</span>—This is rare, yet not unknown, the foal being +bent upon itself with the back, recognizable by its sharp row of spines, +presented at the entrance of the pelvis and the head and all four feet +turned back into the womb. (Plate XVI, fig. 1.) The body of the fetus +may be extended across the opening transversely, so that the head +corresponds to one side (right or left), or it may be vertical, with the +head above or below.</p> + +<p>In any such position the object should be to push the body of the fetus +forward and upward or to one side, as may best promise to bring up the +fore or hind extremities, and bring the latter into the passage so as to +constitute a normal anterior or posterior presentation. This turning of +the fetus may be favored by a given position of the mother, by the free +use of oil or lard on the surface of the fetus, and by the use of a +propeller.<span class='pagenum'><a name="Page_202" id="Page_202">[Pg 202]</a></span></p> + +<p><span class="smcap">Presentation of breast and abdomen.</span>—This is the reverse of the back +presentation, the foal being extended across in front of the pelvic +opening, but with the belly turned toward the passages and with all four +feet engaged in the passage. (Plate XVI, fig. 2.) The most promising +course is to secure the hind feet with nooses and then push the fore +feet forward into the womb. As soon as the fore feet are pushed forward +clear of the brim of the pelvis, traction is made on the hind feet so as +to bring the thighs into the passage and prevent the reentrance of the +fore limbs. If it proves difficult to push the fore limbs back, a noose +may be passed around the fetlock of each and the cord drawn through the +eye of a rope carrier, by means of which the members may be easily +pushed back.</p> + + +<h4>EMBRYOTOMY.</h4> + +<p>Embryotomy consists in the dissection of the fetus, so as to reduce its +bulk and allow of its exit through the pelvis. The indications for its +adoption have been furnished in the foregoing pages. The operation will +vary in different cases according to the necessity for the removal of +one or more parts in order to secure the requisite reduction in size. +Thus it may be needful to remove head and neck, one fore limb or both, +one hind limb or both, to remove different parts of the trunk, or to +remove superfluous (monstrous) parts. Some of the simplest operations in +embryotomy (incision of the head in hydrocephalus, incision of the belly +in dropsy) have already been described. It remains to notice the more +difficult procedures which can be best undertaken by the skilled +anatomist.</p> + +<p><span class="smcap">Amputation of the head.</span>—This is easy when both fore limbs are turned +back and the head alone has made its exit in part. It is more difficult +when the head is still retained in the passages or womb, as in +double-headed monsters. The head is secured by a hook in the lower jaw, +or in the orbit, or by a halter, and the skin is divided circularly +around the lower part of the face or at the front of the ears, according +to the amount of head protruding. Then an incision is made backward +along the line of the throat, and the skin dissected from the neck as +far back as possible. Then the muscles and other soft parts of the neck +are cut across, and the bodies of two vertebra (neck bones) are severed +by cutting completely across the cartilage of the joint. The bulging of +the ends of the bones will serve to indicate the seat of the joint. The +head and detached portion of the neck may now be removed by steady +pulling. If there is still an obstacle, the knife may be again used to +sever any obstinate connections. In the case of a double-headed monster, +the whole of the second neck must be removed with the head. When the +head has been detached, a rope should be passed through the eyeholes, +or<span class='pagenum'><a name="Page_203" id="Page_203">[Pg 203]</a></span> through an artificial opening in the skin, and tied firmly around +the skin, to be employed as a means of traction when the missing limbs +or the second head have been brought up into position.</p> + +<p><span class="smcap">Amputation of the hind limb.</span>—This may be required when there are extra +hind limbs or when the hind limbs are bent forward at hock or hip joint. +In the former condition the procedure resembles that for removal of a +fore limb, but requires more anatomical knowledge. Having noosed the +pastern, a circular incision is made through the skin around the +fetlock, and a longitudinal one from that up to the groin, and the skin +is dissected from the limb as high up as can be reached, over the croup, +if possible. Then cut through the muscles around the hip joint, and, if +possible, the two interarticular ligaments of the joint (pubofemoral and +round), and extract the limb by strong dragging.</p> + +<p><span class="smcap">Amputation of the fore limbs.</span>—This may usually be begun on the fetlock +of the limb projecting from the vulva. An embryotomy knife is desirable. +This knife consists of a blade with a sharp, slightly hooked point, and +one or two rings in the back of the blade large enough to fit on the +middle finger, while the blade is protected in the palm of the hand. +(See Plate XIII, fig. 4.) Another form has the blade inserted in a +mortise in the handle, from which it is pushed out by a movable button +when wanted. First place a noose around the fetlock of the limb to be +amputated, cut the skin circularly entirely around the fetlock, then +make an incision on the inner side of the limb from the fetlock up to +the breastbone. Next dissect the skin from the limb, from the fetlock up +to the breastbone on the inner side, and as far up on the shoulder blade +as possible on the outer side. Finally, cut through the muscles +attaching the limb to the breastbone, and employ strong traction on the +limb, so as to drag out the whole limb, shoulder blade included. The +muscles around the upper part of the shoulder blade are easily torn +through and need not be cut, even if that were possible. In no case +should the fore limb be removed unless the shoulder blade is taken with +it, as that furnishes the greatest obstruction to delivery, above all +when it is no longer advanced by the extension of the fore limb, but is +pressed back so as to increase the already thickest posterior portion of +the chest. The preservation of the skin from the whole limb is +advantageous in various ways; it is easier to cut it circularly at the +fetlock than at the shoulder; it covers the hand and knife in making the +needful incisions, thus acting as a protection to the womb; and it +affords a means of traction on the body after the limb has been removed. +In dissecting the skin from the limb the knife is not needful at all +points; much of it may be stripped off with the fingers or knuckles, or +by a blunt, iron spud, pushed up inside the hide, which is meanwhile +held tense to render the spud effective.<span class='pagenum'><a name="Page_204" id="Page_204">[Pg 204]</a></span></p> + +<p>In case the limb is bent forward at the hock, a rope is passed round +that and pulled so as to bring the point of the hock between the lips of +the vulva. The hamstring and the lateral ligaments of the hock are now +cut through, and the limbs extended by a rope tied round the lower end +of the long bone above (tibia). In case it is still needful to remove +the upper part of the limb, the further procedure is the same as +described in the last paragraph.</p> + +<p>In case the limb is turned forward from the hip, and the fetus so wedged +into the passage that turning is impossible, the case is very difficult. +I have repeatedly succeeded by cutting in on the hip joint and +disarticulating it, then dissecting the muscles back from the upper end +of the thigh bone. A noose was placed around the neck of the bone and +pulled on forcibly, while any unduly resisting structures were cut with +the knife.</p> + +<p>Cartwright recommends to make free incisions round the hip joints and +tear through the muscles when they can not be cut; then with cords round +the pelvic bones, and hooks inserted in the openings in the floor of the +pelvis to drag out the pelvic bones; then put cords around the heads of +the thigh bones and extract them; then remove the intestines; finally, +by means of the loose, detached skin, draw out the body with the +remainder of the hind limbs bent forward beneath it.</p> + +<p>Reuff cuts his way into the pelvis of the foal, and with a knife +separates the pelvic bones from the loins, then skinning the quarter +draws out these pelvic bones by means of ropes and hooks, and along with +them the hind limbs.</p> + +<p>The hind limbs having been removed by one or the other of these +procedures, the loose skin detached from the pelvis is used as a means +of traction and delivery is effected. In case of a monstrosity with +extra hind limbs, it may be possible to bring these up into the passage +and utilize them for traction.</p> + +<p><i>Removal of the abdominal viscera.</i>—In case the belly is unduly large, +from decomposition, tumors, or otherwise, it may be needful to lay it +open with the knife and cut or tear out the contents.</p> + +<p><i>Removal of the thoracic viscera.</i>—To diminish the bulk of the chest it +has been found advisable to cut out the breastbone, remove the heart and +lungs, and allow the ribs to collapse with the lower free ends +overlapping each other.</p> + +<p><i>Dissection of the trunk.</i>—In case it becomes necessary to remove other +portions of the trunk, we should follow the general rule of preserving +the skin so that all manipulations can be made inside this as a +protector, that it may remain available as a means of exercising +traction on the remaining part of the body, and as a covering to protect +the vaginal walls against injuries from bones while such part is +passing.<span class='pagenum'><a name="Page_205" id="Page_205">[Pg 205]</a></span></p> + + +<h4>FLOODING, OR BLEEDING FROM THE WOMB.</h4> + +<p>This is rare in the mare, but not unknown, in connection with a failure +of the womb to contract on itself after parturition, or with eversion of +the womb (casting the withers), and congestion or laceration. If the +blood accumulates in the flaccid womb, the condition may be suspected +only by reason of the rapidly advancing weakness, swaying, unsteady +gait, hanging head, paleness of the eyes and other mucous membranes, and +weak, small, failing pulse. The hand introduced into the womb detects +the presence of the blood partly clotted. If the blood escapes by the +vulva, the condition is evident.</p> + +<p><i>Treatment</i> consists in evacuating the womb of its blood clots, giving a +large dose of powdered ergot of rye, and in the application of cold +water or ice to the loins and external generative organs. Besides this, +a sponge impregnated with a strong solution of alum, or, still better, +with tincture of muriate of iron, may be introduced into the womb and +squeezed so as to bring the liquid in contact with the walls generally.</p> + + +<h4>EVERSION OF THE WOMB.</h4> + +<p>If the womb fails to contract after difficult parturition, the +after-pains will sometimes lead to the fundus passing into the body of +the organ and passing through that and the vagina until the whole +inverted organ appears externally and hangs down on the thighs. The +result is rapid engorgement and swelling of the organ, impaction of the +rectum with feces, and distention of the bladder with urine, all of +which conditions seriously interfere with the return of the mass. In +returning the womb the standing is preferable to the recumbent position, +as the abdomen is more pendent and there is less obstruction to the +return. It may, however, be necessary to put hobbles on the hind limbs +to prevent the mare from kicking. A clean sheet should be held beneath +the womb, and all filth, straw, and foreign bodies washed from its +surface. Then with a broad, elastic (india-rubber) band, or in default +of that a long strip of calico 4 or 5 inches wide, wind the womb as +tightly as possible, beginning at its most dependent part (the extremity +of the horn). This serves two good ends. It squeezes out into the +general circulation the enormous mass of blood which engorged and +enlarged the organ, and it furnishes a strong protective covering for +the now delicate, friable organ, through which it may be safely +manipulated without danger of laceration. The next step may be the +pressure on the general mass while those portions next the vulva are +gradually pushed in with the hands; or the extreme lowest point (the end +of the horn) may be turned within itself and pushed forward into the +vagina by the closed fist, the return being assisted by manipulations by +the other hand, and even by those of assistants. By either mode the +manipulations may be<span class='pagenum'><a name="Page_206" id="Page_206">[Pg 206]</a></span> made with almost perfect safety so long as the +organ is closely wrapped in the bandage. Once a portion has been +introduced into the vagina the rest will usually follow with increasing +ease, and the operation should be completed with the hand and arm +extended the full length within the womb and moved from point to point +so as to straighten out all parts of the organ and insure that no +portion still remain inverted within another portion. Should any such +partial inversion be left it will give rise to straining, under the +force of which it will gradually increase until the whole mass will be +protruded as before. The next step is to apply a truss as an effectual +mechanical barrier to further escape of the womb through the vulva. The +simplest is made with two 1-inch ropes, each about 18 feet long, each +doubled and interwoven at the bend, as seen in Plate XIV, figure 4. The +ring formed by the interlacing of the two ropes is adjusted around the +vulva, the two ends of the one rope are carried up on the right and left +of the tail and along the spine, being wound around each other in their +course, and are finally tied to the upper part of the collar encircling +the neck. The remaining two ends, belonging to the other rope, are +carried downward and forward between the thighs and thence forward and +upward on the sides of the belly and chest to be attached to the right +and left sides of the collar. These ropes are drawn tightly enough to +keep closely applied to the opening without chafing, and will fit still +more securely when the mare raises her back to strain. It is desirable +to tie the mare short so that she may be unable to lie down for a day or +two, and she should be kept in a stall with the hind parts higher than +the fore. Violent straining may be checked by full doses of opium +(one-half dram), and any costiveness or diarrhea should be obviated by a +suitable laxative or binding diet.</p> + +<p>In some mares the contractions are too violent to allow of the return of +the womb, and full doses of opium one-half dram, laudanum 2 ounces, or +chloral hydrate 1 ounce, may be demanded, or the mare must be rendered +insensible by ether or chloroform.</p> + + +<h4>RUPTURE, OR LACERATION, OF THE WOMB.</h4> + +<p>This may occur from the feet of the foal during parturition, or from +ill-directed efforts to assist, but it is especially liable to take +place in the everted, congested, and friable organ. The resultant +dangers are bleeding from the wound, escape of the bowels through the +opening and their fatal injury by the mare's feet or otherwise, and +peritonitis from the extension of inflammation from the wound and from +the poisonous action of the septic liquids of the womb escaping into the +abdominal cavity. The first object is to close the wound, but unless in +eversion of the womb this is practically impossible. In the last-named +condition the wound must be carefully and accurately<span class='pagenum'><a name="Page_207" id="Page_207">[Pg 207]</a></span> sewed up before +the womb is returned. After its return, the womb must be injected daily +with an antiseptic solution (borax, one-half ounce, or carbolic acid, 3 +drams to a quart of tepid water). If inflammation threatens, the abdomen +may be bathed continuously with hot water by means of a heavy woolen +rag, and large doses of opium (one-half dram) may be given twice or +thrice daily.</p> + + +<h4>RUPTURES OF THE VAGINA.</h4> + +<p>These are attended with dangers similar to those belonging to rupture of +the womb, and in addition by the risk of protrusion of the bladder, +which appears through the lips of the vulva as a red, pyriform mass. +Sometimes such lacerations extend downward into the bladder, and in +others upward into the terminal gut (rectum). In still other cases the +anus is torn so that it forms one common orifice with the vulva.</p> + +<p>Too often such cases prove fatal, or at least a recovery is not +attained, and urine or feces or both escape freely into the vagina. The +simple laceration of the anus is easily sewed up, but the ends of the +muscular fibers do not reunite and the control over the lower bowel is +never fully reacquired. The successful stitching up of the wound +communicating with the bladder or the rectum requires unusual skill and +care, and though I have succeeded in a case of the latter kind, I can +not advise the attempt by unprofessional persons.</p> + + +<h4>BLOOD CLOTS IN THE WALLS OF THE VAGINA.</h4> + +<p>(See "Effusion of blood in the vaginal walls," p. 190.)</p> + + +<h4>LAMINITIS, OR FOUNDER, FOLLOWING PARTURITION.</h4> + +<p>This sometimes follows on inflammation of the womb, as it frequently +does on disorder of the stomach. Its symptoms agree with those of the +common form of founder, and treatment need not differ.</p> + + +<h4>INFLAMMATION OF THE WOMB AND PERITONEUM.</h4> + +<p>These may result from injuries sustained by the womb during or after +parturition, from exposure to cold or wet, or from the irritant +infective action of putrid products within the womb. Under the +inflammation the womb remains dilated and flaccid, and decomposition of +its secretions almost always occurs, so that the inflammation tends to +assume a putrid character and general septic infection is likely to +occur.</p> + +<p><i>Symptoms.</i>—The symptoms are ushered in by shivering, staring coat, +small, rapid pulse, elevated temperature, accelerated breathing, loss of +appetite, with arched back, stiff movement of the body, looking back at +the flanks, and uneasy motions of the hind limbs, discharge from the +vulva of a liquid at first watery, reddish, or yellowish, and later it +may be whitish or glairy, and fetid or not in different cases. +Tenderness of the abdomen shown on pressure is<span class='pagenum'><a name="Page_208" id="Page_208">[Pg 208]</a></span> especially +characteristic of cases affecting the peritoneum or lining of the belly, +and is more marked lower down. If the animal survives, the inflammation +tends to become chronic and attended by a whitish mucopurulent +discharge. If, on the contrary, it proves fatal, death is preceded by +extreme prostration and weakness from the general septic poisoning.</p> + +<p><i>Treatment.</i>—In treatment the first thing to be sought is the removal +of all offensive and irritant matters from the womb through a caoutchouc +tube introduced into the womb, and into which a funnel is fitted. Warm +water should be passed until it comes away clear. To insure that all the +womb has been washed out, the oiled hand may be introduced to carry the +end of the tube into the two horns successively. When the offensive +contents have been thus removed, the womb should be injected with a +quart of water holding in solution 1 dram permanganate of potash, or, in +the absence of the latter, 2 teaspoonfuls of carbolic acid, twice daily. +Fomentation of the abdomen, or the application of a warm flaxseed +poultice, may greatly relieve. Acetanilid, in doses of half an ounce, +twice or thrice a day, or sulphate of quinia in doses of one-third +ounce, may be employed to reduce the fever. If the great prostration +indicates septic poisoning, large doses (one-half ounce) bisulphite of +soda, or salicylate of soda, or sulphate of quinin may be resorted to.</p> + + +<h4>LEUCORRHEA.</h4> + +<p>This is a white, glutinous, chronic discharge, the result of a +continued, subacute inflammation of the mucous membrane of the womb. +Like the discharge of acute inflammation, it contains many forms of +bacteria, by some of which it is manifestly inoculable on the penis of +the stallion, producing ulcers and a specific, gonorrheal discharge.</p> + +<p><i>Treatment</i> may consist in the internal use of tonics (sulphate of iron, +3 drams, daily) and the washing out of the womb, as described under the +last heading, followed by an astringent antiseptic injection (carbolic +acid, 2 teaspoonfuls; tannic acid, 1/2 dram; water, 1 quart). This may +be given two or three times a day.</p> + + +<h3>DISEASES OF THE UDDER AND TEATS.</h3> + + +<h4>CONGESTION AND INFLAMMATION OF THE UDDER.</h4> + +<p>This is comparatively rare in the mare, though in some cases the udder +becomes painfully engorged before parturition, and a doughy swelling, +pitting on pressure, extends forward on the lower surface of the +abdomen. When this goes on to active inflammation, one or both of the +glands becomes enlarged, hot, tense, and painful; the milk is dried up +or replaced by a watery or reddish, serous fluid, which at times becomes +fetid; the animal walks lame, loses appetite, and shows general disorder +and fever. The condition may end in recovery, in<span class='pagenum'><a name="Page_209" id="Page_209">[Pg 209]</a></span> abscess, induration, +or gangrene, and, in some cases, may lay the foundation for a tumor of +the gland.</p> + +<p><i>Treatment.</i>—The treatment is simple so long as there is only +congestion. Active rubbing with lard or oil, or, better, camphorated +oil, and the frequent drawing off of the milk, by the foal or with the +hand, will usually bring about a rapid improvement. When active +inflammation is present, fomentation with warm water may be kept up for +an hour and followed by the application of the camphorated oil, to which +has been added some carbonate of soda and extract of belladonna. A dose +of laxative medicine (4 drams Barbados aloes) will be of service in +reducing fever, and one-half ounce saltpeter daily will serve a similar +end. In case the milk coagulates in the udder and can not be withdrawn, +or when the liquid becomes fetid, a solution of 20 grains carbonate of +soda and 10 drops carbolic acid dissolved in an ounce of water should be +injected into the teat. In doing this it must be noted that the mare has +three separate ducts opening on the summit of each teat and each must be +carefully injected. To draw off the fetid product it may be needful to +use a small milking tube, or spring teat dilator designed by the writer. +(Plate XIV, figs. 2 and 3.) When pus forms and points externally and can +not find a free escape by the teat, the spot where it fluctuates must be +opened freely with the knife and the cavity injected daily with the +carbolic-acid lotion. When the gland becomes hard and indolent, it may +be rubbed daily with iodin ointment 1 part, vaseline 6 parts.</p> + + +<h4>TUMORS OF THE UDDER.</h4> + +<p>As the result of inflammation of the udder it may become the seat of an +indurated diseased growth, which may go on growing and seriously +interfere with the movement of the hind limbs. If such swellings do not +give way in their early stages to treatment by iodin, the only resort is +to cut them out with a knife. As the gland is often implicated and has +to be removed, such mares can not in the future suckle their colts and +therefore should not be bred.</p> + + +<h4>SORE TEATS, SCABS, CRACKS, WARTS.</h4> + +<p>By the act of sucking, especially in cold weather, the teats are subject +to abrasions, cracks, and scabs, and as the result of such irritation, +or independently, warts sometimes grow and prove troublesome. The warts +should be clipped off with sharp scissors and their roots burned with a +solid pencil of lunar caustic. This is best done before parturition to +secure healing before suckling begins. For sore teats use an ointment of +vaseline 1 ounce, balsam of tolu 5 grains, and sulphate of zinc 5 +grains.</p> + + + +<hr style="width: 65%;" /> +<p><span class='pagenum'><a name="Page_210" id="Page_210">[Pg 210]</a></span></p> +<h2>DISEASES OF THE NERVOUS SYSTEM.</h2> + +<h3>By <span class="smcap">M. R. Trumbower, V. S.</span></h3> + +<h4>[Revised by John R. Mohler, A. M., V. M. D.]</h4> + + +<h4>ANATOMY AND PHYSIOLOGY OF THE BRAIN AND NERVOUS SYSTEM.</h4> + +<h5>(Pl. XIX.)</h5> + +<p>The nervous system may be regarded as consisting of two sets of organs, +peripheral and central, the function of one being to establish a +communication between the centers and the different parts of the body, +and that of the other to generate nervous force. The whole may be +arranged under two divisions: First, the cerebrospinal system; second, +the sympathetic or ganglionic system. Each is possessed of its own +central and peripheral organs.</p> + +<p>In the first, the center is made up of two portions—one large and +expanded (the brain) placed in the cranial cavity; the other elongated +(spinal cord), continuous with the brain, and lodged in the canal of the +vertebral column. The peripheral portion of this system consists of the +cerebrospinal nerves, which leave the axis in symmetrical pairs and are +distributed to the skin, the voluntary muscles, and the organs.</p> + +<p>In the second, the central organ consists of a chain of ganglia, +connected by nerve cords, which extends on each side of the spine from +the head to the rump. The nerves of this system are distributed to the +involuntary muscles, mucous membrane, viscera, and blood vessels.</p> + +<p>The two systems have free intercommunication, ganglia being at the +junctions.</p> + +<p>Two substances, distinguishable by their color, namely, the white or +medullary and the gray or cortical substance, enter into the formation +of nervous matter. Both are soft, fragile, and easily injured, in +consequence of which the principal nervous centers are well protected by +bony coverings. The nervous substances present two distinct forms—nerve +fibers and nerve cells. An aggregation of nerve cells constitutes a +nerve ganglion.</p> + +<p>The nerve fibers represent a conducting apparatus and serve to place the +central nervous organs in connection with peripheral end organs. The +nerve cells, however, besides transmitting impulses, act as +physiological centers for automatic, or reflex, movements, and also for +the sensory, perceptive, trophic, and secretory functions. A nerve +consists of a bundle of tubular fibers, held together by a<span class='pagenum'><a name="Page_211" id="Page_211">[Pg 211]</a></span> dense +areolar tissue, and inclosed in a membranous sheath—the neurilemma. +Nerve fibers possess no elasticity, but are very strong. Divided nerves +do not retract.</p> + +<p>Nerves are thrown into a state of excitement when stimulated, and are, +therefore, said to possess excitable or irritable properties. The +stimuli may be applied to, or may act upon, any part of the nerve. +Nerves may be paralyzed by continuous pressure being applied. When the +nerves divide into branches, there is never any splitting up of their +ultimate fibers, nor yet is there ever any coalescing of them; they +retain their individuality from their source to their termination.</p> + +<p>Nerves which convey impressions to the centers are termed sensory, or +centripetal, and those which transmit stimulus from the centers to +organs of motion are termed motor, or centrifugal. The function of the +nervous system may, therefore, be defined in the simplest terms, as +follows: It is intended to associate the different parts of the body in +such a manner that stimulus applied to one organ may excite or depress +the activity of another.</p> + +<p>The brain is that portion of the cerebrospinal axis within the cranium, +which may be divided into four parts—the medulla oblongata, the +cerebellum, the pons Varolii, and the cerebrum—and it is covered by +three membranes, called the meninges. The outer of these membranes, the +dura mater, is a thick, white, fibrous membrane which lines the cavity +of the cranium, forming the internal periosteum of the bones; it is +continuous with the spinal cord to the extremity of the canal. The +second, the arachnoid, is a delicate serous membrane, and loosely +envelops the brain and spinal cord; it forms two layers, having between +them the arachnoid space which contains the cerebrospinal fluid, the use +of which is to protect the spinal cord and brain from pressure. The +third, or inner, the pia mater, is closely adherent to the entire +surface of the brain, but is much thinner and more vascular than when it +reaches the spinal cord, which it also envelops, and is continued to +form the sheaths of the spinal nerves.</p> + +<p>The medulla oblongata is the prolongation of the spinal cord, extending +to the pons Varolii. This portion of the brain is very large in the +horse: it is pyramidal in shape, the narrowest part joining the cord.</p> + +<p>The pons Varolii is the transverse projection on the base of the brain, +between the medulla oblongata and the peduncles of the cerebrum.</p> + +<p>The cerebellum is lodged in the posterior part of the cranial cavity, +immediately above the medulla oblongata; it is globular or elliptical in +shape, the transverse diameter being greatest. The body of the +cerebellum is composed of gray matter externally and of white matter in +the center. The cerebellum has the function of co-ordinating<span class='pagenum'><a name="Page_212" id="Page_212">[Pg 212]</a></span> movements; +that is, of so associating them as to cause them to accomplish a +definite purpose. Injuries to the cerebellum cause disturbances of the +equilibrium but do not interfere with the will power or intelligence.</p> + +<p>The cerebrum, or brain proper, occupies the anterior portion of the +cranial cavity. It is ovoid in shape, with an irregular, flattened base, +and consists of lateral halves or hemispheres. The greater part of the +cerebrum is composed of white matter. The hemispheres of the cerebrum +are usually said to be the seat of all psychical activities. Only when +they are intact are the process of feeling, thinking, and willing +possible. After they are destroyed the organism comes to be like a +complicated machine, and its activity is only the expression of the +internal and external stimuli which act upon it.</p> + +<p>The spinal cord, or spinal marrow, is that part of the cerebrospinal +system which is contained in the spinal canal of the backbone, and +extends from the medulla oblongata to a short distance behind the loins. +It is an irregularly cylindrical structure, divided into two lateral, +symmetrical halves by fissures. The spinal cord terminates posteriorly +in a pointed extremity, which is continued by a mass of nerve +trunks—cauda equinæ. A transverse section of the cord reveals that it +is composed of white matter externally and of gray matter internally. +The spinal cord does not fill the whole spinal canal. The latter +contains, besides, a large venous sinus, fatty matter, the membranes of +the cord, and the cerebrospinal fluid.</p> + +<p>The spinal nerves, forty-two or forty-three in number, arise each by two +roots, a superior or sensory, and an inferior or motor. The nerves +originating from the brain are twenty-four in number, and arranged in +pairs, which are named first, second, third, etc., counting from before +backward. They also receive special names, according to their functions +or the parts to which they are distributed, viz:</p> + +<div class="poem"><div class="stanza"> +<span class="i0">1. Olfactory.<br /></span> +<span class="i0">2. Optic.<br /></span> +<span class="i0">3. Oculo-motor.<br /></span> +<span class="i0">4. Pathetic.<br /></span> +<span class="i0">5. Trifacial.<br /></span> +<span class="i0">6. Abducens.<br /></span> +<span class="i0">7. Facial.<br /></span> +<span class="i0">8. Auditory.<br /></span> +<span class="i0">9. Glossopharyngeal.<br /></span> +<span class="i0">10. Pneumogastric.<br /></span> +<span class="i0">11. Spinal accessory.<br /></span> +<span class="i0">12. Hypoglossal.<br /></span> +</div></div> + + +<h4>Inflammation of the Brain and its Membranes (Encephalitis, Meningitis, +Cerebritis).</h4> + +<p>Inflammation may attack these membranes singly, or any one of the +anatomical divisions of the nerve matter, or it may invade the whole at +once. Practical experience, however, teaches us that primary +inflammation of the dura mater is of rare occurrence, except in direct +mechanical injuries to the head or diseases of the bones of the cranium. +Neither is the arachnoid often affected with acute inflammation, except +as a secondary result. The pia mater is most commonly<span class='pagenum'><a name="Page_213" id="Page_213">[Pg 213]</a></span> the seat of +inflammation, acute and subacute, but from its intimate relation with +the surface of the brain the latter very soon becomes involved in the +morbid changes. Practically, we can not separate inflammation of the pia +mater from that of the brain proper. Inflammation may, however, exist in +the center of the great nerve masses—the cerebrum, cerebellum, pons +Varolii, or medulla at the base of the brain—without involving the +surface. When, therefore, inflammation invades the brain and its +enveloping membranes it is properly called encephalitis; when the +membranes alone are affected it is called meningitis, or the brain +substance alone cerebritis. Since all the conditions merge into one +another and can scarcely be recognized separately during the life of the +animal, they may here be considered together.</p> + +<p><i>Causes.</i>—Exposure to extreme heat or cold, sudden and extreme changes +of temperature, excessive continued cerebral excitement, too much +nitrogenous feed, direct injuries to the brain, such as concussion, or +from fracture of the cranium, overexertion, sometimes as sequelæ to +influenza, pyemia, poisons having a direct influence upon the encephalic +mass, extension of inflammation from neighboring structures, food +poisoning, tumors, parasites, metastatic abscesses, etc.</p> + +<p><i>Symptoms.</i>—The diseases here grouped together are accompanied with a +variety of symptoms, almost none of which, however, are associated so +definitely with a special pathological process as to point unmistakably +to a given lesion. Usually the first symptoms indicate mental +excitement, and are followed by symptoms indicating depression. Acute +encephalitis may be ushered in by an increased sensibility to noises, +with more or less nervous excitability, contraction of the pupils of the +eyes, and a quick, hard pulse. In very acute attacks these symptoms, +however, are not always noted. This condition will soon be followed by +muscular twitchings, convulsive or spasmodic movements, eyes wide open +with shortness of sight. The animal becomes afraid to have his head +handled. Convulsions and delirium will develop, with inability of +muscular control, or stupor and coma may supervene. When the membranes +are greatly implicated, convulsions and delirium with violence may be +expected, but if the brain substances are principally affected stupor +and coma will be the prominent symptoms. In the former condition the +pulse will be quick and hard; in the latter, soft and depressed, with +often a dilatation of the pupils, and deep, slow, stertorous breathing. +The symptoms may follow one another in rapid succession, and the disease +approach a fatal termination within 12 hours. In subacute attacks the +symptoms are better defined, and the animal seldom dies before the third +day. Within three or four days gradual improvement may become manifest, +or cerebral softening with partial paralysis<span class='pagenum'><a name="Page_214" id="Page_214">[Pg 214]</a></span> may occur. In all cases of +encephalitis there is a marked rise in temperature from the very onset +of the disease, with a tendency to increase until the most alarming +symptoms develop, succeeded by a decrease when coma becomes manifest. +The violence and character of the symptoms greatly depend upon the +extent and location of the structures involved. Thus, in some cases +there may be marked paralysis of certain muscles, while in others there +may be spasmodic rigidity of muscles in a certain region. Very rarely +the animal becomes extremely violent early in the attack, and by rearing +up, striking with the fore feet, or falling over, may do himself great +injury. Usually, however, the animal maintains the standing position, +propping himself against the manger or wall, until he falls from +inability of muscular control, or from unconsciousness. Occasionally, in +his delirium, he may go through a series of automatic movements, such as +trotting or walking, and, if loose in a stall, will move around +persistently in a circle. Early and persistent constipation of the +bowels is a marked symptom in nearly all acute affections of the brain; +retention of the urine, also, is frequently observed.</p> + +<p>Following these symptoms there are depression, loss of power and +consciousness, lack of ability or desire to move, and usually fall of +temperature. At this stage the horse stands with legs propped, the head +hanging or resting on the manger, the eyes partly closed, and does not +respond when spoken to or when struck with a whip.</p> + +<p>Chronic encephalitis or meningitis may succeed the acute stage, or may +be due to stable miasma, blood poison, narcotism, lead poisoning, etc. +This form may not be characterized in its initial stages by +excitability, quick and hard pulse, and high fever. The animal usually +appears at first stupid; eats slowly; the pupil of the eye does not +respond to light quickly; the animal often throws his head up or shakes +it as if suffering sudden twinges of pain. He is slow and sluggish in +his movements, or there may be partial paralysis of one limb, one side +of the face, neck, or body. These symptoms, with some variations, may be +present for several days and then subside, or the disease may pass into +the acute stage and terminate fatally. Chronic encephalitis may effect +an animal for ten days or two weeks without much variation in the +symptoms before the crisis is reached. If improvement commences, the +symptoms usually disappear in the reverse order to that in which they +developed, with the exception of the paralytic effects, which remain +intractable or permanent. Paralysis of certain sets of muscles is a very +common result of chronic, subacute, and acute encephalitis, and is due +to softening of the brain or to exudation into the cavities of the brain +or arachnoid space.</p> + +<p>Softening and abscess of the brain are terminations of cerebritis. It +may also be due to an insufficient supply of blood as a result<span class='pagenum'><a name="Page_215" id="Page_215">[Pg 215]</a></span> of +diseased cerebral arteries and of apoplexy. The symptoms are drowsiness, +vertigo, or attacks of giddiness, increased timidity, or fear of +familiar objects, paralysis of one limb, hemiplegia, imperfect control +of the limbs, and usually a weak, intermittent pulse. In some cases the +symptoms are analogous to those of apoplexy. The character of the +symptoms depends upon the seat of the softening or abscess within the +brain.</p> + +<p>Cerebral sclerosis sometimes follows inflammation in the structure of +the brain affecting the connective tissues, which eventually become +hypertrophied and press upon nerve cells and fibers, causing their +ultimate disappearance, leaving the parts hard and indurated. This +condition gives rise to a progressive paralysis and may extend along a +certain bundle of fibers into the spinal cord. Complete paralysis almost +invariably supervenes and causes death.</p> + +<p><i>Lesions.</i>—On making post-mortem examinations of horses which have died +in the first stages of either of these diseases we find an excessive +engorgement of the capillaries and small blood vessels, with +correspondingly increased redness and changes in both the contents and +the walls of the vessels. If death has occurred at a later period of the +disease, it will be found that, in addition to the redness and +engorgement, an exudation of the contents of the blood vessels into the +tissues and upon the surfaces of the inflamed parts has supervened. If +the case has been one of encephalitis, there will usually be found more +or less watery fluid in the ventricles (natural cavities in the brain), +in the subarachnoid space, and a serous exudation between the +convolutions and interstitial spaces of the gray matter under the +membranes of the brain. The quantity of fluid varies in different cases. +Exudations of a membranous character may be present, and are found +attached to the surfaces of the pia mater.</p> + +<p>In meningitis, especially in chronic cases, in addition to the serous +effusion, there are changes which may be regarded as characteristic in +the formation of a delicate and highly vascular layer or layers of +membrane or organized structure on the surface of the dura mater, and +also indications of hemorrhages in connection with the membranous +formations. Hematoma, or blood tumors, may be found embedded in this +membrane. In some cases the hemorrhages are copious, causing paralysis +or apoplexy, followed by speedy death. The meningitis may be +suppurative. In this case a puslike exudate is found between the +membranes covering the brain.</p> + +<p>In cerebritis, or inflammation of the interior of the brain, there is a +tendency to softening and suppuration and the formation of abscesses. In +some cases the abscesses are small and numerous, surrounded with a +softened condition of the brain matter, and sometimes we may find one +large abscess. In cases of recent development<span class='pagenum'><a name="Page_216" id="Page_216">[Pg 216]</a></span> the walls of the +abscesses are fringed and ragged and have no lining membrane. In older +or chronic cases the walls of the abscesses are generally lined with a +strong membrane, often having the appearance of a sac or cyst, and the +contents have a very offensive odor.</p> + +<p><i>Treatment.</i>—In all acute attacks of inflammation involving the +membranes or cerebral masses, it is the pressure from the distended and +engorged blood vessels and the rapid accumulation of inflammatory +products that endangers the life of the animal in even the very early +stage of the disease. The earlier the treatment is commenced to lessen +the danger of fatal pressure from the engorged blood vessels, the less +effusion and smaller number of inflammatory products we have to contend +with later. The leading object, then, to be accomplished in the +treatment of the first stage of encephalitis, meningitis, or cerebritis, +and before a dangerous degree of effusion or exudation has taken place, +is to relieve the engorgement of the blood vessels and thereby lessen +the irritation or excitability of the affected structures. If the +attempt to relieve the engorgement in the first stage has been only +partially successful, and the second stage, with its inflammatory +products and exudations, whether serous or plastic, has set in, then the +main objects in further treatment are to keep up the strength of the +animal and hasten the absorption of the exudative products as much as +possible. To obtain these results, when the animal is found in the +initial stage of the disease, if there is unnatural excitability or +stupor with increase of temperature and quickened pulse, we should apply +cold to the head in the form of cold water or ice. For this purpose +cloths or bags may be used, and they should be renewed as often as +necessary. If the disease is still in its early stages and the animal is +strong, bleeding from the jugular vein may be beneficial. Good results +are to be expected only during the stage of excitement, while there is a +strong, full pulse and the mucous membranes of the head are red from a +plentiful supply of blood. The finger should be kept on the pulse and +the blood allowed to flow until there is distinct softening of the +pulse. As soon as the animal recovers somewhat from the shock of the +bleeding the following medicine should be made into a ball or dissolved +in a pint of warm water and be given at one dose: Barbados aloes, 7 +drams; calomel, 2 drams; powdered ginger, 1 dram; tincture of aconite, +20 drops.</p> + +<p>The animal should be placed in a cool, dark place, as free from noise as +possible. When the animal becomes thirsty half an ounce of bromid of +potash may be dissolved in the drinking water every six hours. +Injections of warm water into the rectum may facilitate the action of +the purgative. Norwood's tincture of veratrum viride, in 20-drop doses, +should be given every hour and 1 dram of solid extract of belladonna +every four hours until the symptoms become modified and the pulse +regular and full.</p> + +<p><a name="PLATE_XIX" id="PLATE_XIX"></a></p> +<div class="figcenter" style="width: 450px;"> +<a href="images/plate19.jpg"><img src="images/plate19t.jpg" width="450" height="308" alt="PLATE XIX." title="" /></a> +<span class="caption">PLATE XIX.<br /> + +THE NERVOUS SYSTEM.</span> +</div> + +<p><span class='pagenum'><a name="Page_217" id="Page_217">[Pg 217]</a></span>If this treatment fails to give relief, the disease will pass into the +advanced stages, or, if the animal has been neglected in the early +stages, the treatment must be supplanted with the hypodermic injection +of ergotin, in 5-grain doses, dissolved in 1 dram of water, every six +hours. The limbs may be poulticed above the fetlocks with mustard. Warm +blanketing, to promote perspiration, is to be observed always when there +is no excessive perspiration.</p> + +<p>If the disease becomes chronic (encephalitis or meningitis), we must +place our reliance upon alteratives and tonics, with such incidental +treatment as special symptoms may demand. Iodid of potassium in 2-dram +doses should be given three times a day and 1 dram of calomel once a day +to induce absorption of effusions or thickened membranes. Tonics, in the +form of iodid of iron in 1-dram doses, to which is added 2 drams of +powdered hydrastis, may also be given every six or eight hours, as soon +as the active fever has abated. After the disappearance of the acute +symptoms, blisters (cantharides ointment) may be applied behind the +poll. When paralytic effects remain after the disappearance of all other +symptoms, sulphate of strychnia in 2-grain doses, in combination with +the other tonics, may be given twice a day and be continued until it +produces muscular twitching. In some cases of paralysis, as of the lips +or throat, benefit may be derived from the moderate use of the electric +battery. Many of the recoveries will, however, under the most active and +early treatment, be but partial, and in all cases the animals become +predisposed to subsequent attacks. A long time should be allowed to pass +before the animal is exposed to severe work or great heat. When the +disease depends upon mechanical injuries, they have to be treated and +all causes of irritation to the brain removed. If it is due to stable +miasma, uremic poisoning, pyemia, influenza, rheumatism, toxic agents, +etc., they should receive prompt attention for their removal or +mitigation.</p> + +<p>Cerebral softening, abscess, and sclerosis are practically inaccessible +to treatment, otherwise than such relief as may be afforded by the +administration of opiates and general tonics, and, in fact, the +diagnosis is largely presumptive.</p> + + +<h4>CONGESTION OF THE BRAIN, OR MEGRIMS.</h4> + +<p>Congestion of the brain consists in an accumulation of blood in the +vessels, also called hyperemia, or engorgement. It may be active or +passive—active when there is an undue accumulation of blood or +diminished arterial resistance, and passive when it accumulates in the +vessels of the brain, owing to some obstacle to its return by the veins.</p> + +<p><i>Causes.</i>—Active cerebral congestion may be from hypertrophy of the +left ventricle of the heart, excessive exertion, the influence of<span class='pagenum'><a name="Page_218" id="Page_218">[Pg 218]</a></span> +extreme heat, sudden and great excitement, artificial stimulants, etc. +Passive congestion may be produced by any mechanical obstruction which +prevents the proper return of blood through the veins to the heart, such +as a small or ill-fitting collar, which often impedes the blood current, +tumors or abscesses pressing on the vein in its course, and organic +lesions of the heart with regurgitation.</p> + +<p>Extremely fat animals with short, thick necks are peculiarly subject to +attacks of cerebral congestion. Simple congestion, however, is merely a +functional affection, and in a slight or moderate degree involves no +immediate danger. Extreme engorgement, on the contrary, may be followed +by rupture of previously weakened arteries and capillaries and cause +immediate death, designated then as a stroke of apoplexy.</p> + +<p><i>Symptoms.</i>—Congestion of the brain is usually sudden in its +manifestation and of short duration. The animal may stop very suddenly +and shake its head or stand quietly braced, then stagger, make a plunge, +and fall. The eyes are staring, breathing hurried and stertorous, and +the nostrils widely dilated. This may be followed by coma, violent +convulsive movements, and death. Generally, however, the animal gains +relief in a short time, but may remain weak and giddy for several days. +If it is due to organic change of the heart or the disease of the blood +vessels in the brain, then the symptoms may be of slow development, +manifested by drowsiness, dimness or imperfect vision, difficulty in +voluntary movements, diminished sensibility of the skin, loss of +consciousness, delirium, and death. In milder cases effusion may take +place in the arachnoid spaces and ventricles of the brain, followed by +paralysis and other complications.</p> + +<p><i>Pathology.</i>—In congestion of the brain the cerebral vessels are loaded +with blood, the venous sinuses distended to an extreme degree, and the +pressure exerted upon the brain constitutes actual compression, giving +rise to the symptoms just mentioned. On post-mortem examinations this +engorgement is found universal throughout the brain and its membranes, +which serves to distinguish it from inflammations of these structures, +in which the engorgements are confined more or less to circumscribed +portions. A prolonged congestion may, however, lead to active +inflammation, and in that case we find serous and plastic exudations in +the cavities of the brain. In addition to the intensely engorged +condition of the vessels we find the gray matter of the brain redder +than natural. In cases in which several attacks have occurred the blood +vessels are often found permanently dilated.</p> + +<p><i>Treatment.</i>—The animal should be taken out of harness at once, with +prompt removal of all mechanical obstructions to the circulation. If it +is caused by venous obstruction by too tight a collar, the<span class='pagenum'><a name="Page_219" id="Page_219">[Pg 219]</a></span> loosening of +the collar will give immediate relief. The horse should be bled freely +from the jugular vein. If due to tumors or abscesses, a surgical +operation becomes necessary to afford relief. To revive the animal if it +becomes partially or totally unconscious, cold water should be dashed on +the head. Give a purge of Glauber's salt. If the limbs are cold, +tincture of capsicum or strong mustard water should be applied to them. +If symptoms of paralysis remain after two or three days, an active +cathartic and iodid of potassium will be indicated, to be given as +prescribed for inflammation of the brain. In confirmed cases, treatment +is not advisable, as there is considerable danger to the owner should an +attack occur in a crowded street.</p> + +<p><i>Prevention.</i>—Well-adjusted collar, with strap running from the collar +to the girth, to hold down the collar when pulling upgrade; regular feed +and exercise, without allowing the animal to become excessively +plethoric; moderate checking, allowing a free-and-easy movement of the +head; well-ventilated stabling, proper cleanliness, pure water, etc.</p> + + +<h4>SUNSTROKE, HEAT STROKE, OR HEAT EXHAUSTION.</h4> + +<p>The term sunstroke is applied to affections occasioned not exclusively +by exposure to the sun's rays, as the word signifies, but by the action +of great heat combined generally with humid atmosphere. Exhaustion +produced by long-continued heat is often the essential factor, and is +called heat exhaustion. Horses on the race track undergoing protracted +and severe work in hot weather often succumb to heat exhaustion. Draft +horses which do not receive proper care in watering, feeding, and rest +in shady places and are exposed for many hours to the direct rays of the +sun suffer very frequently from sunstroke.</p> + +<p><i>Symptoms.</i>—Sunstroke is manifested suddenly. The animal stops, drops +his head, begins to stagger, and soon falls to the ground unconscious. +The breathing is marked with great stertor, the pulse is very slow and +irregular, cold sweats break out in patches on the surface of the body, +and the animal often dies without having recovered consciousness.</p> + +<p>The temperature becomes very high, reaching 105° to 109° F.</p> + +<p>In heat exhaustion the animal usually requires urging for some time +prior to the appearance of any other symptoms, generally perspiration is +checked, and then the horse becomes weak in its gait, the breathing +hurried or panting, eyes watery or bloodshot, nostrils dilated and +highly reddened, assuming a dark, purple color; the pulse is rapid and +weak, the heart bounding, followed by unconsciousness and death. If +recovery takes place, convalescence extends over a long period of time, +during which incoordination of movement may persist.<span class='pagenum'><a name="Page_220" id="Page_220">[Pg 220]</a></span></p> + +<p><i>Pathology.</i>—Sunstroke, virtually active congestion of the brain, often +accompanied with effusion and blood extravasation, characterizes this +condition, with often rapid and fatal lowering of all the vital +functions. In many instances the death may be due to the complete +stagnation in the circulation of the brain, inducing anemia, or want of +nourishment of that organ. In other cases it may be directly due to the +excessive compression of the nerve matter controlling the heart's +action, and cause paralysis of that organ. There are also changes in the +composition of the blood.</p> + +<p><i>Treatment.</i>—The animal should be placed in shaded surroundings. Under +no circumstances is blood-letting permissible in sunstroke. Ice or very +cold water should be applied to the head and along the spine, and half +an ounce of carbonate of ammonia or 6 ounces of whisky should be given +in 1 pint of water. Cold water may be used as an enema and should also +be showered upon the body of the horse from the hose or otherwise. This +should be continued until the temperature is down to 103° F. Brisk +friction of the limbs and the application of spirits of camphor often +yields good results. The administration of the stimulants should be +repeated in one hour if the pulse has not become stronger and slower. In +either case, when reaction has occurred, preparations of iron and +general tonics may be given during convalescence: Sulphate of iron, 1 +dram; gentian, 3 drams; red cinchona bark, 2 drams; mix and give in feed +morning and evening.</p> + +<p><i>Prevention.</i>—In very hot weather horses should have wet sponges or +light sunshades on the head when at work, or the head may be sponged +with cold water as many times a day as possible. Proper attention should +be given to feeding and watering, never in excess. During the warm +months all stables should be cool and well ventilated, and if an animal +is debilitated from exhaustive work or disease it should receive such +treatment as will tend to build up the system. Horses should be +permitted to drink as much water as they want while they are at work +during hot weather.</p> + +<p>An animal which has been affected with sunstroke is very liable to have +subsequent attacks when exposed to the necessary exciting causes.</p> + + +<h4>APOPLEXY OR CEREBRAL HEMORRHAGE.</h4> + +<p>Apoplexy is often confounded with cerebral congestion, but true apoplexy +always consists in rupture of cerebral blood vessels, with blood +extravasation and formation of blood clot.</p> + +<p><i>Causes.</i>—Two causes are involved in the production of apoplexy, the +predisposing and the exciting. The predisposing cause is degeneration, +or disease which weakens the blood vessel; the exciting cause is any one +which tends to induce cerebral congestion.<span class='pagenum'><a name="Page_221" id="Page_221">[Pg 221]</a></span></p> + +<p><i>Symptoms.</i>—Apoplexy is characterized by a sudden loss of sensation and +motion, profound coma, and stertorous, difficult breathing. The action +of the heart is little disturbed at first, but soon becomes slower, then +quicker and feebler, and after a little time ceases. If the rupture is +one of a small artery and the extravasation limited, sudden paralysis of +some part of the body is the result. The extent and location of the +paralysis depend upon the location within the brain which is +functionally deranged by the pressure of the extravasated blood; hence +these conditions are very variable.</p> + +<p>In the absence of any premonitory symptoms or an increase of temperature +in the early stage of the attack, we may be reasonably certain in making +the distinction between this disease and congestion of the brain, or +sunstroke.</p> + +<p><i>Pathology.</i>—In apoplexy there is generally found an atheromatous +condition of the cerebral vessels, with weakening and degeneration of +their walls. When a large artery has been ruptured it is usually +followed by immediate death, and large rents may be found in the +cerebrum, with great destruction of brain tissue, induced by the +forcible pressure of the liberated blood. In small extravasations +producing local paralysis without marked general disturbance the animal +may recover after a time; in such cases gradual absorption of the clot +takes place. In large clots atrophy of the brain substances may follow, +or softening and abscess from want of nutrition may result, and render +the animal worthless, ultimately resulting in death.</p> + +<p><i>Treatment.</i>—Place the animal in a quiet, cool place and avoid all +stimulating feed. Administer, in the drinking water or feed, 2 drams of +the iodid of potassium twice a day for several weeks if necessary. +Medical interference with sedatives or stimulants is more liable to be +harmful than of benefit, and blood-letting in an apoplectic fit is +extremely hazardous. From the fact that cerebral apoplexy is due to +diseased or weakened blood vessels, the animal remains subject to +subsequent attacks. For this reason treatment is very unsatisfactory.</p> + + +<h4>COMPRESSION OF THE BRAIN.</h4> + +<p><i>Causes.</i>—In injuries from direct violence a piece of broken bone may +press upon the brain, and, according to its size, the brain is robbed of +its normal space within the cranium. It may also be due to an +extravasation of blood or to exudation in the subdural or arachnoid +spaces. Death from active cerebral congestion results through +compression. The occurrence may sometimes be traced to the direct cause, +which will give assurance for the correct diagnosis.</p> + +<p><i>Symptoms.</i>—Impairment of all the special senses and localized +paralysis. All the symptoms of lessened functional activity of the brain +are manifested to some degree. The paralysis remains to be<span class='pagenum'><a name="Page_222" id="Page_222">[Pg 222]</a></span> our guide +for the location of the cause, for it will be found that the paralysis +occurs on the opposite side of the body from the location of the injury, +and the parts suffering paralysis will denote, to an expert veterinarian +or physician, the part of the brain which is suffering compression.</p> + +<p><i>Treatment.</i>—Trephining, by a skillful operator, for the removal of the +cause when due to depressed bone or the presence of foreign bodies. When +the symptoms of compression follow other acute diseases of the brain, +apoplectic fits, etc., the treatment must be such as the exigencies of +the case demands.</p> + + +<h4>CONCUSSION OF THE BRAIN.</h4> + +<p>This is generally caused by falling over backward and striking the poll, +or perhaps falling forward on the nose, by a blow on the head, etc. +Train accidents during shipping often cause concussion of the brain.</p> + +<p><i>Symptoms.</i>—Concussion of the brain is characterized by giddiness, +stupor, insensibility, or loss of muscular power, succeeding immediately +upon a blow or severe injury involving the cranium. The animal may rally +quickly or not for hours; death may occur on the spot or after a few +days. When there is only slight concussion or stunning, the animal soon +recovers from the shock. When more severe, insensibility may be complete +and continue for a considerable time; the animal lies as if in a deep +sleep; the pupils are insensible to light; the pulse fluttering or +feeble; the surface of the body cold, muscles relaxed, and the breathing +scarcely perceptible. After a variable interval partial recovery may +take place, which is marked by paralysis of some parts of the body, +often of a limb, the lips, ear, etc. Convalescence is usually tedious, +and frequently permanent impairment of some organs remains.</p> + +<p><i>Pathology.</i>—Concussion produces laceration of the brain, or at least a +jarring of the nervous elements, which, if not sufficiently severe to +produce sudden death, may lead to softening or inflammation, with their +respective symptoms of functional derangement.</p> + +<p><i>Treatment.</i>—The first object in treatment will be to establish +reaction or to arouse the feeble and weakening heart. This can often be +accomplished by dashing cold water on the head and body of the animal; +frequent injections of weak ammonia water, ginger tea, or oil and +turpentine should be given per rectum. In the majority of cases this +will soon bring the horse to a state of consciousness. In more severe +cases mustard poultices should be applied along the spine and above the +fetlocks. As soon as the animal gains partial consciousness stimulants, +in the form of whisky or capsicum tea, should be given. Owing to +severity of the structural injury to the brain or the possible rupture +of blood vessels and blood extravasation, the reaction<span class='pagenum'><a name="Page_223" id="Page_223">[Pg 223]</a></span> may often be +followed by encephalitis or cerebritis, and will then have to be treated +accordingly. For this reason the stimulants should not be administered +too freely, and they must be abandoned as soon as reaction is +established. There is no need for further treatment unless complications +develop as a secondary result. Bleeding, which is so often practiced, +proves almost invariably fatal in this form of brain affection. We +should also remember that it is never safe to drench a horse with large +quantities of medicine when he is unconscious, for he is very liable to +draw the medicine into the lungs in inspiration.</p> + +<p><i>Prevention.</i>—Young horses, when harnessed or bitted for the first few +times, should not have their heads checked high, for it frequently +causes them to rear up, and, being unable to control their balance, they +are liable to fall over sideways or backwards, thus causing brain +concussion when they strike the ground.</p> + + +<h4>ANEMIA OF THE BRAIN.</h4> + +<p>This is a physiological condition in sleep. It is considered a disease +or may give rise to disease when the circulation and blood supply of the +brain are interfered with. In some diseases of the heart the brain +becomes anemic, and fainting fits occur, with temporary loss of +consciousness. Tumors growing within the cranium may press upon one or +more arteries and stop the supply of blood to certain parts of the +brain, thus inducing anemia, ultimately atrophy, softening, or +suppuration. Probably the most frequent cause is found in plugging, or +occlusion, of the arteries by a blood clot.</p> + +<p><i>Symptoms.</i>—Imperfect vision, constantly dilated pupils, frequently a +feeble and staggering gait, and occasionally cramps, convulsions, or +epileptic fits occur.</p> + +<p><i>Pathology.</i>—The exact opposite of cerebral hyperemia. The blood +vessels are found empty, the membranes blanched, and the brain substance +softened.</p> + +<p><i>Treatment.</i>—Removal of the remote cause when possible. General tonics, +nutritious feed, rest, and removal from all causes of nervous +excitement.</p> + + +<h4>HYDROCEPHALUS, OR DROPSY OF THE BRAIN.</h4> + +<p>This condition consists in an unnatural collection of fluid about or in +the brain. Depending upon the location of the fluid, we speak of +external and internal hydrocephalus.</p> + +<p>External hydrocephalus is seen chiefly in young animals. It consists in +a collection of fluid under the meninges, but outside the brain proper. +This defect is usually congenital. It is accompanied with<span class='pagenum'><a name="Page_224" id="Page_224">[Pg 224]</a></span> an +enlargement of the skull, especially in the region of the forehead. The +pressure of the fluid may cause the bones to soften. The disease is +incurable and usually fatal.</p> + +<p>Internal hydrocephalus is a disease of mature horses, and consists in +the accumulation of an excessive quantity of fluid in the cavities or +ventricles of the cerebrum. The cause of this accumulation may be a +previous inflammation, a defect in the circulation of blood through the +brain, heat stroke, overwork, excessive nutrition, or long-continued +indigestion. Common, heavy-headed draft horses are predisposed to this +condition.</p> + +<p><i>Symptoms.</i>—The symptoms are an expression of dullness and stupidity, +and from their nature this disease is sometimes known as "dumminess" or +"immobility." A horse so afflicted is called a "dummy." Among the +symptoms are loss of intelligence, stupid expression, poor memory, etc. +The appetite is irregular; the horse may stop chewing with a wisp of hay +protruding from his lips; he seems to forget that it is there. Unnatural +positions are sometimes assumed, the legs being placed in clumsy and +unusual attitudes. Such horses are difficult to drive, as they do not +respond readily to the word, to pressure of the bit, or to the whip. +Gradually the pulse becomes weaker, respiration becomes faster, and the +subject loses weight. Occasionally there are periods of great excitement +due to temporary congestion of the brain. At such times the horse +becomes quite uncontrollable. A horse so afflicted is said to have +"staggers." The outlook for recovery is not good.</p> + +<p>Treatment is merely palliative. Regular work or exercise and nutritious +feed easy of digestion, with plenty of fresh water, are strongly +indicated. Intensive feeding should not be practiced. The bowels should +be kept open by the use of appropriate diet or by the use of small +regular doses of Glauber's salt.</p> + + +<h4>TUMORS WITHIN THE CRANIUM.</h4> + +<p>Tumors within the cranial cavity and the brain occur not infrequently, +and give rise to a variety of symptoms, imperfect control of voluntary +movement, local paralysis, epilepsy, etc. Among the more common tumors +are the following:</p> + +<p>Osseous tumors, growing from the walls of the cranium, are not very +uncommon.</p> + +<p>Dentigerous cysts, containing a formation identical to that of a tooth, +growing from the temporal bone, sometimes are found lying loose within +the cranium.</p> + +<p>Tumors of the choroid plexus, known as brain sand, are frequently met +with on post-mortem examinations, but seldom give rise to any<span class='pagenum'><a name="Page_225" id="Page_225">[Pg 225]</a></span> +appreciable symptoms during life. They are found in horses at all ages, +and are slow of development. They are found in one or both of the +lateral ventricles, enveloped in the folds of the choroid plexus.</p> + +<p>Melanotic tumors have been found in the brain and meninges in the form +of small, black nodules in gray horses, and in one instance are believed +to have induced the condition known as stringhalt.</p> + +<p>Fibrous tumors may develop within or from the meningeal structures of +the brain.</p> + +<p>Gliomatous tumor is a variety of sarcoma very rarely found in the +structure of the cerebellum.</p> + +<p>Treatment for tumors of the brain is impossible.</p> + + +<h4>SPASMS, OR CRAMPS.</h4> + +<p>Spasm is a marked symptom in many diseases of the brain and of the +spinal cord. Spasms may result from irritation of the motor nerves as +conductors, or may result from irritation of any part of the sympathetic +nervous system, and they usually indicate an excessive action of the +reflex motor centers. Spasms may be induced by various medicinal agents +given in poisonous doses, or by effete materials in the circulation, +such as nux vomica or its alkaloid strychnia, lead preparations, or an +excess of the urea products in the circulation, etc. Spasms may be +divided into two classes: Tonic spasm, when the cramp is continuous or +results in persistent rigidity, as in tetanus; clonic spasm, when the +cramping is of short duration, or is alternated with relaxations. Spasms +may affect involuntary as well as the voluntary muscles, the muscles of +the glottis, intestines, and even the heart. They are always sudden in +their development.</p> + +<p><i>Spasm of the glottis.</i>—This is manifested by a strangling respiration; +a wheezing noise is produced in the act of inspiration; extreme anxiety +and suffering for want of air. The head is extended, the body profusely +perspiring; pulse very rapid; soon great exhaustion becomes manifest; +the mucous membranes become turgid and very dark colored, and the animal +thus may suffocate in a short time.</p> + +<p><i>Spasm of the intestines.</i>—(See "Cramp colic," p. 74.)</p> + +<p><i>Spasm of the neck of the bladder.</i>—This may be due to spinal +irritation or a reflex from intestinal irritation, and is manifested by +frequent but ineffectual attempts to urinate.</p> + +<p><i>Spasm of the diaphragm, or thumps.</i>—Spasmodic contraction of the +diaphragm, the principal muscle used in respiration, is generally +occasioned by extreme and prolonged speeding on the race track or road. +The severe strain thus put upon this muscle finally induces irritation +of the nerves controlling it, and the contractions become very forcible +and violent, giving the jerking character known among<span class='pagenum'><a name="Page_226" id="Page_226">[Pg 226]</a></span> horsemen as +"thumps." This condition may be distinguished from violent beating of +the heart by feeling the pulse beat at the angle of the jaw, and at the +same time watching the jerking movement of the body, when it will be +discovered that the two bear no relation to each other. (See +"Palpitation of the heart," p. 259.)</p> + +<p><i>Spasm of the thigh, or cramp of a hind limb.</i>—This is frequently +witnessed in horses that stand on sloping plank floors—generally in +cold weather—or it may come on soon after severe exercise. It is +probably due to an irritation of the nerves of the thigh. In cramps of +the hind leg the limb becomes perfectly rigid, and attempts to flex are +unsuccessful; the animal stands on the affected limb, but is unable to +move it; it is unnaturally cold; it does not, however, appear to cause +much suffering unless attempts are made to change position. This cramp +may be of short duration—a few minutes—or it may persist for several +days. This condition is often taken for a dislocation of the stifle +joint. In the latter the foot is extended backward, and the horse is +unable to advance it, but drags the limb. An examination of the joint +also reveals a change in form. Spasms may affect the eyelids, by closure +or by retraction. Spasm of the sterno-maxillaris muscle has been +witnessed, and the animal was unable to close the jaws until the muscle +became relaxed.</p> + +<p><i>Treatment of spasms.</i>—An anodyne liniment, composed of chloroform 1 +part and soap liniment 4 parts, applied to cramped muscles will usually +cause relaxation. This may be used when single external muscles are +affected. In spasms of the glottis, inhalation of sulphuric ether will +give quick relief. In spasm of the diaphragm, rest and the +administration of half an ounce of chloroform in 3 ounces of whisky, +with a pint of water added, will generally suffice to bring relief, or +if this fails give 5 grains of sulphate of morphia by hypodermic +injection. If spasms result from organic disease of the nervous system, +the latter should receive such treatment as its character demands. In +cramp of the leg, compulsory movement usually causes relaxation very +quickly; therefore the animal should be led out of the stable and be +forced to run or trot. Sudden, nervous excitement caused by a crack of +the whip or smart blow will often bring about immediate relief. Should +this fail, the anodyne liniment may be used along the inside of the +thigh, and chloroform, ether, or laudanum given internally. An ounce of +the chloral hydrate will certainly relieve the spasm when given +internally, but the cramp may return soon after the effect has passed +off, which in many cases it does very quickly.</p> + +<p><i>Convulsions.</i>—Although there is no disease of the nervous system which +can be properly termed convulsive, or justify the use of the word +convulsion to indicate any particular disease, yet it is often such a +prominent symptom that a few words may not be out of place.<span class='pagenum'><a name="Page_227" id="Page_227">[Pg 227]</a></span> General, +irregular muscular contractions of various parts of the body, with +unconsciousness, characterize what we regard as convulsions, and like +ordinary spasms are dependent upon some disease or irritation of the +nervous structures, chiefly of the brain. No treatment is required; in +fact, a general convulsion must necessarily be self-limited in its +duration. Suspending, as it does, respiratory movements, checking the +oxygenation and decarbonization of the blood, the rapid accumulation of +carbonic-acid gas in the blood and the exclusion of oxygen quickly puts +the blood in a condition to produce the most reliable and speedy +sedative effect upon the nerve excitability that could be found, and +consequently furnishes its own remedy so far as the continuance of the +convulsive paroxysm is concerned. Whatever treatment is instituted must +be directed toward a removal of the cause of the convulsive paroxysm.</p> + + +<h4>CHOREA, OR ST. VITUS'S DANCE.</h4> + +<p>Chorea is characterized by involuntary contractions of voluntary +muscles. This disease is an obscure disorder, which may be from pressure +upon a nerve, cerebral or spinal sclerosis, small aneurisms in the +brain, etc. Choreic symptoms have been produced by injecting granules of +starch into the arteries entering the brain. Epilepsy and other forms of +convulsions simulate chorea in appearance.</p> + +<p>Stringhalt is by some termed "chorea." This is manifested by a sudden +jerking up of one or both hind legs when the animal is walking. This +symptom may be very slight in some horses, but has a tendency to +increase with age. In some the catching up of the affected leg is very +violent, and when it is lowered to the ground the motion is equally +sudden and forcible, striking the foot to the ground like a pile driver. +Very rarely chorea may be found to affect one of the fore legs, or the +muscles of one side of the neck or the upper part of the neck. +Involuntary jerking of the muscles of the hip or thigh is seen +occasionally, and is termed "shivering" by horsemen.</p> + +<p>Chorea is often associated with a nervous disposition, and is not so +frequent in animals with a sluggish temperament. The involuntary +muscular contractions cause no pain, and do not appear to produce much +exhaustion of the affected muscles, although the jerking may be regular +and persistent whenever the animal is in motion.</p> + +<p><i>Treatment.</i>—In a few cases, early in the appearance of this affection, +general nerve tonics may be of benefit, viz, iodid of iron, 1 dram; +pulverized nux vomica, 1 dram; pulverized scutellaria (skull-cap), 1 +ounce. Mix and give in the feed once a day for two weeks. Arsenic in the +form of Fowler's solution is often beneficial. If the cause is connected +with organic brain lesions, treatment is usually unsuccessful.<span class='pagenum'><a name="Page_228" id="Page_228">[Pg 228]</a></span></p> + + +<h4>EPILEPSY, OR FALLING FITS.</h4> + +<p>The cause of epilepsy is seldom traceable to any special brain lesions. +In a few cases it accompanies disease of the pituitary body, which is +located in the under surface of the brain. Softening of the brain may +give rise to this affection. Attacks may occur only once or twice a year +or they may be of frequent recurrence.</p> + +<p><i>Symptoms.</i>—No premonitory symptoms precede an epileptic fit. The +animal suddenly staggers; the muscles become cramped; the jaws may be +spasmodically opened and closed, and the tongue become lacerated between +the teeth; the animal foams at the mouth and falls in a spasm. The urine +flows involuntarily, and the breathing may be temporarily arrested. The +paroxysm soon passes off, and the animal gets on its feet in a few +minutes after the return of consciousness.</p> + +<p><i>Treatment.</i>—Dashing cold water on the head during the paroxysm. After +the recovery 1 dram of oxid of zinc may be given in the feed twice a day +for several weeks, or benefit may be derived from the tonic prescribed +for chorea.</p> + + +<h4>PARALYSIS, OR PALSY.</h4> + +<p>Paralysis is a weakness or cessation of the muscular contraction by +diminution of loss of the conducting power or stimulation of the motor +nerves. Paralytic affections are of two kinds, the complete and the +incomplete. The former includes those in which both motion and +sensibility are affected; the latter those in which only one or the +other is lost or diminished. Paralysis may be general or partial. The +latter is divided into hemiplegia and paraplegia. When only a small +portion of the body is affected, as the face, a limb, the tail, it is +designated by the term local paralysis. When the irritation extends from +the periphery of the center it is termed reflex paralysis.</p> + +<p>Causes are much varied. Most of the acute affections of the brain and +spinal cord may lead to paralysis. Injuries, tumors, disease of the +blood vessels of the brain, etc., all have a tendency to produce +suspension of the conducting motive power to the muscular structures. +Pressure upon, or the severing of, a nerve causes a paralysis of the +parts to which such a nerve is distributed. Apoplexy may be termed a +general paralysis, and in nonfatal attacks is a frequent cause of the +various forms of palsy.</p> + +<p><span class="smcap">General paralysis.</span>—This can not take place without producing immediate +death. The term is, however, usually applied to paralysis of the four +extremities, whether any other portions of the body are involved or not. +This form of palsy is due to compression of the brain by congestion of +its vessels, large clot formation in apoplexy,<span class='pagenum'><a name="Page_229" id="Page_229">[Pg 229]</a></span> concussion, or shock, or +any disease in which the whole brain structure is involved in functional +disturbance.</p> + +<p><span class="smcap">Hemiplegia (paralysis of one side or half of the body).</span>—Hemiplegia is +frequently the result of a tumor in the lateral ventricles of the brain, +softening of one hemisphere of the cerebrum, pressure from extravasated +blood, fracture of the cranium, or it may be due to poisons in the blood +or to reflex origin. When hemiplegia is due to or the result of a prior +disease of the brain, especially of an inflammatory character, it is +seldom complete; it may affect only one limb and one side of the head, +neck, or muscles along the back, and may pass off in a few days after +the disappearance of all the other evidences of the primary affection. +In most cases, however, hemiplegia arises from emboli obstructing one or +more blood vessels of the brain, or the rupture of some vessel the wall +of which had become weakened by degeneration and the extravasation of +blood. Sensibility in most cases is not impaired, but in some there is a +loss of sensibility as well as of motion. In some cases the bladder and +rectum are involved in the paralysis.</p> + +<p><i>Symptoms.</i>—In hemiplegia the attack may be very sudden, and the animal +fall, powerless to move one side of the body; one side of the lips will +be relaxed; the tongue may hang out on one side of the mouth; the tail +curved around sideways; an inability to swallow feed or water may be +present, and often the urine dribbles away as fast as it collects in the +bladder. Sensibility of the affected side may be entirely lost or only +partial; the limbs may be cold and sometimes unnaturally warm. In cases +wherein the attack is not so severe the animal may be able to maintain +the standing position, but will have great difficulty in moving the +affected side. In such cases the animal may recover from the disability. +In the more severe, in which there is complete loss of power of +movement, recoveries are rare.</p> + +<p><span class="smcap">Paraplegia (transverse paralysis of the hind extremities).</span>—Paralysis of +the hind extremities is usually due to some injury or inflammation +affecting the spinal cord. (See "Spinal meningitis," p. 232, and +"Myelitis," p. 233.) It may also be due to a reflex irritation from +disease of peripheral nerves, to spinal irritation or congestion caused +by blood poisons, etc.</p> + +<p><i>Symptoms.</i>—When due to mechanical injury of the spinal cord, from a +broken back or spinal hemorrhage, it is generally progressive in its +character, although it may be sudden. When it is caused by agents in the +blood, it may be intermittent or recurrent.</p> + +<p>Paraplegia is not difficult to recognize, for it is characterized by a +weakness and imperfect control of the hind legs and powerless tail. The +urine usually dribbles away as it is formed and the manure is pushed +out, ball by ball, without any voluntary effort, or the passages may +cease entirety. When paraplegia is complete, large and ill-conditioned<span class='pagenum'><a name="Page_230" id="Page_230">[Pg 230]</a></span> +sores soon form on the hips and thighs from chafing and bruising, which +have a tendency quickly to weaken the animal and necessitate his +destruction.</p> + +<p><span class="smcap">Locomotor ataxia, or incoordination of movement.</span>—This is characterized +by an inability to control properly the movement of the limbs. The +animal appears usually perfectly healthy, but when he is led out of his +stall his legs have a wobbly movement and he will stumble or stagger, +especially in turning. When this is confined to the hind parts it may be +termed a modified form of paraplegia, but often it may be seen to affect +nearly all the voluntary muscles when they are called into play, and +must be attributed to some pressure exerted on the base of the brain.</p> + +<p><span class="smcap">Local paralysis.</span>—This is frequently met with in horses. It may affect +many parts of the body, even vital organs, and it is very frequently +overlooked in diagnosis.</p> + +<p><span class="smcap">Facial paralysis.</span>—This is a frequent type of local paralysis, and is +due to impairment of function of the motor nerve of the facial muscles, +the portio dura. The cause may exist at the base of the brain, +compression along its course after it leaves the medulla oblongata, or +to a bruise after it spreads out on the great masseter muscle.</p> + +<p><i>Symptoms.</i>—A flaccid condition of the cheek muscles, pendulous lips, +inability to grasp the feed, often a slow and weak movement in chewing, +and difficulty and slowness in drinking.</p> + +<p><span class="smcap">Laryngismus paralyticus, or roaring.</span>—This condition is characterized by +roaring, and is usually caused by an inflamed or hypertrophied bronchial +gland pressing against the left recurrent laryngeal nerve, which +interferes with its conducting power. A similar condition is +occasionally induced in acute pleurisy, when the recurrent nerve becomes +involved in the diseased process or compressed by plastic exudation.</p> + +<p><span class="smcap">Paralysis of the rectum and tail.</span>—This is generally the result of a +blow or fall on the rump, which causes a fracture of the sacrum bone and +injury to the nerves supplying the tail and part of the rectum and +muscles belonging thereto. This fracture would not be suspected were it +not for the loss of motion of the tail.</p> + +<p><span class="smcap">Intestinal paralysis.</span>—Characterized by persistent constipation; +frequently the strongest purgatives have no effect whatever on the +movement of the bowels. In the absence of symptoms of indigestion, or +special diseases implicating the intestinal canal, torpor of the bowels +must be attributed to deficient innervation. This condition may depend +upon brain affections or be due to reflex paralysis. Sudden checks of +perspiration may induce excessive action of the bowels or paralysis.</p> + +<p><span class="smcap">Paralysis of the bladder.</span>—This usually affects the neck of the bladder, +and is characterized by incontinence of urine; the urine dribbles away +as fast as it is secreted. The cause may be of reflex<span class='pagenum'><a name="Page_231" id="Page_231">[Pg 231]</a></span> origin, disease +of the rectum, tumors growing within the pelvic cavity, injury to the +spinal cord, etc.</p> + +<p><span class="smcap">Paralysis of the optic nerve (amaurosis).</span>—A paralysis of eyesight may +occur very suddenly from rupture of a blood vessel in the brain, acute +local congestion of the brain, the administration of excessive doses of +belladonna or its alkaloid atropia, etc. In amaurosis the pupil is +dilated to its full extent; the eye looks clear, but does not respond to +light.</p> + +<p>Paralysis of hearing, of the external ear, of the eyelid, partial +paralysis of the heart and organs of respiration, of the blood vessels +from injury to the vasomotor nerves of the esophagus, or loss of +deglutition, palsy of the stomach, all may be manifested when the supply +of nervous influence is impaired or suspended.</p> + +<p><span class="smcap">Treatment for paralysis.</span>—In all paralytic affections there may be +anesthesia, or impairment of sensibility, in addition to the loss of +motion, or there may be hyperesthesia, or increased sensibility, in +connection with the loss of motion. These conditions may call for +special treatment in addition to that for loss of motion. If +hyperesthesia is well marked local anodynes may be needed to relieve +suffering. Chloroform liniment or hypodermic injections of from 3 to 5 +grains of sulphate of morphia will allay local pain. If there is marked +anesthesia, or loss of sensibility, it may become necessary to secure +the animal in such way that he can not suffer serious injury from +accidents which he can not avoid or feel. In the treatment of any form +of paralysis we must always refer to the cause, and attempt its removal +if it can be discovered. In cases in which the cause can not be +determined we have to rely solely upon a general external and internal +treatment. Externally, fly blisters or strong, irritant liniments may be +applied to the paralyzed parts. In hemiplegia they should be applied +along the bony part of the side of the neck; in paraplegia, across the +loins. In, some cases hot-water cloths will be beneficial. Internally, +it is well to administer 1 dram of powdered nux vomica or 2 grains of +sulphate of strychnia twice a day until twitching of some of the +voluntary muscles occurs; then discontinue it for several days, and then +commence again with a smaller dose, gradually increasing it until +twitching recurs. Iodid of potassium in 1 to 2 dram doses two or three +times daily may be used with the hope that it will favor the absorption +of the clot or obstruction to the nervous current. In some cases +Fowler's solution of arsenic in teaspoonful doses twice a day in the +drinking water proves beneficial. Occasionally benefit may be derived +from the application of the electric current, especially in cases of +roaring, facial paralysis, paralysis of the eyelid, etc. Nutritious but +not too bulky feed, good ventilation, clean stabling, moderate exercise +if the animal is capable of taking it, good grooming, etc., should be +observed in all cases.<span class='pagenum'><a name="Page_232" id="Page_232">[Pg 232]</a></span></p> + + +<h4>SPINAL MENINGITIS, OR INFLAMMATION OF THE MEMBRANES ENVELOPING THE +SPINAL CORD.</h4> + +<p>This may be induced by the irritant properties of blood poisons, +exhaustion and exposure, spinal concussion, all forms of injury to the +spine, tumors, caries of the vertebræ, rheumatism, etc.</p> + +<p><i>Symptoms.</i>—A chill may be the precursor, a rise in temperature, or a +general weakness and shifting of the legs. Soon a painful, convulsive +twitching of the muscles sets in, followed by muscular rigidity along +the spine, in which condition the animal will move very stiffly and +evince great pain in turning. Evidences of paralysis or paraplegia +develop, retention or incontinence of urine, and oftentimes sexual +excitement is present. The presence of marked fever at the beginning of +the attack, associated with spinal symptoms, should lead us to suspect +spinal meningitis or myelitis. These two conditions usually appear +together, or myelitis follows inflammation of the meninges so closely +that it is almost impossible to separate the two; practically it does +not matter much, for the treatment will be about the same in both cases. +Spinal meningitis generally becomes chronic, and is then marked +principally by paralysis of that portion, or parts of it, posterior to +the seat of the disease.</p> + +<p><i>Pathology.</i>—In spinal meningitis we find essentially the same +condition as in cerebral meningitis; there is an effusion of serum +between the membranes, and often a plastic exudation firmly adherent to +the pia mater serves to maintain a state of paralysis for a long time +after the acute symptoms have disappeared by compressing the cord. +Finally, atrophy, softening, and even abscess may develop within the +cord. Unlike in man, it is usually found localized in horses.</p> + +<p><i>Treatment.</i>—Bags filled with ice should be applied along the spine, to +be followed later by strong blisters. The fever should be controlled as +early as possible by giving 20 drops of Norwood's tincture of veratrum +viride every hour until the desired result is obtained. One dram of the +fluid extract of belladonna, to control pain and vascular excitement of +the spinal cord, may be given every five or six hours until the pupils +of the eyes become pretty well dilated. If the pain is very intense 5 +grains of sulphate of morphia should be injected hypodermically. The +animal must be kept as free from excitement as possible. If the urine is +retained in the bladder it must be drawn off every four or six hours. In +very acute attacks the disease generally proves fatal in a few days. If, +however, the animal grows better, some form of paralysis is liable to +remain for a long time, and the treatment will have to be directed then +toward a removal of the exudative products and a strengthening of the +system and stimulation of the nervous functions. To induce absorption, +iodid of potassium in 2-dram doses, dissolved in the drinking water, may +be given<span class='pagenum'><a name="Page_233" id="Page_233">[Pg 233]</a></span> twice a day. To strengthen the system, iodid of iron 1 dram +twice a day and 1 dram of nux vomica once a day may be given in the +feed. Electricity to the paralyzed and weakened muscles is advisable; +the current should be weak, but be continued for half an hour two or +three times daily. If the disease is due to a broken back, caries of the +vertebræ, or some other irremediable cause, the animal should be +destroyed at once.</p> + + +<h4>MYELITIS, OR INFLAMMATION OF THE SUBSTANCE OF THE SPINAL CORD.</h4> + +<p>This is a rare disease, except as a secondary result of spinal +meningitis or injuries to the spine. Poisoning by lead, arsenic, +mercury, phosphorus, carbonic-acid gas, etc., has been known to produce +it. Myelitis may be confined to a small spot in the cord or may involve +the whole for a variable distance. It may lead to softening abscess or +degeneration.</p> + +<p><i>Symptoms.</i>—The attack may begin with a chill or convulsion; the +muscles twitch or become cramped very early in the disease, and the +bladder usually is affected at the outset, in which there may be either +retention or incontinence of urine. These conditions are followed by +complete or partial paralysis of the muscles posterior to the locality +of the inflamed cord, and the muscles begin to waste away rapidly. The +paralyzed limb becomes cold and dry, due to the suspension of proper +circulation; the joints may swell and become edematous; vesicular +eruptions appear on the skin; and frequently gangrenous sloughs form on +the paralyzed parts. It is exceedingly seldom that recovery takes place. +In a few instances it may assume a chronic type, when all the symptoms +become mitigated, and thus continue for some time, until septicemia, +pyemia, or exhaustion causes death.</p> + +<p><i>Pathology.</i>—The inflammation may involve nearly the whole length of +the cord, but generally it is more intense in some places than others; +when due to mechanical injury, the inflammation may remain confined to a +small section. The cord is swollen and congested, reddened, often +softened and infiltrated with pus cells, and the nerve elements are +degenerated.</p> + +<p><i>Treatment.</i>—Similar to that of spinal meningitis.</p> + + +<h4>SPINAL CONGESTION.</h4> + +<p>This condition consists in an excess of blood. As the blood vessels of +the pia mater are the principal source of supply to the spinal cord, +hyperemia of the cord and of the meninges usually go together. The +symptoms are, therefore, closely allied to those of spinal meningitis +and congestion. When the pia mater is diseased, the spinal cord is +almost invariably affected also.<span class='pagenum'><a name="Page_234" id="Page_234">[Pg 234]</a></span></p> + +<p><i>Cause.</i>—Sudden checking of the perspiration, violent exercise, blows, +and falls.</p> + +<p><i>Symptoms.</i>—The symptoms may vary somewhat with each case, and closely +resemble the first symptoms of spinal meningitis, spinal tumors, and +myelitis. First, some disturbance in movement, lowering the temperature, +and partial loss of sensibility posterior to the seat of the congestion. +If in the cervical region, it may cause interference in breathing and +the action of the heart. When in the region of the loins, there may be +loss of control of the bladder. When the congestion is sufficient to +produce compression of the cord, paraplegia may be complete. Usually +fever, spasms, muscular twitching, or muscular rigidity are absent, +which will serve to distinguish spinal congestion from spinal +meningitis.</p> + +<p><i>Treatment.</i>—Hot-water applications to the spine, 1-dram doses fluid +extract of belladonna repeated every four hours, and tincture of aconite +root 20 drops every hour until the symptoms become ameliorated. If no +inflammatory products occur, the animal is likely to recover.</p> + + +<h4>SPINAL ANEMIA.</h4> + +<p>This may be caused by extreme cold, exhausting diseases, spinal embolism +or plugging of a spinal blood vessel, an interference with the +circulation through the abdominal aorta, from compression, thrombosis, +or aneurism of that vessel; the spinal vessels may be caused to contract +through vasomotor influence, a result of peripheral irritation of some +nerve.</p> + +<p>Spinal anemia causes paralysis of the muscles used in extending the +limbs. When the bladder is affected, it precedes the weakness of motion, +while in spinal congestion it follows, and increased sensibility, in +place of diminished sensibility, as in spinal congestion, is observed. +Pressure along the spine causes excessive pain.</p> + +<p>If the exciting cause can be removed, the animal recovers; if this +fails, the spinal cord may undergo softening.</p> + + +<h4>SPINAL COMPRESSION.</h4> + +<p>When caused by tumors or otherwise, when pressure is slight, it produces +a paralysis of the muscles used in extending a limb and contraction of +those which flex it. When compression is great it causes complete loss +of sensibility and motion posterior to the compressed part of the cord.</p> + +<p>Compression of a lateral half of the cord produces motor paralysis, +disturbance of the circulation, and difficulty of movement, an increased +sensibility on the side corresponding to the compressed section, and a +diminished sensibility and some paralysis on the opposite side.<span class='pagenum'><a name="Page_235" id="Page_235">[Pg 235]</a></span></p> + +<p><i>Treatment.</i>—When it occurs as a sequence of a preceding inflammatory +disease, iodid of potassium and general tonics are indicated. When due +to tumors growing within the spinal canal, or to pressure from displaced +bone, no form of treatment will result in any benefit.</p> + + +<h4>SPINAL HEMORRHAGE.</h4> + +<p>This may occur from changes in the wall of the blood vessels, in +connection with tumors, acute myelitis, traumatic injuries, etc. The +blood may escape through the pia mater into the subarachnoid cavity, and +large clots be formed.</p> + +<p><i>Symptoms.</i>—The symptoms are largely dependent upon the seat and extent +of the hemorrhage, as they are principally owing to the compression of +the cord. A large clot may produce sudden paraplegia, accompanied with +severe pain along the spine; usually, however, the paralysis of both +motion and sensation is not very marked at first; on the second or third +day fever is liable to appear, and increased or diminished sensibility +along the spine posterior to the seat of the clot. When the bladder and +rectum are involved in the symptoms it indicates that the spinal cord is +compressed.</p> + +<p><i>Treatment.</i>—In the occurrence of injuries to the back of a horse, +whenever there is any evidence of paralysis, it is always advisable to +apply bags of ice along the spine to check or prevent hemorrhage or +congestion, and 2 drams of the fluid extract of ergot and 20 drops of +tincture of digitalis may be given every hour until three doses have +been taken. Subsequently tincture of belladonna in half-ounce doses may +be given three times a day. If there is much pain, 5 grains of sulphate +of morphia, injected under the skin, will afford relief and lessen the +excitability of the animal. In all cases the animal should be kept +perfectly quiet.</p> + + +<h4>SPINAL CONCUSSION.</h4> + +<p>This is rarely observed in the horse, and unless it is sufficiently +severe to produce well-marked symptoms it would not be suspected. It may +occur in saddle horses from jumping, or it may be produced by falling +over an embankment, or a violent fall upon the haunches may produce it. +Concussion may be followed by partial paralysis or spinal hemorrhage; +generally, however, it is confined to a jarring and some disturbance of +the nerve elements of the cord, and the paralytic effect which ensues +soon passes off. Treatment consists in rest until the animal has +completely recovered from the shock. If secondary effects follow from +hemorrhage or compression, they have to be treated as heretofore +directed.<span class='pagenum'><a name="Page_236" id="Page_236">[Pg 236]</a></span></p> + + +<h4>SPINAL TUMORS.</h4> + +<p>Within the substance of the cord glioma or the mixed gliosarcomata are +found to be the most frequent, tumors may form from the meninges and the +vertebræ, being of a fibrous or bony nature, and affect the spinal cord +indirectly by compression. In the meninges we may find glioma, cancers, +and psammoma, fibromata; aneurisms of the spinal arteries have been +discovered in the spinal canal.</p> + +<p><i>Symptoms.</i>—Tumors of the spinal canal cause symptoms of spinal +irritation or compression of the cord. The gradual and slow development +of symptoms of paralysis of one or both hind limbs or certain muscles +may lead to a suspicion of spinal tumors. The paralysis induced is +progressive, but not usually marked with atrophy of the muscles or +increased sensibility along the spine. When the tumor is within the +spinal cord itself all the symptoms of myelitis may be present.</p> + +<p><i>Treatment.</i>—General tonics and 1-dram doses of nux vomica may be +given; iodid of iron or iodid of potassium in 1-dram doses, three times +a day in feed, may, in a very few cases, give some temporary benefit. +Usually the disease progresses steadily until it proves fatal.</p> + + +<h4>NEURITIS, OR INFLAMMATION OF A NERVE.</h4> + +<p>This is caused by a bruise or wound of a nerve or by strangulation in a +ligature when the nerve is included in the ligation of an artery. The +changes in an inflamed nerve are an enlargement, reddening of the nerve +sheath, spots of extravasated blood, and sometimes an infiltration of +serum mixed with pus.</p> + +<p><i>Symptoms.</i>—Acute pain of the parts supplied by the nerve and absence +of swelling or increased heat of the part.</p> + +<p><i>Treatment.</i>—Hypodermic injections of from 3 to 5 grains of morphia to +relieve pain, hot fomentations, and rest. If it is due to an inclusion +of a ligature, the nerve should be divided above and below the ligature.</p> + + +<h4>NEUROMA, OR TUMOR OF A NERVE.</h4> + +<p>Neuroma may be from enlargement of the end of a divided nerve or due to +fibrous degeneration of a nerve which has been bruised or wounded. Its +most frequent occurrence is found after the operation of neurotomy for +foot lameness, and it may appear after the lapse of months or even +years. Neuroma usually develops within the sheath of the nerve with or +without implicating the nerve fibers. It is oval, running lengthwise +with the direction of the nerve.</p> + +<p><i>Symptoms.</i>—Pain of the affected limb or part is manifested, more +especially after resting a while, and when pressure is made upon the +tumor it causes extreme suffering.<span class='pagenum'><a name="Page_237" id="Page_237">[Pg 237]</a></span></p> + +<p><i>Treatment.</i>—Excision of the tumor, including part of the nerve above +and below, and then treat it like any other simple wound.</p> + + +<h4>INJURIES TO NERVES.</h4> + +<p>These may consist in wounding, bruising, laceration, stretching, +compression, etc. The symptoms which are produced will depend upon the +extent, seat, and character of the injury. Recovery may quickly take +place, or it may lead to neuritis, neuroma, or spinal or cerebral +irritation, which may result in tetanus, paralysis, and other serious +derangements. In all diseases, whether produced by some form of external +violence or intrinsic causes, the nerves are necessarily involved, and +sometimes it is to a primary injury of them that the principal fault in +movement or change of nutrition of a part is due. It is often difficult +or impossible to discover that an injury to a nerve has been inflicted, +but whenever this is possible it may enable us to remedy that which +otherwise would result in permanent evil. Treatment should consist in +relieving compression, in hot fomentations, the application of anodyne +liniments, excision of the injured part, and rest.</p> + + +<h4>FORAGE POISONING, OR SO-CALLED CEREBROSPINAL MENINGITIS.</h4> + +<p>This disease prevails among horses in nearly all parts of the United +States. Its appearance in America is by no means of recent occurrence, +for the malady was reported by Large in 1847, by Michener in 1850, and +by Liautard in 1869 as appearing in both sporadic and enzootic form in +several of the Eastern States. Since then the disease has occurred +periodically in many States in all sections of the country, and has been +the subject of numerous investigations and publications by a number of +the leading men of the veterinary profession. It is prevalent with more +or less severity every year in certain parts of the United States, and +during the year 1912 the Bureau of Animal Industry received urgent +requests for help from Colorado, Georgia, Iowa, Kansas, Kentucky, +Louisiana, Maryland, Missouri, Nebraska, New Jersey, North Carolina, +Oregon, South Carolina, South Dakota, Virginia, and West Virginia. While +in 1912 the brunt of the disease seemed to fall on Kansas and Nebraska, +other States were also seriously afflicted. In previous years, for +instance in 1882, as well as in 1897, the horses of southeastern Texas +were reported to have died by the thousand, and in the following year +the horses of Iowa were said to have "died like rats." However, Kansas +seems to have had more than her share of this trouble, as a severe +outbreak that extended over almost the entire State occurred in 1891, +while in 1902 and again in 1906 the disease recurred with equal severity +in various portions of the State.<span class='pagenum'><a name="Page_238" id="Page_238">[Pg 238]</a></span></p> + +<p>This condition consists in a poisoning and depression of the nervous +system from eating or drinking feed or water containing poison generated +by mold or bacteria. It has been shown to be owing to eating damaged +ensilage, corn, brewers' grains, oats, etc., or to drinking stagnant +pond water or water from a well contaminated by surface drainage. Horses +at pasture may contract the disease when the growth of grass is so +profuse that it mats together and the lower part dies and ferments or +becomes moldy.</p> + +<p>In England a similar disease has been called "grass staggers," due to +eating rye grass when it is ripening or when it is cut and eaten while +it is heating and undergoing fermentation. In eastern Pennsylvania it +was formerly known by the name of "putrid sore throat" and "choking +distemper." A disease similar in many respects which is very prevalent +in Virgina, especially along the eastern border, is commonly known by +the name of "blind staggers," and in many of the Southern States this +has been attributed to the consumption of worm-eaten, corn. Horses of +all ages and mules are subject to this disease.</p> + +<p><i>Symptoms and lesions.</i>—The symptoms which typify sporadic or epidemic +cerebrospinal meningitis in man are not witnessed among horses, namely, +excessive pain, high fever, and early muscular rigidity. In the +recognition of the severity of the attack we may divide the symptoms +into three grades. In the most rapidly fatal attacks the animal may +first indicate it by weak, staggering gait, partial or total inability +to swallow solids or liquids, impairment of eyesight; twitching of the +muscles and slight cramps may be observed. As a rule, the temperature is +not elevated—indeed, it is sometimes below normal. This is soon +followed by a paralysis of the whole body, inability to stand, delirium +in which the animal sometimes goes through a series of automatic +movements as if trotting or running; the delirium may become very +violent and the unconscious animal may bruise his head very seriously in +his struggles; but usually a deep coma renders him quiet until he +expires. Death in these cases usually takes place in from 4 to 24 hours +from the time the first symptoms become manifest. The pulse is variable +during the progress of the disease; it may be almost imperceptible at +times, and then again very rapid and irregular; the respirations +generally are quick and catching. In the next form in which this disease +may develop it first becomes manifest by a difficulty in swallowing and +slowness in mastication, and a weakness which may be first noticed in +the strength of the tail; the animal will be unable to switch it or to +offer resistance when we bend it up over the croup. The pulse is often a +little slower than normal. There is no evidence of pain; the +respirations are unchanged, and the temperature little less than normal; +the bowels may be somewhat constipated. These symptoms<span class='pagenum'><a name="Page_239" id="Page_239">[Pg 239]</a></span> may remain +unchanged for two or three days and then gradual improvement may take +place, or the power to swallow may become entirely lost and the weakness +and uncertainty in gait more and more perceptible; then sleepiness or +coma may appear; the pulse becomes depressed, slow, and weak, the +breathing stertorous, and paroxysms of delirium develop, with inability +to stand, and some rigidity of the spinal muscles or partial cramp of +the neck and jaws. In such cases death may occur in from 6 to 10 days +from the commencement of the attack. In many cases there is no evidence +of pain, spasm, or fever at any time during the progress of the disease, +and finally profound coma develops and death follows, painless and +without a struggle.</p> + +<p>In the last or mildest form the inability of voluntary control of the +limbs becomes but slightly marked, the power of swallowing never +entirely lost, and the animal has no fever, pain, or unconscious +movements. Generally the animal will begin to improve about the fourth +day and recovers.</p> + +<p>In a few cases the spinal symptoms, manifested by paraplegia, may be the +most prominent symptoms; in others they may be altogether absent and the +main symptoms may be difficulty in mastication and swallowing; rarely it +may affect one limb only. In all cases in which coma remains absent for +six or seven days the animal is likely to recover. When changes toward +recovery take place, the symptoms usually leave in the reverse order to +that in which they developed, but local paralysis may remain for some +time, rarely persistent.</p> + +<p>On post-mortem the number of lesions observable to the naked eye is in +marked contrast to the severity of the symptoms noted. The pharynx and +larynx are inflamed in many cases, and sometimes coated with a +yellowish-white glutinous deposit, extending at times over the tongue +and occasionally a little way down the trachea. The lungs are normal, +except from complications following drenching or recumbence for a long +period. The heart is usually normal in appearance, except an occasional +cluster of hemorrhagic points on the outer surface, while the blood is +dark and firmly coagulated. The lining of the stomach indicates a +subacute gastritis, while occasionally an erosion is noted. An edema is +observed in the submucosa of such cases. The first few inches of the +small intestines likewise may show slight inflammation in certain cases, +while in others it is quite severe; otherwise the digestive tract +appears normal, excluding the presence of varying numbers of bots, +<i>Strongylus vulgatus</i>, and a few other nematodes. The liver is congested +and swollen in some cases, while it appears normal in others. The spleen +is, as a rule, normal, and at times the kidneys are slightly congested. +The bladder is often distended with dark-colored urine, and occasionally +a marked<span class='pagenum'><a name="Page_240" id="Page_240">[Pg 240]</a></span> cystitis has been observed. The adipose tissue throughout the +carcass may show a pronounced icteric appearance in certain cases. On +removing the bones of the skull the brain appears to be normal +macroscopically in a few instances, but in most cases the veins and +capillaries of the meninges of the cerebrum, cerebellum, and +occasionally the medulla is distinctly dilated and engorged, and in a +few cases there are pronounced lesions of a leptomeningitis. An +excessive quantity of cerebrospinal fluid is present in most of the +cases. On the floor of the lateral ventricles of several brains there +was noted a slight softening caused by hemorrhages into the brain +substance. There is always an abundance of fluid in the subarachnoid +spaces, ventricles, and at the base of the brain, usually of the color +of diabetic urine, and containing a limited number of flocculi, but in a +few cases it was slightly blood tinged. The spinal cord was not found +involved in the few cases examined.</p> + +<p><i>Treatment.</i>—One attack of the disease does not confer immunity. Horses +have been observed which have recovered from two attacks, and still +others that recovered from the first but died as a result of the second +attack.</p> + +<p>Inasmuch as a natural immunity does not appear after an attack of +cerebrospinal meningitis, it might be anticipated that serum of +recovered cases would possess neither curative nor prophylactic +qualities. Nevertheless, experiments have been made along these lines +with serum from recovered cases, but without any positive results. +Similar investigations have been conducted by others in Europe with +precisely the same results. With the tendency of the disease to produce +pathological lesions in the central nervous system, it seems scarcely +imaginable that a medicinal remedy will be found to heal these foci, and +even when recovery takes place considerable disturbance in the +functions, as blindness, partial paralysis, dumbness, etc., is liable to +remain. Indeed, when the disease once becomes established in an animal, +drugs seem to lose their physiological action. Therefore, with all the +previously mentioned facts before us, it is evident that the first +principle in the treatment of this disease is prevention, which consists +in the exercise of proper care in feeding only clean, well-cured forage +and grain and pure water. These measures when faithfully carried out +check the development of additional cases of the disease upon the +affected premises.</p> + +<p>While medicinal treatment has proved unsatisfactory in most cases, +nevertheless the first indication is to clean out the digestive tract +thoroughly, and to accomplish this prompt measures must be used early in +the disease. Active and concentrated remedies should be given, +preferably subcutaneously or intravenously, owing to the great +difficulty in swallowing, even in the early stage. Arecolin in<span class='pagenum'><a name="Page_241" id="Page_241">[Pg 241]</a></span> one-half +grain doses, subcutaneously, has given as much satisfaction as any other +drug. After purging the animal the treatment is mostly symptomatic. +Intestinal disinfectants, particularly calomel, salol, and salicylic +acid, have been recommended, and mild, antiseptic mouth washes are +advisable. Antipyretics are of doubtful value, as better results are +obtained, if the temperature is high, by copious cold-water injections. +An ice pack applied to the head is beneficial in case of marked psychic +disturbance. One-ounce doses of chloral hydrate per rectum should be +given if the patient is violent or if muscular spasms are severe. If the +temperature becomes subnormal, the animal should be warmly blanketed, +and if much weakness is shown this should be combated with stimulants, +such as strychnin, camphor, alcohol, atropin, or aromatic spirits of +ammonia. Early in the disease urotropin (hexamethylenamin) in doses of +25 grains, dissolved in water and given by the mouth every two hours, +appeared to have been responsible for the recovery of some cases of the +malady. During convalescence tonic treatment is indicated.</p> + +<p><i>Hygienic measures needful.</i>—Whenever this disease appears in a stable +all the animals should be removed as soon as possible. They should be +provided with clean, well-ventilated, and well-drained stables, and each +animal should receive a laxative and be fed feed and given water from a +new, clean source. The abandoned stable should be thoroughly cleansed +from all waste matters, receive a coat of whitewash containing 4 ounces +of carbolic acid to the gallon of water and should have time to dry +thoroughly before the horses are replaced. A complete change of feed is +of the very greatest importance on account of the belief that the cause +resides in diseased grain, hay, and grass.</p> + + +<h4>TETANUS, OR LOCKJAW.</h4> + +<p>This disease is characterized by spasms affecting the muscles of the +face, neck, body, and limbs and of all muscles supplied by the +cerebrospinal nerves. The spasms or muscular contractions are rigid and +persistent, yet mixed with occasional more intense contractions of +convulsive violence.</p> + +<p><i>Causes.</i>—This disease is caused by a bacillus that is often found in +the soil, in manure, and in dust. This germ forms spores at the end of +the organism and grows only in the absence of oxygen. It produces a +powerful nerve poison, which causes the symptoms of tetanus. The germ +itself multiplies at the point where it is introduced, but its poison is +absorbed and is carried by the blood to all parts of the body, and thus +the nervous system is poisoned. Deep wounds infected by this germ are +more dangerous than superficial wounds, because in them the germ is more +remote from the oxygen of the air. Hence,<span class='pagenum'><a name="Page_242" id="Page_242">[Pg 242]</a></span> nail pricks, etc., are +especially dangerous. In the majority of instances the cause of tetanus +can be traced to wounds, especially pricks and wounds of the feet or of +tendinous structures. It sometimes follows castration, docking, the +introduction of setons, inclusion of a nerve in a ligature, etc. It may +come on a long time after the wound is healed—three or four months. +Horses with a nervous, excitable disposition are more predisposed than +those of a more sluggish nature. Stallions are more subject to develop +tetanus as the result of wounds than geldings, and geldings more than +mares.</p> + +<p><i>Symptoms.</i>—The attacks may be acute or subacute. In an acute attack +the animal usually dies within four days. The first symptoms which +attract the attention of the owner is difficulty in chewing and +swallowing, an extension of the head and protrusion over the inner part +of the eye of the membrana nictitans, or haw. An examination of the +mouth will reveal an inability to open the jaws to their full extent, +and the endeavor to do so will produce great nervous excitability and +increased spasm of the muscles of the jaw and neck. The muscles of the +neck and along the spine become rigid and the legs are moved in a stiff +manner. The slightest noise or disturbance throws the animal into +increased spasm of all the affected muscles. The tail is usually +elevated and held immovable; the bowels become constipated early in the +attack. The temperature and pulse are not much changed. These symptoms +in the acute type become rapidly aggravated until all the muscles are +rigid—in a state of tonic spasm—with a continuous tremor running +through them; a cold perspiration breaks out on the body; the breathing +becomes painful from the spasm of the muscles used in respiration; the +jaws are completely set, eyeballs retracted, lips drawn tightly over the +teeth, nostrils dilated, and the animal presents a picture of the most +extreme agony until death relieves him. The pulse, which at first was +not much affected, will become quick and hard, or small and thready when +the spasm affects the muscles of the heart. In the subacute cases the +jaws may never become entirely locked; the nervous excitability and +rigidity of the muscles are not so great. There is, however, always some +stiffness of the neck or spine manifest in turning; the haw is turned +over the eyeball when the nose is elevated. It is not uncommon for +owners to continue such animals at their work for several days after the +first symptoms have been observed. All the symptoms may gradually +increase in severity for a period of ten days, and then gradually +diminish under judicious treatment, or they may reach the stage wherein +all the characteristics of acute tetanus become developed. In some +cases, however, we find the muscular cramps almost solely confined to +the head or face, perhaps involving those of the neck. In such cases we +have complete trismus (lockjaw), and all the head symptoms are acutely +developed. On the contrary, we may find the<span class='pagenum'><a name="Page_243" id="Page_243">[Pg 243]</a></span> head almost exempt in some +cases, and have the body and limbs perfectly rigid and incapable of +movement without falling.</p> + +<p>Tetanus may possibly be confounded with spinal meningitis, but the +character of the spasm-locked jaw, retraction of the eyeballs, the +difficulty in swallowing due to spasms of the muscles of the pharynx, +and above all, the absence of paralysis, should serve to make the +distinction.</p> + +<p><i>Prevention.</i>—When a valuable horse has sustained a wound that it is +feared may be followed by tetanus, it is well to administer a dose of +tetanus antitoxin. This is injected beneath the skin with a hypodermic +syringe. A very high degree of protection may in this way be afforded. +This antitoxin should be administered only by a competent veterinarian.</p> + +<p><i>Treatment.</i>—The animal should be placed in a box stall without +bedding, as far as possible from other horses. If in a country district, +the animal should be put into an outbuilding or shed, where the noise of +other animals will not reach it; if the place is moderately dark, it is +all the better; in fly time it should be covered with a light sheet. The +attendant must be very careful and quiet to prevent all unnecessary +excitement and increase of spasm. Tetanus antitoxin appears to be useful +as a remedy in some cases, if given in very large quantities early in +the disease; otherwise it is useless. Subcutaneous injections of +carbolic acid in glycerin and water (carbolic acid 30 grains, glycerin +and water each 1 ounce) appear to be useful in some cases. Injections +should be given twice daily.</p> + +<p>A cathartic, composed of Barbados aloes 6 to 8 drams, with which may be +mixed 2 drams of the solid extract of belladonna, should be given at +once. This is best given in a ball form; if, however, the animal is +greatly excited by the attempt or can not swallow, the ball may be +dissolved in 2 ounces of olive oil and thrown on the back of the tongue +with a syringe. If the jaws are set, or nearly so, an attempt to +administer medicine by the mouth should not be made. In such cases +one-quarter of a grain of atropia, with 5 grains of sulphate of morphia, +should be dissolved in 1 dram of pure water and injected under the skin. +This should be repeated sufficiently often to keep the animal +continually under its effect. This will usually mitigate the severity of +the spasmodic contraction of the affected muscles and lessen sensibility +to pain. Good results may be obtained sometimes by the rectal injection +of the fluid extract of belladonna and of cannabis indica, of each 1 +dram, every four or six hours. This may be diluted with a quart of milk. +When the animal is unable to swallow liquids, oatmeal gruel and milk +should be given by injection per rectum to sustain the strength of the +animal. A pailful of cool water should be constantly before him, placed +high enough for him to reach it without special effort; even if drinking +is impossible, the laving of<span class='pagenum'><a name="Page_244" id="Page_244">[Pg 244]</a></span> the mouth is refreshing. Excellent success +frequently may be obtained by clothing the upper part of the head, the +neck, and greater part of the body in woolen blankets kept saturated +with very warm water. This treatment should be continued for six or +eight hours at a time. It often relaxes the cramped muscles and gives +them rest and the animal almost entire freedom from pain; but it should +be used every day until the acute spasms have permanently subsided in +order to be of any lasting benefit.</p> + +<p>Recently subcutaneous injections of brain emulsion have been +recommended. It is thought that the tetanus toxin will attach itself to +the brain cells so injected and thus free the system of this poison. +When it is due to a wound, the wound should be thoroughly cleaned and +disinfected with carbolic acid. If from a wound which has healed, an +excision of the cicatrix may be beneficial. In all cases it is not +uncommon to have a partial recovery followed by relapse when the animal +becomes excited from any cause.</p> + + +<h4>RABIES, HYDROPHOBIA, OR MADNESS.</h4> + +<p>This disease does not arise spontaneously among horses, but is the +result of a bite from a rabid animal—generally a dog or cat. The +development of the disease follows the bite in from three weeks to three +months—very rarely in two weeks. (See also p. 559.)</p> + +<p><i>Symptoms.</i>—The first manifestation of the development of this disease +may be an increased excitability and viciousness; very slight noises or +the approach of a person incites the animal to kick, strike, or bite at +any near object. Very often the horse will bite his own limbs or sides, +lacerating the flesh and tearing the skin. The eyes appear staring, +bloodshot; the ears are on the alert to catch all sounds; the head is +held erect. In some cases the animal will continually rub and bite the +locality of the wound inflicted by the rabid animal. This symptom may +precede all others. Generally the bowels become constipated and the +animal makes frequent attempts at urination, which is painful, and the +urine very dark colored. The furious symptoms appear in paroxysms; at +other times the animal may eat and drink, although swallowing appears to +become painful toward the latter stage of the disease, and may cause +renewed paroxysms. The muscles of the limbs or back may be subject to +intermittent spasms, or spasmodic tremors; finally, the hind limbs +become paralyzed, breathing very difficult, and convulsions supervene, +followed by death. The pulse and respirations are increased in frequency +from the outset of the attack. Rabies may possibly be mistaken for +tetanus. In the latter disease we find tonic spasms of the muscles of +the jaws, or stiffness of the neck or back very early in the attack, and +evidence of viciousness is absent.<span class='pagenum'><a name="Page_245" id="Page_245">[Pg 245]</a></span></p> + +<p><i>Treatment.</i>—As soon as the true nature of the disease is ascertained +the animal should be killed.</p> + +<p><i>Prevention.</i>—When a horse is known to have been bitten by a rabid +animal, immediate cauterization of the wound with a red-hot iron may +possibly destroy the virus before absorption of it takes place.</p> + + +<h4>PLUMBISM, OR LEAD POISONING.</h4> + +<p>This disease is not of frequent occurrence. It may be due to the +habitual drinking of water which has been standing in leaden conductors +or in old paint barrels, etc. It has been met with in enzootic form near +smelting works, where, by the fumes arising from the works, lead in the +form of oxid, carbonate, or sulphate was deposited on the grass and +herbage which the horses ate.</p> + +<p><i>Symptoms.</i>—Lead poisoning produces derangement of the functions of +digestion and locomotion, or it may affect the lungs principally. In +whatever system of organs the lead is mostly deposited there we have the +symptoms of nervous debility most manifest. If in the lungs, the +breathing becomes difficult and the animal gets out of breath very +quickly when compelled to run. Roaring, also, is very frequently a +symptom of lead poisoning. When it affects the stomach, the animal +gradually falls away in flesh, the hair becomes rough, the skin tight, +and colicky symptoms develop. When the deposit is principally in the +muscles, partial or complete paralysis gradually develops. When large +quantities of lead have been taken in and absorbed, symptoms resembling +epilepsy may result, or coma and delirium develop and prove fatal. In +lead poisoning there is seldom any increase in temperature. A blue line +forms along the gums of the front teeth, and the breath assumes a +peculiarly offensive odor. Lead can always be detected in the urine by +chemical tests.</p> + +<p><i>Treatment.</i>—The administration of 2-dram doses of iodid of potassium +three times a day is indicated. This will form iodid of lead in the +system, which is rapidly excreted by the kidneys. If much muscular +weakness or paralysis is present, sulphate of iron in 1-dram doses and +strychnia in 2-grain doses may be given twice a day. In all cases of +suspected lead poisoning all utensils which have entered into the supply +of feed or water should be examined for the presence of soluble lead. If +it occurs near lead works, great care must be given to the supply of +uncontaminated fodder, etc.</p> + + +<h4>UREMIA.</h4> + +<p>Uremic poisoning may affect the brain in nephritis, acute albuminuria, +or when, from any cause, the functions of the kidneys become impaired or +suppressed and urea (a natural product) is no longer eliminated from +these organs, causing it to accumulate in the system and give rise to +uremic poisoning.<span class='pagenum'><a name="Page_246" id="Page_246">[Pg 246]</a></span></p> + +<p>Uremic poisoning is usually preceded by dropsy of the limbs or abdomen; +a peculiar, fetid breath is often noticed; then drowsiness, attacks of +diarrhea, and general debility ensue. Suddenly extreme stupor or coma +develops; the surface of the body becomes cold; the pupils are +insensible to light; the pulse slow and intermitting; the breathing +labored, and death supervenes. The temperature throughout the disease is +seldom increased, unless the disease becomes complicated with acute, +inflammatory disease of the brain or respiratory organs, which often +occur as a result of the urea in the circulation. Albumen and tube casts +may frequently be found in the urine. The disease almost invariably +proves fatal.</p> + +<p>Treatment must be directed to a removal of the cause.</p> + + +<h4>ELECTRIC SHOCK.</h4> + +<p>Electric shock, from coming in contact with electric wires, is becoming +a matter of rather frequent occurrence, and has a similar effect upon +the animal system as a shock from lightning. Two degrees of electric or +lightning shock may be observed, one producing temporary contraction of +muscles and insensibility, from which recovery is possible, the other +killing directly, by producing a condition of nervous and general +insensibility. In shocks which are not immediately fatal the animal is +usually insensible, the respiration slow, labored, or gasping, the pulse +slow, feeble, and irregular, and the pupils dilated and not sensitive, +or they may be contracted and sensitive. The temperature is lowered. +There may be a tendency to convulsions or spasms. The predominating +symptoms are extreme cardiac and respiratory depression.</p> + +<p><i>Treatment.</i>—Sulphate of atropia should be given hypodermically in +one-quarter grain doses every hour or two hours until the heart beats +are invigorated, the number and fullness of the respirations increased, +and consciousness returns. Stimulating injections per rectum may also be +useful in arousing the circulation; for this purpose whisky or ammonia +water may be used.</p> + + + +<hr style="width: 65%;" /> +<p><span class='pagenum'><a name="Page_247" id="Page_247">[Pg 247]</a></span></p> +<h2>DISEASES OF THE HEART, BLOOD VESSELS, AND LYMPHATICS.</h2> + +<h3>By <span class="smcap">M. R. Trumbower, V. S.</span></h3> + +<h4>[Revised by Leonard Pearson, B. S., V. M. D.]</h4> + + +<h4>ANATOMY AND PHYSIOLOGY OF THE HEART AND BLOOD VESSELS.</h4> + +<h5>(Pls. XX and XXI.)</h5> + +<p>The heart is a hollow, muscular organ, situated a little to the left of +the center of the chest. Its impulse is felt on the left side on account +of its location and from the rotary movement of the organ in action. It +is cone-shaped, with the base upward; the apex points downward, +backward, and to the left side. It extends from about the third to the +sixth ribs, inclusive. The average weight is about 7 to 8 pounds. In +horses used for speed the heart is relatively larger, according to the +weight of the animal, than in horses used for slow work. It is suspended +from the spine by the large blood vessels and held in position below by +the attachment of the pericardium to the sternum. It is inclosed in a +sac, the pericardium, which is composed of a dense fibrous membrane +lined by a delicate serous membrane, which is reflected over the heart; +the inner layer is firmly adherent to the heart, the outer to the +fibrous sac, and there is an intervening space, known as the pericardial +space, in which a small amount of serum—a thin translucent liquid—is +present constantly.</p> + +<p>The heart is divided by a shallow fissure into a right and left side; +each of these is again subdivided by a transverse partition into two +compartments which communicate. Thus there are four cardiac +cavities—the superior, or upper, ones called the auricles; the +inferior, or lower, ones the ventricles. These divisions are marked on +the outside by grooves, which contain the cardiac blood vessels, and are +generally filled with fat.</p> + +<p>The right side of the heart may be called the venous side, the left the +arterial side, named from the kind of blood which passes through them. +The auricles are thin-walled cavities placed at the base, and are +connected with the great veins—the venæ cavæ and pulmonary +veins—through which they receive blood from all parts of the body. The +auricles communicate with the ventricles each by a large aperture,<span class='pagenum'><a name="Page_248" id="Page_248">[Pg 248]</a></span> the +auriculo-ventricular orifice, which is furnished with a remarkable +mechanism of valves, allowing the transmission of blood from the +auricles into the ventricles, but preventing a reverse course. The +ventricles are thick-walled cavities, forming the more massive portion +of the heart toward the apex. They are separated by a partition, and are +connected with the great arteries—the pulmonary artery and the +aorta—by which they send blood to all parts of the body. At the mouth +of the aorta and at the mouth of the pulmonary artery is an arrangement +of valves in each case which prevents the reflux of blood into the +ventricles. The auriculo-ventricular valve in the left side is composed +of two flaps, hence it is called the bicuspid valve; in the right side +this valve has three flaps and is called the tricuspid valve. The flaps +which form these valves are connected with a tendinous ring between the +auricles and ventricles; and each flap of the auriculo-ventricular +valves is supplied with tendinous cords, which are attached to the free +margin and under-surface, so as to keep the valves tense when closed—a +condition which is produced by the shortening of muscular pillars with +which the cords are connected. The arterial openings, both on the right +and on the left side, are provided with three-flapped semilunar-shaped +valves, to prevent the regurgitation of blood when the ventricles +contract. The veins emptying into the auricles are not capable of +closure, but the posterior vena cava has an imperfect valve at its +aperture.</p> + +<p>The inner surface of the heart is lined by a serous membrane, the +endocardium, which is smooth and firmly adherent to the muscular +structure of the heart. This membrane is continuous with the lining +membrane of the blood vessels, and it enters into the formation of the +valves.</p> + +<p>The circulation through the heart is as follows: The venous blood is +carried into the right auricle by the anterior and posterior venæ cavæ. +It then passes through the right auriculo-ventricular opening into the +right ventricle, thence through the pulmonary artery to the lungs. It +returns by the pulmonary veins to the left auricle, then is forced +through the auriculo-ventricular opening into the left ventricle, which +propels it through the aorta and its branches into the system, the veins +returning it again to the heart. The circulation, therefore, is double, +the pulmonary, or lesser, being performed by the right side, and the +systemic, or greater, by the left side.</p> + +<p>As the blood is forced through the heart by forcible contractions of its +muscular walls, it has the action of a force pump, and gives the impulse +at each beat, which we call the pulse—the dilatation of the arteries +throughout the system. The contraction of the auricles is quickly +followed by that of the ventricles, and then a slight pause occurs; this +takes place in regular rhythmical order during health.</p> + +<p><a name="PLATE_XX" id="PLATE_XX"></a></p> +<div class="figcenter" style="width: 450px;"> +<a href="images/plate20.jpg"><img src="images/plate20t.jpg" width="450" height="359" alt="PLATE XX." title="" /></a> +<span class="caption">PLATE XX.<br /> + +INTERIOR OF CHEST SHOWING POSITION OF HEART AND DIAPHRAGM.</span> +</div> + +<p><a name="PLATE_XXI" id="PLATE_XXI"></a></p> +<div class="figcenter" style="width: 450px;"> +<a href="images/plate21.jpg"><img src="images/plate21t.jpg" width="450" height="332" alt="PLATE XXI." title="" /></a> +<span class="caption">PLATE XXI.<br /> + +CIRCULATORY APPARATUS.</span> +</div> + +<p><span class='pagenum'><a name="Page_249" id="Page_249">[Pg 249]</a></span>The action of the heart is governed and maintained by the pneumogastric +nerve (tenth pair of cranial nerves); it is the inhibitory nerve of the +heart, and regulates, slows, and governs its action. When the nerve is +cut, the heartbeats increase rapidly, and, in fact, the organ works +without control. When the nerve is unduly irritated the holdback, or +inhibitory force, is increased, and the heart slows up in the same +measure. The left cavities of the heart, the pulmonary veins, and the +aorta, or systemic artery, contain red or florid blood, fit to circulate +through the body. The right cavities of the heart, with the venæ cavæ, +or systemic veins, the pulmonary artery, contain dark blood, which must +be transmitted through the lungs for renovation.</p> + +<p>The arteries, commencing in two great trunks, the aorta and the +pulmonary artery, undergo division, as in the branching of a tree. Their +branches mostly come off at acute angles, and are commonly of uniform +diameter in each case, but successively diminish after and in +consequence of division, and in this manner gradually merge into the +capillary system of blood vessels. As a general rule, the combined area +of the branches is greater than that of the vessels from which they +emanate, and hence the collective capacity of the arterial system is +greatest at the capillary vessels. The same rule applies to the veins. +The effect of the division of the arteries is to make the blood move +more slowly along their branches to the capillary vessels, and the +effect of the union of the branches of the veins is to accelerate the +speed of the blood as it returns from the capillary vessels to the +venous trunks.</p> + +<p>In the smaller vessels a frequent running together, or anastomosis, +occurs. This admits of a free communication between the currents of +blood, and must tend to promote equability of distribution and of +pressure, and to obviate the effects of local interruption. The arteries +are highly elastic, being extensile and retractile both in length and +breadth. During life they are also contractile, being provided with +muscular tissue. When cut across they present, although empty, an open +orifice; the veins, on the other hand, collapse.</p> + +<p>In most parts of the body the arteries are inclosed in a sheath formed +of connective tissue, but are connected so loosely that, when the vessel +is cut across, its ends readily retract some distance within the sheath. +Independently of this sheath, arteries are usually described as being +formed of three coats, named, from the relative positions, external, +middle, and internal. This applies to their structure so far as it is +discernible by the naked eye. The internal, serous, or tunica intima, is +the thinnest, and is continuous with the lining membrane of the heart. +It is made up of two layers—an inner, consisting of a layer of +epithelial scales, and an outer, transparent, whitish, highly elastic, +and perforated. The middle coat, tunica<span class='pagenum'><a name="Page_250" id="Page_250">[Pg 250]</a></span> media, is elastic, dense, and +of a yellow color, consisting of nonstriated muscular and elastic +fibers, thickest in the largest arteries and becoming thinner in the +smaller. In the smallest vessels it is almost entirely muscular. The +external coat, tunica adventitia, is composed mainly of fine and closely +woven bundles of white connective tissue, which chiefly run diagonally +or obliquely around the vessel. In this coat the nutrient vessels, the +vasa vasorum, form a capillary network, from which a few penetrate as +far as the muscular coat.</p> + +<p>The veins differ from arteries in possessing thinner walls, less elastic +and muscular tissue, and for the most part a stronger tunica adventitia. +They collapse when cut across or when they are empty. The majority of +veins are provided with valves; these are folds of the lining membrane, +strengthened by fibrous tissue. They favor the course of the blood and +prevent its reflux. The nerves which supply both the arteries and the +veins come from the sympathetic system. The smaller arteries terminate +in the system of minute vessels known as the capillaries, which are +interposed between the termination of the arteries and the commencement +of the veins. Their average diameter is about one three-thousandth of an +inch.</p> + + +<h4>DISEASES OF THE HEART AND BLOOD VESSELS.</h4> + +<p>In considering diseases of the heart we meet with many difficulties, +depending much upon the position which this organ occupies in the +animal. The shoulders cover so much of the anterior portion of the +chest, and often in very heavy-muscled horses the chest walls are so +thick that a satisfactory examination of the heart is attended with +difficulty. Diseases of the heart are not uncommon among horses; the +heart and its membranes are frequently involved in diseases of the +respiratory organs, diseases of the kidneys, rheumatism, influenza, etc. +Some of the diseases of this organ are never suspected by the ordinary +observer during life, and are so difficult to diagnose with any degree +of certainty that we will have to confine ourselves to a general +outline, giving attention to such symptoms as may serve to lead to a +knowledge of their existence, with directions for treatment, care, etc.</p> + +<p>Nervous affections often produce prominent heart symptoms by causing +functional disturbance of that organ, which, if removed, will leave the +heart restored to perfect vigor and normal action. Organic changes +involving the heart or valves, however, usually grow worse and +eventually prove fatal. Therefore it is necessary that we arrive at an +appreciation of the true nature and causes so that we may be able to +form a true estimate of the possibilities for recovery or encouragement +for medical treatment.<span class='pagenum'><a name="Page_251" id="Page_251">[Pg 251]</a></span></p> + +<p>Disease of the heart may occur at any age, but it is witnessed most +frequently in young horses, which, when being trained for fast work, are +often subjected to excessive hardship and fatigue. Nervous or timid +animals also suffer from such diseases more frequently than those of a +sluggish disposition. Any cause which induces a violent or sudden change +in the circulation may result in injury to the heart. Symptoms which may +frequently denote disease of the heart are difficult breathing or +short-windedness, dropsies of the limbs, habitual coldness of the +extremities, giddiness or fainting attacks, inability to stand work, +although the general appearance would indicate strength and ability, +etc.</p> + + +<h4>MYOCARDITIS, OR INFLAMMATION OF THE MUSCULAR STRUCTURE OF THE HEART.</h4> + +<p>The heart muscle sometimes becomes inflamed as a complication or result +of the existence of general or febrile and of infectious diseases. +Severe influenza or infectious pneumonia is not infrequently followed by +myocarditis. By extension of inflammation of the endocardium or +pericardium the muscle of the heart may become involved. Overexertion or +especially hard work continued for a long time may cause this muscle to +become inflamed.</p> + +<p><i>Symptoms.</i>—Inflammation of the heart muscle is shown by inability to +contract forcibly. This results in a rapid but weak, soft pulse and +irregular heart sounds. The pulse may be quite irregular as a result of +the irregular, tumultuous action of the heart. There is great general +weakness, shortness of breath, and rapid respiratory movements. In some +cases, where the muscle is very much softened and weakened, or, perhaps +when an abscess forms in the wall of the heart, the course of the +disease is very rapid and terminates suddenly from paralysis or rupture +of the heart.</p> + +<p><i>Alterations.</i>—The heart muscle has a brownish or yellowish, boiled +appearance, and is so brittle that it tears easily. There may be a +spotted appearance of the muscle from the intense changes in structure +in small areas. These small areas may be due to suppuration, in which +case they have the characteristics of small abscesses. This last +condition is seen in pyemia (blood poisoning). If the disease is of long +duration, the fibrous tissue in the wall of the heart may increase to +such an extent as to produce an unnatural hardness of the wall.</p> + +<p><i>Treatment.</i>—In this disease the nutrition and strength of the heart +should be kept up as much as possible with good food, good care, and +heart tonics and stimulants. The horse should be tempted to eat such +foods as he will take; he should be kept in an airy box stall; his legs +should be well rubbed as often as necessary to keep them warm and +bandaged loosely with flannel bandages. Internally the horse may have +strychnia, in 2-grain doses twice daily, whisky in 4-ounce<span class='pagenum'><a name="Page_252" id="Page_252">[Pg 252]</a></span> doses every +two to four hours, digitalis in the form of the tincture in doses of 1 +dram every three to six hours. Artificial Carlsbad salts in heaping +tablespoonful doses in the feed may be given three times daily for a +couple of weeks. Rest is of the greatest importance and should be +allowed for a few weeks after recovery seems to be complete.</p> + + +<h4>ENDOCARDITIS, OR INFLAMMATION OF THE LINING MEMBRANE OF THE HEART.</h4> + +<p>Endocarditis frequently occurs as a complication of rheumatism, some of +the specific or zymotic fevers, specific poisoning, etc. This is a more +frequent disease among horses than is generally known, and often gives +rise to symptoms which at first are obscure and unnoticed.</p> + +<p>In influenza we may find the heart becoming involved in the disease, in +consequence of the morbid material conveyed through the heart in the +blood stream. In view of the fact that many affections in even remote +portions of the body may be traced directly to a primary endocardial +disease, we shall feel justified in inviting special attention to this +disease.</p> + +<p>Endocarditis may be acute, subacute, or chronic. In acute inflammation +we find a thickening and a roughened appearance of the endocardium +throughout the cavities of the heart. This condition may be followed by +a coagulation of fibrin upon the inflamed surface, which adheres to it, +and by attrition soon becomes worked up into shreddy-like granular +elevations. This may lead to a formation of fibrinous clots in the heart +and sudden death early in the disease the second or third day.</p> + +<p>Subacute endocarditis, which is the most common form, may not become +appreciable for several days after its commencement. It is characterized +by being confined to one or more anatomical divisions of the heart, and +all the successive morbid changes follow each other in a comparatively +slow process. Often we would not be led to suspect heart affection were +it not for the distress in breathing, which it generally occasions when +the animal is exercised, especially if the valves are much involved. +When coagula or vegetations form upon the inflamed membrane, either in +minute shreds or patches, or when formation of fibrinous clots occurs in +the cavity affected, some of these materials may be carried from the +cavity of the heart by the blood current into remote organs, +constituting emboli that are liable to suddenly plug vessels and thereby +interrupt important functions. In the great majority of either acute or +subacute grades of endocarditis, whatever the exciting cause, the most +alarming symptoms disappear in a week or 10 days, often leaving, +however, such changes in the interior lining or valvular structures as +to cause impairment in the circulation for a much longer period of time. +These changes usually consist of thickening or induration of the +inflamed structures. But<span class='pagenum'><a name="Page_253" id="Page_253">[Pg 253]</a></span> while the effects of the inflammation in the +membrane lining the walls of the ventricles may subside to such a degree +as to cause little or no inconvenience, or even wholly disappear, yet +after the valvular structures have been involved, causing them to be +thicker, less flexible than normal, they usually remain, obstructing the +free passage of the blood through the openings of the heart, thereby +inducing secondary changes, which take place slowly at first, but +ultimately seriously impair the animal's usefulness. What was but a +slight obstruction to the circulation during the first few weeks after +the subsidence of the cardiac inflammatory attack becomes in process of +time so much increased as to induce increased growth in the muscular +structure of the heart, constituting hypertrophy of the walls of the +ventricles, more particularly of the left, with corresponding fullness +of the left auricle and pulmonary veins, thereby producing fullness of +the capillaries in the lungs, pressure upon the air cells, difficult or +asthmatic breathing—greatly increased in attempts to work—until in a +few months many of these cases become entirely disabled for work. +Sometimes, too, dropsical effusions in the limbs or into the cavities of +the body result from the irregular and deficient circulation. +Derangement of the urinary secretion, with passive congestion of the +kidneys, may also appear.</p> + +<p>Endocardial inflammation is seldom fatal in its early stages, but in +many cases the recovery is incomplete, for a large proportion is left +with some permanent thickening of the valves, which constitutes the +beginning of valvular disease.</p> + +<p><i>Symptoms.</i>—Endocarditis may be ushered in by a chill, with sudden and +marked rise in temperature. The pulse rapidly decreases in strength or +may become irregular, while the heart beats more or less tumultuously. +In the early stages soft-blowing sounds may be heard by placing the ear +over the heart on the left side, which correspond in number and rhythm +to the heart's action. Excessive pain, though not so great as in acute +pleuritis, is manifested when the animal is compelled to trot; very +often difficulty in breathing, or shortness of breath, on the slightest +exertion develops early in the attack. When the valves are involved in +the inflammatory process the visible mucous membranes become either very +pale or very dark colored, and fainting may occur when the head is +suddenly elevated. When the valves of the right side are affected we may +find a regurgitant pulsation in the jugular vein. Occasionally it +happens that the heart contracts more frequently than the pulse +beats—that is, there may be twice as many contractions of the heart in +a minute as there are pulse waves in the arteries. The pulse is always +very fast. In some cases we find marked lameness of the left shoulder, +and when the animal is turned short to the left side he may groan with +pain, and the heart's action become violently excited, although +pressure<span class='pagenum'><a name="Page_254" id="Page_254">[Pg 254]</a></span> against the chest wall will not produce pain unless roughly +applied. The animal is not disposed to eat or drink much; the surface of +the body and legs are cold—rarely excessively hot—and frequently the +body of the animal is in a subdued tremor. In nearly all cases there is +partial suppression of the urinary secretion. The symptoms may continue +with very little modification for three or four days, sometimes seven +days, without any marked changes. If large fibrinous clots form in the +heart the change will be sudden and quickly prove fatal unless they +become loosened and are carried away in the circulation; then apoplexy +may result from the plugging of arteries too small to give further +transmission. If the animal manifests symptoms of improvement, the +changes usually are slow and steady until he feels apparently as well as +ever, eats well, and moves freely in his stall or yard. When he is taken +out, however, the seeming strength often proves deceptive, as he may +quickly weaken if urged into a fast gait, the breathing becomes +quickened with a double flank movement as in heaves, and all the former +symptoms reappear in a modified degree. An examination at this stage may +reveal valvular insufficiency, cardiac hypertrophy, or pulmonary +engorgement.</p> + +<p>In fatal cases of endocarditis death often occurs about the fourth day, +from the formation of heart clot or too great embarrassment of the +circulation. Endocarditis may be suspected in all cases where plain +symptoms of cardiac affection are manifested in animals affected with +influenza, rheumatism, or any disease in which the blood may convey +septic matter.</p> + +<p>Acute endocardial inflammation may be distinguished from pleuritis by +the absence of any friction murmur, absence of pain when the chest wall +is percussed, and the absence of effusion in the cavity of the chest. It +may be distinguished from pericarditis by the absence of the friction +sounds and want of an enlarged area of dullness on percussion.</p> + +<p><i>Treatment.</i>—The objects to be attained by treatment will be to remove +or mitigate as much as possible the cause inducing the disease; to find +a medicine which will lessen the irritability of the heart without +weakening it; and, last, to maintain a free urinary secretion and +prevent exudation and hypertrophy. So long as there is an increase of +temperature, with some degree of scantiness of the urine, it may be safe +to believe that there is some degree of inflammatory action existing in +the cardiac structures, and as long as any evidence of inflammatory +action remains, however moderate in degree, there is a tendency to +increase or hypertrophy of the connective tissue of the heart or valves, +thereby rendering it almost certain that the structural changes will +become permanent unless counteracted by persistent treatment and +complete rest.<span class='pagenum'><a name="Page_255" id="Page_255">[Pg 255]</a></span></p> + +<p>The tincture of digitalis, in 20-drop doses, repeated every hour, is +perhaps the most reliable agent we know to control the irritability of +the heart, and this also has a decided influence upon the urinary +secretion. After the desired impression upon the heart is obtained the +dose may be repeated every two or three hours, or as the case may +demand. Tincture of strophanthus, in 2-dram doses, will quiet the +tumultuous action of the heart in some cases where the digitalis fails. +Bleeding, blistering, and stimulating applications to the chest should +be avoided. They serve to irritate the animal and can do no possible +good. Chlorate of potassium in 2-dram doses may be given in the drinking +water every four hours for the first five or six days, and then be +superseded by the nitrate of potassium in half-ounce doses for the +following week or until the urinary secretion becomes abnormally +profuse. Where the disease is associated with rheumatism, 2-dram doses +of salicylate of soda may be substituted for the chlorate of potassium. +To guard against chronic induration of the valves, the iodid of +potassium, in 1 to 2 dram doses, should be given early in the disease +and may be repeated two or three times a day for several weeks. When +chronic effects remain after the acute stage has passed this drug +becomes indispensable.</p> + +<p>When dropsy of the limbs develops, it is due to weakened circulation or +functional impairment of the kidneys. When there is much weakness in the +action of the heart, or general debility is marked, the iodid of iron, +in 1-dram doses, combined with hydrastis, 3 drams, may be given three +times a day. Arsenic, in 5-grain doses twice a day, will give excellent +results in some cases of weak heart associated with difficult breathing. +In all cases absolute rest and warm stabling, with comfortable clothing, +become necessary, and freedom from work should be allowed for a long +time after all symptoms have disappeared.</p> + + +<h4>PERICARDITIS, OR INFLAMMATION OF THE SAC INCLOSING THE HEART.</h4> + +<p><i>Causes.</i>—Pericarditis may be induced by cold and damp stabling, +exposure and fatigue, from wounds caused by broken ribs, etc. Generally, +however, it is associated with an attack of influenza, rheumatism, +pleuritis, etc.</p> + +<p><i>Symptoms.</i>—Usually the disease manifests itself abruptly by a brief +stage of chills coincident with pain in moving, a short painful cough, +rapid and short breathing, and high temperature, with a rapid and hard +pulse. In the early stages of the disease the pulse is regular in beat; +later, when there is much exudation present in the pericardial sac, the +heartbeat becomes muffled, and may be of a double or rebounding +character. By placing the ear against the left side of the chest behind +the elbow a rasping sound may be heard, corresponding<span class='pagenum'><a name="Page_256" id="Page_256">[Pg 256]</a></span> to the frequency +of the heartbeat. This is known as a friction sound. Between the second +and fourth days this sound may disappear, due to a distension of the +pericardium by an exudate or serous effusion. As soon as this effusion +partly fills the pericardium, percussion will reveal an abnormally +increased area of dullness over the region of the heart, the heartbeats +become less perceptible than in health, and in some cases a splashing or +flapping sound may become audible.</p> + +<p>If the effusion becomes absorbed, the friction sound usually recurs for +a short time; this friction may often be felt by applying the hand to +the side of the chest. In a few cases clonic spasms of the muscles of +the neck may be present. In acute pericarditis, when the effusion is +rapid and excessive, the animal may die in a few days or recovery may +begin equally as early. In subacute or in chronic cases the effusion may +slowly become augmented until the pressure upon the lungs and +interference with the circulation become so great that death will +result. Whether the attack is acute, subacute, or chronic, the +characteristic symptoms which will guide us to a correct diagnosis are +the friction sound, which is always synchronous with the heart's action, +the high temperature with hard, irritable pulse, and, in cases of +pericardial effusion, the increased area of dullness over the cardiac +region. When the disease is associated with influenza or rheumatism, +some of the symptoms may be obscure, but a careful examination will +reveal sufficient evidence upon which to base a diagnosis. When +pericarditis develops as a result of or in connection with pleuritis, +the distinction may not be very clearly definable, neither will many +recover. When it results from a wound or broken rib, it almost +invariably proves fatal.</p> + +<p><i>Pathology.</i>—Pericarditis may at all times be regarded as a very +serious affection. At first we will find an intense injection or +accumulation of blood in the vessels of the pericardium, giving it a red +and swollen appearance, during which we have the friction sound. In 24 +to 48 hours this engorgement is followed by an exudation of +sero-fibrinous fluid, the fibrinous portion of which may soon form a +coating over the internal surface of the pericardial sac, and may +ultimately form a union of the opposing surfaces. Generally this +adhesion will only be found to occupy a portion of the surfaces. As the +serous or watery portion of this effusion is absorbed, the distinctness +of the friction sound recurs, and may remain perceptible in a varied +degree for a long time. When the serous effusion is very great, the +pressure exerted upon the heart weakens its action, and may produce +death soon; when it is not so great, it may cause dropsies of other +portions of the body. When the adhesions of the pericardial sac to the +body of the heart are extensive, they generally lead to increased +growth, or hypertrophy, of the heart, with or without<span class='pagenum'><a name="Page_257" id="Page_257">[Pg 257]</a></span> dilatation of its +cavities; when they are but slight, they may not cause any +inconvenience.</p> + +<p><i>Treatment.</i>—In acute or subacute pericarditis the tincture of +digitalis may be given in 20 to 30 drop doses every hour until the pulse +and temperature become reduced. Whisky or carbonate of ammonia may be +given regularly as stimulants. Bandages should be applied to the legs; +if the legs are very cold, tincture of capsicum should be first applied; +the body should be warmly clothed in blankets, to promote perspiration. +When the suffering from pain is very severe, 10 grains of morphin may be +given by the mouth once or twice a day; nitrate of potassium, half an +ounce, in drinking water, every six hours; after the third day, iodid of +potassium, in 2-dram doses, may be substituted. Cold packs to the chest +in the early stages of the disease may give marked relief, or, late in +the disease, smart blisters may be applied to the sides of the chest +with benefit. If the disease becomes chronic, iodid of iron and gentian +to support the strength will be indicated, but the iodid of potassium, +in 1 or 2 dram doses, two or three times a day, must not be abandoned so +long as there is an evidence of effusion or plastic exudate accumulating +in the pericardial sac. Where the effusion is great and threatens the +life of the patient, tapping by an expert veterinarian may save the +animal.</p> + + +<h4>VALVULAR DISEASE OF THE HEART.</h4> + +<p>Acute valvular disease can not be distinguished from endocarditis, and +chronic valvular affections are generally the result of endocardial +inflammation. The valves of the left side are the most subject—the +bicuspid or mitral and the aortic or semilunar. The derangement may +consist of mere inflammation and swelling, or the edges of the valves +may become covered by the organization of the exudation, thus narrowing +the passage. Valvular obstruction and adhesions may occur or the +tendinous cords may be lengthened or shortened, thus obstructing the +orifices and permitting the regurgitation of blood. In protected cases +the fibrous tissue of the valves may be transformed into fibro-cartilage +or bone, or there may be deposits of salts of lime beneath the serous +membrance, which may terminate in ulceration, rupture, or fissures. +Sometimes the valves become covered by fibrinous, fleshy, or hard +vegetations, or excrescences. In cases of considerable dilatation of the +heart there may be atrophy and shrinking of the valves.</p> + +<p><i>Symptoms.</i>—Valvular disease may be indicated by a venous pulse, +jerking pulse, intermittent pulse, irregular pulse; palpitation; +constant abnormal fullness of the jugular veins; difficulty of breathing +when the animal becomes excited or is urged out of a walk or into a<span class='pagenum'><a name="Page_258" id="Page_258">[Pg 258]</a></span> +fast trot; attacks of vertigo; congestion of the brain; dropsical +swelling of the limbs. A blowing, cooing, or bubbling murmur may +sometimes be heard by placing the ear over the heart on the left side of +the chest.</p> + +<p>Hypertrophy, or dilatation, or both, usually follow valvular disease.</p> + +<p><i>Treatment.</i>—When the pulse is irregular or irritable, tonics, such as +preparations of iron, gentian, and ginger, may be given. When the action +of the heart is jerking or violent, 20 to 30 drop doses of tincture of +digitalis or of veratrum viride may be given until these symptoms abate. +As the disease nearly always is the result of endocarditis, the iodid of +potassium and general tonics, sometimes stimulants, when general +debility supervenes, may be of temporary benefit. Very few animals +recover or remain useful for any length of time after once marked +organic changes have taken place in the valvular structure of the heart.