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+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: ASCII
+
+*** 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
+
+
+
+
+
+
+
+
+
+
+U. S. DEPARTMENT OF AGRICULTURE, BUREAU OF ANIMAL INDUSTRY.
+
+A. D. MELVIN, CHIEF OF BUREAU.
+
+       *       *       *       *       *
+
+SPECIAL REPORT
+
+ON
+
+DISEASES OF THE HORSE.
+
+BY
+
+Drs. PEARSON, MICHENER, LAW, HARBAUGH, TRUMBOWER, LIAUTARD, HOLCOMBE,
+HUIDEKOPER, MOHLER, EICHHORN, HALL, AND ADAMS.
+
+       *       *       *       *       *
+
+REVISED EDITION, 1916.
+
+[Illustration]
+
+WASHINGTON:
+GOVERNMENT PRINTING OFFICE.
+1916.
+
+
+
+
+DEPARTMENT OF AGRICULTURE,
+
+_Washington, March 30, 1916._
+
+       *       *       *       *       *
+
+Transcriber's note: The italic markup for single italized letters are
+deleted for easier reading. Minor typos have been corrected and footnotes
+moved to the end of the sections.
+
+       *       *       *       *       *
+
+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:
+
+     _Resolved by the House of Representatives (the Senate
+     concurring)_, 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.
+
+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.
+
+D. F. HOUSTON,
+
+_Secretary._
+
+
+
+
+CONTENTS.
+
+
+                                                                Page.
+
+The examination of a sick horse. By Leonard Pearson                 7
+
+Fundamental principles of disease. By Rush Shippen Huidekoper      27
+
+Methods of administering medicines. By Ch. B. Michener             44
+
+Diseases of the digestive organs. By Ch. B. Michener               49
+
+Diseases of the respiratory organs. By W. H. Harbaugh              95
+
+Diseases of the urinary organs. By James Law                      134
+
+Diseases of the generative organs. By James Law                   164
+
+Diseases of the nervous system. By M. R. Trumbower                210
+
+Diseases of the heart, blood vessels, and lymphatics.
+  By M. R. Trumbower                                              247
+
+Diseases of the eye. By James Law                                 274
+
+Lameness. By A. Liautard                                          298
+
+Diseases of the fetlock, ankle, and foot. By A. A. Holcombe       395
+
+Diseases of the skin. By James Law                                458
+
+Wounds and their treatment. By Ch. B. Michener                    484
+
+Infectious diseases. By Rush Shippen Huidekoper                   507
+
+Shoeing. By John W. Adams                                         583
+
+Index                                                             607
+
+
+
+
+ILLUSTRATIONS.
+
+
+PLATES.
+
+                                                                Page.
+PLATE
+I. Inflammation                                                    32
+
+II. Inflammation                                                   32
+
+III. Digestive apparatus                                           48
+
+IV. Age of horses as indicated by teeth                            58
+
+V. Intestinal worms                                                92
+
+VI. Bots                                                           92
+
+VII. Position of the left lung                                    112
+
+VIII. Longitudinal section through kidney                         136
+
+IX. Microscopic anatomy of kidney                                 136
+
+X. Microscopic anatomy of kidney                                  136
+
+XI. Calculi and instrument for removal                            152
+
+XII. Normal presentation                                          192
+
+XIII. Some factors in difficult labor                             192
+
+XIV. Instruments used in difficult labor                          192
+
+XV. Abnormal presentations                                        200
+
+XVI. Abnormal presentations                                       200
+
+XVII. Abnormal presentations                                      200
+
+XVIII. Abnormal presentations                                     200
+
+XIX. The nervous system                                           216
+
+XX. Interior of chest, showing position of heart and diaphragm    248
+
+XXI. Circulatory apparatus                                        248
+
+XXII. Diagrammatic vertical section through horse's eye           277
+
+XXIII. Skeleton of horse                                          304
+
+XXIV. Superficial layer of muscles                                304
+
+XXV. Splint                                                       312
+
+XXVI. Ringbone                                                    312
+
+XXVII. Various types of spavin                                    312
+
+XXVIII. Bone spavin                                               312
+
+XXIX. Bone spavin                                                 312
+
+XXX. Dislocation of shoulder and elbow, Bourgelat's apparatus     360
+
+XXXI. The sling in use                                            360
+
+XXXII. Anatomy of foot                                            400
+
+XXXIII. Anatomy of foot                                           400
+
+XXXIV. Anatomy and diseases of foot                               400
+
+XXXV. Sound and contracted feet                                   400
+
+XXXVI. Quarter crack and remedies                                 432
+
+XXXVII. Foundered feet                                            432
+
+XXXVIII. The skin and its diseases                                458
+
+XXXIX. Mites that infest the horse                                480
+
+XL. Glanders                                                      544
+
+XLI. Glanders                                                     544
+
+XLII. Glanders                                                    544
+
+
+TEXT FIGURES.
+
+                                                                  Page.
+FIG.
+1. Ground surface of a right fore hoof of the
+  "regular" form                                                    590
+
+2. Pair of fore feet of regular form in regular standing position   591
+
+3. Pair of fore feet of base-wide form in toe-wide standing
+  position                                                          591
+
+4. Pair of fore feet of base-narrow form in toe-narrow standing
+  position                                                          592
+
+5. Side view of an acute-angled fore foot, of a regular fore
+  foot, and of a stumpy fore foot                                   592
+
+6. Side view of foot with the foot-axis broken backward as a
+  result of too long a toe                                          595
+
+7. Left fore hoof of a regular form, shod with a plain fullered
+  shoe                                                              599
+
+8. Side view of hoof and fullered shoe                              599
+
+9. An acute-angled left fore hoof shod with a bar shoe              601
+
+10. A fairly formed right fore ice shoe for a roadster              601
+
+11. Left fore hoof of regular form shod with a rubber pad and
+  "three-quarter" shoe                                              602
+
+12. A narrow right fore hoof of the base-wide standing position
+  shod with a plain "dropped crease" shoe                           602
+
+13. Hoof surface of a right hind shoe to prevent interfering        603
+
+14. Ground surface of shoe shown in fig. 13                         603
+
+15. Side view of a fore hoof shod so as to quicken the "breaking
+  over" in a "forger"                                               604
+
+16. Side view of a short-toed hind hoof of a forger                 604
+
+17. A toe-weight shoe to increase the length of stride of fore
+  feet                                                              605
+
+18. Most common form of punched heel-weight shoe to induce high
+  action in fore feet                                               605
+
+
+
+
+SPECIAL REPORT ON DISEASES OF THE HORSE.
+
+
+
+
+THE EXAMINATION OF A SICK HORSE.
+
+By Leonard Pearson, B. S., V. M. D.
+
+
+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.
+
+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.
+
+
+HISTORY.
+
+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.
+
+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.
+
+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.
+
+
+ATTITUDE AND GENERAL CONDITION.
+
+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 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.
+
+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.
+
+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.
+
+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 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.
+
+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.
+
+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, 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.
+
+
+THE SKIN AND THE VISIBLE MUCOUS MEMBRANES.
+
+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.
+
+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 unable to pump the blood to the
+surface, and that the animal is on the verge of collapse.
+
+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.
+
+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.
+
+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.
+
+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.
+
+
+THE ORGANS OF CIRCULATION.
+
+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.
+
+The normal pulse of the healthy horse varies in frequency as follows:
+
+    Stallion                     28 to 32 beats per minute.
+
+    Gelding                      33 to 38 beats per minute.
+
+    Mare                         34 to 40 beats per minute.
+
+    Foal 2 to 3 years old        40 to 50 beats per minute.
+
+    Foal 6 to 12 months old      45 to 60 beats per minute.
+
+    Foal 2 to 4 weeks old        70 to 90 beats per minute.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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
+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.
+
+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.
+
+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.
+
+
+TEMPERATURE.
+
+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.
+
+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 deg. to 101 deg. F. If the temperature rises to 102.5 deg. the horse is
+said to have a low fever; if the temperature reaches 104 deg. the fever is
+moderate; if it reaches 106 deg. it is high, 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 deg. or 110 deg.. In the ordinary infectious
+diseases it does not often exceed 106 deg.. A temperature of 107.5 deg. and
+above is very dangerous and must be reduced promptly if the horse is to
+be saved.
+
+
+THE ORGANS OF RESPIRATION.
+
+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.
+
+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.
+
+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 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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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, there is an excess of air in the
+chest cavity, the percussion sound becomes abnormally loud and clear.
+
+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.
+
+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.
+
+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 rales. Mucous rales 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 rales 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.
+
+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.
+
+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.
+
+
+THE EXAMINATION OF THE DIGESTIVE TRACT.
+
+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.
+
+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.
+
+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.
+
+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 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.
+
+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.
+
+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.
+
+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 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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+
+THE EXAMINATION OF THE NERVOUS SYSTEM.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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
+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.
+
+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.
+
+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.
+
+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.
+
+
+URINARY AND SEXUAL ORGANS.
+
+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.
+
+To examine the kidneys by pressure the pressure should be brought to
+bear over these organs. The kidneys lie beneath the ends of the
+transverse processes of the vertebrae 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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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 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.
+
+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.
+
+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.
+
+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.
+
+
+
+
+FUNDAMENTAL PRINCIPLES OF DISEASE.
+
+By RUSH SHIPPEN HUIDEKOPER, M. D., VET.
+
+[Revised by Leonard Pearson, B. S., V. M. D.]
+
+
+ANIMAL TISSUES.
+
+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.
+
+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 (a) amorphous
+substances, (b) fibers, and (c) cells.
+
+(a) 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.
+
+(b) 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 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.
+
+(c) 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.
+
+(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.
+
+(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.
+
+(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.
+
+(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.
+
+(5) Bone differs from the above in having the amorphous matter
+impregnated with lime salts, which gives it its rigidity and firmness.
+
+(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. 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.
+
+(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.
+
+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.
+
+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.
+
+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.
+
+Hypernutrition, or excessive nutrition of a tissue, may be normal or
+morbid. If the latter, the tissue becomes congested or inflamed.
+
+
+CONGESTION.
+
+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.
+
+
+ACTIVE CONGESTION.
+
+Active congestion is caused by--
+
+(1) _Functional activity._--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.
+
+(2) _Irritants._--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.
+
+(3) _Nerve influence._--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.
+
+(4) _Plethora and sanguinary temperament._--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.
+
+(5) _Fevers._--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.
+
+(6) _Warm climate and summer heat._--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.
+
+(7) _Previous congestion._--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.
+
+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.
+
+
+PASSIVE CONGESTION.
+
+Passive congestion is caused by interference with the return of the
+current of blood from a part.
+
+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.
+
+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.
+
+The alterations of passive congestion, as in active congestion, consist
+of an increased quantity of blood in the vessels and an exudation 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.
+
+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.
+
+
+INFLAMMATION.
+
+(Plates I and II.)
+
+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.
+
+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 laminae 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.
+
+[Illustration: PLATE I.
+
+INFLAMMATION.
+
+1--_Uninflamed wing of the bat._
+
+2--_Inflamed wing of the bat._]
+
+[Illustration: PLATE II.
+
+INFLAMMATION.
+
+1--_Non-inflamed mesentery of the frog, 400 diameters, reduced 1/2: a,
+a, Venule with red and white corpuscles; b, b, Gelatinous nerve fibre;
+c, Capillary; d, d, Dark-bordered nerve fibre; e, e, Connective tissue
+with connective tissue corpuscles and leucocytes scattered sparsely
+through it._
+
+2--_Inflamed mesentery of the frog, 400 diameters, reduced 1/2: a, a,
+Venule filled with red and white corpuscles, the red in the centre and
+the white crowding along the walls; c, c, Capillary, distended with red
+and white corpuscles, number of the white much decreased; d, d,
+Connective tissue between venule and capillary filled with migrated
+leucocytes; e, e, Connective tissue with less infiltration; f,
+Dark-bordered nerve fibre; g, Number of nuclei, in sheaths increased._]
+
+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.
+
+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 laminae of the feet.
+
+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.
+
+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.
+
+_Symptoms._--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.
+
+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.
+
+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.
+
+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.
+
+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 which, to the less experienced observer, appear to be
+absolutely identical.
+
+_Termination of inflammation._--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 debris 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.
+
+_Treatment of inflammation._--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.
+
+_Local treatment._--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 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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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 or on the legs, as so often used.
+Blisters, iodin, and many other irritants are used in a similar way.
+
+_Constitutional treatment_ 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.
+
+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.
+
+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.
+
+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.
+
+Diuretics operate through the kidneys in the same way.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+
+FEVERS.
+
+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 deg. 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.
+
+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 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.
+
+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.
+
+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.
+
+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.
+
+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 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.
+
+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:
+
+The normal body temperature, which varies from 99 deg. to 100 deg. F., is
+elevated from 1 deg. to 9 deg.. A temperature of 102 deg. or 103 deg. F. is moderate
+fever, 104 deg. to 105 deg. F. is high, and 106 deg. F. and over is excessive. The
+temperature is accurately measured by means of a clinical thermometer
+inserted in the rectum.
+
+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 conjunctivae of the eyes
+and inside of the mouth, change color if the fever is an 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.
+
+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.
+
+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.
+
+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).
+
+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.
+
+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.
+
+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.
+
+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.
+
+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 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.
+
+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.
+
+
+
+
+METHODS OF ADMINISTERING MEDICINES.
+
+By CH. B. MICHENER, V. S.
+
+[Revised by Leonard Pearson, B. S., V. M. D.]
+
+
+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).
+
+BY THE MOUTH.--Medicines can be given by the mouth in the form of
+solids, as powders or pills; liquids, and pastes, or electuaries.
+
+_Powders._--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.
+
+_Pills, or "balls"_ 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.
+
+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.
+
+_Pastes or electuaries_ 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.
+
+_Liquids._--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.
+
+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 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.
+
+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 _drenches must never be given through
+the nose_. 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.
+
+BY THE AIR PASSAGES.--Medicines are administered to the lungs and upper
+air passages by insufflation, inhalation, injection, and nasal douche.
+
+_Insufflation_ consists in blowing an impalpable powder directly into
+the nose. It is but rarely resorted to.
+
+_Inhalation._--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."
+
+_Injections_ 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.
+
+_The nasal douche_ 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.
+
+BY THE SKIN.--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.
+
+BY THE TISSUE BENEATH THE SKIN (HYPODERMATIC METHOD).--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.
+
+BY THE RECTUM.--Medicines may be given by the rectum when they can not
+be given by the mouth, or when they are not retained in 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.
+
+_Suppositories_ 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.
+
+_Enemas_, when given for absorption, should be small in quantity,
+neutral or slightly acid in reaction, and of a temperature of from 90 deg.
+to 100 deg. 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.
+
+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.
+
+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.
+
+BY THE GENITO-URINARY PASSAGES.--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.
+
+BY THE BLOOD.--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.
+
+[Illustration: PLATE III.
+
+DIGESTIVE APPARATUS.
+
+1. Mouth. 2. Pharynx. 3. Esophagus. 4. Diaphragm. 5. Spleen. 6. Stomach.
+7. Duodenum. 8. Liver, upper extremity. 9. Large colon. 10. Cecum. 11.
+Small intestine. 12. Floating colon. 13. Rectum. 14. Anus. 15. Left
+kidney and its ureter. 16. Bladder. 17. Urethra.]
+
+
+
+
+DISEASES OF THE DIGESTIVE ORGANS.
+
+By CH. B. MICHENER, V. S.
+
+[Revised by John R. Mohler, V. M. D.]
+
+
+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.
+
+
+WATER.
+
+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.
+
+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.
+
+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 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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+
+FEEDS AND FEEDING.
+
+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.
+
+
+KINDS OF FEED.
+
+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:
+
+     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
+     (_Cicer arietinum_), 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.
+
+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.
+
+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.
+
+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 the
+part of the digestive organs of the horse. It is thus that, in fact, too
+much feed may make an animal poor.
+
+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.
+
+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.
+
+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 _to feed too soon after a hard day's work_. 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 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.
+
+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 _usual_ 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.
+
+Feeds should also be of a more laxative nature when the horse is to
+stand for several days.
+
+MUSTY OR MOLDY FEEDS.--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.
+
+HAY.--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.
+
+_Second crop, or aftermath._--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. 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.
+
+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.
+
+STRAW.--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.
+
+CHAFF.--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.
+
+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.
+
+GRAINS.--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 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.
+
+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.
+
+WHEAT AND RYE.--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.
+
+BRAN.--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.
+
+MAIZE (CORN).--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.
+
+LINSEED.--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.
+
+POTATOES.--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.
+
+BEETS.--These are not much used as feed for horses.
+
+CARROTS.--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.
+
+GRASSES.--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.
+
+SILAGE.--Regarding silage as a feed for horses, Rommel in Farmers'
+Bulletin 578 writes as follows:
+
+     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.
+
+     It is also unsafe to feed horses frozen silage on account of
+     the danger of colic. * * *
+
+     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.
+
+
+PREPARATION OF FEEDS.
+
+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. e._, removes the laxative tendency
+of most of them.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+
+DISEASES OF THE TEETH.
+
+_Dentition._--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:
+
+     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.
+
+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.
+
+_Irregularities of teeth._--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.
+
+
+[Illustration: PLATE IV.
+
+AGE OF HORSES AS INDICATED BY TEETH.
+
+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.]
+
+_Toothache._--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.
+
+_Deformity._--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.
+
+The method of determining the age of a horse by the teeth is illustrated
+in Plate IV.
+
+
+DISEASES OF THE MOUTH.
+
+
+LAMPAS.
+
+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.
+
+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.
+
+
+STOMATITIS.
+
+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.
+
+
+GLOSSITIS (INFLAMMATION OF THE TONGUE).
+
+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 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.
+
+
+SALIVATION (PTYALISM).
+
+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.
+
+
+PHARYNGITIS.
+
+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.
+
+
+PARALYSIS OF THE PHARYNX.
+
+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 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.
+
+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.
+
+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.
+
+
+ABSCESSES.
+
+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.
+
+
+DISEASES OF THE ESOPHAGUS OR GULLET.
+
+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.
+
+
+CHOKING.
+
+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.
+
+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.
+
+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.
+
+_Symptoms._--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.
+
+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.
+
+_Treatment._--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 mouth to
+protect the hand and arm of the operator. Then, while an assistant, with
+his hands grasped tightly _behind_ 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.
+
+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.
+
+Thoracic choke can be treated only by means of the introduction of oils
+and mucilaginous drinks and the careful use of the probang.
+
+
+STRICTURE OF THE ESOPHAGUS.
+
+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.
+
+
+SACULAR DILATATION OF THE ESOPHAGUS.
+
+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.
+
+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.
+
+
+DISEASES OF THE STOMACH AND INTESTINES.
+
+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 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.
+
+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.
+
+
+COLIC.
+
+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.
+
+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.
+
+ENGORGEMENT COLIC.--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 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.
+
+_Symptoms._--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.
+
+_Treatment._--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.
+
+_Rupture of the stomach._--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.
+
+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.
+
+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.
+
+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.
+
+OBSTRUCTION COLIC.--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.
+
+_Impaction of the large intestines._--This is a very common bowel
+trouble and one which, if not promptly recognized and properly 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.
+
+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.
+
+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 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.
+
+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.
+
+_Constipation, or costiveness._--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.
+
+_Foreign bodies (calculi, stones) in the stomach._--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 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.
+
+_Intestinal concretions (calculi or stones in the intestines)._--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.
+
+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.
+
+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.
+
+_Intussusception, or invagination._--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 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.
+
+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.
+
+_Volvulus, gut tie, or twisting of the bowels._--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.
+
+_Paralysis of the intestine._--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
+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.
+
+_Abnormal growths_, 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.
+
+FLATULENT COLIC (TYMPANITIC COLIC, WIND COLIC, OR BLOAT).--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.
+
+_Symptoms._--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.
+
+_Treatment._--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.
+
+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.
+
+SPASMODIC OR CRAMP COLIC.--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.
+
+_Symptoms._--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 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.
+
+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.
+
+_Treatment._--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.
+
+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 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.
+
+
+INDIGESTION OR GASTROINTESTINAL CATARRH.
+
+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.
+
+The causes of indigestion are numerous, but nearly all are the result of
+errors in feeding.
+
+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.
+
+_Symptoms._--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 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.
+
+_Treatment._--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.
+
+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.
+
+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.
+
+
+DIARRHEA.
+
+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.
+
+The symptoms are the frequent evacuations of liquid stools, with or
+without pronounced abdominal pain, loss of appetite, emaciation, etc.
+
+_Treatment_ 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
+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.
+
+SUPERPURGATION.--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 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.
+
+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.
+
+
+DYSENTERY.
+
+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.
+
+_Causes._--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.
+
+_Symptoms._--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.
+
+_Treatment._--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 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.
+
+
+GASTROENTERITIS.
+
+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.
+
+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.
+
+_Symptoms._--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.
+
+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.
+
+_Treatment._--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 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.
+
+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.
+
+_Antidotes for poisons._--For the various poisons the remedies are as
+follows:
+
+Arsenic: Oxyhydrate of iron solution, 1 pint to 1 quart; or calcined
+magnesia, one-half ounce in 1 pint of water.
+
+Corrosive sublimate (bichlorid of mercury): The whites of a dozen eggs,
+or 2 ounces of flowers of sulphur.
+
+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.
+
+Sulphate of copper: Milk, the whites of eggs, or reduced iron.
+
+Sulphate or chlorid of zinc: Milk, the whites of eggs, or calcined
+magnesia.
+
+Lye or alkalies, as caustic potash or soda: Vinegar, dilute sulphuric
+acid, and linseed tea, with opium, 3 drams.
+
+Mineral acids: Chalk, or calcined magnesia, or baking soda; later give
+linseed tea and opium.
+
+
+HEMORRHOIDS, OR PILES.
+
+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.
+
+_Treatment._--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.
+
+
+HERNIA, OR RUPTURE.
+
+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.
+
+CONGENITAL SCROTAL HERNIA.--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.
+
+SCROTAL HERNIA 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 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.
+
+INGUINAL HERNIA 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.
+
+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.
+
+_Treatment of inguinal hernia._--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."
+
+VENTRAL HERNIA.--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 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.
+
+_Treatment of ventral hernia._--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.
+
+UMBILICAL HERNIA 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.
+
+_Treatment of umbilical hernia._--In the treatment of umbilical hernia
+it should be remembered that congenital hernias are often removed with
+age, but probably congenital _umbilical hernias_ 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. 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.
+
+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.
+
+DIAPHRAGMATIC HERNIA.--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.
+
+
+PERITONITIS.
+
+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.
+
+_Symptoms._--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 deg. to 104 deg. 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.
+
+_Treatment._--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.
+
+
+ASCITES, OR DROPSY OF THE ABDOMEN.
+
+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.
+
+_Symptoms._--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 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.
+
+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.
+
+
+DISEASES OF THE LIVER.
+
+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.
+
+
+HEPATITIS, OR INFLAMMATION OF THE LIVER.
+
+This disease may be general or local, and may assume an acute or chronic
+form.
+
+_Symptoms._--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 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.
+
+_Causes._--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.
+
+_Treatment._--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.
+
+
+JAUNDICE, ICTERUS, OR THE YELLOWS.
+
+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 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.
+
+_Treatment._--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.
+
+
+RUPTURE OF THE LIVER.
+
+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
+_small_ 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.
+
+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.
+
+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.
+
+_Treatment._--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, 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.
+
+
+BILIARY CALCULI, OR GALLSTONES.
+
+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.
+
+
+DISEASES OF THE PANCREAS AND SPLEEN.
+
+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.
+
+
+GASTROINTESTINAL PARASITES.
+
+[By Maurice C. Hall, Ph. D., D. V. M.]
+
+Horses are subject to infestation by a number of species of worms, these
+worms being especially numerous at certain points in the alimentary
+canal.
+
+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.
+
+Flukes occur in horses elsewhere, but have apparently never been
+reported in the United States.
+
+Roundworms, or nematodes, constitute the most important group of
+parasitic worms in the horse. The more important of these are as
+follows:
+
+ROUNDWORM (_Ascaris equorum_).--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 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.
+
+_Treatment_ 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.
+
+PINWORM (_Oxyuris equi_).--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.
+
+STOMACH WORMS OF THE HORSE (_Habronema_ 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 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.
+
+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.
+
+STRONGYLES (_Strongylus_ spp. and _Cylicostomum_ 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.
+
+The larva of _Strongylus vulgaris_ 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.
+
+The larvae of _Strongylus equinus_ are found principally in the liver,
+lungs, and pancreas.
+
+The larvae of _Strongylus edentatus_ may be met with almost anywhere,
+especially under the serous membranes, the pleura and peritoneum.
+
+The embryos and larvae of species of _Cylicostomum_ are found in the
+mucosa of the large intestine.
+
+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 larvae of
+_Cylicostomum_ 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.
+
+[Illustration: PLATE V.
+
+INTESTINAL WORMS.
+
+Oxyuris equi
+
+Strongylus equinus.
+
+Habronema microstoma
+
+Cylichnostomum Sp.
+
+Ascaris equorum]
+
+[Illustration: PLATE VI.
+
+BOTS
+
+1. Bots in the stomach.
+
+2. Bots in the duodenum.]
+
+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.
+
+_Treatment_ 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.
+
+BOTS (_Gastrophilus_ 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.
+
+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 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.
+
+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.
+
+
+
+
+DISEASES OF THE RESPIRATORY ORGANS.
+
+By W. S. HARBAUGH, V. S.
+
+[Revised by Leonard Pearson, B. S., V. M. D.]
+
+
+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.
+
+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.
+
+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.
+
+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.
+
+The horse, in a normal condition, breathes exclusively through the
+nostrils. The organs of respiration are quite liable to become
+diseased, 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.
+
+
+CAUSES OF DISEASES OF RESPIRATORY ORGANS.
+
+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.
+
+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.
+
+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.
+
+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 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.
+
+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.
+
+
+WOUNDS ABOUT THE NOSTRILS.
+
+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.
+
+
+TUMORS WITHIN THE NOSTRILS.
+
+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.
