file which includes the original        
illustrations4       ,see #afcgj-;h4htm 
or #afcgj-;h4zip3                       
7https3_/_/www4gutenberg4org_/dirs_/#a_/
f_/c_/g_/afcgj_/afcgj-;h_/#afcgj-;h4htm7
       or                               
7https3_/_/www4gutenberg4org_/dirs_/#a_/
f_/c_/g_/afcgj_/afcgj-;h4zip7           
,transcriber's ,note3        ,the       
original text was inconsistent in the   
use of accents and       hyphenation4   
,these variants and a small number of   
typographical       errors were         
maintained in this transcription4 ,a    
complete list       of the variant      
spellings is found at the end of the    
book along       with the list of       
typographical errors4        ,the ,table
 of ,contents lists the ,authorities    
,cited section as       preceding the   
,index1 but it was printed following the
 ,index4       ,this order has been     
retained in this transcription4         
,veterinary ,practitioners' ,series     
,no4 #a  ,,lameness ,,of ,,the ,,horse  

by  ,j4 ,v4 ,lacroix1 ,d4,v4,s4         
,professor of ,surgery1 ,the ,kansas    
,city ,veterinary ,college ,author of   
,animal ,castration  ,illustrated       
,chicago ,american ,journal ,of         
,veterinary ,medicine  #aiaf            
,,preface   ,all that can be known on   
the subject of lameness1 is founded on a
 knowledge of anatomy and of the        
physiology of locomotion4 ,without such 
knowledge1 no one can master the        
principles of the diagnosis of lameness4
 ,however1 it must be assumed that the  
readers are informed on these subjects1 
as it is impossible to include this     
fundamental instruction in a work so    
brief as this one4  ,the technic of     
certain operative or corrective         
procedures1 has been described at length
 only where such methods are not        
generally employed4 ,where there is no  
departure from the usual methods1       
treatment that is essentially within the
 domain of surgery or practice is not   
given in specific detail4  ,realizing   

the need for a treatise in the ,english 
language dealing with diagnosis and     
treatment of lameness1 the author       
undertook the preparation of this       
manuscript4 ,that the difficulties of   
depicting by means of word-pictures1 the
 symptoms evinced in baffling cases of  
lameness1 presented themselves in due   
course of writing1 it is needless to    
say4  ,it is hoped that this volume will
 serve its readers to the end that the  
handling of cases of lameness will      
become a more satisfactory and          
successful part of their work2 that both
 the practitioner and his clients may   
profit thereby2 and last but by no means
 least1 that the horse1 which has given 
such incalculable service to mankind and
 is deserving of a more concrete reward1
 will be benefited by the application of
 the principles herein outlined4  ,in   
addition to the consultation of standard
 works bearing on various phases of the 
subject of lameness1 the author wishes  
to thankfully acknowledge helpful advice

 and assistance received from the       
publisher1 ,dr4 ,d4,m4 ,campbell2 to    
appreciatively credit ,drs4 ,l4,a4      
,merillat1 ,a4 ,trickett and ,f4,f4     
,brown for valuable suggestions given   
from time to time4 ,particular          
acknowledgment is made to ,dr4 ,septimus
 ,sisson1 author1 and ,w4,b4 ,saunders  
,co41 publishers of ,the ,anatomy of    
,domestic ,animals1 for permission to   
use a number of illustrations from that 
work4                                   
,j4,v4,l4  ,chicago1 ,illinois1         
,october1 #aiaf4     ,justice shows a   
triumphant face at the works of humane  
practitioners1 who give serious thought 
and expend honest effort1 for the       
alleviation of animal suffering4        
,,table ,,of ,,contents                 
,page ,illustrations                    
#g ,introduction                        
#aa                                     
,,section ,i  ,etiology and ,occurrence 
#ae ,affections of ,bones               
#ae ,rarefying ,osteitis1 or            

,degenerative ,changes                  
#af ,fractures                          
#af ,affections of ,ligaments           
#bj ,luxations--,dislocations           
#ba ,arthritis                          
#bb ,affections of ,bursae and ,thecae  
#bg ,affections of ,muscles and ,tendons
                              #bh       
,affections of ,nerves                  
#cj ,affections of ,blood ,vessels      
#ca ,affections of ,lymph ,vessels and  
,glands                         #cb     
,affections of the ,feet                
#cd                                     
,,section ,,ii  ,diagnostic ,principles 
#cg ,anamnesis                          
#ch ,visual ,examination                
#ci ,attitude of the ,subject           
#da ,examination by ,palpation          
#dc ,passive ,movements                 
#dg ,observing the ,character of the    
,gait                            #dh    
,special ,methods of ,examination       
#ec                                     
,,section ,,iii                         

,lameness in the ,fore ,leg             
,anatomo-,physiological ,review of      
,parts of the ,fore ,leg          #ee   
,shoulder ,lameness                     
#fa ,fracture of the ,scapula           
#fb ,scapulohumeral ,arthritis          
#fe ,infectious ,arthritis              
#ff ,injuries                           
#ff ,wounds                             
#fg ,luxation of the ,scapulohumeral    
,joint                           #fg    
,inflammation of the ,bicipital ,bursa  
#fh ,contusions of the ,triceps ,brachii
                              #ga       
,shoulder ,atrophy 7,sweeny7            
#gc ,paralysis of the ,suprascapular    
,nerve                           #ge    
,radial ,paralysis                      
#gg ,thrombosis of the ,brachial ,artery
                              #ha       
,fracture of the ,humerus               
#hb ,inflammation of the ,elbow         
#hd ,fracture of the ,ulna              
#hf ,fracture of the ,radius            
#hg ,wounds of the ,anterior ,brachial  

,region                         #ij     
,inflammation and ,contraction of the   
,carpal ,flexors             #ic        
,fracture and ,luxation of the ,carpal  
,bones                      #if         
,carpitis                               
#ih ,open ,carpal ,joint                
#ajj ,thecitis and ,bursitis            
#ajd ,fracture of the ,metacarpus       
#ajf ,splints                           
#ajg ,open ,fetlock ,joint              
#aaj ,phalangeal ,exostosis 7,ringbone7 
#aah ,open ,sheath of the ,flexors of   
the ,phalanges                   #abd   
,luxation of the ,fetlock ,joint        
#abe ,sesamoiditis                      
#abg ,fracture of the ,proximal         
,sesamoids                              
#abh ,inflammation of the ,posterior    
,ligaments of the ,pastern     ,proximal
 ,interphalangeal ,joint                
#abi ,fracture of the ,first and ,second
 ,phalanges                    #aca     
,tendinitis 7,inflammation of the       
,flexor ,tendons7               #ace    

,chronic ,tendinitis and ,contraction of
 the ,flexor ,tendons      #acg         
,contracted ,tendons of ,foals          
#adc ,rupture of the ,flexor ,tendons   
and ,suspensory ,ligament         #adf  
,thecitis and ,bursitis in the ,fetlock 
,region                   #aej          
,arthritis of the ,fetlock ,joint       
#aeb ,ossification of the ,cartilages of
 the ,third ,phalanx           #aee     
,navicular ,disease                     
#aeg ,laminitis                         
#afj ,calk ,wounds 7,paronychia7        
#agj ,corns                             
#agb ,quittor                           
#agd ,nail ,punctures                   
#agh                                    
,,section ,,iv                          
,lameness in the ,hind ,leg             
,anatomo-,physiological ,consideration  
of the ,pelvic ,limbs       #ahe ,hip   
,lameness                               
#aie ,fractures of the ,pelvic ,bones   
#aif ,fractures of the ,femur           
#aii ,luxation of the ,femur            

#bja ,gluteal ,tendo-,synovitis         
#bjc ,paralysis of the ,hind ,leg       
#bjd ,paralysis of the ,femoral         
7,crural7 ,nerve                        
#bjd ,paralysis of the ,obturator ,nerve
                              #bjf      
,paralysis of the ,sciatic ,nerve       
#bjh ,iliac ,thrombosis                 
#bji ,fracture of the ,patella          
#bab ,luxation of the ,patella          
#bac ,chronic ,gonitis                  
#bag ,open ,stifle ,joint               
#bbj ,fracture of the ,tibia            
#bbb ,rupture and ,wounds of the ,tendo 
,achillis                      #bbd     
,spring-,halt 7,string-,halt7           
#bbe ,open ,tarsal ,joint               
#bbi ,fracture of the ,fibular ,tarsal  
,bone 7,calcaneum7               #bcj   
,tarsal ,sprains                        
#bcb ,curb                              
#bcc ,spavin 7,bone ,spavin7            
#bce ,distension of the ,tarsal ,joint  
,capsule 7,bog ,spavin7           #bdb  
,distension of the ,tarsal ,sheath of   

the ,deep ,digital ,flexor              
7,thoroughpin7                          
#bdf ,capped ,hock                      
#bea ,rupture and ,division of the ,long
 ,digital ,extensor 7,extensor          
,pedis7                                 
#bec ,wounds from ,interfering          
#bee ,lymphangitis                      
#beg ,authorities ,cited                
#bfe ,index                             
#bfg     ,,illustrations                
,page ,fig4  #a--;,hoof ,testers        
#ec ,fig4  #b--,muscles of ,left        
,thoracic ,limb1 ,lateral ,view         
#ef ,fig4  #c--,muscles of ,left        
,thoracic ,limb1 ,medial ,view          
#eg ,fig4  #d--,sagital ,section of     
,digit and ,distal ,part of             
,metacarpus                             
#ei ,fig4  #e--,ordinary ,type of ,heavy
 ,sling                          #fb    
,fig4  #f--;,a ,sling ,made in ,two     
,parts                             #fc  
,fig4  #g--,paralysis of the            
,suprascapular ,nerve of ,left          

,shoulder                               
#gf ,fig4  #h--,radial ,paralysis       
#gh ,fig4  #i--,merillat's ,method of   
,fixing ,carpus in ,radial              
,paralysis                              
#gi ,fig4 #aj--;,contraction of ,carpal 
,flexors1 ,knee ,sprung          #ie    
,fig4 #aa--,pericarpal ,inflammation and
 ,enlargement ,due to          ,injury  
#ii ,fig4 #ab--;,hygromatous ,condition 
of the ,right ,carpus            #ajj   
,fig4 #ac--;,carpal ,exostosis in ,aged 
,horse                       #aja ,fig4 
#ad--;,exostosis of ,carpus ,resultant  
from ,carpitis          #ajb ,fig4      
#ae--;,distal ,end of ,radius1          
,illustrating ,effects of               
,carpitis                               
#ajb ,fig4 #af--,posterior ,view of     
,radius1 ,illustrating ,effects of      
,splint                                 
#ajh ,fig4 #ag--,phalangeal ,exosteses  
#abj ,fig4 #ah--,rarefying ,osteitis in 
,chronic ,ringbone               #aba   
,fig4 #ai--,phalangeal ,exostoses in    

,chronic ,ringbone             #abb     
,fig4 #bj--;,contraction of ,superficial
 ,digital ,flexor ,tendon          ,due 
to ,tendinitis                          
#ach ,fig4 #ba--;,contraction of ,deep  
,flexor ,tendon ,due to                 
,tendinitis                             
#aci ,fig4 #bb--;,chronic ,case of      
,contraction of ,both ,flexor ,tendons  
of the ,phalanges                       
#adj ,fig4 #bc--;,contraction of        
,superficial and ,deep ,flexor          
,tendons                                
#ada ,fig4 #bd--;,contraction of        
,superficial ,digital ,flexor and       
,slight ,contraction of ,deep ,flexor   
,tendon             #adb ,fig4          
#be--;,fish ,knees                      
#ade ,fig4 #bf--;,extreme ,dorsal       
,flexion                                
#adf ,fig4 #bg--;,a ,good ,style of     
,shoe for ,bracing the ,fetlock         
#adh ,fig4 #bh--,the ,roberts ,brace in 
,operation                       #adi   
,fig4 #bi--;,distension of ,theca of    

,extensor of the ,digit         #aea    
,fig4 #cj--,rarefying ,osteitis ,wherein
 ,articular ,cartilage          ,was    
,destroyed                              
#aec ,fig4 #ca--,ringbone and ,sidebone 
#aef ,fig4 #cb--,position ,assumed by   
,horse ,having ,unilateral              
,navicular ,disease                     
#aei ,fig4 #cc--,the ,hoof in ,chronic  
,laminitis                        #afe  
,fig4 #cd--;,effects of ,laminitis      
#aff ,fig4 #ce--;,cochran ,shoe1        
,inferior ,surface                      
#afh ,fig4 #cf--;,cochran ,shoe1        
,superior ,surface                      
#afi ,fig4 #cg--;,hyperplasia of ,eight 
,forefoot ,due to ,chronic              
,quittor                                
#agf ,fig4 #ch--;,chronic ,quittor1     
,left ,hind ,foot                       
#agg ,fig4 #ci--,skiagraph of ,foot     
#agi ,fig4 #dj--,sagital ,section of    
,eight ,hock                        #ahf
 ,fig4 #da--,muscles of ,right ,leg2    
,front ,view                     #ahg   

,fig4 #db--,muscles of ,lower ,part of  
,thigh1 ,leg and ,foot         #ahi     
,fig4 #dc--,right ,stifle ,joint2       
,lateral ,view                     #aij 
,fig4 #dd--,left ,stifle ,joint2 ,medial
 ,view                       #aia ,fig4 
#de--,left ,stifle ,joint2 ,front ,view 
#aic ,fig4 #df--,oblique ,fracture of   
the ,femur                        #bjj  
,fig4 #dg--;,fracture of ,femur ,after  
,six ,months' ,treatment        #bja    
,fig4 #dh--;,aorta and ,its ,branches   
,showing ,location of          ,thrombi 
#baj ,fig4 #di--,thrombosis of the      
,aorta1 ,iliacs and ,branches           
#baa ,fig4 #ej--;,chronic ,gonitis      
#bah ,fig4 #ea--,position ,assumed in   
,gonitis                          #bai  
,fig4 #eb--,spring-halt                 
#bbf ,fig4 #ec--,lateral ,view of       
,tarsus ,showing ,effects of ,tarsitis  
#bbh ,fig4 #ed--,right ,hock ,joint     
#bca ,fig4 #ee--,spavin                 
#bce ,fig4 #ef--;,bog ,spavin           
#bdc ,fig4 #eg--,thoroughpin            

#bdg ,fig4 #eh--;,fibrosity of ,tarsus  
in ,chronic ,thoroughpin           #bdh 
,fig4 #ei--;,another ,view of ,case     
,shown in ,fig4 #eh                #bdi 
,fig4 #fj--;,capped ,hock               
#beb ,fig4 #fa--;,chronic ,lymphangitis 
#beh ,fig4 #fb--;,elephantiasis         
#bei     ,,introduction   ,lameness is a
 symptom of an ailment or affection and 
is not to be considered in itself as an 
anomalous condition4 ,it is the         
manifestation of a structural or        
functional disorder of some part of the 
locomotory apparatus1 characterized by a
 limping or halting gait4 ,therefore1   
any affection causing a sensation and   
sign of pain which is increased by the  
bearing of weight upon the affected     
member1 or by the moving of such a      
distressed part1 results in an          
irregularity in locomotion1 which is    
known as lameness or claudication4 ,a   
halting gait may also be produced by the
 abnormal development of a member1 or by
 the shortening of the leg occasioned by

 the loss of a shoe4  ,for descriptive  
purposes lameness may be classified as  
true and false4 ,true lameness is such  
as is occasioned by structural or       
functional defects of some part of the  
apparatus of locomotion1 such as would  
be caused by spavin1 ring-bone1 or      
tendinitis4 ,false lameness is an       
impediment in the gait not caused by    
structural or functional disturbances1  
but is brought on by conditions such as 
may result from the too rapid driving of
 an unbridle-wise colt over an irregular
 road surface1 or by urging a horse to  
trot at a pace exceeding the normal gait
 of the animal's capacity1 causing it to
 crow-hop or to lose balance in the     
stride4 ,the latter manifestation might1
 to the inexperienced eye1 simulate true
 lameness of the hind legs1 but in      
reality1 is merely the result of the    
animal having been forced to assume an  
abnormal pace and a lack of balance in  
locomotion is the consequence4  ,the    
degree of lameness1 though variable in  

different instances1 is in most cases   
proportionate to the causative factor1  
and this fact serves as a helpful       
indicator in the matter of establishing 
a diagnosis and giving the prognosis1   
especially in cases of somewhat unusual 
character4 ,an animal may be slightly   
lame and the exhibition of lameness be  
such as to render the cause bafflingly  
obscure4 ,cases of this nature are      
sometimes quite difficult to classify   
and in occasional instances a positive  
diagnosis is impossible4 ,subjects of   
this kind may not be sufficiently       
inconvenienced to warrant their being   
taken out of service1 yet a lame horse1 
no matter how slightly affected1 should 
not be continued in service unless it   
can be positively established that the  
degree of discomfort occasioned by the  
claudication is small and the work to be
 done by the animal1 of the sort that   
will not aggravate the condition4       
,subjects that are very lame--so lame   
that little weight is borne by the      

affected member--are1 of course1 unfit  
for service and as a rule are not       
difficult of diagnosis4 ,for instance1 a
 fracture of the second phalanx would   
cause much more lameness than an injury 
to the lateral ligament of the coronary 
joint wherein there had occurred only a 
slight sprain1 and though crepitation is
 not recognized1 the diagnostician is   
not justified in excluding the          
possibility of fracture1 if the lameness
 seems disproportionate to the apparent 
first cause4  ,the course taken by cases
 of lameness is as variable as the      
degree of its manifestation1 and no one 
can definitely predict the duration of  
any given cause of claudication4        
,because of the fact that horses are not
 often good self-nurses at best1 and    
that it is difficult to enforce proper  
care for the parts affected1 one can not
 wisely state that resolution will      
promptly follow in an acute involvement1
 nor can he predict that the case will  
or will not become chronic4 ,experience 

has proved that complete or partial     
recovery may result1 or again1 that no  
change may occur in any given case1 and 
that in some instances even where       
rational treatment is early             
administered1 a decided aggravation of  
the condition may follow unaccountably4 
,however1 because of the economic       
element to be reckoned with1 it is of   
some value to be able to give a fairly  
accurate prognosis in the handling of   
cases of lameness1 as in the majority of
 instances the treatment and manner of  
after-care are determined largely by the
 expense that any prescribed line of    
attention will occasion4  ,a case of    
acute bone spavin in a horse of little  
value is not generally treated in a     
manner that will incur an expense       
equivalent to one-half the value of the 
subject4 ,the fact is always to be      
considered in such cases1 that even     
where ideal conditions favor proper     
treatment1 the outcome is uncertain4    
,where less than six weeks of rest can  

be allowed the animal1 one affected with
 bone spavin would therefore not be     
treated with the expectation of         
obtaining good results1 as six weeks'   
time1 at least1 is necessary for a      
successful outcome4 ,if the cost        
attending the enforced idleness of an   
animal of this kind is considered       
prohibitive for the employment of proper
 measures to affect a cure1 and if      
lameness is slight1 the animal should be
 given suitable work1 but in cases of   
articular spavin in aged subjects1 they 
should be humanely destroyed and not    
subjected to prolonged misery4  ,a      
thorough knowledge of the structure and 
functions of the affected parts is      
necessary to proceed in cases of        
lameness2 likewise1 the age1            
conformation and temperament of the     
subject need to be taken into           
consideration2 the presence or absence  
of complications demand the attention2  
the kind of care the subject will       
probably receive directly influences the

 outcome2 and the character of service  
expected of the subject1 too1 needs to  
be carefully considered before the      
ultimate outcome may reasonably be      
foretold4  ,the practitioner is often   
confronted with the problem of how best 
to handle certain cases4 ,will they do  
better under conditions where absolute  
quiet is enforced1 or is it preferable  
to allow exercise at will8 ,the         
temperament of the animal must be       
considered in such cases1 and if a lame 
horse is too active and playful when    
given his freedom1 exercise must be     
restricted or prevented1 as the case may
 require4 ,in cases of strains of       
tendons1 during the acute stage1        
immobilization of the affected parts is 
in order4 ,in certain sub-acute         
inflammatory processes or in instances  
of paralytic disturbance where          
convalescence is in progress1 moderate  
exercise is highly beneficial4          
,consequently1 each case in itself      
presents an individual problem to be    

judged and handled in the manner        
experience has taught to be most        
effective1 appropriate and practical1   
and the veterinarian should give due    
consideration to the comfort and welfare
 of the crippled animal as well as to   
the interests of the owner4             
,,section ,i4  ,,etiology ,,and         
,,occurrence4   ,in discussions of      
pathological conditions contributing to 
lameness in the horse1 cause is         
generally classified under two          
heads--predisposing and exciting4 ,it   
becomes necessary1 however1 to adopt a  
more general and comprehensive method of
 classification1 herein1 which will     
enable the reader to obtain a better    
conception of the subject and to more   
clearly associate the parts so grouped  
descriptively4  ,though predisposing    
factors1 such as faulty conformation1   
are often to be reckoned with1 exciting 
causes predominate more frequently in   
any given number of cases4 ,the noble   
tendency of the horse to serve its      

master under the stress of pain1 even to
 the point of complete exhaustion and   
sudden death1 should win for these      
willing servants a deeper consideration 
of their welfare4 ,too frequently are   
their manifestations of discomfort      
allowed to pass unheeded by careless1   
incompetent drivers lacking in a sense  
of compassion4 ,symptoms of malaise     
should never be ignored in any case2 the
 humane and economic features should be 
realized by any owner of animals4  ,in  
the consideration of group causes1      
lameness may be said to originate from  
affections of bones1 ligaments1 thecae  
and bursae1 muscles and tendons1 nerves1
 lymph vessels and glands1 and blood    
vessels1 and may also result from an    
involvement of one or several of the    
aforementioned tissues1 caused by       
rheumatism4 ,further1 affections of the 
feet merit separate consideration1 and1 
finally1 a miscellaneous grouping of    
various dissimilar ailments1 which for  
the most part1 do not directly involve  

the locomotory apparatus but do1 by     
their nature1 impede normal movement4   
,,affections ,,of ,,bones4  ,the bony   
column serving as the framework and     
support of the legs1 probably           
constitutes the most vital element      
having to do with weight bearing and    
locomotion1 and therefore during the    
acute and painful stage of bone         
affections1 the pain becomes more       
intense in the process and pressure of  
standing than when the member is swung  
or advanced4  ,certain bones are so well
 protected by muscular structures that  
they are not frequently injured except  
as a result of violence which may       
produce fracture4 ,however1 there are   
certain bones which receive the constant
 shock of concussion when the animal is 
subjected to daily1 rapid work on hard  
road surfaces4 ,splints1 ringbones and  
spavins are the most general examples   
produced by these conditions4  ,varying 
pathological developments often result  
from concussion1 contusion or other     

violent shocks to the bony structures4  
,in such cases there either follows a   
simple periostitis which may resolve    
spontaneously with no obvious outward   
symptom1 or osteitis1 which may occur   
with tissue changes1 as in exostosis2 or
 the case may produce any degree of     
reaction between these two possible     
extremes4   ,rarefying ,osteitis1 or    
,degenerative ,changes4  ,certain bone  
affections1 such as osteomalacia or     
osteoporosis1 are in the main1          
responsible for distortions and         
morphological changes of bone1 causing  
lameness1 permanent blemish and even    
resulting in death of the affected      
animal4 ,the climatic conditions in some
 localities favor these occurrences but 
they may also be ascribed to improper   
food constituents and to possible       
infective agencies4  ,rarefying         
degenerative changes manifested by      
exostosis involving the phalanges of the
 young1 causing ringbone1 are fairly    
common in occurrence throughout this    