</p> + + +<h4>ADVENTITIOUS GROWTHS IN THE HEART.</h4> + +<p>Fibrous, cartilaginous, and bony formations have been observed in some +rare instances in the muscular tissue. Isolated calcareous masses have +sometimes been embedded in the cardiac walls. Fibrinous coagula and +polypous concretions may be found in the cavities of the heart. The +former consist of coagulated fibrin, separated from the mass of blood, +of a whitish or yellowish white color, translucent, of a jellylike +consistence, and having a nucleus in the center. They may slightly +adhere to the surface of the cavity, from which they can easily be +separated without altering the structure of the endocardium. They +probably result from an excess of coagulability of fibrin, which is +produced by an organization of the lymph during exudation. They are +usually found in the right auricle and ventricle.</p> + +<p>Polypous concretions are firmer than in the preceding, more opaque, of a +fibrous texture, and may be composed of successive layers. In some +instances they are exceedingly minute, while in others they almost fill +one or more of the cavities. Their color is usually white, but +occasionally red from the presence of blood. They firmly adhere to the +endocardium, and when detached from it give it a torn appearance. +Occasionally, a vascular communication seems to exist between them and +the substance of the heart. They may be the result of fibrinous +exudation from inflammation of the inner surface of the heart or the +coagulation of a portion of the blood which afterwards contracts +adhesion with the heart. These concretions prove a source of great +inconvenience and often danger, no matter how formed. They cause a +diminution in the cavity in which they are found, thus narrowing the +orifice through which the<span class='pagenum'><a name="Page_259" id="Page_259">[Pg 259]</a></span> blood passes, or preventing a proper +coaptation of the valves, which may produce most serious valvular +disease.</p> + +<p><i>Symptoms.</i>—These are frequently uncertain; they may, however, be +suspected when the action of the heart suddenly becomes embarrassed with +irregular and confused pulsations, great difficulty of breathing, and +the usual signs dependent upon the imperfect arterialization of the +blood.</p> + +<p><i>Treatment.</i>—Stimulants, whisky, or carbonate of ammonia may be of +service.</p> + + +<h4>PALPITATION OF THE HEART.</h4> + +<p>This is a tumultuous and usually irregular beating of the heart. It may +be due to a variety of causes, both functional and organic. It may occur +as a result of indigestion, fright, increased nervousness, sudden +excitement, excessive speeding, etc. (See "Thumps," p. 225.)</p> + +<p><i>Symptoms.</i>—The heart may act with such violence that each beat may jar +the whole body of the animal; very commonly it may be heard at a short +distance away from the animal. It can usually be traced very readily to +the exciting cause, which we may be able to avoid or overcome in the +future and thereby obviate subsequent attacks. Rest, a mild stimulant, +or a dose or two of tincture of digitalis or opium will generally give +prompt relief. When it is due to organic impairment of the heart it must +be regarded as a symptom, not as a matter of primary specific treatment.</p> + + +<h4>SYNCOPE, OR FAINTING.</h4> + +<p>Actual fainting rarely occurs among horses. It may, however, be induced +by a rapid and great loss of blood, pain of great intensity, a +mechanical interference with the circulation of the brain, etc.</p> + +<p><i>Symptoms.</i>—Syncope is characterized by a decrease or temporary +suspension of the action of the heart and respiration, with partial or +total loss of consciousness. It generally occurs suddenly, though there +may be premonitory symptoms, as giddiness, or vertigo, dilated pupil, +staggering, blanching of the visible mucous membranes, a rapidly sinking +pulse, and dropping to the ground. The pulse is feeble or ceases to +beat; the surface of the body turns cold; breathing is scarcely to be +perceived, and the animal may be entirely unconscious. This state is +uncertain in duration—generally it lasts only a few minutes; the +circulation becomes restored, breathing becomes more distinct, and +consciousness and muscular strength return. In cases attended with much +hemorrhage or organic disease of the heart, the fainting fit may be +fatal; otherwise it will prove but a transient occurrence. In paralysis +of the heart the symptoms may be exactly similar to syncope. Syncope may +be distinguished from apoplexy by<span class='pagenum'><a name="Page_260" id="Page_260">[Pg 260]</a></span> the absence of stertorous breathing +and lividity of the visible mucous membranes.</p> + +<p><i>Treatment.</i>—Dash cold water on the head; administer a stimulant—4 +ounces of whisky or half an ounce of carbonate of ammonia. Prevent the +animal from getting up too soon, or the attack may immediately recur. +Afterwards, if the attack was due to weakness from loss of blood, +impoverished blood, or associated with debility, general tonics, rest, +and nourishing food are indicated.</p> + + +<h4>HYPERTROPHY OF THE HEART, OR CARDIAC ENLARGEMENT.</h4> + +<p>Hypertrophy of the heart implies augmentation of bulk in its muscular +substance, with or without dilatation or contraction of its cavities. It +may exist with or without other cardiac affections. In valvular disease +or valvular insufficiency hypertrophy frequently results as a +consequence of increased demand for propelling power. The difficulties +with which it is most frequently connected are dilatation and +ossification of the valves. It may also occur in connection with +atrophied kidneys, weak heart, etc. It may be caused by an increased +determination of blood to the organ or from a latent form of +myocarditis, and it may arise from a long-continued increase of action +dependent upon nervous disease. All the cavities of the heart may have +their walls hypertrophied or the thickening may involve one or more. +While the wall of a ventricle is thickened, its cavity may retain its +normal size (simple hypertrophy) or be dilated (eccentric hypertrophy), +or it may be contracted (concentric hypertrophy). Hypertrophy of both +ventricles increases the length and breadth of the heart. Hypertrophy of +the left ventricle alone increases its length; of the right ventricle +alone increases its breadth toward the right side. Hypertrophy with +dilatation may affect the chambers of the heart conjointly or +separately. This form is by far the most frequent variety of cardiac +enlargement. When the entire heart is affected, it assumes a globular +appearance, the apex being almost obliterated and situated transversely +in the chest. The bulk may become three or four times greater than the +average heart.</p> + +<p><i>Symptoms.</i>—In hypertrophy of the heart, in addition to the usual +symptoms manifested in organic diseases of the heart, there is a +powerful and heaving impulse at each beat, which may be felt on the left +side, often also on the right. These pulsations are regular, and when +full and strong at the jaw there is a tendency to active congestion of +the capillary vessels, which frequently give rise to local inflammation, +active hemorrhage, etc. If the pulse is small and feeble at the jaw, we +may conclude that there is some obstacle to the escape of the blood from +the left ventricle into the aorta, which has given rise to the +hypertrophy. In case of hypertrophy with dilatation, the impulse is not +only powerful and heaving, but it is diffused over the<span class='pagenum'><a name="Page_261" id="Page_261">[Pg 261]</a></span> whole region of +the heart, and the normal sounds of the heart are greatly increased in +intensity. Percussion reveals an enlarged area of dullness, while the +impulse is usually much stronger than normal.</p> + +<p>Dropsy of the pericardium will give the same wide space of dullness, but +the impulse and sound are lessened. An animal with a moderate degree of +enlargement may possibly live a number of years and be capable of +ordinary work; it depends largely upon concomitant disease. As a rule, +an animal affected with hypertrophy of the heart will soon be +incapacitated for work, and becomes useless and incurable.</p> + +<p><i>Treatment.</i>—If the cause can be discovered and is removable, it should +be done. The iodid of potassium, in cases of valvular thickening, may be +of some benefit if continued for a sufficient length of time; it may be +given in 2-dram doses, twice a day, for a month or more. The tincture of +digitalis may be given, in cases where the pulse is weak, in doses of 2 +teaspoonfuls three times daily. This remedy should not be continued if +the pulse becomes irregular. General tonics, freedom from excitement or +fatigue, avoidance of bulky food, good ventilation, etc., are indicated.</p> + + +<h4>DILATATION OF THE HEART.</h4> + +<p>This is an enlargement, or stretching, of the cavities of the heart, and +may be confined to one or extend to all. Two forms of dilatation may be +mentioned—simple dilatation, where there is normal thickness of the +walls, and passive, or attenuated, dilatation, where the walls are +simply distended or stretched out without any addition of substance.</p> + +<p><i>Causes.</i>—Any cause producing constant and excessive exertion of the +heart may lead to dilatation. Valvular disease is the most frequent +cause. General anemia predisposes to it by producing relaxation of +muscular fiber. Changes in the muscular tissue of the heart walls, +serous infiltration from pericarditis, myocarditis, fatty degeneration +and infiltration, and atrophy of the muscular fibers may all lead to +dilatation.</p> + +<p><i>Symptoms.</i>—The movements of the heart are feeble and prolonged, a +disposition to staggering or vertigo, dropsy of the limbs, very pale or +very dark-colored membranes, and difficult breathing on the slightest +excitement.</p> + +<p><i>Treatment.</i>—General tonics, rich feed, and rest.</p> + + +<h4>FATTY DEGENERATION OF THE HEART.</h4> + +<p>Fatty degeneration may involve the whole organ, or may be limited to its +walls, or even to circumscribed patches. The latter is situated at the +exterior, and gives it a mottled appearance. When<span class='pagenum'><a name="Page_262" id="Page_262">[Pg 262]</a></span> generally involved it +is flabby or flaccid, and in extreme cases collapses when emptied or +cut. Upon dissection the interior of the ventricles is observed to be +covered with buff-colored spots of a singular zigzag form. This +appearance may be noticed beneath the pericardium, and pervading the +whole thickness of the ventricular walls, and in extreme cases those of +the fleshy columns in the interior of the heart. These spots are found +to be degenerated muscular fibers and colonies of oil globules. Fatty +degeneration is often associated with other morbid conditions of the +heart, such as obesity, dilatation, rupture, aneurism, etc. It may be +connected with fatty diseases of other organs, such as the liver, +kidneys, etc. When it exists alone its presence is seldom suspected +previous to death. It may be secondary to hypertrophy of the heart, to +myocarditis, or to pericarditis. It may be due to deteriorated +conditions of the blood in wasting diseases, excessive hemorrhages, +etc., or to poisoning with arsenic and phosphorus.</p> + +<p><i>Symptoms.</i>—The most prominent symptoms of fatty degeneration are a +feeble action of the heart, a remarkably slow pulse, general debility, +and attacks of vertigo. It may exist for a long time, but is apt to +terminate suddenly in death upon the occurrence of other diseases, +surgical operations, etc. It may involve a liability to sudden death +from rupture of the ventricular walls.</p> + +<p><i>Treatment.</i>—Confinement in feed to oats, wheat or rye bran, and +timothy hay. Twenty drops of sulphuric acid may be given in drinking +water three times a day, and hypophosphite of iron in 2-dram doses, +mixed with the feed, twice a day. Other tonics and stimulants as they +may be indicated.</p> + + +<h4>RUPTURE OF THE HEART.</h4> + +<p>This may occur as the result of some previous disease, such as fatty +degeneration, dilatation with weakness of the muscular walls, etc. It +may be caused by external violence, a crushing fall, pressure of some +great weight, etc. Usually death follows a rupture very quickly, though +an animal may live for some time when the rent is not very large.</p> + + +<h4>WEAKNESS OF THE HEART.</h4> + +<p>This may arise from general debility, the result of exhausting disease, +overwork, or heart strain, or loss of blood. It is indicated by a small, +feeble, but generally regular pulse, coldness of the body, etc.</p> + +<p>Treatment should be directed to support and increase the strength of the +animal by tonics, rest, and nutritious feed. Carbonate of ammonia may be +given to stimulate the heart's action and to prevent the formation of +heart clot.<span class='pagenum'><a name="Page_263" id="Page_263">[Pg 263]</a></span></p> + + +<h4>CONGESTION OF THE HEART</h4> + +<p>Congestion, or an accumulation of the blood in the cavities of the +heart, may occur in consequence of fibrinous deposits interfering with +the free movements of the valves, usually the product of endocarditis or +as a result of excessive muscular exertion.</p> + +<p>Symptoms are great difficulty of breathing, paleness of the visible +mucous membranes, great anxiety, frequently accompanied by a general +tremor and cold perspiration, followed by death. It usually results in +death very quickly.</p> + + +<h4>CYANOSIS OF NEWBORN FOALS.</h4> + +<p>This is a condition sometimes found in foals immediately after birth, +and is due to nonclosure of the foramen ovale, which allows a mixture of +the venous with the arterial blood in the left cavities of the heart. It +is characterized by a dark purple or bluish color of the visible mucous +membranes, shortness of breath, and a general feebleness. Foals thus +affected generally live only a few hours after birth.</p> + + +<h4>DISEASES OF ARTERIES, OR ARTERITIS AND ENDARTERITIS.</h4> + +<p>Inflammation of arteries is rarely observed in the horse as a primary +affection. Direct injuries, such as blows, may produce a contusion and +subsequent inflammation of the wall of an artery; severe muscular strain +may involve an arterial trunk; hypertrophy of the heart, by increasing +arterial tension, may result in the production of a general +endarteritis. Septic infection may affect the inner coat and ultimately +involve all three, or it may be the result of an inflammation in the +vicinity of the vessels, etc. Inflammation of arteries, whatever the +cause may be, often leads to very serious results in the development of +secondary changes in their walls. Arteritis may be acute, subacute, or +chronic; when the inner coat alone is affected it is known as +endarteritis.</p> + +<p><i>Symptoms.</i>—Arteritis is characterized by a painful swelling along the +inflamed vessel, throbbing pulse, coldness of the parts supplied by the +inflamed vessel, sometimes the formation of gangrenous sloughs, +suppuration, abscess, etc. In an inflammation of the iliac arteries we +find coldness and excessive lameness or paralysis of one or both hind +limbs.</p> + +<p><i>Pathology.</i>—In acute arteritis we find swelling along the vessel, loss +of elasticity, friability, and thickening of the walls; a roughness and +loss of gloss of the inner coat, with the formation of coagula or pus in +the vessel. Subacute or chronic arteritis may affect only the outer coat +(periarteritis), both the outer and middle coat, or the inner coat alone +(endarteritis); and by weakening the respective coats leads to rupture, +aneurism, or to degenerations, such as bony, calcareous, fatty, +atheromatous, etc. It may also lead to sclerosis or<span class='pagenum'><a name="Page_264" id="Page_264">[Pg 264]</a></span> increase of fibrous +tissue, especially in the kidneys, when it may result in the condition +known as arterio-capillary fibrosis. Chronic endarteritis is fruitful in +the production of thrombus and atheroma. Arteritis may be limited to +single trunks or it may affect, more or less, all the arteries of the +body. Arteries which are at the seat of chronic endarteritis are liable +to suffer degenerative changes, consisting chiefly of fatty +degeneration, calcification, or the breaking down of the degenerated +tissue, and the formation of erosions or ulcerlike openings in the inner +coat. These erosions are frequently called atheromatous ulcers, and +fragments of tissue from these ulcers may be carried into the +circulation, forming emboli. Fibrinous thrombi are apt to form upon the +roughened surface of the inner coat or upon the surface of the erosions.</p> + +<p>Fatty degeneration and calcification of the middle and outer coats may +occur, and large, hard, calcareous plates project inward, upon which +thrombi may form or may exist in connection with atheroma of the inner +coat. When there is much thickening and increase of new tissue in the +wall of the affected artery it may encroach upon the capacity of the +vessel, and even lead to obliteration. This is often associated with +interstitial inflammation of glandular organs.</p> + +<p><i>Treatment.</i>—Carbonate of potassium in 1-dram doses, to be given in 4 +ounces liquor acetate of ammonia every six hours; scalded bran +sufficient to produce loosening of the bowels, and complete rest; +externally, applications of hot water or hot hop infusion.</p> + + +<h4>ATHEROMA.</h4> + +<p>Atheroma is a direct result of an existing chronic endarteritis, the +lining membrane of the vessels being invariably involved to a greater or +less degree. It is most frequently found in the arteries, although the +veins may develop an atheromatous condition when exposed to any source +of prolonged irritation. Atheroma may affect arteries in any part of the +body; in some instances almost every vessel is diseased, in others only +a few, or even parts of one vessel. It is a very common result of +endocarditis extending into the aorta, which we find perhaps the most +frequent seat of atheroma. As a result of this condition the affected +vessel becomes impaired in its contractile power, loses its natural +strength, and, in consequence of its inability to sustain its accustomed +internal pressure, undergoes in many cases dilatation at the seat of +disease, constituting aneurism. In an atheromatous vessel, calcareous +deposits soon occur, which render it rigid, brittle, and subject to +ulceration or rupture. In such vessels the contractility is destroyed, +the middle coat atrophied and beyond repair. Atheroma in the vessels of +the brain is a frequent cause of cerebral apoplexy. No symptoms are +manifested by which we can recognize this condition during life.<span class='pagenum'><a name="Page_265" id="Page_265">[Pg 265]</a></span></p> + + +<h4>CONSTRICTION OF AN ARTERY.</h4> + +<p>This is usually the result of arteritis, and may partly or wholly be +impervious to the flow of blood. When this occurs in a large vessel it +may be followed by gangrene of the parts; usually, however, collateral +circulation will be established to nourish the parts previously supplied +by the obliterated vessel. In a few instances constriction of the aorta +has produced death.</p> + + +<h4>ANEURISM.</h4> + +<p>Aneurism is usually described as true or false. True aneurism is a +dilatation of the coats of an artery over a larger or smaller part of +its course. Such dilatations are usually due to chronic endarteritis and +atheroma. False aneurism is formed after a puncture of an artery by a +dilatation of the adhesive lymph by which the puncture was united.</p> + +<p><i>Symptoms.</i>—If the aneurism is seated along the neck or a limb it +appears as a tumor in the course of an artery and pulsating with it. The +tumor is round, soft, and compressible, and yields a peculiar +fluctuation upon pressure. By applying the ear over it a peculiar +purring or hissing sound may sometimes be heard. Pulsation, synchronous +with the action of the heart, is the diagnostic symptom. It is of a +slow, expansive, and heavy character, as if the whole tumor were +enlarging under the hand. Aneurisms seated internally may occupy the +cavity of the cranium, chest, or abdomen. As regards the first, little +is known during life, for all the symptoms which they produce may arise +from other causes. Aneurism of the anterior aorta may be situated very +closely to the heart or in the arch, and it is very seldom that we can +distinguish it from disease of the heart. The tumor may encroach upon +the windpipe and produce difficulty in breathing, or it may produce +pressure upon the vena cava or the thoracic duct, obstructing the flow +of blood and lymph. In fact, whatever parts the aneurism may reach or +subject to its pressure, may have their functions suspended or +disturbed. When the tumor in the chest is large, we generally find much +irregularity in the action of the heart; the superficial veins of the +neck are distended, and there is usually dropsical swelling under the +breast and of the limbs. There may be a very troublesome cough without +any evidence of lung affection. Sometimes pulsation of the tumor may be +felt at the lower part of the neck where it joins the chest. When the +aneurism occurs in the posterior aorta no diagnostic symptoms are +appreciable; when it occurs in the internal iliac arteries an +examination per rectum will reveal it.</p> + +<p>There is one form of aneurism which is not infrequently overlooked, +affecting the anterior mesenteric artery, primarily induced by a +worm—<i>Strongylus vulgaris</i>. This worm produces an arteritis, with<span class='pagenum'><a name="Page_266" id="Page_266">[Pg 266]</a></span> +atheroma, degeneration, and dilatation of the mesenteric arteries, +associated with thrombus and aneurism. The aneurism gives rise to colic, +which appears periodically in a very violent and often persistent type. +Ordinary colic remedies have no effect, and after a time the animal +succumbs to the disease. In all cases of animals which are habitually +subject to colicky attacks, parasitic aneurism of the anterior +mesenteric artery may be suspected. (See p. 92.)</p> + +<p><i>Pathology.</i>—Aneurisms may be diffuse or sacculated. The diffuse +consists in a uniform dilatation of all the coats of an artery, so that +it assumes the shape of a cylindrical swelling. The wall of the aneurism +is atheromatous, or calcified; the middle coat may be atrophied. The +sacculated, or circumscribed, aneurism consists either in a dilatation +of the entire circumference of an artery over a short portion of its +length, or in a dilatation of only a small portion of one side of the +wall. Aneurism may become very large; as it increases in size it presses +upon and causes the destruction of neighboring tissues. The cavity of +the aneurismal sac is filled with fluid or clotted blood or with layers +of fibrin which adhere closely to its wall. Death is produced usually by +the pressure and interference of the aneurism with adjoining organs or +by rupture. In worm aneurism we usually find large thrombi within the +aneurismal dilatation of the artery, which sometimes plug the whole +vessel or extend into the aorta. Portions of this thrombus, or clot, may +be washed away and produce embolism of a smaller artery. The effect in +either case is to produce anemia of the intestinal canal, serous or +bloody exudation in its walls, which leads to paralysis of the intestine +and resultant colicky symptoms.</p> + +<p><i>Treatment.</i>—The only treatment advisable is to extirpate or ligate the +tumor above and below.</p> + + +<h4>RUPTURE OF AN ARTERY.</h4> + +<p>Endarteritis, with its subsequent changes in the walls of arteries, is +the primary cause of rupture in the majority of instances. The rupture +may be partial, involving only one or two coats, and will then form an +aneurism. If complete, it may produce death when it involves a large +vessel, especially if it is situated in one of the large cavities +permitting an excessive escape of blood. Rupture may be produced by +mechanical violence or accident.</p> + +<p><i>Symptoms.</i>—In fatal rupture, associated with profuse bleeding, the +animal becomes weak, the visible mucous membranes become blanched, the +breathing hurried or gasping, pupils dilated, staggering in gait, +syncope, death. When the hemorrhage is limited the symptoms may not +become noticeable; if it is near the surface of the body a round or +diffuse swelling or tumor may form, constituting a hygroma. If the +rupture is associated with an external wound, the bleeding artery should +be ligated, or where a bandage is applicable,<span class='pagenum'><a name="Page_267" id="Page_267">[Pg 267]</a></span> pressure may be applied +by tight bandaging. As a secondary result of rupture of an artery we may +have formation of abscess, gangrene of a part, etc.</p> + +<p><i>Treatment.</i>—When rupture of a deep-seated artery is suspected, large +doses of fluid extract of ergot may be given to produce contraction of +the blood vessels. Tannin and iron are also useful. The animal should be +allowed to have as much water as he desires. Afterwards stimulants and +nourishing feed are indicated.</p> + + +<h4>THROMBUS AND EMBOLISM.</h4> + +<p>By thrombosis is generally understood the partial or complete closure of +a vessel by a morbid product developed at the site of the obstruction. +The coagulum, which is usually fibrinous, is known as a thrombus. The +term "embolism" designates an obstruction caused by any body detached +and transported from the interior of the heart or of some vessel. +Thrombi occur as the result of an injury to the wall of the vessel or +may follow its compression or dilatation; they may result from some +alteration of the wall of the vessel by disease or by the retardation of +the circulation. These formations may occur during life, in the heart, +arteries, veins, or in the portal system. When a portion of fibrin +coagulates in one of the arteries and is carried along by the +circulation, it will be arrested, of course, in the capillaries, if not +before; when in the veins, it may not be stopped until it reaches the +lungs; and when in the portal system the capillaries of the liver will +prevent its further progress. The formation of thrombi may act primarily +by causing partial or complete obstruction, and, secondarily, either by +larger or smaller fragments becoming detached from their end and by +being carried along by the circulation of the blood to remote vessels, +embolism; or by the coagulum becoming softened and converted into pus, +constituting suppurative phlebitis. These substances occur most +frequently in those affections characterized by great exhaustion or +debility, such as pneumonia, purpura hemorrhagica, endocarditis, +phlebitis, puerperal fever, hemorrhages, etc. These concretions may form +suddenly and produce instantaneous death by retarding the blood current, +or they may arise gradually, in which case the thrombi may be organized +and attached to the walls of the heart, or they may soften, and +fragments of them (emboli) may be carried away. The small, wartlike +excrescences occurring sometimes in endocarditis may occasionally form a +foundation on which a thrombi may develop.</p> + +<p><i>Symptoms.</i>—When heart clot, or thrombus, exists in the right side, the +return of blood from the body and the aeration in the lungs is impeded, +and if death occurs, it is owing to syncope rather than to strangulation +in pulmonary respiration. There will be hurried and<span class='pagenum'><a name="Page_268" id="Page_268">[Pg 268]</a></span> gasping breathing, +paleness and coldness of the surface of the body, a feeble and +intermittent or fluttering pulse, and fainting. When a fibrinous +coagulum is carried into the pulmonary artery from the right side of the +heart, the indications are a swelling and infiltration of the lungs and +pulmonary apoplexy. When the clot is situated in the left cavities of +the heart or in the aorta, death, if it occurs, takes place either +suddenly or at the end of a few hours from coma.</p> + +<p><i>Pathology.</i>—When a coagulum is observed in the heart it may become a +question whether it was formed during life or after death. The loose, +dark coagula so often found after death are polypi. If the deposition +has taken place during the last moments of life, the fibrin will be +isolated and soft, but not adherent to the walls; if it be isolated, +dense, and adherent or closely intertwined with the muscles of the +papillæ and tendinous cords, the deposition has occurred more or less +remote from the act of dying. Occasionally the fibrin may be seen lining +one of the cavities of the heart, like a false endocardium, or else +forming an additional coat to the aorta or other large vessels without +producing much obstruction. Thrombi, in some instances, soften in their +centers, and are then observed to contain a puslike substance. If this +softening has extended considerably, an outer shell, or cyst, only may +remain. The sources of danger exist not only in the interruption of the +circulation of the blood, but also in a morbid state of the system, +produced by the disturbed nutrition of a limb or organ, as well as the +mingling of purulent and gangrenous elements with the blood.</p> + +<p><i>Treatment.</i>—The urgent symptoms should be relieved by rest, +stimulants, and the use of agents which will act as solvents to the +fibrinous clots. Alkalis are specially useful for this purpose. +Carbonate of ammonia may be administered in all cases of thrombus, and +should be continued for a long time in small doses several times a day. +In cases of great debility associated with a low grade of fever, +stimulants and tonics, and nitro-muriatic acid as an antiseptic, may be +beneficial.</p> + + +<h4>DISEASES OF VEINS, OR PHLEBITIS.</h4> + +<p>Inflammation of veins may be simple or diffuse. In simple phlebitis the +disease of the vein is confined to a circumscribed or limited portion of +a vein; in diffuse it involves the vein for a long distance; it may even +extend from a limb or foot to the heart.</p> + +<p><i>Causes.</i>—Phlebitis may be induced by contusions or direct injuries, an +extension of inflammation from surrounding tissue, such as in abscess, +formation of tumor, or malignant growth. It is often due to embolism of +infective material, gangrenous matter, etc. Blood-letting from the +jugular vein is occasionally followed by dangerous phlebitis.<span class='pagenum'><a name="Page_269" id="Page_269">[Pg 269]</a></span></p> + +<p><i>Symptoms.</i>—The symptoms vary according to the extent and severity of +the inflammation. In most cases the vein is swollen, thickened, and +indurated to such a degree as to resemble an artery. A diffused +swelling, with great tenderness, may extend along the affected vessel +and the animal manifest all the symptoms connected with acute fever and +general functional disturbance.</p> + +<p><i>Pathology.</i>—The disease is only serious when large veins are affected. +The coats undergo the same changes as in arteritis; clots of blood and +lymph plug the inflamed vessel, and, if the inflammatory process +continues, these are converted into pus, which ruptures the vessel and +produces a deep abscess; or it may be carried away in the circulation +and produce metastatic abscess in the lungs or other remote organs. In +mild cases the clots may become absorbed and the vessel restored to +health. Phlebitis in the course of the veins of the limbs frequently +leads to numerous abscesses, which may be mistaken for farcy +ulcerations. A very common result of phlebitis is an obliteration of the +affected portion of the vein, but as collateral circulation is readily +established this is seldom of any material inconvenience.</p> + +<p><i>Treatment.</i>—Phlebitis should be treated by the application of a smart +blister along the course of the inflamed vessel; early opening of any +abscesses which may form; the animal should have complete rest, and the +bowels be kept loose with bran mashes. When the fever runs high, +half-ounce doses of nitrate of potassium may be given in the drinking +water, which may be changed in two or three days for 1-dram doses of the +iodid of potassium. If the animal becomes debilitated, carbonate of +ammonia, 1 dram, and powdered gentian, 3 drams, may be given every six +hours.</p> + + +<h4>VARICOSE VEINS, VARIX, OR DILATATION OF VEINS.</h4> + +<p>This may be a result of weakening of the coats from inflammatory disease +and degeneration. It may also be due to mechanical obstruction from +internal or external sources. It is sometimes found in the vein which +lies superficial over the inside of the hock joint, and may be due to +the pressure of a spavin. Occasionally it may be observed in stallions, +which are more or less subject to varicocele, or dilatation of the veins +of the testicular cord. Hemorrhoidal veins, or piles, are occasionally +met with, generally in horses which run at pasture. Varicose veins may +ulcerate and form an abscess in the surrounding tissues, or they may +rupture from internal blood pressure and the blood form large tumors +where the tissues are soft.</p> + +<p><i>Treatment.</i>—Stallions which manifest a tendency to varicocele should +wear suspensory bags when they are exercised. Piles may often be reduced +by astringent washes—tea made from white-oak bark or a saturated +solution of alum. The bowels should be kept loose with bran mashes and +the animal kept quiet in the stable.<span class='pagenum'><a name="Page_270" id="Page_270">[Pg 270]</a></span> When varicose veins exist +superficially and threaten to produce inconvenience, they may be ligated +above and below and thus obliterated. Sometimes absorption may be +induced by constant bandages.</p> + + +<h4>AIR IN VEINS, OR AIR EMBOLISM.</h4> + +<p>It was formerly supposed that the entrance of air into a vein at the +time of the infliction of a wound or in blood-letting was extremely +dangerous and very often produced sudden death by interfering with the +circulation of the blood through the heart and lungs. Danger from air +embolism is exceedingly doubtful, unless great quantities were forced +into a large vein by artificial means.</p> + + +<h4>PURPURA HEMORRHAGICA.</h4> + +<p>Purpura hemorrhagica usually occurs as a sequel to debilitating +diseases, such as strangles, influenza, etc. It may, however, arise in +the absence of any previous disease in badly ventilated stables, among +poorly fed horses, and in animals subject to exhausting work and extreme +temperatures. The disease is probably due to some as yet undiscovered +infectious principle. Its gravity does not depend so much upon the +amount of blood extravasated as it does upon the disturbance or +diminished action of the vasomotor centers.</p> + +<p><i>Symptoms.</i>—This disease becomes manifested by the occurrence of sudden +swellings on various parts of the body, on the head or lips, limbs, +abdomen, etc. These swellings may be diffused or very markedly +circumscribed, though in the advanced stages they cover large areas. +They pit on pressure and are but slightly painful to the touch. The +limbs may swell to a very large size, the nostrils may become almost +closed, and the head and throat may swell to the point of suffocation. +The swellings not infrequently disappear from one portion of the body +and develop on another, or may recede from the surface and invade the +intestinal mucous membrane. The mucous lining of the nostrils and mouth +show more or less dark-red or purple spots. There may be a discharge of +blood-colored serum from the nostrils; the tongue may be swollen so as +to prevent eating or closing of the jaws. In the most intense cases, +within from twenty-four to forty-eight hours bloody serum may exude +through the skin over the swollen parts, and finally large gangrenous +sloughs may form. The temperature is never very high, the pulse is +frequent and compressible, and becomes feebler as the animal loses +strength. A cough is usually present. The urine is scanty and high +colored, and when the intestines are much affected a bloody diarrhea may +set in, with colicky pains. Some of the internal organs become +implicated in the disease, the lungs may become edematous, extravasation +may occur in the intestinal canal, or effusion of serum into the cavity +of the<span class='pagenum'><a name="Page_271" id="Page_271">[Pg 271]</a></span> chest or abdomen; occasionally the brain becomes affected. A few +cases run a mild course and recovery may commence in three or four days; +generally, however, the outlook is unfavorable. In severe cases septic +poisoning is liable to occur, which soon brings the case to a fatal +issue.</p> + +<p><i>Pathology.</i>—On section we find the capillaries dilated, the connective +tissue filled with a coagulable or coagulated lymph, and frequently we +may discover gangrenous spots beneath the skin or involving the skin. +The lymphatic glands are swollen and inflamed. Extensive extravasations +of blood may be found embedded between the coats of the intestines, or +excessive effusion into the substance of the lungs.</p> + +<p><i>Treatment.</i>—Diffusible stimulants and tonics should be given from the +start. Carbonate of ammonia, 1 dram, fluid extract of red cinchona bark, +2 drams, and tincture of ginger half an ounce, with half a pint of +water; thin gruel or milk should be given every four or six hours. But +especial care should be exercised to avoid injury by drenching. If the +horse has difficulty in getting the head up and swallowing, smaller +doses must be given with a small hard-rubber syringe. Sulphate of iron +in 1-dram doses may be dissolved in water and given every six hours. +Chlorate of potassium, in 2-ounce doses, may be given every eight or +twelve hours. Colloidal silver may be administered intravenously in +doses of from 5 to 12 grains. Washings with lead and alum water are +useful and may be repeated several times each day. If the swellings are +very great, they may be incised freely and the resulting wounds should +be washed at least twice daily with a warm 3 per cent solution of +carbolic acid or other good antiseptic. Tracheotomy may be necessary. +Complications, when they arise, must be treated with proper +circumspection.</p> + + +<h4>DISEASES OF THE LYMPHATIC SYSTEM.</h4> + +<p>The lymphatic, or absorbent, system is connected with the blood-vascular +system, and consists of a series of tubes which absorb and convey to the +blood certain fluids. These tubes lead to lymphatic glands, through +which the fluids pass to reach the right lymphatic vein and thoracic +duct, both of which enter the venous system near the heart. Through the +excessively thin walls of the capillaries the fluid part of the blood +transudes to nourish the tissues outside the capillaries; at the same +time fluid passes from the tissues into the blood. The fluid, after it +passes into the tissues, constitutes the lymph, and acts like a stream +irrigating the tissue elements. Much of the surplus of this lymph passes +into the lymph vessels, which in their commencement can hardly be +treated as independent structures, since their walls are so closely +joined with the tissues through which they<span class='pagenum'><a name="Page_272" id="Page_272">[Pg 272]</a></span> pass, being nothing more +than spaces in the connective tissue until they reach the larger lymph +vessels, which finally empty into lymph glands. These lymph glands are +structures so placed that the lymph flowing toward the larger trunks +passes through them, undergoing a sort of filtration. From the fact of +this arrangement lymph glands are subject to inflammatory diseases in +the vicinity of diseased structures, because infective material being +conveyed in the lymph stream lodges in the glands and produces +irritation.</p> + + +<h4>LOCAL INFLAMMATION AND ABSCESS OF LYMPHATIC GLANDS.</h4> + +<p>Acute inflammation of the lymph glands usually occurs in connection with +some inflammatory process in the region from which its lymph is +gathered. Several or all of the glands in a cluster may become affected, +as in strangles, nasal catarrh, or nasal gleet, diseased or ulcerated +teeth, the lymph glands between the branches of the lower jaw almost +invariably become affected, which may lead to suppuration or induration. +Similar results obtain in other portions of the body; in pneumonia the +bronchial glands become affected; in pharyngitis the postpharyngeal +glands lying above the trachea become affected, etc.</p> + +<p><i>Symptoms.</i>—The glands swell and become painful to the touch, the +connective tissue surrounding them becomes involved, suppuration usually +takes place, and one or more abscesses form. If the inflammation is of a +milder type, resolution may take place and the swelling recede, the +exudative material being absorbed, and the gland restored without the +occurrence of suppuration. In the limbs a whole chain of the glands +along the lymphatic vessels may become affected, as in farcy, phlebitis, +or septic poisoning.</p> + +<p><i>Treatment.</i>—Fomentation with hot water and the application of +camphorated soap liniment or camphorated oil may produce a revulsive +action and prevent suppuration. If there is any indication of abscess +forming, poultices of linseed meal and bran made into a paste with hot +water should be applied, or a mild blistering ointment rubbed in over +the swollen gland. As soon as fluctuation can be felt a free opening +must be made for the escape of the contained pus. The wound may +subsequently be washed out with a solution of chlorid of zinc, 5 grains +to the ounce of water, three times a day.</p> + + +<h4>LYMPHANGITIS.</h4> + +<p>Specific inflammation of the lymphatic structures usually affects the +hind legs; very seldom a fore leg. This disease is very sudden in its +attack, exceedingly painful, accompanied by a high temperature and great +general disturbance.<span class='pagenum'><a name="Page_273" id="Page_273">[Pg 273]</a></span></p> + +<p><i>Causes.</i>—Horses of lymphatic or sluggish temperament are predisposed +to this affection. It usually attacks well-fed animals, and in such +cases may be due to an excess of nutritive elements in the blood. Sudden +changes in work or in the habits of the animal may induce an attack.</p> + +<p><i>Symptoms.</i>—It is usually ushered in by a chill, rise in temperature, +and some uneasiness; in a very short time this is followed by lameness +in one leg and swelling on the inside of the thigh. The swelling +gradually surrounds the whole limb and continues on downward until it +reaches the foot. The limb is excessively tender to the touch, the +animal perspires, the breathing is accelerated, pulse hard and quick, +and the temperature may reach 106° F. The bowels early become very +constipated and urine scanty. The symptoms usually are on the increase +for about two days, then they remain stationary for the same length of +time; the fever then abates; the swelling recedes and becomes less +painful. It is very seldom, though, that all the swelling leaves the +leg; generally it leaves some permanent enlargement, and the animal +becomes subject to recurrent attacks. Occasionally the inguinal +lymphatic glands (in the groin) undergo suppuration, and pyemia may +supervene and prove fatal. In severe cases the limb becomes denuded of +hair in patches, and the skin remains indurated with a fibrous growth, +which is known by the name of elephantiasis.</p> + +<p><i>Treatment.</i>—The parts should be bathed freely and frequently with +water as hot as the hand can bear and then fomented with vinegar and +water, equal parts, to which add 2 ounces of nitrate of potassium for +each gallon. This should be applied frequently, after the hot water, for +the first day. Afterwards the leg may be dried with a woolen cloth and +bathed with camphorated soap liniment. Internally administer artificial +Carlsbad salts in 2 to 4 ounce doses three times daily. Feed lightly and +give complete rest. This treatment, if instituted early in the attack, +very frequently brings about a remarkable change within 24 hours.</p> + + + +<hr style="width: 65%;" /> +<p><span class='pagenum'><a name="Page_274" id="Page_274">[Pg 274]</a></span></p> +<h2>DISEASES OF THE EYE.</h2> + +<h3><span class="smcap">By James Law, F. R. C. V. S.</span>,</h3> + +<h4><i>Formerly Professor of Veterinary Science, etc., Cornell University</i>.</h4> + + +<p>We can scarcely overestimate the value of sound eyes in the horse, and +hence all diseases and injuries which seriously interfere with vision +are matters of extreme gravity and apprehension, for should they prove +permanent they invariably depreciate the selling price to a considerable +extent. A blind horse is always dangerous in the saddle or in single +harness, and he is scarcely less so when, with partially impaired +vision, he sees things imperfectly, in a distorted form or in a wrong +place, and when he shies or avoids objects which are commonplace or +familiar. When we add to this that certain diseases of the eyes, like +recurring inflammation (moon blindness), are habitually transmitted from +parent to offspring, we can realize still more fully the importance of +these maladies. Again, as a mere matter of beauty, a sound, full, clear, +intelligent eye is something which must always add a high value to our +equine friends and servants.</p> + + +<h3>STRUCTURE OF THE EYE.</h3> + +<h5>(Pl. XXII.)</h5> + +<h4>THE EYEBALL.</h4> + +<p>A full description of the structure of the eye is incompatible with our +prescribed limits, and yet a short description is absolutely essential +to the clear understanding of what is to follow.</p> + +<p>The horse's eye is a spheroidal body, flattened behind, and with its +posterior four-fifths inclosed by an opaque, white, strong fibrous +membrane (the sclerotic), on the inner side of which is laid a more +delicate, friable membrane, consisting mainly of blood vessels and +pigment cells (the choroid), which in its turn is lined by the extremely +delicate and sensitive expansion of the nerve of sight (the retina). The +anterior fifth of the globe of the eye bulges forward from what would +have been the direct line of the sclerotic, and thus forms a segment of +a much smaller sphere than is inclosed by the sclerotic. Its walls, too, +have in health a perfect translucency, from which it has derived the +name of transparent cornea. This transparent coat is composed, in the +main, of fibers with lymph interspaces,<span class='pagenum'><a name="Page_275" id="Page_275">[Pg 275]</a></span> and it is to the condition of +these and their condensation and compression that the translucency is +largely due. This may be shown by compressing with the fingers the eye +of an ox which has just been killed, when the clear transparent cornea +will suddenly become clouded over with a whitish-blue opacity, and this +will remain until the compression is interrupted. The interior of the +eye contains three transparent media for the refraction of the rays of +light on their way from the cornea to the visual nerve. Of these media +the anterior one (aqueous humor) is liquid, the posterior (vitreous +humor) is semisolid, and the intermediate one (crystalline lens) is +solid. The space occupied by the aqueous humor corresponds nearly to the +portion of the eye covered by the transparent cornea. It is, however, +divided into two chambers, anterior and posterior, by the iris, a +contractile curtain with a hole in the center (the pupil), and which may +be looked on as in some sense a projection inward of the vascular and +pigmentary coat from its anterior margin at the point where the +sclerotic or opaque outer coat becomes continuous with the cornea or +transparent one. This iris, or curtain, besides its abundance of blood +vessels and pigment, possesses two sets of muscular fibers, one set +radiating from the margin of the pupil to the outer border of the +curtain at its attachment to the sclerotic and choroid, and the other +encircling the pupil in the manner of a ring. The action of the two sets +is necessarily antagonistic, the radiating fibers dilating the pupil and +exposing the interior of the eye to view, while the circular fibers +contract this opening and shut out the rays of light. The form of the +pupil in the horse is ovoid, with its longest diameter from side to +side, and its upper border is fringed by several minute, black bodies +(corpora nigra) projecting forward and serving to some extent the +purpose of eyebrows in arresting and absorbing the excess of rays of +light which fall upon the eye from above. These pigmentary projections +in front of the upper border of the pupil are often mistaken for the +products of disease or injury in place of the normal and beneficent +protectors of the nerve of sight which they are. Like all other parts, +they may become the seat of disease, but so long as they and the iris +retain their clear, dark, aspect, without any tints of brown or yellow, +they may be held to be healthy.</p> + +<p>The vitreous or semisolid refracting medium occupies the posterior part +of the eye—the part corresponding to the sclerotic, choroid, and +retina—and has a consistency corresponding to that of the white of an +egg, and a power of refraction of the light rays correspondingly greater +than the aqueous humor.</p> + +<p>The third or solid refracting medium is a biconvex lens, with its +convexity greatest on its posterior surface, which is lodged in a +depression in the vitreous humor, while its anterior surface corresponds +to the opening of the pupil. It is inclosed in a membranous covering<span class='pagenum'><a name="Page_276" id="Page_276">[Pg 276]</a></span> +(capsule) and is maintained in position by a membrane (suspensory +ligament) which extends from the margin of the lens outward to the +sclerotic at the point of junction of the choroid and iris. This +ligament is, in its turn, furnished with radiating, muscular fibers, +which change the form or position of the lens so as to adapt it to see +with equal clearness objects at a distance or close by.</p> + +<p>Another point which strikes the observer of the horse's eye is that in +the darkness a bright, bluish tinge is reflected from the widely dilated +pupil. This is owing to a comparative absence of pigment in the choroid +coat inside the upper part of the eyeball, and enables the animal to see +and advance with security in darkness where the human eye would be of +little use. The lower part of the cavity of the horse's eye, into which +the dazzling rays fall from the sky, is furnished with an intensely +black lining, by which the rays penetrating the inner nervous layer are +instantly absorbed.</p> + + +<h4>MUSCLES OF THE EYE.</h4> + +<p>These consist of four straight muscles, two oblique, and one retractor. +The straight muscles pass from the depth of the orbit forward on the +inner, outer, upper, and lower sides of the eyeball, and are fixed to +the anterior portion of the fibrous (sclerotic) coat, so that in +contracting singly they respectively turn the eye inward, outward, +upward, and downward. When all act together they draw the eyeball deeply +into its socket. The retractor muscle also consists of four muscular +slips, repeating the straight muscles on a smaller scale, but as they +are only attached on the back part of the eyeball they are less adapted +to roll the eye than to draw it down into its socket. The two oblique +muscles rotate the eye on its own axis, the upper one turning its outer +surface upward and inward, and the lower one turning it downward and +inward.</p> + + +<h4>THE HAW (THE WINKING CARTILAGE, OR CARTILAGO NICTITANS).</h4> + +<p>This is a structure which, like the retractor muscle, is not found in +the eye of man, but it serves in the lower animals to assist in removing +foreign bodies from the front of the eyeball. It consists, in the horse, +of a cartilage of irregular form, thickened inferiorly and posteriorly +where it is intimately connected with the muscles of the eyeball and the +fatty material around them, and expanded and flattened anteriorly where +its upper surface is concave, and, as it were, molded on the lower and +inner surface of the eyeball. Externally it is covered by the mucous +membrane which lines the eyelids and extends over the front of the eye. +In the ordinary restful state of the eye the edge of this cartilage +should just appear as a thin fold of membrane at the inner angle of the +eye, but when the eyeball is drawn deeply into the orbit the cartilage +is pushed forward, outward, and upward<span class='pagenum'><a name="Page_277" id="Page_277">[Pg 277]</a></span> over it until the entire globe +may be hidden from sight. This protrusion of the cartilage so as to +cover the eye may be induced in the healthy eye by pressing the finger +and thumb on the upper and lower lids, so as to cause retraction of the +eyeball into the socket. When foreign bodies, such as sand, dust, and +chaff, or other irritants, have fallen on the eyeball or eyelids it is +similarly projected to push them off, their expulsion being further +favored by a profuse flow of tears.</p> + +<p><a name="PLATE_XXII" id="PLATE_XXII"></a></p> +<div class="figcenter" style="width: 433px;"> +<a href="images/plate22.jpg"><img src="images/plate22t.jpg" width="433" height="450" alt="PLATE XXII." title="" /></a> +<span class="caption">PLATE XXII.<br /> + +DIAGRAMMATIC VERTICAL SECTION THROUGH HORSE'S EYE.</span> +</div> + +<p>This is seen, to a lesser extent, in all painful inflammations of the +eye, and to a very marked degree in lockjaw, when the spasm of the +muscles of the eyeball draws the latter deeply into the orbit and +projects forward the masses of fat and the cartilage. The brutal +practice of cutting off this apparatus whenever it is projected +necessitates this explanation, which it is hoped may save to many a +faithful servant a most valuable appendage. That the cartilage and +membrane may become the seat of disease is undeniable, but so long as +its edge is thin and even and its surface smooth and regular the mere +fact of its projection over a portion or the whole of the eyeball is no +evidence of disease in its substance, nor any warrant for its removal. +It is usually but the evidence of the presence of some pain in another +part of the eye, which the suffering animal endeavors to assuage by the +use of this beneficent provision. For the diseases of the cartilage +itself, see "Encephaloid cancer."</p> + + +<h4>LACRIMAL APPARATUS.</h4> + +<p>This consists, first, of a gland for the secretion of the tears, and, +second, of a series of canals for the conveyance of the superfluous +tears into the cavity of the nose.</p> + +<p>The gland is situated above the outer part of the eyeball, and the tears +which have flowed over the eye and reached the inner angle are there +directed by a small, conical papilla (lacrimal caruncle) into two minute +orifices, and thence by two ducts (lacrimal) to a small pouch (lacrimal +sac) from which a canal leads through the bones of the face into the +nose. This opens in the lower part of the nose on the floor of the +passage and a little outside the line of union of the skin which lines +the false nostril with the mucous membrane of the nose. In the ass and +mule this opening is situated on the roof instead of the floor of the +nose, but still close to the external opening.</p> + + +<h4>EXAMINATION OF THE EYE.</h4> + +<p>To avoid unnecessary repetition the following general directions are +given for the examination of the eye: The eye, and to a certain extent +the mucous membrane lining the eyelids, may be exposed to view by gently +parting the eyelids with the thumb and forefinger pressed on the middle +of the respective lids. The pressure, it is true, causes<span class='pagenum'><a name="Page_278" id="Page_278">[Pg 278]</a></span> the protrusion +of the haw over a portion of the lower and inner part of the eye, but by +gentleness and careful graduation of the pressure this may be kept +within bounds, and oftentimes even the interior of the eye can be seen. +As a rule it is best to use the right hand for the left eye, and the +left hand for the right, the finger in each case being pressed on the +upper lid while the thumb depresses the lower one. In cases in which it +is desirable to examine the inner side of the eyelid further than is +possible by the above means, the upper lid may be drawn down by the +eyelashes with the one hand and then everted over the tip of the +forefinger of the other hand, or over a probe laid flat against the +middle of the lid. When the interior of the eye must be examined it is +useless to make the attempt in the open sunshine or under a clear sky. +The worst cases, it is true, can be seen under such circumstances, but +for the slighter forms the horse should be taken indoors, where all +light from above will be shut off, and should be placed so that the +light may fall on the eye from the front and side. Then the observer, +placing himself in front of the animal, will receive the reflected rays +from the cornea, the front of the lens and the back, and can much more +easily detect any cloudiness, opacity, or lack of transparency. The +examination can be made much more satisfactory by placing the horse in a +dark chamber and illuminating the eye by a lamp placed forward and +outward from the eye which is to be examined. Any cloudiness is thus +easily detected, and any doubt may be resolved by moving the lamp so +that the image of the flame may be passed in succession over the whole +surface of the transparent cornea and of the crystalline lens. Three +images of the flame will be seen, the larger one upright, reflected from +the anterior surface of the eye; a smaller one upright, reflected from +the anterior surface of the lens; and a second small one inverted from +the back surface of the lens.</p> + +<p>So long as these images are reflected from healthy surfaces they will be +clear and perfect in outline, but as soon as one strikes on an area of +opacity it will become diffused, cloudy, and indefinite. Thus, if the +large, upright image becomes hazy and imperfect over a particular spot +of the cornea, that will be found to be the seat of disease and opacity. +Should the large image remain clear, but the small upright one become +diffuse and indefinite over a given point, it indicates opacity on the +front of the capsule of the lens. If both upright images remain clear +while the inverted one becomes indistinct at a given point, then the +opacity is in the substance of the lens itself or in the posterior part +of its capsule.</p> + +<p>If in a given case the pupil remains so closely contracted that the +deeper parts of the eye can not be seen, the eyelids may be rubbed with +extract of belladonna, and in a short time the pupil will be found +widely dilated.<span class='pagenum'><a name="Page_279" id="Page_279">[Pg 279]</a></span></p> + + +<h3>DISEASES OF THE EYELIDS.</h3> + + +<h4>CONGENITAL DISORDERS.</h4> + +<p>Some faulty conditions of the eyelids are congenital, as division of an +eyelid in two, after the manner of harelip, abnormally small opening +between the lids, often connected with imperfect development of the eye, +and closure of the lids by adhesion. The first is to be remedied by +paring the edges of the division and then bringing them together, as in +torn lids. The last two, if remediable at all, require separation by the +knife, and subsequent treatment with a cooling astringent eyewash.</p> + + +<h4>NERVOUS DISORDERS.</h4> + +<p><span class="smcap">Spasm of eyelids</span> may be owing to constitutional susceptibility, or to +the presence of local irritants (insects, chemical irritants, sand, +etc.) in the eye, to wounds or inflammation of the mucous membrane, or +to disease of the brain. When due to local irritation it may be +temporarily overcome by instilling a few drops of a 4 per cent solution +of cocaine into the eye, when the true cause may be ascertained and +removed. The nervous or constitutional disease must be treated according +to its nature.</p> + +<p><span class="smcap">Drooping eyelids, or ptosis.</span>—This is usually present in the upper lid, +or is at least little noticed in the lower. It is sometimes but a +symptom of paralysis of one-half of the face, in which case the ear, +lips, and nostrils on the same side will be found soft, drooping, and +inactive, and even the half of the tongue may partake of the palsy. If +the same condition exists on both sides, there is difficult, snuffling +breathing, from the air drawing in the flaps of the nostrils in +inspiration, and all feed is taken in by the teeth, as the lips are +useless. In both there is a free discharge of saliva from the mouth +during mastication. This paralysis is a frequent result of injury, by a +poke, to the seventh nerve, as it passes over the back of the lower jaw. +In some cases the paralysis is confined to the lid, the injury having +been sustained by the muscles which raise it, or by the supraorbital +nerve, which emerges from the bone just above the eye. Such injury to +the nerve may have resulted from fracture of the orbital process of the +frontal bone above the eyeball.</p> + +<p>The condition may, however, be due to spasm of the sphincter muscle, +which closes the lids, or to inflammation of the upper lid, usually a +result of blows on the orbit. In the latter case it may run a slow +course with chronic thickening of the lid.</p> + +<p>The paralysis due to the poke may be often remedied, first, by the +removal of any remaining inflammation by a wet sponge worn beneath the +ear and kept in place by a bandage; secondly, when all inflammation has +passed, by a blister on the same region, or by rubbing<span class='pagenum'><a name="Page_280" id="Page_280">[Pg 280]</a></span> it daily with a +mixture of olive oil and strong aqua ammonia in equal proportions. +Improvement is usually slow, and it may be months before complete +recovery ensues.</p> + +<p>In paralysis from blows above the eyes the same treatment may be applied +to that part.</p> + +<p>Thickening of the lid may be treated by painting with tincture of iodin, +and that failing, by cutting out an elliptical strip of the skin from +the middle of the upper lid and stitching the edges together.</p> + + +<h4>INFLAMMATION OF THE EYELIDS.</h4> + +<p>The eyelids suffer more or less in all severe inflammations of the eye, +whether external or internal, but inasmuch as the disease sometimes +starts in the lids and at other times is exclusively confined to them, +it deserves independent mention.</p> + +<p>Among the causes may be named: Exposure to drafts of cold air, or to +cold rain or snow storms; the bites or stings of mosquitoes, flies, or +other insects; snake bites, pricks with thorns, blows of whip or club; +accidental bruises against the stall or ground, especially during the +violent struggles of colic, enteritis, phrenitis (staggers), and when +thrown for operations. It is also a result of infecting inoculations, as +of erysipelas, anthrax, boil, etc., and is noted by Leblanc as +especially prevalent among horses kept on low, marshy pastures. Finally, +the introduction of sand, dust, chaff, beards of barley and seeds of the +finest grasses, and the contact with irritant, chemical powders, +liquids, and gases (ammonia from manure or factory, chlorin, strong +sulphur fumes, smoke, and other products of combustion, etc.) may start +the inflammation. The eyelids often undergo extreme inflammatory and +dropsical swelling in urticaria (nettlerash, surfeit) and in the general +inflammatory dropsy known as purpura hemorrhagica.</p> + +<p>The affection will, therefore, readily divide itself into (1) +inflammations due to constitutional causes; (2) those due to direct +injury, mechanical or chemical; and (3) such as are due to inoculation +with infecting material.</p> + +<p>(1) Inflammations due to constitutional causes are distinguished by the +absence of any local wound, and the history of a low, damp pasture, +exposure, indigestion from unwholesome feed, or the presence elsewhere +on the limbs or body of the general, doughy swellings of purpura +hemorrhagica. The lids are swollen and thickened; it may be slightly or +it may be so extremely that the eyeball can not be seen. If the lid can +be everted to show its mucous membrane, that is seen to be of a deep-red +color, especially along the branching lines of the blood vessels. The +part is hot and painful, and a profuse flow of tears and mucus escapes +on the side of the face, causing irritation<span class='pagenum'><a name="Page_281" id="Page_281">[Pg 281]</a></span> and loss of the hair. If +improvement follows, this discharge becomes more tenacious, and tends to +cause adhesion to the edges of the upper and lower lids and to mat +together the eyelashes in bundles. This gradually decreases to the +natural amount, and the redness and congested appearance of the eye +disappears, but swelling, thickening, and stiffness of the lids may +continue for a time. There may be more or less fever according to the +violence of the inflammation, but so long as there is no serious disease +of the interior of the eye or of other vital organ, it is usually +moderate.</p> + +<p>The local treatment consists in astringent, soothing lotions (sugar of +lead 30 grains, laudanum 2 teaspoonfuls, rain water—boiled and +cooled—1 pint), applied with a soft cloth kept wet with the lotion, and +hung over the eye by tying it to the headstall of the bridle on the two +sides. If the mucous membrane lining of the lids is the seat of little +red granular elevations, a drop of solution of 2 grains of nitrate of +silver in an ounce of distilled water should be applied with the soft +end of a clean feather to the inside of the lid twice a day. The patient +should be removed from all such conditions (pasture, faulty feed, +exposure, etc.) as may have caused or aggravated the disease, and from +dust and irritant fumes and gases. He should be fed from a manger high +enough to favor the return of blood from the head, and should be kept +from work, especially in a tight collar which would prevent the descent +of blood by the jugular veins. The diet should be laxative and +nonstimulating (grass, bran mashes, carrots, turnips, beets, potatoes, +or steamed hay), and any costiveness should be corrected by a mild dose +of raw linseed oil (1 to 1-1/2 pints). In cold weather warm blanketing +may be needful, and even loose flannel bandages to the limbs, but heat +should never be sought at the expense of pure air.</p> + +<p>(2) In inflammations due to local irritants of a noninfective kind a +careful examination will usually reveal their presence, and the first +step must be their removal with a pair of blunt forceps or the point of +a lead pencil. Subsequent treatment will be in the main the local +treatment advised above.</p> + +<p>(3) In case of infective inflammation there will often be found a prick +or tear by which the septic matter has entered, and in such case the +inflammation will for a time be concentrated at that point. A round or +conical swelling around an insect bite is especially characteristic. A +snake bite is marked by the double prick made by the two teeth and by +the violent and rapidly spreading inflammation. Erysipelas is attended +with much swelling, extending beyond the lids and causing the mucous +membrane to protrude beyond the edge of the eyelid (chemosis). This is +characterized by a bright, uniform, rosy red, disappearing on pressure, +or later by a dark, livid hue, but with less branching redness than in +noninfecting inflammation and<span class='pagenum'><a name="Page_282" id="Page_282">[Pg 282]</a></span> less of the dark, dusky, brownish or +yellowish tint of anthrax. Little vesicles may appear on the skin, and +pus may be found without any distinct limiting membrane, as in abscess. +It is early attended with high fever and marked general weakness and +inappetence. Anthrax of the lids is marked by a firm swelling, +surmounted by a blister, with bloody serous contents, which tends to +burst and dry up into a slough, while the surrounding parts become +involved in the same way. Or it may show as a diffuse, dropsical +swelling, with less of the hard, central sloughing nodule, but, like +that, tending to spread quickly. In both cases alike the mucous membrane +and the skin, if white, assumes a dusky-brown or yellowish-brown hue, +which is largely characteristic. This may pass into a black color by +reason of extravasation of blood. Great constitutional disturbance +appears early, with much prostration and weakness and generalized +anthrax symptoms.</p> + +<p><i>Treatment.</i>—The treatment will vary according to the severity. Insect +bites may be touched with a solution of equal parts of glycerin and aqua +ammonia, or a 10 per cent solution of carbolic acid in water. Snake +bites may be bathed with aqua ammonia, and the same agent given in doses +of 2 teaspoonfuls in a quart of water, or alcohol may be given in pint +or quart doses, according to the size of the animal. In erysipelas the +skin may be painted with tincture of chlorid of iron, or with a solution +of 20 grains of iodin in an ounce of carbolic acid, and one-half an +ounce of tincture of chlorid of iron may be given thrice daily in a +bottle of water. In anthrax the swelling should be painted with tincture +of iodin, or of the mixture of iodin and carbolic acid, and if very +threatening it may have the tincture of iodin injected into the swelling +with a hypodermic syringe, or the hard mass may be freely incised to its +depth with a sharp lancet and the lotion applied to the exposed tissues. +Internally, iodid of potassium may be given in doses of 2 drams thrice a +day, or tincture of the chlorid of iron every four hours.</p> + + +<h4>STY, OR FURUNCLE (BOIL) OF THE EYELID.</h4> + +<p>This is an inflammation of limited extent, advancing to the formation of +matter and the sloughing out of a small mass of the natural tissue of +the eyelid. It forms a firm, rounded swelling, usually near the margin +of the lid, which suppurates and bursts in four or five days. Its course +may be hastened by a poultice of camomile flowers, to which have been +added a few drops of carbolic acid, the whole applied in a very thin +muslin bag. If the swelling is slow to open after having become +yellowish white, it may be opened by a lancet, the incision being made +at right angles to the margin of the lid.<span class='pagenum'><a name="Page_283" id="Page_283">[Pg 283]</a></span></p> + + +<h4>ENTROPION AND ECTROPION, OR INVERSION AND EVERSION OF THE EYELID.</h4> + +<p>These are respectively caused by wounds, sloughs, ulcers, or other +causes of loss of substance of the mucous membrane on the inside of the +lid and of the skin on the outside; also of tumors, skin diseases, or +paralysis which leads to displacement of the margin of the eyelid. As a +rule, they require a surgical operation, with removal of an elliptical +portion of the mucous membrane or skin, as the case may be, but which +requires the skilled and delicate hand of the surgeon.</p> + + +<h4>TRICHIASIS.</h4> + +<p>This consists in the turning in of the eyelashes so as to irritate the +front of the eye. If a single eyelash, it may be snipped off with +scissors close to the margin of the eyelid or pulled out by the root +with a pair of flat-bladed forceps. If the divergent lashes are more +numerous, the treatment may be as for entropion, by excising an +elliptical portion of skin opposite the offending lashes and stitching +the edges together, so as to draw outward the margin of the lid at that +point.</p> + + +<h4>WARTS AND OTHER TUMORS OF THE EYELIDS.</h4> + +<p>The eyelids form a favorite site for tumors, and above all, warts, which +consist in a simple diseased overgrowth (hypertrophy) of the surface +layers of the skin. If small, they may be snipped off with scissors or +tied around the neck with a stout, waxed thread and left to drop off, +the destruction being completed, if necessary, by the daily application +of a piece of sulphate of copper (blue vitriol), until any unhealthy +material has been removed. If more widely spread, the wart may still be +clipped off with curved scissors or knife, and the caustic thoroughly +applied day by day.</p> + +<p>A bleeding wart, or erectile tumor, is more liable to bleed, and is best +removed by constricting its neck with the waxed cord or rubber band, or +if too broad it may be transfixed through its base by a needle armed +with a double thread, which is then to be cut in two and tied around the +two portions of the neck of the tumor. If still broader, the armed +needle may be carried through the base of the tumor at regular +intervals, so that the whole may be tied in moderately sized sections.</p> + +<p>In gray and in white horses black, pigmentary tumors (melanotic) are +common on the black portions of skin, such as the eyelids, and are to be +removed by scissors or knife, according to their size. In the horse they +do not usually tend to recur when thoroughly removed, but at times they +prove cancerous (as is the rule in man), and then they tend to reappear +in the same site or in internal organs with, it may be, fatal effect.<span class='pagenum'><a name="Page_284" id="Page_284">[Pg 284]</a></span></p> + +<p>Encysted, honeylike (melicerous), sebaceous, and fibrous tumors of the +lids all require removal with the knife.</p> + + +<h4>TORN EYELIDS OR WOUNDS OF EYELIDS.</h4> + +<p>The eyelids are torn by attacks with horns of cattle, or with the teeth, +or by getting caught on nails in stall, rack, or manger, on the point of +stumps, fences, or fence rails, on the barbs of wire fences, and on +other pointed bodies. The edges should be brought together as promptly +as possible, so as to effect union without the formation of matter, +puckering of the skin, and unsightly distortions. Great care is +necessary to bring the two edges together evenly without twisting or +puckering. The simplest mode of holding them together is by a series of +sharp pins passed through the lips of the wound at intervals of not more +than a third of an inch, and held together by a thread twisted around +each pin in the form of the figure 8, and carried obliquely from pin to +pin in two directions, so as to prevent gaping of the wound in the +intervals. The points of the pins may then be cut off with scissors, and +the wound may be wet twice a day with a weak solution of carbolic acid.</p> + + +<h4>TUMOR OF THE HAW, OR CARIES OF THE CARTILAGE.</h4> + +<p>Though cruelly excised for alleged "hooks," when itself perfectly +healthy, in the various diseases which lead to retraction of the eye +into its socket, the haw may, like other bodily structures, be itself +the seat of actual disease. The pigmentary, black tumors of white horses +and soft (encephaloid) cancer may attack this part primarily or extend +to it from the eyeball or eyelids; hairs have been found growing from +its surface, and the mucous membrane covering it becomes inflamed in +common with that covering the front of the eye. These inflammations are +but a phase of the inflammation of the external structures of the eye, +and demand no particular notice nor special treatment. The tumors lead +to such irregular enlargement and distortion of the haw that the +condition is not to be confounded with the simple projection of the +healthy structure over the eye when the lids are pushed apart with the +finger and thumb, and the same remark applies to the ulceration, or +caries, of the cartilage. In the latter case, besides the swelling and +distortion of the haw, there is this peculiarity, that in the midst of +the red inflamed mass there appears a white line or mass formed by the +exposed edge of the ulcerating cartilage. The animal having been thrown +and properly fixed, an assistant holds the eyelids apart while the +operator seizes the haw with forceps or hook and carefully dissects it +out with blunt-pointed scissors. The eye is then covered with a cloth, +kept wet with an eyewash, as for external ophthalmia.<span class='pagenum'><a name="Page_285" id="Page_285">[Pg 285]</a></span></p> + + +<h4>OBSTRUCTION OF THE LACRIMAL APPARATUS, OR WATERING EYE.</h4> + +<p>The escape of tears on the side of the cheek is a symptom of external +inflammation of the eye, but it may also occur from any disease of the +lacrimal apparatus which interferes with the normal progress of the +tears to the nose; hence, in all cases when this symptom is not attended +with special redness or swelling of the eyelids, it is well to examine +the lacrimal apparatus. In some instances the orifice of the lacrimal +duct on the floor of the nasal chamber and close to its anterior outlet +will be found blocked by a portion of dry mucopurulent matter, on the +removal of which tears may begin to escape. This implies an inflammation +of the canal, which may be helped by occasional sponging out of the nose +with warm water, and the application of the same on the face. Another +remedy is to feed warm mashes of wheat bran from a nosebag, so that the +relaxing effects of the water vapor may be secured.</p> + +<p>The two lacrimal openings, situated at the inner angle of the eye, may +fail to admit the tears by reason of their deviation outward in +connection with the eversion of the lower lid or by reason of their +constriction in inflammation of the mucous membrane. The lacrimal sac, +into which the lacrimal ducts open, may fail to discharge its contents +by reason of constriction or closure of the duct leading to the nose, +and it then forms a rounded swelling beneath the inner angle of the eye. +The duct leading from the sac to the nose may be compressed or +obliterated by fractures of the bones of the face, and in disease of +these bones (osteosarcoma, so-called osteoporosis, diseased teeth, +glanders of the nasal sinuses, abscess of the same cavities).</p> + +<p>The narrowed or obstructed ducts may be made pervious by a fine, silver +probe passed down to the lacrimal sac, and any existing inflammation of +the passages may be counteracted by the use of steaming mashes of wheat +bran, by fomentations or wet cloths over the face, and even by the use +of astringent eyewashes and the injection of similar liquids into the +lacrimal canal from its nasal opening. The ordinary eyewash may be used +for this purpose, or it may be injected after dilution to half its +strength. The fractures and diseases of the bones and teeth must be +treated according to their special demands when, if the canal is still +left pervious, it may be again rendered useful.</p> + + +<h4>EXTERNAL OPHTHALMIA, OR CONJUNCTIVITIS.</h4> + +<p>In inflammation of the outer parts of the eyeball the exposed vascular +and sensitive mucous membrane (conjunctiva) which covers the ball, the +eyelids, the haw, and the lacrimal apparatus, is usually the most deeply +involved, yet adjacent parts are more or less implicated, and when +disease is concentrated on these contiguous parts it constitutes<span class='pagenum'><a name="Page_286" id="Page_286">[Pg 286]</a></span> a +phase of external opththalmia which demands a special notice. These have +accordingly been already treated of.</p> + +<p><i>Causes.</i>—The causes of external opththalmia are mainly those that act +locally—blows with whips, clubs, and twigs, the presence of foreign +bodies, like hayseed, chaff, dust, lime, sand, snuff, pollen of plants, +flies attracted by the brilliancy of the eye, wounds of the bridle, the +migration of the scabies (mange) insect into the eye, smoke, ammonia +arising from the excretions, irritant emanations from drying marshes, +etc. Road dust containing infecting microbes is a common factor. A very +dry air is alleged to act injuriously by drying the eye as well as by +favoring the production of irritant dust; the undue exposure to bright +sunshine through a window in front of the stall, or to the reflection +from snow or water, also is undoubtedly injurious. The unprotected +exposure of the eyes to sunshine through the use of a very short +overdraw check is to be condemned, and the keeping of the horse in a +very dark stall, from which it is habitually led into the glare of full +sunlight, intensified by reflection from snow or white limestone, must +be set down among the locally acting causes. Exposure to cold and wet, +to wet and snow storms, to cold drafts and wet lairs must also be +accepted as causes of conjunctivitis, the general disorder which they +produce affecting the eye, if that happens to be the weakest and most +susceptible organ of the body, or if it has been subjected to any +special local injury, like dust, irritant gases, or excess of light. +Again, external opththalmia is a constant concomitant of inflammation of +the contiguous and continuous mucous membranes, as those of the nose and +throat—hence the red, watery eyes that attend on nasal catarrh, sore +throat, influenza, strangles, nasal glanders, and the like. In such +cases, however, the affection of the eye is subsidiary and is manifestly +overshadowed by the primary and predominating disease.</p> + +<p><i>Symptoms.</i>—The symptoms are watering of the eye, swollen lids, redness +of the mucous membrane exposed by the separation of the lids—it may be +a mere pink blush with more or less branching redness, or it may be a +deep, dark red, as from effusion of blood—and a bluish opacity of the +cornea, which is normally clear and translucent. Except when resulting +from wounds and actual extravasation of blood, however, the redness is +seen to be superficial, and if the opacity is confined to the edges, and +does not involve the entire cornea, the aqueous humor behind is seen to +be still clear and limpid. The fever is always less severe than in +internal ophthalmia, and runs high only in the worst cases. The eyelids +may be kept closed, the eyeball retracted, and the haw protruded over +one-third or one-half of the ball, but this is due to the pain only and +not to any excessive sensibility to light, as shown by the comparatively +widely dilated pupil. In internal ophthalmia, on the contrary, the +narrow, contracted pupil is<span class='pagenum'><a name="Page_287" id="Page_287">[Pg 287]</a></span> the measure of the pain caused by the +falling of light on the inflamed and sensitive optic nerve (retina) and +choroid.</p> + +<p>If the affection has resulted from a wound of the cornea, not only is +that the point of greatest opacity, forming a white speck or fleecy +cloud, but too often blood vessels begin to extend from the adjacent +vascular covering of the eye (sclerotic) to the white spot, and that +portion of the cornea is rendered permanently opaque. Again, if the +wound has been severe, though still short of cutting into the anterior +layers of the cornea, the injury may lead to ulceration that may +penetrate more or less deeply and leave a breach in the tissue which, if +filled up at all, is repaired by opaque fibrous tissue in place of the +transparent cellular structure. Pus may form, and the cornea assumes a +yellowish tinge and bursts, giving rise to a deep sore which is liable +to extend as an ulcer, and may be in its turn followed by bulging of the +cornea at that point (staphyloma). This inflammation of the conjunctiva +may be simply catarrhal, with profuse mucopurulent discharge; it may be +granular, the surface being covered with minute reddish elevations, or +it may become the seat of a false membrane (diphtheria).</p> + +<p><i>Treatment.</i>—In treating external ophthalmia the first object is the +removal of the cause. Remove any dust, chaff, thorn, or other foreign +body from the conjunctiva, purify the stable from all sources of +ammoniacal or other irritant gas; keep the horse from dusty roads, and, +above all, from the proximity of a leading wagon and its attendant cloud +of dust; remove from pasture and feed from a rack which is neither so +high as to drop seeds, etc., into the eyes nor so low as to favor the +accumulation of blood in the head; avoid equally excess of light from a +sunny window in front of the stall and excess of darkness from the +absence of windows; preserve from cold drafts and rains and wet bedding, +and apply curative measures for inflammation of the adjacent mucous +membranes or skin. If the irritant has been of a caustic nature, remove +any remnant of it by persistent bathing with tepid water and a soft +sponge, or with water mixed with white of egg, or a glass filled with +the liquid may be inverted over the eye so that its contents may dilute +and remove the irritant. If the suffering is very severe, a lotion with +a few grains of extract of belladonna or of morphia in an ounce of water +may be applied, or, if it is available, a few drops of 4 per cent +solution of cocaine may be instilled into the eye.</p> + +<p>In strong, vigorous patients benefit will usually be obtained from a +laxative, such as 2 tablespoonfuls of Glauber's salt daily, and if the +fever runs high from a daily dose of half an ounce of saltpeter. As +local applications, astringent solutions are usually the best, as 30 +grains of borax or of sulphate of zinc in a quart of water, to be +applied constantly on a cloth, as advised under "Inflammation of the<span class='pagenum'><a name="Page_288" id="Page_288">[Pg 288]</a></span> +eyelids." In the absence of anything better, cold water may serve every +purpose. Above all, adhesive and oily agents (molasses, sugar, fats) are +to be avoided, as only adding to the irritation. By way of suggesting +agents that may be used with good effect, salt and sulphate of soda may +be named, in solutions double the strength of sulphate of zinc, or 7 +grains of nitrate of silver may be added to a quart of distilled water, +and will be found especially applicable in granular conjunctivitis, +diphtheria, or commencing ulceration. A cantharides blister (1 part of +Spanish fly to 4 parts lard) may be rubbed on the side of the face 3 +inches below the eye, and washed off next morning with soapsuds and +oiled daily till the scabs are dropped.</p> + + +<h4>WHITE SPECKS AND CLOUDINESS OF THE CORNEA.</h4> + +<p>As a result of external ophthalmia, opaque specks, clouds, or haziness +are too often left on the cornea and require for their removal that they +be daily touched with a soft feather dipped in a solution of 3 grains +nitrate of silver in 1 ounce distilled water. This should be applied +until all inflammation has subsided, and until its contact is +comparatively painless. It is rarely successful with an old, thick scar +following an ulcer, nor with an opacity having red blood vessels running +across it.</p> + + +<h4>ULCERS OF THE CORNEA.</h4> + +<p>These may be treated with nitrate of silver lotion of twice the strength +used for opacities. Powdered gentian, one-half ounce, and sulphate of +iron, one-fourth ounce, daily, may improve the general health and +increase the reparatory power.</p> + + +<h4>INTERNAL OPHTHALMIA (IRITIS, CHOROIDITIS, AND RETINITIS).</h4> + +<p>Although inflammations of the iris, choroid, and retina—the inner, +vascular, and nervous coats of the eye—occur to a certain extent +independently of each other, yet one usually supervenes upon the other, +and, as the symptoms are thus made to coincide, it will be best for our +present purposes to treat the three as one disease.</p> + +<p><i>Causes.</i>—The causes of internal ophthalmia are largely those of the +external form only, acting with greater intensity or on a more +susceptible eye. Severe blows, bruises, punctures, etc., of the eye, the +penetration of foreign bodies into the eye (thorns, splinters of iron, +etc.), sudden transition from a dark stall to bright sunshine, to the +glare of snow or water, constant glare from a sunny window, abuse of the +overdraw checkrein, vivid lightning flashes, drafts of cold, damp air; +above all, when the animal is perspiring, exposure in cold rain or +snowstorms, swimming cold rivers; also certain general diseases like +rheumatism, arthritis, influenza, and disorders of the<span class='pagenum'><a name="Page_289" id="Page_289">[Pg 289]</a></span> digestive +organs, may become complicated by this affection. From the close +relation between the brain and eye—alike in the blood vessels and +nerves—disorders of the first lead to affection of the second, and the +same remark applies to the persistent irritation to which the jaws are +subjected in the course of dentition. So potent is the last agency that +we dread a recurrence of ophthalmia so long as dentition is incomplete, +and hope for immunity if the animal completes its dentition without any +permanent structural change in the eye.</p> + +<p><i>Symptoms.</i>—The symptoms will vary according to the cause. If the +attack is due to direct physical injury, the inflammation of the eyelids +and superficial structures may be quite as marked as that of the +interior of the eye. If, on the other hand, from general causes, or as a +complication of some distant disease, the affection may be largely +confined to the deeper structures, and the swelling, redness, and +tenderness of the superficial structures will be less marked. When the +external coats thus comparatively escape, the extreme anterior edge of +the white or sclerotic coat, where it overlaps the border of the +transparent cornea, is in a measure free from congestion, and, in the +absence of the obscuring dark pigment, forms a whitish ring around the +cornea. This is partly due to the fact that a series of arteries +(ciliary) passing to the inflamed iris penetrate the sclerotic coat a +short distance behind its anterior border, and there is therefore a +marked difference in color between the general sclerotic occupied +between these congested vessels and the anterior rim from which they are +absent. Unfortunately, the pigment is often so abundant in the anterior +part of the sclerotic as to hide this symptom. In internal ophthalmia +the opacity of the cornea may be confined to a zone around the outer +margin of the cornea, and even this may be a bluish haze rather than a +deep, fleecy white. In consequence it becomes impossible to see the +interior of the chamber for the aqueous humor and the condition of the +iris and pupil. The aqueous humor is usually turbid, and has numerous +yellowish-white flakes floating on its substance or deposited in the +lower part of the chamber, so as to cut off the view of the lower +portion of the iris. The still visible portion of the iris has lost its +natural, clear, dark luster, which is replaced by a brownish or +yellowish sere-leaf color. This is more marked in proportion as the iris +is inflamed, and less so as the inflammation is confined to the choroid. +The quantity of flocculent deposit in the chamber of the aqueous humor +is also in direct ratio to the inflammation of the iris. Perhaps the +most marked feature of internal ophthalmia is the extreme and painful +sensitiveness to light. On this account the lids are usually closed, but +when opened the pupil is seen to be narrowly closed, even if the animal +has been kept in a darkened stall. Exceptions to this are seen when +inflammatory effusion<span class='pagenum'><a name="Page_290" id="Page_290">[Pg 290]</a></span> has overfilled the globe of the eye, and by +pressure on the retina has paralyzed it, or when the exudation into the +substance of the retina itself has similarly led to its paralysis. Then +the pupil may be dilated, and frequently its margin loses its regular, +ovoid outline and becomes uneven by reason of the adhesions which it has +contracted with the capsule of the lens, through its inflammatory +exudations. In the case of excessive effusion into the globe of the eye +that is found to have become tense and hard so that it can not be +indented with the tip of the finger, paralysis of the retina is liable +to result. With such paralysis of the retina, vision is heavily clouded +or entirely lost; hence, in spite of the open pupil, the finger may be +approached to the eye without the animal's becoming conscious of it +until it touches the surface, and if the nose on the affected side is +gently struck and a feint made to repeat the blow the patient makes no +effort to evade it. Sometimes the edges of the contracted pupil become +adherent to each other by an intervening plastic exudation, and the +opening becomes virtually abolished. In severe inflammations pus may +form in the choroid or iris, and escaping into the cavity of the aqueous +humor show as a yellowish-white stratum below. In nearly all cases there +is resulting exudation into the lens or its capsule, constituting a +cloudiness or opacity (cataract), which in severe and old-standing cases +appears as a white, fleecy mass behind a widely dilated pupil. In the +slighter cases cataract is to be recognized by examination of the eye in +a dark chamber, with an oblique side light, as described in the +introduction to this article. Cataracts that appear as a simple haze or +indefinite, fleecy cloud are usually on the capsule (capsular), while +those that show a radiating arrangement are in the lens (lenticular), +the radiating fibers of which the exudate follows. Black cataracts are +formed by the adhesion of the pigment on the back of the iris to the +front of the lens, and by the subsequent tearing loose of the iris, +leaving a portion of its pigment adherent to the capsule of the lens. If +the pupil is so contracted that it is impossible to see the lens, it may +be dilated by applying to the front of the eye with a feather some drops +of a solution of 4 grains of atropia in an ounce of water.</p> + +<p><i>Treatment.</i>—The treatment of internal ophthalmia should embrace, +first, the removal of all existing causes or sources of aggravation of +the disease, which need not be repeated here. Special care to protect +the patient against strong light, cold, wet weather, and active exertion +must, however, be insisted on. A dark stall and a cloth hung over the +eye are important, while cleanliness, warmth, dryness, and rest are +equally demanded. If the patient is strong and vigorous, a dose of 4 +drams of Barbados aloes may be given, and if there is any reason to +suspect a rheumatic origin one-half a dram powdered colchicum and +one-half ounce salicylate of soda may be given daily.<span class='pagenum'><a name="Page_291" id="Page_291">[Pg 291]</a></span> Locally the +astringent lotions advised for external ophthalmia may be resorted to, +especially when the superficial inflammation is well marked. More +important, however, is to instill into the eye, a few drops at a time, a +solution of 4 grains of atropia in 1 ounce of distilled water. This may +be effected with the aid of a soft feather, and may be repeated at +intervals of 10 minutes until the pupil is widely dilated. As the horse +is to be kept in a dark stall, the consequent admission of light will be +harmless, and the dilation of the pupil prevents adhesion between the +iris and lens, relieves the constant tension of the eye in the effort to +adapt the pupil to the light, and solicits the contraction of the blood +vessels of the eye and the lessening of congestion, exudation, and +intraocular pressure. Should atropia not agree with the case, it may be +replaced by morphia (same strength) or cocaine in 4 per cent solution. +Another local measure is a blister, which can usually be applied to +advantage on the side of the nose or beneath the ear. Spanish flies may +be used as for external ophthalmia. In very severe cases the parts +beneath the eye may be shaved and three or four leeches applied. Setons +are sometimes beneficial, and even puncture of the eyeball, but these +should be reserved for professional hands.</p> + +<p>The diet throughout should be easily digestible and moderate in +quantity—bran mash, middlings, grass, steamed hay, etc.</p> + +<p>Even after the active inflammation has subsided the atropia lotion +should be continued for several weeks to keep the eye in a state of rest +in its still weak and irritable condition, and during this period the +patient should be kept in semidarkness, or taken out only with a dark +shade over the eye. For the same reason heavy drafts and, rapid paces, +which would cause congestion of the head, should be carefully avoided.</p> + + +<h4>RECURRENT OPHTHALMIA (PERIODIC OPHTHALMIA, OR MOON-BLINDNESS).</h4> + +<p>This is an inflammatory affection of the interior of the eye, intimately +related to certain soils, climates, and systems, showing a strong +tendency to recur again and again, and usually ending in blindness from +cataract or other serious injury.</p> + +<p><i>Causes.</i>—Its causes may be fundamentally attributed to soil. On damp +clays and marshy grounds, on the frequently overflowed river bottoms and +deltas, on the coasts of seas and lakes alternately submerged and +exposed, this disease prevails extensively, and in many instances in +France (Reynal), Belgium, Alsace (Zundel, Miltenberger), Germany, and +England it has very largely decreased under land drainage and improved +methods of culture. Other influences, more or less associated with such +soil, are potent causative factors. Thus damp air and a cloudy, wet +climate, so constantly associated<span class='pagenum'><a name="Page_292" id="Page_292">[Pg 292]</a></span> with wet lands, are universally +charged with causing the disease. These act on the animal body to +produce a lymphatic constitution with an excess of connective tissue, +bones, and muscles of coarse, open texture, thick skins, and gummy legs +covered with a profusion of long hair. Hence the heavy horses of Belgium +and southwestern France have suffered severely from the affection, while +high, dry lands adjacent, like Catalonia, in Spain, and Dauphiny, +Provence, and Languedoc; in France, have in the main escaped.</p> + +<p>The rank, aqueous fodders grown on such soils are other causes, but +these again are calculated to undermine the character of the nervous and +sanguineous temperament and to superinduce the lymphatic. Other feeds +act by leading to constipation and other disorders of the digestive +organs, thus impairing the general health. Hence in any animal +predisposed to this disease, heating, starchy feeds, such as maize, +wheat, and buckwheat, are to be carefully avoided. It has been widely +charged that beans, peas, vetches, and other Leguminosæ are dangerous, +but a fuller inquiry contradicts the statement. If these feeds are well +grown, they invigorate and fortify the system, while, like any other +fodder, if grown rank; aqueous, and deficient in assimilable principles, +they tend to lower the health and open the way for the disease.</p> + +<p>The period of dentition and training is a fertile exciting cause, for +though the malady may appear at any time from birth to old age, yet the +great majority of victims are from 2 to 6 years old, and if a horse +escapes the affection till after 6 there is a reasonable hope that he +will continue to resist it. The irritation about the head during the +eruption of the teeth, and while fretting in the unwonted bridle and +collar, the stimulating grain diet and the close air of the stable all +combine to rouse the latent tendency to disease in the eye, while direct +injuries by bridle, whip, or hay seeds are not without their influence. +In the same way local irritants, like dust, severe rain and snow storms, +smoke, and acrid vapors are contributing causes.</p> + +<p>It is evident, however, that no one of these is sufficient of itself to +produce the disease, and it has been alleged that the true cause is a +microbe, or the irritant products of a microbe, which is harbored in the +marshy soil. The prevalence of the disease on the same damp soils which +produce ague in man and anthrax in cattle has been quoted in support of +this doctrine, as also the fact that, other things being equal, the +malady is always more prevalent in basins surrounded by hills where the +air is still and such products are concentrated, and that a forest or +simple belt of trees will, as in ague, at times limit the area of its +prevalence. Another argument for the same view is found in the fact that +on certain farms irrigated by town sewage this malady has become +extremely prevalent, the sewage being assumed to form a suitable nidus +for the growth of the germ.<span class='pagenum'><a name="Page_293" id="Page_293">[Pg 293]</a></span> But on these sewage farms a fresh crop may +be cut every fortnight, and the product is precisely that aqueous +material which contributes to a lymphatic structure and a low tone of +health. The presence of a definite germ in the system has not yet been +proved, and in the present state of our knowledge we are only warranted +in charging the disease to the deleterious emanations from the marshy +soil in which bacterial ferments are constantly producing them.</p> + +<p>Heredity is one of the most potent causes. The lymphatic constitution is +of course transmitted and with it the proclivity to recurring +ophthalmia. This is notorious in the case of both parents, male and +female. The tendency appears to be stronger, however, if either parent +has already suffered. Thus a mare may have borne a number of sound +foals, and then fallen a victim to the malady, and all foals +subsequently borne have likewise suffered. So it is in the case of the +stallion. Reynal even quotes the appearance of the disease in alternate +generations, the stallion offspring of blind parents remaining sound +through life and yet producing foals which furnish numerous victims of +recurrent ophthalmia. On the contrary, the offspring of diseased parents +removed to high, dry regions and furnished with wholesome, nourishing +rations will nearly all escape. Hence the dealers take colts that are +still sound or have had but one attack from the affected low Pyrenees +(France) to the unaffected Catalonia (Spain), with confidence that they +will escape, and from the Jura Valley to Dauphiny with the same result.</p> + +<p>Yet the hereditary taint is so strong and pernicious that intelligent +horsemen everywhere refuse to breed from either horse or mare that has +once suffered from recurrent ophthalmia, and the French Government studs +not only reject all unsound stallions, but refuse service to any mare +which has suffered with her eyes. It is this avoidance of the hereditary +predisposition more than anything else that has reduced the formerly +wide prevalence of this disease in the European countries generally. A +consideration for the future of our horses would demand the disuse of +all sires that are unlicensed, and the refusal of a license to any sire +which has suffered from this or any other communicable constitutional +disease.</p> + +<p>Other contributing causes deserve passing mention. Unwholesome feed and +a faulty method of feeding undoubtedly predisposes to the disease, and +in the same district the carefully fed will escape in far larger +proportion than the badly fed; it is so also with every other condition +which undermines the general health. The presence of worms in the +intestines, overwork, and debilitating diseases and causes of every kind +weaken the vitality and lay the system more open to attack. Thierry long +ago showed that the improvement of close, low, dark, damp stables, where +the disease had previously prevailed, practically banished the +affection. Whatever contributes to<span class='pagenum'><a name="Page_294" id="Page_294">[Pg 294]</a></span> strength and vigor is protective; +whatever contributes to weakness and poor health is provocative of the +disease in the predisposed subject.</p> + +<p><i>Symptoms.</i>—The symptoms vary according to the severity of the attack. +In some cases there is marked fever, and in some slighter cases it may +be almost altogether wanting, but there is always a lack of vigor and +energy, bespeaking general disorder. The local symptoms are in the main +those of internal ophthalmia, in many cases with an increased hardness +of the eyeball from effusion into its cavity. The contracted pupil does +not expand much in darkness, nor even under the action of belladonna. +Opacity advances from the margin, over a part or whole of the cornea, +but so long as it is transparent there may be seen the turbid, aqueous +humor with or without flocculi, the dingy iris robbed of its clear, +black aspect, the slightly clouded lens, and a greenish-yellow +reflection from the depth of the eye. From the fifth to the seventh day +the flocculi precipitate in the lower part of the chamber, exposing more +clearly the iris and lens, and absorption commences, so that the eye may +be cleared up in ten or fifteen days.</p> + +<p>The characteristic of the disease is, however, its recurrence again and +again in the same eye until blindness results. The attacks may follow +one another after intervals of a month, more or less, but they show no +relation to any particular phase of the moon, as might be inferred from +the familiar name, but are determined rather by the weather, the health, +the feed, or by some periodicity of the system. From five to seven +attacks usually result in blindness, and then the second eye is liable +to be attacked until it also is ruined.</p> + +<p>In the intervals between the attacks some remaining symptoms betray the +condition, and they become more marked after each successive access of +disease. Even after the first attack there is a bluish ring around the +margin of the transparent cornea. The eye seems smaller than the other, +at first because it is retracted in its socket, and often after several +attacks because of actual shrinkage (atrophy). The upper eyelid, in +place of presenting a uniform, continuous arch, has, about one-third +from its inner angle, an abrupt bend, caused by the contraction of the +levator muscle. The front of the iris has exchanged some of its dark, +clear brilliancy for a lusterless yellow, and the depth of the eye +presents more or less of the greenish-yellow shade. The pupil remains a +little contracted, except in advanced and aggravated cases, when, with +opaque lens, it is widely dilated. If, as is common, one eye only has +suffered, the contrast in these respects with the sound eye is all the +more characteristic. Another feature is the erect, attentive carriage of +the ear, to compensate to some extent for the waning vision.<span class='pagenum'><a name="Page_295" id="Page_295">[Pg 295]</a></span></p> + +<p>The attacks vary greatly in severity in different cases, but the +recurrence is characteristic, and all alike lead to cataract and +intraocular effusion, with pressure on the retina and abolition of +sight.</p> + +<p><i>Prevention.</i>—The prevention of this disease is the great object to be +aimed at, and this demands the most careful breeding, feeding, housing, +and general management, as indicated under "Causes." Much can also be +done by migration to a high, dry location, but for this and malarious +affections the improvement of the land by drainage and good cultivation +should be the final aim.</p> + +<p><i>Treatment</i> is not satisfactory, but is largely the same as for common +internal ophthalmia. Some cases, like rheumatism, are benefited by +1-scruple doses of powdered colchicum and 2-dram doses of salicylate of +soda twice a day. In other cases, with marked hardness of the globe of +the eye from intraocular effusion, aseptic puncture of the eye, or even +the excision of a portion of the iris, has helped. During recovery a +course of tonics (2 drams oxid of iron, 10 grains nux vomica, and 1 +ounce sulphate of soda daily) is desirable to invigorate the system and +help to ward off another attack. The vulgar resort to knocking out the +wolf teeth and cutting out the haw can only be condemned. The temporary +recovery would take place in one or two weeks, though no such thing had +been done, and the breaking of a small tooth, leaving its fang in the +jaw, only increases the irritation.</p> + + +<h4>CATARACT.</h4> + +<p>The common result of internal ophthalmia, as of the recurrent type, may +be recognized as described under the first of these diseases. Its +offensive appearance may be obviated by extraction or depression of the +lens, but as the rays of light would no longer be properly refracted, +perfect vision would not be restored, and the animal would be liable to +prove an inveterate shyer. If perfect blindness continued by reason of +pressure on the nerve of sight, no shying would result.</p> + + +<h4>PALSY OF THE NERVE OF SIGHT, OR AMAUROSIS.</h4> + +<p><i>Causes.</i>—The causes of this affection are tumors or other disease of +the brain implicating the roots of the optic nerve, injury to the nerve +between the brain and eye, and inflammation of the optic nerve within +the eye (retina), or undue pressure on the same from dropsical or +inflammatory effusion. It may also occur from overloaded stomach, from a +profuse bleeding, and even from the pressure of the gravid womb in +gestation.</p> + +<p><i>Symptoms.</i>—The symptoms are wide dilatation of the pupils, so as to +expose fully the interior of the globe, the expansion remaining<span class='pagenum'><a name="Page_296" id="Page_296">[Pg 296]</a></span> the +same in light and darkness. Ordinary eyes when brought to the light have +the pupils suddenly contract and then dilate and contract alternately +until they adapt themselves to the light. The horse does not swerve when +a feint to strike is made unless the hand causes a current of air. The +ears are held erect, turn quickly toward any noise, and the horse steps +high to avoid stumbling over objects which it can not see.</p> + +<p><i>Treatment</i> is only useful when the disease is symptomatic of some +removable cause, like congested brain, overloaded stomach, or gravid +womb. When recovery does not follow the termination of these conditions, +apply a blister behind the ear and give one-half dram doses of nux +vomica daily.</p> + + +<h4>TUMORS OF THE EYEBALL.</h4> + +<p>A variety of tumors attack the eyeball—dermoid, papillary, fatty, +cystic, and melanotic—but perhaps the most frequent in the horse is +encephaloid cancer. This may grow in or on the globe, the haw, the +eyelid, or the bones of the orbit, and can be remedied, if at all, only +by early and thorough excision. It may be distinguished from the less +dangerous tumors by its softness, friability, and great vascularity, +bleeding on the slightest touch, as well as by its anatomical structure.</p> + + +<h4>STAPHYLOMA.</h4> + +<p>This consists in a bulging forward of the cornea at a given point by the +sacculate yielding and distention of its coats, and it may be either +transparent or opaque and vascular. In the last form the iris has become +adherent to the back of the cornea, and the whole structure is filled +with blood vessels. In the first form the bulging cornea is attenuated; +in the last it may be thickened. The best treatment is by excision of a +portion of the rise so as to relieve the intraocular pressure.</p> + + +<h4>PARASITES IN THE EYE.</h4> + +<p>Acari in the eye have been incidentally alluded to under inflammation of +the lids.</p> + +<p><i>Filaria palpebralis</i> is a white worm, one-half to 1 inch long, which +inhabits the lacrimal duct and the underside of the eyelids and haw in +the horse, producing a verminous conjunctivitis. The first step in +treatment in such cases is to remove the worm with forceps, then treat +as for external inflammation.</p> + +<p><i>Setaria equina</i> is a delicate, white, silvery-looking worm, which I +have repeatedly found 2 inches in length (a length as great as 5 inches +has been reported). It invades the aqueous humor, where its constant +active movements make it an object of great interest, and it is +frequently<span class='pagenum'><a name="Page_297" id="Page_297">[Pg 297]</a></span> exhibited as a "snake in the eye."<a name="FNanchor_1_1" id="FNanchor_1_1"></a><a href="#Footnote_1_1" class="fnanchor">[1]</a> When present in the +eye it causes inflammation and has to be removed through an incision +made with the lancet in the upper border of the cornea close to the +sclerotic, the point of the instrument being directed slightly forward +to avoid injury to the iris. Then cold water or astringent antiseptic +lotions should be applied.</p> + +<p><i>Filaria conjunctivæ</i>, resembling <i>Setaria equina</i> very much in size and +general appearance, is another roundworm which has been found in the eye +of the horse.</p> + +<p>The echinococcus, the cystic or larval stage of the echinococcus +tapeworm of the dog, has been found in the eye of the horse, and a +cysticercus is also reported.</p> + +<div class="footnotes"><h3>FOOTNOTES:</h3> + +<div class="footnote"><p><a name="Footnote_1_1" id="Footnote_1_1"></a><a href="#FNanchor_1_1"><span class="label">[1]</span></a> This worm is normally a parasite of the peritoneal cavity, +and is probably transmitted from one horse to another by some biting +insect which becomes infected by embryos in the blood.—<span class="smcap">M. C. Hall.</span></p></div> +</div> + + +<hr style="width: 65%;" /> +<p><span class='pagenum'><a name="Page_298" id="Page_298">[Pg 298]</a></span></p> +<h2>LAMENESS: ITS CAUSES AND TREATMENT.</h2> + +<h3><span class="smcap">By A. Liautard, M. D., V. M.</span>,</h3> + +<h5><i>Formerly principal of the American Veterinary College, New York.</i></h5> + +<h4>[Revised by John R. Mohler, A. M., V. M. D.]</h4> + + +<p>It is as living, organized, locomotive machines that the horse, camel, +ox, and their burden-bearing companions are of practical value to man. +Hence the consideration of their usefulness and consequent value to +their human masters ultimately and naturally resolves itself into an +inquiry concerning the condition of that special portion of their +organism which controls their function of locomotion. This is especially +true in regard to the members of the equine family, the most numerous +and valuable of all the beasts of burden, and it naturally follows that +with the horse for a subject of discussion the special topic and leading +theme of inquiry, by an easy lapse, will become an inquest into the +condition and efficiency of his power for usefulness as a carrier or +traveler. There is a great deal of abstract interest in the study of +that endowment of the animal economy which enables its possessor to +change his place at will and convey himself whithersoever his needs or +his moods may incline him; how much greater, however, the interest that +attaches to the subject when it becomes a practical and economic +question and includes within its purview the various related topics +which belong to the domains of physiology, pathology, therapeutics, and +the entire round of scientific investigation into which it is finally +merged as a subject for medical and surgical consideration—in a word, +of actual disease and its treatment. It is not surprising that the +intricate and complicated apparatus of locomotion, with its symmetry and +harmony of movement and the perfection and beauty of its details and +adjuncts, by students of creative design and attentive observers or +nature and her marvelous contrivances and adaptations, should be +admiringly denominated a living machine.</p> + +<p>Of all the animal tribe the horse, in a state of domesticity, is the +largest sharer with his master in his liability to the accidents and +dangers which are among the incidents of civilized life. From his +exposure to the missiles of war on the battlefield to his chance of +picking up a nail from the city pavement there is no hour when he is<span class='pagenum'><a name="Page_299" id="Page_299">[Pg 299]</a></span> +not in danger of incurring injuries which for their repair may demand +the best skill of the veterinary practitioner. This is true not alone of +casualties which belong to the class of external and traumatic cases, +but includes as well those of a kind perhaps more numerous, which may +result in lesions of internal parts, frequently the most serious and +obscure of all in their nature and effects.</p> + +<p>The horse is too important a factor in the practical details of human +life and fills too large a place in the business and pleasure of the +world to justify any indifference to his needs and physical comfort or +neglect in respect to the preservation of his peculiar powers for +usefulness. In entering somewhat largely, therefore, upon a review of +the subject, and treating in detail of the causes, the symptoms, the +progress, the treatment, the results, and the consequences of lameness +in the horse, we are performing a duty which needs no word of apology or +justification. The subject explains and justifies itself, and is its own +vindication and illustration, if any are needed.</p> + +<p>The function of locomotion is performed by the action of two principal +systems of organs, known in anatomical and physiological terminology as +passive and active, the muscles performing the active and the bones the +passive portion of the movement. The necessary connection between the +cooperating parts of the organism is effected by means of a vital +contact by which the muscle is attached to the bone at certain +determinate points on the surface of the latter. These points of +attachment appear sometimes as an eminence, sometimes as a depression, +sometimes a border or an angle, or again as a mere roughness, but each +perfectly fulfilling its purpose, while the necessary motion is provided +for by the formation of the ends of the long bones into the requisite +articulations, joints, or hinges. Every motion is the product of the +contraction of one or more of the muscles, which, as it acts upon the +bony levers, gives rise to a movement of extension or flexion, abduction +or adduction, rotation or circumduction. The movement of abduction is +that which passes from and that of adduction that which passes toward +the median line, or the center of the body. The movements of flexion and +extension are too well understood to need defining. It is the +combination and rapid alterations of these movements which produce the +different postures and various gaits of the animal, and it is their +interruption and derangement, from whatever causes, which constitute the +pathological condition known as lameness.</p> + +<p>A concise examination of the general anatomy of these organs, however, +must precede the consideration of the pathological questions pertaining +to the subject. A statement, such as we have just given, containing only +the briefest hint of matters which, though not necessarily in their +ultimate scientific minutiæ, must be clearly comprehended in order to +acquire a symmetrical and satisfactory view of<span class='pagenum'><a name="Page_300" id="Page_300">[Pg 300]</a></span> the theme as a practical +collation of facts to be remembered, analyzed, applied, and utilized.</p> + +<p>It was the great Bacon who wrote: "The human body may be compared, from +its complex and delicate organization, to a musical instrument of the +most perfect construction, but exceedingly liable to derangement." In +its degree the remark is equally applicable to the equine body, and if +we would keep it in tune and profit by its harmonious action we must at +least acquaint ourselves with the relations of its parts and the mode of +their cooperation.</p> + + +<h4>ANATOMY.</h4> + +<p>The bones, then, are the hard organs which in their connection and +totality constitute the skeleton of an animal (see Plate XXIII). They +are of various forms, three of which—the long, the flat, and the +small—are recognized in the extremities. These are more or less regular +in their form, but present upon their surfaces a variety of aspects, +exhibiting in turn, according to the requirement of each case, a +roughened or smooth surface, variously marked with grooves, crests, +eminences, and depressions, for the necessary muscular attachments, and, +as before mentioned, are connected by articulations and joints, of which +some are immovable and others movable.</p> + +<p>The substance of the bone is composed of a mass of combined earthy and +animal matter surrounded by a fine, fibrous enveloping membrane (the +periosteum) which is intimately adherent to the external surface of the +bone, and is, in fact, the secreting membrane of the bony structure. The +bony tissue proper is of two consistencies, the external portion being +hard and "compact," and called by the latter term, while the internal, +known as the "spongy" or "areolar tissue," corresponds to the +descriptive terms. Those of the bones that possess this latter +consistency contain also, in their spongy portion, the medullary +substance known as marrow, which is deposited in large quantities in the +interior of the long bones, and especially where a central cavity +exists, called, for that reason, the medullary cavity. The nourishment +of the bones is effected by means of what is known as the nutrient +foramen, an opening established for the passage of the blood vessels +which convey the nourishment necessary to the interior of the organ. +Concerning the nourishment of the skeleton, there are other minutiæ, +such as the venous arrangement and the classification of their arterial +vessels into several orders, which, though of interest as an abstract +study, are not of sufficient practical value to refer to here.</p> + +<p>The active organs of locomotion, the muscles (see Plate XXIII), speaking +generally, form the fleshy covering of the external part of the skeleton +and surround the bones of the extremities. They vary<span class='pagenum'><a name="Page_301" id="Page_301">[Pg 301]</a></span> greatly in shape +and size, being flat, triangular, long, short, or broad, and are +variously and capriciously named, some from their shape, some from their +situation, others from their use; and thus we have abductors and +adductors—the pyramidal, orbicular, the digastricus, the vastus, and so +on. Those which are under the control of the will, known as the +voluntary muscles, appear in the form of fleshy structures, red in +color, and with fibers of various degrees of fineness, and are composed +of fasciculi, or bundles of fibers, united by connective or cellular +tissue, each fasciculus being composed of smaller ones but united in a +similar manner to compose the larger formations, each of which is +enveloped by a structure of similar nature known as the sarcolemma. Many +of the muscles are united to the bones by the direct contact of their +fleshy fibers, but in other instances the body of the muscle is more or +less gradually transformed into a cordy or membranous structure known as +the tendon or sinew, and the attachment is made by the very short +fibrous threads through the medium of a long tendinous band, which, +passing from a single one to several others of the bones, effects its +object at a point far distant from its original attachment. In thus +carrying its action from one bone to another, or from one region of a +limb to another, these tendons must necessarily have smooth surfaces +over which to glide, either upon the bones themselves or formed at their +articulations, and this need is supplied by the secretion of the +synovial fluid, a yellowish, unctuous substance, furnished by a peculiar +tendinous synovial sac designed for the purpose.</p> + +<p>Illustrations in point of the agency of the synovial fluid in assisting +the sliding movements of the tendons may be found under their various +forms at the shoulder joint, at the upper part of the bone of the arm, +at the posterior part of the knee joint, and also at the fetlocks, on +their posterior part.</p> + +<p>As the tendons, whether singly or in company with others, pass over +these natural pulleys they are retained in place by strong, fibrous +bands or sheaths, which are by no means exempt from danger of injury, as +will be readily inferred from a consideration of their important special +use as supports and reenforcements of the tendons themselves, with which +they must necessarily share the stress of whatever force or strain is +brought to bear upon both or either.</p> + +<p>We have referred to that special formation of the external surface of a +bone by which it is adapted to form a joint or articulation, either +movable or fixed, and a concise examination of the formation and +structure of the movable articulations will here be in place. These are +formed generally by the extremities of the long bones, or may exist on +the surfaces of the short ones. The points or regions where the contact +occurs are denominated the articular surface, which assumes from this +circumstance a considerable variety of aspect and<span class='pagenum'><a name="Page_302" id="Page_302">[Pg 302]</a></span> form, being in one +case comparatively flat and another elevated; or as forming a protruding +head or knob, with a distinct convexity; and again presenting a +corresponding depression or cavity, accurately adapted to complete, by +their coaptation, the ball-and-socket joint. The articulation of the arm +and shoulder is an example of the first kind, while that of the hip with +the thigh bone is a perfect exhibition of the latter.</p> + +<p>The structure whose office it is to retain the articulating surfaces in +place is the ligament. This is usually a white, fibrous, inelastic +tissue; sometimes, however, it is elastic in character and yellowish. In +some instances it is funicular shaped or corded, serving to bind more +firmly together the bones to which its extremities are attached; in +others it consists of a broad membrane, wholly or partially surrounding +the broad articulations, and calculated rather for the protection of the +cavity from intrusion by the air than for other security. This latter +form, known as capsular, is usually found in connection with joints +which possess a free and extended movement. The capsular and funicular +ligaments are sometimes associated, the capsular appearing as a +membranous sac wholly or partially inclosing the joint, the funicular, +here known as an interarticular ligament, occupying the interior, and +thus securing the union of the several bones more firmly and effectively +than would be possible for the capsular ligament unassisted.</p> + +<p>The universal need which pertains to all mechanical contrivances of +motion has not been forgotten while providing for the perfect working of +the interesting piece of living machinery which performs the function of +locomotion, as we are contemplating it, and nature has consequently +provided for obviating the evils of attrition and friction and insuring +the easy play and smooth movement of its parts by the establishment of +the secretion of the synovia, the vital lubricant of which we have +before spoken, as a yellow, oily, or rather glairy secretion, which +performs the indispensable office of facilitating the play of the +tendons over the joints and certain given points of the bones. This +fluid is deposited in a containing sac, the lining (serous) membrane of +which forms the secreting organ. This membrane is of an excessively +sensitive nature, and while it lines the inner face of the ligaments, +both capsular and fascicular, it is attached only upon the edges of the +bones, without extending upon their length, or between the layers of +cartilage which lie between the bones and their articular surfaces.</p> + +<p>Our object in thus partially and concisely reviewing the structure and +condition of the essential organs of locomotion has been rather to +outline a sketch which may serve as a reference chart of the general +features of the subject than to offer a minute description of the parts +referred to. Other points of interest will receive proper attention<span class='pagenum'><a name="Page_303" id="Page_303">[Pg 303]</a></span> as +we proceed with the illustration of our subject and examine the matters +which it most concerns us to bring under consideration. The foundation +of facts which we have thus far prepared will be found sufficiently +broad, we trust, to include whatever may be necessary to insure a ready +comprehension of the essential matters which are to follow as our review +is carried forward to completion. What we have said touching these +elementary truths will probably be sufficient to facilitate a clear +understanding of the requirements essential to the perfection and +regularity which characterize the normal performance of the various +movements that result in the accomplishment of the action of locomotion. +So long as the bones, the muscles and their tendons, the joints with +their cartilages, their ligaments, and their synovial structure, the +nerves and the controlling influences which they exercise over all, with +the blood vessels which distribute to every part, however minute, the +vitalizing fluid which sustains the whole fabric in being and +activity—so long as these various constituents and adjuncts of animal +life preserve their normal exemption from disease, traumatism, and +pathological change, the function of locomotion will continue to be +performed with perfection and efficiency.</p> + +<p>On the other hand, let any element of disease become implanted in one or +several of the parts destined for combined action, any change or +irregularity of form, dimensions, location, or action occur in any +portion of the apparatus—any obstruction or misdirection of vital power +take place, any interference with the order of the phenomena of normal +nature, any loss of harmony and lack of balance be betrayed—and we have +in the result the condition of lameness.</p> + + +<h4>DEFINITION OF LAMENESS.</h4> + +<p><i>Physiology.</i>—Comprehensively and universally considered, then, the +term lameness signifies any irregularity or derangement of the function +of locomotion, irrespective of the cause which produced it or the degree +of its manifestation. However slightly or severely it may be exhibited, +it is all the same. The nicest observation may be demanded for its +detection, and it may need the most thoroughly trained powers of +discernment to identify and locate it, as in cases in which the animal +is said to be fainting, tender, or to go sore. On the contrary, the +patient may be so far affected as to refuse utterly to use an injured +leg, and under compulsory motion keep it raised from the ground, and +prefer to travel on three legs rather than to bear any portion of his +weight upon the afflicted member. In these two extremes, and in all the +intermediate degrees, the patient is simply lame—pathognomonic minutiæ +being considered and settled in a place of their own.<span class='pagenum'><a name="Page_304" id="Page_304">[Pg 304]</a></span></p> + +<p>This last condition of disabled function—lameness on three legs—and +many of the lower degrees of simple lameness are very easy of detection, +but the first, or mere tenderness or soreness, may be very difficult to +identify, and at times very serious results have followed from the +obscurity which has enveloped the early stages of the malady. For it may +easily occur that in the absence of the treatment which an early correct +diagnosis would have indicated, an insidious ailment may so take +advantage of the lapse of time as to root itself too deeply into the +economy to be subverted, and become transformed into a disabling chronic +case, or possibly one that is incurable and fatal. Hence the impolicy of +depreciating early symptoms because they are not accompanied with +distinct and pronounced characteristics, and from a lack of threatening +appearances inferring the absence of danger. The possibilities of an +ambush can never be safely ignored. An extra caution costs nothing, even +if wasted. The fulfillment of the first duty of a practitioner, when +introduced to a case, is not always an easy task, though it is too +frequently expected that the diagnosis, or "what is the matter" verdict, +will be reached by the quickest and surest kind of an "instantaneous +process" and a sure prognosis, or "how will it end," guessed at +instanter.</p> + +<p>Usually the discovery that the animal is becoming lame is comparatively +an easy matter to a careful observer. Such a person will readily note +the changes of movements which will have taken place in the animal he +has been accustomed to drive or ride, unless they are indeed slight and +limited to the last degree. But what is not always easy is the +detection, after discovering the fact of an existing irregularity, of +the locality of its point of origin, and whether its seat be in the near +or off leg, or in the fore or the hind part of the body. These are +questions too often wrongly answered, notwithstanding the fact that with +a little careful scrutiny the point may be easily settled. The error, +which is too often committed, of pronouncing the leg upon which the +animal travels soundly as the seat of the lameness, is the result of a +misinterpretation of the physiology of locomotion in the crippled +animal. Much depends upon the gait with which the animal moves while +under examination. The act of walking is unfavorable for accurate +observation, though, if the animal walks on three legs, the decision is +easy to reach. The action of galloping will often, by the rapidity of +the muscular movements and their quick succession, interfere with a nice +study of their rhythm, and it is only under some peculiar circumstances +that the examination can be safely conducted while the animal is moving +with that gait. It is while the animal is trotting that the +investigation is made with the best chances of an intelligent decision, +and it is while moving with that gait, therefore, that the points should +be looked for which must form the elements of the diagnosis.</p> + +<p><a name="PLATE_XXIII" id="PLATE_XXIII"></a></p> +<div class="figcenter" style="width: 450px;"> +<a href="images/plate23.jpg"><img src="images/plate23t.jpg" width="450" height="292" alt="PLATE XXIII." title="" /></a> +<span class="caption">PLATE XXIII.<br /> + +SKELETON OF HORSE.</span> +</div> + +<p><a name="PLATE_XXIV" id="PLATE_XXIV"></a></p> +<div class="figcenter" style="width: 450px;"> +<a href="images/plate24.jpg"><img src="images/plate24t.jpg" width="450" height="343" alt="PLATE XXIV." title="" /></a> +<span class="caption">PLATE XXIV.<br /> + +SUPERFICIAL LAYER OF MUSCLES.</span> +</div> + +<p><span class='pagenum'><a name="Page_305" id="Page_305">[Pg 305]</a></span>Our first consideration should be the physiology of normal or healthy +locomotion, that thence we may the more easily reach our conclusions +touching lameness, or that which is abnormal, and by this process we +ought to succeed in obtaining a clew to the solution of the first +problem, to wit, in which leg is the seat of the lameness?</p> + +<p>A word of definition is here necessary, in order to render that which +follows more easily intelligible. In veterinary nomenclature each two of +the legs, as referred to in pairs, is denominated a biped. Of the four +points occupied by the feet of the animal while standing at rest, +forming a square, the two fore legs are known as the anterior biped; the +two hinder, the posterior; the two on one side, the lateral: and one of +either the front or hind biped with the opposite leg of the hind or +front biped will form the diagonal biped.</p> + +<p>Considering, as it is proper to do, that in a condition of health each +separate biped and each individual leg is required to perform an equal +and uniform function and to carry an even or equal portion of the weight +of the body, it will be readily appreciated that the result of this +distribution will be a regular, evenly balanced, and smooth displacement +of the body thus supported by the four legs, and that therefore, +according to the rapidity of the motion in different gaits, each single +leg will be required at certain successive moments to bear the weight +which had rested upon its congener while it was itself in the air, in +the act of moving; or, again, two different legs of a biped may be +called upon to bear the weight of the two legs of the opposite biped +while also in the air in the act of moving.</p> + +<p>To simplify the matter by an illustration, the weight of an animal may +be placed at 1,000 pounds, of which each leg, in a normal and healthy +condition, supports while at rest 250 pounds. When one of the fore legs +is in action, or in the air, and carrying no weight, its 250 pounds +share of the weight will be thrown upon its congener, or partner, to +sustain. If the two legs of a biped are both in action and raised from +the ground, their congeners, still resting in inaction, will carry the +total weight of the other two, or 500 pounds. And as the succession of +movements continues, and the change from one leg to another or from one +biped to another, as may be required by the gait, proceeds, there will +result a smooth, even, and equal balancing of active movements, shifting +the weight from one leg or one biped to another, with symmetrical +precision, and we shall be presented with an interesting example of the +play of vital machanics in a healthy organization.</p> + +<p>Much may be learned from the accurate study of the action of a single +leg. Normally, its movements will be without variation or failure. When +at rest it will easily sustain the weight assigned to it<span class='pagenum'><a name="Page_306" id="Page_306">[Pg 306]</a></span> without +showing hesitancy or betraying pain, and when it is raised from the +ground in order to transfer the weight to its mate it will perform the +act in such manner that when it is again placed upon the ground to rest +it will be with a firm tread, indicative of its ability to receive again +the burden to be thrown back upon it. In planting it upon the ground or +raising it again for the forward movement while in action, and again +replanting it upon the earth, each movement will be the same for each +leg and for each biped, whether the act is that of walking or trotting, +or even of galloping. In short, the regular play of every part of the +apparatus will testify to the existence of that condition of orderly +soundness and efficient activity eloquently suggestive of the condition +of vital integrity which is simply but comprehensively expressed by the +terms health and soundness.</p> + +<p>But let some change, though slight and obscure, occur among the elements +of the case; some invisible agency of evil intrude among the harmonizing +processes going forward; any disorder occur in the relations of +cooperating parts; anything appear to neutralize the efficiency of +vitalizing forces; any disability of a limb to accept and to throw back +upon its mate the portion of the weight which belongs to it to +sustain—present itself, whether as the effect of accident or otherwise; +in short, let anything develop which tends to defeat the purpose of +nature in organizing the locomotive apparatus and we are confronted at +once by that which may be looked upon as a cause of lameness.</p> + +<p>Not the least of the facts which it is important to remember is that it +is not sufficient to look for the manifestation of an existing +discordance in the action of the affected limb alone, but that it is +shared by the sound one and must be searched for in that as well as the +halting member, if the hazard of an error is to be avoided. The mode of +action of the leg which is the seat of the lameness will vary greatly +from that which it exhibited when in a healthy condition, and the sound +leg will also offer important modifications in the same three +particulars before alluded to, to wit, that of resting on the ground, +that of its elevation and forward motion, and that of striking the +ground again when the full action of stepping is accomplished. Inability +in the lame leg to sustain weight will imply excessive exertion by the +sound one, and lack of facility or disposition to rest the lame member +on the ground will necessitate a longer continuance of that action on +the sound side. Changes in the act of elevating the leg, or of carrying +it forward, or in both, will present entirely opposite conditions +between the two. The lame member will be elevated rapidly, moved +carefully forward, and returned to the ground with caution and +hesitancy, and the contact with the earth will be effected as lightly as +possible, while the sound limb will rest longer on the<span class='pagenum'><a name="Page_307" id="Page_307">[Pg 307]</a></span> ground, move +boldly and rapidly forward, and strike the ground promptly and forcibly. +All this is due to the fact that the sound member carries more than its +normal, healthy share of the weight of the body, a share which may be in +excess from 1 to 250 pounds, and thus bring its burden to a figure +varying from 251 to 500 pounds, all depending upon the degree of the +existing lameness, whether it is simply a slight tenderness or soreness, +or whether the trouble has reached a stage which compels the patient to +the awkwardness of traveling on three legs.</p> + +<p>That all this is not mere theory, but rests on a foundation of fact may +be established by observing the manifestations attending a single +alteration in the balancing of the body. In health the support and +equilibrium of that mass of the body which is borne by the fore legs is +equalized and passes by regular alternations from the right to the left +side and vice versa. But if the left leg, becoming disabled, relieves +itself by leaning, as it were, on the right, the latter becomes, +consequently, practically heavier and the mass of the body will incline +or settle upon that side. Lameness of the left side, therefore, means +dropping or settling on the right and vice versa. We emphasize this +statement and insist upon it, the more from the frequency of the +instances of error which have come under our notice, in which persons +have insisted upon their view that the leg which is the seat of the +lameness is that upon which he drops and which the animal is usually +supposed to favor.</p> + + +<h4>HOW TO DETECT THE SEAT OF LAMENESS.</h4> + +<p>Properly appreciating the remarks which have preceded, and fully +comprehending the modus operandi and the true pathology of lameness, but +little remains to be done in order to reach an answer to the question as +to which side of the animal is the seat of the lameness, except to +examine the patient while in action. We have already stated our reasons +for preferring the movement of trotting for this purpose. In conducting +such an examination the animal should be unblanketed, and held by a +plain halter in the hands of a man who knows how to manage his paces, +and the trial should always be made over a firm, hard road whenever it +is available. He is to be examined from various positions—from before, +from behind, and from each side. Watching him as he approaches, as he +passes by, and as he recedes, the observer should carefully study that +important action which we have spoken of as the dropping of the body +upon one extremity or the other, and this can readily be detected by +attending closely to the motions of the head and of the hip. The head +drops on the same side on which the mass of the body will fall, dropping +toward the right when the lameness is in the left fore leg, and the hip +dropping in posterior lameness, also on the sound leg, the reversal of +the conditions,<span class='pagenum'><a name="Page_308" id="Page_308">[Pg 308]</a></span> of course, producing reversed effects. In other words, +when the animal in trotting exhibits signs of irregularity of action, or +lameness, and this irregularity is accompanied with dropping or nodding +the head, or depressing the hip on the right side of the body, at the +time the feet of the right side strike the ground, the horse is lame on +the left side. If the dropping and nodding are on the near side the +lameness is on the off side.</p> + +<p>In a majority of cases, however, the answer to the first question +relating to the lameness of a horse is, after all, not a very difficult +task. There are two other problems in the case more difficult of +solution and which often require the exercise of a closer scrutiny, and +draw upon all the resources of the experienced practitioner to settle +satisfactorily. That a horse is lame in a given leg may be easily +determined, but when it becomes necessary to pronounce upon the query as +to what part, what region, what structure is affected, the easy part of +the task is over, and the more difficult and important, because more +obscure, portion of the investigation has commenced—except, of course, +in cases of which the features are too distinctly evident to the senses +to admit of error. It is true that by carefully noting the manner in +which a lame leg is performing its functions, and closely scrutinizing +the motions of the whole extremity, and especially of the various joints +which enter into its structure; by minutely examining every part of the +limb; by observing the outlines; by testing the change, if any, in +temperature and the state of the sensibility—all these investigations +may guide the surgeon to a correct localization of the seat of trouble, +but he must carefully refrain from the adoption of a hasty conclusion, +and, above all, assure himself that he has not failed to make the foot, +of all the organs of the horse the most liable to injury and lesion, the +subject of the most thorough and minute examination of all the parts +which compose the suffering extremity.</p> + +<p>The greater liability of the foot than of any other part of the +extremities to injury from casualties, natural to its situation and use, +should always suggest the beginning of an inquiry, especially in an +obscure case of lameness at that point. Indeed the lameness may have an +apparent location elsewhere when that is the true seat of the trouble, +and the surgeon who, while examining his lame patient, discovers a +ringbone, and convincing himself that he has encountered the cause of +the disordered action suspends his investigation without subjecting the +foot to a close scrutiny, at a later day when regrets will avail +nothing, may deeply regret his neglect and inadvertence. As in human +pathological experience, however, there are instances when inscrutable +diseases will deliver their fatal messages, while leaving no mark and +making no sign by which they might be identified and classified, so it +will happen that in the humbler animals<span class='pagenum'><a name="Page_309" id="Page_309">[Pg 309]</a></span> the onset and progress of +mysterious and unrecognizable ailments will at times baffle the most +skilled veterinarian, and leave our burden-bearing servants to succumb +to the inevitable, and suffer and perish in unrelieved distress.</p> + + +<h3>DISEASES OF BONES.</h3> + +<h4>PERIOSTITIS, OSTITIS, AND EXOSTOSIS.</h4> + +<p>From the closeness and intimacy of the connection existing between the +two principal elements of the bony structure while in health, it +frequently becomes exceedingly difficult, when a state of disease has +supervened, to discriminate accurately as to the part primarily affected +and to determine positively whether the periosteum or the body of the +bone is originally implicated. Yet a knowledge of the fact is often of +the first importance, in order to obtain a favorable result from the +treatment to be instituted. It is, however, quite evident that in a +majority of instances the bony growths which so frequently appear on the +surface of their structure, to which the general term of exostosis is +applied, have had their origin in an inflammation of the periosteum, or +enveloping membrane, and known as periostitis. However this may be, we +have as a frequent result, sometimes on the body of the bone, sometimes +at the extremities, and sometimes involving the articulation itself, +certain bony growths, or exostoses, known otherwise by the term of +splint, ringbone, and spavin, all of which, in an important sense, may +be finally referred to the periosteum as their nutrient source and +support, at least after their formation, if not for their incipient +existence.</p> + +<p><i>Cause.</i>—It is certain that inflammation of the periosteum is +frequently referable to wounds and bruises caused by external agencies, +and it is also true that it may possibly result from the spreading +inflammation of surrounding diseased tissues, but in any case the result +is uniformly seen in the deposit of a bony growth, more or less diffuse, +sometimes of irregular outline, and at others projecting distinctly from +the surface from which it springs, as so commonly presented in the +ringbone and the spavin.</p> + +<p><i>Symptoms.</i>—This condition of periostitis is often difficult to +determine. The signs of inflammation are so obscure, the swelling of the +parts so insignificant, any increase of heat so imperceptible, and the +soreness so slight, that even the most acute observer may fail to find +the point of its existence, and it is often long after the discovery of +the disease itself that its location is positively revealed by the +visible presence of the exostosis. Yet the first question had been +resolved, in discovering the fact of the lameness, while the second and +third remained unanswered, and the identification of the affected limb +and the point of origin of the trouble remained unknown until their +palpable revelation to the senses.<span class='pagenum'><a name="Page_310" id="Page_310">[Pg 310]</a></span></p> + +<p><i>Treatment.</i>—When, by careful scrutiny, the ailment has been located, a +resort to treatment must be had at once, in order to prevent, if +possible, any further deposit of the calcareous structure and increase +of the exostotic growth. With this view the application of water, either +warm or cold, rendered astringent by the addition of alum or sugar of +lead, will be beneficial. The tendency to the formation of the bony +growth, and the increase of its development after its actual formation, +may often be checked by the application of a severe blister of Spanish +fly. The failure of these means and the establishment of the diseased +process in the form of chronic periostitis cause various changes in the +bone covered by the disordered membrane, and the result may be +softening, degeneration, or necrosis, but more usually it is followed by +the formation of the bony growths referred to, on the cannon bone, the +coronet, the hock, etc.</p> + + +<h4>SPLINTS.</h4> + +<p>We first turn our attention to the splint, as certain bony enlargements +that are developed on the cannon bone, between the knee or the hock and +the fetlock joint, are called. (See Plate XXV.) They are found on the +inside of the leg, from the knee, near which they are frequently found, +downward to about the lower third of the principal cannon bone. They are +of various dimensions, and are readily perceptible both to the eye and +to the touch. They vary considerably in size, ranging from that of a +large nut downward to very small proportions. In searching for them they +may be readily detected by the hand if they have attained sufficient +development in their usual situation, but must be distinguished from a +small, bony enlargement that may be felt at the lower third of the +cannon bone, which is neither a splint nor a pathological formation of +any kind, but merely the buttonlike enlargement at the lower extremity +of the small metacarpal or splint bone.</p> + +<p>We have said that splints are to be found on the inside of the leg. This +is true as a general statement, but it is not invariably so, for they +occasionally appear on the outside. It is also true that they appear +most commonly on the fore legs, but this is not exclusively the case, +because they may at times be found on both the inside and outside of the +hind leg. Usually a splint forms only a true exostosis, or a single bony +growth, with a somewhat diffuse base, but neither is this invariably the +case. In some instances they assume more important dimensions, and pass +from the inside to the outside of the bone, on its posterior face, +between that and the suspensory ligament. This form is termed the pegged +splint, and constitutes a serious and permanent deformity, in +consequence of its interference with the play of the fibrous cord which +passes behind it, becoming thus a source of continual irritation and +consequently of permanent lameness.<span class='pagenum'><a name="Page_311" id="Page_311">[Pg 311]</a></span></p> + +<p><i>Symptoms.</i>—A splint may thus frequently become a cause of lameness +though not necessarily in every instance, but it is a lameness +possessing features peculiar to itself. It is not always continuous, but +at times assumes an intermittent character, and is more marked when the +animal is warm than when cool. If the lameness is near the knee joint, +it is very liable to become aggravated when the animal is put to work, +and the gait acquires then a peculiar character, arising from the manner +in which the limb is carried outward from the knees downward, which is +done by a kind of abduction of the lower part of the leg. Other +symptoms, however, than the lameness and the presence of the splint, +which is its cause, may be looked for in the same connection as those +which have been mentioned as pertaining to certain evidences of +periostitis, in the increase of the temperature of the part, with +swelling and probably pain on pressure. This last symptom is of no +little importance, since its presence or absence has in many cases +formed the determining point in deciding a question of difficult +diagnosis.</p> + +<p><i>Cause.</i>—A splint being one of the results of periostitis, and the +latter one of the effects of external hurts, it naturally follows that +the parts which are most exposed to blows and collisions will be those +on which the splint will most commonly be found, and it may not be +improper, therefore, to refer to hurts from without as among the common +causes of the lesion. But other causes may also be productive of the +evil, and among these may be mentioned the over-straining of an immature +organism by the imposition of excessive labor upon a young animal at a +too early period of his life. The bones which enter into the formation +of the cannon are three in number, one large and two smaller, which, +during the youth of the animal, are more or less articulated, with a +limited amount of mobility, but which become in maturity firmly joined +by a rigid union and ossification of their interarticular surface. If +the immature animal is compelled, then, to perform exacting tasks beyond +his strength, the inevitable result will follow in the muscular +straining, and perhaps tearing asunder of the fibers which unite the +bones at their points of juncture, and it is difficult to understand how +inflammation or periostitis can fail to develop as the natural +consequence of such local irritation. If the result were deliberately +and intelligently designed, it could hardly be more effectually +accomplished.</p> + +<p>The splint is an object of the commonest occurrence—so common, indeed, +that in large cities a horse which can not exhibit one or more specimens +upon some portion of his extremities is one of the rarest of spectacles. +Though it is in some instances a cause of lameness, and its discovery +and cure are sometimes beyond the ability of the shrewdest and most +experienced veterinarians, yet as a source of vital danger to the +general equine organization, or even of functional<span class='pagenum'><a name="Page_312" id="Page_312">[Pg 312]</a></span> disturbance, or of +practical inconvenience, aside from the rare exceptional cases which +exist as mere samples of possibility, it can not be considered to belong +to the category of serious lesions. The worst stigma that attaches to it +is that in general estimation it is ranked among eyesores and continues +indefinitely to be that and nothing different. The inflammation in which +they originated, acute at first, either subsides or assumes the chronic +form, and the bony growth becomes a permanence—more or less +established, it is true, but doing no positive harm and not hindering +the animal from continuing his daily routine of labor. All this, +however, requires a proviso against the occurrence of a subsequent acute +attack, when, as with other exostoses, a fresh access of acute symptoms +may be followed by a new pathological activity, which shall again +develop, as a natural result, a reappearance of the lameness.</p> + +<p><i>Treatment.</i>—It is, of course, the consideration of the comparative +harmlessness of splints that suggests and justifies the policy of +noninterference, except as they become a positive cause of lameness. And +a more positive argument for such noninterference consists in the fact +that any active and irritating treatment may so excite the parts as to +bring about a renewed pathological activity, which may result in a +reduplication of the phenomena, with a second edition, if not a second +and enlarged volume, of the whole story. For our part, our faith is firm +in the impolicy of interference, and this faith is founded on an +experience of many years, during which our practice has been that of +abstention.</p> + +<p>Of course, there will be exceptional conditions which will at times +indicate a different course. These will become evident when the +occasions present themselves, and extraordinary forms and effects of +inflammation and growth in the tumors offer special indications. But our +conviction remains unshaken that surgical treatment of the operative +kind is usually useless, if not dangerous. We have little faith in the +method of extirpation except under very special conditions, among which +that of diminutive size has been named; this seems in itself to +constitute a sufficient negative argument. Even in such a case a resort +to the knife or the gouge could scarcely find a justification, since no +operative procedure is ever without a degree of hazard, to say nothing +of the considerations which are always forcibly negative in any question +of the infliction of pain and the unnecessary use of the knife.</p> + +<p><a name="PLATE_XXV" id="PLATE_XXV"></a></p> +<div class="figcenter" style="width: 450px;"> +<a href="images/plate25.jpg"><img src="images/plate25t.jpg" width="450" height="287" alt="PLATE XXV." title="" /></a> +<span class="caption">PLATE XXV.<br /> + +Splint.</span> +</div> + +<p><a name="PLATE_XXVI" id="PLATE_XXVI"></a></p> +<div class="figcenter" style="width: 450px;"> +<a href="images/plate26.jpg"><img src="images/plate26t.jpg" width="450" height="316" alt="PLATE XXVI." title="" /></a> +<span class="caption">PLATE XXVI.<br /> + +SOUND FOOT.<br /><br /> + +RINGBONE.</span> +</div> + +<p><a name="PLATE_XXVII" id="PLATE_XXVII"></a></p> +<div class="figcenter" style="width: 450px;"> +<a href="images/plate27.jpg"><img src="images/plate27t.jpg" width="450" height="268" alt="PLATE XXVII." title="" /></a> +<span class="caption">PLATE XXVII.<br /> + +VARIOUS TYPES OF SPAVIN.</span> +</div> + +<p><a name="PLATE_XXVIII" id="PLATE_XXVIII"></a></p> +<div class="figcenter" style="width: 450px;"> +<a href="images/plate28.jpg"><img src="images/plate28t.jpg" width="450" height="282" alt="PLATE XXVIII." title="" /></a> +<span class="caption">PLATE XXVIII.<br /> + +Bone Spavin. Hocks, with Skin Removed.</span> +</div> + +<p><a name="PLATE_XXIX" id="PLATE_XXIX"></a></p> +<div class="figcenter" style="width: 267px;"> +<a href="images/plate29.jpg"><img src="images/plate29t.jpg" width="267" height="450" alt="PLATE XXIX." title="" /></a> +<span class="caption">PLATE XXIX.<br /> + +BONE SPAVIN.</span> +</div> + +<p><span class='pagenum'><a name="Page_313" id="Page_313">[Pg 313]</a></span>If an acute periostitis of the cannon bone has been readily discovered, +the treatment we have already suggested for that ailment is at once +indicated, and the astringent lotions may be relied upon to bring about +beneficial results. Sometimes, however, preference may be given to a +lotion possessing a somewhat different quality, the alterative +consisting of tincture of iodin applied to the inflamed spot several +times daily. If the lameness persists under this mild course of +treatment, it must, of course, be attacked by other methods, and we must +resort to the cantharides ointment or Spanish-fly blister, as we have +before recommended. Besides this, and producing an analogous effect, the +compounds of biniodid of mercury are favored by some. It is prepared in +the form of an ointment, consisting of 1 dram of the biniodid to 1 ounce +of either lard or vaseline. It forms an excellent blistering and +alterative application, and is of special advantage in newly formed or +recently discovered exostosis.</p> + +<p>It remains a pertinent query, however, and one which seems to be easily +answered, whether a tumor so diminutive in size that it can be detected +only by diligent search, and which is neither a disfigurement nor an +obstruction to the motion of the limb, need receive any recognition +whatever. Other modes of treatment for splints are recommended and +practiced which belong strictly to the domain of operative veterinary +surgery; among these are to be reckoned actual cauterization, or the +application of the fire iron and the operation of periosteotomy. These +are frequently indicated in the treatment of splints which have resisted +milder means.</p> + +<p>The mode of the development of their growth; their intimacy, greater or +less, with both the large and the small cannon bones; the possibility of +their extending to the back of these bones under the suspensory +ligament; the dangerous complications which may follow the rough +handling of the parts, with also a possibility, and, indeed, a +probability, of their return after removal—these are the considerations +which have influenced our judgment in discarding from our practice and +our approval the method of removal by the saw or the chisel, as +recommended by certain European veterinarians.</p> + + +<h4>RINGBONES.</h4> + +<p>Ringbone is the designation of the exostosis which is found on the +coronet and in the digital and phalangeal regions. (See Plate XXVI.) The +name is appropriate, because the growth extends quite around the +coronet, which it encircles in the manner of a ring, or perhaps because +it often forms upon the back of that bone a regular osseous arch, +through which the back tendons obtain a passage. The places where these +growths are usually developed have caused their subdivision and +classification into three varieties, with the designations of high, +middle, and low, though much can be said as to the importance of the +distinction. It is true that the ringbone or phalangeal exostosis may be +found at various points on the foot, in one case forming a large bunch +on the upper part and quite close to the fetlock joint; in another +around the upper border of the hoof, or perhaps on the extreme front or +on the very back of the coronet. The shape in which they commonly appear +is favorable to their easy discovery,<span class='pagenum'><a name="Page_314" id="Page_314">[Pg 314]</a></span> their form when near the fetlock +usually varying too much from the natural outlines of the part when +compared with those of the opposite side to admit of error in the +matter. (See also page 439.)</p> + +<p>A ringbone, when on the front of the foot, even when not very largely +developed, assumes the form of a diffused convex swelling. If situated +on the lower part, it will form a thick ring, encircling that portion of +the foot immediately above the hoof; when found on the posterior part, a +small, sharp osseous growth somewhat projecting, sometimes on the inside +and sometimes on the outside of the coronet, may comprise the entire +manifestation.</p> + +<p><i>Cause.</i>—As with splints, ringbones may result from severe labor in +early life, before the process of ossification has been fully perfected; +or they may be referred to bruises, blows, sprains, or other violence; +injuries of tendons, ligaments, or joints also may be among the +accountable causes.</p> + +<p>It is certain that they may commonly be traced to diseases and traumatic +lesions of the foot, and their appearance may be reasonably expected +among the sequelæ of an abscess of the coronet; or the cause may be a +severe contusion resulting from calking, or a deep-punctured wound from +picking up a nail or stepping upon any hard object of sufficiently +irregular form to penetrate the sole.</p> + +<p>Moreover, a ringbone may originate in heredity. This is a fact of no +little importance in its relation to questions connected with the +extensive interests of the stock breeder and purchaser.</p> + +<p>That the hereditary transmission of constitutional idiosyncrasies is an +active cause with regard to diseases in general, it would be absurd to +assert, but we do say that a predisposition to contract ringbone through +faulty conformation, such as long, thin pasterns with narrow joints and +steep fetlocks, may be inherited in many cases, and in a smaller +proportion of cases this predisposition may act as a secondary cause in +the formation of ringbone.