+
+_Treatment._--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.
+
+
+COLD IN THE HEAD, OR NASAL CATARRH.
+
+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.
+
+_Symptoms._--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.
+
+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.
+
+_Treatment._--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 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.
+
+The horse may be made to inhale steam four or five times a day, about 15
+or 20 minutes each time.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+
+CHRONIC CATARRH (OR NASAL GLEET, OR COLLECTION IN THE SINUSES).
+
+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 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.
+
+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.
+
+_Symptoms._--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.
+
+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.
+
+_Treatment._--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.
+
+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.
+
+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.
+
+An abscess involving the turbinated bones is similar to the collection
+of pus in the sinuses and must be relieved by trephining.
+
+
+THICKENING OF THE NASAL MEMBRANE.
+
+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.
+
+
+NASAL POLYPUS.
+
+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.
+
+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.
+
+
+PHARYNGEAL POLYPUS.
+
+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.
+
+
+BLEEDING FROM THE NOSE.
+
+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.
+
+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.
+
+
+INFLAMMATION OF THE PHARYNX.
+
+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.
+
+
+SORE THROAT, OR LARYNGITIS.
+
+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 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.
+
+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.
+
+_Symptoms._--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.
+
+_Treatment._--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.
+
+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 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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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 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.
+
+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.
+
+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.
+
+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.
+
+During the time the tube is used the other treatment advised must not be
+neglected. After a few days the discharge from the nostrils 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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+
+SPASM OF THE LARYNX.
+
+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.
+
+
+CROUP AND DIPHTHERIA.
+
+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.
+
+
+THICK WIND AND ROARING.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+An animal that is a roarer should not be used for breeding purposes. The
+taint is transmissible in many instances.
+
+_Grunting._--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, 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.
+
+_High blowing._--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.
+
+_Whistling_ 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.
+
+
+CHRONIC BRONCHITIS.
+
+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.
+
+_Treatment._--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 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.
+
+
+THE LUNGS.
+
+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.
+
+
+CONGESTION OF THE LUNGS.
+
+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.
+
+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 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.
+
+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.
+
+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.
+
+_Treatment._--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.
+
+[Illustration: PLATE VII.
+
+POSITION OF THE LEFT LUNG.]
+
+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.
+
+
+PNEUMONIA, OR LUNG FEVER.
+
+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.
+
+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. The
+fluids thus escaping into the air cells and in the minute branches of
+the little bronchial tubes become coagulated.
+
+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.
+
+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.
+
+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.
+
+_Symptoms._--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 deg. F. or higher. The pulse is frequent, 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.
+
+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.
+
+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.
+
+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 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.
+
+_Treatment._--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 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.
+
+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.
+
+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 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.
+
+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.
+
+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.
+
+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.
+
+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
+the danger; hence double pneumonia is more fatal than pneumonia of one
+lung.
+
+
+THE WINDPIPE.
+
+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.
+
+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."
+
+
+GUTTURAL POUCHES.
+
+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.
+
+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.
+
+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.
+
+
+BRONCHITIS AND BRONCHO-PNEUMONIA.
+
+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.
+
+_Symptoms._--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 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.
+
+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.
+
+_Treatment._--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.
+
+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, 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.
+
+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.
+
+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.
+
+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.
+
+
+PLEURISY.
+
+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 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.
+
+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.
+
+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.
+
+_Symptoms._--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 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 deg. or
+103 deg. to 105 deg. 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.
+
+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.
+
+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.
+
+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 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.
+
+Pleurisy may affect only a small area of one side or it may affect both
+sides. It is oftener confined to the right side.
+
+_Treatment._--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.
+
+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.
+
+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.
+
+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 _Cannabis indica_ may be used in doses of
+2 to 4 drams.
+
+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.
+
+_Hydrothorax_ 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.
+
+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.
+
+
+PLEUROPNEUMONIA.
+
+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.
+
+
+BRONCHO-PLEUROPNEUMONIA.
+
+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.
+
+
+SUPPURATION AND ABSCESS IN THE LUNG.
+
+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.
+
+
+MORTIFICATION.
+
+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.
+
+
+HEMOPTYSIS, OR BLEEDING FROM THE LUNGS.
+
+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 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.
+
+
+TUBERCULOSIS OF THE LUNGS.
+
+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.
+
+
+HEAVES, BROKEN WIND, OR ASTHMA.
+
+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.
+
+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.
+
+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 first. In
+this variety the air finds its way into the lung tissue between the air
+cells or the tissue between the small lobules.
+
+_Symptoms._--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.
+
+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.
+
+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 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.
+
+_Treatment._--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.
+
+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.
+
+
+CHRONIC COUGH.
+
+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.
+
+The treatment of the affections will be found under their appropriate
+heads, to which the reader is referred.
+
+
+PLEURODYNIA.
+
+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.
+
+
+WOUNDS PENETRATING THE WALLS OF THE CHEST.
+
+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 when the symptoms are urgent it is
+recommended that the air be removed by a trocar and cannula or by an
+aspirator.
+
+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.
+
+
+THUMPS, OR SPASM OF THE DIAPHRAGM.
+
+"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.
+
+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.
+
+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 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.
+
+
+RUPTURE OF THE DIAPHRAGM.
+
+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.
+
+
+
+
+DISEASES OF THE URINARY ORGANS.
+
+BY JAMES LAW, F. R. C. V. S.,
+
+_Formerly Professor of Veterinary Science, etc., in Cornell University._
+
+
+USES OF THE URINARY ORGANS.
+
+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.
+
+
+PROMINENT CAUSES OF URINARY DISORDERS.
+
+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), 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.
+
+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.
+
+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--(a) 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; (b) the internal (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 (d) 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 g
+(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.
+
+
+GENERAL SYMPTOMS OF DISEASE.
+
+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.
+
+
+EXAMINATION OF THE URINE.
+
+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) _Color_:
+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) _Density_: 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) _Chemical reaction_, 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) _Organic constituents_, 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) _In its salts_, which may
+crystallize out spontaneously, or on boiling, or on the addition of
+chemical reagents.
+
+[Illustration: PLATE VIII.
+
+LONGITUDINAL SECTION THROUGH KIDNEY.]
+
+[Illustration: PLATE IX.
+
+MICROSCOPIC ANATOMY OF KIDNEY.]
+
+[Illustration: PLATE X.
+
+MICROSCOPIC ANATOMY OF KIDNEY.]
+
+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 pleurae, and even tympany (bloating), doubtless from the same
+cause, and in all congestive or inflammatory diseases of the kidneys,
+acute or chronic.
+
+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.
+
+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.
+
+
+DIURESIS (POLYURIA, DIABETES INSIPIDUS, OR EXCESSIVE SECRETION OF
+URINE).
+
+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.
+
+_Causes._--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.
+
+_Symptoms._--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.
+
+_Treatment_ 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.
+
+
+SACCHARINE DIABETES (DIABETES MELLITUS, GLYCOSURIA, OR INOSURIA).
+
+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.
+
+_Causes._--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.
+
+_Symptoms._--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 deg. to 80 deg.
+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.
+
+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.
+
+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.
+
+_Treatment_ 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.
+
+
+HEMATURIA (BLOODY URINE).
+
+_Cause._--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.
+
+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.
+
+_Treatment._--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.
+
+
+HEMOGLOBINURIA (AZOTURIA, AZOTEMIA, POISONING BY ALBUMINOIDS).
+
+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, 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.
+
+Lignieres has found in hemoglobinuria a streptococcus which produced
+nephritis, bloody urine, and paraplegia in experimental animals,
+including horses.
+
+_Symptoms._--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.
+
+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.
+
+_Prevention._--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.
+
+_Treatment._--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.
+
+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.
+
+
+ACUTE INFLAMMATION OF THE KIDNEYS, OR ACUTE NEPHRITIS.
+
+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.
+
+_Causes._--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 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.
+
+_Symptoms._--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.
+
+_Treatment_ 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 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.
+
+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.
+
+
+CHRONIC INFLAMMATION OF THE KIDNEYS.
+
+_Causes._--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.
+
+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.
+
+_Symptoms._--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.
+
+_Treatment_ 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.
+
+As in the acute inflammation, every attention must be given to secure
+warm clothing, a warm stall, and pure air.
+
+
+TUMORS OF THE KIDNEYS.
+
+Tumors, whether malignant or simple, would give rise to symptoms
+resembling some form of inflammation, and are not liable to be
+recognized during life.
+
+
+PARASITES.
+
+To parasites of the kidney belong the echinococcus, the larval, or
+bladder worm, stage of the small echinococcus tapeworm of the dog.
+_Dioctophyme renale_, 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 _Strongylus equinus_ or a related species, may be
+found in the renal artery or in the kidney itself.
+
+
+SPASM OF THE NECK OF THE BLADDER.
+
+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.
+
+_Causes._--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.
+
+_Symptoms._--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.
+
+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.
+
+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 bladder is usually distended with urine and
+feels enlarged, elastic, and fluctuating.
+
+_Treatment._--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.
+
+
+PARALYSIS OF THE BLADDER.
+
+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.
+
+_Symptoms._--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. 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.
+
+_Treatment._--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.
+
+
+INFLAMMATION OF THE BLADDER (CYSTITIS, OR UROCYSTITIS).
+
+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.
+
+_Symptoms._--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 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.
+
+_Treatment_ 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.
+
+
+IRRITABLE BLADDER.
+
+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 a powerful
+determining cause. The condition is marked in many mares during the
+period of heat.
+
+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).
+
+
+DISEASED GROWTHS IN THE BLADDER.
+
+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.
+
+_Symptoms._--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.
+
+
+DISCHARGE OF URINE BY THE NAVEL, OR PERSISTENT URACHUS.
+
+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 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.
+
+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.
+
+
+EVERSION OF THE BLADDER.
+
+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.
+
+This displacement usually supervenes on a flaccid condition of the
+bladder, the result of paralysis, overdistention, or severe compression
+during a difficult parturition.
+
+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.
+
+[Illustration: PLATE XI.
+
+CALCULI AND INSTRUMENT FOR REMOVAL.]
+
+
+INFLAMMATION OF THE URETHRA (URETHRITIS, OR GLEET).
+
+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.
+
+_Symptoms._--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.
+
+_Treatment_ 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.
+
+Every stallion suffering from urethritis should be withheld from
+service, as should mares with leucorrhea.
+
+
+STRICTURE OF THE URETHRA.
+
+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 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.
+
+
+URINARY CALCULI (STONE, OR GRAVEL).
+
+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:
+
+    Water                                       918.5
+    Urea                                         13.4
+    Uric acid and urates                           .1
+    Hippuric acid                                26.4
+    Lactic acid and lactates                      1.2
+    Mucus and organic matter                     22.0
+    Sulphates (alkaline)                          1.2
+    Phosphates (lime and soda)                     .2
+    Chlorids (sodium)                             1.0
+    Carbonates (potash, magnesia, lime)          16.0
+                                                -----
+                                               1000.0
+
+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.
+
+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,
+Fuestenberg 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. 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 Woehler 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.).
+
+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.
+
+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--(a) when the ration is excessive and especially
+rich in phosphorus (wheat, bran, beans, peas, vetches, rape cake, oil
+cake, cottonseed cake); and (b) 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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+
+CLASSIFICATION OF URINARY CALCULI.
+
+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
+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.
+
+_Renal calculi._--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.
+
+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.
+
+_Ureteric calculi._--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 capsule
+containing an urinous fluid. If both the ureters are similarly blocked,
+the animal will die of uremic poisoning.
+
+_Treatment of renal and ureteric calculi._--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.
+
+_Stone in the bladder (vesical calculus, or cystic calculus)._--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. 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.
+
+_Symptoms of stone in the bladder._--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.
+
+In the mare the hard stone may be touched by the finger introduced
+through the short urethra.
+
+_Treatment of stone in the bladder._--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.
+
+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
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+_Urethral calculus (stone in the urethra)._--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.
+
+_Symptoms of urethral calculus._--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.
+
+_Treatment of urethral calculus_ 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 (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.
+
+_Preputial calculus (calculus in the sheath, or bilocular
+cavity)._--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.
+
+
+
+
+DISEASES OF THE GENERATIVE ORGANS.
+
+By JAMES LAW, F. R. C. V. S.,
+
+Formerly Professor of Veterinary Science, etc., in Cornell University.
+
+
+CONGESTION AND INFLAMMATION OF THE TESTICLES, OR ORCHITIS.
+
+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.
+
+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.
+
+_Symptoms._--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 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.
+
+_Treatment_ 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.
+
+
+SARCOCELE.
+
+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
+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.
+
+The only rational and effective treatment is castration, and when the
+disease is specific (glanders, tuberculosis), even this may not succeed.
+
+
+HYDROCELE, OR DROPSY OF THE SCROTUM.
+
+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.
+
+_Symptoms._--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.
+
+_Treatment_ 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.
+
+
+VARICOCELE.
+
+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.
+
+
+ABNORMAL NUMBER OF TESTICLES.
+
+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.
+
+
+DEGENERATION OF THE TESTICLES.
+
+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 (_Strongylus edentatus_).
+
+
+WARTS ON THE PENIS.
+
+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.
+
+
+DEGENERATION OF PENIS (PAPILLOMA, OR EPITHELIOMA).
+
+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.
+
+
+EXTRAVASATION OF BLOOD IN THE PENIS.
+
+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.
+
+
+PARALYSIS OF THE PENIS.
+
+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 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.
+
+
+SELF-ABUSE, OR MASTURBATION.
+
+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.
+
+
+DOURINE.
+
+This disease is discussed in the chapter on "Infectious Diseases."
+
+
+CASTRATION.
+
+
+CASTRATION OF STALLIONS.
+
+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, 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--(a) enabling the clamps to hold
+more securely and (b) 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.
+
+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.
+
+
+CASTRATION OF CRYPTORCHIDS (RIDGLINGS).
+
+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 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
+ecraseur. 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.
+
+
+CONDITIONS FOLLOWING CASTRATION.
+
+_Pain after castration._--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.
+
+_Bleeding after castration._--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.
+
+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.
+
+_Strangulated spermatic cord._--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.)
+
+_Swelling of the sheath, penis, and abdomen._--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.
+
+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.
+
+_Phymosis and paraphymosis._--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.
+
+_Tumors on the spermatic cord._--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 (_Staphylococcus botriomyces_). 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 ecraseur. 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.
+
+
+CASTRATION BY THE COVERED OPERATION.
+
+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.
+
+
+CASTRATION OF THE MARE.
+
+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 ecraseur 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.
+
+
+STERILITY.
+
+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.
+
+In the stallion sterility may be due to the following causes: (a)
+Imperfect development of the testicles, as in cases in which they are
+retained within the abdomen; (b) inflammation of the testicles,
+resulting in induration; (c) fatty degeneration of the testicles, in
+stallions liberally fed on starchy feed and not sufficiently exercised;
+(d) fatty degeneration of the excretory ducts of the testicles (_vasa
+deferentia_); (e) inflammation or ulceration of these ducts; (f)
+inflammation or ulceration of the mucous membrane covering the penis;
+(g) injuries to the penis from blows (often causing paralysis); (h)
+warty growths on the end of the penis; (i) tumors of other kinds
+(largely pigmentary), affecting the testicles or penis; (j) nervous
+diseases which abolish the sexual appetite or that control the muscles
+which are essential to the act of coition; (k) azoturia with resulting
+weakness or paralysis of the muscles of the loins or the front of the
+thigh (above the stifle); (l) ossification (_anchylosis_) of the
+joints of the back or loins, which render the animal unable to rear or
+mount; (m) 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 (a, b, and c)
+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.
+
+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: (a) Imperfect development of the
+ovary and nonmaturation of ova; (b) cystic or other tumors of the
+ovary; (c) fatty degeneration of the ovary in very obese, pampered
+mares; (d) fatty degeneration of the excretory tubes of the ovaries
+(Fallopian tubes); (e) catarrh of the womb, with mucopurulent
+discharge; (f) irritable condition of the womb, with profuse
+secretion, straining, and ejection of the semen; (g) nervous
+irritability, leading to the same expulsion of the male element; (h)
+high condition (plethora), with profuse secretion and excitement; (i)
+low condition, with imperfect maturation of the ova and lack of sexual
+desire; (j) poor feeding, overwork, and chronic debilitating diseases,
+as leading to the condition just named; (k) closure of the neck of the
+womb, temporarily by spasm or permanently by inflammation and
+induration; (l) closure of the entrance to the vagina through
+imperforate hymen, a rare, though not unknown, condition in the mare;
+(m) acquired indisposition to breed, seen in old, hard-worked mares
+which are first put to the stallion when aged; (n) change of climate
+has repeatedly been followed by barrenness; (o) hybridity, which in
+male and female alike usually entails sterility.
+
+_Treatment._--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.
+
+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 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.
+
+
+PREGNANCY.
+
+INDICATIONS OF PREGNANCY.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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 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.
+
+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.
+
+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.
+
+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.
+
+
+DURATION OF PREGNANCY.
+
+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.
+
+
+HYGIENE OF THE PREGNANT MARE.
+
+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.
+
+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.
+
+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 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.
+
+
+EXTRA-UTERINE GESTATION.
+
+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.
+
+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 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.
+
+
+MOLES, OR ANIDIAN MONSTERS.
+
+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.
+
+
+CYSTIC DISEASE OF THE WALLS OF THE WOMB, OR VESICULAR MOLE.
+
+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 ecraseur or otherwise, following it up with
+antiseptic injections, as advised under the last heading.
+
+
+DROPSY OF THE WOMB.
+
+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 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.
+
+
+DROPSY OF THE AMNION.
+
+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.
+
+_Treatment_ 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.
+
+
+DROPSY OF THE LIMBS, PERINEUM, AND ABDOMEN.
+
+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: 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.
+
+
+CRAMPS OF THE HIND LIMBS.
+
+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.
+
+
+CONSTIPATION.
+
+This may result from compression by gravid womb, and is best corrected
+by a graduated allowance of boiled flaxseed.
+
+
+PARALYSIS.
+
+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.
+
+
+PROLONGED RETENTION OF THE FETUS (FOAL).
+
+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.
+
+_Cause._--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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+
+ABORTION.
+
+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).
+
+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 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.
+
+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 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.
+
+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.
+
+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.
+
+_Treatment_ 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.
+
+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 _Viburnum prunifolium_ (black
+haw), 1 ounce, may be given and repeated if necessary to prevent
+straining.
+
+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 be served again for
+a month or longer, and in no case until after all discharge from the
+vulva has ceased.
+
+
+INFECTIOUS ABORTION IN MARES.
+
+This disease is discussed in the chapter on "Infectious Diseases."
+
+
+PARTURITION.
+
+SYMPTOMS OF PARTURITION.
+
+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.
+
+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.
+
+
+NATURAL PRESENTATION.
+
+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, 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."
+
+
+PREMATURE LABOR PAINS.
+
+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.
+
+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 papillae, 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.
+
+_Treatment._--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. _Viburnum prunifolium_
+(black haw), in ounce doses, may be added if necessary. Should
+parturition become inevitable, it may be favored and any necessary
+assistance furnished.
+
+
+DIFFICULT PARTURITION.
+
+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 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 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.
+
+DIFFICULT PARTURITION FROM NARROW PELVIS.--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.
+
+FRACTURED HIP BONES.--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.
+
+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.
+
+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.
+
+TUMORS IN THE VAGINA AND PELVIS.--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 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
+ecraseur, the chain being passed around the pedicel and gradually
+tightened until that is torn through.
+
+HERNIA OF THE WOMB.--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.
+
+TWISTING OF THE NECK OF THE WOMB.--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.
+
+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.
+
+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 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.
+
+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.
+
+EFFUSION OF BLOOD IN THE VAGINAL WALLS.--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.
+
+CALCULUS (STONE) AND TUMOR IN THE BLADDER.--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 and could be removed piecemeal by
+forceps. Fortunately, mares affected in this way rarely breed.
+
+FECAL IMPACTION OF THE RECTUM.--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.
+
+SPASM OF THE NECK OF THE WOMB.--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.
+
+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.
+
+FIBROUS BANDS CONSTRICTING OR CROSSING THE NECK OF THE WOMB.--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 Caesarean operation, or simply to cut the constricting
+band and attempt delivery by the usual channel.
+
+FIBROUS CONSTRICTION OF VAGINA OR VULVA.--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 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.
+
+FETUS ADHERENT TO THE WALLS OF THE WOMB.--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.
+
+EXCESSIVE SIZE OF FETUS.--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.
+
+CONSTRICTION OF A MEMBER BY THE NAVEL STRING.--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.
+
+WATER IN THE HEAD (HYDROCEPHALUS) OF THE FOAL.--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.
+
+[Illustration: PLATE XII.
+
+NORMAL PRESENTATIONS.]
+
+[Illustration: PLATE XIII.
+
+SOME FACTORS IN DIFFICULT LABOR.]
+
+[Illustration: PLATE XIV.
+
+INSTRUMENTS USED IN DIFFICULT LABOR.]
+
+ASCITES, OR DROPSY OF THE ABDOMEN IN THE FOAL.--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.
+
+GENERAL DROPSY OF THE FETUS.--In this case the tissues generally are
+distended with liquid, and the skin is found at all points tense 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.
+
+EMPHYSEMA, OR SWELLING OF THE FETUS WITH GAS.--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.
+
+CONTRACTIONS OF MUSCLES.--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.
+
+INCLOSED OVUM, OR TUMORS OF THE FETUS.--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.
+
+MONSTROSITIES.--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
+parts, or a redundancy of parts, as in double monsters. Monsters may be
+divided into--
+
+(1) Monsters with absence of parts--absence of head, limb, or other
+organ.
+
+(2) Monsters with some part abnormally small--dwarfed head, limb, trunk,
+etc.
+
+(3) Monsters through unnatural division of parts--cleft head, trunk,
+limbs, etc.
+
+(4) Monsters through absence of natural divisions--absence of mouth,
+nose, eyes, anus, confluent digits, etc.
+
+(5) Monsters through fusion of parts--one central eye, one nasal
+opening, etc.
+
+(6) Monsters through abnormal position or form of parts--curved spine,
+face, limb, etc.
+
+(7) Monsters through excess of formation--enormous head, supernumerary
+digits, etc.
+
+(8) Monsters through imperfect differentiation of sexual
+organs--hermaphrodites.
+
+(9) Double monsters--double-headed, double-bodied, extra limbs, etc.
+
+_Causes._--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 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.
+
+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.
+
+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 Caesarean 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.)
+
+ENTRANCE OF TWINS INTO THE PASSAGE AT ONCE.--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.
+
+
+ABNORMAL PRESENTATIONS.
+
+(Pls. XV-XVIII.)
+
+Abnormal presentations may be tabulated as follows:
+
+                            {               {Incompletely extended.
+                            {               {  Flexor tendons shortened.
+                            {Fore limbs     {Crossed over the neck.
+                            {               {Bent back at the knee.
+                            {               {Bent back from the shoulder.
+   Anterior presentations:  {
+                            {               {Bent downward on the neck.
+                            {               {Head and neck turned back
+                            {               {  beneath the breast.
+                            {Head           {Turned to one side.
+                            {               {Turned upward and backward
+                            {               {  on the back.
+                            {
+                            {Hind limbs     Hind feet engaged in the pelvis.
+                            {
+                            {Transverse     Back of foal to side of pelvis.
+                            {
+                            {Inverted       Back of foal to floor of pelvis.
+
+                            {Hind limbs     {Bent on itself at the hock.
+   Posterior presentations  {               {Bent at the hip.
+                            {
+                            {Transverse      Back of foal to side of pelvis.
+                            {
+                            {Inverted        Back of foal to floor of pelvis.
+
+                                            {With back and loins presented.
+   Transverse presentation of body          {With breast and belly presented.
+
+FORE LIMBS INCOMPLETELY EXTENDED.--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.)
+
+FORE LIMB CROSSED OVER BACK OF NECK.--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.
+
+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.
+
+FORE LIMB BENT AT KNEE.--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.
+
+FORE LIMB TURNED BACK FROM SHOULDERS.--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.
+
+HEAD BENT DOWN BETWEEN FORE LIMBS.--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.
+
+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.
+
+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.
+
+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.
+
+HEAD TURNED ON SHOULDERS.--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.
+
+HEAD TURNED UPWARD ON BACK.--This differs from the last malpresentation
+only in the direction of the head, which has to be sought 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.
+
+HIND FEET ENGAGED IN PELVIS.--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.
+
+ANTERIOR PRESENTATION WITH BACK TURNED TO ONE SIDE.--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.
+
+BACK OF FOAL TURNED TO FLOOR OF PELVIS.--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.
+
+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.
+
+[Illustration: PLATE XV.
+
+ABNORMAL PRESENTATIONS.]
+
+[Illustration: PLATE XVI.
+
+ABNORMAL PRESENTATIONS.]
+
+[Illustration: PLATE XVII.
+
+ABNORMAL PRESENTATIONS.]
+
+[Illustration: PLATE XVIII.
+
+ABNORMAL PRESENTATIONS.]
+
+HIND PRESENTATION WITH LEG BENT AT HOCK.--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.
+
+HIND PRESENTATION WITH LEGS BENT FORWARD FROM HIP.--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.
+
+HIND PRESENTATIONS WITH BACK TURNED SIDEWAYS OR DOWNWARD.--These are the
+counterparts of similar anterior presentations and are to be managed in
+the same way.
+
+PRESENTATION OF THE BACK.--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.
+
+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.
+
+PRESENTATION OF BREAST AND ABDOMEN.--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.
+
+
+EMBRYOTOMY.
+
+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.
+
+AMPUTATION OF THE HEAD.--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 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.
+
+AMPUTATION OF THE HIND LIMB.--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.
+
+AMPUTATION OF THE FORE LIMBS.--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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+_Removal of the abdominal viscera._--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.
+
+_Removal of the thoracic viscera._--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.
+
+_Dissection of the trunk._--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.
+
+
+FLOODING, OR BLEEDING FROM THE WOMB.
+
+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.
+
+_Treatment_ 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.
+
+
+EVERSION OF THE WOMB.