country4 ,this is due1 supposedly1 to a 
lack of mineral substance in the bony   
structure of the affected animals1 and  
is known as rachitis--commonly called   
rickets4 ,since the affected subjects   
suffer involvement of several of the    
extremities at the same time1 the theory
 of rachitic origin seems well          
supported4   ,fractures4  ,fractures of 
bones constitute serious conditions and 
are always manifested by lameness4 ,a   
sub-classification is essential here for
 the student of veterinary medicine who 
would comprehend the technic of         
reduction and subsequent treatment in   
such cases4  ,fractures are classified  
by many authorities as being simple1    
compound1 and comminuted4 ,this method  
is practical because it separates       
dissimilar conditions4 ,there are also  
grouped fractures1 the pathologic       
anatomy of which is similar4            
,classification on an etiological basis 
would attempt to associate conditions1  
the morbid anatomy and gravity of which 

would justly preclude their being       
combined4  ,simple ,fracture is a       
condition where the continuity of the   
bone has been broken without serious    
destruction of the soft structures      
adjacent1 and where no opening has been 
made to the surface of the flesh4 ,such 
fractures do not reduce the bone to     
fragments4 ,long bones are frequently   
subjected to simple fracture1 while     
short thick bones1 such as the second   
phalanx1 may suffer multiple or         
comminuted fractures4  ,compound        
,fracture designates a break of bone    
with the destruction of the soft tissues
 covering it1 making an open wound to   
the surface of the skin4 ,this form of  
fracture is serious because of the      
attendant danger of infection1 and in   
treatment1 necessitates special         
precaution being taken in the           
application of splints that the wound   
may be cared for without infection of   
the tissues4 ,these fractures generally 
occur as a result of some forceful      

impact through the flesh to the bone1 or
 where the bones are driven outward by  
the blow4 ,common examples are in       
fractures of the metacarpus and         
metatarsus of the first phalanx4 ,this  
kind of injury in mature horses usually 
produces an irreparable condition1 and  
viewed economically1 is generally       
considered fatal4  ,comminuted          
,fractures1 as the term implies1 are    
those cases wherein the bone is reduced 
to a number of small pieces4 ,this kind 
of break may be classified as           
simple-comminuted fracture when the skin
 is unbroken1 and when the bone is      
exposed as a result of the injury1 it is
 known as a compound-comminuted         
fracture4 ,such fractures are caused by 
violent contusion or where the member is
 caught between two objects and crushed4
   ,multiple ,fractures4  ,fractures are
 called multiple when the bone is       
reduced to a number of pieces of large  
size4 ,this condition differs from a    
comminuted fracture in that the multiple

 fracture may break the bone into       
several pieces without the pieces being 
ground or crushed1 and the affected bone
 may still retain its normal shape4     
,further classification is of value in  
describing fractures of bone with       
respect to the manner in which the bone 
is broken--the direction of the fissure 
or fissures in relation to its long     
axis4  ,a fracture is transverse when   
the bone is broken at a right angle from
 its long axis4 ,such breaks when       
simple1 are the least trouble to care   
for because there is little likelihood  
that the broken ends of bone will become
 so displaced that they will not remain 
in apposition4 ,simple transverse       
fracture of the metacarpus1 for         
instance1 constitutes a favorable case  
for treatment if other conditions are   
favorable4  ,oblique fractures1 as may  
be surmised1 are solutions of continuity
 of bone in such manner that the fissure
 crosses the long axis of a bone at an  
acute or obtuse angle4 ,these fractures 

are prone to injure the soft structures 
adjacent1 and are frequently compound1  
as well4 ,moreover1 because of the fact 
that the apposing pieces of bone are    
beveled1 the broken ends of bone are    
likely to pass one another in such a way
 as to shorten the distance between the 
extremities of the injured member4      
,contraction of muscles also tends to   
exert traction upon a bone so fractured1
 resulting in a lateral approximation of
 the diaphysis and thus preventing union
 because the broken surfaces are not in 
proper contact4  ,fractures are         
longitudinal when the fissure is        
parallel with the long axis of the bone4
 ,this variety of break is not          
infrequent in the first phalanx2 and a  
vertical fracture of the second phalanx 
is also said to be longitudinal1        
however1 there is little difference 7if 
any1 in some subjects7 between the      
vertical and transverse diameters of    
this particular bone4  ,green stick     
fractures are essentially those         

resulting from falls to young animals4  
,they are usually sub-periosteal and    
when the periosteum is left intact or   
nearly so1 no crepitation is            
discernible4 ,if this fracture is       
simple1 prompt recovery may be expected4
 ,bones of young animals1 because they  
do not contain proportionately as much  
mineral substance as do bones of adults1
 are more resilient and less apt to     
become completely fractured4 ,they are1 
however1 subject to what is known as    
green stick fracture4  ,impacted        
fractures are usually occasioned by     
falls4 ,when the weight of the body is  
suddenly caught by a member in such     
manner as to forcefully drive the       
epiphyseal portions of bone into and    
against the diaphysis1 multiple         
longitudinal fractures occur at the     
point of least resistance4 ,parts so    
affected undergo a fibrillary           
separation1 increasing the transverse   
diameter of the bone2 or if the impact  
has been sufficiently violent1 the      

portion becomes an amorphous mass4  ,in 
a treatise on the subject of lameness1  
the bones chiefly concerned and most    
often affected must be especially       
considered4 ,the shape and size of a    
bone when injured1 determines in a      
measure1 the course and probable outcome
 in most cases1 but of first and greater
 importance is the function of the bone4
 ,a fracture of the fibula in the horse 
need not incapacitate the subject1 but a
 tibial fracture is serious and         
generally proves cause for fatal        
termination4 ,the body of the scapula   
may be completely fractured and recovery
 will probably result in most cases     
without much attention being given to   
the subject1 yet a fracture of the neck 
of this same bone constitutes an injury 
of serious consequence4 ,the difference 
in the function of different parts of   
this same bone1 as well as its shape and
 mode of attachment1 determine the      
gravity of the case2 so it is in        
fractures of other bones with respect to

 the course and prognosis of the        
case--function is the important factor  
to be considered4  ,next in importance  
is the age of the animal suffering      
fracture of the bone4 ,capacity for     
regeneration is naturally greater in a  
vigorous1 young animal than in aged or  
even middle-aged subjects4 ,a healthy   
condition of the bone and the body favor
 the process of repair in case of       
fracture1 and prognosis may be favorable
 or unfavorable1 depending upon these   
factors mentioned for consideration4    
,individuals of the same species1       
differing in temperament1 may comport   
themselves in a manner that is          
conductive to prompt recovery1 or to    
early destruction4 ,this feature cannot 
be overestimated in importance1 as it is
 sometimes a decisive element1          
regardless of other conditions4 ,a horse
 suffering from an otherwise remediable 
pelvic fracture may be so worried and   
tortured by being confined in a sling   
that the case calls for special         

attention and care because of the       
animal's temperament4 ,sometimes1 the   
constant presence of a kind attendant   
will so reassure the subject that it    
will become resigned to unnatural       
confinement1 in a day or two4 ,this     
precaution may1 in itself1 determine the
 outcome1 and the wise veterinarian will
 not overlook this feature or fail to   
deviate from the usual rote in the      
handling of average cases4 ,recovery may
 be brought about in irritable subjects 
by this concession to the individual    
idiosyncrasies of such animals4         
,,affections ,,of ,,ligaments4          
,ligaments which have to do with the    
locomotory apparatus are1 for the most  
part1 inelastic structures which are    
composed of white fibrous tissue and    
serve to join together the articular    
ends of bones2 to bind down tendons2 and
 to act as sheathes or grooves through  
which tendons pass1 and as capsular     
membranes for retention of synovia in   
contact with articular surfaces of      

bones4  ,ligaments are injured less     
frequently than are bones4 ,because of  
their flexibility they escape fracture  
in the manner that bones suffer4 ,they  
are1 however1 completely severed by     
being cut or ruptured1 though fibrillary
 fracture the result of constant or     
intermittent tensile strain is of more  
frequent occurrence4  ,simple           
inflammation of ligaments is of         
occasional occurrence but1 unless       
considerable injury is done this tissue1
 no perceptible manifestation of injury 
results4 ,no doubt many cases wherein   
fibrillary fracture of ligaments        
7sprain7 takes place some lameness is   
caused1 but because of the dense1       
comparatively nonvascular nature of     
these structures1 little if any         
manifestation1 except lameness1 is      
evident4 ,and such cases1 if recognized 
are usually diagnosed by excluding the  
existence of other possible causes and  
conditions which might also cause       
lameness4  ,certain ligaments are       

subjected to strain more than are others
 and therefore1 when so involved1       
frequently cause lameness4 ,examples of 
this kind are affections of the         
collateral 7lateral7 ligaments of the   
phalanges4 ,because of the leverage     
afforded by the transverse diameter of  
the foot1 when an animal is made to     
travel over uneven road surfaces1       
considerable strain is brought to bear  
on the collateral ligaments of the      
phalanges4 ,a sequel to this form of    
injury is a circumscribed periostitis at
 the site of attachment of the ligaments
 and frequently the formation of an     
exostosis--ringbone--results4  ,where   
sudden and violent strain is placed upon
 a ligament and rupture occurs1 the     
division is usually effected by the     
ligament being torn from its attachment 
to the bone4 ,in such cases1 a portion  
of periosteum and bone is usually       
detached and the condition may then     
properly be called one of fracture4 ,in 
some cases of this kind recovery is     

tardy1 because of the difficulty in     
maintaining perfect apposition of the   
divided structures1 and reactionary     
inflammation is not of sufficient extent
 to enhance prompt repair4 ,in fact1    
some cases of this kind seem to progress
 more favorably1 when no attempt at     
immobilization of the affected member is
 attempted4  ,if some freedom of        
movement is allowed1 acute inflammation 
resulting in nature's provisional       
swelling soon develops and repair is    
hastened because of increased           
vascularity4 ,but where luxation of     
phalanges accompanies sprain1 reposition
 and immobilization are necessary--that 
is if cases are thought likely to       
benefit by any treatment4               
,luxations--,dislocations4  ,luxation or
 dislocation is a condition where the   
normal relation between articular ends  
of bones has been deranged to the extent
 that partial or complete loss of       
function results4 ,when a bone is       
luxated 7out of joint71 there has       

occurred a partial or complete rupture  
of certain ligaments or tendons2 or a   
bone may be luxated when an abnormal or 
unusual elasticity of inhibitory        
ligaments or tendons obtains4           
,luxations may be practically classified
 as temporary and fixed4 ,in temporary  
luxations1 disarticulation is but       
momentary and spontaneous reposition    
always results2 while a fixed luxation  
does not reduce spontaneously but       
remains luxated until reposition is     
effected by proper manipulation and     
treatment4 ,fixed luxation may be of    
such character as to be practically     
irreducible because of extensive damage 
done to ligaments or cartilage4 ,where a
 complete luxation of the               
metacarpophalangeal joint exists1 it is 
probable that in most cases sufficient  
injury to collateral and capsular       
ligaments has been done to render       
complete recovery improbable1 if not    
impossible4  ,temporary luxation of the 
patella is a common affection of the    

horse and fixed luxation of this bone   
also occurs4 ,as a matter of fact1 in   
the horse1 patellar luxation is the one 
frequent affection of this kind4  ,as a 
rule1 complete disarticulation          
immobilizes the affected joint and in   
most instances there is noticeable an   
abnormal prominence in the immediate    
vicinity--in patellar luxation1 the     
whole bone4 ,in other instances the     
articular portion only1 of the affected 
bone is malpositioned4 ,usually1        
luxation and fracture may be            
differentiated in that there is no      
crepitation in luxation and more or less
 crepitation exists in fracture4  ,it is
 evident1 when one considers the        
symptomatology and nature of the        
affection1 that fixed luxation is       
usually caused by undue strain or       
violent and abnormal movement of a part4
 ,joints having the greater freedom of  
movement are apt to suffer luxation more
 frequently4   ,arthritis4  ,the study  
of arthritis in the horse is limited to 

a consideration of joint inflammations  
which1 for the most part1 are of        
traumatic origin4 ,unlike the human1 the
 horse is not subject to many forms of  
specific arthritis--tubercular1         
gonorrheal1 syphilitic1 etc4  ,a        
practical manner of classification of   
arthritis is traumatic and metastatic4  
,traumatic arthritis may result from all
 sorts of accidents wherein joints are  
contused4 ,such cases may be considered 
as being caused by direct injuries4     
,instances of this kind1 depending on   
the degree of insult1 manifest evidence 
of injury which ranges from a simple    
synovitis to the most active            
inflammatory involvement of the entire  
structure and adjacent tissues4  ,the   
reactionary inflammation which attends a
 case of tarsitis caused by a horse     
being kicked is a good example of the   
result of direct injury4 ,such cases1 if
 the contusion is of sufficient         
violence1 result in arthritis and       
periarthritis4 ,in inactive farm horses1

 during cold weather1 this condition    
becomes chronic1 swelling remains for   
weeks after all lameness and pain have  
subsided and occasionally hyperthrophy  
is permanent4  ,arthritis occasioned by 
indirect injury1 such as characterizes  
joint inflammation from continuous      
concussion1 is seen in horses that are  
worked at a rapid pace on city streets  
or other hard road surfaces4 ,such      
affections may be acute1 as in some     
cases of spavin1 but are usually        
inflammatory conditions that do not     
occasion serious disturbance when these 
affections become chronic4 ,if the      
involvement persists with sufficient    
active inflammation1 there may follow   
erosion of cartilage and incurable      
lameness4 ,if extensive necrosis of     
cartilage takes place1 the attendant    
pain will be sufficient to cause the    
animal to favor the diseased part and   
such immobilization enhances early      
ankylosis--nature's substitute for      
resolution in this disease4  ,wounds    

invading the tissues adjacent to joints1
 when these wounds are of considerable  
extent1 cause inflammation of such      
articulations by contiguous extension of
 inflammation4 ,as long as an injury    
remains practically aseptic1 or if      
infected and the septic process does not
 involve the joint proper by direct     
extension1 no more serious disturbance  
than a simple synovitis will result4    
,if1 instead1 a periarthritic           
inflammation is serious or destructive  
in character1 the type of arthritis will
 be grave--even though due to an        
indirect cause4  ,where a vulnerant body
 penetrates all structures and invades  
the interior of the joint capsule the   
result is that a more or less active    
disturbance is incited4 ,the            
introduction of a sterile instrument    
into a joint cavity1 under strict       
asepsis1 where a perfect technic is     
executed1 does not cause perceptible    
manifestation of the injury1 if the     
opening so made is small--such as a     

suitable exploratory trocar makes4 ,but 
a puncture made in a similar manner and 
with the same instrument without due    
regard to asepsis is likely to cause an 
infectious synovitis and arthritis      
usually follows4  ,a larger opening than
 is produced by means of an exploratory 
trochar may be made into a joint cavity1
 causing escape of synovia as it is     
secreted for days and even for weeks and
 no serious or permanent trouble is     
experienced in some cases4 ,if the      
synovitis or arthritis remains          
non-infected and the wound1 traumatic or
 surgical1 is not too large1 healing by 
granulation occurs1 and the discharge of
 synovia ceases4 ,however1 if synovial  
discharge persists too long because of  
tardy closure of an open joint1 there is
 great danger of infection gaining      
entrance into the synovial cavity1 or in
 some instances1 desiccation of         
endothelial cells of the articulation   
occurs1 in areas1 and the reactionary   
inflammation eventually results in      

ankylosis4  ,a small puncture which     
introduces into the synovial cavity     
infectious material of active virulence 
will cause an arthritis that is more    
serious1 much more painful and more     
difficult to handle than is occasioned  
by a wound of moderate size1 that       
affords ready escape of synovia even    
through the virulence of the infection  
be the same4  ,synovia is a good culture
 medium and the environment is ideal for
 multiplication of bacteria2            
consequently1 the grave disturbances    
which may attend the introduction of    
pathogenic organisms into a synovial    
cavity as the result of a puncture wound
 are not to be forgotten4 ,the          
veterinarian is in no position to       
estimate the virulency of organisms so  
introduced2 neither can he determine the
 exact degree of resistance possessed by
 the subject in any given case4         
,therefore1 he is uncertain as to the   
best method of handling such cases where
 an injury has been recently inflicted  

and positive evidence of the existence  
of an infectious synovitis is not       
present4 ,if one could determine in     
advance the degree of infection and     
injury that is to follow small penetrant
 wounds of joint capsules1 it would then
 be possible to select certain cases and
 immediately drain away all synovia and 
fill the cavity by injection with       
suitable antiseptic solutions4  ,this   
offers a broad field for experimentation
 which will in time be productive of a  
radical change in the manner of treating
 such cases4  ,metastatic arthritis is  
seen more frequently in colts or young  
animals than in mature horses and we    
here take the liberty of classifying    
with the arthritis of omphalophlebitis  
and strangles the so-called rheumatic   
variety4  ,a specific polyarthritis or  
synovitis which attends navel infection 
of foals is perhaps the most frequent   
form of arthritis that is to be         
considered metastatic4 ,this condition  
is truly a disease of young animals and1

 while it is a specific arthritis1 the  
cause is yet to be attributed to any    
definite pathogenic organism with       
certainty4 ,this condition is well      
defined by ,bollinger as quoted by      
,hoare1#a when he calls it a purulent   
omphalophlebitis due to local infection 
of the umbilicus and umbilical vessels1 
by pyogenic organisms1 causing a        
metastatic pyemia4  ,this affection is  
grave2 its course is comparatively      
brief2 the prognosis is usually         
unfavorable2 and omphalophlebitis       
occasions a form of lameness which at   
once impresses the practitioner that    
serious constitutional disturbance      
exists4 ,its consideration properly     
belongs to discussions on practice or   
obstetrics and diseases of the new born1
 and it has received careful attention  
and is discussed at length in these     
works4  ,a second form of metastatic    
arthritis is met with in strangles4     
,strangles occurs in the young          
principally and is not a frequent cause 

of synovitis or arthritis in the adult  
animal4  ,strangles or distemper is1    
according to most pathologists1 due to  
the ,streptococcus equi4 ,hoare#b states
 that in this type of specific arthritis
 the contagium is probably carried by   
the blood4 ,he gives it as his opinion  
that even laminitis has occurred as a   
result of the streptococcus-equi4 ,this1
 indeed1 would point toward probable    
extension by the blood as well as by way
 of lymph vessels4  ,septic synovitis   
and infectious arthritis are always     
serious affections even in young animals
 and much depends upon individual       
resistance and early rational treatment 
in such cases1 if recovery is to follow4
  ,the same general plan of treatment is
 indicated in this kind of septic       
synovitis as is employed in all cases of
 infective synovitis and septic         
infection in open joints4 ,there is to  
be considered1 however1 the fact that   
the young animal is more agile1 a better
 self-nurse1 and in a general way more  

apt to recover than is the adult1 under 
similar conditions4  ,rheumatic         
arthritis1 if one is justified in       
classifying rheumatic inflammation of   
joints as a metastatic form of          
arthritis1 is not a common condition1   
though seen in mature and aged animals4 
,cases that may be diagnosed with       
certainty are usually advanced          
affections wherein dependable history is
 obtainable and the symptoms are well   
marked4  ,rheumatism may be thought of1 
with respect to arthritic inflammation  
caused thereby1 as a sort of pyemia4    
,undoubtedly1 exposure to wet and cold  
weather is an active factor1 but        
probably a predisposing one only4       
,likewise a member that suffers from    
chronic inflammation due to recurrent   
injury or to constant or repeated strain
 is less able to resist the vicissitudes
 of climate and work4  ,consequently1   
rheumatic arthritis is to be seen       
affecting horses that are in service1   
more often at heavy draft work where    

they are exposed to severe straining of 
joints2 where stabling is insanitary2   
and where they are obliged to lie down  
7if they do not remain standing7 upon   
cold and wet ground or upon hard        
unbedded floors or paving4  ,where such 
inhumane and cruel treatment is given   
animals those responsible ought to be   
impressed with the unfairness to the    
animal as well as the economic loss     
occasioned by inflicting such           
unnecessary and merciless treatment upon
 their helpless and uncomplaining       
subjects4 ,the very nature of the       
veterinarian's work affords him constant
 and frequent opportunity to convince   
those who are responsible for keeping   
animals in this manner1 that it is      
inhumane and unprofitable4  ,cases of   
this kind are not uncommon about some   
grading and lumbering camps and in      
contract work where1 often1 shelter for 
animals is given little thought2 the    
result is a cruel waste of horseflesh4  
,chronic articular rheumatism is        

occasionally observed in young animals  
that have never been in service4 ,in    
these cases it seems that there exists  
an individual susceptibility and in some
 instances the condition is recurrent4  
,each attack is of longer duration1 and 
eventually death results from continued 
suffering1 emaciation and intoxication4 
,,affections ,,of ,,bursae ,,and        
,,thecae4  ,acute bursitis and thecitis 
is of frequent occurrence in horses     
because of direct injury from contusion1
 punctures and other forms of           
traumatism4 ,these synovial membranes1  
with few exceptions1 when inflamed      
occasion a synovitis that may be very   
acute1 yet there is less manifestation  
of pain than in arthritis4  ,it is only 
in structures such as the bursa         
intertubercularis or in the sheath of   
the deep digital flexor that an         
inflammation causes much pain and is apt
 to result in permanent lameness4 ,this 
is due to the peculiar character of the 
function of such structures4  ,an acute 

inflammation of a small bursa may even  
result in the destruction of such       
synovial apparatus without serious      
inconvenience to the subject1 either at 
the time of destruction or thereafter4  
,obliteration of the superficial bursa  
over the summit of the os calcis is not 
likely to cause serious inconvenience or
 distress to the subject unless it be   
due to an infected wound4 ,even then1   
with reasonably good care given the     
animal1 recovery is almost certain4     
,complete return of function of the     
member and cessation of lameness takes  
place within a few weeks in the average 
case4  ,where an infectious synovitis   
involves a structure such as the sheath 
of the tendon of the deep digital flexor
 7perforans7 the condition is grave and 
because of the location of this theca   
the prognosis is not much more favorable
 than in an articular synovitis4        
,inflammation of bursae and thecae may  
be classified on a chronological basis  
with propriety because the duration of  

such affections1 in many cases1         
materially modifies the result4 ,a      
chronic inflammatory involvement of a   
theca through which an important tendon 
plays may cause adhesions to form4 ,or  
there may occur erosions of the parts   
with eventual hypertrophy and loss of   
function1 partial or complete4          
,however1 in general practice a         
classification on an etiological basis  
is probably more practical and we shall 
consider inflammation of bursae and     
thecae as infectious and noninfectious4 
,infectious bursitis and thecitis is    
usually the result of direct            
introduction of septic material into the
 synovial structure by means of         
injuries4 ,infection by contiguous      
extension occurs and also metastatic    
involvement is met with occasionally4   
,the noninfectious inflammation of      
bursae and thecae usually result from   
contusions or strains and generally run 
their course without becoming infective 
in character1 where vitality and        

resistance of the subject are normal4   
,in a general way1 inflammation and     
other affections of bursae and thecae   
are considered very similar to like     
affections of joints4   ,,affections    
,,of ,,muscles ,,and ,,tendons4         
,muscles and tendons having to do with  
locomotion are more frequently injured  
than are any of the other structures    
whose function is to propel the body or 
sustain weight4 ,this is due in part to 
the exposed position of muscles and     
tendons4 ,they serve as a protection to 
the underlying structures and in this   
manner receive many blows the force and 
violence of which are spent before      
injury extends beyond these tissues4    
,muscles of the breast1 shoulder and    
rump are most frequently the recipient  
of injuries of various kinds4 ,the      
abductors of the thigh are subjected to 
bruising when horses are thrown astride 
of wagon poles or similar objects4 ,thus
 in one way or another muscle injuries  
are occasioned and cause lameness4      