</p> + +<p>The importance of this point when considered in reference to the policy +which should be observed in the selection of breeding stock is obvious, +and, as the whole matter is within the control of the owners and +breeders, it will be their own fault if the unchecked transmission of +ringbones from one equine generation to another is allowed to continue. +It is our belief that among the diseases which are known for their +tendency to perpetuate and repeat themselves by individual succession, +those of the bony structures stand first, and the inference from such +fact which would exclude every animal of doubtful soundness in its +osseous apparatus from the stud list and the brood farm is too plain for +argument.</p> + +<p><i>Symptoms.</i>—Periostitis of the phalanges is an ailment requiring +careful exploration and minute inspection for its discovery, and is very +liable to result in a ringbone of which lameness is the result.<span class='pagenum'><a name="Page_315" id="Page_315">[Pg 315]</a></span> The +mode of its manifestation varies according to the state of development +of the diseased growth as affected by the circumstances of its location +and dimensions. It is commonly of the kind which, in consequence of its +intermittent character, is termed lameness when cool, having the +peculiarity of exhibiting itself when the animal starts from the stable +and of diminishing, if not entirely disappearing after some distance of +travel, to return to its original degree, if not indeed a severer one, +when he has again cooled off in his stable. The size of the ringbone +does not indicate the degree to which it cripples the patient, but the +position may, especially when it interferes with the free movement of +the tendons which pass behind and in front of the foot. While a large +ringbone will often interfere but little with the motion of the limb, a +smaller growth, if situated under the tendon, may become the cause of +considerable and continued pain.</p> + +<p>A ringbone is doubtless a worse evil than a splint. Its growth, its +location, its tendency to increased development, its exposure to the +influence of causes of renewed danger, all tend to impart an unfavorable +cast to the prognosis of a case and to emphasize the importance and the +value of an early discovery of its presence and possible growth. Even +when the discovery has been made, it is often the case that the truth +has come to light too late for effectual treatment. Months may have +elapsed after the first manifestation of the lameness before a discovery +has been made of the lesion from which it has originated, and there is +no recall for the lapsed time. And by the uncompromising seriousness of +the discouraging prognosis must the energy and severity of the treatment +and the promptness of its administration be measured. The periostitis +has been overlooked; any chance that might have existed for preventing +its advance to the chronic stage has been lost; the osseous formation is +established; the ringbone is a fixed fact, and the indications are +urgent and pressing.</p> + +<p><i>Treatment.</i>—The preventive treatment consists in keeping colts well +nourished and in trimming the hoof and shoeing to balance the foot +properly and thus prevent an abnormal strain on the ligaments. Even +after the ringbone has developed, a cure may sometimes be occasioned by +proper shoeing directed toward straightening the axis of the foot as +viewed from the side by making the wall of the hoof from the coronet to +the toe continuous with the line formed by the front of the pastern. So +long as inflammation of the periosteum and ligaments remains, a sharp +blister of biniodid of mercury and cantharides may do good if the animal +is allowed to rest for four or five weeks. If this fails, some success +may be accomplished by point firing in two or three lines over the +ringbone. It is necessary to touch the hot iron well into the bone, as +superficial firing does little good. When all these measures have failed +to remove the lameness, or when<span class='pagenum'><a name="Page_316" id="Page_316">[Pg 316]</a></span> the animal is not worth a long and +uncertain treatment, a competent veterinarian should be engaged to +perform double neurectomy, high or low, of the plantar nerves, or +neurectomy of the median nerve as indicated by the seat of the lesion.</p> + + +<h4>SIDEBONES.</h4> + +<p>On each side of the bone of the hoof—the coffinbone—there are normally +two supplementary organs which are called the cartilages of the foot. +They are soft, and though in a degree elastic, yet somewhat resisting, +and are implanted on the lateral wings of the coffinbone. Evidently +their office is to assist in the elastic expansion and contraction of +the posterior part of the hoof, and their healthy and normal action +doubtless contributes in an important degree to the perfect performance +of the functions of that part of the leg. These organs are, however, +liable to undergo a process of disease which results in an entire change +in their properties, if not in their shape, by which they acquire a +character of hardness resulting from the deposit of earthy substance in +the intimate structure of the cartilage, and it is this change, when its +consummation has been effected, that brings to our cognizance the +diseased growth which has received the designation of sidebones. They +are situated on one or both sides of the leg, bulging above the superior +border of the hoof in the form of two hard bodies composed of ossified +cartilage, irregularly square in shape and unyielding under the pressure +of the fingers.</p> + +<p><i>Cause.</i>—Sidebones may be the result of a low inflammatory condition or +of an acute attack as well, or may be caused by sprains, bruises, or +blows; or they may have their rise in certain diseases affecting the +foot proper, such as corns, quarter cracks, or quittor. The deposit of +calcareous matter in the cartilage is not always uniform, the base of +that organ near its line of union with the coffinbone being in some +cases its limit, while at other times it is diffused throughout its +substance, the size and prominence of the growth varying much in +consequence.</p> + +<p><i>Symptoms.</i>—It would naturally be inferred that the degree of +interference with the proper functions of the hoof which must result +from such a pathological change would be proportioned to the size of the +tumor, and that as the dimensions increase the resulting lameness would +be the greater in degree. This, however, is not the fact. A small tumor +while in a condition of acute inflammation during the formative stage +may cripple a patient more severely than a much larger one in a later +stage of the disease. In any case the lameness is never wanting, and +with its intermittent character may usually be detected when the animal +is cooled off after labor or exercise. The class of animals in which +this feature of the disease is most frequently<span class='pagenum'><a name="Page_317" id="Page_317">[Pg 317]</a></span> seen is that of the +heavy draft horse and others similarly employed. There is a wide margin +of difference in respect to the degrees of severity which may +characterize different cases of sidebone. While one may be so slight as +to cause no inconvenience, another may develop elements of danger which +may involve the necessity of severe surgical interference.</p> + +<p><i>Treatment.</i>—The curative treatment should be similar to the +prophylactic, and such means should be used as would tend to prevent the +deposit of bony matters by checking the acute inflammation which causes +it. The means recommended are the free use of the cold bath; frequent +soaking of the feet, and at a later period treatment with iodin, either +by painting the surface with the tincture several times daily or by +applying an ointment made by mixing 1 dram of the crystals with 2 ounces +of vaseline, rubbed in once a day for several days. If this proves to be +ineffective, a Spanish-fly blister to which a few grains of biniodid of +mercury have been added will effect in a majority of cases the desired +result and remove the lameness. If finally this treatment is ineffectual +the case must be relegated to the surgeon for the operation of +neurectomy, or the free and deep application of the firing iron.</p> + + +<h4>SPAVIN.</h4> + +<h5>(Pls. XXVII-XXIX.)</h5> + +<p>This affection, popularly termed bone spavin, is an exostosis of the +hock joint. The general impression is that in a spavined hock the bony +growth should be seated on the anterior and internal part of the joint, +and this is partially correct, as such a growth will constitute a spavin +in the most nearly correct sense of the term. But an enlargement may +appear on the upper part of the hock also, or possibly a little below +the inner side of the lower extremity of the shank bone, forming what is +known as a high spavin; or, again, the growth may form just on the +outside of the hock and become an outside or external spavin. And, +finally, the entire under surface may become the seat of the osseous +deposit, and involve the articular face of all the bones of the hock, +which again is a bone spavin. There would seem, then, to be but little +difficulty in comprehending the nature of a bone spavin, and there would +be none but for the fact that there are similar affections which may +confuse one if the diagnosis is not very carefully made.</p> + +<p>But the hock may be "spavined," while to all outward observation it +still retains its perfect form. With no enlargement perceptible to sight +or touch the animal may yet be disabled by an occult spavin, an +anchylosis in fact, which has resulted from a union of several of the +bones of the joint, and it is only those who are able to realize<span class='pagenum'><a name="Page_318" id="Page_318">[Pg 318]</a></span> the +importance of its action to the perfect fulfillment of the function of +locomotion by the hind leg who can comprehend the gravity of the only +prognosis which can be justified by the facts of the case—a prognosis +which is essentially a sentence of serious import in respect to the +future usefulness and value of the animal. For no disease, if we except +those acute inflammatory attacks upon vital organs to which the patient +succumbs at once, is more destructive to the usefulness and value of a +horse than a confirmed spavin. Serious in its inception, serious in its +progress, it is an ailment which, when once established, becomes a fixed +condition which there is no known means of dislodging.</p> + +<p><i>Cause.</i>—The periostitis, of which it is nearly always a termination, +is usually the effect of a traumatic cause operating upon the +complicated structure of the hock, such as a sprain which has torn a +ligamentous insertion and lacerated some of its fibers, or a violent +effort in jumping, galloping, or trotting, to which the victim has been +compelled by the torture of whip and spur while in use as a gambling +implement by a sporting owner, under the pretext of "improving his +breed"; the extra exertion of starting an inordinately heavy load, or an +effort to recover his balance from a misstep, slipping upon an icy +surface, or sliding with worn shoes upon a bad pavement, and other +kindred causes. We can repeat here what we have before said concerning +bones, in respect to heredity as a cause. From our own experience we +know of equine families in which this condition has been transmitted +from generation to generation, and animals otherwise of excellent +conformation have been rendered valueless by the misfortune of a +congenital spavin.</p> + +<p><i>Symptoms.</i>—The evil is one of the most serious character for other +reasons, among which may be specified the slowness of its development +and the insidiousness of its growth. Certain indefinite phenomena and +alarming changes and incidents furnish usually the only portents of +approaching trouble. Among these signs may be mentioned a peculiar +posture assumed by the patient while at rest, and becoming at length so +habitual that it can not fail to suggest the action of some hidden +disorder. The posture is due to the action of the adductor muscles, the +lower part of the leg being carried inward, and the heel of the shoe +resting on the toe of the opposite foot. Then an unwillingness may be +noticed in the animal to move from one side of the stall to the other. +When driven he will travel, but stiffly, with a sort of sidelong gait +between the shafts, and after finishing his task and resting again in +his stall will pose with the toe pointing forward, the heel raised, and +the hock flexed. Considerable heat and inflammation soon appear. The +slight lameness which appears when backing out of the stall ceases to be +noticeable after a short distance of travel.<span class='pagenum'><a name="Page_319" id="Page_319">[Pg 319]</a></span></p> + +<p>A minute examination of the hock may then reveal the existence of a bony +enlargement which may be detected just at the junction of the hock and +the cannon bone, on the inside and a little in front, and tangible both +to sight and touch. This enlargement, or bone spavin, grows rapidly and +persistently and soon acquires dimensions which renders it impossible to +doubt any longer its existence or its nature. Once established, its +development continues under conditions of progress similar to those to +which we have before alluded in speaking of other like affections. The +argument advanced by some that because these bony deposits are +frequently found on both hocks they are not spavins is fallacious. If +they are discovered on both hocks, it proves merely that they are not +confined to a single joint.</p> + +<p>The characteristic lameness of bone spavin, as it affects the motion of +the hock joint, presents two aspects. In one class of cases it is most +pronounced when the horse is cool, in the other when he is at work. The +first is characterized by the fact that when the animal travels the toe +first touches the ground, and the heel descends more slowly, the motion +of flexion at the hock taking place stiffly, and accompanied with a +dropping of the hip on the opposite side. In the other case the +peculiarity is that the lameness increases as the horse travels; that +when he stops he seeks to favor the lame leg, and when he resumes his +work soon after he steps much on his toe, as in the first variety.</p> + +<p>As with sidebones, though for a somewhat different reason, the +dimensions of the spavin and the degree of the lameness do not seem to +bear any determinate relation, the most pronounced symptoms at times +accompanying a very diminutive growth. The distinction between the two +varieties of cool and warm, however, may easily be determined by +remembering the fact that in most cases the first, or cool, is due to a +simple exostosis, while the second is generally connected with disease +of the articulation, such as ulceration of the articular surface—a +condition which, as we proceed further, will receive our attention when +we reach the subject of stringhalt.</p> + +<p>An excellent test for spavin lameness, which may be readily applied, +consists in lifting the affected leg from the ground for one or two +minutes and holding the foot high so as to flex all the joints. An +assistant, with the halter strap in his hand, quickly starts the animal +off in a trot, when, if the hock joint is affected, the lameness will be +so greatly intensified as to lead readily to a diagnosis.</p> + +<p><i>Prognosis.</i>—Having thus fully considered the history of bone spavin, +we are prepared to give due weight to the reasons that exist for the +adverse prognosis which we must usually feel compelled to pronounce when +encountering it in practice, as well as to realize the importance of +early discovery. It is but seldom, however, that the necessary advantage +of this early knowledge can be obtained, and<span class='pagenum'><a name="Page_320" id="Page_320">[Pg 320]</a></span> when the true nature of +the trouble has become apparent it is usually too late to resort to the +remedial measures which, if duly forewarned, a skillful practitioner +might have employed. We are fully persuaded that but for the loss of the +time wasted in the treatment of purely imaginary ailments very many +cases of bone spavin might be arrested in their incipiency and their +victims preserved for years of comfort for themselves and valuable labor +to their owners.</p> + +<p><i>Treatment.</i>—To consider a hypothetical case: An early discovery of +lameness has been made; that is, the existence of an acute +inflammation—of periostitis—has been detected. The increased +temperature of the parts has been observed, with the stiffened gait and +the characteristic pose of the limb, and the question is proposed for +solution, What is to be done? Even with only these comparatively +doubtful symptoms—doubtful with the nonexpert—we should direct our +treatment to the hock in preference to any other joint, since of all the +joints of the hind leg it is this which is most liable to be attacked, a +natural result from its peculiarities of structure and function. And in +answer to the query, What is the first treatment indicated? We should +answer <i>rest</i>—emphatically, and as an essential condition, <i>rest</i>. +Whether only threatened, suspected, or positively diseased, the animal +must be wholly released from labor, and it must be no partial or +temporary quiet of a few days. In all stages and conditions of the +disease, whether the spavin is nothing more than a simple exostosis, or +whether accompanied with the complication of arthritis, there must be a +total suspension of effort until the danger is over. Less than a month's +quiet ought not to be thought of—the longer the better.</p> + +<p>Good results may also be expected from local applications. The various +lotions which cool the parts, the astringents which lower the tension of +the blood vessels, the tepid fomentations which accelerate the +circulation in the engorged capillaries, the liniments of various +composition, the stimulants, the opiate anodynes, the sedative +preparations of aconite, the alterative frictions of iodin—all these +are recommended and prescribed by one or another. We prefer +counterirritants, for the reason, among many others, that by the +promptness of their action they tend to prevent the formation of the +bony deposits. The lameness will often yield to the blistering action of +cantharides, in the form of ointment or liniment, and to the alterative +preparations of iodin or mercury. If the owner of a "spavined" horse +really succeeds in removing the lameness, he has accomplished all that +he is justified in hoping for; beyond this let him be well persuaded +that a "cure" is impossible.</p> + +<p>For this reason, moreover, he will do well to be on his guard against +the patented "cures" which the traveling horse doctor may urge upon him, +and withhold his faith from the circular of the agent<span class='pagenum'><a name="Page_321" id="Page_321">[Pg 321]</a></span> who will deluge +him with references and certificates. It is possible that nostrums may +in some exceptional instances prove serviceable, but the greater number +of them are capable of producing only injurious effects. The removal of +the bony tumor can not be accomplished by any such means, and if a trial +of these unknown compounds should be followed by complications no worse +than the establishment of one or more ugly, hairless cicatrices, it will +be well for both the horse and his owner.</p> + +<p>Rest and counterirritation, with the proper medicaments, constitute, +then, the prominent points in the treatment designed for the relief of +bone spavin. Yet there are cases in which all the agencies and methods +referred to seem to lack effectiveness and fail to produce satisfactory +results. Either the rest has been prematurely interrupted or the +blisters have failed to modify the serous infiltration, or the case in +hand has some undiscernible characteristics which seem to have rendered +the disease neutral to the agencies used against it. An indication of +more energetic means is then presented, and free cauterization with the +firing iron becomes necessary.</p> + +<p>At this point a word of explanation in reference to this operation of +firing may be appropriate for the satisfaction of any among our readers +who may entertain an exaggerated idea of its severity and possible +cruelty.</p> + +<p>The operation is one of simplicity, but is nevertheless one which, in +order to secure its benefits, must be reserved for times and occasions +of which only the best knowledge and highest discretion should be +allowed to judge. It is not the mere application of a hot iron to a +given part of the body which constitutes the operation of firing. It is +the methodical and scientific introduction of heat into the structure +with a view to a given effect upon a diseased organ or tissue by an +expert surgeon. The first is one of the degrees of mere burning. The +other is scientific cauterization, and is a surgical manipulation which +should be committed exclusively to the practiced hand of the veterinary +surgeon.</p> + +<p>Either firing alone or stimulation with blisters is of great efficacy +for the relief of lameness from bone spavin. Failure to produce relief +after a few applications and after allowing a sufficient interval of +rest should be followed by a second or, if needed, a third firing.</p> + +<p>In case of further failure there is a reserve of certain special +operations which have been tried and recommended, among which those of +cunean tenotomy, periosteotomy, the division of nervous branches, etc., +may be mentioned. These, however, belong to the peculiar domain of the +veterinary practitioner, and need not now engage our attention.<span class='pagenum'><a name="Page_322" id="Page_322">[Pg 322]</a></span></p> + + +<h4>FRACTURES.</h4> + +<p>In technical language a fracture is a "solution of continuity in the +structure or substance of a bone." It ranks among the most serious of +the lesions to which the horse—or any animal—can be subject. It is a +subject of special interest to veterinarians and horse owners in view of +the fact that it occurs in such a variety of forms and subjects the +patient to much loss of time, resulting in the suspension of his earning +capacity. Though of less serious consequence in the horse than in man, +it is always a matter of grave import. It is always slow and tedious in +healing and is frequently of doubtful and unsatisfactory result.</p> + +<p>This solution of continuity may take place in two principal ways. In the +most numerous instances it includes the total thickness of the bone and +is a complete fracture. In other cases it involves only a portion of the +thickness of the bone, and for that reason is described as incomplete. +If the bone is divided into two separate portions and the soft parts +have received no injury, the fracture is a simple one, or it becomes +compound if the soft parts have suffered laceration, and comminuted if +the bones have been crushed or ground into fragments, many or few. The +direction of the break also determines its further classification. +Broken at a right angle, it is transverse; at a different angle it +becomes oblique, and it may be longitudinal or lengthwise. In a complete +fracture, especially of the oblique kind, there is a condition of great +importance in respect to its effect upon the ultimate result of the +treatment in the fact that from various causes, such as muscular +contractions or excessive motion, the bony fragments do not maintain +their mutual coaptation, but become separated at the ends, which makes +it necessary to add another descriptive term—with displacement. These +words again suggest the negative and introduce the term without +displacement, when the facts justify that description. Furthermore, a +fracture may be intra-articular or extra-articular, as it extends into a +joint or otherwise, and, once more, intra-periosteal when the periosteum +remains intact. Finally, there is no absolute limit to the use of +descriptive terminology in the case.</p> + +<p>The condition of displacement is largely influential in determining the +question of treatment and as affecting the final result of a case of +fracture. This, however, is dependent upon its location or whether its +seat is in one or more of the axes of the bone, in its length, its +breadth, its thickness, or its circumference. An incomplete fracture may +also be either simple or comminuted. In the latter case the fragments +are held together by the periosteum when it is intact; in that case the +fracture belongs to the intra-periosteal class. At times, also, there is +only a simple fissure or split in the bone, making a condition of much +difficulty of diagnosis.<span class='pagenum'><a name="Page_323" id="Page_323">[Pg 323]</a></span></p> + +<p><i>Causes.</i>—Two varieties of originating cause may be recognized in cases +of fracture. They are the predisposing and the occasional. As to the +first, different species of animals differ in the degree of their +liability. That of the dog is greater than that of the horse, and in +horses the various questions of age, the mode of labor, the season of +the year, the portion of the body most exposed, and the existence of +ailments, local and general, are all to be taken into account.</p> + +<p>Among horses, those employed in heavy draft work or that are driven over +bad roads are more exposed than light-draft or saddle horses, and +animals of different ages are not equally liable. Dogs and young horses, +with those which have become sufficiently aged for their bones to have +acquired an enhanced degree of frangibility, are more liable than those +which have not exceeded the time of their prime. The season of the year +is undoubtedly, though in an incidental way, an important factor in the +problem of the etiology of these accidents, for though they may be +observed at all times, it is during the months when the slippery +condition of the icy roads renders it difficult for both men and beasts +to keep their feet that they occur most frequently. The long bones, +those especially which belong to the extremities, are most frequently +the seat of fractures, from the circumstance of their superficial +position, their exposure to contact and collision, and the violent +muscular efforts involved both in their constant, rapid movement and +their labor in the shafts or at the pole of heavy and heavily laden +carriages.</p> + +<p>The relation between sundry idiosyncrasies and diathesis and a liability +to fractures is too constant and well-established a pathological fact to +need more than a passing reference. The history of rachitis, of +melanosis, and of osteoporosis, as related to an abnormal frangibility +of the bones, is a part of our common medical knowledge. There are few +persons who have not known of cases among their friends of frequent and +almost spontaneous fractures, or at least of such as seem to be produced +by the slightest and most inadequate violence, and there is no tangible +reason for doubting an analogous condition in dividuals of the equine +race. Among local predisposing causes mention must not be omitted of +such bony diseases as caries, tuberculosis, and others of the same +class.</p> + +<p>Exciting, occasional, or "efficient" causes of fracture are in most +instances external traumatisms, as violent contacts, collisions, falls, +etc., or sudden muscular contractions. These external accidents are +various in their character, and are usually associated with quick +muscular exertion. A violent, ineffectual effort to move too heavy a +load; a semispasmodic bracing of the frame to avoid a fall or resist a +pressure; a quick jump to escape a blow; stopping too suddenly after +speeding; struggling to liberate a foot from a rail, perhaps to be +thrown in the effort—all these are familiar and easy examples of +accidents<span class='pagenum'><a name="Page_324" id="Page_324">[Pg 324]</a></span> happening hourly by which our equine servants become +sufferers. We may add to these the fracture of the bones of the +vertebræ, occurring when casting a patient for the purpose of undergoing +a surgical operation, quite as much as the result of muscular +contraction as of a preexisting diseased condition of the bones. A +fracture occurring under these circumstances may be called with +propriety indirect, while one which has resulted from a blow or a fall +differently caused is of the direct kind.</p> + +<p><i>Symptoms.</i>—We now return to the first items in our classification of +the varieties of fractures for the purpose of bringing them in turn +under an orderly review, and our first examination will include those +which belong to the first category, or the complete kind. Irregularity +in the performance of the functions of the apparatus to which the +fractured bone belongs is a necessary consequence of the existing +lesion, and this is lameness. If the broken bone belongs to one of the +extremities, the impossibility of the performance of its natural +function in sustaining the weight of the body and contributing to the +act of locomotion is usually complete, though the degree of disability +will vary according to the kind of fracture and the bone which is +injured. For example, a fracture of the cannon bone without +displacement, or of one of the phalanges, which are surrounded and +sustained by a complex fibrous structure, is, in a certain degree, not +incompatible with some amount of resting on the foot. On the contrary, +if the shank bone, or that of the forearm is the implicated member, it +would be very difficult for the leg to exercise any agency whatever in +the support of the body, and in a fracture of the lower jaw it would be +obviously unreasonable to expect it to contribute materially to the +mastication of feed.</p> + +<p>It seldom happens that a fracture is not accompanied with a degree of +deformity, greater or less, of the region or the leg affected. This is +due to the exudation of the blood into the meshes of the surrounding +tissues and to the displacement which occurs between the fragments of +the bones, with subsequently the swelling which follows the inflammation +of the surrounding tissues. The character of the deformity will mainly +depend upon the manner in which the displacement occurs.</p> + +<p>In a normal state of things the legs perform their movements with the +joints as their only centers or bases of action, with no participation +of intermediate points, while with a fracture the flexibility and motion +which will be observed at unnatural points are among the most strongly +characteristic signs of the lesion. No one need be told that, when the +shaft of a limb is seen to bend midway between the joints, with the +lower portion swinging freely, the leg is broken. There are still some +conditions, however, in which the excessive mobility is not easy to +detect. Such are the cases in which the fracture<span class='pagenum'><a name="Page_325" id="Page_325">[Pg 325]</a></span> exists in a short +bone, near a movable joint, or in a bone of a region where several short +and small bones are united in a group, or even in a long bone the +situation of which is such that the muscular covering prevents the +visible manifestation of the symptom.</p> + +<p>If the situation of a fracture precludes its discovery by means of this +abnormal flexibility, other modes of detection remain. There is one +method which is absolute and positive and which can be applied in by far +the most, though not in all cases. This is crepitation, or the peculiar +effect which is produced by the friction of the fractured surfaces one +against another. Though discerned by the organs of hearing it can +scarcely be called a sound, for the grating of the parts as the rubbing +takes place is more felt than heard; however, there is no mistaking its +import in cases favorable for the application of the test. The +conditions in which it is not available are those of incomplete +fracture, in which the mobility of the part is lacking, and those in +which the whole array of phenomena are usually obscure. To obtain the +benefit of this pathognomonic sign requires deliberate, careful, and +gentle manipulation. Sometimes the slightest of movements will be +sufficient for its development, after much rougher handling has failed +to discover it. Perhaps the failure in the latter case is due to a sort +of defensive spasmodic rigidity caused by the pain resulting from the +rude interference.</p> + +<p>More or less reactive fever is a usual accompaniment of a fracture. +Ecchymosis in the parts is but a natural occurrence, and is more easily +discovered in animals possessing a light-colored and delicate skin than +in those of any other character.</p> + +<p>There are difficulties in the way of the diagnosis of an incomplete +fracture, even sometimes when there is a degree of impairment in the +function of locomotion, with evidences of pain and swelling at the seat +of lesion. There should then be a careful examination for evidences of a +blow or other violence sufficient to account for the fracture, though +very often a suspicion of its existence can be converted into a +certainty only by a minute history of the patient if it can be obtained +up to the moment of the occurrence of the injury. A diagnosis ought not +to be hastily pronounced, and where good ground for suspicion exists it +ought not to be rejected upon any evidence less than the best. We too +often read of serious and fatal complications following careless +conclusions in similar cases, among which we may refer to one instance +of a complete fracture manifesting itself in an animal during the act of +rising in his stall after a decision had been pronounced that he had no +fracture at all.</p> + +<p>Fractures are of course liable to complications, especially those which +are of a traumatic character, such as extensive lacerations, tearing of +tissues, punctures, contusions, etc. Unless these are in communication +with the fracture itself the indication is to treat them<span class='pagenum'><a name="Page_326" id="Page_326">[Pg 326]</a></span> simply as +independent lesions upon other parts of the body. A traumatic emphysema +at times causes trouble, and abscesses, more or less deep and diffused, +may follow. In some cases small, bony fragments from a comminuted +fracture, becoming loose and acting as foreign bodies, give rise to +troublesome fistulous tracts. A frequent complication is hemorrhage, +which often becomes of serious consequence. A fracture in close +proximity to a joint may be accompanied with dangerous inflammations of +important organs, and induce an attack of pneumonia, pleurisy, +arthritis, etc., especially if near the chest; it may also cause +luxations, or dislocations. Gangrene, as a consequence of contusions or +of hemorrhage or of an impediment to the circulation, caused by +unskillfully applied apparatus, must not be overlooked among the +occasional incidents; nor must lockjaw, which is not an uncommon +occurrence. Even founder, or laminitis, has been met with as the result +of forced and long-continued immobility of the feet in the standing +posture, as one of the involvements of unavoidably protracted treatment.</p> + +<p>When a simple fracture has been properly treated and the broken ends of +the bone have been securely held in coaptation, one of two things will +occur. Either—and this is the more common event—there will be a union +of the two ends by a solid cicatrix, the callus, or the ends will +continue separated or become only partially united by an intermediate +fibrous structure. In the first instance the fracture is consolidated or +united; in the second there is a false articulation, or pseudarthrosis.</p> + +<p>The time required for a firm union or true consolidation of a fracture +varies with the character of the bone affected, the age and constitution +of the patient, and the general conditions of the case. The union will +be perfected earlier in a young than in an adult animal, and sooner in +the latter than in the aged, and a general healthy condition is, of +course, in every respect, an advantage.</p> + +<p>The mode of cicatrization, or method of repair in lesions of the bones, +has been a subject of much study among investigators in pathology, and +has elicited various expressions of opinion from those high in +authority. The weight of evidence and preponderance of opinion are about +settled in favor of the theory that the law of reparation is the same +for both the hard and the soft tissues. In one case a simple exudation +of material, with the proper organization of newly formed tissue, will +bring about a union by the first intention, and in another the work will +be accompanied with suppuration, or union by the second intention, a +process so familiar in the repair of the soft structures by granulation.</p> + +<p>Considering the process in its simplest form, in a case in which it +advances without interruption or complication to a favorable result, it +may probably be correctly described in this wise:<span class='pagenum'><a name="Page_327" id="Page_327">[Pg 327]</a></span></p> + +<p>On the occurrence of the injury an effusion of blood takes place between +the ends of the bone. The coagulation of the fluid soon follows, and +this, after a few days, undergoes absorption. There is then an excess of +inflammation in the surrounding structure, which soon spreads to the +bony tissue, when a true ostitis is established, and the compact tissue +of the bone becomes the seat of a new vascular organization, and of a +certain exudation of plastic lymph, appearing between the periosteum and +the external surface of the bone, as well as on the inner side of the +medullary cavity. After a few days the ends of the bone thus surrounded +by this exudate become involved in it, and the lymph, becoming vascular, +is soon transformed into cartilaginous, and in due time into bony, +tissue.</p> + +<p>Thus the time required for the consolidation of the fractured segments +is divisible into two distinct periods. In the first they are surrounded +by an external bony ring, and the medullary cavity is closed by a bony +plug or stopper, constituting the period of the provisional callus. This +is followed by the period of permanent callus, during which the process +of converting the cartilaginous into the osseous form is going forward.</p> + +<p>The restorative process is sooner completed in the carnivorous than in +the herbivorous tribes. In the former the temporary callus may attain +sufficient fineness of consistency for the careful use of the limb +within four weeks, but with the latter a period of from six weeks to two +months is not too long to allow before removing the supporting apparatus +from the limb.</p> + +<p>This, in general terms, represents the fact when the resources of nature +have not been thwarted by untoward accidents, such as a want of vigor in +the constitution of the patient or a lack of skill on the part of the +practitioner, and especially when, from any cause, the bony fragments +have not been kept in a state of perfect immobility and the constant +friction has prevented the osseous union of the two portions. Failures +and misfortunes are always more than possible, and instead of a solid +and practicable bony union the sequel of the accident is sometimes a +false joint, composed of mere flexible cartilage, a poor pseudarthrosis. +The explanation of this appears to be that, first, the sharp edges of +the ends of the bone disappear by becoming rounded at their extremities +by friction and polishing against each other. Then follows an exudation +of a plastic nature which becomes transformed into a cartilaginous layer +of a rough, articular aspect. In this bony nuclei soon appear, and the +lymph secreted between the segments thus transformed, instead of +becoming truly ossified, is changed into a sort of fibrocartilaginous +pouch, or capsular sac, in which a somewhat albuminous secretion, or +pseudo-synovia, permits the movement to take place. Most commonly, +however, in our animals, the union of the bony fragments is obtained<span class='pagenum'><a name="Page_328" id="Page_328">[Pg 328]</a></span> +wholly through the medium of a layer of fibrous tissue, and it is +because the union has been accomplished by a ligamentous formation only +that motion becomes practicable.</p> + +<p><i>Prognosis.</i>—The prognosis in a case of fracture in an animal is one of +the gravest vital import to the patient, and therefore of serious +pecuniary concern to his owner. The period has not long elapsed when to +have received such a hurt was quite equivalent to undergoing a sentence +of death for the suffering animal, and perhaps to-day a similar verdict +is pronounced in many cases in which the exercise of a little mechanical +ingenuity, with a due amount of careful nursing, might secure a contrary +result and insure the return of the patient to his former condition of +soundness and usefulness.</p> + +<p><i>Treatment.</i>—Considered per se, a fracture in an animal is in fact no +less amenable to treatment than the same description of injury in any +other living being. But the question of the propriety and expediency of +treatment is dependent upon certain specific points of collateral +consideration.</p> + +<p>(1) The nature of the lesion is a point of paramount importance. A +simple fracture occurring in a bone where the ends can be firmly secured +in coaptation presents the most favorable condition for successful +treatment. If it is that of a long bone, it will be the less serious if +situated at or near the middle of its length than if it were in close +proximity to a joint, from the fact that perfect immobility can rarely, +in the latter case, be secured without incurring the risk of subsequent +rigidity of the joint.</p> + +<p>A simple is always less serious than a compound fracture. A comminuted +is always more dangerous than a simple, and a transverse break is easier +to treat than one which is oblique. The most serious are those which are +situated on parts of the body in which it is difficult to obtain perfect +immobility, and especially those which are accompanied with severe +contusions and lacerations in the soft parts; the protrusion of +fragments through the skin; the division of blood vessels by the broken +ends of the bone; the existence of an articulation near the point to +which inflammation is liable to extend; the luxation of a fragment of +the bone; laceration of the periosteum; the presence of a large number +of bony particles, the result of the crushing of the bone—all these are +circumstances which discourage a favorable prognosis, and weigh against +the hope of saving the patient for future usefulness.</p> + +<p>Fractures which may be accounted curable are those which are not +conspicuously visible, as those of the ribs, where displacements are +either very limited or do not occur, the parts being kept in situ by the +nature of their position, the shape of the bones, the articulations they +form with the vertebra, the sternum, or their cartilages of +prolongation; those of transverse processes of the lumbar vertebra; +those of<span class='pagenum'><a name="Page_329" id="Page_329">[Pg 329]</a></span> the bones of the face; those of the ilium; and that of the +coffinbones. To continue the category, the following are evidently +curable when their position and the character of the patient contribute +to aid the treatment: Those of the cranium, in the absence of cerebral +lesions; those of the jaws; of the ribs, with displacement; of the hip; +and those of the bones of the leg in movable regions, but where their +vertical position admits of perfect coaptation.</p> + +<p>On the contrary, a compound, complicated, or comminuted, fracture, in +whatever region it may be situated, may be counted incurable.</p> + +<p>In treating fractures time is an important element and "delays are +dangerous." Those of recent occurrence unite more easily and more +regularly than older ones.</p> + +<p>(2) As a general rule, fractures are less serious in animals of the +smaller species than in those of more bulky dimensions. This influence +of species will be readily appreciated when we realize that the +difficulties involved in the treatment of the latter class have hardly +any existence in connection with the former. The difference in weight +and size, and consequent facility in handling and making the necessary +applications of dressings and other appliances for the purpose of +securing the indispensable immobility of the parts, and usually a less +degree of uneasiness in the deportment of the patients are +considerations in this connection of great weight.</p> + +<p>(3) In respect to the utilization of the animal, the most obvious point +in estimating the gravity of the case in a fracture accident is the +certainty of the total loss of the services of the patient during +treatment—certainly for a considerable period of time; perhaps +permanently. For example, the fracture of the jaw of a steer just +fattening for the shambles will involve a heavier loss than a similar +accident to a horse. Usually the fracture of the bones of the +extremities in a horse is a very serious casualty, the more so +proportionately as the higher region of the limb is affected. In working +animals it is exceedingly difficult to treat a fracture in such manner +as to restore a limb to its original perfection of movement. A fracture +of a single bone of an extremity in a breeding stallion or mare will not +necessarily impair the value of the animal as a breeder. Other +specifications under this head, though pertinent and more or less +interesting, may be omitted.</p> + +<p>(4) Age and temper are important factors of cure. A young, growing, +robust patient whose vis vitæ is active is amenable to treatment which +one with a waning constitution and past mature energies would be unable +to endure, and a docile, quiet disposition will act cooperatively with +remedial measures which would be neutralized by the fractious opposition +of a peevish and intractable sufferer.</p> + +<p>The fulfillment of three indications is indispensable in all fractures. +The first is the reduction, or the replacement, of the parts as nearly<span class='pagenum'><a name="Page_330" id="Page_330">[Pg 330]</a></span> +as possible in their normal position. The second is their retention in +that position for a period sufficient for the formation of the +provisional callus, and the third, which, in fact, is but an incident of +the second, the careful avoidance of any accidents or causes of +miscarriage which might disturb the curative process.</p> + +<p>In reference to the first consideration, it must be remembered that the +accident may befall the patient at a distance from his home, and his +removal becomes the first duty to be attended to. Of course, this must +be done as carefully as possible. If he can be treated on the spot, so +much the better, though this is seldom practicable, and the method of +removal becomes the question calling for settlement. But two ways +present themselves—he must either walk or be carried. If the first, it +is needless to say that every caution must be observed in order to +obviate additional pain and to avoid any aggravation of the injury. Led +slowly, and with partial support, if practicable, the journey will not +always involve untoward results. If he is carried, it must be by means +of a wagon, a truck, or an ambulance; the last being designed and +adapted to the purpose, would, of course, be the most suitable vehicle. +As a precaution which should never be overlooked, a temporary dressing +should first be applied. This may be so done as for the time to answer +all the purposes of the permanent adjustment and bandaging. Without thus +securing the patient, a fracture of an inferior degree may be +transformed to one of the severest kind, and, indeed, a curable changed +to an incurable injury. We recall a case in which a fast-trotting horse, +after running away in a fright caused by the whistle of a locomotive, +was found on the road limping with excessive lameness in the off fore +leg, and walked with comparative ease some 2 miles to a stable before +being seen by a surgeon. His immediate removal in an ambulance was +advised, but before that vehicle could be procured the horse lay down, +and upon being made to get upon his feet was found with a well-marked +comminuted fracture of the os suffraginis, with considerable +displacement. The patient, however, after long treatment, made a +comparatively good recovery and though with a large, bony deposit, a +ringbone, was able to trot in the forties.</p> + +<p>The two obvious indications in cases of fracture are reduction, or +replacement, and retention.</p> + +<p>In an incomplete fracture, where there is no displacement, the necessity +of reduction does not exist. With the bone kept in place by an intact +periosteum, and the fragments secured by the uninjured fibrous and +ligamentous structure which surrounds them, there is no dislocation to +correct. Reduction is also at times rendered impossible by the seat of +the fracture itself, by its dimensions, alone, or by the resistance +arising from muscular contraction. That is illustrated even in small +animals, as in dogs, by the exceeding difficulty<span class='pagenum'><a name="Page_331" id="Page_331">[Pg 331]</a></span> encountered in +bringing together the ends of a broken femur or humerus, the muscular +contractions being even in these animals sufficiently forcible to renew +the displacement.</p> + +<p>It is generally, therefore, only fractures of the long bones, and then +at points not in close proximity to the trunk, that may be considered to +be amenable to reduction. It is true that some of the more superficial +bones, as those of the head, of the pelvis, and of the thoracic walls, +may in some cases require special manipulations and appliances for their +retention in their normal positions; hence the treatment of these and of +a fractured leg can not be the same.</p> + +<p>The methods of accomplishing reduction vary with the features of each +case, the manipulations being necessarily modified to meet different +circumstances. If the displacement is in the thickness of the bone, as +in transverse fracture, the manipulation of reduction consists in +applying constant pressure upon one of the fragments, while the other is +kept steady in its place, the object of the pressure being the +reestablishment of the exact coincidence of the two bony surfaces. If +the displacement has taken place at an angle it will be sufficient in +order to effect the reduction to press upon the summit, or apex, of the +angle until its disappearance indicates that the parts have been brought +into coaptation. This method is often practiced in the treatment of a +fractured rib. In a longitudinal fracture, or when the fragments are +pressed together by the contraction of the muscles to which they give +insertion until they so overlap as to correspond by certain points of +their circumference, the reduction is to be accomplished by effecting +the movements of extension, counter extension, and coaptation. Extension +is accomplished by making traction upon the lower portion of the limb. +Counter extension consists in firmly holding or confining the upper or +body portion in such manner, that it shall not be affected by the +traction applied to the lower part. In other words, the operator, +grasping the limb below the fracture, draws it down or away from the +trunk, while he seeks not to draw away, but simply to hold the upper +portion still until the broken ends of bone are brought to their natural +relative positions, when the coaptation, which is thus effected, has +only to be made permanent by the proper dressings to perfect the +reduction.</p> + +<p>In treating fractures in small animals the strength of the hand is +usually sufficient for the required manipulations. In the fracture of +the forearm of a dog, for example, while the upper segment is firmly +held by one hand the lower may be grasped by the other and the bone +itself made to serve the purpose of a lever to bring about the desired +coaptation. In such case that is sufficient to overcome the muscular +contraction and correct the overlapping or other malposition of the +bones. If, however, the resistance can not be overcome in this way, the +upper segment may be committed to an assistant for<span class='pagenum'><a name="Page_332" id="Page_332">[Pg 332]</a></span> the management of +the counter extension, leaving to the operator the free use of both +hands for the further manipulation of the case.</p> + +<p>If the reduction of fractures in small animals is an easy task, however, +it is far from being so when the patient is a large animal whose +muscular force is largely greater than that of several men combined. In +such case resort must be had not only to superior numbers for the +necessary force, but in many cases to mechanical aids. A reference to +the manner of proceeding in a case of fracture with displacement of the +forearm of a horse will illustrate the matter. The patient is first to +be carefully cast, on the uninjured side, with ropes or a broad, leather +strap about 18 feet long passed under and around his body and under the +axilla of the fractured limb and secured at a point opposite to the +animal and toward his back. This will form the mechanical means of +counter extension. Another rope will then be placed around the inferior +part of the leg below the point of fracture, with which to produce +extension, and this will sometimes be furnished with a block and +pulleys, in order to augment the power when necessary; there is, in +fact, always an advantage in their use, on the side of steadiness and +uniformity, as well as of increased power. It is secured around the +fetlock or the coronet or, what is better, above the knee and nearer the +point of fracture, and is committed to assistants. The traction on this +should be firm, uniform, and slow, without relaxing or jerking, while +the operator carefully watches the process. If the bone is superficially +situated he is able, by the eye, to judge of any changes that may occur +in the form or length of the parts under traction, and discovering, at +the moment of its happening, the restoration of symmetry in the +disturbed region he gently but firmly manipulates the place until all +appearance of severed continuity has vanished. Sometimes the fact and +the instant of restoration are indicated by a peculiar sound or "click" +as the ends of the bones slip into contact, to await the next step of +the restorative procedure.</p> + +<p>The process is the same when the bones are covered with thick muscular +masses except that it is attended with greater difficulties from the +fact that the finger must be substituted for the eye and taxis must take +the place of sight.</p> + +<p>It frequently happens that perfect coaptation is prevented by the +interposition, between the bony surfaces, of such substances as a small +fragment of detached bone or a clot of blood; sometimes the extreme +obliquity of the fracture, by permitting the bones to slip out of place, +is the opposing cause. These are difficulties which can not always be +overcome, even in small-sized animals, and still it is only when they +are mastered that a correct consolidation can be looked for. Without it +the continuity between the fragments will be<span class='pagenum'><a name="Page_333" id="Page_333">[Pg 333]</a></span> by a deformed callus, the +union will leave a shortened, crooked, or angular limb, and the animal +will be disabled.</p> + +<p>If timely assistance can be obtained, and the reduction accomplished +immediately after the occurrence of the accident, that is the best time +for it, but if it can not be attended to until inflammation has become +established and the parts have become swollen and painful, time must be +allowed for the subsidence of these symptoms before attempting the +operation. A spasmodic, muscular contraction which sometimes interposes +a difficulty may be easily overcome by subjecting the patient to general +anesthesia, and need not, therefore, cause any loss of time. A tendency +to this may also be overcome by the use of sedatives and antiphlogistic +remedies.</p> + +<p>The reduction of the fracture having been accomplished, the problem +which follows is that of retention. The parts which have been restored +to their natural position must be kept there, without disturbance or +agitation, until the perfect formation of a callus, and it is here that +ample latitude exists for the exercise of ingenuity and skill by the +surgeon in the contrivance of the necessary apparatus. One of the most +important of the conditions which are available by the surgeon in +treating human patients is denied to the veterinarian in the management +of those which belong to the animal tribes. This is position. The +intelligence of the human patient cooperates with the instructions of +the surgeon, in the case of the animal sufferer there is a continual +antagonism between the parties, and the forced extension and fatiguing +position which must for a considerable period be maintained as a +condition of restoration require special and effective appliances to +insure successful results. To obtain complete immobility is scarcely +possible, and the surgeon must be content to reach a point as near as +possible to that which is unattainable. For this reason, as will +subsequently be seen, the use of slings and the restraint of patients in +very narrow stalls is much to be preferred to the practice sometimes +recommended of allowing entire freedom of motion by turning them loose +in box stalls. Temporary and movable apparatus are not usually of +difficult use in veterinary practice, but the restlessness of the +patients and their unwillingness to submit quietly to the changing of +the dressings render it obligatory to have recourse to permanent and +immovable bandages, which should be retained without disturbance until +the process of consolidation is complete.</p> + +<p>The materials composing the retaining apparatus consist of oakum, +bandages, and splints, with an agglutinating compound which forms a +species of cement by which the different constituents are blended into a +consistent mass to be spread upon the surface covering the locality of +the fracture. Its components are black pitch, rosin, and Venice +turpentine, blended by heat. The dressing may be applied<span class='pagenum'><a name="Page_334" id="Page_334">[Pg 334]</a></span> directly to +the skin, or a covering of thin linen may be interposed. A putty made +with powdered chalk and the white of egg is recommended for small +animals, though a mixture of sugar of lead and burnt alum with the +albumen is preferred by others. Another formula is spirits of camphor, +Goulard's extract, and albumen. Another recommendation is to saturate +the oakum and bandages with an adhesive solution formed with gum arabic, +dextrin, flour paste, or starch. This is advised particularly for small +animals, as is also the silicate of soda. Dextrin mixed while warm with +burnt alum and alcohol cools and solidifies into a stony consistency, +and is preferable to plaster of Paris, which is less friable and has +less solidity, besides being heavier and requiring constant additions as +it becomes older. Starch and plaster of Paris form another good +compound.</p> + +<p>In applying the dressing the leg is usually padded with a cushion of +oakum thick and soft enough to equalize the irregularities of the +surface and to form a bedding for the protection of the skin from +chafing. Over this the splints are placed. The material for these is, +variously, pasteboard, thin wood, bark, laths, gutta-percha, strips of +thin metal, as tin or perhaps sheet iron. They should be of sufficient +length not only to cover the region of the fracture but to extend +sufficiently above and below to render the immobility more nearly +complete than in the surrounding joints. The splints, again, are covered +with cloth bandages—linen preferably—soaked in a glutinous mixture. +These bandages are to be carefully applied, with a perfect condition of +lightness. They are usually made to embrace the entire length of the leg +in order to avoid the possibility of interference with the circulation +of the extremity as well as for the prevention of chafing. They should +be rolled from the lower part of the leg upward and carefully secured +against loosening. In some instances suspensory bandages are +recommended, but except for small animals our experience does not +justify a concurrence in the recommendation.</p> + +<p>These permanent dressings always need careful watching with reference to +their immediate effect upon the region they cover, especially during the +first days succeeding that of their application. Any manifestation of +pain, or any appearance of swelling above or below, or any odor +suggestive of suppuration should excite suspicion, and a thorough +investigation should follow without delay. The removal of the dressing +should be performed with great care, and especially so if time enough +has elapsed since its application to allow of a probability of a +commencement of the healing process or the existence of any points of +consolidation. With the original dressing properly applied in its +entirety in the first instance, the entire extremity will have lost all +chance of mobility, and the repairing process may be permitted to +proceed without interference. There will be no necessity<span class='pagenum'><a name="Page_335" id="Page_335">[Pg 335]</a></span> and there need +be no haste for removal or change except under such special conditions +as have just been mentioned, or when there is reason to judge that +solidification has become perfect, or for the comfort of the animal, or +for its readaptation in consequence of the atrophy of the limb from want +of use. Owners of animals are often tempted to remove a splint or +bandage prematurely at the risk of producing a second fracture in +consequence of the failure of the callus properly to consolidate.</p> + +<p>The method of applying the splints which we have described refers to the +simple variety only. In a compound case the same rules must be observed, +with the modification of leaving openings through the thickness of the +dressing, opposite the wound, in order to permit the escape of pus and +to secure access to the points requiring the application of treatment.</p> + + +<h4>FRACTURE OF CRANIAL BONES.</h4> + +<p>Fractures of the cranial bones in large animals are comparatively rare, +though the records are not destitute of cases. When they occur, it is as +the result of external violence, the sufferers being usually run-aways +which have come in collision with a wall or a tree or other obstruction, +or it may occur in those which in pulling upon the halter have broken it +with a jerk and been thrown backward, as may occur in rearing too +violently. Under these conditions we have witnessed fractures of the +parietal, of the frontal, and of the sphenoid bones. These fractures may +be of both the complete and the incomplete kinds, which indeed is +usually the case with those of the flat bones, and they are liable to be +complicated with lacerations of the skin, in consequence of which they +are easily brought under observation. When the fact is otherwise and the +skin is intact, however, the diagnosis becomes difficult.</p> + +<p><i>Symptoms.</i>—The incomplete variety may be unaccompanied with any +special symptoms, but in the complete kind one of the bony plates may be +so far detached as to press upon the cerebral substance with sufficient +force to produce serious nervous complications. When the injury occurs +at the base of the cranium hemorrhage may be looked for, with paralytic +symptoms, and when these are present the usual termination is death. It +may happen, however, that the symptoms of an apparently very severe +concussion may disappear, resulting in an early and complete recovery, +and the surgeon will therefore do well to avoid undue haste in venturing +upon a prognosis. In fractures of the orbital or the zygomatic bones the +danger is less pressing than with injuries otherwise located about the +head.</p> + +<p><i>Treatment.</i>—The treatment of cranial fractures is simple, though +involving the best skill of an experienced surgeon. When incomplete +hardly any interference is needed; even plain bandaging may usually<span class='pagenum'><a name="Page_336" id="Page_336">[Pg 336]</a></span> be +dispensed with. In the complete variety the danger to be combated is +compression of the brain, and attention to this indication must not be +delayed. The means to be employed are the trephining of the skull over +the seat of the fracture and the elevation of the depressed bone or the +removal of the portion which is causing the trouble. Fragments of bone +in comminuted cases, bony exfoliations, collections of fluid, or even +protruding portions of the brain substance must be carefully cleansed +away and a simple bandage so applied as to facilitate the application of +subsequent dressings.</p> + + +<h4>FRACTURES OF THE BONES OF THE FACE.</h4> + +<p>In respect to their origin—usually traumatic—these injuries rank with +the preceding, and are commonly of the incomplete variety. They may +easily be overlooked, and may even sometimes escape recognition until +the reparative process has been well established and the wound is +discovered owing to the prominence caused by the presence of the +provisional callus which marks its cure. When the fracture is complete +it will be marked by local deformity, mobility of the fragments, and +crepitation. Nasal hemorrhage, roaring, frequent sneezing, loosening or +loss of teeth, difficulty of mastication, and inflammation of the +cavities of the sinuses are varying complications of these accidents. +The object of the treatment should be the restoration of the depressed +bones as nearly as possible to their normal position and their retention +in place by protecting splints, which should cover the entire facial +region. Special precautions should be observed to prevent the patient +from disturbing the dressing by rubbing his head against surrounding +objects, such as the stall, manger, rack, etc. Clots of blood in the +nasal passages must be washed out, collections of pus removed from the +sinuses, and, if the teeth are loosened and liable to fall out, they +should be removed. If roaring is threatened, tracheotomy is indicated.</p> + + +<h4>FRACTURES OF THE PREMAXILLARY BONE.</h4> + +<p>These are mentioned by continental authors and are usually encountered +in connection with fractures of the nasal bone, and may take place +either in the width or the length of the bone.</p> + +<p>The deformity of the upper lip, which is drawn sidewise in this lesion, +renders it easy of diagnosis. The abnormal mobility and the crepitation, +with the pain manifested by the patient when undergoing examination, are +concurrent symptoms. Looseness of the teeth, abundant salivation, and +entire inability to grasp the feed complete the symptomatology of these +accidents. In the treatment splints of gutta-percha or leather are +sometimes used, but they are of difficult application. Our own judgment +and practice are in favor of the union of the bones by means of metallic +sutures.<span class='pagenum'><a name="Page_337" id="Page_337">[Pg 337]</a></span></p> + + +<h4>FRACTURES OF THE LOWER JAW.</h4> + +<p>A fracture here is not an injury of infrequent occurrence. It involves +the body of the bone, at its symphysis, or back of it, and includes one +or both of its branches, either more or less forward, or at the +posterior part near the temporomaxillary articulation, at the coronoid +process.</p> + +<p>Falls, blows, or other external violence, or powerful muscular +contractions during the use of the speculum, may be mentioned among the +causes of this lesion. The fracture of the neck, or that portion formed +by the juncture of the two opposite sides, and of the branches in front +of the cheeks, causes the lower jaw, the true dental arch, to drop, +without the ability to raise it again to the upper, and the result is a +peculiar and characteristic physiognomy. The prehension and mastication +of feed become impossible; there is an abundant escape of fetid and +sometimes bloody saliva, especially if the gums have been wounded; there +is excessive mobility of the lower end of the jawbone; and there is +crepitation, and frequently paralysis of the under lip. Although an +animal suffering with a complete and often compound and comminuted +fracture of the submaxilla presents at times a serious aspect, the +prognosis of the case is comparatively favorable, and recovery is +usually only a question of time. The severity of the lesion corresponds +in degree to that of the violence to which it is due, also to the +resulting complications and the situation of the wound. It is simple +when at the symphysis, but becomes more serious when it affects one of +the branches, and most aggravated when both are involved. Fracture of +the coronoid process becomes important principally as an evidence of the +existence of a morbid diathesis, such as osteoporosis, or the like.</p> + +<p>The particular seat of the injury, with its special features, will, of +course, determine the treatment. For a simple fracture, without +displacement, provided there is no laceration of the periosteum, an +ordinary supporting bandage will usually be sufficient, but when there +is displacement the reduction of the fracture must first be +accomplished, and for this special splints are necessary. In a fracture +of the symphysis or of the branches the adjustment of the fragments by +securing them with metallic sutures is the first step necessary, to be +followed by the application of supports, consisting of splints of +leather or sheets of metal, the entire front of the head being then +covered with bandages prepared with adhesive mixtures. During the entire +course of treatment a special method of feeding becomes necessary. The +inability of the patient to appreciate the situation, of course, +necessitates a resort to an artificial mode of introducing the necessary +feed into his stomach; this is accomplished by forcing between the +commissures of the lips, in a liquid form, by means of a<span class='pagenum'><a name="Page_338" id="Page_338">[Pg 338]</a></span> syringe, the +milk or nutritive gruels selected for his sustenance until the +consolidation is sufficiently advanced to permit the ingestion of feed +of a more solid consistency. The callus will usually be sufficiently +hardened in two or three weeks to allow of a change of diet to mashes of +cut hay and scalded grain, until the removal of the dressing restores +the animal to its old habit of mastication.</p> + + +<h4>FRACTURES OF VERTEBRÆ.</h4> + +<p>These are not very common, but when they do occur the bones most +frequently injured are those of the back and loins.</p> + +<p><i>Causes.</i>—The ordinary causes of fracture are responsible here as +elsewhere, such as heavy blows on the spinal column, severe falls while +conveying heavy loads, and especially violent efforts in resisting the +process of casting. Although occurring more or less frequently under the +latter circumstances, the accident is not always attributable to +carelessness or error in the management. It may, of course, sometimes +result from such a cause as a badly prepared bed, or the accidental +presence of a hard body concealed in the straw, or to a heavy fall when +the movements of the patient have not been sufficiently controlled by an +effective apparatus and its skillful adaptation, but it is quite as +liable to be caused by the violent resistance and the consequent +powerful muscular contraction by the frightened patient. The simple fact +of the overarching of the vertebral column, with excessive pressure +against it from the intestinal mass, owing to the spasmodic action of +the abdominal muscles, may account for it, and so also may the struggles +of the animal to escape from the restraint of the hobbles while frantic +under the pain of an operation without anesthesia. In these cases the +fracture usually occurs in the body or the annular part, or both, of the +posterior dorsal or the anterior lumbar vertebra. When the transverse +processes of the last-named bones are injured, it is probably in +consequence of the heavy concussion incident to striking the ground when +cast. The diagnosis of a fracture of the body of a vertebra is not +always easy, especially when quite recent, and more especially when +there is no accompanying displacement.</p> + +<p><i>Symptoms.</i>—There are certain peculiar signs accompanying the +occurrence of the accident while an operation is in progress which +should at once excite the suspicion of the surgeon. In the midst of a +violent struggle the patient becomes suddenly quiet; the movement of a +sharp instrument, which at first excited his resistance, fails to give +rise to any further evidence of sensation; perhaps a general trembling, +lasting for a few minutes, will follow, succeeded by a cold, profuse +perspiration, particularly between the hind legs, and frequently there +will be micturition and defecation. Careful examination of the vertebral +column may then detect a slight depression or<span class='pagenum'><a name="Page_339" id="Page_339">[Pg 339]</a></span> irregularity in the +direction of the spine, and there may be a diminution or loss of +sensation in the posterior part of the trunk, while the anterior portion +continues to be as sensitive as before. In making an attempt to get upon +his feet, however, upon the removal of the hobbles, only the fore part +of the body will respond to the effort, a degree of paraplegia being +present, and while the head, neck, and fore part of the body will be +raised, the hind quarters and hind legs will remain inert. The animal +may perhaps succeed in rising and probably may be removed to his stall, +but the displacement of the bone will follow, converting the fracture +into one of the complete kind, either through the exertion of walking or +by a renewed attempt to rise after another fall before reaching his +stall. By this time the paralysis is complete, and the extension of the +meningitis, which has become established, is a consummation soon +reached.</p> + +<p>To say that the prognosis of fracture of the body of the vertebra is +always serious is to speak very mildly. It would be better, perhaps, to +say that <i>occasionally</i> a case <i>may</i> recover. Fractures of the +transverse processes are less serious.</p> + +<p><i>Treatment.</i>—Instead of stating the indication in this class of cases +as if assuming them to be amenable to treatment, the question naturally +would be: Can any treatment be recommended in a fracture of the body of +a vertebra? The only indication in such a case, in our opinion, is to +reach the true diagnosis in the shortest possible time and to act +accordingly. If there is displacement, and the existence of serious +lesions may be inferred from the nervous symptoms, the destruction of +the suffering animal appears to suggest itself as the one conclusion in +which considerations of policy, humanity, and science at once unite.</p> + +<p>If, however, it is fairly evident that no displacement exists; that +pressure upon the spinal cord is not yet present; that the animal with a +little assistance is able to rise upon his feet and to walk a short +distance—it may be well to experiment upon the case to the extent of +placing the patient in the most favorable circumstances for recovery and +allow nature to operate without further interference. This may be +accomplished by obtaining immobility of the whole body as much as +possible, and especially of the suspected region, by placing the patient +in slings, in a stall sufficiently narrow to preclude lateral motion, +and covering the loins with a thick coat of agglutinative mixture. +Developments should be watched and awaited.</p> + + +<h4>FRACTURE OF THE RIBS.</h4> + +<p>The different regions of the chest are not equally exposed to the +violence that causes fractures of the ribs, and they are therefore +either more common or more easily discovered during life at some points +than at others. The more exposed regions are the middle and<span class='pagenum'><a name="Page_340" id="Page_340">[Pg 340]</a></span> the +posterior, while the front is largely covered and defended by the +shoulder. A single rib may be the seat of fracture, or a number may be +involved, and there may be injuries on both sides of the chest at the +same time. It may take place lengthwise, in any part of the bone, though +the middle, being the most exposed, is the most frequently hurt. +Incomplete fractures are usually lengthwise, involving a portion only of +the thickness of one or other of the surfaces. The complete kind may be +either transverse or oblique, and are most commonly denticulated. The +fracture may be comminuted, and a single bone may show one of the +complete and one of the incomplete kind at different points. The extent +of surface presented by the thoracic region, with its complete exposure +at all points, explains the liability of the ribs to suffer from all the +forms of external violence.</p> + +<p><i>Symptoms.</i>—In many instances fractures, especially the incomplete +variety, of these bones continue undiscovered, without displacement, +though the evidences of local pain, a certain amount of swelling, and a +degree of disturbance of the respiration, if noticed during the +examination of a patient, may suggest a suspicion of their existence. +Abnormal mobility and crepitation are difficult of detection, even when +present, and they are not always present. When there is displacement the +deformity which it occasions will betray the fact, and when such an +injury exists the surgeon, in view of possible and probable +complications of thoracic trouble, of course will become vigilant and +prepare himself for an encounter with a case of traumatic pleuritis or +pneumonia. Fatal injuries of the heart are recorded. Subcutaneous +emphysema is a common accompaniment of broken ribs, and I recall the +death, from this cause, of a patient of my own which had suffered a +fracture of two ribs in the region of the withers, under the cartilages +of the shoulder, and of which the diagnosis was made only after the +fatal ending of the case.</p> + +<p>These hurts are not often of a very serious character, though the union +is never so solid and complete as in other fractures, the callus being +usually imperfect and of a fibrous character, with an amphiarthrosis +formation. Still, complications occur which may impart gravity to the +prognosis.</p> + +<p><i>Treatment.</i>—Fractures with but a slight or no displacement need no +reduction. All that is necessary is a simple application of a blistering +nature as a preventive of inflammation or for its subjugation when +present, and in order to excite an exudation which will tend to aid in +the support and immobilization of the parts. At times, however, a better +effect is obtained by the application of a bandage placed firmly around +the chest, although, while this limits the motion of the ribs, it is +liable to render the respiration more labored.</p> + +<p>If there is displacement, with much accompanying pain and evident +irritation of the lungs, the fracture must be reduced without<span class='pagenum'><a name="Page_341" id="Page_341">[Pg 341]</a></span> delay. +The means of effecting this vary according to whether the displacement +is outward or inward. In the first case the bone may be straightened by +pressure from without, while in the second the end of it must be raised +by a lever, for the introduction of which a small incision through the +skin and intercostal spaces will be necessary. When coaptation has been +effected it must be retained by the external application of an adhesive +mixture, with splints and bandages around the chest.</p> + + +<h4>FRACTURES OF THE BONES OF THE PELVIS.</h4> + +<p>These fractures will be considered under their separate denominations, +as those of the sacrum and the os innominatum, or hip, which includes +the subdivisions of the ilium, the pubes, and the ischium.</p> + +<p><i>The sacrum.</i>—Fractures of this bone are rarely met with among +solipeds. Among cattle, however, it is of common occurrence, being +attributed not only to the usual varieties of violence, as blows and +other external hurts, but to the act of coition and violent efforts in +parturition. It is generally of the transverse kind and may be +recognized by the deformity which it occasions. This is due to the +dropping of the bone, with a change in its direction and a lower +attachment of the tail, which also becomes more or less paralyzed. The +natural and spontaneous relief which usually interposes in these cases +has doubtless been observed by the extensive cattle breeders of the +West, and their practice and example fully establish the inutility of +interference. Still, cases may occur in which reduction may be +indicated, and it then becomes a matter of no difficulty. It is effected +by the introduction of a round, smooth piece of wood into the rectum as +far as the fragment of bone and using it as a lever, resting upon +another as a fulcrum placed under it outside. The bone, having been thus +returned, may be kept in place by the ordinary external means in use.</p> + +<p><i>The os innominatum.</i>—Fracture of the ilium may be observed either at +the angle of the hip or at the neck of the bone; those of the pubes may +take place at the symphysis, or in the body of the bone; those of the +ischium on the floor of the bone, or at its posterior external angle. +Or, again, the fracture may involve all three of these constituent parts +of the hip bone by having its situation in the articular cavity—the +acetabulum by which it joins the femur or thigh bone.</p> + +<p><i>Symptoms.</i>—Some of these fractures are easily recognized, while others +are difficult to identify. The ordinary deformity which characterizes a +fracture of the external angle of the ilium, its dropping and the +diminution of that side of the hip in width, unite in indicating the +existence of the condition expressed by the term "hipped." An incomplete +fracture, however, or one that is complete without displacement, or even +one with displacement, often demands the closest<span class='pagenum'><a name="Page_342" id="Page_342">[Pg 342]</a></span> scrutiny for its +discovery. The lameness may be well marked, and an animal may show it +but little while walking, though upon being urged into a trot will +manifest it more and more, until presently it will cease to use the +crippled limb altogether, and travel entirely on three legs. The acute +character of the lameness will vary in degree as the seat of the lesion +approximates the acetabulum. In walking, the motion at the hip is very +limited, and the leg is dragged; while at rest it is relieved from +bearing its share in sustaining the body. An intelligent opinion and +correct conclusion will depend largely upon a knowledge of the history +of the case, and while in some instances that will be but a report of +the common etiology of fractures, such as blows, hurts, and other +external violence, the simple fact of a fall may furnish in a single +word a satisfactory solution of the whole matter.</p> + +<p>With the exception of the deformity of the ilium in a fracture of its +external angle, and unless there has been a serious laceration of +tissues and infiltration of blood, or excessive displacement, there are +no very definite external symptoms in a case of a fracture of the hip +bone. There is one, however, which, in a majority of cases, will not +fail—it is crepitation. This evidence is attainable by both external +and internal examination—by manipulation of the gluteal surface and by +rectal taxis. Very often a lateral motion, or balancing of the hinder +parts by pressing the body from one side to the other, will be +sufficient to render the crepitation more distinct—a slight sensation +of grating, which may be perceived even through the thick coating of +muscle which covers the bone—and the sensation may not only be felt, +but to the expert may even become audible. This external manifestation +is, however, not always sufficient in itself, and should invariably be +associated with the rectal taxis for corroboration. It is true that this +may fail to add to the evidence of fracture, but till then the simple +testimony afforded by the detection of crepitation from the surface, +though a strong confirmatory point, is scarcely sufficiently absolute to +establish more than a reasonable probability or strong suspicion in the +case.</p> + +<p>In addition to the fact that the rectal examination brings the exploring +hand of the surgeon into near proximity to the desired point of search, +and to an accurate knowledge of the situation of parts, both pro and con +as respects his own views, there is another advantage attendant upon it +which is well entitled to appreciation. This is the facility with which +he can avail himself of the help of an assistant, who can aid him by +manipulating the implicated limb and placing it in various positions, so +far as the patient will permit, while the surgeon himself is making +explorations and studying the effect from within. By this method he can +hardly fail to ascertain the character of the fracture and the condition +of the bony ends. By<span class='pagenum'><a name="Page_343" id="Page_343">[Pg 343]</a></span> the rectal taxis, as if with eyes in the finger +ends, he will "see" what is the extent of the fracture of the ilium or +of the neck of that bone; to what part of the central portion of the +bone (the acetabulum) it reaches; whether this is free from disease or +not, and in what location on the floor of the pelvis the lesion is +situated. By this method we have frequently been able to detect a +fracture at the symphysis, which, from its history and symptoms and an +external examination, could only have been guessed at. Yet, with all its +advantages, the rectal examination is not always necessary, as, for +example, when the fracture is at the posterior and external angle of the +ischium, when by friction of the bony ends the surgeon may discern the +crepitation without it.</p> + +<p>Every variety of complication, including muscular lacerations with the +formation of deep abscesses and injuries to the organs of the pelvic +cavity, the bladder, the rectum, and the uterus, may be associated with +fractures of the hip bone.</p> + +<p><i>Prognosis.</i>—The prognosis of these lesions will necessarily vary +considerably. A fracture of the most superficial part of the bone of the +ilium or of the ischium, especially if there is little displacement, +will unite rapidly, leaving a comparatively sound animal often quite +free from subsequent lameness. If there is much displacement, however, +only a ligamentous union will take place, with much deformity and more +or less irregularity in the gait. Other fractures may be followed by +complete disability of the patient, as, for example, when the cotyloid +cavity is involved, or when the reparatory process has left bony +deposits in the pelvic cavity at the seat of the union, which may, in +the case of the female, interfere with the steps of parturition, or +induce some local paralysis by pressure upon the nerves which govern the +muscles of the hind legs. This is a condition not infrequently observed +when the callus has been formed on the floor of the pelvis near the +obturator foramen, pressing upon the course or involving the obturator +nerve.</p> + +<p><i>Treatment.</i>—In our estimation, the treatment of all fractures of the +hip bone should be of the simplest kind. Rendered comparatively +immovable by the thickness of the muscles by which the region is +enveloped, one essential indication suggests itself, and that is to +place the animal in a position which, so far as possible, will be fixed +and permanent. For the accomplishment of this purpose the best measure, +as we consider it, is to place the horse in a stall of just sufficient +width to admit him, and to apply a set of slings, snugly, but +comfortably. (See Plate XXXI.) This will fulfill the essential +conditions of recovery—rest and immobility. Blistering applications +would be injurious, though the adhesive mixture might prove in some +degree beneficial.<span class='pagenum'><a name="Page_344" id="Page_344">[Pg 344]</a></span></p> + +<p>The minimum period allowable for solid union in a fractured hip is, in +our judgment, two months, and we have known cases in which that was too +short a time.</p> + +<p>As we have said before, there may be cases in which the treatment for +fracture at the floor of the pelvis has been followed by symptoms of +partial paralysis, the animal, when lying down, being unable to regain +his feet, but moving freely when placed in an upright position. This +condition is owing to the interference of the callus with the functions +of the obturator nerve, which it presses upon or surrounds. By my +experience in similar cases I feel warranted in cautioning owners of +horses in this condition to exercise due patience, and to avoid a +premature sentence of condemnation against their invalid servants; they +are not all irrecoverably paralytic. With alternations of moderate +exercise, rest in the slings, and the effect of time while the natural +process of absorption is taking effect upon the callus, with other +elements of change that may be so operating, the horse in due time may +become able once more to earn his subsistence and serve his master.</p> + + +<h4>FRACTURE OF THE SCAPULA.</h4> + +<p>This bone is seldom fractured, its comparative exemption being due to +its free mobility and the protection it receives from the superimposed +soft tissues. Only direct and powerful causes are sufficient to effect +the injury, and when it occurs the large rather than the smaller animals +are the subjects.</p> + +<p><i>Cause.</i>—The causes are heavy blows or kicks and violent collisions +with unyielding objects. Those which are occasioned by falls are +generally at the neck of the bone, and of the transverse and comminuted +varieties.</p> + +<p><i>Symptoms.</i>—The diagnosis is not always easy. The symptoms are +inability to rest the leg on the ground and to carry weights, and they +are present in various degrees from slight to severe. The leg rests upon +the toe, seems shortened, and locomotion is performed by jumps. Moving +the leg while examining it and raising the foot for inspection seem to +produce much pain and cause the animal to rear. Crepitation is readily +felt with the hand upon the shoulder when the leg is moved. If the +fracture occurs in the upper part of the bone, overlapping of the +fragments and displacement will be considerable.</p> + +<p>The fracture of this bone is usually classed among the more serious +accidents, though cases may occur which are followed by recovery without +very serious ultimate results, especially when the seat of the injury is +at some of the upper angles of the bone or about the acromion crest. But +if the neck and the joint are the parts involved, complications which +are likely to disable the animal for life are liable to be present.<span class='pagenum'><a name="Page_345" id="Page_345">[Pg 345]</a></span></p> + +<p><i>Treatment.</i>—If there is no displacement, a simple adhesive dressing to +strengthen and immobilize the parts will be sufficient. A coat of black +pitch dissolved with wax and Venice turpentine, and kept in place over +the region with oakum or linen bands, will be all the treatment +required, especially if the animal is kept quiet in the slings.</p> + +<p>Displacement can not be remedied, and reduction is next to impossible. +Sometimes an iron plate is applied over the parts and retained by +bandages, as in the dressing of Bourgelat (Plate XXX); this may be +advantageously replaced by a pad of thick leather. In smaller animals +the parts are retained by figure-8 bandages, embracing both the normal +and the diseased shoulders, crossing each other in the axilla and +covered with a coating of adhesive mixture.</p> + + +<h4>FRACTURES OF THE HUMERUS.</h4> + +<p>These are more common in small than in large animals, and are always the +result of external traumatism, such as falls, kicks, and collisions. +They are generally very oblique, are often comminuted, and though more +usually involving the shaft of the bone will in some cases extend to the +upper end and into the articular head.</p> + +<p><i>Symptoms.</i>—There is ordinarily considerable displacement in +consequence of the overlapping of the broken ends of the bone, and this +of course causes more or less shortening of the limb. There will also be +swelling, with difficulty of locomotion, and crepitation will be easy of +detection. This fracture is always a serious damage to the patient, +leaving him with a permanently shortened limb and an incurable, lifelong +lameness.</p> + +<p><i>Treatment.</i>—If treatment is determined on, it will consist in the +reduction of the fracture by means of extension and counter extension, +to accomplish which the animal must be thrown. If successful in the +reduction, then follows the application and adjustment of the apparatus +of retention, which must be of the most perfect and efficient kind. +Finally, this, however skillfully contrived and carefully adapted, will +often fail to effect any good purpose whatever.</p> + + +<h4>FRACTURES OF THE FOREARM.</h4> + +<p>A fracture in this region may also involve the radius or the ulna, the +latter being broken at times in its upper portion above the radio-ulnar +arch at the olecranon. If the fracture occurs at any part of the forearm +from the radio-ulnar arch down to the knee, it may involve either the +radius alone or the radius and the cubitus, which are there intimately +united.</p> + +<p><i>Cause.</i>—Besides having the same etiology with most of the fractures, +those of the forearm are, nevertheless, more commonly due to kicks from +other animals, especially when crowded together in large<span class='pagenum'><a name="Page_346" id="Page_346">[Pg 346]</a></span> numbers in +insufficient space. It is a matter of observation that under these +circumstances fractures of the incomplete kind are those which occur on +the inside of the leg, the bone being in that region almost entirely +subcutaneous, while those of the complete class are either oblique or +transverse. The least common are the longitudinal, in the long axis of +the bone.</p> + +<p><i>Symptoms.</i>—This variety of fracture is easily recognized by the +appearance of the leg and the different changes it undergoes. There is +inability to use the limb; impossibility of locomotion; mobility below +the injury; the ready detection of crepitation—in a word, the +assemblage of all the signs and symptoms which have been already +considered as associated with the history of broken bones.</p> + +<p>The fracture of the ulna alone, principally above the radio-ulnar arch, +may be ascertained by the aggravated lameness, the excessive soreness on +pressure, and perhaps a certain increase of motion, with a very slight +crepitation if tested in the usual way. Displacement is not likely to +take place except when it is well up toward the olecranon or its +tuberosity, the upper segment of the bone being in that case likely to +be drawn upward. For a simple fracture of this region there is a fair +chance of recovery, but in a case of the compound and comminuted class +there is less ground for a favorable prognosis, especially if the elbow +joint has suffered injury. A fracture of the ulna alone is not of +serious importance, except when the same conditions prevail. A fracture +of the olecranon is less amenable to treatment, and promises little +better than a ligamentous union.</p> + +<p><i>Treatment.</i>—Considering all the various conditions involving the +nature and extent of these lesions, the position and direction of the +bones of the forearm are such as to render the chances for recovery from +fracture as among the best. The reduction, by extension and +counterextension; the maintenance of the coaptation of the segments; the +adaptation of the dressing by splints, oakum, and agglutinative +mixtures; in fact, all the details of treatment may be here fulfilled +with a degree of facility and precision not attainable in any other part +of the organism. An important, if not an essential, point, however, must +be emphasized in regard to the splints. Whether they are of metal, wood, +or other material, they should reach from the elbow joint to the ground, +and should be placed on the posterior face and on both sides of the leg. +This is then to be so confined in a properly constructed box as to +preclude all possibility of motion, while yet it must sustain a certain +portion of the weight of the body. The iron splint (represented in Plate +XXX) recommended by Bourgelat is designed for fractures of the forearm, +of the knee, and of the cannon bone, and will prove to be an appliance +of great value. For small animals the preference is for an external +covering of gutta-percha, embracing the entire leg. A sheet of this +substance of suitable thickness, according<span class='pagenum'><a name="Page_347" id="Page_347">[Pg 347]</a></span> to the size of the animal, +softened in lukewarm water, is, when sufficiently pliable, molded on the +outside of the leg, and when suddenly hardened by the application of +cold water forms a complete casing sufficiently rigid to resist all +motion. Patients treated in this manner have been able to use the limb +freely, without pain, immediately after the application of the dressing. +The removal of the splint is easily effected by cutting it away, either +wholly or in sections, after softening it by immersing the leg in a warm +bath.</p> + + +<h4>FRACTURE OF THE KNEE.</h4> + +<p>This accident, happily, is of rare occurrence, but when it takes place +is of a severe character, and always accompanied with synovitis, with +disease of the joint.</p> + +<p><i>Cause.</i>—It may be caused by falling upon a hard surface, and is +usually compound and comminuted. Healing seldom occurs, and when it does +there is usually a stiffness of the joint from arthritis.</p> + +<p><i>Symptoms.</i>—As a result of this fracture there is inability to bear +weight on the foot. The leg is flexed as in complete radial paralysis, +or fracture of the ulna. There is abnormal mobility of the bones of the +knee, but crepitation is usually absent.</p> + +<p><i>Prognosis.</i>—Healing is hard to effect, as one part of the knee is +drawn upward by the two flexor muscles which separate it from the lower +part. The callus which forms is largely fibrous, and if the animal is +put to work too quickly this callus is liable to rupture. In favorable +cases healing takes place in two or three months. Many horses during the +treatment develop founder, with consequent drop sole in the sound leg, +as a result of pressure due to continuous standing.</p> + +<p><i>Treatment.</i>—Place the animal in the slings, bring the pieces of bone +together if possible, and try to keep them in place by a tight +plaster-of-Paris dressing about the leg, extending down to the fetlock. +Place the animal in a roomy box stall well provided with bedding so that +he can lie down, to prevent founder.</p> + + +<h4>FRACTURE OF THE FEMUR.</h4> + +<p>The protection which this bone receives from the large mass of muscles +in which it is enveloped does not suffice to invest it with immunity in +regard to fractures.</p> + +<p><i>Cause.</i>—It contributes its share to the list of accidents of this +description, sometimes in consequence of external violence and sometimes +as the result of muscular contraction; sometimes it takes place at the +upper extremity of the bone; sometimes at the lower; sometimes at the +head, when the condyles become implicated; but it is principally found +in the body or diaphysis. The fracture may be<span class='pagenum'><a name="Page_348" id="Page_348">[Pg 348]</a></span> of any of the ordinary +forms, simple or compound, complete or incomplete, transverse or +oblique, etc. A case of the comminuted variety is recorded in which 85 +fragments of bone were counted and removed.</p> + +<p>The thickness of the muscular covering sometimes renders the diagnosis +difficult by interfering with the manipulation, but the crepitation test +is readily available, even when the swelling is considerable, and which +is liable to be the case as the result of the interstitial hemorrhage +which naturally follows the laceration of the blood vessels of the +region involved.</p> + +<p><i>Symptoms.</i>—If the fracture is at the neck of the bone the muscles of +that region (the gluteal) are firmly contracted, and the leg seems to be +shortened in consequence. Locomotion is impossible. There is intense +pain and violent sweating at first. Crepitation may in some cases be +discerned by rectal examination, with one hand resting over the +coxo-femoral (hip) articulation. Fractures of the tuberosities of the +upper end of the bone, the great trochanter, may be identified by the +deformity, the swelling, the impossibility of rotation, and the dragging +of the leg in walking. Fracture of the body is always accompanied with +displacement, and as a consequence a shortening of the leg, which is +carried forward. The lameness is excessive, the foot being moved, both +when raising it from the ground and when setting it down, very timidly +and cautiously. The manipulations for the discovery of crepitation +always cause much pain. Lesions of the lower end of the bone are more +difficult to diagnosticate with certainty, though the manifestation of +pain while making heavy pressure upon the condyles will be so marked +that only crepitation will be needed to turn a suspicion into a +certainty.</p> + +<p><i>Treatment.</i>—The question as to treatment in fractures of this +description resolves itself into the query whether any treatment can be +suggested that will avail anything practically as a curative measure; +whether, upon the hypothesis of reduction as an accomplished fact, any +permanent or efficient device as a means of retention is within the +scope of human ingenuity. If the reduction were successfully performed, +would it be possible to keep the parts in place by any known means at +our disposal? At the best the most favorable result that could be +anticipated would be a reunion of the fragments with a considerable +shortening of the bone and a helpless, limping, crippled animal to +remind us that for human achievement there is a "thus far and no +farther."</p> + +<p>In small animals, such as dogs and cats, however, attempts at treatment +are justifiable, and we are convinced that in many cases of difficulty +in the application of splints and bandages a patient may be placed in a +condition of undisturbed quiet and left to the processes of nature for +"treatment" as safely and with as good an<span class='pagenum'><a name="Page_349" id="Page_349">[Pg 349]</a></span> assurance of a favorable +result as if he had been subjected to the most heroic secundum artem +doctoring known to science. As a case in point, mention may be made of +the case of a pregnant bitch which suffered a fracture of the upper end +of the femur by being run over by a light wagon. Her "treatment" +consisted in being tied up in a large box and let alone. In due time she +was delivered of a family of puppies, and in three weeks she was running +in the streets, limping very slightly, and nothing the worse for her +accident.</p> + + +<h4>FRACTURE OF THE PATELLA.</h4> + +<p>This, fortunately, is a rare accident, and can result only from direct +violence, as a kick or other blow. The lameness which follows it is +accompanied with enormous tumefaction of the joint, pain, inability to +bear weight upon the foot, and finally disease of the articulation. +Crepitation is absent, because the hip muscles draw away the upper part +of the bone. The prognosis is unavoidably adverse, destruction being the +only termination of this incurable and very painful injury. Most of the +reported cases of cures are based upon a wrong diagnosis.</p> + + +<h4>FRACTURES OF THE TIBIA.</h4> + +<p>Of all fractures these are probably more frequently encountered than any +others among the class of accidents we are considering. As with injuries +of the forearm of a like character, they may be complete or incomplete; +the former when the bone is broken in the middle or at the extremities, +and transverse, oblique, or longitudinal. The incomplete kind are more +common in this bone than in any other.</p> + +<p><i>Symptoms.</i>—Complete fractures are easy to recognize, either with or +without displacement. The animal is very lame, and the leg is either +dragged or held clear from the ground by flexion at the stifle, while +the lower part hangs down. Carrying weight or moving backward is +impossible. There is excessive mobility below the fracture, and +well-marked crepitation. If there is much displacement, as in an oblique +fracture, there will be considerable shortening of the leg.</p> + +<p>While incomplete fractures can not be recognized in the tibia with any +greater degree of certainty than in any other bone, there are some facts +associated with them by which a diagnosis may be justified. The +hypothetical history of a case may serve as an illustration:</p> + +<p>An animal has received an injury by a blow or a kick on the inside of +the bone, perhaps without showing any mark. Becoming very lame +immediately afterwards, he is allowed a few days' rest. If taken out +again, he seems to have recovered his soundness, but within<span class='pagenum'><a name="Page_350" id="Page_350">[Pg 350]</a></span> a day or +two he betrays a little soreness, and this increasing he becomes very +lame again, to be furloughed once more, with the result of a temporary +improvement, and again a return to labor and again a relapse of the +lameness; and this alternation seems to be the rule. The leg being now +carefully examined, a local periostitis is readily discovered at the +point of the injury, the part being warm, swollen, and painful. What +further proof is necessary? Is it not evident that a fracture has +occurred, first superficial—a mere split in the bony structure, which, +fortunately, has been discovered before some extra exertion or a casual +misstep had developed it into one of the complete kind, possibly with +complications? What other inference can such a series of symptoms thus +repeated establish?</p> + +<p>The prognosis of fracture of the tibia, as a rule, must be unfavorable.</p> + +<p><i>Treatment.</i>—The difficulty of obtaining a union without shortening, +and consequently without lameness, is proof of the futility of ordinary +attempts at treatment, but though this may be true in respect to +fractures of the complete kind, it is not necessarily so with the +incomplete variety, and with this class the simple treatment of the +slings is all that is necessary to obtain consolidation. A few weeks of +this confinement will be sufficient.</p> + +<p>With dogs and other small animals there are cases which may be +successfully treated. If the necessary dressings can be successfully +applied and retained, a cure will follow.</p> + + +<h4>FRACTURES OF THE HOCK.</h4> + +<p>Injuries of the astragalus which had a fatal termination have been +recorded. Fractures of the os calcis have also been observed, but never +with a favorable prognosis, and attempts to induce recovery, as might +have been expected, have proved futile.</p> + + +<h4>FRACTURES OF THE CANNON BONES.</h4> + +<p>Whether these occur in the fore or hind legs, they appear either in the +body or near their extremities. If in the body as a rule the three +metacarpal or metatarsal bones are affected, and the fracture is +generally transverse and oblique. On account of the absence of soft +tissue and tightness of the skin, the broken bones pierce the skin and +render the fracture a complicated one. The diagnosis is easy when all +the bones are completely broken, but the incomplete fracture can be only +suspected.</p> + +<p><i>Symptoms.</i>—There is no displacement, but excessive mobility, +crepitation, inability to sustain weight, and the leg is kept off the +ground by the flexion of the upper joint.<span class='pagenum'><a name="Page_351" id="Page_351">[Pg 351]</a></span></p> + +<p>No region of the body affords better facilities for the application of +treatment, and the prognosis on this account is usually favorable. We +recall a case, however, which proved fatal, though under exceptional +circumstances. The patient was a valuable stallion of highly nervous +organization, with a compound fracture of one of the cannon bones, and +his unconquerable resistance to treatment, excited by the intense pain +of the wound, precluded all chance of recovery, and ultimately caused +his death.</p> + +<p><i>Treatment.</i>—The general form of treatment for these lesions will not +differ from that which has been already indicated for other fractures. +Reduction, sometimes necessitating the casting of the patient; +coaptation, comparatively easy by reason of the subcutaneous situation +of the bone; retention, by means of splints and bandages—applied on +both sides of the region, and reaching to the ground as in fractures of +the forearm—these are always indicated. We have obtained excellent +results by the use of a mold of thick gutta-percha, composed of two +sections and made to surround the entire lower part of the leg as in an +inflexible case.</p> + + +<h4>FRACTURE OF THE FIRST PHALANX.</h4> + +<p>The hind extremity is more liable than the fore to this injury. It is +usually the result of a violent effort, or of a sudden misstep or +twisting of the leg, and may be transverse, or, as has usually been the +case in our experience, longitudinal, extending from the upper articular +surface down to the center of the bone, and generally oblique and often +comminuted. The symptoms are the swelling and tenderness of the region, +possibly crepitation; a certain abnormal mobility; an excessive degree +of lameness, and in some instances a dropping back of the fetlock, with +perhaps a straightened or upright condition of the pastern.</p> + +<p>The difficulty of reduction and coaptation in this accident, and the +probability of bony deposits, as of ringbones, resulting in lameness, +are circumstances which tend to discourage a favorable prognosis.</p> + +<p>The treatment is that which has been recommended for all fractures, so +far as it can be applied. The iron splint which has been mentioned gives +excellent results in many instances, but if the fracture is incomplete +and without displacement, a form of treatment less energetic and severe +should be attempted. One case is within our knowledge in which the owner +lost his horse by his refusal to subject the animal to treatment, the +post-mortem revealing only a simple fracture with very slight +displacement.</p> + + +<h4>FRACTURES OF THE SECOND PHALANX (CORONET).</h4> + +<p>Though these are generally of the comminuted kind, there are often +conditions associated with them which justify the surgeon in<span class='pagenum'><a name="Page_352" id="Page_352">[Pg 352]</a></span> attempting +their treatment. Though crepitation is not always easy to detect, the +excessive lameness, the soreness on pressure, the inability to carry +weight, the difficulty experienced in raising the foot, all these +suggest, as the solution of the question of diagnosis, the fracture of +the coronet, with the accompanying realization of the fact that there is +yet, by reason of the situation of the member, immobilized as it is by +its structure and its surroundings, room left for a not unfavorable +prognosis. Only a slight manipulation will be needed in the treatment of +this lesion. To render the immobility of the region more fixed, to +support the bones in their position by bandaging, and to establish +forced immobility of the entire body with the slings is usually all that +is required. Ringbone, being a common sequela of the reparative process, +must receive due attention subsequently. One of the severest +complications liable to be encountered is an immobile joint +(anchylosis). Neurectomy of the median nerve may relieve lameness after +a fracture of the phalanges.</p> + +<h4>FRACTURES OF THE THIRD PHALANX (OS PEDIS).</h4> + +<p>These lesions may result from a penetrating street nail, or follow +plantar or median neurectomy. In the latter instance it is caused by the +animal setting the foot down carelessly and too violently, and partly +due to degeneration of bone tissue which follows nerving.</p> + +<p>Though these fractures are not of very rare occurrence, their +recognition is not easy, and there is more of speculation than of +certainty pertaining to their diagnosis. The animal is very lame and +spares the injured foot as much as possible, sometimes resting it upon +the toe alone and sometimes holding it from the ground. The foot is very +tender, and the exploring pinchers of the examining surgeon cause much +pain. During the first 24 hours there is no increased pulsation in the +digital and plantar arteries, but on the second day it is apparent.</p> + +<p>There is nothing to encourage a favorable prognosis, and a not unusual +termination is an anchylosis with either the navicular bone or the +coronet.</p> + +<p>No method of treatment needs to be suggested here, the hoof performing +the office of retention unaided. Local treatment by baths and +fomentations will do the rest. It may be months before there is any +mitigation of the lameness.</p> + +<p>An ultimate recovery depends to a great extent upon whether the other +foot can support the weight during the healing process without causing a +drop sole in the supporting foot.</p> + + +<h4>FRACTURE OF THE SESAMOID BONES.</h4> + +<p>This lesion has been considered by veterinarians, erroneously, we think, +as one of rare occurrence. We believe it to be more frequent<span class='pagenum'><a name="Page_353" id="Page_353">[Pg 353]</a></span> than has +been supposed. Many observations and careful dissections have convinced +us that fractures of these little bones have been often mistaken for +specific lesions of the numerous ligaments that are implanted upon their +superior and inferior parts, and which have been described as a "giving +way" or "breaking down" of these ligaments. In my post-mortem +examinations I have always noted the fact that when the attachments of +the ligaments were torn from their bony connections minute fragments of +bony structure were also separated, though we have failed to detect any +diseased process of the fibrous tissue composing the ligamentous +substance.</p> + +<p><i>Cause.</i>—From whatever cause this lesion may arise, it can hardly be +considered as of a traumatic nature, no external violence having any +apparent agency in producing it, and it is our belief that it is due to +a peculiar degeneration or softening of the bones themselves, a theory +which acquires plausibility from the consideration of the spongy +consistency of the sesamoids. The disease is a peculiar one, and the +suddenness with which different feet are successively attacked, at short +intervals and without any obvious cause, seems to prove the existence of +some latent, morbid cause which has been unsuspectedly incubating. It is +not peculiar to any particular class of horses, nor to any special +season of the year, having fallen under our observation in each of the +four seasons.</p> + +<p><i>Symptoms.</i>—The general fact is reported in the history of most cases +that it makes its appearance without premonition in animals which, after +enjoying a considerable period of rest, are first exercised or put to +work, though in point of fact it may manifest itself while the horse is +still idle in his stable. A hypothetical case, in illustration, will +explain our theory: An animal which has been at rest in his stable is +taken out to work, and it will be presently noticed that there is +something unusual in his movement. His gait is changed, and he travels +with short, mincing steps, without any of his accustomed ease and +freedom. This may continue until his return to the stable, and then, +after being placed in his stall, he will be noticed shifting his weight +from side to side and from one leg to another, continuing the movement +until rupture of the bony structure takes place. But it may happen that +the lameness in one or more of the extremities, anterior or posterior, +suddenly increases, and it becomes evident that the rupture has taken +place in consequence of a misstep or a stumble while the horse is at +work. Then, upon coming to a standstill, he will be found with one or +more of his toes turned up; he is unable to place the affected foot flat +on the ground. The fetlock has dropped and the leg rests upon this part, +the skin of which may have remained intact or may have been more or less +extensively lacerated. It seldom happens that more than one toe at a<span class='pagenum'><a name="Page_354" id="Page_354">[Pg 354]</a></span> +time will turn up, yet still the lesion in one will be followed by its +occurrence in another. Commonly two feet, either the anterior or +posterior, are affected, and we recall one case in which the two fore +and one of the hind legs were included at the same time. The accident, +however, is quite as liable to happen while the horse is at rest in his +stall, and he may be found in the morning standing on his fetlocks. One +of the earliest of the cases occurring in my own experience had been +under care for several weeks for suspected disease of the fetlocks, the +nature of which had not been made out, when, apparently improved by the +treatment which he had undergone, the patient was taken out of the +stable to be walked a short distance into the country, but had little +more than started when he was called to a halt by the fracture of the +sesamoids of both fore legs.</p> + +<p>While there are no positive premonitory symptoms of these fractures +known, we believe that there are signs and symptoms which come but +little short of being so, and the appearance of which will always +justify a strong suspicion of the truth of the case. These have been +indicated when referring to the soreness in standing, the short, mincing +gait, and the tenderness betrayed when pressure is made over the +sesamoids on the sides of the fetlock, with others less tangible and +definable.</p> + +<p><i>Prognosis.</i>—These injuries can never be accounted less than serious, +and in our judgment will never be other than fatal. If our theory of +their pathology is the correct one, and the cause of the lesions is +truly the softening of the sesamoidal bony structure and independent of +any changes in the ligamentous fibers, the possibility of a solid +osseous union can hardly be considered admissible.</p> + +<p><i>Treatment.</i>—In respect to the treatment to be recommended and +instituted it can be employed only with any rational hope of benefit +during the incubation, and with the anticipatory purpose of prevention. +It must be suggested by a suspicion of the verities of the case, and +applied before any rupture has taken place. To prevent this and to +antagonize the causes which might precipitate the final catastrophe—the +elevation of the toes—resort must be had to the slings and to the +application of firm bandages or splints, perhaps of plaster of Paris, +with a high shoe, as about the only indications which science and nature +are able to offer. When the fracture is an occurred event, and the toes, +one or more, are turned up, any further resort to treatment will be +futile.</p> + + +<h4>DISEASES OF JOINTS.</h4> + +<p>Three classes of injury will be considered under this head. These are, +affections of the synovial sacs, those of the joint structures, or of +the bones and their articular surfaces, and those forms of solution of +continuity known as dislocations or luxations.<span class='pagenum'><a name="Page_355" id="Page_355">[Pg 355]</a></span></p> + + +<h4>DISEASES OF THE SYNOVIAL SACS.</h4> + +<p>Two forms of affection here present themselves, one being the result of +an abnormal secretion which induces a dropsical condition of the sac +without any acute, inflammatory action, while the other is characterized +by excessive inflammatory symptoms, with their modifications, +constituting synovitis.</p> + + +<h4>SYNOVIAL DROPSIES.</h4> + +<p>We have already considered in a general way the presence of these +peculiar oil bags in the joints, and in some regions of the legs where +the passage of the tendons takes place, and have noticed the similarity +of structure and function of both the articular and the tendinous bursæ, +as well as the etiology of their injuries and their pathological +history, and we will now treat of the affections of both.</p> + + +<h4>WINDGALLS.</h4> + +<p>This name is given to the dilated bursæ found at the posterior part of +the fetlock joint. They have their origin in a dropsical condition of +the bursæ of the joint itself, also of the tendon which slides behind +it, and are therefore further known by the designations of articular and +tendinous windgalls, or puffs. (See also p. 401.)</p> + +<p>They appear in the form of soft and somewhat symmetrical tumors, of +varying dimensions, and generally well defined in their circumference. +They are more or less tense, according to the quantity of secretion they +contain, apparently becoming softer as the foot is raised and the +fetlock flexed. Usually they are painless and only cause lameness under +certain conditions, as when they begin to develop themselves under the +stimulus of inflammatory action, or when large enough to interfere with +the functions of the tendons, or again when they have undergone certain +pathological changes, such as calcification, which is among their +tendencies.</p> + +<p><i>Cause.</i>—Windgalls may be attributed to external causes, such as severe +labor or strains resulting from heavy pulling, fast driving, or jumping, +or they may be among the sequelæ of internal disorders, such as +strangles or the resultants of a pleuritic or pneumonic attack.</p> + +<p>Unnecessary anxiety is sometimes experienced respecting these growths, +with much questioning touching the expediency of their removal, all of +which might be spared, for, while they constitute a blemish, their +unsightliness will not hinder the usefulness of the animal, and in any +case they rarely fail to show themselves easily amenable to treatment.</p> + +<p><i>Treatment.</i>—When in their acute stage, and when the dropsical +condition is not excessive, the inflammation may be checked during the +day by continuous, cold-water irrigation by means of a hose or<span class='pagenum'><a name="Page_356" id="Page_356">[Pg 356]</a></span> soaking +tub and at night by applying a moderately tight-roller bandage. Later +absorption may be promoted by a Priessnitz bandage,<a name="FNanchor_2_2" id="FNanchor_2_2"></a><a href="#Footnote_2_2" class="fnanchor">[2]</a> pressure by +roller bandages, sweating, the use of liniments, or if necessary by a +sharp blister of biniodid of mercury. This treatment should subdue the +inflammation, abate the soreness, absorb the excess of secretion, +strengthen the walls of the sac, and finally cause the windgalls to +disappear, provided the animal is not too quickly returned to labor and +exposed to the same factors that occasioned them at first.</p> + +<p>If the inflammation has become chronic, however, and the enlargement has +been of considerable duration, the negative course will be the wiser +one. If any benefit results from treatment it will be of only a +transient kind, the dilatation returning when the patient is again +subjected to labor, and it will be a fortunate circumstance if +inflammation has not supervened.</p> + +<p>Notwithstanding the generally benignant nature of the swelling there are +exceptional cases, usually when it is probably undergoing certain +pathological changes, which may result in lameness and disable the +animal, in which case surgical treatment will be indicated, especially +if repeated blisters have failed to improve the symptoms. Line firing is +then a preeminent suggestion, and many a useful life has received a new +lease as the result of this operation timely performed. Another method +of firing, which consists in emptying the sac by means of punctures +through and through, made with a red-hot needle or wire, and the +subsequent injection of certain irritating and alterative compounds into +the cavity, designed to effect its closure by exciting adhesive +inflammation, such as tincture of iodin, may be commended. But they are +all too active and energetic in their effects and require too much +special attention and intelligent management to be trusted to any hands +other than those of an expert veterinarian.</p> + + +<h4>BLOOD SPAVIN, BOG SPAVIN, AND THOROUGHPIN.</h4> + +<p>The blood spavin is situated in front and to the inside of the hock and +is merely a varicose or dilated condition of the saphena vein. It occurs +directly over the point where the bog spavin is found, and has thus been +frequently confused with the latter.</p> + +<p>The complicated arrangement of the hock joint, and the powerful tendons +which pass on the posterior part, are lubricated with the product of +secretion from one tendinous synovial and several articular synovial +sacs. A large articular sac contributes to the lubrication<span class='pagenum'><a name="Page_357" id="Page_357">[Pg 357]</a></span> of the shank +bone (the tibia) and one of the bones of the hock (the astragalus). The +tendinous sac lies back of the articulation itself and extends upward +and downward in the groove of that joint through which the flexor +tendons slide. The dilatation of this articular synovial sac is what is +denominated bog spavin, the term thoroughpin being applied to the +dilatation of the tendinous capsule.</p> + +<p>The bog spavin is a round, smooth, well-defined, fluctuating tumor +situated in front and a little inward of the hock. On pressure it +disappears at this point to reappear on the outside and just behind the +hock. If pressed to the front from the outside it will then appear on +the inside of the hock. On its outer surface it presents a vein which is +quite prominent, running from below upward, and it is to the +preternatural dilatation of this blood vessel that the term blood spavin +is applied.</p> + +<p>The thoroughpin is found at the back and on the top of the hock in that +part known as the "hollows," immediately behind the shank bone. It is +round and smooth, but not so regularly formed as the bog spavin, and is +most apparent when viewed from behind. The swelling is usually on both +sides and a little in front of the so-called hamstring, but may be more +noticeable on the inside or on the outside.</p> + +<p>In their general characteristics bog spavins and thoroughpins are +similar to windgalls, and one description of the origin, symptoms, +pathological changes, and treatment will serve for all equally, except +that it is possible for a bog spavin to cause lameness, and thus to +involve a verdict of unsoundness in the patient, a circumstance which +will, of course, justify its classification by itself as a severer form +of a single type of disease.</p> + +<p>We have already referred to the subject of treatment and the means +employed—rest, of course—with liniments, blisters, etc., and what we +esteem as the most active and beneficial of any, early, deep, and +well-performed cauterization. There are, besides, commendatory reports +of a form of treatment by the application of pressure pads and peculiar +bandages upon the hocks, and it is asserted that the removal of the +tumors has been effected by their use. Our experience with this +apparatus, however, has not been accompanied with such favorable results +as would justify our indorsement of the flattering representations which +have sometimes appeared in its behalf.</p> + + +<h4>OPEN JOINTS, BROKEN KNEES, SYNOVITIS, AND ARTHRITIS.</h4> + +<p>The close relationship which exists among these several affections, +their apparently possible connection as successive developments of a +similar, if not an essentially identical, origin, together with the +advantage gained by avoiding frequent repetitions in the details<span class='pagenum'><a name="Page_358" id="Page_358">[Pg 358]</a></span> of +symptoms, treatment, etc., are our reasons for treating under a single +head the ailments we have grouped together in the present section.</p> + +<p><i>Cause.</i>—The great, comprehensive, common cause of, sometimes +permanent, sometimes only transient, disability of the horse is external +traumatism.</p> + +<p>Blows, bruises, hurts by nearly every known form of violence, falls, +kicks, lacerations, punctures—we may add compulsory speed in racing and +cruel overloading of draft animals—cover the entire ground of causation +of the diseases and injuries of the joints now receiving our +consideration.</p> + +<p>In one case, a working horse making a misstep stumbles, and falling on +his knees receives a hurt, variously severe, from a mere abrasion of the +skin to a laceration, a division of the tegument, a slough, +mortification, and the escape of the synovial fluid, with or without +exposure of the bones and their articular cartilages.</p> + +<p>In another case, an animal, from one cause or another, perhaps an +impatient temper, has formed the habit of striking or pawing his manger +with his fore feet until inflammation of the knee joint is induced, +first as a little swelling, diffused, painless; then as a periostitis of +the bones of the knee; later as bony deposits, then lameness, and +finally the implication of the joint, with all the various sequelæ of +chronic inflammation of the knee joint.</p> + +<p>In another case, a horse has received a blow with a fork from a careless +hostler on or near a joint, or has been kicked by a stable companion, +with the result of a punctured wound, at first mild-looking, painless, +apparently without inflammation, and not yet causing lameness, but +which, in a few hours, or it may be only after a few days, becomes +excessively painful, grows worse, the entire joint swells, presently +discharges, and at last a case of suppurative synovitis is presented, +with perhaps disease of the joint proper, and arthritis as a climax. The +symptoms of articular injuries vary not only in the degrees of the hurt +but in the nature of the lesion.</p> + +<p>Or the condition of broken knees, resulting as we have said, may have +for its starting point a mere abrasion of the skin—a scratch, +apparently, which disappears without a scar. The injury may, however, +have been more severe, the blow heavier, the fall aggravated by +occurring upon an irregular surface, or sharp or rough object, with +tearing or cutting of the skin, and this laceration may remain. A more +serious case than the first is now brought to our notice.</p> + +<p>Another time, immediately following the accident, or possibly as a +sequel of the traumatism, the tendinous sacs may be opened, with the +escape of the synovia, or, worse, the tendons which pass in front of the +knee are torn, the inflammation spreads, the joint and leg are swollen, +the animal is becoming very lame; synovitis has set in.<span class='pagenum'><a name="Page_359" id="Page_359">[Pg 359]</a></span> With this the +danger becomes very great, for soon suppuration will be established, +then the external coat of the articulation proper becomes ulcerated, if +it is not already in that state, and we find ourselves in the presence +of an open joint with suppurative synovitis—that is, with the worst +among the conditions of diseased processes, because of the liability of +the suppuration to become infiltrated into every part of the joint, +macerating the ligaments and irritating the cartilages, soon to be +succeeded by their ulceration, with the destruction of the articular +surface—or the lesion of ulcerative arthritis, one of the gravest among +all the disorders known to the animal economy.</p> + +<p>Ulcerative arthritis and suppurative synovitis may be developed +otherwise than in connection with open joints; the simplest and +apparently most harmless punctures may prove to be sufficient cause. For +example, a horse may be kicked, perhaps, on the inside of the hock; +there is a mark and a few drops of blood to indicate the spot; he is put +to work apparently free from pain or lameness and performs his task with +his usual ease and facility. On the following morning, however, the hock +is found to be a little swollen and there is some stiffness. A little +later on he betrays a degree of uneasiness in the leg, and shrinks from +resting his weight upon it, moving it up and down for relief. The +swelling has increased and is increasing; the pain is severe; and +finally, at the spot where the kick inpinged, there is an oozing of an +oily liquid mixed with whitish drops of suppuration. The mischief is +done; a simple, harmless, punctured wound has expanded into a case of +ulcerative arthritis and suppurative synovitis.</p> + +<p><i>Prognosis.</i>—From ever so brief and succinct description of this +traumatism of the articulations, the serious and important character of +these lesions, irrespective of which particular joint is affected, will +be readily understood. Yet there will be modifications in the prognosis +in different cases, in accordance with the peculiarities of structure in +the joint specially involved, as, for example, it is obvious that a +better result may be expected from treatment when but a single joint, +with only its plain articular surfaces, is the place of injury, than in +one which is composed of several bones, united in a complex formation, +as in the knee or hock. As severe a lesion as suppurative synovitis +always is, and as frequently fatal as it proves to be, still cases arise +in which, the inflammation assuming a modified character and at length +subsiding, the lesion terminates favorably and leaves the animal with a +comparatively sound and useful joint. There are cases, however, which +terminate in no more favorable a result than the union of the bones and +occlusion of the joint, to form an anchylosis, which is scarcely a +condition to justify a high degree of satisfaction, as it insures a +permanent lameness with very little capacity for usefulness.<span class='pagenum'><a name="Page_360" id="Page_360">[Pg 360]</a></span></p> + +<p>Appreciating now the dangers associated with all wounds of +articulations, however simple and apparently slight, and how serious and +troublesome are the complications which are liable to arise during their +progress and treatment, we are prepared to understand and realize the +necessity and the value of early and prompt attention upon their +discovery and diagnosis.</p> + +<p><i>Treatment.</i>—For simple bruises, like those which appear in the form of +broken knees or of carpitis, simple remedies, such as warm fomentations +or cold-water applications and compresses of astringent mixtures, +suggest themselves at once. Injuries of a more complicated character, as +lacerations of the skin or tearing of soft structures, will also be +benefited by simple dressings with antiseptic mixtures, as those of the +carbolic-acid order. The escape of synovia should suggest the prompt use +of collodion dressings to check the flow and prevent the further escape +of the fluid. But if the discharge is abundant and heavily suppurative, +little can be done more than to put in practice the "expectant" method +with warm fomentations, repeatedly applied, and soothing, mucilaginous +poultices. Improvement, if any is possible, will be but slow to manifest +itself. The most difficult of all things to do, in view of varying +interests and opinions—that is, in a practical sense—is to abstain +from "doing" entirely, and yet in the cases we are considering we are +firmly convinced that noninterference is the best and wisest policy.</p> + +<p>In cases which are carried to a successful result the discharge will +diminish by degrees, the extreme pain will gradually subside, the +convalescent will begin timidly to rest his foot upon the ground, and +presently to bear weight upon it, and perhaps, after a long and tedious +process of recuperation, he may be returned to his former and normal +condition of usefulness. When the discharge has wholly ceased and the +wounds are entirely healed, a blister covering the whole of the joint +for the purpose of stimulating the absorption of the exudation will be +of great service. If, on the contrary, there is no amelioration of +symptoms and the progress of the disease resists every attempt to check +it; if the discharge continues to flow not only without abatement but in +an increased volume, and not alone by a single opening but by a number +of fistulous tracts which have successively formed; if it seems evident +that this drainage is rapidly and painfully sapping the suffering +animal's vitality, and a deficient <i>vis vitæ</i> fails to cooperate with +the means of cure—all rational hope of recovery may be finally +abandoned. Any further waiting for chances, or time lost in +experimenting, will be mere cruelty and there need be no hesitation +concerning the next step. The poor beast is under sentence of death, and +every consideration of interest and of humanity demands an anticipation +of nature's evident intent in the quick and easy execution of the +sentence.</p> + +<p><a name="PLATE_XXX" id="PLATE_XXX"></a></p> +<div class="figcenter" style="width: 273px;"> +<a href="images/plate30.jpg"><img src="images/plate30t.jpg" width="273" height="450" alt="PLATE XXX." title="" /></a> +<span class="caption">PLATE XXX.<br /> + +DISLOCATION OF SHOULDER AND ELBOW<br /><br /> + +Bourgelat's apparatus</span> +</div> + +<p><a name="PLATE_XXXI" id="PLATE_XXXI"></a></p> +<div class="figcenter" style="width: 450px;"> +<a href="images/plate31.jpg"><img src="images/plate31t.jpg" width="450" height="450" alt="PLATE XXXI." title="" /></a> +<span class="caption">PLATE XXXI.<br /> + +THE SLING IN USE</span> +</div> + +<p><span class='pagenum'><a name="Page_361" id="Page_361">[Pg 361]</a></span>One of the essentials of treatment, and probably an indispensable +condition when recovery is in any wise attainable, is the suspension of +the patient in slings. He should be continued in them so long as he can +be made to submit quietly to their restraint.</p> + + +<h4>DISLOCATIONS.</h4> + +<p>Dislocations and luxations are interchangeable terms, meaning the +separation and displacement of the articulating surfaces of the bones +entering into the formation of a joint. This injury is rarely +encountered in our large animals on account of the combination of +strength and solidity in the formation of their joints. It is met with +but seldom in cattle and less so in horses, while dogs and smaller +animals are more often the sufferers.</p> + +<p><i>Cause.</i>—The accident of a luxation is less often encountered in the +animal races than in man. This is not because the former are less +subject to occasional violence involving powerful muscular contractions, +or are less often exposed to casualties similar to those which result +in luxations in the human skeleton, but because it requires the +cooperation of conditions—anatomical, physiological, and perhaps +mechanical—present in the human race and lacking in the others, which, +however, can not in every case be clearly defined. Perhaps the greater +relative length of the bony levers in the human formation may constitute +a cause of the difference.</p> + +<p>Among the predisposing causes in animals may be enumerated caries of +articular surfaces, articular abscesses, excessive dropsical conditions, +degenerative softening of the ligaments, and any excessive laxity of the +soft structures.</p> + +<p><i>Symptoms and diagnosis.</i>—Three signs of dislocation must usually be +taken into consideration. They are: (1) An alteration in the shape of +the joint and in the normal relationship of the articulating surfaces; +(2) an alteration in the length of the limb, either shortening or +lengthening; (3) an alteration in the movableness of the joint, usually +an unnatural immobility. Only the first, however, can be relied upon as +essential. Luxations are not always complete; they may be partial; that +is, the articulating surfaces may be displaced but not separated. In +such cases several symptoms may not be present. And not only may the +third sign be absent, but the mobility of the first be greatly increased +when the character of the injury has been such as to produce extensive +lacerations of the articular ligaments.</p> + +<p>In addition to the above signs, a luxation is usually characterized by +pain, swelling, hemorrhage beneath the skin from damaged or ruptured +blood vessels, and even paralysis, when important nerves are pressed on +by the displaced bones.<span class='pagenum'><a name="Page_362" id="Page_362">[Pg 362]</a></span></p> + +<p>Sometimes a bone is fractured in the immediate vicinity of a joint. The +knowledge of this fact requires us to be able to diagnose between a +dislocation and such a fracture. In this we generally have three points +to assist us: (1) The immobility of a dislocated joint as against the +apparently remarkable freedom of movement in fracture; (2) in a +dislocation there is no true crepitus—that peculiar grating sensation +heard as well as felt on rubbing together the rough ends of fractured +bones; however, it must be remembered that in a dislocation two or three +days old the inflammatory changes around the joint may give rise to a +crackling sensation similar to that in fracture; (3) as a rule, in +luxations, if the ligamentous and muscular tissues about the joint are +not badly torn, the displacement, when reduced, does not recur.</p> + +<p><i>Prognosis.</i>—The prognosis of a luxation is comparatively less serious +than that of a fracture, though at time the indications of treatment may +prove to be so difficult to apply that complications of a very severe +character may arise.</p> + +<p><i>Treatment.</i>—The treatment of luxations must, of course, be similar to +that of fractures. Reduction, naturally, will be the first indication in +both cases, and the retention of the replaced parts must follow. The +reduction involves the same steps of extension and counter extension, +performed in the same manner, with the patient subdued by anesthetics.</p> + +<p>The difference between the reduction of a dislocation and that of a +fracture consists in the fact that in the former the object is simply to +restore the bones to their true, normal position, with each articular +surface in exact contact with its companion surface, the apparatus +necessary afterwards to keep them in situ being similar to that which is +employed in fracture cases, and which will usually require to be +retained for a period of from 40 to 50 days, if not longer, before the +ruptured retaining ligaments are sufficiently firm to be trusted to +perform their office unassisted. A variety of manipulations are to be +used by the surgeon, consisting in pushing, pulling, pressing, rotating, +and, indeed, whatever movement may be necessary, until the bones are +forced into such relative positions that the muscular contraction, +operating in just the right directions, pulls the opposite matched ends +together in true coaptation—a head into a cavity, an articular eminence +into a trochlea, as the case may be. The "setting" is accompanied with a +peculiar, snapping sound, audible and significant, as well as a visible +return of the surface to its normal symmetry.</p> + +<p><i>Special dislocations.</i>—While all the articulations of the body are +liable to this form of injury, there are three in the large animals +which may claim a special consideration, viz:<span class='pagenum'><a name="Page_363" id="Page_363">[Pg 363]</a></span></p> + + +<h4>THE SHOULDER JOINT.</h4> + +<p>We mention this displacement without intending to imply the +practicability of any ordinary attempt at treatment, which is usually +unsuccessful, the animal whose mishap it has been to become a victim to +it being disabled for life. The superior head of the arm bone as it is +received into the lower cavity of the shoulder blade is so situated as +to be liable to be forced out of place in four directions. It may escape +from its socket, according to the manner in which the violence affects +it—outward, inward, backward, or forward—and the deformity which +results and the effects which follow will correspondingly differ. We +have said that treatment is generally unsuccessful. It may be added that +the difficulties which interpose in the way of reduction are nearly +insurmountable, and that the application of means for the retention of +the parts after reduction would be next to impossible. The prognosis, +from any point of view, is sufficiently grave for the luckless animal +with a dislocated shoulder.</p> + + +<h4>THE HIP JOINT.</h4> + +<p>This joint partakes very much of the characteristics of the +humero-scapular articulation, but is more strongly built. The head of +the thigh bone is more separated, or prominent and rounder in form, and +the cup-like cavity, or socket, into which it fits is much deeper, +forming together a deep, true ball-and-socket joint, which is, moreover, +reenforced by two strong cords of funicular ligaments, which unite them. +It will be easily comprehended, from this hint of the anatomy of the +region, that a luxation of the hip joint must be an accident of +comparatively rare occurrence; yet cases are recorded in which the head +of the bone has been affirmed to slip out of its cavity and assume +various positions—inward, outward, forward, or backward.</p> + +<p>The indications of treatment are those of all cases of dislocation. When +the reduction is accomplished the surgeon will be apprised of the fact +by the peculiar, snapping sound usually heard on such occasions.</p> + + +<h4>PSEUDO-LUXATIONS OF THE PATELLA.</h4> + +<p>This is not a true dislocation. The stifle bone is so peculiarly +articulated with the thigh bone that the means of union are of +sufficient strength to resist the causes which usually give rise to +luxations, yet there is sometimes discovered a peculiar, pathological +state in the hind legs of animals, the effect of which is closely to +simulate the manifestation of many of the general symptoms of +dislocations. This condition originates in muscular cramps, the action +of which is seen in a certain change in the coaptation of the articular +surfaces of the stifle and thigh bone, resulting in the exhibition of a<span class='pagenum'><a name="Page_364" id="Page_364">[Pg 364]</a></span> +sudden and alarming series of symptoms which have suggested the phrase +of "stifle out" as a descriptive term.</p> + +<p><i>Symptoms.</i>—The animal so affected stands quietly and firmly in his +stall, or perhaps with one of his hind legs extended backward, and +resists every attempt to move him backward. If urged to move forward he +will either refuse or comply with a jump, with the toe of the disabled +leg dragging on the ground and brought forward by a second effort. There +is no flexion at the hock and no motion at the stifle, while the +circular motion of the hip is quite free. The leg appears to be much +longer than the other, owing to the straightened position of the thigh +bone, which forms almost a straight line with the tibia from the hip +joint down. The stifle joint is motionless, and the motions of all the +joints below it are more or less interfered with. External examination +of the muscles of the hip and thigh reveals a certain degree of +rigidity, with perhaps some soreness, and the stifle bone may be seen +projecting more or less on the outside and upper part of the joint.</p> + +<p>This state of things may continue for some time and until treatment is +applied, or it may spontaneously and suddenly terminate, leaving +everything in its normal condition, but perhaps to return again.</p> + +<p><i>Cause.</i>—Pseudo-dislocation of the patella is liable to occur under +many of the conditions which cause actual dislocation, and yet it may +often occur in animals which have not been exposed to the ordinary +causes, but which have remained at rest in their stables. Sometimes +these cases are assignable to falls in a slippery stall, or perhaps +slipping when endeavoring to rise; sometimes to weakness in convalescing +patients; sometimes to lack of tonicity of structure and general +debility; sometimes to relaxation of tissues from want of exercise or +use. A straight leg, sloping croup, and the young are predisposed to +this dislocation.</p> + +<p><i>Treatment.</i>—The reduction of these displacements of the patella is not +usually attended with difficulty. A sudden jerk or spasmodic action will +often be all that is required to spring the patella into place, when the +flexion of the leg at the hock ends the trouble for the time. But this +is not always sufficient, and a true reduction may still be indicated. +To effect this the leg must be drawn well forward by a rope attached to +the lower end, and the patella, grasped with the hand, forcibly pushed +forward and inward and made to slip over the outside border of the +trochlea of the femur. The bone suddenly slips into position, the +excessive rigor of the leg ceases with a spasmodic jerk, and the animal +may walk or trot away without suspicion of lameness. Though this may end +the trouble for the time, and the restoration seem to be perfect and +permanent, a repetition of the entire transaction may subsequently take +place, and perhaps from<span class='pagenum'><a name="Page_365" id="Page_365">[Pg 365]</a></span> the loss of some proportion of tensile power +which would naturally follow the original attack in the muscles involved +the lesion might become a habitual weakness.</p> + +<p>Warm fomentations and douches with cold water will often promote +permanent recovery, and liberty in a box stall or in the field will in +many cases insure constant relief. The use of a high-heeled shoe is +recommended by European veterinarians. The use of stimulating liniments, +with frictions, charges, or even severe blisters, may be resorted to in +order to prevent the repetition of the difficulty by strengthening and +toning up the parts.</p> + + +<h3>DISEASES OF MUSCLES AND TENDONS.</h3> + +<h4>SPRAINS.</h4> + +<p>This term expresses a more or less complete laceration or yielding of +the fibers of the muscles, tendons, or the sheaths surrounding and +supporting them. The usual cause of a sprain is external violence, such +as a fall or a powerful exertion of strength, with following symptoms of +soreness, heat, swelling, and a suspension of function. Their +termination varies from simple resolution to suppuration, and commonly +fibrinous exudation difficult to remove. None of the muscles or tendons +of the body are exempt from liability to this lesion, though naturally +from their uses and the exposure of their situation the extremities are +more liable than other regions to become their seat. The nature of the +prognosis will be determined by a consideration of the seat of the +injury and the complications likely to arise.</p> + +<p><i>Treatment.</i>—The treatment will resolve itself into the routine of +local applications, including warm fomentations, stimulating liniments, +counterirritation by blistering, and in some cases even firing. Rest, in +the stable or in a box stall, will be of advantage by promoting the +absorption of whatever fibrinous exudation may have formed, or +absorption may be stimulated by the careful persevering application of +iodin in the form of ointments of various degrees of strength.</p> + +<p>There are many conditions in which not only the muscular and tendinous +structures proper are affected by a strain, but, by contiguity of parts, +the periosteum of neighboring bones may become involved, with a +complication of periostitis and its sequelæ.</p> + + +<h4>LAMENESS OF THE SHOULDER.</h4> + +<p>The frequency of the occurrence of lameness in the shoulder from sprains +entitles it to precedence of mention in the present category, for, +though so well covered with its muscular envelope, it is often the seat +of injuries which, from the complex structure of the region, become +difficult to diagnosticate with satisfactory precision and facility. The +flat bone which forms the skeleton of that region is<span class='pagenum'><a name="Page_366" id="Page_366">[Pg 366]</a></span> articulated in a +comparatively loose manner with the bone of the arm, but the joint is, +notwithstanding, rather solid, and is powerfully strengthened by tendons +passing outside, inside, and in front of it. Still, shoulder lameness or +sprain may exist, originating in lacerations of the muscles, the tendons +or the ligaments of the joint, or perhaps in diseases of the bones +themselves. "Slip of the shoulder" is a phrase frequently applied to +such lesions.</p> + +<p>The identification of the particular structures involved in these +lesions is of much importance, in view of its bearing upon the question +of prognosis. For example, while a simple superficial injury of the +spinatus muscles, or the muscles by which the leg is attached to the +trunk, may not be of serious import and may readily yield to treatment, +or even recover spontaneously and without interference, the condition is +quite changed in a case of tearing of the flexor brachii, or of its +tendons as they pass in front of the articulation, or, what is still +more serious, if there is inflammation or ulceration in the groove over +which this tendon slides, or upon the articular surfaces or their +surroundings, or periostitis at any point adjacent.</p> + +<p><i>Causes.</i>—The frequency of attacks of shoulder lameness is not +difficult to account for. The superficial and unprotected position of +the part and the numerous movements of which it is capable, and which, +in fact, it performs, render it both subjectively and objectively +preeminently liable to accident or injury. It would be difficult and +would not materially avail to enumerate all the forms of violence by +which the shoulder may be crippled. A fall, accompanied with powerful +concussion; a violent muscular contraction in starting a heavily loaded +vehicle from a standstill; a misstep following a quick muscular effort; +a jump accompanied with miscalculated results in alighting; a slip on a +smooth, icy road; balling the feet with snow; colliding with another +horse or other object—indeed, the list may be indefinitely extended, +but without profit or utility.</p> + +<p><i>Symptoms.</i>—Some of the symptoms of shoulder lameness are peculiar to +themselves, and yet the trouble is frequently mistaken for other +affections—navicular disease more often than any other. The fact that +in both affections there are instances when the external symptoms are +but imperfectly defined, and that one of them especially is very similar +in both, is sufficient to mislead careless or inexperienced observers +and to occasion the error which is sometimes committed of applying to +one disease the name of the other, erring both ways in the interchange. +The true designation of pathological lesions is very far at times from +being of certain and easy accomplishment, and, owing to the massive +structure of the parts we are considering, this is especially true in +the present connection. Still there are many cases in which there is +really no reasonable excuse for an error in diagnosis by an average +practitioner.<span class='pagenum'><a name="Page_367" id="Page_367">[Pg 367]</a></span></p> + +<p>Shoulder lameness will, of course, manifest itself by signs and +appearances more or less distinct and pronounced, according to the +nature of the degrees and the extent of the originating cause. We +summarize some of these signs and appearances:</p> + +<p>The lameness is not intermittent, but continued, the disturbance of +motion gaging the severity of the lesion and its extent. It is more +marked when the bones are diseased than when the muscles alone are +affected. When in motion the two upper bony levers—the shoulder blade +and the bone of the upper arm—are reduced to nearly complete immobility +and the walking is performed by the complete displacement of the entire +mass, which is dragged forward without either flexion of extension. The +action of the joint below, as a natural consequence, is limited in its +flexion. In many instances there is a certain degree of swelling at the +point of injury—at the joint, or, more commonly, in front of it, or on +the surface of the spinatus muscle. Again, instead of swelling there +will be muscular atrophy, though, while this condition of loss of +muscular power may interfere with perfect locomotion, it is not in +itself usually a cause of shoulder lameness. "Sweenied" shoulders are +more often due to disease below the fetlock than to affections above the +elbow.</p> + +<p>During rest the animal often carries his leg forward, somewhat analogous +to the "pointing" position of navicular disease, though in some cases +the painful member drops at the elbow in a semiflexed position. The +backing is sometimes typical, the animal when performing it, instead of +flexing his shoulder, dragging the whole leg without motion in the upper +segment of the extremity.</p> + +<p>The peculiar manner in which the leg is brought forward in the air for +another step in the act of walking or trotting is in some instances +characteristic of injuries of the shoulder. The lameness also manifests +itself in bringing the leg forward with a circumflex swinging motion and +a shortening in the extension of the step. The foot is carried close to +the ground and stumbling is frequent, especially on an uneven road.</p> + +<p>With the utmost scrutiny and care the vagueness and uncertainty of the +symptoms will contribute to perplex and discredit the diagnosis and +embarrass the surgeon, and sometimes the expedient is tried of +aggravating the symptoms by way of intensifying their significance, and +thus rendering them more intelligible. This has been sought by requiring +the patient to travel on hard or very soft ground and compelling him to +turn on the sound leg as a pivot, with other motions calculated to +betray the locality of the pain.</p> + +<p><i>Treatment.</i>—It is our conviction that lameness of the shoulder will in +many cases disappear with no other prescription than that of rest. +Provided the lesions occasioning it are not too severe, time is all that +is required. But the negation of letting alone is seldom accepted as<span class='pagenum'><a name="Page_368" id="Page_368">[Pg 368]</a></span> a +means of doing good, in the place of the active and the positive forms +of treatment. This is in accordance with a trait of human nature which +is universal, and is unlimited in its applications; hence something must +be done. In mild cases of shoulder lameness, then, the indications are +water, either in the cold douche or by showering, or by warm +fomentations. Warm, wet blankets are of great service; in addition, or +as alternative, anodyne liniments, camphor, belladonna, either in the +form of tincture or the oils, are of benefit, and at a later period +stimulating friction with suitable mixtures, sweating liniments, +blistering compounds, subcutaneous injections over the region of the +muscle of 1-1/2 grains of veratrin (the variety insoluble in water) +mixed in 2 drams of water, etc., will find their place, and finally, +when necessity demands it, the firing iron and the seton.</p> + +<p>The duration of the treatment must be determined by its effects and the +evidence that may be offered of the results following the action of the +reparative process. But the great essential condition of cure, and the +one without which the possibility of relapse will always remain as a +menace, is, as we have often reiterated in analogous cases, <i>rest</i>, +imperatively rest, irrespective of any other prescriptions with which it +may be associated.</p> + + +<h4>SPRAIN OF THE ELBOW MUSCLES.</h4> + +<p><i>Causes.</i>—This injury, which fortunately is not very common, is mostly +encountered in cities among heavy draft horses or rapidly driven animals +which are obliged to travel, often smooth shod, upon slippery, icy, or +greasy pavements, where they are easily liable to lose their foothold. +The region of the strain is the posterior part of the shoulder, and the +affected muscles are those which occupy the space between the posterior +border of the scapula and the posterior face of the arm. It is the +muscles of the olecranon which give way.</p> + +<p><i>Symptoms.</i>—The symptoms are easily recognized, especially when the +animal is in action. While at rest the attitude may be normal, or by +close scrutiny a peculiarity may perhaps be detected. The leg may seem +to drop; the elbow may appear to be lower than its fellow, with the knee +and lower part of the leg flexed and the foot resting on the toe, with +the heel raised. Such an attitude, however, may be occasionally assumed +by an animal without having any special significance, but when it +becomes more pronounced in motion the fact acquires a symptomatic value, +and this is the case in the present instance. A rapid gait becomes quite +impossible, and the walk, as in some few other diseases, becomes +sufficiently characteristic to warrant a diagnosis even when observed +from a distance. An entire dropping of the anterior part of the trunk +becomes manifest, and no weight is carried on the disabled side in +consequence of the loss of<span class='pagenum'><a name="Page_369" id="Page_369">[Pg 369]</a></span> action in the suspensory muscles. There are +often heat, pain, and swelling in the muscular mass at the elbow, though +at times a hollow, or depression, may be observed near the posterior +border of the scapula, which is probably the seat of injury.</p> + +<p>These hurts are of various degrees of importance, varying from mere +minor casualties of quick recovery to lesions which are of sufficient +severity to render an animal useless and valueless for life.</p> + +<p><i>Treatment.</i>—The prime elements of treatment, which should be strictly +observed, are rest and quiet. Prescriptions of all kinds, of course, +have their advocates. Among them are ether, chloroform, camphor, +alcoholic frictions, warm fomentations, blisters, setons, etc. Unless +the conclusions of experience are to be ignored, my own judgment is +decisive in favor of rest, judiciously applied, however, and my view of +what constitutes a judicious application of rest has been more than once +presented in these pages. There are degrees of this rest. One +contemplates simple immobility in a narrow stall. Another means the +enforced mobility of the slings and a narrow stall as well. Another a +box stall, with ample latitude as to posture and space, and option to +stand or lie down. As wide as this range may appear to be, radical +recovery has occurred under all of these modified forms of <i>letting our +patients alone.</i></p> + + +<h4>HIP LAMENESS.</h4> + +<p>The etiology of injuries and diseases of the hip is one and the same +with that of the shoulder. The same causes operate and the same results +follow. The only essential change, with an important exception, which +would be necessary in passing from one region to the other in a +description of its anatomy, its physiology, and its pathology would be a +substitution of anatomical names in reference to certain bones, +articulations, muscles, ligaments, and membranes concerned in the +injuries and diseases described. It would be only a useless repetition +to cover again the ground over which we have so recently passed in +recital of the manner in which certain forms of external violence +(falls, blows, kicks, etc.) result in other certain forms of lesion +(luxation, fracture, periostitis, ostitis, etc.), and to recapitulate +the items of treatment and the names of the medicaments proper to use. +The same rules of diagnosis and the same indications and prognosis are +applicable equally to every portion of the organism, with only such +modifications in applying dressings and apparatus as may be required by +differences of conformation and other minor circumstances, which must +suggest themselves to the judgment of every experienced observer when +the occasion arrives for its exercise.<span class='pagenum'><a name="Page_370" id="Page_370">[Pg 370]</a></span></p> + +<p>An exception is to be made, while considering the subject in connection +with the region now under advisement, in respect to the formidable +affection known as morbus coxarius, or hip-joint disease; and leaving +the detail of other lesions to take their place under other heads, that +relating to the shoulder, for instance, we turn to the hip joint and its +ailments as the chief subject of our present consideration.</p> + +<p><i>Symptoms.