+
+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 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.
+
+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.
+
+
+RUPTURE, OR LACERATION, OF THE WOMB.
+
+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 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.
+
+
+RUPTURES OF THE VAGINA.
+
+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.
+
+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.
+
+
+BLOOD CLOTS IN THE WALLS OF THE VAGINA.
+
+(See "Effusion of blood in the vaginal walls," p. 190.)
+
+
+LAMINITIS, OR FOUNDER, FOLLOWING PARTURITION.
+
+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.
+
+
+INFLAMMATION OF THE WOMB AND PERITONEUM.
+
+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.
+
+_Symptoms._--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 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.
+
+_Treatment._--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.
+
+
+LEUCORRHEA.
+
+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.
+
+_Treatment_ 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.
+
+
+DISEASES OF THE UDDER AND TEATS.
+
+
+CONGESTION AND INFLAMMATION OF THE UDDER.
+
+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 abscess, induration,
+or gangrene, and, in some cases, may lay the foundation for a tumor of
+the gland.
+
+_Treatment._--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.
+
+
+TUMORS OF THE UDDER.
+
+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.
+
+
+SORE TEATS, SCABS, CRACKS, WARTS.
+
+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.
+
+
+
+
+DISEASES OF THE NERVOUS SYSTEM.
+
+By M. R. TRUMBOWER, V. S.
+
+[Revised by John R. Mohler, A. M., V. M. D.]
+
+
+ANATOMY AND PHYSIOLOGY OF THE BRAIN AND NERVOUS SYSTEM.
+
+(Pl. XIX.)
+
+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.
+
+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.
+
+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.
+
+The two systems have free intercommunication, ganglia being at the
+junctions.
+
+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.
+
+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 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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+The pons Varolii is the transverse projection on the base of the brain,
+between the medulla oblongata and the peduncles of the cerebrum.
+
+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 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.
+
+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.
+
+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 equinae. 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.
+
+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:
+
+    1. Olfactory.
+    2. Optic.
+    3. Oculo-motor.
+    4. Pathetic.
+    5. Trifacial.
+    6. Abducens.
+    7. Facial.
+    8. Auditory.
+    9. Glossopharyngeal.
+    10. Pneumogastric.
+    11. Spinal accessory.
+    12. Hypoglossal.
+
+
+Inflammation of the Brain and its Membranes (Encephalitis, Meningitis,
+Cerebritis).
+
+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 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.
+
+_Causes._--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 sequelae 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.
+
+_Symptoms._--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 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.
+
+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.
+
+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.
+
+Softening and abscess of the brain are terminations of cerebritis. It
+may also be due to an insufficient supply of blood as a result 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.
+
+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.
+
+_Lesions._--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.
+
+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.
+
+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 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.
+
+_Treatment._--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.
+
+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.
+
+[Illustration: PLATE XIX.
+
+THE NERVOUS SYSTEM.]
+
+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.
+
+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.
+
+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.
+
+
+CONGESTION OF THE BRAIN, OR MEGRIMS.
+
+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.
+
+_Causes._--Active cerebral congestion may be from hypertrophy of the
+left ventricle of the heart, excessive exertion, the influence of
+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.
+
+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.
+
+_Symptoms._--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.
+
+_Pathology._--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.
+
+_Treatment._--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 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.
+
+_Prevention._--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.
+
+
+SUNSTROKE, HEAT STROKE, OR HEAT EXHAUSTION.
+
+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.
+
+_Symptoms._--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.
+
+The temperature becomes very high, reaching 105 deg. to 109 deg. F.
+
+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.
+
+_Pathology._--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.
+
+_Treatment._--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 deg. 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.
+
+_Prevention._--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.
+
+An animal which has been affected with sunstroke is very liable to have
+subsequent attacks when exposed to the necessary exciting causes.
+
+
+APOPLEXY OR CEREBRAL HEMORRHAGE.
+
+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.
+
+_Causes._--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.
+
+_Symptoms._--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.
+
+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.
+
+_Pathology._--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.
+
+_Treatment._--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.
+
+
+COMPRESSION OF THE BRAIN.
+
+_Causes._--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.
+
+_Symptoms._--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 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.
+
+_Treatment._--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.
+
+
+CONCUSSION OF THE BRAIN.
+
+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.
+
+_Symptoms._--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.
+
+_Pathology._--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.
+
+_Treatment._--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 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.
+
+_Prevention._--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.
+
+
+ANEMIA OF THE BRAIN.
+
+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.
+
+_Symptoms._--Imperfect vision, constantly dilated pupils, frequently a
+feeble and staggering gait, and occasionally cramps, convulsions, or
+epileptic fits occur.
+
+_Pathology._--The exact opposite of cerebral hyperemia. The blood
+vessels are found empty, the membranes blanched, and the brain substance
+softened.
+
+_Treatment._--Removal of the remote cause when possible. General tonics,
+nutritious feed, rest, and removal from all causes of nervous
+excitement.
+
+
+HYDROCEPHALUS, OR DROPSY OF THE BRAIN.
+
+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.
+
+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 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.
+
+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.
+
+_Symptoms._--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.
+
+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.
+
+
+TUMORS WITHIN THE CRANIUM.
+
+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:
+
+Osseous tumors, growing from the walls of the cranium, are not very
+uncommon.
+
+Dentigerous cysts, containing a formation identical to that of a tooth,
+growing from the temporal bone, sometimes are found lying loose within
+the cranium.
+
+Tumors of the choroid plexus, known as brain sand, are frequently met
+with on post-mortem examinations, but seldom give rise to any
+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.
+
+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.
+
+Fibrous tumors may develop within or from the meningeal structures of
+the brain.
+
+Gliomatous tumor is a variety of sarcoma very rarely found in the
+structure of the cerebellum.
+
+Treatment for tumors of the brain is impossible.
+
+
+SPASMS, OR CRAMPS.
+
+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.
+
+_Spasm of the glottis._--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.
+
+_Spasm of the intestines._--(See "Cramp colic," p. 74.)
+
+_Spasm of the neck of the bladder._--This may be due to spinal
+irritation or a reflex from intestinal irritation, and is manifested by
+frequent but ineffectual attempts to urinate.
+
+_Spasm of the diaphragm, or thumps._--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 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.)
+
+_Spasm of the thigh, or cramp of a hind limb._--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.
+
+_Treatment of spasms._--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.
+
+_Convulsions._--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. 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.
+
+
+CHOREA, OR ST. VITUS'S DANCE.
+
+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.
+
+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.
+
+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.
+
+_Treatment._--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.
+
+
+EPILEPSY, OR FALLING FITS.
+
+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.
+
+_Symptoms._--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.
+
+_Treatment._--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.
+
+
+PARALYSIS, OR PALSY.
+
+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.
+
+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.
+
+GENERAL PARALYSIS.--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, concussion, or shock, or
+any disease in which the whole brain structure is involved in functional
+disturbance.
+
+HEMIPLEGIA (PARALYSIS OF ONE SIDE OR HALF OF THE BODY).--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.
+
+_Symptoms._--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.
+
+PARAPLEGIA (TRANSVERSE PARALYSIS OF THE HIND EXTREMITIES).--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.
+
+_Symptoms._--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.
+
+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
+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.
+
+LOCOMOTOR ATAXIA, OR INCOORDINATION OF MOVEMENT.--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.
+
+LOCAL PARALYSIS.--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.
+
+FACIAL PARALYSIS.--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.
+
+_Symptoms._--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.
+
+LARYNGISMUS PARALYTICUS, OR ROARING.--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.
+
+PARALYSIS OF THE RECTUM AND TAIL.--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.
+
+INTESTINAL PARALYSIS.--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.
+
+PARALYSIS OF THE BLADDER.--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 origin, disease
+of the rectum, tumors growing within the pelvic cavity, injury to the
+spinal cord, etc.
+
+PARALYSIS OF THE OPTIC NERVE (AMAUROSIS).--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.
+
+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.
+
+TREATMENT FOR PARALYSIS.--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.
+
+
+SPINAL MENINGITIS, OR INFLAMMATION OF THE MEMBRANES ENVELOPING THE
+SPINAL CORD.
+
+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 vertebrae, rheumatism, etc.
+
+_Symptoms._--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.
+
+_Pathology._--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.
+
+_Treatment._--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 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
+vertebrae, or some other irremediable cause, the animal should be
+destroyed at once.
+
+
+MYELITIS, OR INFLAMMATION OF THE SUBSTANCE OF THE SPINAL CORD.
+
+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.
+
+_Symptoms._--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.
+
+_Pathology._--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.
+
+_Treatment._--Similar to that of spinal meningitis.
+
+
+SPINAL CONGESTION.
+
+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.
+
+_Cause._--Sudden checking of the perspiration, violent exercise, blows,
+and falls.
+
+_Symptoms._--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.
+
+_Treatment._--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.
+
+
+SPINAL ANEMIA.
+
+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.
+
+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.
+
+If the exciting cause can be removed, the animal recovers; if this
+fails, the spinal cord may undergo softening.
+
+
+SPINAL COMPRESSION.
+
+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.
+
+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.
+
+_Treatment._--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.
+
+
+SPINAL HEMORRHAGE.
+
+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.
+
+_Symptoms._--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.
+
+_Treatment._--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.
+
+
+SPINAL CONCUSSION.
+
+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.
+
+
+SPINAL TUMORS.
+
+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
+vertebrae, 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.
+
+_Symptoms._--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.
+
+_Treatment._--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.
+
+
+NEURITIS, OR INFLAMMATION OF A NERVE.
+
+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.
+
+_Symptoms._--Acute pain of the parts supplied by the nerve and absence
+of swelling or increased heat of the part.
+
+_Treatment._--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.
+
+
+NEUROMA, OR TUMOR OF A NERVE.
+
+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.
+
+_Symptoms._--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.
+
+_Treatment._--Excision of the tumor, including part of the nerve above
+and below, and then treat it like any other simple wound.
+
+
+INJURIES TO NERVES.
+
+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.
+
+
+FORAGE POISONING, OR SO-CALLED CEREBROSPINAL MENINGITIS.
+
+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.
+
+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.
+
+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.
+
+_Symptoms and lesions._--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 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.
+
+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.
+
+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.
+
+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,
+_Strongylus vulgatus_, 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 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.
+
+_Treatment._--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.
+
+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.
+
+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 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.
+
+_Hygienic measures needful._--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.
+
+
+TETANUS, OR LOCKJAW.
+
+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.
+
+_Causes._--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, 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.
+
+_Symptoms._--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 head almost exempt in some
+cases, and have the body and limbs perfectly rigid and incapable of
+movement without falling.
+
+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.
+
+_Prevention._--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.
+
+_Treatment._--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.
+
+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 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.
+
+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.
+
+
+RABIES, HYDROPHOBIA, OR MADNESS.
+
+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.)
+
+_Symptoms._--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.
+
+_Treatment._--As soon as the true nature of the disease is ascertained
+the animal should be killed.
+
+_Prevention._--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.
+
+
+PLUMBISM, OR LEAD POISONING.
+
+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.
+
+_Symptoms._--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.
+
+_Treatment._--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.
+
+
+UREMIA.
+
+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.
+
+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.
+
+Treatment must be directed to a removal of the cause.
+
+
+ELECTRIC SHOCK.
+
+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.
+
+_Treatment._--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.
+
+
+
+
+DISEASES OF THE HEART, BLOOD VESSELS, AND LYMPHATICS.
+
+By M. R. TRUMBOWER, V. S.
+
+[Revised by Leonard Pearson, B. S., V. M. D.]
+
+
+ANATOMY AND PHYSIOLOGY OF THE HEART AND BLOOD VESSELS.
+
+(Pls. XX and XXI.)
+
+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.
+
+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.
+
+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 venae cavae 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, 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.
+
+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.
+
+The circulation through the heart is as follows: The venous blood is
+carried into the right auricle by the anterior and posterior venae cavae.
+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.
+
+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.
+
+[Illustration: PLATE XX.
+
+INTERIOR OF CHEST SHOWING POSITION OF HEART AND DIAPHRAGM.]
+
+[Illustration: PLATE XXI.
+
+Heart.
+
+Right half, red.
+Left half, blue.
+Auricles, at upper end.
+Ventricles, at lower end.
+Arteries, red.
+Veins, blue.
+
+1. Left carotid artery.
+
+2. Left jugular vein.
+
+3. Portal system.
+
+4. Vessels of the liver.
+
+5. Arteries of the stomach. (Caeliac axis).
+
+6. Vessels of the large intestine.
+
+7. Vessels of the small intestine.
+
+8. Artery of left kidney.
+
+CIRCULATORY APPARATUS.]
+
+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 venae cavae,
+or systemic veins, the pulmonary artery, contain dark blood, which must
+be transmitted through the lungs for renovation.
+
+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.
+
+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.
+
+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 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.
+
+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.
+
+
+DISEASES OF THE HEART AND BLOOD VESSELS.
+
+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.
+
+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.
+
+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.
+
+
+MYOCARDITIS, OR INFLAMMATION OF THE MUSCULAR STRUCTURE OF THE HEART.
+
+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.
+
+_Symptoms._--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.
+
+_Alterations._--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.
+
+_Treatment._--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 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.
+
+
+ENDOCARDITIS, OR INFLAMMATION OF THE LINING MEMBRANE OF THE HEART.
+
+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.
+
+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.
+
+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.
+
+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 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.
+
+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.
+
+_Symptoms._--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 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.
+
+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.
+
+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.
+
+_Treatment._--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.
+
+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.
+
+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.
+
+
+PERICARDITIS, OR INFLAMMATION OF THE SAC INCLOSING THE HEART.
+
+_Causes._--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.
+
+_Symptoms._--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 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.
+
+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.
+
+_Pathology._--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 dilatation of its
+cavities; when they are but slight, they may not cause any
+inconvenience.
+
+_Treatment._--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.
+
+
+VALVULAR DISEASE OF THE HEART.
+
+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.
+
+_Symptoms._--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
+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.
+
+Hypertrophy, or dilatation, or both, usually follow valvular disease.
+
+_Treatment._--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.
+
+
+ADVENTITIOUS GROWTHS IN THE HEART.
+
+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.
+
+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 blood passes, or preventing a proper
+coaptation of the valves, which may produce most serious valvular
+disease.
+
+_Symptoms._--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.
+
+_Treatment._--Stimulants, whisky, or carbonate of ammonia may be of
+service.
+
+
+PALPITATION OF THE HEART.
+
+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.)
+
+_Symptoms._--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.
+
+
+SYNCOPE, OR FAINTING.
+
+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.
+
+_Symptoms._--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 the absence of stertorous breathing
+and lividity of the visible mucous membranes.
+
+_Treatment._--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.
+
+
+HYPERTROPHY OF THE HEART, OR CARDIAC ENLARGEMENT.
+
+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.
+
+_Symptoms._--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 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.
+
+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.
+
+_Treatment._--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.
+
+
+DILATATION OF THE HEART.
+
+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.
+
+_Causes._--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.
+
+_Symptoms._--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.
+
+_Treatment._--General tonics, rich feed, and rest.
+
+
+FATTY DEGENERATION OF THE HEART.
+
+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 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.
+
+_Symptoms._--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.
+
+_Treatment._--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.
+
+
+RUPTURE OF THE HEART.
+
+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.
+
+
+WEAKNESS OF THE HEART.
+
+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.
+
+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.
+
+
+CONGESTION OF THE HEART
+
+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.
+
+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.
+
+
+CYANOSIS OF NEWBORN FOALS.
+
+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.
+
+
+DISEASES OF ARTERIES, OR ARTERITIS AND ENDARTERITIS.
+
+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.
+
+_Symptoms._--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.
+
+_Pathology._--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 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.
+
+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.
+
+_Treatment._--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.
+
+
+ATHEROMA.
+
+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.
+
+
+CONSTRICTION OF AN ARTERY.
+
+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.
+
+
+ANEURISM.
+
+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.
+
+_Symptoms._--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.
+
+There is one form of aneurism which is not infrequently overlooked,
+affecting the anterior mesenteric artery, primarily induced by a
+worm--_Strongylus vulgaris_. This worm produces an arteritis, with
+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.)
+
+_Pathology._--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.
+
+_Treatment._--The only treatment advisable is to extirpate or ligate the
+tumor above and below.
+
+
+RUPTURE OF AN ARTERY.
+
+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.
+
+_Symptoms._--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, 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.
+
+_Treatment._--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.
+
+
+THROMBUS AND EMBOLISM.
+
+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.
+
+_Symptoms._--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 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.
+
+_Pathology._--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
+papillae 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.
+
+_Treatment._--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.
+
+
+DISEASES OF VEINS, OR PHLEBITIS.
+
+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.
+
+_Causes._--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.
+
+_Symptoms._--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.
+
+_Pathology._--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.
+
+_Treatment._--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.
+
+
+VARICOSE VEINS, VARIX, OR DILATATION OF VEINS.
+
+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.
+
+_Treatment._--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. 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.
+
+
+AIR IN VEINS, OR AIR EMBOLISM.
+
+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.
+
+
+PURPURA HEMORRHAGICA.
+
+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.
+
+_Symptoms._--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 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.
+
+_Pathology._--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.
+
+_Treatment._--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.
+
+
+DISEASES OF THE LYMPHATIC SYSTEM.
+
+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 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.
+
+
+LOCAL INFLAMMATION AND ABSCESS OF LYMPHATIC GLANDS.
+
+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.
+
+_Symptoms._--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.
+
+_Treatment._--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.
+
+
+LYMPHANGITIS.
+
+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.
+
+_Causes._--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.
+
+_Symptoms._--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 deg. 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.
+
+_Treatment._--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.
+
+
+
+
+DISEASES OF THE EYE.
+
+BY JAMES LAW, F. R. C. V. S.,
+
+_Formerly Professor of Veterinary Science, etc., Cornell University_.
+
+
+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.
+
+
+STRUCTURE OF THE EYE.
+
+(Pl. XXII.)
+
+THE EYEBALL.
+
+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.
+
+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, 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.
+
+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.
+
+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
+(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.
+
+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.
+
+
+MUSCLES OF THE EYE.
+
+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.
+
+
+THE HAW (THE WINKING CARTILAGE, OR CARTILAGO NICTITANS).
+
+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 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.
+
+[Illustration: PLATE XXII.
+
+DIAGRAMMATIC VERTICAL SECTION THROUGH HORSE'S EYE.]
+
+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."
+
+
+LACRIMAL APPARATUS.
+
+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.
+
+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.
+
+
+EXAMINATION OF THE EYE.
+
+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 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.
+
+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.
+
+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.
+
+
+DISEASES OF THE EYELIDS.
+
+
+CONGENITAL DISORDERS.
+
+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.
+
+
+NERVOUS DISORDERS.
+
+SPASM OF EYELIDS 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.
+
+DROOPING EYELIDS, OR PTOSIS.--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.
+
+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.
+
+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 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.
+
+In paralysis from blows above the eyes the same treatment may be applied
+to that part.
+
+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.
+
+
+INFLAMMATION OF THE EYELIDS.
+
+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.
+
+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.
+
+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.
+
+(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 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.
+
+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.
+
+(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.
+
+(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 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.
+
+_Treatment._--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.
+
+
+STY, OR FURUNCLE (BOIL) OF THE EYELID.
+
+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.
+
+
+ENTROPION AND ECTROPION, OR INVERSION AND EVERSION OF THE EYELID.
+
+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.
+
+
+TRICHIASIS.
+
+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.
+
+
+WARTS AND OTHER TUMORS OF THE EYELIDS.
+
+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.
+
+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.
+
+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.
+
+Encysted, honeylike (melicerous), sebaceous, and fibrous tumors of the
+lids all require removal with the knife.
+
+
+TORN EYELIDS OR WOUNDS OF EYELIDS.
+
+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.
+
+
+TUMOR OF THE HAW, OR CARIES OF THE CARTILAGE.
+
+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.
+
+
+OBSTRUCTION OF THE LACRIMAL APPARATUS, OR WATERING EYE.
+
+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.
+
+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).
+
+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.
+
+
+EXTERNAL OPHTHALMIA, OR CONJUNCTIVITIS.
+
+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 a
+phase of external opththalmia which demands a special notice. These have
+accordingly been already treated of.
+
+_Causes._--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.
+
+_Symptoms._--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 the measure of the pain caused by the
+falling of light on the inflamed and sensitive optic nerve (retina) and
+choroid.
+
+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).
+
+_Treatment._--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.
+
+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
+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.
+
+
+WHITE SPECKS AND CLOUDINESS OF THE CORNEA.
+
+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.
+
+
+ULCERS OF THE CORNEA.
+
+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.
+
+
+INTERNAL OPHTHALMIA (IRITIS, CHOROIDITIS, AND RETINITIS).
+
+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.
+
+_Causes._--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 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.
+
+_Symptoms._--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 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.
+
+_Treatment._--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. 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.
+
+The diet throughout should be easily digestible and moderate in
+quantity--bran mash, middlings, grass, steamed hay, etc.
+
+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.
+
+
+RECURRENT OPHTHALMIA (PERIODIC OPHTHALMIA, OR MOON-BLINDNESS).
+
+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.
+
+_Causes._--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 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.
+
+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 Leguminosae 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.
+
+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.
+
+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. 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.
+
+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.
+
+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.
+
+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 strength and vigor is protective;
+whatever contributes to weakness and poor health is provocative of the
+disease in the predisposed subject.
+
+_Symptoms._--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.
+
+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.
+
+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.
+
+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.
+
+_Prevention._--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.
+
+_Treatment_ 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.
+
+
+CATARACT.
+
+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.
+
+
+PALSY OF THE NERVE OF SIGHT, OR AMAUROSIS.
+
+_Causes._--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.
+
+_Symptoms._--The symptoms are wide dilatation of the pupils, so as to
+expose fully the interior of the globe, the expansion remaining 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.
+
+_Treatment_ 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.
+
+
+TUMORS OF THE EYEBALL.
+
+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.
+
+
+STAPHYLOMA.
+
+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.
+
+
+PARASITES IN THE EYE.
+
+Acari in the eye have been incidentally alluded to under inflammation of
+the lids.
+
+_Filaria palpebralis_ 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.
+
+_Setaria equina_ 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 exhibited as a "snake in the eye."[1] 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.
+
+_Filaria conjunctivae_, resembling _Setaria equina_ very much in size and
+general appearance, is another roundworm which has been found in the eye
+of the horse.
+
+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.
+
+FOOTNOTES:
+
+[1] 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.--M. C. HALL.
+
+
+
+
+LAMENESS: ITS CAUSES AND TREATMENT.
+
+BY A. LIAUTARD, M. D., V. M.,
+
+_Formerly principal of the American Veterinary College, New York._
+
+[Revised by John R. Mohler, A. M., V. M. D.]
+
+
+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.
+
+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
+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.
+
+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.
+
+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.
+
+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 minutiae, must be clearly comprehended in order to
+acquire a symmetrical and satisfactory view of the theme as a practical
+collation of facts to be remembered, analyzed, applied, and utilized.
+
+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.
+
+
+ANATOMY.
+
+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.
+
+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 minutiae,
+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.
+
+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 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.
+
+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.
+
+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.
+
+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 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.
+
+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.
+
+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.
+
+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 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.
+
+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.
+
+
+DEFINITION OF LAMENESS.
+
+_Physiology._--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 minutiae
+being considered and settled in a place of their own.
+
+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.
+
+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.
+
+[Illustration: PLATE XXIII.
+
+SKELETON OF HORSE.]
+
+[Illustration: PLATE XXIV.
+
+SUPERFICIAL LAYER OF MUSCLES.]
+
+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?
+
+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.
+
+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.
+
+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.
+
+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 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.
+
+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.
+
+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 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.
+
+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.
+
+
+HOW TO DETECT THE SEAT OF LAMENESS.
+
+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, 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.
+
+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.
+
+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 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.
+
+
+DISEASES OF BONES.
+
+PERIOSTITIS, OSTITIS, AND EXOSTOSIS.
+
+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.
+
+_Cause._--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.
+
+_Symptoms._--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.
+
+_Treatment._--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.
+
+
+SPLINTS.
+
+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.
+
+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.
+
+_Symptoms._--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.
+
+_Cause._--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.
+
+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 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.
+
+_Treatment._--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.
+
+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.
+
+[Illustration: PLATE XXV.
+
+SPLINT.]
+
+[Illustration: PLATE XXVI.
+
+SOUND FOOT.
+
+RINGBONE.]
+
+[Illustration: PLATE XXVII.
+
+VARIOUS TYPES OF SPAVIN.]
+
+[Illustration: PLATE XXVIII.
+
+BONE SPAVIN. HOCKS, WITH SKIN REMOVED.]
+
+[Illustration: PLATE XXIX.
+
+BONE SPAVIN.]
+
+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.
+
+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.
+
+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.
+
+
+RINGBONES.
+
+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, 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.)
+
+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.
+
+_Cause._--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.
+
+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 sequelae 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.
+
+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.
+
+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.
+
+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.
+
+_Symptoms._--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. 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.
+
+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.
+
+_Treatment._--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 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.
+
+
+SIDEBONES.
+
+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.
+
+_Cause._--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.
+
+_Symptoms._--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 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.
+
+_Treatment._--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.
+
+
+SPAVIN.
+
+(Pls. XXVII-XXIX.)
+
+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.
+
+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 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.
+
+_Cause._--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.
+
+_Symptoms._--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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+_Prognosis._--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 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.
+
+_Treatment._--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 _rest_--emphatically, and as an essential condition, _rest_.
+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.
+
+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.
+
+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 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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+
+FRACTURES.
+
+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.
+
+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.
+
+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.
+
+_Causes._--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.
+
+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.
+
+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.
+
+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 happening hourly by which our equine servants become
+sufferers. We may add to these the fracture of the bones of the
+vertebrae, 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.
+
+_Symptoms._--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.
+
+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.
+
+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 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.
+
+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.
+
+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.
+
+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.
+
+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 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.
+
+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.
+
+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.
+
+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.
+
+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:
+
+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.
+
+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.
+
+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.
+
+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
+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.