,traumatic affection of muscles of      
locomotion may be surface or            
subsurface--subsurface with little      
injury done the skin and fascia1 but    
with subsurface extravasation of blood  
and masceration of tissue4 ,puncture    
wounds wherein the vulnerant body is of 
small diameter1 are observed1 and they  
occasion deep seated infectious         
inflammation of the parts affected1 with
 surface wounds that are often          
unnoticeable4 ,such injuries--puncture  
wounds--are always serious1 and because 
of the fact that1 there exists little   
evidence of injury at the time of their 
infliction1 treatment is usually        
deferred several days and often         
infection has become quite extensive    
when the practitioner is consulted4     
,where infective wounds of muscles of   
locomotion occur1 the course and gravity
 of the affection are directly          
influenced by the proximity of the      
injury to lymph plexuses4 ,for instance1
 injuries causing an infectious         

inflammatory involvement of the         
adductors of the thigh may result in a  
generalization of the infection by way  
of the inguinal lymph glands4  ,large   
open wounds that extend deep into       
muscles1 render inactive such           
structures1 and even where division is  
not complete1 the pain occasioned causes
 the subject to favor the part in every 
way possible4 ,contraction of muscular  
fibers of such parts increases pain and 
because of this fact groups of muscles  
are at times disabled because of injury 
done to one muscle4 ,instances of this  
kind are frequently seen where shoulder 
injuries1 which affect but one muscle1  
exist2 yet because of such injury a     
marked swinging-leg lameness is present4
  ,tendons1 because of their            
inelasticity1 are subjected to injuries 
peculiar to themselves4 ,in addition to 
being affected as are muscles1 wounds of
 many kinds are found to affect         
tendons--contusions1 interference       
wounds1 penetrant wounds1 incised wounds

 and lacerations4  ,however1 the        
commoner form of injury done tendons1 is
 strain or sprain4 ,because of the      
sudden tensile strain brought to bear   
upon tendons in the shocks of           
concussion1 as well as in propulsion of 
the body1 there frequently occurs a     
rupture of fibers and this we know as   
sprain4  ,sprains may be considered as  
fibrillary fractures of soft structures 
and since this form of injury is        
subsurface1 and limited to fractional   
portions of tendons1 the inflammation   
occasioned usually remains an aseptic   
one4 ,reaction to this form of injury is
 characterized by inflammation1 the     
course of which is erratic and variable4
 ,in chronic inflammation of tendons1   
where animals are continued in service1 
the usual sequel is contraction1 or     
shortening of these structures4  ,the   
degree of contraction as well as its    
import varies in different subjects and 
in the various tendons which may be     
affected4 ,contraction is a slow-going  

process that is progressive1 gradually  
causing a decrease in the length of the 
affected structure and eventually       
rendering the animal useless4  ,the     
practice of applying shoes with extended
 toe-calks for the purpose of stretching
 contracted deep digital flexor tendons 
7flexor pedis perforans7 cannot be too  
strongly condemned4 ,while the addition 
of an extension such as is ordinarily   
employed to the toe of a shoe of this   
kind1 prevents for a time1 frequent     
stumbling in such cases1 the increased  
tensile strain which is thus occasioned 
hastens further contraction and subjects
 animals so shod to much unnecessary    
pain4   ,,affections ,,of ,,nerves4     
,because of their being protected by    
other structures1 nerve trunks1 which   
supply muscles of locomotion1 are not   
subjected to frequent injuries such as  
contusions4 ,however1 they do become    
injured at times and the result is      
lameness1 more or less severe4          
,lameness originating from nerve        

affection1 may involve central          
structures as1 for example1 the spinal  
cord1 medulla oblongata or parts of the 
brain4 ,in making an examination of some
 lame animals it is necessary to        
distinguish between cases of lameness   
that are of central origin and marked by
 incooerdination of movement1 and       
disturbances caused by other affections4
 ,tetanus in its incipiency should not  
be confused with laminitis involving all
 four feet1 or with certain forms of    
pleuritis1 when careful examination is  
made1 yet1 in a way1 to one not trained1
 the clinical symptoms are similar4     
,disturbances of nerve function are     
caused in a variety of ways4 ,it is not 
within the scope of this work to discuss
 central nervous disturbances caused by 
ingestion of mouldy provender1 or       
disturbances of the brain or cord       
occasioned by infectious diseases1 but  
mention of the existence of such        
conditions is appropriate4  ,by direct  
injury the result of blows1 certain     

nerves are injured and muscles supplied 
by such nerves are rendered inactive4   
,depending upon the nature and extent of
 an injury thus inflicted1 so the manner
 in which the affection is manifested   
varies4 ,the suprascapular nerve is     
rather frequently injured causing       
partial or complete loss of function of 
the structures supplied by this nerve1  
and abduction of the scapulohumeral     
joint naturally results4  ,in some cases
 of dystocia the obturator nerve1 7or   
nerves1 if the involvement is           
bilateral71 becomes injured by being    
caught between the maternal pelvis and  
some dense part of the fetus4 ,this     
results in paralysis of the adductors of
 the thigh if sufficient injury is done4
  ,it is said that nerves become        
over-stretched and held tense1 in       
certain positions in which animals are  
obliged to remain while cast in         
confinement such as in some instances   
where unusual methods of restraint are  
employed4 ,when the fore feet are drawn 

backward in such manner that great      
strain is put upon the radial nerve1 it 
suffers more or less injury1 and this is
 followed by partial or complete        
paralysis which may be temporary or     
permanent4  ,degenerative changes       
affecting nerves1 as in other tissues1  
occur and more or less locomotory       
impediment will follow--this depending  
upon the nerve or nerves affected and   
the nature of such involvement4 ,tumors 
may surround nerves and eventually the  
nerve so exposed becomes implicated in  
the destructive process4 ,before        
degenerative changes take place in the  
nerve substance1 in such cases1 pressure
 may completely paralyze a nerve when it
 is so situated4 ,melanotic tumors in   
the paraproctal tissue in some cases1   
because of the large size of the        
new-growths1 cause paralysis of the     
sciatic nerve4 ,the author has seen one 
case of brachial paralysis occasioned by
 an enormous development of fibrous     
tissue involving the structures about   

the ulna4   ,,affections ,,of ,,blood   
,,vessels4  ,lameness caused by         
disturbances of circulation may be due  
to structural affection of vessels1 or  
functional disorders of the heart1 and  
in some instances1 a combination of     
these causes may be active4  ,direct    
involvement of vessels is the commoner  
form of circulatory disturbance which   
occasions lameness1 and the most        
frequent cause is of parasitic origin4  
,sclerostomiasis with attendant         
arteritis1 thrombus formation and       
subsequent lodgement of emboli in the   
iliac1 femoral1 or other arteries1      
causes sufficient obstruction to prevent
 free circulation of blood1 and the     
characteristic lameness of thrombosis   
results4  ,indirect injury to vessels   
may occur because of contused wounds and
 subsequent inflammation of tissues     
supplied by such vessels4 ,if the injury
 be of sufficient extent1 considerable  
extravasation of blood will take place  
and the painfully swollen parts         

necessarily impair locomotion4 ,in such 
instances lymph vessels participate in  
the disturbance1 and the condition then 
becomes one wherein lymphangitis is the 
predominant disturbing element4         
,angiomatous tumors are occasionally    
found affecting horses' legs--usually   
the result of some injury2 and because  
of their size or position1 they         
mechanically interfere with function4   
,furthermore1 when such tumors are      
located on the inner or flexor side of  
joints1 enough pain is occasioned that  
affected animals show evidence of       
distress1 usually by intermittent       
lameness4  ,horses do not suffer from   
distension of veins as does man1 that   
is1 there is rarely to be seen a case   
wherein much disturbance from this      
source exists4   ,,affections ,,of      
,,lymph ,,vessels ,,and ,,glands4       
,inflamed lymph vessels and glands1 the 
result of various causes1 is a rather   
common source of lameness of horses4    
,when one considers the proportion of   

tissue that is composed of lymph vessels
 and glands1 it is then obvious that    
inflammation of these structures should 
cause a painful affection of members1   
when so affected1 and that marked       
lameness and1 in some instances1 general
 constitutional disturbance such as     
anorexia1 hyperthermia and general      
circulatory disorder are to follow4     
,lymphangitis is most frequently        
occasioned by the introduction of septic
 material into the tissues2             
consequently1 infectious lymphangitis is
 more frequently observed than the      
non-infectious type4  ,specific         
infectious forms of lymphangitis are    
seen in glanders and in strangles2      
infectious types of this disturbance are
 found in many instances where1         
initially1 a localized or circumscribed 
infection has occurred--the contagium   
having been introduced by way of an     
injury4 ,an example of this kind is to  
be seen in a wound perforating the      
tibial fascia1 where the injury is      

inflicted by means of a horse being     
kicked by another animal shod with sharp
 shoe-calks4 ,cases of this kind        
invariably result in a septic           
lymphangitis1 and frequently            
lymphadenitis also occurs1 for the      
inguinal lymph glands are so situated   
that their becoming contaminated is     
almost certain4  ,the trite phrase that 
the tissues are bathed in lymph should  
make clear the reason for the frequent  
occurrence of infectious lymphangitis   
and lymphadenitis4 ,foreign substances1 
bacteria and their products1 inorganic  
material and in fact1 anything that is  
introduced into the tissues1 if soluble 
or miscible1 will be taken up and       
conveyed by the afferent lymph vessels  
and disseminated throughout the         
system--hence the constitutional        
disturbances so frequently thus caused4 
,a non-infectious type of lymphangitis  
is frequently seen in the heavy draft   
breeds of horses and in such cases one  
or both hind legs are involved--it is   

very seldom that the thoracic limbs     
become so affected4 ,law#c refers to    
this ailment as ,acute ,lymphangitis of 
,plethora in ,horse4 ,when one takes    
into consideration that these cases so  
frequently occur in heavy draft animals 
that are not worked regularly1 that the 
pelvic limbs are the ones involved1 and 
that the disorder often runs a short    
course 7recovery often taking place     
within two or three days1 with no       
treatment given other than a purge1     
circulatory stimulants and walking      
exercise7 it is plausible to ascribe the
 condition to idiopathic factors4       
,admitting the frequency of             
non-infectious lymphangitis1 the        
practitioner must not confuse this type 
with similar lymphatic inflammation     
occasioned by nail punctures of the     
foot4 ,it is very embarrassing indeed to
 make a diagnosis of                    
lymphangitis--expecting that the        
disturbance will terminate favorably and
 uneventually--and later to discover a  

sub-solar abscess caused by a nail prick
 in the region of the heel4  ,recurrent 
attacks of this disturbance cause       
hypertrophy of the lymph vessels and in 
some cases lymphangiectasis4 ,in old    
subjects used for dissection or surgical
 purposes1 it is very evident that in   
the ones which have suffered from       
chronic lymphangitis there exists an    
excessive amount of sub-facial          
connective tissue1 making subcutaneous  
neurectomies quite difficult in some    
instances4  ,a sequel of chronic        
lymphangitis is a condition known as    
elephantiasis4 ,in such cases there     
occurs a hyperplasia of the skin and    
subcutaneous tissues1 resulting in some 
instances1 in the affected member       
attaining an enormous size4 ,sporadic   
cases of this kind are to be seen       
occasionally1 and are apparently caused 
by repeated attacks of lymphangitis4    
,the affection is not benefited by      
treatment1 and while a horse's leg may  
become so heavy and cumbersome as to    

mechanically impede its gait1 as well as
 to fatigue the subject when made to do 
service even at a slow pace1            
elephantiasis causes no constitutional  
derangement4 ,the hind legs1 in         
elephantiasis1 are affected and a       
unilateral involvement is more often    
seen than a bilateral one4 ,the legs may
 be enlarged from the extremity to the  
body1 but ordinarily the affection does 
not extend higher than the hock or the  
mid-tibial region4  ,a chronic1         
progressive1 hyperplastic-degeneration  
exists in some cases and the subjects   
are in time rendered unserviceable      
because of the burden of getting about  
encumbered by the affected extremity4   
,in other animals hyperplasia progresses
 for a time--until the parts become     
greatly enlarged and conditions         
apparently attain an immutable state4   
,nevertheless animals so affected may   
continue in service for years without   
being distressed4   ,,affections ,,of   
,,the ,,feet4  ,lameness is very often  

due to affections of the feet1 and in   
all foot diseases probably the most     
constant cause is injury inflicted in   
some manner4 ,resultant from injury1    
there frequently develops complications 
and the one most often seen is          
infection4  ,because of the fact that   
the feet are constantly exposed to      
germ-laden soil and filth1 if not       
actually bathed in such infectious      
materials1 it naturally follows that    
septic infection of some part of the    
feet must be of frequent occurrence4    
,subsequent to being obliged to stand in
 mud and other damp or wet media1       
exposure to desiccating influences such 
as stabling upon dry floors1 or at      
service on hot and dry road surfaces    
causes the insensitive parts of the feet
 to become dry1 hard and brittle4 ,this 
favors checking of the protecting       
structures and it frequently results in 
the formation of large fissures which   
expose the underlying sensitive parts of
 the feet and lameness is the inevitable

 outcome4  ,the function of the         
feet--bearing the weight of the animal  
at all times when the subject is not    
recumbent1 and in addition to this1 the 
increased strain put upon them at heavy 
draft work1 together with the concussion
 and buffeting occasioned by locomotion1
 make the feet susceptible to frequent  
affections of various kinds4  ,being    
almost completely encased by a somewhat 
inexpansible and insensitive wall and   
sole1 renders the foot subject to       
pathologic changes peculiar to itself4  
,the very nature of the structure of the
 foot together with the function of the 
sensitive lamina is sufficient cause for
 an affection unlike that seen involving
 other tissues--laminitis4  ,an         
exhaustive consideration of foot        
affections is a study in itself and one 
that comes within the realm of          
pathologic shoeing2 nevertheless1 a     
practical knowledge of diseases of the  
foot is indispensable in the diagnosis  
of lameness wherein the foot may be at  

fault4  ,the peculiar nature of foot    
affections renders them difficult of    
classification on any sort of basis that
 is helpful in the consideration of this
 subject4 ,injuries are the most        
constant cause of foot lameness1 yet one
 must admit that there results          
complications because of infection in   
most instances2 and that in some cases  
the injury is slight--just enough to    
permit the introduction of vulnerant    
organisms into the tissues4 ,therefore1 
one might well classify affections of   
the feet as infectious and              
non-infectious4 ,there can be grouped in
 the class of infectious affections such
 conditions as nail pricks1 calk wounds 
and canker4 ,in the class of            
non-infectious affections one may       
consider conditions such as laminitis1  
strain and fractures4  ,,footnotes3     
,footnote #a3 ,a ,system of ,veterinary 
,medicine by ,e4 ,wallis ,hoare1        
,f4,r4,c4,v4,s41 ,vol4 ,i1 page #eai4   
,footnote #b3 ,ibid1 page #hjg4         

,footnote #c3 ,vol4 ,i1 page #ecd1      
,veterinary ,medicine1 by ,james ,law1  
,f4,r4,c4,v4,s4     ,,section ,,ii4     
,,diagnostic ,,principles4   ,to observe
 attentively is to remember             
distinctly4--,poe4  ,before treatment is
 administered in constitutional         
disturbances resulting in disease1 cause
 is logically sought2 so1 in order to   
handle effectively any case of lameness1
 it is necessary first to discover the  
source of the trouble and contributing  
conditions affecting the structures4    
,hence1 diagnostic ability is the prime 
requisite2 and a thorough knowledge of  
pathologic anatomy or of surgical       
technic is of little value if this      
knowledge is not applied with the       
insight of the trained diagnostician4   
,the cruel and unnecessary methods      
employed by those untrained for         
diagnostics1 cannot be too vigorously   
condemned4 ,for instance1 the           
application of an active and depilating 
vesicant upon a large area on the       

gluteal or crural region1 in a case     
where the practitioner guesses the      
condition to be one of hip lameness1    
constitutes an exposition of gross      
ignorance1 and at once stamps the       
perpetrator as a crude bungler without  
scientific insight whose works are no   
credit to his profession4 ,how much     
better it would be1 if the practitioner 
does not see fit to call in a competent 
consultant1 to prescribe a suitable     
agent to be given internally1 and to    
recommend complete rest for the subject4
  ,in establishing a diagnosis in such  
cases1 the student or practitioner      
seldom has recourse to laboratory       
assistance1 and his work is done by     
means of physical examination2          
therefore1 a thorough knowledge and a   
clear conception of the physiology of   
locomotion are essential4 ,memorizing   
nosological facts without an            
understanding of underlying principles  
is of no more practical benefit for     
qualification as a diagnostician in     

cases of lameness1 than is the          
employment of similar methods in the    
study of theory and practice4 ,a        
knowledge of the dosage of drugs does   
not in itself qualify one as being      
competent to administer such therapeutic
 agents to a proper effect4 ,how much is
 a practitioner benefited by the        
knowledge that a high temperature is    
usually present in septic intoxication1 
if he is not possessed of a scientific  
understanding of anatomy1 physiology1   
bacteriology and pathology1 as well as  
the principles of clinical diagnosis8   
,in order to determine the reasons for  
certain symptoms manifested by the      
subject1 an analysis of these symptoms  
is the proper method of procedure1      
insofar as this is possible4 ,if one may
 reason that an animal assumes a certain
 position while at rest to allow        
relaxation of an inflamed tendon or     
ligament1 such a fact enables the       
diagnostician to recall that this is    
indicative of some specific ailment4 ,in

 acute tendinitis1 the subject while at 
rest1 maintains the affected member in  
volar flexion because this position     
permits relaxation of the inhibitory    
apparatus1 including the inflamed       
tendon4 ,likewise1 the various abnormal 
positions assumed1--adduction1          
abduction1 undue flexion or             
pointing--have their own significance   
and are taken into account by the       
trained diagnostician in the course of  
an examination4  ,in the examination of 
lame subjects1 where the cause is not   
obvious1 a systematic method of         
diagnosis is pursued even by the most   
expert practitioners4 ,in all obscure   
cases of lameness a methodical and      
thoroughly practical examination of the 
animal according to an established      
procedure is necessary to determine the 
nature and source of the affliction4    
,anamnesis4  ,the first thing to be     
given consideration in diagnosis is the 
fact that related history of the case is
 not always dependable1 because of lack 

of accurate observation or wilful deceit
 on the part of the owner or attendant4 
,the successful veterinarian soon       
acquires the faculty of obtaining       
information in a manner best adapted to 
his client1--either by direct           
interrogation or by subtle means of     
suggestion1 and in this way he draws out
 evaded facts essential to his          
diagnosis4 ,in time he learns to make   
allowance for misstatements made to     
shield the owner or driver and to hide  
the facts of apparent neglect or abuse  
that the subject may have experienced4  
,a suppurating cartilaginous quittor1   
complicated by the presence of a large  
amount of hyperplastic tissue1 cannot be
 successfully represented to be an acute
 and recently developed affection1 where
 a trained practitioner is left to judge
 the validity of the statement4  ,in    
complicated conditions1 where there is  
evident a chronic disturbance which     
could not be conceived as sufficient    
cause for a marked manifestation of     

lameness1 accurate history of the case  
may be of great aid in arriving at a    
diagnosis4 ,an aged animal1 having      
recently become very lame1 showing a    
small exostosis on the first phalanx1   
and with the history given that the     
osseous deposit was of long standing1   
should at once lead the veterinarian to 
seek the source of trouble elsewhere4   
,visual ,examination4  ,as in all       
diagnostic work1 a careful visual       
examination of the subject should be    
made before it is approached4 ,the      
novice is given to hasty examination by 
palpation1 not realizing how much may be
 revealed by a careful scrutiny of the  
subject4 ,in this way he is led to      
erroneous conclusions which the skilled 
diagnostician has learned from          
experience to avoid4 ,too much emphasis 
cannot be placed on the importance of   
making a thoughtful visual examination  
in every instance before the subject is 
approached4 ,in this examination1 type1 
conformation and temperament are taken  

into account at once1 for each of these 
qualities is in itself1 a determining   
factor in predisposing a subject to     
certain ailments or inherent attributes1
 which may exert a favorable or         
unfavorable influence upon existing     
conditions and thus make recovery       
probable or otherwise4  ,draft animals  
are less likely to be permanently       
incapacitated as a result of tendinitis1
 than are thoroughbreds4 ,likewise1 one 
would not expect to find this affection 
present in heavy harness horses as      
frequently as in light harness animals4 
,mal-formation of a part1 or an         
asymmetrical development of the body as 
a whole1 may render an animal           
susceptible to certain affections which 
cause lameness4 ,a tied in hock         
predisposes the subject to curb1 and an 
animal having powerful and              
well-developed hips and imperfectly     
formed hocks1 will1 if subjected to     
heavy work1 be a favorable subject for  
bone spavin4  ,the matter of temperament

 cannot be disregarded in diagnosis1 for
 in some instances1 it is the chief     
determining factor which materially     
influences the outcome of the case4 ,a  
nervous1 excitable animal1 that is kept 
at hard work1 may1 under some           
conditions1 be expected to experience   
disturbances which more lethargic       
subjects escape4 ,nervous subjects1 it  
is known1 are more prone to azoturia    
than are those of lymphatic temperament4
 ,furthermore1 the lymphatic subject    
often recovers from certain bone        
fractures which are successfully treated
 only when the animal is sufficiently   
resigned by nature to remain confined in
 a sling for weeks without resistance4  
,the physiognomy of a subject is often  
indicative of the gravity of its        
condition4 ,the facial expression of an 
animal suffering the throes of tetanus1 
azoturia1 or acute synovitis1 is readily
 recognized by the experienced eye1 and 
upon physiognomy alone1 in many         
instances1 may the opinions regarding   

prognosis be based4 ,particularly is    
this true where death is a matter of    
minutes1 or at most is only a few hours 
distant4  ,due allowance should be made 
for restiveness manifested by some more 
nervous animals when the surroundings   
are strange and unusual4 ,in such       
instances1 even pathognomic symptoms may
 be masked to the extent that little1 if
 any1 sign of pain or malaise is        
evinced4 ,in these cases the subject    
should be given sufficient time to      
adjust itself to the new environment1 or
 it should be removed to a more suitable
 place for examination4 ,animals quickly
 detect the note of friendly reassurance
 in the human voice and can very often  
be calmed by being spoken to4  ,by      
visual examination one may detect the   
presence of various swellings or        
enlargements1 such as characterize      
bruises and strains of tendons where    
inflammation is acute4 ,inflammation of 
the plantar 7calcaneocuboid7 ligament in
 curb is readily detected when the      

affected member is viewed in profile4   
,spavin1 ringbone1 splints1 quittor and 
many other anomalous conditions may all 
be observed from certain proper angles4 
,the fact that the skins of most animals
 are pigmented and covered with hair1   
precludes the easy detection of erythema
 by visual examination1 consequently    
this indicator of possible inflammation 
is not often made use of in the         
examination of equine subjects4         
,attitude of the ,subject4  ,the        
position assumed while the subject is in
 repose1 is often characteristic of     
certain affections and this1 of course1 
is noted at once4 ,the manner in which  
the weight is borne by the animal at    
rest1 should attract the attention of   
the diagnostician and if the attitude of
 the subject is abnormal or peculiar1   
the examiner tries to determine the     
reason for it4 ,if weight-bearing causes
 symptoms of pain1 the affected member  
will invariably be favored and held in  
some one of a number of positions4 ,the 