</i>—In investigating for morbus coxarius, let the observer +first examine the lame animal by scanning critically the outlines of the +joint and the region adjacent for any difference of size or disturbance +of symmetry in the parts, any prominence or rotundity, and on both +sides. The lame side will probably be warmer, more developed, and +fuller, both to the touch and to the eye. Let him then grasp the lower +part of the leg (as he would in examining a case of shoulder lameness) +and endeavor to produce excessive passive motion. This will probably +cause pain when the leg is made to assume a given position. Let him push +the thigh forcibly against the hip bone, and the contact will again +probably cause a manifestation of pain. If the horse is trotted, the +limited action of the hip joint proper and the excessive dropping and +rising of the hip of the opposite side will be easily recognized. +Usually the animal does not extend the foot so far as customarily and +picks it up much sooner.</p> + +<p>The abductive or circumflex motion observed in shoulder lameness is also +present in hip lameness, but under special conditions, and the test of +the difficulty, either by traveling on soft ground or in turning the +horse in a circle, may here also contribute to the diagnosis, as in +testing for lameness in the anterior extremity.</p> + +<p><i>Prognosis.</i>—The prognosis of hip lameness is at times quite serious, +not only on account of the long duration of treatment required to effect +good results, and because of the character which may be assumed by the +disease, but of the permanence of the disability resulting from it. +Exostosis and ulcerative arthritis are sequelæ which often resist every +form of treatment.</p> + +<p><i>Treatment.</i>—As before intimated, this is little more than a repetition +of the remarks upon the lameness of the shoulder, with slight +modifications occasioned by the muscular structure of the hip, and we +are limited to the same recommendations of treatment. The advantages of +rest must be reaffirmed, with local applications, of which, however, it +may be said that they are more distinctly indicated and likely to be +more effective in their results than in shoulder lameness, and may be +more freely employed, whether in the form of liniments, blisters (singly +or repeated), firing, or setoning.<span class='pagenum'><a name="Page_371" id="Page_371">[Pg 371]</a></span></p> + + +<h4>SPRAINS OF SUSPENSORY LIGAMENTS AND OF FLEXOR TENDONS OR THEIR SHEATHS.</h4> + +<p>The fibrous structure situated behind the cannon bones, both in the fore +and hind legs, is often the seat of lacerations or sprains resulting +from violent efforts or sudden jerks.</p> + +<p><i>Cause.</i>—The injury may be considered serious or trifling, according to +the circumstances of each case as judged by its own history. Among the +predisposing causes are a long, thin fetlock and a narrow knee or hock +as viewed from the side, with the flexor muscles tied in just below the +joint. The longer and more oblique the pastern the greater is the strain +on the flexor tendons and suspensory ligaments; hence a low quarter, a +toe calk, and no heel calks, or a thin calk placed at the tip under the +toe, and leaving the quarters long abnormally stretches the back tendons +and causes a great strain upon them just before the weight is shifted +from the foot in locomotion. In runners and hunters the disease is +liable to be periodic. In driving horses it is most common in well-bred +animals of nervous temperament. Draft horses suffer most frequently in +the hind legs.</p> + +<p><i>Symptoms.</i>—The injury is readily recognized by the changed aspect of +the region and the accompanying local symptoms. The parts which in +health are well defined, with the outlines of the tendons and ligaments +well marked, become the seat of a swelling, more or less developed, from +a small spot on the middle of the back of the tendon to a tumefaction +reaching from the knee down to and even involving the fetlock itself. It +is always characterized by heat, and it is variously sensitive, ranging +from a mere tenderness to a degree of soreness which shrinks from the +lightest touch. The degree of the lameness varies, and it has a +corresponding range with the soreness, sometimes showing only a slight +halting and at others the extreme of lameness on three legs, with +intermediate degrees.</p> + +<p>The lameness is always worse when the weight is thrown on the foot and +is most marked toward the end of the phase of contact with the ground. +Either passive irritation of the leg or turning the animal in a circle +causes pain as in diseases of the joints. Sometimes the horse likes to +get the heels on a stone or some elevation so as to relieve the weight +from the flexor tendons. Finally, in cases of long standing, a +shortening of the tendons occurs, resulting in the abnormal flexion of +the foot known by horsemen as "broken down," or a more upright position +of the foot may follow, producing perhaps knuckling or the so-called +clubfoot.</p> + +<p><i>Prognosis.</i>—It may be safely assumed on general principles that a leg +which has received such injuries seldom returns to a perfect condition +of efficiency and soundness, and that as a fact a certain absolute +amount of thickening and deformity will remain permanent, even when the +lameness has entirely disappeared.<span class='pagenum'><a name="Page_372" id="Page_372">[Pg 372]</a></span></p> + +<p><i>Treatment.</i>—The injured member should receive the earliest attention +possible, not only when the inflammatory condition is present, but when +it is subsiding and there is only the thickening of the ligaments, the +tendons, or the sheath.</p> + +<p>The most important remedy is rest, and the shoes should always be +removed. During the first three days cold in the form of immersion or +continuous irrigation is indicated. Then warm moisture and continuous +pressure are advised. The latter is best applied by placing two padded +splints about the thickness of the thumb along the two sides of the +tendon and binding them in place with even pressure by bandage. Frequent +bathing with warm soap suds is also beneficial. The absorption of the +exudate may be promoted and the work of restoration effected by +frictions with alcohol, tincture of soap, spirits of camphor, mild +liniments, strong, sweating liniments, and blisters. An excellent +ointment to apply with massage consists of equal parts of blue ointment +and green soap, with double the quantity of vaseline. The action of +blisters in these cases depends chiefly upon the massage used in +applying them and upon the continuous pressure of the swollen skin on +the inflamed tendons. In old cases more beneficial results will follow +line firing. In these cases shoeing is very important. Leave the +quarters long, shorten the toe, give the shoe rolling motion, and either +put short heel calks on the branches or thicken the branches. Although +this line of treatment is efficacious in many cases, there are others in +which the thickening of the tendons refuses to yield and the changed +tissues remain firmly organized, leaving them in the form of a thick +mass resting upon the back part of the cannon bone.</p> + + +<h4>KNUCKLING OF FETLOCK.</h4> + +<p>As a consequence of the last-mentioned lesion of the tendons, a new +condition presents itself in the articular disposition, constituting the +deformity known as the knuckling fetlock. (See also p. 400.)</p> + +<p>By this is meant a deformity of the fetlock joint by which the natural +angle is changed from that which pertains to the healthy articulation. +The first pastern, or suffraginis, loses its oblique direction and +assumes another, which varies from the upright to the oblique, from +before backward, and from above downward; in other words, forming an +angle with its apex in front.</p> + +<p><i>Causes.</i>—This condition, as we have seen, may be the result of chronic +disease producing structural changes in the tendons, and it may also +occur as the result of other affections or some peculiarity independent +of this and situated below the fetlock, such as ringbones, sidebones, or +traumatic disease of the foot proper. Animals are sometimes predisposed +to knuckling, such, for example, as are naturally straight in their +pasterns, or animals which are compelled to labor when too young. The +hind legs are more predisposed than the<span class='pagenum'><a name="Page_373" id="Page_373">[Pg 373]</a></span> fore to this deformity, in +consequence of the greater amount of labor they are required to perform +as the propelling levers of the body.</p> + +<p><i>Symptoms.</i>—The symptoms of knuckling are easily recognized. The +changes in the direction of the bones vary more or less with the degree +of the lesion, sometimes assuming such a direction that it almost +becomes a true dislocation of the pastern.</p> + +<p>The effect of knuckling upon the gait also varies according to the +degree of the deformity. As the different degrees of the shortening of +the leg affect the motion of the fetlock, the lameness may be very +slight or quite extreme. Another consequence of this shortening is such +a change in the position of the foot that the heels cease to come in +contact with the ground and assume a greater elevation, and the final +result of this is soon witnessed in the development of a clubfoot.</p> + +<p><i>Treatment.</i>—To whatever cause the knuckling may be ascribed, it is +always a severe infirmity, and there is but little room for hoping to +overcome it unless it be during the very first stages of the trouble, +and the hope dwindles to still smaller dimensions when it is secondary +to other diseases below the fetlock. If it is caused by overworking the +animal, the first indication, of course, will be rest. Line firing has +proved very efficacious in these cases. The animal must be turned loose +and left unemployed. Careful attention should be given to the condition +of his feet and to the manner of shoeing, while time is allowed for the +tendons to become restored to their normal state and the irritation +caused by excessive stretching has subsided. A shoe with a thick heel +will contribute to this. If no improvement can be obtained, however, and +the tendons though retracted have yet been relieved of much of their +thickening, the case is not a desperate one, and may yet be benefited by +the operation of tenotomy, single or double—an operative expedient +which must be committed to the experienced surgeon for its performance.</p> + + +<h4>SPRUNG KNEES.</h4> + +<p>Though not positively the result of diseases of the tendons acting upon +the knees, we venture to consider this deformity in connection with that +which we have just described. It consists in such an alteration in the +direction and articulation of the bones which form the various carpal +joints that instead of forming a vertical line from the lower end of the +forearm to the cannon bone they are so united that the knee is more or +less bent forward, presenting a condition caused by the retraction of +two of the principal muscles by which the cannon bone is flexed.</p> + +<p><i>Cause.</i>—This flexion of the knee may be a congenital deformity and +have continued from the foaling of the animal; or, like clubfoot, it may +be the result of heavy labor which the animal has been compelled<span class='pagenum'><a name="Page_374" id="Page_374">[Pg 374]</a></span> to +perform when too young. It may also be due to other diseases existing in +parts below the knee joint.</p> + +<p><i>Symptoms.</i>—This change of direction largely influences the movement of +the animal by detracting from its firmness and practically weakening the +entire frame, even to the extent of rendering him insecure on his feet +and liable to fall. This condition of weakness is sometimes so +pronounced that he is exposed to fall even when standing at rest and +unmolested, the knees being unable even to bear their portion of the +mere weight of the frame. This results in another trouble—that of being +unable to keep permanently upright. He is liable to fall on his knees, +and by this act becomes presently a sufferer from the lesion known by +the term of "broken knees."</p> + +<p><i>Treatment.</i>—Whatever may be the originating cause of this +imperfection, it detracts very largely from the usefulness and value of +a horse, disqualifying him for ordinary labor and wholly unfitting him +for service under the saddle without jeopardizing the safety of his +rider. If, however, the trouble is known from the start, and is not the +result of congenital deformity or weakness of the knee joint, or +secondary to other diseases, rest, with fortifying frictions, may +sometimes aid in strengthening the joints; and the application of +blisters on the posterior part of the knee, from a short distance above +to a point a little below the joint, may be followed by some +satisfactory results; but with this trouble, as with knuckling fetlocks, +the danger of relapse must be kept in mind as a contingency always +liable to occur.</p> + + +<h4>CURB.</h4> + +<p>This lesion is the bulging backward of the posterior part of the hock, +where in the normal state there should be a straight line, extending +from the upper end of the point of the hock down to the fetlock.</p> + +<p><i>Cause.</i>—The cause may be a sprain of the tendon which passes on the +posterior part of the hock, or of one of its sheaths, or of the strong +ligament situated on the posterior border of the os calcis.</p> + +<p>Hocks of a certain conformation seems to possess a greater liability to +curb than others. They are overbent, coarse, and thick in appearance, or +may be too narrow from front to back across the lower portion. This +condition may therefore result as a sequence to congenital malformation, +as in the case of horses that are "saber-legged." It often occurs, also, +as the result of violent efforts, of heavy pulling, of high jumping, or +of slipping; in a word, it may result from any of the causes heretofore +considered as instrumental in producing lacerations of muscular, +tendinous, or ligamentous structure.</p> + +<p><i>Symptoms.</i>—A hock affected with curb will present at the outset a +swelling more or less diffuse on its posterior portion, with varying +degrees of heat and soreness, and these will be accompanied with<span class='pagenum'><a name="Page_375" id="Page_375">[Pg 375]</a></span> +lameness of a permanent character. At a later period, however, the +swelling will become better defined, the deformity more characteristic, +the prominent, curved line readily detected, and the thickness of the +infiltrated tissue easily determined by the fingers. At this time, also, +there may be a condition of lameness, varying in degree, while at +others, again, the irregularity of action at the hock will be so slight +as to escape detection, the animal betraying no appearance of its +existence.</p> + +<p>A curb constitutes, by a strict construction of the term, an +"unsoundness," since the hock thus affected is less able to endure +severe labor, and is more liable to give way with the slightest effort. +Yet the prognosis of a curb can not be considered to be serious, as it +generally yields to treatment, or at least the lameness it may occasion +is generally easily relieved, though the loss of contour caused by the +bulging will always constitute a blemish.</p> + +<p><i>Treatment.</i>—On the first appearance of a curb, when it exhibits the +signs of an acute inflammation, the first indication is to subdue it by +the use of cold applications, as intermittent or constant irrigation or +an ice poultice; when these have exhausted their effect and the swelling +has assumed better defined boundaries, and the infiltration of the +tendons or of the ligaments is all that remains of a morbid state, then +every effort must be directed to the object of effecting its absorption +and reducing its dimensions by pressure and other methods. The +medicaments most to be trusted are blisters of cantharides and frictions +with ointments of iodin, or, preferably, biniodid of mercury. Mercurial +agents alone, by their therapeutic properties or by means of the +artificial bandages which they furnish by their incrustations when their +vesicatory effects are exhausted, will give good results in some +instances by a single application, and often by repeated applications. +The use of the firing iron must, however, be frequently resorted to, +either to remove the lameness or to stimulate the absorption. We believe +that its early application ought to be resorted to in preference to +waiting until the exudation is firmly organized. Firing in dull points +or in lines will prove as beneficial in curb as in any other disease of +a similar nature.</p> + + +<h4>LACERATED TENDONS.</h4> + +<p>This form of injury, whether of a simple or of a compound character, may +become a lesion of a very serious nature, and will usually require long +and careful treatment, which may yet prove unavailing in consequence +either of the intrinsically fatal character of the wound itself or the +complications which have rendered it incurable.</p> + +<p><i>Cause.</i>—Like all similar injuries, they are the result of traumatic +violence, such as contact with objects either blunt or sharp; a +curb-stone in the city; in the country, a tree stump or a fence, +especially<span class='pagenum'><a name="Page_376" id="Page_376">[Pg 376]</a></span> one of wire. It may easily occur to a runaway horse when he +is "whipped" with fragments of harness or "flogged" by fragments of +splintered shafts "thrashing" his legs, or by the contact of his legs +with the wagon he has overturned and shattered with his heels while +disengaging himself from the wreck.</p> + +<p><i>Symptoms.</i>—It is not always necessary that the skin be involved in +this form of injury. On the contrary, the tegument is frequently left +entirely intact, especially when the injury follows infectious diseases +or occurs during light exercise after long periods of rest in the +stable. Again, the skin may be cut through and the tendons nearly +severed. A point a little above the fetlock is usually the seat of the +injury. But irrespective of this, and whether the skin is or is not +implicated, the symptoms resemble very much those of a fracture. There +is excessive mobility, at least more than in a normal state, with more +or less inability to carry weight. There may be swelling of the parts, +and on passing the hands carefully along the tendon to the point of +division the stumps of the divided structure will be felt more or less +separated, perhaps wholly divided. The position of the animal while at +rest and standing is peculiar and characteristic. While the heels are +well placed on the ground, the toe is correspondingly elevated, with a +tendency to turn up—a form of breaking down which was described when +speaking of the fracture of the sesamoids. Carrying weight is done only +with considerable difficulty, but with comparatively little pain, and +the animal will unconsciously continue to move the leg as if in great +suffering, notwithstanding the fact that his general condition may be +very good and his appetite unimpaired.</p> + +<p>The effect upon the general organism of compound lacerated wounds of +tendinous structures, or those which are associated with injuries of the +skin, are different. The wound becomes in a short time the seat of a +high degree of inflammation, with abundant suppuration filling it from +the bottom; the tendon, whether as the result of the bruise or of the +laceration, or of maceration in the accumulated pus, undergoes a process +of softening, and necrosis and sloughing ensue. This complicates the +case and probably some form of tendinous synovitis follows, running into +suppurative arthritis, to end, if close to a joint, with a fatal result.</p> + +<p><i>Prognosis.</i>—The prognosis of lacerated tendons should be very +conservative. Under the most favorable circumstances a period of from +six weeks to two months will be necessary for the treatment, before the +formation of the cicatricial callus and the establishment of a firm +union between the tendinous stumps.</p> + +<p><i>Treatment.</i>—As with fractures, and even in a greater degree, the +necessity is imperative, in the treatment of lacerated tendons, to +obtain as perfect a state of immobility as can be obtained compatibly<span class='pagenum'><a name="Page_377" id="Page_377">[Pg 377]</a></span> +with the disposition of the patient; the natural opposition of the +animal, sometimes ill-tempered and fractious at best, under the +necessary restraint causing at times much embarrassment to the +practitioner in applying the necessary treatment. Without the necessary +immobility there can be no close connection of the ends of the tendons. +To fulfill this necessary condition the posterior part of the foot and +the fetlock must be supported and the traction performed by them +relieved, an object which can be obtained by the use of the high-heeled +and bar shoe, or possibly better accomplished with a shoe of the same +kind extending about 2 or 2-1/2 inches back of the heels. The perfect +immobility of the legs is obtained in the same way as in the treatment +of fracture, with splints, bandages, iron apparatus, plaster of adhesive +mixtures, and similar means. So long as the dressings remain in place +undisturbed and no chafing or other evidence of pain is present, the +dressings may be continued without changing, the patient being kept in +the slings for a period sufficient to insure the perfect union of the +tendons. For a compound lesion when there is laceration of the skin some +special care is necessary. The wound must be carefully watched and the +dressings removed at intervals of a few days or as often as may be +needful, all of which additional manipulation and extra nursing, however +indispensable, still adds to the gravity of the case and renders the +prognosis more and more serious. When the tendons have sloughed in +threads of various dimensions, or if in the absence of this process of +mortification healthy granulations should form and fill up the wound, +still very careful attention will be required, the granulating ends of +the tendons having a tendency to bulge between the edges of the skin and +to assume large dimensions, forming bulky excrescences or growths of a +warty or cauliflower appearance, the removal of which becomes a +troublesome matter.</p> + +<p>The union of the tendons will at times leave a thickening of varying +degree near the point of cicatrization, the absorption of which becomes +an object of difficult and doubtful accomplishment, but which may be +promoted by moderate blistering and the use of alterative and absorbent +mixtures or perhaps the fire iron. A shoe with heels somewhat higher +than usual will prove a comfort to the animal and aid in moderating and +relieving the tension of the tendons.</p> + + +<h4>RUPTURE OF THE FLEXOR METATARSI.</h4> + +<p>This is a muscle of the anterior part of the shank. It is situated in +front of the tibia, and is of peculiar formation, being composed of a +muscular portion with a very powerful tendon, which are at first +distinct and separate, to be intimately united lower down, and +terminating at the lower end by a division into four tendinous bands. It +is a powerful muscle of the hinder shank bone, and also acts as a<span class='pagenum'><a name="Page_378" id="Page_378">[Pg 378]</a></span> +strong means of support for the stifle joint; that is, of the +articulation of the thigh and shank bone, in front and outside of which +it passes. Its situation and its use cause it to be liable to severe +stretching and straining, and a rupture of some of its fibers is +sometimes the consequence.</p> + +<p><i>Cause.</i>—This injury may be the result of a violent effort of the +animal in leaping over a high obstacle; in missing his foothold and +suddenly slipping backward while powerfully grasping the ground with the +feet in striving to start a heavily loaded vehicle; in making a violent +effort to prevent a probable fall; or in attempting to lift the feet +from miry ground.</p> + +<p><i>Symptoms.</i>—The accident is immediately followed by disability which +will vary according to the true seat of the injury and the period of its +duration. This rupture will not prevent the horse from standing +perfectly and firmly on his feet when kept at rest, and while no +muscular efforts are required from him there is no appearance of any +lesion or unsoundness. An attempt to move him backward, however, will +cause him to throw all his weight upon his hind-quarters, and he will +refuse to raise his foot from the ground. If compelled to do so, or +required to move forward, the hock being no longer capable of flexion, +the muscle which effects that movement being the injured one, the +opposite muscles, the extensors, acting freely, the entire lower part of +the leg, from the hock down, will be suddenly, with a jerk, extended on +the tibia or shank bone, and simultaneously with this the tendo +Achillis, the cord of the hock, the tendons of the extensors of the hock +will be put in a wrinkled and relaxed condition. The leg is behind the +animal and the toe rests on the ground. Examination of the fore part of +the shank from the stifle down to the hock may reveal soreness, and +possibly some swelling and heat at the seat of the lesion.</p> + +<p><i>Treatment.</i>—Our experience with injuries of this form convinces us +that, generally speaking, they are amenable to treatment. Provided a +sufficient time has been allowed for union to take place, very few +instances in which radical recovery has not been effected have come to +our knowledge. The more flexed the leg can be kept, the quicker will it +heal.</p> + +<p>In these cases, as in those of simple laceration of tendons, already +considered, the indications resemble those which apply in the treatment +of fractures, as near as coaptation of the lacerated ends is possible, +with immobility, being the necessary conditions to secure. The first is +a matter of very difficult accomplishment, by bandaging alone, and some +have recommended instead the application of charges or blisters in order +to compel the animal to keep more quiet.</p> + +<p>To secure the necessary immobility the animal should be placed in slings +snugly applied, and kept in a narrow stall. He should also be<span class='pagenum'><a name="Page_379" id="Page_379">[Pg 379]</a></span> tied +short, and restrained from any backward movement by ropes or boards, and +should, moreover, be kept in as quiet a temper as possible by the +exclusion of all causes of irritation or excitement. Weeks must then +elapse, not less, but frequently more than six, often eight, before he +can be considered out of danger and able to return to his labor, which +should for a time be light and easy, and gradually, if ever, increased +to the measure of a thoroughly sound and strong animal. If he is used +too soon the newly formed tissue between the ends of the muscle will be +liable to stretch and leave the flexor muscle too long and permanently +displaced.</p> + + +<h4>SUNDRY ADDITIONAL AFFECTIONS OF THE EXTREMITIES.</h4> + +<p>Among these there are three which will principally occupy our attention, +and, which may be considered as forming a single group. In some parts of +the legs may be found certain peculiar little structures of a saclike +formation, containing an oily substance designed for the lubrication of +the parts upon which they are placed for the purpose of facilitating the +movements of the tendons which pass over them. These little sacs or +muco-synovial capsules, under peculiar conditions of traumatism, are +liable to become subject to a diseased process, which consists +principally in a hypersecretion of their contents and an increase in +dimensions, and they may undergo peculiar pathological changes of such +character as to disable an animal, and in many instances to cause +serious blemishes which can but depreciate its value. These growths, +which are known as hygromata, may result from external violence, as +blows or bruises, and may appear in the form of small, soft tumors, +painless and not inflammatory in character, but, by a repetition of the +cause or renewal of violence, liable to acquire increased severity. +Severe inflammation, with suppuration, may follow, which, filling up the +cavity, the walls will become thickened and hard, resulting in the +formation of a tumor.</p> + +<p>The elbow, the knee, and the hock are the parts of the body where these +lesions are ordinarily found, and on account of their peculiar shape and +the position they occupy they have received the denomination "capped." +They will be considered in their peculiar aspect.</p> + + +<h4>CAPPED ELBOW.</h4> + +<p>Capped elbow, or "shoe boil," is a term applied to an enlargement often +found at the point of the elbow.</p> + +<p><i>Cause.</i>—This lesion is due to injury or pressure of the part while it +is resting on the ground. The horse, unlike the cow, does not rest +directly on the under surface of the sternum, or breastbone, on account +of its sharp, ridge-like formation. He rests more on the side of the +breastbone and chest, and consequently the leg which is flexed<span class='pagenum'><a name="Page_380" id="Page_380">[Pg 380]</a></span> under +the body is subject to considerable pressure. If the leg is flexed under +the body so that the hoof or shoe is directly in contact with the elbow, +which may occur in horses having an extremely long cannon bone or +excessive length in the shoes, the greater part of the weight of the +chest is concentrated at this point and the pressure may cause a bruise +or an inflammation.</p> + +<p><i>Symptoms.</i>—Under these conditions the point of the elbow may become +swollen and tender and exhibit heat and pain. This swelling may not only +cover the point of the elbow, but sometimes reaches the axilla and +assumes such proportions that there is great difficulty in using the +leg, the animal showing signs of lameness even to the extent of the +circumflex step, as in shoulder lameness. This edematous condition, +however, does not remain stationary. It may by degrees subside or +perhaps disappear. In the first instance it will become more distinctly +defined, with better marked boundaries, until it is reduced to a soft, +round, fluctuating tumor, with or without heat or pain. There is then +either a bloody or serous tumor or a purulent collection, and following +the puncture of its walls with the knife there will be an escape of +blood, serum, or pus, as the case may be, in variable quantities. In +either case, but principally in that of the cystic form, the tumor will +be found to be subdivided by septa, or bands running in various +directions.</p> + +<p>Various changes will follow the opening of the tumor and the escape of +its contents. In a majority of cases the process of cicatrization will +take place, and the cavity fill up by granulation, the discharge, at +first abundant, gradually diminishing and the wound closing, usually +without leaving any mark. At times, however, and especially if the +disease has several times repeated its course, there may remain a +pendulous sac, partly obliterated, which a sufficient amount of +excitement or irritation may soon restore to its previous dimensions and +condition.</p> + +<p>In other cases an entirely different process takes place. The walls of +the cavity, cyst, or abscess become ulcerated and thickened, the +granulations of the sac become fibrous in their structure and fill up +the cavity, and it assumes the character of a hard tumor on the back of +the elbow, sometimes partly and sometimes entirely covered by the skin. +It is fibrous in its nature, painless to the touch, well defined in its +contour, and may vary in size from that of a small apple to that of a +child's head.</p> + +<p>This last form of capped elbow is the most serious of any, resisting all +known forms of mild treatment, and removable by the knife only. The +other forms, even that with the inflammatory aspect and its large +edematous swelling which interferes with the work of the animal, may +justify a much milder prognosis, and, aside from their liability to +recur, may be ranked with the comparatively harmless affections.<span class='pagenum'><a name="Page_381" id="Page_381">[Pg 381]</a></span></p> + +<p><i>Treatment.</i>—So long as the danger of recurrence is the principal bad +feature of capped elbow the most important consideration is that of +devising a means for its prevention. To prevent the animal from lying +down is evidently the simplest method of keeping the heels and the elbow +apart; but the impracticability of this prescription is apparent, since +most animals are obliged to lie down when they sleep, though it is true +that a few take their sleep on their feet. The question of shoeing here +enters into the discussion. The shortening of the inside branch of the +shoe, which is the one with which the pressure is made, may be of +advantage, and especially if the truncated end of the shoe is smooth and +filed over to remove all possibility of pressure and contusion upon the +skin. The protection of the skin of the elbow by interposing soft +tissues between that and the shoe, or by bandaging the heel with bags or +covering it with boots, is considered by many the best of the preventive +methods, and the advantage to be obtained by resorting to it can not be +overlooked when the number of horses which develop shoe boil whenever +the use of the boot is intermitted is considered. In order to prevent +the animal from assuming the sternal decubitus, many give preference to +the plan of fastening a piece of wood across the stall at some distance +from the front wall or manger. It is a simple expedient, primitive, +perhaps, but nevertheless practical, and followed by good results.</p> + +<p>The therapeutic treatment is also important. The edematous swelling, +when recognized by its external appearance and the existing +inflammation, should be treated without delay. Warm fomentations, +repeated several times daily, are then indicated, the degree of warmth +being as high as can be borne comfortably. They are easily applied and +often yield decided relief in a few hours. In some cases, however, +astringents, in the form of poultices or pastes, are used in preference; +these are made to cover the entire swelling and allowed to remain, +drying after a short time, it is true, and perhaps falling off, but are +easily renewed and reapplied. An excellent astringent for these cases is +a putty made of powdered chalk and vinegar (acetate of lime), and the +whole swelling is then covered with a thick coating of soft clay made +into a mass with water.</p> + +<p>These simple remedies are often all that is required. Under their use +the swelling passes off by degrees and after a short interval the animal +is fit for work again, but not uncommonly instead a swelling develops, +puffy, not painful, and perhaps giving a sensation of crepitation when +pressure is applied with the finger. It is soft, evidently contains a +liquid, and when freely opened with a good-sized incision discharges a +certain quantity of blood, partly liquid and partly coagulated, and +perhaps a little hemorrhage will follow. The cavity should then be well +washed out and a plug of oakum introduced, leaving a small portion +protruding through the cut to prevent it<span class='pagenum'><a name="Page_382" id="Page_382">[Pg 382]</a></span> from closing prematurely. It +may be taken off the next day, and a daily cleansing will then be all +that is necessary. In another case the tumor becomes very soft in its +whole extent, with evident fluctuation and a well-defined form. The +discharge of the fluid is then indicated, and a free incision will be +followed by the escape of a quantity of thin yellowish liquid from a +single sac. The wound should be kept clean and dressed frequently, in +order to insure prompt healing. But if the cavity is found to be +subdivided in its interior by numerous bands and the cyst proves to be +multilocular the partitions should be torn out with the fingers and the +cavity then treated in the same manner as the unilocular sac. In still +another case the swelling may be warm and painful with indistinct +fluctuation, or fluctuation only at a certain point. This indicates an +abscess, and necessitates an incision to drain the pus, followed by the +careful cleansing and dressing of the wound.</p> + +<p>But cases occur in which all the treatment that has been described fails +to effect a full recovery, and instead a fibrous tumor begins to +develop. A change of treatment is, of course, then in order. The +inflammation being chronic will necessitate stimulating treatment of the +part in order to increase the process of absorption. We must again draw +upon the resources of experience in the form of blisters, the +fomentations, the iodin, and the mercurial ointments, as heretofore +mentioned. Good results may always be insured from their judicious and +timely administration. In applying the powerful mineral inunctions much +patience and wisdom are required. It should be done by carefully and +perseveringly rubbing in small quantities daily; it should be done +softly and gently, not with force, nor with the expectation of producing +an astonishing effect by heavy dosing and main strength in a few hours; +it should be after the manner of a siege rather than that of a charge. +The object is to induce the drugs to permeate the affected part until +the entire mass is penetrated. Of course cases will be encountered which +resist all forms of medical treatment. The tumor remains as a fixed +fact; it continues to grow; it is large and pendulous at the elbow; its +weight is estimated in pounds; it is not an eyesore merely, but an +uncomfortable, burdensome mass, excoriating all the surrounding parts +and being itself excoriated in turn; mild treatment has failed and is no +longer to be relied on.</p> + +<p>Resort must now be made to surgical methods, and here again we must +choose between the ligature, the cautery, and the knife. Each has its +advocates among practitioners. In a case like the present, one of the +difficulties arises in connection with the application and retention of +bandages and other dressings after the amputation has been performed. It +is a somewhat difficult problem, owing to the conformation and +proportions of the body of the patient, and involves<span class='pagenum'><a name="Page_383" id="Page_383">[Pg 383]</a></span> the exercise of +considerable practical ingenuity to adjust and retain the appliances +necessary to insure a good final result.</p> + +<p>In the long description of the treatment of the varieties of capped +elbow I have thus far omitted any mention of one method which is +practiced and commended by not a few. I refer to the use of setons, +introduced through the tumor. My own experience and the observation of +many failures from this method led me to abandon it.</p> + + +<h4>CAPPED KNEE.</h4> + +<p>The passage of the tendons of the extensor muscle of the cannon, as it +glides in front of the knee joint, is assisted by one of the little +bursæ before mentioned, and when this becomes the seat of dropsical +collection a hygroma is formed and the knee is "capped." Though in its +history somewhat analogous to the capped elbow, there are points of +difference between them. Their development may prove a source of great +annoyance from the fact of the blemish which they constitute.</p> + +<p><i>Cause.</i>—The capped knee presents itself under various conditions. It +is sometimes the result of a bruise or contusion, often repeated, +inflicted upon himself by a horse addicted to the habit of pawing while +in the stable and striking the front of the stall with his knees. +Another class of patients is formed of those weak-kneed animals which +are subject to falling and bruising the front of the joint against the +ground, the results not being always of the same character.</p> + +<p><i>Symptoms.</i>—The lesion may be a simple bruise, or it may be a severe +contusion with swelling, edema, heat, and pain. The joint becomes so +stiff and rigid that it interferes with locomotion and yet under careful +simple treatment the trouble may disappear.</p> + +<p>Again, instead of altogether passing off, the edema may diminish in +extent, becoming more defined in form and may remain as a swelling on +the front part of the knee. Resulting from the crushing of small blood +vessels, this is necessarily full of blood. The swelling is somewhat +soft, diffuse, not painful, more or less fluctuating, and after a few +days becomes crepitant under the pressure of the hand.</p> + +<p>Instead of being filled with blood the swelling may be full of serum, as +often occurs when violence, though perhaps slight, has been frequently +repeated. In that case the swelling is generally well defined, soft, and +painless, with more or less fluctuation, and it may even become +pendulous. In other cases the swelling may be of an acute, inflammatory +nature, with heat and pain, accompanied with stiffness of the joint. +This leads to the formation of an abscess. Whatever the nature of these +swellings may be, either full of blood, serum, or pus, some blemish +usually remains after treatment.</p> + +<p><i>Prognosis.</i>—Though simple bruises of the knee without extensive +lesions are usually of trifling account, a different prognosis must be<span class='pagenum'><a name="Page_384" id="Page_384">[Pg 384]</a></span> +pronounced when the lesion assumes more important dimensions, and though +a capped knee may be comparatively of little importance we have seen +cases in which not only extensive blemishes were left to disfigure the +patient, but the animals had become worthless in consequence of the +extension of the diseased process to the various elements composing the +joint, and giving rise to the most complicated cases of carpitis.</p> + +<p><i>Treatment.</i>—Usually the first symptom of trouble is the edematous +swelling on the front of the "knee." The prevention of the inflammation +and consequently of the abscess, is the prime object in view, and it may +be realized by the use of warm-water fomentations or compresses applied +over the swelling, which may be used either in a simple form or combined +with astringents, such as Goulard's extract, alum, or sulphate of zinc. +The application of warm poultices of oil meal or ground flaxseed, +enveloping the whole joint and kept in place by bandages, is often +followed by absorption of the swelling, or, if the abscess is in process +of formation, by the active excretion of pus. If an abscess forms in +spite of these precautions it may be treated surgically in several ways.</p> + +<p>In one it should be done by a careful incision, which will allow the +escape of the blood or the serum, or of the pus which is inclosed in the +sac; in another it may be by means of a seton, in order that the +discharge may be maintained and allowed to escape; for another we may +adopt the more cautious manner of emptying the cavity by means of +punctures with small trocars or aspirators. The danger attending this +last method arises from the possible sloughing of large portions of the +skin, while that attending the first is the hazard of the possibility of +the extension of the inflammation to the capsular ligament of the knee, +with the possibility of an open joint in prospect.</p> + +<p>As we have remarked, the cavity after being emptied may rapidly close +and leave in a short time but slight traces of its previous existence. +But in many, if not in most cases, there will remain, after the +cicatrization is complete, a thickening or organized exudation at one +time round and well defined, at another spreading by a diffused +infiltration, to which it will be necessary to give immediate attention, +from the fact of its tendency to form into an organized and permanent +body. To stimulate inflammation in this diseased structure, blisters are +recommended, but chiefly for the purpose of promoting the process of +absorption.</p> + +<p>If this treatment fails, the use of iodin and mercurial preparations is +recommended.</p> + +<p>Plain mercurial or plain iodin ointment, or both in combination as iodid +of mercury, are commonly used, and may be applied either moderately and +by gentle degrees, as we have suggested, or more freely and vigorously +with a view to more immediate effects, which,<span class='pagenum'><a name="Page_385" id="Page_385">[Pg 385]</a></span> however, will also be +more superficial. The use of the firing iron applied deeply with fine +points is then to be strongly recommended, to be followed by blisters +and various liniments. This course may generally be relied on as quite +sure to be followed by satisfactory results.</p> + +<p>While the treatment is in progress it will, of course, be necessary to +secure the animal in such manner that a recurrence of the injury will be +impossible from similar causes to those which were previously +responsible.</p> + + +<h4>CAPPED HOCK.</h4> + +<p>A bad habit of rubbing or striking the partitions of their stalls with +their hocks prevails among some horses, with the result of an injury +which shows itself on the upper points of those bones, the summit of the +os calcis. From its analogy to the condition of capped elbow the +designation of capped hock has been applied to this condition.</p> + +<p><i>Symptoms.</i>—A capped hock is therefore but the development of a bruise +at the point of the hock, which if many times repeated may excite an +inflammatory process, with all its usual external symptoms of swelling, +heat, soreness, and the rest of the now-familiar phenomena. The swelling +is at first diffused, extending more or less on the exterior part of the +hock, and in a few instances running up along the tendons and muscles of +the back of the shank. Soon, however, unless the irritating causes are +continued and repeated, the edema diminishes, and, becoming more defined +in its external outlines, leaves the hock capped with a hygroma. The +hygroma, at the very beginning of the trouble, contains a bloody +serosity which soon becomes strictly serum, and this, through the +influence of an acute inflammatory action, is liable to undergo a change +which converts it into the usual purulent product of suppuration.</p> + +<p>The external appearance ought to be sufficient to determine the +diagnosis, but there are a few signs which may contribute toward a nicer +identification of the lesion. The capped hock, whether under the +appearance of an acute, edematous swelling, or as a bloody serous +collection, or as a simple serous cyst, does not give rise to any +remarkable local manifestation other than such as have already passed +under our survey in considering similar cases, nor will it be liable to +interfere with the functions which belong to the member in question, +unless it assumes very large dimensions and on each side of the tendons, +as well as on the summit of the bone. But if the inflammation is quite +high, if suppuration is developing, if there is a true abscess, or—and +this is a common complication—especially when the kicking or rubbing of +the animal is frequently recurring, then, besides the<span class='pagenum'><a name="Page_386" id="Page_386">[Pg 386]</a></span> local trouble of +the cyst or of the abscess, the bones become diseased and the periosteum +inflamed; perhaps the superior ends of the bone and its fibro-cartilage +become affected, and a simple lesion or bruise, whatever it may have +been, becomes complicated with periostitis and ostitis, and is naturally +accompanied with lameness, developed in a greater or less degree, which +in some cases may be permanent and in others increased by work. These +complications, however, are not common or frequent.</p> + +<p><i>Treatment.</i>—Capped hocks are in many cases amenable to treatment, and +yet they often become the opprobrium of the practioner by remaining, as +they frequently do, an eyesore on the top of the hock; they do not +interfere, it is true, with the work of the horse, but fixing upon him +the stigma of what, in human estimation, is a most unreliable and +objectionable reputation, to wit, that of being an habitual "kicker," +and, worse than all, one that kicks when fed.</p> + +<p>The maxim that "an ounce of prevention is worth a pound of cure" fits +the present case very neatly. A horse whose hocks have a somewhat puffy +look and whose skin on the front of the hock is loose and flabby, justly +subjects himself to a suspicion of addictedness to this bad habit, but a +little watching will soon establish the truth. If, then, the verdict is +one of conviction, precautions should be immediately adopted against a +continuance of the evil. The padding of the sides of the stall with +straw mats or mattresses and covering the posts with similar material, +in such manner as to expose no hard surface with which to come in +contact, will reduce the evil to its minimum. The animal may jar his +frame when he kicks, but even then there will be less force in the +concussion than if it impinged upon the solid plank, and cuts and +abrasions can not be inflicted by a properly made cushion. Hobbles are +also rightly recommended with a view to the required restraint of +motion, so applied as to secure the leg with which the kicking is +performed, or even both hind legs, in such manner as not to interfere +with the movement of lying down and rising again and yet preventing that +of kicking backward. Boots similar in pattern to those which are used +for the prevention of shoe boil are also prescribed. These are placed +above the hock and retained by straps tightly fastened. We apprehend, +however, that the difficulty of retaining them in the proper place +without the danger of chafing from the tightness of the straps may form +an objection to their use. Notwithstanding all precautions, hocks will +be capped in the future as in the past, and the study of their treatment +will always be in order.</p> + +<p>The mode of dealing with them will, of course, be greatly influenced by +the condition of the parts. When the inflammation is excessive and the +swelling large, hot, and painful to the touch, the application of warm +water will be very painful. The leg should be<span class='pagenum'><a name="Page_387" id="Page_387">[Pg 387]</a></span> well fomented several +times a day, for from 15 to 20 minutes each time, a strong decoction of +marsh-mallow leaves being added to the water, and after each application +swathed with flannel bandages soaked in the same warm mixture. A few +days of this treatment will usually effect a resolution of the +inflammation; if not complete, at least sufficiently so to disclose the +correct outlines of the hygroma and exhibit its peculiar and specific +symptoms. The expediency of its removal and the method of accomplishing +it are then to be considered, with the question of opening it to give +exit to its contents. If the fluid is of a purulent character, the +indication is in favor of its immediate discharge. No time should be +lost, and it should be by means of a small opening made with a narrow +bistoury. If, however, the fluid is a serosity, we prefer to remove it +by punctures with a very small trocar. Our reason for special caution in +these cases is our fear of the possibility of the existence of diseased +conditions of a severe character in the pseudo joint. For the same +reason we prefer the treatment of those growths by external +applications. In the first stages of the disease a severe and stiff +blister, such as the cantharidate of collodium, entirely covering the +cyst, perhaps not yet completely formed, when the inflammation has +subsided, will be of great benefit by its stimulating effect, the +absorption it may excite, and the pressure which, when dry, it will +maintain upon the tumor. If, however, the thickening of the growth fails +to diminish, it should be treated with some of the iodin preparations in +the form of ointments, pure or in combination with potassium, mercury, +etc., of various strengths and in various proportions. My opinion of +setons is not favorable, but the actual cautery, by deep and fine +firing, in points—needle cauterization—I believe to be the best mode +of treatment, and especially when applied early.</p> + +<p>A very satisfactory way to treat these cases is to burst the swelling by +pressure from without. A strap or strong linen bandage is placed about +the hock, pressing on the bursa, while the affected leg is on the +ground, the other hind foot being lifted up. When the bandage is in +place the leg should be released, and the horse will violently flex the +bandaged limb and produce pressure on the bursa, with consequent +bursting and discharging of its contents.</p> + +<p>Whatever treatment may be adopted for capped hock, patience must be one +of the ingredients. In these parts absorption is slow, the skin is very +thick, and its return to a soft, pliable, natural condition, if effected +at all, will take place only after weeks added to other weeks of medical +treatment and patient waiting.</p> + + +<h4>INTERFERING, AND SPEEDY CUTS.</h4> + +<p>These designations belong to certain special injuries of the +extremities, produced by similar causes, giving rise to kindred +pathological<span class='pagenum'><a name="Page_388" id="Page_388">[Pg 388]</a></span> lesions with allied phenomena, requiring about the same +treatment and often followed by the same results, to wit, a blemish +which may not only subject the animal to a suspicion of unsoundness, but +in some special circumstances may interfere with his ability to labor. +It is known as "interfering" when the location of the trouble is the +inside of the fetlock of either the fore or hind leg. It is called +"speedy cut" when it occurs on the inside of the fore leg, a little +below the knee, at the point of contact of that joint with the cannon. +It is always the result of a blow, self-inflicted, of varying severity, +and giving rise to various lesions. (See also p. 399.)</p> + +<p><i>Symptoms.</i>—At times the injury is too slight to be seriously noticed, +the hair being scarcely cut and the skin unmarked. At other times the +skin will be cut through, partly or wholly, and it may for the time +cause sufficient pain to check the motion of the animal and induce him +to suspend his labor through his inability to use the wounded limb, +traveling meanwhile for a short space on three legs only. Sometimes a +single blow will suffice, or again there will be a repetition of lighter +strokes. In the latter case the parts will become much swollen, hot, and +so painful to the touch that the motion of the knee or the fetlock will +be sufficiently disturbed to cause lameness of a degree of severity +corresponding to that of the lesion. Following the subsidence of this +diffused and edematous swelling is sometimes the formation of a tumor, +either at the knee or the fetlock. This may be soft at first or become +so by degrees, with fluctuation, its contents being at first +extravasated blood, and later a serosity; or, if there has been a +sufficient degree of inflammation, it may become suppurative. The result +of the fault of interfering may thus be exhibited, whether at the knee +or at the fetlock, as characterized by all the pathological conditions +which have appeared as accompaniments of capped knee or capped hock. If, +in consequence of the force of the blow or blows, the inflammation has +been usually severe, a mortification of the skin may become one of the +consequences, a slough taking-place, succeeded by a cutaneous ulcer on +the inside of the fetlock or when the greater number of the original +wounds are inflicted. If the interfering has been often repeated it may +be followed by another condition, which has been considered in our +remarks upon other affections. It is a plastic exudation or thickening +of the parts, which are commonly said to have become "callous," and the +effect of it is to destroy the regularity of the outlines of the joint +to an extent which constitutes a serious blemish, which will be +permanent, and according to the degree of the aberration from the +natural and symmetrical lines will inevitably depreciate the commercial +value of the animal.</p> + +<p>An animal in interfering may thus exhibit a range of symptoms which from +the simplest form of a mere "touching," may successively<span class='pagenum'><a name="Page_389" id="Page_389">[Pg 389]</a></span> assume the +serious characters of an ugly cicatrix, a hard, plastic swelling, or +perhaps, as witnessed at the knee, of periostitis with its sequelæ.</p> + +<p>If a single and constantly recurring cause—a blow—is the starting +point in interfering, we may now consider the subject of the +predisposition which brings such serious results upon the suffering +animal, and the conditions which lead to and accompany it. These are +numerous, but the first in frequency and importance is peculiarity of +conformation in the animals addicted to it. The first class will include +horses, whose chests are narrow and whose legs do not stand straight and +upright, but are crooked and pigeon-toed in and out. The second class +includes those whose legs are weak, either from youth or hard labor, or +from severe attacks of sickness. Another class is made up of those +having abnormally developed feet, or which have been badly shod with +unnecessarily wide or heavy shoes. Another class consists of those that +are affected with swollen fetlocks or chronic, edematous swelling of the +leg. Another is formed of animals with a peculiar action, as those whose +knee action is very high, and it is these that furnish most of the cases +of speedy cut.</p> + +<p><i>Prognosis.</i>—The prognosis of interfering is never a very serious one. +However violent the blow may be it is rarely that subsequent +complications of a troublesome nature occur. The principal evil +attending it is a liability to be followed by a thickened or callous +deposit which is not only an eyesore and a blemish, but constitutes a +new and increased predisposition. The remark that "an animal which has +interfered once is always liable to interfere," is often confirmed and +sanctioned by a recurrence of the trouble.</p> + +<p><i>Treatment.</i>—Another point in which there is a resemblance between this +lesion and others which we have considered is in its responsiveness to +the same treatment with them. Indeed, the prescription of warm +fomentations, soothing applications, and astringent and resolvent +mixtures, in a majority of cases, is the first that occurs all through +the list. If the swelling assumes the character of a serous collection, +pressure, cold water, and bandages will contribute to its removal. If +suppuration seems to be established and the swelling assumes the +character of a developing abscess, hot poultices of flaxseed or of +boiled vegetables and the embrocations of sedative ointments, those of +basilicon, or vaseline, impregnated with preparations of opium or +belladonna—all these recommend themselves by their general adaptation +and the beneficial results which have followed their administration, not +less in one case than in another. When an abscess has formed and is +fluctuating, it should be carefully but fully opened to evacuate the +pus. If it is a serous cyst, some care is necessary in emptying it, and +the possibility of the extension of the inflammation to the joint must +be taken into consideration. When the<span class='pagenum'><a name="Page_390" id="Page_390">[Pg 390]</a></span> cavities have been emptied and +have closed by filling up with granulations, or if, not being opened, +the contents have been reabsorbed, and there remains in either case a +plastic exudation and a tendency to the callous organization that may +yet exist, blisters under their various forms, including those of +cantharides, of mercury, and of iodin, are then indicated, principally +in the early stages, as it is then that their effects will prove most +satisfactory. The use of the actual cautery, with fine points, +penetrating deeply throughout the enlargement, has in our hands, when +used in the very early stages of its formation, nearly always brought on +a radical recovery with complete absorption of the thickening.</p> + + +<h4>STRINGHALT.</h4> + +<p>This is an involuntary movement of one or both hind legs, in which the +foot is suddenly and spasmodically lifted from the ground much higher +than it is normally carried, with excessive flexion of one bone upon the +other. This peculiarity is usually prominent, although it may disappear +with work, only to reappear after a short rest. Sometimes it is most +apparent at a trot, sometimes at a walk, and other times only when +turned around; or it may not be affected by the gait of the horse. It +does not seem to be influenced by the horse's age, young and old being +alike affected. Its first manifestations are sometimes very slight. It +has been noticed as occurring in an animal when backing out of his +stable and ceasing immediately after. In some animals it is best seen +when the animal is turning around on the affected leg, and it is not +noticed when he moves straight forward. That this peculiar action +interferes with facility of locomotion and detracts from a horse's claim +to soundness can not for a moment be denied.</p> + +<p><i>Cause.</i>—Veterinarians and pathologists are yet in doubt in respect to +the cause of this affection, as well as to its essential nature. Whether +it results from disease of the hock, of an ulcerative character; whether +it springs from a malformation; whether it is a shortening of the +ligaments, a chronic inflammation of the sciatic nerve, or a disease of +the spinal cord; whether it is purely a muscular or purely a nervous +lesion, or a compound of both—it still continues, if an etiologist is +bound to possess universal knowledge within the scope of his special +studies, to be his reproach and his puzzle.</p> + +<p><i>Treatment.</i>—When there is a known or suspected cause the treatment +should be directed toward this factor. If due to local inflammation of +the hock or foot, only this local lesion should be treated. If it +remains after the local lesion has healed, or if we have no assignable +cause, the best results have followed the sectioning of the lateral +extensor of the foot. A competent veterinarian alone should undertake +this operation.<span class='pagenum'><a name="Page_391" id="Page_391">[Pg 391]</a></span></p> + + +<h4>THROMBOSIS.</h4> + +<p>There are certain forms of lameness which are very peculiar in their +manifestation, and which to the nonprofessional mind must appear to +belong to the domain of mystery or theory instead of occupying a +well-established position among the subjects of equine pathology. Yet +they are no less susceptible of actual demonstration and of positive +comprehension than many facts which, plain and familiar to the general +understanding now, were once ranked among things occult and +unsearchable. A thrombus, considered as a cause of lameness, may find a +place among these understood mysteries.</p> + +<p><i>Cause.</i>—Under certain peculiar conditions of inflammation of the blood +vessels, and also in aneurisms, clots of blood are sometimes formed in +the arteries and find their way in the general circulation. At first, +while very small, or sufficiently so to pass from one vessel to another, +they move from a small vessel to a larger, and from that to one still +larger, constantly increasing in size until at some given point, from +their inability to enter smaller vessels, their movement is finally +arrested. The artery is thus effectually dammed, and the clot in a short +time cuts off completely the supply of blood from the parts beyond. This +is thrombosis, and it often gives rise to sudden and excessive lameness +of a very painful character.</p> + +<p><i>Symptoms.</i>—Thrombi may form in any of the arteries, and doubtless have +been the cause of many cases of lameness which could never be accounted +for. If they exist in small arteries their diagnosis will probably fail +to be made out with certainty, but when situated in the larger trunks a +strong suspicion of their presence may be excited. In some cases they +may even be recognized with positive accuracy, as when the vessels which +supply the posterior extremities are affected by the blocking up of the +posterior aorta or its ramifications.</p> + +<p>The existence of thrombosis of the arteries of the hind leg may always +be suspected when the following history is known: The general health of +the animal is good, but symptoms of lameness in one of the legs have +been developed, becoming more marked as he is worked, and especially +when driven at a fast gait. But the disturbance is not permanent, and +the lameness disappears almost immediately after a rest. There is an +increase of the difficulty, however, and, though the animal may walk +normally, he will, when made to trot, very soon begin to slacken his +pace and to show signs of the trouble, and if urged to increase his +speed will become lamer and lamer; an abundant perspiration will break +out; he will refuse to go, and if forced he shows weakness behind, seems +ready to fall, and perhaps does fall. While on his feet the leg is kept +in constant motion, up and down, and is kept from the ground as if the +contact were too painful to bear. If undisturbed this series of symptoms +will gradually subside, sometimes very soon, and occasionally after a +few hours he will<span class='pagenum'><a name="Page_392" id="Page_392">[Pg 392]</a></span> return to an apparently perfect condition. A return +to labor will lead to a renewal of the same incidents.</p> + +<p>A history like this suggests a strong suspicion of a thrombus in an +artery of the hind leg, and this suspicion will be confirmed by the +external symptoms exhibited by the animal. The total absence of any +other disease which might account for the lameness, and a manifest +diminution of heat over a part or the whole of the extremity, when +compared with the opposite side or with any other portion of the body; a +sensation of cold attendant on the pain, but gradually subsiding as the +pain subsides, and the circulation, quickened by the rest, has been +reestablished throughout the extremity; all these are confirmatory +circumstances. Still, it is thus far only a suspicion, and absolute +certainty is yet wanting. To establish the truth of the case the rectal +exploration must be resorted to. The hands then, well prepared and +carefully introduced into the rectum, must explore for the truth, first +feeling for the large blood vessels which, divided at the aorta, +separate to supply the right and left legs. These must be compared in +respect to the pulsation and other particulars. The artery which is +healthy will, of course, exhibit all the proper conditions of that +state. On the other hand, if the vessel appears to the feel hard, more +or less cordy, and pulseless, or giving a sensation of fluttering, as of +a small volume of blood with a trickling motion passing through a +confined space, the difference between the sides will make the case +plain. The first will be the full flow of the circulation through an +unobstructed channel, the other a forced passage of the fluid between +the thrombus and the coats of the artery. In such case the prognosis is +necessarily a grave one and the disease is more liable to grow Worse +than better.</p> + +<p><i>Treatment.</i>—No form of treatment can be advised; the suffering or a +helpless and useless animal can only be terminated by that which ends +all.</p> + +<p>Cases occur, however, where this condition of the blood vessels exists +in a much less degree, and the diseased condition is not sufficiently +pronounced for final condemnation. There may even be a possibility of +the absorption of the clot, or that an increase of the collateral +circulation may be sufficient to supply the parts with blood. In such +cases spontaneous recovery may follow moderate exercise in the pasture, +field, or stable, or continuous light work may be given, but too much +hope should not be placed in such treatment.</p> + + +<h4>SPRAINS OF THE LOINS.</h4> + +<p>This is an affection which suggests to the mind the idea of muscular +injury, and is difficult to distinguish from many similar cases. If the +animal shrinks from the slightest pressure or pinching of the spine in +the region of the loins, he is by many pronounced to be<span class='pagenum'><a name="Page_393" id="Page_393">[Pg 393]</a></span> "lame in the +loins," or "sprained in the loins," or "weak in the kidneys." This is a +grave error, as in fact this simple and gentle yielding to such a +pressure is not a pathological sign, but is normal and significant of +health. Yet there are several conditions to which the definition of +"sprains of the loins" may apply which are not strictly normal.</p> + +<p><i>Cause.</i>—The muscles of the back and those of the loins proper, as the +psoas, may have been injured, or again there may be trouble of a +rheumatic nature, perhaps suggestive of lumbago. Diseases of the bones +of the vertebral column, or even those of the organs of circulation, may +give rise to an exhibition of similar symptoms.</p> + +<p><i>Symptoms.</i>—The symptoms are characteristic of a loss of rigidity or +firmness of the vertebral column, both when the animal is at rest and in +action. In the former condition, or when at rest, there is an arched +condition of the back and a constrained posture in standing, with the +hind legs separated. In the latter there is a lateral, balancing +movement at the loins, principally noticeable while the animal is in the +act of trotting—a peculiar motion, sometimes referred to as a "crick in +the back," or what the French call a "tour de bateau." If, while in +action, the animal is suddenly made to halt, the act is accompanied with +much pain, the back suddenly arching or bending laterally, and perhaps +the hind legs thrown under the body, as if unable to perform their +functions in stopping, and sometimes it is only accomplished at the cost +of a sudden and severe fall. This manifestation is also exhibited when +the animal is called upon to back, when a repetition of the same +symptoms will also occur.</p> + +<p>If a slight pressure on the back or the loins is followed by a moderate +yielding of the animal, it is, as before remarked, a good sign of +health. With a sprain of the loins pressure of any kind is painful, and +will cause the animal to bend or to crouch under it more or less, +according to the weight of the pressure. Heavy loads, and even heavy +harnessing, will develop this tenderness. In lying down he seems to +suffer much discomfort, and often accompanies the act with groaning, and +when compelled to rise does so only with great difficulty and seldom +succeeds without repeated efforts.</p> + +<p>Sprains of muscles proper, when recent, will always be accompanied with +this series of symptoms, and the fact of their exhibition, with an +excessive sensibility of the parts, and possibly with a degree of +swelling, will always justify a diagnosis of acute muscular lesion, and +especially so if accompanied with a history of violent efforts, powerful +muscular strains, falls, heavy loading, etc., connected with the case. +If the symptoms have been of slow development and gradual increase, it +becomes a more difficult task to determine whether the diagnosis points +to pathological changes in the structure of the muscles or of the bones, +the nervous centers, or the blood vessels of<span class='pagenum'><a name="Page_394" id="Page_394">[Pg 394]</a></span> the region. And yet it is +important to decide as to which particular structure is affected in +reference to the question of prognosis, as the degree of gravity of the +lesion will depend largely upon whether the disabled condition of the +animal is due to an acute or a chronic disease.</p> + +<p><i>Treatment.</i>—The prescription which will necessarily first of all +suggest itself for sprains of the loins is rest. An animal so affected +should be immediately placed in slings, and none of his efforts to +release himself should be allowed to succeed. Hot compresses, cold-water +douches, sweating applications, stimulating frictions, strengthening +charges, blistering ointments of cantharides and the actual cautery, all +have their advocates, but in no case can the immobility obtained by the +slings be dispensed with. In many cases in which the weakness of the +hind quarters was caused by disease of the nervous centers electricity +has also yielded good results.</p> + +<div class="footnotes"><h3>FOOTNOTES:</h3> + +<div class="footnote"><p><a name="Footnote_2_2" id="Footnote_2_2"></a><a href="#FNanchor_2_2"><span class="label">[2]</span></a> This bandage consists of a cloth drenched in warm water or +a dripping bandage laid around the diseased part, then covered by +several layers of woolen blanket or cloth, which is in turn covered by +parchment paper, rubber cloth, or other impervious material. Heat, +moisture, and pressure are obtained by such a bandage if water is poured +upon it several times daily.</p></div> +</div> + + +<hr style="width: 65%;" /> +<p><span class='pagenum'><a name="Page_395" id="Page_395">[Pg 395]</a></span></p> +<h2>DISEASES OF THE FETLOCK, ANKLE, AND FOOT.</h2> + +<h3>By <span class="smcap">A. A. Holcombe</span>, D. V. S.,</h3> + +<h4><i>Veterinary Inspector, Bureau of Animal Industry.</i></h4> + + +<h4>ANATOMICAL REVIEW OF THE FOOT.</h4> + +<p>In a description of the foot of the horse it is customary to include +only the hoof and its contents, yet, from a zoological standpoint, the +foot includes all the leg from the knee and the hock down.</p> + +<p>The foot of the horse is undoubtedly the most important part of the +animal, so far as veterinary surgery is concerned, for the reason that +it is subject to so many injuries and diseases which in part or in whole +render the patient unfit for the labor demanded of him. The old aphorism +"no foot no horse" is as true to-day as when first expressed; in fact, +domestication, coupled with the multiplied uses to which the animal is +put, and the constant reproduction of hereditary defects and tendencies, +has largely transformed the ancient "companion of the wind" into a very +common piece of machinery which is often out of repair, and at best is +but shortlived in its usefulness.</p> + +<p>Since the value of the horse depends largely or even entirely upon his +ability to labor, it is essential that his organs of locomotion be kept +sound. To accomplish this end it is necessary not only to know how to +cure all diseases to which these organs are liable but, better still, +how to prevent them.</p> + +<p>An important prerequisite to the detection and cure of disease is a +knowledge of the construction and function of the parts which may be +involved in the diseased process. Hence, first of all, the anatomical +structures must be understood. (See also p. 583.)</p> + +<p>The bones of the fetlock and foot constitute the skeleton on which the +other structures are built and comprise the lower end of the cannon bone +(the metacarpus in the fore leg, the metatarsus in the hind leg), the +two sesamoids, the large pastern or os suffraginis, the small pastern or +coronet, the small sesamoid or navicular bone, and the coffin bone or os +pedis. (Plate XXXIV, fig. 3.)</p> + +<p>The cannon bone extends from the knee or hock to the fetlock, is +cylindrical in shape, and stands nearly or quite perpendicular.</p> + +<p>The sesamoids occur in pairs, are small, shaped like a three-faced +pyramid, and are set behind the fetlock joint, at the upper end of the +large pastern, with the base of the pyramid down.<span class='pagenum'><a name="Page_396" id="Page_396">[Pg 396]</a></span></p> + +<p>The large pastern is a very compact bone, set in an oblique direction +downward and forward, and extends from the cannon bone to the coronet.</p> + +<p>The coronet is a short, cube-shaped bone, set between the large pastern +and coffin bone, in the same oblique direction.</p> + +<p>The navicular bone is short, flattened above and below, and is attached +to the coffin bone behind.</p> + +<p>The coffin bone forms the end of the foot and is shaped like the horny +box in which it is inclosed.</p> + +<p>All these bones are covered on the surfaces which go to make up the +joints with a cartilage of incrustation, while the portions between are +covered with a fibrous membrane called the periosteum.</p> + +<p>The joints of the legs are of especial importance, since any +interference with their function very largely impairs the value of the +animal for most purposes. As the joints of the foot and ankle are at the +point of greatest concussion they are the ones most subject to injury +and disease.</p> + +<p>There are three of these joints—the fetlock, pastern, and coffin. They +are made by the union of two or more bones, held together by ligaments +of fibrous tissue, and are lubricated by a thick, viscid fluid, called +synovia, which is secreted by a special membrane inclosing the joints.</p> + +<p>The fetlock joint is made by the union of the lower end of the cannon +and the upper end of the large pastern bones, supplemented by the two +sesamoids, so placed behind the upper end of the pastern that the joint +is capable of a very extensive motion. These bones are held together by +ligaments, only one of which—the suspensory—demands special mention.</p> + +<p>The suspensory ligament of the fetlock starts from the knee, extends +down behind the cannon, lying behind the two splint bones, until near +the fetlock, where it divides and sends a branch on each side of the +joint, downward and forward, to become attached on the sides of the +extensor tendon at the lower end of the pastern bone. As it crosses the +sesamoids, on the posterior borders of the fetlock, it throws out fibers +which hold it fast to these bones. (Plate XXXIV, fig. 2.)</p> + +<p>The pastern joint is made by the union of the two pastern bones.</p> + +<p>The coffin joint is made by the union of the small pastern, coffin, and +small sesamoid, or navicular bones, the latter being set behind and +beneath the joint surface of the coffin bone in such way as to receive +largely the weight of the small pastern.</p> + +<p>Three tendons serve to move the bones of the foot one on another. Two of +these flex, or bend, the joints, while the other extends, or +straightens, the column of bones. (Plate XXXIII, fig. 5.)<span class='pagenum'><a name="Page_397" id="Page_397">[Pg 397]</a></span></p> + +<p>The flexor pedis perforans, or deep flexor of the foot, passes down +behind the cannon bone, lying against the suspensory ligament in front, +crosses the fetlock joint in the groove made by the union of the two +sesamoids, and is attached to the bottom on the coffin bone, after +covering the navicular, by a wide expansion of its fibers. It is the +function of this tendon to flex the coffin bone and, with it, the horny +box.</p> + +<p>The flexor pedis perforatus, or superficial flexor of the foot, follows +the course of the preceding tendon and is attached to the middle of the +ankle. The function of this tendon is to flex the foot at the fetlock.</p> + +<p>The extensor pedis runs down in front of the leg, is attached on the +most prominent point of the coffin bone, and has for function the +straightening of the bones of the ankle and foot.</p> + +<p>The bones, ligaments, and tendons are covered by a loose connective +tissue, which gives a symmetry to the parts by filling up and rounding +off, and all are protected by the skin and hoof.</p> + +<p>The skin of the fetlock and ankle is generally characterized by its +thickness and the length of its hairs, especially around the hind parts +of the fetlock joint in certain breeds of horses. The most important +part of this envelope is that known as the coronary band.</p> + +<p>The coronary band is that portion of the skin which secretes the horn of +which the wall of the hoof is made. This horn much resembles the nail +which grows on the fingers and toes of man. It is composed of +cylindrical tubes, which are held together by a tenacious, opaque +matter. The horn extends from the coronary band to the lower border of +the hoof. (Plate XXXII, fig. 1.)</p> + +<p>The hoof is a box of horn, consisting of a wall, sole, and frog, and +contains, besides the coffin, navicular, and part of the small pastern +bones, the sensitive laminæ, plantar cushion, and the lateral +cartilages. (Plate XXXIII, fig. 4.)</p> + +<p>The sole of the foot incloses the box on the ground surface, is shaped +like the circumference of the foot, except that a V-shaped opening is +left behind for the reception of the frog, and is concave on the lower +surface. The sole is produced by the velvety tissue, a thin membrane +covering the plantar cushion and other soft tissues beneath the coffin +bone. The horn of the sole differs from the horn of the wall in that its +tubes are not straight and from the fact that it scales off in pieces +over the whole surface.</p> + +<p>The frog is a triangular-shaped body, divided into two equal parts by a +deep fissure, extending from its apex in front to the base. It fills the +triangular space in the sole, to which it is intimately attached by its +borders. The horn of the frog is produced in the same manner as the +sole; but it differs from both the wall and sole in that the horn<span class='pagenum'><a name="Page_398" id="Page_398">[Pg 398]</a></span> is +soft, moist, and elastic to a remarkable degree. It is the function of +the frog to destroy shock and to prevent slipping.</p> + +<p>The sensitive laminæ are thin plates of soft tissue covering the entire +anterior surface of the coffin bone. They are present in great numbers, +and by fitting into corresponding grooves on the inner surface of the +horn of the wall the union of the soft and horny tissues is made +complete. (Plate XXXII, fig. 1.)</p> + +<p>The plantar cushion is a thick pad of fibrous tissue placed behind and +under the navicular and coffin bones and resting on the sole and frog, +for the purpose of receiving the downward pressure of the column of +bones and to destroy shock. (Plate XXXII, fig. 4.)</p> + +<p>The lateral cartilages are attached, one on each side, to the wings of +the coffin bone by their inferior borders. They are thin plates of +fibro-cartilage, and their function is to assist the frog and adjacent +structures to regain their proper position after having been displaced +by the weight of the body while the foot rested on the ground. (Plate +XXXII, fig. 2.)</p> + + +<h4>FAULTS OF CONFORMATION.</h4> + +<p>A large percentage of horses have feet which are not perfect in +conformation, and as a consequence they are especially predisposed to +certain injuries and diseases.</p> + +<p><i>Flatfoot</i> is that condition in which the sole has little or no +convexity. It is a peculiarity common to some breeds, especially heavy, +lymphatic animals raised on low, marshy soils. It is confined to the +fore feet, which are generally broad, low-heeled, and with a wall less +upright than is seen in the perfect foot.</p> + +<p>In flatfoot there can be little or no elasticity in the sole, for the +reason that it has no arch, and the weight of the animal is received on +he entire plantar surface, as it rests upon the ground instead of on the +wall. For these reasons such feet are particularly liable to bruises of +the sole, corns, pumiced sole, and excessive suppuration when the +process is once established. Horses with flatfoot should be shod with a +shoe having a wide web, pressing on the wall only, while the heels and +frog are never to be pared. Flatfoot generally has weak walls, and as a +consequence the nails of the shoe are readily loosened and the shoe +cast.</p> + +<p><i>Clubfoot</i> is a term applied to such feet as have the walls set nearly +perpendicular. When this condition is present the heels are high, the +fetlock joint is thrown forward, or knuckles, and the weight of the +animal is received on the toes. Many mules are clubfooted, especially +behind, where it seems to cause little or no inconvenience. Severe cases +of clubfoot may be cured by cutting the tendons, but as a rule special +shoeing is the only measure of relief that can be adopted. The toe +should not be pared, but the heels are to be lowered as much as<span class='pagenum'><a name="Page_399" id="Page_399">[Pg 399]</a></span> +possible and a shoe put on with a long, projecting toe piece, slightly +turned up, while the heels of the shoe are to be made thin.</p> + +<p><i>Crookedfoot</i> is that condition in which one side of the wall is higher +than the other. If the inside wall is the higher, the ankle is thrown +outward, so that the fetlock joints are abnormally wide apart and the +toes close together. Animals with this deformity are "pigeon-toed," and +are prone to interfere, the inside toe striking the opposite fetlock. If +but one foot is affected, the liability to interfere is still greater, +for the reason that the fetlock of the perfect leg is nearer the center +plane.</p> + +<p>When the outside heel is the higher the ankle is thrown in and the toe +turns out. Horses with such feet interfere with the heel. If but one +foot is so affected, the liability to interfere is less than when both +feet are affected, for the reason that the ankle of the perfect leg is +not so near to the center plane. Such animals are especially liable to +stumbling and to lameness from injury to the ligaments of the fetlock +joints. This deformity is to be overcome by such shoeing as will +equalize the disparity in length of walls, and by proper boots to +protect the fetlocks from interfering.</p> + + +<h4>INTERFERING.</h4> + +<p>An animal is said to interfere when one foot strikes the opposite leg, +as it passes by, during locomotion. The inner surface of the fetlock +joint is the part most subject to this injury, although, under certain +conditions, it may happen to any part of the ankle. It is seen more +often in the hind than in the fore legs. Interfering causes a bruise of +the skin and deeper tissues, generally accompanied with an abrasion of +the surface. It may cause lameness, dangerous tripping, and thickening +of the injured parts. (See also p. 387.)</p> + +<p><i>Causes.</i>—Faulty conformation is the most prolific cause of +interfering. When the bones of the leg are so united that the toe of the +foot turns in (pigeon-toed), or when the fetlock joints are close +together and the toe turns out, when the leg is so deformed that the +whole foot and ankle turn either in or out, interfering is almost sure +to follow. It may happen, also, when the feet grow too long, from +defective shoeing, rough or slippery roads, from the exhaustion of labor +or sickness, swelling of the leg, high knee action, fast work, and +because the chest or hips are too narrow.</p> + +<p><i>Symptoms.</i>—Generally, the evidences of interfering are easily +detected, for the parts are tender, swollen, and the skin broken. But +very often, especially in trotters, the flat surface of the hoof strikes +the fetlock without evident injury, and attention is directed to these +parts only by the occasional tripping and unsteady gait. In such cases +proof of the cause may be had by walking and trotting the<span class='pagenum'><a name="Page_400" id="Page_400">[Pg 400]</a></span> animal, after +first painting the inside toe and quarter of the suspected foot with a +thin coating of chalk, charcoal, mud, or paint.</p> + +<p><i>Treatment.</i>—When the trouble is due to deformity or faulty +conformation it may not be possible to overcome the defect.</p> + +<p>In such cases, and as well in those due to exhaustion or fatigue, the +fetlock or ankle boot must be used. In many instances interfering may be +prevented by proper shoeing. The outside heel and quarter of the foot on +the injured leg should be lowered sufficiently to change the relative +position of the fetlock joint by bringing it farther away from the +center plane of the body, thereby permitting the other foot to pass by +without striking.</p> + +<p>A very slight change is often sufficient to effect this result. At the +same time the offending foot should be so shod that the shoe may set +well under the hoof at the point responsible for the injury. The shoe +should be reset every three or four weeks.</p> + +<p>When the cause has been removed, cold-water bandages to the injured +parts will soon remove the soreness and swelling, especially in recent +cases. If, however, the fetlock has become calloused from long-continued +bruising, a Spanish-fly blister over the parts, repeated in two or three +weeks if necessary, will aid in reducing the leg to its natural +condition.</p> + + +<h4>KNUCKLING, OR COCKED ANKLES.</h4> + +<p>Knuckling is a partial dislocation of the fetlock joint, in which the +relative position of the pastern bone to the cannon and coronet bones is +changed, the pastern becoming more nearly perpendicular, with the lower +end of the cannon bone resting behind the center line of the large +pastern, while the lower end of this bone rests behind the center line +of the coronet. While knuckling is not always an unsoundness, it +nevertheless predisposes to stumbling and to fracture of the pastern.</p> + +<p><i>Causes.</i>—Young foals are quite subject to this condition, but in the +great majority of cases it is only temporary. It is largely due to the +fact that before birth the legs were flexed, and time is required after +birth for the ligaments, tendons, and muscles to adapt themselves to the +function of sustaining the weight of the body.</p> + +<p>As they grow old, horses with erect pasterns are very prone to knuckle, +especially in the hind legs. All kinds of heavy work, particularly in +hilly districts, and fast work on hard race tracks or roads are exciting +causes of knuckling. It is also commonly seen as an accompaniment of +that faulty conformation called clubfoot, in which the toe of the wall +is perpendicular and short, and the heels high—a condition most often +seen in the mule, especially in the hind feet.</p> + +<p><a name="PLATE_XXXII" id="PLATE_XXXII"></a></p> +<div class="figcenter" style="width: 450px;"> +<a href="images/plate32.jpg"><img src="images/plate32t.jpg" width="450" height="306" alt="PLATE XXXII." title="" /></a> +<span class="caption">PLATE XXXII.<br /> + +Anatomy of Foot.</span> +</div> + +<p><a name="PLATE_XXXIII" id="PLATE_XXXIII"></a></p> +<div class="figcenter" style="width: 450px;"> +<a href="images/plate33.jpg"><img src="images/plate33t.jpg" width="450" height="279" alt="PLATE XXXIII." title="" /></a> +<span class="caption">PLATE XXXIII.<br />Anatomy of Foot.</span> +</div> + +<p><a name="PLATE_XXXIV" id="PLATE_XXXIV"></a></p> +<div class="figcenter" style="width: 266px;"> +<a href="images/plate34.jpg"><img src="images/plate34t.jpg" width="266" height="450" alt="PLATE XXXIV." title="" /></a> +<span class="caption">PLATE XXXIV.<br /> + +ANATOMY AND DISEASES OF THE FOOT.</span> +</div> + +<p><a name="PLATE_XXXV" id="PLATE_XXXV"></a></p> +<div class="figcenter" style="width: 288px;"> +<a href="images/plate35.jpg"><img src="images/plate35t.jpg" width="288" height="450" alt="PLATE XXXV." title="" /></a> +<span class="caption">PLATE XXXV.<br /> + +SOUND AND CONTRACTED FEET.</span> +</div> + +<p><span class='pagenum'><a name="Page_401" id="Page_401">[Pg 401]</a></span>Lastly, knuckling is produced by disease of the suspensory ligament or +of the flexor tendons, whereby they are shortened, and by disease of the +fetlock joints. (See p. 372.)</p> + +<p><i>Treatment.</i>—In young foals no treatment is necessary, unless there is +some deformity present, since the legs straighten up without +interference in the course of a few weeks. When knuckling has commenced, +the indications are to relieve the tendons and ligaments by proper +shoeing. The foot is to be prepared for the shoe by shortening the toe +as much as possible, leaving the heels high; or if the foot is prepared +in the usual way the shoe should be thin in front, with thick heels or +high calks. For the hind feet a long-heeled shoe with calks seems to do +best. Of course, when possible, the causes of knuckling are to be +removed; since this can not always be done, however, the time may come +when the patient can no longer perform any service, particularly in +those cases in which both fore legs are affected, and it becomes +necessary either to destroy the animal or obtain relief by surgical +interference. In such cases the tendons between the fetlock and knee may +be divided for the purpose of obtaining temporary relief. Firing and +blistering the parts responsible for the knuckling may, in some +instances, effect a cure; but a consideration of these measures belongs +properly to the treatment of the disease in which knuckling appears +simply as a sequel.</p> + + +<h4>WINDGALL.</h4> + +<p>Joints and tendons are furnished with sacs containing a lubricating +fluid called synovia. When these sacs are overdistended by reason of an +excessive secretion of synovia, they are called windgalls. They form a +soft, puffy tumor about the size of a hickory nut, and are most often +found in the fore leg, at the upper part of the fetlock joint, between +the tendon and the shin bone. When they develop in the hind leg it is +not unusual to see them reach the size of a walnut. Occasionally they +appear in front of the fetlock on the border of the tendon. The majority +of horses are not subject to them after colt-hood has passed. (See also +p. 355.)</p> + +<p><i>Causes.</i>—Windgalls are often seen in young, overgrown horses, in which +the body seems to have outgrown the ability of the joints to sustain the +weight. In cart and other horses used to hard work, in trotters with +excessive knee action, in hurdle racers and hunters, and in most cow +ponies there is a predisposition to windgalls. Street-car horses and +others used to start heavy loads on slippery streets are the ones most +liable to develop windgalls in the hind legs.</p> + +<p><i>Symptoms.</i>—The tumor is more or less firm and tense when the foot is +on the ground, but is soft and compressible when the foot is off the +ground. In old horses windgalls generally develop slowly and cause<span class='pagenum'><a name="Page_402" id="Page_402">[Pg 402]</a></span> no +inconvenience. If they are caused by excessive tension of the joint the +tumor develops rapidly, is tense, hot, and painful, and the animal is +exceedingly lame. The patient stands with the joint flexed, and walks +with short steps, the toe only being placed on the ground. When the +tumor is large and situated upon the inside of the leg it may be injured +by interfering, causing stumbling and inflammation of the sac. Rest +generally causes the tumor to diminish in size, only to fill up again +after renewed labor. In old cases the tumors are hardened, and may +become converted into bone by a deposit of the lime salts.</p> + +<p><i>Treatment.</i>—The large, puffy joints of suckling colts, as a rule, +require no treatment, for as the animal grows older the parts clean up +and after a time the swelling entirely disappears.</p> + +<p>When the trouble is from an injury, complete rest is to be obtained by +the use of slings and a high-heeled shoe. Cold-water douches should be +used once or twice a day, followed by cold-water bandages, until the +fever has subsided and the soreness is largely removed, when a blister +is to be applied.</p> + +<p>In old windgalls, which cause more or less stiffness, some relief may be +had by the use of cold-compress bandages, elastic boots, or the red +iodid of mercury blisters. Opening the sacs, as recommended by some +authors, is of doubtful utility, and should be adopted only by the +surgeon capable of treating the wound he has made. Enforced rest until +complete recovery is effected should always be insisted upon, since a +too early return to work is sure to be followed by relapse.</p> + + +<h4>SPRAIN OF THE FETLOCK.</h4> + +<p>Sprain of the fetlock joint is most common in the fore legs, and, as a +rule, affects but one at a time. Horses doing fast work, as trotters, +runners, steeplechasers, hunters, cow ponies, and those that interfere, +are particularly liable to this injury.</p> + +<p><i>Causes.</i>—Horses knuckling at the fetlock, and all those with diseases +which impair the powers of locomotion, such as navicular disease, +contracted heels, sidebones, chronic laminitis, etc., are predisposed to +sprains of the fetlock. It generally happens from a misstep, stumbling, +or slipping, which results in the joint being extended or flexed to +excess. The same result may happen where the foot is caught in a rut, a +hole in a bridge, or in a car track, and the animal falls or struggles +violently. Direct blows and punctured wounds may also set up +inflammation of the joint.</p> + +<p><i>Symptoms.</i>—The symptoms of sprain of the fetlock vary with the +severity of the injury. If slight, there may be no lameness, but simply +a little soreness, especially when the foot strikes on uneven ground and +the joint is twisted a little. In more severe cases the joint swells, is +hot and puffy, and the lameness may be so intense as to compel the<span class='pagenum'><a name="Page_403" id="Page_403">[Pg 403]</a></span> +animal to hobble on three legs. While at rest the leg is flexed at the +joint affected, and the toe rests on the ground.</p> + +<p><i>Treatment.</i>—If the injury is slight, cold-water bandages and a few +days' rest are sufficient to effect recovery. When there is an intense +lameness, swelling, etc., the leg should be placed under a constant +stream of cold water, as described in the treatment for quittor. When +the inflammation has subsided, a blister to the joint should be applied.</p> + +<p>In some cases, especially in old horses long accustomed to fast work, +the ligaments of the joints are ruptured, in whole or in part, and the +lameness may last a long time. In these cases the joint should be kept +completely at rest; this condition is best obtained by the application +of plaster of Paris bandages, as in cases of fracture. As a rule, +patients take kindly to this bandage, and, while wearing it, may be +given the freedom of a roomy box or yard. If they are disposed to tear +it off, or if sufficient rest can not otherwise be obtained, the patient +must be kept in slings.</p> + +<p>In the majority of instances the plaster bandage should remain on from +two to four weeks. If the lameness returns when the bandage is removed, +a new one should be put on. The swellings which always remains after the +other evidences of the disease have disappeared, may be largely +dissipated and the joint strengthened by the rise of the firing iron and +blisters.</p> + +<p>A joint once injured by a severe sprain never entirely regains its +original strength, and is ever after particularly liable to a repetition +of the injury.</p> + + +<h4>RUPTURE OF THE SUSPENSORY LIGAMENT.</h4> + +<p>Sprain with or without rupture of the suspensory ligament may happen in +either the fore or hind legs, and is occasionally seen in horses of all +classes and at all ages. Old animals, however, and especially hunters, +runners, and trotters, are the most subject to this injury, and with +them the seat of the trouble is nearly always in one or both the fore +legs. Horses used for heavy draft are more liable to have the ligament +of the hind legs affected.</p> + +<p>When the strain upon the suspensory ligament becomes too great, one or +both of the branches may be torn from the sesamoid bones, one or both of +the branches may be torn completely across, or the ligament may rupture +above the point of division.</p> + +<p><i>Symptoms.</i>—The most common injury to the suspensory ligament is sprain +of the internal branch in one of the fore legs. The trouble is indicated +by lameness, heat, swelling, and tenderness of the affected branch, +beginning just above the sesamoid bone and extending obliquely downward +and forward to the front of the ankle. If the whole ligament is +involved, the swelling comes on gradually, and is<span class='pagenum'><a name="Page_404" id="Page_404">[Pg 404]</a></span> found above the +fetlock and in front of the flexor tendons. The patient stands or walks +upon the toe as much as possible, keeping the fetlock joint flexed so as +to relieve the ligament of tension.</p> + +<p>When both branches are torn from their attachments to the sesamoids, or +both are torn across, the lameness comes on suddenly and is most +intense; the fetlock descends, the toe turns up, and, as the animal +attempts to walk, the leg has the appearance of being broken off at the +fetlock. These symptoms, followed by heat, pain, and swelling of the +parts at the point of injury, will enable anyone to make a diagnosis.</p> + +<p><i>Treatment.</i>—Sprain of the suspensory ligament, no matter how mild it +may be, should always be treated by enforced rest of at least a month, +and the application of cold douches and cold-water bandages, firmly +applied until the fever has subsided, when a cantharides blister should +be put on and repeated in two or three weeks if necessary. When rupture +has taken place the patient should be put into slings and a constant +stream of cold water allowed to trickle over the seat of injury until +the fever is reduced. In the course of a week or ten days a plaster of +Paris splint, such as is used in fractures, is to be applied and left on +for a month or six weeks. When this is taken off, blisters may be used +to remove the remaining soreness; but it is useless to expect a removal +of all the thickening, for, in the process of repair, new tissue has +been formed which will always remain.</p> + +<p>In old cases of sprain the firing iron may often be used with good +results. As a rule, severe injuries to the suspensory ligament +incapacitate the subject for anything but slow, light work.</p> + + +<h4>OVERREACH.</h4> + +<p>When the shoe of the hind foot strikes and injures the heel or quarter +of the forefoot the horse is said to overreach. It rarely happens except +when the animal is going fast; hence is most common in trotting and +running horses. In trotters the accident generally happens when the +animal breaks from a trot to a run. The outside heels and quarters are +most liable to the injury.</p> + +<p><i>Symptoms.</i>—The coronet at the heel or quarter is bruised or cut, the +injury in some instances involving the horn as well. When the hind foot +strikes well back on the heel of the fore foot—an accident known among +horsemen as "grabbing"—the shoe may be torn from the forefoot or the +animal may fall to its knees. Horses accustomed to overreaching are +often "bad breakers," for the reason that the pain of the injury so +excites them that they can not readily be brought back to the trotting +gait.</p> + +<p><i>Treatment.</i>—If the injury is but a slight bruise, cold-water bandages +applied for a few days will remove all the soreness. If the parts are +deeply cut, more or less suppuration will follow, and, as a rule, it<span class='pagenum'><a name="Page_405" id="Page_405">[Pg 405]</a></span> is +well to poultice the parts for a day or two, after which cold baths may +be used, or the wounds dressed with tincture of aloes, oakum, and a +roller bandage.</p> + +<p>When an animal is known to be subject to overreaching, he should never +be driven fast without quarter boots, which are specially made for the +protection of the heels and quarters.</p> + +<p>If there is a disposition to "grab" the forward shoes, the trouble may +be remedied by having the heels of these shoes made as short as +possible, while the toe of the hind foot should project well over the +shoe. When circumstances permit of their use, the fore feet may be shod +with the "tips" instead of the common shoe, as described in treatment +for contracted heels.</p> + + +<h4>CALK WOUNDS.</h4> + +<p>Horses wearing shoes with sharp calks are liable to wounds of the +coronary region, either from trampling on themselves or on each other. +These injuries are most common in heavy draft horses, especially on +rough roads and slippery streets. The fore feet are more liable than the +hind ones, and the seat of injury is commonly on the quarters. In the +hind feet the wound often results from the animal resting with the heel +of one foot set directly over the front of the other. In these cases the +injury is generally close to the horn, and often involves the coronary +band, the sensitive laminæ, the extensor tendon, and even the coffin +bone.</p> + +<p><i>Treatment.</i>—Preventive measures include the use of boots to protect +the coronet of the hind foot and of a blunt calk on the outside heel of +the fore shoe, since this is generally the offending instrument when the +fore feet are injured. If the wound is not deep and the soreness slight, +cold-water bandages and a light protective dressing, such as carbolized +cosmoline, will be all that is needed. When the injury is deep, followed +by inflammation and suppuration of the coronary band, lateral +cartilages, sensitive laminæ, etc., active measures must be resorted to. +Cold, astringent baths, made by adding 2 ounces of sulphate of iron to 1 +gallon of water, should be used, followed by poultices, if it is +necessary to hasten the cleansing of the wound by stimulating the +sloughing process. If the wound is deep between the horn and the skin, +especially over the anterior tendon, the horn should be cut away so that +the injured tissues may be exposed. The subsequent treatment in these +cases should follow the directions given in the article on toe cracks.</p> + + +<h4>FROSTBITES.</h4> + +<p>Excepting the ears, the feet and legs are about the only parts of the +horse liable to become frostbitten. The cases most commonly seen are +found in cities, especially among car horses, where salt is used for the +purpose of melting the snow on curves and switches.<span class='pagenum'><a name="Page_406" id="Page_406">[Pg 406]</a></span> This mixture of +snow and salt is splashed over the feet and legs, rapidly lowering the +temperature of the parts to the freezing point. In mountainous +districts, where the snowfall is heavy and the cold often intense, +frostbites are not uncommon, even among animals running at large.</p> + +<p><i>Symptoms.</i>—When the frosting is slight the skin becomes pale and +bloodless, followed soon after by intense redness, heat, pain, and +swelling. In these cases the hair may fall out and the epidermis peel +off, but the inflammation soon subsides, the swelling disappears, and +only an increased sensitiveness to cold remains.</p> + +<p>In more severe cases irregular patches of skin are destroyed and after a +few days slough away, leaving slow-healing ulcers behind. If produced by +low temperatures and deep snow, the coronary band is the part most often +affected.</p> + +<p>In many instances there is no destruction of the skin, but simply a +temporary suspension of the horn-producing function of the coronary +band. The fore feet are more often affected than the hind ones, and the +heels and quarters are less often involved than the front part of the +foot. The coronary band becomes hot, swollen, and painful, and after two +or three days the horn separates from the band and slight suppuration +follows. For a few days the animal is lame, but as the suppuration +disappears the lameness subsides. New horn, often of an inferior +quality, is produced by the coronary band, and in time the cleft is +grown off and complete recovery is effected. The frog is occasionally +frostbitten and may slough off, exposing the soft tissues beneath and +causing severe lameness for a time.</p> + +<p><i>Treatment.</i>—Simple frostbites are best treated by cold fomentations +followed by applications of a 5 per cent solution of carbolized oil. +When portions of the skin are destroyed, their early separation should +be hastened by warm fomentations and poultices. Ulcers are to be treated +by the application of stimulating dressings, such as carbolized oil, a 1 +per cent solution of nitrate of silver or of chlorid of zinc, with pads +of oakum and flannel bandages. In many of these cases recovery is +exceedingly slow. The new tissue by which the destroyed skin is replaced +always shrinks in healing, and, as a consequence, unsightly scars are +unavoidable. When the coronary band is involved it is generally +advisable to blister the coronet over the seat of injury as soon as the +suppuration ceases, for the purpose of stimulating the growth of new +horn. Where a crevasse is formed between the old and the new horn no +serious trouble is liable to be met with until the cleft is nearly grown +out, when the soft tissues may be exposed by a breaking off of the +partly detached horn. But even if this accident happens final recovery +is effected by poulticing the foot until a sufficient growth of horn +protects the parts from injury.<span class='pagenum'><a name="Page_407" id="Page_407">[Pg 407]</a></span></p> + + +<h4>QUITTOR.</h4> + +<p>Quittor is a term applied to various affections of the foot wherein the +tissues which are involved undergo a process of degeneration that +results in the formation of a slough followed by the elimination of the +diseased structures by means of a more or less extensive suppuration.</p> + +<p>For convenience of consideration quittors may be divided into four +classes, as suggested by Girard: (1) Cutaneous quittor, which is known +also as simple quittor, skin quittor, and carbuncle of the coronet; (2) +tendinous quittor; (3) subhorny quittor; and (4) cartilaginous quittor.</p> + + +<h4>CUTANEOUS QUITTOR.</h4> + +<p>Simple quittor consists in a local inflammation of the skin and +subcutaneous connective tissue on some part of the coronet, followed by +a slough and the formation of an ulcer which heals by suppuration.</p> + +<p>It is an extremely painful disease, owing to the dense character of the +tissues involved; for in all dense structures the swelling which +accompanies inflammation always produces intense pressure. This pressure +not only adds to the patient's suffering but may at the same time +endanger the life of the affected parts by strangulating the blood +vessels. It is held by some writers that simple quittor is most often +met with in the hind feet, but in my experience more than two-thirds of +the cases have developed in the fore feet. While any part of the coronet +may become the seat of attack, the heels and quarters are undoubtedly +most liable.</p> + +<p><i>Causes.</i>—Bruises and other wounds of the coronet are often the cause +of cutaneous quittor, yet there can be no question that in the great +majority of cases the disease develops without any known cause. For some +reason not yet satisfactorily explained most cases happen in the fall of +the year. One explanation of this fact has been attempted in the +statement that the disease is due to the injurious action of cold and +mud. This claim, however, seems to lose force when it is remembered that +in many parts of this country the most mud, accompanied with freezing +and thawing weather, is seen in the early springtime without a +corresponding increase of quittor. Furthermore, the serious outbreaks of +this disease in the mountainous regions of Colorado, Wyoming, and +Montana are seen in the fall and winter seasons, when the weather is the +driest. It may be claimed, and perhaps with justice, that during these +seasons, when the water is low, animals are compelled to wade through +more mud to drink from lakes and pools than is necessary at other +seasons of the year, when these lakes and pools are full. Add to these +conditions the further fact that much of this mud is impregnated with<span class='pagenum'><a name="Page_408" id="Page_408">[Pg 408]</a></span> +alkaline salts which, like the mineral substances always found in the +mud of cities, are more or less irritating, and it seems fair to +conclude that under certain circumstances mud may become an important +factor in the production of quittor.<a name="FNanchor_3_3" id="FNanchor_3_3"></a><a href="#Footnote_3_3" class="fnanchor">[3]</a></p> + +<p>While this disease attacks any and all classes of horses, it is the +large, common breeds, with thick skins, heavy coats, and coarse legs +that are most often affected. Horses well groomed and cared for in +stables seem to be less liable to the disease than those running at +large or than those which are kept and worked under adverse +circumstances.</p> + +<p><i>Symptoms.</i>—Lameness, lasting from one to three or four days, nearly +always precedes the development of the strictly local evidences of +quittor. The next sign is the appearance of a small, tense, hot, and +painful tumor in the skin of the coronary region. If the skin of the +affected foot is white, the inflamed portion will present a dark-red or +even a purplish appearance near the center. Within a few hours the +ankle, or even the whole leg as high as the knee or hock, becomes much +swollen. The lameness is now so great that the patient refuses to use +the foot at all, but carries it if compelled to move. As a consequence, +the opposite leg is required to do the work of both, and if the animal +persists in standing a greater part of the time it, too, becomes +swollen. In many of these cases the suffering is so intense during the +first few days as to cause general fever, dullness, loss of appetite, +and increased thirst. Generally the tumor shows signs of suppuration +within 48 to 72 hours after its first appearance; the summit softens, a +fluctuating fluid is felt beneath the skin, which soon ulcerates +completely through, causing the discharge of a thick, yellow, bloody +pus, containing shreds of dead tissue which have sloughed away. The sore +is now converted into an open ulcer, generally deep, nearly or quite +circular in outline, and with hardened base and edges. In exceptional +cases large patches of skin, varying from 1 to 2-1/2 inches in diameter, +slough away at once, leaving an ugly superficial ulcer. These sores, +especially when deep, suppurate freely, and if there are no +complications they tend to heal rapidly as soon as the degenerated +tissue has softened and is entirely removed. When suppuration is fully +established, the lameness and general symptoms subside. When but a +single tumor and abscess form, the disease progresses rapidly, and +recovery, under proper treatment, may be effected<span class='pagenum'><a name="Page_409" id="Page_409">[Pg 409]</a></span> in from two to three +weeks; but when two or more tumors are developed at once, or if the +formation of one tumor is rapidly succeeded by another for an indefinite +time, the sufferings of the patient are greatly increased, the case is +more difficult to treat, and recovery is more slow and less certain.</p> + +<p>This form of quittor is often complicated with the tendinous and +subhorny quittors by an extension of the sloughing process.</p> + +<p><i>Treatment.</i>—The first step in the treatment of an outbreak of quittor +should be the removal of all exciting causes. Crowding animals into +small corrals and stables, where injuries to the coronet are likely to +happen from trampling, especially among unbroken range horses, must be +avoided as much as possible.</p> + +<p>Watering places accessible without having to wade through mud should be +provided. In towns, where the mud or dust is largely impregnated with +mineral products, it is not possible to adopt complete preventive +measures. Much can be done, however, by careful cleansing of the feet +and legs as soon as the animal returns from work. Warm water should be +used to remove the mud and dirt, after which the parts are to be +thoroughly dried with soft cloths.</p> + +<p>The means which are to be adopted for the cure of cutaneous quittor vary +with the stage of the disease at the time the case is presented for +treatment. If the case is seen early—that is, before any of the signs +of suppuration have developed—the affected foot is to be placed under a +constant stream of cold water, with the object of arresting a further +extension of the inflammatory process. To accomplish this, put the +patient in slings in a narrow stall having a slat or open floor. Bandage +the foot and leg to the knee or hock, as the case may be, with flannel +bandages loosely applied. Set a tub or barrel filled with cold water +above the patient, and by the use of a small rubber hose of sufficient +length make a siphon which will carry the water from the bottom of the +tub to the leg at the top of the bandage. The stream of water should be +quite small, and is to be continued until the inflammation has entirety +subsided or until the presence of pus can be detected in the tumor. When +suppuration has commenced, the process should be aided by the use of +warm baths and poultices of lineseed meal or boiled turnips. If the +tumor is of rapid growth, accompanied with intense pain, relief is +obtained and sloughing largely limited by a free incision of the parts. +The incision should be vertical and deep into the tumor, care being +taken not to divide the coronary band entirely. If the tumor is large, +more than one incision may be necessary.</p> + +<p>The foot should now be placed in a warm bath for half an hour or longer +and then poulticed. The hemorrhage produced by the cutting and +encouraged by the warm bath is generally very copious and soon gives +relief to the overtension of the parts.<span class='pagenum'><a name="Page_410" id="Page_410">[Pg 410]</a></span></p> + +<p>In other cases it will be found that suppuration is well under way, so +that the center of the tumor is soft when the patient is first presented +for treatment. It is always good surgery to relieve the tumor of pus +whenever its presence can be detected; hence, in these cases a free +incision must be made into the softened parts, the pus evacuated, and +the foot poulticed.</p> + +<p>By surgical interference the tumor is now converted into an open sore or +ulcer, which, after it has been well cleaned by warm baths and poultices +applied for two or three days, needs to be protected by proper +dressings. The best of all protective dressings is made of small balls, +or pledgets, of oakum, carefully packed into the wound and held in place +by a roller bandage 4 yards long, from 3 to 4 inches wide, made of +common bedticking and skillfully applied.</p> + +<p>The remedies which may be used to stimulate the healing process are +many, and, as a rule, they are applied in the form of solutions or +tinctures.</p> + +<p>In my own practice I prefer a solution of bichlorid of mercury 1 part, +water 500 parts, with a few drops of muriatic acid or a few grains of +muriate of ammonia added to dissolve the mercury. The balls of oakum are +wet with this solution before they are applied to the wound.</p> + +<p>Among the other remedies which may be used, and perhaps with equally as +good results, will be noted the sulphate of copper, iron, and zinc, 5 +grains of either to the ounce of water; chlorid of zinc, 5 grains to the +ounce; carbolic acid, 20 drops dissolved in an equal quantity of +glycerin and added to 1 ounce of water; and nitrate of silver, 10 grains +to the ounce of water.</p> + +<p>If the wound is slow to heal, it will be found of advantage to change +the remedies every few days.</p> + +<p>If the wound is pale in color, the granulations transparent and +glistening, the tincture of aloes, tincture of gentian, or the spirits +of camphor may do best.</p> + +<p>When the sore is red in color and healing rapidly, an ointment made of 1 +part of carbolic acid to 40 parts of cosmoline or vaseline is all that +is needed.</p> + +<p>If the granulations continue to grow until a tumor is formed which +projects beyond the surrounding skin, it should be cut off with a sharp, +clean knife, and the foot poulticed for twenty-four hours, after which +the wound is to be well cauterized daily with lunar caustic and the +bandages applied with great firmness.</p> + +<p>The question as to how often the dressings should be renewed must be +determined by the condition of the wound, etc. If the sore is +suppurating freely, it will be necessary to renew the dressing every 24 +or 48 hours; if the discharge is small in quantity and the patient +comfortable, the dressing may be left on for several days; in fact,<span class='pagenum'><a name="Page_411" id="Page_411">[Pg 411]</a></span> the +less often the wound is disturbed, the better, so long as the healing +process is healthy. When the sore commences to "skin over," the edges +should be lightly touched with lunar caustic at each dressing. The +patient may now be given a little exercise daily, but the bandages must +be kept on until the wound is entirely healed.</p> + + +<h4>TENDINOUS QUITTOR.</h4> + +<p>This form of quittor differs from the cutaneous in that it not only +affects the skin and subcutaneous tissues, but involves also the tendons +of the leg, the ligaments of the joints, and, in many cases, the bones +of the foot as well.</p> + +<p>Fortunately, this form of quittor is less common than the preceding, yet +any case beginning as simple cutaneous quittor may at any time during +its course become complicated by the death of some part of the tendons, +by gangrene of the ligaments, sloughing of the coronary band, caries of +the bones, or inflammation and suppuration of the synovial sacs and +joints, thereby converting a simple quittor into one which will, in all +probability, either destroy the patient's life or maim him for all time.</p> + +<p><i>Causes.</i>—Tendinous quittor is caused by the same injuries and +influences that produce the simple form. Zundel believes it to be a not +infrequent accompaniment of distemper. In my own experience I have seen +nothing to verify this belief, but I am convinced that young animals are +more liable to have tendinous quittor than older ones, and that they are +much more likely to make a good recovery.</p> + +<p><i>Symptoms.</i>—When a case of simple quittor is transformed into the +tendinous variety the change is announced by a sudden increase in the +severity of all the symptoms. On the other hand, if the attack primarily +is one of tendinous quittor, the earliest symptom seen is a well-marked +lameness. In those cases due to causes other than injuries this lameness +is at first very slight, and the animal limps no more in trotting than +in walking; later on, generally during the next 48 hours, the lameness +increases to such extent that the patient often refuses to use the leg +at all. An examination made during the first two days rarely discloses +any cause for this lameness; it may not be possible even to say with +certainty that the foot is the seat of the trouble. On the third or +fourth day, sometimes as late as the fifth, a doughy-feeling tumor will +be found forming on the heel or quarter. This tumor grows rapidly, feels +hot to the touch, and is extremely painful. As the tumor develops, all +the other symptoms increase in intensity; the pulse is rapid and hard; +the breathing quick; the temperature elevated 3° or 4°; the appetite is +gone; thirst increased; and the lameness so great that the foot is +carried if locomotion is attempted. At this stage of the disease the +patient generally seeks relief by lying upon the broad side, with +outstretched legs; the coat<span class='pagenum'><a name="Page_412" id="Page_412">[Pg 412]</a></span> is bedewed with a clammy sweat, and every +respiration is accompanied with a moan. The leg soon swells to the +fetlock; later this swelling gradually extends to the knee or hock, and +in some cases reaches the body. As a rule, several days elapse before +the disease develops a well-defined abscess, for, owing to the dense +structure of the bones, ligaments, and tendons, the suppurative process +is a slow one, and the pus is prevented from readily collecting in a +mass.</p> + +<p>I made a post-mortem examination on a typical case of this disease, in +which the animal had died on the fourth day after being found on the +range slightly lame. The suffering had been intense, yet the only +external evidences of the disease consisted in the shedding of the hoof +from the right fore foot and a limited swelling of the leg to the knee. +The sloughing of the hoof took place two or three hours before death, +and was accompanied with but little suppuration and no hemorrhage. The +skin from the knee to the foot was thickened from watery infiltration +(edema), and on the inside quarter three holes, each about one-half inch +in diameter, were found. All had ragged edges, while but one had gone +deep enough to perforate the coronary band. The loose connective tissue +beneath the skin was distended, with a gelatinous infiltration over the +whole course of the flexor tendons and to the fetlock joint over the +tendon in front. The soft tissues covering the coffin bone were loosened +in patches by collections of pus which had formed beneath the sensitive +laminæ. The coffin and pastern joints were inflamed, as were also the +coffin, navicular, and coronet bones, while the outside toe of the +coffin bone had become softened from suppuration until it readily +crumbled between the fingers. The coronary band was largely destroyed +and completely separated from the other tissues of the foot. The inner +lateral cartilage was gangrenous, as was also a small spot on the +extensor tendon near its point of attachment on the coffin bone. Several +small collections of pus were found deep in the connective tissue of the +coronary region; along the course of the sesamoid ligaments; in the +sheath of the flexor tendons; under the tendon just below the fetlock +joint in front; and in the coffin joint.</p> + +<p>But all cases of tendinous quittor are by no means so complicated as +this one was. In rare instances the swelling is slight, and after a few +days the lameness and other symptoms subside, without any discharge of +pus from an external opening. In most cases, however, from one to half a +dozen or more soft points arise on the skin of the coronet, open, and +discharge slowly a thick, yellow, fetid, and bloody matter. In other +cases the suppurative process is largely confined to the sensitive +laminæ and plantar cushion, when the suffering is intense until the pus +finds an avenue of escape<span class='pagenum'><a name="Page_413" id="Page_413">[Pg 413]</a></span> by separating the hoof from the coronary +band, at or near the heels, without causing a loss of the whole horny +box. When the flexor tendon is involved deep in the foot, the discharge +of pus usually takes place from an opening in the follow of the heel; if +the sesamoid ligament or the sheath of the flexors are affected, the +opening is nearer the fetlock joint, although in most of these cases the +suppuration spreads along the course of the tendons until the navicular +joint is involved, and extensive sloughing of the deeper parts follows.</p> + +<p><i>Treatment.</i>—The treatment of tendinous quittor is to be directed +toward the saving of the foot. First of all an effort must be made to +prevent suppuration; if the patient is seen at the beginning, cold +irrigation, recommended in the treatment for cutaneous quittor, is to be +resorted to. Later, when the tumor is forming on the coronet, the knife +must be used, and a free and deep incision made into the swelling. +Whenever openings appear, from which pus escapes, they should be +carefully probed; in all instances these fistulous tracts lead down to +dead tissue which nature is trying to remove by the process of +sloughing. If a counter opening can be made, which will enable a more +ready escape of the pus, it should be done at once; for instance, if the +probe shows that the discharge originates from the bottom of the foot, +the sole must be pared through over the seat of trouble. Whenever +suppuration has commenced the process is to be stimulated by the use of +warm baths and poultices. The pus which accumulates in the deeper parts, +especially along the tendons, around the joints, and in the hoof, is to +be removed by pressure and injections made with a small syringe, +repeated two or three times a day. As soon as the discharge assumes a +healthy character and diminishes in quantity, stimulating solutions are +to be injected into the open wounds. When the tendons, ligaments, and +other deeper parts are affected, a strong solution of carbolic acid—1 +to 4—should be used at first; or strong solutions of tincture of iodin, +sulphate of iron, sulphate of copper, bichlorid of mercury, etc., may be +used in place of the carbolic; after this the remedies and dressings +directed for use in simple quittor are to be used. In those cases in +which the fistulous tracts refuse to heal it is often necessary to burn +them out with a saturated solution of caustic soda, equal parts of +muriatic acid and water, or, better still, with a long, thin iron, +heated white hot.</p> + +<p>But no matter what treatment is adopted, a large percentage of the cases +of tendinous quittor fail to make good recoveries. If the entire hoof +sloughs away, the growth of a new, but soft and imperfect hoof may be +obtained by carefully protecting the exposed tissues with proper +bandages. When the joints are opened by deep sloughing, recovery may +eventually take place, but the joint remains immovable ever after. If +caries of a small part of the coffin bone takes<span class='pagenum'><a name="Page_414" id="Page_414">[Pg 414]</a></span> place, it may be +removed by an operation; but if much of the bone is affected, or if the +navicular and coronet bones are involved in the carious process, the +only hope for a cure is in the amputation of the foot. This operation is +advisable only when the animal is valuable for breeding purposes. In all +other cases in which there is no hope for recovery the patient's +suffering should be relieved by death. In tendinous quittor much +thickening of the coronary region, and sometimes of the ankle and +fetlock, remains after suppuration has ceased and the fistulous tracts +have healed. To stimulate the reabsorption of this new and unnecessary +tissue, the parts should be fired with the hot iron, or, in its absence, +repeated blistering with the biniodid of mercury ointment may largely +accomplish the same results.</p> + + +<h4>SUBHORNY QUITTOR.</h4> + +<p>This is the most common form of the disease. It is generally seen in but +one foot at a time, and more often in the fore than in the hind feet. It +nearly always attacks the inside quarter, but may affect the outside, +the band in front, or the heel, where it is of but little consequence. +It consists in the inflammation of a small part of the coronary band and +adjacent skin, followed by sloughing and suppuration, which in most +cases extends to the neighboring sensitive laminæ.</p> + +<p><i>Causes.</i>—Injuries to the coronet, such as bruises, overreaching, and +calk wounds, are considered as the common causes of this disease. Still, +cases occur in which there appears to be no existing cause, just as in +the other forms of quittor, and it seems fair to conclude that subhorny +quittor may also be produced by internal causes.</p> + +<p><i>Symptoms.</i>—At the outset the lameness is always severe, and the +patient often refuses to use the affected foot. Swelling of the coronet +close to the top of the hoof causes the quarter to protrude beyond the +wall. This tumor is extremely sensitive, and the whole foot is hot and +painful. After a few days a small spot in the skin, over the most +elevated part of the tumor, softens and opens or the hoof separates from +the coronary band at the quarter or well back toward the heel. From this +opening, wherever it may be, a thin, watery, often dark, offensive +discharge escapes, at times mixed with blood and always containing a +considerable percentage of pus.</p> + +<p>Probing will now disclose a fistulous tract leading to the bottom of the +diseased tissues. If the opening is small, there is a tendency upon the +part of the suppurative process to spread downward; the pus gradually +separates the hoof from the sensitive laminæ until the sole is reached, +and even a portion of this may be undermined.</p> + +<p>As a rule, the slough in this form of quittor is not deep, and if the +case receives early and proper treatment complications are generally +avoided; but if the case is neglected, and, occasionally, even in spite<span class='pagenum'><a name="Page_415" id="Page_415">[Pg 415]</a></span> +of the best treatment, the disease spreads until the tendon in front, +the lateral cartilage, or the coffin bone and joint as well are +involved.</p> + +<p>In all cases of subhorny quittor much relief is experienced when the +slough comes away, and rapid recovery is made. If, however, after the +lapse of a few days, the lameness remains and the wound continues to +discharge a thin, unhealthy matter, the probabilities are that the +disease is spreading, and pus collecting in the deeper parts of the +foot. In Zundel's opinion, if the use of the probe now detects a pus +cavity below the opening, a cartilaginous quittor is in the course of +development.</p> + +<p><i>Treatment.</i>—Hot baths and poultices are to be used until the presence +of pus can be determined, when the tumor is to be opened with a knife or +sharp-pointed iron heated white hot. The hot baths and poultices are now +continued for a few days or until the entire slough has come away and +the discharge is diminished, when dressings recommended in the treatment +for cutaneous quittor are to be used until recovery is completed. In +cases in which the discharge comes from a cleft between the upper border +of the hoof and the coronary band, always pare away the loosened horn, +so that the soft tissues beneath are fully exposed, care being taken not +to injure the healthy parts. This operation permits of a thorough +inspection of the diseased parts, the easy removal of all gangrenous +tissue, and a better application of the necessary remedies and +dressings. The only objection to the operation is that the patient is +prevented from being early returned to work.</p> + +<p>When the probe shows that pus has collected under the coffin bone the +sole must be pared through, and, if caries of the bone is present, the +dead parts cut away. After either of these operations the wound is to be +dressed with the oakum balls, saturated in the bichlorid of mercury +solution, as previously directed, and the bandages tightly applied. +Generally the discharge for the first two or three days is so great that +the dressings need to be changed every 24 hours; but when the discharge +diminishes, the dressing may be left on from one to two weeks. Before +the patient is returned to work, a bar shoe should be applied, since the +removed quarter or heel can only be made perfect again by a new growth +from the coronary band.</p> + +<p>Tendinous or cartilaginous complications are to be treated as directed +under those headings.</p> + + +<h4>CARTILAGINOUS QUITTOR.</h4> + +<p>This form of quittor may commence as a primary inflammation of the +lateral cartilage, but in the great majority of cases it appears as a +sequel to cutaneous or subhorny quittor. It may affect either the fore +or hind feet, but is most commonly seen in the former. As a<span class='pagenum'><a name="Page_416" id="Page_416">[Pg 416]</a></span> rule, it +attacks but one foot at a time, and but one of the cartilages, generally +the inner one. It is always a serious affection for the reason that, in +many cases, it can only be cured by a surgical operation, requiring a +thorough knowledge of the anatomy of the parts involved, and much +surgical skill.</p> + +<p><i>Causes.</i>—Direct injuries to the coronet, such as trampling, pricks, +burns, and the blow of some heavy falling object which may puncture, +bruise, or crush the cartilage, are the common direct causes of +cartilaginous quittor. Besides being a sequel to the other forms of +quittor, it sometimes develops as a complication in suppurative corn, +canker, grease, laminitis, and punctured wounds of the foot. Animals +used for heavy draft, and those with flat feet and low heels, are more +liable to the disease than others, for the reason that they are more +exposed to injury. Rough roads also predispose to the disease by +increasing liability to injury.</p> + +<p><i>Symptoms.</i>—When the disease commences as a primary inflammation of the +cartilage, lameness develops with the formation of a swelling on the +side of the coronet over the quarter. The severity of this lameness +depends largely upon the part of the cartilage which is diseased, for if +the disease is situated in that part of the cartilage nearest the heel, +where the surrounding tissues are soft and spongy, the lameness may be +very slight, especially if the patient is required to go no faster than +a walk; but when the middle and anterior parts of the cartilage are +diseased, the pain and consequent lameness are much greater, for the +tissues are less elastic and the coffin joint is more liable to become +affected.</p> + +<p>Except in the cases to be noted hereafter, one or more fistulous +openings finally appear in the tumor on the coronet. These openings are +surrounded by a small mass of granulations which are elevated above the +adjacent skin and bleed readily if handled. A probe shows these +fistulous tracts to be more or less sinuous, but always leading to one +point—the gangrenous cartilage. When cartilaginous quittor happens as a +complication of suppurative corn, or from punctured wounds of the foot, +the fistulous tract may open alone at the point of injury on the sole.</p> + +<p>The discharge in this form of quittor is generally thin, watery, and +contains pus enough to give it a pale-yellow color; it is offensive to +the sense of smell, due to the detachment of small flakes of cartilage +which have become gangrenous and are seen in the discharge as small, +greenish-colored particles. In old cases it is not unusual to find some +of the fistulous openings heal at the surface; this is followed by the +gradual collection of pus in the deeper parts, forming an abscess, which +in a short time opens at a new point. The wall of the hoof, over the +affected quarter and heel, in very old cases becomes rough and wrinkled +like the horn of a ram, and generally it is thicker than<span class='pagenum'><a name="Page_417" id="Page_417">[Pg 417]</a></span> the +corresponding quarter, owing to the stimulating effect which the disease +has upon the coronary band.</p> + +<p>Complications may arise by an extension of the disease to the lateral +ligament of the coffin joint, to the joint itself, to the plantar +cushion, and by caries of the coffin bone.</p> + +<p><i>Treatment.</i>—Before recovery can take place all the dead cartilage must +be removed. In rare instances this is effected by nature without +assistance. Usually, however, the disease does not tend to recovery, and +active curative measures must be adopted. The best and simplest +treatment, in a majority of cases, is the injection of strong caustic +solutions, which destroy the diseased cartilage and cause its discharge, +along with the other products of suppuration. In favorable cases these +injections will secure a healing of the wound in from two to three +weeks. While the saturated solution of sulphate of copper, or a solution +of 10 parts of bichlorid of mercury to 100 parts of water, has given the +best results in my hands, equally as favorable success has been secured +by others from the use of caustic soda, nitrate of silver, sulphate of +zinc, tincture of iodin, etc. No matter which one of these remedies may +be selected, however, it must be used at least twice a day for a time. +The solution is injected into the various openings with force enough to +drive it to the bottom of the wound, after which the foot is to be +dressed with a pad of oakum, held in place by a roller bandage tightly +applied. While it is not always necessary, it is often of advantage to +relieve the pressure on the parts by rasping away the hoof over the seat +of the cartilage; the coronary band and laminæ should not be injured in +the operation.</p> + +<p>If the caustic injections prove successful, the discharge will become +healthy and gradually diminish, so that by the end of the second week +the fistulous tracts are closing up and the injections are made with +much difficulty.</p> + +<p>If, on the other hand, there is but little or no improvement after this +treatment has been used for three weeks, it may reasonably be concluded +that the operation for the removal of the lateral cartilage must be +resorted to for the cure of the trouble. As this operation can be safely +undertaken only by an expert surgeon, it will not be described in this +connection.</p> + + +<h4>THRUSH.</h4> + +<p>Thrush is characterized by an excessive secretion of unhealthy matter +from the cleft of the frog. While all classes of horses are liable to +this affection, it is more often seen in the common draft horse than in +any other breed, owing to the conditions of servitude and not to the +fault of the breed. Country horses are much less<span class='pagenum'><a name="Page_418" id="Page_418">[Pg 418]</a></span> subject to the +disease, except in wet, marshy districts, than are the horses used in +cities and towns.</p> + +<p><i>Causes.</i>—The most common cause of thrush is the filthy condition of +the stable in which the animal is kept. Mares are more liable to +contract the disease in the hind feet when filth is the cause, while the +gelding and stallion are more liable to develop it in the fore feet. +Hard work on rough and stony roads may also induce the disease, as may a +change from dryness to excessive moisture. The latter cause is often +seen to operate in old track horses, whose feet are constantly soaked in +the bathtub for the purpose of relieving soreness. Muddy streets and +roads, especially where mineral substances are plentiful, excite this +abnormal condition of the frog. Contracted heels, scratches, and +navicular disease predispose to thrush, while by some a constitutional +tendency is believed to exist among certain animals which otherwise +present a perfect frog.</p> + +<p><i>Symptoms.</i>—At first there is simply an increased moisture in the cleft +of the frog, accompanied with an offensive smell. After a time a +considerable discharge takes place—thin, watery, and highly offensive, +changing gradually to a thicker puriform matter, which rapidly destroys +the horn of the frog. Only in old and severe cases is the patient lame +and the foot feverish—cases in which the whole frog is involved in the +diseased process.</p> + +<p><i>Treatment.</i>—Thrushes are to be treated by cleanliness, the removal of +all exciting causes, and a return of the frog to its normal condition. +As a rule, the diseased and ragged portions of horn are to be pared away +and the foot poulticed for a day or two with boiled turnips, to which +may be added a few drops of carbolic acid or a handful of powdered +charcoal to destroy the offensive smell. The cleft of the frog and the +grooves on its edges are then to be cleaned and well filled with dry +calomel and the foot dressed with oakum and a roller bandage. If the +discharge is profuse, the dressing should be changed daily; otherwise it +may be left on two or three days. Where a constitutional taint is +supposed to exist, with swelling of the legs, grease, etc., a purgative, +followed by dram doses of sulphate of iron, repeated daily, may be +prescribed. In cases where the growth of horn seems too slow a +Spanish-fly blister applied to the heels is often followed by good +results. Feet in which the disease is readily induced may be protected +in the stable with a leather boot. If the thrush is but a sequel to +other disease, a permanent cure may not be possible.</p> + + +<h4>CANKER.</h4> + +<p>Canker of the foot is due to the rapid reproduction of a vegetable +parasite. It not only destroys the sole and frog, but, by setting up a +chronic inflammation in the deeper tissues, prevents the growth of<span class='pagenum'><a name="Page_419" id="Page_419">[Pg 419]</a></span> a +healthy horn by which the injury may be repaired. Heavy cart horses are +more often affected than those of any other class.</p> + +<p><i>Causes.</i>—The essential element in the production of canker is the +parasite; consequently the disease may be called contagious. As in all +other diseases due to specific causes, however, the seeds of the +disorder must find a suitable soil in which to grow before they are +reproduced. It may be said, then, that the conditions which favor the +preparation of the tissues for a reception of the seeds of this disease +are simply predisposing causes.</p> + +<p>The condition most favorable to the development of canker is +dampness—in fact, dampness seems indispensable to the existence and +growth of the parasite; the disease is rarely, if ever, seen in high, +dry districts, and is much more common in rainy than in dry seasons. +Filthy stables and muddy roads have been classed among the causes of +canker; but it is very doubtful whether these conditions can do more +than favor a preparation of the foot for the reception of the disease +germ.</p> + +<p>All injuries to the feet, by exposing the soft tissues, may render the +animal susceptible to infection; but neither the injury nor the +irritation and inflammation of the tissues which follow are sufficient +to induce the disease.</p> + +<p>For some unknown reason horses with lymphatic temperaments—thick skins, +flat feet, fleshy frogs, heavy hair, and particularly with white feet +and legs—are especially liable to canker.</p> + +<p><i>Symptoms.</i>—Usually, canker is confined to one foot; but it may attack +two, three, or all of the feet at once; or, as is more commonly seen, +the disease attacks first one then another, until all may have been +successively affected. When the disease follows an injury which has +exposed the soft tissues of the foot, the wound shows no tendency to +heal, but instead there is secreted from the inflamed parts a profuse, +thin, fetid, watery discharge, which gradually undermines and destroys +the surrounding horn, until a large part of the sole and frog is +diseased. The living tissues are swollen, dark colored, and covered at +certain points with particles of new, soft, yellowish, thready horn, +which are constantly undergoing maceration in the abundant liquid +secretion by which they are immersed. As this secretion escapes to the +surrounding parts, it dries and forms small, cheesy masses composed of +partly dried horny matter, exceedingly offensive to the sense of smell. +When the disease originates independently of an injury, the first +evidences of the trouble are the offensive odor of the foot, the liquid +secretion from the cleft and sides of the frog, and the rotting away of +the horn of the frog and sole.</p> + +<p>In the earlier stages there is no interference with locomotion, but +later the foot becomes sensitive, particularly if the animal is used on<span class='pagenum'><a name="Page_420" id="Page_420">[Pg 420]</a></span> +rough roads, and, finally, when the sole and frog are largely destroyed +the lameness is severe.</p> + +<p><i>Treatment.</i>—Since canker does not destroy the power of the tissues to +produce horn, but rather excites them to an excessive production of an +imperfect horn, the indications for treatment are to restore the parts +to a normal condition, when healthy horn may again be secreted. In my +experience, limited though it has been, the old practice of stripping +off the entire sole and deep cauterization, with either the hot iron or +strong acids, is not attended with uniformly good results.</p> + +<p>I am of the opinion that recovery can generally be effected as surely +and as speedily with measures which are less heroic and much less +painful. True, the treatment of canker is likely to exhaust the +patience, and sometimes the resources, of the attendant; but after all +success depends more on the persistent application of simple remedies +and great cleanliness than on the special virtues of any particular +drug.</p> + +<p>First, then, clean the foot with warm baths and apply a poultice +containing powdered charcoal or carbolic acid. A handful of the charcoal +or a tablespoonful of the acid mixed with the poultice serves to destroy +much of the offensive odor. The diseased portions of horn are to be +carefully removed with sharp instruments, until only healthy horn +borders the affected parts. The edges of the sound horn are to be pared +thin, so that the swollen soft tissues may not overlap their borders. +With sharp scissors cut off all the prominent points on the soft +tissues, shorten the walls of the foot, and nail on a broad, plain shoe. +The foot is now ready for the dressings, and any of the many stimulating +and drying remedies may be used; but it will be necessary to change +frequently from one to another, until finally all may be tried.</p> + +<p>The list from which a selection may be made comprises wood tar, gas tar, +petroleum, creosote, phenic acid; sulphates of iron, copper, and zinc; +chlorid of zinc, bichlorid of mercury, calomel, caustic soda, nitrate of +silver, chlorid of lime; carbolic, nitric, and sulphuric acids.</p> + +<p>In practice I prefer to give the newly shod foot a bath for an hour or +two in a solution of the sulphate of iron made by adding 2 ounces of the +powdered sulphate to a gallon of cold water. When the foot is removed +from the bath it is dressed with oakum balls dipped in a mixture made of +Barbados tar 1 part, oil of turpentine 8 parts, to which is slowly added +2 parts of sulphuric acid, and the mixture well stirred and cooled. The +diseased parts being well covered with the balls, a pad of oakum +sufficiently thick to cause considerable pressure is placed over them, +and all are held in place by pieces of heavy tin fitted to slip under +the shoe. The whole foot is now incased in a boot or folded gunny sack +and the patient turned into a loose,<span class='pagenum'><a name="Page_421" id="Page_421">[Pg 421]</a></span> dry box. The dressings are to be +changed daily or even twice a day at first. When they are removed, all +pieces of new horny matter which are now firmly adherent must be rubbed +off with the finger or a tent of oakum. As the secretion diminishes, dry +powders, such as calomel, sulphates of iron, copper, etc., may prove of +most advantage. The sulphates should not be used pure, but are to be +mixed with powdered animal charcoal in the proportion of one of the +former to eight or ten of the latter. When the soft tissues are all +horned over, the dressings should be continued for a time, weak +solutions being used to prevent a recurrence of the disease. If the +patient is run down in condition, bitter tonics, such as gentian, may be +given in 2-dram doses twice a day and a liberal diet of grain allowed.</p> + + +<h4>CORNS.</h4> + +<p>A corn is an injury to the living horn of the foot, involving the soft +tissues beneath, whereby the capillary blood vessels are ruptured and a +small quantity of blood escapes which, by permeating the horn in the +immediate neighborhood, stains it a dark color. If the injury is +continuously repeated, the horn becomes altered in character and the +soft tissues may suppurate or a horny tumor develop. Corns always appear +in the sole in the angle between the bar and the outside wall of the +hoof. In many cases the laminæ of the bar, of the wall, or of both, are +involved at the same time.</p> + +<p>Three kinds of corns are commonly recognized—the dry, the moist, and +the suppurative—a division based solely on the character of the +conditions which follow the primary injury.</p> + +<p>The fore feet are almost exclusively the subjects of the disease, for +two reasons: First, because they support a greater part of the body; +secondly, because the heel of the fore foot during progression is first +placed upon the ground, whereby it receives much more concussion than +the heel of the hind foot, in which the toe first strikes the ground.</p> + +<p><i>Causes.</i>—It may be said that all feet are exposed to corns, and that +even the best feet may suffer from them when conditions necessary to the +production of the peculiar injury are present. The heavier breeds of +horses generally used for heavy work on rough roads and streets seem to +be most liable to this trouble. Mules rarely have corns.</p> + +<p>Among the causes and conditions which predispose to corns may be named +high heels, which change the natural relative position of the bones of +the foot and thereby increase the concussion to which these parts are +subject; contracted heels, which in part destroy the elasticity of the +foot, increase the pressure upon the soft tissues of the heel, and +render lacerations more easy; long feet, which by removing the frog and +heels too far from the ground deprive them<span class='pagenum'><a name="Page_422" id="Page_422">[Pg 422]</a></span> of necessary moisture; this, +in turn, reduces the elastic properties of the horn and diminishes the +transverse diameter of the heels; weak feet, or those in which the horn +of the wall is too thin to resist the tendency to spread, whereby the +soft tissues are easily lacerated. Wide feet with low heels are always +accompanied with a flat sole whose posterior wings either rest upon the +ground or the shoe, and as a consequence are easily bruised; at the same +time the arch of the sole is so broad and flat that it can not support +the weight of the body, and in the displacement which happens when the +foot is rested upon the ground the soft tissues are liable to become +bruised or torn.</p> + +<p>It is universally conceded that shoeing, either as a direct or +predisposing cause, is most prolific in producing corns. One of the most +serious as well as the most common of the errors in shoeing is to be +found in the preparation of the foot. Instead of seeking to maintain the +integrity of the arch, the first thing done is to weaken it by freely +paring away the sole; nor does the mutilation end here, for the frog, +which is nature's main support to the branches of the sole and the +heels, is also largely cut away. This not only permits of an excessive +downward movement of the contents of the horny box, but it at the same +time removes the one great means by which concussion of the foot is +destroyed. As adjuncts to the foregoing errors must be added the faults +of construction in the shoe and in the way it is adjusted to the foot. +An excess of concavity in the shoe, extending it too far back on the +heels, high calks, thin heels which permit the shoe to spring, short +heels with a calk set under the foot, and a shoe too light for the +animal wearing it or for the work required of him, are all to be avoided +as causes of corns. A shoe so set so as to press upon the sole or one +that has been on so long that the hoof has overgrown it until the heels +rest upon the sole and bars becomes a direct cause of corns. Indirectly +the shoe becomes the cause of corns when small stones, hard, dry earth, +or other objects collect between the sole and shoe. Lastly, a rapid gait +and excessive knee action, especially on hard roads, predispose to this +disease of the feet.</p> + +<p><i>Symptoms.</i>—Ordinarily a corn induces sufficient pain to cause +lameness. It may be intense, as seen in suppurative corn, or it may be +but a slight soreness, such as that which accompanies dry corn. It is by +no means unusual in chronic corns to see old horses apparently so +accustomed to the slight pain which they suffer as not to limp at all. +But they are generally very restless. They paw their bedding behind them +at night and often refuse to lie down for a long rest. The lameness of +this disease, however, can hardly be said to be characteristic, for the +reason that it varies so greatly in intensity; but the position of the +leg while the patient is at rest is generally the same in all cases. The +foot is so advanced that it is relieved of all weight, and the fetlock +is flexed until all pressure by the contents of the hoof<span class='pagenum'><a name="Page_423" id="Page_423">[Pg 423]</a></span> is removed +from the heels. In suppurative corn the lameness subsides or entirely +disappears as soon as the abscess opens. When the injured tissues are +much inflamed, as may happen in severe and recent cases, the heel of the +affected side, or even the whole foot, is hot and tender to pressure. In +dry corn and in most chronic cases all evidences of local fever are +often wanting. It is in these cases that the patient goes well when +newly shod, for the smith cuts away the sole over the seat of injury +until all pressure by the shoe is removed and lowers the heels so that +concussion is reduced to a minimum.</p> + +<p>If a corn is suspected, the foot should be examined for increased +sensibility of the inside heel. Tapping the heel of the shoe with a +hammer and grasping the wall and bar between the jaws of pincers with +moderate pressure will cause more or less flinching if the disease is +present. For further evidence the shoe is removed and the heel cut away +with the drawing knife. As the horn is pared out, not only the sole in +the angle is found discolored, but in many instances the insensible +laminæ of the bar and wall adjacent are also stained with the escaped +blood. In moist and suppurative corns this discoloration is less marked +than in dry corn and even may be entirely wanting. In these cases the +horn is soft, often white, and stringy or mealy, as seen in pumiced sole +resulting from founder. When the whole thickness of the sole is +discolored and the horn dry and brittle it is generally evidence that +the corn is an old one and that the exciting cause has existed +continuously. A moist corn differs from the dry one in that the injury +is more severe. The parts affected are more or less inflamed, and the +horn of the sole in the angle is undermined by a citron-colored fluid, +which often permeates the injured sole and laminæ, causing the horn to +become somewhat spongy.</p> + +<p>A suppurative corn differs from others in that the inflammation ends in +suppuration. The pus collects at the point of injury and finally escapes +by working its way between the sensitive and insensible laminæ to the +top of the hoof, where an opening is made between the wall and coronary +band at or near the heels. This is the most serious form of corns, for +the reason that it may induce gangrene of the plantar cushion, +cartilaginous quittor, or caries of the coffin bone.</p> + +<p><i>Treatment.</i>—Since a diversity of opinion exists as to what measures +must be adopted for the radical cure of corns, the author will advise +the use of those which have proved most efficient in his hands.</p> + +<p>As in all other troubles, the cause must be discovered, if possible, and +removed. In the great majority of cases the shoeing is at fault. While +sudden changes in the method of shoeing are not advisable, it may be +said that all errors, either in the preparation of the foot, in the +construction of the shoe, or in its application may very properly be +corrected at any time. Circumstances may at times make it imperative +that shoes be worn which are not free from objections;<span class='pagenum'><a name="Page_424" id="Page_424">[Pg 424]</a></span> as, for +instance, the shoe with a high calk; but in such cases it is considered +that the injuries liable to result from the use of calks are less +serious than those which are sure to happen for the want of them.</p> + +<p>For a sound foot perfectly formed, a flat shoe, with heels less thick +than the toe, and which rests evenly on the wall proper, is the best. In +flat feet it is often necessary to concave the shoe as much as possible +on the upper surface, so that the sole may not be pressed upon. If the +heels are very low the heels of the shoe may be made thicker. If the +foot is very broad and the wall light toward the heels, a bar shoe +resting upon the frog will aid to prevent excessive tension upon the +soft tissues when the foot receives the weight of the body. A piece of +leather placed between the foot and shoe serves largely to destroy +concussion, and its use is absolutely necessary on some animals to +enable them to work.</p> + +<p>Last among the preventive measures may be mentioned those which serve to +maintain the suppleness of the hoof. The dead horn upon the surface of +the sole not only retains moisture for a long time, but protects the +living horn beneath from the effects of evaporation; for this reason the +sole should be pared as little as possible. Stuffing the feet with +flaxseed meal, wet clay, or other like substances, or damp dirt floors +or damp bedding of tanbark, greasy hoof ointments, etc., are all means +which may be used to keep the feet from becoming too dry and hard.</p> + +<p>As to the curative measures which are to be adopted much will depend +upon the extent of the injury. If the case is one of chronic dry corn, +with but slight lameness, the foot should be poulticed for a day or two +and the discolored horn pared out, care being taken not to injure the +soft tissues. The heel on the affected side is to be lowered until all +pressure is removed and, if the patient's labor is required, the foot +must be shod with a bar shoe or with one having stiff heels. Care must +be taken to reset the shoe before the foot has grown too long, else the +shoe will no longer rest on the wall, but on the sole and bar.</p> + +<p>I believe in cutting moist corns out. If there is inflammation, cold +baths and poultices should be used; when the horn is well softened and +the fever allayed, pare out the diseased horn, lightly cauterize the +soft tissues beneath, and poultice the foot for two or three days. When +the granulations look red, dress the wound with oakum balls saturated in +a weak solution of tincture of aloes or spirits of camphor and apply a +roller bandage. Change the dressing every two or three days until a +firm, healthy layer of new horn covers the wound, when the shoe may be +put on, as in dry corn, and the patient returned to work.</p> + +<p>In suppurative corns the loosened horn must be removed, so that the pus +may freely escape. If the pus has worked a passage to the<span class='pagenum'><a name="Page_425" id="Page_425">[Pg 425]</a></span> coronary band +and escapes from an opening between the band and hoof, an opening must +be made on the sole, and cold baths made astringent with a little +sulphate of iron or copper are to be used for a day or two. When the +discharge becomes healthy, the fistulous tracts may be injected daily +with a weak solution of bichlorid of mercury, nitrate of silver, etc., +and the foot dressed as after operation for moist corns. When +complications arise, the treatment must be varied to meet the +indications; if gangrene of the lateral cartilage takes place it must be +treated as directed under the head of cartilaginous quittor; if the +velvety tissue is gangrenous, it must be cut away; if the coffin bone is +necrosed, it must be scraped, and the resulting wounds treated on +general principles. After any of the operations for corns have been +performed, in which the soft tissues have been laid bare, it is best to +protect the foot by a sole of soft leather set beneath the shoe when the +animal is returned to work. Only in rare instances are the complications +of corns so serious as to destroy the life or usefulness of the patient. +It is the wide, flat foot with low heels and thin wall which is most +liable to resist all efforts toward effecting a complete cure.</p> + + +<h4>BRUISE OF THE FROG.</h4> + +<p>When the frog is severely bruised the injury is followed by suppuration +beneath the horn, and at times by partial gangrene of the plantar +cushion.</p> + +<p><i>Causes.</i>—A bruise of the frog generally happens from stepping on a +rough stone or other hard object. It is more liable to take place when +trotting, running, or jumping than when at a slower pace. A stone wedged +in the shoe and pressing on the frog or between the sides of the frog +and the shoe, if it remains for a time, produces the same results. A cut +through the horny frog with some sharp instrument or a punctured wound +by a blunt-pointed instrument may also cause suppuration and gangrene of +the plantar cushion. Broad, flat feet with low heels and a fleshy frog +are most liable to these injuries.</p> + +<p><i>Symptoms.</i>—Lameness, severe in proportion to the extent of the bruise +and the consequent suppuration, is always an early symptom. When the +animal moves, the toe only is placed to the ground or the foot is +carried and the patient hobbles along on three legs. When he is at rest, +the foot is set forward with the toe on the ground and the leg flexed at +the fetlock joint. As soon as the pus finds its way to the surface the +lameness improves. If the frog is examined early the injured spot may +usually be found; later, if no opening exists, the pus may be discovered +working its way toward the heels. The horn is loosened from the deeper +tissues, and, if pared through, a thin, yellow, watery and offensive pus +escapes. In other cases a<span class='pagenum'><a name="Page_426" id="Page_426">[Pg 426]</a></span> ragged opening is found in the frog, leading +down to a mass of dead, sloughing tissues, which are pale green in color +if gangrene of the plantar cushion has set in. In rare cases the coffin +bone may be involved in the injury and a small portion of it may become +carious.</p> + +<p><i>Treatment.