+
+_Prognosis._--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.
+
+_Treatment._--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.
+
+(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.
+
+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.
+
+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 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.
+
+On the contrary, a compound, complicated, or comminuted, fracture, in
+whatever region it may be situated, may be counted incurable.
+
+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.
+
+(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.
+
+(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.
+
+(4) Age and temper are important factors of cure. A young, growing,
+robust patient whose vis vitae 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.
+
+The fulfillment of three indications is indispensable in all fractures.
+The first is the reduction, or the replacement, of the parts as nearly
+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.
+
+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.
+
+The two obvious indications in cases of fracture are reduction, or
+replacement, and retention.
+
+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 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.
+
+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.
+
+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.
+
+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 the management of
+the counter extension, leaving to the operator the free use of both
+hands for the further manipulation of the case.
+
+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.
+
+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.
+
+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 by a deformed callus, the
+union will leave a shortened, crooked, or angular limb, and the animal
+will be disabled.
+
+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.
+
+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.
+
+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 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.
+
+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.
+
+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 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.
+
+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.
+
+
+FRACTURE OF CRANIAL BONES.
+
+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.
+
+_Symptoms._--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.
+
+_Treatment._--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 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.
+
+
+FRACTURES OF THE BONES OF THE FACE.
+
+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.
+
+
+FRACTURES OF THE PREMAXILLARY BONE.
+
+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.
+
+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.
+
+
+FRACTURES OF THE LOWER JAW.
+
+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.
+
+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.
+
+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 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.
+
+
+FRACTURES OF VERTEBRAE.
+
+These are not very common, but when they do occur the bones most
+frequently injured are those of the back and loins.
+
+_Causes._--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.
+
+_Symptoms._--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 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.
+
+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 _occasionally_ a case _may_ recover. Fractures of the
+transverse processes are less serious.
+
+_Treatment._--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.
+
+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.
+
+
+FRACTURE OF THE RIBS.
+
+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 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.
+
+_Symptoms._--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.
+
+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.
+
+_Treatment._--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.
+
+If there is displacement, with much accompanying pain and evident
+irritation of the lungs, the fracture must be reduced without 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.
+
+
+FRACTURES OF THE BONES OF THE PELVIS.
+
+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.
+
+_The sacrum._--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.
+
+_The os innominatum._--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.
+
+_Symptoms._--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 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.
+
+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.
+
+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 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.
+
+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.
+
+_Prognosis._--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.
+
+_Treatment._--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.
+
+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.
+
+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.
+
+
+FRACTURE OF THE SCAPULA.
+
+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.
+
+_Cause._--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.
+
+_Symptoms._--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.
+
+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.
+
+_Treatment._--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.
+
+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.
+
+
+FRACTURES OF THE HUMERUS.
+
+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.
+
+_Symptoms._--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.
+
+_Treatment._--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.
+
+
+FRACTURES OF THE FOREARM.
+
+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.
+
+_Cause._--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 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.
+
+_Symptoms._--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.
+
+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.
+
+_Treatment._--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 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.
+
+
+FRACTURE OF THE KNEE.
+
+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.
+
+_Cause._--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.
+
+_Symptoms._--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.
+
+_Prognosis._--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.
+
+_Treatment._--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.
+
+
+FRACTURE OF THE FEMUR.
+
+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.
+
+_Cause._--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 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.
+
+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.
+
+_Symptoms._--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.
+
+_Treatment._--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."
+
+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 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.
+
+
+FRACTURE OF THE PATELLA.
+
+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.
+
+
+FRACTURES OF THE TIBIA.
+
+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.
+
+_Symptoms._--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.
+
+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:
+
+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 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?
+
+The prognosis of fracture of the tibia, as a rule, must be unfavorable.
+
+_Treatment._--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.
+
+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.
+
+
+FRACTURES OF THE HOCK.
+
+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.
+
+
+FRACTURES OF THE CANNON BONES.
+
+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.
+
+_Symptoms._--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.
+
+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.
+
+_Treatment._--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.
+
+
+FRACTURE OF THE FIRST PHALANX.
+
+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.
+
+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.
+
+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.
+
+
+FRACTURES OF THE SECOND PHALANX (CORONET).
+
+Though these are generally of the comminuted kind, there are often
+conditions associated with them which justify the surgeon in 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.
+
+
+FRACTURES OF THE THIRD PHALANX (OS PEDIS).
+
+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.
+
+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.
+
+There is nothing to encourage a favorable prognosis, and a not unusual
+termination is an anchylosis with either the navicular bone or the
+coronet.
+
+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.
+
+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.
+
+
+FRACTURE OF THE SESAMOID BONES.
+
+This lesion has been considered by veterinarians, erroneously, we think,
+as one of rare occurrence. We believe it to be more frequent 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.
+
+_Cause._--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.
+
+_Symptoms._--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
+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.
+
+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.
+
+_Prognosis._--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.
+
+_Treatment._--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.
+
+
+DISEASES OF JOINTS.
+
+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.
+
+
+DISEASES OF THE SYNOVIAL SACS.
+
+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.
+
+
+SYNOVIAL DROPSIES.
+
+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 bursae,
+as well as the etiology of their injuries and their pathological
+history, and we will now treat of the affections of both.
+
+
+WINDGALLS.
+
+This name is given to the dilated bursae found at the posterior part of
+the fetlock joint. They have their origin in a dropsical condition of
+the bursae 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.)
+
+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.
+
+_Cause._--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 sequelae of internal disorders, such as
+strangles or the resultants of a pleuritic or pneumonic attack.
+
+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.
+
+_Treatment._--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 soaking
+tub and at night by applying a moderately tight-roller bandage. Later
+absorption may be promoted by a Priessnitz bandage,[2] 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.
+
+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.
+
+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.
+
+
+BLOOD SPAVIN, BOG SPAVIN, AND THOROUGHPIN.
+
+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.
+
+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 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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+
+OPEN JOINTS, BROKEN KNEES, SYNOVITIS, AND ARTHRITIS.
+
+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 of
+symptoms, treatment, etc., are our reasons for treating under a single
+head the ailments we have grouped together in the present section.
+
+_Cause._--The great, comprehensive, common cause of, sometimes
+permanent, sometimes only transient, disability of the horse is external
+traumatism.
+
+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.
+
+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.
+
+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 sequelae of
+chronic inflammation of the knee joint.
+
+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.
+
+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.
+
+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. 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.
+
+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.
+
+_Prognosis._--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.
+
+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.
+
+_Treatment._--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.
+
+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 _vis vitae_ 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.
+
+[Illustration: PLATE XXX.
+
+DISLOCATION OF SHOULDER AND ELBOW
+
+Bourgelat's apparatus]
+
+[Illustration: PLATE XXXI.
+
+THE SLING IN USE]
+
+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.
+
+
+DISLOCATIONS.
+
+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.
+
+_Cause._--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.
+
+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.
+
+_Symptoms and diagnosis._--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.
+
+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.
+
+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.
+
+_Prognosis._--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.
+
+_Treatment._--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.
+
+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.
+
+_Special dislocations._--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:
+
+
+THE SHOULDER JOINT.
+
+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.
+
+
+THE HIP JOINT.
+
+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.
+
+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.
+
+
+PSEUDO-LUXATIONS OF THE PATELLA.
+
+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
+sudden and alarming series of symptoms which have suggested the phrase
+of "stifle out" as a descriptive term.
+
+_Symptoms._--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.
+
+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.
+
+_Cause._--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.
+
+_Treatment._--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 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.
+
+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.
+
+
+DISEASES OF MUSCLES AND TENDONS.
+
+SPRAINS.
+
+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.
+
+_Treatment._--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.
+
+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 sequelae.
+
+
+LAMENESS OF THE SHOULDER.
+
+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 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.
+
+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.
+
+_Causes._--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.
+
+_Symptoms._--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.
+
+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:
+
+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.
+
+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.
+
+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.
+
+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.
+
+_Treatment._--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 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.
+
+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, _rest_,
+imperatively rest, irrespective of any other prescriptions with which it
+may be associated.
+
+
+SPRAIN OF THE ELBOW MUSCLES.
+
+_Causes._--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.
+
+_Symptoms._--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 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.
+
+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.
+
+_Treatment._--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 _letting our
+patients alone._
+
+
+HIP LAMENESS.
+
+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.
+
+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.
+
+_Symptoms._--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.
+
+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.
+
+_Prognosis._--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 sequelae which often resist every
+form of treatment.
+
+_Treatment._--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.
+
+
+SPRAINS OF SUSPENSORY LIGAMENTS AND OF FLEXOR TENDONS OR THEIR SHEATHS.
+
+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.
+
+_Cause._--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.
+
+_Symptoms._--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.
+
+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.
+
+_Prognosis._--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.
+
+_Treatment._--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.
+
+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.
+
+
+KNUCKLING OF FETLOCK.
+
+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.)
+
+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.
+
+_Causes._--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 fore to this deformity, in
+consequence of the greater amount of labor they are required to perform
+as the propelling levers of the body.
+
+_Symptoms._--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.
+
+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.
+
+_Treatment._--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.
+
+
+SPRUNG KNEES.
+
+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.
+
+_Cause._--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 to
+perform when too young. It may also be due to other diseases existing in
+parts below the knee joint.
+
+_Symptoms._--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."
+
+_Treatment._--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.
+
+
+CURB.
+
+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.
+
+_Cause._--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.
+
+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.
+
+_Symptoms._--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
+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.
+
+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.
+
+_Treatment._--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.
+
+
+LACERATED TENDONS.
+
+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.
+
+_Cause._--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 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.
+
+_Symptoms._--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.
+
+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.
+
+_Prognosis._--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.
+
+_Treatment._--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
+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.
+
+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.
+
+
+RUPTURE OF THE FLEXOR METATARSI.
+
+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
+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.
+
+_Cause._--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.
+
+_Symptoms._--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.
+
+_Treatment._--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.
+
+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.
+
+To secure the necessary immobility the animal should be placed in slings
+snugly applied, and kept in a narrow stall. He should also be 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.
+
+
+SUNDRY ADDITIONAL AFFECTIONS OF THE EXTREMITIES.
+
+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.
+
+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.
+
+
+CAPPED ELBOW.
+
+Capped elbow, or "shoe boil," is a term applied to an enlargement often
+found at the point of the elbow.
+
+_Cause._--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 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.
+
+_Symptoms._--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.
+
+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.
+
+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.
+
+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.
+
+_Treatment._--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.
+
+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.
+
+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 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.
+
+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.
+
+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 the exercise of
+considerable practical ingenuity to adjust and retain the appliances
+necessary to insure a good final result.
+
+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.
+
+
+CAPPED KNEE.
+
+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
+bursae 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.
+
+_Cause._--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.
+
+_Symptoms._--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.
+
+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.
+
+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.
+
+_Prognosis._--Though simple bruises of the knee without extensive
+lesions are usually of trifling account, a different prognosis must be
+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.
+
+_Treatment._--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.
+
+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.
+
+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.
+
+If this treatment fails, the use of iodin and mercurial preparations is
+recommended.
+
+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, 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.
+
+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.
+
+
+CAPPED HOCK.
+
+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.
+
+_Symptoms._--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.
+
+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 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.
+
+_Treatment._--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.
+
+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.
+
+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 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.
+
+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.
+
+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.
+
+
+INTERFERING, AND SPEEDY CUTS.
+
+These designations belong to certain special injuries of the
+extremities, produced by similar causes, giving rise to kindred
+pathological 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.)
+
+_Symptoms._--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.
+
+An animal in interfering may thus exhibit a range of symptoms which from
+the simplest form of a mere "touching," may successively assume the
+serious characters of an ugly cicatrix, a hard, plastic swelling, or
+perhaps, as witnessed at the knee, of periostitis with its sequelae.
+
+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.
+
+_Prognosis._--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.
+
+_Treatment._--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 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.
+
+
+STRINGHALT.
+
+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.
+
+_Cause._--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.
+
+_Treatment._--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.
+
+
+THROMBOSIS.
+
+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.
+
+_Cause._--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.
+
+_Symptoms._--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.
+
+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 return to an apparently perfect condition. A return
+to labor will lead to a renewal of the same incidents.
+
+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.
+
+_Treatment._--No form of treatment can be advised; the suffering or a
+helpless and useless animal can only be terminated by that which ends
+all.
+
+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.
+
+
+SPRAINS OF THE LOINS.
+
+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 "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.
+
+_Cause._--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.
+
+_Symptoms._--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.
+
+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.
+
+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 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.
+
+_Treatment._--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.
+
+FOOTNOTES:
+
+[2] 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.
+
+
+
+
+DISEASES OF THE FETLOCK, ANKLE, AND FOOT.
+
+By A. A. HOLCOMBE, D. V. S.,
+
+_Veterinary Inspector, Bureau of Animal Industry._
+
+
+ANATOMICAL REVIEW OF THE FOOT.
+
+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.
+
+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.
+
+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.
+
+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.)
+
+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.)
+
+The cannon bone extends from the knee or hock to the fetlock, is
+cylindrical in shape, and stands nearly or quite perpendicular.
+
+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.
+
+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.
+
+The coronet is a short, cube-shaped bone, set between the large pastern
+and coffin bone, in the same oblique direction.
+
+The navicular bone is short, flattened above and below, and is attached
+to the coffin bone behind.
+
+The coffin bone forms the end of the foot and is shaped like the horny
+box in which it is inclosed.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.)
+
+The pastern joint is made by the union of the two pastern bones.
+
+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.
+
+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.)
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.)
+
+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 laminae, plantar cushion, and the lateral
+cartilages. (Plate XXXIII, fig. 4.)
+
+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.
+
+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 is
+soft, moist, and elastic to a remarkable degree. It is the function of
+the frog to destroy shock and to prevent slipping.
+
+The sensitive laminae 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.)
+
+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.)
+
+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.)
+
+
+FAULTS OF CONFORMATION.
+
+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.
+
+_Flatfoot_ 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.
+
+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.
+
+_Clubfoot_ 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
+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.
+
+_Crookedfoot_ 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.
+
+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.
+
+
+INTERFERING.
+
+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.)
+
+_Causes._--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.
+
+_Symptoms._--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 animal, after
+first painting the inside toe and quarter of the suspected foot with a
+thin coating of chalk, charcoal, mud, or paint.
+
+_Treatment._--When the trouble is due to deformity or faulty
+conformation it may not be possible to overcome the defect.
+
+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.
+
+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.
+
+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.
+
+
+KNUCKLING, OR COCKED ANKLES.
+
+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.
+
+_Causes._--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.
+
+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.
+
+[Illustration: PLATE XXXII.
+
+ANATOMY OF FOOT.]
+
+[Illustration: PLATE XXXIII.
+
+ANATOMY OF FOOT.]
+
+[Illustration: PLATE XXXIV.
+
+ANATOMY AND DISEASES OF THE FOOT.]
+
+[Illustration: PLATE XXXV.
+
+SOUND AND CONTRACTED FEET.]
+
+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.)
+
+_Treatment._--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.
+
+
+WINDGALL.
+
+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.)
+
+_Causes._--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.
+
+_Symptoms._--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 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.
+
+_Treatment._--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.
+
+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.
+
+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.
+
+
+SPRAIN OF THE FETLOCK.
+
+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.
+
+_Causes._--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.
+
+_Symptoms._--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
+animal to hobble on three legs. While at rest the leg is flexed at the
+joint affected, and the toe rests on the ground.
+
+_Treatment._--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.
+
+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.
+
+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.
+
+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.
+
+
+RUPTURE OF THE SUSPENSORY LIGAMENT.
+
+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.
+
+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.
+
+_Symptoms._--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 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.
+
+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.
+
+_Treatment._--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.
+
+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.
+
+
+OVERREACH.
+
+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.
+
+_Symptoms._--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.
+
+_Treatment._--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 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.
+
+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.
+
+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.
+
+
+CALK WOUNDS.
+
+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 laminae, the extensor tendon, and even the coffin
+bone.
+
+_Treatment._--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 laminae, 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.
+
+
+FROSTBITES.
+
+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. 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.
+
+_Symptoms._--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.
+
+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.
+
+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.
+
+_Treatment._--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.
+
+
+QUITTOR.
+
+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.
+
+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.
+
+
+CUTANEOUS QUITTOR.
+
+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.
+
+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.
+
+_Causes._--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
+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.[3]
+
+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.
+
+_Symptoms._--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 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.
+
+This form of quittor is often complicated with the tendinous and
+subhorny quittors by an extension of the sloughing process.
+
+_Treatment._--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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+If the wound is slow to heal, it will be found of advantage to change
+the remedies every few days.
+
+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.
+
+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.
+
+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.
+
+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, 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.
+
+
+TENDINOUS QUITTOR.
+
+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.
+
+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.
+
+_Causes._--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.
+
+_Symptoms._--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 deg. or 4 deg.; 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 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.
+
+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
+laminae. 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.
+
+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
+laminae and plantar cushion, when the suffering is intense until the pus
+finds an avenue of escape 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.
+
+_Treatment._--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.
+
+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 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.
+
+
+SUBHORNY QUITTOR.
+
+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 laminae.
+
+_Causes._--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.
+
+_Symptoms._--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.
+
+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 laminae until the sole is reached,
+and even a portion of this may be undermined.
+
+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
+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.
+
+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.
+
+_Treatment._--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.
+
+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.
+
+Tendinous or cartilaginous complications are to be treated as directed
+under those headings.
+
+
+CARTILAGINOUS QUITTOR.
+
+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 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.
+
+_Causes._--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.
+
+_Symptoms._--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.
+
+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.
+
+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 the
+corresponding quarter, owing to the stimulating effect which the disease
+has upon the coronary band.
+
+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.
+
+_Treatment._--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 laminae should not be injured in
+the operation.
+
+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.
+
+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.
+
+
+THRUSH.
+
+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 subject to the
+disease, except in wet, marshy districts, than are the horses used in
+cities and towns.
+
+_Causes._--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.
+
+_Symptoms._--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.
+
+_Treatment._--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.
+
+
+CANKER.
+
+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 a
+healthy horn by which the injury may be repaired. Heavy cart horses are
+more often affected than those of any other class.
+
+_Causes._--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.
+
+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.
+
+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.
+
+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.
+
+_Symptoms._--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.
+
+In the earlier stages there is no interference with locomotion, but
+later the foot becomes sensitive, particularly if the animal is used on
+rough roads, and, finally, when the sole and frog are largely destroyed
+the lameness is severe.
+
+_Treatment._--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.
+
+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.
+
+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.
+
+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.
+
+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, 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.
+
+
+CORNS.
+
+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 laminae of the bar, of the wall, or of both, are
+involved at the same time.
+
+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.
+
+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.
+
+_Causes._--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.
+
+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 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.
+
+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.
+
+_Symptoms._--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 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.
+
+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
+laminae 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 laminae, causing the horn to
+become somewhat spongy.
+
+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 laminae 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.
+
+_Treatment._--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.
+
+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; 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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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 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.
+
+
+BRUISE OF THE FROG.
+
+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.
+
+_Causes._--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.
+
+_Symptoms._--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 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.
+
+_Treatment._--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.
+
+
+PUNCTURED WOUNDS OF THE FOOT.
+
+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.
+
+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 their depth, involve
+the plantar cushion, the plantar aponeurosis, the sesamoid sheath, the
+navicular bone, or the coffin joint.
+
+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.
+
+_Symptoms._--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.
+
+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.
+
+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.
+
+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. 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).
+
+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.
+
+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.
+
+_Treatment._--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.
+
+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.
+
+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.
+
+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
+should be introduced to the bottom of the wound and the foot dressed as
+directed above.
+
+The other complications are to be treated as directed under their proper
+headings.
+
+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.
+
+"_Prick in shoeing_" 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.
+
+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.
+
+
+CONTRACTED HEELS, OR HOOFBOUND.
+
+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 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.)
+
+_Causes._--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.
+
+_Symptoms._--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.
+
+_Treatment._--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 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.
+
+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.
+
+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.
+
+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.
+
+
+SAND CRACKS.
+
+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.)
+
+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.
+
+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
+laminae, 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.
+
+_Causes._--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.
+
+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.
+
+[Illustration: PLATE XXXVI.
+
+QUARTER-CRACK AND REMEDIES.]
+
+[Illustration: PLATE XXXVII.
+
+FOUNDERED FEET.]
+
+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.
+
+_Symptoms._--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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+_Treatment._--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.
+
+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.
+
+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.
+
+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 laminae. 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., 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.
+
+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.
+
+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.
+
+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.
+
+
+NAVICULAR DISEASE.
+
+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.)
+
+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.
+
+_Causes._--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.
+
+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 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.
+
+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.
+
+_Symptoms._--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 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.
+
+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 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.
+
+_Treatment._--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.
+
+
+SIDEBONES.
+
+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.
+
+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.)
+
+_Causes._--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.
+
+_Symptoms._--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 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.
+
+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.
+
+_Treatment._--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.
+
+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.
+
+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.
+
+
+RINGBONE.
+
+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.)
+
+_Causes._--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.
+
+_Symptoms._--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.
+
+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.
+
+_Treatment._--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.
+
+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.
+
+Since ringbone is considered to be one of the hereditary diseases, no
+animal suffering from this trouble should ever be used for breeding
+purposes.
+
+
+LAMINITIS, OR FOUNDER.
+
+Laminitis is a simple inflammation of the sensitive laminae 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.
+
+_Causes._--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.
+
+_Predisposing causes._--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 laminae 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.
+
+_Exciting causes._--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.
+
+(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 laminae.
+
+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.
+
+(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.
+
+(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.
+
+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.
+
+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.
+
+(4) Rapid changes of temperature act as an exciting cause of laminitis
+by impairing the normal blood supply.
+
+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 laminae, and laminitis is more readily induced
+than congestion or inflammation of the skin or other surface organs,
+because the laminae 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 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.
+
+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.
+
+(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 laminae, 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
+laminae 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.
+
+(6) Fortunately purgative medicines rarely cause inflammation of the
+laminae. 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.
+
+(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 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.
+
+_Symptoms._--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.
+
+_General symptoms._--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 deg. F.; it generally ranges between
+102.5 deg. and 105 deg. 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.
+
+_Special symptoms._--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 feet become simply
+the fulcra of the levers of progression, and are almost exempt from
+concussion.
+
+_One foot._--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.
+
+_Both fore feet._--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.
+
+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.
+
+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.
+
+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.
+
+_Both hind feet._--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."
+
+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 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.
+
+_All four feet._--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.
+
+_Course._--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.
+
+_Simple congestion._--Those cases of simple congestion of the laminae,
+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.
+
+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 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.
+
+_Acute._--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 laminae. 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.
+
+_Subacute._--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.
+
+_Chronic._--Chronic laminitis is a term used by many to designate any of
+the sequelae of the acute and subacute forms of this disease. Pure,
+chronic inflammation of the laminae 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.
+
+_Complications._--Complications concurrent with or supervening upon
+laminitis are frequent and varied, and are often dependent upon causes
+not fully understood.
+
+_Excessive purgation_ 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 laminae, 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.
+
+_Septicemia and pyemia._--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 laminae results. They die, as a
+rule, within three days after showing signs of the complication.
+
+_Pneumonia._--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.
+
+_Sidebones._--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 laminae 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.
+
+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 laminae 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 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.
+
+_Suppuration_ 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.
+
+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.
+
+Suppuration of the sensitive sole is more common than of the sensitive
+laminae 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.
+
+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.
+
+_Peditis._--This is the term that Williams applies to that serious
+complication of laminitis in which not only the laminae, but the
+periosteum 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.
+
+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.
+
+_Gangrene_ 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.
+
+_Pumiced sole_ 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 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.
+
+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.
+
+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.
+
+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.
+
+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 away of
+the horn when applying the shoe, thereby keeping the sole at this point
+too thin.
+
+_Turning up of the toe._--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.
+
+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.
+
+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."
+
+The lesions of turning up of the toe are permanent, and are the most
+interesting pathologically of all the complications of laminitis.
+
+_Treatment._--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.
+
+_Prevention._--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 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 laminae 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.
+
+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. 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.
+
+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.
+
+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.
+
+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.
+
+_Curative measures._--In cases of simple congestion of the laminae 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 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.
+
+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.
+
+The feet should be kept in a tub of water at a temperature of 45 deg. to 50 deg.
+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.
+
+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.
+
+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.
+
+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 up of the toe, blistering
+of the coronet, _in front only_, 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.
+
+When suppuration of the laminae 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.
+
+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.
+
+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.
+
+
+
+
+DISEASES OF THE SKIN.
+
+By JAMES LAW, F. R. C. V. S.,
+
+_Formerly Professor of Veterinary Science, etc., Cornell University._
+
+
+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.
+
+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.
+
+[Illustration: PLATE XXXVIII.
+
+THE SKIN AND ITS DISEASES.]
+
+
+STRUCTURE OF THE SKIN.
+
+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.)
+
+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.
+
+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.
+
+The superficial layer of the dermis is formed into a series of minute,
+conical elevations, or papillae, 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.
+
+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.
+
+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.
+
+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.")
+
+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.
+
+Diseases of the skin may be conveniently divided, according to their
+most marked features, into--
+
+(1) Those in which congestion and inflammation are the most marked
+features, varying according to the grade or form into (a) congestion
+with simple redness, dryness, and heat, but no eruption (erythema);
+(b) inflammation with red-pointed elevations, but no blisters
+(papules); (c) inflammation with fine, conical elevations, each
+surmounted by a minute blister (vesicle); (d) inflammation with a
+similar eruption but with larger blisters, like half a pea and upwards
+(bullae); (e) inflammation with a similar eruption, but with a small
+sac of white, creamy pus on the summit of each elevation (pustules);
+(f) 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); (g) the formation of round, nodular, transient
+swellings in the true skin (tubercles); and (h) the excessive
+production of scales, or dandruff (scaly or squamous affections).
+
+(2) Diseases in which there are only deranged sensations of itching,
+heat, tenderness, etc. (neurosis).
+
+(3) Diseased growths, such as warts, callosities, horny growths, cancer,
+etc.
+
+(4) Diseases from parasites, animal and vegetable.