foot may contact the ground squarely and
 yet the leg may remain relaxed and free
 from pressure2 volar flexion1 in such  
cases1 is indicative of inflammation of 
a part of the flexor apparatus4 ,if the 
condition be very painful1 position of  
the afflicted member is frequently      
shifted1 but in all cases where the pain
 is not so keenly felt1 the inflamed    
member is held in a state of relaxation4
 ,there is need then1 for a knowledge of
 anatomy and certain principles in      
physics to enable the observer to       
determine just which structures are     
purposely eased in this manner4 ,where  
palpation of parts is possible1 one does
 not need to depend on visual           
examination alone1 and it is always wise
 to take into consideration every factor
 that may influence conditions4         
,manipulation or palpation of the       
structures thought to be involved1      
should not be resorted to until a       
careful and thorough observation of the 
subject has revealed all that it can    

reveal to the diagnostician4  ,in all   
conditions where extreme pain is        
manifested by the constant desire of the
 animal to keep its foot in motion off  
the ground1 examination should be made  
for local cause4 ,this is seen in       
certain septic inflammations of the feet
 such as those caused by nail punctures 
invading the navicular joint1 or in     
newly made wounds where nerves have been
 divided and the proximal end of such a 
nerve is exposed to pressure or         
irritation4  ,pointing affords a        
comfortable position in some cases of   
navicular disease1 and in a unilateral  
affection1 one may observe the subject  
bearing weight with one sound member1   
while the affected foot is planted well 
ahead of the sound one4 ,in a bilateral 
involvement of this kind1 weight may be 
frequently shifted from one foot to the 
other1 or in chronic cases1 where no    
marked pain is experienced1 the subject 
stands squarely upon both front feet and
 no peculiar shifting of weight or      

pointing is evident4  ,in some cases of 
hip or shoulder involvement1 complete   
relaxation of all parts of the affected 
member may be noticed4 ,in brachial     
paralysis1 the pectoral member is held  
limply2 if the patient is made to move1 
it is evident there is lack of          
innervation to the afflicted part4 ,in  
some cases where contusion has caused   
acute inflammation of the member1 the   
subject instinctively tries to keep it  
inactive to relieve the pain which      
movement occasions4  ,where there is an 
active and painful inflammation of the  
prescapular lymph glands and contiguous 
structures1 in some cases of            
levator-humeri abscess1 the             
scapulohumeral joint is extended4 ,this 
is brought about by flexion of the elbow
 and carpal joints4  ,there are some    
cases of bi-lateral affections which    
occasion such pain during weight-bearing
 that the subject shifts its weight from
 one affected leg to the other2 an      
example of this condition may be        

observed in any acute case of gonitis   
which affects both patellar regions1    
making it equally painful to bear the   
weight on either member4  ,a peculiar   
characteristic position is assumed in   
acute laminitis of the fore feet4 ,in   
such instances1 the hind feet are       
brought forward under the body          
sufficiently to relieve the front feet  
of the weight1 insofar as is possible by
 the abnormal position taken in cases of
 acute laminitis4  ,so in each position 
that is abnormal to any degree1 assumed 
by a suffering animal1 there may be     
deduced1 the fact that the subject is   
attempting to relieve the affected      
structures1 and in each clinical picture
 of this kind1 the trained diagnostician
 sees some index to the nature and      
source of the trouble4 ,further         
examination is rendered more effective  
because of this preliminary visual      
examination which has precluded the     
unnecessary annoyance of the animal by  
manipulating unaffected structures4  ,it

 has been presupposed in the foregoing1 
that the one making visual examination  
of a lame animal for diagnostic         
purposes1 will remember that with the   
normal animal the weight is borne       
equally well with both fore legs2 and   
that this is done without shifting from 
one to the other2 and that the pelvic   
limbs do not support the body in this   
manner4 ,normal subjects shift their    
weight from one hind leg to the other   
and the one relaxed1 rests in a state of
 flexion with the toe on the ground and 
the heel raised4   ,examination by      
,palpation4  ,in nearly every case where
 lameness exists an examination of the  
affected parts1 by palpation or by      
digital manipulation1 is necessary      
before an accurate conclusion may be    
drawn2 but in making this kind of an    
examination one needs to exercise good  
judgment lest he fail to acquire a      
correct impression of the actual        
existent conditions4 ,there is need for 
the diagnostician1 here1 as well as in  

other conditions where physical         
examination is made1 to approach the    
subject in a manner that will not excite
 or disturb to the extent that the      
animal will1 in one way or another1     
resist or object to the approach of the 
diagnostician1 thereby masking the      
symptoms sought4 ,the practitioner would
 best acquire skill as a horseman--if he
 is not possessed of such--and handle   
each individual subject in the manner   
calculated to best suit the temperament 
of the animal examined4 ,the unbroken   
subject is not handled as satisfactorily
 as is the intelligent family horse2 in 
the former1 in some cases1 little       
dependence is placed upon digital       
examination4  ,by palpation one is      
enabled to recognize hyperthermia and   
this1 in lieu of dependable history1 is 
at times sufficient evidence upon which 
to determine the duration of any given  
inflammatory affection4  ,by comparison 
of different parts of the same member or
 with an analogous portion of another   

member any marked increase in the       
apparently normal temperature of a part 
at once signalizes inflammation4 ,in    
this manner1 in examining a case where  
laminitis or other inflammation of the  
feet is suspected1 one may arrive at a  
fairly accurate conclusion without the  
employment of other means4 ,throbbing   
vessels are not always easily recognized
 if the subject is a victim of chronic  
lymphangitis4  ,in some instances1 where
 a moderate degree of lameness exists   
and cause is apparently obscure1 the    
recognition of hyperthermia may be the  
deciding factor in establishing a       
diagnosis4 ,in cases of sprained        
ligaments in the phalangeal region1     
because of the dense character of the   
structures involved1 little if any      
evidence of the cause of lameness1 other
 than local heat1 may be found          
twenty-four hours after the injury has  
been inflicted4  ,in order to determine 
the amount or extent of hyperthermia    
with a fair degree of accuracy in any   

given case1 one must make due allowance 
for external conditions affecting       
temperature2 also the effect of a       
considerable amount of hair covering an 
area1 as well as any possible dirt      
contacting the surface of the skin must 
be taken into account4 ,all dirt should 
be removed if practicable1 so that the  
diagnostician's palms may come as nearly
 in contact with the inflamed structures
 as possible4 ,then1 too1 the sense of  
touch if the operator's hands are       
chilled1 is not dependable4 ,in such    
instances the novice will need to be    
deliberate as to his findings--whether  
or not hyperthermia really exists4 ,such
 an examination is of little value where
 the subject's feet are wet and an      
examination is hurriedly made1 as in    
cases of suspected laminitis4  ,often1  
before being able to distinguish the    
presence of a hyperthermic condition1   
one is impressed with the fact that an  
animal manifests evidence of being      
supersensitive4 ,in fact1 some animals  

in the anticipation of pain at the touch
 of an injured part1 will instinctively 
withdraw--in self-protection--such an   
ailing member or resist the approach of 
the practitioner4 ,this sensitiveness is
 more apparent in animals that have been
 subjected to previous manipulation or  
treatment which has occasioned pain1 and
 consequently1 allowance must be made   
for this exhibition of fear4 ,no better 
example of this condition can be        
imagined than is present in cases of    
shoe boil1 where there exists an        
extensive area of acute inflammation of 
the elbow4 ,there is always more or less
 surface disturbance wherever vesication
 has been produced1 and in cases where  
irritants of any kind have been employed
 for several days or a week previous to 
an examination1 more or less            
supersensitiveness is to be expected4   
,one must not lose sight of the fact    
that unscrupulous                       
dealers1--traders--make use of their    
knowledge of this principle in various  

way usually for the purpose of          
attracting attention to a part1 which1  
presumably might have been blistered in 
order to intentionally produce          
inflammation of tissues1 in this way1   
causing lameness which is not manifested
 until an animal has been kept by its   
new owner for twenty-four hours or more4
 ,this1 to be sure1 usually makes a     
dissatisfied purchaser who is willing to
 dispose of his newly acquired animal at
 a sacrifice1 thus enabling the original
 owner or his agent to regain possession
 of the victimized animal at less than  
its real value4  ,some nervous animals1 
because of the manner of approach of the
 practitioner1 are wont to flinch1 and  
there is manifested a                   
pseudo-supersensitiveness4 ,young       
animals not accustomed to being handled 
are likely to be timorous1 and one must 
not hastily conclude that a part is     
painful to the touch because the subject
 resents even gentle digital            
manipulation of such parts4 ,in         

instances of this kind1 one needs to    
compare sensibility by manipulation of  
different parts of the subject's body in
 a careful and gentle manner2 and by    
exercising patience and good judgment in
 such work1 it is possible to actually  
distinguish between normal sensibility  
and abnormal sensitiveness1 in most     
cases4 ,here1 again1 the diagnostician  
needs to possess skill as a horseman and
 good judgment as to individual         
temperament of different animals1 under 
any condition which may exist at the    
time he makes his examination4  ,by     
palpation alone1 one can recognize the  
presence of fluctuating enlargements2   
one may not only recognize such         
conditions1 but distinguish between a   
fluctuating mass such as exists in      
non-strangulated hernia and a large     
fibrous tumor4 ,by palpation1 for the   
recognition of density and for          
determining the presence or absence of  
hyperthermia1 one may decide that there 
exists an abscess and not a tumor4      

,edematous swellings are recognized by  
palpation1--the characteristic          
indentations which may be made in       
dropsical swellings are pathognomonic   
indicators4 ,in this manner it is easy  
to differentiate post-operative or      
post-traumatic edemas which may or may  
not cause lameness4 ,at any rate1 it is 
essential to take into account all      
determinate conditions that may assist  
in the prognosis of any given case1 for 
the purpose of being able to outline    
rational remedial measures4 ,to be able 
to distinguish between the              
generalization of a septic infection in 
its incipiency1 and a more or less      
benign edema1 is largely possible by    
digital manipulation alone4 ,an         
extremity may be greatly swollen because
 of the existence of chronic            
lymphangitis1 influenza1 or an acute    
septic infection occasioned by the      
introduction of pathogenic and aerogenic
 organisms4 ,since the effect produced  
by these dissimilar ailments are        

productive of conditions that may       
terminate favorably or unfavorably1 it  
becomes necessary for the diagnostician 
to develop a trained1 discriminating1   
tactile-digital sense1 in order to      
correctly interpret existing conditions1
 and handle cases in a rational and     
skillful manner4  ,in order to ascertain
 the extent and exact location of a     
tumor1 an exostosis1 or other           
enlargements1 the diagnostician1 here   
also1 needs to be in possession of a    
trained tactile sense and in addition if
 he be fortified with an accurate       
knowledge of normal anatomy and         
pathology1 he is able to arrive at      
proper conclusions1 when digital        
manipulations have been employed4       
,fibrous tumors are sometimes located in
 the inferior part of the medial side of
 the tarsus--exactly over the seat of   
bone-spavin4 ,such tumors1 when the     
affected member is supporting weight1   
are not to be distinguished from        
exostoses2 but as soon as the affected  

leg ceases to bear weight1 it may be    
passively flexed and the nature of the  
enlargement recognized because it may be
 slightly displaced by digital          
manipulation4 ,displacement1 of course1 
is not possible with an exostosis4  ,a  
necessary qualification1 which the      
diagnostician must possess1 is that of  
being able to judge carefully the       
nearness of any given exostosis to      
articular structures4 ,also1 the extent 
or area of the base of an exostosis as  
well as its exact position1 needs be    
determined before one may estimate the  
probable outcome in any case1--whether  
treatment should be encouraged or       
discouraged by the practitioner4        
,periarticular ringbone may1 because of 
the size and location of the exostosis1 
constitute a condition which cannot be  
relieved in any way in one case1 and in 
another1 because of the manner of       
distribution of such osseous deposits1  
the condition may be such that prompt   
recovery will follow proper treatment4  

,in the examination of an exostosis of  
the tarsus1 it is particularly important
 to determine the exact location of the 
exostosis--whether or not the spavin    
involves the tibial tarsal 7astragulus7 
bone very near its tibial articular     
portions4 ,obviously1 if articular      
surfaces of joints are involved1        
complete recovery cannot result despite 
the most skillful attention given the   
subject4   ,passive ,movements4         
,wherever it is possible to gain the    
confidence of a tractable animal to the 
extent that it will relax the structures
 sufficiently to make possible passive  
movement of affected parts1 much is to  
be learned as a result of such          
manipulation4 ,by this method one may   
differentiate true crepitation1 false   
crepitation1 luxation and inflammation  
of ligaments that have been injured1 as 
in sprains of such structures in the    
phalangeal region4  ,true crepitation is
 recognizable by the characteristic     
vibration which is interpreted by       

tactile sense4 ,it is possible to       
recognize fracture by the use of other  
methods--auscultation1 tuning fork      
tests1 etc41 but in ordinary veterinary 
practice one must rely upon the sense of
 touch for recognition of crepitation4  
,where pain is not so great that        
relaxation of parts does not occur1 one 
can1 by gently moving an extremity in   
various directions--as in flexion1      
extension and lateral motion as well as 
by rotation--cause to be manifested this
 peculiar grating1--the friction of     
newly broken bone4 ,this is known as    
true crepitation4 ,where the subject1   
suffering phalangeal fracture1 manifests
 evidence of pain due to tensing the    
structures about a fractured part1 one  
may anesthetize the parts by using about
 two cubic centimeters of a two per     
cent4 solution of cocain upon the       
plantar nerves1 proximal to the         
fracture4 ,it is perhaps best to deposit
 the cocain solution by means of two    
hypodermic punctures at different points

 along the course of each nerve1 though 
closely situated to one another1 thereby
 making more sure of the solution       
actually contacting the nerve4 ,in some 
multiple fractures of the first or      
second phalanx this is quite necessary2 
otherwise1 pain produced by passive     
manipulation causes the subject to keep 
the tendons so tense that crepitation   
may not be detected4 ,the unnecessary   
infliction of pain is always to be      
avoided4  ,we know as false crepitation 
a vibrating impulse occasioned by normal
 contact of articular portions of bones 
such as in the metacarpophalangeal joint
 when this structure is passively moved1
 where the subject permits the parts to 
remain in a state of complete           
relaxation4  ,attempts to recognize     
supersensitiveness or inflammation by   
means of passive movement of the        
shoulder or hip1 whether gently or      
forcefully1 is not productive of good1  
in any case1 in large animals4 ,because 
of the bulk and weight of parts so      

manipulated1 as well as the resistance  
the subject offers even in normal cases1
 no accurate conclusion is to be arrived
 at in this manner in the average       
instance4 ,animals nearly always resist 
the placing of members in any position  
that is so unusual and uncomfortable as 
that which is required to materially    
displace the component tissues of the   
shoulder or hip2 therefore1 such        
practice is useless because one can not 
distinguish between normal resistance   
and flinching caused by painful         
sensations in injured parts4 ,such      
manipulations are practical in small    
animals4   ,observing the ,character of 
the ,gait4  ,in order to determine the  
degree of lameness as well as its       
character1 it is necessary to cause the 
subject which is being examined1 to move
 in some manner4 ,the degree of         
inconvenience or distress experienced by
 a lame animal that is being so examined
 is manifested by the character of the  
claudication2 and where much pain is    

occasioned in locomotion there is       
disturbance of respiration2 perspiration
 may be noticeable and in some instances
 manifestation of nervous shock are very
 evident--this in timid1 nervous animals
 that anticipate being punished when    
approached and1 consequently1 make every
 effort possible to move when urged to  
do so4 ,an animal1 then1 should be moved
 only sufficiently to cause it to       
exhibit the degree of lameness present  
in any given case1 and if a marked      
impediment is manifested it is not      
necessary to cause the subject to be    
exerted to the extent of inflicting1 in 
such manner1 unnecessary punishment4    
,further or conclusive examination is   
made by palpation4 ,to cause the subject
 to move1 an assistant may simply lead  
the animal with a halter and compel it  
to walk a few steps4 ,in this way1      
lameness1 whether manifested during the 
weight-bearing period of an affected    
member1 or when such a member is being  
advanced1 or whether a combination of   

the two conditions exists1 is made      
apparent4 ,in the words of ,dollar1 one 
is thus enabled to recognize the        
existence of supporting-leg-lameness1   
swinging-leg-lameness or mixed lameness4
  ,when the cause of lameness is not    
strikingly apparent it becomes necessary
 to have the subject moved farther than 
a few steps and at different paces4     
,depending then1 upon the character of  
lameness manifested1 as well as upon its
 degree of intensity1 one needs to      
exercise the subject in various ways1   
but this should not be overdone4  ,the  
first thing apparent in the lame subject
 in action1 is the lame leg4 ,if this is
 not readily determinable1 as in some   
complicated cases1 the leg or legs which
 are at fault are to be discovered by   
further examination1 and to do          
this1--word-pictures convey little that 
is helpful in difficult cases1--long    
practice is the one route by which one  
may become efficient2 that is1 by       
experience gained after fundamental     

principles in the diagnosis of lameness 
have been mastered4  ,for a careful     
study of supporting-leg-lameness        
involving a fore limb1 the subject is   
driven or led toward the one making such
 examination4 ,if a hind leg is to be   
observed1 the animal is made to travel  
away from the examiner4 ,where there    
exists swinging-leg-lameness1 the       
subject should be caused to move past   
the diagnostician1 so that he may get a 
side view of the subject while it is in 
motion4  ,in every case such            
examinations are made to the best       
advantage if the practitioner can view  
his patient from a little distance4     
,here1 again1 a visual examination is   
made but this cannot be successfully    
executed1 in difficult cases1 if the    
practitioner is stationed at too close  
range4  ,the average subject is best    
observed by being led1 rather than being
 ridden1 and in so doing the animal     
should be given moderately free rein4 ,a
 close grasp on the lead may interfere  

somewhat with head movements4 ,nodding  
of the head with the catching up of     
weight by a sound member in             
supporting-leg-lameness of a fore leg1  
constitutes the chief symptom considered
 in detecting the lame leg4  ,where     
supporting-leg-lameness affects a hind  
limb the head is raised at the time     
weight is caught by the sound           
member--here the long axis of the       
subject's body may be likened unto a    
lever of the first class4 ,the posterior
 part of the body1 at the time weight is
 taken upon the sound leg1 is as the    
long arm3 the fore limbs the fulcrum1   
and the subject's head the weight1 which
 is lifted4 ,the head movements of a    
horse at a trot1 in                     
supporting-leg-lameness of a front leg1 
synchronize with the discharge of weight
 from a lame leg to the opposite one if 
sound2 but in pelvic limb affections1   
the head is thrown or jerked upward as  
weight is caught by the sound           
member1--this peculiar nodding movement 

is opposite in the two instances4  ,in  
pacing horses1 since front and hind legs
 of the same side are advanced at the   
same time1 there occurs in              
supporting-leg-lameness1 a nodding of   
the head with discharge of weight from  
the lame leg1 and a dropping of the hip 
as weight is caught by the sound pelvic 
member4 ,in observing animals that are  
limping1 7as in supporting-leg-lameness7
 one notices particularly the           
sacro-iliac region in hind leg          
affections and the occipital region in  
lameness of the front legs4  ,where     
there exists a bilateral affection1     
7such as characterizes some cases of    
navicular disease or other affections   
causing supporting-leg-lameness7 there  
occurs no nodding of the head2 weight is
 supported for an equal length of time  
upon each one of the two legs1 but the  
stride#d is shortened4 ,the gait1 in    
such cases1 is peculiar1 animals        
appearing stiff and they are said1 by   
horsemen1 to have a choppy gait4  ,it is

 desirable1 in some cases1 to cause an  
animal to move from side to side2 in    
other instances the subject is best made
 to walk or trot in a circle1 and if the
 circle be very small the animal then   
particularly employs the inner fore leg 
as a pivotal supporting member4 ,to     
augment the manifestation of certain    
affections1 it is necessary to cause the
 patient to walk backward1 and each one 
of these tests of locomotion serves to  
point out in a more or less             
characteristic manner1 the site of the  
affection which is causing lameness in  
different cases4  ,sprains or injuries  
of lateral ligaments of the extremities1
 ringbone and certain foot affections1  
are made manifest by a side to side     
movement or a pivotal movement4 ,in     
fact1 wherever it is possible to cause  
undue or unusual tension to be exerted  
upon an inflamed structure1             
manifestation of pain is the response4  
,in an inflamed condition of the lateral
 side of the phalanges1 unequal         

weight-bearing such as a rough road     
surface will1 by virtue of the leverage 
which the solar surface of the foot     
affords1 cause undue strain upon such   
inflamed parts1 and increased lameness  
is evident4  ,when an animal is made to 
travel in a circle1 when a member       
affected with supporting-leg-lameness is
 on the inner side of the circle1       
lameness is accentuated because weight  
is borne by the lame leg for a greater  
length of time1 the result of such      
circuitous manner of locomotion4 ,in    
swinging-leg-lameness1 on the other     
hand1 because pain is increased at the  
time an affected member is being        
advanced1 lameness is increased when the
 subject is made to travel in a circle1 
with the lame leg on the outside of a   
circle thus described4  ,in             
supporting-leg-lameness1 the            
transientness of the weight-bearing     
period upon the affected member is the  
determining factor in the production of 
lameness4 ,this unequal period of       

weight-bearing upon the front legs1 for 
instance1 causes an acceleration in the 
advancement of the sound member1 in     
order to relieve the diseased one which 
is bearing weight4 ,in other words1 when
 an animal that is affected with        
supporting-leg-lameness travels in a    
straight line1 since weight is borne by 
the diseased leg for an abnormally short
 period of time1 the sound member needs 
be in the act of advancement a          
correspondingly short period4 ,the      
result is then1 an unequal division of  
stride2 a nodding of the head with the  
catching up of weight by the sound      
leg1--in front leg affections--and this 
is termed limping4  ,with continuous    
exertion as in travel for a considerable
 distance1 in some cases1 lameness      
becomes less evident--as in spavin4     
,this warming out process is due in a   
measure to the parts becoming less      
sensitive upon exertion1 and is to be   
seen1 to a limited extent1 in all       
inflammatory affections that are not too

 severe2 consequently1 in some cases1   
examination of a lame animal should     
begin in the stall1 for in instances    
where the impediment is not marked1     
there may be no evidence of lameness    
after the subject has walked a few      
steps4 ,in other cases1 lameness        
increases as the subject continues to   
travel1 and often to the extent that the
 impediment becomes too severe to allow 
the animal being serviceable4           
,therefore1 one can not1 in every case  
of lameness observed1 positively        
determine the gravity of the situation1 
without having seen the affected animal 
in action for a sufficient length of    
time to understand the nature of the    
condition existing4 ,this necessitates  
driving the animal for several miles in 
certain cases4  ,sometimes it is        
impossible to arrive at any definite    
conclusion1 as the result of a single   
examination1 and it then becomes        
necessary to see the subject again at a 
later date1 or under more favorable     

circumstances4 ,this is to be expected  
in some conditions where there exists   
rheumatic affections1 and also in some  
foot diseases4  ,in the examination of  
young animals1 unused to harness and to 
other strange incumbrances1 one is      
obliged to make allowance for           
impediments of gait1 which are not      
occasioned by diseased conditions4 ,such
 affections have been termed false      
lameness4 ,young mules that are not well
 broken to harness1 are difficult       
subjects for examination and in some    
cases it is necessary to have them led  
or driven for a considerable distance   
before one can definitely interpret the 
nature of the impediment in the gait    
when lameness is not pronounced4 ,it is 
especially difficult to satisfactorily  
examine such subjects1 for the reason   
that their normal rebellious            
temperaments cause resistance whenever a
 strange person approaches them1 as it  
is necessary to do for an examination by
 palpation4 ,in such cases--if an       