</i>—If the injury is seen at once, the foot should be placed +in a bath of cold water to prevent suppuration. If suppuration has +already set in, the horn of the frog, and of the bars and branches of +the sole, if necessary, is to be pared thin so that all possible +pressure may be removed, and the foot poulticed. When the pus has +loosened the horn, all the detached portions are to be cut away. If the +pus is discharging from an opening near the hair, the whole frog, or +one-half of it, will generally be found separated from the plantar +cushion, and is to be removed with the knife. After a few days the +gangrenous portion of the cushion will slough off from the effects of +the poultice; under rare circumstances only should the dead parts be +removed by surgical interference. When the slough is all detached, the +remaining wound is to be treated with simple stimulating dressings, such +as tincture of aloes or turpentine, oakum balls, and bandages as +directed in punctured wounds. When the lameness has subsided, and a thin +layer of new horn has covered the exposed parts, the foot may be shod. +Cover the frog with a thick pad of oakum, held in place by pieces of tin +fitted to slide under the shoe, and return to slow work. Where caries of +the coffin bone, etc., follow the injury the treatment recommended for +these complications in punctured wounds of the foot must be resorted to.</p> + + +<h4>PUNCTURED WOUNDS OF THE FOOT.</h4> + +<p>Of all the injuries to which the foot of the horse is liable, none are +more common than punctured wounds, and none are more serious than these +may be when involving the more important organs within the hoof. A nail +is the most common instrument by which the injury is inflicted, yet +wounds may happen from glass, wire, knives, sharp pieces of rock, etc.</p> + +<p>A wound of the foot is more serious when made by a blunt-pointed +instrument than when the point is sharp, and the nearer the injury is to +the center of the foot the more liable are disastrous results to follow. +Wounds in the heel and in the posterior parts of the frog are attended +with but little danger, unless they are so deep as to injure the lateral +cartilages, when quittor may follow. Punctured wounds of the anterior +parts of the sole are more dangerous, for the reason that the coffin +bone may be injured, and the suppuration, even when the wound is not +deep, tends to spread and always gives rise to intense suffering. The +most serious of the punctured wounds are those which happen to the +center of the foot, and which, in proportion to<span class='pagenum'><a name="Page_427" id="Page_427">[Pg 427]</a></span> their depth, involve +the plantar cushion, the plantar aponeurosis, the sesamoid sheath, the +navicular bone, or the coffin joint.</p> + +<p>Punctured wounds are more liable to be deep in flat or convex feet than +in well-made feet, and as a rule, recovery is neither so rapid nor so +certain. These wounds are less serious in animals used for heavy draft +than in those required to do faster work; for the former may be useful, +even if complete recovery is not effected. Lastly, punctured wounds of +the fore feet are more serious than of the hind feet, for the reason +that in the former the instrument is liable to enter the foot in a +nearly perpendicular line, and, consequently, is more liable to injure +the deeper structures of the foot; in the hind foot, the injury is +generally near the heels and the wound oblique and less deep.</p> + +<p><i>Symptoms.</i>—A nail or other sharp instrument may penetrate the frog and +remain for several days without causing lameness; in fact, in many cases +of punctured wound of the frog the first evidence of the injury is the +finding of the nail or the appearance of an opening where the skin and +frog unite, from which more or less pus escapes. Even when the sole is +perforated, if the injury is not too deep, no lameness develops until +suppuration is established. In all cases of foot lameness, especially if +the cause is obscure, the foot should be examined for evidence of +injury.</p> + +<p>The lameness from punctured wounds, accompanied with suppuration, is +generally severe, the patient often refusing to use the affected member +at all. The pain being lancinating in character, he stands with the +injured foot at rest or constantly moves it back and forth. In other +cases the patient lies down most of the time with the feet outstretched; +the breathing is rapid, the pulse fast, the temperature elevated, and +the body covered with patches of sweat.</p> + +<p>When the plantar aponeurosis is injured, the pus escapes with difficulty +and the wound shows no signs of healing; the whole foot is hot and very +painful. If the puncture involves the sesamoid sheath, the synovial +fluid escapes. At first this fluid is pure, like joint water, but later +becomes mixed with the products of suppuration and loses its clear, +amber color. Suppuration generally extends up the course of the flexor +tendon, an abscess forms in the hollow of the heel, and finally opens +somewhere below the fetlock joint. The whole coronet is more or less +swollen, the discharge is profuse and often mixed with blood, yet the +suffering is greatly relieved from the moment the abscess opens.</p> + +<p>If the puncture reaches the navicular bone the lameness is intense from +the beginning; but the only certain way to determine the existence of +this complication is by the use of the probe; and unless there is a free +escape of synovia it must be used with the greatest of care, else the +coffin joint may be opened.<span class='pagenum'><a name="Page_428" id="Page_428">[Pg 428]</a></span> If the coffin joint has been penetrated, +either by the offending instrument or by the process of suppuration, +acute inflammation of the joint follows, accompanied with high fever, +loss of appetite, etc. The ankle and coronet are now greatly swollen, +and dropsy of the leg to the knee or hock, or even to the body, often +follows. If the process of suppuration continues, small abscesses appear +at intervals on different parts of the coronet, the patient rapidly +loses flesh, and may die from intense suffering and blood poisoning. In +other cases the suppuration soon disappears, and recovery is effected by +the joint becoming stiff (anchylosis).</p> + +<p>When the wound is forward, near the toe, and deep enough to injure the +coffin bone, caries always results. The presence of the dead pieces of +bone can be determined by the use of the probe; the bone feels rough and +gritty. Furthermore, there is no disposition upon the part of the wound +to heal.</p> + +<p>Besides the complications above mentioned, others equally as serious may +be met with. The tendons may soften and rupture, the hoof may slough +off, quittors develop, or sidebones and ringbones grow. Finally, +laminatis of the opposite foot may happen if the patient persists in +standing, or lockjaw may cause early death.</p> + +<p><i>Treatment.</i>—In all cases the horn around the seat of injury should be +thinned down, a free opening made for the escape of the products of +suppuration, and the foot placed in a poultice. If the injury is not +serious, recovery takes place in a few days. When the wound is deeper it +is better to put the foot into a cold bath or under a stream of cold +water, as advised in the treatment for quittor.</p> + +<p>If the bone is injured, cold baths, containing about 2 ounces each of +sulphate of copper and sulphate of iron, may be used until the dead bone +is well softened, when it should be removed by an operation. The animal +must be cast for this operation. The sole is pared away until the +diseased bone is exposed, when all the dead particles are to be removed +with a drawing knife, and the wound dressed with 3 per cent compound +cresol solution or a 5 per cent solution of carbolic acid, oakum balls, +and a roller bandage.</p> + +<p>Wounds of the bone which are made by a blunt-pointed instrument, like +the square-pointed cut nail, in which a portion of the surface is driven +into the deeper parts of the bone, always progress slowly, and should be +operated upon as soon as the conditions are favorable. Even wounds of +the navicular bone, accompanied with caries, may be operated on and the +life of the patient saved; but the most skillful surgery is required and +only the experienced operator should undertake their treatment.</p> + +<p>If there is an escape of pure synovial fluid from a wound of the sole, +without injury to the bone, a small pencil of corrosive sublimate<span class='pagenum'><a name="Page_429" id="Page_429">[Pg 429]</a></span> +should be introduced to the bottom of the wound and the foot dressed as +directed above.</p> + +<p>The other complications are to be treated as directed under their proper +headings.</p> + +<p>After healing of the wounds has been effected, lameness, with more or +less swelling of the coronary region, may remain. In such cases the +coronet should be blistered or even fired with the actual cautery, and +the patient turned to pasture. If the lameness still persists, and is +not due to a stiff joint, unnerving may be resorted to in many cases +with very good results. If the joint is anchylosed, no treatment can +relieve it, and the patient must either be put to very slow work or kept +for breeding purposes only.</p> + +<p>"<i>Prick in shoeing</i>" is an injury which should be considered under the +head of punctured wounds of the foot. The nails by which the shoe is +fastened to the hoof may produce an injury followed by inflammation and +suppuration in two days, by penetrating the soft tissues directly or by +being driven so deep that the inner layers of the horn of the wall are +pressed against the soft tissues with such force as to crush them. In +either case, unless the injury is at the toe, the animal generally goes +lame soon after shoeing, when the first evidence of the trouble may be +the discharge of pus at the coronet. If lameness follows close upon the +setting of the shoes, without other appreciable cause, each nail should +be lightly struck with a hammer, when the one at fault will be detected +by the flinching of the animal.</p> + +<p>Treatment consists in drawing the nail, and if the soft tissues have +been penetrated or suppuration has commenced, the horn must be pared +away until the diseased parts are exposed. The foot is now to be +poulticed for a day or two, or until the lameness and suppuration have +ceased. If the discharge of pus from the coronet is the first evidence +of the disease, the offending nail must be found and removed, the horn +pared out, and a weak solution of carbolic acid or compound cresol +injected at the coronet until the fistulous tract has healed.</p> + + +<h4>CONTRACTED HEELS, OR HOOFBOUND.</h4> + +<p>Contracted heels, or hoofbound, is a common disease among horses kept on +hard floor in dry stables, and in such as are subject to much saddle +work. It consists in an atrophy, or shrinking, of the tissues of the +foot, whereby the lateral diameter of the heels is diminished. It +affects the fore feet principally; but it is seen occasionally in the +hind feet, where it is of less importance, for the reason that the hind +foot first strikes the ground with the toe, and consequently less +expansion of the heels is necessary than in the fore feet, where the +weight is first received on the heels. Any interference with the +expansibility of this part of the foot interferes with locomotion and +ultimately<span class='pagenum'><a name="Page_430" id="Page_430">[Pg 430]</a></span> gives rise to lameness. Usually but one foot is affected at +a time, but when both are diseased the change is greater in one than in +the other. Occasionally but one heel, and that the inner one, is +contracted; in these cases there is less liable to be lameness and +permanent impairment of the animal's usefulness. According to the +opinion of some of the French veterinarians, hoofbound should be divided +into two classes—total contraction, in which the whole foot is shrunken +in size, and contraction of the heels, when the trouble extends only +from the quarters backward. (Pl. XXXV, figs. 4 and 7.)</p> + +<p><i>Causes.</i>—Animals raised in wet or marshy districts, when taken to +towns and kept on dry floors, are liable to have contracted heels, not +alone because the horn becomes dry, but because fever of the feet and +wasting away of the soft tissues result from the change. Another common +cause of contracted heels is to be found in faulty shoeing, such as +rasping the wall, cutting away the frog, heels, and bars; high calks and +the use of nails too near the heels. Contracted heels may happen as one +of the results of other diseases of the foot; for instance, it often +accompanies thrush, sidebones, ringbones, canker, navicular disease, +corns, sprains of the flexor tendons, of the sesamoid and suspensory +ligaments, and from excessive knuckling of the fetlock joint.</p> + +<p><i>Symptoms.</i>—In contraction of the heels the foot has lost its circular +shape, and the walls from the quarters backward approach to a straight +line. The ground surface of the foot is now smaller than the coronary +circumference; the frog is pinched between the inclosing heels, is much +shrunken, and at times is affected with thrush. The sole is more concave +than natural, the heels are higher, and the bars are long and nearly +perpendicular. The whole hoof is dry and so hard that it can scarcely be +cut; the parts toward the heels are scaly and often ridged like the +horns of a ram, while fissures, more or less deep, may be seen at the +quarters and heels following the direction of the horn fibers. (Plate +XXXVI, fig. 10.) When the disease is well advanced lameness is present, +while in the earlier stages there is only an uneasiness evinced by +frequent shifting of the affected foot. Stumbling is common, especially +on hard or rough roads. In most cases the animal comes out of the stable +stiff and inclined to walk on the toe, but after exercise he may go free +again. He wears his shoes off at the toe in a short time, no matter +whether he works or remains in the stable. If the shoe is removed and +the foot pared in old cases, a dry, mealy horn will be found where the +sole and wall unite, extending upward in a narrow line toward the +quarters.</p> + +<p><i>Treatment.</i>—First of all, the preventive measures must be considered. +The feet are to be kept moist and the horn from drying out by the use of +damp sawdust or other bedding; by occasional poultices of boiled +turnips, linseed meal, etc., and greasy hoof ointments to the sole and +walls of the feet. The wall of the foot should be spared<span class='pagenum'><a name="Page_431" id="Page_431">[Pg 431]</a></span> from the abuse +of the rasp; the frog, heels, and bars are not to be mutilated with the +knife, nor should calks be used on the shoe except when absolutely +necessary. The shoes should be reset at least once a month to prevent +the feet from becoming too long, and daily exercise must be insisted on.</p> + +<p>As to curative measures, a diversity of opinion exists. A number of +kinds of special shoes have been invented, having for an object the +spreading of the heels, and perhaps any of these, if properly used, +would eventually effect the desired result. But a serious objection to +most of these shoes is that they are expensive and often difficult to +make and apply. The method of treatment which I have adopted is not only +attended with good results, but is inexpensive, if the loss of the +patient's services for a time is not considered a part of the question. +It consists, first, in the use of poultices or baths of cold water until +the horn is thoroughly softened. The foot is now prepared for the shoe +in the usual way, except that the heels are lowered a little and the +frog remains untouched. A shoe, called a "tip," is made by cutting off +both branches at the center of the foot and drawing the ends down to an +edge. The tapering of the branches should begin at the toe, and the shoe +should be of the usual width, with both the upper and lower surfaces +flat. This tip is to be fastened on with six or eight small nails, all +set well forward, two being in the toe. With a common foot rasp begin at +the heels, close to the coronet, and cut away the horn of the wall until +only a thin layer covers the soft tissues beneath. Cut forward until the +new surface meets the old 2-1/2 or 3 inches from the heel. The same +sloping shape is to be observed in cutting downward toward the bottom of +the foot, at which point the wall is to retain its normal thickness. The +foot is now blistered all round the coronet with Spanish-fly ointment; +when this is well set, the patient is to be turned to pasture in a damp +field or meadow. The blister should be repeated in three or four weeks, +and, as a rule, the patient can be returned to work in two or three +months.</p> + +<p>The object of the tip is to throw the weight on the frog and heels, +which are readily spread after the horn has been cut away on the sides +of the wall. The internal structures of the foot at the heels, being +relieved of excessive pressure, regain their normal condition if the +disease is not of too long standing. The blister tends to relieve any +inflammation which may be present, and stimulates a rapid growth of +healthy horn, which, in most cases, ultimately forms a wide and normal +heel. In old, chronic cases, with a shrunken frog and increased +concavity of the sole, accompanied with excessive wasting of all the +internal tissues of the foot, satisfactory results can not be expected +and are rarely obtained. Still, much relief, if not an entire cure, may +be effected by these measures.<span class='pagenum'><a name="Page_432" id="Page_432">[Pg 432]</a></span></p> + +<p>When thrush is present as a complication, its cure must be sought by +measures directed under that heading. If sidebones, ringbones, navicular +disease, contracted tendons, or other diseases have been the cause of +contracted heels, treatment will be useless until the cause is removed.</p> + + +<h4>SAND CRACKS.</h4> + +<p>A sand crank is a fissure in the horn of the wall of the foot. These +fissures are quite narrow, and, as a general rule, they follow the +direction of the horny fibers. They may occur on any part of the wall, +but ordinarily are only seen directly in front, when they are called toe +cracks; or on the lateral parts of the walls, when they are known as +quarter cracks. (Plate XXXVI.)</p> + +<p>Toe cracks are most common in the hind feet, while quarter cracks nearly +always affect the fore feet. The inside quarter is more liable to the +injury than the outside, for the reason that this quarter is not only +the thinner, but during locomotion receives a greater part of the weight +of the body. A sand crack may be superficial, involving only the outer +parts of the wall, or it may be deep, involving the whole thickness of +the wall and the soft tissues beneath.</p> + +<p>The toe crack is most likely to be complete—that is, extending from the +coronary band to the sole—while the quarter crack is nearly always +incomplete, at least when of comparatively recent origin. Sand cracks +are most serious when they involve the coronary band in the injury. They +may be complicated at any time by hemorrhage, inflammation of the +laminæ, suppuration, gangrene of the lateral cartilage and of the +extensor tendon, caries of the coffin bone, or the growth of a horny +tumor known as a keraphyllocele.</p> + +<p><i>Causes.</i>—Relative dryness of the horn is the principal predisposing +cause of sand cracks. Excessive dryness is perhaps not a more prolific +cause of cracks in the horn than alternate changes from damp to dry. It +is even claimed that these injuries are more common in animals working +on wet roads than those working on roads that are rough and dry; at +least these injuries are not common in mountainous countries. Animals +used to running at pasture when transferred to stables with hard, dry +floors are more liable to quarter cracks than those accustomed to +stables. Small feet, with thick, hard hoofs, and feet which are +excessively large, are more susceptible to sand cracks than those of +better proportion. A predisposition to quarter cracks exists in +contracted feet, and in those where the toe turns out or the inside +quarter turns under.</p> + +<p>Heavy shoes, large nails, and nails set too far back toward the heels, +together with such diseases as canker, quittor, grease, and suppurative +corns, must be included as occasional predisposing causes of sand +cracks.</p> + +<p><a name="PLATE_XXXVI" id="PLATE_XXXVI"></a></p> +<div class="figcenter" style="width: 266px;"> +<a href="images/plate36.jpg"><img src="images/plate36t.jpg" width="266" height="450" alt="PLATE XXXVI." title="" /></a> +<span class="caption">PLATE XXXVI.<br /> + +QUARTER-CRACK AND REMEDIES.</span> +</div> + +<p><a name="PLATE_XXXVII" id="PLATE_XXXVII"></a></p> +<div class="figcenter" style="width: 450px;"> +<a href="images/plate37.jpg"><img src="images/plate37t.jpg" width="450" height="269" alt="PLATE XXXVII." title="" /></a> +<span class="caption">PLATE XXXVII.<br /> + +FOUNDERED FEET.</span> +</div> + +<p><span class='pagenum'><a name="Page_433" id="Page_433">[Pg 433]</a></span>Fast work on hard roads, jumping, and blows on the coronet, together +with calk wounds of the feet, are accidental causes of quarter cracks in +particular. Toe cracks are more likely to be caused by heavy pulling on +slippery roads and pavements or on steep hills.</p> + +<p><i>Symptoms.</i>—The fissure in the horn is ofttimes the only evidence of +the disease; even this may be accidentally or purposely hidden from +casual view by mud, ointments, tar, wax, putty, gutta-percha, or by the +long hairs of the coronet.</p> + +<p>Sand cracks sometimes commence on the internal face of the wall, +involving its whole thickness excepting a thin layer on the outer +surface. In these cases the existence of the injury may be suspected +from a slight depression, which begins near the coronary band and +follows the direction of the horny fibers; but the trouble can only be +positively diagnosed by paring away the outside layers of horn until the +fissure is exposed. In toe cracks the walls of the fissure are in close +apposition when the foot receives the weight of the body, but when the +foot is raised from the ground the fissure opens. In quarter crack the +opposition is true; the fissure closes when the weight is removed from +the foot. As a rule, sand cracks begin at the coronary band, and as they +become older they not only extend downward, but they also grow deeper. +In old cases, particularly in toe cracks, the horn on the borders of the +fissure loses its vitality and scales off, sometimes through the greater +part of its thickness, leaving behind a rough and irregular channel +extending from the coronet to the end of the toe.</p> + +<p>In many cases of quarter crack, and in some cases of toe crack as well, +if the edges remain close together, with but little motion, the fissure +is dry; but in other cases a thin, offensive discharge issues from the +crack and the ulcerated soft tissues, or a funguslike growth protrudes +from the narrow opening.</p> + +<p>When the cracks are deep and the motion of their edges considerable, so +that the soft tissues are bruised and pinched with every movement, a +constant inflammation of the parts is maintained and the lameness is +severe.</p> + +<p>Ordinarily the lameness of sand crack is slight when the patient walks, +but it is greatly aggravated when he is made to trot, and the harder the +road the worse he limps. Furthermore, the lameness is greater going +downhill than up, for the reason that these conditions are favorable to +an increased motion in the edges of the fissure. Lastly, more or less +hemorrhage accompanies the inception of a sand crack when the whole +thickness of the wall is involved. Subsequent hemorrhages may also take +place from fast work, jumping, or a misstep.<span class='pagenum'><a name="Page_434" id="Page_434">[Pg 434]</a></span></p> + +<p><i>Treatment.</i>—So far as preventive measures are concerned, but little +can be done. The suppleness of the horn is to be maintained by the use +of ointments, damp floor, bedding, etc. The shoe is to be proportioned +to the weight and work of the animal; the nails holding it in place are +to be of proper size and not driven too near the heels; sufficient calks +and toe pieces must be added to the shoes of horses working on slippery +roads; also, the evils of jumping, fast driving, etc., are to be +avoided.</p> + +<p>When a fissure has made its appearance, means are to be adopted which +will prevent it from growing longer or deeper; this can only be done by +arresting all motion in the edges. The best and simplest artificial +appliance for holding the borders of a toe crack together is the +Vachette clasp. These clasps and the instruments necessary for their +application can be had of any prominent maker of veterinary instruments. +(Pl. XXXVI.) These instruments comprise a cautery iron, with which two +notches are burned in the wall, one on each side of the crack, and +forceps with which the clasps are closed into place in the bottom of the +notches and the edges of the fissure brought close together. The clasps, +being made of stiff steel wire, are strong enough to prevent all motion +in the borders of the crack. Before these clasps are applied the fissure +should be thoroughly cleansed and dried, and if the injury is of recent +origin the crack may be filled with a putty made of 2 parts of +gutta-percha and 1 part of gum ammoniac. The number of clasps to be used +is to be determined by the length of the crack, the amount of motion to +be arrested, etc. Generally the clasps are from one-half to +three-quarters of an inch apart. The clasps answer equally as well in +quarter crack if the wall is sufficiently thick and not too dry and +brittle to withstand the strain.</p> + +<p>In the absence of these instruments and clasps a hole may be drilled +through the horn across the fissure and the crack closed with a thin +nail made of tough iron, neatly clinched at both ends. A plate of steel +or brass is sometimes fitted to the parts and fastened on with short +screws; while this appliance may prevent much gaping of the fissure, it +does not entirely arrest motion of the edges, for the reason that the +plate and screw can not be rendered immobile.</p> + +<p>If, for any reason, the measures above fail or can not be used, recourse +must be had to an operation. The horn is softened by the use of warm +baths and poultices, the patient cast, and the walls of the fissure +entirely removed with the knife. The horn removed is in the shape of the +letter V, with the base at the coronet. Care must be taken not to injure +the coronary band and the laminæ. The wound is to be treated with mild +stimulant dressings, such as compound cresol solution, a weak solution +of carbolic acid, tincture of aloes, etc.,<span class='pagenum'><a name="Page_435" id="Page_435">[Pg 435]</a></span> oakum balls, and a roller +bandage. After a few days the wound will be covered with a new, white +horn, and only the oakum and bandages will be needed. As the new quarter +grows out, the lameness disappears, and the patient may be shod with a +bar shoe and returned to work.</p> + +<p>In all cases of sand crack the growth of horn should be stimulated by +cauterizing the coronary band or by the use of blisters. In simple +quarter crack recovery will often take place if the coronet is +blistered, the foot shod with a "tip," and the patient turned to +pasture.</p> + +<p>The shoe in toe crack should have a clip on each side of the fissure and +should be thicker at the toe than at the heels. The foot should be +lowered at the heels by paring, and spared at the toe, except directly +under the fissure, where it is to be pared away until it sets free from +the shoe.</p> + +<p>When any of the complications referred to above arise, special measures +must be resorted to. For the proper treatment of gangrene of the lateral +cartilage and extensor tendon and caries of the coffin bone reference +may be had to the articles on quittors. If the horny tumor, known as +keraphyllocele, should develop, it is to be removed by the use of the +knife. Since this tumor develops on the inside of the horny box and may +involve other important organs of the foot in disease, its removal +should only be undertaken by a skillful surgeon.</p> + + +<h4>NAVICULAR DISEASE.</h4> + +<p>Navicular disease is an inflammation of the sesamoid sheath, induced by +repeated bruising or laceration, and complicated in many cases by +inflammation and caries of the navicular bone. In some instances the +disease undoubtedly begins in the bone, and the sesamoid sheath becomes +involved subsequently by an extension of the inflammatory process. +(Plate XXXIV, fig. 5.)</p> + +<p>The Thoroughbred horse is more commonly affected than any other, yet no +class or breed of horses is entirely exempt. The mule, however, seems +rarely, if ever, to suffer from it. For reasons which will appear when +considering the causes of the disease, the hind feet are not liable to +be affected. Usually but one fore foot suffers from the disease, but if +both should be attacked the trouble has become chronic in the first +before the second shows signs of the disease.</p> + +<p><i>Causes.</i>—To comprehend fully how navicular disease may be caused by +conditions and usages common to nearly all animals, it is necessary to +recall the peculiar anatomy of the parts involved in the process and the +functions which they perform in locomotion.</p> + +<p>It must be remembered that the fore legs largely support the weight of +the body when the animal is at rest, and that the faster he moves<span class='pagenum'><a name="Page_436" id="Page_436">[Pg 436]</a></span> the +greater is the shock which the fore feet must receive as the body is +thrown forward by the propelling force of the hind legs. This shock +could not be withstood by the tissues of the fore feet and legs were it +not that it is largely dissipated by the elastic muscles which bind the +shoulder to the body, the ease with which the arm closes on the shoulder +blade, and the spring of the fetlock joint. Even these means, however, +are not sufficient within themselves to protect the foot from injury; so +nature has further supplemented them by placing the coffin joint on the +hind part of the coffin bone instead of directly on top of it, whereby a +large part of the shock of locomotion is dispersed before it can reach +the vertical column represented by the cannon, knee, and arm bones. A +still further provision is made by placing a soft, elastic pad—the frog +and plantar cushion—at the heels to receive the sesamoid expansion of +the flexor tendon as it is forced downward by the pressure of the +coronet bone against the navicular. Extraordinary as these means may +appear for the destruction of shock, and ample as they are when the +animal is at a slow pace or unweighted by rider or load, they fail to +relieve the parts completely from concussion and excessive pressure +whenever the opposite conditions are present. The result, then, is that +the coronet bone forces the navicular hard against the flexor tendon, +which, in turn, presses firmly against the navicular as the force of the +contracting muscles lifts the tendon into place. It is self-evident, +then, that the more rapid the pace and the greater the load, the greater +must these contending forces be, and the greater the liability to +injury. For the same reason horses with excessive knee action are more +liable to suffer from this disease than others, concussion of the foot +and intense pressure on the tendon being common among such horses.</p> + +<p>Besides the above-mentioned exciting causes must be considered those +which predispose to the disease. Most prominent among these is heredity. +It may be claimed, however, that an inherited predisposition to +navicular disease consists not so much in a special susceptibility of +the tissues which are involved in the process as in a vice of +conformation which, as is well known, is liable to be transmitted from +parent to offspring. The faults of conformation most likely to be +followed by the development of navicular disease are an insufficient +plantar cushion, a small frog, high heels, excessive knee action, and +contracted heels. Finally, the environments of domestication and use, +such as dry stables, heavy pulling, bad shoeing, punctured wounds, etc., +all have their influence in developing this disease.</p> + +<p><i>Symptoms.</i>—In the early stages of navicular disease the symptoms are +generally very obscure. When the disease begins in inflammation of the +navicular bone, the animal while at rest points the<span class='pagenum'><a name="Page_437" id="Page_437">[Pg 437]</a></span> affected foot a +time before any lameness is seen. While at work he apparently travels as +well as ever, but when placed in the stable one foot is set out in front +of the other, resting on the toe, with fetlock and knee flexed. After a +time, if the case is closely watched, the animal takes a few lame steps +while at work, but the lameness disappears as suddenly as it came, and +the driver doubts whether the animal was really lame at all. Later the +patient has a lame spell which may last during a greater part of the +day, but the next morning it is gone; he leaves the stable all right, +but goes lame again during the day. In times he has a severe attack of +lameness, which may last for a week or more, when a remission takes +place and it may be weeks or months before another attack supervenes. +Finally, he becomes constantly lame, and the more he is used the greater +the lameness.</p> + +<p>In the lameness from navicular disease the affected leg always takes a +short step, and the toe of the foot first strikes the ground; so the +shoe is most worn at this point. If the patient is made to move +backward, the foot is set down with exceeding great care, and the weight +rests upon the affected leg but a moment. When exercised he often +stumbles, and if the road is rough he may fall on his knees. If he is +lame in both feet the gait is stilty, the shoulders seem stiff, and, if +made to work, he sweats profusely from intense pain. Early in the +development of the disease a careful examination will reveal some +increased heat in the heels and frog, particularly after work; as the +disease progresses this becomes more marked, until the whole foot is hot +to the touch. At the same time there is an increased sensibility of the +foot, for the patient flinches from the percussion of a hammer lightly +applied to the frog and heels or from the pressure of the smith's +pincers. The frog is generally shrunken, often of a pale-red color, and +at times is affected with thrush. If the heels are pared away so that +all the weight is received on the frog, or if the same result is +attained by the application of a bar shoe, the animal is excessively +lame. The muscles of the leg and shoulder shrink away and often tremble +as the animal stands at rest. After months of lameness the foot is found +to be shrunken in its diameter and apparently lengthened; the horn is +dry and brittle and has lost its natural gloss, while circular ridges, +developed most toward the heels, cover the upper part of the hoof. When +both feet are affected the animal points first one foot then the other, +and stands with the hind feet well forward beneath the body, so as to +relieve the fore feet as much as possible from bearing weight. In old +cases the wasting of the muscles and the knuckling at the fetlock become +so great that the leg can not be straightened and locomotion can +scarcely be performed. The disease generally makes<span class='pagenum'><a name="Page_438" id="Page_438">[Pg 438]</a></span> a steady progress +without inclining to recovery—the remission of symptoms in the earlier +stages should not be interpreted as evidence that the process has +terminated. The complications usually seen are ringbones, sidebones, +thrush, contracted heels, quartercracks, and fractures of the navicular, +coronet, and pastern bones.</p> + +<p><i>Treatment.</i>—But few cases of navicular disease recover. In the early +stages the wall of the heels should be rasped away, as directed in the +treatment for contracted heels, until the horn is quite thin; the +coronet should be well blistered with Spanish-fly ointment, and the +patient turned to grass in a damp field or meadow. After three or four +weeks the blister should be repeated. This treatment is to be continued +for two or three months. Plane shoes are to be put on when the patient +is returned to work. In chronic cases the animal should be put to slow, +easy work. To relieve the pain, neurotomy may be performed—an operation +in which the sense of feeling is destroyed in the foot by cutting out +pieces of the nerve at the fetlock. This operation in nowise cures the +disease, and, since it may be attended with serious results, can be +advised only in certain favorable cases, to be determined by the +veterinarian.</p> + + +<h4>SIDEBONES.</h4> + +<p>A sidebone consists in a transformation of the lateral cartilages found +on the wings of the coffin bone into bony matter by the deposition of +lime salts. The disease is a common one, especially in heavy horses used +for draft, in cavalry horses, cow ponies, and other saddle horses, and +in runners and trotters.</p> + +<p>Sidebones are peculiar to the fore feet, yet they occasionally develop +in the hind feet, where they are of little importance since they cause +no lameness. In many instances sidebones are of slow growth and, being +unaccompanied with acute inflammation, they cause no lameness until such +time as, by reason of their size, they interfere with the action of the +joint. (Plate XXXIV, fig. 4.)</p> + +<p><i>Causes.</i>—Sidebones often grow in heavy horses without any apparent +injury, and their development has been attributed to the over-expansion +of the cartilages caused by the great weight of the animal. Blows and +other injuries to the cartilages may set up an inflammatory process +which ends in the formation of these bony growths. High-heeled shoes, +high calks, and long feet are always classed among the conditions which +may excite the growth of sidebones. They are often seen in connection +with contracted heels, ringbones, navicular disease, punctured wounds of +the foot, quarter cracks, and occasionally as a sequel to founder.</p> + +<p><i>Symptoms.</i>—In the earlier stages of the disease, if inflammation is +present, the only evidence of the trouble to be detected is a little +fever over the seat of the affected cartilage and a slight lameness. In +the<span class='pagenum'><a name="Page_439" id="Page_439">[Pg 439]</a></span> lameness of sidebones the toe of the foot first strikes the ground +and the step is shorter than natural. The subject comes out of the +stable stiff and sore, but the gait is more free after exercise.</p> + +<p>Since the deposit of bony matter often begins in that part of the +cartilage where it is attached to the coffin bone, the diseased process +may exist for some time before the bony growth can be seen or felt. +Later, however, the cartilage can be felt to have lost its elastic +character, and by standing in front of the animal a prominence of the +coronary region at the quarters can be seen. Occasionally these bones +become so large as to bulge the hoof outward, and by pressing on the +joint they so interfere with locomotion that the animal becomes entirely +useless.</p> + +<p><i>Treatment.</i>—So soon as the disease can be diagnosed active treatment +should be adopted. Cold-water bandages are to be used for a few days to +relieve the fever and soreness.</p> + +<p>The improvement consequent on the use of these simple measures often +leads to the belief that the disease has recovered; but with a return to +work the lameness, fever, etc., reappears. For this reason the use of +blisters, or, better still, the firing iron, should follow on the +discontinuance of the cold bandages.</p> + +<p>But in many instances no treatment will arrest the growth of these bony +tumors, and as a palliative measure neurotomy must be resorted to. +Generally this operation will so relieve the pain of locomotion that the +patient may be used for slow work; but in animals used for fast driving +or for saddle purposes, the operation is practically useless. Some years +ago at Fort Leavenworth I unnerved a number of cavalry horses that were +suffering from sidebones, and the records show that in less than seven +months all were more lame than ever. Since a predisposition to develop +sidebones may be inherited, animals suffering from this disease should +not be used for breeding purposes unless the trouble is known to have +originated from an accident.</p> + + +<h4>RINGBONE.</h4> + +<p>A ringbone is the growth of a bony tumor on the ankle. This tumor is, in +fact, not the disease, but simply the result of an inflammatory action +set up in the periosteum and bone tissue proper of the pastern bones. +(Plate XXXIV, fig. 1.) (See also p. 313.)</p> + +<p><i>Causes.</i>—Injuries, such as blows, sprains, overwork in young, +undeveloped animals, fast work on hard roads, jumping, etc., are among +the principal exciting causes of ringbone. Horses most disposed to this +disease are those with short, upright pasterns, for the reason that the +shock of locomotion is but imperfectly dissipated in the fore legs of +these animals. Improper shoeing, such as the use of high calks, a too +great shortening of the toe and correspondingly high heels, predispose +to this disease by increasing the concussion to the feet.<span class='pagenum'><a name="Page_440" id="Page_440">[Pg 440]</a></span></p> + +<p><i>Symptoms.</i>—The first symptom of an actively developed ringbone is the +appearance of a lameness more or less acute. If the bony tumor forms on +the side or upper parts of the large pastern, its growth is generally +unattended with acute inflammatory action, and consequently produces no +lameness or evident fever. These are called "false" ringbones. But when +the tumors form on the whole circumference of the ankle, or simply in +front under the extensor tendon, or behind under the flexor tendons, or +if they involve the joints between the two pastern bones, or between the +small pastern and the coffin bone, the lameness is always severe. These +constitute the true ringbone. Besides lameness, the ankle of the +affected limb presents more or less heat, and in many instances a rather +firm, though limited, swelling of the deeper tissues over the seat of +the inflammatory process. The lameness of ringbone is characteristic in +that the heel is first placed on the ground when the disease is in a +fore leg, and the ankle is kept as rigid as possible. In the hind leg, +however, the toe strikes the ground first, when the ringbone is high on +the ankle, just as in health, but the ankle is maintained in a rigid +position. If the bony growth is under the front tendon of the hind leg, +or if it involves the coffin joint, the heel is brought to the ground +first. In the early stages of the disease it is not always easy to +diagnose ringbone, but when the deposits have reached some size they can +be felt and seen as well.</p> + +<p>The importance of a ringbone depends on its seat and often on its size. +If it interferes with the joints or with the tendons it may cause an +incurable lameness, even though small. If it is on the sides of the +large pastern, the lameness generally disappears as soon as the tumor +has reached its growth and the inflammation subsides. Even when the +pastern joint is involved, if complete anchylosis results, the patient +may recover from the lameness with simply an imperfect action of the +foot remaining, due to the stiff joint.</p> + +<p><i>Treatment.</i>—Before the bony growth has commenced the inflammatory +process may be cut short by the use of cold baths and wet bandages, +followed by one or more blisters. If the bony deposits have begun, the +firing iron should always be used. Even when the tumors are large and +the pastern joint involved, firing often hastens the process of +anchylosis and should always be tried.</p> + +<p>When the lower joint is involved, or if the tumor interferes with the +action of the tendons, recovery is not to be expected. In many of these +latter cases, however, the animal may be made serviceable by proper +shoeing. If the patient walks with the toe on the ground, the foot +should be shod with a high-heeled shoe and a short toe. On the other +hand, if he walks on the heel, a thick-toed and thin-heeled shoe must be +worn.<span class='pagenum'><a name="Page_441" id="Page_441">[Pg 441]</a></span></p> + +<p>Since ringbone is considered to be one of the hereditary diseases, no +animal suffering from this trouble should ever be used for breeding +purposes.</p> + + +<h4>LAMINITIS, OR FOUNDER.</h4> + +<p>Laminitis is a simple inflammation of the sensitive laminæ of the feet, +characterized by the general phenomena attending inflammation of the +skin and mucous membranes, producing no constitutional disturbances +except those dependent upon the local disease, and having a strong +tendency, in severe cases, to destructive disorganization of the tissues +affected.</p> + +<p><i>Causes.</i>—The causes of laminitis are as wide and variable as in any of +the local inflammations, and may be divided into two classes—the +predisposing and the exciting.</p> + +<p><i>Predisposing causes.</i>—From personal observation I do not know that any +particular construction of foot or any special breed of horses is +predisposed to this disease, neither can I find anything to warrant the +assumption that it is in any way hereditary; so that while we may easily +cultivate a predisposition to the disease, it does not originate without +an exciting cause. Like most other tissues, a predisposition to +inflammation may be induced in the sensitive laminæ by any cause which +lessens their power of withstanding the work imposed on them. It exists +to an extent in those animals unaccustomed to work, particularly if they +are plethoric, and in all that have been previous subjects of the +disease, for the same rule holds good here that we find in so many +diseases—i. e., that one attack impairs the functional activity of the +affected tissues and renders them more easy of a subsequent +inflammation. Unusual excitement by determining an excessive blood +supply, bad shoeing, careless paring of the feet by removing the sole +support, and high calkings without corresponding toe pieces must be +included under this head.</p> + +<p><i>Exciting causes.</i>—The exciting causes of laminitis are many and +varied. The most common are concussion, overexertion, exhaustion, rapid +changes of temperature, ingestion of certain feeds, purgatives, and the +oft-mentioned metastasis.</p> + +<p>(1) Concussion produces this disease by local overstimulation. The +excessive excitement is followed by an almost complete exhaustion of the +functional activity of the laminated tissues, the exhaustion by +congestion, and eventually by inflammation. But congestion here, as in +all other tissues, is not necessarily followed by inflammation; for, +although the principal symptoms belonging to true laminitis are present, +the congestion may be relieved before the processes of inflammation are +fully established. This is the condition in the many so-called cases of +laminitis which recover in from 24 to 48 hours. They should be called +congestion of the laminæ.<span class='pagenum'><a name="Page_442" id="Page_442">[Pg 442]</a></span></p> + +<p>Laminitis from concussion is common in trotting horses that are raced +when not in condition, especially if they carry the obnoxious toe +weights, and in green horses put to work on city pavements to which they +are unaccustomed. Concussion from long drives on dirt roads is at times +productive of the same results, notably when the weather is extremely +warm, or at least when the relative change of temperature is great. But +the exhaustion of these circumstances must prove an exciting cause as +well as the long-continued concussion. This combination of causes must +also determine the disease at times in hunters, for the weight of the +rider increases the demands made upon the function of these tissues, and +their powers are the sooner exhausted.</p> + +<p>(2) Overexertion, as heavy pulling or rapid work, even when there is no +immoderate concussion, occasionally results in this disease. Here also +exhaustion is a conjunctive cause, for overexertion can not be long +continued without exhaustion.</p> + +<p>(3) Exhaustion is nearly as prolific a source of laminitis as is +concussion, for when the physical strength is impaired, even though +temporarily, some part of the economy is rendered more vulnerable to +disease than others. To this cause we must ascribe those cases which +follow a hard day's work, in which at no time has there been +overexertion or immoderate concussion.</p> + +<p>The tendency to laminitis in horses on sea voyages results from the +continual constrained position the animal maintains on account of the +rocking motion of the vessel.</p> + +<p>If one foot has been blistered, or if one limb is incapacitated from any +cause, the opposite member, doing double duty, soon becomes exhausted, +and congestion, followed by inflammation, results. When one foot only +becomes laminitic, it is customary to find the corresponding member +participating at a later date; not always because of sympathy, but +because one foot had to do the work of two.</p> + +<p>(4) Rapid changes of temperature act as an exciting cause of laminitis +by impairing the normal blood supply.</p> + +<p>This change of temperature may be induced by drinking large quantities +of cold water while in an overheated condition. Here the internal heat +is rapidly reduced, the neighboring tissues and blood vessels +constrained, and the blood supply to these organs greatly diminished, +while the quantity sent to the surface is correspondingly increased. +True, in many cases there has not been sufficient labor performed to +impair the powers of the laminæ, and laminitis is more readily induced +than congestion or inflammation of the skin or other surface organs, +because the laminæ can not relieve themselves of threatened congestion +by the general safety valve of perspiration. A cold wind or relatively +cold air allowed to play upon the body when heated and wet with sweat +has virtually the same result, for it<span class='pagenum'><a name="Page_443" id="Page_443">[Pg 443]</a></span> arrests evaporation and rapidly +cools the external surface, thereby determining an excess of blood to +such organs and tissues as are protected from this outside influence. In +many instances this happens to be some of the internal organs, as the +lungs, if the previous work has been rapid and their functional activity +impaired; but in numerous other instances the determination is toward +the feet, and that it is so depends upon two very palpable facts: First, +that these tissues have been greatly excited and are already receiving +as much blood as they can accommodate consistently with health; second, +even though these tissues are classed with those of the surface, their +protection from atmospheric influences by means of the thick box of horn +incasing them renders them in this respect equivalent to internal +organs.</p> + +<p>A more limited local action of cold may excite this disease, by driving +through water or washing the feet and legs while the animal is warm or +just in from work. Here a very marked reaction takes place in the +surface tissues of the limbs, and passive congestion of the foot results +from an interference with the return flow of blood which is being sent +to these organs in excess. These are more liable to be simple cases of +congestion, soon to recover, yet they may become true cases of +laminitis.</p> + +<p>(5) Why it is that certain kinds of grain will cause laminitis does not +seem to be clearly understood. Certainly they possess no specific action +upon the laminæ, for all animals are not alike affected; neither do they +always produce these results in the same animal. Some of these feeds +cause a strong tendency to indigestion, and the consequent irritation of +the alimentary canal may be so great as to warrant the belief that the +laminæ are affected through sympathy. In other instances there is no +apparent interference with digestion nor evidence of any irritation of +the mucous membranes, yet the disease is in some manner dependent upon +the feed for its inception. Barley, wheat, and sometimes corn are the +grains most liable to cause this disease. With some horses there appears +to be a particular susceptibility to this influence of corn, and the use +of this grain is followed by inflammation of the feet, lasting from a +few days to two weeks. In these animals, to all appearances healthy, the +corn neither induces colic, indigestion, nor purging, and apparently no +irritation whatever of the alimentary canal.</p> + +<p>(6) Fortunately purgative medicines rarely cause inflammation of the +laminæ. That it is, then, the result of sympathetic action is no doubt +more than hypothetical, for when there is no derangement of the +alimentary canal a dose of cathartic medicine will at times bring on +severe laminitis.</p> + +<p>(7) Almost all the older authorities were agreed that metastatic +laminitis is a reality. In my opinion metastatic laminitis is nothing +more nor less than concurrent laminitis, and presents little in any<span class='pagenum'><a name="Page_444" id="Page_444">[Pg 444]</a></span> way +peculiar outside the imperfectly understood exciting cause. The +practitioner who allows the acute symptoms of the laminitis to mislead +him, simply because their severity has overshadowed those of the primary +disease, may lose his case through unguarded subsequent treatment. This +form of laminitis is by no means commonly met with. It may be found in +conjunction with pneumonia, according to Youatt with inflammation of the +bowels and eyes, and according to Law and Williams sometimes with +bronchitis.</p> + +<p><i>Symptoms.</i>—Laminitis is characterized by a congregation of symptoms so +well marked as scarcely to be misinterpreted by the most casual +observer. They are nearly constant in their manifestations, modified by +the number of feet affected, the cause which has induced the disease, +the previous condition of the patient, and the various other influences +which to some extent operate in all diseases. They may be divided into +general symptoms, which are concomitants of all cases of the disease, +subject to variations in degree only, and special symptoms, or those +which serve to determine the feet affected and the complications which +may arise.</p> + +<p><i>General symptoms.</i>—Usually, the first symptom is the interference with +locomotion. Occasionally the other symptoms are presented first. As the +lameness develops the pulse becomes accelerated, full, hard, and strikes +the finger strongly; the temperature soon rises several degrees above +the normal, reaching sometimes 106° F.; it generally ranges between +102.5° and 105° F. The respirations are rapid and panting in character, +the nostrils widely dilated, and the mucous membranes highly injected. +The facial expression is anxious and indicative of the most acute +suffering, while the body is more or less bedewed with sweat. At first +there may be a tendency to diarrhea, or it may appear later as the +result of the medicines used. The urine is high colored, scant in +quantity, and of increased specific gravity, owing to the water being +eliminated by the skin instead of the kidneys. The appetite is impaired, +sometimes entirely lost, but thirst is greatly increased. The affected +feet are hot and dry, and as much as possible are relieved from bearing +weight. Rapping them with a hammer, or compelling the animal to stand +upon one affected member, causes intense pain. The artery at the fetlock +throbs beneath the finger.</p> + +<p><i>Special symptoms.</i>—Liability to affection varies in the different feet +according to the exciting cause. Any one or more of the feet may become +the subject of this disease, although it appears more often in the fore +feet than in the hind ones. This is due to the difference of the +function, i. e., that the fore feet are the bases of the columns of +support, receiving nearly all the body weight during progression and +consequently most of the concussion, while the hind<span class='pagenum'><a name="Page_445" id="Page_445">[Pg 445]</a></span> feet become simply +the fulcra of the levers of progression, and are almost exempt from +concussion.</p> + +<p><i>One foot.</i>—Injuries and excessive functional performance are the +causes of the disease in only one foot. The general symptoms, as a rule, +are not severe, there being often no loss of appetite and no unusual +thirst, while the pulse, temperature, and respiration remain about +normal. The weight of the body is early thrown upon the opposite foot, +and the affected one is extended, repeatedly raised from the floor, and +then carefully replaced. When made to move forward the lame foot is +either carried in the air while progression is accomplished by hopping +with the healthy one, or else the heel of the first is placed upon the +ground and receives little weight while the sound limb is quickly +advanced. Progression in a straight line is more easy than turning +toward the lame side.</p> + +<p><i>Both fore feet.</i>—When both fore feet are affected the symptoms are +well marked. The lameness is excessive and the animal almost immovable. +When standing the head hangs low down, or rests upon the manger as a +means of support and to relieve the feet; the fore feet are well +extended so that the weight is thrown upon the heels, where the tissues +are least sensitive, least inflamed, and most capable of relief by free +effusion. The hind feet are brought forward beneath the body to receive +as much weight as possible, thereby relieving the diseased ones. If +progression is attempted, which rarely happens voluntarily during the +first three or four days, it is accomplished with very great pain and +lameness at the starting, which usually subsides to an extent after a +few minutes' exercise. During this exercise, if the animal happens to +step upon a small stone or other hard substance, he stumbles painfully +and is excessively lame in the offended member for a number of steps, +owing to the acute pain which pressure upon the sole causes in the +tissues beneath. The manner of the progression is pathognomonic of the +complaint. Sometimes the affected feet are simultaneously raised from +the ground (the hind ones sustaining the weight), then advanced a short +distance and carefully replaced; at almost the same moment the hind ones +are quickly shuffled forward near to the center of gravitation.</p> + +<p>In other instances one foot at a time is advanced and placed with the +heel upon the ground in the same careful manner, all causes of +concussion being carefully avoided. In attempting to back the animal he +is found to be almost stationary, simply swaying the body backward on +the haunches and elevating the toes of the diseased feet as they rest +upon their heels. In attempting to turn either to the right or left he +allows his head to be drawn to the one side to its full extent before +moving, then makes his hind feet the axis around which the forward ones +describe a shuffling circle.<span class='pagenum'><a name="Page_446" id="Page_446">[Pg 446]</a></span></p> + +<p>In most of cases of laminitis in the fore feet the animal persists in +standing until he is nearly recovered. In other cases he as persistently +lies, standing only when necessity seems to compel it, and then for as +short a time as possible. If the recumbent position is once assumed, the +relief experienced tempts the patient to seek it again; so we often find +him down a greater part of the time. But this is not true of all cases; +sometimes he will make the experiment, then cautiously guard against a +repetition. Even in cases of enforced recumbency, he ofttimes takes +advantage of the first opportunity and gets upon his feet, doggedly +remaining there until again laid upon his side. How to explain this +diversity of action I do not know; theoretically the recumbent position +is the only appropriate one, except when complications exist, and the +one which should give the most comfort, yet it is rejected by very many +patients and, no doubt, for some good reason. It has been suggested as +an explanation that when the animal gets upon his feet after lying for a +time the suffering is so greatly augmented that the memory of this +experience deters him from an attempted repetition. If this were true, +the horse with the first attack must necessarily make the experiment +before knowing the after effects of lying down, yet many remain standing +without even an attempt at gaining this experimental knowledge.</p> + +<p>The most-favored position of the animal when down is on the broadside, +with the feet and legs extended. While in this position the general +symptoms greatly subside; the respirations and pulse become almost +normal; the temperature falls and the perspiration dries. It is with +difficulty that he is made to rise. When he attempts it he gets up +rapidly and "all of a heap," as it were, shifting quickly from one to +the other foot until they become accustomed to the weight thrown upon +them. Occasionally a patient will get up like a cow, rising upon the +hind feet first. Although enforced exercise relieves the soreness to +some extent, it is but temporary, for after a few minutes' rest it +returns with all its former severity.</p> + +<p><i>Both hind feet.</i>—When only both hind feet are affected, they are, +while standing, maintained in the same position as when only the fore +ones are the subjects of the disease, but with an entirely different +object in view. Instead of being there to receive weight, they are so +advanced that the heels only may receive what little weight is +necessarily imposed on them; the fore feet at the same time are placed +well back beneath the body, where they become the main supports; the +animal standing, as Williams describes it, "all of a heap."</p> + +<p>Progression is even more difficult now than when the disease is confined +to the anterior extremities. The fore feet are dubiously advanced a +short distance and the hind ones brought forward with a sort of kangaroo +hop that results in an apparent loss of equilibrium<span class='pagenum'><a name="Page_447" id="Page_447">[Pg 447]</a></span> which the animal is +a few moments in regaining. The general symptoms, or, in other words, +the degree of suffering, seem more severe than when the disease affects +the fore feet alone. The standing position is not often maintained, the +patient seeking relief in recumbency. This fact is easily understood +when we consider how cramped and unnatural is the position he assumes +while standing and, if it were maintained for any considerable length of +time, would, no doubt, excite the disease in the fore feet, as explained +by D'Arboval.</p> + +<p><i>All four feet.</i>—Laminitis of all four feet is but uncommonly met with. +The author has seen but three such cases. In all these the position +assumed was nearly normal. All the feet were slightly advanced, and +first one, then another, momentarily raised from the ground and +carefully replaced, this action being kept up almost continually during +the time the animal remained standing. The suffering is most acute, the +appetite lost, and, although the patient lies most of the time, the +temperature remains too high. The pulse and respirations are greatly +accelerated, the body covered with sweat, and bed sores are unpleasant +accompaniments.</p> + +<p><i>Course.</i>—The course which laminitis takes varies greatly in different +cases, being influenced more or less by the exciting cause, the animal's +previous condition, the acuteness of the attack, and the subsequent +treatment. The first symptoms rarely exhibit themselves while the animal +is at his work, although we occasionally see the gait impaired by +stumbling, the body covered with a profuse sweat, and the respirations +become blowing in character as premonitions of the oncoming disease; +but, as a rule, nothing amiss with the animal is noted until he has +stood for some time after coming in from work, when, in attempting to +move him, he is found very stiff. Like all congestions, the early +symptoms usually develop rapidly; yet this is not always the case, for +often there appears to be no well-defined period of congestion, the +disease seemingly commencing at a point and gradually spreading until a +large territory is involved in the morbid process.</p> + +<p><i>Simple congestion.</i>—Those cases of simple congestion of the laminæ, +which we erroneously call laminitis, are rapidly developed, the symptoms +are but moderately severe, and but one to three days are required for +recovery. There are no structural changes and but a moderate exudate. +This is rapidly reabsorbed, leaving the parts in the same condition as +they were previous to the attack. If the congestion has been excessive, +a rupture of some of the capillaries will be found, a condition more +liable to exist if the animal is made to continue work after a +development of symptoms has begun.</p> + +<p>True, the majority of these last-described cases prove to be the +laminitis in fact, yet the congestion may pass away and the extravasated +blood be absorbed without inflammation sufficient to warrant<span class='pagenum'><a name="Page_448" id="Page_448">[Pg 448]</a></span> calling it +laminitis. The seat of greatest congestion will always be found in the +neighborhood of the toe, because of the increased vascularity of that +part, and, although at times it is limited to the podophyllous tissue +alone, any or all parts of the keratogenous membrane may be affected by +the congestion and followed finally by inflammation.</p> + +<p><i>Acute.</i>—In the acute form of laminitis the symptoms may all develop +rapidly, or it may commence by the appearance of a little soreness of +the feet which in 24 or 48 hours develops into a well-marked case. This +peculiarity of development is due to one of two causes. Either the +congestion is general, but takes place slowly, or it begins in one or +more points and gradually spreads throughout the laminæ. These acute +cases generally run their course in from one to two weeks. Usually a +culmination of the symptoms is reached, if the patient is properly +treated, in from three to five days; then evidences of recovery are +discernible in favorable cases. The lameness improves, the other +symptoms gradually subside, and eventually health is regained. It is in +these cases that a strong tendency to disorganization of a destructive +character exists; hence it is we see so many recover imperfectly, with +marked structural changes permanently remaining.</p> + +<p><i>Subacute.</i>—Subacute laminitis is most often seen as a termination of +the acute form, although it may exist independent of or precede an acute +attack. It is characterized by the mildness of its symptoms, slow +course, and moderate tissue changes. It may be present a long time +before any pathological lesions result other than those found in the +acute form, and when these changes do take place they should be viewed +rather as complications.</p> + +<p><i>Chronic.</i>—Chronic laminitis is a term used by many to designate any of +the sequelæ of the acute and subacute forms of this disease. Pure, +chronic inflammation of the laminæ is not very commonly met with, but is +most frequent in horses that have long done fast track work. They have +"fever in the feet" at all times and are continually sore, both +conditions being aggravated by work. Like chronic inflammation of other +parts, there is a strong tendency to the development of new connective +tissue which, by its pressure upon the blood vessels, interferes with +nutrition. Wasting of the coffin bone and inflammation of its covering +with caries is not unusual. The continued fever and impaired function of +secretion result in the production of a horn deficient in elasticity, +somewhat spongy in character, and inclined to crumble. In some cases of +"soreness" in horses used to hard or fast work there is evident weakness +of the coats of the vessels, brought on by repeated functional +exhaustion. Here slight work brings on congestion, which results in +serous effusion and temporary symptoms similar to those of chronic +laminitis.<span class='pagenum'><a name="Page_449" id="Page_449">[Pg 449]</a></span></p> + +<p><i>Complications.</i>—Complications concurrent with or supervening upon +laminitis are frequent and varied, and are often dependent upon causes +not fully understood.</p> + +<p><i>Excessive purgation</i> is one of the simplest of these, and not usually +attended with dangerous consequences. It rarely occurs unless induced by +a purgative, and the excessive action of the medicine is probably to be +explained upon the theory that the mucous membrane sympathizes with the +diseased laminæ, is irritable, and readily becomes overexcited. The +discharges are thin and watery, sometimes offensively odorous, and +occasionally persist in spite of treatment. It may prove disastrous to +the welfare of the patient by the rapid exhaustion which it causes, +preventing resolution of the laminitis, and may even cause death.</p> + +<p><i>Septicemia and pyemia.</i>—Septicemia and pyemia are unusual +complications and are seen only in the most severe cases in which bed +sores are present or suppuration of the laminæ results. They die, as a +rule, within three days after showing signs of the complication.</p> + +<p><i>Pneumonia.</i>—the so-called metastatic—needs no special consideration, +for in its lesions and symptoms it does not differ from ordinary +pneumonia, although it may be overlooked entirely by the practitioner. +Examinations of the chest should be made every day, so as to detect the +disease at its onset and render proper aid.</p> + +<p><i>Sidebones.</i>—A rapid development of sidebones is one of the +complications, or, perhaps better, a sequel of laminitis not often met +with in practice. Here the inflammatory process extends to the lateral +cartilages, with a strong tendency to calcification. The deposition of +the lime salts is sometimes most rapid, so that the "bones" are +developed in a few weeks; in other instances they are deposited slowly +and their growth is not noted until long after the subsidence of the +laminitis, so that the exciting cause is not suspected. This change in +the cartilages may commence as early as the first of the laminitis; and +although the trouble in the laminæ is removed in the course of a +fortnight the symptoms do not entirely subside, the animal retains the +shuffling gait, the sidebones continue to grow, and the patient usually +remains quite lame. This alteration of the cartilages generally prevents +the patient from recovering his natural gait, and the practitioner +receives unjust censure for a condition of affairs he could neither +foresee nor prevent.</p> + +<p>The laminitic process occasionally extends to the covering of the +coronet bone, or at least concurrent with and subsequent to laminitis +the development of "low ringbone" is seen, and it is apparently +dependent upon the disease of the laminæ for its exciting cause. The +impairment of function and consequent symptoms are much less marked here +than in sidebones. The coronet remains hot and sensitive<span class='pagenum'><a name="Page_450" id="Page_450">[Pg 450]</a></span> and somewhat +thickened after the laminitis subsides, and a little lameness is +present. This lameness persists, and the deposits of new bone may +readily be detected.</p> + +<p><i>Suppuration</i> of the sensitive membrane is a somewhat common +complication, and even when present in its most limited form is always a +serious matter; but when it becomes extensive, and especially when the +suppurative process extends to the periosteum, the results are liable to +be fatal. When suppuration occurs the exudation does not appear to be +excessive. It is rich in leucocytes and seems to have caused detachment +of the sensitive tissues from the horn prior to the formation of pus in +some instances; in others the tissues are still attached to the horn, +and the suppuration takes place in the deeper tissues.</p> + +<p>Limited suppuration may take place in any part of the sensitive tissues +of the foot during laminitis, and may ultimately be reabsorbed instead +of being discharged upon the surface, but generally the process begins +in the neighborhood of the toe and spreads backward and upward toward +the coronet, finally separating the horn from the coronary band at the +quarters. At the same time it spreads over the sole and eventually the +entire hoof is loosened and sloughs away, leaving the tissues beneath +entirely unprotected. In other instances—and these are generally the +cases not considered unusually severe—the suppuration begins at the +coronary band. It extends but a short distance into the tissues, yet +destroys the patient by separating the hoof from the coronary band, upon +which it depends for support and growth. This form of the suppurative +process usually begins in front. It is this part of the coronary band +that is always most actively affected with inflammation, and +consequently it is here that impairments first occur.</p> + +<p>Suppuration of the sensitive sole is more common than of the sensitive +laminæ and coronary band. It is present in the majority of cases in +which there is a dropping of the coffin bone, and in other instances +when the effusion at this point is so great as to arrest the production +of horn and uncover the sensitive tissues. Except when the result of +injury it begins at the toe and spreads backward, and, if not relieved +by opening the sole, escapes at the heel. Suppuration of the sole is +much less serious than in other parts of the foot.</p> + +<p>If the acute constitutional symptoms developed from sloughing of the +foot do not result in death, a new hoof of very imperfect horn may be +developed after a time; but unless the animal is to be kept for breeding +purposes alone the foot will ever be useless for work and death should +relieve the suffering. When only the sole sloughs, recovery takes place +with proper treatment.</p> + +<p><i>Peditis.</i>—This is the term that Williams applies to that serious +complication of laminitis in which not only the laminæ, but the +periosteum<span class='pagenum'><a name="Page_451" id="Page_451">[Pg 451]</a></span> membrane covering the bone and coffin bone also are subjects +of the inflammatory process. Neither is this all; in some of these cases +of peditis acute inflammation of the coffin joint is present, and +occasionally suppuration of the joint. A mild form of periostitis, in +which the exudation is in the outer layer of the periosteum only, is a +more common condition than is recognized generally by practitioners. +Intimate contiguity of structures is the predisposing cause, for the +disease either spreads from the original seat or the complication occurs +as one of the primary results of the exciting cause. In the severer +cases in which the exudate separates the periosteum from the bone, +suppuration, gangrene, and superficial caries are common results. If +infiltration of the bone tissues is rapid the blood supply is cut off by +pressure upon the vessels and death of the coffin bone follows. Grave +constitutional symptoms mark these changes, which soon prove fatal.</p> + +<p>In the mild cases of periostitis it is by no means easy positively to +determine its presence, for there are no special symptoms by which it +may be distinguished from pure laminitis. In a majority of acute cases, +though, which show no signs of improvement by the fifth to seventh day, +it is safe to suspect periostitis, particularly if the coronets are very +hot, the pulse full and hard, and the lameness acute. In the fortunately +rare cases in which the bone is affected with inflammation and +suppuration the agony of the patient is intense; he occupies the +recumbent position almost continually, never standing for more than a +few minutes at a time; suffers from the most careful handling of the +affected feet; maintains a rapid pulse and respiration, high +temperature, loss of appetite, and great thirst. It is in these cases +that the patient continually grows worse, and the appearance of +suppuration at the top of the hoof in about two weeks after the +inception of the disease proves the inefficiency of any treatment which +may have been used and the hopelessness of the case. These patients die +usually between the tenth and twentieth days either from exhaustion or +pyemic infection.</p> + +<p><i>Gangrene</i> occurs in the periosteum as the result of excessive +detachment from the bone and compression due to excessive exudation. +Other parts of the sensitive tissues are subject occasionally to the +same fate, and at times large areas will be found dead.</p> + +<p><i>Pumiced sole</i> is that condition in which the horny sole in the +neighborhood of the toe readily crumbles away and leaves the sensitive +tissues more or less exposed. It is not a complication of laminitis +only, for it is seen under other conditions. Williams has described the +horny tissue of pumiced sole as "weak, cheesy, or spongy, like macerated +horn, or even grumous (thick, clotted)." Crumbling horn, when critically +examined, shows almost an entire absence of the cohesive matter which +unites the healthy fibers, while the fibers themselves<span class='pagenum'><a name="Page_452" id="Page_452">[Pg 452]</a></span> are irregular +and granular in appearance. Pumiced sole depends upon an impairment of +the horn-secreting powers of the sensitive sole or upon a separation of +the horny from the soft tissues which maintain its vitality.</p> + +<p>Punctured wounds of the foot, accompanied with any considerable +destruction of the soft tissues, present the same peculiarities of horn +in the immediate neighborhood of the injury. Bruises of the sole are +followed by this change when the exudation has been excessive and has +separated the horn from the living tissues. True, in these cases we +rarely see the soft tissues laid bare, for the reason that new horn is +constantly secreted and replaces that undergoing disintegration.</p> + +<p>Laminitis presents three conditions under which pumiced sole may appear: +First, when free exudation separates the horn from the other tissues, or +when the process of inflammation arrests the production of horn by +impairing or destroying the horn-secreting membrane; second, when +depression of the coffin bone causes pressure upon and arrests the +formation of horn; and, third, when the elevation of the sole compresses +the soft tissues against the pedal bone and induces the same condition.</p> + +<p>Pumiced sole, from simple exudation and separation of tissues, is of +little importance for the reason given above in connection with bruises; +but when suppuration occurs in restricted portions of the foot in +conjunction with laminitis, it always lays bare the tissues beneath and +temporarily impairs the animal's value. Recovery takes place after a few +weeks by the tissues "horning over," as in injuries attended by the same +process. Depression of the coffin bone is not sufficient within itself +to cause pumiced sole; for, if the relative change in the bone takes +place slowly, or if the horn is thin, the sole becomes convex from +gradual pressure and the soft tissues adapt themselves to the change +without having their function materially impaired. But when the dropping +is sudden and the soft tissues are destroyed, the horn rapidly crumbles +away and the toe of the bone comes through. In many of these cases the +soft tissues remain uncovered for months. When they are eventually +covered it is with a thin, slightly adherent horn that stands but little +or no wear. The sole being now convex, the diseased tissues bear unusual +weight by coming in contact with the ground, and hence it is that these +animals are generally incurable cripples.</p> + +<p>In most cases in which the sole is raised to meet the pedal bone and +pumiced sole occurs it is due not to pressure of the bone from within +(for the tissues are capable of adapting themselves to the gradual +change) but to impaired vitality of the sensitive tissues from the +inflammation and to the constant concussion and pressure applied from +without during progression. To this is to be added the paring<span class='pagenum'><a name="Page_453" id="Page_453">[Pg 453]</a></span> away of +the horn when applying the shoe, thereby keeping the sole at this point +too thin.</p> + +<p><i>Turning up of the toe.</i>—In many cases of laminitis which have become +chronic it is found that the toe of the foot turns up; that the heels +are longer than natural; while the hoof near the coronary band is +circled with ridges like the horn of a ram. Even in cases in which +recovery has taken place, and in other diseases than laminitis, these +ridges may be found in the wall of the foot. In such cases, however, the +ridges are equally distant from one another all around the foot, while +in turning up of the toe the ridges are wide apart at the heels and +close together in front, as seen in the figure. (Plate XXXVII, fig. 4.) +These ridges are produced by periods of interference with the growth of +horn alternating with periods during which a normal or nearly normal +growth takes place. When the toe turns up it is because the coronary +band in front produces horn very slowly, while at the heels it grows +much faster, causing marked deformity.</p> + +<p>Animals so affected always place the abnormally long heel first upon the +ground, not alone because the heel is too long, nor as in acute or +subacute laminitis to relieve the pain, but for the reason that the toe +is too short and lifted away from its natural position. To bring the toe +to the ground the leg knuckles at the fetlock joint.</p> + +<p>The pain and impairment of function in these cases always result in +marked atrophy of the muscles of the forearm and shoulder, and to some +extent of the pectorals, while the position of the fore legs advances +the shoulder joints so far forward as to cause a sunken appearance of +the breast, which the laity recognize as "chest founder."</p> + +<p>The lesions of turning up of the toe are permanent, and are the most +interesting pathologically of all the complications of laminitis.</p> + +<p><i>Treatment.</i>—The treatment of laminitis is probably more varied than of +any other disease, and yet a large number of cases recover for even the +poorest practitioner.</p> + +<p><i>Prevention.</i>—To guard against and prevent disease, or to render an +unpreventable attack less serious than it otherwise would be, is the +highest practice of the healing art. In a disease so prone to result +from the simplest causes, especially when the soundest judgment may not +be able to determine the extent of the disease-resisting powers of the +tissues which are liable to be affected, or of what shall in every +instance constitute an overexcitement, it is not strange that horse +owners find themselves in trouble from unintentional transgression. If +the disease were dependent upon specific causes, or if the stability of +the tissues were of a fixed or more nearly determinate quality, some +measures might be instituted that would prove generally preventive; but +the predisposing causes are common conditions and often can not<span class='pagenum'><a name="Page_454" id="Page_454">[Pg 454]</a></span> be +remedied. That which is gentle work in one instance may incite disease +in another. That which is feed to-day may to-morrow prove disastrous to +health. Finally, necessary medical interference, no matter how +judicious, may cause a more serious complaint than that which was being +treated. Notwithstanding these difficulties there are some general rules +to be observed that will in part serve to prevent the development of an +unusual number of cases. First of all the predisposing causes must be +removed when possible; when impossible, unusual care must be taken not +to bring an exciting cause into operation. Under no circumstances should +fat animals have hard work. If the weather is warm or the variation of +temperature great, all horses should have but slow, gentle labor until +they become inured to it, the tissues hardened, and their excitability +reduced to a minimum. Green horses should have moderate work, +particularly when taken from the farm and dirt roads to city pavements; +for under these circumstances increased concussion, changed hygienic +conditions, and artificial living readily become active causes of the +disease. Army horses just out of winter quarters, track horses with +insufficient preparation, and farmers' horses put to work in the spring +are among the most susceptible classes, and must be protected by work +that is easy and gradual. If long marches or drives are imperative, the +incumbrances must be as light as possible and the journey interspersed +with frequent rests, for this allows the laminæ to regain their impaired +functional activity and to withstand much more work without danger. +Furthermore, it permits early detection of an attack, and prevents +working after the disease begins, which renders subsequent medication +more effective by cutting the process short at the stage of congestion.</p> + +<p>All animals when resting immediately after work should be protected from +cold air or drafts. If placed in a stable that is warm and without +draft, no covering is necessary; under opposite conditions blankets +should be used until the excitement and exhaustion of labor have +entirely passed away. It is still better that all animals coming in warm +from work be "cooled out" by slow walking until the perspiration has +dried and the circulation and respiration are again normal. Animals +stopped on the road even for a few moments should always be protected +from rapid change of temperature by appropriate clothing. If it can be +avoided, horses that are working should never be driven or ridden +through water. If unavoidable, they should be cooled off before passing +through, and then kept moving until completely dried. The same care is +to be practiced with washing the legs in cold water when just in from +work, for occasionally it proves to be the cause of a most acute attack +of this disease.<span class='pagenum'><a name="Page_455" id="Page_455">[Pg 455]</a></span> Unusual changes in the manner of applying the shoes +should not be hastily made. If a plane shoe has been worn, high heels or +toes must not be substituted at once; but the change, if necessary, +should gradually be made, so that the different tissues may adapt +themselves to the altered conditions. If radical changes are imperative, +as is sometimes the case, the work must be so reduced in quantity and +quality that it can not excite the disease.</p> + +<p>Laminitis from the effects of purgatives can scarcely be guarded +against. I can not determine from the cases in which I have seen this +result that there are any conditions present that would warn us of +danger. The trouble does not seem to depend upon the size of the +purgative, the length of time before purgation begins, or the activity +and severity with which the remedy acts. Medicines known to have +unusually irritating effects on the alimentary canal should be used only +when necessity demands it, and then in moderate doses.</p> + +<p>Experience alone will determine what animals are liable to suffer from +this disease through the use of feeds. When an attack can be ascribed to +any particular feed it should be withheld, unless in small quantities. +Horses that have never been fed upon Indian corn should receive but a +little of it at a time, mixed with bran, oats, or other feed, until it +has been determined that no danger exists. Corn is less safe in warm +than in cold weather, and for this reason it should always be fed with +caution during spring and summer months.</p> + +<p>When an animal is excessively lame in one foot the shoe of the opposite +member should be removed, and cold water frequently applied to the well +foot. At the same time, if the subject remains standing, the slings +should be used. Horses should under no circumstances be overworked; to +guard against this, previous work, nature of roads, state of weather, +and various other influences must be carefully considered. Watering +while warm is a pernicious habit, and, unless the animal is accustomed +to it, is liable to result in some disorder, ofttimes in laminitis.</p> + +<p><i>Curative measures.</i>—In cases of simple congestion of the laminæ the +body should be warmly clothed and warm drinks administered. The feet +should be placed in a warm bath to increase the return flow of blood. In +course of an hour the feet may be changed to cold water and kept there +until recovery is completed. If the constitutional symptoms demand it, +diuretics should be given. Half-ounce doses of saltpeter three times a +day in the water answer the purpose. In cases of active congestion the +warm footbaths should be omitted and cold ones used from the +commencement. Subacute laminitis demands the same treatment, with +laxatives if there is constipation, and the addition of low-heeled +shoes. The diuretics may need to be continued for some time and their +frequency increased. Regarding acute laminitis, what has been called the +"American treatment" is<span class='pagenum'><a name="Page_456" id="Page_456">[Pg 456]</a></span> simple and efficient. It consists solely in the +administration of large doses of nitrate of potash and the continued +application to the feet and ankles of cold water.</p> + +<p>Three to four ounces of saltpeter in a pint of water, repeated every six +hours, is a proper dose. The laminitis frequently subsides within a +week. These large doses may be continued for a week without danger. +Under no circumstances have I seen the kidneys irritated to excess or +other unfavorable effects produced.</p> + +<p>The feet should be kept in a tub of water at a temperature of 45° to 50° +F., unless the animal is lying down, when swabs are to be used and wet +every half hour with the cold water. The water keeps the horn soft and +moist and acts directly upon the inflamed tissues by reducing the +temperature. Cold maintains the vitality and disease-resisting qualities +of the soft tissues, tones up the coats of the blood vessels, diminishes +the supply of blood, and limits the exudation. Furthermore, it has an +anesthetic effect upon the diseased tissues and relieves the pain.</p> + +<p>Aconite may be given in conjunction with the niter when the heart is +greatly excited and beats strongly. Ten-drop doses, repeated every 2 +hours for 24 hours, are sufficient. The use of cathartics is dangerous, +for they may excite superpurgation. Usually the niter will relieve the +constipation; yet if it should prove obstinate, laxatives may be +carefully given. Bleeding, both general and local, should be guarded +against. The shoes must be early removed and the soles left unpared.</p> + +<p>Paring of the soles presents two objections: First, while it may +temporarily relieve the pain by relieving pressure, it favors greater +exudation, which may more than counterbalance the good effects. +Secondly, it makes the feet tender and subject to bruises when the +animal again goes to work. The shoes should be replaced when +convalescence sets in and the animal is ready to take exercise. Exercise +should never be enforced until the inflammation has subsided; for +although it temporarily relieves the pain and soreness it maintains the +irritation, increases the exudation, and postpones recovery.</p> + +<p>If at the end of the fifth or sixth day prominent symptoms of recovery +are not apparent, apply a stiff blister of cantharides around the +coronet and omit the niter for about 48 hours. When the blister is well +set, the feet may again receive wet swabs. If one blister does not +remove the soreness it may be repeated, or the actual cautery applied. +The same treatment should be adopted where sidebones form or +inflammation of the coronet bone follows. When the sole breaks through, +exposing the soft tissues, the feet must be carefully shod with thin +heels and thick toes if there is a tendency to walk on the heels, and +the sole must be well protected with appropriate dressings and pressure +over the exposed parts. When there is turning<span class='pagenum'><a name="Page_457" id="Page_457">[Pg 457]</a></span> up of the toe, blistering +of the coronet, <i>in front only</i>, sometimes stimulates the growth of +horn, but as a rule judicious shoeing is the only treatment that will +enable the animal to do light, slow work.</p> + +<p>When suppuration of the laminæ is profuse, it is better to destroy your +patient at once and relieve his suffering: but if the suppuration is +limited to a small extent of tissue, especially of the sole, treatment, +as in acute cases, may induce recovery and should always be tried. If +from bed sores or other causes septicemia or pyemia is feared, the +bisulphite of soda, in half-ounce doses, may be given in conjunction +with tonics and such other treatment as is indicated in these diseases.</p> + +<p>As to enforced recumbency I doubt the propriety of insisting on it in +the majority of cases, for I think the patient usually assumes whatever +position gives most comfort. No doubt recumbency diminishes the amount +of blood sent to the feet, and may greatly relieve the pain, so that +forcing the patient to lie down may be tried, yet should not be renewed +if he thereafter persists in standing.</p> + +<p>When the animal persistently stands, or constant lying indicates it (to +prevent extensive sores), the patient should be placed in slings. When +all four feet are affected it may be impossible to use slings, for the +reason that the patient refuses to support any of his weight and simply +hangs in them. Lastly, convalescent cases must not be returned to work +too early, else permanent recovery may never be effected.</p> + + + +<hr style="width: 65%;" /> +<p><span class='pagenum'><a name="Page_458" id="Page_458">[Pg 458]</a></span></p> +<h2>DISEASES OF THE SKIN.</h2> + +<h3>By <span class="smcap">James Law</span>, F. R. C. V. S.,</h3> + +<h4><i>Formerly Professor of Veterinary Science, etc., Cornell University.</i></h4> + + +<p>As we find them described in systematic works, the diseases of the skin +are very numerous and complex, which may be largely accounted for by the +fact that the cutaneous covering is exposed to view at all points, so +that shades of difference in inflammatory and other diseased processes +are easily seen and distinguished from one another. In the horse the +hairy covering serves to some extent to mask the symptoms, and hence the +nonprofessional man is tempted to apply the term "mange" to all alike, +and it is only a step further to apply the same treatment to all these +widely different disorders. Yet even in the hairy quadruped the +distinction can be made in a way which can not be done in disorders of +that counterpart and prolongation of the skin—the mucous membrane, +which lines the air passages, the digestive organs, the urinary and +generative apparatus. Diseased processes, therefore, which in these +organs it might be difficult or impossible to distinguish from one +another, can usually be separated and recognized when appearing in the +skin.</p> + +<p>Nor is this differentiation unimportant. The cutaneous covering presents +such an extensive surface for the secretion of cuticular scales, hairs, +horn, sebaceous matter, sweat, and other excretory matters, that any +extensive disorder in its functions may lead to serious internal disease +and death. Again, the intimate nervous sympathy of different points of +the skin with particular internal organs renders certain skin disorders +causative of internal disease and certain internal diseases causative of +affections of the skin. The mere painting of the skin with an +impermeable coating of glue is speedily fatal; a cold draft striking on +the chest causes inflammation of the lungs or pleura; a skin eruption +speedily follows certain disorders of the stomach, the liver, the +kidneys, or even the lungs; simple burns of the skin cause inflammations +of internal organs, and inflammation of such organs cause in their turn +eruptions on the skin. The relations—nervous, secretory, and +absorptive—between the skin and internal organs are most extensive and +varied, and therefore a visible disorder in the skin may point at once +and specifically to a particular fault in diet, to an injudicious use of +cold water when the system is heated, to a fault in drainage, +ventilation, or lighting of the stables, to indigestion, to liver +disease, to urinary disorder, etc.</p> + +<p><a name="PLATE_XXXVIII" id="PLATE_XXXVIII"></a></p> +<div class="figcenter" style="width: 322px;"> +<a href="images/plate38.jpg"><img src="images/plate38t.jpg" width="322" height="450" alt="PLATE XXXVIII." title="" /></a> +<span class="caption">PLATE XXXVIII.<br /> + +THE SKIN AND ITS DISEASES.</span> +</div> + + +<h4>STRUCTURE OF THE SKIN.</h4> + +<p><span class='pagenum'><a name="Page_459" id="Page_459">[Pg 459]</a></span>The skin consists primarily of two parts: (1) The superficial +nonvascular (without blood vessels) layer, the cuticle, or epidermis; +and (2) the deep vascular (with blood vessels) layer, the corium, +dermis, or true skin. (See Pl. XXXVIII, fig. 1.)</p> + +<p>The cuticle is made up of cells placed side by side and more or less +modified in shape by their mutual compression and by surface evaporation +and drying. The superficial stratum consists of the cells dried in the +form of scales, which fall off continually and form dandruff. The deep +stratum (the mucous layer) is formed of somewhat rounded cells with +large central nuclei, and in colored skin containing numerous pigment +granules. These cells have prolongations, or branches, by which they +communicate with one another and with the superficial layer of cells in +the true skin beneath. Through these prolongations they receive nutrient +liquids for their growth and increase, and pass on liquids absorbed by +the skin into the vessels of the true skin beneath. The living matter in +the cells exercises an equally selective power on what they shall take +up for their own nourishment and on what they shall admit into the +circulation from without. Thus, certain agents, like iodin and +belladonna, are readily admitted, whereas others, like arsenic, are +excluded by the sound, unbroken epidermis. Between the deep and +superficial layers of the epidermis there is a thin, translucent layer +(septum lucidum) consisting of a double stratum of cells, and forming a +medium of transition from the deep spheroidal to the superficial scaly +cuticle.</p> + +<p>The true skin, or dermis, has a framework of interlacing bundles of +white and yellow fibers, large and coarse in the deeper layers, and fine +in the superficial, where they approach the cuticle. Between the fibrous +bundles are left interspaces which, like the bundles, become finer as +they approach the surface, and inclose cells, vessels, nerves, glands, +gland ducts, hairs, and in the deeper layers fat.</p> + +<p>The superficial layer of the dermis is formed into a series of minute, +conical elevations, or papillæ, projecting into the deep portion of the +cuticle, from which they are separated by a very fine transparent +membrane. This papillary layer is very richly supplied with capillary +blood vessels and nerves, and is at once the seat of acute sensation and +the point from which the nutrient liquid is supplied to the cells of the +cuticle above. It is also at this point that the active changes of +inflammation are especially concentrated; it is the immediately +superposed cell layers (mucous) that become morbidly increased in the +earlier stages of inflammation; it is on the surface of the papillary +layer that the liquid is thrown out which raises the cuticle in the form +of a blister, and it is at this point mainly that pus forms in the +ordinary pustule.<span class='pagenum'><a name="Page_460" id="Page_460">[Pg 460]</a></span></p> + +<p>The fibrous bundles of the true skin contain plain, muscular fibers, +which are not controlled by the will, but contract under the influence +of cold and under certain nervous influences, as in some skin diseases +and in the chill of a fever, and lead to contraction, tightening, or +corrugation of the skin, contributing to produce the "hidebound" of the +horseman. Other minute, muscular filaments are extended from the surface +of the dermis to the hair follicle on the side to which the hair is +inclined, and under the same stimulating influences produce that +erection of the hair which is familiarly known as "staring coat." +Besides these, the horse's skin is furnished with an expansion of red, +voluntary muscle, firmly attached to the fibrous bundles, and by which +the animal can not only dislodge insects and other irritants, but even +shake off the harness. This fleshy envelope covers the sides of the +trunk and the lower portions of the neck and head, the parts unprotected +by the mane and tail, and serves to throw the skin of these parts into +puckers, or ridges, in certain irritating skin diseases.</p> + +<p>The hairs are cuticular products growing from an enlarged papilla lodged +in the depth of a follicle or sac, hollowed out in the skin and +extending to its deepest layers. The hair follicle is lined by cells of +epidermis, which at the bottom are reflected on the papilla and become +the root of the hair. The hair itself is formed of the same kind of +cells firmly adherent to one another by a tough, intercellular +substance, and overlapping each other, like slates on a roof, in a +direction toward the free end.</p> + +<p>The sebaceous glands are branching tubes ending in follicles or sacs and +opening into the hair follicles, lined by a very vascular fibrous +network representing the dermis, and an internal layer of cells +representing the mucous layer of the cuticle. The oily secretion gives +gloss to the hair and prevents its becoming dry and brittle, and keeps +the skin soft and supple, protecting it at once against undue exhalation +of water and undue absorption when immersed in that medium. Besides +those connected with the hair follicles there are numerous, isolated, +sebaceous glands, opening directly on the surface of the skin, producing +a somewhat thicker and more odorous secretion. They are found in large +numbers in the folds of the skin, where chafing would be liable if the +surface were dry, as on the sheath, scrotum, mammary glands, and inner +side of the thigh, around the anus and vulva, in the hollow of the heel, +beneath the fine horn of the frog, on the inner side of the elbow, on +the lips, nostrils, and eyelids. When closed by dried secretion or +otherwise these glands may become distended so as to form various-sized +swellings on the skin, and when inflamed they may throw out offensive, +liquid discharges, as in "grease," or produce red, tender fungous +growths ("grapes.")<span class='pagenum'><a name="Page_461" id="Page_461">[Pg 461]</a></span></p> + +<p>The sweat glands of the horse, like those of man, are composed of simple +tubes, which extend down through the cuticle and dermis in a spiral +manner, and are coiled into balls in the deeper layer of the true skin. +In addition to their importance in throwing offensive waste products out +of the system, these glands tend to cool the skin and the entire economy +of the animal through the evaporation of their watery secretion. Their +activity is therefore a matter of no small moment, as besides regulating +the animal heat and excreting impurities, they influence largely the +internal organs through the intimate sympathy maintained between them +and the skin.</p> + +<p>Diseases of the skin may be conveniently divided, according to their +most marked features, into—</p> + +<p>(1) Those in which congestion and inflammation are the most marked +features, varying according to the grade or form into (<i>a</i>) congestion +with simple redness, dryness, and heat, but no eruption (erythema); +(<i>b</i>) inflammation with red-pointed elevations, but no blisters +(papules); (<i>c</i>) inflammation with fine, conical elevations, each +surmounted by a minute blister (vesicle); (<i>d</i>) inflammation with a +similar eruption but with larger blisters, like half a pea and upwards +(bullæ); (<i>e</i>) inflammation with a similar eruption, but with a small +sac of white, creamy pus on the summit of each elevation (pustules); +(<i>f</i>) the formation of pustules implicating the superficial layer of the +true skin, a small portion of which dies and is thrown off as a slough, +or "core" (boils); (<i>g</i>) the formation of round, nodular, transient +swellings in the true skin (tubercles); and (<i>h</i>) the excessive +production of scales, or dandruff (scaly or squamous affections).</p> + +<p>(2) Diseases in which there are only deranged sensations of itching, +heat, tenderness, etc. (neurosis).</p> + +<p>(3) Diseased growths, such as warts, callosities, horny growths, cancer, +etc.</p> + +<p>(4) Diseases from parasites, animal and vegetable.</p> + +<p>(5) Diseases connected with a specific poison, such as horsepox, +erysipelas, anthrax, farcy, or cutaneous glanders, etc.</p> + +<p>(6) Physical injuries, like wounds, burns, scalds, etc.</p> + + +<h4>CONGESTION (RED EFFLORESCENCE, OR ERYTHEMA).</h4> + +<p>This is a congested or slightly inflamed condition of the skin, +unattended with any eruption. The part is slightly swollen, hot, tender, +or itchy, and dry, and if the skin is white there is redness. The +redness is effaced by pressure, but reappears instantly when it is +removed. Except in transient cases the hairs are liable to be shed. It +may be looked on as the first stage of inflammation, and therefore when +it becomes aggravated it may merge in part or in whole into a papular, +vesicular, or pustular eruption.<span class='pagenum'><a name="Page_462" id="Page_462">[Pg 462]</a></span></p> + +<p>Erythema may arise from a variety of causes, and is often named in +accordance with its most prominent cause. Thus the chilling, or partial +freezing, of a part will give rise to a severe reaction and congestion. +When snowy or icy streets have been salted this may extend to severe +inflammation, with vesicles, pustules, or even sloughs of circumscribed +portions of the skin of the pastern (chilblain, frost-bite). Heat and +burning have a similar effect, and this often comes from exposure to the +direct rays of the sun. The skin that does not perspire is the most +subject, and hence the white face or white limb of a horse becoming +dried by the intensity of the sun's rays often suffers to the exclusion +of the rest of the body (white face and foot disease). The febrile state +of the general system is also a potent cause; hence the white-skinned +horse is rendered the more liable if kept on a heating ration of +buckwheat, or even of wheat or maize. Contact of the skin with oil of +turpentine or other essential oils, with irritant liquids, vegetable or +mineral, with rancid fats, with the acrid secretions of certain animals, +like the irritating toad, with pus, sweat, tears, urine, or liquid +feces, will produce congestion or even inflammation. Chafing is a common +cause, and is especially liable to affect the fat horse between the +thighs, by the side of the sheath or scrotum, on the inner side of the +elbow, or where the harness chafes on the poll, shoulder, back, +breastbone, and under the tail. The accumulation of sweat and dust +between the folds of the skin and on the surface of the harness, and the +specially acrid character of the sweat in certain horses, contribute to +chafing or "intertrigo." The heels often become congested owing to the +irritation caused by the short, bristly hairs in clipped heels. Again, +congestion may occur from friction by halter, harness, or other foreign +body under the pastern, or inside the thigh or arm, or by reason of +blows from another foot (cutting, interfering, overreach). Finally, +erythema is especially liable to occur in spring, when the coat is being +shed, and the hair follicles and general surface are exposed and +irritable in connection with the dropping of the hairs.</p> + +<p>If due only to a local irritant, congestion will usually disappear when +the cause has been removed, but when the feeding or system is at fault +these conditions must be first corrected. While the coat is being shed +the susceptibility will continue, and the aim should be to prevent the +disease from developing and advancing so as to weaken the skin, render +the susceptibility permanent, and lay the foundation of persistent or +frequently recurring skin disease. Therefore at such times the diet +should be nonstimulating, any excess of grain, and above all of +buckwheat, Indian corn, or wheat, being avoided. A large grain ration +should not be given at once on return from hard work, when the general +system and stomach are unable to cope with<span class='pagenum'><a name="Page_463" id="Page_463">[Pg 463]</a></span> it; the animal should not be +given more than a swallow or two of cold water when perspiring and +fatigued, nor should he be allowed a full supply of water just after his +grain ration; he should not be overheated or exhausted by work, nor +should dried sweat and dust be allowed to accumulate on the skin or on +the harness pressing on it. The exposure of the affected heels to damp, +mud, and snow, and, above all, to melting snow, should be guarded +against; light, smooth, well-fitting harness must be obtained, and where +the saddle or collar irritates an incision should be made in them above +and below the part that chafes, and, the padding between having been +removed, the lining should be beaten so as to make a hollow. A zinc +shield in the upper angle of the collar will often prevent chafing in +front of the withers.</p> + +<p><i>Treatment.</i>—Wash the chafed skin and apply salt water (one-half ounce +to the quart), extract of witch-hazel, a weak solution of oak bark, or +camphorated spirit. If the surface is raw use bland powders, such as +oxid of zinc, lycopodium, starch, or smear the surface with vaseline, or +with 1 ounce of vaseline intimately mixed with one-half dram each of +opium and sugar of lead. In cases of chafing rest must be strictly +enjoined. If there is constitutional disorder or acrid sweat, 1 ounce +cream of tartar or a teaspoon of bicarbonate of soda may be given twice +daily.</p> + + +<h4>CONGESTION, WITH SMALL PIMPLES, OR PAPULES.</h4> + +<p>In this affection there is the general blush, heat, etc., of erythema, +together with a crop of elevations from the size of a poppy seed to a +coffee bean, visible when the hair is reversed or to be felt with the +finger where the hair is scanty. In white skins they vary from the +palest to the darkest red. All do not retain the papular type, but some +go on to form blisters (eczema, bullæ) or pustules, or dry up into +scales, or break out into open sores, or extend into larger swellings +(tubercles). The majority, however, remaining as pimples, characterize +the disease. When very itchy the rubbing breaks them open, and the +resulting sores and scales hide the true nature of the eruption.</p> + +<p>The general and local causes may be the same as for erythema, and in the +same subject one portion of the skin may have simple congestion and +another adjacent papules. As the inflammatory action is more pronounced, +so the irritation and itching are usually greater, the animal rubbing +and biting himself severely. This itching is especially severe in the +forms which attack the roots of the mane and tail, and there the disease +is often so persistent and troublesome that the horse is rendered +virtually useless.<span class='pagenum'><a name="Page_464" id="Page_464">[Pg 464]</a></span></p> + +<p>The bites of insects often produce a papular eruption, but in many such +cases the swelling extends wider into a buttonlike elevation, one-half +to an inch in diameter. The same remarks apply to the effects of the +poison ivy and poison sumac.</p> + +<p><i>Treatment.</i>—In papular eruption first remove the cause, then apply the +same general remedies as for simple congestion. In the more inveterate +cases use a lotion of one-half ounce sulphid of potassium in 2 quarts of +water, to which a little Castile soap has been added, or use a wash with +one-half ounce oil of tar, 2 ounces Castile soap, and 20 ounces water.</p> + + +<h4>INFLAMMATION WITH BLISTERS, OR ECZEMA.</h4> + +<p>In this the skin is congested, thickened, warm (white skins are +reddened), and shows a thick crop of little blisters formed by effusions +of a straw-colored fluid between the true skin and the cuticle. The +blisters may be of any size from a millet seed to a pea, and often crack +open and allow the escape of the fluid, which concretes as a slightly +yellowish scab or crust around the roots of the hairs. This exudation +and the incrustation are especially common where the hairs are long, +thick, and numerous, as in the region of the pastern of heavy draft +horses. The term eczema is now applied very generally to eruptions of +all kinds that depend on internal disorders or constitutional conditions +and that tend to recurrences and inveteracy. Eczema may appear on any +part of the body, but in horses it is especially common on the heels and +the lower parts of the limbs, and less frequently on the neck, shoulder, +and abdomen. The limbs appear to be especially liable because of their +dependent position, all blood having to return from them against the +action of gravity and congestions and swellings being common, because of +the abundance of blood vessels in this part of the skin and because of +the frequent contact with the irritant dung and urine and their +ammoniacal emanations. The legs further suffer from contact with wet and +mud when at work, from snow and ice, from drafts of cold air on the wet +limbs, from washing with caustic soaps, or from the relaxing effects of +a too deep and abundant litter. Among other causes may be named +indigestion and the presence of irritant matters in the blood and sweat, +the result of patent medicated feeds and condition powders (aromatics, +stimulants), green food, new hay, new oats, buckwheat, wheat, maize, +diseased potatoes, smut, or ergot in grains, decomposing green feed, +brewers' grains, or kitchen garbage. The excitement in the skin, caused +by shedding the coat, lack of grooming, hot weather, hot, boiled, or +steamed feed conduces to the eruption. Lastly, any sudden change of feed +may induce it.</p> + +<p>The blisters may in part go on to suppuration so that vesicles and +pustules often appear on the same patch, and, when raw from rubbing,<span class='pagenum'><a name="Page_465" id="Page_465">[Pg 465]</a></span> +the true nature of the eruption may be completely masked. In well-fed +horses, kept in close stables with little work, eczema of the limbs may +last for months and years. It is a very troublesome affection in draft +stallions.</p> + +<p><i>Treatment.</i>—This disease is so often the result of indigestion that a +laxative of 1 pound Glauber's salt in 3 or 4 quarts water or 1-1/2 pints +olive oil is often demanded to clear away irritants from the alimentary +canal. Following this, in recent and acute cases, give 2 drams of +acetate or bicarbonate of potash twice a day in the drinking water. If +the bowels still become costive, give daily 1 ounce sulphate of soda and +20 grains of powdered nux vomica. In debilitated horses combine the nux +vomica with one-half ounce powdered gentian root. As a wash for the skin +use 1 dram bicarbonate of soda and 1 dram carbolic acid in a quart of +water, after having cleansed the surface with tepid water. Employ the +same precautions as regards feeding, stabling, and care of harness as in +simple congestion of the skin.</p> + +<p>In the more inveterate forms of eczema more active treatment is +required. Soak the scabs in fresh sweet oil, and in a few hours remove +these with tepid water and Castile soap; then apply an ointment of +sulphur or iodid of sulphur day by day. If this seems to be losing its +effect after a week, change for mercurial ointment or a solution of +sulphid of potassium, or of hyposulphite of soda, 3 drams to the quart +of water. In these cases the animal may take a course of sulphur (1 +ounce daily), bisulphite of soda (one-half ounce daily), or of arsenic +(5 grains daily) mixed with 1 dram bicarbonate of soda.</p> + + +<h4>INFLAMMATION WITH PUSTULES.</h4> + +<p>In this affection the individual elevations on the inflamed skin show in +the center a small sac of white, creamy pus, in place of the clear +liquid of a blister. They vary in size from a millet seed to a hazelnut. +The pustules of glanders (farcy buds) are to be distinguished by the +watery contents and the cordlike swelling, extending from the pustules +along the line of the veins, and those of boils by the inflammation and +sloughing out of a core of the true skin. The hair on the pustule stands +erect, and is often shed with the scab which results. When itching is +severe the parts become excoriated by rubbing, and, as in the other +forms of skin disease, the character of the eruption may become +indistinct. Old horses suffer mainly at the root of the mane and tail +and about the heels, and suckling foals around the mouth, on the face, +inside the thighs, and under the tail.</p> + +<p>Pustules, like eczema, are especially liable to result from unwholesome +feed and indigestion, from a sudden change of feed—above all, from dry +to green. In foals it may result from overheating of the<span class='pagenum'><a name="Page_466" id="Page_466">[Pg 466]</a></span> mare and +allowing the first milk after she returns, or by milk rendered +unwholesome by faulty feeding of the dam. If a foal is brought up by +hand the souring and other decompositions in the milk derange the +digestion and cause such eruption. Vetches and other plants affected +with honeydew and buckwheat have been the cause of these eruptions on +white portions of the skin. Disorders of the kidneys or liver are common +causes of this affection.</p> + +<p><i>Treatment.</i>—Apply soothing ointments, such as benzonated oxid of zinc, +or vaseline with 1 dram oxid of zinc in each ounce. Or a wash of 1 dram +sugar of lead or 2 drams hyposulphite of soda in a quart of water may be +freely applied. If the skin is already abraded and scabby, smear thickly +with vaseline for some hours, then wash with soapsuds and apply the +above dressings. When the excoriations are indolent they may be painted +with a solution of lunar caustic 2 grains to 1 ounce of distilled water. +Internally counteract costiveness and remove intestinal irritants by the +same means as in eczema, and follow this with one-half ounce doses daily +of hyposulphite of soda, and one-half ounce doses of gentian. Inveterate +cases may often be benefited by a course of sulphur, bisulphite of soda, +or arsenic. In all, the greatest care must be taken with regard to feed, +feeding, watering, cleanliness, and work. In wet and cold seasons +predisposed animals should, so far as possible, be protected from wet, +mud, snow, and melted snow—above all, from that which has been melted +by salt.</p> + + +<h4>BOILS, OR FURUNCLES.</h4> + +<p>These may appear on any part of the skin, but are especially common on +the lower parts of the limbs, and on the shoulders and back where the +skin is irritated by accumulated secretion and chafing with the harness. +In other cases the cause is constitutional, or attended with unwholesome +diet and overwork with loss of general health and condition. They also +follow on weakening diseases, notably strangles, in which irritants are +retained in the system from overproduction of poisons and effete matter +during fever, and imperfect elimination. There is also the presence of a +pyogenic bacterium, by which the disease may be maintained and +propagated.</p> + +<p>While boils are pus producing, they differ from simple pustule in +affecting the deepest layers of the true skin, and even the superficial +layers of the connective tissues beneath, and in the death and sloughing +out of the central part of the inflamed mass (core). The depth of the +hard, indurated, painful swelling, and the formation of this central +mass or core, which is bathed in pus and slowly separated from +surrounding parts, serve to distinguish the boil alike from the pustule, +from the farcy bud, and from a superficial abscess.</p> + +<p><i>Treatment.</i>—To treat very painful boils a free incision with a lancet +in two directions, followed by a dressing with one-half an<span class='pagenum'><a name="Page_467" id="Page_467">[Pg 467]</a></span> ounce +carbolic acid in a pint of water, bound on with cotton wool or lint, may +cut them short. The more common course is to apply a warm poultice of +linseed meal or wheat bran, and renew daily until the center of the boil +softens, when it should be lanced and the core pressed out.</p> + +<p>If the boil is smeared with a blistering ointment of Spanish flies and a +poultice put over it, the formation of matter and separation of the core +is often hastened. A mixture of sugar and soap laid on the boil is +equally good. Cleanliness of the skin and the avoidance of all causes of +irritation are important items, and a teaspoonful of bicarbonate of soda +once or twice a day will sometimes assist in warding off a new crop.</p> + + +<h4>NETTLERASH (SURFEIT, OR URTICARIA).</h4> + +<p>This is an eruption in the form of cutaneous nodules, in size from a +hazelnut to a hickory nut, transient, with little disposition to the +formation of either blister or pustule, and usually connected with +shedding of the coat, sudden changes of weather, and unwholesomeness or +sudden change in the feed. It is most frequent in the spring and in +young and vigorous animals (good feeders). The swelling embraces the +entire thickness of the skin and terminates by an abrupt margin in place +of shading off into surrounding parts. When the individual swellings run +together there are formed extensive patches of thickened integument. +These may appear on any part of the body, and may be general; the +eyelids may be closed, the lips rendered immovable, or the nostrils so +thickened that breathing becomes difficult and snuffling. It may be +attended with constipation or diarrhea or by colicky pains. The eruption +is sudden, the whole skin being sometimes covered in a few hours, and it +may disappear with equal rapidity or persist for six or eight days.</p> + +<p><i>Treatment.</i>—This consists in clearing out the bowels by 5 drams +Barbados aloes, or 1 pound Glauber's salt, and follow the operation of +these by daily doses of one-half ounce powdered gentian and 1 ounce +Glauber's salt. A weak solution of alum may be applied to the swellings.</p> + + +<h4>PITYRIASIS, OR SCALY SKIN DISEASE.</h4> + +<p>This affection is characterized by an excessive production and +detachment of dry scales from the surface of the skin (dandruff). It is +usually dependent on some fault in digestion and an imperfect secretion +from the sebaceous glands and is most common in old horses with spare +habit of body. Williams attributes it to feed rich in saccharine matter +(carrots, turnips) and to the excretion of oxalic acid by the skin. He +has found it in horses irregularly worked and well<span class='pagenum'><a name="Page_468" id="Page_468">[Pg 468]</a></span> fed and advises the +administration of pitch for a length of time and the avoidance of +saccharine feed. Otherwise the horse may take a laxative followed by +dram doses of carbonate of potash, and the affected parts may be bathed +with soft, tepid water and smeared with an ointment made with vaseline +and sulphur. In obstinate cases sulphur may be given daily in the feed.</p> + + +<h4>PRURITUS, OR NERVOUS IRRITATION OF THE SKIN.</h4> + +<p>This is seen in horses fed to excess on grain and hay, kept in close +stables, and worked irregularly. Though most common in summer, it is +often severe in hot, close stables in winter. Pimples, vesicles, and +abrasions may result, but as the itching is quite as severe on other +parts of the skin, these may be the result of scratching merely. It is +especially common and inveterate about the roots of the mane and tail.</p> + +<p><i>Treatment</i> consists in a purgative (Glauber's salt, 1 pound), +restricted, laxative diet, and a wash of water slightly soured with oil +of vitriol and rendered sweet by carbolic acid. If obstinate, give daily +1 ounce of sulphur and 20 grains nux vomica. If the acid lotion fails, 2 +drams carbonate of potash and 2 grains of cyanid of potassium in a quart +of water will sometimes benefit. If from pinworms in the rectum, the +itching of the tail may be remedied by an occasional injection of a +quart of water in which chips of quassia wood have been steeped for 12 +hours.</p> + + +<h4>HERPES.</h4> + +<p>This name has been applied to a disease in which there is an eruption of +minute vesicles in circular groups or clusters, with little tendency to +burst, but rather to dry up into fine scabs. If the vesicles break, they +exude a slight, gummy discharge which concretes into a small, hard scab. +It is apparently noncontagious and not appreciably connected with any +disorder of internal organs. It sometimes accompanies or follows +specific fevers, and is, on the whole, most frequent at the seasons of +changing the coat—spring and autumn. It is seen on the lips and +pastern, but may appear on any part of the body. The duration of the +eruption is two weeks or even more, the tendency being to spontaneous +recovery. The affected part is very irritable, causing a sensitiveness +and a disposition to rub out of proportion to the extent of the +eruption.</p> + +<p><i>Treatment.</i>—It may be treated by oxid of zinc ointment, and to relieve +the irritation a solution of opium or belladonna in water, or of sugar +of lead or oil of peppermint. A course of bitters (one-half an ounce of +Peruvian bark daily for a week) may be serviceable in bracing the system +and producing an indisposition to the eruption.<span class='pagenum'><a name="Page_469" id="Page_469">[Pg 469]</a></span></p> + + +<h4>BLEEDING SKIN ERUPTIONS, OR DERMATORRHAGIA PARASITICA.</h4> + +<p>In China, Hungary, Spain, and other countries horses frequently suffer +from the presence of a threadworm (<i>Filaria hæmorrhagica</i> Railliet, <i>F. +multipapillosa</i> Condamine and Drouilly) in the subcutaneous connective +tissue, causing effusions of blood under the scurf skin and +incrustations of dried blood on the surface. The eruptions, which appear +mainly on the sides of the trunk, but may cover any part of the body, +are rounded elevations about the size of a small pea, containing blood +which bursts through the scurf skin and concretes like a reddish scab +around the erect, rigid hairs. These swellings appear in groups, which +remain out for several days, gradually diminishing in size; new groups +appear after an interval of three or four weeks, the manifestation being +confined to three or four months of spring and disappearing in winter. A +horse will suffer for several years in succession and then permanently +recover. A fatal issue is not unknown. To find the worm the hair is +shaved from the part where the elevations are felt, and as soon as a +bleeding point is shown the superficial layer is laid open with the +knife, when the parasite will be seen drawing itself back into the parts +beneath. The worm is about 2 inches long and like a stout thread, +thicker toward the head than toward the tail, and with numerous little +conical elevations (papillæ) around the head. The young worms are +numerous in the body of the adult female worm. The worm has become +common in given localities, and probably enters the system with feed or +water.</p> + +<p><i>Treatment</i> is not satisfactory, but the affected surface should be kept +clean by sponging, and the pressure of harness on any affected part must +be avoided. Thus rest may become essential. The part may be frequently +washed with a strong solution of potassium sulphid.</p> + + +<h4>SUMMER SORES FROM FILARIA IRRITANS.</h4> + +<p>The summer sores of horses (dermatitis granulosa, boils) have been +traced to the presence in the skin of another parasite, 3 millimeters in +length and extremely attenuated (<i>Filaria irritans</i> Railliet). The sores +may be seen as small as a millet seed, but more frequently the size of a +pea, and may become an inch in diameter. They may appear on any point, +but are especially obnoxious where the harness presses or on the lower +parts of the limbs. They cause intense and insupportable itching, and +the victim rubs and bites the part until extensive raw surfaces are +produced. Aside from such friction the sore is covered by a +brownish-red, soft, pulpy material with cracks or furrows filled with +serous pus. In the midst of the softened mass are small, firm, rounded +granulations, fibrinous, and even caseated, and when the soft, +pultaceous material has been scraped<span class='pagenum'><a name="Page_470" id="Page_470">[Pg 470]</a></span> off, the surface bears a +resemblance to the fine, yellow points of miliary tuberculosis in the +lung. The worm or its débris is found in the center of such masses. +These sores are very obstinate, resisting treatment for months in +summer, and even after apparent recovery during the cold season they may +appear anew the following summer. In bad cases the rubbing and biting +may cause exposure of synovial sacs and tendons, and cause irremediable +injury. Even in winter, however, when the diseased process seems +arrested, there remain the hard, firm, resistant patches of the skin +with points in which the diseased product has become softened like +cheese.</p> + +<p>The apparent subsidence of the disease in winter is attributed to the +coldness and comparative bloodlessness of the skin, whereas in summer, +with high temperature, active circulation, and rapid cell growth, +inflammation is increased, itching follows, and from the animal rubbing +the part the irritation is persistently increased. The hotter the +climate the more troublesome the disease.<a name="FNanchor_4_4" id="FNanchor_4_4"></a><a href="#Footnote_4_4" class="fnanchor">[4]</a></p> + +<p><i>Treatment</i> consists, first, in placing the animal in a cool place and +showering the surface with cold water. The parasite may be destroyed by +rubbing the surface of the wound with iodoform and covering it with a +layer of collodion, and repeating the applications very 24 hours for 15 +days, or until the sores heal up. Ether or chloroform, poured on cotton +wool and applied to the sore for two minutes before painting it with +collodion, may be used in place of iodoform.<a name="FNanchor_5_5" id="FNanchor_5_5"></a><a href="#Footnote_5_5" class="fnanchor">[5]</a></p> + + +<h4>CRACKED HEELS (SCRATCHES, OR CHAPS ON KNEE AND HOCK).</h4> + +<p>This usually sets in with swelling, heat, and tenderness of the hollow +of the heel, with erections of the hairs and redness (in white skins), +with stiffness and lameness, which may be extreme in irritable horses. +Soon slight cracks appear transversely, and may gain in depth and width, +and may even suppurate. More frequently they<span class='pagenum'><a name="Page_471" id="Page_471">[Pg 471]</a></span> become covered at the +edges or throughout by firm incrustations resulting from the drying of +the liquids thrown out, and the skin becomes increasingly thick and +rigid. A similar condition occurs behind the knee and in front of the +hock (malanders and salanders), and may extend from these points to the +hoof, virtually incasing that side of the limb in a permanent incrusting +sheath.</p> + +<p><i>Causes.</i>—Besides a heavy lymphatic constitution, which predisposes to +this affection, the causes are overfeeding on grain, unwholesome fodder, +close, hot, dirty stables, constant contact with dung and urine and +their emanations, working in deep, irritant mud; above all, in limestone +districts, irritation by dry limestones or sandy dust in dry weather on +dirt roads; also cold drafts, snow, and freezing mud, washing the legs +with caustic soap, wrapping the wet legs in thick woolen bandages which +soak the skin and render it sensitive when exposed next day, clipping +the heels, weak heart and circulation, natural or supervening on +overwork, imperfect nourishment, impure air, lack of sunshine, chronic +exhausting, or debilitating diseases, or functional or structural +diseases of the heart, liver, or kidneys. These last induce dropsical +swelling of the limbs (stocking), weaken the parts, and induce cracking. +Finally the cicatrix of a preexisting crack, weak, rigid, and +unyielding, is liable to reopen under any severe exertion; hence rapid +paces and heavy draft are active causes.</p> + +<p><i>Treatment.</i>—In treatment the first step is to ascertain and remove the +cause whenever possible. If there is much local heat and inflammation, a +laxative (5 drams aloes or 1 pound Glauber's salt) may be given, and for +the pampered animal the grain should be reduced or replaced altogether +by bran mashes, flaxseed, and other laxative, nonstimulating feed. In +the debilitated, on the other hand, nutritious food and bitter tonics +may be given, and even a course of arsenic (5 grains arsenic with 1 dram +bicarbonate of soda daily). When the legs swell, exercise on dry roads, +hand rubbing, and evenly applied bandages are good, and mild +astringents, like extract of witch-hazel, may be applied and the part +subsequently rubbed dry and bandaged. If there is much heat but unbroken +skin, a lotion of 2 drams sugar of lead to 1 quart of water may be +applied on a thin bandage, covered in cold weather with a dry one. The +same may be used after the cracks appear, or a solution of sulphurous +acid 1 part, glycerin 1 part, and water 1 part, applied on cotton and +well covered by a bandage. In case these should prove unsuitable to the +particular case, the part may be smeared with vaseline 1 ounce, sugar of +lead 1 dram, and carbolic acid 10 drops.<span class='pagenum'><a name="Page_472" id="Page_472">[Pg 472]</a></span></p> + + +<h4>INFLAMMATION OF THE HEELS WITH SEBACEOUS SECRETION (GREASE, OR CANKER).</h4> + +<p>This is a specific affection of the heels of horses usually associated +with the growth of a parasitic fungus, an offensive discharge from the +numerous sebaceous glands, and, in bad cases, the formation of red, raw +excrescences (grapes) from the surface. It is to be distinguished (1) +from simple inflammation in which the special fetid discharge and the +tendency to the formation of "grapes" are absent; (2) from horsepox, in +which the abundant exudate forms a firm, yellow incrustation around the +roots of the hair, and is embedded at intervals in the pits formed by +the individual pocks, and in which there is no vascular excrescence; (3) +from foot scabies (mange), in which the presence of an acarus is +distinctive; (4) from lymphangitis, in which the swelling appears +suddenly, extending around the entire limb as high as the hock, and on +the inner side of the thigh along the line of the vein to the groin, and +in which there is active fever, and (5) from erysipelas, in which there +is active fever (wanting in grease), the implication of the deeper +layers of the skin and of the parts beneath giving a boggy feeling to +the parts, the absence of the fetid, greasy discharge, and finally a +tendency to form pus loosely in the tissues without any limiting +membrane, as in abscess. Another distinctive feature of grease is its +tendency to implicate the skin which secretes the bulbs or heels of the +horny frog and in the cleft of the frog, constituting the disease known +as canker.</p> + +<p><i>Causes.</i>—The predisposing causes of grease are essentially the same as +those of simple inflammation of the heel, so that the reader may consult +the preceding section. Though a specific fungus and bacteria of +different kinds are present, they tend mainly to aggravation of the +disease, and are not proved to be essential factors in causation.</p> + +<p><i>Symptoms.</i>—The symptoms vary according to whether the disease comes on +suddenly or more tardily. In the first case there is a sudden swelling +of the skin in the heel, with heat, tenderness, itching, and stiffness, +which is lessened during exercise. In the slower forms there is seen +only a slight swelling after rest, and with little heat or inflammation +for a week or more. Even at this early stage, a slight, serous oozing +may be detected. As the swelling increases, extending up toward the hock +or knees, the hairs stand erect, and are bedewed by moisture no longer +clear and odorless, but grayish, milky, and fetid. The fetor of the +discharge draws attention to the part whenever one enters the stable, +and the swollen pastern and wet, matted hairs on the heel draw attention +to the seat of the malady. If actively treated, the disease may not +advance further, but if neglected the tense, tender skin cracks open, +leaving open sores from which vascular bleeding growths grow up, +constituting the "grapes." The<span class='pagenum'><a name="Page_473" id="Page_473">[Pg 473]</a></span> hair is shed, and the heel may appear +but as one mass of rounded, red, angry excrescences which bleed on +handling and are covered with the now repulsively fetid, decomposing +discharge. During this time there is little or no fever, the animal +feeds well, and but for its local trouble it might continue at work. +When the malady extends to the frog, there is a fetid discharge from its +cleft or from the depressions at its sides, and this gradually extends +to its whole surface and upon the adjacent parts of the sole. The horn +meanwhile becomes soft, whitish, and fleshy in aspect, its constituent +tubes being greatly enlarged and losing their natural cohesion; it grows +rapidly above the level of the surrounding horn, and when pared is found +to be penetrated to an unusual depth by the secreting papillæ, and that +at intervals these have bulged out into a vascular fungous mass +comparable to the "grapes."</p> + +<p><i>Treatment.</i>—In treatment hygienic measures occupy a front rank, but +are in themselves insufficient to establish a cure. All local and +general conditions which favor the production and persistence of the +disease must be guarded against. Above all, cleanliness and purity of +the stable and air must be obtained; also nourishing diet, regular +exercise, and the avoidance of local irritants—septic, muddy, chilling, +etc. At the outset benzoated oxid of zinc ointment may be used with +advantage. A still better dressing is made with 1 ounce vaseline, 2 +drams oxid of zinc, and 20 drops iodized phenol. If the surface is much +swollen and tender, a flaxseed poultice may be applied, over the surface +of which has been poured some of the following lotion: Sugar of lead, +one-half ounce; carbolic acid, 1 dram; water, 1 quart. All the +astringents of the pharmacopœia have been employed with more or less +advantage, and some particular one seems to suit particular cases or +patients. To destroy the grapes, they may be rubbed daily with strong +caustics (copperas, bluestone, lunar caustic), or each may be tied round +its neck with a stout, waxed thread, or, finally and more speedily, they +may be cut off by a black-smith's shovel heated to redness and applied +with its sharp edge toward the neck of the excrescence, over a cold +shovel held between it and the skin to protect the skin from the heat. +The cold shovel must be kept cool by frequent dipping in water. After +the removal of the grapes the astringent dressing must be persistently +applied to the surface. When the frog is affected, it must be pared to +the quick and dressed with dry caustic powders (quicklime, copperas, +bluestone) or carbolic acid and subjected to pressure, the dressing +being renewed every day at least.<span class='pagenum'><a name="Page_474" id="Page_474">[Pg 474]</a></span></p> + + +<h4>ERYSIPELAS.</h4> + +<p>This is a specific contagious disease, characterized by spreading, +dropsical inflammation of the skin and subcutaneous tissues, attended +with general fever. It differs from most specific diseases in the +absence of a definite period of incubation, a regular course and +duration, and a conferring of immunity on the subject after recovery. On +the contrary, one attack of erysipelas predisposes to another, partly, +doubtless, by the loss of tone and vitality in the affected tissues, but +also, perhaps, because of the survival of the infecting germ.</p> + +<p><i>Cause.</i>—It is no longer to be doubted that the microbes found in the +inflammatory product are the true cause of erysipelas, as by their means +the disease can be successfully transferred from man to animals and from +one animal to another. This transition may be direct or through the +medium of infected buildings or other articles. Yet from the varying +severity of erysipelas in different outbreaks and localities it has been +surmised that various different microbes are operative in this disease, +and a perfect knowledge of them might perhaps enable us to divide +erysipelas into two or more distinct affections. At present we must +recognize it as a specific inflammation due to a bacterial poison and +closely allied to septicemia. Erysipelas was formerly known as surgical +when it spread from a wound (through which the germ had gained access) +and medical, or idiopathic, when it started independently of any +recognizable lesion. Depending as it does, however, upon a germ distinct +from the body, the disease must be looked upon as such, no matter by +what channel the germ found an entrance. Erysipelas which follows a +wound is usually much more violent than the other form, the difference +being doubtless partly due to the lowered vitality of the wounded +tissues and to the oxidation and septic changes which are invited on the +raw, exposed surface. As apparently idiopathic cases may be due to +infection through bites of insects, the small amount of poison inserted +may serve to moderate the violence.</p> + +<p>This affection may attack a wound on any part of the horse's body, +while, apart from wounds, it is most frequent about the head and the +hind limbs. It is to be distinguished from ordinary inflammations by its +gradual extension from the point first attacked, by the abundant liquid +exudation into the affected part, by the tension of the skin over the +affected part, by its soft, boggy feeling, allowing it to be deeply +indented by the finger, by the abrupt line of limitation between the +diseased and the healthy skin, the former descending suddenly to the +healthy level instead of shading off slowly toward it, by the tendency +of the inflammation to extend deeply into the subjacent tissues and into +the muscles and other structures, by the great tendency to death and +sloughing of portions of skin and of the structures<span class='pagenum'><a name="Page_475" id="Page_475">[Pg 475]</a></span> beneath, by the +formation of pus at various different points throughout the diseased +parts without any surrounding sac to protect the surrounding structures +from its destructive action, and without the usual disposition of pus to +advance harmlessly toward the surface and escape; and, finally, by a +low, prostrating type of fever, with elevated temperature of the body, +coated tongue, excited breathing, and loss of appetite. The pus when +escaping through a lancet wound is grayish, brownish, or reddish, with a +heavy or fetid odor, and inter-mixed with shreds of broken-down tissues. +The most destructive form, however, is that in which pus is deficient +and gangrene and sloughing more speedy and extensive.</p> + +<p><i>Treatment</i> resolves itself mainly into the elimination from the system +of the poisonous products of the bacteria by laxatives and diuretics, +the sustaining of the failing vitality by tonics and stimulants, above +all those of the nature of antiferments, and the local application of +astringent and antiseptic agents. Internal treatment may consist in 4 +drams tincture of muriate of iron and one-half dram muriate of ammonia +or chlorate of potash, given in a pint of water every two hours. To this +may be added, liberally, whisky or brandy when the prostration is very +marked. Locally a strong solution of iron, alum, or of sulphate of iron +and laudanum may be used; or the affected part may be painted with +tincture of muriate of iron or with iodized phenol. In mild cases a +lotion of 4 drams sugar of lead and 2 ounces laudanum in a quart of +water may be applied. It is desirable to avoid the formation of wounds +and the consequent septic action, yet when pus has formed and is felt by +fluctuation under the finger to be approaching the surface it should be +freely opened with a clean, sharp lancet, and the wound thereafter +disinfected daily with carbolic acid 1 part to water 10 parts, with a +saturated solution of hyposulphite of soda, or with powders of iodoform +or salol.</p> + + +<h4>HORSEPOX, ANTHRAX, AND CUTANEOUS GLANDERS (FARCY).</h4> + +<p>These subjects are discussed under the head of contagious diseases.</p> + + +<h4>CALLOSITIES.</h4> + +<p>These are simple thickening and induration of the cuticle by reason of +continued pressure, notably in lying down on a hard surface. Being +devoid of hair, they cause blemishes; hence, smooth floors and good +bedding should be provided as preventives.</p> + + +<h4>HORNY SLOUGHS (SITFASTS), OR SLOUGHING CALLOSITIES.</h4> + +<p>These are circumscribed sloughs of limited portions of the skin, the +result of pressure by badly fitting harness or by irritating masses of +dirt, sweat, and hairs under the harness. They are most common under the +saddle, but may be found under collar or breeching as well.<span class='pagenum'><a name="Page_476" id="Page_476">[Pg 476]</a></span> The sitfast +is a piece of dead tissue which would be thrown off but that it has +formed firm connections with the fibrous skin beneath, or even deeper +with the fibrous layers (fascia) of the muscles, or with the bones, and +is thus bound in its place as a persistent source of irritation. The +hornlike slough may thus involve the superficial part of the skin only, +or the whole thickness of the skin, and even of some of the structures +beneath. The first object is to remove the dead irritant by dissecting +it off with a sharp knife, after which the sore may be treated with +simple wet cloths or a weak carbolic-acid lotion, like a common wound. +If the outline of the dead mass is too indefinite, a linseed-meal +poultice will make its outline more evident to the operator. If the +fascia or bone has become gangrenous, the dead portion must be removed +with the hornlike skin. During and after treatment the horse must be +kept at rest or the harness must be so adjusted that no pressure can +come near the affected parts. (See also page 496.)</p> + + +<h4>WARTS.</h4> + +<p>These are essentially a morbid overgrowth of the superficial papillary +layer of the skin and of the investing cuticular layer. They are mostly +seen in young horses, about the lips, eyelids, cheeks, ears, beneath the +belly, and on the sheath, but may develop anywhere. The smaller ones may +be clipped off with scissors and the raw surface cauterized with +bluestone. The larger may be sliced off with a sharp knife, or if with a +narrow neck they may be twisted off and then cauterized. If very +vascular they may be strangled by a wax thread or cord tied around their +necks, at least three turns being made around and the ends being fixed +by passing them beneath the last preceding turn of the cord, so that +they can be tightened day by day as they slacken by shrinkage of the +tissues. If the neck is too broad it may be transfixed several times +with a double-threaded needle and then be tied in sections. Very broad +warts that can not be treated in this way may be burned down with a +soldering bolt at a red heat to beneath the surface of the skin, and any +subsequent tendency to overgrowth kept down by bluestone.</p> + + +<h4>BLACK PIGMENT TUMORS, OR MELANOSIS.</h4> + +<p>These are common in gray and in white horses on the naturally black +parts of the skin at the roots of the tail, around the anus, vulva, +udder, sheath, eyelids, and lips. They are readily recognized by their +inky-black color, which extends throughout the whole mass. They may +appear as simple, pealike masses, or as multiple tumors aggregating many +pounds, especially around the tail. In the horse these are usually +simple tumors, and may be removed with the knife. In exceptional cases +they prove cancerous, as they usually are in man.<span class='pagenum'><a name="Page_477" id="Page_477">[Pg 477]</a></span></p> + + +<h4>EPITHELIAL CANCER, OR EPITHELIOMA.</h4> + +<p>This sometimes occurs on the lips at the angle of the mouth and +elsewhere in the horse. It begins as a small, wartlike tumor, which +grows slowly at first, but finally bursts open, ulcerates, and extends +laterally and deeply in the skin and other tissues, destroying them as +it advances (rodent ulcer). It is made up of a fibrous framework and +numerous round, ovoid, or cylindrical cavities, lined with masses of +epithelial cells, which may be squeezed out as a fetid, caseous +material. Early and thorough removal with the knife is the most +successful treatment.</p> + + +<h4>VEGETABLE PARASITES OF THE SKIN.</h4> + +<h5>(Pl. XXXVIII, figs. 2, 3, 4.)</h5> + +<p><span class="smcap">Parasite</span>: <i>Trichophyton tonsurans.</i> <span class="smcap">Malady</span>: <i>Tinea tonsurans, or +circinate ringworm.</i>—This is especially common in young horses coming +into training and work, in low-conditioned colts in winter and spring +after confinement indoors, during molting, in lymphatic rather than +nervous subjects, and at the same time in several animals that have +herded together. The disease is common to man, and among the domestic +animals to horse, ox, goat, dog, cat, and in rare instances to sheep and +swine. Hence it is common to find animals of different species and their +attendants suffering at once, the diseases having been propagated from +one to the other.</p> + +<p><i>Symptoms.</i>—In the horse the symptoms are the formation of a circular, +scurfy patch where the fungus has established itself, the hairs of the +affected spot being erect, bristly, twisted, broken, or split up and +dropping off. Later the spot first affected has become entirely bald, +and a circular row of hairs around this are erect, bristly, broken, and +split. These in turn are shed and a new row outside passes through the +same process, so that the extension is made in more or less circular +outline. The central bald spot, covered with a grayish scurf and +surrounded by a circle of broken and split hairs, is characteristic. If +the scurf and diseased hairs are treated with caustic-potash solution +and put under the microscope, the natural cells of the cuticle and hair +will be seen to have become transparent, while the groups of spherical +cells and branching filaments of the fungus stand out prominently in the +substance of both, dark and unchanged. The eruption usually appears on +the back, loins, croup, chest, and head. It tends to spontaneous +recovery in a month or two, leaving for a time a dappled coat from the +spots of short, light-colored hair of the new growth.</p> + +<p>The most effective way of reaching the parasite in the hair follicles is +to extract the hairs individually, but in the horse the mere shaving of +the affected part is usually enough. It may then be painted with<span class='pagenum'><a name="Page_478" id="Page_478">[Pg 478]</a></span> +tincture of iodin twice a day for two weeks. Germs about the stable may +be covered up or destroyed by a whitewash of freshly burned quicklime, +the harness, brushes, etc., may be washed with caustic soda, and then +smeared with a solution of corrosive sublimate one-half dram and water 1 +pint. The clothing may be boiled and dried.</p> + +<p><span class="smcap">Parasite</span>: <i>Achorion schönleini.</i> <span class="smcap">Malady</span>: <i>Favus, or honeycomb +ringworm.</i>—Mégnin and Goyau, who describe this in the horse, say that +it loses its characteristic honeycomb or cup-shaped appearance, and +forms only a series of closely aggregated, dry, yellowish crusts the +size of hemp seed on the trunk, shoulders, flanks, or thighs. They are +accompanied by severe itching, especially at night. The cryptogam, +formed of spherical cells with a few filaments only, grows in the hair +follicles and on the cuticle, and thus a crust often forms around the +root of a hair. Like the other cryptogams, their color, as seen under +the microscope, is unaffected by acetic acid, alcohol, ether, or oil of +turpentine, while the cells are turned bluish by iodin. For treatment, +remove the hair and apply tincture of iodin or corrosive sublimate +lotion, as advised under the last paragraph.</p> + +<p><span class="smcap">Parasite</span>: <i>Microsporon furfur.</i> <span class="smcap">Malady</span>: <i>Parasitic pityriasis.</i>—This +attacks the horse's head where the harness presses, and leads to +dropping of the hair, leaving bald patches covered with a branlike +scurf, without any eruption, heat, tenderness, swelling, or rigidity of +the skin. A lotion of carbolic acid 1 dram and water 2-1/2 ounces is +usually applied to effect a cure.</p> + + +<h3>ANIMAL PARASITES OF THE SKIN.<a name="FNanchor_6_6" id="FNanchor_6_6"></a><a href="#Footnote_6_6" class="fnanchor">[6]</a></h3> + +<h4>ACARIASIS, OR MANGE.</h4> + +<p>This affection is due to the irritation of the skin caused by the +presence of nearly microscopic acari, or mites. The disease varies, +however, according to the species of acarus which infests the skin, so +that we must treat of several different kinds of acariasis.</p> + +<p><span class="smcap">Parasite</span>: <i>Sarcoptes scabiei equi.</i> <span class="smcap">Malady</span>: <i>Sarcoptic acariasis.</i>—This +is the special <i>Sarcoptes</i> of the horse, but under favorable conditions +it can be transmitted to ass and mule, and even to man, and may live +indefinitely on the human skin. The mite (Pl. XXXIX, fig. 1) is nearly +microscopical, but may be detected with a magnifying lens among moving +scurf taken from the infected skin. Like all <i>Sarcoptes</i>, it burrows +little galleries in and beneath the scurf skin, where it hides and lays +its eggs and where its young are hatched. It is therefore often +difficult to find the parasite on the surface, unless the skin has been +heated by a temporary exposure to the sun or in a warm room. The mite +may be detected more readily by placing<span class='pagenum'><a name="Page_479" id="Page_479">[Pg 479]</a></span> scrapings on black cardboard +and warming, or better by macerating scabs or scrapings in a solution of +caustic soda or potash and then examining them microscopically. Like +other acari, this is wonderfully prolific, a new generation of fifteen +individuals being possible every fifteen days, so that in three months +the offspring of a single pair may produce generations aggregating +1,500,000 young. The <i>Sarcoptes</i> have less vitality than the +nonburrowing acari, as they die in an hour when kept apart from the skin +in dry air at a heat of 145° F. They live 12 to 14 days apart from the +skin in the damp air of a stable. On a piece of damp hide they lived +till the twenty-fourth day, when they began to die, and all were dead on +the twenty-eighth.</p> + +<p><i>Symptoms.</i>—The symptoms are an incessant, intolerable, and increasing +itching of some part of the skin (head, mane, tail, back, etc.), the +horse inclining himself toward the hand that scratches him, and moving +his lips as if himself scratching. The hairs may be broken and rubbed +off, but the part is never entirely bald, as in ringworm, and there may +be papules or any kind of eruption or open sores from the energy of the +scratching. Scabs of any thickness may form, but the special features +are the intense itching and the presence of the acarus.</p> + +<p><i>Treatment</i> consists in the removal of the scabs by soapsuds, and, if +necessary, a brush and the thorough application of tobacco 1-1/2 ounces +and water 2 pints, prepared by boiling. This may be applied more than +once, and should always be repeated after 15 days, to destroy the new +brood that may have been hatched in the interval. All harness and stable +utensils should be similarly treated; blankets and rubbers may be +boiled, and the stalls should be covered with a whitewash of quicklime, +containing one-fourth pound of chlorid of lime to the gallon.</p> + +<p>When there are too many animals to treat by means of hand dressings, the +lime-and-sulphur dip or the tobacco dip may be used and are very +effective, though the cresol dips are fairly effective. These dips may +be purchased and made up in the dilution called for on the container. +The affected animals may be dipped when the number warrants it and +facilities are available; otherwise the dips may be applied with a swab +or a spray pump. Directions for constructing a dipping vat may be +obtained from the United States Department of Agriculture on +application. Any treatment used should be repeated in the course of 10 +to 14 days. If the stables are not disinfected, animals should be +removed after treatment and put in clean stables or on clean pasture for +at least a month to allow the mites in the infested stables to die. +Otherwise the disease may recur.<span class='pagenum'><a name="Page_480" id="Page_480">[Pg 480]</a></span></p> + +<p><span class="smcap">Parasite</span>: <i>Psoroptes equi</i> (<i>Dermatocoptes equi</i>, +<i>Dermatodectes equi</i>). <span class="smcap">Malady</span>: <i>Psoroptic +acariasis.</i>—Psoroptic mange is less common than sarcoptic +mange in horses, and as the parasite (Pl. XXXIX, fig. 3) only +bites the surface and lives among the crusts under the shelter of the +hair, it is very easily discovered. It reproduces itself with equal +rapidity and causes similar symptoms to those produced by the +<i>Sarcoptes</i>. The same treatment will suffice and is more promptly +effectual. The purifying of the stable must be more thorough, as the +<i>Psoroptes</i> will survive twenty to thirty days in the moist atmosphere +of a stable, and may even revive after six or eight weeks when subjected +to moist warmth. Infested pastures will therefore prove dangerous to +horses for that length of time, and, with rubbing posts, etc, should not +be used.</p> + +<p><span class="smcap">Parasite</span>: <i>Chorioptes equi</i> (<i>Symbiotes equi</i>, <i>Dermatophagus equi</i>, +<i>Chorioptes spathiferus</i>). <span class="smcap">Malady</span>: <i>Foot mange.</i>—The acarus (Pl. XXXIX, +fig. 2) attacks the heels and lower parts of the legs, especially the +hind ones, and may be present for years without extending upon the body. +Like the <i>Psoroptes</i>; it lives on the surface, on the hairs, and among +the scabs. It gives rise to great itching, stamping, rubbing of the one +leg with the other, and the formation of papules, wounds, ulcerous +sores, and scabs. The intense itching will always suggest this parasite, +and the discovery of the acarus will identify the disease. The treatment +is the same as for the <i>Sarcoptes</i>, but may be confined to the legs and +the parts with which they come in contact.</p> + +<p><span class="smcap">Parasite</span>: <i>Dermanyssus gallinæ, or chicken acari.</i> <span class="smcap">Malady</span>: <i>Poultry +acariasis.</i>—This is a large-sized acarus, though usually miscalled "hen +louse," and the disease "poultry lousiness." The mite (Pl. XXXIX, fig. +4) lives in droppings and in crevices of chicken houses, but temporarily +passes on to the skin of man and of the horse and other quadrupeds, when +occasion serves. It causes much irritation, with the eruption of papules +or vesicles and the formation of sores and scabs. The examination of the +skin is usually fruitless, as the attacks are mostly made at night and +the effects only may be seen during the day. The proximity of hen manure +swarming with the acari explains the trouble, and the removal of this +and a white-washing with quicklime, with or without chlorid of lime, +will prevent future attacks. The skin may still require bland ointments +or lotions, as for congestion.</p> + +<p><span class="smcap">Parasite</span>: <i>Larva of a Trombidium, Leptus americanus, or harvest bug, +misnamed jigger (chigoe).</i> <span class="smcap">Malady</span>: <i>Autumn mange.</i>—This parasite is a +brick-red acarus, visible to the naked eye on a dark ground, and living +on green vegetation in many localities. It attacks man, and the horse, +ox, dog, etc., burrowing under the skin and giving rise to small papules +and intolerable irritation. This continues for two or three days only +from a single invasion, but will last until cold weather sets in if +there is a fresh invasion daily. Horses at pasture suffer mainly on the +lower part of the face. If kept indoors the disease will disappear, or +if left at pasture a weak tar water or solution of tobacco may be +applied to the face.</p> + +<p><a name="PLATE_XXXIX" id="PLATE_XXXIX"></a></p> +<div class="figcenter" style="width: 308px;"> +<a href="images/plate39.jpg"><img src="images/plate39t.jpg" width="308" height="450" alt="PLATE XXXIX." title="" /></a> +<span class="caption">PLATE XXXIX.<br /> + +MITES THAT INFEST THE HORSE.</span> +</div> + + +<h4>TICKS.</h4> + +<p><span class='pagenum'><a name="Page_481" id="Page_481">[Pg 481]</a></span>The wood ticks are familiar to inhabitants of uncultivated lands, and +prove troublesome parasites to man and beast alike. The tick lives on +bushes, and attaches itself to the mammal only to secure a feast of +blood, for when gorged it drops off to sleep off its debauch on the +soil. The tick produces great irritation by boring into the skin with +its armed proboscis. If pulled out, the head and thorax are often left +in the skin. They may be covered with oil to shut out the air from their +breathing pores, or by touching them with a hot penknife they will be +impelled to let go their hold.</p> + + +<h4>GRUBS IN SKIN.</h4> + +<p><span class="smcap">Parasite</span>: <i>Hypoderma lineata</i>. <span class="smcap">Malady</span>: <i>Larvæ</i> (<i>grubs</i>) <i>under the +skin</i>.—The larvæ of a fly (probably <i>Hypoderma lineata</i>, whose larvæ in +the skin of cattle are commonly known as "warbles") are occasionally +found in little sacs beneath the skin of horses. The mature larva +escapes in early summer and develops into a fly. In districts where they +exist the grubs should be pressed out of the skin in the course of the +winter and destroyed.</p> + + +<h4>LARVÆ (GRUBS) ON THE SKIN, OR FLYBLOW.</h4> + +<p>The following flies, among others, deposit their eggs on open sores or +on wet, filthy parts of the skin, where their larvæ or grubs give rise +to serious trouble: <i>Lucilia cæsar</i> (bluebottle), <i>Cochliomyia +macellaria</i> (screwworm fly), <i>Musca vomitoria</i> (meat fly), and +<i>Sarcophaga carnaria</i> (flesh fly). To prevent their attacks, wet, filthy +hair should be removed and wounds kept clean and rendered antiseptic by +a lotion of carbolic acid 1 part, water 50 parts, or by a mixture of 1 +ounce oil of tar in 20 ounces sweet oil, or by some other antiseptic. If +the grubs are already present they should be picked off and one of these +dressings freely applied.</p> + + +<h4>FLIES.</h4> + +<p>A number of flies attack horses and suck their blood, producing great +annoyance and in some instances death. These insects not only suck the +blood, but also often instill an acid poison into the skin, and in +exceptional cases transfer infectious germs from animal to animal by +inoculation.</p> + +<p>Various devices are resorted to to prevent the attacks, as to sponge the +skin with a decoction of walnut or elder leaves, of tobacco, to dust<span class='pagenum'><a name="Page_482" id="Page_482">[Pg 482]</a></span> +with Persian insect powder, to keep a light blanket or fly net on the +horse, to close doors and windows with fine screens and destroy by +pyrethrum any flies that have gained admission, to remove all manure +heaps that would prove breeding places for flies, to keep the stalls +clean, deodorize by gypsum, and to spread in them trays of dry chlorid +of lime. For the poisoned bites apply ammonia, or a solution of 1 part +of carbolic acid in 20 parts of sweet oil or glycerin, or one-fourth +ounce bicarbonate of soda and 1 dram of carbolic acid in a quart of +water may be used.