+
+(5) Diseases connected with a specific poison, such as horsepox,
+erysipelas, anthrax, farcy, or cutaneous glanders, etc.
+
+(6) Physical injuries, like wounds, burns, scalds, etc.
+
+
+CONGESTION (RED EFFLORESCENCE, OR ERYTHEMA).
+
+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.
+
+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.
+
+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 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.
+
+_Treatment._--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.
+
+
+CONGESTION, WITH SMALL PIMPLES, OR PAPULES.
+
+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, bullae) 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.
+
+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.
+
+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.
+
+_Treatment._--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.
+
+
+INFLAMMATION WITH BLISTERS, OR ECZEMA.
+
+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.
+
+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,
+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.
+
+_Treatment._--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.
+
+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.
+
+
+INFLAMMATION WITH PUSTULES.
+
+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.
+
+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 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.
+
+_Treatment._--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.
+
+
+BOILS, OR FURUNCLES.
+
+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.
+
+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.
+
+_Treatment._--To treat very painful boils a free incision with a lancet
+in two directions, followed by a dressing with one-half an 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.
+
+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.
+
+
+NETTLERASH (SURFEIT, OR URTICARIA).
+
+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.
+
+_Treatment._--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.
+
+
+PITYRIASIS, OR SCALY SKIN DISEASE.
+
+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 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.
+
+
+PRURITUS, OR NERVOUS IRRITATION OF THE SKIN.
+
+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.
+
+_Treatment_ 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.
+
+
+HERPES.
+
+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.
+
+_Treatment._--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.
+
+
+BLEEDING SKIN ERUPTIONS, OR DERMATORRHAGIA PARASITICA.
+
+In China, Hungary, Spain, and other countries horses frequently suffer
+from the presence of a threadworm (_Filaria haemorrhagica_ Railliet, _F.
+multipapillosa_ 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 (papillae) 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.
+
+_Treatment_ 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.
+
+
+SUMMER SORES FROM FILARIA IRRITANS.
+
+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 (_Filaria irritans_ 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 off, the surface bears a
+resemblance to the fine, yellow points of miliary tuberculosis in the
+lung. The worm or its debris 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.
+
+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.[4]
+
+_Treatment_ 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.[5]
+
+
+CRACKED HEELS (SCRATCHES, OR CHAPS ON KNEE AND HOCK).
+
+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 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.
+
+_Causes._--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.
+
+_Treatment._--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.
+
+
+INFLAMMATION OF THE HEELS WITH SEBACEOUS SECRETION (GREASE, OR CANKER).
+
+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.
+
+_Causes._--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.
+
+_Symptoms._--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 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 papillae, and that
+at intervals these have bulged out into a vascular fungous mass
+comparable to the "grapes."
+
+_Treatment._--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 pharmacopoeia 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.
+
+
+ERYSIPELAS.
+
+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.
+
+_Cause._--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.
+
+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 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.
+
+_Treatment_ 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.
+
+
+HORSEPOX, ANTHRAX, AND CUTANEOUS GLANDERS (FARCY).
+
+These subjects are discussed under the head of contagious diseases.
+
+
+CALLOSITIES.
+
+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.
+
+
+HORNY SLOUGHS (SITFASTS), OR SLOUGHING CALLOSITIES.
+
+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. 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.)
+
+
+WARTS.
+
+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.
+
+
+BLACK PIGMENT TUMORS, OR MELANOSIS.
+
+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.
+
+
+EPITHELIAL CANCER, OR EPITHELIOMA.
+
+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.
+
+
+VEGETABLE PARASITES OF THE SKIN.
+
+(Pl. XXXVIII, figs. 2, 3, 4.)
+
+PARASITE: _Trichophyton tonsurans._ MALADY: _Tinea tonsurans, or
+circinate ringworm._--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.
+
+_Symptoms._--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.
+
+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
+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.
+
+PARASITE: _Achorion schoenleini._ MALADY: _Favus, or honeycomb
+ringworm._--Megnin 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.
+
+PARASITE: _Microsporon furfur._ MALADY: _Parasitic pityriasis._--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.
+
+
+ANIMAL PARASITES OF THE SKIN.[6]
+
+ACARIASIS, OR MANGE.
+
+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.
+
+PARASITE: _Sarcoptes scabiei equi._ MALADY: _Sarcoptic acariasis._--This
+is the special _Sarcoptes_ 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 _Sarcoptes_, 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 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 _Sarcoptes_ 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 deg. 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.
+
+_Symptoms._--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.
+
+_Treatment_ 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.
+
+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.
+
+PARASITE: _Psoroptes equi_ (_Dermatocoptes equi_,
+_Dermatodectes equi_). MALADY: _Psoroptic
+acariasis._--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
+_Sarcoptes_. The same treatment will suffice and is more promptly
+effectual. The purifying of the stable must be more thorough, as the
+_Psoroptes_ 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.
+
+PARASITE: _Chorioptes equi_ (_Symbiotes equi_, _Dermatophagus equi_,
+_Chorioptes spathiferus_). MALADY: _Foot mange._--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 _Psoroptes_; 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 _Sarcoptes_, but may be confined to the legs and
+the parts with which they come in contact.
+
+PARASITE: _Dermanyssus gallinae, or chicken acari._ MALADY: _Poultry
+acariasis._--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.
+
+PARASITE: _Larva of a Trombidium, Leptus americanus, or harvest bug,
+misnamed jigger (chigoe)._ MALADY: _Autumn mange._--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.
+
+[Illustration: PLATE XXXIX.
+
+MITES THAT INFEST THE HORSE.]
+
+
+TICKS.
+
+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.
+
+
+GRUBS IN SKIN.
+
+PARASITE: _Hypoderma lineata_. MALADY: _Larvae_ (_grubs_) _under the
+skin_.--The larvae of a fly (probably _Hypoderma lineata_, whose larvae 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.
+
+
+LARVAE (GRUBS) ON THE SKIN, OR FLYBLOW.
+
+The following flies, among others, deposit their eggs on open sores or
+on wet, filthy parts of the skin, where their larvae or grubs give rise
+to serious trouble: _Lucilia caesar_ (bluebottle), _Cochliomyia
+macellaria_ (screwworm fly), _Musca vomitoria_ (meat fly), and
+_Sarcophaga carnaria_ (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.
+
+
+FLIES.
+
+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.
+
+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
+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.
+
+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.
+
+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.
+
+
+FLEAS.
+
+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 larvae 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.
+
+The chigoe (_Pulex penetrans_) 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.
+
+
+LICE, OR PEDICULI.
+
+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
+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.
+
+
+STINGS OF BEES, WASPS, AND HORNETS.
+
+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.
+
+_Treatment_ 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.
+
+
+TARANTULA AND SCORPION.
+
+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.
+
+
+SNAKE BITES.
+
+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.
+
+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.
+
+
+BURNS AND SCALDS.
+
+These subjects are discussed in the following chapter.
+
+
+WOUNDS OF THE SKIN.
+
+Wounds of the skin are fully discussed in the next chapter.
+
+FOOTNOTES:
+
+[3] 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.
+
+[4] Descazeaux has shown that the worms found in these summer sores are
+probably larval forms of the stomach worms of the horse, _Habronema
+megastoma_, _H. microstoma_, and _H. muscae_. Ransom has shown that the
+larval stage of _H. muscae_ 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 _Habronema_ 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.
+
+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.--M. C. HALL.
+
+[5] 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.
+
+[6] Revised by M. C. Hall.
+
+
+
+
+WOUNDS AND THEIR TREATMENT.
+
+By CH. B. MICHENER, V. S.
+
+[Revised by John R. Mohler, V. M. D., A. M.]
+
+
+DESCRIPTION OF WOUNDS.
+
+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.
+
+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.
+
+
+HEMOSTASIA.
+
+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.
+
+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 of arresting hemorrhage,
+since it disturbs healing least and gives the greatest security against
+secondary hemorrhage.
+
+
+SUTURES.
+
+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.
+
+
+PROCESS OF HEALING.
+
+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 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.
+
+
+HEALING UNDER A SCAB.
+
+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 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.
+
+
+LACERATED AND CONTUSED WOUNDS.
+
+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.
+
+In wounds that are lacerated the amount of hemorrhage is mostly
+inconsiderable; even very large blood vessels may be torn apart without
+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.
+
+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.
+
+_Treatment._--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.
+
+
+BRUISES.
+
+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, 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.
+
+
+PUNCTURED WOUNDS.
+
+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.
+
+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 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 laminae) 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.
+
+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.
+
+_Symptoms and treatment._--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 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.
+
+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.
+
+
+PUNCTURED WOUNDS OF JOINTS, OR OPEN JOINTS.
+
+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 deg. to 106 deg. 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.
+
+_Treatment_ 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.
+
+
+WOUNDS OF THE TENDON SHEATHS.
+
+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.
+
+
+GUNSHOT WOUNDS.
+
+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.
+
+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 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.
+
+
+POISONED WOUNDS.
+
+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.
+
+_Treatment._--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.
+
+
+HARNESS GALLS (SITFASTS).
+
+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.)
+
+_Treatment._--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.
+
+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.
+
+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.
+
+
+BURNS AND SCALDS.
+
+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, 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.
+
+_Treatment._--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 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.
+
+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.
+
+
+GANGRENE.
+
+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.
+
+_Symptoms._--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.
+
+_Treatment._--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.
+
+
+ULCERATION.
+
+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.
+
+_Causes._--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.
+
+_Treatment._--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.
+
+
+ABSCESSES.
+
+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.
+
+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.
+
+
+ACUTE ABSCESSES.
+
+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.
+
+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.
+
+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.
+
+
+COLD ABSCESSES.
+
+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.
+
+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.
+
+_Treatment._--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 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.
+
+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.
+
+
+FISTULAS.
+
+_Definition._--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.
+
+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.
+
+_Causes._--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.
+
+_Symptoms._--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
+vertebrae, 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.
+
+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 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.
+
+_Treatment._--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.
+
+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.
+
+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.
+
+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 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.
+
+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.
+
+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.
+
+It sometimes happens that the erosions have burrowed so deeply or in
+such a direction that the opening of a drainage passage becomes
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+
+
+
+INFECTIOUS DISEASES.
+
+By RUSH SHIPPEN HUIDEKOPER, M. D., Vet.
+
+[Revised by A. Eichhorn, D. V. S.]
+
+
+GENERAL DISCUSSION.
+
+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.
+
+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.
+
+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.
+
+The introduction of the infection may take place in various ways. The
+most frequent method is by ingestion. Further, the entrance of 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.
+
+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.
+
+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.
+
+
+DISINFECTION.
+
+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.
+
+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:
+
+1. Sweep ceilings, side walls, stall partitions, floors, and other
+surfaces until free from cobwebs and dust.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+
+VACCINATION.
+
+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.
+
+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.
+
+
+INFLUENZA.
+
+     _Synonyms._--Pinkeye, typhoid fever, epizooty, epihippic fever,
+     hepatic fever, bilious fever, etc.; flevre typhoide, grippe
+     (French); Pferdestaupe (German); gastro-enteritis of Vatel and
+     d'Arboval; febris erysipelatodes, Zundel; typhus of Delafond.
+
+_Definition._--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 laminae 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 sequelae 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.
+
+The first description of influenza is given by Laurentius Rusius in
+1301, when it spread over a considerable portion of Italy, causing
+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.
+
+_Etiology._--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.
+
+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 free from
+the disease, it certainly appears after the introduction of an
+apparently healthy animal.
+
+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.
+
+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.
+
+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 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.
+
+_Symptoms._--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.
+
+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 deg., 104.5 deg., and 105 deg. F., or even in severe cases to 107 deg. 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
+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.
+
+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 deg. or 106 deg. 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.
+
+_Terminations._--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 debris 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; 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.
+
+_Complications._--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
+laminae 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 laminae, more rarely commence in epizootic form, but are to be found
+in a certain small percentage of cases in all epizootics.
+
+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.
+
+_Complication of the intestines._--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 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 deg. to 1.5 deg. 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.
+
+_Complication of the lungs._--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 deg. to 2 deg., 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.
+
+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 rales 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 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.
+
+_Complication of the brain._--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.
+
+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.
+
+_Complication of the feet._--The feet are the organs which are next in
+frequency predisposed to congestion. This congestion takes place in the
+laminae (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 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.
+
+_Pleurisy._--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.
+
+_Pericarditis_ 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.
+
+_Peritonitis_, 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.
+
+Other occasional complications are nephritis, hepatitis, inflammation of
+the flexor tendons and rupture of them, and abscesses.
+
+_Diagnosis._--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, which indicates the importance of running the hand daily
+over the hoofs to detect any sudden elevation of temperature on their
+surface.
+
+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 conjunctivae.
+
+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.
+
+_Prognosis._--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.
+
+_Alterations._--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.
+
+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.
+
+_Treatment._--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.
+
+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.
+
+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.
+
+In complication of the lungs iodid of potash and digitalis are most
+frequently indicated, in addition to the remedies used for the disease
+itself.
+
+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.
+
+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.
+
+_Prevention._--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.
+
+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.
+
+
+CONTAGIOUS PNEUMONIA.
+
+     _Synonyms._--Edematous pneumonia; stable pneumonia; equine
+     pleuropneumonia; influenza pectoralis equorum; pleuropneumonia;
+     influenzal pneumonia; Brustseuche (German).
+
+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.
+
+_Etiology._--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 by
+intravenous or subcutaneous injections of blood and of emulsions made
+from nasal discharge, urine, the lung, and other organs.
+
+The most recent experimental results of Gaffky and Lueber 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.
+
+Two organisms were formerly especially considered to play an important
+part in the cause of the disease, the _Streptococcus pyogenes equi_,
+which has been isolated from most cases of the disease, and the
+_Bacillus equisepticus_, 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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+_Symptoms._--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.
+
+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.
+
+Suddenly, without the preliminary rales 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. 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 deg. or 105 deg. 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.
+
+_Terminations._--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.
+
+_Complications._--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 rales 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 rales, 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 rales 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 deg.
+or 2 deg., 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 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 rales are heard in the
+larger bronchi, cavities may be found at any part of these organs, and
+points of lobular pneumonia may be detected.
+
+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.
+
+_Diagnosis._--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.
+
+_Prognosis._--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.
+
+_Alterations._--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.
+
+_Treatment._--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.
+
+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 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.
+
+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.
+
+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.
+
+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.
+
+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 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.
+
+The same procedure as given for influenza should be carried out in the
+prevention of this affection.
+
+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.
+
+
+STRANGLES.
+
+     _Synonyms._--Distemper; colt-ill; catarrhal fever; one form of
+     shipping fever; febris pyogenica.
+
+_Definition._--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.
+
+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.
+
+_Causes._--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.
+
+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.
+
+_Symptoms._--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, or hind quarters, or
+in severe cases of the whole body, with trembling of the muscles and
+dryness of the skin.
+
+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.
+
+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.
+
+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 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).
+
+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.
+
+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.
+
+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.
+
+_Pathology._--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.
+
+_Prevention._--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.
+
+_Treatment._--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 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.
+
+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 _not_ 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.
+
+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.
+
+
+PURPURA HEMORRHAGICA.
+
+     _Synonyms._--Anasarca; petechial fever; morbus maculosus.
+
+_Definition._--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.
+
+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.
+
+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.
+
+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 petechiae,
+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 fraenum. If
+the external swelling has been on the head, the petechiae 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.
+
+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 fossae 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 deg., 103 deg., or 104 deg. F.
+
+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 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.
+
+_Terminations._--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.
+
+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.
+
+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.
+
+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.
+
+_Alterations._--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.
+
+_Diagnosis._--The diagnosis of anasarca must principally be made from
+farcy or glanders. In anasarca the swelling is nonsensitive, 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 fossae, 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.
+
+_Prognosis._--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.
+
+_Treatment._--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.
+
+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.
+
+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 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.
+
+_Externally._--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.
+
+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.
+
+After recovery the animal regains its ordinary health, and there is no
+predisposition to a return of the disease.
+
+
+HORSEPOX, OR EQUINE VARIOLA.
+
+     _Synonyms._--Variola equina; pustular grease; phlyctenold
+     herpes.
+
+_Definition._--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 body, but
+chiefly, and often exclusively, upon the pasterns and fetlocks. The
+eruption may commence upon the lips, or about the nostrils or eyes.
+
+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.
+
+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.
+
+_Causes._--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.
+
+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 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.
+
+_Symptoms._--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 deg. or 105 deg. F. within 36 or 48 hours from
+the appearance of the first symptoms.
+
+The visible mucous membranes, especially the conjunctivae, 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.
+
+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.
+
+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.
+
+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.
+
+_Complications._--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.
+
+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.
+
+_Diagnosis._--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 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.
+
+_Prognosis._--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.
+
+_Treatment._--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.
+
+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 that is needed,
+except perhaps a little Glauber's salt to prevent constipation.
+
+_Prophylactic treatment._--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.
+
+
+ANTHRAX.
+
+     _Synonyms:_ Carbuncle, splenic fever, splenic apoplexy, etc.;
+     charbon, sang de rate (French); Miltzbrand (German).
+
+_Definition._--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 _Bacillus anthracis_, or
+its spores.
+
+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.
+
+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.
+
+_Causes._--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 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.
+
+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 debris from the body of one previously
+infected.
+
+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 debris 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.
+
+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.
+
+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 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.
+
+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.
+
+_Symptoms._--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 deg. or 105 deg. 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.
+
+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 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.
+
+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.
+
+_Treatment._--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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+_Prevention._--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.
+
+
+GLANDERS AND FARCY.
+
+(Pls. XL-XLII.)
+
+_Definition._--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.
+
+Glanders is a contagious constitutional disease of the genus _Equus_
+(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.
+
+[Illustration: PLATE XL.
+
+GLANDERS.
+
+Nasal septum of horse, right side, showing acute lesions.]
+
+[Illustration: PLATE XLI.
+
+GLANDERS.
+
+Middle region of nasal septum, left side, showing ulcers.]
+
+[Illustration: PLATE XLII.
+
+GLANDERS.
+
+Posterior half of nasal septum, right side, showing cicatrices.]
+
+_History._--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.
+
+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.
+
+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."
+
+Bourgelat, the founder of veterinary schools, in his "Elements of
+Hippiatry," published in 1755, establishes glanders as a virulent
+disease.
+
+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.
+
+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 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.
+
+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.
+
+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.
+
+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.
+
+_Causes._--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 _Bacillus
+mallei_.
+
+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.
+
+While a virus from a case of glanders if inoculated into an animal of
+the genus _Equus_ 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 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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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 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.
+
+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.
+
+The animals of the genus _Equus_--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.
+
+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,
+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.
+
+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.
+
+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 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.
+
+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.
+
+
+CHRONIC FARCY.
+
+_Symptoms._--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, the ragged edges are beveled off, and the chancre is
+turned into a simple ulcer which rapidly heals.
+
+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.
+
+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.
+
+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.
+
+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 rales. 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 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.
+
+Chronic farcy in the ass and mule is an excessively rare condition, but
+sometimes occurs.
+
+
+CHRONIC GLANDERS.
+
+_Symptoms._--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.
+
+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.
+
+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 not separated from the skin and
+subcutaneous connective tissues found in strangles, in laryngitis, and
+in other simple inflammatory troubles.
+
+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.
+
+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.
+
+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.
+
+
+ACUTE GLANDERS.
+
+_Symptoms._--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.
+
+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 deg.,
+104 deg., or 105 deg. F.
+
+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 rales 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.
+
+_Diagnosis._--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.
+
+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.
+
+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.)
+
+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 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.
+
+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.
+
+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.
+
+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.
+
+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 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.
+
+_Treatment._--Almost the entire list of drugs in the pharmacopoeia 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.
+
+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.
+
+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.
+
+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 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.
+
+
+SPOROTRICHOSIS (MYCOTIC LYMPHANGITIS).
+
+By JOHN R. MOHLER, V. M. D., _Assistant Chief, Bureau of Animal
+Industry_.
+
+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
+_Sporotrichum schenckii_, 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.
+
+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.
+
+_Bacteriology._--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 deg.
+do they develop into the characteristic spore-carrying threads.
+
+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.
+
+The natural infection without doubt is caused through superficial
+wounds, such as galls, barbed-wire cuts, or through various stable
+utensils, harness, bandages, insects, etc. Solipeds are mostly
+susceptible, but cattle may also be infected.
+
+_Symptoms._--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.
+
+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 deg. F. The appetite is not impaired
+except in the advanced cases.
+
+_Lesions._--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.
+
+_Diagnosis._--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 double
+outline. Furthermore, the injection of mallein in cases of
+sporotrichosis will be attended with negative results.
+
+_Treatment._--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.
+
+In the most favorable cases recovery results in from five to seven
+weeks; as a rule, however, it requires several months.
+
+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.
+
+
+RABIES, HYDROPHOBIA, OR MADNESS.
+
+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.
+
+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 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.
+
+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.
+
+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, 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.
+
+_Symptoms._--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).
+
+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.
+
+_Diagnosis._--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.
+
+Recovery from rabies may be considered as a question of the correctness
+of the original diagnosis. Rabies is always fatal.
+
+_Treatment._--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.
+
+
+DOURINE.
+
+By JOHN R. MOHLER, V. M. D., _Assistant Chief, Bureau of Animal
+Industry_.
+
+Dourine (also known as maladie du coit, 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
+_Trypanosoma equiperdum_.
+
+_History._--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.
+
+_Symptoms._--There are many variations in the symptoms of dourine, and
+this is particularly true of the disease as it occurs in this country.
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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 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.
+
+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.
+
+_Diagnosis._--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.
+
+_Treatment._--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.
+
+
+INFECTIOUS ABORTION IN MARES.
+
+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.
+
+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.
+
+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 substantiated by many
+investigators abroad, as well as in this country, notably so by De Jong,
+Dassonville, and Riviere, 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 "_Bacillus abortivus equinus_" as the name for
+the specific organism.
+
+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.
+
+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.
+
+_Symptoms._--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.
+
+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
+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 role in the spreading of the disease. Schofield considers
+this method of infection as the principal source of spreading the
+disease.
+
+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.
+
+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.
+
+_Diagnosis._--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.
+
+Infected animals usually abort only once; however, in a certain
+proportion of cases they may abort even two, three, or four times in
+succession.
+
+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.
+
+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.
+
+_Treatment and prevention._--Medicinal treatment is usually of no avail,
+and all efforts should be directed toward the prevention of the
+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.
+
+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.)
+
+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.
+
+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.
+
+By carefully and persistently carrying out the sanitary measures it may
+be possible to control and finally eradicate the disease.
+
+
+NAVEL ILL OF COLTS.
+
+Navel ill of colts is also known as joint ill, omphalophlebitis, septic
+arthritis of sucklings, and pyosepticemia of the newly born. 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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+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.
+
+
+INFECTIOUS ANEMIA OR SWAMP FEVER.
+
+By JOHN R. MOHLER, V. M. D., _Assistant Chief, Bureau of Animal
+Industry_.
+
+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.
+
+_Cause._--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.
+
+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.
+
+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.
+
+_Symptoms._--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 deg. 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.
+
+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. Petechiae, 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.
+
+_Lesions._--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 and most constant
+lesion is probably the petechiae, 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 petechiae, with a serous exudate present in the
+thoracic cavity. In addition to the petechiae 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 petechiae. 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.
+
+_Diagnosis._--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.
+
+_Prognosis._--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.
+
+_Treatment._--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 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:
+
+    Arsenious acid            grams       2
+    Powdered nux vomica         do       28
+    Powdered cinchona bark      do       85
+    Powdered gentian root       do      110
+
+These should be well mixed and one-half teaspoonful given to the
+affected animal at each feed.
+
+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.
+
+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.
+
+
+SURRA.
+
+By CH. WARDELL STILES, PH. D.
+
+_Professor of Zoology, United States Public Health Service._
+
+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 _Trypanosoma evansi_,
+20 to 34  mu long by 1 to 2  mu 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.
+
+Surra is a wet-weather disease, occurring chiefly during or immediately
+after heavy rainfalls, floods, or inundations.
+
+Surra attacks especially horses, asses, and mules, but it may occur in
+carabao, camels, elephants, cats, and dogs, and has been transmitted 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.
+
+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.
+
+_Method of infection._--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.
+
+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.
+
+_Symptoms._[7]--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 deg. to 104 deg. 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 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 petechiae 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 petechiae 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 this time the wasting
+has been steadily progressive, especially of the muscles of the back and
+those surrounding the hip joint and the glutei.
+
+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.
+
+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 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.
+
+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 deg. or 105.8 deg. 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 petechiae 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.
+
+_Diagnosis._--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.
+
+_Treatment._--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.
+
+
+OSTEOPOROSIS OR BIGHEAD.
+
+By JOHN R. MOHLER, V. M. D., _Assistant Chief, Bureau of Animal
+Industry_.
+
+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.
+
+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.
+
+_Cause._--The cause of this disease still remains obscure, although
+various theories have been advanced, some entirely erroneous, others
+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. Petrone believes that the _Micrococcus nitrificans_ 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.
+
+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.
+
+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.
+
+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 diseased, although the
+cows and sheep of this farm remained unaffected.
+
+_Symptoms._--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 vertebrae 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.
+
+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.
+
+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 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.
+
+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.
+
+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.
+
+_Lesions._--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 vertebrae 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 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.
+
+_Treatment._--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.
+
+FOOTNOTES:
+
+[7] This summary of symptoms is based upon work by Lingard.
+
+
+
+
+HORSESHOEING.
+
+By JOHN W. ADAMS, A. B., V. M.,
+
+_Professor of Surgery and Lecturer on Shoeing, Veterinary Department,
+University of Pennsylvania._
+
+
+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.
+
+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.
+
+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.
+
+
+GROSS ANATOMY OF THE FOOT.
+
+(Pls. XXXII-XXXIV.)
+
+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.)
+
+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.
+
+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.
+
+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.
+
+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.
+
+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 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.
+
+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.
+
+The functions of the pododerm are to produce the hoof and to unite it
+firmly to the foot.
+
+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, 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.
+
+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.