examination does not reveal the cause of
 trouble1 rest must be recommended and  
further examination made at a later     
date1 whereupon any new developments may
 be noted1 if such changes exist4       
,special ,methods of ,examination4      
,after having completed a general       
examination of a lame animal--obtaining 
the history of the case1 noting its     
temperament1 type1 size1 conformation1  
position assumed while at repose1       
swellings or enlargements if present1   
causing the subject to move to note the 
degree and character of lameness        
manifested2 palpating and manipulating  
the parts affected to acquire a fairly  
definite notion of the nature of an     
inflammation or to recognize crepitation
 it becomes necessary in some cases to  
employ peculiar means of examination in 
singular instances4 ,this may be done by
 making use of cocain in solution for   
the production of local anesthesia as in
 lameness of the phalanges4 ,such means 
are not1 in themselves1 dependable but  

are valuable when used in conjunction   
with all other available and practical  
methods4  ,trial use of various shoes in
 order to shift the weight from one part
 of the foot to another or to cause an  
animal to break over in a different     
manner so that the gait may be changed1 
constitutes a special test procedure4   
,the use of hoof testers or of a hammer 
to note the degree or presence of       
supersensitiveness is another means that
 is of practical service4 ,no           
examination1 in any case of lameness1 is
 complete without having removed the    
shoe and scrutinized the solar surface  
of the foot4  ,illustration3 ,fig4      
#a--;,hoof testers with special jaws of 
sufficient size to grasp the largest    
foot4  ,diagnosis by exclusion1 finally1
 is resorted to1 and1 as in any other   
case where the recognition of cause is  
difficult1 exclusion of the existence of
 conditions1--one at a time1 by an      
analysis of symptoms--generally enables 
the practictioner to eliminate all but  

the disturbing element4  ,,footnotes3   
,footnote #d3 ,by stride is meant the   
distance between two successive imprints
 of the same foot4 ,the term is not used
 in this work as being synonymous with  
step4     ,,section ,,iii4  ,,lameness  
,,in ,,the ,,fore ,,leg4                
,anatomo-,physiological ,review of parts
 of the ,fore ,leg4  ,for supporting    
weight1 whether the subject is at rest  
or in motion1 the bony column of the    
leg1 together with attached ligaments1  
tendons and muscles1 is wonderfully well
 adapted by nature for the function     
which they perform4 ,the several bones  
which go to make up the supportive      
portion of the leg1 are so joined at    
their points of articulation1 that a    
minimum degree of strain is put upon    
each attachment4  ,the upper third of   
the scapula1 with its cartilage of      
prolongation1 is sufficiently broad and 
flattened that it fits snugly against   
the thorax without necessity for a      
complicated method of attachment--the   

clavicle being absent1 attachment is    
muscular4  ,smith#e has very aptly      
stated that3  ,it seems quite legitimate
 to regard the muscular union between   
the thorax and forelimb as a joint4     
,there are no bones resting on each     
other1 no synovia2 but where the scapula
 has its largest range of movement there
 is a remarkable amount of areolar      
tissue1 which renders movement easy4    
,the whole central area beneath the     
scapula and humerus not occupied by     
muscular attachment1 is filled with this
 easy-moving1 apparently gaseously      
distended1 crepitant1 areolar tissue    
over which the fore legs glide on the   
chest wall as freely as if the parts    
were a large1 well lubricated joint4    
,the scapulohumeral articulation        
7shoulder joint7 is an enarthrodial     
7ball and socket7 joint but because of  
its being held more or less firmly      
against the thoracic wall by muscular   
and tendinous attachment1 and because a 
part of this attachment affords a means 

of support for the body itself1 there is
 no need for binding ligaments and      
movement is possible in all directions  
even though restricted as to extent4    
,illustration3 ,fig4 #b--,muscles of    
,left ,thoracic ,limb from ,elbow       
,downward2 ,lateral 7,external7 ,view4  
a1 ,extensor carpi radialis2 g1         
brachialis2 g'1 anterior superficial    
pectoral2 c1 common digital extensor2 e1
 ulnaris lateralis4 7,after             
,ellenberger-,baum1 ,anat4 fuer         
,kuenstler47 7,from ,sisson's ,anatomy  
of the ,domestic ,animals74             
,illustration3 ,fig4 #c--,muscles of    
,left ,thoracic ,limb from ,elbow       
,downward2 ,medial 7,internal7 ,view4   
,the fascia and the ulnar head of the   
flexor carpi ulnaris have been removed4 
#a1 ,distal end of humerus2 #b1 median  
vessels and nerve4 7,from ,sisson's     
,anatomy of the ,domestic ,animals74    
,undue extension1 7by extension is meant
 such movement as will cause the long   
axis of two articulating bones to assume

 a position which approaches or forms a 
straight line--opposite to flexion71 of 
the scapulohumeral joint is impossible  
while weight is borne1 because of the   
normally flexed position of the humerus 
on the scapula2 whereas flexion1 beyond 
desirable limits1 is inhibited by the   
biceps brachii 7flexor brachii or       
coracoradialis7 muscle4  ,the distal end
 of the humerus1 however1 articulating  
with the radius and ulna in a fashion   
that no support is lent by any sort of  
contact with the body1 is a ginglymus   
7hinge7 joint and lateral motion1       
because of the long transverse diameter 
of its articular portions1 is easily    
prevented by the medial and lateral     
ligaments 7internal and external        
ligaments74 ,flexion of this1 the       
humeroradioulnar joint 7elbow71 is      
restrained by the triceps brachii and   
extension is checked by the biceps      
brachii 7flexor brachii74  ,the carpal  
joint 7erroneously called the knee      
joint71 is composed of the several      

carpal bones which interarticulate and1 
when taken as a group1 serve as a means 
of attachment and articulation for the  
radius and metacarpal bones4  ,the      
transverse diameter of this joint is    
long1 thus giving it contacting surfaces
 that are sufficiently extensive to     
minimize the strain upon the mesial and 
lateral ligaments 7internal and external
 lateral common ligaments74 ,motion is  
that of flexion and extension2 slight   
rotation is possible when the position  
is that of flexion4 ,while supporting   
weight the carpus is fixed in position  
by a slight dorsal flexion1 but undue   
dorsal flexion is prevented by the      
flexor muscles and tendons and          
volar-carpal or annular ligament1       
together with the superior check        
ligament4  ,the metacarpophalangeal     
articulation 7fetlock joint71 is a hinge
 joint and its articular surfaces       
contact one another1 with respect to    
their having a long bearing surface from
 side to side1 as do all ginglymus      

7hinge7 joints4 ,two common lateral     
ligaments bind the bones together4      
,while bearing weight1 there is assumed 
a position of slight dorsal flexion1    
undue flexion being checked by the      
inhibitory apparatus of the joint--check
 ligaments1 and their tendons and the   
suspensory ligament4 ,the inhibitory    
apparatus of the fetlock joint is       
materially reinforced by the proximal   
sesamoid bones4 ,situated as they are1  
between the bifurcating portions of the 
suspensory ligament and the posterior   
part of the distal end of the           
metacarpus--with which they             
articulate--the sesamoid bones serve to 
change the course of the branches of the
 suspensory ligament in a manner that   
they give firm support to this joint4   
,volar flexion is limited by the        
extensors of the phalanges4             
,illustration3 ,fig4 #d--,sagital       
,section of ,digit and ,distal ,part of 
,metacarpus4  ,a1 ,metacarpal bone2 ,b1 
first phalanx2 ,c1 second phalanx1 ,d1  

third phalanx2 ,e1 distal sesamoid bone2
 #a1 volar pouch of capsule of fetlock  
joint2 #b1 inter-sesamoidean ligament2  
#c1 #d1 proximal end of digital synovial
 sheath2 #e1 ring formed by superficial 
flexor tendon2 #f1 fibrous tissue       
underlying ergot2 #g1 ergot2 #h1 #i1    
#i'1 branches of digital vessels2 #aj1  
distal ligament of distal sesamoid bone2
 #aa1 suspensory ligament of distal     
sesamoid bone2 #ab1 #ab'1 proximal and  
distal ends of bursa podotrochlearis4   
7,from ,sisson's ,anatomy of the        
,domestic ,animals74  ,the first phalanx
 7os suffraginis7 normally sets at an   
angle of about #ej to #ee degrees from a
 horizontal plane while weight is being 
supported4 ,its distal end articulates  
with the second or median phalanx 7os   
corona7 and forms the proximal          
interphalangeal 7pastern or             
suffraginocoronary7 joint4 ,this also1  
is a ginglymus joint1 having but slight 
lateral motion1 and that only when it is
 in a state of flexion4 ,a rather broad 

articular surface--from side to         
side--exists here1 lessening the strain 
on the collateral ligaments somewhat4   
,dorsal flexion is checked by the flexor
 tendons and dorsal ligaments4 ,volar   
flexion is restrained by the extensor   
tendons4  ,the distal end of the second 
phalanx 7os corona7 has but slight      
lateral motion and this is manifested   
principally when it is in a state of    
volar flexion4 ,undue dorsal flexion is 
prevented by the deep flexor tendon     
7perforans7 and volar flexion is        
inhibited by the extensor of the digit  
7extensor pedis74 ,thus it is seen1 that
 when the leg is a weight-bearing       
member1 weight is supported by the bony 
framework whose constituent parts are   
joined together by ligaments and tendons
 and each one of the several bones      
articulates in such manner that the     
joint is locked4 ,the articular parts of
 bones rest upon or against an          
inhibitory apparatus1 and are slightly  
flexed1 as in the carpus1 or            

considerably flexed such as in the      
fetlock joint when weight is being      
supported4 ,in the first instance1 for  
example1 the flexors of the carpus and  
the superior check ligament assisted by 
the flexors of the phalanges constitute 
the inhibitory apparatus4  ,it will be  
noted that provision for weight bearing 
is so arranged that muscular energy is  
not required except in the matter of    
suspension of the body between the      
scapulae and here tonic impulses only   
are necessary to maintain an            
equilibrium#f1 yet in every instance    
where weight is not supported by bones1 
inelastic ligaments or tendinous        
structures relieve the musculature of   
this constant strain4 ,this explains the
 fact that some horses do not lie in the
 stall1 yet in spite of their constant  
standing position1 they are able to rest
 and sleep4  ,the student of lameness is
 interested in the function of the legs 
in the role of supporting weight and as 
propelling parts1 and not particularly  

in the capacity of these members for    
inflicting offense or as weapons of     
defense4 ,yet1 in the exercise of their 
functions other than that of locomotive 
appliances1 injury often results1 but   
usually it is the recipient of a blow   
that suffers the injury1 such as an     
animal may receive upon being kicked4   
,therefore1 we do not often concern     
ourselves with strains or other injuries
 that the subject experiences as the    
result of efforts put forth in kicking  
or striking4 ,where such injuries occur1
 however1 a diagnosis is established by 
making use of the principles heretofore 
discussed4  ,as propelling members the  
front legs bear weight and are advanced 
alternately when the horse is walking or
 trotting--in cantering this is not so4 
,when the normal subject travels in a   
straight line1 at a walk or a trot1 the 
length of the stride is the same with   
the right and left members4 ,the stride 
of the right foot then1 for example1 is 
equally divided by the imprint of the   

left foot1 in the normal horse1 when    
traveling at a walk and in a straight   
line4   ,shoulder ,lameness4  ,this     
enigmatical term is frequently employed 
by the diagnostician when he is baffled 
in the matter of definitely locating the
 cause of lameness2 when he has by      
exclusion and otherwise arrived at a    
decision that lameness is high up4      
,shoulder lameness may be caused by any 
one or several of a number of           
conditions1 e4g41 fractures of the      
scapula or humerus2 arthritis of the    
shoulder or elbow joint2 luxation of the
 shoulder or elbow joint 7rarely72      
injuries of muscles and tendons of the  
region due to strains1 contusions or    
penetrant wounds2 paralysis of the      
brachial plexus or of the prescapular   
nerve2 involvement of lymph glands2     
arterial thrombosis2 metastatic         
infections2 rheumatic disturbances2 and 
as the result of inflammation1          
infectious or non-infectious occasioned 
by collar bruises4 ,in some instances   

such inflammation is due to the manner  
of treatment of collar injuries4        
,therefore1 when one considers the      
numerous and dissimilar possible causes 
of shoulder lameness1 it behooves the   
practitioner to become proficient in    
diagnostic principles4  ,a principle    
which is elemental in the diagnosis of  
locomotory impediment1 is that lameness 
of the shoulder or hip is usually       
manifested by more or less difficulty in
 swinging the affected member4          
,swinging-leg-lameness1 then1 is usually
 present in shoulder affections4 ,in    
some instances lameness is mixed as in  
joint ailments1 involvement of the      
bicipital bursa 7bursa                  
intertubercularis71 etc4 ,in affections 
of the extremity there exists supporting
 leg lameness4 ,consequently1 we employ 
this elemental principle1 and1 by a     
visual examination of the subject1 which
 is being made to travel suitably1 one  
may decide that lameness is either high 
up--shoulder lameness or1 low down--of  

the extremity4  ,illustration3 ,fig4    
#e--,ordinary type of heavy sling4  ,to 
make practical use of this principle1   
the examiner must be thoroughly familiar
 with the anatomy of the various        
structures concerned in advancing the   
leg--those which support weight as well 
as those concerned both in weight       
bearing and swinging the member4        
,fracture of the ,scapula4  ,etiology   
and ,occurrence4--,fractures of the body
 of the scapula are of infrequent       
occurrence in horses for the reason that
 protection is afforded this bone       
because of its position4 ,its function1 
too1 is such that very unusual          
conditions are necessary to subject it  
to fracture4 ,the spine is occasionally 
broken due to blows such as kicks1 etc41
 and here frequently a compound fracture
 exists4  ,illustration3 ,fig4 #f--;,a  
sling made in two parts so that horses  
may be supported without use of central 
part or bodice4 ,this sling is more     
comfortable than is the ordinary style  

and is particularly useful in cases that
 require a long period of this manner of
 confinement4  ,where fractures of the  
body of the scapula occur1 heavy        
contusions have been the cause as a     
rule1 and serious injury is done the    
subject2 consequently1 treatment of     
fracture of the body of the scapula is  
seldom successfully practised4          
,fractures of the body of this bone     
resulting from accidents not involving  
internal injury or other disturbances   
and which would not seriously interfere 
with the vitality of the subject1 are   
not necessarily serious unless compound4
  ,fractures of the neck of the scapula 
are serious because of the fact that    
there occurs displacement of the broken 
parts and perfect apposition of the     
fractured ends is difficult1 if not     
impossible4  ,fractures that extend to  
the articular surface are very serious1 
and complete recovery in such instances 
is practically impossible4 ,the         
cartilage of prolongation of the scapula

 is sometimes seriously involved in     
certain cases of fistulous withers1 and 
in some instances it has been separated 
from its attachment to the rhomboidea   
muscles1 and lameness has resulted4 ,in 
such instances1 the upper portion of the
 scapula is disjoined from all          
attachment1 and with every movement the 
animal makes1 the scapula is moved back 
and forth4 ,complete recovery in such   
cases does not occur4                   
,symptomatology4--,fractures of the     
scapular spine are ordinarily readily   
recognized because there is usually     
visible displacement of the broken part4
 ,crepitation is also detected without  
difficulty4  ,in fractures of the body  
of the scapula where an examination may 
be made before much swelling has taken  
place1 and in subjects that are not     
heavily muscled1 one should have no     
difficulty in recognizing the           
crepitation4  ,fractures of the neck of 
the scapula are recognized by           
crepitation1 by passively moving the    

leg1 but it is necessary to exclude     
fractures of the humerus when one       
depends upon the finding of crepitation 
by this means4 ,however1 unless undue   
swelling exists1 the exact location of  
the crepitation is recognized without   
serious difficulty4  ,treatment4--,the  
treatment of compound fractures of the  
scapular spine consists in the removal  
of the broken piece of bone by way of a 
cutaneous incision so situated that good
 drainage of the wound will follow4     
,simple fractures of the body of the    
scapula are best treated by placing the 
subject in a sling1 if the animal is    
halter broken1 and enforcing absolute   
quiet for a period of from three to six 
weeks4 ,splints or similar appliances   
are not of practical value in scapular  
fractures4  ,compound fractures of the  
scapula usually result from violence1   
which at the same time does serious     
injury to adjacent structures1 and it   
then becomes necessary to administer an 
expectant treatment1 observing general  

surgical principles and providing in so 
far as possible for the comfort of the  
patient4   ,scapulohumeral ,arthritis4  
,anatomy4--,the scapulohumeral joint is 
an enarthrodial 7ball and socket7 joint 
wherein the ball or humeral articulating
 head greatly exceeds in size the socket
 or glenoid cavity of the scapula4 ,the 
capsular ligament surrounding this joint
 is very large and admits of free and   
extensive movement of the articulation4 
,there exist no lateral or common       
ligaments jointing the scapula and      
humerus as in other joints1 but instead 
the tendinous portions of muscles       
perform this function4 ,the principal   
ones which are attached to the scapula  
and humerus that act as ligaments are   
the supraspinatus 7antea-spinatus71     
infraspinatus 7postea-spinatus7         
biceps-brachii 7flexor brachii7 and     
subscapularis muscles4  ,etiology and   
,occurrence4--,inflammation of the      
scapulohumeral articulation results from
 injuries of various kinds1 including   

punctures which perforate the joint     
capsule1 bruises from collars1          
metastatic infections and involvement as
 a result of direct extension of        
infectious conditions situated near the 
joint4  ,classification4--,acute        
arthritis may be septic or aseptic1 and 
there seems to be a remarkable tendency 
for recovery in cases of septic         
arthritis involving this joint in the   
horse4  ,chronic arthritis with         
destruction of articular surfaces and   
ankylosis1 is seldom observed4 ,it is   
only in cases of severe injury1 where   
the articular portions of the bones are 
damaged at the time of infliction of the
 injury1 and where the articulation     
remains exposed for weeks at a time1    
together with immobility of the parts   
because of attending pain1 that         
permanent ankylosis results4            
,scapulohumeral arthritis may result    
then from infections1 local or          
metastatic2 from injuries1 such as      
contusions of various kinds2 from       

wounds1 which break the surface         
structure or perforate the joint        
capsule2 or from luxations4             
,infectious ,arthritis4  ,infectious    
arthritis of the scapulohumeral joint   
the result of local causes other than   
produced by septic wounds1 seldom causes
 serious inconvenience to the subject4  
,where such occurs1 however1 there is   
manifested mixed lameness and complete  
extension of the extremity is           
impossible4 ,local swelling is present  
and manifestations of pain are evident  
upon palpation of the affected area4    
,treatment4--,during the first stage of 
the infection1 local applications1 hot  
or cold1 are indicated4 ,a hot poultice 
of bran or other suitable material      
contained within a muslin sack1 may be  
supported by means of cords or tapes    
which are passed over the withers and   
tied around the opposite fore leg4 ,such
 an appliance may be held in position   
more securely by attaching it to the    
affected member4 ,following the acute   

stage of such an infection1 any local   
counter-irritating application or even a
 vesicant is in order4  ,where abatement
 of the infectious process does not take
 place1 and suppuration of the          
structures in the vicinity of the joint 
occurs1 it is necessary to provide      
drainage for pus4 ,in some cases of     
strangles1 for instance1 large pus      
cavities are formed and drainage is     
imperative4 ,however1 metastatic        
inflammation of this joint is seldom    
observed except in cases of strangles4  
,the animal should be kept perfectly    
quiet until recovery has taken place4   
,injuries4  ,injuries to the            
scapulohumeral joint may be the result  
of kicks1 runaway accidents or bruises  
from the collar1 and there may result1  
because of such injuries1 reactionary   
inflammation which will vary in         
intensity from the mildest synovitis to 
the most severe arthritis1 causing more 
or less lameness4  ,treatment4--,the    
general plan of treatment in this form  

of arthritis is the same as has been    
outlined under the head of infectious   
arthritis1 with the exception that there
 is seldom occasion to provide for      
drainage of pus4   ,wounds4  ,wounds    
which cause a break of the skin and     
fascia overlying the scapulohumeral     
joint are usually of little consequence1
 unless the blow is of sufficient force 
to directly injure the articulation1 and
 in such cases1 the treatment of the    
injury along general surgical           
principles1 such as cleansing the area1 
providing drainage for wound secretion1 
and the administration of suitable      
dressing materials such as antiseptic   
dusting powder1 is all that is required 
for the wound4 ,the symptoms manifested 
by the subject in such cases are the    
same as have been discussed heretofore  
and merit no special consideration4     
,prognosis4--,unless very serious injury
 be done the articular portions of the  
scapula or the humerus1 resulting in the
 destruction of the capsular ligament1  

prognosis is entirely favorable4  ,open 
,joint4--,where the capsular ligament is
 perforated and the condition becomes   
one of open joint1 then a special wound 
treatment becomes necessary4 ,the       
surface of the skin is first freed from 
all hair and filth in the vicinity of   
the wound4 ,the wound proper is cleared 
of all foreign material either by       
clipping with the scissors1 curetting or
 mopping with cotton or gauze pledgets4 
,the whole exposed wound surface as well
 as the interior of the joint cavity1 if
 much exposed1 is moistened with        
tincture of iodin4 ,subsequent treatment
 consists in a local application of a   
desiccant dusting powder1 which should  
be applied five or six times daily4 ,the
 composition of the powder should be    
such as to permit of its liberal use1   
thereby affording mechanical protection 
to the wound as well as exerting a      
desiccative effect4 ,equal parts of     
boric acid and exsiccated alum serve    
very well in such cases4  ,animals      

suffering from open joints of this kind 
should be confined in a standing        
position1 preferably in slings1 and kept
 so confined for three or four weeks4   
,since they usually bear weight upon the
 affected member1 there is no danger of 
laminitis resulting4   ,luxation of the 
,scapulohumeral ,joint4  ,because of the
 large humeral head articulating as it  
does with a glenoid cavity1             
scapulohumeral luxations are very rare  
in the horse4 ,according to ,moller#g1  
luxation is generally due to excessive  
flexion of the scapulohumeral joint4 ,in
 such cases the head of the humerus is  
displaced anterior to the articular     
portion of the scapula and remains so   
fixed4  ,symptoms4--,complete luxation  
of the scapula is recognized because of 
immobility of the scapulohumeral joint  
and of the abnormal position of the head
 of the humerus1 which can be recognized
 by palpation1 unless the swelling be   
excessive4 ,immobility of the           
scapulohumeral joint is noticeable when 

one attempts to passively move the      
parts4  ,treatment4--,reduction of the  
luxation is effected by making use of   
the same general principles that are    
employed in the reduction of all        
luxations1 and they are--the control of 
the animal so that the manipulations of 
the operator are not antagonized by     
muscular contraction1 which is best     
accomplished by anesthesia2 placing the 
luxated bones in the position which they
 have taken to become unjointed2 and    
then making use of force which is       
directed in a manner opposite to that   
which has effected the luxation4  ,in a 
forward luxation of this kind1 the      
operator should further flex the        
humerus1 and while it is in this flexed 
position1 force is exerted upon the     
articular head of this bone1 and it is  
pushed downward and backward into its   
normal position4  ,after-care consists  
in restriction of exercise and1 if      
necessary1 confining the subject in a   
sling and the application of a vesicant 

over the scapulohumeral region4         
,inflammation of the ,bicipital ,bursa4 
7,bursitis ,intertubercularis47         
,anatomy4--,there is interposed between 
the tendon of the biceps brachii 7flexor
 brachii7 and the intertubercular or    
bicipital groove a heavy cartilaginous  
pad1 which is a part of the bursa of the
 biceps brachii4 ,this synovial bursa   
forms a smooth groove through which the 
biceps brachii glides in the anterior   
scapulohumeral region4 ,great strain is 
put upon these parts because the biceps 
brachii is the chief inhibiting         
structure of the scapulohumeral         
articulation--the one which prevents    
further flexion of the humerus during   
weight bearing4 ,passing1 as it does1   
over two articulations1 the biceps      
brachii has a somewhat complicated      
function1 being a flexor of the radius  
and an extensor of the humerus4 ,thus it
 is seen1 the biceps brachii is a weight
 bearing structure1 as well as one that 
has to do with swinging the leg4        