</p> + +<p>A large number of fly repellents have been recommended, but most of them +must be applied daily in order to maintain the protective effect. Among +the things used are carbolic solutions, pine tar, oil of tar, fish oil, +laurel oil, oil of citronella, oil of sassafras, oil of camphor, and +cod-liver oil. These things must be used judiciously or they will result +in poisoning or removal of the hair from the animal in some instances. +Ten per cent oil of tar in Beaumont oil or in cottonseed oil was found +to be safe and efficacious by Graybill.</p> + +<p>The use of the fly-maggot trap noted under stomach worms of the horse, +and of the various forms of the Hodge flytrap, is recommended.</p> + + +<h4>FLEAS.</h4> + +<p>The flea of man and those of poultry, when numerous, will bite the horse +and give rise to rounded swellings on the skin. To dispose of them it is +needful to clear the surroundings of the grublike larvæ as well as to +treat the victim. The soil may be sprinkled with quicklime, carbolic +acid, coal tar, or petroleum; the stalls may be deluged with boiling +water and afterwards painted with oil of turpentine and littered with +fresh pine sawdust, and all blankets should be boiled. The skin may be +sponged with a solution of 1 part carbolic acid in 50 parts of water. +Other animals should be kept free from fleas or kept away from the +vicinity of the stable.</p> + +<p>The chigoe (<i>Pulex penetrans</i>) of the Gulf coast is still more +injurious, because it burrows under the surface and deposits its eggs to +be hatched out slowly with much irritation. The tumor formed by it +should be laid-open and the parasite extracted. If it bursts so that its +eggs escape into the wound, they may be destroyed by introducing +chloroform into the wound.</p> + + +<h4>LICE, OR PEDICULI.</h4> + +<p>Two kinds of lice attack the horse, one of which is furnished with +narrow head and a proboscis for perforating the skin and sucking the +blood, and the other—the broad-headed kind—with strong mandibles, by +which it bites the skin only. The poor condition, itching, and loss of +hair should lead to suspicion, and a close examination will detect the +lice. They may be destroyed by rubbing the victim with sulphur<span class='pagenum'><a name="Page_483" id="Page_483">[Pg 483]</a></span> +ointment, or with sulphuret of potassium 4 ounces, water 1 gallon, or +with tar water, or the skin may be sponged with benzine. The application +should be repeated a week later to destroy all lice hatched from the +nits in the interval. Buildings, clothes, etc., should be treated as for +fleas.</p> + + +<h4>STINGS OF BEES, WASPS, AND HORNETS.</h4> + +<p>These are much more irritating than the bites of flies, partly because +the barbed sting is left in the wound and partly because of the quantity +and quality of the venom. When a swarm attacks an animal the result may +prove fatal.</p> + +<p><i>Treatment</i> consists in the application of wet clay, or of a lotion of +soda or ammonia, or of carbolic acid, or permanganate of potash, 2 +grains to the ounce; or of sugar of lead 2 drams, laudanum 1 ounce, and +water 1 pint. The embedded stings should be extracted with fine forceps +or even with the finger nails.</p> + + +<h4>TARANTULA AND SCORPION.</h4> + +<p>The bite of the first and the sting of the second are poisonous, and may +be treated like other insect venom, by carbolated glycerin, or a strong +solution of ammonia, or permanganate of potash.</p> + + +<h4>SNAKE BITES.</h4> + +<p>These are marked by the double incision caused by the two fangs, by the +excessive doughy (dark red) swelling around the wounds, and in bad cases +by the general symptoms of giddiness, weakness, and prostration. They +are best treated by enormous doses of alcohol, whisky, or brandy, or by +aqua ammonia very largely diluted in water, the object being to sustain +life until the poison shall have spent its power. As local treatment, if +the wound is in a limb, the latter may have a handkerchief or cord tied +around it above the injury and drawn tight by a stick twisted into it. +In this way absorption may be checked until the poison can be destroyed +by the application, of a hot iron or a piece of nitrate of silver or +other caustic. A poultice of tobacco leaves is a favorite remedy, and +may be used to soothe the sore after cauterization.</p> + +<p>A treatment which has been highly recommended consists in prompt and +vigorous scarification at the site of puncture and rubbing crystals of +potassium permanganate into the wound.</p> + + +<h4>BURNS AND SCALDS.</h4> + +<p>These subjects are discussed in the following chapter.</p> + + +<h4>WOUNDS OF THE SKIN.</h4> + +<p>Wounds of the skin are fully discussed in the next chapter.</p> + +<div class="footnotes"><h3>FOOTNOTES:</h3> + +<div class="footnote"><p><a name="Footnote_3_3" id="Footnote_3_3"></a><a href="#FNanchor_3_3"><span class="label">[3]</span></a> An outbreak of quittor near Cheyenne, Wyo., which came +under the author's observation, was caused by the mud through which the +horses had to wade to reach the watering troughs. These troughs were +furnished with water by windmills, and the mudholes were caused by the +waste water. More than 50 cases developed inside of two months, or +during September and October. In these 50 cases all forms of the disease +and all possible complications were presented. During the rainy season +at Leadville, Colo., outbreaks of quittor are common, and the disease is +so virulent that it has long been known as the "Leadville foot rot." The +soil being rich in mineral matters is no doubt the cause of the +outbreaks. In the city of Montreal quittor is said to be very common in +the early springtime, when the streets are muddy from the melting snow +and ice.</p></div> + +<div class="footnote"><p><a name="Footnote_4_4" id="Footnote_4_4"></a><a href="#FNanchor_4_4"><span class="label">[4]</span></a> Descazeaux has shown that the worms found in these summer +sores are probably larval forms of the stomach worms of the horse, +<i>Habronema megastoma</i>, <i>H. microstoma</i>, and <i>H. muscæ</i>. Ransom has shown +that the larval stage of <i>H. muscæ</i> develops in the common housefly, the +fly becoming infested as a maggot in horse manure. Infestation with the +adult worms in the stomach of the horse (Pl. V, fig. 4) may take place +through the ingestion of such infested flies, or by the escape of the +larva from the proboscis of the fly as it feeds on the moist lips of the +horse. In view of this it may be surmised that summer sores may arise as +the result of flies so infested feeding on the moisture on the skin of +the horse. In some forms of summer sores along the abdomen there are +found immature stages of <i>Habronema</i> which apparently have just escaped +from the egg and which are younger than some of the stages found in the +fly. In this case it is surmised that these embryos from the manure +enter the soiled skin of the horse, as it lies down on dirty bedding and +manure, and develop in the skin as they would ordinarily in the fly. +Descazeaux calls these summer sores cutaneous habronemiasis. +</p><p> +Preventive measures consist in the removal of the adult worms from the +stomach of the horse by the use of anthelmintics, the destruction of the +embryos in the manure, fly-control measures, and the use of clean +bedding.—<span class="smcap">M. C. HALL</span>.</p></div> + +<div class="footnote"><p><a name="Footnote_5_5" id="Footnote_5_5"></a><a href="#FNanchor_5_5"><span class="label">[5]</span></a> Descazeaux recommends the application and injection of 2 to +3 per cent trypanblue, though he states that the only truly efficacious +treatment is the early and complete ablation of the invaded tissue.—M. +C. H.</p></div> + +<div class="footnote"><p><a name="Footnote_6_6" id="Footnote_6_6"></a><a href="#FNanchor_6_6"><span class="label">[6]</span></a> Revised by M. C. Hall.</p></div> +</div> + + +<hr style="width: 65%;" /> +<p><span class='pagenum'><a name="Page_484" id="Page_484">[Pg 484]</a></span></p> +<h2>WOUNDS AND THEIR TREATMENT.</h2> + +<h3>By <span class="smcap">Ch. B. Michener</span>, V. S.</h3> + +<h4>[Revised by John R. Mohler, V. M. D., A. M.]</h4> + + +<h4>DESCRIPTION OF WOUNDS.</h4> + +<p>A wound is an injury to any part of the body involving a solution of +continuity or disruption of the affected parts and is caused by +violence, with or without laceration of the skin. In accordance with +this definition we have the following varieties of wounds: Incised, +punctured, contused, lacerated, gunshot, and poisoned. They may further +be classified as superficial, deep, or penetrating, and also as unclean, +if hair, dirt, or splinters of wood are present; as infected when +contaminated with germs, and as aseptic if the wound does not contain +germs.</p> + +<p>An incised wound is a simple cut made with a sharp body, like a knife, +producing merely a division of the tissues. The duller the body the more +force is required, the more tissues destroyed, and a greater time will +be required for healing. In a cut wound the edges are even and definite, +while those of a lacerated wound are irregular and torn. Three +conditions are present as a result of an incised wound: (1) Pain, (2) +hemorrhage, (3) gaping of the wound. The first pain is due to the +crushing and tearing of the nerve fibers. In using a sharp knife and by +cutting quickly, the animal suffers less pain and healing occurs more +rapidly. The secondary pain is usually due to the action of the air and +inflammatory processes. When air is kept from the wound pain ceases soon +after the lesion is produced. Hemorrhage is absent only in wounds of +nonvascular tissues, as the cornea of the eye, the cartilage of joints, +and other similar structures. Bleeding may be from the arteries, veins, +or capillaries. In the last form of bleeding the blood oozes from the +part in drops. Hemorrhage from the veins is dark red and issues in a +steady stream without spurting. In arterial bleeding the blood is bright +red and spurts with each heart beat. This latter variety of hemorrhage +is the most dangerous, and should be stopped at once before attempting +any further treatment. Bleeding from small veins and capillaries ceases +in a short time spontaneously, while larger vessels, especially +arteries, require some form of treatment to cause complete stoppage of +the hemorrhage.<span class='pagenum'><a name="Page_485" id="Page_485">[Pg 485]</a></span></p> + + +<h4>HEMOSTASIA.</h4> + +<p>By this term is meant the checking of the flow of blood. It may be +accomplished by several methods, such as compress bandages, torsion, hot +iron, and ligatures. The heat from a hot iron will cause the immediate +clotting of the blood in the vessels, and this clot is further supported +by the production of a scab, or crust, over the portion seared. The iron +should be at a red heat. If at a white heat, the tissue is charred, +which makes it brittle and the bleeding is liable to be renewed. If the +iron is at a black heat, the tissue will stick to the iron and will pull +away from the surface of the wound. Cold water and ice bags quickly stop +capillary bleeding, while hot water is preferable in more excessive +hemorrhages. Some drugs, called styptics, possess the power of +contracting the walls of blood vessels and also of clotting the blood. A +solution of the chlorid of iron placed on a wound alone or by means of +cotton drenched in the liquid produces a rapid and hard clot. Tannic +acid, alum, acetic acid, alcohol, and oil of turpentine are all more or +less active in this respect. To check bleeding from large vessels +compression may be adopted. When it is rapid and dangerous and from an +artery, the fingers may be used for pressing between the wound and the +heart (digital compression), but if from a vein, the pressure should be +exerted on the other side of the wound. Tourniquet may also be used by +passing a strap around the part and tightening after placing a pad over +the hemorrhage. The rubber ligature has now replaced the tourniquet and +is bound tightly around the limb to arrest the bleeding. Tampons, such +as cotton, tow, or oakum, may be packed tightly in the wound and then +sewed up. After remaining there for twenty-four or forty-eight hours +they are removed. Bleeding may sometimes be easily checked by passing a +pin under the vessel and by taking a horsehair and forming a figure 8 by +running it above and below the pin, thus causing pressure on the vessel. +Torsion is the twisting of the blood vessel until the walls come +together and form a barrier to the flow of blood. It may be accomplished +by the fingers, forceps, or by running a pin through the vessel, turning +it several times, and then running the point into the tissue to keep it +in a fixed position.</p> + +<p>Ligation is the third method for stopping a hemorrhage. The blood vessel +should be seized with the artery forceps, a clean thread of silk passed +around it, and tied about one-half inch from its end. The silk should be +sterilized by placing it in an antiseptic solution so as not to impede +the healing process or cause blood poisoning or lockjaw, which often +follows the ligation of a vein with unsterilized material. Sometimes it +will be impossible to reach the bleeding vessel, so it is necessary to +pass the ligature around a mass of tissue which includes the blood +vessel. Ligation is the most useful method<span class='pagenum'><a name="Page_486" id="Page_486">[Pg 486]</a></span> of arresting hemorrhage, +since it disturbs healing least and gives the greatest security against +secondary hemorrhage.</p> + + +<h4>SUTURES.</h4> + +<p>After the bleeding has been controlled and all foreign bodies removed +from the wound, the gaping of the wound is noticeable. It is caused by +the contraction of the muscles and elastic fibers, and its degree +depends on the extent, direction, and nature of the cut. This gaping +will hinder the healing process so that it must be overcome by bringing +the edges together by some sort of sutures or pins or by a bandage +applied from below upward. As suture material, ordinary cotton thread is +good, if well sterilized, as are also horsehair, catgut, silk, and +various kinds of wire. If the suture is made too tight the subsequent +swelling may cause the stitch to tear out. In order to make a firm +suture the depth of the stitch should be the same as the distance the +stitch is from the edge of the wound. The deeper the suture the more +tissue is embraced and the fewer the number of stitches required. In +tying a suture the square or reef knot should be used. Closure of wounds +by means of adhesive plaster, collodion, and metal clamps is not +practiced to any great extent in veterinary practice.</p> + + +<h4>PROCESS OF HEALING.</h4> + +<p>In those cases where perfect stoppage of bleeding, perfect coaptation of +the edges of the wound, and perfect cleanliness are obtained, healing +occurs within three days, without the formation of granulations, pus, or +proud flesh, by what is termed first intention. If wounds do not heal in +this manner they will gap somewhat and become warm and painful. Healing +then occurs by granulation or suppuration, which is termed healing by +second intention. The sides of the wound become covered with granulation +tissue which may fill the wound and sometimes overlap the lips, forming +a fungoid growth called proud flesh. Under favorable conditions the +edges of the wound appear to grow together by the end of the first week, +and the whole surface gradually becomes dry, and finally covered with +pigmented skin, when the wound is healed. The cause of pus formation in +wounds is usually the presence of germs. For this reason the utmost care +should be adopted to keep clean wounds aseptic, or free from germs, and +to make unclean wounds antiseptic by using antiseptic fluids to kill the +microbes present in the wound. The less the injurious action of this +fluid on the wound and the greater its power to kill germs, the more +valuable it becomes. All antiseptics are not equally destructive, and +some germs are more susceptible to one antiseptic than to another. The +most important are (1) bichlorid of mercury, which is to be preferred on +horses. It becomes weakened<span class='pagenum'><a name="Page_487" id="Page_487">[Pg 487]</a></span> in its action if placed in a wooden pail or +on an oily or greasy surface. It is used in the strength of 1 part of +bichlorid to 1,000 to 5,000 parts of water, according to the delicacy of +the tissue to which it is applied. (2) Carbolic acid in from 2 to 5 per +cent solution is used on infected wounds and for cleaning instruments, +dressings, and sponges. It unites well with oil and is preferred to the +bichlorid on a greasy surface. A 5 per cent solution in oil is often +used under the name of carbolized oil. (3) Aluminum acetate is an +efficient and cheap antiseptic, and is composed of 1 part alum and 5 +parts acetate of lead, mixed in 20 parts of water. (4) Boric acid is +good, in a 2 to 4 per cent solution, to cleanse wounds and wash eyes. +Compound cresol may be used in a 1 to 3 per cent solution in water. +Iodoform is one of the most used of the antiseptics, and it also acts as +an anodyne, stimulates granulation, and checks wound secretion. A very +efficacious and inexpensive powder is made by taking 5 parts of iodoform +and 95 parts of sugar, making what is called iodoform sugar. Tannic acid +is a useful drug in the treatment of wounds, as it arrests hemorrhage, +checks secretion, and favors the formation of a scab. A mixture of 1 +part tannic acid and 3 parts iodoform is good in suppurating wounds. +Iodol, white sugar, ground and roasted coffee, and powdered charcoal are +all used as protectives and absorbents on suppurating surfaces. More +depends on the care and the method of application of the drug than on +the drug itself. On aseptic wounds use only those antiseptics that do +not irritate the tissue. If care is used in the application of the +antiseptic, corrosive sublimate or carbolic acid is to be recommended. +In order to keep air from the wound and to absorb all wound secretions +rapidly, a dressing should be applied. If the wound is aseptic, the +dressing should be likewise, such as cotton gauze, sterile cotton, +oakum, or tow. This dressing should be applied with uniform pressure at +all times and secured by a bandage. Allow it to remain for a week or ten +days if the wound is aseptic or if the dressing does not become loose or +misplaced or become drenched with secretions from the wound, or if pain, +fever, or loss of appetite does not develop. The dressing should then be +removed, the wound treated antiseptically, and a sterilized dressing +applied.</p> + + +<h4>HEALING UNDER A SCAB.</h4> + +<p>This often occurs in small superficial wounds that have been kept +aseptic. In order that a scab may form, the wound must not gap, secrete +freely, or become infected with germs. The formation of scab is favored +by astringents and styptics, such as tannic acid, iodoform, and 5 per +cent solution of zinc chlorid. In case of fistulous withers, open +joints, or other large, hollow wounds that can not be dressed, +antisepsis may be obtained by warm-water irrigation with<span class='pagenum'><a name="Page_488" id="Page_488">[Pg 488]</a></span> or without an +antiseptic fluid. It should continue day and night, and never be +interrupted for more than eight hours, for germs will then have gained +headway and will be difficult to remove. Four or five days of irrigation +will be sufficient, for granulations will then have formed and pus will +remain on the outside if it forms. For permanent irrigation the stream +should be very small, or drop by drop, but should play over the entire +surface of the wound. It is always better to heal an infected wound +under a scab, or treat it as an open wound, than it is to suture it, +thus favoring the growth of the inclosed germs and retarding ultimate +healing. In the latter case pus may develop in the wound, form pockets +by sinking into the tissues, and cause various complications. The +pockets should be well drained, either through incisions at the bottom +or by drainage tubes or setons. They should then be frequently syringed +out or continuously irrigated. In case proud flesh appears it should be +kept down either by pressure or by caustics, as powdered bluestone, +silver nitrate, chlorid of antimony, or by astringents, such as burnt +alum. If they prove resistant to this treatment they may be removed by +scissors, the knife, or by searing with the hot iron. The following +rules for the treatment of wounds should be followed: (1) See that the +wound is clean, removing all foreign bodies. (2) For this purpose use a +clean finger rather than a probe. (3) All hemorrhage should be arrested +before closing the wound. (4) Antiseptics should only be used if you +suspect the wound to be infected. (5) When pus is present treat without +closing the wound. (6) This may be accomplished by drainage tubes, +absorbent dressings, setons, or continuous irrigations. (7) Protect the +wound against infection while healing.</p> + + +<h4>LACERATED AND CONTUSED WOUNDS.</h4> + +<p>Lacerated and contused wounds may be described together although there +is, of course, this difference, that in contused wounds there is no +break or laceration of the skin. Lacerated wounds, however, are, as a +rule, also contused—the surrounding tissues are bruised to a greater or +lesser extent. While at first sight such wounds may not appear to be as +serious as incised wounds, they are commonly very much more so. +Lacerations and contusions, when extensive, are always to be regarded as +dangerous. Many horses die from septic infection or mortification as a +result of these injuries. We find in severe contusions an infiltration +of blood into the surrounding tissues: disorganization and mortification +follow, and involve often the deeper seated structures. Abscesses, +single or multiple, may also result and call for special treatment.</p> + +<p>In wounds that are lacerated the amount of hemorrhage is mostly +inconsiderable; even very large blood vessels may be torn apart without<span class='pagenum'><a name="Page_489" id="Page_489">[Pg 489]</a></span> +inducing a fatal result. The edges of the wound are ragged and uneven. +These wounds are produced by barbed wire or some blunt object, as when a +horse runs against fences, board piles, the corners of buildings, or +when he is struck by the pole or shafts of another team, falling on +rough, irregular stones, etc.</p> + +<p>Contused wounds are caused by blunt instruments moving with sufficient +velocity to bruise and crush the tissues, as kicks, running against +objects, or falling on large, hard masses.</p> + +<p><i>Treatment.</i>—In lacerated wounds great care must at first be exercised +in examining or probing to the very bottom of the rent or tear, to see +whether any foreign body is present. Very often splinters of wood or +bits of stone or dirt are thus lodged, and unless removed prevent the +wound from healing; or if it should heal, the wound soon opens again, +discharging a thin, gluey matter that is characteristic of the presence +of some object in the part. After a thorough exploration these wounds +are to be carefully and patiently fomented with warm water, to which has +been added carbolic acid in the proportion of 1 part to 100 of water. +Rarely, if ever, are stitches to be inserted in lacerated wounds. The +surrounding tissues and skin are so weakened in vitality and structure +by the contusions that stitches will not hold; they only irritate the +parts. It is better to endeavor to obtain coaptation by means of +bandages, plasters, or collodion. One essential in the treatment of +lacerated wounds is to provide a free exit for the pus. If the orifice +of the wound is too high, or if pus is found to be burrowing in the +tissues beneath the opening, we must then make a counter opening as low +as possible. This will admit of the wound being thoroughly washed out, +at first with warm water, and afterwards injected with some mild +astringent and antiseptic wash, as chlorid of zinc, 1 dram to a pint of +water. A dependent opening must be maintained until the wound ceases to +discharge. Repeated hot fomentations over the region of lacerated wounds +afford much relief and should be persisted in.</p> + + +<h4>BRUISES.</h4> + +<p>Bruises are nothing but contused wounds where the skin has not been +ruptured. There is often considerable solution of continuity of the +parts under the skin, subcutaneous hemorrhage, etc., which may result in +local death (mortification) and slough of the bruised parts. If the +bruise or contusion is not so severe, many cases are quickly cured by +constant fomentation with hot water for from two to four hours. The +water should be allowed about this time to become cool gradually and +then cold. Cold fomentation must then be kept up for another hour or +two. The parts should be thoroughly and quickly dried and bathed freely +with camphor 1 ounce, sweet oil 8 ounces, or with equal parts of lead +water and laudanum. A dry,<span class='pagenum'><a name="Page_490" id="Page_490">[Pg 490]</a></span> light bandage should then be applied, the +horse allowed to rest, and if necessary the treatment may be repeated +each day for two or three days. If, however, the wound is so severe that +sloughing must ensue, we should encourage it by poultices made of +linseed meal, wheat bran, turnips, onions, bread and milk, or hops. +Charcoal is to be sprinkled over the surface of the poultice when the +wound is bad smelling. After the slough has fallen off the wound is to +be dressed with warm washes of carbolic acid, chlorid of zinc, +permanganate of potash, or other antiseptic. If granulating (filling up) +too fast, use burnt alum or air-slaked lime. Besides this local +treatment, we find that the constitutional symptoms of fever and +inflammation call for measures to prevent or control them. This is best +done by placing the injured animal on soft or green feed. A physic of +Barbados aloes, 1 ounce, should be given as soon as possible after the +accident. Sedatives, such as tincture of aconite root, 15 drops, three +times a day, or ounce doses of saltpeter every four hours, may also be +administered. When the symptoms of fever are abated, and if the +discharges from the wound are abundant, the strength of the patient must +be supported by good feed and tonics. One of the best tonics is as +follows: Powdered sulphate of iron, powdered gentian, and powdered +ginger, of each 4 ounces. Mix thoroughly and give a heaping +tablespoonful twice a day, on the feed or as a drench.</p> + + +<h4>PUNCTURED WOUNDS.</h4> + +<p>Punctured wounds are produced by the penetration of a sharp or +blunt-pointed substance, such as a thorn, fork, nail, etc., and the +orifice of these wounds is always small in proportion to their depth. In +veterinary practice punctured wounds are much more common than the +others. They involve the feet most frequently, next the legs, and often +the head and face from nails protruding through the stalls and trough. +They are not only the most frequent, but they are also the most serious, +owing to the difficulty of obtaining thorough disinfection. Another +circumstance rendering them so is the lack of attention that they at +first receive. The external wound is so small that but little or no +importance is attached to it, yet in a short time swelling, pain, and +acute inflammation, often of a serious character, are manifested.</p> + +<p>Considering the most common of the punctured wounds, we must give +precedence to those of the feet. Horses worked in cities, about iron +works, around building places, etc., are most likely to receive "nails +in the feet." The animal treads upon nails, pieces of iron or screws, +forcing them into the soles of the feet. If the nail, or whatever it is +that has punctured the foot, is fast in some large or heavy body, and is +withdrawn as the horse lifts his foot, lameness may last for only a few +steps; but unless properly attended to at<span class='pagenum'><a name="Page_491" id="Page_491">[Pg 491]</a></span> once he will be found in a +day or two to be very lame in the injured member. If the foreign body +remains in the foot, he gradually grows worse from the time of puncture +until the cause is discovered and removed. If, when shoeing, a nail is +driven into the "quick" (sensitive laminæ) and allowed to remain, the +horse gradually evinces more pain from day to day; but if the nail has +at once been removed by the smith, lameness does not, as a rule, show +itself for some days; or, if the nail is simply driven "too close," not +actually pricking the horse, he may not show any lameness for a week or +even much longer. At this point it is due to the blacksmith to say that, +considering how thin the walls of some feet are, the uneasiness of many +horses while shoeing, the ease with which a nail is diverted from its +course by striking an old piece of nail left in the wall, or from the +nail itself splitting, the wonder is not that so many horses are pricked +or nails driven "too close," but rather that many more are not so +injured. It is not, by any means, always carelessness or ignorance on +the part of the smith that is to account for this accident. Bad and +careless shoers we do meet with, but let us be honest and say that the +rarity of these accidents points rather to the general care and +attention given by these much-abused mechanics.</p> + +<p>From the construction of the horse's foot (being incased in an +impermeable, horny box), and from the elasticity of the horn closing the +orifice, punctured wounds of the feet are almost always productive of +lameness. Inflammation results, and as there is no relief afforded by +swelling and no escape for the product of inflammation, this matter must +and does burrow between the sole or wall and the sensitive parts within +it until it generally opens "between hair and hoof." We can thus see why +pain is so much more severe, why tetanus (lockjaw) more frequently +follows wounds of the feet, and why, from the extensive, or at times +complete, separation and "casting" of the hoof, these wounds must always +be regarded with grave apprehension.</p> + +<p><i>Symptoms and treatment.</i>—A practice which, if never deviated +from—that of picking up each foot, cleaning the sole, and thoroughly +examining the foot each and every time the horse comes into the +stable—will enable us to reduce to the minimum the serious consequences +of punctured wounds of the feet. If the wound has resulted from +pricking, lameness follows soon after shoeing; if from the nails being +driven too close, it usually appears from four to five days or a week +afterwards. We should always inquire as to the time of shoeing, examine +the shoe carefully, and see whether it has been partially pulled and the +horse has stepped back upon some of the nails or the clip. The pain from +these wounds is lancinating; the horse is seen to raise and lower the +limb or hold it from the ground altogether; often he points the foot, +flexes the leg, and knuckles at the fetlock. Swelling<span class='pagenum'><a name="Page_492" id="Page_492">[Pg 492]</a></span> of the fetlock +and back tendons is also frequently seen and is liable to mislead us. +The foot must be carefully examined, and this can not be properly done +without removing the shoe. The nails should be drawn separately and +carefully examined. If there is no escape of pus from the nail holes, or +if the nails themselves are not moist, we must continue our examination +of the foot by carefully pinching or tapping it at all parts. With a +little practice we can detect the spot where pain is the greatest or +discover the delicate line or scar left at the point of entrance of the +foreign body. The entire sole is then to be thinned, after which we are +carefully to cut down upon the point where pain is greatest upon +pressure, and, finally, through the sole at this spot. When the matter +has escaped, the sole, so far as it was undermined by pus, is to be +removed. The foot must now be poulticed for one or two days and +afterwards dressed with a compress of oakum saturated with carbolic-acid +solution or other antiseptic dressing.</p> + +<p>If we discover a nail or other object in the foot, the principal +direction, after having removed the offending body, is to cut away the +sole, in a funnel shape, down to the sensitive parts beneath. This is +imperative, and if a good free opening has been made and is maintained +for a few days, and hot fomentations and antiseptic dressings applied, +the cure is mostly easy, simple, quick, and permanent. The horse should +be shod with a leather sole under the shoe, first of all applying tar +and oakum to prevent any dirt from entering the wound. In some instances +nails may puncture the flexor tendons, the coffin bone, or enter the +coffin joint. Such injuries are always serious, their recovery slow and +tedious, and the treatment so varied and difficult that the services of +a veterinarian will be necessary.</p> + + +<h4>PUNCTURED WOUNDS OF JOINTS, OR OPEN JOINTS.</h4> + +<p>These wounds are more or less frequent. They are always serious, and +often result in anchylosis (stiffening) of the joint or the death of the +animal. The joints mostly punctured are the hock, fetlock, or knee, +though other joints may, of course, suffer this injury. As the symptoms +and treatment are much the same for all, only the accident as it occurs +in the hock joint will be described. Probably the most common mode of +injury is from the stab of a fork, but it may result from the kick of +another horse that is newly shod, or in many other ways. At first the +horse evinces but slight pain or lameness. The owner discovers a small +wound scarcely larger than a pea, and pays but little attention to it. +In a few days, however, the pain and lameness become excessive; the +horse can no longer bear any weight upon the injured leg; the joint is +very much swollen and painful upon pressure; there are well-marked +symptoms of constitutional disturbance—quick pulse, hurried breathing, +high temperature, 103°<span class='pagenum'><a name="Page_493" id="Page_493">[Pg 493]</a></span> to 106° F., the appetite is lost, thirst is +present, the horse reeks with sweat, and his anxious countenance shows +the pain he suffers. He may lie down, though mostly he persists in +standing, and the opposite limb becomes greatly swollen from bearing the +entire weight and strain for so long a time. The wound, which at first +appeared so insignificant, is now constantly discharging a thin, whitish +or yellowish fluid—joint oil or water, which becomes coagulated about +the mouth of the wound and adheres to the part in clots like jelly, or +resembling somewhat the white of an egg. Not infrequently the joint +opens at different places, discharging at first a thin, bloody fluid +that soon assumes the character above described.</p> + +<p><i>Treatment</i> of these wounds is most difficult and unsatisfactory. We can +do much to prevent this array of symptoms if the case is seen +early—within the first 24 or 48 hours after the injury; but when +inflammation of the joint is once fairly established the case becomes +one of grave tendencies. Whenever a punctured wound of a joint is +noticed, even though apparently of but small moment, we should apply +without the least delay a strong cantharides blister over the entire +joint, being even careful to fill the orifice of the wound with the +blistering ointment. This treatment is almost always effectual. It +operates to perform a cure in two ways—first, the swelling of the skin +and tissues underneath it completely closes the wound and prevents the +ingress of air; second, by the superficial inflammation established it +acts to check and abate all deep-seated inflammation. In the great +majority of instances, if pursued soon after the accident, this +treatment performs a cure in about one week; but should the changes +described as occurring later in the joint have already taken place, we +must then treat by cooling lotions and the application to the wound of +chlorid of zinc, 10 grains to the ounce of water, or a paste made of +flour and alum. A bandage is to hold these applications in place, which +is only to be removed when swelling of the leg or increasing febrile +symptoms demand it. In the treatment of open joints our chief aim must +be to close the orifice as soon as possible. For this reason repeated +probing or even injections are contraindicated. The only probing of an +open joint that is to be sanctioned is on our first visit, when we +should carefully examine the wound for foreign bodies or dirt, and after +removing them the probe must not again be used. The medicines used to +coagulate the synovial discharge are best simply applied to the surface +of the wound, on pledgets of tow, and held in place by bandages. +Internal treatment is also indicated in those cases of open joints in +which the suffering is great. At first we should administer a light +physic and follow this up with sedatives and anodynes, as directed for +contused wounds. Later, however, we should give quinin or salicylic acid +in 1-dram doses two or three times a day.<span class='pagenum'><a name="Page_494" id="Page_494">[Pg 494]</a></span></p> + + +<h4>WOUNDS OF THE TENDON SHEATHS.</h4> + +<p>Wounds of tendon sheaths are similar to open joints in that there is an +escape of synovial fluid, "sinew water." Where the tendons are simply +punctured by a thorn, nail, or fork, we must, after a thorough +exploration of the wound for any remaining foreign substance, treat with +the flour-and-alum paste, bandages, etc., as for open joint. Should the +skin and tendons be divided the case is even more serious and is often +incurable. There is always a large bed of granulations (proud flesh) at +the seat of injury, and a thickening more or less pronounced remains. +When the back tendons of the leg are severed we should apply at once a +high-heel shoe (which is to be gradually lowered as healing advances) +and bandage firmly with a compress moistened with a 10-grain chlorid of +zinc solution. When proud flesh appears it is best kept under control by +repeated applications of a red-hot iron. Mares that are valuable as +brood animals and stock horses should always be treated for this injury, +as, even though blemished, their value is not seriously impaired. If the +subject is old and comparatively valueless, the length of time required +and the expense of treatment will cause us to hesitate in attempting a +cure.</p> + + +<h4>GUNSHOT WOUNDS.</h4> + +<p>These wounds vary in size and character, depending on the size and +quality of the projectile and also the tissue injured. They are so +seldom met with in our animals that an extended reference to them seems +unnecessary. If a wound has been made by a bullet a careful examination +should be made to ascertain whether the ball has passed through or out +of the body. If it has not we must then probe for it, and if it can be +located it is to be cut out when practicable to do so. Oftentimes a ball +may be so lodged that it can not be removed, and it then may become +encysted and remain for years without giving rise to any inconvenience. +It is often difficult to locate a bullet, as it is very readily +deflected by resistances met with after entering the body.</p> + +<p>The entering wound is the size of the projectile, the edges are inverted +and often scorched. The wound produced in case of the bullet's exit is +larger than the projectile, the edges are turned out and ragged. A +bullet heated by the friction of the barrel or air often softens and +becomes flattened on striking a bone or other tissue. Modern bullets +that have an outer steel layer may pass through bone without splintering +it. Lead bullets may split, producing two exit wounds. Spent bullets may +only produce a bruise. Should bones be struck by a ball they are +sometimes shattered and splintered to such an extent as to warrant us in +having the animal destroyed. A gunshot wound, when irreparable injury +has not been done, is to<span class='pagenum'><a name="Page_495" id="Page_495">[Pg 495]</a></span> be treated the same as punctured wounds, i. +e., stop the hemorrhage, remove the foreign body if possible, and apply +hot fomentations or poultices to the wound until suppuration is fairly +established. Anti-septic and disinfectant injections may then be used. +Should pus accumulate in the tissues, openings must be made at the most +depending parts for its escape. Wounds from shotguns fired close to the +animals are serious. They are virtually lacerated and contused wounds. +Remove all the shot possible from the wound and treat as directed for +contusions. When small shot strike the horse from a distance they stick +in the skin or only go through it. The shot grains must be picked out, +but as a rule this "peppering" of the skin amounts to but little.</p> + + +<h4>POISONED WOUNDS.</h4> + +<p>These injuries are the result of bites of snakes, rabid dogs, stings of +bees, wasps, etc. A single sting is not dangerous, but an animal is +often stung by a swarm of insects, when the chief danger occurs from the +swelling produced. If stung about the head, the nostrils may be closed +as a result of the swelling, causing labored breathing and possibly +asphyxiation. Intoxication may be produced by the absorption of this +poison and is manifested by staggering gait, spreading of the legs, +paralysis of the muscles, difficult respiration, and a rise of +temperature. Death may follow in five to ten hours.</p> + +<p><i>Treatment.</i>—Douse animal with cold water and apply any alkaline +liquid, such as soapsuds, bicarbonate of soda, or weak solution of +ammonia. Internally give alcohol, ether, or camphor to strengthen the +heart. In case of bites by rattlesnakes, moccasin, or other poisonous +snakes, a painful swelling occurs about the bitten part, which is +followed by labored breathing, weakness, retching, fever, and death from +collapse. The animal usually recovers if it can be kept alive over the +third day. In treating the animal, a tight ligature should be passed +about the part above the wound to keep the poison from entering the +general circulation. Wash out the wound thoroughly with antiseptics and +then apply a caustic, such as silver nitrate, or burn with a hot +instrument. A subcutaneous injection of one-fourth dram of 1 per cent +solution of chromic acid above the wound is also beneficial. Cold water +may be applied to the wound to combat the inflammation. Bites of rabid +dogs produce an infected wound, and the virus of rabies introduced in +this manner should be removed or destroyed in the wound. Therefore +produce considerable bleeding by incising the wound, wash out thoroughly +with 10 per cent solution of zinc chlorid, and then apply caustics or +the actual cautery.<span class='pagenum'><a name="Page_496" id="Page_496">[Pg 496]</a></span></p> + + +<h4>HARNESS GALLS (SITFASTS).</h4> + +<p>Wounds or abrasions of the skin are frequently caused by ill-fitting +harness or saddles. When a horse has been resting from steady work for +some time, particularly after being idle in a stable on a scanty +allowance of grain, as in winter, he is soft and tender and sweats +easily when put to work again. In this condition he is liable to sweat +and chafe under the harness, especially if it is hard and poorly fitted. +This chafing is likely to cause abrasions of the skin, and thus pave the +way for an abscess or for a chronic blemish, unless attended to very +promptly. Besides causing the animal considerable pain, chafing, if long +continued, leads to the formation of a callosity. This may be +superficial, involving only the skin, or it may be deep-seated, +involving the subcutaneous fibrous tissue and sometimes the muscle and +even the bone. This causes a dry slough to form, which is both +inconvenient and unsightly. Sloughs of this kind are commonly called +"sitfasts" and, while they occur in other places, are most frequently +found under the saddle. (See also p. 475.)</p> + +<p><i>Treatment.</i>—Abrasions are best prevented by bringing the animal +gradually into working shape after it has had a prolonged rest, in order +that the muscles may be hard and the skin tough. The harness should be +well fitted, neither too large nor too small, and it should be cleaned +and oiled to remove all dirt and to make it soft and pliable. Saddles +should be properly fitted so as to prevent direct pressure on the spine, +and the saddle blankets should be clean and dry. Parts of the horse +where chafing is likely to occur, as on the back under the saddle, +should be cleaned and brushed free of dirt.</p> + +<p>The remedies for simple harness galls are numerous. Among them may be +mentioned alcohol, 1 pint, in which are well shaken the whites of two +eggs; a solution of nitrate of silver, 10 grains to the ounce of water; +sugar of lead or sulphate of zinc, 20 grains to an ounce of water; +carbolic acid, 1 part in 15 parts of glycerin, and so on almost without +end. Any simple astringent wash or powder will effect a cure, provided +the sores are not irritated by friction.</p> + +<p>If a sitfast has developed, the dead hornlike slough must be carefully +dissected out and the wound treated carefully with antiseptics. During +treatment it is always best to allow the animal to rest, but if this is +inconvenient care should be taken to prevent injury to the abraded or +wounded surface by padding the harness so that chafing can not occur.</p> + + +<h4>BURNS AND SCALDS.</h4> + +<p>These wounds of domestic animals are fortunately of rare occurrence; +however, when they do occur, if at all extensive, they prove to be quite +troublesome and in many cases are fatal. According to the severity of +the burn we distinguish three degrees: First degree,<span class='pagenum'><a name="Page_497" id="Page_497">[Pg 497]</a></span> where there is a +simple reddening of the skin; second degree, where there is a formation +of vesicles, or blisters; third degree, where there is a complete +destruction of vitality of the tissues, such as would occur in charring +from direct contact with flames or from escaping steam. Besides the +burns caused by flames and steam, there are other causative agents, such +as chemicals (caustic alkalis and acids), lightning stroke, and +occasionally the broken trolley wires of electric railways. When a large +surface of the skin is burned or scalded, the animal (if it does not die +at once from shock) will soon show signs of fever—shivering, coldness +of the extremities, weakness, restlessness, quick and feeble pulse, and +labored breathing. No matter which agent is a factor in the production +of burns, the lesions are practically of the same nature. The extent and +site of the burn should lead one in the determination and course of +treatment. Burns of the shoulder and those about the region of the elbow +or other parts where there is much movement of the tissues are grave, +and, if at all extensive, treatment should not be attempted, but the +immediate destruction of the animal is advised. A burn of the third +degree, where there is a destruction of the vitality of large areas of +tissue, even on parts not subject to much motion, is extremely tedious +to treat; in fact, it is questionable whether the treatment and keep of +the animal will ever be compensated for, even though recovery does take +place; this, in any event, will require at least six or eight weeks. +Burns caused by lightning stroke and trolley wires are liable to occur +in irregular lines, and, unless death occurs at once, they generally are +not serious.</p> + +<p><i>Treatment.</i>—Treatment should be prompt and effective. If the burns are +extensive, the constitutional symptoms should be combated with whisky +and milk and eggs, or ammonia carbonate, strychnin, caffein, or other +stimulant to prevent shock. In the local treatment, to alleviate the +pain, the application of cold water in some form and the hypodermic +injection of morphine are to be recommended. In burns of the first +degree, where there is only a superficial inflammation, lead carbonate +(white lead) ointment is very good. Carron oil (limewater and linseed +oil, equal parts) is a standard remedy, but a modification of it known +as Stahl's liniment is perhaps better. This is composed of linseed oil +and limewater each 200 parts, bicarbonate of soda 100 parts, and thymol +1 part. The scorched surface should be covered with this liniment and +then with a layer of borated gauze or absorbent cotton, to protect from +the air. The application should be frequently renewed. Carbolated +vaseline may be used in place of the above. In case the burn is more +extensive, the following solution may be used: Picric acid 2 parts, +alcohol 40 parts, water 400 parts. The lesion should be thoroughly +cleansed with this<span class='pagenum'><a name="Page_498" id="Page_498">[Pg 498]</a></span> solution used on absorbent cotton. The vesicles, if +any appear, should be opened with a clean needle, allowing the skin to +remain. Strips of gauze or absorbent cotton saturated with the solution +should now be applied and renewed only occasionally. In burns of the +second and third degrees more satisfactory results may be obtained with +nonpoisonous, dry dressing powder, such as is used in ordinary open +wounds, as tannic acid 8 parts and iodoform 1 part, or a salve made of +this powder and a sufficient quantity of vaseline. When sloughing of the +tissues takes place the wounds should be cleansed with a warm 3 per cent +solution of carbolic acid, all loose fragments of tissue removed, and +either a dry, antiseptic dressing powder or carbolated vaseline ointment +applied to exclude the air. Granulation tissue (proud flesh) should be +controlled by the application of silver nitrate in the form of a caustic +pencil.</p> + +<p>Burns due to mineral acids may be first treated by flushing the parts +with a copious quantity of cold water or by the application of whiting +or chalk. Either use a large quantity of water at the start or use the +chalk first, then wash with water. If the irritant has been a caustic +alkali, such as potash, lye, ammonia, or soda, then vinegar should be +the first application. Stahl's liniment is probably the best general +application for all burns for the first week; then this should be +followed by the ordinary antiseptic wound dressings.</p> + + +<h4>GANGRENE.</h4> + +<p>Gangrene, or mortification, denotes the death of the affected part, and +is mostly found attacking soft tissue near the surface of the body. +Gangrenous areas may occur as a result of shutting off their blood +supply. Constitutional diseases, such as ergotism, anthrax, and +septicemia, predispose to gangrene. As external causes we have acids and +alkalies, freezing and burning, contusions and continuous pressure that +interrupt the circulation. There are two forms of gangrene—dry and +moist. Dry gangrene is most often seen in horses from continuous lying +down (decubitus) or from uneven pressure of some portion of the harness.</p> + +<p><i>Symptoms.</i>—There is a lack of sensation due to the death of nerves. In +dry gangrene the skin is leathery and harsh, while in moist gangrene the +tissues are soft, wrinkled, and friable; the hair is disturbed, and the +skin is usually moist and soapy and sometimes covered with blebs. The +tissue surrounding the moist gangrenous patch is usually inflamed, +swollen, and hot, but this is less noticeable in the case of dry +gangrene. Moist gangrene often spreads and involves deeper tissue, +sheaths of tendons and joints producing septic synovitis or septic +arthritis leading to pyemia and death. Dry gangrene is seldom dangerous, +but the rapidity of its spread will indicate its virulence.<span class='pagenum'><a name="Page_499" id="Page_499">[Pg 499]</a></span></p> + +<p><i>Treatment.</i>—The preventive treatment consists in avoiding all the +influences that tend to disturb the nutrition of the tissues, such as +excessive cold or heat or continuous pressure. Gangrene following +decubitus may be prevented by using soft bedding and frequently turning +the animal from one side to the other. In dry gangrene moist heat in the +form of poultices or anointing the tissue with oils and fats will be +found beneficial in hastening the dead tissue to slough off. When the +outer skin begins to suppurate, it should be removed with a pair of +pincers, and the patch treated as an open wound. In moist gangrene the +tissue should be thoroughly disinfected with a 3 per cent solution of +compound cresol, or particularly an alcoholic tincture of camphor. +Continuous irritation with antiseptic fluids prevents the accumulation +and absorption of poisonous liquids. Incisions into the dead tissue may +be made, and when sloughing commences the tissue should be removed with +forceps and the resulting wound treated as in dry gangrene.</p> + + +<h4>ULCERATION.</h4> + +<p>An ulcer is a circumscribed area of necrosis occurring on the skin or +mucous membrane and covered with granulation tissue. It is a process of +destruction, and when this process is going on faster than regeneration +can take place, we have a gnawing, or eating, ulcer. When such an ulcer +increases rapidly in size it is termed a phagedenic ulcer. A fungoid +ulcer is one in which the bottom of the ulcer projects beyond the edge +of the skin. These ulcers secrete milky or bloody-white liquid called +ichor. When the ulcer is of an ashen or leaden color, with the bottom +and sides formed of dense, hard connective tissue, which gives but +little discharge and is not sensitive, it is termed callous, torpid, or +indolent ulcer.</p> + +<p><i>Causes.</i>—As in the case of gangrene, disturbances of circulation are +among the most frequent causes. A wound to a tissue with slight +recuperative power may be followed by ulceration, as in tumors. Certain +germs may produce ulcers, as the glanders bacilli, which cause the +ulcerations on the nasal septum in glanders.</p> + +<p><i>Treatment.</i>—This consists in removing the exciting cause at once. The +secretions of the ulcer should be washed off with antiseptic solutions +and the formation of granulation tissues stimulated by antiseptic +salves, such as carbolated vaseline, lead ointment, or by dressings of +camphor. Air should be kept from the ulcer by occlusive dressings. Where +the ulcers are inflamed, warm lead water or lead water and laudanum will +be found efficacious. Callous ulcers are best removed by a curette, +knife, or hot iron and then treated like a common wound. Mechanical +irritation should be avoided.<span class='pagenum'><a name="Page_500" id="Page_500">[Pg 500]</a></span></p> + + +<h4>ABSCESSES.</h4> + +<p>These consist of accumulations of pus within circumscribed walls, at +different parts of the body, and may be classed as acute and cold or +chronic abscesses.</p> + +<p>When an abscess occurs about a hair follicle it is called a boil or +furuncle; when several hair follicles are involved, resulting in the +formation of more than one exit for the inflammatory products, it is +called a carbuncle.</p> + + +<h4>ACUTE ABSCESSES.</h4> + +<p>Acute abscesses follow as the result of local inflammation in glands, +muscular tissue, or even bones. They are very common in the two former. +The abscesses most commonly met with in the horse (and the ones which +will be here described) are those of the salivary glands, occurring +during the existence of "strangles," or "colt distemper." The glands +behind or under the jaw are seen to increase slowly in size, becoming +firm, hard, hot, and painful. At first the swelling is uniformly hard +and resisting over its entire surface, but in a little while becomes +soft (fluctuating) at some portion, mostly in the center. From this time +on the abscess is said to be "pointing," or "coming to a head," which is +shown by a small elevated or projecting prominence, which at first is +dry, but soon becomes moist with transuded serum. The hairs over this +part loosen and fall off, and in a short time the abscess opens, the +contents escape, and the cavity gradually fills up—heals by +granulations.</p> + +<p>Abscesses in muscular tissue are usually the result of bruises or +injuries. In all cases in which abscesses are forming we should hurry +the ripening process by frequent hot fomentations and poultices. When +they are very tardy in their development a blister over their surface is +advisable. It is a common rule with surgeons to open an abscess as soon +as pus can be plainly felt, but this practice can scarcely be +recommended indiscriminately to owners of stock, since this little +operation frequently requires an exact knowledge of anatomy. It will +usually be found the better plan to encourage the full ripening of an +abscess and allow it to open of itself. This is imperative if the +abscess is in the region of joints, etc. When open, we must not squeeze +the walls of the abscess to any extent. They may be very gently pressed +with the fingers at first to remove the clots—inspissated pus—but +after this the orifice is simply to be kept open by the introduction of +a clean probe, should it be disposed to heal too soon. If the opening is +at too high a level another should be made into the lowest portion of +the abscess so as to permit the most complete drainage. Hot fomentations +or poultices are sometimes required for a day or two after an abscess +has opened, and are particularly indicated when the base of the abscess +is hard and indurated.<span class='pagenum'><a name="Page_501" id="Page_501">[Pg 501]</a></span></p> + +<p>The cavity should be thoroughly washed with stimulating antiseptic +solutions, such as 3 per cent solution of carbolic acid, 3 per cent +solution of compound cresol, 1 to 1,000 bichlorid of mercury, or 1 per +cent permanganate of potash solution. If the abscesses are foul and bad +smelling, their cavities should first be syringed with 1 part of +hydrogen peroxid to 2 parts of water and then followed by the injection +of any of the above-mentioned antiseptics.</p> + + +<h4>COLD ABSCESSES.</h4> + +<p>Cold abscess is the term applied to those large, indolent swellings that +are the result of a low or chronic form of inflammation, in the center +of which there is a small collection of pus. They are often seen near +the point of the shoulder, forming the so-called breast boil. The +swelling is diffuse and of enormous extent, but slightly hotter than +surrounding parts, and not very painful upon pressure. A pronounced +stiffness, rather than pain, is evinced upon moving the animal. Such +abscesses have the appearance of a hard tumor, surrounded by a softer +edematous swelling, involving the tissues to the extent of a foot or +more in all directions from the tumor. This diffused swelling gradually +subsides and leaves the large, hardened mass somewhat well defined. One +of the characteristics of cold abscesses is their tendency to remain in +the same condition for a great length of time. There is neither heat nor +soreness; no increase nor lessening in the size of the tumor; it remains +in statu quo. If, however, the animal should be put to work for a short +time the irritation of the collar causes the surrounding tissues to +assume again an edematous condition, which after a few days' rest +disappears, leaving the tumor as before or but slightly larger. Upon +careful manipulation we may discover what appears to be a fluid deep +seated in the center of the mass. The quantity of matter so contained is +very small—often not more than a tablespoonful—and for this reason it +can not, in all cases, be detected.</p> + +<p>Cold abscesses are mostly, if not always, caused by the long-continued +irritation of a loose and badly fitting collar. There is a slow +inflammatory action going on, which results in the formation of a small +quantity of matter inclosed in very thick and but partially organized +walls that are not so well defined as is the circumference of fibrous +tumors, which they most resemble.</p> + +<p><i>Treatment.</i>—The means recommended to bring the acute abscess "to a +head" are but rarely effectual with this variety; or, if successful, too +much time has been occupied in the cure. We must look for other and more +rapid methods of treatment. These consist, first of all, in carefully +exploring the tumor for the presence of pus. The incisions must be made +over the softest part and carried deep into the tumor—to its very +bottom, if necessary—and the matter allowed to<span class='pagenum'><a name="Page_502" id="Page_502">[Pg 502]</a></span> escape. After this, and +whether we have found matter or not, we must induce an active +inflammation of the tumor, in order to promote solution of the thick +walls of the abscess. This may be done by inserting well into the +incision a piece of oakum or cotton saturated with turpentine, carbolic +acid, tincture of iodin, etc., or we may pack the incision with powdered +sulphate of zinc and keep the orifice plugged for 24 hours. These agents +set up a destructive inflammation of the walls. Suppuration follows, and +this should now be encouraged by hot fomentations and poultices. The +orifice must be kept open, and should it be disposed to heal we must +again introduce some of the agents above described. A favored treatment +with many, and it is probably the best, is to plunge a red-hot iron to +the bottom of the incision and thoroughly sear all parts of the walls of +the abscess. This is to be repeated after the first slough has taken +place if the walls remain thickened and indurated.</p> + +<p>It is useless to waste time with fomentations, poultices, or blisters in +the treatment of cold abscesses, since though apparently removed by such +methods, they almost invariably return when the horse is put to work. +Extirpation by the knife is not practicable, as the walls of the tumor +are not sufficiently defined. If treated as above directed, and properly +fitted with a good collar after healing, there will not remain any track +or trace of the large, unsightly mass.</p> + + +<h4>FISTULAS.</h4> + +<p><i>Definition.</i>—The word fistula is applied to any ulcerous lesion upon +the external surface of the body which is connected by ducts, or +passages, with some internal cavity. Because of this particular +formation the term fistulous tract is often used synonymously with the +word fistula. Fistulas may exist in any part of the body, but the name +has come to be commonly accepted as applicable only to such lesions when +found upon the withers. Poll evil is a fistula upon the poll, and in no +sense differs from fistulous withers except in location. The description +of fistula will apply, then, in the main, to poll evil equally well. +Quittor presents the characteristic tubular passages of a fistula and +may, therefore, be considered and treated as fistula of the foot. +Fistulous passages may also be developed upon the sides of the face, +through which saliva is discharged instead of flowing into the mouth, +and are called salivary fistulas. A dental fistula may arise from the +necrosis of the root of a tooth. Again, a fistula is sometimes noted at +the umbilicus associated with hernia, and recto-vaginal fistulas have +been developed in mares, following difficult parturition. Fistulas may +arise from wounds of glandular organs or their ducts, and thus we have +the so-called mammary or lacrimal fistulas.<span class='pagenum'><a name="Page_503" id="Page_503">[Pg 503]</a></span></p> + +<p>Fistulous tracts are lined with a false, or adventitious, membrane and +show no disposition to heal. They constantly afford means of exit to the +pus or ichorous material discharged by the unhealthy parts below. They +are particularly liable to develop at the withers or poll because of the +exposed positions which these parts occupy, and, having once become +located there, they usually assert a tendency to further extension, +because the vertical and laminated formation of the muscles and tendons +of these parts allows the forces of gravitation to assist the pus in +gaining the deeper-lying structures and also favors its retention among +them.</p> + +<p><i>Causes.</i>—Fistulas follow as a result of abscesses, bruises, wounds, or +long-continued irritation by the harness. Among the more common causes +of fistula of the poll (poll evil) are chafing by the halter or heavy +bridle; blows from the butt end of the whip; the horse striking his head +against the hayrack, beams of the ceiling, low doors, etc. Fistulous +withers are seen mostly in those horses that have thick necks as well as +those that are very high in the withers; or, among saddle horses, those +that are very low in the withers, the saddle here riding forward and +bruising the parts. In either of these locations ulcers of the skin, or +simple abscesses, if not properly and punctually treated, may become +fistulas. They are often caused by bad-fitting collars or saddles, by +direct injuries from blows, and from the horse rolling upon rough or +sharp stones. The pus burrows and finds lodgment deep down between the +muscles, and escapes only when the sinus becomes surcharged or when, +during motion of the parts, the matter is forced to the surface.</p> + +<p><i>Symptoms.</i>—These, of course, will vary according to the progress made +by the fistula. Following an injury we may often notice soreness or +stiffness of the front legs, and upon careful examination of the withers +we see small tortuous lines running from the point of irritation +downward and backward over the region of the shoulder. These are +superficial lymphatics, and are swollen and painful to the touch. In a +day or two a swelling is noticed on one or both sides of the dorsal +vertebræ, which is hot, painful, and rapidly enlarging. The stiffness of +the limbs may disappear at this time, and the heat and soreness of the +parts may become less noticeable, but the swelling remains and continues +to enlarge.</p> + +<p>A fistulous ulcer of the poll may be first indicated by the opposition +which the animal offers to the application of stable brush or bridle. At +this time the parts are so sore and sensitive that there is some danger +that unless handled with the greatest care the patient will acquire +disagreeable stable habits. The disease in its early stages may be +recognized as a soft, fluctuating tumor surrounded by inflammatory +swelling, with the presence of enlarged lymphatic vessels and stiffness +of the neck. Later the inflammation of the surrounding tissues<span class='pagenum'><a name="Page_504" id="Page_504">[Pg 504]</a></span> may +disappear, leaving a prominent tumor. The swelling, whether situated +upon the head or the withers, may open and form a running ulcer, or its +contents may dry up and leave a tumor which gradually develops the +common characteristics of a fibrous tumor. When the enlargement has +opened we should carefully examine its cavity, as upon its condition +will wholly depend our treatment.</p> + +<p><i>Treatment.</i>—In the earliest stage, when there is soreness, enlarged +lymphatics, but no well-marked swelling, the trouble may frequently be +aborted. To do this requires both general and local treatment. A physic +should be given, and the horse receive 1 ounce of powdered saltpeter +three times a day in his water or feed. If the fever runs high, 20-drop +doses of tincture of aconite root every two hours may be administered. +The local application of cold water to the inflamed spot for an hour at +a time three or four times a day has often proved very beneficial, and +has afforded great relief.</p> + +<p>Cooling lotions, muriate of ammonia, or saltpeter and water; sedative +washes, such as tincture of opium and aconite, chloroform liniment, or +camphorated oil, are also to be frequently applied. Should this +treatment fail to check the progress of the trouble, the formation of +pus should be hastened as rapidly as possible. Hot fomentations and +poultices are to be constantly used, and as soon as the presence of pus +can be detected, the abscess wall is to be opened at its lowest point. +In this procedure lies our hope of a speedy cure. As with any simple +abscess, if drainage can be so provided that the pus will run off as +fast as formed without remaining within the interstices of the tissues, +the healing will be rapid and satisfactory.</p> + +<p>Attention is again called to the directions given above as to the +necessity of probing the cavity when opened. If upon a careful +examination with the probe we find that there are no pockets, no +sinuses, but a simple, regular abscess wall, the indication for +treatment is to make an opening from below so that all the matter must +escape. Rarely is anything more needed than to keep the orifice open and +to bathe or inject the parts with some simple antiseptic wash that is +not irritant or caustic. A low opening and cleanliness constitute the +essential and rational treatment.</p> + +<p>If the abscess has already opened, giving vent to a quantity of purulent +matter, and the pipes and tubes leading from the opening are found to be +extensive and surrounded with thick fungoid membranes, there is +considerable danger that the internal ligaments or even some of the +bones have become affected, in which case the condition has assumed a +serious aspect. Or, on the other hand, if the abscess has existed for +some time without a rupture, its contents will frequently be found to +consist of dried purulent matter, firm and dense, and the walls +surrounding the mass will be found greatly thickened. In such a case we +must generally have recourse to the<span class='pagenum'><a name="Page_505" id="Page_505">[Pg 505]</a></span> application of caustics which will +cause a sloughing of all of the unhealthy tissue, and will also +stimulate a rapid increase of healthy organized material to replace that +destroyed in the course of the development and treatment of the disease. +Threads or cords soaked in gum-arabic solution and rolled in powdered +corrosive sublimate may be introduced into the canal and allowed to +remain. The skin on all parts of the shoulder and leg beneath the +fistula should be carefully greased with lard or oil, as this will +prevent the discharge that comes from the opening after the caustic is +introduced from irritating or blistering the skin over which it flows. +In obstinate cases a piece of caustic potash (fused) 1 to 2 inches in +length may be introduced into the opening and should be covered with +oakum or cotton. The horse should then be secured so that he can not +reach the part with his teeth. After the caustic plug has been in place +for 24 hours, it may be removed and hot fomentations applied. As soon as +the discharge has become again established the abscess should be opened +from its lowest extremity, and the passage thus formed may be kept open +by the introduction of a seton. If the pipes become established in the +deep tissues beneath the shoulder blade or among the spines of the +vertebral column, it will often be found impossible to provide proper +drainage for the abscess from below, and treatment must consist of +caustic solutions carefully injected into all parts of the suppurating +sinuses. A very effective remedy for this purpose consists of 1 ounce of +chlorid of zinc in half a pint of water, injected three times during a +week, after which a weak solution of the same may be occasionally +injected. Injections of Villate's solution or alcoholic solution of +corrosive sublimate, strong carbolic acid, or possibly oil of turpentine +will also prove beneficial. Pressure should be applied from below, and +endeavors made to heal the various pipes from the bottom.</p> + +<p>Should the swelling become general, without forming a well-defined +tumor, the placing of 20 to 30 grains of arsenious acid, wrapped in a +single layer of tissue paper, in a shallow incision beneath the skin, +will often produce a sloughing of the affected parts in a week or 10 +days, after which the formation of healthy tissue follows. The +surrounding parts of the skin should be protected from any damage from +escaping caustics by the application of lard or oil, as previously +suggested.</p> + +<p>Although the successful treatment of fistulas requires time and +patience, the majority of cases are curable. The sinuses must be opened +at their lowest extremity and kept open. Caustic applications must be +thoroughly used once or twice, after which mild astringent antiseptic +washes should be persistently used until a cure is reached.</p> + +<p>It sometimes happens that the erosions have burrowed so deeply or in +such a direction that the opening of a drainage passage becomes<span class='pagenum'><a name="Page_506" id="Page_506">[Pg 506]</a></span> +impracticable. In other cases the bones may be attacked in some +inaccessible location, or the joints may be affected, and in these cases +it is often best to destroy the horse at once.</p> + +<p>The reappearance of the fistula after it has apparently healed is not +uncommon. The secondary attack in these cases is seldom serious. The +lesion should be carefully cleaned and afterwards injected with a +solution of zinc sulphate, 20 grains to the ounce of water, every second +or third day until a cure is effected.</p> + +<p>In fistula of the foot we see the same tendency toward the burrowing of +pus downward to lower structures, or in some cases upward toward the +coronet. Prior to the development of a quittor there is always swelling +at the coronet, accompanied with heat and pain. Every effort should now +be made to prevent the formation of an abscess at the point of injury. +Wounds caused by nails, gravel, or any other foreign body which may have +lodged in the sole of the foot should be opened at once from below, so +as to allow free exit to all purulent discharges. Should the injury have +occurred directly to the coronet the application of cold fomentations +may prove efficient in preventing the formation of an abscess.</p> + +<p>When a quittor becomes fully established it should be treated precisely +as a fistula situated in any other part of the body; that is, the +sinuses should all be opened from their lowest extremities, so as to +afford constant drainage. All fragments of diseased tissue should be +trimmed away, antiseptic solutions injected, and, after covering the +wound with a pad of oakum saturated with some good antiseptic wash, the +whole foot may be carefully covered with clean bandages, which will +afford valuable assistance to the healing process by excluding all dirt +from the affected part.</p> + +<p>Another form of treatment for this class of infections consists in the +use of bacterial vaccines. Such treatment appears to be well adapted for +the purpose, and according to current veterinary literature has met with +success. These vaccines are composed of several strains of the organisms +usually found in these pustular infections of the horse. Two kinds of +vaccines are used: First, autogenic vaccines, which consist of heated +(killed) cultures of the organism or organisms which are causing the +trouble and which have been isolated from the lesions; second, stock +vaccines, consisting of dead organisms of certain species generally +found in these lesions and which are used in diseased conditions caused +by one or the other of these germs. The vaccine is administered +subcutaneously by means of a syringe, but the quantity of the vaccine to +be injected and the number of doses to be used should be left to the +judgment of a competent veterinarian.</p> + + + +<hr style="width: 65%;" /> +<p><span class='pagenum'><a name="Page_507" id="Page_507">[Pg 507]</a></span></p> +<h2>INFECTIOUS DISEASES.</h2> + +<h3>By <span class="smcap">Rush Shippen Huidekoper</span>, M. D., Vet.</h3> + +<h4>[Revised by A. Eichhorn, D. V. S.]</h4> + + +<h4>GENERAL DISCUSSION.</h4> + +<p>An infectious disease may be defined as any malady caused by the +introduction into the body of minute organisms of the vegetable or +animal kingdom which have the power to multiply indefinitely and set +free certain peculiar poisons which are chiefly responsible for morbid +changes. Nearly all diseases of animals for which a definite cause may +be attributed are caused by bacteria; such are tuberculosis, anthrax, +blackleg, lockjaw, and others. There are some diseases, as, for +instance, Texas fever and rabies, which are caused by a minute animal +parasite known as protozoa, while others again, like lumpy jaw and +aspergillosis, are caused by fungi. Besides there are infectious +diseases in which the causative agents have never been successfully +isolated, as they are so small that they can not be detected by the aid +of the most powerful microscope, and accordingly they are termed as +ultravisible viruses. Hog cholera, foot-and-mouth disease, smallpox, and +others belong to this group.</p> + +<p>Bacteria may be defined as very minute unicellular organisms of +plantlike character. They multiply either by simple division or by spore +formation, the latter usually taking place when the conditions +pertaining to the growth of the bacteria become unfavorable. The spores +are much more resistant to destruction than the bacteria which produce +them.</p> + +<p>Another group of parasites producing disease is known as protozoa. These +are more complex than bacteria, and their artificial cultivation is also +much more difficult than is the case with the bacterial parasites. Of +the representatives of this group, causing disease in animals, are the +trypanosomes, which are the causative factors of dourine and surra, and +the piroplasma, which induce Texas fever in cattle and malaria or +biliary fever of horses. There are also disease-producing fungi which +are responsible for certain affections in horses; among these the most +important are mycotic lymphangitis, or sporotrichosis, and +streptotrichosis.</p> + +<p>The introduction of the infection may take place in various ways. The +most frequent method is by ingestion. Further, the entrance of<span class='pagenum'><a name="Page_508" id="Page_508">[Pg 508]</a></span> the +germs may occur by inhalation, skin abrasions, wounds of any kind, +through the genital organs, and at times also through the milk ducts of +the teats. As a general rule infectious diseases have a period of +incubation which comprises the time elapsing between the exposure to the +infection and the actual appearance of the disease. This period varies +in the different diseases.</p> + +<p>The treatment of infectious diseases is, as a rule, unsatisfactory. When +the symptoms have once appeared a disease is liable to run its course in +spite of treatment, and if it is one from which animals usually recover, +all that can be done is to put them into the most favorable +surroundings. Many infectious diseases lead sooner or later to death; +treatment is useless so far as the sick animals are concerned, and it +may be worse than useless for those not yet affected. All animals +suffering with infectious diseases are more or less directly a menace to +all others. They represent for the time being manufactories of disease +germs, and they are giving them off more or less abundantly during the +period of disease. They may infect others directly or they may scatter +the virus about and the surroundings may become the future source of +infection.</p> + +<p>Therefore, in the control of infectious diseases prevention is the most +important procedure. The isolation or segregation of healthy animals +from infected ones should be primarily considered, and if at any time an +animal manifests the symptoms of an infectious disease it is essential +to protect the others from such a source of danger. In some of the +infectious diseases it may become advisable to kill the infected animals +in order to avoid the spread of the disease. This is especially +important in diseases which are slow in their course, such as +tuberculosis. At times when diseases appear in a country where they have +not been prevalent it becomes advisable and necessary to protect the +healthy herds by the slaughter of all the infected animals. Pursuance of +this policy has resulted in control of the foot-and-mouth disease, and +has proved to be a very satisfactory method of eradication.</p> + + +<h4>DISINFECTION.</h4> + +<p>Disinfection is a very important phase in the control of infectious +disease. This consists in the use of certain substances which possess +the power to destroy bacteria or their spores, or both. The cheapest and +most available for animal diseases are ordinary freshly slaked lime, or +unslaked lime in powder form, chlorid of lime, crude carbolic acid, +corrosive sublimate, formalin, formaldehyde, gas, cresol, etc.</p> + +<p>In the disinfection of stables and premises it is essential to execute +the work in a most thorough manner. This may be satisfactorily +accomplished by carrying out the following directions:<span class='pagenum'><a name="Page_509" id="Page_509">[Pg 509]</a></span></p> + +<p>1. Sweep ceilings, side walls, stall partitions, floors, and other +surfaces until free from cobwebs and dust.</p> + +<p>2. Scrape away all accumulation of filth, and if woodwork has become +decayed, porous, or absorbent, it should be removed, burned, and +replaced with new material.</p> + +<p>3. If floor is of earth, remove 4 inches from the surface, and in places +stained with urine a sufficient depth should be replaced to expose fresh +earth. All earth removed should be replaced with earth from an +uncontaminated source; it would be better still to lay a new floor of +concrete, which is very durable and easily cleaned.</p> + +<p>4. All refuse and material from stable and barnyard should be removed to +a place not accessible to cattle or hogs. The manure should be spread on +fields and turned under, while the wood should be burned.</p> + +<p>5. The entire interior of the stable, especially the feeding troughs and +drains, should be saturated with a disinfectant, as liquor cresolis +compositus (U. S. P.), or carbolic acid, 6 ounces to every gallon of +water, to which 4 ounces of chlorid of lime should be added. The best +method of applying the disinfectant and the lime wash is by means of a +strong spray pump, such as those used by orchardists. This method is +efficient in disinfection against most of the contagious and infectious +diseases of animals, and should be applied immediately following any +outbreak, and, as a matter of precaution, it may be used once or twice +yearly.</p> + +<p>6. It is important that arrangements be made to admit a plentiful supply +of sunlight and fresh air by providing an ample number of windows, +thereby eliminating dampness, bad odor, and other insanitary conditions. +Good drainage is also very necessary.</p> + +<p>If the use of liquor cresolis compositus, carbolic acid, or other +coal-tar products is inadmissible because of the readiness with which +their odor is imparted to milk and other dairy products, bichlorid of +mercury may be used in proportion of 1 to 800, or 1 pound of bichlorid +to 100 gallons of water. All portions of the stable soiled with manure, +however, should first be thoroughly scraped and cleaned, as the albumin +contained in manure would otherwise greatly diminish the disinfecting +power of the bichlorid. Disinfection with this material should be +supervised by a veterinarian or other person trained in the handling of +poisonous drugs and chemicals, as the bichlorid is a powerful, corrosive +poison. The mangers and the feed boxes, after drying, following spraying +with this material, should be washed out with hot water, as cattle are +especially susceptible to mercurial poisoning. The bichlorid solution +should be applied by means of a spray pump, as recommended for the +liquor cresolis compositus.<span class='pagenum'><a name="Page_510" id="Page_510">[Pg 510]</a></span></p> + + +<h4>VACCINATION.</h4> + +<p>In recent years vaccination for the prevention of certain infectious +diseases has been successfully developed, and without a doubt the future +has a great deal in store for this phase of prevention. At the present +time vaccination has been found effective against blackleg, hog cholera, +anthrax, lockjaw, strangles, rabies, hemorrhagic septicemia, white +scours, etc. It is always essential, of course, that the products used +for the vaccination be pure and potent; also they should be employed +only with the advice of competent authorities and with proper care. The +biological products prepared for the cure and prevention of infections +are prepared by manufacturers who, in order to conduct an interstate +business, are required to obtain a license from the United States +Department of Agriculture for the manufacture of such preparations.</p> + +<p>Since July 1, 1913, the Department of Agriculture, by an act of Congress +of March 4, 1913, has had control of the manufacture of biological +products for the treatment of domestic animals. The numerous complaints +which were received from time to time relative to the impotency of some +of the preparations, and also the fact that in some instances the use of +the products were directly responsible in causing outbreaks of disease, +made the necessity for such control obvious. This supervision is no +doubt of far-reaching importance, as it assures the users that the +preparations are reliable.</p> + + +<h4>INFLUENZA.</h4> + +<div class="blockquot"><p><i>Synonyms.</i>—Pinkeye, typhoid fever, epizooty, epihippic fever, +hepatic fever, bilious fever, etc.; flèvre typhoide, grippe +(French); Pferdestaupe (German); gastro-enteritis of Vatel and +d'Arboval; febris erysipelatodes, Zundel; typhus of Delafond.</p></div> + +<p><i>Definition.</i>—The term influenza is applied to a febrile, contagious, +infectious disease of horses, which is characterized by a blood +infection, with inflammation of the mucous membranes, which frequently +involves the lungs. Inflammatory complications also occur in the form of +swellings of the subcutis, tendons, and tendinous sheaths and laminæ of +the feet. The causative agent has not been satisfactorily established. +One attack usually protects the animal from future ones of the same +disease, but not always. An apparently complete recovery is sometimes +followed by serious sequelæ of the nervous and blood-vessel systems. +Under certain conditions of the atmosphere or from unknown causes, the +disease is very liable to assume an epizootic form, with tendency to +complications of especial organs, as, at one period, the lungs, at +another the intestines, etc.</p> + +<p>The first description of influenza is given by Laurentius Rusius in +1301, when it spread over a considerable portion of Italy, causing<span class='pagenum'><a name="Page_511" id="Page_511">[Pg 511]</a></span> +great loss among the war horses of Rome and the surrounding district. +Later, in 1648, an epizootic of this disease visited Germany and spread +to other parts of Europe. In 1711, under the name of "epidemica +equorum," it followed the tracks of the great armies all over Europe, +causing immense losses among the horses, while rinderpest was scourging +the cattle of the same regions. The two diseases were confounded with +each other, and were, by the scientists of the day, supposed to be +allied to the typhus, which was a plague to the human race at the same +time. We find the first advent of this disease to the British Islands in +an epizootic among the horses of London and the southern counties of +England in 1732, which is described by Gibson. In 1758 Robert Whytt +recounts the devastation of the horses of the north of Scotland from the +same trouble. Throughout the eighteenth century a number of epizootics +occurred in Hanover and other portions of Germany and in France, which +were renewed early in the present century, with complications of the +intestinal tract, which obtained for it its name of gastro-enteritis. In +1766 it first attacked the horses in North America, but is not described +as again occurring in a severe form until 1870-1872, when it spread over +the entire country, from Canada south to Ohio, and then eastward to the +Atlantic and westward to California. It is now a permanent disease in +our large cities, selecting for the continuance of its virulence young +or especially susceptible horses which pass through the large and +ill-ventilated and uncleaned stables of dealers, and assumes from time +to time an enzootic form, when from some reason its virulence increases. +It assumes this form also when, from reasons of rural economy and +commerce, large numbers of young and more susceptible animals are +exposed to its contagion.</p> + +<p><i>Etiology.</i>—The experiments of Dieckerhoff many years ago proved that +the disease may be transmitted to healthy animals by intravenous +injection of warm blood from affected horses.</p> + +<p>Further investigations revealed the fact that blood from affected +horses, even when passed through porcelain filters, may transmit the +disease, thereby proving that the causative agent belongs to the +so-called filterable viruses. This has been further substantiated by +Gaffky, who showed in his recent experiments that the disease may be +transmitted with defibrinated as well as with filtered blood, in which +cases the typical form of influenza developed in inoculated animals in +from five to six days. These findings were also substantiated by Basset. +Further observations have also proved that apparently recovered animals +may harbor the infection for a long time and still be capable of +transmitting the disease. Such virus carriers are no doubt responsible +for numerous outbreaks of this disease when, in a locality<span class='pagenum'><a name="Page_512" id="Page_512">[Pg 512]</a></span> free from +the disease, it certainly appears after the introduction of an +apparently healthy animal.</p> + +<p>As one attack is usually self-protective, numbers of old horses, having +had an earlier attack, are not capable of contracting it again; but, +aside from this, young horses, especially those about four or five years +of age, are much more predisposed to be attacked, while the older ones, +even if they have not had the disease, are less liable to it. Again, the +former age is that in which the horse is brought from the farm, where it +has been free from the risk of exposure, and is sold to pass through the +stables of the country taverns, the dirty, infected railway cars, and +the foul stockyards and damp stables of dealers in our large cities. +Overfed, fat, young horses which have just come through the sales +stables are much more susceptible to contagion than the same horses are +after a few months of steady work.</p> + +<p>Pilger, in 1805, was the first to recognize infection as the direct +cause of the disease. Roll and others studied the contagiousness of +influenza, and, finding it so much more virulent and permanent in old +stables than elsewhere, classed it as a "stall miasm." The contagion +will remain in the straw bedding and droppings of the animal and in the +feed in an infected stable for a considerable time and if these are +removed to other localities it may be carried in them. It may be carried +in the clothing of those who have been in attendance on horses suffering +from the disease. The drinking water in troughs and even running water +may hold the virus and be a means of its communication to other animals, +even at a distance.</p> + +<p>The studies of Dieckerhoff, in 1881, in regard to the contagion of +influenza were especially interesting. He found that during a local +enzootic, produced by the introduction of infected horses into an +extensive stable otherwise perfectly healthy, the infection took place +in what at first seemed to be a most irregular manner, but which was +shown later to be dependent on the ventilation and currents of air +through the various buildings. His experiments showed that the virus of +influenza is excessively diffusible, and that it will spread rapidly to +the roof of a building and pass by the apertures of ventilation to +others in the neighborhood. The writer has seen cases that have appeared +to spread through a brick wall and attack animals on the opposite side +before others even in the same stable were affected. Brick walls, old +woodwork, and the dirt which is too frequently left about the feed boxes +of a horse stall will hold the contagion for several days, if not weeks, +and communicate it to susceptible animals when placed in the same +locality. On two successive mornings a 4-year-old colt belonging to the +writer stood for about 10 minutes at the open door, fully 40 feet from +the stalls, of a<span class='pagenum'><a name="Page_513" id="Page_513">[Pg 513]</a></span> stable in which two cases of influenza had broken out +the day before: in six days the colt developed the disease. On the +morning when the trouble in the colt was recognized it stood in an +infirmary with a dozen horses that were being treated for various +diseases, but was immediately isolated; within one week two-thirds of +the other horses had contracted the disease.</p> + +<p><i>Symptoms.</i>—After the exposure of a susceptible horse to infection a +period of incubation of from four to seven days elapses, during which +the animal seems in perfect health, before any symptom is visible. When +the symptoms of influenza develop they may be intense, or so moderate as +to occasion but little alarm, but the latter condition frequently +exposes the animal to use and to the danger of the exciting causes of +complications which would not have happened had it been left quietly in +its stall in place of being worked or driven out to show to prospective +purchasers. The disease may run a simple course as a specific fever, +with alterations only of the blood, or at any period it may become +complicated by local inflammatory troubles, the gravity of which is +augmented by developing in an animal with an impoverished blood, an +already irritated, rapid circulation, and defective nutritive and +reparative functions.</p> + +<p>The first symptoms are those of a rapidly developing fever, which +becomes intense within a very short period. The animal becomes dejected +and inattentive to surrounding objects; stands with its head down, and +not back on the halter as in serious lung diseases. In the flanks, the +muscles of the croup and of the shoulders, or of the entire body it has +chills lasting from 15 to 30 minutes, and frequently a grinding of the +teeth which warns one that a severe attack may be expected. The hairs +become dry and rough and stand on end. The body temperature increases to +104°, 104.5°, and 105° F., or even in severe cases to 107° F., within +the first twelve or eighteen hours. The horse becomes stupid, stands +immobile with its head hanging, the ears listless, and it pays but +little attention to the surrounding attendants or the crack of a whip. +The stupor becomes rapidly more marked, the eyes become puffy and +swollen with excessive lacrimation, so that the tears run from the +internal canthus of the eye over the cheeks and may blister the skin in +their course. The respiration becomes accelerated to 25 or 30 in a +minute, and the pulse is quickened to 70, 80, or even 100, moderate in +volume and in force. There is great depression of muscular force; the +animal stands limp, as if excessively fatigued. There is diminution, or +in some cases total loss, of sensibility of the skin, so that it may be +pricked or handled without attracting the attention of the animal. On +movement, the horse staggers and shows a want of coordination of all the +muscles of its limbs. The senses of hearing, sight, and taste are<span class='pagenum'><a name="Page_514" id="Page_514">[Pg 514]</a></span> +diminished, if not entirely destroyed. The visible mucous membranes (as +the conjunctiva), from which it received the name pinkeye, and the +mouth, and the natural openings become of a deep saffron, ocher, or +violet-red color. This latter is especially noticeable on the rim of the +gums and is a condition not found in any other disease, so that it is an +almost diagnostic symptom. In some outbreaks there is much more swelling +of the lids and weeping from the eyes than in others. If the animal is +bled at this period the blood is found more coagulable than normal, but +at a later period it becomes of a dark color and less coagulable. There +is great diminution or total loss of appetite, with an excessive thirst, +but in many cases cold-blooded horses may retain a certain amount of +appetite, eating slowly at hay, oats, or other feed. There is some +irritation of the mucous membrane of the respiratory tract, as shown by +discharge of mucus from the nose, and by cough. Pregnant mares are +liable to abort.</p> + +<p>We have, following the fever, a tumefaction, or edema, of the +subcutaneous tissues at the fetlocks, of the under surface of the belly, +and of the sheath of the penis, which may be excessive. The infiltration +is noninflammatory in character and produces an insensibility of the +skin like the excessive stocking which we see in debilitated animals +after exposure to cold. In ordinary cases the temperature has reached +its maximum of 105° or 106° F. in from 24 to 48 hours from the origin of +the fever. It remains stationary for a period of from 3 to 4 days +without so much variation between morning and evening temperature as we +have in pneumonia or other serious diseases of the lungs. At the +termination of the specific course of the disease, which is generally +from 6 to 10 days, the fever abates, the swelling of the legs and under +surface of belly diminishes, the appetite returns, the strength is +rapidly regained, the mucous membranes lose their yellowish color, which +they attain so rapidly at the commencement of the disease, and the +animal convalesces promptly to its ordinary good condition and health, +and rapidly regains the large amount of weight which it lost in the +early part of the disease, a loss which frequently reaches 30, 50, or +even 75 pounds each 24 hours. For the first three days of the high +temperature there is a great tendency to constipation, which should be +avoided if possible by the use of the means recommended below, for, if +it has been marked, it may be followed by a troublesome diarrhea.</p> + +<p><i>Terminations.</i>—The terminations of simple influenza may be death by +extreme fever, with failure of the heart's action; from excessive coma, +due generally to a rapid congestion of the brain; to the poisonous +effects of the débris of the disintegrated blood corpuscles and the +toxin of the disease; to an asphyxia, following congestion of the lungs; +or the disease terminates by subsidence of the fever, return of the +appetite and nutritive functions of the organs, and rapid +convalescence;<span class='pagenum'><a name="Page_515" id="Page_515">[Pg 515]</a></span> or, in an unfortunately large number of cases, the +course of the disease is complicated by local inflammatory troubles, +whose gravity is greater in influenza than it is when they occur as +sporadic diseases.</p> + +<p><i>Complications.</i>—The complications are congestions, followed by +inflammatory phenomena in the various organs of the body, but they are +most commonly located in the intestines, lungs, brain, or vascular +laminæ of the feet. Atmospheric influence or other surrounding +influences of unknown quality seem to be an important factor in the +determination of the local lesions. At certain seasons of the year, and +in certain epizootics, we find 40 and 50 per cent or even a greater +percentage of the cases rendered more serious by complication of the +intestines; at other seasons of the year, or in other epizootics, we +find the same percentage of cases complicated by inflammation of the +lungs, while at the same time a small percentage of them are complicated +by troubles of the other organs; inflammatory changes of the brain, of +the laminæ, more rarely commence in epizootic form, but are to be found +in a certain small percentage of cases in all epizootics.</p> + +<p>Exciting causes are important factors in complicating individual cases +of influenza, or in localizing special lesions, during either enzootics +or epizootics. These exciting or determining causes act much as they +would in sporadic inflammatory diseases, but in this case we find the +animal much more susceptible and predisposed to be acted upon than +ordinary healthy animals. With a temperature already elevated, with the +heart's action driving the blood in increased quantity into the +distended blood vessels, which become dilated and lose their +contractility, with a congestion of all the vascular organs already +established, it takes but little additional irritation to carry the +congestion one step further and produce inflammation.</p> + +<p><i>Complication of the intestines.</i>—When any cause acts as an irritant to +the intestinal tract during the course of this specific fever it may +produce inflammation of the organs belonging to it. This cause may be +constipation, which can find relief only in a congestion which offers to +increase the function of the glands and relieve the inertia caused by a +temporary cessation of activity; or irritant medicines, especially any +increased use of antimony, turpentine, or the more active remedies; the +taking of indigestible feed, or of feed in too great quantities, or that +has been altered in any way by fungus or other injurious alterations; +the swallowing of too cold water; or any other irritant may cause +congestion. This complication is ushered in by colics. The animal paws +with the fore feet and evinces a great sensibility of the belly; it +looks with the head from side to side, and may lie down and get up, not +with violence, but with care for itself, perfectly protecting the +surface of the belly from any violence. At<span class='pagenum'><a name="Page_516" id="Page_516">[Pg 516]</a></span> first we find a decided +constipation; the droppings if passed are small and hard, coated with a +viscous varnish or even with false membranes. In from 36 to 40 hours the +constipation is followed by diarrhea. The alimentary discharge becomes +mixed with a sero-mucous exudation, which is followed by a certain +amount of suppurative matter. The animal becomes rapidly exhausted and +unstable, staggers on movement, losing the little appetite which may +have remained, and has exacerbations of fever. The pulse becomes softer +and weaker, the respiration becomes gradually more rapid, the +temperature is about 1° to 1.5° F. higher. If a fatal result is not +produced by the extensive diarrhea the discharge is arrested in from 5 +to 10 days and a rapid recovery takes place.</p> + +<p><i>Complication of the lungs.</i>—If at any time during the course of the +fever the animal is exposed to cold or drafts of air, or in any other +way to the causes of repercussion, the lungs may become affected. In the +majority of cases, however, after three, four, or five days of the +fever, congestion of the lungs commences without any exposure or +apparent exciting cause. Unless this congestion of the lungs is soon +relieved it is followed by an inflammation constituting pneumonia. This +pneumonia, while it is in its essence the same, differs from an ordinary +pneumonia at the commencement by an insidious course. The animal +commences to breathe heavily, which is distinctly visible in the heaving +of the flanks, the dilatation of the nostrils, and frequently in the +swaying movement of the unsteady body. The respirations increase in +number, what little appetite remained is lost, the temperature increases +from 1° to 2°, the pulse becomes more rapid, and at times, for a short +period, more tense and full, but the previous poisoning of the specific +disease has so weakened the tissues that it never becomes the +characteristic full, tense pulse of a simple pneumonia.</p> + +<p>On percussion of the chest dullness is found over the inflamed areas; on +auscultation at the base of the neck over the trachea a tubular murmur +is heard. The crepitant râles and tubular murmurs of pneumonia are heard +on the sides of the chest if the pneumonia is peripheral, but in +pneumonia complicating influenza the inflamed portions are frequently +disseminated in islands of variable size and are sometimes deep-seated, +in which case the characteristic auscultory symptoms are sometimes +wanting. From this time on the symptoms of the animal are those of an +ordinary grave pneumonia, rendered more severe by occurring in a +debilitated animal. The cough is at first hacky and aborted; later, more +full and moist. There is discharge from the nostrils, which may be +mucopurulent, purulent, or hemorrhagic. As in simple pneumonia, in the +outset this discharge may be "rusty," owing to capillary hemorrhages. We +find that the<span class='pagenum'><a name="Page_517" id="Page_517">[Pg 517]</a></span> blood is thoroughly mixed with the matter, staining it +evenly, instead of being mixed with it in the form of clots. At the +commencement of the complication the animal may be subject to chills, +which may again occur in the course of the disease, in which case, if +severe, an unfavorable termination by gangrene may be looked for. If +gangrene occurs it is shown by preliminary chills, a rapid elevation of +temperature, a tumultuous heart, a flaky discharge from the nostrils, +and a fetid breath; the symptoms are identical with those which occur in +gangrene complicating other diseases.</p> + +<p><i>Complication of the brain.</i>—At any time during the course of the +disease congestion of the brain may occur; at an early period if the +fever has been intense from the outset, but in ordinary cases more +frequently after three or four days. The animal, which has been stupid +and immobile, becomes suddenly restless, walks forward in the stall +until it fastens its head in the corner. If in a box stall and it +becomes displaced from its position, it follows the wall with the nose +and eyes, rubbing it along until it reaches the corner and again fastens +itself. It may become more violent and rear and plunge. If disturbed by +the entrance of the attendant or any loud noise or bright light, it will +stamp with its fore feet and strike with its hind feet, but is not +definite in fixing the object which it is resisting, which is a +diagnostic point between meningitis and rabies and which renders the +animal with the former disease less dangerous to handle. If fastened by +a rope to a stake or post, the animal will wander in a circle at the end +of the rope. It wanders almost invariably in one direction. The pupils +may be dilated or contracted, or we may find one condition in one eye +and the opposite in the other.</p> + +<p>The period of excitement is followed by one of profound coma, in which +the animal is immobile, the head hanging and placed against the corner +of the stall, the body limp, and the motion, if demanded of the animal, +unsteady. Little or no attention is paid to the surrounding noises, the +crack of a whip, or even a blow on the surface of the body. The +respiration becomes slower, the pulsations are diminished, the coma +lasts for variable time, to be followed by excesses of violence, after +which the two alternate, but if severe the period of coma becomes longer +and longer until the animal dies of spasms of the lungs or of heart +failure. It may die from injuries which occur in the ungovernable +attacks of violence.</p> + +<p><i>Complication of the feet.</i>—The feet are the organs which are next in +frequency predisposed to congestion. This congestion takes place in the +laminæ (podophyllous structures) of the feet. The stupefied animal is +roused from its condition by excessive pain in the feet and assumes the +position of a foundered horse; that is, if the fore feet alone are +affected, they are carried forward until they rest on the<span class='pagenum'><a name="Page_518" id="Page_518">[Pg 518]</a></span> heels; and if +the hind feet are affected, all the feet are carried forward, resting on +their heels, the hind ones as near the center of gravity as possible. In +some cases the stupor of the animal is so great that the pain is not +felt, and little or no change of the position of the animal is +noticeable. The foot is found hot to the touch, and after a given time +the depressed convex sole of typical founder is recognized.</p> + +<p><i>Pleurisy.</i>—This is a rare complication, but when it does occur it is +ushered in by the usual symptoms of depression, rapid pulse, small +respiration, elevation of the temperature, subcutaneous edema of the +legs and under surface of the belly, and we find a line of dullness on +either side of the chest and an abscess of respiratory murmur at the +lower part. If it is severe, there may be an effusion filling one-fourth +to one-third of the thoracic cavity in from 36 to 48 hours.</p> + +<p><i>Pericarditis</i> is an occasional complication of influenza. It is ushered +in by chills, elevation of the temperature; the pulse becomes rapid, +thready, and imperceptible. The heart murmurs become indistinct or can +not be heard. A venous pulse is seen on the line of the jugular veins +along the neck. Respiration becomes more difficult and rapid. If the +animal is moved the symptoms become more marked or it may drop suddenly +dead from heart failure.</p> + +<p><i>Peritonitis</i>, or inflammation of the membranes lining the belly and +covering the organs contained in it, sometimes takes place. The general +symptoms are similar to those of a commencing pericarditis. The local +symptoms are those of pain, especially to pressure on side of the flanks +and belly, distention of the latter, and sometimes the formation of +flatus, or gas, and constipation.</p> + +<p>Other occasional complications are nephritis, hepatitis, inflammation of +the flexor tendons and rupture of them, and abscesses.</p> + +<p><i>Diagnosis.</i>—The diagnosis of influenza is based upon continued fever, +with great depression and symptoms of stupor and coma; the rapidly +developing, dark-saffron, ocher, yellowish discoloration of the mucous +membranes, swelling of the legs and soft tissues of the genitals. When +these symptoms have become manifested the diagnosis of a local +complication is based upon the same symptoms that are produced in the +local diseases from other causes, but in influenza the local symptoms +are frequently masked or even entirely hidden by the intense stupor of +the animal, which renders it insensible to pain. The evidence of colic +and congestion, which is followed by diarrhea, indicates enteritis. The +rapid breathing or difficulty of respiration points to a complication of +the lungs, but, as we have seen in the study of the symptoms, the local +evidences of lung lesions are frequently hidden. Again, we have seen +that inflammation of the feet, or founder, complicating influenza is +frequently not shown on account of the insensibility to pain on the part +of the animal,<span class='pagenum'><a name="Page_519" id="Page_519">[Pg 519]</a></span> which indicates the importance of running the hand daily +over the hoofs to detect any sudden elevation of temperature on their +surface.</p> + +<p>The diagnosis of brain trouble is based upon the excessive violence +which occurs in the course of the disease, for during the intervening +period or coma there is no means of determining that it is due to this +complication. Severe cases of influenza may simulate anthrax in the +horse. In both we have stupor, the intense coloration of the mucous +membranes of the eyes, and a certain amount of swelling of the legs and +under surface of the belly. The diagnosis here can be made only by +microscopic examination of the blood. In strangles, equine variola, and +scalma we have an intensely red, rosy coloration of the mucous +membranes, full, tense pulse, and although in these diseases we may have +depression, we do not have the stupor and coma except in severe cases +which have lasted for several days. In influenza we have no evidence of +the formation of pus on the mucous membranes as in the other diseases, +except sometimes in the conjunctivæ.</p> + +<p>In severe pneumonia (lung fever) we may find profound coma, +dark-yellowish coloration of the mucous membranes, and swelling of the +under surface of the belly and legs; but in pneumonia we have the +history of the difficulty of breathing and an acute fever of a sthenic +type from the outset, and the other symptoms do not occur for several +days, while in influenza we have the history of characteristic symptoms +for several days before the rapid breathing and difficulty of +respiration indicate the appearance of the complication. Without the +history it is frequently difficult to diagnose a case of influenza of +several days' standing, complicated by pneumonia, from a case of severe +pneumonia of five or six days' standing, but from a prognostic point of +view it is immaterial, as the treatment of both are identical. The fact +that other horses in the same stable or neighborhood have influenza may +aid in the diagnosis.</p> + +<p><i>Prognosis.</i>—Influenza is a serious disease chiefly on account of its +numerous complications. Uncomplicated influenza is a comparatively +simple malady, and is fatal in but 1 to 5 per cent of all cases. In some +outbreaks, however, complications of one kind or another preponderate; +in such instances the rate of mortality is much increased.</p> + +<p><i>Alterations.</i>—The chief alteration of influenza occurs in the +digestive tract, and consists in hyperemia, infiltration, and swelling +of the mucous membrane, and especially of the Peyer's patches near the +ileocecal valve. The tissues throughout the body are found stained, and +of a more or less yellowish hue. There is always found a congested +condition of all the organs, muscles, and interstitial tissues of the +body. The coverings of the brain and spinal cord partake in the +congested and discolored condition of the rest of the tissues.<span class='pagenum'><a name="Page_520" id="Page_520">[Pg 520]</a></span></p> + +<p>Other alterations are dependent entirely upon the complications. If the +lungs have been affected, we find effusions identical in their intimate +nature with those of simple pneumonia, but they differ somewhat in their +general appearance in not being so circumscribed in their area of +invasion. The alterations of meningitis and laminitis are identical with +those of sporadic cases of founder and inflammation of the brain.</p> + +<p><i>Treatment.</i>—While the appetite remains the patient should have a +moderate quantity of sound hay, good oats, and bran; or even a little +fresh clover, if obtainable, can be given in small quantities. It is not +so important that a special diet shall be observed as that the horse +shall eat a moderate quantity of nourishing feed, and he may be tempted +with any feed of good quality that he relishes. He should be placed in a +well-ventilated box stall away from other horses. Grass, roots, apples, +and milk may be offered and, if relished, allowed freely. To reduce the +temperature the safest simple plan is to inject large quantities of cold +water into the rectum. Antipyrene may be used with alcohol or strychnia. +Derivatives in the form of essential oils and mustard poultices, baths +of alcohol, turpentine, and hot water, after which the animal must be +immediately dried and blanketed, serve to waken the animal from the +stupor and relieve the congestion of the internal organs. This treatment +is especially indicated when complication by congestion of the lungs, +intestines, or of the brain is threatened. Quinin and salicylic acid in +1-dram doses will lower the temperature, but too continuous use of the +former in some cases increases the depression. Iodid of potash reduces +the excessive nutrition of the congested organs and thereby reduces the +temperature; again, this drug in moderate quantities is a stimulant to +the digestive tract and acts as a diuretic, causing the elimination of +waste matter by the kidneys. Small doses of Glauber's salt and +bicarbonate of soda, used from the outset, stimulate the digestive tract +and prevent constipation and its evil results.</p> + +<p>In cases of severe depression and weakness of the heart digitalis can be +used with advantage. At the end of the fever, and when convalescence is +established, alcohol in one-half pint doses and good ale in 1-pint doses +may be given as stimulants. To these may be added 1-dram doses of +turpentine.</p> + +<p>In complications of the intestines camphor and asafetida are most +frequently used to relieve the pain causing the colics; diarrhea is also +relieved by the use of bicarbonate of soda, nitrate of potash, and +drinks made from boiled rice or starch, to which may be added small +doses of laudanum.</p> + +<p>In complication of the lungs iodid of potash and digitalis are most +frequently indicated, in addition to the remedies used for the disease +itself.<span class='pagenum'><a name="Page_521" id="Page_521">[Pg 521]</a></span></p> + +<p>Founder occurring as a complication of influenza is difficult to treat. +It is, unfortunately, frequently not recognized until inflammatory +changes have gone on for several days. If recognized at once, local +bleeding and the use of hot or cold water, as the condition of the +animal may permit, are most useful, but in the majority of cases the +stupefied animal is unable to be moved satisfactorily or to have one +foot lifted for local treatment; the only treatment consists in local +bleeding above the coronary bands and the application of poultices.</p> + +<p>During convalescence small doses of alkalines may be kept up for a short +time, but the greatest care must be used, while furnishing the animal +with plenty of nutritious, easily digestible feed, not to over-load the +intestinal tract, causing constipation and consequent diarrhea. Special +care must be taken for several weeks not to expose the animal to cold.</p> + +<p><i>Prevention.</i>—In order to prevent the introduction of the disease it is +advisable to isolate newly purchased animals for at least a week. +Further, the stabling of healthy horses in sales and feed stables should +also be guarded against. At the beginning of an outbreak the disease may +be checked by immediate isolation of the affected horses, by taking the +temperatures of the healthy animals, and by the segregation of those +showing a marked elevation.</p> + +<p>Bacterial vaccines are now being prepared for the prevention of this +disease and also for its cure, but to date the results are not +convincing as to the beneficial action of these products. Since the +cause of the disease has not yet been satisfactorily determined it is +difficult to conceive how immunity could be produced with the aid of the +germs which enter into the preparation of these products. The reports +would indicate, however, that vaccines exert a favorable influence upon +the course of the disease, probably preventing severe complications +which under ordinary conditions are the principal factors in determining +the severity of the outbreak.</p> + + +<h4>CONTAGIOUS PNEUMONIA.</h4> + +<div class="blockquot"><p><i>Synonyms.</i>—Edematous pneumonia; stable pneumonia; equine +pleuropneumonia; influenza pectoralis equorum; pleuropneumonia; +influenzal pneumonia; Brustseuche (German).</p></div> + +<p>Contagious pleuropneumonia is an acute contagious disease of horses +manifesting itself either as a croupous pneumonia or a pleuropneumonia +with complications in the form of serous infiltrations of the +subcutaneous tissues and tendons.</p> + +<p><i>Etiology.</i>—Investigators of this disease incriminated various kinds of +microorganisms as the cause of this affection. Transmission experiments +were usually negative with these organisms. This was also the case in +attempts to transmit the disease by feeding with affected parts of the +lungs, intestinal contents, and nasal discharge; likewise<span class='pagenum'><a name="Page_522" id="Page_522">[Pg 522]</a></span> by +intravenous or subcutaneous injections of blood and of emulsions made +from nasal discharge, urine, the lung, and other organs.</p> + +<p>The most recent experimental results of Gaffky and Lüber proved that at +least at the beginning of the disease the bronchial secretion contains +the infection. Upon killing horses affected with the typical forms of +the disease on the third or fourth day of the affection the air passages +are usually found to be filled with a yellowish, tenacious, germ-free +secretion with which they succeeded in infecting healthy colts. The +virus has not been isolated. The possibility of its being a protozoan is +suggested by the above-named investigators through their observations of +round or rod-shaped bodies in the round cells of the secretions.</p> + +<p>Two organisms were formerly especially considered to play an important +part in the cause of the disease, the <i>Streptococcus pyogenes equi</i>, +which has been isolated from most cases of the disease, and the +<i>Bacillus equisepticus</i>, which by some investigators was considered to +be the cause of contagious pleuropneumonia. Although there is no doubt +as to the presence of these microorganisms in most of the cases, their +association with the cause of this disease, however, is now doubted, +especially since attempts to transmit the disease with pure cultures of +these germs failed to reproduce the typical form of the disease. They, +however, are of great significance in connection with the pathological +changes occurring in connection with the infection and probably are the +determining factor in the course of the disease. They exert their action +after the animal has already been attacked by the true virus, and then +produce the inflammatory changes attributed to these secondary invaders.</p> + +<p>This disease is the adynamic pneumonia of the older veterinarians, who +did not recognize any essential difference in its nature from an +ordinary inflammation of the lungs, except in the profound sedation of +the force of the animal affected with it, which is a prominent symptom +from the outset of the disease. Again, this same prostration of the +vital force of the animal, combined with the staggering movement and +want of coordination of the muscles, caused it for a long time to be +confounded with influenza, with which at certain periods it certainly +has a strong analogy of symptoms, but from which, as from sporadic +pneumonia, it can be separated very readily if the case can be followed +throughout its whole course.</p> + +<p>Infectious pneumonia is a specific inflammation of the lungs, +accompanied with interstitial edema and inflammation of the tissues of +these organs and a constitutional disturbance and fever. It causes a +profound sedation of the nervous system, which may be so great as to +cause death. It is sometimes attended with pleurisy, inflammation of the +heart or septic complications, which also prove fatal.<span class='pagenum'><a name="Page_523" id="Page_523">[Pg 523]</a></span></p> + +<p>Old, cold, damp, foul, unclean, and badly drained and ventilated stables +allow rapid dissemination of the disease to other horses in the same +stable and act as rich reservoirs for preserving the contagion, which +may be retained for over a year.</p> + +<p>The virus is but moderately volatile, and in a stable seems rather to +follow the lines of the walls and irregular courses than the direct +currents of air and the tracts of ventilation. Prof. Dieckerhoff found +that the contagion of influenza was readily diffusible throughout an +entire stable and through any opening to other buildings, but he also +found that the contagion of infectious pneumonia is not transmissible at +any great distance, nor is it very diffusible in the atmosphere. A brick +wall 8 feet in height served, in one instance, to prevent the infection +of other animals placed on the opposite side from a horse ill with the +disease, while others placed on the same side and separated from the +focus of contagion only by open bars in the stall were infected and +developed the disease in its typical form.</p> + +<p><i>Symptoms.</i>—The symptoms differ slightly from those of a frank, +fibrinous pneumonia, but not so much by the introduction of new symptoms +as by the want of or absence of the distinct evidences of local lesions +which are found in the latter disease. All the pneumonias throughout the +whole course of the trouble are less marked and less clearly defined.</p> + +<p>The symptoms may develop slowly or rapidly. If slowly, there is fever +and the animal gives a rare cough which resembles that of a heavy horse +affected with a slight chronic bronchitis; it becomes somewhat dejected +and dull, at times somnolent, and has a diminished appetite. This +condition lasts for several days, or the disease may begin with high +fever, and the symptoms described below are severe and develop in rapid +sequence. The respiration increases to 24, 30, or 36 to the minute, and +a small, running, soft pulse attains a rhythm of 50, 70, or even more +beats in the sixty seconds. The heart, however, contrary to the +debilitated condition of the pulse, is found beating violently and +tumultuously, as it does in anthrax and septic intoxication. The mucous +membranes of the eyes and mouth and of the genital organs are found +somewhat edematous, and they rapidly assume a dirty, saffron color, at +times approaching an ocher, but distinguishable from the similar +coloration in influenza by the want of the luster belonging to the +latter and by the muddy, dull tint, which is characteristic throughout +the disease.</p> + +<p>Suddenly, without the preliminary râles which precede grave lesions of +the lungs in other diseases, the blowing murmur of pneumonia is heard +over a variable area of the chest, usually, however, much more +distinctly over the trachea at the base of the neck and directly behind +the shoulder on each side of the chest. In some cases the evidence of +lung lesion can be detected only over the trachea.<span class='pagenum'><a name="Page_524" id="Page_524">[Pg 524]</a></span> The lesions of the +lungs may be scattered throughout both lungs, involving numerous small +areas, or they may be confined to and more or less fully occupy one or +two lobes. Occasionally there is a general involvement of both lungs. +The body temperature has now reached 104° or 105° F., or in extreme +cases even a degree higher. The debility of the animal is great without +the stupefaction or evidence of cerebral trouble, which is constant with +such grave constitutional phenomena in influenza or severe pneumonia. +The animal is subject to occasional chills, and staggers in its gait. +The yellow coloration of the visible mucous membrane is rendered pale by +infiltration of the liquid of the blood into the tissues; the pulse may +become so soft as to be almost imperceptible, the heart movement and +sounds being at the same time exaggerated. The animal loses flesh +rapidly, and dropsies of the extremities, of the under surface of the +belly, or of the internal organs may show themselves.</p> + +<p><i>Terminations.</i>—These symptoms may gradually subside after five to +eight days, with an improved appetite the inanition may cease and the +animal commence to nourish its impoverished blood and tissues; the pulse +becomes stronger and the heart more regular and less tumultuous; the +mucous membranes assume a brighter and more distinct color; the +difficulty of respiration is removed, and the animal may make a +recovery. When death occurs it is usually directly due to heart failure; +in some cases it is caused by asphyxia, owing to the great amount of +exudation into the lung tissue, rendering its further function +impossible.</p> + +<p><i>Complications.</i>—The pulmonary complications of infectious pneumonia +are secondary inflammatory or necrotic changes in the lungs themselves. +Suppuration at times takes place in the bronchi and may extend to the +lung tissue. In this case mucous râles develop which are most distinctly +heard over the trachea and on the sides of the chest directly behind the +shoulders. With the development of the mucous râles, to be heard on +auscultation, we have a more purulent discharge from the nostrils, +similar to that of a chronic or subacute bronchitis. If the inflammation +has been of some standing, cavernous râles may be heard, indicating the +destruction of a considerable portion of lung tissue and the formation +of a cavity. The effects of this more acute inflammatory process are not +appreciable in the general condition of the animal, except to weaken it +still further and add to its debilitated and emaciated cachexia. +Gangrene sometimes occurs. A sudden rise of the body temperature of 1° +or 2°, with a more enfeebled pulse and a still more tumultous heart, +develop simultaneously with the appearance of a discharge from the +nostrils. This discharge is gray in color, serous or watery in +consistency, mixed with the detritus of broken-down lung tissue, and +sometimes contains clots of blood, or in more serious cases may be +marked by<span class='pagenum'><a name="Page_525" id="Page_525">[Pg 525]</a></span> a quantity of fluid blood from a hemorrhage, which proves +fatal. The discharge is fetid to the smell. The animal emaciates +rapidly. On examination of the lungs mucous râles are heard in the +larger bronchi, cavities may be found at any part of these organs, and +points of lobular pneumonia may be detected.</p> + +<p>A very serious complication is an inflammation of the heart muscle. This +is shown by a very weak and rapid pulse, great prostration, some filling +of the lungs. This complication nearly always terminates in death. Other +complications which may be mentioned are inflammation of the kidneys, +blood poisoning, congestion of the brain, and inflammation of the +tendinous sheaths and the tendons of the legs.</p> + +<p><i>Diagnosis.</i>—As fever is the first symptom of infectious pneumonia, it +is useful during an outbreak of this disease to make daily temperature +measurements of the exposed horses, so that the first indication of +disease may be discovered and the horse removed from contact with those +that are sound.</p> + +<p><i>Prognosis.</i>—The mortality in this disease may be as high as 25 per +cent, but it is usually not more than 10 per cent. If there is a special +tendency to complications of some sort, the mortality is increased.</p> + +<p><i>Alterations.</i>—At the time of death from infectious pneumonia we +frequently find septic changes and the evidences of putrefaction. The +solidification of the lung tissue is found irregular in shape and high +around the root of the lungs and the large bronchi, and is generally +covered by sound lung tissue. The anterior lobes of the lungs are +usually entirely affected. The diseased portion appears of a +gray-yellowish color, somewhat watery, and tears readily. Matter is +found in the air tubes which form gutters through the jellylike mass of +the diseased lung. Abscesses from the size of a nut to larger masses may +be found throughout the lungs. The blood is dark in color, fluid, or +only clotted into soft, jellylike masses. Masses of gangrenous or +dead-black tissue may be present.</p> + +<p><i>Treatment.</i>—Bleeding is not to be used, because it would only still +further weaken an already enfeebled animal; antimony or the alterants +would increase the depression of a too-depraved constitution. There is +in this disease no acute congestion of a particular organ to draw off by +depletive measures, nor any violent blood current to be retarded, for +fear of hypernutrition of any special part.</p> + +<p>Revulsives do good, as they excite the nervous system and awaken the +torpor of the weakened blood vessels, which aid in the reestablishment +of the functions. As in other diseases, mustard poultices may be applied +over the belly and sides of the chest, but caution must be used in the +employment of blisters, as ugly ulcers may result from their action on a +tissue of weakened vitality. Setons are dangerous<span class='pagenum'><a name="Page_526" id="Page_526">[Pg 526]</a></span> from the great +tendency in this disease to septic complications. Repeated friction of +the legs by hand-rubbing and warmth by bandaging and by rubbing the +surface of the body with turpentine and alcohol, which is immediately to +be dried by rough towels, will excite the circulation and stimulate the +emunctories of the skin.</p> + +<p>Stimulants are given internally from the outset of the disease. +Turpentine in 1-dram doses regulates the heart and excites the kidneys +to carry off waste matter, but if repeated too frequently may disturb +the already delicate digestive system. Alcohol rectifies the latter +danger, and is a useful stimulant to the heart and digestive system, if +given with care in small doses. It is an antiputrid, and is especially +indicated when septic complications and gangrene are present. The +aromatics and bitter tonics are useful; gentian and tea in warm +decoction form a useful menstruum for other remedies. Digitalis is a +useful remedy. Strychnin and quinin may be given throughout almost the +whole course of the disease. The various preparations of iron are +astringents and excitants to the digestive system. Carbolic acid is an +antiputrid which is of marked benefit in edematous pneumonia; it should +be given in small doses diluted in alcohol.</p> + +<p>Salicylic acid may be given in 1 or 2 dram doses every few hours. It is +much used for troubles of the serous membranes, lowers the temperature, +and is of value in this disease in preventing the exudation into the +tissue of the lungs. The alkalines, as the sulphate and bicarbonate of +soda, the nitrate of potash, and very small doses of the iodid of +potash, should be employed to regulate the digestive tract, the kidneys, +and the other excreting glands, and to stimulate absorption of the waste +matter.</p> + +<p>The biological products enumerated under the treatment of the catarrhal +form of influenza are also recommended for this disease. The bacterial +vaccines in particular are being employed to a great extent, but the +results are not uniformly satisfactory, especially with regard to +prevention. They might, however, exert a beneficial influence against an +attack of the secondary invaders and complications. A serum is also +being prepared especially for the treatment of this disease, and since +this is obtained from animals which have been highly immunized against +the various organisms found in association with influenza it no doubt is +beneficial, especially when the life of the animal is threatened. Such +serum, however, should be used in sufficiently large doses, as repeated +experience has proved that small doses have no beneficial action on the +disease.</p> + +<p>More recently salvarsan is being highly recommended for the treatment of +the pneumonic form of influenza, and by many investigators it is +considered as a specific for this affection. A single injection of this +preparation is supposed to result in a rapid clearing<span class='pagenum'><a name="Page_527" id="Page_527">[Pg 527]</a></span> of the lungs and +the recovery of the animal is hastened. The cost of this product, +however, at the present time, is exorbitant, and it should be considered +only in the treatment of very valuable animals.</p> + +<p>The same procedure as given for influenza should be carried out in the +prevention of this affection.</p> + +<p>The diet demands the strictest attention from the outset. In many of the +fevers the feed has to be diminished in quantity and regulated in the +quality of its heat-producing components during the acute part of the +disease, so as to lessen the material for combustion in the inflamed +organs. In edematous pneumonia, on the contrary, all the feed that can +possibly be digested and assimilated must be given. Choice must be made +of the richest material which can be handled by the weakened stomach and +intestines without fatiguing them. Good, sound hay should be chopped +short and dampened or partly boiled; in the latter case the hay tea can +be reserved to use as a drink. Oats may be preferred dry or in other +cases are taken better scalded; in most cases, however, it is better to +give slops of oatmeal, to which may be added a little bran, barley +flour, or boiled milk and wheat flour. Pure cow's milk, not too rich in +fatty matter, may be given alone or with beaten eggs; frequently the +horse has to be coaxed with the milk diluted with several parts of water +at first, but will soon learn to drink the pure milk. Apples and carrots +cut up raw or boiled are useful, and fresh clover in small quantities +will frequently stimulate the appetite. In other words, various feeds +and combinations should be given to the horse. Throughout the course of +the disease and during convalescence the greatest attention must be +taken to cleaning the coat thoroughly so as to keep the glands of the +skin in working order, and light, warm covering must be used to protect +the animal from cold or drafts of air.</p> + + +<h4>STRANGLES.</h4> + +<div class="blockquot"><p><i>Synonyms.</i>—Distemper; colt-ill; catarrhal fever; one form of +shipping fever; febris pyogenica.</p></div> + +<p><i>Definition.</i>—Strangles is an infectious disease of the horse, mule, +and ass, seen most frequently in young animals, and usually leaving them +immune from future trouble of the same kind.</p> + +<p>It appears as a fever lasting for a few days, and is usually associated +with an abscess formation of lymph glands, especially those under the +jaw, which have a tendency to break on the outside. It usually leaves +the animal after convalescence perfectly healthy and as good as it was +before, but sometimes leaves it a roarer or is followed by the +development of deep-seated abscesses which may prove fatal.<span class='pagenum'><a name="Page_528" id="Page_528">[Pg 528]</a></span></p> + +<p><i>Causes.</i>—The cause of strangles is infection by direct contact with an +animal suffering from the disease, or indirectly through contact with +the discharges from an infected animal, or by means of the atmosphere in +which an infected animal has been. There are many predisposing causes +which render some animals much more subject to contract the disease than +others. Early age, which has given it the popular name of colt-ill, +offers many more subjects than the later periods of life do, for the +animal can contract the disease but once, and the large majority of +adult and old animals have derived an immunity from previous attacks. At +3, 4, or 5 years of age the colt, which has been at home, safe on a +meadow or in a cozy barnyard, far from all intercourse with other +animals or sources of contagion, is first put to work and driven to the +market town or county fairs to be exposed to an atmosphere or to stables +contaminated by other horses suffering from disease and serving as +infecting agents. If it fails to contract it there, it is sold and +shipped in foul, undisinfected railway cars to dealers' stables, equally +unclean, where it meets many opportunities of infection. If it escapes +so far, it reaches the time for heavier work and daily contact on the +streets of towns or large cities, with numerous other horses and mules, +some of which are sure to be the bearers of the germs of this or some +other infectious disease, and at last it succumbs.</p> + +<p>The period of the eruption of the last permanent teeth, or the end of +the period of development from the colt to an adult horse, at which time +the animals usually have a tendency to fatten and be excessively +full-blooded, also seems to be a predisposing period for the contraction +of this as well as of the other infectious diseases. Thoroughbred colts +are very susceptible, and frequently contract strangles at a somewhat +earlier age than those of more humble origin. Mules and asses are much +less susceptible and are but rarely affected. Other animals are not +subject to this disease, but there is a certain analogy between it and +distemper in dogs. After exposure to infection there is a period of +incubation of the disease, lasting from two to four days, during which +the animal enjoys its ordinary health.</p> + +<p><i>Symptoms.</i>—The horse at first is a little sluggish if used, or when +placed in its stable is somewhat dejected, paying but moderate attention +to the various disturbing surroundings. Its appetite is somewhat +diminished in many cases, while in some cases the animal eats well +throughout. Thirst is increased, but not a great deal of water is taken +at one time. If a bucket of water is placed in the manger the patient +will dip its nose into it and swallow a few mouthfuls, allowing some of +it to drip back and then stop, to return to it in a short time. The coat +becomes dry and the hairs stand on end. At times the horse will have +chills of one or the other leg, the fore quarters,<span class='pagenum'><a name="Page_529" id="Page_529">[Pg 529]</a></span> or hind quarters, or +in severe cases of the whole body, with trembling of the muscles and +dryness of the skin.</p> + +<p>If the eyes and mouth are examined the membranes are found reddened to a +bright rosy color. The pulse is quickened and the breathing may be +slightly accelerated. At the end of two days a cough is heard and a +discharge begins to come from the nostrils. This discharge is at first +watery; it then becomes thicker, somewhat bluish in color, and sticky, +and finally it assumes the yellowish color of matter and increases +greatly in quantity.</p> + +<p>At the outset the colt may sneeze occasionally and a cough is heard. The +cough is at first repeated and harsh, but soon becomes softer and moist +as the discharge increases. Again, the cough varies according to the +source of the discharge, for in light cases this may be only a catarrh +of the nasal canals, or it may be from the throat, the windpipe, or the +air tubes of the lungs, or even from the lungs themselves. According to +the organ affected the symptoms and character of cough are similar to +those of a laryngitis, bronchitis, or lung fever caused by ordinary +cold.</p> + +<p>Shortly after the discharge is seen a swelling takes place under the +jaw, or in the intermaxillary space. This is at first puffy, somewhat +hot and tender, and finally becomes distinctly so, and an abscess is +felt, or having broken itself the discharge is seen dripping from a +small opening. When the discharge from the nostrils has fully developed +the fever usually disappears and the animal regains its appetite, unless +the swelling is sufficient to interfere with the function of the throat, +causing pain on any attempt to swallow. At the end of four or six days +the discharge lessens, the soreness around the throat diminishes, the +horse regains its appetite, and in two weeks has regained its usual +condition. Old and strong horses may have the disease in so light a form +that the fever is not noticeable; they may continue to eat and perform +their ordinary work as usual and no symptom may be seen beyond a slight +discharge from the nose and a rare cough, which is not sufficient to +worry any but the most particular owner. But, on the other hand, the +disease may assume a malignant form or become complicated so as to +become a most serious disease, and even prove fatal in many cases. +Inflammation of the larynx and bronchi, if excessive, produce violent, +harsh coughing, which may almost asphyxiate the animal. The large amount +of discharge may be mixed with air by the difficult breathing, and the +nostrils, the front of the animal, manger, and surrounding objects +become covered with a white foam. The inflammation may be in the lung +itself (lobular pneumonia) and cause the animal to breathe heavily, +heave at the flanks, and show great distress. In this condition marked +symptoms of fever are seen, the appetite is lost, the coat<span class='pagenum'><a name="Page_530" id="Page_530">[Pg 530]</a></span> is dry, the +horse stands back in its stall at the end of the halter strap with its +neck extended and its legs propped apart to favor breathing. This +condition may end by resolution, leaving the horse for some time with a +severe cough, or the animal may die from choking up of the lungs +(asphyxia).</p> + +<p>The swelling under the jaw may be excessive, and if the abscess is not +opened it burrows toward the throat or to the side and causes +inflammation of the parotid glands and breaks in annoying fistulas at +the sides of the throat and even up as high as the ears. Roaring may +occur either during a moderately severe attack from inflammation of the +throat (larynx), or at a later period as the result of continued lung +trouble. Abscesses may develop in other parts of the body, in the poll, +in the withers, or in the spaces of loose tissue under the arms, in the +fold of the thigh, and, in entire horses, in the testicles.</p> + +<p>During the course of the disease, or later, when the animal seems to be +on the road to perfect recovery, abscesses may form in the internal +organs and produce symptoms characteristic of disease of those parts.</p> + +<p>Roaring, plunging, wandering in a circle, or standing with the head +wedged in a corner of the stall indicate the collection of matter in the +brain. Sudden and severe lung symptoms, without previous discharge, +point to an abscess between the lungs, in the mediastinum; colic, which +is often continuous for days, is the result of the formation of an +abscess in some part of the abdominal cavity, usually in the mesentery.</p> + +<p><i>Pathology.</i>—The lesions of strangles are found on the surface of the +mucous membranes, essentially of the respiratory system, and in the +loose connective tissue fibers of the internal organs and glands, and +consist of acute inflammatory changes, tending to the formation of +matter. The blood is unaltered, though it is rich in fibrin, and if the +animal has died of asphyxia it is found dark colored and uncoagulated +when the body is first opened. If the animal has died while suffering +from high fever the ordinary alterations throughout the body, which are +produced by any fever not attended by alteration of blood, are found.</p> + +<p><i>Prevention.</i>—Healthy horses should be separated from the infected +animals, and the stables in which the disease has occurred should be +thoroughly disinfected. Since the disease frequently occurs annually on +infected premises, systematic disinfection should be practiced after an +outbreak. The stables, as well as all utensils which might have come in +contact with the infection, should be thoroughly disinfected. By such +practices recurrences of the disease may be prevented.</p> + +<p><i>Treatment.</i>—Ordinary light cases require but little treatment beyond +diet, warm washes, moistened hay, warm coverings, and protection from +exposure to cold. The latter is urgently called for, as lung +complications, severe bronchitis, and laryngitis are often the<span class='pagenum'><a name="Page_531" id="Page_531">[Pg 531]</a></span> results +of neglect of this precaution. If the fever is excessive, the horse may +receive small quantities of Glauber's salt (handful three times a day) +as a laxative, bicarbonate of soda or niter in one-dram doses every few +hours, and small doses of antimony, iodid of potash, aconite, or quinin. +Steaming the head with the vapor of warm water poured over a bucket of +bran and hay, in which belladonna leaves or tar have been placed, will +allay the inflammation of the mucous membranes and greatly ease the +cough.</p> + +<p>The swelling of the glands should be promptly treated by flaxseed +poultices and bathing with warm water, and as soon as there is any +evidence of the formation of matter it should be opened. Prompt action +in this will often save serious complications. Blisters and irritating +liniments should <i>not</i> be applied to the throat. When lung complications +show themselves the horse should have mustard applied to the belly and +to the sides of the chest. When convalescence begins great care must be +taken not to expose the animal to cold, which may bring on relapses, and +while exercise is of great advantage it must not be turned into work +until the animal has entirely regained its strength.</p> + +<p>Bacterial vaccines are now being extensively used for the prevention and +treatment of this disease. They are prepared from the specific germ of +the disease and frequently exert a very beneficial influence. A serum is +also being prepared from horses, which is injected with gradually +increasing doses of this germ. This serum possesses considerable +curative value and may prove especially valuable in cases in which the +animals have failed to respond to other forms of treatment, or when +valuable animals are affected with the disease.</p> + + +<h4>PURPURA HEMORRHAGICA.</h4> + +<div class="blockquot"><p><i>Synonyms.</i>—Anasarca; petechial fever; morbus maculosus.</p></div> + +<p><i>Definition.</i>—This disease is a septic bacterial intoxication, acute +and infectious in character, and is manifested by edematous swellings of +the subcutaneous connective tissue, and hemorrhages on the mucous +membrane and in the internal organs.</p> + +<p>A previous attack of influenza is a common predisposing cause of this +disease, which appears most frequently a few weeks after convalescence +is established. It occurs more frequently in those animals which have +made a rapid convalescence and are apparently perfectly well than it +does in those which have made a slower recovery.</p> + +<p>Anasarca commences by symptoms which are excessively variable. The local +lesions may be confined to a small portion of the animal's body and the +constitutional phenomena be nil. The appearance and gravity of the local +lesions may be so unlike, from difference of location, that they seem to +belong to a separate disease, and complications may completely mask the +original trouble.<span class='pagenum'><a name="Page_532" id="Page_532">[Pg 532]</a></span></p> + +<p>In the simplest form the first symptom noticed is a swelling, or several +swellings, occurring on the surface of the body—on the forearm, the +leg, the under surface of the belly, or the side of the head. The +tumefaction is at first the size of a hen's egg; not hot, little +sensitive, and distinctly circumscribed by a marked line from the +surrounding healthy tissue. These tumors gradually extend until they +coalesce, and in a few hours we have swelling of the legs, legs and +belly, or the head, to an enormous size; they have always the +characteristic constricted border, which looks as if it had been tied +with a cord. In the nostrils are found small reddish spots, or petechiæ, +which gradually assume a brownish and frequently a black color. +Examination of the mouth will frequently reveal similar lesions on the +surface of the tongue, along the lingual gutter, and on the frænum. If +the external swelling has been on the head, the petechiæ of the mucous +membranes are liable to be more numerous and to coalesce into patches of +larger size than when the dropsy is confined to the legs. The animal may +be rendered stiff by the swelling of the legs, or be annoyed by an +awkward swollen head, which at times may be so enormous as to resemble +that of a hippopotamus rather than that of a horse. During this period +the temperature remains normal; the pulse, if altered at all, is only a +little weaker; the respiration is only hurried if the swelling of the +head infringes on the caliber of the nostrils. The appetite remains +normal. The animal is attentive to all that is going on, and, except for +the swelling, apparently in perfect health.</p> + +<p>In from two to four days, in severe cases, the tissues can no longer +resist the pressure of the exuded fluid. Over the surface of the skin +which covers the dropsy we find a slight serous sweating, which loosens +the epidermis and dries so as to simulate the eruption of some cutaneous +disease. If this is excessive we may see irritated spots which are +suppurating. In the nasal fossæ the hemorrhagic spots have acted as +irritants, and, inviting an increased amount of blood to the +Schneiderian membrane, produce a coryza or even a catarrh. We may now +find some enlargement and peripheral edema of the lymphatic glands, +which are fed from the affected part. The thermometer indicates a slight +rise in the body temperature, while the pulse and respiration are +somewhat accelerated. The appetite usually remains good. In the course +of a few days the temperature may have reached 102°, 103°, or 104° F.</p> + +<p>Fever is established, not an essential or specific fever in any way, but +a simple secondary fever produced by the dead material from the surface +or superficial suppuration, and by the oxidization and absorption of the +colloid mass contained in the tissues. The skin may suppurate or slough +more or less over the areas of greatest tension or where it is irritated +by blows or pressure. The great swelling about<span class='pagenum'><a name="Page_533" id="Page_533">[Pg 533]</a></span> the head may by closure +of the nostrils interfere seriously with breathing. Internal edema may +occur in the throat, lungs, or intestines. Septicemia, or blood +poisoning, may result from anasarca.</p> + +<p><i>Terminations.</i>—The simple form of the disease most frequently +terminates favorably on the eighth or tenth day by resolution or +absorption of the effusion, with usually a profuse diuresis, and with or +without diarrhea. The appetite remains good or is at times capricious.</p> + +<p>Death may occur from mechanical asphyxia, produced by closure of the +nostrils or closure of the glottis. Metastasis to the lungs is almost +invariably fatal, causing death by asphyxia, Metastasis to the +intestines may cause death from pain, enteritis, or hemorrhage.</p> + +<p>Excessive suppuration, lymphangitis, and gangrene are causes of a fatal +termination by exhaustion. Mortal exhaustion is again produced by +inability to swallow in cases of excessive swelling of the head.</p> + +<p>Peritonitis may arise secondary to the enteric edema, or by perforation +of the stomach or intestines by a gangrenous spot. Septicemia terminates +fatally with its usual train of symptoms.</p> + +<p><i>Alterations.</i>—The essential alterations of anasarca are exceedingly +simple; the capillaries are dilated, the lymphatic spaces between the +fibers of the connective tissue are filled with serum, and the +coagulable portion of the blood presents a yellowish or citrine mass, +jellylike in consistency, which has stretched out the tissue like the +meshes of a sponge. Where the effusion has occurred between the muscles, +as in the head, these are found dissected and separated from each other +like those of a hog's head by the masses of fat. The surface of the skin +is desquamated and frequently denuded of the hair. Frequently there are +traces of suppuration and of ulceration. The mucous membrane of the nose +is found studded with small, hemorrhagic spots, sometimes red, more +frequently brown or black, often coalesced with each other in +irregular-sized patches and surrounded by a reddish zone, the product of +irritation. If edema of the intestines has occurred, the membrane is +found four or five times its normal thickness, reddish in color, with +hemorrhages on the free surface. Edema of the lungs leaves these organs +distended. The secondary alterations vary according to the +complications. There are frequently the lesions of asphyxia; externally +we find ulcers, abscesses, and gangrenous spots and the deep ulcers +resulting from the latter. The lymphatic cords and glands are found with +all the lesions of lymphangitis. Again are found the traces of excessive +emaciation, or the lesions of septicemia. Except from the complications +the blood is not altered in anasarca.</p> + +<p><i>Diagnosis.</i>—The diagnosis of anasarca must principally be made from +farcy or glanders. In anasarca the swelling is nonsensitive,<span class='pagenum'><a name="Page_534" id="Page_534">[Pg 534]</a></span> while +sensitive in the acute swelling of farcy. The nodes of farcy are +distinct and hard and never circumscribed, as in the other disease. The +eruption of glanders on the mucous membranes is nodular, hard, and +pelletlike. The redness disappears on pressure. In case of excessive +swelling of the head in anasarca, there may occur an extensive +sero-fibrinous exudation from the mucous membranes of the nose, poured +out as a semifluid mass or as a cast of the nasal fossæ, never having +the appearance or typical oily character which it has in glanders. The +inflammation of the lymphatic cords and glands in anasarca does not +produce the indurated character which is found in farcy.</p> + +<p><i>Prognosis.</i>—While anasarca is not an excessively fatal disease, the +prognosis must always be guarded. The majority of cases run a simple +course and terminate favorably at the end of 8 or 10 days, or possibly, +after one to two relapses, requiring several weeks for complete +recovery. Effusion into the head renders the prognosis much more grave +from the possible danger of mechanical asphyxia. Threatened mechanical +asphyxia is especially dangerous on account of the risk of blood +poisoning after an operation of tracheotomy. Edema of the viscera is a +most serious complication. The prognosis is based on the complications, +their extent, and their individual gravity, existing, as they do here, +in an already debilitated subject.</p> + +<p><i>Treatment.</i>—The treatment of anasarca may be as variable as are the +lesions. The indications are at once shown by the alterations and +mechanism of the disease, which we have just studied.</p> + +<p>Hygiene comes into play as the most important factor. Oats, oat-and-hay +tea, milk, eggs—anything which the stomach or rectum can be coaxed to +take care of—must be employed to give the nutriment, which is the only +thing that will permanently strengthen the tissues; they must be +strengthened in order to keep the capillaries at their proper caliber.</p> + +<p>Laxatives, diaphoretics, and diuretics must be used to stimulate the +emunctories so that they may carry off the large amount of the products +of decomposition which result from the stagnated effusions of anasarca. +Of these the sulphate of soda in small, repeated doses, the nitrate of +potash and bicarbonate of soda in small quantity, or the chlorate of +potash in single large doses will be found useful. Williams cites the +chlorate of potash as an antiputrid. Stimulants and astringents are +directly indicated. Spirits of turpentine serves the double purpose of a +cardiac stimulant and a powerful, warm diuretic, for the kidneys in this +disease will stand a wonderful amount of work. Camphor can be used with +advantage. Coffee and tea are two of the diffusible stimulants which are +too much neglected in veterinary medicine; both are valuable adjuncts in +treatment of anasarca, as they are during convalescence at the end of +any grave<span class='pagenum'><a name="Page_535" id="Page_535">[Pg 535]</a></span> disease which has tended to render the patient anemic. Dilute +sulphuric and hydrochloric acids are, perhaps, the best examples of a +combination of stimulant, astringent, and tonic which can be employed. +The simple astringents of mineral origin, sulphates of iron, copper, +etc., are useful as digestive tonics; I doubt whether they have any +constitutional effect. The vegetable astringents, tannic acid, etc., +have not proved efficacious in my hands. Iodid of potash in small doses +serves the triple purpose of digestive tonic, denutritive for +inflammation, and diuretic. Among the newer forms of treatment are +diluted Lugol's solution injected into the trachea, anti-streptococcus +serum and colloidal silver solution injected into the circulation. No +one but a qualified veterinarian would be competent to apply these +remedies.</p> + +<p><i>Externally.</i>—Sponging the swollen parts, especially the head, when the +swelling occurs there, is most useful. The bath should be at an extreme +of temperature—either ice cold to constrict the tissues or hot water to +act as an emollient and to favor circulation. Vinegar may be added as an +astringent. When we have excessively denuded surfaces, suppuration, or +open wounds, disinfectants should be added to the wash.</p> + +<p>In cases of excessive swelling, especially of the head, mechanical +relief may be required. Even in country practice, punctures of the part +should be made with the hot iron, as no other disease so predisposes to +septic contamination. When mechanical asphyxia is threatened tracheotomy +may be demanded. With the first evidence of dyspnea, not due to closing +of the nostrils or glottis, or with the first pawing which gives rise to +a suspicion of colic, a mustard plaster should be applied over the whole +belly and chest. The sinapism will draw the current of the circulation +to the exterior, the metastasis to the lungs or intestines is prevented, +and the enfeebled nervous system is stimulated to renewed vigor by the +peripheral irritation. The organs are encouraged by it to renewed +functional activity; the local inflammation produced by it favors +absorption of the exudation. The objection to the use of blisters is +their more severe action and the danger of mortification. Septicemia, +when occurring as a complication, requires the ordinary treatment for +the putrid diseases, with little hope of a good result.</p> + +<p>After recovery the animal regains its ordinary health, and there is no +predisposition to a return of the disease.</p> + + +<h4>HORSEPOX, OR EQUINE VARIOLA.</h4> + +<div class="blockquot"><p><i>Synonyms.</i>—Variola equina; pustular grease; phlyctenold +herpes.</p></div> + +<p><i>Definition.</i>—Horsepox is a specific, infectious fever of the horse, +attended by an eruption of pustules, or pocks, over any part of the skin +or on the mucous membranes lining the various cavities in the<span class='pagenum'><a name="Page_536" id="Page_536">[Pg 536]</a></span> body, but +chiefly, and often exclusively, upon the pasterns and fetlocks. The +eruption may commence upon the lips, or about the nostrils or eyes.</p> + +<p>This disease was described by the early Roman agricultural writers and +by the veterinarians of the eighteenth century. It received its first +important notice from the great Jenner, who confounded it with grease in +horses, since animals with this disease are very liable to have the +eruption of variola appear on the fetlocks. He saw these cases transmit +the disease to cattle in the byres and to the stablemen and milkmaids +who attended them, and furnish the latter with immunity from smallpox, +which led to the discovery of vaccination. Horsepox is also frequently +mistaken for the exanthemata attending some forms of venereal disease in +horses.</p> + +<p>Variola in the horse, while it is identical in principle, general +course, complications, and lesions with variola in other animals, is a +disease of the horse itself, and is not transmissible in the form of +variola to any other animal; nor is the variola of any other animal +transmissible to the horse. Cattle and men, if inoculated from a case of +horsepox, develop vaccinia, but vaccinia from the latter animals is not +so readily reinoculated into the horse with success. If it does develop, +it produces the original disease.</p> + +<p><i>Causes.</i>—The direct cause of horsepox is infection. A large number of +predisposing causes favor the development of the disease, as in the case +of strangles, and this trouble, like almost all contagious diseases, +renders the animal which has had one attack immune. The chief +predisposing cause is youthfulness. Old horses which have not been +affected are less liable to become infected when exposed than younger +ones. The exposure incident to shipment, through public stables, cars, +etc., acts as a predisposing cause, as in the other infectious diseases. +The period of final dentition is a time which renders it peculiarly +susceptible.</p> + +<p>Dupaul states that the infection is transmissible through the atmosphere +for several hundred yards. The more common means of contagion is by +direct contact or by means of fomites. Feed boxes and bridles previously +used by horses affected with variola are probably the most frequent +carriers of the virus, and we find the lesions in the majority of cases +developed in the neighborhood of the lips and nostrils. Coition is a +frequent cause. A stallion suffering from this disease may be the cause +of a considerable epizootic, as he transmits it to a number of brood +mares and they in turn return to the farms where they are surrounded by +young animals to which they convey the contagion. The saddle and croup +straps are frequent agents of infection. The presence of a wound greatly +favors the inoculation of the disease, which is also sometimes carried +by surgical instruments or sponges. Trasbot recites a case in which a +set of hobbles, which<span class='pagenum'><a name="Page_537" id="Page_537">[Pg 537]</a></span> had been used on an animal suffering from +variola, were used on a horse for a quittor operation and transmitted +the disease, which developed on the edges of the wound.</p> + +<p><i>Symptoms.