+
+The bars (see fig. 1c) 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 _the more slanting half of a hoof is
+always the thicker_. 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.
+
+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.
+
+The frog, secreted by the pododerm covering the plantar cushion or fatty
+frog, and presenting almost the same form as the latter, lies 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.
+
+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.
+
+
+THE PHYSIOLOGICAL MOVEMENTS OF THE HOOF.
+
+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.
+
+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 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.
+
+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.
+
+
+GROWTH OF THE HOOF.
+
+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 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.
+
+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.
+
+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.
+
+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 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.
+
+
+THE CARE OF UNSHOD HOOFS.
+
+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.
+
+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.
+
+[Illustration: 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.]
+
+
+CHARACTERISTICS OF A HEALTHY HOOF.
+
+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
+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.
+
+[Illustration: FIG. 2.--Pair of fore feet of regular form in regular
+standing position.]
+
+
+VARIOUS FORMS OF HOOFS.
+
+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.
+
+[Illustration: FIG. 3.--Pair of fore feet of base-wide form in toe-wide
+standing position.]
+
+
+FORMS OF FEET VIEWED FROM IN FRONT AND IN PROFILE.
+
+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).
+
+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.
+
+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.
+
+[Illustration: FIG. 4.--Pair of fore feet of base-narrow form in
+toe-narrow standing position.]
+
+Viewing the foot in profile, we distinguish the regular position (fig.
+5b) and designate all forward deviations as acute-angled (long toe and
+low heel, fig. 5a), and all deviations backward from the regular
+(steep toe and high heel, fig. 5c) 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.
+
+[Illustration: 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 deg.); c, side view of a stumpy, or
+"upright," fore foot; obliquity above 50 deg.. 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.]
+
+_A front hoof of the regular standing position._--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 deg. to 50 deg. 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.
+
+_A hoof of the base-wide position_ 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.
+
+_A hoof of the base-narrow position_ 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.
+
+_A regular hoof_ (fig. 5b), viewed from one side, has a straight
+foot-axis inclined to the horizon at an angle of 45 deg. to 50 deg.. The weight
+falls near the center of the foot and there is moderate expansion of the
+quarters.
+
+_An acute-angled hoof_ (fig. 5a) has a straight foot-axis inclined at
+an angle less than 45 deg. 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.
+
+_Upright or stumpy hoof._--In the upright or stumpy hoof (fig. 5c) the
+foot-axis is straight and more than 55 deg. 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.
+
+_Wide and narrow hoofs._--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.
+
+_Hind hoofs_ 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 deg. steeper than in front hoofs.
+
+
+EXAMINATION PRELIMINARY TO SHOEING.
+
+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.
+
+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.
+
+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. 6c)? 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.
+
+If the long pastern stands steeper than the toe (fig. 6a) the
+foot-axis is broken backward, in which case the toe is too long or the
+quarters are too low (short). In figures 6a and 6c 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 6b.
+Note also the length of the shoe.
+
+Next, the feet should be raised and the examiner should note the outline
+of the foot, the conformation of the sole, form and quality 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.
+
+[Illustration: 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.]
+
+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.
+
+An exception should be noted, however, in founder, in which the
+grounding wear is most pronounced at the heels.
+
+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 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!
+
+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.
+
+No man is competent either to shoe a horse or to direct the work till he
+has made the precited observations.
+
+
+PREPARATION OF THE HOOF FOR THE SHOE.
+
+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.
+
+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 _never pared on the side_. 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 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.
+
+
+THE SHOE.
+
+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.
+
+_Form._--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.
+
+_Width._--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.
+
+_Thickness._--The thickness should be sufficient to make the shoe last
+about four weeks and should be uniform except in special cases.
+
+_Length._--This will depend upon the obliquity of the hoof viewed in
+profile. The acute-angled hoof (fig. 5a) 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. 5b and 8)
+the branches should project an amount equal to the thickness of the
+shoe. In a stumpy hoof (fig. 5c) 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.
+
+_Surfaces._--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 a, b,
+c.) 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).
+
+_Borders._--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.
+
+_Fullering._--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.
+
+_Nail holes._--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.
+
+_Clips._--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.
+
+
+SPECIAL FEATURES AND FITTING THE SHOES.
+
+_A shoe for a regular hoof_ (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, 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.
+
+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.
+
+[Illustration: 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.]
+
+_A shoe for a base-wide hoof_ 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.
+
+[Illustration: 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.]
+
+_A shoe for a base-narrow hoof_ should be just the reverse of the
+preceding. The outer branch should be somewhat longer than the inner.
+
+_A shoe for an acute-angled hoof_ 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. 5a).
+
+_A shoe for a stumpy hoof_ 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.
+
+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.
+
+_Hot fitting._--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.
+
+_Nailing._--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.
+
+
+THE BAR SHOE.
+
+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.
+
+[Illustration: 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.]
+
+[Illustration: 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.]
+
+
+THE RUBBER PAD.
+
+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.
+
+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.
+
+[Illustration: FIG. 11.--Left fore hoof of regular form shod with a
+rubber pad and "three-quarter" shoe. (Ground surface.)]
+
+[Illustration: 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.]
+
+
+OTHER SPECIAL FORMS.
+
+Some drawings, designed to illustrate shoeing in connection with
+"interfering" and "forging," and other special conditions, are shown in
+figures 13 to 18.
+
+[Illustration: 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.]
+
+[Illustration: 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.]
+
+[Illustration: 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.]
+
+[Illustration: 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.]
+
+[Illustration: 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.]
+
+[Illustration: 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.]
+
+
+
+
+INDEX.
+
+
+Abdomen--
+  dropsy, in foal, or ascites, description and treatment, 193
+  dropsy, or ascites, description, symptoms, and treatment, 86
+  limbs, and perineum, dropsy affecting, description and treatment, 180
+  sheath, and penis, swelling, cause and treatment, 171
+
+Abnormal presentations at birth, 197-202
+
+Abortion, description, cause, symptoms, and treatment, 182
+
+Abscess--
+  and inflammation of lymphatic glands, descriptions, symptoms,
+    treatment, 272
+  in lung and suppuration, symptoms, 127
+
+Abscesses--
+  acute, description and treatment, 500
+  cold, description and treatment, 501
+  description, 500
+  in throat, treatment, 62
+
+_Acari_, parasites of eye, 296
+
+Acariasis, or mange, note, 478
+
+_Achorion schoenleini_, vegetable parasite of skin, description, 478
+
+Adams, John W., chapter on "Horseshoeing", 583-605
+
+Air embolism, or air in veins, note, 270
+
+Albuminoid poisoning, hemoglobinuria, azoturia, azotemia, symptoms,
+prevention, and treatment, 141
+
+Aloes, use against bots in horses, 93
+
+Amaurosis, or palsy of nerve of sight, causes, symptoms, and
+treatment, 231, 295
+
+Amnion, dropsy, description and treatment, 180
+
+Anasarca, or purpura hemorrhagica, causes, symptoms, treatment, etc., 531,
+533
+
+Anatomy and physiology of brain and nervous system, 210
+
+Anemia--
+  of brain, causes, symptoms, pathology, and treatment, 223
+  spinal, symptoms and treatment, 234
+
+Aneurism--
+  description, symptoms, pathology, and treatment, 265
+  one form caused by _Strongylus vulgaris_, 265
+
+Anidian monsters, or moles, description, 179
+
+Animal parasites, description of kinds, 478
+
+Ankle--
+  and fetlock, skin, note, 397
+  fetlock, and foot, diseases, chapter by A. A. Holcombe, 395-457
+
+Ankles, cocked, or knuckling, description, causes, and treatment, 400
+
+Anthrax--
+  definition, causes, symptoms, and treatment, 540-544
+  prevention by destruction of bacteria, 544
+  vaccination as preventive, 544
+
+Apoplexy, or cerebral hemorrhage, causes, symptoms, pathology, and
+treatment, 220
+
+Arteries--
+  description, 249
+  diseases, or arteritis, and endarteritis, description, symptoms,
+  pathology, and treatment, 263
+
+Artery--
+  constriction, description, 265
+  rupture, description, symptoms, and treatment, 266
+
+Arthritis, open joints, broken knees, and synovitis, cause and treatment, 357
+
+_Ascaris equorum_, intestinal worm, note, 90
+
+Ascites, or dropsy of abdomen, description, symptoms, and treatment, 86, 193
+
+Asthma, heaves, or broken wind, definition, symptoms, and treatment, 128
+
+Atheroma of veins and arteries, description, 264
+
+Autogenic vaccines, description, 506
+
+Autumn mange, description and treatment, 480
+
+Azotemia, hemoglobinuria, azoturia, poisoning by albuminoids, symptom,
+prevention, and treatment, 141
+
+Azoturia, hemoglobinuria, azotemia, poisoning by albuminoids, symptoms,
+prevention, and treatment, 141
+
+
+_Bacillus equisepticus_, cause of pneumonia, 522
+
+Bacteria, kinds responsible for pneumonia in horses, 522
+
+Bacteria vaccines, kinds and uses, 506, 531
+
+Balls, or pills, description and manner of administering, 44
+
+Bar shoe, uses, 601
+
+Bees, wasps, and hornets, stings, treatment, 485
+
+Beets as feed, 56
+
+Bichlorid, use in disinfection, 509
+
+Bighead (osteoporosis)--
+  chapter by John R. Mohler, 578-582
+  symptoms, lesions, and treatment, 580
+
+Biliary calculi, or gallstones, symptoms and treatment, 90
+
+Bilocular cavity, or calculus in sheath, or preputial calculus, description
+and treatment, 163
+
+Birth, abnormal presentations at, 197-202
+
+Black pigment tumors, or melanosis, description and treatment, 476
+
+Bladder--
+  calculus, or stone, and tumor affecting, 190
+  diseases growths, symptoms and treatment, 151
+  eversion, description and treatment, 152
+  inflammation, cystitis, or urocystitis, symptoms and treatment, 149
+  irritable, cause and treatment, 150
+  neck, spasms affecting, causes, symptoms, and treatment, 146, 225
+  paralysis, description and cause, 230
+  paralysis, symptoms and treatment, 148
+  stone, vesical calculus, or cystic calculus, description, symptoms,
+    and treatment, 159
+  worm of kidney, 146
+
+Bleeding--
+  after castration, treatment, 170
+  from lungs, or hemoptysis, causes, description, and treatment, 127
+  from nose, causes and treatment, 103
+  or flooding from womb, treatment, 205
+  skin eruptions, or _Dermatorrhagia parasitica_, description and
+    treatment, 469
+
+Blisters, inflammation, or eczema, description and treatment, 464
+
+Bloat colic, cause, symptoms, and treatment, 73
+
+Blood--
+  circulation of heart, description, 248
+  clots in walls of vagina, 207
+  medicine administered into veins, 48
+  medium of disease transmission, 511
+  of penis, extravasation, cause and treatment, 167
+  spavin, bog spavin, and thoroughpin, description and treatment, 356
+
+Blood vessels--
+  and heart, diseases, remarks, 250
+  heart, and lymphatics, diseases, chapter by M. R. Trumbower, 247-273
+  physiology and anatomy, 247
+
+Bloody urine, or hematuria, cause and treatment, 141
+
+Blowing, high, description, 110
+
+Bluebottle (_Lucilia caesar_), note 481
+
+Bog spavin, blood spavin, and thoroughpin, description and treatment, 356
+
+Boil of eyelid, description and treatment, 282
+
+Boils--
+  or _Dermatitis granulosa_, 469
+  or furuncles, description and treatment, 466
+
+Bone--
+  hip, fracture, or on innominatum, description, symptoms, prognosis, and
+    treatment, 341
+  premaxillary, fractures, description and treatment, 336
+  spavin. _See_ Spavin
+
+Bones--
+  cannon, fractures, description, symptoms, and treatment, 350, 395
+  cranial, fractures, causes, symptoms, and treatment, 335
+  diseases, description, 309
+  dislocations and luxations, cause, symptoms, and treatment, 361
+  of face, fractures, description, and treatment, 366
+  of fetlock and foot, description, 395
+  of hip, fractures, causes, 188
+  one system of locomotion, 299, 301
+  sesamoid, fractures, cause, symptoms, prognosis, and treatment, 352
+
+Botfly, habits and treatment, 93
+
+Bots, injury to horses, symptoms, and treatment, 93-94
+
+Bowels, twisting, volvulus, or gut-tie, cause, symptoms, and treatment, 72
+
+Brain--
+  and membranes, inflammation, description, 212, 213
+  and nervous system, anatomy, and physiology, 210
+  anemia, causes, symptoms, pathology, and treatment, 223
+  compression, causes, symptoms, and treatment, 221
+  concussion, causes, symptoms, treatment, and prevention, 222
+  congestion, or megrims, description, causes, symptoms, treatment, and
+    prevention, 217
+  description, 211
+  dropsy, or hydrocephalus, causes, symptoms, and treatment, 223
+
+Bran, value as feed, 55
+
+Broken knee, open joints, synovitis, and arthritis, cause, prognosis, and
+treatment, 357
+
+Broken wind, heaves, or asthma, definition, symptoms, and treatment, 128
+
+Bronchitis--
+  and broncho-pneumonia, description, symptoms, and treatment, 120
+  chronic, description and treatment, 110
+
+Broncho-pleuropneumonia, description, 126
+
+Broncho-pneumonia and bronchitis, description, symptoms, and treatment, 120
+
+Bruise of frog, causes, symptoms, and treatment, 425
+
+Burns and scalds, treatment, 483, 496
+
+
+Calculi--
+  biliary, or gallstones, symptoms and treatment, 90
+  or stones, in intestines, description, symptoms, and treatment, 71
+  or stones, in stomach, symptoms and treatment, 70
+  renal, description, symptoms, and treatment, 158
+  ureteric, description and treatment, 158-159
+  urinary, classification, 157
+  urinary, stone, or gravel, 154,156
+
+Calculus--
+  in sheath, or bilocular cavity, or preputial calculus, description, and
+     treatment, 163
+  or stone, and tumor in bladder, 190
+  urethral, or stone in urethra, description, symptoms, and treatment, 162
+  vesical, stone in bladder, or cystic calculus, description, symptoms, and
+    treatment, 159
+
+Calk wounds, description and treatment, 405
+
+Callosities--
+  description, 475
+  sloughing, horny sloughs, or sitfasts, description and treatment, 475, 496
+
+Cancer, epithelial, or epithelioma, description and treatment, 477
+
+Canker--
+  of foot, description, causes, symptoms, and treatment, 418
+  or grease (inflammation of heels with sebaceous secretion), description,
+    causes, symptoms, and treatment, 472
+
+Cannon bone--
+  description, 395
+  fractures, description, symptoms, and treatment, 350
+
+Capped elbow, cause, symptoms, and treatment, 379
+
+Capped hock, cause, symptoms, and treatment, 385
+
+Capped knee, description, cause, treatment, etc., 383
+
+Carbolic acid, use in disinfection, 509
+
+Carbon disulphid, use against worms in horse, 93, 94
+
+Cardiac enlargement, or hypertrophy of heart, description, symptoms, and
+treatment, 260
+
+Caries of cartilage, or tumor of haw, description and treatment, 284
+
+Carrots, value as feed, 56
+
+Cartilaginous quittor, description, causes, symptoms, and treatment, 415
+
+Cartilago nictitans, or winking cartilage (the haw), description, 276
+
+Castration--
+  bleeding after operation, treatment, 170
+  by covered operation, method, 172
+  of cryptorchids, or ridglings, method, 169
+  of mare, method, 172
+  of stallions, method, 168
+  pain after operation, treatment, 170
+  successful method, 169
+
+Cataract, remarks, 295
+
+Catarrh--
+  chronic, nasal gleet or collection in sinuses, causes, symptoms, and
+    treatment, 99
+  gastrointestinal, or indigestion, cause, symptoms, and treatment, 76
+  nasal, or cold in head, symptoms, and treatment, 98
+
+Cerebral hemorrhage, or apoplexy, causes, symptoms, and treatment, 220
+
+Cerebritis, causes, symptoms, and treatment, 212
+
+Cerebrospinal meningitis, so called, or forage poisoning, causes, symptoms,
+and treatment, 237
+
+Cervical choke, description, 63, 64
+
+Chaff for feeding, 54
+
+Chaps on knee and hock, scratches, or cracked heels, description, causes,
+and treatment, 470
+
+Chest walls, wounds penetrating, description and treatment, 131
+
+Chicken acari, or _Dermanyssus gallinae_, animal parasite of skin, 480
+
+Chigoe, or jigger--
+  larvae of _Trombidium_, _Leptus americanus_, animal parasite of
+    skin, 480
+  _Pulex penetrans_, bite, treatment, 482
+
+Choke--
+  cervical, description, 63, 64
+  pharyngeal, cervical, and thoracic, symptoms and treatment, 63
+
+Chorea, or St. Vitus dance, description and treatment 227
+
+_Chorioptes_--
+  _bovis_ (_Symbiotes equi_, _Dermatophagus equi_), animal
+    parasite of skin, 480
+  _spathiferus_, animal parasite of skin, 480
+
+Choroiditis, cause, symptoms, and treatment, 288
+
+Chronic bronchitis, description and treatment, 110
+
+Circinate ringworm, or _Tinea tonsurans_, description, symptoms,
+treatment, 477
+
+Circulation organs, methods of examination, 13
+
+Clubfoot, description, 398
+
+Clysters, or enemas, description and manner of administering, 48
+
+Cocked ankles, or knuckling, description, causes, and treatment, 400
+
+Coffin joint, description, 396
+
+Coffinbone, description, 396
+
+Cold in head, or nasal catarrh, symptoms and treatment, 98
+
+Colic--
+  bloat, cause, symptoms, and treatment, 73
+  cramp, or spasmodic, cause, symptoms, and treatment, 74
+  flatulent, cause, symptoms, and treatment, 73
+  obstruction, caused by impaction of large intestine, symptoms, and
+    treatment, 68
+  specific forms, 66
+  wind, cause, symptoms, and treatment, 73
+  worms, description, symptoms, and treatment, 90-94
+  tympanitic, cause, symptoms, and treatment, 73
+
+Colt. _See_ Foal.
+
+Compression of brain, causes, symptoms, and treatment 222
+
+Concussion--
+  of brain, causes, symptoms, and treatment, 222
+  spinal, causes and treatment, 235
+
+Conformation--
+  of foot, faults, 398
+  of horse, 10
+
+Congenital scrotal hernia, description and treatment, 82
+
+Congestion--
+  active, causes, 30
+  and inflammation of skin, description of kinds, 461
+  and inflammation of testicles, or orchitis, causes, symptoms, and
+    treatment, 164
+  description, 30
+  of brain, or megrims, causes, symptoms, treatment, etc., 217
+  of heart, description and symptoms, 263
+  of lungs, description and treatment, 111
+  of skin, red efflorescence, or erythema, description and treatment, 461
+  of skin, with small pimples, or pauples, description and treatment, 463
+  of spine, cause, symptoms, and treatment, 233
+  passive, causes, 31
+
+Conjunctives, or external ophthalmia, description, causes, symptoms, and
+treatment, 285
+
+Constipation, or costiveness, cause and treatment, 70, 181
+
+Constitution of horse, 10
+
+Consumption, or tuberculosis, note, 128
+
+Contagious pneumonia, discussion, 521-527
+
+Convulsions, description and treatment, 226
+
+Cord--
+  spermatic, strangulated, cause and treatment, 170
+  spermatic, tumors, causes and treatment, 171
+  spinal, description, 212
+
+Corn, or maize, how to feed, 55
+
+Cornea--
+  ulcers, treatment, 288
+  white specks and cloudiness, cause and treatment, 288
+
+Corns, description, causes, symptoms, and treatment, 421
+
+Coronary band, description, 397
+
+Coronet--
+  description, 396
+  fractures, symptoms and treatment, 351
+
+Costiveness, or constipation, cause and treatment, 70, 181
+
+Cough, chronic, description, 131
+
+Cracked heels, or scratches, causes and treatment, 470
+
+Cramp--
+  of hind limb, or spasm of thigh, description and treatment, 226
+  or spasmodic, or colic, cause, symptoms, and treatment, 74
+
+Cramps--
+  of hind limbs, cause and treatment, 181
+  or spasms, causes and treatment, 226
+
+Cranial bones, fractures, causes, symptoms, and treatment, 335
+
+Cranium, tumor within, description of kinds, 224
+
+Cresol, use in disinfection, 579
+
+Crookedfoot, description, 399
+
+Croup and diphtheria, mistakes in diagnosis, 108
+
+Cryptorchids, or ridglings, castration, method, 169
+
+Curb of hock, cause, symptoms, and treatment, 374
+
+Currying, value as preventive of bots, 94
+
+Cutaneous quittor, description, causes, symptoms, and treatment, 407
+
+Cuticle, description, 459
+
+Cyanosis of newborn foals, description, 263
+
+_Cylicostomum_ spp., parasite, danger and remedies, 92-93
+
+Cystic calculus, or stone in bladder, description, symptoms, and
+treatment, 159
+
+Cystic disease of wall of womb, or vesticular mole, description and
+treatment, 179
+
+_Cysticercus_, parasite of eye, 297
+
+Cystitis, inflammation of bladder, or urocystitis, symptoms and
+treatment, 149
+
+
+_Dermanyssus gallinae_, or chicken acari, animal parasite of skin, 480
+
+_Dermatitis granulosa_, or boils, 469
+
+_Dermatocoptes equi_, animal parasite of skin, 480
+
+_Dermatodectes equi_, animal parasite of skin, 480
+
+_Dermatophagus equi_, animal parasite of skin, 480
+
+_Dermatorrhagia parasitica_, or bleeding skin eruptions, description and
+treatment, 469
+
+Dermis, or true skin, description, 459
+
+Descazeaux, study of summer sores, note, 470
+
+Diabetes--
+  insipidous, diuresis, polyuria, or excessive secretion of urine, causes,
+    symptoms, and treatment, 138
+  mellitus, saccharine diabetes, glycosuria, or inosuria, causes, symptoms,
+    and treatment, 139
+
+Diaphragm--
+  rupture, cause and symptoms, 133
+  spasm, or thumps, description and treatment, 132, 225
+
+Diaphragmatic hernia, description, 85
+
+Diarrhea, causes, symptoms, and treatment, 77
+
+Dieckerhoff, experiments in disease transmission, note, 511
+
+Digestive organs, diseases, chapter by Ch. B. Michener, 49-94
+
+Digestive tract, examination, 20
+
+Dilatation--
+  of heart, description, causes, symptoms, and treatment, 261
+  of veins, varicose, or varix, causes and treatment, 269
+
+_Dioctophyme renale_, roundworm of kidney, 146
+
+Diphtheria and cramp, mistakes in diagnosis, 108
+
+Dips, use against mange in horses, 479
+
+Diseases, fundamental principles of, chapter by Rush Shippen
+Huidekoper, 27-43
+
+Disinfection, directions and materials, 508-509
+
+Dislocations and luxations of bones, causes, symptoms, treatment, etc., 361
+
+Distemper, cause, symptoms, and treatment, 527-531
+
+Diuresis, polyuria, diabetes insipidus, or excessive secretion of urine,
+causes, symptoms, and treatment, 138
+
+Douche, nasal, in administering medicines, 47
+
+Dourine, or maladie du coit--
+  article by John R. Mohler, 562-564
+  description and treatment, 562
+  symptoms and treatment, 562-564
+
+Drench, methods, 45
+
+Dropsies, synovial, remarks, 355
+
+Dropsy--
+  general, of fetus, description and treatment, 193
+  of abdomen in foal, or ascites, description and treatment, 193
+  of abdomen, or ascites, description, symptoms, and treatment, 86
+  of amnion, description and treatment, 180
+  of brain, or hydrocephalus, causes, symptoms, and treatment, 223
+  of limbs, perineum, and abdomen, description and treatment, 180
+  of scrotum, or hydrocele, symptoms and treatment, 166
+  of womb, cause, symptoms, and treatment, 179
+
+Dysentery, description, causes, symptoms, and treatment, 79
+
+
+_Echinococcus_--
+  parasite of eye, 296
+  parasite of kidney, 146
+
+Ectropion and entropion, or eversion and inversion of eyelid, causes and
+treatment, 283
+
+Eczema, or inflammation with blisters, description and treatment, 464
+
+Edematous pneumonia, definition, causes, symptoms, treatment, etc., 521-527
+
+Elbow--
+  capped, cause, symptoms, and treatment, 379
+  muscles, sprains, causes, symptoms, and treatment, 368
+
+Electric shock, causes, description, and treatment, 246
+
+Electuries, or pastes, description, and manner of administering, 45
+
+Embolism--
+  air, or air in veins, note, 270
+  and thrombus, description, symptoms, and treatment, 267
+
+Embryotomy of parts at abnormal births, 202
+
+Emphysema, or swelling of fetus with gas, description and treatment, 194
+
+Encephalitis, cause, symptoms, and treatment, 212
+
+Endarteritis, and arteritis, description, symptoms, and treatment, 263
+
+Endocarditis, or inflammation of lining membrane of heart, cause, symptoms,
+and treatment, 252
+
+Enemas, or clysters, description, and manner of administering, 48
+
+Engorgement colic, description, symptoms, and treatment, 66
+
+Enteritis, definition, 66
+
+Entropion and ectropion, or inversion and eversion of eyelid, causes and
+treatment, 283
+
+Epilepsy, or falling fits, symptoms and treatment, 227
+
+Epithelial cancer, or epithelioma, description and treatment, 477
+
+Epithelioma--
+  degeneration of penis, or papilloma, 167
+  or epithelial cancer, description and treatment, 477
+
+Equine variola, or horsepox, causes, symptoms, treatment, etc., 535-540
+
+Eruptions, bleeding skin, or _Dermatorrhagia parasitica_, description
+and treatment, 469
+
+Erysipelas, description, cause, and treatment, 474
+
+Erythema, congestion of skin, or red efflorescence, description and
+treatment, 461
+
+Esophagus--
+  dilatation, causes, symptoms, and treatment, 65
+  or gullet, treatment for foreign bodies, 62
+  stricture, description and treatment, 65
+
+Eversion--
+  and inversion of eyelid, or ectropion and entropion, causes and
+    treatment, 283
+  of bladder, description and treatment, 152
+  or womb after difficult parturition, treatment, 205
+
+Exostosis, cause, description, and treatment, 309
+
+Extravasation of blood of penis, causes and treatment, 167
+
+Eye--
+  diseases, chapter by James Law, 274-297
+  examination, 277
+  haw, or winking cartilage, description, 276
+  lachrymal apparatus, 277
+  muscles, description, 276
+  palsy of nerve of sight, or amaurosis, causes, symptoms, and treatment, 295
+  parasites, affecting, description of different kinds, 296
+  watering, or obstruction of lachrymal apparatus, description and
+    remedies, 285
+
+Eyeball--
+  description, 274
+  tumors affecting, 296
+
+Eyelid--
+  diseases, description of different kinds, 279
+  inflammation, causes and treatment, 280
+  inversion and eversion, or entropion and ectropion, causes and
+    treatment, 283
+  sty, or furuncle (boil), affecting, description and treatment, 282
+  torn, or wounds affecting, description and treatment, 284
+  warts and tumors affecting, description and treatment, 283
+
+Face bones, fractures, description and treatment, 336
+
+Facial paralysis, cause and symptoms, 230
+
+Fainting, or syncope, symptoms and treatment, 259
+
+Farcy--
+  and glanders, definition, causes, etc., 544-557
+  chronic, symptoms, 550
+
+Fatty degeneration of heart, causes, symptoms, and treatment, 261
+
+Favus, or honeycomb ringworm, description and treatment, 478
+
+Feces, impaction of rectum, 191
+
+Feed--
+  kinds to give, 51
+  musty and moldy, effect on digestive organs, 53
+  preparation, 57
+
+Feeding, corn, 55
+
+Feet, interfering, causes, symptoms, and treatment, 399
+
+Femur, fracture, cause, symptoms, and treatment, 347
+
+Fetlock--
+  and ankle skin, note, 397
+  and foot bones, description, 395
+  ankle, and foot, diseases, chapter by A. A. Holcombe, 395-457
+  joint, description, 396
+  knuckling, causes, symptoms, and treatment, 372
+  sprain, causes, symptoms, and treatment, 402
+
+Fetus
+  adherent to walls of womb, description, cause, and treatment, 192
+  excessive size, 192
+  general dropsy, description and treatment, 193
+  or foal, prolonged retention, cause and treatment, 181
+  swelling with gas, or emphysema, description and treatment, 194
+  tumors, or inclosed ovum, description and treatment, 194
+
+Fever, description, causes, and treatment, 38-43
+
+Fibrous bands constricting and crossing neck of womb, description and
+treatment, 191
+
+Fibrous constriction of vagina or vulva, cause and treatment, 191
+
+_Filaria_--
+  _conjunctivae_, parasite of eye, 297
+  _equina_, parasite of eye, 297
+  _haemorrhagica_, threadworm causing skin disease, 469
+  _irritans_, parasite causing summer sores, description and treatment, 469
+  _multipapillosa_, threadworm causing bleeding skin eruptions, 469
+  _palpebralis_, parasite of eye, 296
+
+Fistulas, causes, symptoms, and treatment, 502-506
+
+Fits, falling, or epilepsy, symptoms and treatment, 227
+
+Flatfoot, description, 398
+
+Flatulent colic, cause, symptoms, and treatment, 73
+
+Flea, or pulex, prevention and treatment of bite, 482
+
+Flesh fly (_Sarcophaga carnaria_), note, 481
+
+Flexor--
+  metatarsis, rupture, description, cause, symptoms, and treatment, 377
+  pedis perforans, description, 397
+  pedis perforatus, description, 397
+  tendons or their sheath, and suspensory ligaments, sprains, cause,
+    symptoms, and treatment, 371
+
+Flies, method of attacking horses; prevention and treatment for bite, 481
+
+Flooding, or bleeding from womb, treatment, 205
+
+Flukes, occurrence in horses, note, 90
+
+Flyblow, or grubs in skin, description and treatment, 481
+
+Foal--
+  contractions of muscles, description and treatment, 194
+  monstrosities, description of kinds, causes, and treatment, 194
+  natural presentation, 185
+  prolonged retention, cause and treatment, 181
+  water in head, or hydrocephalus, description and treatment, 192
+
+Foals, newborn, cyanosis affecting, description, 263
+
+Foot--
+  anatomical review, 395, 583
+  and fetlock bones, description, 395
+  canker, causes, symptoms, and treatment, 418
+  conformation, faults, 398
+  fetlock, and ankle, diseases, chapter by A. A. Holcombe, 395-457
+  mange, description and treatment, 480
+  punctured wounds, description, symptoms, and treatment, 426
+  sand-cracks, causes, symptoms, and treatment, 432
+  sole description, 397
+  _See also_ Hoof.