,etiology and ,occurrence4--,because of 
the exposed position of the bicipital   
bursa 7bursa-intertubercularis7 it is   
occasionally injured4 ,blows and        
injuries received in runaway accidents  
do serious injury to the bursa and      
because of the peculiar and important   
part it plays during locomotion1 serious
 injuries are not likely to resolve1 and
 too often chronic lameness results4 ,it
 is to be noted that the tendon of the  
biceps brachii 7flexor brachii7 is      
always involved in cases of inflammation
 of the bicipital bursa1 and according  
to the late ,dr4 ,bell#h strain of the  
biceps brachii is a frequent cause of   
lameness in city horses1 more frequent  
than is generally supposed4             
,pathological ,anatomy4--,more or less  
destruction of the cartilaginous portion
 of the bursa1 sometimes involving the  
tendinous portion of the biceps1 takes  
place and1 according to ,moller1 in some
 instances there occurs ossification of 
the tendon4 ,autopsies in some old      

horses reveal the presence of erosions  
of cartilage and hyperthrophy of the    
inflamed parts4  ,symptoms4--,in acute  
inflammations1 there is always marked   
lameness4 ,this is manifested to a      
greater degree when the subject advances
 the affected leg4 ,there is incomplete 
advancement of the member2 the toe is   
dragged when the horse is made to walk  
and the foot kept in a position         
posterior to the opposite or weight     
bearing foot while the subject is at    
rest4 ,lameness is disproportionate to  
the amount of local manifestation in the
 way of heat1 swelling and pain that is 
to be recognized on palpation4 ,in fact1
 in some cases so much pain attends the 
condition that no weight is borne by the
 affected member1 and when compelled to 
walk1 the subject hops on the sound leg4
  ,chronic inflammation of the bicipital
 bursa is occasionally met with wherein 
both members are affected4 ,because of  
the nature of the structures involved1  
when inflamed1 chronic inflammation is a

 more frequent termination than is      
complete recovery4 ,bilateral affections
 are seen in horses that are driven for 
years1 regularly at a fast pace on paved
 streets4 ,in such cases1 the gait is   
stilted1 that is1 there is incomplete   
advancement of both members and1 of     
course1 the period of weight bearing is 
correspondingly shortened2 hence the    
short strides4  ,in chronic cases1      
little if any evidence of inflammation  
is to be detected by digital            
manipulation of the parts4 ,if flinching
 occurs1 one is often unable to         
interpret the manifestation as to       
whether it is due to inflammation or    
not4  ,there is no marked warming out in
 this condition1 and animals are nearly 
as lame after having been driven a      
considerable distance as when started1  
although the lameness is not as a rule  
very great4  ,treatment4--,in very      
painful cases acute inflammation is     
treated by employing cold applications  
during the initial stage4 ,cracked ice  

when contained in a suitable sack may be
 held in contact with the affected part 
and the pack is supported by means of   
cords or tapes as suggested in the      
discussion on treatment of              
scapulohumeral arthritis on page #ff4   
,later1 hot applications may be employed
 to good advantage4  ,in the course of  
ten days or two weeks1 if the acute     
painful condition has entirely subsided1
 vesication is indicated4 ,the ordinary 
mercury and cantharides combination does
 very well4 ,depending upon the course  
taken in any given case1 one is guided  
in the treatment employed4 ,if prompt   
resolution comes to pass1 the subject   
may be given free run at pasture after  
three or four weeks confinement in a box
 stall4 ,if1 however1 the case does not 
progress in a prompt and satisfactory   
manner1 absolute quiet must be enforced 
for six weeks or more4 ,repeated        
blistering is beneficial1 although it is
 doubtful if firing is of sufficient    
benefit in the average chronic case of  

intertubercular bursitis to justify the 
punishment which this form of treatment 
inflicts1 unless infliction of pain is  
the thing sought1 to enforce repose in  
restless subjects4 ,patients are best   
given a long rest at pasture and        
returned to work for two or three months
 after an acute attack of inflammation  
of the bursa1 lest the condition become 
chronic4 ,when due consideration is     
given the pathology of such cases1 the  
frequent unsatisfactory termination     
under the most careful treatment1 is    
readily understood4   ,contusions of the
 ,triceps ,brachii4 7,triceps ,extensor 
,brachii3 ,caput ,muscles47             
,anatomy4--,the triceps brachii is the  
principal structure which fills the     
space between the posterior border of   
the scapula and the humerus4 ,the       
several heads originate for the most    
part on the border of the scapula1 the  
deltoid tuberosity of the humerus and   
the shaft of the humerus4 ,insertion of 
this large muscular mass is effected by 

means of several tendons to the         
olecranon4 ,a synovial bursa is situated
 underneath the tendinous attachment of 
the posterior portion of the triceps    
brachii--the long head or caput magnum4 
,the function of the triceps as a whole 
is to flex the shoulder joint and extend
 the forearm4 ,the triceps brachii is   
the chief antagonist of the biceps      
brachii4  ,etiology and                 
,occurrence4--,owing to the exposed     
position of this structure1 it is not   
infrequently contused1 the result of    
falls1 kicks and other injuries4 ,the   
function of the triceps is such that it 
becomes strained upon rare occasions    
when a horse resists confinement of     
restraint in such manner that the parts 
are unduly tensed in contraction4 ,this 
sort of resistance may stretch the      
radial nerve or its branches in a way   
that paralysis results4 ,a condition    
known as dropped elbow is described by  
,henry ,taylor1 ,f4,r4,c4,v4,s41 in the 
,veterinary ,record#i1 wherein a        

two-year-old colt while resisting       
confinement was so injured4  ,the       
triceps group because of its convenient 
location1 constitutes the site for      
hypodermic injection of drugs and       
biologic agents1 with some              
practitioners2 and as a result1 more or 
less inflammation may occur4 ,the author
 has observed and treated some twenty   
cases where an intensely painful        
infectious inflammation of the triceps  
brachii was caused by the intramuscular 
injection of a caustic solution by a    
cruel and unscrupulous empiric1 whose   
object was to increase his practice4    
,symptomatology4--,as the triceps       
brachii is not particularly taxed during
 weight bearing in the subject at rest1 
there may be no unnatural position      
assumed during inflammation of the      
triceps4 ,more or less swelling and     
supersensitiveness is always present1   
however1 and great care and             
discrimination must be exercised in     
digital manipulation of the triceps     

region because many animals are normally
 sensitive to palpation of these parts4 
,it is sometimes difficult to correctly 
interpret the true state of conditions  
because of this peculiarity4  ,there is 
always swinging-leg-lameness1 which is  
accentuated when the subject is urged to
 trot4 ,where symptoms are pronounced1  
it is unnecessary to cause the subject  
to move at a faster pace than at a walk 
to recognize the condition4 ,the forward
 stride is shortened and in extremley   
painful conditions1 no attempt is made  
to extend the leg4 ,it is simply carried
 en une piece--flexion of the shoulder  
and elbow joints is carefully avoided4  
,treatment4--,during the early stage of 
inflammation1 hot or cold applications  
are beneficial4 ,long continued use of  
moist heat--fomentations--allays pain   
and stimulates resolution4 ,keeping in  
contact with the painfully swollen parts
 a suitable bag filled with bran1 which 
can be moistened at intervals with warm 
water1 constitutes a practical and easy 

means of treatment4 ,by employing this  
method1 one is more likely to succeed in
 having his patient properly cared for1 
in that less work is entailed than if   
hot fomentations are prescribed4  ,after
 the acute and painful stage has        
subsided1 a stimulating liniment is of  
benefit4 ,the subject should be kept    
within a comfortable and roomy box stall
 for a sufficient length of time to     
favor prompt resolution4 ,wild and      
nervous subjects1 if not so confined1   
will probably overexert the affected    
parts if allowed the freedom of a       
paddock or pasture4  ,where the         
inflammation becomes infective1 surgical
 interference is necessary4 ,the prompt 
evacuation of pus1 with adequate        
provision for wound discharge1 should be
 attended to before extensive           
destruction of tissue takes place4      
,resolution is prompt as a rule in such 
cases because of the vascularity of the 
structures and the ease with which      
proper drainage may be effected4 ,no    

special after-care is necessary if      
drainage is perfect1 except that one    
should avoid injecting the wound cavity 
with aqueous solutions unless it be     
absolutely necessary to cleanse such    
cavity1 and then it is best to swab the 
wound rather than to irrigate it freely4
   ,shoulder ,atrophy4 7,sweeny or      
,swinney7  ,no satisfactory             
consideration of the pathogeny of this  
condition is recorded1 but practitioners
 have long distinguished between        
muscular atrophies which are apparently 
caused without doing serious injury to  
nerves and muscular atrophy which seems 
to be due to nerve affection4 ,in the   
first instance1 recovery when proper    
attention is given1 is prompt2 whereas1 
in the latter1 regeneration of the      
wasted tissues requires months in spite 
of the best sort of treatment4  ,the    
parts more frequently affected are the  
supra- and infrascapularis 7antea- and  
posteaspinatus7 muscles4 ,but in some   
cases the triceps group is involved2    

however1 this occurs in unusual and     
chronic affections4 ,no doubt1 these    
chronic cases are due to suspended      
innervation and are not to be classed   
with the ordinary case of atrophy of the
 abductor muscles of the humerus 7supra-
 and infraspinatus7 as in the usual case
 of sweeny4  ,occurrence4--,shoulder    
atrophy such as the general practitioner
 commonly meets with1 is an affection1  
more often seen in young animals and it 
seems to be due to injuries of various  
kinds which contuse the muscles of the  
shoulder4 ,ill-fitting collars and      
pulling in a manner that there occurs   
side draft with unusual strain on the   
muscles of one side of the neck and     
shoulder1 seem to be the more frequent  
causes of this trouble4 ,blows such as  
are occasioned by kicks and falls       
frequently result in atrophy of shoulder
 muscles4  ,course4--,in some cases a   
rapidly progressive atrophy             
characterizes the case and lameness and 
atrophy appear at about the same time4  

,the affection in such instances does   
not recover spontaneously but           
constitutes a condition which requires  
prompt and rational treatment so that   
function may be fully restored to the   
parts involved4  ,occasionally one may  
observe cases where there is but slight 
atrophy2 where the disease progresses   
slowly and atrophy is not extensive or  
marked4 ,in vigorous young animals that 
are left to run at pasture when so      
mildly affected1 spontaneous recovery   
occurs4  ,symptomatology4--,lameness is 
the first manifestation of shoulder     
atrophy1 and in many cases where        
lameness is slight1 the veterinarian may
 fail to discover the exact nature of   
the trouble if he is not very proficient
 as a diagnostician of lameness or if he
 is careless in taking into             
consideration obtainable history1 age of
 the subject1 etc4 ,because of the fact 
that the average layman believes that   
practically every case of fore-leg      
lameness wherein it is not obvious that 

the cause is elsewhere1 is due to a     
shoulder affection of some kind1 we may 
be too hasty in giving the client       
assurance that no sweeny exists4 ,in    
some of these cases where a diagnosis of
 shoulder lameness has been made and the
 client has been assured that no sweeny 
exists1 the patient is returned in about
 a week and there is then marked atrophy
 of one or both of the spinatus muscles4
  ,a mixed type of lameness             
characterizes this affection1 and in the
 average case there exists little       
evidence of local pain4 ,the salient    
points in recognizing the condition are 
a consideration of history if           
obtainable2 age of the subject2 finding 
slight local soreness1 by carefully     
manipulating the muscles which are      
usually involved2 noting the character  
of the lameness if any is present2 and  
where atrophy is evident1 of course1 the
 true condition is obvious4             
,treatment4--,subcutaneous injections of
 equal parts of refined oil of          

turpentine and alcohol1 with a suitable 
hypodermic syringe1 is a practical and  
ordinarily effective treatment4 ,from   
five to fifteen cubic centimeters 7the  
quantity varies with the size of the    
animal71 of this mixture is injected    
into the atrophied parts at different   
points1 taking care to introduce only   
about one to two cubic centimeters at   
each point of injection4 ,the syringe   
should be sterile and1 needless to say1 
the site of injections must be          
surgically clean4  ,other agents1 such  
as tincture of iodin1 solutions of      
silver nitrate1 saline solutions and    
various more or less irritating         
preparations have been employed2 but in 
the use of these preparations one may   
either fail to stimulate sufficient     
inflammation to cause regeneration to   
take place1 or infection is apt to      
occur4 ,where suppuration results1      
surgical evacuation of pus must be      
promptly effected else large suppurating
 cavities form4  ,the employment of     

setons constitutes a dependable method  
of treatment of shoulder atrophy1 but   
because of the attendant suppurative    
process which inevitably results1 this  
method is not popular with modern       
surgeons and is a last resort procedure4
  ,after-care4--,regular exercise such  
as the horse usually takes when at      
pasture1 is very helpful in treating    
atrophy1 and in some cases it has been  
found that no reasonable amount of      
irritation would stimulate muscular     
regeneration2 but by later allowing     
patients to exercise at will1 recovery  
took place in a satisfactory manner4 ,no
 special attention is ordinarily        
necessary4   ,paralysis of the          
,suprascapular ,nerve4  ,anatomy4--,the 
suprascapular 7anterior scapular7 nerve1
 a small branch of the brachial plexus1 
is given off from the anterior portion  
of this plexus4 ,the nerve rounds the   
anterior border of the neck of the      
scapula1 passing upward and backward    
under the supraspinatus 7antea-spinatus7

 muscle and terminating in the          
infraspinatus 7postea-spinatus7 muscle4 
,etiology and ,occurrence4--,as the     
result of direct injury to this nerve by
 contusion such as may be received in   
runaway accidents1 collar bruises1      
especially collar bruises in young      
horses that are not accustomed to       
pulling and that walk in a manner to    
cause side draft1 injury to the nerve   
occurs1 and partial or complete         
paralysis supervenes4 ,some writers     
state that it may be produced by        
confining an animal in recumbency1 with 
the casting harness4 ,the common cause  
of paralysis or paresis of this nerve in
 cases such as one observes in country  
practice1 is bruises from the collar in 
colts that are put to heavy farm work or
 where ill fitting collars are used4    
,symptomatology4--,with partial or      
complete suspension of function of the  
suprascapular nerve there results       
enervation of the supraspinatus and     
infraspinatus muscles4 ,since these     

muscles act as external lateral         
ligaments of the scapulohumeral joint1  
when they are incapacitated1 there      
naturally follows more or less abduction
 of the shoulder when weight is borne4  
,in extreme cases1 as soon as the ailing
 animal is caused to support weight with
 the affected member1 the joint is      
suddenly thrown outward in a manner that
 the average layman at once concludes   
that there must be scapulohumeral       
luxation1 and the veterinarian receives 
a call to see a case wherein the        
shoulder is out of place4 ,there exists1
 however1 no luxation in such cases4    
,if serious injury is done the nerve so 
that it undergoes degenerative changes1 
there will result atrophy of the muscles
 that derive their nerve supply from the
 suprascapular nerve4  ,illustration3   
,fig4 #g--,paralysis of the             
suprascapular nerve of the left shoulder
  ,treatment4--,during the first few    
days following injuries which result in 
this form of paralysis1 it is well to   

keep the subject inactive1 and if much  
inflammation of the injured structures  
contiguous to the nerve exists1 the     
application of cold packs is beneficial4
 ,later1 as soon as acute inflammation  
has subsided1 vesication of a liberal   
area around the anteroexternal part of  
the scapulohumeral joint and over the   
course of the suprascapular nerve1 will 
stimulate recovery in favorable cases4  
,as a rule1 in mild cases1 the subject  
is in a condition to return to work in  
two or three weeks4   ,radial           
,paralysis4  ,described under the titles
 of ,radial ,paralysis and ,brachial    
,paralysis1 there is to be found in     
veterinary literature a discussion of   
conditions which vary in character from 
the almost insignificant form of paresis
 to the incurably affected conditions   
wherein the whole shoulder is completely
 paralyzed4  ,when one considers the    
anatomy of the brachial nerve plexus and
 the distribution of its various        
branches1 the location of this plexus   

and its proximity to the first rib1 and 
the inevitable injury it must suffer in 
fracture of this bone1 together with the
 inaccessibility of the plexus1 it is   
not strange that a correct diagnosis of 
the various affections of the brachial  
plexus and the radial nerve is often    
impossible until several days or weeks  
have passed4 ,and1 in some instances1   
diagnosis is not established until an   
autopsy has been performed4 ,here1 too1 
we fail to find cause for paralysis in  
some rare instances4  ,anatomy4--,the   
radial nerve is a large branch of the   
brachial plexus and is chiefly derived  
from the first thoracic root of the     
plexus and is here situated posterior to
 the deep brachial artery4 ,it is       
directed downward and backward under the
 subscapularis and teres major muscles1 
rounding the posterior part of the      
humerus1 and passing to the anterior and
 distal end of the humerus1 it finally  
terminates in the anterior carpal       
region4 ,the radial nerve supplies      

branches to the three heads of the      
triceps brachii1 to the common and      
lateral extensors of the digit and also 
to the skin covering the forearm4       
,etiology and ,occurrence4--,nothing    
definite is known about the cause of    
some forms of radial paralysis4         
,however1 radial paralysis is           
encountered following injury to the     
nerve occasioned by its being stretched1
 as in cases where the triceps brachii  
is unduly extended in restraining       
subjects by means of a casting harness4 
,berns#aj states that in confining      
horses on an old operating table where  
it was necessary to draw the affected   
foot forward twenty-four to thirty-six  
inches in advance of its fellow1 which  
was secured in a natural vertical       
position1 radial paralysis of a mild    
form was of frequent occurrence4        
,country practitioners1 in restraining  
colts by casting with harness or ropes1 
occasionally observe a form of paresis  
wherein the radial nerve suffers        

sufficient injury that there is caused a
 temporary loss of function of the      
triceps brachii4 ,such cases recover    
within three or four days and are not a 
true paralysis1 but nevertheless        
constitute conditions wherein normal    
nerve function is temporarily suspended4
  ,illustration3 ,fig4 #h--,radial      
paralysis4  ,symptoms4--,immediately    
subsequent to injuries which involve the
 radial nerve1 there is manifested more 
or less impairment of function4         
,remembering the structures supplied by 
the radial nerve and its branches1 one  
can readily understand that there should
 occur as ,cadiot#aa has stated3        
,in complete paralysis1 the joints of   
the affected limb with the              
exception of the shoulder are usually   
flexed when the horse is      resting4  
,in consequence of loss of power in the 
triceps and      anterior brachial      
muscles1 the arm is extended and        
straightened on      the shoulder1 the  
scapulohumeral angle is open1 and the   

elbow      depressed4 ,the forearm is   
flexed on the arm by the contraction of 
the coracoradialis 7biceps brachii71    
while the metacarpus and      phalanges 
are bent by the action of the posterior 
antibrachial      muscles4 ,the knee is 
carried in advance1 level with1 or in   
front      of1 a vertical line dropped  
from the point of the shoulder4 ,the    
hoof is usually rested on the toe1 but  
when advanced beyond the      above     
mentioned vertical line1 it may be      
placed flat on the ground1      the     
joints then being less markedly bent4   
,when the limb as a whole      is       
flexed1 it may be brought into normal   
position by thrusting back      the knee
 with sufficient force to counteract the
 action of the      flexor muscles4     
,illustration3 ,fig4 #i--,merillat's    
method of fixing carpus in radial       
paralysis4 ,courtesy1 ,alex4 ,eger4     
,when made to walk1 the animal being    
unable to exert muscular action with the
 paralyzed structures1 limply carries   

the member as a whole1 and there is     
shortening of the anterior portion of   
the stride4 ,there being loss of        
function of the triceps brachii1 it is  
impossible for the subject to straighten
 the leg in the normal position for     
supporting weight2 therefore1 any       
attempt to bear weight results in       
further flexion of the affected member  
and the animal will fall if the body is 
not suddenly caught up with the sound   
leg4  ,differential ,diagnosis4--,in    
making examination of these cases1 one  
can exclude fracture by absence of      
crepitation and usually1 also1 swelling 
is absent in radial paralysis4 ,in a    
typical case of radial paralysis1 the   
affected leg can sustain its normal     
share of weight if placed in position1  
that is1 if the carpal joint is extended
 in such manner that the leg is         
positioned as in its normal             
weight-bearing attitude4 ,in brachial   
paralysis1 whether due to fracture of   
the first rib or to other serious       

injury1 it is impossible for the subject
 to support weight with the affected    
member even when it is passively placed 
in position4  ,no difficulty is         
ordinarily experienced in               
differentiating radial paralysis from   
muscular injuries to the triceps2 yet1  
in some cases of dropped elbow1 it is   
necessary to observe the progress of the
 case for ten days or two weeks before  
one can positively establish a          
diagnosis4       ,quoting ,merillat#ab3 
,when1 after four weeks1 there is no    
amelioration of the paralysis1 the      
muscles have atrophied1 and the         
patient has become emaciated from pain  
and discomfort1 the      diagnosis of   
brachial paralysis with fracture of the 
first rib may      then be announced4   
,prognosis4--,when no complete paralysis
 of the brachial plexus or no fracture  
of the first rib exists1 the majority of
 cases recover completely in from ten   
days to six weeks4 ,some writers claim  
that recoveries occur in ninety per cent

 of cases when conditions are favorable4
  ,treatment4--,when incomplete radial  
paralysis exists1 little needs be done  
except to allow the subject moderate    
exercise and to provide for its comfort4
 ,local applications1 stimulative in    
character1 are beneficial1 and the      
internal administration of strychnin is 
indicated4  ,in the cases where weight  
is not supported without the affected   
leg being passively placed in position1 
it is necessary to provide for the      
subject's comfort in several ways4      
,mechanical appliances such as braces of
 some kind in order to keep the affected
 leg in a position of carpal extension1 
constitute the essential part of        
treatment4 ,the leg is supported in such
 a manner that flexion of the carpus is 
impossible4 ,due regard is given to     
prevent chafing or pressure necrosis by 
contact of the skin with the            
braces--this may be done by bandaging   
with cotton4 ,the supportive appliance  
is kept in position for ten days or two 

weeks4 ,at the end of this time the     
brace may be removed and the subject    
given a chance to walk1 and improvement1
 if any exists1 will be evident4 ,when  
there is manifested an amelioration of  
the condition1 moderate daily exercise  
and massage of the affected parts are   
helpful4  ,should the subject be        
seriously inconvenienced by the         
application of a brace or other         
supportive appliances1 it is necessary  
to employ slings4 ,further1 if weight is
 supported entirely by the unaffected   
member1 laminitis may supervene if a    
sling is not used4   ,thrombosis of the 
,brachial ,artery4  ,thrombosis of the  
brachial artery or of its principal     
branches is of very rare occurrence in  
horses4  ,etiology4--,partial or        
complete obstruction of arteries        
7brachial or others7 occurs as the      
result of direct injury to the vessel   
wall from compression and tension of    
muscles and resultant arteritis2 lodging
 of emboli2 and parasitic invasion of   