</i>—There is a period of incubation, after an animal has been +exposed, of from five to eight days, during which there is no +appreciable alteration in the health. This period is shorter in summer +than in winter. At the end of this time small nodes develop at the point +of inoculation and the animal becomes feverish. The horse is dull and +dejected, loses its appetite, and has a rough, dry coat with the hairs +on end. There is moderate thirst. The respirations are somewhat +quickened and the pulse becomes rapid and full. The body temperature is +elevated, frequently reaching 104° or 105° F. within 36 or 48 hours from +the appearance of the first symptoms.</p> + +<p>The visible mucous membranes, especially the conjunctivæ, are of a +bright rosy red. In the lymphatic, cold-blooded, and more common horses +these symptoms of fever are less marked; even with a comparatively high +temperature the animal may retain its appetite and work comparatively +well, but these cases, if worked and overheated, are liable to develop +serious complications.</p> + +<p>At the end of from three and a half to four days the eruption breaks +out, the fever abates, and the general symptoms improve. The eruption in +severe cases may be generalized; it may be confined to the softer skin +of the nose and lips, the genital organs, and the inside of the thighs, +or it may be localized in the neighborhood of a wound or in the +irritated skin of a pair of greasy heels. It consists of a varying +number of little nodes which, on a mucous membrane, as in the nostrils +or vagina, or on soft, unpigmented skin, appear red and feel at first +like shot under the epidermis. These nodes soften and show a yellowish +spot in the center when they become pustules. The epidermis is dissolved +and the matter escapes as a viscid fluid at first citrine and later +cloudy and purulent, which dries rapidly, forming scabs; if these fall +off or are removed they leave a little shallow, concave ulcer which +heals in the course of five or six days. In the softer skin if pigmented +the cicatrices are white and frequently remain so for about a year, when +the pigment returns. The lips or genital organs of a colored horse, if +covered with a number of small white spots about the size of a pea, will +usually indicate that the animal has been affected with the horsepox.</p> + +<p>At times the pustules may become confluent and produce large, +superficial, serpentine ulcers on the membrane of the nostrils, around +the lips or eyelids, or on the borders of wounds and in greasy heels; in +this case the part becomes swollen, hot, painful, and is covered with a +profuse discharge of matter. In this form there is frequently a +secondary fever lasting for a day or two.<span class='pagenum'><a name="Page_538" id="Page_538">[Pg 538]</a></span></p> + +<p>In severe cases there may be a suppurative adenitis, or inflammation of +the lymphatic glands which are fed from the affected part. If the +eruption is around the nostrils and lips, the glands between the jaws +(submaxillary) form abscesses as in a case of strangles; if the eruption +is in a pair of greasy heels abscesses may form in the fold of the groin +(inguinal). There may be so much tumefaction of the nostrils as to +produce difficulty in breathing.</p> + +<p><i>Complications.</i>—A case of horsepox may be attended with various +complications of varying degrees of importance. Adenitis, or suppuration +of the glands, has just been mentioned. Confluent eruptions irritate the +part and induce the animal to rub the inflamed part against the manger +or scratch it in other ways and thus produce troublesome ulcers, which +may leave ugly scars. Irritation of the mucous membrane of the nose +causes severe coryza with purulent discharge.</p> + +<p>The eruption may occur in the throat or in the air tubes to the lungs, +developing an acute laryngitis or bronchitis. If the animal is exposed +to cold, or worked so as to engorge the lungs with blood at the +termination of the specific fever, just when the eruption is about to +localize, it may be determined to the lungs. In this case we have a +short, dry cough, labored breathing, the development of a secondary +fever of some gravity, and all the external symptoms of a pneumonia. +This pneumonia differs, however, from an ordinary pneumonia in the +symptoms furnished by the examination of the lungs themselves. In place +of a large mass of the lung tissue being affected the inflammation is +disseminated in smaller spots over the entire lung.</p> + +<p><i>Diagnosis.</i>—The diagnosis of horsepox is to be based on the presence +of a continuous fever, with rosy mucous membranes, for several days and +the appearance of the characteristic eruption. If the eruption is in the +nasal cavities, marked by a considerable discharge and attended with +submaxillary abscesses, it may be confounded with strangles. If the +throat is affected, it may be confounded with an angina (laryngitis or +pharyngitis), but in the latter the local trouble precedes or is +concomitant with the fever, while in the former the fever precedes the +local trouble by several days. Variola may be confounded with bronchitis +or pneumonia if complicated with these troubles and the eruption is +absent from the exterior, but it is of little moment, as the treatment +for both is much the same. When the eruption is in the neighborhood of +the genital organs the disease has been mistaken for dourine. In variola +the eruption is a temporary one; the nodes and pustules are followed by +shallow ulcers and rapid cicatrization unless continued in the vagina or +on the penis by the rubbing of the walls and filth which accumulates; +there are apt to be pustules at other parts of the body. In the venereal +disease<span class='pagenum'><a name="Page_539" id="Page_539">[Pg 539]</a></span> the local trouble commences as a papule and breaks into an +ulcer without having formed a pustule. The ulcer has not the convex rosy +appearance of that of the less serious discharge; the symptoms last for +a longer period, by which time others aid in differentiating the two. In +glanders the tubercle is hard and, after breaking into an ulcer, the +indurated bottom remains, grayish or dirty white in color, ragged, and +exuding a viscous, oily discharge. There is no disposition to +suppuration of the neighboring glands. In variola the rosy shallow ulcer +and healthy pus, with the acutely tumefied glands, should not be +mistaken, at least after a day. I have seen in mules acute glanders +which required a day's delay to differentiate from strangles; at that +time the farcy buds appeared.</p> + +<p><i>Prognosis.</i>—The average case of horsepox runs a course of dejection, +loss of appetite, and more or less fever for about four days, followed +by a rapid convalescence, and leaves the animal as well and as sound as +before. If the eruption has been excessive or confluent, the ulcerations +may act as irritants and render the animal unfit for use for several +weeks. Laryngitis, pharyngitis, bronchitis, and pneumonia in this +disease are not of greater gravity than they are when occurring from +other causes. The spots denuded of pigment left by the pustules on the +lips and genitals may temporarily depreciate the value of the animal to +a slight degree.</p> + +<p><i>Treatment.</i>—As this is a disease unattended by alterations of the +blood itself, although a specific fever, and is of a sthenic type, +active remedies are admissible and indicated. The horse should be placed +on a low diet (little or no oats)—bran mashes, a moderate quantity of +good, sound hay, a few carrots or apples, which will act as laxatives; +also slop feed. Barley flour is more cooling for mashes than bran or +oatmeal. Water may be given as the animal desires it, but it should not +be cold; if a half bucketful of water is kept in the manger, the horse +will take but a few swallows at a time. One-dram doses of nitrate of +potash or 1-ounce doses of sweet spirits of niter are useful in the +drinking water. If the fever is high, the antipyretics are indicated: +Sulphate of quinin in 1-dram doses; iodid of potash in 1-dram doses; +infusion of pine tops, of juniper leaves, of the aromatic herbs, or of +English breakfast tea are useful in the later stages. If complications +of the air passages or lungs are threatened, a large mustard poultice +should be applied to the belly and sides of the chest. Oxid of zinc +ointment should be used on confluent eruptions, and if the ulceration is +excessive it may have to be touched with caustic.</p> + +<p>Great care must be taken to keep the animal protected from cold drafts +of air or other exposure. Blankets or sheets should be used on the body +and bandages on the legs. After convalescence is established, nutritious +feed of easy digestion and walking exercise are all<span class='pagenum'><a name="Page_540" id="Page_540">[Pg 540]</a></span> that is needed, +except perhaps a little Glauber's salt to prevent constipation.</p> + +<p><i>Prophylactic treatment.</i>—When horsepox breaks out among a large number +of horses, especially on a farm where there are a number of colts, it +may be assumed that the greater majority will contract the disease, and +it is more economical that they should have it and be through with it at +once. If the weather is moderate, all the animals which have not been +affected can be inoculated, which will produce the disease in a mild +form, with the eruption at a point of election, and render the danger of +complication a minimum one. For inoculation the discharge from the +pustules of a mild case should be selected and inoculated by +scarification on the belly or the under surface of the neck.</p> + + +<h4>ANTHRAX.</h4> + +<div class="blockquot"><p><i>Synonyms:</i> Carbuncle, splenic fever, splenic apoplexy, etc.; +charbon, sang de rate (French); Miltzbrand (German).</p></div> + +<p><i>Definition.</i>—Anthrax is a severe and usually fatal contagious disease, +characterized by chills, great depression and stupor of the animal, and +a profound alteration of the blood. It is caused by the entrance into +the animal's body of a bacterium, known as the <i>Bacillus anthracis</i>, or +its spores.</p> + +<p>Practically all animals are susceptible to anthrax. The herbivora are +especially susceptible, in the following order: The sheep, the ox, and +the horse. The guinea pig, the hog, the rabbit, mice, and other animals +die quickly from its effects. Man, the dog, and other omnivora and +carnivora may be attacked by it in a constitutional form as fatal as in +the herbivora, but fortunately in many cases develop from it only local +trouble, followed by recovery.</p> + +<p>Anthrax has been a scourge of the animals of the civilized world since +the first written history we have of any of their diseases. In 1709-1712 +extensive outbreaks of anthrax occurred in Germany, Hungary, and Poland. +In the first half of the nineteenth century it had become an extensively +spread disease in Russia, Holland, and England, and for the last century +has been gradually spreading in the Americas, more so in South America +than here. In 1864, in the five governments of Petersburg, Novgorod, +Olonetz, Twer, and Jaroslaw, in Russia, more than 10,000 horses and +nearly 1,000 persons perished from the disease.</p> + +<p><i>Causes.</i>—The causes of anthrax were for a long time attributed +entirely to climatic influence, soil, and atmospheric temperature, and +they are still recognized as predisposing factors in the development of +the disease, for it is usually found, especially when outbreaks in a +great number of animals occur, in low, damp, marshy countries during the +warm seasons. It is more frequent in districts where marshy<span class='pagenum'><a name="Page_541" id="Page_541">[Pg 541]</a></span> lands dry +out during the heat of summer and are then covered with light rains. +Decaying vegetable matter seems most favorable for nourishing and +preserving the virus.</p> + +<p>The direct cause of anthrax is always infection of a previously sound +animal, either directly from a diseased animal or through various media +which contain excretions or the débris from the body of one previously +infected.</p> + +<p>The specific virus of anthrax was first discovered by Davaine in 1851. +He recognized microscopic bodies in the form of little rods in the blood +of animals suffering from anthrax. It was not, however, till a quarter +of a century later that Pasteur defined the exact nature of the +bacillus, the mode of its propagation, and its exact relationship to +anthrax as the sole cause of the disease. In the animal body the bacilli +have a tendency to accumulate in the spleen, liver, and elsewhere, so +that these organs are much more virulent than the muscles or less +vascular tissues. When eliminated from the animal in the excretions, or +when exposed to outside influences by the death of the animal and the +disintegration of the tissues, the body of the rod is destroyed and the +spores only remain. These spores, which may be called the seeds of the +bacilli, retain their vitality for a long period; they resist ordinary +putrefaction; they are unchanged by moisture; and they are not affected +by moderate heat. If scattered with the débris of a dead animal on the +surface of the ground, they may remain around the roots of the grass in +a pasture or may be washed to the nearest low-lying ground or marsh. If +buried in the body of an animal dead from anthrax, they may be washed +deep into the ground, and in later years (in one proved case 17 years) +be brought to the surface and infect other animals. They are frequently +brought to the surface of the earth, having been swallowed by +earthworms, in the bodies of which they have been found.</p> + +<p>This accounts for the outbreaks at the time of the first rains after a +dry season. During the latter the earthworm goes deep in the ground in +search of moisture; it finds the spore which has been washed there in +past years, swallows it, and afterwards brings it to the surface. The +virus is carried with the wool from infected sheep and remains in it +through the process of manufacture into cloth. The spores remain in the +hides of animals which have died of anthrax and retain their vitality +throughout months of soaking in the tanners' pits, the working of the +harness maker or the cobbler, and after the oiling of the completed +leather. The dried spores in the dust from any of these products may be +carried by the atmosphere.</p> + +<p>Infection of an animal takes place through inoculation or contact of the +bacillus or its spores with an abraded surface or mucous membrane, on a +sound animal. In an infected district horses may eat with impunity the +rich pasturage of spring and early summer, but when<span class='pagenum'><a name="Page_542" id="Page_542">[Pg 542]</a></span> grass gets low they +crop it close to the ground, pull up the roots around which the virus +may be lodged, and under these conditions the animals are more apt to +have abrasions of the lips or tongue by contact with dried stubble and +the dirt on the roots; this favors the introduction of the germs into +the system. The virus may be introduced with feed and enter the +blood-vessel system from the stomach and intestines. If in the dust, +dried hay, or on the parched pasture of late summer, the virus may be +inhaled and be absorbed from the lining of the lungs. If in harness +leather, it needs but an abrasion of the skin, as the harness rubs it, +to transfer the spore from the leather to the circulation of the animal.</p> + +<p>The writer saw a case of anthrax occur in a groom from the use of a new +horse brush. The strap which passes over the back of the hand inoculated +an abrasion on the knuckle of the first finger, and in 12 hours a +"pustule" had formed and the arm had become infected.</p> + +<p><i>Symptoms.</i>—The symptoms of anthrax usually develop with extreme +rapidity. The horse is dejected and falls into a state of profound +stupor, attended with great muscular weakness. The feeble, indolent +animal, if forced to move, drags its legs. There are severe chills, +agitation of the muscles, symptoms of vertigo, and at times colicky +pains. The mucous membranes turn a deep ocher or bluish-red color. The +body temperature is rapidly elevated to 104° or 105° F. The breathing is +increased to 30 or 40 respirations in the minute and the pulse is +greatly accelerated, but while the arteries are soft and almost +imperceptible, the heart beats can be felt and heard, violent and +tumultuous. In some cases, when inoculation is through the skin, large +subcutaneous swellings appear; these may involve a leg, a shoulder, one +side of the body, or the neck or head. The swelling is at first hot and +painful, but afterwards it becomes necrotic and sensation is lost. The +symptoms last but two, three, or four days at most, when the case +usually terminates fatally. An examination of the blood shows a dark +fluid which will not clot, and which remains black after exposure to the +air. After death the bodies putrefy rapidly and bloat up; the tissues +are filled with gases, and a bloody foam exudes from the mouth, +nostrils, and anus, and frequently the mucous membranes of the rectum +protrude from the latter. The hairs detach from the skin. Congestion of +all the organs and tissues is found, with interstitial hemorrhages. The +muscles are friable and are covered with ecchymotic spots. This is +especially marked in the heart.</p> + +<p>The black, uncoagulated, and incoagulable blood shows an iridescent scum +on its surface, which is due to the fat of the animal dissolved by the +ammonia produced by the decomposed tissues. The serum oozes out of every +tissue and contains broken-down blood, which, when examined +microscopically, is found to have the red<span class='pagenum'><a name="Page_543" id="Page_543">[Pg 543]</a></span> globules crenated and the +leucocytes granular. A high power of the microscope also reveals the +bacteria in the shape of little rodlike bodies of homogeneous texture +with their brilliant spores.</p> + +<p>The lymphatic ganglia are increased four, five, six, or ten times their +natural size, enlarged by the engorgement of blood. The spleen shows +nodulated black spots containing a muddy blood, which is found teeming +with the virus. This organ is much enlarged and is quite friable. The +mucous membranes of the intestines are congested and reddish brown; the +surface of the intestines is in many places denuded of its lining +membrane, showing fissures and hemorrhagic spots. The liver has a cooked +appearance; the kidneys are congested and friable; the urine is red; the +pleura, lungs, and the meninges are congested, and the bronchi of the +lungs contain a bloody foam.</p> + +<p><i>Treatment.</i>—Treatment of anthrax in animals by medicinal means has not +proved satisfactory. In cases of local anthrax an incision of the +swelling followed by the application of disinfectants sometimes causes +good results. In such cases, however, the danger of disseminating the +infection from the wounds tends to make this procedure inadvisable +unless great care is taken.</p> + +<p>Good results are obtained from the use of serum in the treatment of the +disease. For this purpose 30 to 100 cubic centimeters should be +administered subcutaneously or intravenously. If no improvement is +noticed within 24 hours the injection should be repeated. In a number of +instances afforded to test the curative value of the serum in cases of +anthrax in man and animals splendid results were obtained.</p> + +<p>The prophylactic treatment formerly consisted in the avoidance of +certain fields and marshes which were recognized as contaminated during +the months of August and September and had been occupied the years in +which the outbreaks usually occurred. It underwent, however, a +revolution after the discovery by Pasteur of the possibility of a +prophylactic inoculation or vaccination which granted immunity from +future attacks of the disease similar to that granted by the recovery of +an animal from an ordinary attack of the disease.</p> + +<p>This treatment consists in the use of a vaccine which is made by the +artificial cultivation of the virus of anthrax in broth and in the +treatment of it by means of continued exposure to a high temperature for +a certain time, which weakens the virus to such extent that it is +capable of producing only a very mild and not dangerous attack of +anthrax in the animal in which it is inoculated, and thus protects it +from inoculation of a stronger virus. The production of this virus, +which is carried on in some countries at the expense of the governments +and is furnished at a small cost to the farmers in regions where the +disease prevails, in this country is made in private laboratories only.<span class='pagenum'><a name="Page_544" id="Page_544">[Pg 544]</a></span></p> + +<p>At the present time very good results are being obtained with +vaccination consisting of an injection of highly potent anthrax serum on +one side of the animal and a vaccine on the other side. This method of +treatment requires only a single handling of the animals and further +possesses advantages over the Pasteur treatment in that it immediately +makes animals immune. In the numerous applications of this form of +treatment very good results have been obtained and the immunity produced +thereby visually lasts at least one year. The vaccinated animals should +be kept for a period of ten days to two weeks from exposure, since +during that period they are at times even more susceptible to the +disease, and therefore care should be taken not to reduce their +vitality.</p> + +<p><i>Prevention.</i>—In attempts to control the disease it is essential, aside +from protective vaccination, to prevent the reinfection of localities. +For this purpose it is essential, if possible, to drain thoroughly and +keep under cultivation the infected areas before animals are permitted +to pasture on them. The complete destruction of all anthrax carcasses is +also very important. This is best accomplished by burning, but as this +method of disposal is impracticable in many localities, deep burial may +be found to be better. Covering the carcasses within their graves with +quicklime adds another valuable precaution against further dissemination +of the infection. No animal dying from anthrax should ever be skinned or +cut open, as the blood from these sources is one of the most dangerous +means of spreading the infection, being charged, while in the animal, +with great numbers of bacilli, which quickly turn into spores as soon as +spread about upon the face of the ground. All discharges from the body +openings should also be burned or buried deeply, as they are frequently +of a virulent character.</p> + + +<h4>GLANDERS AND FARCY.</h4> + +<h5>(Pls. XL-XLII.)</h5> + +<p><i>Definition.</i>—Let it be understood at the outset that glanders and +farcy are one and the same disease, differing only in that the first +term is applied to the disease when the local lesions predominate in the +internal organs, especially in the nostrils, lungs, and air tubes, and +that the second term is applied to it when the principal manifestation +is an outbreak of the lesions on the exterior or skin of the animal. The +term glanders applies to the disease in both forms, while the term farcy +is limited to the visible appearance of external trouble only; but in +the latter case internal lesions always exist, although they may not be +evident.</p> + +<p>Glanders is a contagious constitutional disease of the genus <i>Equus</i> +(the horse, ass, and mule), readily communicable to man, the dog, the +cat, the rabbit, and the guinea pig. It is transmitted with difficulty +to sheep and goats, and cattle seem to be entirely immune. It runs a +variable course and usually produces the death of the animal affected +with it. It is characterized by the formation of neoplasms, or nodules, +of connective tissue, which degenerate into ulcers, from which exude a +peculiar discharge. It is accompanied with a variable degree of fever, +according to the rapidity of its course. It is subject to various +complications of the lymphatic glands, of the lungs, of the testicles, +of the internal organs, and of the subcutaneous connective tissue.</p> + +<p><a name="PLATE_XL" id="PLATE_XL"></a></p> +<div class="figcenter" style="width: 187px;"> +<a href="images/plate40.jpg"><img src="images/plate40t.jpg" width="187" height="450" alt="PLATE XL." title="" /></a> +<span class="caption">PLATE XL.<br /> + +GLANDERS.<br /><br /> + +Nasal septum of horse, right side, showing acute lesions.</span> +</div> + +<p><a name="PLATE_XLI" id="PLATE_XLI"></a></p> +<div class="figcenter" style="width: 325px;"> +<a href="images/plate41.jpg"><img src="images/plate41t.jpg" width="325" height="450" alt="PLATE XLI." title="" /></a> +<span class="caption">PLATE XLI.<br />GLANDERS.<br /><br /> +Middle region of nasal septum, left side, showing ulcers.</span> +</div> + +<p><a name="PLATE_XLII" id="PLATE_XLII"></a></p> +<div class="figcenter" style="width: 292px;"> +<a href="images/plate42.jpg"><img src="images/plate42t.jpg" width="292" height="450" alt="PLATE XLII." title="" /></a> +<span class="caption">PLATE XLII.<br /> + +GLANDERS.<br /><br /> + +Posterior half of nasal septum, right side, showing cicatrices.</span> +</div> + +<p><span class='pagenum'><a name="Page_545" id="Page_545">[Pg 545]</a></span><i>History.</i>—Glanders is one of the oldest diseases of which we have +definite knowledge in the history of medicine. Absyrtus, the Greek +veterinarian in the army of Constantine the Great, described it with +considerable accuracy and recognized the contagiousness of its +character. Another Greek veterinarian, Vegetius Renatus, who lived in +the time of Theodosius (381 A. D.), described, under the name of +"malleus humidus," a disease of the horse characterized by a nasal +discharge and accompanied by superficial ulcers. He recognized the +contagious properties of the discharge of the external ulcers, and +recommended that all animals sick with the disease be separated at once +with the greatest care from the others and should be pastured in +separate fields, for fear the other animals should become affected.</p> + +<p>In 1682 Sollysel, the stable master of Louis XIV, published an account +of glanders and farcy, which he considered closely related to each +other, although he did not recognize them as identical. He admitted the +existence of a virus which communicated the disease from an infected +animal to a sound one. He called special attention to the feed troughs +and water buckets as being the media of contagion. He divided glanders +into two forms—one malignant and contagious and the other benign—and +he stated that there was always danger of infection.</p> + +<p>Garsault in 1746 said that "as this disease is communicated very easily +and can infect in a very short time a prodigious number of horses by +means of the discharges which may be licked up, animals infected with +glanders should be destroyed."</p> + +<p>Bourgelat, the founder of veterinary schools, in his "Elements of +Hippiatry," published in 1755, establishes glanders as a virulent +disease.</p> + +<p>Extensive outbreaks of glanders are described as prevailing in the great +armies of continental Europe and England from time to time during the +periods of all the wars of the last few centuries.</p> + +<p>Glanders was imported into America at the close of the eighteenth +century, and before the end of the first half of the last century had +spread to a considerable degree among the horses of the Middle and +immediately adjoining Southern States. This disease was unknown<span class='pagenum'><a name="Page_546" id="Page_546">[Pg 546]</a></span> in +Mexico until carried there during the Mexican War by the badly diseased +horses of the United States Army. During the first half of the last +century a large body of veterinarians and medical men protested against +the contagious character of the disease, and by their opinion prevailed +to such an extent against the common opinion that several of the +Governments of Europe undertook a series of experiments to determine the +right between the contesting parties.</p> + +<p>At the veterinary school at Alfort and at the farm of Lamirault in +France several hundred horses which had passed examination as sound had +placed among them glandered horses under various conditions. The results +of these experiments proved conclusively the contagious character of the +disease.</p> + +<p>In 1881 Bouchard, of the faculty of medicine in Paris, assisted by +Capitan and Charrin, undertook a series of experiments with matter taken +from the farcy ulcer of a human being. They afterwards continued their +experiments with matter taken from horses, and in 1883 succeeded in +showing that glanders is caused by a bacterium which is capable of +propagation and reproduction of others of its own kind if placed in the +proper media. In 1882 the specific germ of glanders was first discovered +and described by Loeffler and Schuetz in Germany.</p> + +<p>When we come to study the etiology of glanders, the difference of +susceptibility on the part of different species of animals, or even on +the part of individuals of the same species, and when we come to find +proof of the slow incubation and latent character of the disease as it +exists in certain individuals, we understand how in a section of country +containing a number of glandered animals others can seem to contract and +develop the disease without having apparently been exposed to contagion.</p> + +<p><i>Causes.</i>—The contagious nature of glanders, in no matter what form it +appears, being to-day definitely demonstrated, we can recognize but one +cause for all cases, and that is contagion by means of the specific +virus of the disease. The causative organism is known as the <i>Bacillus +mallei</i>.</p> + +<p>In studying the writings of the older authors on glanders, and the works +of those authors who contested the contagious nature of the disease, we +find a large number of predisposing causes assigned as factors in the +development of the malady.</p> + +<p>While a virus from a case of glanders if inoculated into an animal of +the genus <i>Equus</i> will inevitably produce the disease, we find a vast +difference in the contagious activity of different cases of glanders. We +find a great variation in the manner and rapidity of the development of +the disease in different individuals and that the contagion is much more +liable to be carried to sound animals under certain circumstances than +it is under others. Only certain species of animals are<span class='pagenum'><a name="Page_547" id="Page_547">[Pg 547]</a></span> susceptible of +contracting the disease, and while some of these contract it as a +general constitutional malady, in others it develops as only a local +sore.</p> + +<p>In acute glanders the contagion is found in its most virulent form, as +is shown by the inevitable infection of susceptible animals inoculated +with the disease, while the discharge from chronic semilatent glanders +and farcy may at times be inoculated with a negative result; again, in +acute glanders, as we have a free discharge, a much greater quantity of +virus-containing matter is scattered in the neighborhood of an infected +horse to serve as a contagion to others than is found in the small +amount of discharge of the chronic cases.</p> + +<p>The chances of contagion are much greater when sound horses, asses, or +mules are placed in the immediate neighborhood of glandered horses, +drink from the same bucket, stand in the next stall, or work in the same +wagon, or are fed from feed boxes or mangers which have been impregnated +by the saliva and soiled by the discharge of sick animals. Transmission +occurs by direct contact of the discharges of a glandered animal with +the tissues of a sound one, either on the exterior, when swallowed mixed +with feed into the digestive tract, or when dried and inhaled as dust.</p> + +<p>The stable attendants serve as one of the most common carriers of the +virus. Dried or fresh discharges are collected from the infected animals +in cleaning, harnessing, feeding, and by means of the hands, clothing, +the teeth of the currycomb, the sponge, the bridle, and the halter, and +are thus carried to other animals.</p> + +<p>An animal affected with chronic glanders in a latent form is moved from +one part of the stable to another, or works hitched with one horse and +then with another, and may be an active agent in the spreading of the +disease without the cause being recognized.</p> + +<p>Glanders is found frequently in the most insidious forms, and we +recognize that it can exist without being apparent; that is, it may +affect a horse for a long period without showing any symptoms that will +allow even the most experienced veterinarian to make a diagnosis. An old +gray mare belonging to a tavern keeper was reserved for family use with +good care and light work for a period of eight years, during which time +other horses in the tavern stable were from time to time affected with +glanders without an apparent cause. The mare, whose only trouble was an +apparent attack of heaves, was sold to a huckster who placed her at hard +work. Want of feed and overwork and exposure rapidly developed a case of +acute glanders, from which the animal died, and at the autopsy were +found the lesions of an acute pneumonia of glanders grafted on chronic +lesions, consisting of old nodules which had undoubtedly existed for +years.</p> + +<p>In a case that once came under the care of the writer, a coach horse was +examined for soundness and passed as sound by a prominent<span class='pagenum'><a name="Page_548" id="Page_548">[Pg 548]</a></span> veterinarian, +who a few months afterwards treated the horse for a skin eruption from +which it recovered. Twelve months afterwards it came into the hands of +the writer, hidebound, with a slight cough and a slight eruption of the +skin, which was attributed to clipping and the rubbing of the harness, +but which had nothing suspicious in its character. The horse was placed +on tonics and put to regular light driving. In six weeks it developed a +bronchitis without having been specially exposed, and in two days this +trouble was followed by a lobular pneumonia and the breaking of an +abscess in the right lung. Farcy buds developed on the surface of the +body and the animal died. The autopsy showed the existence of a number +of old glanderous nodules in the lungs which must have existed previous +to purchase, more than a year before.</p> + +<p>Public watering troughs and the feed boxes of boarding stables and the +tavern stables of market towns are among the most common recipients for +the virus of glanders, which is most dangerous in its fresh state, but +cases have been known to be caused by feeding animals in the box or +stall in which glandered animals had stood several months before. While +the discharge from a case of chronic glanders is much less liable to +contain many active bacilli than that from a case of acute glanders, the +former, if it infects an animal, will produce the same disease as the +latter. It may assume from the outset an acute or chronic form, +according to the susceptibility of the animal infected, and this does +not depend upon the character of the disease from which the virus was +derived.</p> + +<p>The animals of the genus <i>Equus</i>—the horse, the ass, and the mule—are +those which are the most susceptible to contract glanders, but in these +we find a much greater receptivity in the ass and mule than we do in the +horse. In the ass and mule in almost all cases the period of incubation +is short and the disease develops in an acute form. We find that the +kind of horse infected has an influence on the character of the disease; +in full-blooded, fat horses of a sanguinary temperament, the disease +usually develops in an acute form, while in the lymphatic, cold-blooded, +more common race of horses the disease usually assumes a chronic form. +If the disease develops first in the chronic form in a horse in fair +condition, starvation and overwork are liable to bring on an acute +attack, but when the disease is inoculated into a debilitated and +impoverished animal it is apt to start in the latent form. Inoculation +on the lips or the exterior of the animal is frequently followed by an +acute attack, while infection by ingestion of the virus and inoculation +by means of the digestive tract is often followed by the trouble in the +chronic latent form.</p> + +<p>In the dog the inoculation of glanders may develop a constitutional +disease with all the symptoms which are found in the horse, but more +frequently the virus pullulates only at the point of inoculation,<span class='pagenum'><a name="Page_549" id="Page_549">[Pg 549]</a></span> +remaining for some time as a local sore, which may then heal, leaving a +perfectly sound animal; but while the local sore is continuing to +ulcerate, and specific virus exists in it, it may be the carrier of +contagion to other animals. In man we find a greater receptivity to +glanders than in the dog, and in many unfortunate cases the virus +spreads from the point of inoculation to the entire system and destroys +the wretched mortal by extensive ulcers of the face and hemorrhage or by +destruction of the lung tissue; in other cases, however, glanders may +develop, as in the dog, in local form only, not infecting the +constitution and terminating in recovery, while the specific ulcer by +proper treatment is turned into a simple one. In the feline species +glanders is more destructive than in the dog. The point of inoculation +ulcerates rapidly and the entire system becomes infected.</p> + +<p>While a student the writer saw a lion in the service of Prof. Trasbot, +at Alfort, which had contracted the disease by eating glandered meat and +died with the lung riddled with nodules. A litter of kittens lapped the +blood from the lungs of a glandered horse on which an autopsy was being +made, and in four days almost their entire faces, including the nasal +bones, were eaten away by rapid ulceration. Nodules were found in the +lungs. A pack of wolves in the Philadelphia Zoological Garden died in 10 +days after being fed with the meat of a glandered horse. The rabbit, +guinea pig, and mice are especially susceptible to the inoculation of +glanders, and these animals are convenient witnesses and proofs of the +existence of suspected cases of the glanders in other animals by the +results of successful inoculations.</p> + +<p>The primary lesion in any form is a local point in which occurs a rapid +proliferation of the cell elements which make up the animal tissue with +formation of new connective tissue, with a crowding together of the +elements until their own pressure on one another cuts off the +circulation and nutrition, and death takes place in them in the form of +ulceration or gangrene. Following this primary lesion we have an +extension of infection by means of the spread of the bacilli into those +tissues immediately surrounding the first infected spot, which are most +suitable for the development of simple inflammatory phenomena or the +specific virus. The primary symptoms are the result of specific reaction +at the point of inoculation, but at a later time the virus is carried by +means of the blood vessels and lymphatic vessels to other parts of the +body and becomes lodged at different places and develops in them; again, +when the disease has existed in the latent form in the lungs of the +animal and the virus is wakened into action from any cause, we have it +carried to various parts of the body and developing in the most +susceptible regions or organs. The points of development are most +frequently determined by the activity of the<span class='pagenum'><a name="Page_550" id="Page_550">[Pg 550]</a></span> circulation and the +effects of exterior irritants. For example, if a horse which has been so +slightly affected with the virus of glanders that no symptoms are +visible is exposed to cold, rain, or sleet, or by the rubbing of the +harness on the body and the irritation of mud on the legs, the disease +is liable to develop on the exterior in the form of farcy, while a +full-blooded horse which is employed at speed and has its lungs and +respiratory tract gorged with blood from the extreme use of these organs +will develop glanders as the local manifestation of the disease in the +respiratory tract.</p> + +<p>The previous reference to the existence of glanders under the two forms +more commonly differentiated as glanders and as farcy, and our reference +to the various conditions in which it may exist as acute, chronic, and +latent, show that the disease may assume several different phases. +Without for a moment losing sight of the fact that all these varied +conditions are identical in their origin and in their essence, for +convenience of study we may divide glanders into three classes—chronic +farcy, chronic glanders, and acute glanders with or without farcy.</p> + + +<h4>CHRONIC FARCY.</h4> + +<p><i>Symptoms.</i>—In farcy the symptoms commence by formation of little nodes +on the under surface of the skin, which rapidly infringe on the tissues +of the skin itself. These nodes, which are known as farcy "buds" and +farcy "buttons," are from the size of a bullet to the size of a walnut. +They are hot, sensitive to the touch, at first elastic and afterwards +become soft; the tissue is destroyed, and infringing on the substance of +the skin the disease produces an ulcer, which is known as a chancre. +This ulcer is irregular in shape, with ragged edges which overhang the +sore; it has a gray, dirty bottom and the discharge is sometimes thin +and sometimes purulent; in either case it is mixed with a viscous, +sticky, yellowish material like the white of an egg in consistency and +like olive oil in appearance. The discharge is almost diagnostic; it +resembles somewhat the discharge which we have in greasy heels and in +certain attacks of lymphangitis, but to the expert the specific +discharge is characteristic. The discharge accumulates on the hair +surrounding the ulcer and over its surface and dries, forming scabs +which become thicker by successive deposits on the under surface until +they fall off, to be replaced by others of the same kind; and the excess +of discharge may drop on the hairs below and form similar brownish +yellow crusts. The farcy ulcers may retain their specific form for a +considerable time—days or even weeks—but eventually the discharge +becomes purulent in character and assumes the appearance of healthy +matter. The surface of the gangrenous bottom of the ulcer is replaced by +rosy granulations,<span class='pagenum'><a name="Page_551" id="Page_551">[Pg 551]</a></span> the ragged edges are beveled off, and the chancre is +turned into a simple ulcer which rapidly heals.</p> + +<p>The farcy buttons occur most frequently on the sides of the lips, the +sides of the neck, the lower part of the shoulders, the inside of the +thighs, or the outside of the legs, but may occur on any part of the +body.</p> + +<p>We have next an irritation of the lymphatic vessels in the neighborhood +of the chancres. Those become swollen and then indurated and appear like +great ridges underneath the skin; they are hot to the touch and +sensitive. The cords may remain for a considerable time and then +gradually disappear, or they may ulcerate like a farcy bud itself, +forming elongated, irregular, serpentine ulcers with a characteristic, +dirty, gray bottom and ragged edges, and pour out a viscous, oily +discharge like the chancres themselves.</p> + +<p>The essential symptoms of farcy are, as above described, the button, the +chancre, the cord, and the discharge. We have in addition to these +symptoms a certain number of accessory symptoms, which, while not +diagnostic in themselves, are of great service in aiding the diagnosis +in cases where the eruption takes place in small quantities, and when +the ulcers are not characteristic.</p> + +<p>Epistaxis, or bleeding from the nose without previous work or other +apparent cause, is one of the frequent concomitant symptoms in glanders, +and such hemorrhage from the nostrils should always be regarded with +suspicion. The animal with farcy frequently develops a cough, resembling +much that which we find in heaves—a short, dry, aborted, hacking cough, +with little or no discharge from the nostrils. With this we find an +irregular movement of the flanks, and on auscultation of the lungs we +find sibilant or at times a few mucous râles. Another common symptom is +a sudden swelling of one of the hind legs; it is found suddenly swollen +in the region of the cannon, the enlargement extending below to the +pastern and above as high as the stifle. This swelling is hot and +painful to the touch, and renders the animal stiff and lame. On pressure +with the finger the swelling can be indented, but the pits so formed +soon fill again on removal of the pressure. In severe cases we may have +ulceration of the skin, and serum pours out from the surface, resembling +the oozing which we have after a blister or in a case of grease. This +swelling is not to be confounded with the stocking in lymphatic horses +or the edema which we have in chronic heart or in kidney trouble, as in +the last the swelling is cool, not painful, and the pitting on pressure +remains for some time after the latter is withdrawn. It is not to be +confounded with greasy heels. In these the disease commences in the +neighborhood of the pastern and gradually extends up the leg, rarely +passing beyond the neighborhood of the hock. The<span class='pagenum'><a name="Page_552" id="Page_552">[Pg 552]</a></span> swollen leg in +glanders almost invariably swells for the entire length in a single +night or within a very short period. When greasy heels are complicated +by lymphangitis we have a condition very much resembling that of farcy. +The swelled leg in farcy is frequently followed by an outbreak of farcy +buttons and ulcers over its surface. In the entire horse the testicles +are frequently swollen and hot and sensitive to the touch, but they have +no tendency to suppuration. The acute inflammation is rapidly followed +by the specific induration, which corresponds to the local lesions in +other parts of the body.</p> + +<p>Chronic farcy in the ass and mule is an excessively rare condition, but +sometimes occurs.</p> + + +<h4>CHRONIC GLANDERS.</h4> + +<p><i>Symptoms.</i>—In chronic glanders we find the same train of inflammatory +phenomena, varying in appearance from those of chronic farcy only by the +difference of the tissues in which they are situated. In chronic +glanders there is first the nodule, from the size of a shot to that of a +small pea, which forms in the mucous membranes of the respiratory tract. +This may be just inside the wings of the nostrils or on the septum which +divides the one nasal cavity from the other, and may be easily detected, +or it may be higher in the nasal cavities on the turbinated bones, or it +may form in the larnyx itself or on the surface of the trachea or deep +in the lungs.</p> + +<p>The nodules, which are first red and hard and consist of new connective +tissue, soon soften and become yellow; the yellow spots break and we +have a small ulcer the size of the preceding nodule, which has a gray, +dirty bottom and ragged edges and is known as a chancre. This ulcer +pours from its surface a viscous, oily discharge similar to that which +we have seen in the farcy ulcer. The irritation of the discharge may +ulcerate the lining mucous membrane of the nose, causing serpentine +gutters with bottoms resembling those of the chancres themselves. If the +nodules have formed in large numbers, we may have them causing an acute +inflammation of the Schneiderian membrane, with a catarrhal discharge +which may mark the specific discharge, or that which comes from the +ulcers and resembles the discharge of strangles or simple inflammatory +diseases.</p> + +<p>The eruption of the ulcers and discharge soon cause an irritation of the +neighboring lymphatics; and in the intermaxillary space, deep inside of +the jaws, we find an enlargement of the glands, which for the first few +days may seem soft and edematous, but which rapidly becomes confined to +the glands, these being from the size of an almond to that of a small +bunch of berries, exceedingly hard and nodulated. This enlargement of +the glands is found high on the inside of the jaws, firmly adherent to +the base of the tongue. It is not to be confounded with the puffy, +edematous swelling, which is<span class='pagenum'><a name="Page_553" id="Page_553">[Pg 553]</a></span> not separated from the skin and +subcutaneous connective tissues found in strangles, in laryngitis, and +in other simple inflammatory troubles.</p> + +<p>These glands bear a great resemblance to the indurated glands which we +find in connection with the collection of pus in the sinuses; but in the +latter disease the glands have not the extreme nodulated feel which they +have in glanders. With the glands we find indurated cords, feeling like +balls of tangled wire or twine, fastening the glands together.</p> + +<p>The essential symptoms of glanders are the nodule, the chancre, the +glands, and the discharge. With the development of the nodules in the +respiratory tract, according to their number and the amount of eruption +which they cause, we may find a cough which resembles that of a coryza, +a laryngitis, a bronchitis, or a broncho-pneumonia, according to the +location of the lesions. In chronic glanders we find the same accessory +symptoms that occur in chronic farcy, the hemorrhage of the nose, the +swelling of the legs, the chronic cough, and, in the entire horse, the +swelling of the testicles.</p> + +<p>On healing, the chancres on the mucous membranes leave small, whitish, +star-shaped scars, hard and indurated to the touch, and which remain for +almost an indefinite time. The chancres heal and the other local +symptoms disappear, with the exception of the enlargement of the glands, +and we find these so diminished in size that they are scarcely +perceptible on examination. During the subacute attacks, with a minimum +quantity of local troubles, in chronic glanders and in chronic farcy the +animal rarely shows any degree of fever, but does have a generally +depraved appearance; it loses flesh and becomes hidebound; the skin +becomes dry and the hairs stand on end. There is a cachexia, however, +which resembles greatly that of any chronic, organic trouble, but is not +diagnostic, although it has in it certain appearances and conditions +which often render the animal suspicious to the eye of the expert +veterinarian, while, without the presence of local lesions he would be +unable to state on what he has based his opinion.</p> + + +<h4>ACUTE GLANDERS.</h4> + +<p><i>Symptoms.</i>—In the acute form of glanders we find the symptoms which we +have just studied in chronic farcy and in chronic glanders in a more +acute and aggravated form. There is a rapid outbreak of nodules in the +respiratory tract which rapidly degenerate into chancres and pour out a +considerable discharge from the nostrils. There is a cough of more or +less severity according to the amount and site of the local eruption. +Over the surface of the body swellings occur which are rapidly followed +by farcy buttons, which break into ulcers; we find the indurated cords +and enlargement of the lymphatics.<span class='pagenum'><a name="Page_554" id="Page_554">[Pg 554]</a></span></p> + +<p>Bleeding from the nose, sudden swelling of one of the hind legs, and the +swelling of the testicles are liable to precede an acute eruption of +glanders. As the symptoms become more marked the animal has difficulty +of respiration, the flanks heave, the respiration becomes rapid, the +pulse becomes quickened, and the temperature becomes elevated to 103°, +104°, or 105° F.</p> + +<p>With the other symptoms of an acute fever the general appearance and +station of the animal is that of one suffering from an acute pneumonia, +but upon examination, while we may find sibilant and mucous râles over +the side of the chest, and may possibly hear tubular murmurs at the base +of the neck over the trachea, we fail to find the tubular murmur or the +large area of dullness on percussion over the sides of the chest which +belongs to simple pneumonia.</p> + +<p><i>Diagnosis.</i>—When there is doubt as to the diagnosis, the mallein test, +the inoculation test, or the complement-fixation test may be employed. +The mallein test is made by injecting mallein (a sterilized extract from +a culture of glanders bacilli) beneath the skin. If the horse has +glanders there results a febrile reaction and a swelling at the point of +injection. If the horse does not have glanders the mallein has no effect +or, at most, it produces a slight swelling only at the point of +injection. The inoculation test consists in the inoculation of a +susceptible animal (usually a guinea pig) with some of the suspected +discharge from the nose or a farcy ulcer. If the material is properly +used, and if it contains bacilli of glanders, the experimental animal +will develop the disease.</p> + +<p>The eye test is now universally accepted as a very satisfactory means of +diagnosing glanders. This consists in dropping into an eye of a +suspected animal a specially prepared solution of mallein, as a result +of which in an infected animal the inflammation develops in the eye, +resulting in a discharge which varies in intensity from a mucopurulent +character to a thick, sticky pus. The eyelids may also swell and many +times become glued together. The reaction usually appears in from 8 to +20 hours after the introduction of the mallein.</p> + +<p>Neither of these tests should be put into use except by a competent +veterinarian. The complement-fixation test is a highly specialized +laboratory test and can be carried out only by one versed in laboratory +technique. (See Bureau of Animal Industry Bulletin 136.)</p> + +<p>The post-mortem examination of the lungs shows that the pneumonia of +glanders is a lobular, V-shaped pneumonia scattered throughout the lungs +and caused by the specific inflammatory process taking place at the +divergence of the smaller air tubes of the lungs. In some cases of acute +glanders the formation of nodules may so irritate the mucous membrane of +the respiratory tract and cause such a profuse discharge of mucopurulent +or purulent matter that the specific character of the original discharge +is entirely masked. In this<span class='pagenum'><a name="Page_555" id="Page_555">[Pg 555]</a></span> case, too, for a few days the submaxillary +space may so swell as to resemble the edematous, inflamed glands of +strangles, equine variola, or laryngitis. This condition is especially +liable to be marked in an acute outbreak of glanders in a drove of +mules.</p> + +<p>Cases of chronic farcy and glanders, if not destroyed, may live in a +depraved condition until the animal dies from general emaciation and +anemia, but in the majority of cases, from some sudden exposure to cold, +it develops an acute pneumonia or other simple inflammatory trouble +which starts the latent disease and the animal has acute glanders.</p> + +<p>In the ass, mule, and plethoric horses acute glanders usually terminates +by lobular pneumonia. In other cases the general symptoms may subside. +The symptoms of pneumonia gradually disappear, the temperature lowers, +the pulse becomes slower, the ulcers heal, leaving small, indurated +cicatrices, and the animal may return to apparent health, or may at +least be able to do a small amount of work with but a few symptoms of +the disease remaining in a chronic form. During the attack of acute +glanders the inflammation of the nasal cavities frequently spreads into +the sinuses or air cells, which are found in the forehead and in front +of the eyes on either side of the face, and causes abscesses of these +cavities, which may remain as the only visible symptom of the disease. +An animal which has recovered from a case of acute glanders, like the +animals which are affected by chronic glanders and chronic farcy, is +liable to be affected with emphysema of the lungs (heaves), and to have +a chronic cough. In this condition it may continue for a long period, +serving as a dangerous source of contagion, the more so because the +slight quantity of discharge does not serve as a warning to the owner or +driver as profuse discharge does in the more acute cases.</p> + +<p>At the post-mortem examination of an animal which has been destroyed or +has died of glanders we find evidences of the various lesions which we +have studied in the symptoms. In addition to this, we find nodules +similar to those which we have seen on the exterior throughout the +various organs of the body. Nodules may be found in the liver, in the +spleen, and in the kidneys. We may find inflammation of the periosteum +of the bones, and we have excessive alterations in the marrow in the +interior of the bones themselves. Both these conditions during the life +of the animal may have been the cause of the lamenesses which were +difficult to diagnose.</p> + +<p>In one case which came under the observation of the writer, a lame horse +was destroyed and found to have a large abscess of the bone of the arm, +with old nodules of the lungs. When an animal has died immediately after +an attack of a primary, acute case of glanders, we find small V-shaped +spots of acute pneumonia in the lungs. If the animal has made an +apparent recovery from acute glanders, and in<span class='pagenum'><a name="Page_556" id="Page_556">[Pg 556]</a></span> cases of chronic farcy +and chronic glanders, no matter how few the external and visible +symptoms may have been, there is a deposit of nodules—small, hard, +indurated nodes—of new connective tissue to be found in the lungs. When +these have existed for some time we may find a deposit of lime salts in +them. These indurated nodules retain the virus and their power to give +out contagion for almost an indefinite time, and predispose to the +causes which we have studied as the common factors in developing a +chronic case into an acute case; that is, an inflammatory process wakens +their vitality and produces a reinfection of the entire animal. The +blood of an animal suffering from chronic glanders and farcy is not +virulent and is unaltered, but during the attack of acute glanders, +while the animal has fever, the blood becomes virulent and remains so +for a few days.</p> + +<p><i>Treatment.</i>—Almost the entire list of drugs in the pharmacopœia has +been tested in the treatment of glanders. Good hygienic surroundings, +good feed, with alteratives and tonics, frequently ameliorate the +symptoms, and often do so to such an extent that the animal would pass +the examination of any expert as a perfectly sound animal. While in this +case the number of nodules of the lungs, which are invariably there, may +be so few as not to cause sufficient disturbance in the respiration as +to attract the attention of the examiner, yet they exist, and will +remain there almost indefinitely, with the constant possibility of a +return of acute symptoms.</p> + +<p>It is probable that some horses may recover from glanders if the +infection is slight, but it will not do to depend upon this except under +the most stringent veterinary supervision. With good care, good feed, +good surroundings and little work, an animal affected with glanders may +live for months or even years in a state of apparently perfect health, +but with the first deprivation of feed, with a few days of severe hard +work, with exposure to cold or with the attack of a simple fever or +inflammatory trouble from other causes, the latent seeds of the disease +break out and develop the trouble again in an acute form.</p> + +<p>In several celebrated cases horses which have been affected with +glanders have been known to work for years and die from other causes +without ever having had the return of symptoms; but allowing that these +cases may occur, they are so few and far between, and the danger of +infection of glanders to other horses and to the stable attendants is so +great, that no animal which has once been affected with the disease +should be allowed to live unless repeated mallein tests have shown him +to have become free from taint of glanders.</p> + +<p>In all civilized countries, with the exception of some of the States in +the United States, the laws are most stringent regarding the prompt +declaration on the part of the owner and attending veterinarian at the +first suspicion of a case of glanders, and they allow<span class='pagenum'><a name="Page_557" id="Page_557">[Pg 557]</a></span> indemnity for the +animal. When this is done, in all cases the animal is destroyed and the +articles with which it has been in contact are thoroughly disinfected. +When the attendants have attempted to hide the presence of the disease +in a community, punishment is meted out to the owner, attending +veterinarian, or other responsible parties. Several States have passed +excellent laws in regard to glanders, but these laws are not always +carried out with the rigidity with which they should be.</p> + + +<h3>SPOROTRICHOSIS (MYCOTIC LYMPHANGITIS).</h3> + +<h4>By <span class="smcap">JOHN R. MOHLER</span>, V. M. D., <i>Assistant Chief, Bureau of Animal +Industry</i>.</h4> + +<p>This disease has previously been known in this country as epizootic +lymphangitis, or pseudo-farcy. It is a chronic, contagious disease, +particularly of equines, caused by a specific organism, the +<i>Sporotrichum schenckii</i>, and characterized by a suppurative +inflammation of the subcutaneous lymph vessels and the neighboring lymph +glands. Owing to the fact that this affection does not spread as an +epizootic and that its causal factor is a fungus, the name +sporotrichosis has been suggested.</p> + +<p>The disease in man was first described by Schenck and by Beurmann and +Gougerot. Carougeau observed its occurrence among horses and mules in +Madagascar, while in the United States it was first observed by Pearson +in Pennsylvania in 1907, although it is probable that it had existed for +many years in various parts of this country. Page and Frothingham were +first to recognize its mycotic nature in the United States. More +recently Meyer has also made valuable contributions with regard to the +existence of this affection. Its presence has been definitely +established in Ohio, Iowa, California, and North Dakota, and there is a +probability of its existence in Indiana and several Western States.</p> + +<p><i>Bacteriology.</i>—The sporotrichum is 2 microns thick, cylindrical and +segmented, having more or less branching threads, which bear spores at +the end. In the pus they occur as slightly ovoid bodies 3 to 5 microns +long, which are somewhat pointed toward the poles, have a sharp double +contour, and only on artificial cultivation at a temperature of over 18° +do they develop into the characteristic spore-carrying threads.</p> + +<p>The period of incubation varies greatly, extending from three days to +four months, or even longer. In artificial inoculations with pus through +wounds in the skin, inflammation and swelling of the lymph vessels may +be noticed in ten to sixty days; these vessels show in their course a +development of hard nodules, from which abscesses form.</p> + +<p>The natural infection without doubt is caused through superficial +wounds, such as galls, barbed-wire cuts, or through various stable<span class='pagenum'><a name="Page_558" id="Page_558">[Pg 558]</a></span> +utensils, harness, bandages, insects, etc. Solipeds are mostly +susceptible, but cattle may also be infected.</p> + +<p><i>Symptoms.</i>—The inflammation of the lymph vessels is usually first +observed on the extremities, especially on one or both hind legs; it may +also appear on the forelegs, shoulder, or neck, and more rarely on the +rump, udder, and scrotum. The lesions, as a rule, develop in the tissue +adjacent to the place of inoculation. In the early stages of the disease +the lymph vessels appear very hard and thickened, and along their course +hard nodules develop, ranging in size from a pea to a hen's egg. Later +these nodules soften, burst spontaneously, and discharge a thick, +yellowish pus. The surface of the resulting ulcers or abscess cavities +soon fills up with exuberant granulations which protrude beyond the +surface of the skin, giving it a fungoid appearance. The affected +extremities are considerably enlarged, similar to cases of simple +lymphangitis. In rare cases the mucous membrane of the nostrils may also +become affected, showing yellowish flat elevations and ulcerations, and +these may extend by metastasis to internal organs. In cases in which the +mucous membrane is affected, the submaxillary lymph gland may also +become enlarged and suppurate.</p> + +<p>The constitutional symptoms accompanying this disease are not very +marked and may be altogether absent. There is usually only a very slight +fever, which seldom runs over 102° F. The appetite is not impaired +except in the advanced cases.</p> + +<p><i>Lesions.</i>—The anatomical changes are most marked in the skin and the +subcutaneous tissues. They may become 2 to 3 inches thick and indurated +as the result of fibrous-tissue formation, owing to the inflammation +present. On the baconlike cut surface suppurative areas and granulating +sores may be noticed of various sizes, also enlarged lymph vessels +filled with clotted lymph mixed with pus. The neighboring lymph glands +are usually enlarged and frequently contain suppurating foci. Rarely the +internal organs may show metastatic abscesses.</p> + +<p><i>Diagnosis.</i>—The diagnosis is based on the characteristic appearance of +the ulcerations, which show exuberant granulation of a bright red color, +inverted edges, and a thick, creamy, glutinous discharge. These +manifestations differentiate the disease from glanders, in which the +ulcers are craterlike, do contain exuberant granulations, and the +discharge is of a viscous, oily character. The submaxillary and other +nodes as well as the corded lymphatics in glanders are more firmly +attached to the adjacent tissues, and are therefore less movable. In +some chronic cases of sporotrichosis, however, the lesions may closely +resemble those of farcy, and in these cases the microscopical +examination of the pus will disclose the nature of the affection. In the +pus the causative organism can be easily seen in the unstained specimen, +and is recognized by its size, shape, and highly refractory<span class='pagenum'><a name="Page_559" id="Page_559">[Pg 559]</a></span> double +outline. Furthermore, the injection of mallein in cases of +sporotrichosis will be attended with negative results.</p> + +<p><i>Treatment.</i>—At the onset of the disease treatment consists in entire +extirpation of the nodules, in case the lesions are localized. In cases +in which the nodules have formed abscesses, their opening is +recommended, followed by the application of the actual cautery or a 1 to +250 solution of bichlorid of mercury. It must be borne in mind that the +organism is quite resistant to antiseptics, and the best results will be +obtained from the application of a solution of a strong antiseptic +following the opening of the lesions. Internally, potassium iodid is +recommended in 2-dram doses, dissolved in drinking water, twice a day.</p> + +<p>In the most favorable cases recovery results in from five to seven +weeks; as a rule, however, it requires several months.</p> + +<p>In order to prevent the spreading of the disease the affected animals +should be isolated, the products of the disease should be destroyed, and +the stable should be disinfected with very strong liquid disinfectants +in consideration of the resistance of the causative organism.</p> + + +<h4>RABIES, HYDROPHOBIA, OR MADNESS.</h4> + +<p>Rabies is a contagious disease, which is usually transmitted by a bite +and by the introduction of a virus contained in the saliva of an +affected animal. It may, however, be transmitted in other ways. It is +characterized by symptoms of aberration of the nervous system and +invariably terminates fatally. It is accompanied with lesions, +inflammation, and degeneration in the central nervous system. It is a +disease that is most common in the dog, but is transmitted to the horse, +either from dogs or from any other animal affected with it. (See also +remarks on page 244.) As a disease of the horse it is invariably the +result of the bite of a rabid animal, usually a dog.</p> + +<p>Perhaps no disease in medicine has been the object of more controversy +than rabies. Certain medical men of prominence have even doubted its +existence, and many others have claimed for it a spontaneous origin. The +experience of ages, however, has shown that contagion can be proved in +the great majority of cases, and, by analogy with other contagious +diseases, we may only believe that the development of one case requires +the preexistence of a case from which the virus has been transmitted. +Pasteur has further added to our knowledge of the disease by showing +that a virus capable of cultivation exists in the nervous system, +especially in the lower part of the brain (medulla oblongata) and in the +anterior part of the spinal column. He has further shown that that +portion of the nervous system which contains the virus, the exact nature +of which has not yet been demonstrated, will retain it for a very long +time<span class='pagenum'><a name="Page_560" id="Page_560">[Pg 560]</a></span> if kept at a very low temperature or if left surrounded by +carbolic acid; but if the nerve matter, which is virulent at first, is +exposed to the air and is kept from putrefaction by substances which +will absorb the surrounding moisture, it will gradually lose its +virulence and become inoffensive in about fifteen days. He has also +further shown that the action of a weak virus on an animal will prevent +the development of a stronger virus, and from this he has formulated his +method of prophylactic treatment. This treatment consists in the +successive inoculation of portions of the nerve matter containing the +virus from a rabid animal which has been exposed to the atmosphere for +thirteen days, ten days, seven days, and four days, until the virulent +matter which will produce rabies in any unprotected animal can be +inoculated with impunity. A curious result of the experiments of Pasteur +is that an animal which has first been inoculated with a virus of full +strength can be protected by subsequent inoculations of attenuated virus +repeated in doses of increasing strength.</p> + +<p>Innumerable attempts have been made to discover the causative agent, and +investigators have announced the finding of many of the lower forms of +animal and vegetable life as the pathogenic factor. Among the recently +described causes, certain protozoanlike bodies found in the ganglionic +cells in 1903 by Negri, and termed Negri bodies, are of a very +suggestive nature. Negri claims that these bodies are not only specific +for rabies, but that they are protozoa and the cause of the disease. His +work has been corroborated by investigators in all parts of the +scientific world. An examination of the vitality of these bodies will +show a striking resemblance to the vitality of an emulsion of the +virulent tissue. Thus, they have been found to be quite resistant to +external agencies, such as putrefaction, drying, etc., and are about the +last portion of the nerve cell to survive the advance of decomposition. +They are also found in more than 96 per cent of the cases of rabies +examined, but have not been proved to exist in other diseases.</p> + +<p>Valenti states, as his strongest evidence of the protozoan nature of the +bodies, that the virus of rabies is neutralized in test tubes by quinin, +while no other alkaloid has this property. As a result of the work +performed in the New York City Board of Health laboratory, Park claims +that Negri bodies are found in animals before the beginning of visible +symptoms, and evidence is given that they may be found early enough to +account for the infectiousness of the central nervous system. These +bodies are now almost universally considered as diagnostic of rabies, +and in the pathological laboratory of the Bureau of Animal Industry +their detection in the nerve cells of the brain suffices for a diagnosis +of rabies without animal inoculations. In case these granular bodies are +not found in a suspected animal,<span class='pagenum'><a name="Page_561" id="Page_561">[Pg 561]</a></span> the plexiform ganglion is next +examined, and should negative results still be obtained, the inoculation +of rabbits is then made as a last resort. It is indeed rare that +positive results are obtained from the latter method after the first two +methods have been negative, but it has occurred occasionally in cases in +which the animal had been killed in the early stages of the disease.</p> + +<p><i>Symptoms.</i>—From the moment of inoculation by the bite of a rabid dog +or other rabid animal or by other means, a variable time elapses before +the development of any symptoms. This time may be eight days or it may +be several months; it is usually about four weeks. The first symptom is +an irritation of the original wound. This wound, which may have healed +completely, commences to itch until the horse rubs or bites it into a +new sore. The horse then becomes irritable and vicious, and it is +especially susceptible to moving objects, excessive light, noises, the +entrance of an attendant, or any other disturbance will cause the +patient to be on the defensive. It apparently sees imaginary objects; +the slightest noise is exaggerated into threatening violence; the +approach of an attendant or another animal, especially a dog, is +interpreted as an assault and the horse will strike and bite. The +violence on the part of the rabid horse is not for a moment to be +confounded with the fury of the same animal suffering from meningitis or +any other trouble of the brain. But in rabies there is a volition, a +premeditated method, in the attacks which the animal will make, which is +not found in the other diseases. Between the attacks of fury the animal +may become calm for a variable period. The writer attended a case in +which, after a violent attack of an hour, the horse was sufficiently +calm to be walked 10 miles and only developed violence again an hour +after being placed in the new stable. In the period of fury the horse +will bite at the reopened original wound; it will rear and attempt to +break its halter and fastenings; it will bite at the woodwork and +surrounding objects in the stable. If the animal lives long enough it +shows paralytic symptoms and falls to the ground, unable to use two or +more of its extremities, but in the majority of cases in its excesses of +violence it does physical injury to itself. It breaks its jaws in biting +at the manger or fractures other bones in throwing itself on the ground +and dies of hemorrhage or internal injuries. At times throughout the +course of the disease there is an excessive sensibility of the skin +which, if irritated by the touch, will bring on attacks of violence. +Throughout the course of the disease the animal may have appetite and +desire water, but on attempting to swallow has a spasm of the throat +which renders the act impossible. This latter condition, which is common +in all rabid animals, has given the disease the name of hydrophobia +(fear of water).<span class='pagenum'><a name="Page_562" id="Page_562">[Pg 562]</a></span></p> + +<p>In a case under the care of the writer a horse, four weeks after being +bitten on the forearm by a rabid dog, developed local irritation in the +healed wound and tore it with its teeth into a large ulcer. This was +healed by local treatment in 10 days, and the horse was kept under +surveillance for more than a month. On the advice of another +practitioner the horse was taken home and put to work; within 3 days it +developed violent symptoms and had to be destroyed.</p> + +<p><i>Diagnosis.</i>—The diagnosis of rabies in the horse is to be made from +the various brain troubles to which the animal is subject; first by the +history of a previous bite of a rabid animal or inoculation by other +means; second, by the evident volition and consciousness on the part of +the animal in its attacks, offensive and defensive, on persons, animals, +or other disturbing surroundings. The irritation and reopening of the +original wound or point of inoculation is a valuable factor in +diagnosis. Diagnosis after death may be made by microscopic examination +for Negri bodies or by the inoculation of rabbits, as already mentioned.</p> + +<p>Recovery from rabies may be considered as a question of the correctness +of the original diagnosis. Rabies is always fatal.</p> + +<p><i>Treatment.</i>—No remedial treatment has ever been successful. All the +anodynes and anesthetics, opium, belladonna, bromid of potash, ether, +chloroform, etc., have been used without avail. The prophylactic +treatment of successive inoculations is being used on human beings, and +has experimentally proved efficacious in dogs, but would be +impracticable in the horse unless the conditions were quite exceptional.</p> + + +<h3>DOURINE.</h3> + +<h4>By <span class="smcap">JOHN R. MOHLER</span>, V. M. D., <i>Assistant Chief, Bureau of Animal +Industry</i>.</h4> + +<p>Dourine (also known as maladie du coït, equine syphilis, covering +disease, breeding paralysis) is a specific infectious disease affecting +under normal conditions only the horse and ass, transmitted from animal +to animal by the act of copulation, and due to an animal parasite, the +<i>Trypanosoma equiperdum</i>.</p> + +<p><i>History.</i>—It is described as having existed as early as 1796 in the +Eastern Hemisphere, and was more or less prevalent in several of the +European countries, including France, Germany, Austria, and Switzerland, +during the first half of the nineteenth century. Its presence was +recognized for the first time in the United States in 1886, when an +outbreak occurred in Illinois. Since then the existence of the disease +has been observed at irregular intervals in numerous other States, +including Nebraska, Iowa, Montana, Wyoming, New Mexico, North Dakota, +and South Dakota.</p> + +<p><i>Symptoms.</i>—There are many variations in the symptoms of dourine, and +this is particularly true of the disease as it occurs in this country.<span class='pagenum'><a name="Page_563" id="Page_563">[Pg 563]</a></span> +Two distinct stages may be noted which vary somewhat from those +described in textbooks, but probably no more than could be expected when +differences of climatic conditions and methods of handling are taken +into consideration.</p> + +<p>The first stage chiefly concerns the sexual organs and therefore differs +somewhat in the male and female. In the second stage the symptoms +indicating an affection of the nervous system are more prominent and are +not dependent upon the sex of the animal.</p> + +<p>Following a variable period of incubation of from 8 days to 2 months, +there is seen in the stallion an irritation and swelling about the penis +and sheath. In a few days small vesicles or blisters may appear on the +penis, which later break, discharging a yellowish, serous fluid and +having irregular, raw ulcers. The ulcers show a tendency to heal +rapidly, leaving scars which are permanent. There may be more or less +continuous dripping from the urethra of a yellowish, serouslike fluid. +Stallions may show great excitement when brought in the vicinity of +mares, but service is often impossible because of the fact that a +complete erection of the penis does not occur.</p> + +<p>In the mare the first symptoms may be so slight as to be overlooked. The +disease, being the result of copulation, usually begins with +inflammation of the vulva and vagina. There may be a mucopurulent +discharge, which may be slight or profuse in quantity, agglutinating the +hairs of the tail. The mare may appear uneasy and urinate frequently. +Vesicles may appear on the external vulva and mucous membrane of the +vulva and vagina which later rupture and form ulcers. On the dark skin +of the external vulva the scars resulting from healing of the ulcers are +white, more or less circular in outline, from one-eighth to half an inch +in diameter, and pitlike. This depigmentation of the skin about the +external genitals is permanent.</p> + +<p>Urticarial eruptions or plaques which break out over various parts of +the body are a frequent symptom seen in animals of either sex. These are +sharply defined and edematous swellings of the skin about the size of a +half dollar or may be even larger. The usual locations of these plaques +are the croup, belly, and neck.</p> + +<p>The intensity of the symptoms mentioned which are significant of the +early stage of the disease may vary to a wide extent and in many +instances be so mild as to escape the attention of any but the most +careful observer. They commonly disappear after a brief period. The +apparent recovery, however, is not permanent, for such animals after a +period of variable length manifest constitutional or nervous symptoms. +These may not appear for several months or even years. They consist of a +general nervous disorder with staggering, swaying gait, especially in +the hind limbs. The animal generally becomes emaciated, the abdomen +assuming a tucked-up appearance. The first indication of paralysis will +be noted in traveling, when the<span class='pagenum'><a name="Page_564" id="Page_564">[Pg 564]</a></span> animal fails to pick up one of the hind +feet as freely as the other, or both may become affected at the same +time, at which time knuckling is a common symptom. Labored breathing is +occasionally noted. When the paralysis of the hind limbs starts to +appear the disease usually progresses rapidly. The horse goes down, is +unable to rise, and dies in a short time from nervous exhaustion. The +appetite usually remains good up to the last.</p> + +<p>Although a case of dourine may now and then recover, as a rule the +disease is present in the latent stage. Bad weather, exposure, +insufficient feed, and complicating diseases like influenza, distemper, +or in fact any condition which tends to lower the vitality of the +animal, may hasten the termination of the disease.</p> + +<p><i>Diagnosis.</i>—The complement-fixation test furnishes by far the most +reliable means of diagnosis and is especially valuable in a chronic +affection of this character, when the symptoms manifested are variable +and frequently so obscure as to escape observation. This is a laboratory +test requiring special facilities and the services of a trained +bacteriologist.</p> + +<p><i>Treatment.</i>—Little benefit can be obtained from medicinal treatment, +nor is such treatment desirable in this country, where the disease has +existed only in restricted areas, and where sanitary considerations +demand its prompt eradication.</p> + + +<h4>INFECTIOUS ABORTION IN MARES.</h4> + +<p>Infectious abortion (also known as contagious abortion, epizootic +abortion, enzootic abortion, slinking of colts) is a disease of mares +which from a specific cause results in the premature expulsion of the +fetus and its membranes from the uterus. It is characterized by an +inflammatory condition of the female reproductive organs.</p> + +<p>The contagious nature of the disease had not been recognized until +recently, the disease being principally attributed to various +conditions, such as traumatic influences, various infectious diseases, +spoiled feed, drugs, and other factors. Ostertag was the first to study +premature births in mares, attributing as the cause of the same a +streptococcus, which he was supposed to have been able to use +successfully in artificially producing abortion, either by inoculations +or feeding. His findings could not be substantiated by other +investigators.</p> + +<p>The earliest appearance of the disease in this country was in 1886, at +which time it caused considerable damage to the horse-breeding industry +in the Mississippi Valley. Smith and Kilbourne investigated an outbreak +in Pennsylvania in 1893, at which time they incriminated another germ +belonging to the paratyphus B group as the causative factor of the +disease. These findings have been subsequently<span class='pagenum'><a name="Page_565" id="Page_565">[Pg 565]</a></span> substantiated by many +investigators abroad, as well as in this country, notably so by De Jong, +Dassonville, and Rivière, and by Good and Meyer. More recently very +valuable information was contributed to our knowledge on this disease by +Schofield, of Canada, especially with regard to the biological tests for +diagnosis. Good suggested "<i>Bacillus abortivus equinus</i>" as the name for +the specific organism.</p> + +<p>The causative agent of this disease is not identical with the germ +causing abortion in cattle. It exerts its action, however, in a similar +manner, and appears to have, under certain conditions, a predilection +for the genital organs of the mare, where it induces certain morbid +changes whereby a premature expulsion of the fetus is the result. The +germ is usually present in the fetal membranes and also in the aborted +fetus. Mares may harbor the infection without disclosing any apparent +ill effects. It appears to exert its influence mainly upon the female +genital organs, where it may induce an inflammatory condition of the +uterus.</p> + +<p>The infected animals may carry the fetus through the normal period of +pregnancy, giving birth to either a normal or a weak colt, or again +abortion may take place at any time during pregnancy, mostly, however, +from the sixth to the ninth month.</p> + +<p><i>Symptoms.</i>—The symptoms suggestive of abortion are frequently entirely +absent. At times the abortion may be ushered in by symptoms of colicky +pains, restlessness, and periodical straining; these, however, are by no +means constant, especially if the abortion takes place in the early +months of pregnancy. The genital organs are usually swollen, showing a +mucous discharge. Immediately before abortion the symptoms are more +aggravated. Following abortion the discharge is more characteristic, +being of a dark-brown color, sometimes even bloody, and contains streaky +or flaky pus. The fetal membranes in all cases are not expelled with the +aborted fetus, but there is a tendency toward retention of these +membranes, which frequently has serious consequences upon the health of +the animal. At times it becomes necessary to resort to manual removal of +the afterbirth, and the inflammation of the uterus and a chronic +discharge usually follow such conditions. The expelled fetuses, as a +rule, die soon after the abortion, and if the expulsion has taken place +at a time close to its full term the fetuses are usually poorly +developed and subject to various kinds of digestive and septic +disorders. The fetuses do not disclose any particular abnormal +appearance on external examination; in many cases, however, the +post-mortem examination reveals inflammatory changes of various organs.</p> + +<p>The method of infection has not yet been satisfactorily established; +nevertheless it is essential that we consider as the principal mode of +infection the ways which have been proved for the contagious abortion<span class='pagenum'><a name="Page_566" id="Page_566">[Pg 566]</a></span> +in cattle. These are especially by ingestion; that is, by taking up the +germs with the feed, water, or other means, which have become +contaminated with the germs. The infection through the genital organs is +probably not so frequent, but in this regard the stallion no doubt plays +an important rôle in the spreading of the disease. Schofield considers +this method of infection as the principal source of spreading the +disease.</p> + +<p>It must be considered that in infected stables the germs may be present +throughout the premises, and by keeping animals which have aborted in +such stables a contamination of feed and utensils may continually take +place, since the aborted mares usually discharge a considerable quantity +of material which is often heavily charged with the germs. The germ is +taken up by the body with the feed or water, passing from the intestines +into the blood, and from there is carried to the genital organs, where +it finds suitable conditions for its development. Milk from an infected +mare may also contain the germ, and colts may become infected by sucking +the milk of infected mothers. In such instances the infection may remain +dormant until the colt develops and becomes pregnant, when the organism, +finding a condition suitable for its development, produces the disease.</p> + +<p>On the other hand, stallions used in covering infected mares may be +carriers of the germs, and when used for the breeding of healthy animals +may in this manner readily transmit the disease to them.</p> + +<p><i>Diagnosis.</i>—Contagious abortion may be diagnosed by the changes which +occur in the fetal membranes, and also in the expelled feces. In order, +however, to substantiate a diagnosis with certainty, demonstration of +the germ by microscopical examination is necessary. The occurrence of +frequent abortions among the mares in a stable is also an additional +evidence of the contagious character of the malady. It must be +considered that at times infected mares may carry the fetus to full +maturity, in which case the diagnosis is possible only by blood +examinations in a laboratory.</p> + +<p>Infected animals usually abort only once; however, in a certain +proportion of cases they may abort even two, three, or four times in +succession.</p> + +<p>Animals which establish a tolerance for the infection, and carry the +fetus to full maturity, may nevertheless remain a source of danger for +spreading the disease.</p> + +<p>The tests used in laboratories for the diagnosis are the agglutination +and complement-fixation tests, by which the disease may be diagnosed +from a sample of blood from a suspected animal. Such tests, however, +have to be confined to the laboratories, which are equipped for such +work.</p> + +<p><i>Treatment and prevention.</i>—Medicinal treatment is usually of no avail, +and all efforts should be directed toward the prevention of the<span class='pagenum'><a name="Page_567" id="Page_567">[Pg 567]</a></span> +disease. Various medicinal agents have been recommended and are being +exploited for the treatment, but to the present time no satisfactory +evidence has been established as to their merits. Bacterial vaccines +prepared from the specific organism have been given limited trials, but +to date they can not be considered as entirely satisfactory, since it +will require considerable experience with them before their usefulness +can be definitely established.</p> + +<p>The prevention should consist largely in sanitary measures directed +toward the disinfection of premises and animals. (For a method for +disinfection of premises see article under that heading.)</p> + +<p>The following procedure is advised for the disinfection of animals: To +prevent a stallion from carrying the infection from a diseased mare to a +healthy one the sheath and the penis should be disinfected with a +solution of 1/2 per cent of compound cresol solution, lysol, or +trikresol, or a 1 per cent carbolic acid or 1 to 1,000 potassium +permanganate solution in warm water. For this purpose it is advisable to +use a soft-rubber tube with a large funnel attached to one end, or an +ordinary syringe and tube would serve the purpose. The tube should be +inserted into the sheath, and the foreskin held with the hand to prevent +the immediate escape of the fluid. In addition to this the hair of the +belly and inner side of the thighs should be sponged with an antiseptic. +This disinfection should invariably precede and follow every service.</p> + +<p>With regard to the mares, a period of three months should elapse between +abortion and a subsequent breeding, and especially if there is any +evidence of a discharge the breeding of the animal should not be +undertaken. The mare showing signs of abortion should be immediately +isolated and the fetus and membranes should be burned. The fetus should +never be dragged across a barnyard or stable, but should be removed by +other means by which the contamination of the premises may be prevented. +The stall in which the animal aborted should be thoroughly disinfected +and the genital organs of the mare washed daily with a disinfectant. The +antiseptic washing recommended for the treatment of the stallions prior +to and after breeding should be also used for the irrigation of the +uterus of mares which have aborted. This treatment should be continued +daily until all evidence of discharge has ceased. The isolation of the +animal should be carried out for at least one month after the evidence +of a discharge has ceased.</p> + +<p>By carefully and persistently carrying out the sanitary measures it may +be possible to control and finally eradicate the disease.</p> + + +<h4>NAVEL ILL OF COLTS.</h4> + +<p>Navel ill of colts is also known as joint ill, omphalophlebitis, septic +arthritis of sucklings, and pyosepticemia of the newly born.<span class='pagenum'><a name="Page_568" id="Page_568">[Pg 568]</a></span> The +unfavorable outlook after the appearance of the disease, together with +the fact that the disease when present requires the attention of a +veterinarian, demands that the breeder concern himself with its +prevention.</p> + +<p>The disease is caused by a microorganism and several bacteria have been +suspected of being responsible. Every one of the suspected organisms is +found abundantly in manure and objects contaminated with manure. The +infective material gains entrance into the colt through the open +umbilical cord as a result of its coming into contact with litter, +floors, or discharges from its dam contaminated by one of the organisms +which cause the trouble. There are cases on record in which the +infection has taken place before birth, and while some investigators +assert that this method is the principal mode of infection still, in a +large number of cases, the prophylactic measures adopted to guard +against the infection through the navel cord have given good results. +Since infection before birth can not be controlled satisfactorily, we +are justified, for all practical purposes, in preventing navel ill by +guarding against the infection through the cord at birth or soon +afterwards.</p> + +<p>Cleanliness of stables where pregnant mares are kept must be insisted +upon. This is especially necessary where outbreaks of navel ill have +been known to exist. Mares in the last stages of gestation should be +placed in a box stall which has previously been cleaned and disinfected. +The bedding should be frequently renewed and the external genitals and +neighboring tissues should be kept clean and disinfected with a 2 per +cent solution of carbolic acid or 1 per cent liquor cresolis compositus, +or any other reliable disinfecting agent. Operations for opening +abscesses and removal of afterbirths from cows should not be executed in +the immediate vicinity of mares in an advanced stage of pregnancy.</p> + +<p>The foal when dropped should be placed on clean bedding. In any event +the cord of the foal should be washed in a disinfectant solution and +tied at about 1-1/2 inches from the navel with a band or string which +has previously been soaked in a disinfectant solution. With a sharp pair +of scissors the navel cord is then severed about one-half inch below the +band and again disinfected. The ligature should not be tightened, +however, until pulsation of the vessels in the cord has ceased. The +stump of the cord is then painted with strong carbolic-acid solution, +tincture of iodin, or a mixture of equal parts of tincture of iodin and +glycerin. The stump should be washed daily with a disinfectant and +either painted with iodin mixture or carbolic acid or dusted with some +reliable antiseptic healing powder. After five days the parchmentlike +dried stump may be cut off and the navel wound washed with a +disinfectant solution and dusted with powder until healed.<span class='pagenum'><a name="Page_569" id="Page_569">[Pg 569]</a></span></p> + +<p>The cases of navel ill resulting from infection before birth can not +well be guarded against. By keeping mares, advanced in pregnancy, in +good physical condition, the fetus will be expelled immediately upon the +opening of the uterine cavity.</p> + +<p>Once the infection of the navel cord has set in, the cord should not be +ligated but should be washed in a disinfectant solution and a +veterinarian called for the subsequent treatment.</p> + + +<h3>INFECTIOUS ANEMIA OR SWAMP FEVER.</h3> + +<h4>By <span class="smcap">John R. Mohler</span>, V. M. D., <i>Assistant Chief, Bureau of Animal +Industry</i>.</h4> + +<p>Infectious anemia of horses, known also by a number of other names, as +swamp fever, American surra, malarial fever, typhoid fever of horses, +the unknown disease, no-name disease, plains paralysis, and pernicious +anemia, has recently been the subject of much investigation. The cause +of the disease has now been definitely determined as an invisible virus, +which is capable of passing through the pores of the finest porcelain +filters, like the infection of foot-and-mouth disease, rinderpest, hog +cholera, and similar diseases. The disease is most prevalent in +low-lying and badly drained sections of the country, although it has +been found on marshy pastures during wet seasons in altitudes as high as +7,500 feet. Therefore proper drainage of infected pastures is indicated +as a preventive. It is also more prevalent during wet years than in dry +seasons. It usually makes its appearance in June and increases in +frequency until October, although the chronic cases may be seen in the +winter, having been contracted during the warm season.</p> + +<p><i>Cause.</i>—It has been conclusively proved that infectious anemia is +produced by an invisible filterable organism which is transmissible to +horses, mules, and asses by subcutaneous inoculation of blood serum. The +virus which is present in the blood may be transmitted to a number of +equines in a series of inoculations by injecting either the whole blood, +the defibrinated blood, or the blood serum which has been passed through +a fine Pasteur filter, thus eliminating all the visible forms of +organismal life, including bacteria, trypanosoma, piroplasma, etc. This +virus has also been found to be active in the carcass of an affected +animal 24 hours after death.</p> + +<p>Following the injection of the infectious principle there is a period of +incubation which may extend from ten days to one and one-half months, at +the end of which time the onset of the disease is manifested by a rise +of temperature. If uncomplicated, the infection runs a chronic course, +terminating in death in from two months to one and one-half years, or +even longer. The probability of the virus being spread by an +intermediate host, such as flies, mosquitoes, internal parasites, etc., +is now receiving careful investigation.<span class='pagenum'><a name="Page_570" id="Page_570">[Pg 570]</a></span></p> + +<p>From experiments already conducted it appears that this disease, +formerly supposed to be confined to Manitoba and Minnesota, is more or +less prevalent in Kansas, Nebraska, Colorado, Wyoming, Montana, North +Dakota, Virginia, Texas, and New York. It also occurs in Europe, having +been reported in Germany under the name of infectious anemia and in +France as infectious typho-anemia.</p> + +<p><i>Symptoms.</i>—The disease is characterized by a progressive pernicious +anemia, remittent fever, polyuria, and gradual emaciation in spite of a +voracious appetite. It begins to manifest itself by a dull, listless +appearance and by general weakness, the animal tiring very easily. This +stage is followed closely by a staggering, swaying, uncertain gait, the +hind legs being mostly affected. There is also noted a weakness and +tenderness in the region of the loins, and at the same time the pulse, +though weak, stringy, and intermittent, increases in rapidity and may +run as high as 70. The temperature may rise to 103° F. or higher, +remaining high for several days, and then dropping to rise again +irregularly. Toward the end of the disease the temperature occasionally +remains persistently high. The horse may improve for a time, but usually +this improvement is followed by a more severe attack than the first. +Venous regurgitation is sometimes noticed in the jugular before death. +The quantity of urine passed is enormous in some cases. Death finally +occurs from exhaustion or syncope.</p> + +<p>The blood shows a slight decrease in the number of white blood cells, +while there is a gradual but marked diminution of red corpuscles, the +count running as low as 2,000,000 per cubic millimeter, the normal count +being 7,000,000. If the blood is drawn from such an animal, the +resulting red clot will be about one-fifth of the amount drawn. +Occasionally a slow dripping of blood-tinged serum from the nostrils is +observed as a result of this very thin blood oozing from the mucous +membranes. Petechiæ, or small hemorrhagic points, are sometimes noticed +on the nictitating membrane and conjunctiva, while paleness of the +visible mucous membranes of the nose and mouth is usually in evidence, +although they may have a yellow or mahogany tinge. Often a fluctuating, +pendulous swelling may appear on the lower lip, point of elbow, sheath, +legs, under the belly, or on some other pendent portion, especially late +in the disease, which is indicative of poor circulation, thinning of the +blood, and consequent loss of capillary action.</p> + +<p><i>Lesions.</i>—After death the carcass is found to be very much emaciated +and anemic, the visible mucosa being very pale. This marked absence of +adipose tissue makes the skinning of the animal a difficult task. +Subcutaneous and intermuscular edema and hemorrhages are frequently +observed, although in many cases it is remarkable to see how few +macroscopic lesions may be present. The predominating<span class='pagenum'><a name="Page_571" id="Page_571">[Pg 571]</a></span> and most constant +lesion is probably the petechiæ, so often observed in the muscle or on +the serous membranes of the heart. The heart is generally enlarged and +may be the only organ to show evidence of disease. In other cases the +lungs may be studded with petechiæ, with a serous exudate present in the +thoracic cavity. In addition to the petechiæ already noted, the +pericardial sac generally contains an increased quantity of fluid. The +abdominal cavity may show peritonitis and a hemorrhagic condition of the +intestines, which probably result from overfeeding in consequence of the +ravenous appetite. The liver, although usually normal, sometimes +presents a few areas of degeneration. The spleen is at times found to be +enlarged and covered with petechiæ. The kidneys may appear normal or +anemic and flaccid, but microscopically they usually show a chronic +parenchymatous degeneration. The lymph glands may be enlarged and +hemorrhagic.</p> + +<p><i>Diagnosis.</i>—The diagnosis of the disease is not difficult, especially +in advanced stages. The insidious onset, remittent fever, progressive +emaciation and anemia, unimpaired or ravenous appetite, staggering gait +and polyuria are a train of symptoms which make the disease sufficiently +characteristic to differentiate it from other diseases affecting horses +in this country. The peculiar relapsing type of fever, the great +reduction in the number of red blood cells, and the absence of +eosinophila are sufficient to differentiate it from the anemias produced +by internal parasites, while it may be readily distinguished from surra +by the nonsusceptibility of cattle and by the great ease with which the +trypanosoma may be found in the latter affection.</p> + +<p><i>Prognosis.</i>—The prognosis of the disease is very unfavorable. +Veterinarians in different sections of the country where it is prevalent +report a mortality of 75 per cent or even higher. Recovery takes place +only when treatment is begun early or when the animal has a long +convalescent period.</p> + +<p><i>Treatment.</i>—The treatment of the disease has so far been far from +satisfactory. The iodid, permanganate, and carbonate of potash have been +used. Arsenic, axytol, quinin, and silver preparations have been +suggested, but all have been uniformly without success. Intestinal +antiseptics have been resorted to, and the results are encouraging but +not altogether satisfactory. Symptomatic treatment seems to be the most +dependable. For instance, Davison, of this bureau, was able to reduce +greatly the mortality from this affection by giving an antipyretic of 40 +grains of quinin, 2 drams of acetanilid, and 30 grains of powdered nux +vomica four times daily. In the late stages, with weak heart action, +alcohol should be substituted for acetanilid. Cold-water sponge baths +may be given, and in addition frequent copious injections of cold water +per rectum, which has a beneficial effect in reducing the temperature +and in<span class='pagenum'><a name="Page_572" id="Page_572">[Pg 572]</a></span> stimulating peristalsis of the bowels, which, as a result of the +disease, show a tendency to become torpid during the fever. Purgatives, +on account of their debilitating effect, should not be given unless +absolutely necessary, but laxatives and easily digested feeds should be +given instead. Not infrequently a dirty yellowish tinge of the visible +mucous membranes has been observed, in which cases 20 grains of calomel +in from 2 to 4 drams of aloes in a ball, or 2-dram doses of fluid +extract of podophyllin, may be given. Following the subsidence of the +fever, a tonic should be administered, composed of the following drugs +in combination:</p> + + + +<div class='center'> +<table border="0" cellpadding="4" cellspacing="0" summary=""> +<tr><td align='left'>Arsenious acid</td><td align='center'>grams</td><td align='right'>2</td></tr> +<tr><td align='left'>Powdered nux vomica</td><td align='center'>do</td><td align='right'>28</td></tr> +<tr><td align='left'>Powdered cinchona bark</td><td align='center'>do</td><td align='right'>85</td></tr> +<tr><td align='left'>Powdered gentian root</td><td align='center'>do</td><td align='right'>110</td></tr> +</table></div> + + +<p>These should be well mixed and one-half teaspoonful given to the +affected animal at each feed.</p> + +<p>As in the case of all other infectious diseases, the healthy should be +separated from the sick horses and thorough disinfection of the infected +stables, stalls, litter, and stable utensils should be carried out in +order to prevent the recurrence of the disease. As a disinfectant the +compound solution of cresol, carbolic acid, or chlorid of lime may be +used, by mixing 6 ounces of any one of these chemicals with 1 gallon of +water. One of the approved coal-tar sheep dips may also be used to +advantage in a 5 per cent solution (6 ounces of dip to 1 gallon of +water). The disinfectant solution should be applied liberally to all +parts of the stable, and sufficient lime may be added to the solution to +make the disinfected area conspicious.</p> + +<p>Investigations are now in progress with a view of producing a vaccine or +serum that will protect horses that have been exposed to the disease.</p> + + +<h3>SURRA.</h3> + +<h4>By <span class="smcap">Ch. Wardell Stiles, Ph. D.</span></h4> + +<h5><i>Professor of Zoology, United States Public Health Service.</i></h5> + +<p>Surra is not known to occur in the United States, but it is more or less +common in the Philippine Islands and India. It is caused by a +microscopic, flagellate animal parasite, known as <i>Trypanosoma evansi</i>, +20 to 34 µ long by 1 to 2 µ broad, which lives in the blood and destroys +the red blood corpuscles. In general the disease is very similar to and +belongs in the same general class with tsetse-fly disease, or nagana, of +Africa and mal de caderas, of South America.</p> + +<p>Surra is a wet-weather disease, occurring chiefly during or immediately +after heavy rainfalls, floods, or inundations.</p> + +<p>Surra attacks especially horses, asses, and mules, but it may occur in +carabao, camels, elephants, cats, and dogs, and has been transmitted<span class='pagenum'><a name="Page_573" id="Page_573">[Pg 573]</a></span> to +cattle, buffaloes, sheep, goats, rabbits, guinea pigs, rats, and +monkeys. No birds, reptiles, amphibia (frogs, etc.), or fish are known +to suffer from it. It attacks both male and female animals, young and +old. Australian breeds of horses and white and gray mules are said to be +more susceptible than animals of other breeds and color.</p> + +<p>Surra in equines and camels is said to be an invariably fatal disease, +but cattle occasionally recover from it. There is no history of a +definite onset of the disease, and the condition is progressive, usually +with a number of relapses. The period of incubation may vary somewhat; +in experimental cases it is from 2 to 75 (usually 6 to 8) days, +according to conditions. The duration varies with the species of animal +attacked, their age, and general condition. The average duration in the +horse is reported at less than two months, though some cases may +terminate fatally in less than one to two weeks.</p> + +<p><i>Method of infection.</i>—All evidence now available seems to indicate +that surra is strictly a wound disease, namely, that the parasite may +enter the body only through a wound of some kind. Apparently by far the +most common method is through wounds produced by biting flies whose +mouth parts are moist with the infected blood of some animal bitten by +the same flies immediately before biting the healthy animal. Crows may +also transmit the infection by pecking at sores on a diseased animal, +soiling their beaks with blood, and transferring this infected blood to +a healthy animal. Likewise, if a scratch is made on a horse and then +infected blood is rubbed on the scratch, the horse will become diseased. +If, in experiment, infected blood is fed to a healthy animal, the latter +may contract surra in case it has an abraded or wounded spot in the +mouth; but if no part of the lining of the alimentary canal is wounded, +infection does not take place. Thus dogs and cats may contract the +disease by wounding the lining of the mouth (as with splinters of bone) +while feeding on the carcasses of surra subjects. All available evidence +indicates that under normal conditions of pregnancy the disease is not +transmitted from mother to fetus.</p> + +<p>There is a popular view that surra may be contracted by drinking +stagnant water and by eating grass and other vegetation grown upon land +subject to inundation, but there is no good experimental evidence to +support this view: Probably the correct interpretation of the facts +cited in support of this theory is that biting flies are numerous around +stagnant water and in inundated pastures; hence, that a great number of +possible transmitters of the disease are present in these places.<span class='pagenum'><a name="Page_574" id="Page_574">[Pg 574]</a></span></p> + +<p><i>Symptoms.</i><a name="FNanchor_7_7" id="FNanchor_7_7"></a><a href="#Footnote_7_7" class="fnanchor">[7]</a>—The invasion of this disease when contracted naturally +is usually marked by symptoms of a trivial character; the skin feels +hot, and there may be more or less fever; there is also slight loss of +appetite, and the animal appears dull and stumbles during action; early +a symptom sometimes appears which may be the first intimation of the +animal's indisposition, and which, as a guide to diagnosis, is of great +importance; it is the presence of a general or localized urticarial +eruption. If the blood is examined microscopically, it may be found to +present a normal appearance; but in the majority of cases a few small, +rapidly moving organisms will be observed, giving to the blood, as it +passes among the corpuscles, a peculiar, vibrating movement, which if +once observed will not easily be forgotten. If the parasite has not been +discovered in the blood for several days, the symptoms mentioned above +may be the only ones noticed, and, as a rule, when treated with +febrifuges, the horse quickly improves in health and the appetite +returns. This condition does not last for more than a few days, when the +animal is again observed to present a dull and dejected appearance, and +on examination well-marked symptoms are found; the skin is hot, the +temperature more or less elevated—101.7° to 104° F.; the pulse full and +frequent—56 to 64 beats a minute; the visible mucous membranes may +appear clean, but the conjunctival membranes, especially those covering +the membrana nictitans, are usually the seat of dark-red patches of +ecchymosis, varying in size in different animals. There is more or less +thirst and slight loss of appetite; the animal eats its grain and green +grass, but leaves all or a portion of the hay with which it has been +supplied. At the same time there are slight catarrhal symptoms present, +including lacrimation and a little mucous discharge from the nostrils. +Occasionally at this period of the disease the submaxillary glands may +be found enlarged and perhaps somewhat tender on manipulation. One +symptom is markedly absent, namely, the presence of rigors or the +objective sign of chilliness. In addition, it will be noted that there +is some swelling and edema of the legs, generally between the fetlock +and the hock, which pits but is not painful on pressure, and in case of +horses there may be also some swelling of the sheath at this stage of +the disease. When the fever and concomitant symptoms have declared +themselves for a short period, one thing becomes especially noticeable +in every animal attacked, namely, the rapidity with which it loses +flesh. If the blood has been examined microscopically during the second +period of fever, at first a few parasites will have been observed in it, +which day by day increase in number and reach a maximum, where they +remain for a varying period, or at once suddenly or<span class='pagenum'><a name="Page_575" id="Page_575">[Pg 575]</a></span> gradually disappear +during the period of apyrexia. After the fever and the accompanying +symptoms have for the second time been present for a few days—the +period varying from one to six—the animal is found to have lost the +dull, dejected appearance and to look bright. The temperature has fallen +and, in some cases, has attained normal or even subnormal limits. The +visible mucous membranes are clean, and the conjunctival petechiæ begin +to fade; the pulse, however, will be found to be weak and thready in +character, but the appetite excellent, and, in fact, if it were not for +the loss of flesh and slight edema of the legs, there would be little to +show that the animal was sick. Unfortunately, however, this condition +does not continue for any great length of time, for again the +temperature is elevated; in the course of a few hours the thermometer +registers a still higher degree, the animal is dull and dejected, and by +the following day the visible mucous membranes present a yellow tinge; +large ecchymoses, dark in color, appear on the conjunctival membranes, +the action of the heart is irritable, the pulse full and quick, or at +times intermittent, and regurgitation may be observed in the jugulars, +the breathing is quickened, and the individual respirations are shallow. +On watching an animal in this condition it may be noticed that it takes +seven or eight very short inspirations, followed by a much more +prolonged and sonorous one; at the same time the breathing is more +abdominal than thoracic in character. On examination of the legs it will +be found that the swelling and edema have increased considerably, and +that on the under surface of the abdomen, where previously it was +confined to the sheath, it has now commenced to spread forward along the +subcutaneous tissue between the skin and the muscles. During the whole +of this time the appetite will have varied little, and the evacuations +will be only slightly, if at all, altered in character. In the blood a +repetition of the previous events takes place, the parasites make their +appearance and increase to a maximum and again suddenly or gradually +disappear, according to the length of the fever period. These periods, +alternating with and without fever, may go on for a considerable time. +The progress of the disease is variable and greatly depends upon the +condition of the animal attacked, the weak one succumbing very rapidly, +but each return of the fever brings with it, as a rule, an increase in +the severity of the symptoms. There is increased yellowness of the +membranes, fresh crops of petechiæ on the conjunctiva, a collection of +gelatinous material at the inner angle, which at times becomes red in +color from an admixture of blood, and which on microscopic examination +is found to contain a varying number of the surra parasites; increased +swelling and edema of the extremities and abdomen, which now extends +between the fore limbs and up the chest. During<span class='pagenum'><a name="Page_576" id="Page_576">[Pg576]</a></span> this time the wasting +has been steadily progressive, especially of the muscles of the back and +those surrounding the hip joint and the glutei.</p> + +<p>Toward the termination of the disease it will be noticed that an animal +is disinclined to move, and when made to do so there is manifest loss of +power over the hind quarters, somewhat simulating a slight partial +paralysis, and the hind quarters of the animal reel from side to side. +In connection with this it may be noted that frequently there is +paralysis of the sphincter ani and a dilated condition of the anus. +These symptoms taken together point to some interference with the normal +functions of the spinal cord in the lower dorsal and lumbar regions, and +are probably owing to pressure caused by an exudation within the spinal +membranes. In many cases shortly before death the heart's action becomes +exceedingly violent, shaking the whole frame at each beat, so that the +sound can be heard at some distance from the animal. In some of these +cases the animal may suddenly drop dead; in others the emaciation and +weakness become so pronounced that it falls to the ground, and, after a +short struggle, succumbs to the disease. In other cases, again, the +animal falls to the ground and appears to be suffering from acute pain, +struggles violently, sweat covers the body, and respiration is very +hurried. The struggles soon exhaust the patient's strength, and for a +time it lies quiet; soon, however, the struggles commence again, +continuing until death occurs. In some cases the appetite is voracious.</p> + +<p>The symptoms of the disease as observed in experimentally inoculated +animals are as follows: Twenty-four hours after the subcutaneous +injection of a small quantity of surra blood, in the great majority of +cases, a small circumscribed and somewhat raised swelling is noticed at +the seat of the inoculation. After forty-eight hours the tumor has +increased in size and is accompanied with some edema; it presents a +certain amount of tension of the parts involved, and is generally tender +on manipulation. These conditions continue to increase, until by the +fourth day the tumor may measure 3 or 4 inches in; one direction by 2 or +3 in the other, and raised to the extent of an inch or an inch and a +half above the surrounding tissues, or in some cases the tumor presents +an almost circular form throughout. It will be also found that, if the +tumor is firmly grasped, it is not fixed, but can be lifted up from the +subcutaneous tissue. According to the nature and quantity of the +inoculated blood, these symptoms rapidly present themselves, and either +attain a maximum or are retarded until, varying from the fourth to the +thirteenth day, the tumor at the seat of inoculation will be found to +have lost a certain amount of its tension and tenderness. From this date +the swelling and edema gradually begin to grow less, until finally, +after a period of<span class='pagenum'><a name="Page_577" id="Page_577">[Pg 577]</a></span> 10 to 14 days, the only sign left of the former +swelling is a slight thickening of the skin over the point of the +injection; but at the moment when the tension and tenderness of the +parts at the seat of inoculation become suddenly decreased a symptom of +the utmost clinical importance takes place, namely, at that moment the +parasite of surra enters the blood of the general circulation.</p> + +<p>The temperature on the day of inoculation, and, in fact, for several +days afterwards, may remain normal in character, there being only a few +degrees difference between the morning and evening observations. In +other cases there may be a slight rise from the first evening, and a +gradual progressive rise until the swelling at the seat of inoculation +shows signs of reduction in size, when the temperature generally takes a +decided rise again, and may attain 104° or 105.8° F. This elevation will +last a varying period of from two to six days, and on the day following +its onset the ordinary symptoms of fever will be noticed, and in +addition there will be petechiæ on the conjunctival membranes, +lacrimation, a slight mucous discharge from the nose, and in severe +cases some edema of the lower portion of the legs, and perhaps of the +sheath in horses. At the termination of the period of fever the +temperature will be found to have fallen to normal or nearly so; the +animal will present a brighter aspect, and there is every appearance of +its return to health; in a few days, however, the animal again appears +dull and half asleep; the temperature is elevated, a relapse takes +place, and a repetition of all the symptoms in the primary paroxysm, +including the reappearance of the parasite, is observed.</p> + +<p><i>Diagnosis.</i>—A diagnosis may also be established by the +complement-fixation or agglutination tests with the sera from suspected +animals. This, however, can be carried out only in laboratories and +requires special facilities for its execution.</p> + +<p><i>Treatment.</i>—No satisfactory treatment is known. Intravenous injections +of Fowler's solution of arsenic give temporary relief, but relapses +occur. In view of the great economic importance of this disease, it +would not be advisable to attempt to treat any sporadic cases should +they occur in this country. On the contrary, the animals should be +slaughtered immediately and their carcasses promptly burned.<span class='pagenum'><a name="Page_578" id="Page_578">[Pg 578]</a></span></p> + + +<h3>OSTEOPOROSIS OR BIGHEAD.</h3> + +<h4>By <span class="smcap">John R. Mohler</span>, V. M. D., <i>Assistant Chief, Bureau of Animal +Industry</i>.</h4> + +<p>Osteoporosis is a general disease of the bones which develops slowly and +progressively and is characterized by the absorption of the calcareous +or compact bony substance and the formation of enlarged, softened, and +porous bone. It is particularly manifest in the bones of the head, +causing enlargement and bulging of the face and jaws, thereby giving +rise to the terms "bighead" and "swelled head," which are applied to it. +The disease affects horses, mules, and asses of all ages, classes, and +breeds, and of both sexes, and is found under all soil, dietetic, and +climatic conditions. It may occur in sporadic form, but in certain +regions, such as South Africa, Australia, Madagascar, India, Hawaii, and +in this country it seems to be enzootic, several cases usually appearing +in the same stable or on the same farm, and numerous animals being +affected in the same district. In the United States the disease has been +found in all the States bordering the Delaware River and Chesapeake Bay, +in some of the New England States, and in many of the Southern States, +especially in low regions along the coast. In Europe the disease appears +to be quite rare, and is usually described as a form of osteomalacia, a +disease which is not uncommon among cattle of that continent. The +opinion that bighead is only a form of osteomalacia, however, can not be +accepted, nor can the infrequency of the former among European horses +and the frequency of the latter among other live stock be conceded on +the argument which has been presented, namely, that the better care +which horses receive prevents them from becoming affected. In the +Southwest, where osteomalacia, or creeps, has not infrequently been +observed among range cattle by the writer, no case of osteoporosis of +the horses using the same range has been noted, although the latter +animals are given no more attention than the cattle.</p> + +<p>The appropriate treatment of osteomalacia in cattle is so effective that +if osteoporosis were a similar manifestation of disease a similar line +of treatment should prove equally efficacious. However, this is not the +fact. On the other hand, the occurrence of osteomalacia on old, worn-out +soil, or on land deficient in lime salts, or from eating feed lacking in +these bone-forming substances, or drinking water with a lime deficiency, +is in perfect accord with our knowledge of the disease. But osteoporosis +may occur on rich, fertile soil, in the most hygienic stables, and in +animals receiving the best of care and of bone-forming feeds with a +proper amount of mineral salts in the drinking water.</p> + +<p><i>Cause.</i>—The cause of this disease still remains obscure, although +various theories have been advanced, some entirely erroneous, others<span class='pagenum'><a name="Page_579" id="Page_579">[Pg 579]</a></span> +more or less plausible; but none of them has been established. Thus the +idea that feeding fodder and cereals poor in mineral salts and grazing +in pastures where the soil is poor in lime and phosphates will cause the +disease has been entirely disproved in many instances. Others have +considered that the disease starts as a muscular rheumatism which is +followed by an inflammatory condition of the bones, terminating in +osteoporosis. The idea that the disease is contagious has been advanced +by many writers, although no causative agent has been isolated. Numerous +experiments have been made by inoculating the blood of an affected horse +into normal horses without results. A piece of bone taken by Pearson +from the diseased lower jaw of a colt was transplanted into a cavity +made for it in the jaw of a normal horse, but without reproducing the +disease. Pétrone believes that the <i>Micrococcus nitrificans</i> causes +osteomalacia in man as a result of its producing nitrous acid, which +dissolves the calcareous tissues, and when injected into dogs in pure +culture a similar disease is produced. It is probable that if this work +is confirmed a somewhat similar causative factor will be discovered for +osteoporosis.</p> + +<p>Elliott considers the latter disease to be of microbic origin, the +result of climatic conditions, and divides the island of Hawaii into two +districts, in one of which the rainfall is 150 inches annually, where +bighead is very prevalent, and the second of which is dry and rarely +visited by rain, where the disease is unknown. Removal of animals from +the wet to the dry district is followed by immediate improvement and +frequently by recovery. In the wet district horses in both good and bad +stables take the disease, but in the dry districts no unfavorable or +unhygienic surroundings produce the affection. As both native and +imported horses are equally susceptible, there is no indication of an +acquired immunity to be observed.</p> + +<p>Theiler has recently stated that his experiments in transfusing blood +from diseased to normal horses were negative, and has suggested that the +causative agent may be transmitted by an intermediate host only, as in +the case of Texas fever. He draws attention to this method of spreading +East African coast fever, although blood inoculations, as in +osteoporosis, are always without result. We know that coast fever is +infectious, and that it can not be transmitted by blood inoculations, +but is conveyed with remarkable ease by ticks from diseased cattle. That +the cause has not been observed may be accounted for by its being +invisible even to the high magnification of the microscope.</p> + +<p>On some farms and in some stables bighead is quite prevalent, a number +of cases following one after another. On one farm of Thoroughbreds in +Pennsylvania all the yearling colts and some of the aged horses were +affected during one year, and on a similar farm in Virginia a large +proportion of the horses for several years were<span class='pagenum'><a name="Page_580" id="Page_580">[Pg 580]</a></span> diseased, although the +cows and sheep of this farm remained unaffected.</p> + +<p><i>Symptoms.</i>—The commencement of the disease is usually unobserved by +the owner, and these symptoms which do develop are generally not well +marked or are misleading unless other cases have been noted in the +vicinity. Until the bones become enlarged the symptoms remain so vague +as not to be diagnosed readily. The disease may be present itself under +a variety of symptoms. If the bones of the hock become affected, the +animal will first show a hock lameness. If the long bones are involved, +symptoms of rheumatism will be the first observed, while if the dorsal +or lumbar vertebræ are affected indications of a strain of the lumbar +region are in evidence. Probably the first symptom to be noticed is a +loss of vitality combined with an irregular appetite or other digestive +disturbance and with a tendency to stumble while in action. These +earlier symptoms, however, may pass unobserved, and the appearance of an +intermittent or migratory lameness without any visible cause may be the +first sign to attract attention. This shifting and indefinite lameness, +involving first one leg and then the other, is very suggestive, and is +even more important when it is associated with a tendency to lie down +frequently in the stall and the absence of a desire to get up, or the +presence of evident pain and difficulty in arising.</p> + +<p>About this time, or probably before, swelling of the bones of the face +and jaw, which is almost constantly present in this disease, will be +observed. The bones of the lower jaw are the most frequently involved, +and this condition is readily detected with the fingers by the bulging +ridge of the bone outside and along the lower edge of the molar teeth. A +thickening of the lower jawbone may likewise be identified by feeling on +both sides of each branch at the same time and comparing it with the +thinness of this bone in a normal horse. As a result mastication becomes +difficult or impossible and the teeth become loose and painful. The +imperfect chewing which follows causes balls of feed to form which drop +out of the mouth into the manger. Similar enlargements of the bones of +the upper jaw may be seen, causing a widening of the face and a bulging +of the bones about midway between the eyes and the nostrils. In some +cases the nasal bones also become swollen and deformed, which, together +with the bulging of the bones under the eyes, gives a good illustration +of the reason for the application of the term bighead.</p> + +<p>Other bones of the body will undergo similar changes, but these +alterations are not so readily noted except by the symptoms they +occasion. The alterations of the bones of the spinal column and the +limbs, while difficult of observation, are nevertheless indicated by the +reluctance of the animal to get up and the desire to remain lying for +long periods of time. The animal easily tires, moves less<span class='pagenum'><a name="Page_581" id="Page_581">[Pg 581]</a></span> rapidly, and +if urged to go faster may sustain a fracture or have a ligament torn +from its bony attachments, especially in the lower bones of the leg. An +affected horse weighing 1,000 pounds was seen by the writer to fracture +the large pastern bone from rearing during halter exercise.</p> + +<p>The animal becomes poor in flesh, the coat is rough and lusterless, and +the skin tight and harsh, producing a condition termed "hidebound," with +considerable "tucking up" of the abdomen. The horse shows a short, +stilted, choppy gait, which later becomes stiffer and more restricted, +while on standing a position simulating that in founder is assumed, with +a noticeable drop to the croup. The animal at this stage usually lies +down and remains recumbent for several days at a time. Bed sores +frequently arise and fractures are not uncommon in consequence of +attempts to arise, which complications, in addition to emaciation, +result in death.</p> + +<p>The disease may exist in this manner for variable periods extending from +two or three months to two years. The termination of the disease is +uncertain at best, but is likely to be favorable if treatment and a +change of feed, water, and location is adopted in the early stages of +the malady.</p> + +<p><i>Lesions.</i>—As has been stated, the bones are the principal tissues +involved. The nutrition of the bone is disturbed, as is indicated by the +diminished density or rarefaction of the bony substances, the increase +in the size or widening of the Haversian canal and the medullary cavity, +and the enlargement of the network of spaces in the spongy tissue, the +absorptive changes following the course of the Haversian system. In this +process of absorption there are formed within the substance of the bone +areas of erosion, indentations, or hollow spaces of irregular shape. +These spaces increase in size and become confluent, causing an +appearance resembling some varieties of coral. The affected bone may be +readily incised with a knife, the cut surface appearing finely porous. +This porous area is soft, pliable, and yields easily to the pressure of +the finger. It has been shown by chemical analysis that the bone of an +osteoporotic horse, when compared with that of a normal horse, shows a +reduction in the amount of fat, phosphoric acid, lime, and soda, but a +slight increase in organic matter and silicic acid. The bones lose their +yellowish-white appearance, becoming gray and brittle. The affected +bones may be those of any region or portion of the body. Besides the +change already noted in the bones of the face, the ends of the long +bones, such as the ribs, are involved, and may be sectioned, though not +so readily as the facial bones. The bones of the vertebræ are also +frequently involved, necessitating great care in casting a horse, as the +writer has seen several cases of broken backs in casting such animals +for other operations. The marrow and cancellated<span class='pagenum'><a name="Page_582" id="Page_582">[Pg 582]</a></span> tissue of the long +bones may contain hemorrhages and soft gelatinous material or coagulated +fibrin. The internal organs are usually normal, but a catarrhal +condition of the gastrointestinal tract may be noted as the result of +the improper mastication, resulting from the enlargement of the jaws and +soreness of the teeth.</p> + +<p><i>Treatment.</i>—The affected animal should be immediately placed under new +conditions, both as to feed and surroundings. If the horse has been +stable fed, it is advisable to turn it out on grass for two or three +months, preferably in a higher altitude. If the disease has been +contracted while running on pasture, place the animal in the stable or +corral. In the early stages of the disease beneficial results have +followed the supplemental use of lime given in the drinking water. One +peck of lime slaked in a cask of water and additional water added from +time to time is satisfactory and can be provided at slight expense. This +treatment may be supplemented by giving a tablespoonful of powdered bone +meal in each feed, with free access to a large piece of rock salt, or +the bone meal may be given with four tablespoonfuls of molasses mixed +with the feed. Feeds containing mineral salts, such as beans, cowpeas, +oats, and cottonseed meal, may prove beneficial in replenishing the bony +substance that is being absorbed. Cottonseed meal is one of the best +feeds for this purpose, but it should be fed carefully. The animal +should not be allowed to work at all during the active stage of the +disease, nor should it be used for breeding purposes.</p> + +<div class="footnotes"><h3>FOOTNOTES:</h3> + +<div class="footnote"><p><a name="Footnote_7_7" id="Footnote_7_7"></a><a href="#FNanchor_7_7"><span class="label">[7]</span></a> This summary of symptoms is based upon work by Lingard.</p></div> +</div> + + +<hr style="width: 65%;" /> +<p><span class='pagenum'><a name="Page_583" id="Page_583">[Pg 583]</a></span></p> +<h2>HORSESHOEING.</h2> + +<h3>By <span class="smcap">John W. Adams</span>, A. B., V. M.,</h3> + +<h4><i>Professor of Surgery and Lecturer on Shoeing, Veterinary Department, +University of Pennsylvania.</i></h4> + + +<p>Bad and indifferent shoeing so frequently leads to diseases of the feet +and in irregularities of gait, which may render a horse unserviceable, +that it has been thought appropriate to conclude this book with a brief +chapter on the principles involved in shoeing healthy hoofs.</p> + +<p>In unfolding this subject in the limited space at my disposal, I can +only hope to give the intelligent horse owner a sufficient number of +facts, based on experience and upon the anatomy and physiology of the +foot and leg, to enable him to avoid the more serious consequences of +improper shoeing.</p> + +<p>Let us first examine this vital mechanism, the foot, and learn something +of its structure and of the natural movements of its component parts, +that we may be prepared to recognize deviations from the normal and to +apply the proper corrective.</p> + + +<h4>GROSS ANATOMY OF THE FOOT.</h4> + +<h5>(Pls. XXXII-XXXIV.)</h5> + +<p>The bones of the foot are four in number, three of which—the long +pastern, short pastern, and coffin bone, placed end to end—form a +continuous straight column passing downward and forward from the fetlock +joint to the ground. A small accessory bone, the navicular, or +"shuttle," bone, lies crosswise in the foot between the wings of the +coffin bone and forms a part of the joint surface of the latter. The +short pastern projects about 1-/2 inches above the hoof and extends +about an equal distance to it. (See also page 395.)</p> + +<p>The pastern and the coffin bone are held together by strong fibrous +cords passing between each two bones and placed at the sides so as not +to interfere with the forward and backward movement of the bones. The +joints are therefore hinge joints, though imperfect, because, while the +chief movements are those of extension and flexion in a single plane, +some slight rotation and lateral movements are possible.<span class='pagenum'><a name="Page_584" id="Page_584">[Pg 584]</a></span></p> + +<p>The bones are still further bound together and supported by three long +fibrous cords, or tendons. One, the extensor tendon of the toe, passes +down the front of the pasterns and attaches to the coffin bone just +below the edge of the hair; when pulled upon by its muscle this tendon +draws the toe forward and enables the horse to place the hoof flat upon +the ground. The other two tendons are placed behind the pasterns and are +called flexors, because they flex, or bend, the pasterns and coffin bone +backward. One of the tendons is attached to the upper end of the short +pastern, while the other passes down between the heels, glides over the +under surface of the navicular bone, and attaches itself to the under +surface of the coffin bone. These two tendons not only flex, or fold up, +the foot as the latter leaves the ground during motion, but at rest +assist the suspensory ligament in supporting the fetlock joint.</p> + +<p>The foot-axis is an imaginary line passing from the fetlock joint +through the long axes of the two pasterns and coffin bone. This +imaginary line, which shows the direction of the pasterns and coffin +bone, should always be straight—that is, never broken, either forward +or backward when viewed from the side, or inward or outward when +observed from in front. Viewed from one side, the long axis of the long +pastern, when prolonged to the ground, should be parallel to the line of +the toe. Viewed from in front, the long axis of the long pastern, when +prolonged to the ground, should cut the hoof exactly at the middle of +the toe.</p> + +<p>Raising the heel or shortening the toe not only tilts the coffin bone +forward and makes the hoof stand steeper at the toe, but slackens the +tendon that attaches to the under surface of the coffin bone (perforans +tendon), and therefore allows the fetlock joint to sink downward and +backward and the long pastern to assume a more nearly horizontal +position. The foot-axis, viewed from one side, is now broken forward; +that is, the long pastern is less steep than the toe, and the heels are +either too long or the toe is too short. On the other hand, raising the +toe or lowering the heels of a foot with a straight foot-axis not only +tilts the coffin bone backward and renders the toe more nearly +horizontal, but tenses the perforans tendon, which then forces the +fetlock joint forward, causing the long pastern to stand steeper. The +foot-axis, seen from one side, is now broken backward—an indication +that the toe is relatively too long or that the heels are relatively too +low.</p> + +<p>The elastic tissues of the foot are preeminently the lateral cartilages +and the plantar cushion. The lateral cartilages are two irregularly +four-sided plates of gristle, one on either side of the foot, extending +from the wings of the coffin bone backward to the heels and upward to a +distance of an inch or more above the edge of the hair, where they may +be felt by the fingers. When sound, these plates are elastic and<span class='pagenum'><a name="Page_585" id="Page_585">[Pg 585]</a></span> yield +readily to moderate finger pressure, but from various causes may undergo +ossification, in which condition they are hard and unyielding. The +plantar cushion is a wedge-shaped mass of tough, elastic, fibro-fatty +tissue filling all the space between the lateral cartilages, forming the +fleshy heels and the fleshy frog, and serving as a buffer to disperse +shock when the foot is set to the ground. It extends forward underneath +the navicular bone and perforans tendon, and protects these structures +from injurious pressure from below. Instantaneous photographs show that +at speed the horse sets the heels to the ground before other parts of +the foot—conclusive proof that the function of this tough, elastic +structure is to dissipate and render harmless violent impact of the foot +with the ground.</p> + +<p>The horn-producing membrane, or "quick," as it is commonly termed, is +merely a downward prolongation of the "derm," or true skin, and may be +conveniently called the pododerm (foot skin). The pododerm closely +invests the coffin bone, lateral cartilages, and plantar cushion, much +as a sock covers the human foot, and is itself covered by the horny +capsule, or hoof. It differs from the external skin, or hair skin, in +having no sweat or oil glands, but, like it, is richly supplied with +blood vessels and sensitive nerves. And, just as the derm of the hair +skin produces upon its outer surface layer upon layer of horny cells +(epiderm), which protect the sensitive and vascular derm, so, likewise, +in the foot the pododerm produces over its entire surface soft cells, +which, pushed away by more recent cells forming beneath, lose moisture +by evaporation and are rapidly transformed into the corneous material +which we call the hoof. It is proper to regard the hoof as a greatly +thickened epiderm having many of the qualities possessed by such +epidermal structures as hair, feathers, nails, claws, etc.</p> + +<p>The functions of the pododerm are to produce the hoof and to unite it +firmly to the foot.</p> + +<p>There are five parts of the pododerm, easily distinguishable when the +hoof has been removed, namely: (1) The perioplic band, a narrow ridge +from one-sixteenth to one-eighth of an inch wide, running along the edge +of the hair from one heel around the toe to the other. This band +produces the perioplic horn, the thin varnishlike layer of glistening +horn, which forms the surface of the wall or "crust," and whose purpose +seems to be to retard evaporation of moisture from the wall. (2) The +coronary band, a prominent fleshy cornice encircling the foot just below +and parallel to the perioplic band. At the heels it is reflected forward +along the sides of the fleshy frog, to become lost near the apex of this +latter structure. The coronet produces the middle layer of the wall, and +the reflexed portions produce the "bars," which are, therefore, to be +regarded merely as a turning forward of the wall. (3) The fleshy leaves, +500 to 600 in number,<span class='pagenum'><a name="Page_586" id="Page_586">[Pg 586]</a></span> parallel to one another, running downward and +forward from the lower edge of the coronary band to the margin of the +fleshy sole. They produce the soft, light-colored horny leaves which +form the deepest layer of the wall, and serve as a strong bond of union +between the middle layer of the wall and the fleshy leaves with which +they dovetail. (4) The fleshy sole, which covers the entire under +surface of the foot, excepting the fleshy frog and bars. The horny sole +is produced by the fleshy sole. (5) The fleshy frog, which covers the +under surface of the plantar cushion and produces the horny frog.</p> + +<p>The horny box or hoof consists of wall and bars, sole and frog. The wall +is all that part of the hoof which is visible when the foot is on the +ground (see fig. 8). As already stated, it consists of three layers—the +periople, the middle layer, and the leafy layer.</p> + +<p>The bars (see fig. 1<i>c</i>) are forward prolongations of the wall, and are +gradually lost near the point of the frog. The angle between the wall +and a bar is called the "buttress." Each bar lies against the horny frog +on one side and incloses a wing of the sole on the other, so that the +least expansion or contraction of the horny frog separates or +approximates the bars, and through them the lateral cartilages and the +walls of the quarters. The lower border of the wall is called the +"bearing edge," and is the surface against which the shoe bears. By +dividing the entire lower circumference of the wall into five equal +parts, a toe, two side walls, and two quarters will be exhibited. The +"heels," strictly speaking, are the two rounded soft prominences of the +plantar cushion, lying one above each quarter. The outer wall is usually +more slanting than the inner, and <i>the more slanting half of a hoof is +always the thicker</i>. In front hoofs the wall is thickest at the toe and +gradually thins out toward the quarters, where in some horses it may not +exceed one-fourth of an inch. In hind hoofs there is much less +difference in thickness between the toe, side walls, and quarters. The +horny sole, from which the flakes of old horn have been removed, is +concave and about as thick as the wall at the toe. It is rough, uneven +and often covered by flakes of dead horn in process of being loosened +and cast off. Behind the sole presents an opening into which are +received the bars and horny frog. This opening divides the sole into a +body and two wings.</p> + +<p>The periphery of the sole unites with the lower border of the wall and +bars through the medium of the white line, which is the cross section of +the leafy horn layer of the wall and of short plugs of horn which grow +down from the lower ends of the fleshy leaves. This white line is of +much importance to the shoer, since its distance from the outer border +of the hoof is the thickness of the wall, and in the white line all +nails should be driven.</p> + +<p>The frog, secreted by the pododerm covering the plantar cushion or fatty +frog, and presenting almost the same form as the latter, lies<span class='pagenum'><a name="Page_587" id="Page_587">[Pg 587]</a></span> as a soft +and very elastic wedge between the bars and between the edges of the +sole just in front of the bars. A broad and shallow depression in its +center divides it into two branches, which diverge as they pass backward +into the horny bulbs of the heel. In front of the middle cleft the two +branches unite to form the body of the frog, which ends in the point of +the frog. The bar of a bar shoe should rest on the branches of the frog. +In unshod hoofs the bearing edge of the wall, the sole, frog, and bars +are all on a level; that is, the under surface of the hoof is perfectly +flat, and each of these structures assists in bearing the body weight.</p> + +<p>With respect to solidity, the different parts of the hoof vary widely. +The middle layer of the wall is harder and more tenacious than the sole, +for the latter crumbles away or passes off in larger or smaller flakes +on its under surface, while no such spontaneous shortening of the wall +occurs. The white line and the frog are soft-horn structures, and differ +from hard horn in that their horn cells do not under natural conditions +become hard and hornlike. They are very elastic, absorb moisture +rapidly, and as readily dry out and become hard, brittle, and easily +fissured. Horn of good quality is fine grained and tough, while bad horn +is coarse grained and either mellow and friable or hard and brittle. All +horn is a poor conductor of heat, and the harder (drier) the horn the +more slowly does it transmit extremes of temperature.</p> + + +<h4>THE PHYSIOLOGICAL MOVEMENTS OF THE HOOF.</h4> + +<p>A hoof while supporting the body weight has a different form, and the +structures inclosed within the hoof have a different position than when +not bearing weight. Since the amount of weight borne by a foot is +continually changing, and the relations of internal pressure are +continuously varying, a foot is, from a physiological viewpoint, never +at rest. The most marked changes of form of the hoof occur when the foot +bears the greatest weight, namely, at the time of the greatest descent +of the fetlock. Briefly, these changes of form are: (1) An expansion or +widening of the whole back half of the foot from the coronet to the +lower edge of the quarters. This expansion varies between one-fiftieth +and one-twelfth of an inch. (2) A narrowing of the front half of the +foot, measured at the coronet. (3) A sinking of the heels and a +flattening of the wings of the sole. These changes are more marked in +the half of the foot that bears the greater weight.</p> + +<p>The changes of form occur in the following order. When the foot is set +to the ground the body weight is transmitted through the bones and +sensitive and horny leaves to the wall. The coffin bone and navicular +bone sink a little and rotate backward. At the same time<span class='pagenum'><a name="Page_588" id="Page_588">[Pg 588]</a></span> the short +pastern sinks backward and downward between the lateral cartilages and +presses the perforans tendon upon the plantar cushion. This cushion +being compressed from above and being unable to expand downward by +reason of the resistance of the ground acting against the horny frog, +acts like any other elastic mass and expands toward the sides, pushing +before it the yielding lateral cartilages and the wall of the quarters. +This expansion of the heels is assisted and increased by the +simultaneous flattening and lateral expansion of the resilient horny +frog, which crowds the bars apart. Of course, when the lateral +cartilages are ossified, not only is no expansion of the quarters +possible, but frog pressure often leads to painful compression of the +plantar cushion and to increase of lameness. Frog pressure is therefore +contraindicated in lameness due to sidebones (ossified cartilages). +Under the descent of the coffin bone the horny sole sinks a little; that +is, the arch of the sole around the point of the frog and the wings of +the sole become somewhat flattened. All these changes of form are most +marked in sound unshod hoofs, because in them ground pressure on the +frog and sole is pronounced; they are more marked in fore hoofs than in +hind hoofs.</p> + +<p>The movement of the different structures within the foot and the changes +of form that occur at every step are indispensable to the health of the +hoof, so that these elastic tissues must be kept active by regular +exercise, with protection against drying out of the hoof. Long-continued +rest in the stable, drying out of the hoof, and shoeing decrease or +alter the physiological movements of the hoof and sometimes lead to foot +diseases. Since these movements are complete and spontaneous only in +unshod feet, shoeing must be regarded as an evil, albeit a necessary +one, and indispensable if we wish to keep horses continuously +serviceable on hard, artificial roads. However, if in shoeing we bear in +mind the structure and functions of the hoof and apply a shoe whose +branches have a wide and level bearing surface, so as to interfere as +little as may be with the expansion and contraction of the quarters, in +so far as this is not hindered by the nails, we need not be apprehensive +of trouble, provided the horse has reasonable work and his hoofs proper +care.</p> + + +<h4>GROWTH OF THE HOOF.</h4> + +<p>All parts of the hoof grow downward and forward with equal rapidity, the +rate of growth being largely dependent upon the amount of blood supplied +to the pododerm, or "quick." Abundant and regular exercise, good +grooming, moistness and suppleness of the hoof, going barefoot, plenty +of good feed, and at proper intervals removing the overgrowth of hoof +and regulating the bearing surface, by increasing the volume and +improving the quality of the blood<span class='pagenum'><a name="Page_589" id="Page_589">[Pg 589]</a></span> flowing into the pododerm, favor the +rapid growth of horn of good quality; while lack of exercise, dryness of +the horn, and excessive length of the hoof hinder growth.</p> + +<p>The average rate of growth is about one-third of an inch a month. Hind +hoofs grow faster than fore hoofs and unshod ones faster than shod ones. +The time required for the horn to grow from the coronet to the ground, +though influenced to a slight degree by the precited conditions, varies +in proportion to the distance of the coronet from the ground. At the +toe, depending on its height, the horn grows down in 11 to 13 months, at +the side wall in 6 to 8 months, and at the heels in 3 to 5 months. We +can thus estimate with tolerable accuracy the time required for the +disappearance of such defects in the hoof as cracks, clefts, etc.</p> + +<p>Irregular growth is not infrequent. The almost invariable cause of this +is an improper distribution of the body weight over the hoof—that is, +an unbalanced foot. Colts running in soft pasture or confined for long +periods in the stable are frequently allowed to grow hoofs of excessive +length. The long toe becomes "dished"—that is, concave from the coronet +to the ground—the long quarters curl forward and inward and often +completely cover the frog and lead to contraction of the heels, or the +whole hoof bends outward or inward, and a crooked foot, or, even worse, +a crooked leg, is the result if the long hoof be allowed to exert its +powerful and abnormally directed leverage for but a few months upon +young plastic bones and tender and lax articular ligaments. All colts +are not foaled with straight legs, but failure to regulate the length +and bearing of the hoof may make a straight leg crooked and a crooked +leg worse, just as intelligent care during the growing period can +greatly improve a congenitally crooked limb. If breeders were more +generally cognizant of the power of overgrown and unbalanced hoofs to +divert the lower bones of young legs from their proper direction, and, +therefore, to cause them to be moved improperly, with loss of speed and +often with injury to the limbs, we might hope to see fewer knock-kneed, +bow-legged, "splay-footed," "pigeon-toed," cow-hocked, interfering, and +paddling horses.</p> + +<p>If in shortening the hoof one side wall is, from ignorance, left too +long or cut down too low with relation to the other, the foot will be +unbalanced, and in traveling the long section will touch the ground +first and will continue to do so till it has been reduced to its proper +level (length) by the increased wear which will take place at this +point. While this occurs rapidly in unshod hoofs, the shoe prevents wear +of the hoof, though it is itself more rapidly worn away beneath the high +(long) side than elsewhere, so that by the time the shoe is worn out the +tread of the shoe may be flat. If this mistake be repeated from month to +month, the part of the wall left too high will<span class='pagenum'><a name="Page_590" id="Page_590">[Pg 590]</a></span> grow more rapidly than +the low side whose pododerm is relatively anemic as a result of the +greater weight falling into this half of the hoof, and the ultimate +result will be a "wry," or crooked foot.</p> + + +<h4>THE CARE OF UNSHOD HOOFS.</h4> + +<p>The colt should have abundant exercise on dry ground. The hoofs will +then wear gradually, and it will only be necessary from time to time to +regulate any uneven wear with the rasp and to round off the sharp edge +about the toe in order to prevent breaking away of the wall.</p> + +<p>Colts in the stable can not wear down their hoofs, so that every four to +six weeks they should be rasped down and the lower edge of the wall well +rounded to prevent chipping. The soles and clefts of the frog should be +picked out every few days and the entire hoof washed clean. Plenty of +clean straw litter should be provided. Hoofs that are becoming "awry" +should have the wall shortened in such a manner as to straighten the +foot-axis. This will ultimately produce a good hoof and will improve the +position of the limb.</p> + +<div class="figcenter" style="width: 438px;"> +<img src="images/illus_fig_1.jpg" width="438" height="450" alt="Fig. 1." title="" /> +<span class="caption">Fig. 1.—Ground surface of a right fore hoof of the +regular form: a, a, wall; a-a, the toe; a-b, the side walls; +b-d, the quarters; c, c, the bars; d, d, the buttress; e, +lateral cleft of the frog; f, body of the sole; g, g', g", leafy +layer (white line) of the toe and bars; h, body of the frog; i, i, +branches of the frog; k, k, horny bulbs of the heels; l, middle +cleft of the frog.</span> +</div> + + +<h4>CHARACTERISTICS OF A HEALTHY HOOF.</h4> + +<p>A healthy hoof (figs. 1 and 8) is equally warm at all parts, and is not +tender under pressure with the hands or moderate compression with +pincers. The coronet is soft and elastic at all points and does not +project beyond the surface of the wall. The wall (fig. 8) is straight +from coronet to ground, so that a straightedge laid against the wall +from coronet to ground parallel to the direction of the horn tubes will +touch at every point. The wall should be covered with the outer +varnishlike layer (periople) and should show no cracks or clefts. Every +hoof shows "ring formation," but the rings should not be strongly marked +and should always run parallel to the coronary band. Strongly marked +ring-formation over the entire wall is an evidence of a weak hoof, but<span class='pagenum'><a name="Page_591" id="Page_591">[Pg 591]</a></span> +when limited to a part of the wall is evidence of previous local +inflammation. The bulbs of the heels should be full, rounded, and of +equal height. The sole (fig. 1) should be well hollowed out, the white +line solid, the frog well developed, the middle cleft of the frog broad +and shallow, the spaces between the bars and the frog wide and shallow, +the bars straight from the buttress toward the point of the frog, and +the buttresses themselves so far apart as not to press against the +branches of the frog. A hoof can not be considered healthy if it +presents reddish discolored horn, cracks in the wall, white line, bars, +or frog, thrush of the frog, contraction or displacement of the heels. +The lateral cartilages should yield readily to finger pressure.</p> + +<div class="figcenter" style="width: 450px;"> +<img src="images/illus_fig_2.jpg" width="450" height="266" alt="Fig. 2." title="" /> +<span class="caption">Fig. 2.—Pair of fore feet of regular form in regular +standing position.</span> +</div> + + +<h4>VARIOUS FORMS OF HOOFS.</h4> + +<p>As among a thousand human faces no two are alike, so among an equal +number of horses no two have hoofs exactly alike. A little study of +different forms soon shows us, however, that the form of every hoof is +dependent in great measure on the direction of the two pastern bones as +viewed from in front or behind, or from one side; and that all hoofs +fall into three classes when we view them from in front and three +classes when we observe them in profile. Inasmuch as the form of every +foot determines the peculiarities of the shoe that is best adapted to +it, no one who is ignorant of, or who disregards the natural form of, a +hoof can hope to understand physiological shoeing.</p> + +<div class="figcenter" style="width: 450px;"> +<img src="images/illus_fig_3.jpg" width="450" height="283" alt="Fig. 3." title="" /> +<span class="caption">Fig. 3.—Pair of fore feet of base-wide form in toe-wide +standing position.</span> +</div> + + +<h4>FORMS OF FEET VIEWED FROM IN FRONT AND IN PROFILE.</h4> + +<p>Whether a horse's feet be observed from in front or from behind, their +form corresponds to, or at least resembles, either that of the regular +position (fig. 2), the base-wide or too-wide position (fig. 3), or the +base-narrow position (fig. 4).<span class='pagenum'><a name="Page_592" id="Page_592">[Pg 592]</a></span></p> + +<p>By the direction of the imaginary line passing through the long axes of +the two pasterns (figs. 2, 4, 5) we determine whether or not the hoof +and pasterns stand in proper mutual relation.</p> + +<p>In the regular standing position (fig. 2) the foot-axis runs straight +downward and forward; in the base-wide position (fig. 3) it runs +obliquely downward and outward, and in the base-narrow position (fig. 4) +it runs obliquely downward and inward.</p> + +<div class="figcenter" style="width: 450px;"> +<img src="images/illus_fig_4.jpg" width="450" height="256" alt="Fig. 4." title="" /> +<span class="caption">Fig. 4.—Pair of fore feet of base-narrow form in +toe-narrow standing position.</span> +</div> + +<p>Viewing the foot in profile, we distinguish the regular position (fig. +5<i>b</i>) and designate all forward deviations as acute-angled (long toe and +low heel, fig. 5<i>a</i>), and all deviations backward from the regular +(steep toe and high heel, fig. 5<i>c</i>) as steep-toed, or stumpy. When the +body weight is evenly distributed over all four limbs, the foot-axis +should be straight; the long pastern, short pastern, and wall at the toe +should have the same slant.</p> + +<div class="figcenter" style="width: 450px;"> +<img src="images/illus_fig_5.jpg" width="450" height="155" alt="Fig. 5." title="" /> +<span class="caption">Fig. 5.—a, Side view of an acute-angled fore foot +(shod); b, side view of a regular fore foot, showing the most +desirable degree of obliquity (34°); c, side view of a stumpy, or +"upright," fore foot; obliquity above 50°. In a, b, c, note +particularly the relation between the length of the slope and the +overhanging of the heels. Note also the toe roll of the shoes.</span> +</div> + +<p><i>A front hoof of the regular standing position.</i>—The outer wall is a +little more slanting and somewhat thicker than the inner. The lower +border of the outer quarter describes the arc of a smaller circle—that +is, is more sharply bent than the inner quarter. The weight falls near +the center of the foot and is evenly distributed over the whole bottom +of the hoof. The toe forms an angle with the ground of 45° to 50° and is +parallel to the direction of the long pastern. The toe points straight +ahead, and when the horse is moving forward in a straight line the hoofs +are picked up and carried forward in a line parallel to the middle line +of the body, and are set down flat. Coming straight toward the observer +the hoofs seem to rise and fall perpendicularly.<span class='pagenum'><a name="Page_593" id="Page_593">[Pg 593]</a></span></p> + +<p><i>A hoof of the base-wide position</i> is always awry. The outer wall is +more slanting, longer, and thicker than the inner, the outer quarter +more curved than the inner, and the outer half of the sole wider than +the inner. The weight falls largely into the inner half of the hoof. In +motion the hoof is moved in a circle. From its position on the ground it +breaks over the inner toe, is carried forward and inward close to the +supporting leg, thence forward and outward to the ground, which the hoof +meets first with the outer toe. Horses that are toe-wide +("splay-footed"—toes turned outward) show all these peculiarities of +hoof-form and hoof-flight to a still more marked degree and are +therefore more prone to "interfere" when in motion.