+
+Forage poisoning, or cerebrospinal meningitis, symptoms and treatment, 237
+
+Forearm, fracture, description, cause, symptoms, and treatment, 345
+
+Founder, or laminitis--
+  acute, subacute, and chronic, description, 447-449
+  complications, 449
+  curative measures, 455
+  description and causes, 441
+  following parturition, cause, 207
+  sequel of superpurgation, 79
+  symptoms, 444
+  treatment and prevention, 453
+
+Fractures--
+  causes and symptoms, 322
+  description of different kinds, 322
+  of different bones, description, 335
+  prognosis and treatment, 328
+
+Frog--
+  bruises, causes, symptoms, and treatment, 425
+  description, 397
+
+Frostbites, description, symptoms, and treatment, 405
+
+Furuncle--
+  or boil, description and treatment, 466
+  or sty (boil), of eyelid, description and treatment, 282
+
+
+Gaffky, investigation of pneumonia infection, note, 522
+
+Galls, harness, or sitiasts, description and treatment, 475, 496
+
+Gallstones, or biliary calculi, symptoms, and treatment, 90
+
+Gangrene--
+  or mortification, causes, 127
+  or mortification, description, symptoms, and treatment, 498
+
+Gas, swelling of fetus, or emphysema, description and treatment, 194
+
+Gastritis, definition, 66
+
+Gastro-enteritis, description, symptoms, and treatment, 80
+
+Gastrointestinal catarrh, or indigestion, description, cause, symptoms, and
+treatment, 76
+
+Gastrointestinal parasites, description and treatment, discussion by
+Maurice C. Hall, 90-94
+
+_Gastrophilus_, spp., injury to horses, symptoms and treatment, 93-94
+
+Generative organs, diseases affecting, chapter by James Law, 164-209
+
+Genito-urinary passages, method of medication, 48
+
+Gentian, use against pinworms in horses, 91
+
+Gestation, extra-uterine, description, symptoms, and treatment, 178
+
+Glanders--
+  acute, symptoms, 553
+  and farcy, definition, causes, etc., 544-557
+  chronic, symptoms, 552
+  treatment, 556
+
+Glands--
+  lymphatic, description, symptoms, and treatment, 271
+  sebaceous, description, 460
+  sweat, description, 461
+
+Gleet--
+  inflammation of urethra, or urethritis, symptoms and treatment, 153
+  nasal, chronic catarrh, or collection in sinuses, causes, symptoms, and
+    treatment, 99-101
+
+Glossitis, description and treatment, 60-61
+
+Glottis, spasm, description, 225
+
+Glycosuria, saccharine diabetes mellitus, or inosuria, causes, symptoms,
+and treatment, 139
+
+Grains for feeding, 54
+
+Grasses, important feed, 56
+
+Gravel, urinary calculi, or stone, description, and causes, 154, 156
+
+Grease or canker, causes, symptoms, and treatment, 472
+
+Grubs--
+  or flyblow, description and treatment, 481
+  under the skin, description and treatment, 481
+
+Grunting, testing, 109
+
+Gullet, or esophagus, treatment for foreign bodies, 62
+
+Gunshot wounds, description and treatment, 494
+
+Gut-tie, volvulus, or twisting of bowels, cause, symptoms, and treatment, 72
+
+Guttural pouches, description and treatment, 119
+
+
+_Habronema_, spp., cause of summer sores, etc., note, 470
+
+Hairs on skin, description, 460
+
+Harbaugh, W. H., chapter on "Diseases of respiratory organs", 95-133
+
+Harness galls, or sitiasts, description and treatment, 475, 496
+
+Harvest bug, larvae of _Trombidium_, _Leptus americanus_, jigger
+(chigoe), animal parasite of skin, 480
+
+Haw--
+  or winking cartilage of the eye, description, 276
+  tumor, or caries of cartilage of the eye, description and treatment, 284
+
+Hay, kinds for feeding, 53
+
+Heart--
+  adventitious growths, description, symptoms, and treatment, 258
+  anatomy and physiology, 247
+  and blood vessels, diseases, remarks, 250
+  blood vessels, and lymphatics, diseases, chapter by M. R.
+    Trumbower, 247-273
+  circulation of blood, description, 248
+  congestion, description, and symptoms, 263
+  dilatation, description, causes, symptoms, and treatment, 261
+  fatty degeneration, description, causes, symptoms, and treatment, 261
+  hypertrophy, or cardiac enlargement, description, symptoms, and
+    treatment, 260
+  inflammation of lining membrane, or endocarditis, cause, description,
+  symptoms, and treatment, 251
+  inflammation of muscular structure, or myocarditis, symptoms, alterations,
+  and treatment, 251
+  inflammation of sac inclosing, or pericarditis, causes, symptoms, and
+    treatment, 255
+  inflammatory diseases, description and treatment, 251
+  palpitation, description, symptoms, and treatment, 259
+  rupture, description and cause, 262
+  valvular disease, description, symptoms, and treatment, 257
+  weakness, causes, symptoms, and treatment, 262
+
+Heat exhaustion, sunstroke, or heat stroke, symptoms, pathology, treatment,
+and prevention, 219
+
+Heaves, broken wind, or asthma, definition, symptoms, and treatment, 128
+
+Heels--
+  contracted, or hoofbound, description, causes, symptoms, and
+    treatment, 429
+  cracked, scratches, or chaps on knee and hock, description, causes, and
+    treatment, 470
+  inflammation, with sebaceous secretion, grease, or canker, description,
+  causes, symptoms, and treatment, 472
+
+Hematuria, or bloody urine, cause and treatment, 141
+
+Hemiplegia, or paralysis of on side, or half the body, description and
+symptoms, 228
+
+Hemoglobinuria, azoturia, azotemia, poisoning by albuminoids, symptoms,
+prevention, and treatment, 141
+
+Hemoptysis, or bleeding from lungs, causes, description, and treatment, 127
+
+Hemorrhage--
+  process of healing and method of treatment, 486
+  spinal, symptoms and treatment, 225
+
+Hemorrhoids, or piles, description and treatment, 81
+
+Hemostasia, description and treatment, 485
+
+Hepatitis, or inflammation of liver, symptoms, causes, and treatment, 87
+
+Hernia--
+  congenital scrotal, description and treatment, 82
+  diaphragmatic, description, 85
+  inguinal, description, symptoms, and treatment, 83
+  of womb, description and treatment, 189
+  or rupture, description of different kinds, 82
+  scrotal, cause, 82
+  umbilical, description and treatment, 84
+  ventral, description and treatment, 83
+
+Herpes, description and treatment 468
+
+High blowing, description, 110
+
+Hip--
+  bone, or os innominatum, description, symptoms, and treatment, 341
+  bones, fractured, causes, 158
+  joint, luxation, description and treatment 363
+  lameness, description, symptoms, and treatment, 369
+
+Hock--
+  and knee, chaps or scratches, description, causes, and treatment, 470
+  capped, cause, symptoms, and treatment, 385
+  curb, cause, symptoms, and treatment, 374
+  fractures, note, 350
+
+Holcombe, A. A., chapter on "Diseases of ankle, fetlock, and foot", 395-457
+
+Honeycomb ringworm, or favus, description and treatment, 478
+
+Hoof--
+  bound, or contracted heels, description, causes, symptoms, and
+    treatment, 429
+  description, 397
+  growth, 588
+  healthy, characteristics, 590
+  physiological movements, 587
+  preparation for the shoe, 596
+  _See also_ Foot.
+
+Hoofs--
+  unshod, care, 590
+  various forms, 591
+
+Hornets, bees, and wasps, treatment for stings, 483
+
+Horny sloughs (sitfasts), or sloughing callosities, description and
+treatment, 475, 496
+
+Horse, sick--
+  attitude and general condition indicative of disease, 8
+  conformation and constitution, 10
+  danger from silage as feed, 56-57
+  examination, chapter by Leonard Pearson, 7-26
+  history of diseases necessary in examination, 8
+  parasites, intestinal, and injuries from them, 90-94
+
+Horsepox, or equine variola, causes, symptoms, and treatment, 535-540
+
+Horses--
+  anatomy, description, 300
+  danger from silage as feed, 56-57
+
+Horseshoes. _See_ Shoe.
+
+Huidekoper, Rush Shippen, chapter on "Infectious diseases", 507-582
+
+Humerus, fractures, symptoms and treatment, 345
+
+Hydrocele, or dropsy of scrotum, symptoms and treatment, 166
+
+Hydrocephalus--
+  or dropsy of brain, causes, symptoms, and treatment, 223
+  or water in head, of foal, description and treatment, 192
+
+Hydrophobia. _See_ Rabies.
+
+Hydrothorax, treatment, 126
+
+Hypertrophy of heart, or cardiac enlargement, description, symptoms, and
+treatment, 260
+
+_Hypoderma-lineata_, note, 481
+
+
+Icterus, jaundice, or yellows, description and treatment, 88
+
+Impaction--
+  of large intestine, cause of obstruction colic, symptoms and treatment, 68
+  of rectum with feces, 191
+
+Indigestion, or gastrointestinal catarrh, description, causes, symptoms,
+and treatment, 76
+
+Infectious anemia--
+  chapter by John R. Mohler, 569-572
+  cause and localities infected, 569
+  diagnosis and treatment, 571
+  symptoms and lesions, 570
+
+Infectious diseases--
+  chapter by Rush Shippen Huidekoper, 507-582
+  general discussion, 507-508
+
+Inflammation--
+  acute, of kidneys, or acute nephritis, causes, symptoms, and treatment, 143
+  and abscess of lymphatic glands, description, symptoms, and treatment, 272
+  and congestion of skin, description of kinds, 461
+  and congestion of teats and udder, symptoms and treatment, 208
+  and congestion of testicles, or orchitis, causes, symptoms, and
+    treatment, 164
+  chronic, of kidneys, causes, symptoms, and treatment, 145
+  description, symptoms, termination, and treatment, 32-38
+  local, and abscess of lymphatic glands, description, symptoms, and
+    treatment, 272
+  of bladder, cystitis, or urocystitis, symptoms and treatment, 149
+  of brain and its membranes, description, 193, 212, 213
+  of eyelids, causes and treatment, 280
+  of heels, with sebaceous secretion, grease, or canker, description, causes,
+    symptoms, and treatment, 472
+  of lining membrane of heart, or endocarditis, cause, description, symptoms,
+    and treatment, 251
+  of liver, or hepatitis, symptoms, causes, and treatment, 87
+  of membranes, a complication of influenza, 518
+  of membranes of spinal cord, causes, symptoms, and treatment, 232
+  of muscular structure of heart, or myocarditis, symptoms, alterations, and
+    treatment, 251
+  of nerve, or neuritis, cause, symptoms, and treatment, 236
+  of pharynx, description, 103
+  of sac inclosing heart, or pericarditis, causes, symptoms, pathology, and
+    treatment, 255
+  of substance of spinal cord, or myelitis, causes, symptoms, pathology, and
+    treatment, 233
+  of urethra, urethritis, or gleet, symptoms and treatment, 153
+  of womb and peritoneum, symptoms and treatment, 207
+  with blisters, or eczema, description and treatment, 464
+  with pustules, description and treatment, 465
+
+Inflammatory diseases of the heart, description and treatment, 251
+
+Influenza, definition, symptoms, termination, complications, and treatment,
+510-521
+
+Inguinal, hernia, description, symptoms, and treatment, 83
+
+Inhalation, manner of administering medicines, 47
+
+Injections, methods of administering medicines, 47
+
+Inosuria, saccharine diabetes, diabetes mellitus, or glycosuria, causes,
+symptoms, and treatment, 139
+
+Insufflation, description, 46
+
+Interfering--
+  and speedy cuts, description, symptoms, prognosis, and treatment, 387
+  of feet, causes, symptoms, and treatment, 399
+
+Intestinal--
+  paralysis, cause, 230
+  worm, or Ascaris equorum, note, 90
+
+Intestines--
+  and stomach, diseases, remarks, 65
+  calculi, or stones, description, symptoms, and treatment, 71
+  large, impaction, cause of obstruction colic, symptoms and treatment, 68
+  paralysis, description and treatment, 72
+  spasms, 225
+
+Intussusception, or invagination, description, symptoms, and treatment, 71
+
+Invagination, or intussusception, description, symptoms, and treatment. 71
+
+Iritis, causes, symptoms, and treatment, 288
+
+Irritation, nervous, of skin, or pruritus, description and treatment, 468
+
+Jaundice, icterus, or yellows, description and treatment, 88
+
+Jaw, lower, fracture, description, causes, and treatment, 337
+
+Jigger, or chigoe, Leptus americanus, animal parasite of skin, 480
+
+Joint--
+  hip, luxation, description and treatment, 361
+  shoulder, displacement, description and treatment, 363
+
+Joints
+  diseases, note, 354
+  open, cause, prognosis, and treatment, 357
+
+
+Kidneys--
+  acute inflammation, or acute nephritis, causes, symptoms, and treatment, 143
+  chronic inflammation, causes, symptoms, and treatment, 145
+  bladder worm and roundworm affecting, 146
+  tumors, note, 146
+
+Knee--
+  broken, cause, prognosis, and treatment, 357
+  capped, description, cause, symptoms, prognosis, and treatment, 383
+  fracture, cause, symptoms, prognosis, and treatment, 347
+  or hock, chaps, scratches, or cracked heels, description, causes, and
+    treatment, 470
+
+Knees, sprung, cause, symptoms, and treatment, 373
+
+Knuckling--
+  of fetlock, description, causes, symptoms, and treatment, 372
+  or cocked ankles, description, causes, and treatment, 400
+
+
+Labor pains, premature, cause, and treatment, 186
+
+Lachrymal apparatus of eye--
+  description, 277
+  obstruction, or watering eye, description and remedy, 285
+
+Lameness--
+  definition, physiology and description, 303
+  how to detect the seat, 307
+  how to discover, 304
+  its causes and treatment, chapter by A. A. Liautard, 298-394
+  of hip, description, symptoms, prognosis, and treatment, 369
+  of shoulder, description, causes, symptoms, and treatment, 365
+
+Laminae, sensitive, description, 398
+
+Laminitis. _See_ Founder.
+
+Lampas, description and treatment, 60
+
+Laryngismus paralyticus, or roaring, description and treatment, 108, 230
+
+Laryngitis, or sore throat, description, symptoms and treatment, 103
+
+Larynx, spasms, description and treatment, 107
+
+Law, James--
+  chapter on "Diseases of the eye", 274-297
+  chapter on "Diseases of the generative organs", 164-209
+  chapter on "Diseases of the skin", 458, 483
+  chapter on "Diseases of the urinary organs", 134-163
+
+Lead poisoning, or plumbism, causes, symptoms, and treatment, 245
+
+Leptus americanus, or harvest bug, animal parasite of skin, 480
+
+Leucorrhea, description and treatment, 208
+
+Liautard, A., chapter on "Lameness: Its causes and treatment", 298 394
+
+Lice, or pediculi, description and treatment for bite, 482
+
+Ligament--
+  suspensory, description, 396
+  suspensory, rupture, description, symptoms, and treatment, 403
+
+Ligaments--
+  description and functions, 302
+  suspensory, sprains, causes, symptoms, prognosis, and treatment, 371
+
+Limbs--
+  hind, cramp, cause and treatment, 181
+  perineum, and abdomen, dropsy, description and treatment, 180
+
+Lime-and-sulphur dip, use against mange in horse, 479
+
+Linseed, ground, value as laxative, 55
+
+Liver--
+  diseases, remarks, 87
+  inflammation, or hepatitis, symptoms, causes, and treatment, 87
+  rupture, causes, symptoms, and treatment, 88
+
+Lockjaw, or tetanus, causes, symptoms, prevention, and treatment, 241
+
+Locomotor ataxia, or incoordination of movement, description, 230
+
+Loins, sprains, description, cause, symptoms, and treatment, 392
+
+Lueber, investigation of pneumonia infection, 522
+
+_Lucilia caesar_, or bluebottle, and _L. hominivorax_, or screwworm fly,
+note, 481
+
+Lung--
+  abscess, and suppuration, symptoms, 127
+  fever, or pneumonia, description, symptoms, and treatment, 113
+
+Lungs--
+  bleeding, or hemoptysis, causes, description, and treatment, 127
+  congestion, description and treatment, 111
+  description, 111
+
+Luxations and dislocations of bones, cause, symptoms, and treatment, 361
+
+Lymphangitis, causes, symptoms, and treatment, 272
+
+Lymphatic--
+  glands, local inflammation, and abscess affecting, description, symptoms,
+    and treatment, 272
+  system, diseases, description, 271
+
+Lymphatics, heart, and blood vessels, diseases, chapter by M. R. Trumbower,
+247-273
+
+
+Madness, rabies, or hydrophobia, cause, symptoms, treatment, and
+prevention, 244, 559
+
+Maize, or corn, how to feed 55
+
+_Maladie de coit_, or dourine, description and treatment, 562
+
+Mange--
+  autumn, and mange of foot, description and treatment, 480
+  horse, treatment, 479
+  or acariasis, note, 478
+
+Mare--
+  castration, method, 172
+  pregnant, hygiene, 177
+  sterility, causes and treatment, 172
+
+Masturbation, or self-abuse, remedy, 168
+
+Meat fly, or _Musca vomitoria_, note, 481
+
+Medicines, methods of administering, chapter by Ch. B. Michener, 44-48
+
+Megrims, or congestion of brain, description, causes, symptoms, treatment,
+etc., 217
+
+Melanosis, or black pigment tumor, description and treatment, 476
+
+Membrane--
+  lining, of heart, inflammation, or endocarditis, cause, description,
+    symptoms, and treatment, 252
+  of nose, thickening, symptoms and treatment, 101
+
+Membranes--
+  inflammation, a complication of influenza, 518
+  mucous, visible, and skin may indicate disease, 11
+  of brain, inflammation, description, 212, 213
+  of spinal cord, inflammation, causes, symptoms, and treatment, 232
+
+Meningitis--
+  causes, symptoms, and treatment, 212
+  spinal, causes, symptoms, pathology, and treatment, 232
+
+Metatarsi, flexor, rupture, description, cause, symptoms, and treatment, 377
+
+Michener, Ch. B.--
+  chapter on "Diseases of the digestive organs", 49-94
+  chapter on "Methods of administering medicines", 44-48
+  chapter on "Wounds and their treatment," 484-506
+
+_Microsporon furfur_, vegetable parasite of skin 478
+
+Mohler, John R.--
+  chapter on "Dourine", 562-564
+  chapter on "Infectious anemia", 569-572
+  chapter on "Mycotic lymphangitis", 557-559
+  chapter on "Osteoporosis, or bighead", 578-582
+
+Mold, silage, danger to horses, 56-57
+
+Mole, vesicular, or cystic disease of walls of womb, description and
+treatment, 179
+
+Moles, or anidian monsters, description, 179
+
+Monstrosities in foal, description of kinds, causes, and treatment, 194
+
+Moonblindness, or periodic ophthalmia, causes, symptoms, treatment, 291
+
+Mortification, or gangrene. _See_ Gangrene.
+
+Mouth, diseases, remarks, 60
+
+Mucous membranes, visible, and skin may indicate disease, 11
+
+Mules, danger from silage as feed, 56-57
+
+_Musca vomitoria_, or meat fly, note, 481
+
+Muscles--
+  and tendons, diseases, 365
+  contraction in foal, description and treatment, 194
+  of elbow, sprain, causes, symptoms, and treatment, 368
+  of eye, description, 276
+  one system of locomotion, 299, 300
+
+Mycotic lymphangitis--
+  and glanders, differentiation, 557
+  chapter by John R. Mohler, 557-559
+  diagnosis and treatment, 558
+  symptoms and lesions, 558
+
+Myelitis, or inflammation of substance of spinal cord, causes, symptoms,
+and treatment, 233
+
+Myocarditis, or inflammation of muscular structure of heart, symptoms,
+alterations, and treatment, 251
+
+
+Nasal--
+  catarrh, or cold in head, symptoms and treatment, 98
+  douche, used in administering medicines, 47
+  gleet, chronic catarrh, or collection in sinuses, causes, symptoms, and
+    treatment, 99
+  polypus, description and treatment, 102
+
+Navel--
+  discharge of urine, or persistent urachus, description and treatment, 151
+  string, constriction of a member, description, 192
+
+Navicular--
+  bone, description, 396
+  disease, description, causes, symptoms, and treatment, 435
+
+Neck of womb, twisting, description and treatment, 189
+
+Nephritis, acute, or acute inflammation of kidneys, causes, symptoms, and
+treatment, 143
+
+Nerve--
+  inflammation, or neuritis, cause, symptoms, and treatment, 236
+  tumor, or neuroma, cause, symptoms, and treatment, 236
+
+Nerves--
+  injuries, description and treatment, 237
+  spinal, designations, 212
+
+Nervous system--
+  and brain, anatomy and physiology, 210
+  diseases affecting, chapter by M. R. Trumbower, 210-246
+  examination, 23
+
+Nettlerash, surfeit, or urticaria, description and treatment, 467
+
+Neuritis, or inflammation of a nerve, cause, symptoms, and treatment, 236
+
+Neuroma, or tumor of a nerve, cause, symptoms, and treatment, 236
+
+Nose--
+  bleeding, causes and treatment, 103
+  membrane, thickening, symptoms and treatment, 101
+
+Nostrils, tumors and wounds, treatment, 97
+
+
+Obstruction colic, cause, 68
+
+Open joints. _See_ Joints.