vessel walls causing internal arteritis4
  ,symptomatology4--,if sufficient      
collateral circulation exists to supply 
the parts with blood1 no inconvenience  
is manifested while the subject is at   
rest4 ,where the lumen of the affected  
vessel is not completely occluded1 there
 may be no manifestation of lameness    
when the ailing animal is moderately    
exercised4 ,consequently1 the degree of 
lameness depends upon the extent of the 
obstruction to circulation2 and1        
likewise1 the course and prognosis      
depend upon the character and extent of 
such obstruction4  ,in severe cases1    
lameness is markedly increased by       
causing the animal to travel at a fast  
pace for only a short distance4 ,there  
are evinced symptoms of pain1 muscular  
tremors and sudation1 but the affected  
member remains dry and there is a marked
 difference of temperature between the  
normal areas and the cool anemic parts4 
,when the subject is allowed to rest1   
circulation is not taxed1 and there is a

 return to the original and apparently  
normal condition1 only to recur again   
with exertion4 ,this condition          
characterizes thrombosis4               
,treatment4--,in these cases1 little if 
any good directly results from any sort 
of treatment in the way of medication4  
,absolute rest is thought to be helpful4
 ,potassium iodid1 alkaline agents such 
as ammonium carbonate and potassium     
carbonate1 have been administered4      
,circulatory stimulants also have been  
given1 but it is doubtful if any good   
has come from medication4   ,fracture of
 ,humerus4  ,the shaft of the humerus1  
protected as it is by heavy muscles1 is 
not frequently fractured2 and fractures 
of its less protected parts1 as for     
example1 the head1 are complicated in   
such manner that resultant arthritis    
soon constitutes the more serious       
condition4  ,as a result of falls on    
frozen ground1 kicks or any other form  
of heavy contusion1 the humerus is      
occasionally broken4 ,it is rarely      

fractured otherwise4 ,because of the    
force of contusions usually required to 
effect humeral fracture1 the manner in  
which the bone is broken1 with respect  
to direction1 is variable4 ,often       
oblique fractures exist and occasionally
 there occurs multiple fracture4 ,in    
addition to the ordinarily serious      
nature of the fracture itself1 there is 
always much injury done the adjoining   
structures4  ,symptomatology4--,mixed   
lameness and manifestation of severe    
pain characterize this affection4       
,considerable swelling which increases1 
in some cases for a week or more1 is to 
be observed4 ,crepitation is readily    
detected1 if pain and swelling is not   
too great to prevent passive movement of
 the member4 ,where intense pain is not 
manifested1 because of manipulation1 one
 may abduct the extremity and thereby   
occasion distinct crepitation2 but when 
it is possible to recognize crepitation 
by holding the hand in contact with the 
olecranon while the animal is made to   

walk1 this method is to be preferred1 if
 the subject can move without serious   
difficulty4 ,the pathognomonic symptom  
here is recognition of crepitation1 but 
this may be very difficult to recognize 
in fracture of condyles1 and in such    
instances1 a careful examination is     
necessary4 ,gentle manipulation in a    
manner that pain is not aggravated will 
tend to inspire confidence on the part  
of the subject and relaxation of muscles
 will enable the operator to detect     
crepitation4  ,course and               
,prognosis4--,because of the direction  
of the long axis of the humerus1 with   
relation to the bony column of the      
extremity1 it is obvious that any       
lateral movement of the leg tends to    
rotate the shaft of this bone4 ,in      
fractures of the shaft of the humerus1  
then1 it is apparent that immobilization
 is very difficult if at all possible4  
,the proximity to the axillary lymph    
glands makes for easy dissemination of  
infection when the contused musculature 

becomes infected4 ,the adjacent brachial
 nerve plexus is so very apt to become  
involved1 if not actually injured at the
 time fracture occurs1 that paralysis is
 a probable complication4 ,consequently1
 it is logical to reason that because of
 the many possible serious              
complications1 such as shock1 occasioned
 by the injury and the distress and pain
 which this accident produces1 recovery 
must be the exception in fracture of the
 humerus4 ,however1 recoveries do take  
place and in addition to the reported   
recoveries by ,liautard1 ,moller1       
,stockfleth1 ,lafosse1 ,frohner and     
others1 we have instances cited by      
,american practitioners where cases     
resulted in recovery4 ,thompson#ac      
reports a good recovery in a #afjj-pound
 mare where there existed an oblique    
fracture of the humerus4 ,this mare was 
kept in slings for eight weeks4         
,walters#ad reports complete recovery in
 humeral fracture in a foal three days  
old4 ,the only treatment given was the  

application of a pitch plaster from the 
top of the scapula to the radius4 ,the  
colt was kept in a comfortable box stall
 and in about four weeks regained use of
 the leg4 ,complete recovery eventually 
resulted4 ,in the experience of the     
author1 recovery has not occurred in    
humeral fractures4  ,treatment4--,when  
animals are not aged and of sufficient  
value to justify treatment1 they are    
best supported in a sling1 if halter    
broken4 ,if subjects are nervous1 wild  
and unbroken1 it is possible to employ  
the sling1 if care is given to train the
 animal to this manner of restraint4    
,the presence of an attendant for a day 
or two will reassure such subjects so   
that even in these cases it may be      
practicable to employ the sling4        
,braces and other mechanical appliances 
intended to immobilize the parts are not
 of practical benefit in the horse4     
,unlike the dog1 the horse as yet has   
not been successfully subjected to      
tolerating rigid braces for the shoulder

 and hip4  ,everything possible must be 
done that will make for the patient's   
comfort4 ,if the subject turns out to be
 a good self nurse1 and the nature of   
the fracture is such that practical     
apposition of the broken ends of bone   
may be maintained1 recovery will occur  
in some cases4   ,inflammation of the   
,elbow4 7,arthritis47  ,affections of   
this articulation other than those which
 are produced by traumatism are rare4   
,this joint has wide articular surfaces1
 and securely joined as they are by the 
heavy medial and lateral ligaments      
7internal and external lateral          
ligaments71 luxation is practically     
impossible4 ,when luxation does occur1  
irreparable injury is usually done4     
,castagne as quoted by ,liautard#ae1    
reports a case of true luxation of the  
elbow joint in a horse where reduction  
was effected and complete recovery took 
place at the end of twenty-five days4   
,this is an unusual case4 ,the average  
practitioner does not meet with such    

instances4  ,anatomy4--,the condyles of 
the humerus articulate with the glenoid 
cavities of the radius and a portion of 
the ulna4 ,two strong collateral        
ligaments pass from the distal end of   
the humerus to the head of the radius4  
,the capsular ligament is a large1 loose
 membrane which encloses the articular  
portion of the humerus with the radius  
and ulna and also the radioulnar        
articulation4 ,it is attached anteriorly
 to the tendon of the biceps brachii    
7flexor brachii74 ,the capsule extends  
downward beneath the origin of these    
digital flexors4 ,this fact should be   
remembered in dealing with puncture     
wounds in the region1 lest an error be  
made in estimating their extent and an  
open joint be overlooked at the initial 
examination4  ,etiology and             
,occurrence4--,exclusive of specific or 
metastatic arthritis1 which is seldom   
observed except in young animals1       
inflammation of the elbow joint is      
usually caused by injury4 ,this         

articulation is not subject to          
pathologic changes due to concussion or 
sprains as occasioned by ordinary       
service1 but is frequently injured by   
contusion from falls1 blows from the    
wagon-pole and kicks4 ,wounds which     
affect the elbow joint1 then1 may be    
thought of in most cases1 as resultant  
from external violence4 ,they may be    
contused wounds or penetrant wounds4    
,sharp shoe-calks afford a means of     
infliction of penetrant wounds which may
 occasion open joint and infectious     
arthritis4  ,classification4--,a        
practical manner of classifying         
inflammation of the elbow is on an      
etiological basis4 ,eliminating the     
forms of elbow inflammation1 such as are
 caused by metastatic infection and     
other conditions which properly belong  
to the domain of theory of practice1 we 
may consider this affection under the   
classification of contusive wounds and  
penetrative wounds4                     
,symptomatology4--,any injury which is  

of sufficient violence to occasion      
inflammation of the elbow causes marked 
lameness and manifestation of pain4 ,the
 degree of lameness and distress        
manifested by the subject1 depends upon 
the nature and extent of the            
involvement4 ,a contusion suffered as   
the result of a fall1 which occasions a 
circumscribed inflammation of the       
structures covering this joint and where
 little inflammation of the articulating
 parts exists1 marked evidence of pain  
and lameness might be absent4 ,on the   
other hand1 if a true arthritis is      
incited1 there will be evident distress 
manifested1 such as hurried respiration1
 accelerated pulse1 inappetence1 mixed  
lameness1 local evidence of inflammation
 and particularly marked                
supersensitiveness of the affected      
parts4 ,considering these two extremes  
of manifested distress and injury1 one  
may readily conclude that in the        
frequently seen case1 wherein contusion 
has occasioned a moderate degree of     

injury1 prognosis is favorable and      
recovery ordinarily follows in the      
course of a few weeks' treatment4  ,in  
cases of arthritis due to penetrative   
wounds 7because of the important        
function of this joint and its large    
capsule1 which when inflamed discharges 
synovia in a manner that closure of such
 an open joint is seldom possible7 a    
very grave condition results4           
,treatment4--,inflammation of the elbow1
 such as is frequently seen in general  
practice where horses are turned out    
together and exposed to kicks and other 
injuries1 yields to treatment readily1  
if an open joint does not exist4  ,hot  
packs supported in contact with the     
elbow and kept around the inflamed      
articulation for a few days1 materially 
decrease pain and tend to reduce        
inflammation4 ,the subject must be kept 
quiet in a comfortable stall and1 if    
necessary1 a sling used4 ,where it is   
impossible for the animal to support    
much weight with the injured member the 

sling should be employed4  ,as          
inflammation abates1 which it does in   
the course of from one to three weeks in
 uncomplicated cases1 the subject may be
 allowed the freedom of a comfortable   
box stall4 ,vesication of the parts is  
in order1 and this may be repeated in   
the course of two weeks1 if it is deemed
 necessary4  ,penetrative wounds        
resulting in open joint are not treated 
with success as a rule1 and because of  
the handicap under which veterinarians  
labor1 methods of handling such cases1  
where large1 important articulations are
 affected1 are not being rapidly        
improved4 ,prognosis is usually         
unfavorable1 and for humane and economic
 reasons1 animals so affected should be 
destroyed4  ,ordinary wounds of the     
region of the elbow are treated along   
general lines usually employed4 ,they   
merit no special consideration1 except  
that it may be mentioned that with such 
injuries concomitant contusion of the   
parts occasions injury that does not    

recover quickly4   ,fracture of the     
,ulna4  ,etiology and                   
,occurrence4--,fractures of the ulna in 
the horse are not common in spite of the
 exposed position of the olecranon4     
,this bone when broken1 is usually      
fractured by heavy blows and any form of
 ulnar fracture is serious because of   
its function and position in relation to
 the joint capsule4 ,transverse         
fractures do not readily unite because  
of the tension of the triceps muscles1  
which prevent close approximation of the
 broken ends of the bone4  ,thompson#af1
 however1 reports a case of transverse  
simple fracture of the ulna in a mare1  
the result of a kick1 in which complete 
recovery took place4 ,he kept the       
subject in a sling for six weeks and    
then allowed six months rest4           
,symptomatology4--,the position assumed 
by a horse suffering from a transverse  
fracture of the ulna1 is similar to that
 in radial paralysis4 ,crepitation may  
be detected by manipulating the parts1  

and in some instances of fracture of the
 olecranon1 there occurs marked         
displacement of the broken portions of  
the bone4 ,lameness is intense and the  
parts are swollen and supersensitive4   
,the capsular ligament of the elbow     
joint is usually involved in the injury 
because fracture of the ulna may        
directly extend within the capsular     
ligament4 ,in such cases1 there is      
synovitis1 and later arthritis causes a 
fatal termination4  ,treatment4--,the   
impossibility of applying a bandage in  
any way to practically immobilize these 
parts in fracture of the ulna1 prevents 
our employing bandages and splints4     
,therefore1 one can do little else than 
to put the patient in a sling and try to
 keep it quiet and as nearly comfortable
 as circumstances allow4   ,fracture of 
the ,radius4  ,etiology and             
,occurrence4--,from heavy blows received
 such as kicks1 collision with trees or 
in falls in runaway accidents1 the      
radius is occasionally fractured4 ,in   

very young foals1 fracture of the       
radius1 as well as of the tibia and     
other bones1 results from their being   
trampled upon by the mother4            
,symptomatology4--,excepting in some    
cases of radial fracture of foals where 
considerable swelling has taken place1  
there is no difficulty in readily       
recognizing this condition4 ,the heavy  
brachial fascia materially contributes  
to the support of the radius1 and in    
cases where swelling is marked1         
crepitation may not be readily detected4
 ,in fact1 a sub-periosteal fracture may
 exist for several days or a week or    
more and then1 with subsequent fracture 
of the periosteum1 crepitation and      
abnormal mobility of the member are to  
be recognized4 ,in such cases1 the      
subject will bear some weight upon the  
affected member1 but this causes much   
distress4 ,in one instance the author   
observed a transverse fracture of the   
lower third of the radius which was not 
positively diagnosed until about ten    

days after injury was inflicted4 ,in    
this case1 without doubt1 the subject   
originally suffered a sub-periosteal    
fracture of the bone and because the    
animal was a good self nurse1 the       
brachial fascia supported the radius    
until the periosteum gave way and the   
leg dangled4 ,in this instance infection
 took place and suppuration resulted4   
,it was deemed advisable to destroy this
 animal4  ,prognosis4--,in adult        
animals1 radial fracture constitutes a  
grave condition2 generally speaking1    
prognosis1 in such cases1 is            
unfavorable4 ,because of the leverage   
afforded by the extremity1              
immobilization of the radius is         
difficult4 ,any sort of mechanical      
appliance1 which will immobilize these  
parts1 is likely to produce             
pressure-necrosis of the soft structures
 so contacted4 ,there is occasioned     
thereby much pain and the subject       
becomes restive1 unmanageable and       
sometimes the splints are completely    

deranged because of the animal's        
struggles1 and much additional injury to
 the leg is done4 ,occasionally1 an     
otherwise favorable case is thus        
rendered hopelessly impossible to       
handle1 and the subject must be         
destroyed several days after treatment  
has been instituted4  ,consequently1    
unless all conditions are good1 and the 
affected animal a favorable subject1    
young1 of good disposition1 and the     
fracture a simple transverse one1       
complete recovery is not likely to      
result from any practical means of      
handling4  ,treatment4--,mature subjects
 ought to be put in slings and kept so  
restrained throughout the entire time of
 treatment4 ,immobilization of the      
broken parts of the bone is the object  
sought4 ,this is attempted by           
practitioners who employ various        
methods1 and each method has its        
advocates4  ,casts are used by some and 
serve very well in many cases2 but      
because of their bulk and unyielding and

 rigid nature1 they are not well adapted
 to use on fractures of bones proximal  
to the carpus and tarsus4 ,this is in   
reference to plaster-of-paris casts or  
those of any similar material4          
,appliances which depend on glue or     
other adhesive substances combined with 
leather1 wood or fiber for their        
support1 are efficacious but not        
comfortable4  ,the use of heavy leather 
when the member has been suitably padded
 with cotton and bandages1 constitutes a
 very good manner of reducing fracture  
of the radius or of the tibia4 ,leather 
when cut to fit both the medial and     
lateral sides of a leg1 and firmly held 
with bandages1 will form a firm support 
that yields slightly to changes of      
position1 thus making for comfort of the
 subject4  ,such a splint or support    
should extend from the fetlock region to
 the elbow1 but the cotton and bandages 
are to reach to the foot4 ,when one     
considers that1 with the supportive     
appliance placed on each side of the    

affected member1 rigidity is            
accomplished as much from tensile strain
 put upon the leather as from its own   
stiffness1 it is seen that the leather  
need not be of the heaviest--sole       
leather is unnecessary4 ,because of the 
more comfortable immobilizing appliance1
 the subject is less restive1 and       
chances for a successful outcome are    
materially increased thereby4  ,in the  
mature subject1 six or eight weeks' time
 is required for union of the parts to  
occur sufficiently so that splints may  
be dispensed with4 ,rearrangement of the
 supportive apparatus1 however1 is      
possible and usually necessary during   
the first few weeks of treatment4 ,by   
employing care in handling the parts1   
the subject will be unlikely to do      
itself injury at the time readjustment  
of splints is being effected4  ,in      
foals1 it is best to give them the run  
of a box stall with the mother4 ,being  
agile1 they get up and lie at will      
without doing injury to the fractured   

member4 ,the splints 7leather is        
preferable in these cases also7 are     
looked after and readjusted as necessity
 demands4  ,three or four weeks time is 
all that is required for the average    
young colt to be kept in splints when   
suffering from simple transverse        
fracture of the radius4  ,compound      
fractures are necessarily more difficult
 to treat than are the simple variety1  
but even in such cases recovery results 
sometimes1 and the practitioner is      
justified in attempting treatment after 
having explained the situation to his   
client4  ,oblique fractures1 even when  
simple1 do not completely recover4      
,muscular and tendinous contraction1    
together with the natural tendency for  
the beveled contacting parts of the     
broken bone to pass one another in      
oblique fracture1 results in shortening 
of the leg and1 if union results1 a     
large callus usually forms4 ,where      
shortening of bones occur1 necessarily1 
permanent lameness follows4   ,wounds of

 the ,anterior ,brachial ,region4       
,etiology and ,occurrence4--,contusions 
and lacerations of the forearm are of   
frequent occurrence in horses and are   
troublesome cases to handle2            
particularly is this noticeable where   
extensive laceration of the parts       
occurs4 ,these injuries are caused by   
animals being kicked2 by striking the   
forearm against bars in jumping2 and in 
sections of the country where barbed    
wire is used to enclose pastures1       
extensive lacerated wounds are met with 
when horses jump into such fences4      
,symptomatology4--,any wound which      
causes inflammation of the structures of
 the anterior half of the forearm1 is   
characterized by swinging-leg-lameness4 
,depending upon the nature and extent of
 the injury1 manifestation varies4 ,in  
cases where laceration has practically  
divided all of the substance of the     
extensor tendons1 it is1 of course1     
impossible for the subject to advance   
the leg2 but where lacerated wounds     

involve only a part of the extensor     
apparatus of the foreleg1 not so much   
inconvenience is evident1 unless the    
wound is seriously infected and         
inflammation involves contiguous        
structures4 ,therefore1 in many         
instances1 lameness is more pronounced  
in contusions of the anterior brachial  
region than where tissues have been     
divided more or less keenly4  ,in every 
instance diagnosis is easily            
established4 ,the injury is quite       
evident1 and the manner of locomotion is
 not in itself an essential feature to  
be considered in a discussion of        
symptoms4 ,where a contusion of the     
anterior brachial structures occurs1    
there is1 in addition to lameness1      
swelling which is painful because of the
 pressure occasioned by the heavy       
non-yielding brachial fascia4 ,and where
 suppuration occurs1 there is then an   
intensely painful condition which is not
 relieved until pus has been evacuated4 
,rather frequently1 drainage for wound  

secretions is a difficult problem1 and  
approximation of the divided ends of    
muscles is always difficult to maintain4
  ,treatment4--,contused wounds of the  
anterior brachial region are treated    
along usual lines2 that is1 attempt is  
made to stimulate prompt resolution4    
,hot or cold applications are employed  
throughout the acute stage of the       
affection4 ,complete rest is provided   
for until all pain has subsided4 ,later1
 stimulating liniments are beneficial4  
,where no injury is done the periosteum 
or bone1 complete resorption of all     
products of inflammation usually occurs1
 though in many instances1 this is      
tardy--six weeks or more are sometimes  
required for recovery to take place4    
,if suppuration occurs1 it is necessary 
to provide for drainage as soon as it is
 possible to distinguish the presence of
 pus4 ,due regard is given the manner of
 establishing drainage because of the   
usual existence of sub-fascial fistulae4
 ,in these cases1 one avoids injecting  

solutions of aqueous antiseptics4 ,by   
gently compressing the parts1 pus is    
caused to drain out and in enforcing a  
moderate amount of exercise at a walk1  
when lameness is not intense1 drainage  
is maintained4 ,cotton packs1 moistened 
with hot antiseptic solutions1 and kept 
around the forearm for several hours    
daily1 are helpful because drainage is  
facilitated1 and resolution is          
stimulated by the increase of blood thus
 attracted to the parts1 and pain       
materially diminishes4  ,in lacerated   
wounds of the anterior brachial region1 
after having controlled hemorrhage1 an  
area around the wound margin is freed of
 hair by clipping or shaving4 ,the wound
 is carefully examined1 and the best    
site for drainage is selected and a     
suitable opening for wound discharge is 
provided for4 ,where the extensor       
carpiradialis 7metacarpi magnus7 with   
other structures1 is divided and the    
distal portion is torn downward1 as     
frequently is the case in barbed wire   

cuts1 it is necessary to make careful   
provision for drainage4 ,the wound is   
thoroughly cleansed by means of         
ablutions if necessary2 but preferably  
by swabbing with pledgets of cotton or  
gauze which are moistened in antiseptic 
solutions4 ,all shreds of macerated     
tissue are clipped with scissors and    
finally the whole wound surface is      
painted with tincture of iodin4  ,if    
drainage is made by cutting through the 
tissues in the median portion of the    
structures that have been displaced1 the
 opening should be packed with gauze so 
that it may remain patent after swelling
 has occurred4 ,such packing is left in 
situ for twenty-four hours4  ,the       
pendant muscular portions of tissues are
 sutured up by means of tapes and1 while
 perfect apposition is not ordinarily   
possible1 it is very essential to train 
the pendant tissues in their normal     
position even if they require resuturing
 within a week4 ,this minimizes         
granulation of tissue1 and there results

 less scar if the detached portions are 
kept near1 even if not in contact with  
the proximal wound margins4 ,the skin   
together with subcutaneous fascia is    
sutured on either side unless drainage  
is to be provided for on one side1 and  
the lowermost part of that side is left 
unsutured4  ,after-care4--,where        
extensive suturing of tissues has been  
necessary1 subjects must be kept quiet4 
,they are best confined in box stalls   
and not taken out for several weeks4    
,particularly is this true where        
transverse division of extensors has    
taken place4 ,sutures are removed at the
 end of from ten days to three weeks as 
cases permit4 ,drainage of wound        
secretions1 which usually become        
infected1 is necessary1 because with    
obstructed drainage in an infected wound
 of this kind1 there will result an     
early destruction of tissue at some     
point sutured4 ,daily irrigation done in
 a manner that practical asepsis is     
carried out1 is necessary for about a   

week4 ,all irrigation is done by way of 
the drainage opening1 and this with warm
 aqueous solutions of suitable          
antiseptics4 ,after a week or ten days' 
time1 the wound should not be dressed   
more frequently than twice weekly4  ,if 
it is necessary to leave a portion of   
the wound uncovered1 as in cases where  
skin is destroyed1 the frequent 7three  
or four daily7 application of a suitable
 antiseptic powder is necessary to check
 exuberant granulation4 ,this may be    
directly effected by the use of an      
astringent or desiccant preparation1 and
 such dressing serves as a mechanical   
protection as well4  ,when such wounds  
are kept clean1 where drainage is       
properly maintained1 and the subject    
kept quiet1 no particular attention     
other than the local application of an  
astringent lotion 7such as the zinc and 
lead lotion7 is necessary after the     
first three or four weeks4 ,usually1 if 
the animal gnaws at the parts or        
otherwise manifests evidence of         

discomfort1 it is an indication that new
 areas of infection are being           
established because of obstructed       
drainage or retained eschars4 ,a        
thorough cleansing of the wound with a  
two per cent solution of ,liquor        
,cresolis ,compositus and this followed 
by moistening every part of the wound   
with tincture of iodin1 will check all  
such disturbance if done promptly4      
,where practically all of the anterior  
surface of the radius has been denuded1 
recovery is tardy and there is in some  
cases imperfect extension of the leg for
 months after the wound has healed4 ,but
 in such instances1 animals gradually   
regain complete use of the affected     
member and in the course of a year      
function is fully restored4             
,inflammation and ,contraction of the   
,carpal ,flexors4  ,anatomy4--,the      
structures which are usually considered 
as true flexors of the carpus are a     
group of three muscles1 which have      
separate heads of origin and different  