</p> + +<p><i>A hoof of the base-narrow position</i> is awry, but not to so marked a +degree as the base-wide hoof. The inner wall is usually a little more +slanting than the outer, the inner half of the sole wider than the +outer, and the inner quarter more curved than the outer. The outer +quarter is often flattened and drawn in at the bottom. The weight falls +largely into the outer half of the hoof. In motion the hoof breaks over +the outer toe, is carried forward and outward at some distance from the +supporting leg, thence forward and inward to the ground, which it +generally meets with the outer toe. The foot thus moves in a circle, +whose convexity is outward, a manner of flight called "paddling." A +base-narrow horse, whose toes point straight ahead, frequently +"interferes," while a toe-narrow (pigeon-toed) animal seldom does.</p> + +<p><i>A regular hoof</i> (fig. 5<i>b</i>), viewed from one side, has a straight +foot-axis inclined to the horizon at an angle of 45° to 50°. The weight +falls near the center of the foot and there is moderate expansion of the +quarters.</p> + +<p><i>An acute-angled hoof</i> (fig. 5<i>a</i>) has a straight foot-axis inclined at +an angle less than 45° to the horizon. The weight falls more largely in +the back half of the hoof and there is greater length of hoof in contact +with the ground and greater expansion of the heels than in the regular +hoof.</p> + +<p><i>Upright or stumpy hoof.</i>—In the upright or stumpy hoof (fig. 5<i>c</i>) the +foot-axis is straight and more than 55° steep. The hoof is relatively +short from toe to heel, the weight falls farther forward, and there is +less expansion of the heels than in the regular hoof.</p> + +<p><i>Wide and narrow hoofs.</i>—Finally, there are wide hoofs and narrow +hoofs, dependent solely upon race and breeding. The wide hoof is almost +circular on the ground surface, the sole but little concave, the frog +large, and the quality of the horn coarse. The narrow hoof has a +strongly "cupped" sole, a small frog, nearly perpendicular side walls, +and fine-grained, tough horn.<span class='pagenum'><a name="Page_594" id="Page_594">[Pg 594]</a></span></p> + +<p><i>Hind hoofs</i> are influenced in shape by different directions of their +pasterns much as front feet are. A hind hoof is not round at the toe as +a front hoof is, but is more pointed. Its greatest width is two-thirds +of the way back from toe to heel, the sole is more concave, the heels +relatively wider, and the toe about 10° steeper than in front hoofs.</p> + + +<h4>EXAMINATION PRELIMINARY TO SHOEING.</h4> + +<p>The object of the examination is to ascertain the direction and position +of the limbs, the shape, character, and quality of the hoofs, the form, +length, position, and wear of the shoe, the number, distribution, and +direction of the nails, the manner in which the hoof leaves the ground, +its line of flight, the manner in which it is set to the ground, and all +other peculiarities, that at the next and subsequent shoeings proper +allowances may be made and observed faults corrected. The animal must, +therefore, be observed both at rest and in motion.</p> + +<p>At rest, the observer should stand in front and note the slant of the +long pasterns. Do they drop perpendicularly, or slant downward and +outward (base-wide foot), or downward and inward (base-narrow foot)? +Whatever be the direction to the long pastern, an imaginary line passing +through its long axis, when prolonged to the ground, should apparently +pass through the middle of the toe. But if such line cuts through the +inner toe the foot-axis is not straight, as it should be, but is broken +inward at the coronet, an indication that either the outer wall of the +hoof is too long (high) or that the inner wall is too short (low). On +the contrary, if the center line of the long pastern falls through the +outer toe the foot-axis is broken outward at the coronet, an indication +that either the inner wall is too long or the outer wall too short.</p> + +<p>The observer should now place himself at one side, two or three paces +distant, in order to view the limb and hoof in profile. Note the size of +the hoof in relation to the height and weight of the animal, and the +obliquity of the hoof. Is the foot-axis straight—that is, does the long +pastern have the same slant as the toe, or does the toe of the hoof +stand steeper than the long pastern (fig. 6<i>c</i>)? In which case the +foot-axis is broken forward at the coronet, an indication, usually, that +the quarters are either too high or that the toe is too short.</p> + +<p>If the long pastern stands steeper than the toe (fig. 6<i>a</i>) the +foot-axis is broken backward, in which case the toe is too long or the +quarters are too low (short). In figures 6<i>a</i> and 6<i>c</i> the dotted lines +passing from toe to quarters indicate the amount of horn which must be +removed in order to straighten the foot-axis, as shown in figure 6<i>b</i>. +Note also the length of the shoe.</p> + +<p>Next, the feet should be raised and the examiner should note the outline +of the foot, the conformation of the sole, form and quality<span class='pagenum'><a name="Page_595" id="Page_595">[Pg 595]</a></span> of the +frog, form of the shoe, wear of the shoe, and the number and +distribution of the nails. Does the shoe fully cover the entire lower +border of the wall? or is it too narrow, or fitted so full on the inside +that it has given rise to interfering? or has the shoe been nailed on +crooked? or has it become loose and shifted? is it too short, or so wide +at the ends of the branches as not to support the buttresses of the +hoof? Does the shoe correspond with the form of the hoof? Are the nails +distributed so as to interfere as little as possible with the expansion +of the quarters? are there too many? are they too large? driven too +"fine" or too high? These are questions which the observer should put to +himself.</p> + +<div class="figcenter" style="width: 450px;"> +<img src="images/illus_fig_6.jpg" width="450" height="177" alt="Fig. 6." title="" /> +<span class="caption">Fig. 6.—a, Side view of foot with the foot-axis broken +backward as a result of too long a toe. The amount of horn to be removed +from the toe in order to straighten the foot-axis is denoted by a dotted +line; b, side view of a properly balanced foot, with a straight +foot-axis of desirable slant; c, side view of stumpy foot with +foot-axis broken forward, as a result of overgrowth of the quarters. The +amount of horn to be removed in order to straighten the foot-axis is +shown by a dotted line.</span> +</div> + +<p>Note carefully the wear of the old shoe. It is the unimpeachable +evidence of the manner in which the hoof has been set to the ground +since the shoe was nailed to it, and gives valuable "pointers" in +leveling the hoof. Wear is the effect of friction between the shoe and +the ground at the moment of contact. Since the properly leveled hoof is +set flat to the ground, the "grounding wear" of a shoe should be uniform +at every point, though the toe will always show wear due to scouring at +the moment of "breaking over." Everything which tends to lengthen the +stride tends also to make the "grounding wear" more pronounced in the +heels of the shoe, while all causes which shorten the stride—as +stiffening of the limbs through age, overwork, or disease—bring the +grounding wear nearer the toe.</p> + +<p>An exception should be noted, however, in founder, in which the +grounding wear is most pronounced at the heels.</p> + +<p>If one branch of the shoe is found to be worn much thinner than the +other, the thinner branch has either been set too near the middle line +of the foot (fitted too close), where it has been bearing greater weight +while rubbing against the ground, or, what is much more often the case, +the section of wall above the thinner branch has been<span class='pagenum'><a name="Page_596" id="Page_596">[Pg 596]</a></span> too long (too +high), or the opposite section of wall has been too short (too low). +"One-sided wear, uneven setting down of the feet, and an unnatural +course of the wall are often found together." How much an old shoe can +tell us, if we take time and pains to decipher its scars!</p> + +<p>The horse should next be observed at a walk and at a trot or pace, from +in front, from behind, and from the side, and the "breaking over," the +carriage of the feet, and the manner of setting them to the ground +carefully noted and remembered. A horse does not always move just as his +standing position would seem to imply. Often there is so great a +difference in the form and slant of two fore hoofs or two hind hoofs +that we are in doubt as to their normal shape, when a few steps at a +trot will usually solve the problem instantly by showing us the line of +flight of the hoofs and referring them to the regular, base-wide, or +base-narrow form.</p> + +<p>No man is competent either to shoe a horse or to direct the work till he +has made the precited observations.</p> + + +<h4>PREPARATION OF THE HOOF FOR THE SHOE.</h4> + +<p>After raising the clinches of the nails with a rather dull clinch cutter +("buffer") and drawing the nails one at a time, the old shoe is +critically examined and laid aside. Remaining stubs of nails are then +drawn or punched out and the hoof freed of dirt and partially detached +horn. The farrier has now to "dress" the overgrown hoof to receive the +new shoe; in other words, he has to form a base of support so inclined +to the direction of the pasterns that in motion this surface shall be +set flat upon the ground. He must not rob the hoof nor leave too much +horn; either mistake may lead to injury. If he has made a careful +preliminary examination he knows what part of the wall requires removal +and what part must be left, for he already knows the direction of the +foot axis and the wear of the old shoe and has made up his mind just +where and how much horn must be removed to leave the hoof of proper +length and the foot axis straight.</p> + +<p>A greatly overgrown hoof may be quickly shortened with sharp nippers and +the sole freed of semidetached flakes of horn. The concave sole of a +thick-walled, strong hoof may be pared out around the point of the frog, +but not so much as to remove all evidences of exfoliation. The wall +should be leveled with the rasp till its full thickness, the white line, +and an eighth of an inch of the margin of the sole are in one horizontal +plane, called the "bearing surface of the hoof." The bars, if long, may +be shortened, but <i>never pared on the side</i>. The branches of the sole in +the angle between the bars and the wall of the quarters should be left a +little lower than the wall, so as not to be pressed upon by the inner +web of the shoe. "Corns," or bruises of the pododerm, are usually a +result of leaving a thick mass of dry, unyielding horn at this point. +The frog should not be<span class='pagenum'><a name="Page_597" id="Page_597">[Pg 597]</a></span> touched further than to remove tags or layers +that are so loose as to form no protection. A soft frog will shorten +itself spontaneously by the exfoliation of superficial layers of horn, +while if the frog is dry, hard, and too prominent it is better to soften +it by applying moisture in some form, and to allow it to wear away +naturally than to pare it down. It is of advantage to have the frog +project below the level of the wall an amount equal to the thickness of +a plain shoe, though we rarely see frogs of such size except in draft +horses. The sharp lower border of the wall should be rounded with the +rasp to prevent its being bent outward and broken away. Finally, the +foot is set to the ground and again observed from all sides to make +sure, that the lines bounding the hoof correspond with the direction of +the long pastern.</p> + + +<h4>THE SHOE.</h4> + +<p>The shoe is an artificial base of support, by no means ideal, because it +interferes to a greater or less degree with the physiology of the foot, +but indispensable except for horses at slow work on soft ground. Since a +proper surface of support is of the greatest importance in preserving +the health of the feet and legs, it is necessary to consider the various +forms of shoes best adapted to the different forms of hoofs. Certain +properties are common to all shoes and may be considered first. They are +form, width, thickness, length, surfaces, borders, "fullering," nail +holes, and clips.</p> + +<p><i>Form.</i>—Every shoe should have the form of the hoof for which it is +intended, provided the hoof retains its proper shape; but for every hoof +that has undergone change of form we must endeavor to give the shoe that +form which the hoof originally possessed. Front shoes and hind shoes, +rights and lefts, should be distinctly different and easily +distinguishable.</p> + +<p><i>Width.</i>—All shoes should be wider at the toe than at the ends of the +branches. The average width should be about double the thickness of the +wall at the toe.</p> + +<p><i>Thickness.</i>—The thickness should be sufficient to make the shoe last +about four weeks and should be uniform except in special cases.</p> + +<p><i>Length.</i>—This will depend upon the obliquity of the hoof viewed in +profile. The acute-angled hoof (fig. 5<i>a</i>) has long overhanging heels, +and a considerable proportion of the weight borne by the leg falls in +the posterior half of the hoof. For such a hoof the branches of the shoe +should extend back of the buttresses to a distance nearly double the +thickness of the shoe. For a hoof of the regular form (figs. 5<i>b</i> and 8) +the branches should project an amount equal to the thickness of the +shoe. In a stumpy hoof (fig. 5<i>c</i>) the shoe need not project more than +one-eighth of an inch. In all cases the shoe should cover the entire +"bearing surface" of the wall.<span class='pagenum'><a name="Page_598" id="Page_598">[Pg 598]</a></span></p> + +<p><i>Surfaces.</i>—The surface that is turned toward the hoof is known as the +"upper," or "hoof surface," of the shoe. That part of the hoof surface +which is in actual contact with the horn is called the "bearing surface" +of the shoe. The "bearing surface" should be perfectly horizontal from +side to side, and wide enough to support the full thickness of the wall, +the white line, and about an eighth of an inch of the margin of the +sole. The bearing surface should also be perfectly flat, except that it +may be turned up at the toe ("rolling-motion" shoe, fig. 5 <i>a</i>, <i>b</i>, +<i>c</i>.) The surface between the bearing surface and the inner edge of the +shoe is often beaten down or concaved to prevent pressure too far inward +upon the sole. This "concaving," or "seating," should be deeper or +shallower as the horny sole is less or more concave. As a rule, strongly +"cupped" soles require no concaving (hind hoofs, narrow fore hoofs).</p> + +<p><i>Borders.</i>—The entire outer border should be beveled under the foot. +Such a shoe is not so readily loosened, nor is it so apt to lead to +interfering.</p> + +<p><i>Fullering.</i>—This is a groove in the ground surface of the shoe. It +should pass through two-thirds of the thickness of the shoe, be clean, +and of uniform width. It is of advantage in that it makes the shoe +lighter in proportion to its width and, by making the ground surface +somewhat rough, tends to prevent slipping.</p> + +<p><i>Nail holes.</i>—The shoe must be so "punched" that the nail holes will +fall directly on the white line. They should be confined to the fore +half of front shoes, but may occupy the anterior two-thirds of hind +shoes. For a medium-weight shoe three nail holes in each branch are +sufficient, but for heavier shoes, especially those provided with long +calks, eight holes are about right, though three on the inside and four +on the outside may do.</p> + +<p><i>Clips.</i>—These are half-circular ears drawn up from the outer edge of +the shoe either at the toe or opposite the side wall. The height of a +clip should equal the thickness of the shoe, though they should be even +higher on hind shoes and when a leather sole is interposed between the +shoe and hoof. Clips secure the shoe against shifting. A side clip +should always be drawn up on that branch of the shoe that first meets +the ground in locomotion.</p> + + +<h4>SPECIAL FEATURES AND FITTING THE SHOES.</h4> + +<p><i>A shoe for a regular hoof</i> (figs. 7 and 8) fits when its outer border +follows the wall closely in the region of the nail holes and from the +last nail to the end of the branch gradually projects beyond the surface +of the wall to an eighth of an inch and extends back of the buttresses +an amount equal to the thickness of the shoe. The shoe must be straight, +firm, air-tight, its nail holes directly over the white line,<span class='pagenum'><a name="Page_599" id="Page_599">[Pg 599]</a></span> and its +branches far enough from the branches of the frog to permit the passage +of a foot pick. Branches of the shoe must be of equal length.</p> + +<p>In fitting a shoe to a hoof of regular form we follow the form of the +hoof, but in base-wide and base-narrow hoofs, which are of irregular +form, we must pay attention not only to the form of the hoof but also to +the direction of the pasterns and the consequent distribution of weight +in the hoof, because where the most weight falls the surface of support +of the foot must be widened, and where the least weight falls (opposite +side of the hoof) the surface of support should be narrowed. In this way +the improper distribution of weight within the hoof is evenly +distributed over the surface of support.</p> + +<div class="figcenter" style="width: 363px;"> +<img src="images/illus_fig_7.jpg" width="363" height="450" alt="Fig. 7." title="" /> +<span class="caption">Fig. 7.—Left fore hoof of regular form, shod with a +plain "fullered" shoe. Note the distribution of the nails, length of the +fuller (crease), and the closeness of the ends of the shoe to the +branches of the frog.</span> +</div> + +<p><i>A shoe for a base-wide hoof</i> should be fitted full on the inner side of +the foot and fitted close on the outer side, because the inner side +bears the most weight. The nails in the outer branch are placed well +back, but in the inner branch are crowded forward toward the toe.</p> + +<div class="figcenter" style="width: 450px;"> +<img src="images/illus_fig_8.jpg" width="450" height="224" alt="Fig. 8." title="" /> +<span class="caption">Fig. 8.—Side view of hoof and shoe shown in fig. 7. Note +the straight toe, weak ring formation running parallel to the coronet, +clinches low down and on a level, length of the shoe, and the +under-bevel at the toe and heel.</span> +</div> + +<p><i>A shoe for a base-narrow hoof</i> should be just the reverse of the +preceding. The outer branch should be somewhat longer than the inner.<span class='pagenum'><a name="Page_600" id="Page_600">[Pg 600]</a></span></p> + +<p><i>A shoe for an acute-angled hoof</i> should be long in the branches, +because most of the weight falls in the posterior half of the foot. The +support in front should be diminished either by turning the shoe up at +the toe or by beveling it under the toe (fig. 5<i>a</i>).</p> + +<p><i>A shoe for a stumpy hoof</i> should be short in the branches, and for +pronounced cases should increase the support of the toe, where the most +of the weight falls, by being beveled downward and forward.</p> + +<p>In many cases, especially in draft horses, where the hoofs stand very +close together, the coronet of the outer quarter is found to stand out +beyond the lower border of the quarter. In such cases the outer branch +of the shoe from the last nail back must be fitted so full that an +imaginary perpendicular dropped from the coronet will just meet the +outer border of the shoe. The inner branch, on the other hand, must be +fitted as "close" as possible. The principal thought should be to set +the new shoe farther toward the more strongly worn side. Such a practice +will render unnecessary the widespread and popular fad of giving the +outer quarter and heel calk of hind shoes an extreme outward bend. Care +should be taken, however, that in fitting the shoe "full" at the quarter +the bearing surface of the hoof at the quarter be not left unsupported +or incompletely covered, to be pinched and squeezed inward against the +frog. This will be obviated by making the outer branch of the shoe +sufficiently wide and punching it so coarse that the nails will fall +upon the white line.</p> + +<p><i>Hot fitting.</i>—Few farriers have either the time or the skill necessary +to adjust a cold shoe to the hoof so that it will fit, as we say, +"air-tight." Though the opponents of hot fitting draw a lurid picture of +the direful consequences of applying a hot shoe to the hoof, it is only +the abuse of the practice that is to be condemned. If a heavy shoe at a +yellow heat be held tightly pressed against a hoof which has been pared +too thin, till it embeds itself, serious damage may be done. But a shoe +at a dark heat may be pressed against a properly dressed hoof long +enough to scorch, and thus indicate to the farrier the portions of horn +that should be lowered without appreciable injury to the hoof and to the +ultimate benefit of the animal.</p> + +<p><i>Nailing.</i>—The horse owner should insist on the nails being driven low. +They should pierce the wall not above an inch and five-eighths above the +shoe. A nail penetrating the white line and emerging low on the wall +destroys the least possible amount of horn, has a wide and strong +clinch, rather than a narrow one, which would be formed near the point +of the nail, and, furthermore, has the strongest possible hold on the +wall, because its clinch is pulling more nearly at a right angle to the +grain (horn tubes) of the wall than if driven high. Finally, do not +allow the rasp to touch the wall above the clinches.<span class='pagenum'><a name="Page_601" id="Page_601">[Pg 601]</a></span></p> + + +<h4>THE BAR SHOE.</h4> + +<p>The bar shoe (fig. 9) has a variety of uses. It enables us to give the +frog pressure, to restore it to its original state of activity and +development when, by reason of disuse, it has become atrophied. It gives +the hoof an increased surface of support and enables us to relieve one +or both quarters of undue pressure that may have induced inflammation +and soreness. The bar of the shoe should equal the average width of the +remainder of the shoe and should press but lightly on the branches of +the frog. The addition of a leather sole with tar and oakum sole-packing +allows us to distribute the weight of the body over the entire ground +surface of the hoof.</p> + +<div class="figcenter" style="width: 365px;"> +<img src="images/illus_fig_9.jpg" width="365" height="450" alt="Fig. 9." title="" /> +<span class="caption">Fig. 9.—An acute-angled left fore hoof shod with a bar +shoe. Note the width and position of the bar and the fact that the nails +are placed well toward the toe, so as not to interfere with the +expansion of the quarters.</span> +</div> + +<div class="figcenter" style="width: 267px;"> +<img src="images/illus_fig_10.jpg" width="267" height="450" alt="Fig. 10." title="" /> +<span class="caption">Fig. 10.—A fairly formed right fore ice shoe for a +roadster. The top and outer-heel calks cut at right angles, and the +inner-heel calk is slender and blunt. The back surface of the toe calk +should be perpendicular.</span> +</div> + + +<h4>THE RUBBER PAD.</h4> + +<p>Various forms of rubber pads, rubber shoes, rope shoes, fiber shoes, and +other contrivances to diminish shock and prevent slipping on the hard +and slippery pavements of our large cities are in use in different parts +of the world. In Germany the rope shoe (a malleable-iron shoe with a +groove in its ground surface in which lies a piece of tarred rope) is +extensively used with most gratifying results. It is cheap, durable, +easily applied, and effective.<span class='pagenum'><a name="Page_602" id="Page_602">[Pg 602]</a></span></p> + +<p>In the large cities of England and the United States rubber pads are +extensively used. They are rather expensive, but are quite efficient in +preventing slipping on polished and gummy pavements, though not so +effective on ice. Figure 11 is an illustration of one of the best of +many rubber pads. The rubber is stitched and cemented to a leather sole +and is secured by the nails of a three-quarter shoe. Such a pad will +usually last as long as two shoes. They may be used continuously, not +only without injury to the hoof, but to its great benefit. The belief, +unsupported by evidence, that rubber pads "draw the feet" keeps many +from using them. A human foot encased in a rubber boot may eventually be +blistered by the sweat poured upon the surface of the skin and held +there by the impervious rubber till decomposition takes place with the +formation of irritating fatty acids; but there is no basis for an +analogy in the hoof of a horse.</p> + +<div class="figcenter" style="width: 406px;"> +<img src="images/illus_fig_11.jpg" width="406" height="450" alt="Fig. 11." title="" /> +<span class="caption">Fig. 11.—Left fore hoof of regular form shod with a +rubber pad and "three-quarter" shoe. (Ground surface.)</span> +</div> + +<div class="figcenter" style="width: 396px;"> +<img src="images/illus_fig_12.jpg" width="396" height="450" alt="Fig. 12." title="" /> +<span class="caption">Fig. 12.—A narrow right fore hoof of the base-wide +(toe-wide) standing position, shod with a plain "dropped-crease" shoe to +prevent the toe cutting (interfering). The dotted line at the inner toe +indicates the edge of the wall which was rasped away in order to narrow +the hoof along the striking section. Note the inward bevel of the shoe +at this point, the dropped crease, the distribution of the nails, the +long "full" inner branch, and the short "close" outer branch.</span> +</div> + + +<h4>OTHER SPECIAL FORMS.</h4> + +<p>Some drawings, designed to illustrate shoeing in connection with +"interfering" and "forging," and other special conditions, are shown in +figures 13 to 18.<span class='pagenum'><a name="Page_603" id="Page_603">[Pg 603]</a></span></p> + +<div class="figleft" style="width: 425px;"> +<img src="images/illus_fig_13.jpg" width="425" height="450" alt="Fig. 13." title="" /> +<span class="caption">Fig. 13.—Hoof surface of a right hind shoe to prevent +interfering. The inner branch has no nail holes and is fitted and +beveled under the hoof. Note the number and position of the nail holes, +the clip on the outer side wall, and the narrowness and bend of the +inner branch.</span> +</div> + +<div class="figright" style="width: 430px;"> +<img src="images/illus_fig_14.jpg" width="430" height="450" alt="Fig. 14." title="" /> +<span class="caption">Fig. 14.—Ground surface of shoe shown in the previous +figure. The inner, nailless branch has the thickness of the outer branch +plus its calk, so that the inner and outer quarters of the hoof are +equidistant from the ground.</span> +</div><p><span class='pagenum'><a name="Page_604" id="Page_604">[Pg 604]</a></span></p> + +<div class="figleft" style="width: 450px;"> +<img src="images/illus_fig_15.jpg" width="450" height="314" alt="Fig. 15." title="" /> +<span class="caption">Fig. 15.—Side view of a fore hoof shod so as to quicken +the "breaking over" (quicken the action) in a "forger." Note the short +shoe, heel calks inclined forward, and the rolled toe.</span> +</div> + +<div class="figright" style="width: 450px;"> +<img src="images/illus_fig_16.jpg" width="450" height="274" alt="Fig. 16." title="" /> +<span class="caption">Fig. 16.—Side view of a short-toed hind hoof of a +forger, shod to slow the action and to prevent injury to the fore heels +by the toe of the hind shoe. Note the elevation of the short toe by +means of a toe calk and the projection of the toe beyond the shoe. When +such a hoof has grown more toe, the toe calk can be dispensed with and +the shoe set farther forward.</span> +</div><p><span class='pagenum'><a name="Page_605" id="Page_605">[Pg 605]</a></span></p> + +<div class="figleft" style="width: 441px;"> +<img src="images/illus_fig_17.jpg" width="441" height="450" alt="Fig. 17." title="" /> +<span class="caption">Fig. 17.—A toe-weight shoe to increase the length of +stride of fore feet. The nails are placed too far back, and the shoe has +no characteristic form but the weight is properly placed.</span> +</div> + +<div class="figright" style="width: 450px;"> +<img src="images/illus_fig_18.jpg" width="450" height="370" alt="Fig. 18." title="" /> +<span class="caption">Fig. 18.—Most common form of punched heel-weight shoe to +induce high action in fore feet. The profile of the shoe shows a "roll" +at the toe and "swelled" heels. The weight is well placed, but "rolling" +the toe and raising the heels lower action. The shoe would be much more +effective if of uniform thickness and with no roll at the toe.</span> +</div> + + + +<hr style="width: 65%;" /> +<p><span class='pagenum'><a name="Page_607" id="Page_607">[Pg 607]</a></span></p> +<h2>INDEX.</h2> + + +<p> +Abdomen—<br /> +<span style="margin-left: 1em;">dropsy, in foal, or ascites, description and treatment, <a href='#Page_193'>193</a></span><br /> +<span style="margin-left: 1em;">dropsy, or ascites, description, symptoms, and treatment, <a href='#Page_86'>86</a></span><br /> +<span style="margin-left: 1em;">limbs, and perineum, dropsy affecting, description and treatment, <a href='#Page_180'>180</a></span><br /> +<span style="margin-left: 1em;">sheath, and penis, swelling, cause and treatment, <a href='#Page_171'>171</a></span><br /> +<br /> +Abnormal presentations at birth, <a href='#Page_197'>197</a>-202<br /> +<br /> +Abortion, description, cause, symptoms, and treatment, <a href='#Page_182'>182</a><br /> +<br /> +Abscess—<br /> +<span style="margin-left: 1em;">and inflammation of lymphatic glands, descriptions, symptoms, treatment, <a href='#Page_272'>272</a></span><br /> +<span style="margin-left: 1em;">in lung and suppuration, symptoms, <a href='#Page_127'>127</a></span><br /> +<br /> +Abscesses—<br /> +<span style="margin-left: 1em;">acute, description and treatment, <a href='#Page_500'>500</a></span><br /> +<span style="margin-left: 1em;">cold, description and treatment, <a href='#Page_501'>501</a></span><br /> +<span style="margin-left: 1em;">description, <a href='#Page_500'>500</a></span><br /> +<span style="margin-left: 1em;">in throat, treatment, <a href='#Page_62'>62</a></span><br /> +<br /> +<i>Acari</i>, parasites of eye, <a href='#Page_296'>296</a><br /> +<br /> +Acariasis, or mange, note, <a href='#Page_478'>478</a><br /> +<br /> +<i>Achorion schönleini</i>, vegetable parasite of skin, description, <a href='#Page_478'>478</a><br /> +<br /> +Adams, John W., chapter on "Horseshoeing", <a href='#Page_583'>583</a>-605<br /> +<br /> +Air embolism, or air in veins, note, <a href='#Page_270'>270</a><br /> +<br /> +Albuminoid poisoning, hemoglobinuria, azoturia, azotemia, symptoms, prevention, and treatment, <a href='#Page_141'>141</a><br /> +<br /> +Aloes, use against bots in horses, <a href='#Page_93'>93</a><br /> +<br /> +Amaurosis, or palsy of nerve of sight, causes, symptoms, and treatment, <a href='#Page_231'>231</a>, <a href='#Page_295'>295</a><br /> +<br /> +Amnion, dropsy, description and treatment, <a href='#Page_180'>180</a><br /> +<br /> +Anasarca, or purpura hemorrhagica, causes, symptoms, treatment, etc., <a href='#Page_531'>531</a>,<br /> +533<br /> +<br /> +Anatomy and physiology of brain and nervous system, <a href='#Page_210'>210</a><br /> +<br /> +Anemia—<br /> +<span style="margin-left: 1em;">of brain, causes, symptoms, pathology, and treatment, <a href='#Page_223'>223</a></span><br /> +<span style="margin-left: 1em;">spinal, symptoms and treatment, <a href='#Page_234'>234</a></span><br /> +<br /> +Aneurism—<br /> +<span style="margin-left: 1em;">description, symptoms, pathology, and treatment, <a href='#Page_265'>265</a></span><br /> +<span style="margin-left: 1em;">one form caused by <i>Strongylus vulgaris</i>, <a href='#Page_265'>265</a></span><br /> +<br /> +Anidian monsters, or moles, description, <a href='#Page_179'>179</a><br /> +<br /> +Animal parasites, description of kinds, <a href='#Page_478'>478</a><br /> +<br /> +Ankle—<br /> +<span style="margin-left: 1em;">and fetlock, skin, note, <a href='#Page_397'>397</a></span><br /> +<span style="margin-left: 1em;">fetlock, and foot, diseases, chapter by A. A. Holcombe, <a href='#Page_395'>395</a>-457</span><br /> +<br /> +Ankles, cocked, or knuckling, description, causes, and treatment, <a href='#Page_400'>400</a><br /> +<br /> +Anthrax—<br /> +<span style="margin-left: 1em;">definition, causes, symptoms, and treatment, <a href='#Page_540'>540</a>-544</span><br /> +<span style="margin-left: 1em;">prevention by destruction of bacteria, <a href='#Page_544'>544</a></span><br /> +<span style="margin-left: 1em;">vaccination as preventive, <a href='#Page_544'>544</a></span><br /> +<br /> +Apoplexy, or cerebral hemorrhage, causes, symptoms, pathology, and treatment, <a href='#Page_220'>220</a><br /> +<br /> +Arteries—<br /> +<span style="margin-left: 1em;">description, <a href='#Page_249'>249</a></span><br /> +<span style="margin-left: 1em;">diseases, or arteritis, and endarteritis, description, symptoms, pathology, and treatment, <a href='#Page_263'>263</a></span><br /> +<br /> +Artery—<br /> +<span style="margin-left: 1em;">constriction, description, <a href='#Page_265'>265</a></span><br /> +<span style="margin-left: 1em;">rupture, description, symptoms, and treatment, <a href='#Page_266'>266</a></span><br /> +<br /> +Arthritis, open joints, broken knees, and synovitis, cause and treatment, <a href='#Page_357'>357</a><br /> +<br /> +<i>Ascaris equorum</i>, intestinal worm, note, <a href='#Page_90'>90</a><br /> +<br /> +Ascites, or dropsy of abdomen, description, symptoms, and treatment, <a href='#Page_86'>86</a>, <a href='#Page_193'>193</a><br /> +<br /> +Asthma, heaves, or broken wind, definition, symptoms, and treatment, <a href='#Page_128'>128</a><br /> +<br /> +Atheroma of veins and arteries, description, <a href='#Page_264'>264</a><br /> +<br /> +<span class='pagenum'><a name="Page_608" id="Page_608">[Pg 608]</a></span>Autogenic vaccines, description, <a href='#Page_506'>506</a><br /> +<br /> +Autumn mange, description and treatment, <a href='#Page_480'>480</a><br /> +<br /> +Azotemia, hemoglobinuria, azoturia, poisoning by albuminoids, symptom, prevention, and treatment, <a href='#Page_141'>141</a><br /> +<br /> +Azoturia, hemoglobinuria, azotemia, poisoning by albuminoids, symptoms, prevention, and treatment, <a href='#Page_141'>141</a><br /> +<br /> +<br /> +<i>Bacillus equisepticus</i>, cause of pneumonia, <a href='#Page_522'>522</a><br /> +<br /> +Bacteria, kinds responsible for pneumonia in horses, <a href='#Page_522'>522</a><br /> +<br /> +Bacteria vaccines, kinds and uses, <a href='#Page_506'>506</a>, <a href='#Page_531'>531</a><br /> +<br /> +Balls, or pills, description and manner of administering, <a href='#Page_44'>44</a><br /> +<br /> +Bar shoe, uses, <a href='#Page_601'>601</a><br /> +<br /> +Bees, wasps, and hornets, stings, treatment, <a href='#Page_485'>485</a><br /> +<br /> +Beets as feed, <a href='#Page_56'>56</a><br /> +<br /> +Bichlorid, use in disinfection, <a href='#Page_509'>509</a><br /> +<br /> +Bighead (osteoporosis)—<br /> +<span style="margin-left: 1em;">chapter by John R. Mohler, <a href='#Page_578'>578</a>-582</span><br /> +<span style="margin-left: 1em;">symptoms, lesions, and treatment, <a href='#Page_580'>580</a></span><br /> +<br /> +Biliary calculi, or gallstones, symptoms and treatment, <a href='#Page_90'>90</a><br /> +<br /> +Bilocular cavity, or calculus in sheath, or preputial calculus, description and treatment, <a href='#Page_163'>163</a><br /> +<br /> +Birth, abnormal presentations at, <a href='#Page_197'>197</a>-202<br /> +<br /> +Black pigment tumors, or melanosis, description and treatment, <a href='#Page_476'>476</a><br /> +<br /> +Bladder—<br /> +<span style="margin-left: 1em;">calculus, or stone, and tumor affecting, <a href='#Page_190'>190</a></span><br /> +<span style="margin-left: 1em;">diseases growths, symptoms and treatment, <a href='#Page_151'>151</a></span><br /> +<span style="margin-left: 1em;">eversion, description and treatment, <a href='#Page_152'>152</a></span><br /> +<span style="margin-left: 1em;">inflammation, cystitis, or urocystitis, symptoms and treatment, <a href='#Page_149'>149</a></span><br /> +<span style="margin-left: 1em;">irritable, cause and treatment, <a href='#Page_150'>150</a></span><br /> +<span style="margin-left: 1em;">neck, spasms affecting, causes, symptoms, and treatment, <a href='#Page_146'>146</a>, <a href='#Page_225'>225</a></span><br /> +<span style="margin-left: 1em;">paralysis, description and cause, <a href='#Page_230'>230</a></span><br /> +<span style="margin-left: 1em;">paralysis, symptoms and treatment, <a href='#Page_148'>148</a></span><br /> +<span style="margin-left: 1em;">stone, vesical calculus, or cystic calculus, description, symptoms, and treatment, <a href='#Page_159'>159</a></span><br /> +<span style="margin-left: 1em;">worm of kidney, <a href='#Page_146'>146</a></span><br /> +<br /> +Bleeding—<br /> +<span style="margin-left: 1em;">after castration, treatment, <a href='#Page_170'>170</a></span><br /> +<span style="margin-left: 1em;">from lungs, or hemoptysis, causes, description, and treatment, <a href='#Page_127'>127</a></span><br /> +<span style="margin-left: 1em;">from nose, causes and treatment, <a href='#Page_103'>103</a></span><br /> +<span style="margin-left: 1em;">or flooding from womb, treatment, <a href='#Page_205'>205</a></span><br /> +<span style="margin-left: 1em;">skin eruptions, or <i>Dermatorrhagia parasitica</i>, description and treatment, <a href='#Page_469'>469</a></span><br /> +<br /> +Blisters, inflammation, or eczema, description and treatment, <a href='#Page_464'>464</a><br /> +<br /> +Bloat colic, cause, symptoms, and treatment, <a href='#Page_73'>73</a><br /> +<br /> +Blood—<br /> +<span style="margin-left: 1em;">circulation of heart, description, <a href='#Page_248'>248</a></span><br /> +<span style="margin-left: 1em;">clots in walls of vagina, <a href='#Page_207'>207</a></span><br /> +<span style="margin-left: 1em;">medicine administered into veins, <a href='#Page_48'>48</a></span><br /> +<span style="margin-left: 1em;">medium of disease transmission, <a href='#Page_511'>511</a></span><br /> +<span style="margin-left: 1em;">of penis, extravasation, cause and treatment, <a href='#Page_167'>167</a></span><br /> +<span style="margin-left: 1em;">spavin, bog spavin, and thoroughpin, description and treatment, <a href='#Page_356'>356</a></span><br /> +<br /> +Blood vessels—<br /> +<span style="margin-left: 1em;">and heart, diseases, remarks, <a href='#Page_250'>250</a></span><br /> +<span style="margin-left: 1em;">heart, and lymphatics, diseases, chapter by M. R. Trumbower, <a href='#Page_247'>247</a>-273</span><br /> +<span style="margin-left: 1em;">physiology and anatomy, <a href='#Page_247'>247</a></span><br /> +<br /> +Bloody urine, or hematuria, cause and treatment, <a href='#Page_141'>141</a><br /> +<br /> +Blowing, high, description, <a href='#Page_110'>110</a><br /> +<br /> +Bluebottle (<i>Lucilia cæsar</i>), note <a href='#Page_481'>481</a><br /> +<br /> +Bog spavin, blood spavin, and thoroughpin, description and treatment, <a href='#Page_356'>356</a><br /> +<br /> +Boil of eyelid, description and treatment, <a href='#Page_282'>282</a><br /> +<br /> +Boils—<br /> +<span style="margin-left: 1em;">or <i>Dermatitis granulosa</i>, <a href='#Page_469'>469</a></span><br /> +<span style="margin-left: 1em;">or furuncles, description and treatment, <a href='#Page_466'>466</a></span><br /> +<br /> +Bone—<br /> +<span style="margin-left: 1em;">hip, fracture, or on innominatum, description, symptoms, prognosis, and treatment, <a href='#Page_341'>341</a></span><br /> +<span style="margin-left: 1em;">premaxillary, fractures, description and treatment, <a href='#Page_336'>336</a></span><br /> +<span class='pagenum'><a name="Page_609" id="Page_609">[Pg 609]</a></span><span style="margin-left: 1em;">spavin. <i>See</i> Spavin</span><br /> +<br /> +Bones—<br /> +<span style="margin-left: 1em;">cannon, fractures, description, symptoms, and treatment, <a href='#Page_350'>350</a>, <a href='#Page_395'>395</a></span><br /> +<span style="margin-left: 1em;">cranial, fractures, causes, symptoms, and treatment, <a href='#Page_335'>335</a></span><br /> +<span style="margin-left: 1em;">diseases, description, <a href='#Page_309'>309</a></span><br /> +<span style="margin-left: 1em;">dislocations and luxations, cause, symptoms, and treatment, <a href='#Page_361'>361</a></span><br /> +<span style="margin-left: 1em;">of face, fractures, description, and treatment, <a href='#Page_366'>366</a></span><br /> +<span style="margin-left: 1em;">of fetlock and foot, description, <a href='#Page_395'>395</a></span><br /> +<span style="margin-left: 1em;">of hip, fractures, causes, <a href='#Page_188'>188</a></span><br /> +<span style="margin-left: 1em;">one system of locomotion, <a href='#Page_299'>299</a>, <a href='#Page_301'>301</a></span><br /> +<span style="margin-left: 1em;">sesamoid, fractures, cause, symptoms, prognosis, and treatment, <a href='#Page_352'>352</a></span><br /> +<br /> +Botfly, habits and treatment, <a href='#Page_93'>93</a><br /> +<br /> +Bots, injury to horses, symptoms, and treatment, <a href='#Page_93'>93</a>-94<br /> +<br /> +Bowels, twisting, volvulus, or gut-tie, cause, symptoms, and treatment, <a href='#Page_72'>72</a><br /> +<br /> +Brain—<br /> +<span style="margin-left: 1em;">and membranes, inflammation, description, <a href='#Page_212'>212</a>, <a href='#Page_213'>213</a></span><br /> +<span style="margin-left: 1em;">and nervous system, anatomy, and physiology, <a href='#Page_210'>210</a></span><br /> +<span style="margin-left: 1em;">anemia, causes, symptoms, pathology, and treatment, <a href='#Page_223'>223</a></span><br /> +<span style="margin-left: 1em;">compression, causes, symptoms, and treatment, <a href='#Page_221'>221</a></span><br /> +<span style="margin-left: 1em;">concussion, causes, symptoms, treatment, and prevention, <a href='#Page_222'>222</a></span><br /> +<span style="margin-left: 1em;">congestion, or megrims, description, causes, symptoms, treatment, and prevention, <a href='#Page_217'>217</a></span><br /> +<span style="margin-left: 1em;">description, <a href='#Page_211'>211</a></span><br /> +<span style="margin-left: 1em;">dropsy, or hydrocephalus, causes, symptoms, and treatment, <a href='#Page_223'>223</a></span><br /> +<br /> +Bran, value as feed, <a href='#Page_55'>55</a><br /> +<br /> +Broken knee, open joints, synovitis, and arthritis, cause, prognosis, and treatment, <a href='#Page_357'>357</a><br /> +<br /> +Broken wind, heaves, or asthma, definition, symptoms, and treatment, <a href='#Page_128'>128</a><br /> +<br /> +Bronchitis—<br /> +<span style="margin-left: 1em;">and broncho-pneumonia, description, symptoms, and treatment, <a href='#Page_120'>120</a></span><br /> +<span style="margin-left: 1em;">chronic, description and treatment, <a href='#Page_110'>110</a></span><br /> +<br /> +Broncho-pleuropneumonia, description, <a href='#Page_126'>126</a><br /> +<br /> +Broncho-pneumonia and bronchitis, description, symptoms, and treatment, <a href='#Page_120'>120</a><br /> +<br /> +Bruise of frog, causes, symptoms, and treatment, <a href='#Page_425'>425</a><br /> +<br /> +Burns and scalds, treatment, <a href='#Page_483'>483</a>, <a href='#Page_496'>496</a><br /> +<br /> +<br /> +Calculi—<br /> +<span style="margin-left: 1em;">biliary, or gallstones, symptoms and treatment, <a href='#Page_90'>90</a></span><br /> +<span style="margin-left: 1em;">or stones, in intestines, description, symptoms, and treatment, <a href='#Page_71'>71</a></span><br /> +<span style="margin-left: 1em;">or stones, in stomach, symptoms and treatment, <a href='#Page_70'>70</a></span><br /> +<span style="margin-left: 1em;">renal, description, symptoms, and treatment, <a href='#Page_158'>158</a></span><br /> +<span style="margin-left: 1em;">ureteric, description and treatment, <a href='#Page_158'>158</a>-159</span><br /> +<span style="margin-left: 1em;">urinary, classification, <a href='#Page_157'>157</a></span><br /> +<span style="margin-left: 1em;">urinary, stone, or gravel, <a href='#Page_154'>154</a>, <a href='#Page_156'>156</a></span><br /> +<br /> +Calculus—<br /> +<span style="margin-left: 1em;">in sheath, or bilocular cavity, or preputial calculus, description, and treatment, <a href='#Page_163'>163</a></span><br /> +<span style="margin-left: 1em;">or stone, and tumor in bladder, <a href='#Page_190'>190</a></span><br /> +<span style="margin-left: 1em;">urethral, or stone in urethra, description, symptoms, and treatment, <a href='#Page_162'>162</a></span><br /> +<span style="margin-left: 1em;">vesical, stone in bladder, or cystic calculus, description, symptoms, and treatment, <a href='#Page_159'>159</a></span><br /> +<br /> +Calk wounds, description and treatment, <a href='#Page_405'>405</a><br /> +<br /> +Callosities—<br /> +<span style="margin-left: 1em;">description, <a href='#Page_475'>475</a></span><br /> +<span style="margin-left: 1em;">sloughing, horny sloughs, or sitfasts, description and treatment, <a href='#Page_475'>475</a>, <a href='#Page_496'>496</a></span><br /> +<br /> +Cancer, epithelial, or epithelioma, description and treatment, <a href='#Page_477'>477</a><br /> +<br /> +Canker—<br /> +<span style="margin-left: 1em;">of foot, description, causes, symptoms, and treatment, <a href='#Page_418'>418</a></span><br /> +<span style="margin-left: 1em;">or grease (inflammation of heels with sebaceous secretion), description, causes, symptoms, and treatment, <a href='#Page_472'>472</a></span><br /> +<br /> +Cannon bone—<br /> +<span style="margin-left: 1em;">description, <a href='#Page_395'>395</a></span><br /> +<span style="margin-left: 1em;">fractures, description, symptoms, and treatment, <a href='#Page_350'>350</a></span><br /> +<br /> +Capped elbow, cause, symptoms, and treatment, <a href='#Page_379'>379</a><br /> +<br /> +Capped hock, cause, symptoms, and treatment, <a href='#Page_385'>385</a><br /> +<br /> +Capped knee, description, cause, treatment, etc., <a href='#Page_383'>383</a><br /> +<br /> +<span class='pagenum'><a name="Page_610" id="Page_610">[Pg 610]</a></span>Carbolic acid, use in disinfection, <a href='#Page_509'>509</a><br /> +<br /> +Carbon disulphid, use against worms in horse, <a href='#Page_93'>93</a>, <a href='#Page_94'>94</a><br /> +<br /> +Cardiac enlargement, or hypertrophy of heart, description, symptoms, and treatment, <a href='#Page_260'>260</a><br /> +<br /> +Caries of cartilage, or tumor of haw, description and treatment, <a href='#Page_284'>284</a><br /> +<br /> +Carrots, value as feed, <a href='#Page_56'>56</a><br /> +<br /> +Cartilaginous quittor, description, causes, symptoms, and treatment, <a href='#Page_415'>415</a><br /> +<br /> +Cartilago nictitans, or winking cartilage (the haw), description, <a href='#Page_276'>276</a><br /> +<br /> +Castration—<br /> +<span style="margin-left: 1em;">bleeding after operation, treatment, <a href='#Page_170'>170</a></span><br /> +<span style="margin-left: 1em;">by covered operation, method, <a href='#Page_172'>172</a></span><br /> +<span style="margin-left: 1em;">of cryptorchids, or ridglings, method, <a href='#Page_169'>169</a></span><br /> +<span style="margin-left: 1em;">of mare, method, <a href='#Page_172'>172</a></span><br /> +<span style="margin-left: 1em;">of stallions, method, <a href='#Page_168'>168</a></span><br /> +<span style="margin-left: 1em;">pain after operation, treatment, <a href='#Page_170'>170</a></span><br /> +<span style="margin-left: 1em;">successful method, <a href='#Page_169'>169</a></span><br /> +<br /> +Cataract, remarks, <a href='#Page_295'>295</a><br /> +<br /> +Catarrh—<br /> +<span style="margin-left: 1em;">chronic, nasal gleet or collection in sinuses, causes, symptoms, and treatment, <a href='#Page_99'>99</a></span><br /> +<span style="margin-left: 1em;">gastrointestinal, or indigestion, cause, symptoms, and treatment, <a href='#Page_76'>76</a></span><br /> +<span style="margin-left: 1em;">nasal, or cold in head, symptoms, and treatment, <a href='#Page_98'>98</a></span><br /> +<br /> +Cerebral hemorrhage, or apoplexy, causes, symptoms, and treatment, <a href='#Page_220'>220</a><br /> +<br /> +Cerebritis, causes, symptoms, and treatment, <a href='#Page_212'>212</a><br /> +<br /> +Cerebrospinal meningitis, so called, or forage poisoning, causes, symptoms, and treatment, <a href='#Page_237'>237</a><br /> +<br /> +Cervical choke, description, <a href='#Page_63'>63</a>, <a href='#Page_64'>64</a><br /> +<br /> +Chaff for feeding, <a href='#Page_54'>54</a><br /> +<br /> +Chaps on knee and hock, scratches, or cracked heels, description, causes, and treatment, <a href='#Page_470'>470</a><br /> +<br /> +Chest walls, wounds penetrating, description and treatment, <a href='#Page_131'>131</a><br /> +<br /> +Chicken acari, or <i>Dermanyssus gallinæ</i>, animal parasite of skin, <a href='#Page_480'>480</a><br /> +<br /> +Chigoe, or jigger—<br /> +<span style="margin-left: 1em;">larvæ of <i>Trombidium</i>, <i>Leptus americanus</i>, animal parasite of skin, <a href='#Page_480'>480</a></span><br /> +<span style="margin-left: 1em;"><i>Pulex penetrans</i>, bite, treatment, <a href='#Page_482'>482</a></span><br /> +<br /> +Choke—<br /> +<span style="margin-left: 1em;">cervical, description, <a href='#Page_63'>63</a>, <a href='#Page_64'>64</a></span><br /> +<span style="margin-left: 1em;">pharyngeal, cervical, and thoracic, symptoms and treatment, <a href='#Page_63'>63</a></span><br /> +<br /> +Chorea, or St. Vitus dance, description and treatment <a href='#Page_227'>227</a><br /> +<br /> +<i>Chorioptes</i>—<br /> +<span style="margin-left: 1em;"><i>bovis</i> (<i>Symbiotes equi</i>, <i>Dermatophagus equi</i>), animal parasite of skin, <a href='#Page_480'>480</a></span><br /> +<span style="margin-left: 1em;"><i>spathiferus</i>, animal parasite of skin, <a href='#Page_480'>480</a></span><br /> +<br /> +Choroiditis, cause, symptoms, and treatment, <a href='#Page_288'>288</a><br /> +<br /> +Chronic bronchitis, description and treatment, <a href='#Page_110'>110</a><br /> +<br /> +Circinate ringworm, or <i>Tinea tonsurans</i>, description, symptoms, treatment, <a href='#Page_477'>477</a><br /> +<br /> +Circulation organs, methods of examination, <a href='#Page_13'>13</a><br /> +<br /> +Clubfoot, description, <a href='#Page_398'>398</a><br /> +<br /> +Clysters, or enemas, description and manner of administering, <a href='#Page_48'>48</a><br /> +<br /> +Cocked ankles, or knuckling, description, causes, and treatment, <a href='#Page_400'>400</a><br /> +<br /> +Coffin joint, description, <a href='#Page_396'>396</a><br /> +<br /> +Coffinbone, description, <a href='#Page_396'>396</a><br /> +<br /> +Cold in head, or nasal catarrh, symptoms and treatment, <a href='#Page_98'>98</a><br /> +<br /> +Colic—<br /> +<span style="margin-left: 1em;">bloat, cause, symptoms, and treatment, <a href='#Page_73'>73</a></span><br /> +<span style="margin-left: 1em;">cramp, or spasmodic, cause, symptoms, and treatment, <a href='#Page_74'>74</a></span><br /> +<span style="margin-left: 1em;">flatulent, cause, symptoms, and treatment, <a href='#Page_73'>73</a></span><br /> +<span style="margin-left: 1em;">obstruction, caused by impaction of large intestine, symptoms, and treatment, <a href='#Page_68'>68</a></span><br /> +<span style="margin-left: 1em;">specific forms, <a href='#Page_66'>66</a></span><br /> +<span style="margin-left: 1em;">wind, cause, symptoms, and treatment, <a href='#Page_73'>73</a></span><br /> +<span style="margin-left: 1em;">worms, description, symptoms, and treatment, <a href='#Page_90'>90</a>-94</span><br /> +<span style="margin-left: 1em;">tympanitic, cause, symptoms, and treatment, <a href='#Page_73'>73</a></span><br /> +<br /> +Colt. <i>See</i> Foal.<br /> +<br /> +Compression of brain, causes, symptoms, and treatment <a href='#Page_222'>222</a><br /> +<br /> +Concussion—<br /> +<span style="margin-left: 1em;">of brain, causes, symptoms, and treatment, <a href='#Page_222'>222</a></span><br /> +<span class='pagenum'><a name="Page_611" id="Page_611">[Pg 611]</a></span><span style="margin-left: 1em;">spinal, causes and treatment, <a href='#Page_235'>235</a></span><br /> +<br /> +Conformation—<br /> +<span style="margin-left: 1em;">of foot, faults, <a href='#Page_398'>398</a></span><br /> +<span style="margin-left: 1em;">of horse, <a href='#Page_10'>10</a></span><br /> +<br /> +Congenital scrotal hernia, description and treatment, <a href='#Page_82'>82</a><br /> +<br /> +Congestion—<br /> +<span style="margin-left: 1em;">active, causes, <a href='#Page_30'>30</a></span><br /> +<span style="margin-left: 1em;">and inflammation of skin, description of kinds, <a href='#Page_461'>461</a></span><br /> +<span style="margin-left: 1em;">and inflammation of testicles, or orchitis, causes, symptoms, and treatment, <a href='#Page_164'>164</a></span><br /> +<span style="margin-left: 1em;">description, <a href='#Page_30'>30</a></span><br /> +<span style="margin-left: 1em;">of brain, or megrims, causes, symptoms, treatment, etc., <a href='#Page_217'>217</a></span><br /> +<span style="margin-left: 1em;">of heart, description and symptoms, <a href='#Page_263'>263</a></span><br /> +<span style="margin-left: 1em;">of lungs, description and treatment, <a href='#Page_111'>111</a></span><br /> +<span style="margin-left: 1em;">of skin, red efflorescence, or erythema, description and treatment, <a href='#Page_461'>461</a></span><br /> +<span style="margin-left: 1em;">of skin, with small pimples, or pauples, description and treatment, <a href='#Page_463'>463</a></span><br /> +<span style="margin-left: 1em;">of spine, cause, symptoms, and treatment, <a href='#Page_233'>233</a></span><br /> +<span style="margin-left: 1em;">passive, causes, <a href='#Page_31'>31</a></span><br /> +<br /> +Conjunctives, or external ophthalmia, description, causes, symptoms, and treatment, <a href='#Page_285'>285</a><br /> +<br /> +Constipation, or costiveness, cause and treatment, <a href='#Page_70'>70</a>, <a href='#Page_181'>181</a><br /> +<br /> +Constitution of horse, <a href='#Page_10'>10</a><br /> +<br /> +Consumption, or tuberculosis, note, <a href='#Page_128'>128</a><br /> +<br /> +Contagious pneumonia, discussion, <a href='#Page_521'>521</a>-527<br /> +<br /> +Convulsions, description and treatment, <a href='#Page_226'>226</a><br /> +<br /> +Cord—<br /> +<span style="margin-left: 1em;">spermatic, strangulated, cause and treatment, <a href='#Page_170'>170</a></span><br /> +<span style="margin-left: 1em;">spermatic, tumors, causes and treatment, <a href='#Page_171'>171</a></span><br /> +<span style="margin-left: 1em;">spinal, description, <a href='#Page_212'>212</a></span><br /> +<br /> +Corn, or maize, how to feed, <a href='#Page_55'>55</a><br /> +<br /> +Cornea—<br /> +<span style="margin-left: 1em;">ulcers, treatment, <a href='#Page_288'>288</a></span><br /> +<span style="margin-left: 1em;">white specks and cloudiness, cause and treatment, <a href='#Page_288'>288</a></span><br /> +<br /> +Corns, description, causes, symptoms, and treatment, <a href='#Page_421'>421</a><br /> +<br /> +Coronary band, description, <a href='#Page_397'>397</a><br /> +<br /> +Coronet—<br /> +<span style="margin-left: 1em;">description, <a href='#Page_396'>396</a></span><br /> +<span style="margin-left: 1em;">fractures, symptoms and treatment, <a href='#Page_351'>351</a></span><br /> +<br /> +Costiveness, or constipation, cause and treatment, <a href='#Page_70'>70</a>, <a href='#Page_181'>181</a><br /> +<br /> +Cough, chronic, description, <a href='#Page_131'>131</a><br /> +<br /> +Cracked heels, or scratches, causes and treatment, <a href='#Page_470'>470</a><br /> +<br /> +Cramp—<br /> +<span style="margin-left: 1em;">of hind limb, or spasm of thigh, description and treatment, <a href='#Page_226'>226</a></span><br /> +<span style="margin-left: 1em;">or spasmodic, or colic, cause, symptoms, and treatment, <a href='#Page_74'>74</a></span><br /> +<br /> +Cramps—<br /> +<span style="margin-left: 1em;">of hind limbs, cause and treatment, <a href='#Page_181'>181</a></span><br /> +<span style="margin-left: 1em;">or spasms, causes and treatment, <a href='#Page_226'>226</a></span><br /> +<br /> +Cranial bones, fractures, causes, symptoms, and treatment, <a href='#Page_335'>335</a><br /> +<br /> +Cranium, tumor within, description of kinds, <a href='#Page_224'>224</a><br /> +<br /> +Cresol, use in disinfection, <a href='#Page_579'>579</a><br /> +<br /> +Crookedfoot, description, <a href='#Page_399'>399</a><br /> +<br /> +Croup and diphtheria, mistakes in diagnosis, <a href='#Page_108'>108</a><br /> +<br /> +Cryptorchids, or ridglings, castration, method, <a href='#Page_169'>169</a><br /> +<br /> +Curb of hock, cause, symptoms, and treatment, <a href='#Page_374'>374</a><br /> +<br /> +Currying, value as preventive of bots, <a href='#Page_94'>94</a><br /> +<br /> +Cutaneous quittor, description, causes, symptoms, and treatment, <a href='#Page_407'>407</a><br /> +<br /> +Cuticle, description, <a href='#Page_459'>459</a><br /> +<br /> +Cyanosis of newborn foals, description, <a href='#Page_263'>263</a><br /> +<br /> +<i>Cylicostomum</i> spp., parasite, danger and remedies, <a href='#Page_92'>92</a>-93<br /> +<br /> +Cystic calculus, or stone in bladder, description, symptoms, and treatment, <a href='#Page_159'>159</a><br /> +<br /> +Cystic disease of wall of womb, or vesticular mole, description and treatment, <a href='#Page_179'>179</a><br /> +<br /> +<i>Cysticercus</i>, parasite of eye, <a href='#Page_297'>297</a><br /> +<br /> +Cystitis, inflammation of bladder, or urocystitis, symptoms and treatment, <a href='#Page_149'>149</a><br /> +<br /> +<br /> +<i>Dermanyssus gallinæ</i>, or chicken acari, animal parasite of skin, <a href='#Page_480'>480</a><br /> +<br /> +<i>Dermatitis granulosa</i>, or boils, <a href='#Page_469'>469</a><br /> +<br /> +<i>Dermatocoptes equi</i>, animal parasite of skin, <a href='#Page_480'>480</a><br /> +<br /> +<i>Dermatodectes equi</i>, animal parasite of skin, <a href='#Page_480'>480</a><br /> +<br /> +<span class='pagenum'><a name="Page_612" id="Page_612">[Pg 612]</a></span><i>Dermatophagus equi</i>, animal parasite of skin, <a href='#Page_480'>480</a><br /> +<br /> +<i>Dermatorrhagia parasitica</i>, or bleeding skin eruptions, description and treatment, <a href='#Page_469'>469</a><br /> +<br /> +Dermis, or true skin, description, <a href='#Page_459'>459</a><br /> +<br /> +Descazeaux, study of summer sores, note, <a href='#Page_470'>470</a><br /> +<br /> +Diabetes—<br /> +<span style="margin-left: 1em;">insipidous, diuresis, polyuria, or excessive secretion of urine, causes, symptoms, and treatment, <a href='#Page_138'>138</a></span><br /> +<span style="margin-left: 1em;">mellitus, saccharine diabetes, glycosuria, or inosuria, causes, symptoms, and treatment, <a href='#Page_139'>139</a></span><br /> +<br /> +Diaphragm—<br /> +<span style="margin-left: 1em;">rupture, cause and symptoms, <a href='#Page_133'>133</a></span><br /> +<span style="margin-left: 1em;">spasm, or thumps, description and treatment, <a href='#Page_132'>132</a>, <a href='#Page_225'>225</a></span><br /> +<br /> +Diaphragmatic hernia, description, <a href='#Page_85'>85</a><br /> +<br /> +Diarrhea, causes, symptoms, and treatment, <a href='#Page_77'>77</a><br /> +<br /> +Dieckerhoff, experiments in disease transmission, note, <a href='#Page_511'>511</a><br /> +<br /> +Digestive organs, diseases, chapter by Ch. B. Michener, <a href='#Page_49'>49</a>-94<br /> +<br /> +Digestive tract, examination, <a href='#Page_20'>20</a><br /> +<br /> +Dilatation—<br /> +<span style="margin-left: 1em;">of heart, description, causes, symptoms, and treatment, <a href='#Page_261'>261</a></span><br /> +<span style="margin-left: 1em;">of veins, varicose, or varix, causes and treatment, <a href='#Page_269'>269</a></span><br /> +<br /> +<i>Dioctophyme renale</i>, roundworm of kidney, <a href='#Page_146'>146</a><br /> +<br /> +Diphtheria and cramp, mistakes in diagnosis, <a href='#Page_108'>108</a><br /> +<br /> +Dips, use against mange in horses, <a href='#Page_479'>479</a><br /> +<br /> +Diseases, fundamental principles of, chapter by Rush Shippen Huidekoper, <a href='#Page_27'>27</a>-43<br /> +<br /> +Disinfection, directions and materials, <a href='#Page_508'>508</a>-509<br /> +<br /> +Dislocations and luxations of bones, causes, symptoms, treatment, etc., <a href='#Page_361'>361</a><br /> +<br /> +Distemper, cause, symptoms, and treatment, <a href='#Page_527'>527</a>-531<br /> +<br /> +Diuresis, polyuria, diabetes insipidus, or excessive secretion of urine, causes, symptoms, and treatment, <a href='#Page_138'>138</a><br /> +<br /> +Douche, nasal, in administering medicines, <a href='#Page_47'>47</a><br /> +<br /> +Dourine, or maladie du coït—<br /> +<span style="margin-left: 1em;">article by John R. Mohler, <a href='#Page_562'>562</a>-564</span><br /> +<span style="margin-left: 1em;">description and treatment, <a href='#Page_562'>562</a></span><br /> +<span style="margin-left: 1em;">symptoms and treatment, <a href='#Page_562'>562</a>-564</span><br /> +<br /> +Drench, methods, <a href='#Page_45'>45</a><br /> +<br /> +Dropsies, synovial, remarks, <a href='#Page_355'>355</a><br /> +<br /> +Dropsy—<br /> +<span style="margin-left: 1em;">general, of fetus, description and treatment, <a href='#Page_193'>193</a></span><br /> +<span style="margin-left: 1em;">of abdomen in foal, or ascites, description and treatment, <a href='#Page_193'>193</a></span><br /> +<span style="margin-left: 1em;">of abdomen, or ascites, description, symptoms, and treatment, <a href='#Page_86'>86</a></span><br /> +<span style="margin-left: 1em;">of amnion, description and treatment, <a href='#Page_180'>180</a></span><br /> +<span style="margin-left: 1em;">of brain, or hydrocephalus, causes, symptoms, and treatment, <a href='#Page_223'>223</a></span><br /> +<span style="margin-left: 1em;">of limbs, perineum, and abdomen, description and treatment, <a href='#Page_180'>180</a></span><br /> +<span style="margin-left: 1em;">of scrotum, or hydrocele, symptoms and treatment, <a href='#Page_166'>166</a></span><br /> +<span style="margin-left: 1em;">of womb, cause, symptoms, and treatment, <a href='#Page_179'>179</a></span><br /> +<br /> +Dysentery, description, causes, symptoms, and treatment, <a href='#Page_79'>79</a><br /> +<br /> +<br /> +<i>Echinococcus</i>—<br /> +<span style="margin-left: 1em;">parasite of eye, <a href='#Page_296'>296</a></span><br /> +<span style="margin-left: 1em;">parasite of kidney, <a href='#Page_146'>146</a></span><br /> +<br /> +Ectropion and entropion, or eversion and inversion of eyelid, causes and treatment, <a href='#Page_283'>283</a><br /> +<br /> +Eczema, or inflammation with blisters, description and treatment, <a href='#Page_464'>464</a><br /> +<br /> +Edematous pneumonia, definition, causes, symptoms, treatment, etc., <a href='#Page_521'>521</a>-527<br /> +<br /> +Elbow—<br /> +<span style="margin-left: 1em;">capped, cause, symptoms, and treatment, <a href='#Page_379'>379</a></span><br /> +<span style="margin-left: 1em;">muscles, sprains, causes, symptoms, and treatment, <a href='#Page_368'>368</a></span><br /> +<br /> +Electric shock, causes, description, and treatment, <a href='#Page_246'>246</a><br /> +<br /> +Electuries, or pastes, description, and manner of administering, <a href='#Page_45'>45</a><br /> +<br /> +Embolism—<br /> +<span style="margin-left: 1em;">air, or air in veins, note, <a href='#Page_270'>270</a></span><br /> +<span style="margin-left: 1em;">and thrombus, description, symptoms, and treatment, <a href='#Page_267'>267</a></span><br /> +<br /> +Embryotomy of parts at abnormal births, <a href='#Page_202'>202</a><br /> +<br /> +Emphysema, or swelling of fetus with gas, description and treatment, <a href='#Page_194'>194</a><br /> +<br /> +Encephalitis, cause, symptoms, and treatment, <a href='#Page_212'>212</a><br /> +<br /> +Endarteritis, and arteritis, description, symptoms, and treatment, <a href='#Page_263'>263</a><br /> +<br /> +Endocarditis, or inflammation of lining membrane of heart, cause, symptoms, +<span class='pagenum'><a name="Page_613" id="Page_613">[Pg 613]</a></span>and treatment, <a href='#Page_252'>252</a><br /> +<br /> +Enemas, or clysters, description, and manner of administering, <a href='#Page_48'>48</a><br /> +<br /> +Engorgement colic, description, symptoms, and treatment, <a href='#Page_66'>66</a><br /> +<br /> +Enteritis, definition, <a href='#Page_66'>66</a><br /> +<br /> +Entropion and ectropion, or inversion and eversion of eyelid, causes and treatment, <a href='#Page_283'>283</a><br /> +<br /> +Epilepsy, or falling fits, symptoms and treatment, <a href='#Page_227'>227</a><br /> +<br /> +Epithelial cancer, or epithelioma, description and treatment, <a href='#Page_477'>477</a><br /> +<br /> +Epithelioma—<br /> +<span style="margin-left: 1em;">degeneration of penis, or papilloma, <a href='#Page_167'>167</a></span><br /> +<span style="margin-left: 1em;">or epithelial cancer, description and treatment, <a href='#Page_477'>477</a></span><br /> +<br /> +Equine variola, or horsepox, causes, symptoms, treatment, etc., <a href='#Page_535'>535</a>-540<br /> +<br /> +Eruptions, bleeding skin, or <i>Dermatorrhagia parasitica</i>, description and treatment, <a href='#Page_469'>469</a><br /> +<br /> +Erysipelas, description, cause, and treatment, <a href='#Page_474'>474</a><br /> +<br /> +Erythema, congestion of skin, or red efflorescence, description and treatment, <a href='#Page_461'>461</a><br /> +<br /> +Esophagus—<br /> +<span style="margin-left: 1em;">dilatation, causes, symptoms, and treatment, <a href='#Page_65'>65</a></span><br /> +<span style="margin-left: 1em;">or gullet, treatment for foreign bodies, <a href='#Page_62'>62</a></span><br /> +<span style="margin-left: 1em;">stricture, description and treatment, <a href='#Page_65'>65</a></span><br /> +<br /> +Eversion—<br /> +<span style="margin-left: 1em;">and inversion of eyelid, or ectropion and entropion, causes and treatment, <a href='#Page_283'>283</a></span><br /> +<span style="margin-left: 1em;">of bladder, description and treatment, <a href='#Page_152'>152</a></span><br /> +<span style="margin-left: 1em;">or womb after difficult parturition, treatment, <a href='#Page_205'>205</a></span><br /> +<br /> +Exostosis, cause, description, and treatment, <a href='#Page_309'>309</a><br /> +<br /> +Extravasation of blood of penis, causes and treatment, <a href='#Page_167'>167</a><br /> +<br /> +Eye—<br /> +<span style="margin-left: 1em;">diseases, chapter by James Law, <a href='#Page_274'>274</a>-297</span><br /> +<span style="margin-left: 1em;">examination, <a href='#Page_277'>277</a></span><br /> +<span style="margin-left: 1em;">haw, or winking cartilage, description, <a href='#Page_276'>276</a></span><br /> +<span style="margin-left: 1em;">lachrymal apparatus, <a href='#Page_277'>277</a></span><br /> +<span style="margin-left: 1em;">muscles, description, <a href='#Page_276'>276</a></span><br /> +<span style="margin-left: 1em;">palsy of nerve of sight, or amaurosis, causes, symptoms, and treatment, <a href='#Page_295'>295</a></span><br /> +<span style="margin-left: 1em;">parasites, affecting, description of different kinds, <a href='#Page_296'>296</a></span><br /> +<span style="margin-left: 1em;">watering, or obstruction of lachrymal apparatus, description and remedies, <a href='#Page_285'>285</a></span><br /> +<br /> +Eyeball—<br /> +<span style="margin-left: 1em;">description, <a href='#Page_274'>274</a></span><br /> +<span style="margin-left: 1em;">tumors affecting, <a href='#Page_296'>296</a></span><br /> +<br /> +Eyelid—<br /> +<span style="margin-left: 1em;">diseases, description of different kinds, <a href='#Page_279'>279</a></span><br /> +<span style="margin-left: 1em;">inflammation, causes and treatment, <a href='#Page_280'>280</a></span><br /> +<span style="margin-left: 1em;">inversion and eversion, or entropion and ectropion, causes and treatment, <a href='#Page_283'>283</a></span><br /> +<span style="margin-left: 1em;">sty, or furuncle (boil), affecting, description and treatment, <a href='#Page_282'>282</a></span><br /> +<span style="margin-left: 1em;">torn, or wounds affecting, description and treatment, <a href='#Page_284'>284</a></span><br /> +<span style="margin-left: 1em;">warts and tumors affecting, description and treatment, <a href='#Page_283'>283</a></span><br /> +<br /> +Face bones, fractures, description and treatment, <a href='#Page_336'>336</a><br /> +<br /> +Facial paralysis, cause and symptoms, <a href='#Page_230'>230</a><br /> +<br /> +Fainting, or syncope, symptoms and treatment, <a href='#Page_259'>259</a><br /> +<br /> +Farcy—<br /> +<span style="margin-left: 1em;">and glanders, definition, causes, etc., <a href='#Page_544'>544</a>-557</span><br /> +<span style="margin-left: 1em;">chronic, symptoms, <a href='#Page_550'>550</a></span><br /> +<br /> +Fatty degeneration of heart, causes, symptoms, and treatment, <a href='#Page_261'>261</a><br /> +<br /> +Favus, or honeycomb ringworm, description and treatment, <a href='#Page_478'>478</a><br /> +<br /> +Feces, impaction of rectum, <a href='#Page_191'>191</a><br /> +<br /> +Feed—<br /> +<span style="margin-left: 1em;">kinds to give, <a href='#Page_51'>51</a></span><br /> +<span style="margin-left: 1em;">musty and moldy, effect on digestive organs, <a href='#Page_53'>53</a></span><br /> +<span style="margin-left: 1em;">preparation, <a href='#Page_57'>57</a></span><br /> +<br /> +Feeding, corn, <a href='#Page_55'>55</a><br /> +<br /> +Feet, interfering, causes, symptoms, and treatment, <a href='#Page_399'>399</a><br /> +<br /> +Femur, fracture, cause, symptoms, and treatment, <a href='#Page_347'>347</a><br /> +<br /> +Fetlock—<br /> +<span style="margin-left: 1em;">and ankle skin, note, <a href='#Page_397'>397</a></span><br /> +<span style="margin-left: 1em;">and foot bones, description, <a href='#Page_395'>395</a></span><br /> +<span style="margin-left: 1em;">ankle, and foot, diseases, chapter by A. A. Holcombe, <a href='#Page_395'>395</a>-457</span><br /> +<span style="margin-left: 1em;">joint, description, <a href='#Page_396'>396</a></span><br /> +<span style="margin-left: 1em;">knuckling, causes, symptoms, and treatment, <a href='#Page_372'>372</a></span><br /> +<span class='pagenum'><a name="Page_614" id="Page_614">[Pg 614]</a></span><span style="margin-left: 1em;">sprain, causes, symptoms, and treatment, <a href='#Page_402'>402</a></span><br /> +<br /> +Fetus<br /> +<span style="margin-left: 1em;">adherent to walls of womb, description, cause, and treatment, <a href='#Page_192'>192</a></span><br /> +<span style="margin-left: 1em;">excessive size, <a href='#Page_192'>192</a></span><br /> +<span style="margin-left: 1em;">general dropsy, description and treatment, <a href='#Page_193'>193</a></span><br /> +<span style="margin-left: 1em;">or foal, prolonged retention, cause and treatment, <a href='#Page_181'>181</a></span><br /> +<span style="margin-left: 1em;">swelling with gas, or emphysema, description and treatment, <a href='#Page_194'>194</a></span><br /> +<span style="margin-left: 1em;">tumors, or inclosed ovum, description and treatment, <a href='#Page_194'>194</a></span><br /> +<br /> +Fever, description, causes, and treatment, <a href='#Page_38'>38</a>-43<br /> +<br /> +Fibrous bands constricting and crossing neck of womb, description and treatment, <a href='#Page_191'>191</a><br /> +<br /> +Fibrous constriction of vagina or vulva, cause and treatment, <a href='#Page_191'>191</a><br /> +<br /> +<i>Filaria</i>—<br /> +<span style="margin-left: 1em;"><i>conjunctivæ</i>, parasite of eye, <a href='#Page_297'>297</a></span><br /> +<span style="margin-left: 1em;"><i>equina</i>, parasite of eye, <a href='#Page_297'>297</a></span><br /> +<span style="margin-left: 1em;"><i>hæmorrhagica</i>, threadworm causing skin disease, <a href='#Page_469'>469</a></span><br /> +<span style="margin-left: 1em;"><i>irritans</i>, parasite causing summer sores, description and treatment, <a href='#Page_469'>469</a></span><br /> +<span style="margin-left: 1em;"><i>multipapillosa</i>, threadworm causing bleeding skin eruptions, <a href='#Page_469'>469</a></span><br /> +<span style="margin-left: 1em;"><i>palpebralis</i>, parasite of eye, <a href='#Page_296'>296</a></span><br /> +<br /> +Fistulas, causes, symptoms, and treatment, <a href='#Page_502'>502</a>-506<br /> +<br /> +Fits, falling, or epilepsy, symptoms and treatment, <a href='#Page_227'>227</a><br /> +<br /> +Flatfoot, description, <a href='#Page_398'>398</a><br /> +<br /> +Flatulent colic, cause, symptoms, and treatment, <a href='#Page_73'>73</a><br /> +<br /> +Flea, or pulex, prevention and treatment of bite, <a href='#Page_482'>482</a><br /> +<br /> +Flesh fly (<i>Sarcophaga carnaria</i>), note, <a href='#Page_481'>481</a><br /> +<br /> +Flexor—<br /> +<span style="margin-left: 1em;">metatarsis, rupture, description, cause, symptoms, and treatment, <a href='#Page_377'>377</a></span><br /> +<span style="margin-left: 1em;">pedis perforans, description, <a href='#Page_397'>397</a></span><br /> +<span style="margin-left: 1em;">pedis perforatus, description, <a href='#Page_397'>397</a></span><br /> +<span style="margin-left: 1em;">tendons or their sheath, and suspensory ligaments, sprains, cause, symptoms, and treatment, <a href='#Page_371'>371</a></span><br /> +<br /> +Flies, method of attacking horses; prevention and treatment for bite, <a href='#Page_481'>481</a><br /> +<br /> +Flooding, or bleeding from womb, treatment, <a href='#Page_205'>205</a><br /> +<br /> +Flukes, occurrence in horses, note, <a href='#Page_90'>90</a><br /> +<br /> +Flyblow, or grubs in skin, description and treatment, <a href='#Page_481'>481</a><br /> +<br /> +Foal—<br /> +<span style="margin-left: 1em;">contractions of muscles, description and treatment, <a href='#Page_194'>194</a></span><br /> +<span style="margin-left: 1em;">monstrosities, description of kinds, causes, and treatment, <a href='#Page_194'>194</a></span><br /> +<span style="margin-left: 1em;">natural presentation, <a href='#Page_185'>185</a></span><br /> +<span style="margin-left: 1em;">prolonged retention, cause and treatment, <a href='#Page_181'>181</a></span><br /> +<span style="margin-left: 1em;">water in head, or hydrocephalus, description and treatment, <a href='#Page_192'>192</a></span><br /> +<br /> +Foals, newborn, cyanosis affecting, description, <a href='#Page_263'>263</a><br /> +<br /> +Foot—<br /> +<span style="margin-left: 1em;">anatomical review, <a href='#Page_395'>395</a>, <a href='#Page_583'>583</a></span><br /> +<span style="margin-left: 1em;">and fetlock bones, description, <a href='#Page_395'>395</a></span><br /> +<span style="margin-left: 1em;">canker, causes, symptoms, and treatment, <a href='#Page_418'>418</a></span><br /> +<span style="margin-left: 1em;">conformation, faults, <a href='#Page_398'>398</a></span><br /> +<span style="margin-left: 1em;">fetlock, and ankle, diseases, chapter by A. A. Holcombe, <a href='#Page_395'>395</a>-457</span><br /> +<span style="margin-left: 1em;">mange, description and treatment, <a href='#Page_480'>480</a></span><br /> +<span style="margin-left: 1em;">punctured wounds, description, symptoms, and treatment, <a href='#Page_426'>426</a></span><br /> +<span style="margin-left: 1em;">sand-cracks, causes, symptoms, and treatment, <a href='#Page_432'>432</a></span><br /> +<span style="margin-left: 1em;">sole description, <a href='#Page_397'>397</a></span><br /> +<span style="margin-left: 1em;"><i>See also</i> Hoof.</span><br /> +<br /> +Forage poisoning, or cerebrospinal meningitis, symptoms and treatment, <a href='#Page_237'>237</a><br /> +<br /> +Forearm, fracture, description, cause, symptoms, and treatment, <a href='#Page_345'>345</a><br /> +<br /> +Founder, or laminitis—<br /> +<span style="margin-left: 1em;">acute, subacute, and chronic, description, <a href='#Page_447'>447</a>-449</span><br /> +<span style="margin-left: 1em;">complications, <a href='#Page_449'>449</a></span><br /> +<span style="margin-left: 1em;">curative measures, <a href='#Page_455'>455</a></span><br /> +<span style="margin-left: 1em;">description and causes, <a href='#Page_441'>441</a></span><br /> +<span style="margin-left: 1em;">following parturition, cause, <a href='#Page_207'>207</a></span><br /> +<span style="margin-left: 1em;">sequel of superpurgation, <a href='#Page_79'>79</a></span><br /> +<span style="margin-left: 1em;">symptoms, <a href='#Page_444'>444</a></span><br /> +<span style="margin-left: 1em;">treatment and prevention, <a href='#Page_453'>453</a></span><br /> +<br /> +Fractures—<br /> +<span style="margin-left: 1em;">causes and symptoms, <a href='#Page_322'>322</a></span><br /> +<span style="margin-left: 1em;">description of different kinds, <a href='#Page_322'>322</a></span><br /> +<span style="margin-left: 1em;">of different bones, description, <a href='#Page_335'>335</a></span><br /> +<span class='pagenum'><a name="Page_615" id="Page_615">[Pg 615]</a></span><span style="margin-left: 1em;">prognosis and treatment, <a href='#Page_328'>328</a></span><br /> +<br /> +Frog—<br /> +<span style="margin-left: 1em;">bruises, causes, symptoms, and treatment, <a href='#Page_425'>425</a></span><br /> +<span style="margin-left: 1em;">description, <a href='#Page_397'>397</a></span><br /> +<br /> +Frostbites, description, symptoms, and treatment, <a href='#Page_405'>405</a><br /> +<br /> +Furuncle—<br /> +<span style="margin-left: 1em;">or boil, description and treatment, <a href='#Page_466'>466</a></span><br /> +<span style="margin-left: 1em;">or sty (boil), of eyelid, description and treatment, <a href='#Page_282'>282</a></span><br /> +<br /> +<br /> +Gaffky, investigation of pneumonia infection, note, <a href='#Page_522'>522</a><br /> +<br /> +Galls, harness, or sitiasts, description and treatment, <a href='#Page_475'>475</a>, <a href='#Page_496'>496</a><br /> +<br /> +Gallstones, or biliary calculi, symptoms, and treatment, <a href='#Page_90'>90</a><br /> +<br /> +Gangrene—<br /> +<span style="margin-left: 1em;">or mortification, causes, <a href='#Page_127'>127</a></span><br /> +<span style="margin-left: 1em;">or mortification, description, symptoms, and treatment, <a href='#Page_498'>498</a></span><br /> +<br /> +Gas, swelling of fetus, or emphysema, description and treatment, <a href='#Page_194'>194</a><br /> +<br /> +Gastritis, definition, <a href='#Page_66'>66</a><br /> +<br /> +Gastro-enteritis, description, symptoms, and treatment, <a href='#Page_80'>80</a><br /> +<br /> +Gastrointestinal catarrh, or indigestion, description, cause, symptoms, and treatment, <a href='#Page_76'>76</a><br /> +<br /> +Gastrointestinal parasites, description and treatment, discussion by Maurice C. Hall, <a href='#Page_90'>90</a>-94<br /> +<br /> +<i>Gastrophilus</i>, spp., injury to horses, symptoms and treatment, <a href='#Page_93'>93</a>-94<br /> +<br /> +Generative organs, diseases affecting, chapter by James Law, <a href='#Page_164'>164</a>-209<br /> +<br /> +Genito-urinary passages, method of medication, <a href='#Page_48'>48</a><br /> +<br /> +Gentian, use against pinworms in horses, <a href='#Page_91'>91</a><br /> +<br /> +Gestation, extra-uterine, description, symptoms, and treatment, <a href='#Page_178'>178</a><br /> +<br /> +Glanders—<br /> +<span style="margin-left: 1em;">acute, symptoms, <a href='#Page_553'>553</a></span><br /> +<span style="margin-left: 1em;">and farcy, definition, causes, etc., <a href='#Page_544'>544</a>-557</span><br /> +<span style="margin-left: 1em;">chronic, symptoms, <a href='#Page_552'>552</a></span><br /> +<span style="margin-left: 1em;">treatment, <a href='#Page_556'>556</a></span><br /> +<br /> +Glands—<br /> +<span style="margin-left: 1em;">lymphatic, description, symptoms, and treatment, <a href='#Page_271'>271</a></span><br /> +<span style="margin-left: 1em;">sebaceous, description, <a href='#Page_460'>460</a></span><br /> +<span style="margin-left: 1em;">sweat, description, <a href='#Page_461'>461</a></span><br /> +<br /> +Gleet—<br /> +<span style="margin-left: 1em;">inflammation of urethra, or urethritis, symptoms and treatment, <a href='#Page_153'>153</a></span><br /> +<span style="margin-left: 1em;">nasal, chronic catarrh, or collection in sinuses, causes, symptoms, and treatment, <a href='#Page_99'>99</a>-101</span><br /> +<br /> +Glossitis, description and treatment, <a href='#Page_60'>60</a>-61<br /> +<br /> +Glottis, spasm, description, <a href='#Page_225'>225</a><br /> +<br /> +Glycosuria, saccharine diabetes mellitus, or inosuria, causes, symptoms, and treatment, <a href='#Page_139'>139</a><br /> +<br /> +Grains for feeding, <a href='#Page_54'>54</a><br /> +<br /> +Grasses, important feed, <a href='#Page_56'>56</a><br /> +<br /> +Gravel, urinary calculi, or stone, description, and causes, <a href='#Page_154'>154</a>, <a href='#Page_156'>156</a><br /> +<br /> +Grease or canker, causes, symptoms, and treatment, <a href='#Page_472'>472</a><br /> +<br /> +Grubs—<br /> +<span style="margin-left: 1em;">or flyblow, description and treatment, <a href='#Page_481'>481</a></span><br /> +<span style="margin-left: 1em;">under the skin, description and treatment, <a href='#Page_481'>481</a></span><br /> +<br /> +Grunting, testing, <a href='#Page_109'>109</a><br /> +<br /> +Gullet, or esophagus, treatment for foreign bodies, <a href='#Page_62'>62</a><br /> +<br /> +Gunshot wounds, description and treatment, <a href='#Page_494'>494</a><br /> +<br /> +Gut-tie, volvulus, or twisting of bowels, cause, symptoms, and treatment, <a href='#Page_72'>72</a><br /> +<br /> +Guttural pouches, description and treatment, <a href='#Page_119'>119</a><br /> +<br /> +<br /> +<i>Habronema</i>, spp., cause of summer sores, etc., note, <a href='#Page_470'>470</a><br /> +<br /> +Hairs on skin, description, <a href='#Page_460'>460</a><br /> +<br /> +Harbaugh, W. H., chapter on "Diseases of respiratory organs", <a href='#Page_95'>95</a>-133<br /> +<br /> +Harness galls, or sitiasts, description and treatment, <a href='#Page_475'>475</a>, <a href='#Page_496'>496</a><br /> +<br /> +Harvest bug, larvæ of <i>Trombidium</i>, <i>Leptus americanus</i>, jigger (chigoe), animal parasite of skin, <a href='#Page_480'>480</a><br /> +<br /> +Haw—<br /> +<span style="margin-left: 1em;">or winking cartilage of the eye, description, <a href='#Page_276'>276</a></span><br /> +<span style="margin-left: 1em;">tumor, or caries of cartilage of the eye, description and treatment, <a href='#Page_284'>284</a></span><br /> +<br /> +<span class='pagenum'><a name="Page_616" id="Page_616">[Pg 616]</a></span>Hay, kinds for feeding, <a href='#Page_53'>53</a><br /> +<br /> +Heart—<br /> +<span style="margin-left: 1em;">adventitious growths, description, symptoms, and treatment, <a href='#Page_258'>258</a></span><br /> +<span style="margin-left: 1em;">anatomy and physiology, <a href='#Page_247'>247</a></span><br /> +<span style="margin-left: 1em;">and blood vessels, diseases, remarks, <a href='#Page_250'>250</a></span><br /> +<span style="margin-left: 1em;">blood vessels, and lymphatics, diseases, chapter by M. R. Trumbower, <a href='#Page_247'>247</a>-273</span><br /> +<span style="margin-left: 1em;">circulation of blood, description, <a href='#Page_248'>248</a></span><br /> +<span style="margin-left: 1em;">congestion, description, and symptoms, <a href='#Page_263'>263</a></span><br /> +<span style="margin-left: 1em;">dilatation, description, causes, symptoms, and treatment, <a href='#Page_261'>261</a></span><br /> +<span style="margin-left: 1em;">fatty degeneration, description, causes, symptoms, and treatment, <a href='#Page_261'>261</a></span><br /> +<span style="margin-left: 1em;">hypertrophy, or cardiac enlargement, description, symptoms, and treatment, <a href='#Page_260'>260</a></span><br /> +<span style="margin-left: 1em;">inflammation of lining membrane, or endocarditis, cause, description, symptoms, and treatment, <a href='#Page_251'>251</a></span><br /> +<span style="margin-left: 1em;">inflammation of muscular structure, or myocarditis, symptoms, alterations, and treatment, <a href='#Page_251'>251</a></span><br /> +<span style="margin-left: 1em;">inflammation of sac inclosing, or pericarditis, causes, symptoms, and treatment, <a href='#Page_255'>255</a></span><br /> +<span style="margin-left: 1em;">inflammatory diseases, description and treatment, <a href='#Page_251'>251</a></span><br /> +<span style="margin-left: 1em;">palpitation, description, symptoms, and treatment, <a href='#Page_259'>259</a></span><br /> +<span style="margin-left: 1em;">rupture, description and cause, <a href='#Page_262'>262</a></span><br /> +<span style="margin-left: 1em;">valvular disease, description, symptoms, and treatment, <a href='#Page_257'>257</a></span><br /> +<span style="margin-left: 1em;">weakness, causes, symptoms, and treatment, <a href='#Page_262'>262</a></span><br /> +<br /> +Heat exhaustion, sunstroke, or heat stroke, symptoms, pathology, treatment, and prevention, <a href='#Page_219'>219</a><br /> +<br /> +Heaves, broken wind, or asthma, definition, symptoms, and treatment, <a href='#Page_128'>128</a><br /> +<br /> +Heels—<br /> +<span style="margin-left: 1em;">contracted, or hoofbound, description, causes, symptoms, and treatment, <a href='#Page_429'>429</a></span><br /> +<span style="margin-left: 1em;">cracked, scratches, or chaps on knee and hock, description, causes, and treatment, <a href='#Page_470'>470</a></span><br /> +<span style="margin-left: 1em;">inflammation, with sebaceous secretion, grease, or canker, description, causes, symptoms, and treatment, <a href='#Page_472'>472</a></span><br /> +<br /> +Hematuria, or bloody urine, cause and treatment, <a href='#Page_141'>141</a><br /> +<br /> +Hemiplegia, or paralysis of on side, or half the body, description and symptoms, <a href='#Page_228'>228</a><br /> +<br /> +Hemoglobinuria, azoturia, azotemia, poisoning by albuminoids, symptoms, prevention, and treatment, <a href='#Page_141'>141</a><br /> +<br /> +Hemoptysis, or bleeding from lungs, causes, description, and treatment, <a href='#Page_127'>127</a><br /> +<br /> +Hemorrhage—<br /> +<span style="margin-left: 1em;">process of healing and method of treatment, <a href='#Page_486'>486</a></span><br /> +<span style="margin-left: 1em;">spinal, symptoms and treatment, <a href='#Page_225'>225</a></span><br /> +<br /> +Hemorrhoids, or piles, description and treatment, <a href='#Page_81'>81</a><br /> +<br /> +Hemostasia, description and treatment, <a href='#Page_485'>485</a><br /> +<br /> +Hepatitis, or inflammation of liver, symptoms, causes, and treatment, <a href='#Page_87'>87</a><br /> +<br /> +Hernia—<br /> +<span style="margin-left: 1em;">congenital scrotal, description and treatment, <a href='#Page_82'>82</a></span><br /> +<span style="margin-left: 1em;">diaphragmatic, description, <a href='#Page_85'>85</a></span><br /> +<span style="margin-left: 1em;">inguinal, description, symptoms, and treatment, <a href='#Page_83'>83</a></span><br /> +<span style="margin-left: 1em;">of womb, description and treatment, <a href='#Page_189'>189</a></span><br /> +<span style="margin-left: 1em;">or rupture, description of different kinds, <a href='#Page_82'>82</a></span><br /> +<span style="margin-left: 1em;">scrotal, cause, <a href='#Page_82'>82</a></span><br /> +<span style="margin-left: 1em;">umbilical, description and treatment, <a href='#Page_84'>84</a></span><br /> +<span style="margin-left: 1em;">ventral, description and treatment, <a href='#Page_83'>83</a></span><br /> +<br /> +Herpes, description and treatment <a href='#Page_468'>468</a><br /> +<br /> +High blowing, description, <a href='#Page_110'>110</a><br /> +<br /> +Hip—<br /> +<span style="margin-left: 1em;">bone, or os innominatum, description, symptoms, and treatment, <a href='#Page_341'>341</a></span><br /> +<span style="margin-left: 1em;">bones, fractured, causes, <a href='#Page_158'>158</a></span><br /> +<span style="margin-left: 1em;">joint, luxation, description and treatment <a href='#Page_363'>363</a></span><br /> +<span style="margin-left: 1em;">lameness, description, symptoms, and treatment, <a href='#Page_369'>369</a></span><br /> +<br /> +Hock—<br /> +<span style="margin-left: 1em;">and knee, chaps or scratches, description, causes, and treatment, <a href='#Page_470'>470</a></span><br /> +<span style="margin-left: 1em;">capped, cause, symptoms, and treatment, <a href='#Page_385'>385</a></span><br /> +<span style="margin-left: 1em;">curb, cause, symptoms, and treatment, <a href='#Page_374'>374</a></span><br /> +<span style="margin-left: 1em;">fractures, note, <a href='#Page_350'>350</a></span><br /> +<br /> +Holcombe, A. A., chapter on "Diseases of ankle, fetlock, and foot", <a href='#Page_395'>395</a>-457<br /> +<br /> +<span class='pagenum'><a name="Page_617" id="Page_617">[Pg 617]</a></span>Honeycomb ringworm, or favus, description and treatment, <a href='#Page_478'>478</a><br /> +<br /> +Hoof—<br /> +<span style="margin-left: 1em;">bound, or contracted heels, description, causes, symptoms, and treatment, <a href='#Page_429'>429</a></span><br /> +<span style="margin-left: 1em;">description, <a href='#Page_397'>397</a></span><br /> +<span style="margin-left: 1em;">growth, <a href='#Page_588'>588</a></span><br /> +<span style="margin-left: 1em;">healthy, characteristics, <a href='#Page_590'>590</a></span><br /> +<span style="margin-left: 1em;">physiological movements, <a href='#Page_587'>587</a></span><br /> +<span style="margin-left: 1em;">preparation for the shoe, <a href='#Page_596'>596</a></span><br /> +<span style="margin-left: 1em;"><i>See also</i> Foot.</span><br /> +<br /> +Hoofs—<br /> +<span style="margin-left: 1em;">unshod, care, <a href='#Page_590'>590</a></span><br /> +<span style="margin-left: 1em;">various forms, <a href='#Page_591'>591</a></span><br /> +<br /> +Hornets, bees, and wasps, treatment for stings, <a href='#Page_483'>483</a><br /> +<br /> +Horny sloughs (sitfasts), or sloughing callosities, description and treatment, <a href='#Page_475'>475</a>, <a href='#Page_496'>496</a><br /> +<br /> +Horse, sick—<br /> +<span style="margin-left: 1em;">attitude and general condition indicative of disease, <a href='#Page_8'>8</a></span><br /> +<span style="margin-left: 1em;">conformation and constitution, <a href='#Page_10'>10</a></span><br /> +<span style="margin-left: 1em;">danger from silage as feed, <a href='#Page_56'>56</a>-57</span><br /> +<span style="margin-left: 1em;">examination, chapter by Leonard Pearson, <a href='#Page_7'>7</a>-26</span><br /> +<span style="margin-left: 1em;">history of diseases necessary in examination, <a href='#Page_8'>8</a></span><br /> +<span style="margin-left: 1em;">parasites, intestinal, and injuries from them, <a href='#Page_90'>90</a>-94</span><br /> +<br /> +Horsepox, or equine variola, causes, symptoms, and treatment, <a href='#Page_535'>535</a>-540<br /> +<br /> +Horses—<br /> +<span style="margin-left: 1em;">anatomy, description, <a href='#Page_300'>300</a></span><br /> +<span style="margin-left: 1em;">danger from silage as feed, <a href='#Page_56'>56</a>-57</span><br /> +<br /> +Horseshoes. <i>See</i> Shoe.<br /> +<br /> +Huidekoper, Rush Shippen, chapter on "Infectious diseases", <a href='#Page_507'>507</a>-582<br /> +<br /> +Humerus, fractures, symptoms and treatment, <a href='#Page_345'>345</a><br /> +<br /> +Hydrocele, or dropsy of scrotum, symptoms and treatment, <a href='#Page_166'>166</a><br /> +<br /> +Hydrocephalus—<br /> +<span style="margin-left: 1em;">or dropsy of brain, causes, symptoms, and treatment, <a href='#Page_223'>223</a></span><br /> +<span style="margin-left: 1em;">or water in head, of foal, description and treatment, <a href='#Page_192'>192</a></span><br /> +<br /> +Hydrophobia. <i>See</i> Rabies.<br /> +<br /> +Hydrothorax, treatment, <a href='#Page_126'>126</a><br /> +<br /> +Hypertrophy of heart, or cardiac enlargement, description, symptoms, and treatment, <a href='#Page_260'>260</a><br /> +<br /> +<i>Hypoderma-lineata</i>, note, <a href='#Page_481'>481</a><br /> +<br /> +<br /> +Icterus, jaundice, or yellows, description and treatment, <a href='#Page_88'>88</a><br /> +<br /> +Impaction—<br /> +<span style="margin-left: 1em;">of large intestine, cause of obstruction colic, symptoms and treatment, <a href='#Page_68'>68</a></span><br /> +<span style="margin-left: 1em;">of rectum with feces, <a href='#Page_191'>191</a></span><br /> +<br /> +Indigestion, or gastrointestinal catarrh, description, causes, symptoms, and treatment, <a href='#Page_76'>76</a><br /> +<br /> +Infectious anemia—<br /> +<span style="margin-left: 1em;">chapter by John R. Mohler, <a href='#Page_569'>569</a>-572</span><br /> +<span style="margin-left: 1em;">cause and localities infected, <a href='#Page_569'>569</a></span><br /> +<span style="margin-left: 1em;">diagnosis and treatment, <a href='#Page_571'>571</a></span><br /> +<span style="margin-left: 1em;">symptoms and lesions, <a href='#Page_570'>570</a></span><br /> +<br /> +Infectious diseases—<br /> +<span style="margin-left: 1em;">chapter by Rush Shippen Huidekoper, <a href='#Page_507'>507</a>-582</span><br /> +<span style="margin-left: 1em;">general discussion, <a href='#Page_507'>507</a>-508</span><br /> +<br /> +Inflammation—<br /> +<span style="margin-left: 1em;">acute, of kidneys, or acute nephritis, causes, symptoms, and treatment, <a href='#Page_143'>143</a></span><br /> +<span style="margin-left: 1em;">and abscess of lymphatic glands, description, symptoms, and treatment, <a href='#Page_272'>272</a></span><br /> +<span style="margin-left: 1em;">and congestion of skin, description of kinds, <a href='#Page_461'>461</a></span><br /> +<span style="margin-left: 1em;">and congestion of teats and udder, symptoms and treatment, <a href='#Page_208'>208</a></span><br /> +<span style="margin-left: 1em;">and congestion of testicles, or orchitis, causes, symptoms, and treatment, <a href='#Page_164'>164</a></span><br /> +<span style="margin-left: 1em;">chronic, of kidneys, causes, symptoms, and treatment, <a href='#Page_145'>145</a></span><br /> +<span style="margin-left: 1em;">description, symptoms, termination, and treatment, <a href='#Page_32'>32</a>-38</span><br /> +<span style="margin-left: 1em;">local, and abscess of lymphatic glands, description, symptoms, and ">treatment, <a href='#Page_272'>272</a></span><br /> +<span style="margin-left: 1em;">of bladder, cystitis, or urocystitis, symptoms and treatment, <a href='#Page_149'>149</a></span><br /> +<span style="margin-left: 1em;">of brain and its membranes, description, <a href='#Page_193'>193</a>, <a href='#Page_212'>212</a>, <a href='#Page_213'>213</a></span><br /> +<span style="margin-left: 1em;">of eyelids, causes and treatment, <a href='#Page_280'>280</a></span><br /> +<span style="margin-left: 1em;">of heels, with sebaceous secretion, grease, or canker, description, causes, + symptoms, and treatment, <a href='#Page_472'>472</a></span><br /><span class='pagenum'><a name="Page_618" id="Page_618">[Pg 618]</a></span> +<span style="margin-left: 1em;">of lining membrane of heart, or endocarditis, cause, description, symptoms, and treatment, <a href='#Page_251'>251</a></span><br /> +<span style="margin-left: 1em;">of liver, or hepatitis, symptoms, causes, and treatment, <a href='#Page_87'>87</a></span><br /> +<span style="margin-left: 1em;">of membranes, a complication of influenza, <a href='#Page_518'>518</a></span><br /> +<span style="margin-left: 1em;">of membranes of spinal cord, causes, symptoms, and treatment, <a href='#Page_232'>232</a></span><br /> +<span style="margin-left: 1em;">of muscular structure of heart, or myocarditis, symptoms, alterations, and treatment, <a href='#Page_251'>251</a></span><br /> +<span style="margin-left: 1em;">of nerve, or neuritis, cause, symptoms, and treatment, <a href='#Page_236'>236</a></span><br /> +<span style="margin-left: 1em;">of pharynx, description, <a href='#Page_103'>103</a></span><br /> +<span style="margin-left: 1em;">of sac inclosing heart, or pericarditis, causes, symptoms, pathology, and treatment, <a href='#Page_255'>255</a></span><br /> +<span style="margin-left: 1em;">of substance of spinal cord, or myelitis, causes, symptoms, pathology, and treatment, <a href='#Page_233'>233</a></span><br /> +<span style="margin-left: 1em;">of urethra, urethritis, or gleet, symptoms and treatment, <a href='#Page_153'>153</a></span><br /> +<span style="margin-left: 1em;">of womb and peritoneum, symptoms and treatment, <a href='#Page_207'>207</a></span><br /> +<span style="margin-left: 1em;">with blisters, or eczema, description and treatment, <a href='#Page_464'>464</a></span><br /> +<span style="margin-left: 1em;">with pustules, description and treatment, <a href='#Page_465'>465</a></span><br /> +<br /> +Inflammatory diseases of the heart, description and treatment, <a href='#Page_251'>251</a><br /> +<br /> +Influenza, definition, symptoms, termination, complications, and treatment, <a href='#Page_510'>510</a>-521<br /> +<br /> +Inguinal, hernia, description, symptoms, and treatment, <a href='#Page_83'>83</a><br /> +<br /> +Inhalation, manner of administering medicines, <a href='#Page_47'>47</a><br /> +<br /> +Injections, methods of administering medicines, <a href='#Page_47'>47</a><br /> +<br /> +Inosuria, saccharine diabetes, diabetes mellitus, or glycosuria, causes, symptoms, and treatment, <a href='#Page_139'>139</a><br /> +<br /> +Insufflation, description, <a href='#Page_46'>46</a><br /> +<br /> +Interfering—<br /> +<span style="margin-left: 1em;">and speedy cuts, description, symptoms, prognosis, and treatment, <a href='#Page_387'>387</a></span><br /> +<span style="margin-left: 1em;">of feet, causes, symptoms, and treatment, <a href='#Page_399'>399</a></span><br /> +<br /> +Intestinal—<br /> +<span style="margin-left: 1em;">paralysis, cause, <a href='#Page_230'>230</a></span><br /> +<span style="margin-left: 1em;">worm, or Ascaris equorum, note, <a href='#Page_90'>90</a></span><br /> +<br /> +Intestines—<br /> +<span style="margin-left: 1em;">and stomach, diseases, remarks, <a href='#Page_65'>65</a></span><br /> +<span style="margin-left: 1em;">calculi, or stones, description, symptoms, and treatment, <a href='#Page_71'>71</a></span><br /> +<span style="margin-left: 1em;">large, impaction, cause of obstruction colic, symptoms and treatment, <a href='#Page_68'>68</a></span><br /> +<span style="margin-left: 1em;">paralysis, description and treatment, <a href='#Page_72'>72</a></span><br /> +<span style="margin-left: 1em;">spasms, <a href='#Page_225'>225</a></span><br /> +<br /> +Intussusception, or invagination, description, symptoms, and treatment, <a href='#Page_71'>71</a><br /> +<br /> +Invagination, or intussusception, description, symptoms, and treatment. <a href='#Page_71'>71</a><br /> +<br /> +Iritis, causes, symptoms, and treatment, <a href='#Page_288'>288</a><br /> +<br /> +Irritation, nervous, of skin, or pruritus, description and treatment, <a href='#Page_468'>468</a><br /> +<br /> +Jaundice, icterus, or yellows, description and treatment, <a href='#Page_88'>88</a><br /> +<br /> +Jaw, lower, fracture, description, causes, and treatment, <a href='#Page_337'>337</a><br /> +<br /> +Jigger, or chigoe, Leptus americanus, animal parasite of skin, <a href='#Page_480'>480</a><br /> +<br /> +Joint—<br /> +<span style="margin-left: 1em;">hip, luxation, description and treatment, <a href='#Page_361'>361</a></span><br /> +<span style="margin-left: 1em;">shoulder, displacement, description and treatment, <a href='#Page_363'>363</a></span><br /> +<br /> +Joints<br /> +<span style="margin-left: 1em;">diseases, note, <a href='#Page_354'>354</a></span><br /> +<span style="margin-left: 1em;">open, cause, prognosis, and treatment, <a href='#Page_357'>357</a></span><br /> +<br /> +<br /> +Kidneys—<br /> +<span style="margin-left: 1em;">acute inflammation, or acute nephritis, causes, symptoms, and treatment, <a href='#Page_143'>143</a></span><br /> +<span style="margin-left: 1em;">chronic inflammation, causes, symptoms, and treatment, <a href='#Page_145'>145</a></span><br /> +<span style="margin-left: 1em;">bladder worm and roundworm affecting, <a href='#Page_146'>146</a></span><br /> +<span style="margin-left: 1em;">tumors, note, <a href='#Page_146'>146</a></span><br /> +<br /> +Knee—<br /> +<span style="margin-left: 1em;">broken, cause, prognosis, and treatment, <a href='#Page_357'>357</a></span><br /> +<span style="margin-left: 1em;">capped, description, cause, symptoms, prognosis, and treatment, <a href='#Page_383'>383</a></span><br /> +<span style="margin-left: 1em;">fracture, cause, symptoms, prognosis, and treatment, <a href='#Page_347'>347</a></span><br /> +<span style="margin-left: 1em;">or hock, chaps, scratches, or cracked heels, description, causes, and treatment, <a href='#Page_470'>470</a></span><br /> +<br /> +Knees, sprung, cause, symptoms, and treatment, <a href='#Page_373'>373</a><br /> +<br /> +Knuckling—<br /> +<span style="margin-left: 1em;">of fetlock, description, causes, symptoms, and treatment, <a href='#Page_372'>372</a></span><br /> +<span class='pagenum'><a name="Page_619" id="Page_619">[Pg 619]</a></span><span style="margin-left: 1em;">or cocked ankles, description, causes, and treatment, <a href='#Page_400'>400</a></span><br /> +<br /> +<br /> +Labor pains, premature, cause, and treatment, <a href='#Page_186'>186</a><br /> +<br /> +Lachrymal apparatus of eye—<br /> +<span style="margin-left: 1em;">description, <a href='#Page_277'>277</a></span><br /> +<span style="margin-left: 1em;">obstruction, or watering eye, description and remedy, <a href='#Page_285'>285</a></span><br /> +<br /> +Lameness—<br /> +<span style="margin-left: 1em;">definition, physiology and description, <a href='#Page_303'>303</a></span><br /> +<span style="margin-left: 1em;">how to detect the seat, <a href='#Page_307'>307</a></span><br /> +<span style="margin-left: 1em;">how to discover, <a href='#Page_304'>304</a></span><br /> +<span style="margin-left: 1em;">its causes and treatment, chapter by A. A. Liautard, <a href='#Page_298'>298</a>-394</span><br /> +<span style="margin-left: 1em;">of hip, description, symptoms, prognosis, and treatment, <a href='#Page_369'>369</a></span><br /> +<span style="margin-left: 1em;">of shoulder, description, causes, symptoms, and treatment, <a href='#Page_365'>365</a></span><br /> +<br /> +Laminæ, sensitive, description, <a href='#Page_398'>398</a><br /> +<br /> +Laminitis. <i>See</i> Founder.<br /> +<br /> +Lampas, description and treatment, <a href='#Page_60'>60</a><br /> +<br /> +Laryngismus paralyticus, or roaring, description and treatment, <a href='#Page_108'>108</a>, <a href='#Page_230'>230</a><br /> +<br /> +Laryngitis, or sore throat, description, symptoms and treatment, <a href='#Page_103'>103</a><br /> +<br /> +Larynx, spasms, description and treatment, <a href='#Page_107'>107</a><br /> +<br /> +Law, James—<br /> +<span style="margin-left: 1em;">chapter on "Diseases of the eye", <a href='#Page_274'>274</a>-297</span><br /> +<span style="margin-left: 1em;">chapter on "Diseases of the generative organs", <a href='#Page_164'>164</a>-209</span><br /> +<span style="margin-left: 1em;">chapter on "Diseases of the skin", <a href='#Page_458'>458</a>, <a href='#Page_483'>483</a></span><br /> +<span style="margin-left: 1em;">chapter on "Diseases of the urinary organs", <a href='#Page_134'>134</a>-163</span><br /> +<br /> +Lead poisoning, or plumbism, causes, symptoms, and treatment, <a href='#Page_245'>245</a><br /> +<br /> +Leptus americanus, or harvest bug, animal parasite of skin, <a href='#Page_480'>480</a><br /> +<br /> +Leucorrhea, description and treatment, <a href='#Page_208'>208</a><br /> +<br /> +Liautard, A., chapter on "Lameness: Its causes and treatment", <a href='#Page_298'>298</a>, <a href='#Page_394'>394</a><br /> +<br /> +Lice, or pediculi, description and treatment for bite, <a href='#Page_482'>482</a><br /> +<br /> +Ligament—<br /> +<span style="margin-left: 1em;">suspensory, description, <a href='#Page_396'>396</a></span><br /> +<span style="margin-left: 1em;">suspensory, rupture, description, symptoms, and treatment, <a href='#Page_403'>403</a></span><br /> +<br /> +Ligaments—<br /> +<span style="margin-left: 1em;">description and functions, <a href='#Page_302'>302</a></span><br /> +<span style="margin-left: 1em;">suspensory, sprains, causes, symptoms, prognosis, and treatment, <a href='#Page_371'>371</a></span><br /> +<br /> +Limbs—<br /> +<span style="margin-left: 1em;">hind, cramp, cause and treatment, <a href='#Page_181'>181</a></span><br /> +<span style="margin-left: 1em;">perineum, and abdomen, dropsy, description and treatment, <a href='#Page_180'>180</a></span><br /> +<br /> +Lime-and-sulphur dip, use against mange in horse, <a href='#Page_479'>479</a><br /> +<br /> +Linseed, ground, value as laxative, <a href='#Page_55'>55</a><br /> +<br /> +Liver—<br /> +<span style="margin-left: 1em;">diseases, remarks, <a href='#Page_87'>87</a></span><br /> +<span style="margin-left: 1em;">inflammation, or hepatitis, symptoms, causes, and treatment, <a href='#Page_87'>87</a></span><br /> +<span style="margin-left: 1em;">rupture, causes, symptoms, and treatment, <a href='#Page_88'>88</a></span><br /> +<br /> +Lockjaw, or tetanus, causes, symptoms, prevention, and treatment, <a href='#Page_241'>241</a><br /> +<br /> +Locomotor ataxia, or incoordination of movement, description, <a href='#Page_230'>230</a><br /> +<br /> +Loins, sprains, description, cause, symptoms, and treatment, <a href='#Page_392'>392</a><br /> +<br /> +Lüber, investigation of pneumonia infection, <a href='#Page_522'>522</a><br /> +<br /> +<i>Lucilia cæsar</i>, or bluebottle, and <i>L. hominivorax</i>, or screwworm fly, note, <a href='#Page_481'>481</a><br /> +<br /> +Lung—<br /> +<span style="margin-left: 1em;">abscess, and suppuration, symptoms, <a href='#Page_127'>127</a></span><br /> +<span style="margin-left: 1em;">fever, or pneumonia, description, symptoms, and treatment, <a href='#Page_113'>113</a></span><br /> +<br /> +Lungs—<br /> +<span style="margin-left: 1em;">bleeding, or hemoptysis, causes, description, and treatment, <a href='#Page_127'>127</a></span><br /> +<span style="margin-left: 1em;">congestion, description and treatment, <a href='#Page_111'>111</a></span><br /> +<span style="margin-left: 1em;">description, <a href='#Page_111'>111</a></span><br /> +<br /> +Luxations and dislocations of bones, cause, symptoms, and treatment, <a href='#Page_361'>361</a><br /> +<br /> +Lymphangitis, causes, symptoms, and treatment, <a href='#Page_272'>272</a><br /> +<br /> +Lymphatic—<br /> +<span style="margin-left: 1em;">glands, local inflammation, and abscess affecting, description, symptoms, and treatment, <a href='#Page_272'>272</a></span><br /> +<span style="margin-left: 1em;">system, diseases, description, <a href='#Page_271'>271</a></span><br /> +<br /> +Lymphatics, heart, and blood vessels, diseases, chapter by M. R. Trumbower, <a href='#Page_247'>247</a>-273<br /> +<br /> +<br /> +Madness, rabies, or hydrophobia, cause, symptoms, treatment, and prevention, <a href='#Page_244'>244</a>, <a href='#Page_559'>559</a><br /> +<br /> +Maize, or corn, how to feed <a href='#Page_55'>55</a><br /> +<br /> +<span class='pagenum'><a name="Page_620" id="Page_620">[Pg 620]</a></span><i>Maladie de coït</i>, or dourine, description and treatment, <a href='#Page_562'>562</a><br /> +<br /> +Mange—<br /> +<span style="margin-left: 1em;">autumn, and mange of foot, description and treatment, <a href='#Page_480'>480</a></span><br /> +<span style="margin-left: 1em;">horse, treatment, <a href='#Page_479'>479</a></span><br /> +<span style="margin-left: 1em;">or acariasis, note, <a href='#Page_478'>478</a></span><br /> +<br /> +Mare—<br /> +<span style="margin-left: 1em;">castration, method, <a href='#Page_172'>172</a></span><br /> +<span style="margin-left: 1em;">pregnant, hygiene, <a href='#Page_177'>177</a></span><br /> +<span style="margin-left: 1em;">sterility, causes and treatment, <a href='#Page_172'>172</a></span><br /> +<br /> +Masturbation, or self-abuse, remedy, <a href='#Page_168'>168</a><br /> +<br /> +Meat fly, or <i>Musca vomitoria</i>, note, <a href='#Page_481'>481</a><br /> +<br /> +Medicines, methods of administering, chapter by Ch. B. Michener, <a href='#Page_44'>44</a>-48<br /> +<br /> +Megrims, or congestion of brain, description, causes, symptoms, treatment, etc., <a href='#Page_217'>217</a><br /> +<br /> +Melanosis, or black pigment tumor, description and treatment, <a href='#Page_476'>476</a><br /> +<br /> +Membrane—<br /> +<span style="margin-left: 1em;">lining, of heart, inflammation, or endocarditis, cause, description, symptoms, and treatment, <a href='#Page_252'>252</a></span><br /> +<span style="margin-left: 1em;">of nose, thickening, symptoms and treatment, <a href='#Page_101'>101</a></span><br /> +<br /> +Membranes—<br /> +<span style="margin-left: 1em;">inflammation, a complication of influenza, <a href='#Page_518'>518</a></span><br /> +<span style="margin-left: 1em;">mucous, visible, and skin may indicate disease, <a href='#Page_11'>11</a></span><br /> +<span style="margin-left: 1em;">of brain, inflammation, description, <a href='#Page_212'>212</a>, <a href='#Page_213'>213</a></span><br /> +<span style="margin-left: 1em;">of spinal cord, inflammation, causes, symptoms, and treatment, <a href='#Page_232'>232</a></span><br /> +<br /> +Meningitis—<br /> +<span style="margin-left: 1em;">causes, symptoms, and treatment, <a href='#Page_212'>212</a></span><br /> +<span style="margin-left: 1em;">spinal, causes, symptoms, pathology, and treatment, <a href='#Page_232'>232</a></span><br /> +<br /> +Metatarsi, flexor, rupture, description, cause, symptoms, and treatment, <a href='#Page_377'>377</a><br /> +<br /> +Michener, Ch. B.—<br /> +<span style="margin-left: 1em;">chapter on "Diseases of the digestive organs", <a href='#Page_49'>49</a>-94</span><br /> +<span style="margin-left: 1em;">chapter on "Methods of administering medicines", <a href='#Page_44'>44</a>-48</span><br /> +<span style="margin-left: 1em;">chapter on "Wounds and their treatment," <a href='#Page_484'>484</a>-506</span><br /> +<br /> +<i>Microsporon furfur</i>, vegetable parasite of skin <a href='#Page_478'>478</a><br /> +<br /> +Mohler, John R.—<br /> +<span style="margin-left: 1em;">chapter on "Dourine", <a href='#Page_562'>562</a>-564</span><br /> +<span style="margin-left: 1em;">chapter on "Infectious anemia", <a href='#Page_569'>569</a>-572</span><br /> +<span style="margin-left: 1em;">chapter on "Mycotic lymphangitis", <a href='#Page_557'>557</a>-559</span><br /> +<span style="margin-left: 1em;">chapter on "Osteoporosis, or bighead", <a href='#Page_578'>578</a>-582</span><br /> +<br /> +Mold, silage, danger to horses, <a href='#Page_56'>56</a>-57<br /> +<br /> +Mole, vesicular, or cystic disease of walls of womb, description and treatment, <a href='#Page_179'>179</a><br /> +<br /> +Moles, or anidian monsters, description, <a href='#Page_179'>179</a><br /> +<br /> +Monstrosities in foal, description of kinds, causes, and treatment, <a href='#Page_194'>194</a><br /> +<br /> +Moonblindness, or periodic ophthalmia, causes, symptoms, treatment, <a href='#Page_291'>291</a><br /> +<br /> +Mortification, or gangrene. <i>See</i> Gangrene.<br /> +<br /> +Mouth, diseases, remarks, <a href='#Page_60'>60</a><br /> +<br /> +Mucous membranes, visible, and skin may indicate disease, <a href='#Page_11'>11</a><br /> +<br /> +Mules, danger from silage as feed, <a href='#Page_56'>56</a>-57<br /> +<br /> +<i>Musca vomitoria</i>, or meat fly, note, <a href='#Page_481'>481</a><br /> +<br /> +Muscles—<br /> +<span style="margin-left: 1em;">and tendons, diseases, <a href='#Page_365'>365</a></span><br /> +<span style="margin-left: 1em;">contraction in foal, description and treatment, <a href='#Page_194'>194</a></span><br /> +<span style="margin-left: 1em;">of elbow, sprain, causes, symptoms, and treatment, <a href='#Page_368'>368</a></span><br /> +<span style="margin-left: 1em;">of eye, description, <a href='#Page_276'>276</a></span><br /> +<span style="margin-left: 1em;">one system of locomotion, <a href='#Page_299'>299</a>, <a href='#Page_300'>300</a></span><br /> +<br /> +Mycotic lymphangitis—<br /> +<span style="margin-left: 1em;">and glanders, differentiation, <a href='#Page_557'>557</a></span><br /> +<span style="margin-left: 1em;">chapter by John R. Mohler, <a href='#Page_557'>557</a>-559</span><br /> +<span style="margin-left: 1em;">diagnosis and treatment, <a href='#Page_558'>558</a></span><br /> +<span style="margin-left: 1em;">symptoms and lesions, <a href='#Page_558'>558</a></span><br /> +<br /> +Myelitis, or inflammation of substance of spinal cord, causes, symptoms, and treatment, <a href='#Page_233'>233</a><br /> +<br /> +Myocarditis, or inflammation of muscular structure of heart, symptoms, alterations, and treatment, <a href='#Page_251'>251</a><br /> +<br /> +<br /> +Nasal—<br /> +<span style="margin-left: 1em;">catarrh, or cold in head, symptoms and treatment, <a href='#Page_98'>98</a></span><br /> +<span style="margin-left: 1em;">douche, used in administering medicines, <a href='#Page_47'>47</a></span><br /> +<span style="margin-left: 1em;">gleet, chronic catarrh, or collection in sinuses, causes, symptoms, and treatment, <a href='#Page_99'>99</a></span><br /> +<span class='pagenum'><a name="Page_621" id="Page_621">[Pg 621]</a></span><span style="margin-left: 1em;">polypus, description and treatment, <a href='#Page_102'>102</a></span><br /> +<br /> +Navel—<br /> +<span style="margin-left: 1em;">discharge of urine, or persistent urachus, description and treatment, <a href='#Page_151'>151</a></span><br /> +<span style="margin-left: 1em;">string, constriction of a member, description, <a href='#Page_192'>192</a></span><br /> +<br /> +Navicular—<br /> +<span style="margin-left: 1em;">bone, description, <a href='#Page_396'>396</a></span><br /> +<span style="margin-left: 1em;">disease, description, causes, symptoms, and treatment, <a href='#Page_435'>435</a></span><br /> +<br /> +Neck of womb, twisting, description and treatment, <a href='#Page_189'>189</a><br /> +<br /> +Nephritis, acute, or acute inflammation of kidneys, causes, symptoms, and treatment, <a href='#Page_143'>143</a><br /> +<br /> +Nerve—<br /> +<span style="margin-left: 1em;">inflammation, or neuritis, cause, symptoms, and treatment, <a href='#Page_236'>236</a></span><br /> +<span style="margin-left: 1em;">tumor, or neuroma, cause, symptoms, and treatment, <a href='#Page_236'>236</a></span><br /> +<br /> +Nerves—<br /> +<span style="margin-left: 1em;">injuries, description and treatment, <a href='#Page_237'>237</a></span><br /> +<span style="margin-left: 1em;">spinal, designations, <a href='#Page_212'>212</a></span><br /> +<br /> +Nervous system—<br /> +<span style="margin-left: 1em;">and brain, anatomy and physiology, <a href='#Page_210'>210</a></span><br /> +<span style="margin-left: 1em;">diseases affecting, chapter by M. R. Trumbower, <a href='#Page_210'>210</a>-246</span><br /> +<span style="margin-left: 1em;">examination, <a href='#Page_23'>23</a></span><br /> +<br /> +Nettlerash, surfeit, or urticaria, description and treatment, <a href='#Page_467'>467</a><br /> +<br /> +Neuritis, or inflammation of a nerve, cause, symptoms, and treatment, <a href='#Page_236'>236</a><br /> +<br /> +Neuroma, or tumor of a nerve, cause, symptoms, and treatment, <a href='#Page_236'>236</a><br /> +<br /> +Nose—<br /> +<span style="margin-left: 1em;">bleeding, causes and treatment, <a href='#Page_103'>103</a></span><br /> +<span style="margin-left: 1em;">membrane, thickening, symptoms and treatment, <a href='#Page_101'>101</a></span><br /> +<br /> +Nostrils, tumors and wounds, treatment, <a href='#Page_97'>97</a><br /> +<br /> +<br /> +Obstruction colic, cause, <a href='#Page_68'>68</a><br /> +<br /> +Open joints. <i>See</i> Joints.<br /> +<br /> +Ophthalmia—<br /> +<span style="margin-left: 1em;">external, or conjunctivitis, description, causes, symptoms, and treatment, <a href='#Page_285'>285</a></span><br /> +<span style="margin-left: 1em;">internal, causes, symptoms, and treatment, <a href='#Page_288'>288</a></span><br /> +<span style="margin-left: 1em;">periodic, or moonblindness, causes, symptoms, and treatment, <a href='#Page_291'>291</a></span><br /> +<br /> +Optic nerve, paralysis, or amaurosis, cause, <a href='#Page_231'>231</a><br /> +<br /> +Orchitis, or congestion and inflammation of testicles, causes, symptoms, and treatment, <a href='#Page_164'>164</a><br /> +<br /> +Os innominatum, or hip-bone fracture, description, symptoms, and treatment, <a href='#Page_341'>341</a><br /> +<br /> +Os pedis, or third phalanx, fractures, cause and treatment, <a href='#Page_352'>352</a><br /> +<br /> +Osteoporosis, or bighead, chapter by John R. Mohler, <a href='#Page_578'>578</a>-582<br /> +<br /> +Ostitis, cause, symptoms, and treatment, <a href='#Page_309'>309</a><br /> +<br /> +Overreach, description, symptoms, and treatment, <a href='#Page_404'>404</a><br /> +<br /> +Ovum, inclosed, or tumors of fetus, description and treatment, <a href='#Page_194'>194</a><br /> +<br /> +Oxyurus equorum, parasite, symptoms and treatment for, <a href='#Page_91'>91</a><br /> +<br /> +<br /> +Palpitation of heart, description, symptoms, and treatment, <a href='#Page_259'>259</a><br /> +<br /> +Palsy—<br /> +<span style="margin-left: 1em;">of nerve of sight, or amaurosis, causes, symptoms, and treatment, <a href='#Page_295'>295</a></span><br /> +<span style="margin-left: 1em;">of paralysis, description and causes, <a href='#Page_228'>228</a></span><br /> +<br /> +Pancreas and spleen, diseases, remarks, <a href='#Page_90'>90</a><br /> +<br /> +Papilloma, epithelioma, or degeneration of penis, <a href='#Page_167'>167</a><br /> +<br /> +Papules, or congestion of skin with small pimples, description and treatment, <a href='#Page_463'>463</a><br /> +<br /> +Paralysis—<br /> +<span style="margin-left: 1em;">facial, symptoms and cause, <a href='#Page_230'>230</a></span><br /> +<span style="margin-left: 1em;">general, cause, <a href='#Page_228'>228</a></span><br /> +<span style="margin-left: 1em;">of bladder, description and cause, <a href='#Page_140'>140</a>, <a href='#Page_230'>230</a></span><br /> +<span style="margin-left: 1em;">of hind legs, cause and treatment, <a href='#Page_181'>181</a></span><br /> +<span style="margin-left: 1em;">of intestines, cause, <a href='#Page_72'>72</a>, <a href='#Page_230'>230</a></span><br /> +<span style="margin-left: 1em;">of one side or half the body or hemiplegia, description and symptoms, <a href='#Page_228'>228</a></span><br /> +<span style="margin-left: 1em;">of optic nerve, or amaurosis, cause, <a href='#Page_231'>231</a></span><br /> +<span style="margin-left: 1em;">of penis, cause and treatment, <a href='#Page_167'>167</a></span><br /> +<span style="margin-left: 1em;">of pharynx, description and treatment, <a href='#Page_61'>61</a></span><br /> +<span style="margin-left: 1em;">of rectum and tail, cause, <a href='#Page_230'>230</a></span><br /> +<span style="margin-left: 1em;">or palsy, description and causes, <a href='#Page_228'>228</a></span><br /> +<span style="margin-left: 1em;">transverse, of hind extremities, or paraplegia, description and symptoms, <a href='#Page_229'>229</a></span><br /> +<span style="margin-left: 1em;">treatment, <a href='#Page_231'>231</a></span><br /> +<br /> +Paraphymosis and phymosis, description and treatment, <a href='#Page_171'>171</a><br /> +<br /> +Paraplegia, or transverse paralysis of hind extremities, cause and treatment, <a href='#Page_229'>229</a><br /> +<br /> +<span class='pagenum'><a name="Page_622" id="Page_622">[Pg 622]</a></span> +Parasites—<br /> +<span style="margin-left: 1em;">animal, of skin, description of kinds, <a href='#Page_478'>478</a></span><br /> +<span style="margin-left: 1em;">causing worm colic, <a href='#Page_91'>91</a>, <a href='#Page_92'>92</a>, <a href='#Page_93'>93</a></span><br /> +<span style="margin-left: 1em;">gastrointestinal, <a href='#Page_90'>90</a>-94</span><br /> +<span style="margin-left: 1em;">in eye, description of kinds, <a href='#Page_296'>296</a></span><br /> +<span style="margin-left: 1em;">specific kinds affecting urinary organs, <a href='#Page_146'>146</a></span><br /> +<span style="margin-left: 1em;">vegetable, of skin, description of kinds, symptoms, and treatment, <a href='#Page_477'>477</a></span><br /> +<br /> +Parasitic pityriasis, description and treatment, <a href='#Page_478'>478</a><br /> +<br /> +Parturition—<br /> +<span style="margin-left: 1em;">different presentations, <a href='#Page_197'>197</a></span><br /> +<span style="margin-left: 1em;">difficult, from narrow pelvis, cause and treatment, <a href='#Page_186'>186</a>, <a href='#Page_188'>188</a></span><br /> +<span style="margin-left: 1em;">symptoms, <a href='#Page_185'>185</a></span><br /> +<br /> +Pastern joint, description, <a href='#Page_396'>396</a><br /> +<br /> +Pastes, or electuaries, description and manner of administering, <a href='#Page_45'>45</a><br /> +<br /> +Pasture, relation to worms in horses, <a href='#Page_93'>93</a><br /> +<br /> +Patella—<br /> +<span style="margin-left: 1em;">fracture, description, <a href='#Page_349'>349</a></span><br /> +<span style="margin-left: 1em;">pseudoluxations, descriptions, symptoms, cause, and treatment, <a href='#Page_363'>363</a></span><br /> +<br /> +Pearson, Leonard, chapter on "Examination of a sick horse", <a href='#Page_7'>7</a>-26<br /> +<br /> +Pediculi, or lice, description and treatment for bite, <a href='#Page_482'>482</a><br /> +<br /> +Pelvis—<br /> +<span style="margin-left: 1em;">and vagina, tumors affecting, description and treatment, <a href='#Page_188'>188</a></span><br /> +<span style="margin-left: 1em;">bones, fracture, different kinds, <a href='#Page_341'>341</a></span><br /> +<span style="margin-left: 1em;">narrow, cause of difficult parturition, cause and treatment, <a href='#Page_188'>188</a></span><br /> +<br /> +Penis—<br /> +<span style="margin-left: 1em;">degeneration, papilloma, or epithelioma, <a href='#Page_167'>167</a></span><br /> +<span style="margin-left: 1em;">extravasation of blood and paralysis, cause and treatment, <a href='#Page_167'>167</a></span><br /> +<span style="margin-left: 1em;">sheath, and abdomen, swelling, cause and treatment, <a href='#Page_171'>171</a></span><br /> +<span style="margin-left: 1em;">warts, treatment, <a href='#Page_167'>167</a></span><br /> +<br /> +Pericarditis—<br /> +<span style="margin-left: 1em;">a complication of influenza, <a href='#Page_518'>518</a></span><br /> +<span style="margin-left: 1em;">or inflammation of sac inclosing the heart, causes, symptoms, and treatment, <a href='#Page_255'>255</a></span><br /> +<br /> +Perineum, limbs, and abdomen, dropsy, description and treatment, <a href='#Page_180'>180</a><br /> +<br /> +Periostitis, cause, symptoms, and treatment, <a href='#Page_309'>309</a><br /> +<br /> +Peritoneum and womb, inflammation, symptoms and treatment, <a href='#Page_207'>207</a><br /> +<br /> +Peritonitis—<br /> +<span style="margin-left: 1em;">a complication of influenza, <a href='#Page_518'>518</a></span><br /> +<span style="margin-left: 1em;">description, symptoms, and treatment, <a href='#Page_85'>85</a></span><br /> +<br /> +Phalanx, first, second, and third, fracture, cause, symptoms and treatment, <a href='#Page_351'>351</a>, <a href='#Page_352'>352</a><br /> +<br /> +Pharyngeal polypus, description and treatment, <a href='#Page_102'>102</a><br /> +<br /> +Pharyngitis, description and treatment, <a href='#Page_61'>61</a><br /> +<br /> +Pharynx—<br /> +<span style="margin-left: 1em;">inflammation, description, <a href='#Page_103'>103</a></span><br /> +<span style="margin-left: 1em;">paralysis, description and treatment, <a href='#Page_61'>61</a></span><br /> +<br /> +Phlebitis, or diseases of veins, description, causes, symptoms, and treatment, <a href='#Page_268'>268</a><br /> +<br /> +Phymosis and paraphymosis, description and treatment, <a href='#Page_171'>171</a><br /> +<br /> +Physiology and anatomy of brain and nervous system, <a href='#Page_210'>210</a><br /> +<br /> +Piles, or hemorrhoids, description and treatment, <a href='#Page_81'>81</a><br /> +<br /> +Pills, or balls, description and manner of administering, <a href='#Page_44'>44</a><br /> +<br /> +Pimples, small, or congestion of skin, description and treatment, <a href='#Page_463'>463</a><br /> +<br /> +Pinworm, description and treatment, <a href='#Page_91'>91</a><br /> +<br /> +Pityriasis, or scaly skin disease, description and treatment, <a href='#Page_467'>467</a><br /> +<br /> +Plantar cushion, description, <a href='#Page_398'>398</a><br /> +<br /> +Pleurisy—<br /> +<span style="margin-left: 1em;">a complication of influenza, <a href='#Page_518'>518</a></span><br /> +<span style="margin-left: 1em;">description, symptoms, and treatment, <a href='#Page_122'>122</a></span><br /> +<br /> +Pleurodynia, symptoms and treatment, <a href='#Page_131'>131</a><br /> +<br /> +Pleuropneumonia, description and treatment, <a href='#Page_126'>126</a><br /> +<br /> +Plumbism, or lead poisoning, causes, symptoms, and treatment, <a href='#Page_245'>245</a><br /> +<br /> +Pneumonia—<br /> +<span style="margin-left: 1em;">contagious, causes, symptoms, treatment, etc., <a href='#Page_521'>521</a>-527</span><br /> +<span style="margin-left: 1em;">infection, transmission, <a href='#Page_521'>521</a>-522</span><br /> +<span style="margin-left: 1em;">or lung fever, description, symptoms, and treatment, <a href='#Page_113'>113</a></span><br /> +<br /> +Poisoning—<br /> +<span style="margin-left: 1em;">albuminoid, or azotemia, symptoms, prevention, and treatment, <a href='#Page_141'>141</a></span><br /> +<span style="margin-left: 1em;">forage, or cerebrospinal meningitis, causes, symptoms, and treatment, <a href='#Page_237'>237</a></span><br /> +<span style="margin-left: 1em;">lead, or plumbism, causes, symptoms, and treatment, <a href='#Page_245'>245</a></span><br /> +<br /> +Poll evil, description, causes, symptoms, treatment, <a href='#Page_502'>502</a>-506<br /> +<br /> +<span class='pagenum'><a name="Page_623" id="Page_623">[Pg 623]</a></span> +Polypus—<br /> +<span style="margin-left: 1em;">description and treatment, <a href='#Page_102'>102</a></span><br /> +<span style="margin-left: 1em;">pharyngeal, description and treatment, <a href='#Page_102'>102</a></span><br /> +<br /> +Polyuria, diuresis, diabetes insipidus, causes, symptoms, and treatment, <a href='#Page_138'>138</a><br /> +<br /> +Pouches, guttural, description and treatment, <a href='#Page_119'>119</a><br /> +<br /> +Poultry, acariasis, description and treatment, <a href='#Page_480'>480</a><br /> +<br /> +Powders, manner of administering, <a href='#Page_44'>44</a><br /> +<br /> +Pregnancy—<br /> +<span style="margin-left: 1em;">duration, <a href='#Page_177'>177</a></span><br /> +<span style="margin-left: 1em;">mare, hygiene, <a href='#Page_177'>177</a></span><br /> +<span style="margin-left: 1em;">medication, <a href='#Page_175'>175</a></span><br /> +<br /> +Premaxillary bone, fracture, description and treatment, <a href='#Page_336'>336</a><br /> +<br /> +Preputial calculus, calculus in sheath, description and treatment, <a href='#Page_163'>163</a><br /> +<br /> +Presentations at birth, abnormal, <a href='#Page_197'>197</a>-200<br /> +<br /> +Pruritis, or nervous irritation of skin, description and treatment, <a href='#Page_468'>468</a><br /> +<br /> +Pseudoluxations of patella, description, symptoms, cause, and treatment, <a href='#Page_363'>363</a><br /> +<br /> +<i>Psoroptes equi</i>, animal parasite of skin, <a href='#Page_480'>480</a><br /> +<br /> +Psoroptic acariasis, description and treatment, <a href='#Page_480'>480</a><br /> +<br /> +Ptyalism, or salivation, description and treatment, <a href='#Page_61'>61</a><br /> +<br /> +Pulex—<br /> +<span style="margin-left: 1em;">or flea, prevention and treatment for bite, <a href='#Page_482'>482</a></span><br /> +<span style="margin-left: 1em;"><i>penetrans</i>, or chigoe, bite, treatment, <a href='#Page_482'>482</a></span><br /> +<br /> +Pulse, how to count, <a href='#Page_13'>13</a><br /> +<br /> +Purpura hemorrhagica—<br /> +<span style="margin-left: 1em;">description, symptoms, and treatment, <a href='#Page_270'>270</a></span><br /> +<span style="margin-left: 1em;">or anasarca, causes, symptoms, and treatment, <a href='#Page_531'>531</a></span><br /> +<br /> +Pustules, inflammation, description and treatment, <a href='#Page_465'>465</a><br /> +<br /> +<br /> +Quittor, description of different kinds, <a href='#Page_407'>407</a><br /> +<br /> +<br /> +Rabies—<br /> +<span style="margin-left: 1em;">description, symptoms, and treatment, <a href='#Page_244'>244</a>-245, <a href='#Page_559'>559</a>-562</span><br /> +<span style="margin-left: 1em;">fatality of, <a href='#Page_562'>562</a></span><br /> +<br /> +Ransom, study of flies and worms, <a href='#Page_470'>470</a><br /> +<br /> +Rectum—<br /> +<span style="margin-left: 1em;">and tail, paralysis, cause, <a href='#Page_230'>230</a></span><br /> +<span style="margin-left: 1em;">impaction with feces, <a href='#Page_191'>191</a></span><br /> +<span style="margin-left: 1em;">methods of administering medicines, <a href='#Page_47'>47</a></span><br /> +<br /> +Red efflorescence, or erythema, description and treatment, <a href='#Page_461'>461</a><br /> +<br /> +Renal calculi, description, symptoms, and treatment, <a href='#Page_158'>158</a><br /> +<br /> +Respiratory organs—<br /> +<span style="margin-left: 1em;">description, <a href='#Page_95'>95</a></span><br /> +<span style="margin-left: 1em;">diseases, chapter by W. H. Harbaugh, <a href='#Page_95'>95</a>-133</span><br /> +<span style="margin-left: 1em;">methods of examination, <a href='#Page_16'>16</a></span><br /> +<br /> +Retinitis, causes, symptoms, and treatment, <a href='#Page_288'>288</a><br /> +<br /> +Ribs, fractures, description, symptoms, and treatment, <a href='#Page_339'>339</a><br /> +<br /> +Ridglings, or cryptorchids, castration method, <a href='#Page_169'>169</a><br /> +<br /> +Ringbone, description, causes, symptoms, and treatment, <a href='#Page_313'>313</a>, <a href='#Page_439'>439</a><br /> +<br /> +Ringworm—<br /> +<span style="margin-left: 1em;">circinate, or <i>Tinea tonsurans</i>, description, symptoms, and treatment, <a href='#Page_477'>477</a></span><br /> +<span style="margin-left: 1em;">honeycomb, or favus, description and treatment, <a href='#Page_478'>478</a></span><br /> +<br /> +Roaring and thick wind, description and treatment, <a href='#Page_108'>108</a>, <a href='#Page_230'>230</a><br /> +<br /> +Roundworm of kidney, <a href='#Page_146'>146</a><br /> +<br /> +Roundworms, horse, dangers and treatment, <a href='#Page_90'>90</a>-91<br /> +<br /> +Rubber pads in shoes, uses, <a href='#Page_601'>601</a><br /> +<br /> +Rupture—<br /> +<span style="margin-left: 1em;">of an artery, description, symptoms, and treatment, <a href='#Page_266'>266</a></span><br /> +<span style="margin-left: 1em;">of diaphragm, causes and symptoms, <a href='#Page_133'>133</a></span><br /> +<span style="margin-left: 1em;">of flexor metatarsi, description, cause, symptoms, and treatment, <a href='#Page_377'>377</a></span><br /> +<span style="margin-left: 1em;">of heart, description and cause, <a href='#Page_262'>262</a></span><br /> +<span style="margin-left: 1em;">of liver, cause, symptoms, and treatment, <a href='#Page_89'>89</a></span><br /> +<span style="margin-left: 1em;">of stomach, result of engorgement, colic, symptoms, and treatment, <a href='#Page_66'>66</a>, <a href='#Page_67'>67</a></span><br /> +<span style="margin-left: 1em;">of suspensory ligament, description, symptoms, and treatment, <a href='#Page_403'>403</a></span><br /> +<span style="margin-left: 1em;">of vagina, description and treatment, <a href='#Page_207'>207</a></span><br /> +<span style="margin-left: 1em;">or hernia, description of different kinds, <a href='#Page_82'>82</a></span><br /> +<span style="margin-left: 1em;">or laceration of womb, causes and treatment, <a href='#Page_206'>206</a></span><br /> +<br /> +<br /> +<span class='pagenum'><a name="Page_624" id="Page_624">[Pg 624]</a></span>Saccharine diabetes, diabetes mellitus, glycosuria, or inosuria, causes, symptoms, and treatment, <a href='#Page_130'>130</a><br /> +<br /> +Sacrum, fractures, description and treatment, <a href='#Page_341'>341</a><br /> +<br /> +St. Vitus dance, or chorea, description and treatment, <a href='#Page_227'>227</a><br /> +<br /> +Salivation, or plyalism, description and treatment, <a href='#Page_61'>61</a><br /> +<br /> +Sand-cracks of foot, description, causes, symptoms, and treatment, <a href='#Page_432'>432</a><br /> +<br /> +Sarcocele, description and treatment, <a href='#Page_165'>165</a><br /> +<br /> +<i>Sarcophaga carnaria</i>, or flesh fly, note, <a href='#Page_481'>481</a><br /> +<br /> +<i>Sarcoptes</i>, <i>scabiei equi</i>, animal parasite of skin, <a href='#Page_478'>478</a><br /> +<br /> +Sarcoptic acariasis, description, symptoms, and treatment, <a href='#Page_478'>478</a><br /> +<br /> +Scalds and burns, treatment, <a href='#Page_483'>483</a>, <a href='#Page_496'>496</a><br /> +<br /> +Scaly skin disease, or pityriasis, description and treatment, <a href='#Page_467'>467</a><br /> +<br /> +Scapula, fracture, cause, symptoms, and treatment, <a href='#Page_344'>344</a><br /> +<br /> +Scorpion and tarantula, treatment for sting or bite, <a href='#Page_483'>483</a><br /> +<br /> +Scratches, or chaps on knee and hock, or cracked heels, causes and treatment, <a href='#Page_467'>467</a><br /> +<br /> +Screw-worm fly, or <i>Lucilia hominivorax</i>, note, <a href='#Page_481'>481</a><br /> +<br /> +Scrotal or congenital hernia, cause, description, and treatment, <a href='#Page_82'>82</a><br /> +<br /> +Scrotum, dropsy, or hydrocele, symptoms and treatment, <a href='#Page_166'>166</a><br /> +<br /> +Sebaceous glands, description, <a href='#Page_460'>460</a><br /> +<br /> +Self-abuse, or masturbation, remedy, <a href='#Page_168'>168</a><br /> +<br /> +Serum, use against strangles and anthrax, <a href='#Page_531'>531</a>, <a href='#Page_544'>544</a><br /> +<br /> +Sesamoid bones, fracture, cause, symptoms, treatment, etc., <a href='#Page_352'>352</a><br /> +<br /> +Sesamoid sheath, inflammation, or navicular disease, description, symptoms, and treatment, <a href='#Page_435'>435</a><br /> +<br /> +Sesamoids, description, <a href='#Page_395'>395</a><br /> +<br /> +Sexual and urinary organs, examination, <a href='#Page_24'>24</a><br /> +<br /> +Sheath—<br /> +<span style="margin-left: 1em;">calculus, or bilocular cavity, or preputial calculus, description and treatment, <a href='#Page_163'>163</a></span><br /> +<span style="margin-left: 1em;">of flexor tendons, sprains, cause, symptoms, and treatment, <a href='#Page_371'>371</a></span><br /> +<span style="margin-left: 1em;">penis, and abdomen, swelling, cause and treatment, <a href='#Page_171'>171</a></span><br /> +<br /> +Shock, electric, description and treatment, <a href='#Page_246'>246</a><br /> +<br /> +Shoe—<br /> +<span style="margin-left: 1em;">bar, uses, <a href='#Page_601'>601</a></span><br /> +<span style="margin-left: 1em;">detailed description, <a href='#Page_597'>597</a></span><br /> +<span style="margin-left: 1em;">hot fitting, <a href='#Page_600'>600</a></span><br /> +<br /> +Shoeing—<br /> +<span style="margin-left: 1em;">chapter by John W. Adams, <a href='#Page_583'>583</a>-605</span><br /> +<span style="margin-left: 1em;">preliminary examination, <a href='#Page_594'>594</a></span><br /> +<span style="margin-left: 1em;">preparation of the hoof, <a href='#Page_596'>596</a></span><br /> +<span style="margin-left: 1em;">rubber pads, <a href='#Page_601'>601</a></span><br /> +<br /> +Shoes, special peculiarities of chief classes, <a href='#Page_598'>598</a><br /> +<br /> +Shoulder—<br /> +<span style="margin-left: 1em;">joint, displacement, description and treatment, <a href='#Page_363'>363</a></span><br /> +<span style="margin-left: 1em;">lameness, description, causes, symptoms, and treatment, <a href='#Page_365'>365</a></span><br /> +<br /> +Sick horse. <i>See</i> Horse, sick.<br /> +<br /> +Sidebones, description, cause, symptoms, and treatment, <a href='#Page_316'>316</a>, <a href='#Page_438'>438</a><br /> +<br /> +Silage, use and danger as horse feed, <a href='#Page_56'>56</a>-57<br /> +<br /> +Sinuses, collection in, chronic catarrh, or nasal gleet, causes, symptoms, and treatment, <a href='#Page_99'>99</a><br /> +<br /> +Sitfasts—<br /> +<span style="margin-left: 1em;">horny sloughs, or sloughing callosities, description and treatment, <a href='#Page_475'>475</a></span><br /> +<span style="margin-left: 1em;">or harness galls, description and treatment, <a href='#Page_496'>496</a></span><br /> +<br /> +Skin—<br /> +<span style="margin-left: 1em;">and visible mucous membranes, may indicate disease, <a href='#Page_11'>11</a></span><br /> +<span style="margin-left: 1em;">animal parasites affecting, description of kinds, <a href='#Page_478'>478</a></span><br /> +<span style="margin-left: 1em;">bleeding eruptions, description and treatment, <a href='#Page_469'>469</a></span><br /> +<span style="margin-left: 1em;">congestion, red efflorescence, or erythema, description and treatment, <a href='#Page_461'>461</a></span><br /> +<span style="margin-left: 1em;">disease, scaly, or pityriasis, description and treatment, <a href='#Page_467'>467</a></span><br /> +<span style="margin-left: 1em;">diseases, chapter by James Law, <a href='#Page_458'>458</a>-483</span><br /> +<span style="margin-left: 1em;">grubs under, description and treatment, <a href='#Page_481'>481</a></span><br /> +<span style="margin-left: 1em;">hairs, description, <a href='#Page_460'>460</a></span><br /> +<span style="margin-left: 1em;">inflammation and congestion, description of kinds, <a href='#Page_461'>461</a></span><br /> +<span style="margin-left: 1em;">nervous irritation, or pruritis, description and treatment, <a href='#Page_468'>468</a></span><br /> +<span style="margin-left: 1em;">of fetlock and ankle, note, <a href='#Page_397'>397</a></span><br /> +<span class='pagenum'><a name="Page_625" id="Page_625">[Pg 625]</a></span><span style="margin-left: 1em;">parasites, <a href='#Page_477'>477</a>-483</span><br /> +<span style="margin-left: 1em;">structure, divisions, <a href='#Page_459'>459</a></span><br /> +<span style="margin-left: 1em;">true, or dermis, description <a href='#Page_459'>459</a></span><br /> +<span style="margin-left: 1em;">vegetable parasites, description of kinds, symptoms and treatment, <a href='#Page_477'>477</a></span><br /> +<span style="margin-left: 1em;">wounds, description of different kinds and treatment, <a href='#Page_463'>463</a>-470</span><br /> +<br /> +Sloughs, horny, sitfasts, or sloughing callosities, description and treatment, <a href='#Page_475'>475</a>, <a href='#Page_496'>496</a><br /> +<br /> +Snake bites, treatment, <a href='#Page_483'>483</a><br /> +<br /> +Sole of foot, description, <a href='#Page_397'>397</a><br /> +<br /> +Sore throat, or laryngitis, description, symptoms, and treatment, <a href='#Page_103'>103</a><br /> +<br /> +Sores, summer, caused by <i>Filaria irritans</i>, treatment, <a href='#Page_469'>469</a>, <a href='#Page_470'>470</a><br /> +<br /> +Spasm—<br /> +<span style="margin-left: 1em;">of diaphragm, or thumps, description and treatment, <a href='#Page_132'>132</a>, <a href='#Page_225'>225</a></span><br /> +<span style="margin-left: 1em;">of glottis or intestines, description and treatment, <a href='#Page_225'>225</a></span><br /> +<span style="margin-left: 1em;">of larynx, description and treatment, <a href='#Page_107'>107</a></span><br /> +<span style="margin-left: 1em;">of neck of bladder, causes, symptoms, and treatment, <a href='#Page_146'>146</a>, <a href='#Page_225'>225</a></span><br /> +<span style="margin-left: 1em;">of neck of womb, description and treatment, <a href='#Page_191'>191</a></span><br /> +<span style="margin-left: 1em;">of thigh, or cramp of hind limb, description and treatment, <a href='#Page_226'>226</a></span><br /> +<br /> +Spasmodic or cramp colic, cause, symptoms, and treatment, <a href='#Page_74'>74</a><br /> +<br /> +Spasms, or cramps, causes and treatment, <a href='#Page_226'>226</a><br /> +<br /> +Spavin—<br /> +<span style="margin-left: 1em;">blood, bog spavin, and thorough pin, description and treatment, <a href='#Page_356'>356</a></span><br /> +<span style="margin-left: 1em;">description, cause, symptoms, prognosis, and treatment, <a href='#Page_317'>317</a></span><br /> +<br /> +Speedy cuts and interfering, description, symptoms, treatment, etc. <a href='#Page_387'>387</a><br /> +<br /> +Spermatic cord—<br /> +<span style="margin-left: 1em;">strangulated, cause and treatment, <a href='#Page_170'>170</a></span><br /> +<span style="margin-left: 1em;">tumors, causes and treatment, <a href='#Page_171'>171</a></span><br /> +<br /> +Spinal—<br /> +<span style="margin-left: 1em;">anemia, symptoms and treatment, <a href='#Page_234'>234</a></span><br /> +<span style="margin-left: 1em;">compression and concussion, cause, description, and treatment, <a href='#Page_234'>234</a></span><br /> +<span style="margin-left: 1em;">concussion, causes, and treatment, <a href='#Page_235'>235</a></span><br /> +<span style="margin-left: 1em;">congestion, cause, symptoms, and treatment, <a href='#Page_233'>233</a></span><br /> +<span style="margin-left: 1em;">cord, description, <a href='#Page_212'>212</a></span><br /> +<span style="margin-left: 1em;">cord, inflammation of membranes, causes, symptoms, treatment, etc., <a href='#Page_232'>232</a></span><br /> +<span style="margin-left: 1em;">cord, inflammation of substance, or myelitis, causes, symptoms, treatment, <a href='#Page_233'>233</a></span><br /> +<span style="margin-left: 1em;">hemorrhage, symptom and treatment, <a href='#Page_235'>235</a></span><br /> +<span style="margin-left: 1em;">meningitis, causes, symptoms, pathology, and treatment, <a href='#Page_232'>232</a></span><br /> +<span style="margin-left: 1em;">nerves, designation, <a href='#Page_212'>212</a></span><br /> +<span style="margin-left: 1em;">tumors, symptoms and treatment, <a href='#Page_236'>236</a></span><br /> +<br /> +Spleen and pancreas, diseases, remarks, <a href='#Page_90'>90</a><br /> +<br /> +Splint, description, symptoms, cause, and treatment, <a href='#Page_310'>310</a><br /> +<br /> +Sprain—<br /> +<span style="margin-left: 1em;">of elbow muscles, causes, symptoms, and treatment, <a href='#Page_368'>368</a></span><br /> +<span style="margin-left: 1em;">of fetlock, causes, symptoms, and treatment, <a href='#Page_402'>402</a></span><br /> +<br /> +Sprains—<br /> +<span style="margin-left: 1em;">description and treatment, <a href='#Page_365'>365</a>-374, <a href='#Page_392'>392</a>-394</span><br /> +<span style="margin-left: 1em;">of loins, description, cause, symptoms, and treatment, <a href='#Page_392'>392</a></span><br /> +<span style="margin-left: 1em;">of suspensory ligaments and of flexor tendons or their sheath, cause, symptoms, and treatment, <a href='#Page_371'>371</a>-372</span><br /> +<br /> +Sprung knees, cause, symptoms, and treatment, <a href='#Page_373'>373</a><br /> +<br /> +Staphyloma, or bulging cornea, description and treatment, <a href='#Page_296'>296</a><br /> +<br /> +Stallion—<br /> +<span style="margin-left: 1em;">castration, methods, <a href='#Page_168'>168</a></span><br /> +<span style="margin-left: 1em;">sterility, cause and treatment, <a href='#Page_172'>172</a></span><br /> +<br /> +Sterility in mare and stallion, cause and treatment, <a href='#Page_172'>172</a><br /> +<br /> +Stiles, Ch. Wardell, chapter on "Surra", <a href='#Page_572'>572</a>-577<br /> +<br /> +Stock vaccines, administration, <a href='#Page_506'>506</a><br /> +<br /> +Stomach—<br /> +<span style="margin-left: 1em;">and intestines, diseases, remarks, <a href='#Page_65'>65</a></span><br /> +<span style="margin-left: 1em;">calculi, or stones, symptoms and treatment, <a href='#Page_70'>70</a></span><br /> +<span style="margin-left: 1em;">rupture, result of engorgement colic, symptoms and treatment <a href='#Page_68'>68</a></span><br /> +<span style="margin-left: 1em;">worms, description, etc., <a href='#Page_91'>91</a>-92</span><br /> +<br /> +Stomatitis, description and treatment, <a href='#Page_60'>60</a><br /> +<br /> +Stone—<br /> +<span style="margin-left: 1em;">in bladder, vesical calculus, or cystic calculus, description, symptoms, and treatment, <a href='#Page_160'>160</a></span><br /> +<span class='pagenum'><a name="Page_626" id="Page_626">[Pg 626]</a></span><span style="margin-left: 1em;">in urethra, or urethral calculus, description, symptoms, and treatment, <a href='#Page_162'>162</a></span><br /> +<span style="margin-left: 1em;">or calculus, and tumor in bladder, <a href='#Page_190'>190</a></span><br /> +<span style="margin-left: 1em;">urinary calculi, or gravel, description, <a href='#Page_154'>154</a>, <a href='#Page_157'>157</a></span><br /> +<br /> +Stones—<br /> +<span style="margin-left: 1em;">or calculi, in intestines, description, symptoms, and treatment, <a href='#Page_71'>71</a></span><br /> +<span style="margin-left: 1em;">or calculi, in stomach, symptoms and treatment, <a href='#Page_70'>70</a></span><br /> +<br /> +Strangles, definition, causes, symptoms, and treatment, <a href='#Page_527'>527</a>-531<br /> +<br /> +Strangulated spermatic cord, cause and treatment, <a href='#Page_170'>170</a><br /> +<br /> +<i>Streptococcus pyogenes equi</i>, cause of pneumonia, <a href='#Page_522'>522</a><br /> +<br /> +Stricture—<br /> +<span style="margin-left: 1em;">of esophagus, description and treatment, <a href='#Page_65'>65</a></span><br /> +<span style="margin-left: 1em;">of urethra, description and treatment, <a href='#Page_153'>153</a></span><br /> +<br /> +Stringhalt, description, cause and treatment, <a href='#Page_227'>227</a>, <a href='#Page_390'>390</a><br /> +<br /> +Strongyles, injuries to horses, symptoms and treatment, <a href='#Page_92'>92</a>-93<br /> +<br /> +<i>Strongylus</i>—<br /> +<span style="margin-left: 1em;"><i>equinum</i>, parasite of kidney, <a href='#Page_146'>146</a></span><br /> +<span style="margin-left: 1em;">spp. injuries by and treatment, <a href='#Page_92'>92</a>-93</span><br /> +<span style="margin-left: 1em;"><i>vulgaris</i>, worm causing one form of aneurism, <a href='#Page_265'>265</a></span><br /> +<br /> +Sty, furuncle, or boil of eyelid, description and treatment, <a href='#Page_282'>282</a><br /> +<br /> +Suffraginis, description, <a href='#Page_395'>395</a><br /> +<br /> +Summer sores, caused by <i>Filaria irritans</i>, description and treatment, <a href='#Page_469'>469</a>, <a href='#Page_470'>470</a><br /> +<br /> +Sunstroke, heat stroke, or heat exhaustion, symptoms, treatment, etc., <a href='#Page_219'>219</a><br /> +<br /> +Superpurgation, description and treatment, <a href='#Page_78'>78</a><br /> +<br /> +Suppositories, description and uses, <a href='#Page_48'>48</a><br /> +<br /> +Suppuration and abscess in lung, symptoms, <a href='#Page_127'>127</a><br /> +<br /> +Surfeit, nettlerash, or urticaria, description and treatment, <a href='#Page_467'>467</a><br /> +<br /> +Surra—<br /> +<span style="margin-left: 1em;">chapter by Ch. Wardell Stiles, <a href='#Page_572'>572</a>-577</span><br /> +<span style="margin-left: 1em;">climatic conditions, animals affected, and lethality, <a href='#Page_572'>572</a></span><br /> +<span style="margin-left: 1em;">diagnosis and treatment, <a href='#Page_577'>577</a></span><br /> +<span style="margin-left: 1em;">method of infection, symptoms, <a href='#Page_573'>573</a></span><br /> +<br /> +Suspensory ligament—<br /> +<span style="margin-left: 1em;">and flexor tendons, or their sheaths, sprains, cause, symptoms, treatment, <a href='#Page_371'>371</a>-372</span><br /> +<span style="margin-left: 1em;">description, <a href='#Page_395'>395</a></span><br /> +<span style="margin-left: 1em;">rupture, description, symptoms, and treatment, <a href='#Page_403'>403</a></span><br /> +<br /> +Sutures, description and uses, <a href='#Page_486'>486</a><br /> +<br /> +Swamp fever. <i>See</i> Infectious anemia.<br /> +<br /> +Sweat glands, description, <a href='#Page_461'>461</a><br /> +<br /> +<i>Symbiotes equi</i>, <i>Dermatophagus equi</i>, or <i>Chorioptes spathiferus</i>, animal parasite of skin, <a href='#Page_480'>480</a><br /> +<br /> +Syncope, or fainting, symptoms and treatment, <a href='#Page_259'>259</a><br /> +<br /> +Synovial—<br /> +<span style="margin-left: 1em;">dropsies, remarks, <a href='#Page_355'>355</a></span><br /> +<span style="margin-left: 1em;">sacs, diseases, description, <a href='#Page_355'>355</a></span><br /> +<br /> +Synovitis, cause, prognosis, and treatment, <a href='#Page_357'>357</a><br /> +<br /> +<br /> +Tail and rectum, paralysis, cause, <a href='#Page_230'>230</a><br /> +<br /> +Tapeworms, horse, kind and injuries, <a href='#Page_90'>90</a><br /> +<br /> +Tarantula and scorpion, treatment for bite and sting, <a href='#Page_483'>483</a><br /> +<br /> +Teats, sore, scabs, cracks, warts, cause, and treatment, <a href='#Page_209'>209</a><br /> +<br /> +Teeth—<br /> +<span style="margin-left: 1em;">diseases period of dentition, <a href='#Page_58'>58</a></span><br /> +<span style="margin-left: 1em;">irregularities, remedies, <a href='#Page_58'>58</a></span><br /> +<br /> +Temperament of horse, <a href='#Page_10'>10</a><br /> +<br /> +Temperature, method of determining, <a href='#Page_15'>15</a><br /> +<br /> +Tendon sheaths, wounds, description and treatment, <a href='#Page_494'>494</a><br /> +<br /> +Tendons—<br /> +<span style="margin-left: 1em;">and muscles, diseases, <a href='#Page_365'>365</a></span><br /> +<span style="margin-left: 1em;">flexor, or their sheath, sprains, cause, symptoms, and treatment, <a href='#Page_371'>371</a></span><br /> +<span style="margin-left: 1em;">functions, <a href='#Page_301'>301</a></span><br /> +<span style="margin-left: 1em;">lacerated, cause, symptoms, prognosis, and treatment, <a href='#Page_376'>376</a></span><br /> +<span style="margin-left: 1em;">of foot, function, <a href='#Page_396'>396</a></span><br /> +<br /> +Testicles—<br /> +<span style="margin-left: 1em;">abnormal number, causes of degeneration, <a href='#Page_166'>166</a></span><br /> +<span style="margin-left: 1em;">or orchitis, congestion and inflammation, causes, symptoms, treatment, <a href='#Page_166'>166</a></span><br /> +<br /> +<span class='pagenum'><a name="Page_627" id="Page_627">[Pg 627]</a></span>Tetanus, or lockjaw, causes, symptoms, prevention, and treatment, <a href='#Page_241'>241</a><br /> +<br /> +Thick wind and roaring, description and treatment, <a href='#Page_108'>108</a><br /> +<br /> +Thigh, spasm, or cramp of hind limb, description and treatment, <a href='#Page_226'>226</a><br /> +<br /> +Thoracic choke, description and treatment, <a href='#Page_63'>63</a>, <a href='#Page_64'>64</a><br /> +<br /> +Thoroughpin, blood spavin, and bog spavin, description and treatment, <a href='#Page_356'>356</a><br /> +<br /> +Threadworms, cause of bleeding skin eruptions, <a href='#Page_469'>469</a><br /> +<br /> +Throat—<br /> +<span style="margin-left: 1em;">abscesses affecting, treatment, <a href='#Page_62'>62</a></span><br /> +<span style="margin-left: 1em;">sore, or laryngitis, description, symptoms, and treatment, <a href='#Page_103'>103</a></span><br /> +<br /> +Thrombosis, description, cause, symptoms, and treatment, <a href='#Page_391'>391</a><br /> +<br /> +Thrombus and embolism, description, symptoms, and treatment, <a href='#Page_267'>267</a><br /> +<br /> +Thrush, description, causes, symptoms, and treatment, <a href='#Page_417'>417</a><br /> +<br /> +Thumps, or spasm of diaphragm, description and treatment, <a href='#Page_132'>132</a>, <a href='#Page_225'>225</a><br /> +<br /> +Tibia, fractures, symptoms and treatment, <a href='#Page_349'>349</a><br /> +<br /> +Ticks, description and treatment, <a href='#Page_481'>481</a><br /> +<br /> +Timothy, best hay for feeding, <a href='#Page_53'>53</a><br /> +<br /> +<i>Tinea tonsurans</i>, or circinate ringworm, description and treatment, <a href='#Page_477'>477</a><br /> +<br /> +Tissues, description, <a href='#Page_27'>27</a><br /> +<br /> +Tobacco dip, use against mange in horses, <a href='#Page_479'>479</a><br /> +<br /> +Toothache, how to determine and treat, <a href='#Page_59'>59</a><br /> +<br /> +Trichiasis, or turned eyelashes, description and treatment, <a href='#Page_283'>283</a><br /> +<br /> +<i>Trichophyton tonsurans</i>, vegetable parasite of skin, <a href='#Page_477'>477</a><br /> +<br /> +Trumbower, M. R.—<br /> +<span style="margin-left: 1em;">chapter on "Diseases of heart, blood vessels, and lymphatics", <a href='#Page_247'>247</a>-273</span><br /> +<span style="margin-left: 1em;">chapter on "Diseases of nervous system", <a href='#Page_210'>210</a>-246</span><br /> +<br /> +<i>Trypanosoma equiperdum</i>, cause of dourine, note, <a href='#Page_562'>562</a><br /> +<br /> +Tuberculosis, or consumption, note, <a href='#Page_128'>128</a><br /> +<br /> +Tumor—<br /> +<span style="margin-left: 1em;">and calculus, or stone in bladder, <a href='#Page_190'>190</a></span><br /> +<span style="margin-left: 1em;">of haw, or caries of cartilage, description and treatment, <a href='#Page_284'>284</a></span><br /> +<span style="margin-left: 1em;">of nerve, or neuroma, cause, symptoms, and treatment, <a href='#Page_236'>236</a></span><br /> +<span style="margin-left: 1em;">on spermatic cord, causes and treatment, <a href='#Page_171'>171</a></span><br /> +<br /> +Tumors—<br /> +<span style="margin-left: 1em;">and warts of eyelids, description and treatment, <a href='#Page_283'>283</a></span><br /> +<span style="margin-left: 1em;">black pigment, or melanosis, description and treatment, <a href='#Page_476'>476</a></span><br /> +<span style="margin-left: 1em;">in nostrils, treatment, <a href='#Page_97'>97</a></span><br /> +<span style="margin-left: 1em;">in vagina and pelvis, description and treatment, <a href='#Page_188'>188</a></span><br /> +<span style="margin-left: 1em;">of eyeball, remarks, <a href='#Page_296'>296</a></span><br /> +<span style="margin-left: 1em;">of fetus, or inclosed ovum, description and treatment, <a href='#Page_194'>194</a></span><br /> +<span style="margin-left: 1em;">of kidneys, note, <a href='#Page_146'>146</a></span><br /> +<span style="margin-left: 1em;">of spine, symptoms and treatment, <a href='#Page_236'>236</a></span><br /> +<span style="margin-left: 1em;">of udder, cause and treatment, <a href='#Page_209'>209</a></span><br /> +<span style="margin-left: 1em;">of abnormal growths, cause of colic, <a href='#Page_73'>73</a></span><br /> +<span style="margin-left: 1em;">within cranium, description of kinds, <a href='#Page_224'>224</a></span><br /> +<br /> +Twins, remarks, <a href='#Page_196'>196</a><br /> +<br /> +Tympanitic colic, cause, symptoms, and treatment, <a href='#Page_73'>73</a><br /> +<br /> +<br /> +Udder—<br /> +<span style="margin-left: 1em;">congestion and inflammation, symptoms and treatment, <a href='#Page_208'>208</a></span><br /> +<span style="margin-left: 1em;">tumors, cause and treatment, <a href='#Page_209'>209</a></span><br /> +<br /> +Ulceration, description, causes, and treatment, <a href='#Page_499'>499</a><br /> +<br /> +Ulcers on cornea, treatment, <a href='#Page_288'>288</a><br /> +<br /> +Umbilical hernia, description and treatment, <a href='#Page_84'>84</a><br /> +<br /> +Urachus, persistent, or discharge of urine by navel, description and treatment, <a href='#Page_151'>151</a><br /> +<br /> +Uremia, description, symptoms, and treatment, <a href='#Page_245'>245</a><br /> +<br /> +Urethra—<br /> +<span style="margin-left: 1em;">inflammation, urethritis, or gleet, symptoms and treatment, <a href='#Page_153'>153</a></span><br /> +<span style="margin-left: 1em;">stone, or urethral calculus, description, symptoms, and treatment, <a href='#Page_162'>162</a></span><br /> +<span style="margin-left: 1em;">stricture, description and treatment, <a href='#Page_153'>153</a></span><br /> +<br /> +Urethral calculi, description and treatment, <a href='#Page_159'>159</a><br /> +<br /> +Urethral calculus, or stone in urethra, description, symptoms, and treatment, <a href='#Page_162'>162</a><br /> +<br /> +Urethritis, inflammation of urethra, or gleet, symptoms, and treatment, <a href='#Page_153'>153</a><br /> +<br /> +Urinary—<br /> +<span style="margin-left: 1em;">and sexual organs, examination, <a href='#Page_24'>24</a></span><br /> +<span style="margin-left: 1em;">calculi, classification, <a href='#Page_157'>157</a></span><br /> +<span class='pagenum'><a name="Page_628" id="Page_628">[Pg 628]</a></span><span style="margin-left: 1em;">calculi, stone, or gravel, description and causes, <a href='#Page_154'>154</a>, <a href='#Page_157'>157</a></span><br /> +<span style="margin-left: 1em;">disorders, causes, <a href='#Page_134'>134</a></span><br /> +<span style="margin-left: 1em;">organs, diseases, chapter by James Law, <a href='#Page_134'>134</a>-163</span><br /> +<span style="margin-left: 1em;">organs, parasites affecting, <a href='#Page_146'>146</a></span><br /> +<span style="margin-left: 1em;">organs, symptoms of disease, <a href='#Page_136'>136</a></span><br /> +<span style="margin-left: 1em;">organs, uses, <a href='#Page_134'>134</a></span><br /> +<br /> +Urine—<br /> +<span style="margin-left: 1em;">analysis, <a href='#Page_154'>154</a></span><br /> +<span style="margin-left: 1em;">bloody, or hematuria, cause and treatment, <a href='#Page_141'>141</a></span><br /> +<span style="margin-left: 1em;">discharge by navel, or persistent urachus, description and treatment, <a href='#Page_151'>151</a></span><br /> +<span style="margin-left: 1em;">excessive secretion, diuresis, polyuria, diabetes insipidus, causes, symptoms, and treatment, <a href='#Page_138'>138</a></span><br /> +<span style="margin-left: 1em;">how to examine, <a href='#Page_136'>136</a></span><br /> +<span style="margin-left: 1em;">of healthy horse, description, <a href='#Page_25'>25</a></span><br /> +<br /> +Urocystitis, inflammation of bladder, or cystitis, symptoms and treatment, <a href='#Page_149'>149</a><br /> +<br /> +Urticaria, nettlerash, or surfeit, description and treatment, <a href='#Page_467'>467</a><br /> +<br /> +<br /> +Vaccination—<br /> +<span style="margin-left: 1em;">use against diseases and manufacture of material, <a href='#Page_510'>510</a></span><br /> +<span style="margin-left: 1em;">use against strangles and anthrax, <a href='#Page_531'>531</a>, <a href='#Page_544'>544</a></span><br /> +<br /> +Vaccines, kinds and use, <a href='#Page_506'>506</a>, <a href='#Page_531'>531</a><br /> +<br /> +Vagina—<br /> +<span style="margin-left: 1em;">and pelvis, tumors affecting, description and treatment, <a href='#Page_188'>188</a></span><br /> +<span style="margin-left: 1em;">rupture, description and treatment, <a href='#Page_207'>207</a></span><br /> +<br /> +Vaginal walls, effusion of blood, <a href='#Page_190'>190</a><br /> +<br /> +Valvular disease of heart, symptoms and treatment, <a href='#Page_257'>257</a><br /> +<br /> +Varicocele, description and treatment, <a href='#Page_166'>166</a><br /> +<br /> +Varicose veins, varix, or dilatation of veins, causes and treatment, <a href='#Page_269'>269</a><br /> +<br /> +Variola, equine, or horsepox, causes, symptoms, and treatment, <a href='#Page_535'>535</a>-540<br /> +<br /> +Veins—<br /> +<span style="margin-left: 1em;">description, <a href='#Page_250'>250</a></span><br /> +<span style="margin-left: 1em;">dilatation, varicose veins, or varix, causes and treatment, <a href='#Page_269'>269</a></span><br /> +<span style="margin-left: 1em;">diseases, or phlebitis, causes, symptoms, and treatment, <a href='#Page_268'>268</a></span><br /> +<br /> +Ventral hernia, description and treatment, <a href='#Page_83'>83</a><br /> +<br /> +Vertebra, fractures, causes, symptoms, and treatment, <a href='#Page_338'>338</a><br /> +<br /> +Vesical calculus, stone in bladder, or cystic calculus, description, symptoms, and treatment, <a href='#Page_159'>159</a><br /> +<br /> +Vesicular mole, or cystic disease of walls of womb, description and treatment, <a href='#Page_179'>179</a><br /> +<br /> +Volvulus, gut-tie, or twisting of bowels, cause, symptoms, and treatment, <a href='#Page_72'>72</a><br /> +<br /> +Vulva, or vagina, fibrous constriction, cause and treatment, <a href='#Page_191'>191</a><br /> +<br /> +Warts—<br /> +<span style="margin-left: 1em;">and tumors of eyelids, description and treatment, <a href='#Page_283'>283</a></span><br /> +<span style="margin-left: 1em;">description and treatment, <a href='#Page_476'>476</a></span><br /> +<span style="margin-left: 1em;">on penis, treatment, <a href='#Page_167'>167</a></span><br /> +<br /> +Wasps, bees, and hornets, stings, treatment, <a href='#Page_483'>483</a><br /> +<br /> +Water—<br /> +<span style="margin-left: 1em;">impure, cause of disease, time to give, <a href='#Page_49'>49</a></span><br /> +<span style="margin-left: 1em;">in head, or hydrocephalus of foal, description and treatment, <a href='#Page_192'>192</a></span><br /> +<br /> +Watering eye, or obstruction of lachrymal apparatus, description and remedy, <a href='#Page_285'>285</a><br /> +<br /> +Whistling, description, <a href='#Page_110'>110</a><br /> +<br /> +Wind—<br /> +<span style="margin-left: 1em;">broken, heaves, or asthma, definition, symptoms, and treatment, <a href='#Page_128'>128</a></span><br /> +<span style="margin-left: 1em;">colic, cause, symptoms, and treatment, <a href='#Page_73'>73</a></span><br /> +<br /> +Windgalls, description, causes, symptoms, and treatment, <a href='#Page_355'>355</a>, <a href='#Page_401'>401</a><br /> +<br /> +Windpipe, description, <a href='#Page_119'>119</a><br /> +<br /> +Winking cartilage, or cartilago nictitans, description, <a href='#Page_276'>276</a><br /> +<br /> +Womb—<br /> +<span style="margin-left: 1em;">and peritoneum, inflammation, symptoms, and treatment, <a href='#Page_206'>206</a></span><br /> +<span style="margin-left: 1em;">bleeding, or flooding, treatment, <a href='#Page_205'>205</a></span><br /> +<span style="margin-left: 1em;">dropsy, cause, symptoms, and treatment, <a href='#Page_179'>179</a></span><br /> +<span style="margin-left: 1em;">eversion, description and method of treatment, <a href='#Page_205'>205</a></span><br /> +<span style="margin-left: 1em;">hernia, description and treatment, <a href='#Page_189'>189</a></span><br /> +<span style="margin-left: 1em;">laceration, or rupture, causes and treatment, <a href='#Page_206'>206</a></span><br /> +<span style="margin-left: 1em;">neck, twisting, description and treatment, <a href='#Page_189'>189</a></span><br /> +<br /> +<span class='pagenum'><a name="Page_629" id="Page_629">[Pg 629]</a></span>Worm colic, notes <a href='#Page_93'>93</a><br /> +<br /> +Worms—<br /> +<span style="margin-left: 1em;">bladder, affecting kidneys, <a href='#Page_146'>146</a></span><br /> +<span style="margin-left: 1em;">injuries by, and treatment, <a href='#Page_90'>90</a>-94</span><br /> +<span style="margin-left: 1em;">strongyle, danger and treatment, <a href='#Page_92'>92</a>-93</span><br /> +<span style="margin-left: 1em;">treatment with dips, <a href='#Page_479'>479</a></span><br /> +<br /> +Wounds—<br /> +<span style="margin-left: 1em;">and their treatment, chapter by Ch. B. Michener, <a href='#Page_484'>484</a>-506</span><br /> +<span style="margin-left: 1em;">gunshot, description and treatment, <a href='#Page_494'>494</a></span><br /> +<span style="margin-left: 1em;">healing under a scab, treatment, <a href='#Page_487'>487</a></span><br /> +<span style="margin-left: 1em;">in nostrils, cause and treatment, <a href='#Page_97'>97</a></span><br /> +<span style="margin-left: 1em;">lacerated and contused, description and treatment, <a href='#Page_488'>488</a></span><br /> +<span style="margin-left: 1em;">penetrating walls of chest, description and treatment, <a href='#Page_131'>131</a></span><br /> +<span style="margin-left: 1em;">poisoned, description and treatment, <a href='#Page_495'>495</a></span><br /> +<span style="margin-left: 1em;">punctured, description, symptoms, and treatment, <a href='#Page_426'>426</a>, <a href='#Page_490'>490</a></span><br /> +<br /> +<br /> +Yellows, jaundice, or icterus, description and treatment, <a href='#Page_88'>88</a><br /></p> + +<hr style="width: 65%;" /> +<p class="center"> +ADDITIONAL COPIES<br /> +OF THIS PUBLICATION MAY BE PROCURED FROM<br /> +THE SUPERINTENDENT OF DOCUMENTS<br /> +GOVERNMENT PRINTING OFFICE<br /> +WASHINGTON. D.C.<br /> +AT<br /> +$1.00 PER COPY<br /> +</p> + + + + + + + + + +<pre> + + + + + +End of the Project Gutenberg EBook of Special Report on Diseases of the Horse, by +United States Department of Agriculture and Leonard Pearson and Rush Shippen Huidekoper and Ch. B. Michener and W. H. 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