+
+Ophthalmia--
+  external, or conjunctivitis, description, causes, symptoms, and
+    treatment, 285
+  internal, causes, symptoms, and treatment, 288
+  periodic, or moonblindness, causes, symptoms, and treatment, 291
+
+Optic nerve, paralysis, or amaurosis, cause, 231
+
+Orchitis, or congestion and inflammation of testicles, causes, symptoms,
+and treatment, 164
+
+Os innominatum, or hip-bone fracture, description, symptoms, and
+treatment, 341
+
+Os pedis, or third phalanx, fractures, cause and treatment, 352
+
+Osteoporosis, or bighead, chapter by John R. Mohler, 578-582
+
+Ostitis, cause, symptoms, and treatment, 309
+
+Overreach, description, symptoms, and treatment, 404
+
+Ovum, inclosed, or tumors of fetus, description and treatment, 194
+
+Oxyurus equorum, parasite, symptoms and treatment for, 91
+
+
+Palpitation of heart, description, symptoms, and treatment, 259
+
+Palsy--
+  of nerve of sight, or amaurosis, causes, symptoms, and treatment, 295
+  of paralysis, description and causes, 228
+
+Pancreas and spleen, diseases, remarks, 90
+
+Papilloma, epithelioma, or degeneration of penis, 167
+
+Papules, or congestion of skin with small pimples, description and
+treatment, 463
+
+Paralysis--
+  facial, symptoms and cause, 230
+  general, cause, 228
+  of bladder, description and cause, 140, 230
+  of hind legs, cause and treatment, 181
+  of intestines, cause, 72, 230
+  of one side or half the body or hemiplegia, description and symptoms, 228
+  of optic nerve, or amaurosis, cause, 231
+  of penis, cause and treatment, 167
+  of pharynx, description and treatment, 61
+  of rectum and tail, cause, 230
+  or palsy, description and causes, 228
+  transverse, of hind extremities, or paraplegia, description and
+    symptoms, 229
+  treatment, 231
+
+Paraphymosis and phymosis, description and treatment, 171
+
+Paraplegia, or transverse paralysis of hind extremities, cause and
+treatment, 229
+
+Parasites--
+  animal, of skin, description of kinds, 478
+  causing worm colic, 91, 92, 93
+  gastrointestinal, 90-94
+  in eye, description of kinds, 296
+  specific kinds affecting urinary organs, 146
+  vegetable, of skin, description of kinds, symptoms, and treatment, 477
+
+Parasitic pityriasis, description and treatment, 478
+
+Parturition--
+  different presentations, 197
+  difficult, from narrow pelvis, cause and treatment, 186, 188
+  symptoms, 185
+
+Pastern joint, description, 396
+
+Pastes, or electuaries, description and manner of administering, 45
+
+Pasture, relation to worms in horses, 93
+
+Patella--
+  fracture, description, 349
+  pseudoluxations, descriptions, symptoms, cause, and treatment, 363
+
+Pearson, Leonard, chapter on "Examination of a sick horse", 7-26
+
+Pediculi, or lice, description and treatment for bite, 482
+
+Pelvis--
+  and vagina, tumors affecting, description and treatment, 188
+  bones, fracture, different kinds, 341
+  narrow, cause of difficult parturition, cause and treatment, 188
+
+Penis--
+  degeneration, papilloma, or epithelioma, 167
+  extravasation of blood and paralysis, cause and treatment, 167
+  sheath, and abdomen, swelling, cause and treatment, 171
+  warts, treatment, 167
+
+Pericarditis--
+  a complication of influenza, 518
+  or inflammation of sac inclosing the heart, causes, symptoms, and
+    treatment, 255
+
+Perineum, limbs, and abdomen, dropsy, description and treatment, 180
+
+Periostitis, cause, symptoms, and treatment, 309
+
+Peritoneum and womb, inflammation, symptoms and treatment, 207
+
+Peritonitis--
+  a complication of influenza, 518
+  description, symptoms, and treatment, 85
+
+Phalanx, first, second, and third, fracture, cause, symptoms and treatment,
+351, 352
+
+Pharyngeal polypus, description and treatment, 102
+
+Pharyngitis, description and treatment, 61
+
+Pharynx--
+  inflammation, description, 103
+  paralysis, description and treatment, 61
+
+Phlebitis, or diseases of veins, description, causes, symptoms, and
+treatment, 268
+
+Phymosis and paraphymosis, description and treatment, 171
+
+Physiology and anatomy of brain and nervous system, 210
+
+Piles, or hemorrhoids, description and treatment, 81
+
+Pills, or balls, description and manner of administering, 44
+
+Pimples, small, or congestion of skin, description and treatment, 463
+
+Pinworm, description and treatment, 91
+
+Pityriasis, or scaly skin disease, description and treatment, 467
+
+Plantar cushion, description, 398
+
+Pleurisy--
+  a complication of influenza, 518
+  description, symptoms, and treatment, 122
+
+Pleurodynia, symptoms and treatment, 131
+
+Pleuropneumonia, description and treatment, 126
+
+Plumbism, or lead poisoning, causes, symptoms, and treatment, 245
+
+Pneumonia--
+  contagious, causes, symptoms, treatment, etc., 521-527
+  infection, transmission, 521-522
+  or lung fever, description, symptoms, and treatment, 113
+
+Poisoning--
+  albuminoid, or azotemia, symptoms, prevention, and treatment, 141
+  forage, or cerebrospinal meningitis, causes, symptoms, and treatment, 237
+  lead, or plumbism, causes, symptoms, and treatment, 245
+
+Poll evil, description, causes, symptoms, treatment, 502-506
+
+Polypus--
+  description and treatment, 102
+  pharyngeal, description and treatment, 102
+
+Polyuria, diuresis, diabetes insipidus, causes, symptoms, and treatment, 138
+
+Pouches, guttural, description and treatment, 119
+
+Poultry, acariasis, description and treatment, 480
+
+Powders, manner of administering, 44
+
+Pregnancy--
+  duration, 177
+  mare, hygiene, 177
+  medication, 175
+
+Premaxillary bone, fracture, description and treatment, 336
+
+Preputial calculus, calculus in sheath, description and treatment, 163
+
+Presentations at birth, abnormal, 197-200
+
+Pruritis, or nervous irritation of skin, description and treatment, 468
+
+Pseudoluxations of patella, description, symptoms, cause, and treatment, 363
+
+_Psoroptes equi_, animal parasite of skin, 480
+
+Psoroptic acariasis, description and treatment, 480
+
+Ptyalism, or salivation, description and treatment, 61
+
+Pulex--
+  or flea, prevention and treatment for bite, 482
+  _penetrans_, or chigoe, bite, treatment, 482
+
+Pulse, how to count, 13
+
+Purpura hemorrhagica--
+  description, symptoms, and treatment, 270
+  or anasarca, causes, symptoms, and treatment, 531
+
+Pustules, inflammation, description and treatment, 465
+
+
+Quittor, description of different kinds, 407
+
+
+Rabies--
+  description, symptoms, and treatment, 244-245, 559-562
+  fatality of, 562
+
+Ransom, study of flies and worms, 470
+
+Rectum--
+  and tail, paralysis, cause, 230
+  impaction with feces, 191
+  methods of administering medicines, 47
+
+Red efflorescence, or erythema, description and treatment, 461
+
+Renal calculi, description, symptoms, and treatment, 158
+
+Respiratory organs--
+  description, 95
+  diseases, chapter by W. H. Harbaugh, 95-133
+  methods of examination, 16
+
+Retinitis, causes, symptoms, and treatment, 288
+
+Ribs, fractures, description, symptoms, and treatment, 339
+
+Ridglings, or cryptorchids, castration method, 169
+
+Ringbone, description, causes, symptoms, and treatment, 313, 439
+
+Ringworm--
+  circinate, or _Tinea tonsurans_, description, symptoms, and
+    treatment, 477
+  honeycomb, or favus, description and treatment, 478
+
+Roaring and thick wind, description and treatment, 108, 230
+
+Roundworm of kidney, 146
+
+Roundworms, horse, dangers and treatment, 90-91
+
+Rubber pads in shoes, uses, 601
+
+Rupture--
+  of an artery, description, symptoms, and treatment, 266
+  of diaphragm, causes and symptoms, 133
+  of flexor metatarsi, description, cause, symptoms, and treatment, 377
+  of heart, description and cause, 262
+  of liver, cause, symptoms, and treatment, 89
+  of stomach, result of engorgement, colic, symptoms, and treatment, 66, 67
+  of suspensory ligament, description, symptoms, and treatment, 403
+  of vagina, description and treatment, 207
+  or hernia, description of different kinds, 82
+  or laceration of womb, causes and treatment, 206
+
+
+Saccharine diabetes, diabetes mellitus, glycosuria, or inosuria, causes,
+symptoms, and treatment, 130
+
+Sacrum, fractures, description and treatment, 341
+
+St. Vitus dance, or chorea, description and treatment, 227
+
+Salivation, or plyalism, description and treatment, 61
+
+Sand-cracks of foot, description, causes, symptoms, and treatment, 432
+
+Sarcocele, description and treatment, 165
+
+_Sarcophaga carnaria_, or flesh fly, note, 481
+
+_Sarcoptes_, _scabiei equi_, animal parasite of skin, 478
+
+Sarcoptic acariasis, description, symptoms, and treatment, 478
+
+Scalds and burns, treatment, 483, 496
+
+Scaly skin disease, or pityriasis, description and treatment, 467
+
+Scapula, fracture, cause, symptoms, and treatment, 344
+
+Scorpion and tarantula, treatment for sting or bite, 483
+
+Scratches, or chaps on knee and hock, or cracked heels, causes and
+treatment, 467
+
+Screw-worm fly, or _Lucilia hominivorax_, note, 481
+
+Scrotal or congenital hernia, cause, description, and treatment, 82
+
+Scrotum, dropsy, or hydrocele, symptoms and treatment, 166
+
+Sebaceous glands, description, 460
+
+Self-abuse, or masturbation, remedy, 168
+
+Serum, use against strangles and anthrax, 531, 544
+
+Sesamoid bones, fracture, cause, symptoms, treatment, etc., 352
+
+Sesamoid sheath, inflammation, or navicular disease, description, symptoms,
+and treatment, 435
+
+Sesamoids, description, 395
+
+Sexual and urinary organs, examination, 24
+
+Sheath--
+  calculus, or bilocular cavity, or preputial calculus, description and
+    treatment, 163
+  of flexor tendons, sprains, cause, symptoms, and treatment, 371
+  penis, and abdomen, swelling, cause and treatment, 171
+
+Shock, electric, description and treatment, 246
+
+Shoe--
+  bar, uses, 601
+  detailed description, 597
+  hot fitting, 600
+
+Shoeing--
+  chapter by John W. Adams, 583-605
+  preliminary examination, 594
+  preparation of the hoof, 596
+  rubber pads, 601
+
+Shoes, special peculiarities of chief classes, 598
+
+Shoulder--
+  joint, displacement, description and treatment, 363
+  lameness, description, causes, symptoms, and treatment, 365
+
+Sick horse. _See_ Horse, sick.
+
+Sidebones, description, cause, symptoms, and treatment, 316, 438
+
+Silage, use and danger as horse feed, 56-57
+
+Sinuses, collection in, chronic catarrh, or nasal gleet, causes, symptoms,
+and treatment, 99
+
+Sitfasts--
+  horny sloughs, or sloughing callosities, description and treatment, 475
+  or harness galls, description and treatment, 496
+
+Skin--
+  and visible mucous membranes, may indicate disease, 11
+  animal parasites affecting, description of kinds, 478
+  bleeding eruptions, description and treatment, 469
+  congestion, red efflorescence, or erythema, description and treatment, 461
+  disease, scaly, or pityriasis, description and treatment, 467
+  diseases, chapter by James Law, 458-483
+  grubs under, description and treatment, 481
+  hairs, description, 460
+  inflammation and congestion, description of kinds, 461
+  nervous irritation, or pruritis, description and treatment, 468
+  of fetlock and ankle, note, 397
+  parasites, 477-483
+  structure, divisions, 459
+  true, or dermis, description 459
+  vegetable parasites, description of kinds, symptoms and treatment, 477
+  wounds, description of different kinds and treatment, 463-470
+
+Sloughs, horny, sitfasts, or sloughing callosities, description and
+treatment, 475, 496
+
+Snake bites, treatment, 483
+
+Sole of foot, description, 397
+
+Sore throat, or laryngitis, description, symptoms, and treatment, 103
+
+Sores, summer, caused by _Filaria irritans_, treatment, 469, 470
+
+Spasm--
+  of diaphragm, or thumps, description and treatment, 132, 225
+  of glottis or intestines, description and treatment, 225
+  of larynx, description and treatment, 107
+  of neck of bladder, causes, symptoms, and treatment, 146, 225
+  of neck of womb, description and treatment, 191
+  of thigh, or cramp of hind limb, description and treatment, 226
+
+Spasmodic or cramp colic, cause, symptoms, and treatment, 74
+
+Spasms, or cramps, causes and treatment, 226
+
+Spavin--
+  blood, bog spavin, and thorough pin, description and treatment, 356
+  description, cause, symptoms, prognosis, and treatment, 317
+
+Speedy cuts and interfering, description, symptoms, treatment, etc. 387
+
+Spermatic cord--
+  strangulated, cause and treatment, 170
+  tumors, causes and treatment, 171
+
+Spinal--
+  anemia, symptoms and treatment, 234
+  compression and concussion, cause, description, and treatment, 234
+  concussion, causes, and treatment, 235
+  congestion, cause, symptoms, and treatment, 233
+  cord, description, 212
+  cord, inflammation of membranes, causes, symptoms, treatment, etc., 232
+  cord, inflammation of substance, or myelitis, causes, symptoms,
+    treatment, 233
+  hemorrhage, symptom and treatment, 235
+  meningitis, causes, symptoms, pathology, and treatment, 232
+  nerves, designation, 212
+  tumors, symptoms and treatment, 236
+
+Spleen and pancreas, diseases, remarks, 90
+
+Splint, description, symptoms, cause, and treatment, 310
+
+Sprain--
+  of elbow muscles, causes, symptoms, and treatment, 368
+  of fetlock, causes, symptoms, and treatment, 402
+
+Sprains--
+  description and treatment, 365-374, 392-394
+  of loins, description, cause, symptoms, and treatment, 392
+  of suspensory ligaments and of flexor tendons or their sheath, cause,
+    symptoms, and treatment, 371-372
+
+Sprung knees, cause, symptoms, and treatment, 373
+
+Staphyloma, or bulging cornea, description and treatment, 296
+
+Stallion--
+  castration, methods, 168
+  sterility, cause and treatment, 172
+
+Sterility in mare and stallion, cause and treatment, 172
+
+Stiles, Ch. Wardell, chapter on "Surra", 572-577
+
+Stock vaccines, administration, 506
+
+Stomach--
+  and intestines, diseases, remarks, 65
+  calculi, or stones, symptoms and treatment, 70
+  rupture, result of engorgement colic, symptoms and treatment 68
+  worms, description, etc., 91-92
+
+Stomatitis, description and treatment, 60
+
+Stone--
+  in bladder, vesical calculus, or cystic calculus, description, symptoms,
+    and treatment, 160
+  in urethra, or urethral calculus, description, symptoms, and treatment, 162
+  or calculus, and tumor in bladder, 190
+  urinary calculi, or gravel, description, 154, 157
+
+Stones--
+  or calculi, in intestines, description, symptoms, and treatment, 71
+  or calculi, in stomach, symptoms and treatment, 70
+
+Strangles, definition, causes, symptoms, and treatment, 527-531
+
+Strangulated spermatic cord, cause and treatment, 170
+
+_Streptococcus pyogenes equi_, cause of pneumonia, 522
+
+Stricture--
+  of esophagus, description and treatment, 65
+  of urethra, description and treatment, 153
+
+Stringhalt, description, cause and treatment, 227, 390
+
+Strongyles, injuries to horses, symptoms and treatment, 92-93
+
+_Strongylus_--
+  _equinum_, parasite of kidney, 146
+  spp. injuries by and treatment, 92-93
+  _vulgaris_, worm causing one form of aneurism, 265
+
+Sty, furuncle, or boil of eyelid, description and treatment, 282
+
+Suffraginis, description, 395
+
+Summer sores, caused by _Filaria irritans_, description and treatment,
+469, 470
+
+Sunstroke, heat stroke, or heat exhaustion, symptoms, treatment, etc., 219
+
+Superpurgation, description and treatment, 78
+
+Suppositories, description and uses, 48
+
+Suppuration and abscess in lung, symptoms, 127
+
+Surfeit, nettlerash, or urticaria, description and treatment, 467
+
+Surra--
+  chapter by Ch. Wardell Stiles, 572-577
+  climatic conditions, animals affected, and lethality, 572
+  diagnosis and treatment, 577
+  method of infection, symptoms, 573
+
+Suspensory ligament--
+  and flexor tendons, or their sheaths, sprains, cause, symptoms,
+    treatment, 371-372
+  description, 395
+  rupture, description, symptoms, and treatment, 403
+
+Sutures, description and uses, 486
+
+Swamp fever. _See_ Infectious anemia.
+
+Sweat glands, description, 461
+
+_Symbiotes equi_, _Dermatophagus equi_, or _Chorioptes
+spathiferus_, animal parasite of skin, 480
+
+Syncope, or fainting, symptoms and treatment, 259
+
+Synovial--
+  dropsies, remarks, 355
+  sacs, diseases, description, 355
+
+Synovitis, cause, prognosis, and treatment, 357
+
+
+Tail and rectum, paralysis, cause, 230
+
+Tapeworms, horse, kind and injuries, 90
+
+Tarantula and scorpion, treatment for bite and sting, 483
+
+Teats, sore, scabs, cracks, warts, cause, and treatment, 209
+
+Teeth--
+  diseases period of dentition, 58
+  irregularities, remedies, 58
+
+Temperament of horse, 10
+
+Temperature, method of determining, 15
+
+Tendon sheaths, wounds, description and treatment, 494
+
+Tendons--
+  and muscles, diseases, 365
+  flexor, or their sheath, sprains, cause, symptoms, and treatment, 371
+  functions, 301
+  lacerated, cause, symptoms, prognosis, and treatment, 376
+  of foot, function, 396
+
+Testicles--
+  abnormal number, causes of degeneration, 166
+  or orchitis, congestion and inflammation, causes, symptoms, treatment, 166
+
+Tetanus, or lockjaw, causes, symptoms, prevention, and treatment, 241
+
+Thick wind and roaring, description and treatment, 108
+
+Thigh, spasm, or cramp of hind limb, description and treatment, 226
+
+Thoracic choke, description and treatment, 63, 64
+
+Thoroughpin, blood spavin, and bog spavin, description and treatment, 356
+
+Threadworms, cause of bleeding skin eruptions, 469
+
+Throat--
+  abscesses affecting, treatment, 62
+  sore, or laryngitis, description, symptoms, and treatment, 103
+
+Thrombosis, description, cause, symptoms, and treatment, 391
+
+Thrombus and embolism, description, symptoms, and treatment, 267
+
+Thrush, description, causes, symptoms, and treatment, 417
+
+Thumps, or spasm of diaphragm, description and treatment, 132, 225
+
+Tibia, fractures, symptoms and treatment, 349
+
+Ticks, description and treatment, 481
+
+Timothy, best hay for feeding, 53
+
+_Tinea tonsurans_, or circinate ringworm, description and treatment, 477
+
+Tissues, description, 27
+
+Tobacco dip, use against mange in horses, 479
+
+Toothache, how to determine and treat, 59
+
+Trichiasis, or turned eyelashes, description and treatment, 283
+
+_Trichophyton tonsurans_, vegetable parasite of skin, 477
+
+Trumbower, M. R.--
+  chapter on "Diseases of heart, blood vessels, and lymphatics", 247-273
+  chapter on "Diseases of nervous system", 210-246
+
+_Trypanosoma equiperdum_, cause of dourine, note, 562
+
+Tuberculosis, or consumption, note, 128
+
+Tumor--
+  and calculus, or stone in bladder, 190
+  of haw, or caries of cartilage, description and treatment, 284
+  of nerve, or neuroma, cause, symptoms, and treatment, 236
+  on spermatic cord, causes and treatment, 171
+
+Tumors--
+  and warts of eyelids, description and treatment, 283
+  black pigment, or melanosis, description and treatment, 476
+  in nostrils, treatment, 97
+  in vagina and pelvis, description and treatment, 188
+  of eyeball, remarks, 296
+  of fetus, or inclosed ovum, description and treatment, 194
+  of kidneys, note, 146
+  of spine, symptoms and treatment, 236
+  of udder, cause and treatment, 209
+  of abnormal growths, cause of colic, 73
+  within cranium, description of kinds, 224
+
+Twins, remarks, 196
+
+Tympanitic colic, cause, symptoms, and treatment, 73
+
+
+Udder--
+  congestion and inflammation, symptoms and treatment, 208
+  tumors, cause and treatment, 209
+
+Ulceration, description, causes, and treatment, 499
+
+Ulcers on cornea, treatment, 288
+
+Umbilical hernia, description and treatment, 84
+
+Urachus, persistent, or discharge of urine by navel, description and
+treatment, 151
+
+Uremia, description, symptoms, and treatment, 245
+
+Urethra--
+  inflammation, urethritis, or gleet, symptoms and treatment, 153
+  stone, or urethral calculus, description, symptoms, and treatment, 162
+  stricture, description and treatment, 153
+
+Urethral calculi, description and treatment, 159
+
+Urethral calculus, or stone in urethra, description, symptoms, and
+treatment, 162
+
+Urethritis, inflammation of urethra, or gleet, symptoms, and treatment, 153
+
+Urinary--
+  and sexual organs, examination, 24
+  calculi, classification, 157
+  calculi, stone, or gravel, description and causes, 154, 157
+  disorders, causes, 134
+  organs, diseases, chapter by James Law, 134-163
+  organs, parasites affecting, 146
+  organs, symptoms of disease, 136
+  organs, uses, 134
+
+Urine--
+  analysis, 154
+  bloody, or hematuria, cause and treatment, 141
+  discharge by navel, or persistent urachus, description and treatment, 151
+  excessive secretion, diuresis, polyuria, diabetes insipidus, causes,
+    symptoms, and treatment, 138
+  how to examine, 136
+  of healthy horse, description, 25
+
+Urocystitis, inflammation of bladder, or cystitis, symptoms and
+treatment, 149
+
+Urticaria, nettlerash, or surfeit, description and treatment, 467
+
+
+Vaccination--
+  use against diseases and manufacture of material, 510
+  use against strangles and anthrax, 531, 544
+
+Vaccines, kinds and use, 506, 531
+
+Vagina--
+  and pelvis, tumors affecting, description and treatment, 188
+  rupture, description and treatment, 207
+
+Vaginal walls, effusion of blood, 190
+
+Valvular disease of heart, symptoms and treatment, 257
+
+Varicocele, description and treatment, 166
+
+Varicose veins, varix, or dilatation of veins, causes and treatment, 269
+
+Variola, equine, or horsepox, causes, symptoms, and treatment, 535-540
+
+Veins--
+  description, 250
+  dilatation, varicose veins, or varix, causes and treatment, 269
+  diseases, or phlebitis, causes, symptoms, and treatment, 268
+
+Ventral hernia, description and treatment, 83
+
+Vertebra, fractures, causes, symptoms, and treatment, 338
+
+Vesical calculus, stone in bladder, or cystic calculus, description,
+symptoms, and treatment, 159
+
+Vesicular mole, or cystic disease of walls of womb, description and
+treatment, 179
+
+Volvulus, gut-tie, or twisting of bowels, cause, symptoms, and treatment, 72
+
+Vulva, or vagina, fibrous constriction, cause and treatment, 191
+
+Warts--
+  and tumors of eyelids, description and treatment, 283
+  description and treatment, 476
+  on penis, treatment, 167
+
+Wasps, bees, and hornets, stings, treatment, 483
+
+Water--
+  impure, cause of disease, time to give, 49
+  in head, or hydrocephalus of foal, description and treatment, 192
+
+Watering eye, or obstruction of lachrymal apparatus, description and
+remedy, 285
+
+Whistling, description, 110
+
+Wind--
+  broken, heaves, or asthma, definition, symptoms, and treatment, 128
+  colic, cause, symptoms, and treatment, 73
+
+Windgalls, description, causes, symptoms, and treatment, 355, 401
+
+Windpipe, description, 119
+
+Winking cartilage, or cartilago nictitans, description, 276
+
+Womb--
+  and peritoneum, inflammation, symptoms, and treatment, 206
+  bleeding, or flooding, treatment, 205
+  dropsy, cause, symptoms, and treatment, 179
+  eversion, description and method of treatment, 205
+  hernia, description and treatment, 189
+  laceration, or rupture, causes and treatment, 206
+  neck, twisting, description and treatment, 189
+
+Worm colic, notes 93
+
+Worms--
+  bladder, affecting kidneys, 146
+  injuries by, and treatment, 90-94
+  strongyle, danger and treatment, 92-93
+  treatment with dips, 479
+
+Wounds--
+  and their treatment, chapter by Ch. B. Michener, 484-506
+  gunshot, description and treatment, 494
+  healing under a scab, treatment, 487
+  in nostrils, cause and treatment, 97
+  lacerated and contused, description and treatment, 488
+  penetrating walls of chest, description and treatment, 131
+  poisoned, description and treatment, 495
+  punctured, description, symptoms, and treatment, 426, 490
+
+
+Yellows, jaundice, or icterus, description and treatment, 88
+
+
+ADDITIONAL COPIES
+OF THIS PUBLICATION MAY BE PROCURED FROM
+THE SUPERINTENDENT OF DOCUMENTS
+GOVERNMENT PRINTING OFFICE
+WASHINGTON. D.C.
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+
+
+
+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. Harbaugh
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