points of tendinous insertion4  ,the    
flexor carpiradialis 7flexor metacarpi  
internus7 originates from the medial    
epicondyle of the humerus4 ,it is       
inserted to the proximal end of the     
medial metacarpal 7inner metacarpal or  
splint7 bone4 ,this muscle is the       
smaller of the three and is not usually 
divided in doing carpal tenotomy4  ,the 
flexor carpiulnaris 7flexor metacarpi   
medius7 has two heads of origin2 one1   
the larger1 originates from the         
epicondyle of the humerus and the other 
from the posterior surface of the       
olecranon4 ,the two heads unite at the  
upper third of the radius and the       
muscle1 becoming tendinous1 as is the   
case with the other carpal flexors1 is  
attached by one point of insertion to   
the accessory carpal bone 7trapezum74   
,the other blends with the posterior    
annular ligament of the carpus4  ,the   
ulnaris lateralis 7flexor metacarpi     
externus7 has its origin from the       
lateral epicondyle of the humerus and   

inserts to the proximal extremity of the
 fourth metacarpal 7outer splint7 bone  
and by another attachment to the        
accessory carpal bone 7trapezium7 with  
the tendon of the flexor carpiulnaris   
7flexor metacarpi medius74  ,acting     
together1 these muscles flex the carpus 
or extend the elbow and this action is  
antagonized by the biceps brachii       
7flexor brachii7 and extensors of the   
carpus and phalanges4  ,etiology and    
,occurrence4--,inflammation of the      
muscular or tendinous parts of the      
carpal flexors1 does not occur as       
frequently as does inflammation of the  
flexors of the extremity4 ,they are     
subject to injury such as is occasioned 
by hard work and concussion and contract
 as a result2 but1 more frequently a    
congenital malformation of the leg is   
responsible for undue strain upon these 
parts4 ,horses that are knee sprung or  
that have a congenital condition where  
in the anterior line1 as formed by the  
radius1 carpal and metacarpal bones1 is 

bent forward at the carpus1 are subject 
to inflammation and contraction of the  
carpal flexors4 ,when these flexors are 
contracted1 the condition is commonly   
known among horsemen as buck knee4 ,in  
itself1 inflammation of the carpal      
flexors is not a condition which is     
likely to prove troublesome1 but because
 of carpal involvement 7which is often  
present7 the cause of the trouble       
remains1 and inflammation of the carpal 
flexors recurs or becomes chronic and   
contraction of tendons results4         
,symptomatology4--,inflammation of the  
carpal flexors1 when acute and          
uncomplicated1 is characterized by a    
painfully swollen condition of the      
affected tendons4 ,no weight is borne   
upon the affected leg and the carpal    
joint is flexed4 ,mixed lameness is     
present4 ,there is no difficulty        
encountered in arriving at a diagnosis  
because of the very noticeably inflamed 
parts4  ,many fully developed cases of  
contraction of the tendons of the carpal

 flexors are observed where the         
condition has become established        
gradually and no lameness has resulted  
from tendinitis or carpitis4 ,in some of
 these cases1 subjects are stumblers and
 when they are carelessly handled or    
kept at fast work over irregular or hard
 roads1 chronic carpitis with           
hyperplasia of the structures of the    
anterior carpal region results1 owing to
 frequent bruising from falls4          
,illustration3 ,fig4 #aj--;,contraction 
of carpal flexors1 knee sprung4  ,where 
inflammation is caused by a puncture    
wound and subfascial infection occurs1  
there is evident manifestation of pain4 
,no weight is supported by the affected 
member and because of the pressure1     
occasioned by the swollen muscles       
confined within the non-yielding        
brachial fascia1 there exists marked    
supersensitiveness of the affected      
parts4 ,flexion of the elbow is avoided 
because contraction of the biceps       
brachii 7flexor brachii7 or the         

extensors1 which are antagonists of the 
flexors of the carpus1 tenses the carpal
 flexors and pain is thereby increased4 
,however1 in most instances1 the        
practitioner's attention is not directed
 to typical and uncomplicated cases1 but
 to subacute or chronic inflammations   
which are often attended with           
contraction of the tendinous parts of   
the carpal flexors1 and in such cases   
carpitis is present4 ,animals so        
affected have lost the rigidity which   
characterizes the normal carpal joint   
when the leg is a weight bearing member1
 and because of its sprung condition1   
the leg trembles when supporting weight4
  ,treatment4--,acute inflammation is   
treated by means of local application of
 cold or hot packs until the pain and   
acute stage of inflammation has subsided
 and later stimulating liniments are    
indicated4 ,absolute quiet must be      
enforced4 ,especially where the carpus  
is involved must the subject be kept    
quiet until all evidence of inflammation

 has subsided4  ,the application of     
vesicants or line-firing is beneficial  
in subacute inflammation of the tendons 
of the carpal flexors4 ,where           
contraction of tendons exists and no    
osseous or ligamentous change prevents  
correction of the condition1 tenotomy is
 necessary4 ,the reader is referred to  
,merillat's ,veterinary ,surgery#ag for 
a good description of the technic of    
this operation4  ,in all serious cases  
of inflammation of the carpal flexors1  
whether tenotomy has been performed or  
not1 the subject needs a long period of 
rest subsequent to treatment4 ,in fact1 
three or four months at pasture is      
necessary to permit of recovery and this
 where no congenital deformity has      
predisposed the subject to such         
affection of the flexors4 ,return to    
work must be gradual and the character  
of the work such as to enable the animal
 to become inured to service without a  
recurrence of the trouble if possible4  
,it follows then1 that tenotomy1 here as

 in other cases1 is not practical from  
an economic viewpoint1 unless the animal
 be of sufficient value to justify the  
long period of rest for recovery4       
,tenotomy is not of practical benefit   
unless ample time is allowed for        
regeneration of divided tendinous       
tissue4   ,fracture and ,luxation of the
 ,carpal ,bones4  ,etiology and         
,occurrence4--,fracture of the carpal   
bones is of infrequent occurrence in    
horses and1 when it does occur1 it is   
usually due to injuries1 and because of 
their nature 7resulting as they         
generally do from heavy falls or in     
being run over by street cars or        
wagons71 a comminuted fracture of one or
 more bones exists4 ,the accessory      
carpal bone 7trapezium7 is said to be   
fractured at times without being        
subjected to blows or like injuries1 but
 this is exceptional4  ,luxations of the
 carpal joint are of rare occurrence1   
and very few cases of this kind are on  
record4 ,walters#ah reports a case of   

carpometacarpal luxation in a pony      
wherein reduction was spontaneous and an
 uneventful recovery followed4 ,his     
reason for reporting the case1 as he    
states1 is its rarity4                  
,symptomatology4--,fractures of the     
carpal bones as they usually take place 
are diagnosed without difficulty4       
,because of their usually being         
comminuted1 abnormal movement of the    
joint is possible4 ,such movement is not
 restricted and flexion of the leg at   
the carpus in any direction is possible4
 ,crepitation is readily detected and   
frequently these fractures are of the   
compound-comminuted variety4  ,in       
fracture of the accessory carpal bone   
7trapezium7 or in fracture of any other 
single bone when such exists1 there is  
no increase in the movement of the      
joint4 ,the accessory carpal bone may be
 readily manipulated and when fractured1
 its parts are more or less displaced4  
,recognition of fracture of any other   
single carpal bone must be done by      

detecting crepitation unless it be a    
compound fracture1 whereupon probing is 
of aid in establishing a diagnosis4     
,carpal luxation when present is to be  
recognized by finding the apposing      
carpal bones joined in an abnormal      
manner--that is1 out of position4 ,there
 is restricted or suspended function of 
the joint1 and in the cases recorded1 no
 difficulty has been experienced in     
making a diagnosis4 ,the carpometacarpal
 portion of the articulation is the part
 which is usually affected4  ,prognosis 
and ,treatment4--,there is no chance for
 complete recovery in the usual case of 
carpal fracture because of the fact that
 there results sufficient arthritis to  
destroy articular cartilage beyond      
repair4 ,in the average instance1       
because of arthritis which persists for 
a considerable length of time1 more or  
less ankylosis results4 ,at best1 one   
can only hope for partial recovery1 that
 is to say1 the member may regain its   
usefulness as a weight-supporting part1 

but because of restricted or abolished  
joint function1 locomotion is more or   
less difficult4 ,exostoses1 articular   
and periarticular1 occur and the carpus 
usually becomes a large immobile        
articulation4 ,there is danger of       
infection resulting in simple carpal    
fractures and1 needless to say1 in a    
compound-comminuted fracture of the     
carpus1 infection usually occurs and a  
fatal outcome is probable4  ,when       
treatment is instituted1 antiseptic     
precautions are taken in handling the   
compound fractures1 and in any case     
immobilization of the parts is sought4  
,here1 as has been previously pointed   
out1 it is best to employ leather       
splints1 so that a maximum degree of    
rigidity with a minimum of distress and 
inconvenience to the patient will       
result4 ,the leg must be bandaged from  
the hoof upward1 making use of a        
sufficient amount of cotton to ensure   
against pressure-necrosis4 ,the leather 
splints are placed mesially and         

laterally and1 of course1 need to extend
 as high as the proximal end of the     
radius4 ,subjects must be kept in slings
 until union of bones has become        
established1 and as a rule there will   
then exist marked ankylosis4  ,there is 
no particular difference in the handling
 of carpal luxation and dislocation of  
other bones4 ,where ligaments have not  
been destroyed to the extent that       
reduction is of no practical use1 the   
parts are kept immobilized1 if thought  
necessary4 ,later1 vesication of the    
whole pericarpal region is done and the 
subject allowed exercise at will4       
,carpitis4  ,etiology and               
,occurrence4--,inflammation of the      
carpus is caused by contusions1 such as 
are occasioned in falling1 by kicks by  
striking the carpus against objects in  
jumping and sometimes by striking it    
against the manger in pawing4 ,the      
condition is of rather frequent         
occurrence4  ,symptomatology4--,evident 
symptoms of inflammation in carpitis are

 always present--hyperthermia1          
supersensitiveness and swelling4 ,also1 
there exists lameness which is          
characterized by an apparent inability  
to flex the leg1 and there is           
circumduction of the leg as it is       
advanced because in this way little if  
any flexion of the carpus 7which        
increases pain7 is necessary4           
,depending upon the nature of the cause1
 there occurs a marked difference in the
 character and amount of swelling4      
,illustration3 ,fig4 #aa--,pericarpal   
inflammation and enlargement due to     
injury4  ,naturally1 when much          
extravasation of serum and blood takes  
place1 there is occasioned a fluctuating
 swelling which is usually less painful 
to the subject upon manipulation than is
 a dense inflammatory change without    
marked extravasation4  ,in acute        
carpitis1 there is present1 then1 a very
 painful condition which involves the   
articulation1 causing marked lameness1  
disturbance of appetite and some        

elevation of temperature4  ,chronic     
cases do not occasion serious pain or   
constitutional disturbances1 but do     
interfere with locomotion in direct     
proportion to the existing articular    
inflammation and periarticular          
hypertrophy of ligamentous and tendinous
 structures4  ,treatment4--,if possible1
 keep the subject absolutely quiet1     
employing the sling if necessary4       
,during the first stages of             
inflammation1 the application of ice    
packs to the affected parts1 is of      
marked benefit4 ,at the end of          
forty-eight hours1 hot applications may 
be used and this treatment continued    
throughout several days4 ,anodyne       
liniments are of service and should be  
employed throughout the acute stage of  
inflammation during intervals between   
the hydrotherapeutic treatments4  ,as   
inflammation subsides1 a                
counterirritating application such as a 
suitable liniment and later blistering  
or line-firing is helpful in stimulating

 resolution4  ,illustration3 ,fig4      
#ab--;,hygromatous condition of the     
right carpus1 also distension of sheaths
 of extensor tendons of both fore legs4 
,open ,carpal ,joint4  ,anatomy4--,the  
carpal bones as they articulate with one
 another and with the radius and        
metacarpal bones1 as classed by         
anatomists1 form three distinct         
articular parts of the joint as a whole 
and are known as radiocarpal1           
intercarpal and carpometacarpal4 ,these 
three pairs of articulating surfaces are
 all enclosed within one capsular       
ligament4 ,on the anterior face of the  
bones1 the capsular ligament is attached
 to the carpal bones in such manner that
 an imperfect partitioning of the three 
joint compartments is formed4           
,posteriorly1 the capsule is very heavy 
and forms a sort of padding over the    
irregular surfaces of the bones1 and    
also its reflexions constitute the      
sheaths of the flexor tendons4 ,the     
anterior portion of the capsular        

ligament forms sheaths for the extensor 
tendons1 and both portions of the joint 
have an attachment around the distal end
 of the radius and another at the       
proximal end of the metacarpal bones4   
,illustration3 ,fig4 #ac--;,carpal      
exostosis in aged horse4  ,etiology and 
,occurrence4--,puncture wounds of any   
kind may serve to perforate the joint   
capsule and such traumatisms are        
occasioned by falls1 kicks and in       
various ways in runaway accidents1 and  
open carpal joint may follow4           
,symptomatology4--,the pathognomonic    
symptoms of the existence of an open    
joint is the exposure to view of        
articular surfaces of bones or noting   
the escape of synovia from the joint    
capsule4 ,as has been previously        
referred to1 there always exists a      
peculiar suspension of carpal flexion in
 all cases of carpitis4  ,non-infective 
wounds which may cause open joint are   
not necessarily productive of an active 
carpitis--a synovitis may be the extent 

of the disturbance4 ,unlike synovitis1  
which may characterize a non-infectious 
penetrative wound of the capsular       
ligament1 septic arthritis which may    
supervene is a very painful inflammatory
 disturbance4 ,it is characterized by   
all of the symptoms which attend the    
case of open joint and synovitis plus   
the obvious manifestation of great pain4
 ,there is an elevation of temperature  
of from two to five degrees above       
normal2 circulation is accelerated2 the 
pulse is bounding2 respiration is       
hurried2 there is an expression of pain 
as indicated by the physiognomy2 and    
because of rapid erosive changes of     
cartilages which take place1 there is   
soon so much of the articulation        
destroyed that death is inevitable4     
,death is usually due to generalization 
of the arthritic infection4             
,illustration3 ,fig4 #ad--;,exostosis of
 carpus resultant from carpitis4        
,illustration3 ,fig4 #ae--;,distal end  
of radius4 ,illustrating the effects of 

chronic carpitis4  ,in the meanwhile1 if
 the character of the infectious        
material is not so virulent1 the disease
 will take on a slower course and the   
subject may experience laminitis from   
supporting weight upon the sound member1
 or because of continued recumbency1    
decubital gangrene and emaciation       
sometimes cause death4 ,if the subject  
does not soon succumb1 it is compelled  
to undergo days or even weeks of        
unnecessary suffering1 and too often in 
such cases1 it is later deemed advisable
 to destroy the animal because of the   
cost of continuing treatment until the  
horse is serviceable4 ,therefore1 it is 
evident that when such joints as the    
carpus or tarsus are open and infection 
exists1 if they are not promptly treated
 and the infectious process checked1 it 
is neither humane nor practical to      
prolong treatment4  ,distinction must be
 made between the different joints when 
infected as the condition is much more  
serious in some cases than in others4   

,all things considered1 perhaps open    
joints rank1 with respect to being      
serious cases as follows3 elbow1        
navicular1 stifle1 tarsus1 carpus1      
fetlock and pastern4 ,this1 of course1  
is restricted to articulations of the   
locomotory apparatus4                   
,treatment4--,preliminary care in the   
treatment of an open carpal joint1 is   
the same as has been described in this  
condition as it affects the             
scapulohumeral articulation described on
 page #fe4 ,likewise the further        
treatment of such cases is along the    
same lines except that where it is      
possible1 the parts are kept covered    
with cotton and bandages4 ,however1 in  
some cases1 animals have been           
successfully treated without bandaging  
and by keeping the patient in a standing
 position and on pillar reins until     
recovery resulted4 ,such cases were of  
the non-infectious type and recovery was
 possible within three or four weeks4   
,further1 the condition is not          

sufficiently painful in such instances  
as to prevent the subjects bearing      
weight with the affected member2 hence1 
no danger of resulting laminitis is     
incurred4 ,and finally1 where bandages  
are not employed1 the frequent use of   
antiseptic dusting powders is           
substituted for cotton as a protector4  
,when bandaged1 such wounds need        
dressing more or less frequently1 as    
individual instances demand4 ,the       
purulent infective inflammation of a    
carpal joint will require daily         
dressing2 whereas1 in other cases       
7non-infective71 semi-weekly change of  
bandages is sufficient4 ,equal parts of 
boric acid and exsiccated alum          
constitute a suitable combination for   
the treatment of these cases1 and this  
powder should be liberally employed4    
,tincture of iodin may be injected into 
the joint capsule where there is        
provision for its ready evacuation1 as  
conditions seem to require4 ,daily      
injections for three1 four or five days1

 are not harmful and will control       
infection in many instances4   ,thecitis
 and ,bursitis4  ,etiology and          
,occurrence4--,the thecae and bursae of 
the leg are several in number4 ,in the  
carpal region1 the flexors of the       
phalanges are contained together in the 
carpal sheath1 and this is the principal
 theca in the carpal region4 ,each of   
the tendons is provided with synovial   
sheaths which are subject to            
inflammation and occasionally synovitis 
and distension of these synovial sheaths
 occur4  ,because of faulty             
conformation1 some animals are subject  
to inflammation of these sheaths1 and   
all forms of strenuous work which taxes 
the tendons greatly is apt to result in 
synovitis4 ,direct injury such as blows 
may be the cause of synovial distension 
of thecae and the affection is to be    
seen in all horses that have done much  
fast work on hard road surfaces or      
pavements4  ,the usual case as it occurs
 in practice is a non-infective         

synovitis1 but where puncture wounds    
cause the trouble1 an infectious        
inflammation obtains4                   
,symptomatology4--,no trouble is        
experienced in diagnosing distension of 
tendon sheaths1 for the affection is    
very palpable4 ,during acute            
inflammatory stages of this affection1  
some lameness is present--in infectious 
inflammation lameness is intense4 ,local
 heat and pain upon manipulation are    
readily discernible in all acute cases4 
,and finally1 where there is reason for 
doubt1 an aseptic exploratory puncture  
of the wall of the fluctuating          
enlargement may be made with a suitable 
trocar1 and the discharging synovia will
 be proof of the existence of synovial  
distension4  ,after the affection       
becomes subacute or chronic1 no lameness
 or inconvenience is manifested1 and the
 condition is undesirable only because  
of its being a blemish4                 
,treatment4--,acute non-infectious      
synovial distension of tendon sheaths is

 treated by aspirating as much synovia  
as possible from the affected theca     
7this is1 of course1 done under strict  
asepsis7 and by means of bandages1 a    
uniform degree of pressure is kept over 
the parts for ten days or two weeks4    
,the patient is kept quiet and in the   
course of two weeks an active blistering
 agent is employed over the region      
affected4 ,usually1 at the end of a     
month's time1 complete recovery has     
taken place and the subject may be      
gradually returned to work4  ,when      
synovial distensions are of long        
standing1 it is necessary to take       
special precautions to check excessive  
secretion of synovial fluid1 and1 also  
because of the atonic condition of the  
tissues affected1 resolution is tardy4  
,in addition to aspirating synovia1 the 
introduction of equal parts of alcohol  
and tincture of iodin into the theca is 
necessary4 ,the quantity of this        
combination injected1 depends upon the  
size of the sheath affected and the     

amount of synovia retained at the time  
injection is made4 ,experience is       
necessary to judge as to this part of   
the work1 but one may consider that a   
quantity between three and ten cubic    
centimeters of equal parts of tincture  
of iodin and alcohol constitutes the    
proper amount to employ4 ,where much    
synovia is contained within the sheath  
at the time of injection1 there occurs  
great dilution of the agent injected and
 consequently less irritation results4  
,the object of such injections is to    
check synovial secretion1 and this is   
sought by the local effect of iodin in  
contact with the secreting cells        
together with the reactionary swelling  
which occasions pressure4 ,an increase  
in the local blood supply also follows4 
,in all cases where it is possible to   
employ suitable bandages1 this should be
 done4 ,the ordinary derby bandages     
serve well and if their use is continued
 for a sufficient length of time1 good  
results follow4  ,there are other       

methods of treating these affections1   
and each has its advantages and         
disadvantages4 ,line-firing1 instead of 
the vesicant is made use of by some1 but
 the object desired is the same and     
results obtained are similar4  ,sheaths 
may be opened surgically by means of a  
knife1 and the removal of a portion of  
the wall of distended and atonic tendon 
sheaths is possible4 ,these operations  
belong to the realm of surgery and are  
not properly a part of this treatise4   
,however1 in passing1 it may be said    
that if a perfect technic is possible in
 doing the last named operation1 a      
permanent recovery is the outcome4      
,fracture of the ,metacarpus4  ,etiology
 and ,occurrence4--,as the result of all
 sorts of violence1 such as falls and   
injuries in accidents of various kinds  
wherein the metacarpals are subjected to
 contusions1 fractures may result4 ,in  
the horse it is unusual for fracture of 
one of the small metacarpal bones to    
take place without there being at the   

same time a fracture of the third       
7large7 metacarpal bone4                
,classification4--,fractures of the     
metacarpal bones as they occur1 are as  
likely to be compound as simple1 and the
 multiple and comminuted varieties are  
occasionally observed4 ,the manner in   
which the third 7large7 metacarpus is   
fractured1 largely determines the       
outcome in any given case4              
,symptomatology4--,abnormal mobility of 
the broken parts of bone and crepitation
 mark fracture of the metacarpus1 and   
the condition is easily diagnosed4 ,in  
many instances1 when compound fracture  
exists1 broken ends of bone are         
protruding through the skin4 ,no weight 
is borne upon the fractured member      
ordinarily1 although during the         
excitement occasioned by runaways1      
horses are sometimes seen to support    
weight with a broken leg even when the  
protruding bone is sunk into the ground 
in so doing4  ,prognosis4--,generally   
speaking1 fractures other than the      

simple-transverse in young animals1 are 
considered unfavorable cases4 ,with the 
metacarpus1 however1 there are instances
 where compound fracture occurs in colts
 that justify treatment4 ,but in all    
cases of compound fracture1 the element 
of infection in addition to the         
increased difficulty in maintaining     
immobility of the broken bone1 creates  
almost insuperable difficulties in the  
average instance4 ,and unless the       
practitioner distinctly explains to his 
client the various reasons which make   
treatment an economic impracticability1 
dissatisfaction is likely to follow if  
treatment is instituted without such an 
understanding4  ,treatment4--,perfect   
apposition of the broken ends of bone is
 easily effected and less difficulty is 
encountered in maintaining such         
relations in metacarpal fractures than  
in fractures of the radius4 ,however1   
reduction and immobilization of this as 
in all fractures1 must be done without  
delay4 ,in simple fracture1 the         

metacarpus is covered with enough cotton
 to pad the parts1 and this is retained 
in position by bandages4 ,splints of    
heavy leather or of thin pieces of tough
 flexible wood are placed on each side  
of the leg and firmly held in position  
with bandages4 ,bandages may be put on  
in layers and a coating of glue applied 
over each layer if this is thought      
necessary4 ,the advantage gained in     
using glue or other adhesive materials  
is that the cast thus formed is more    
rigid than where such material is not   
employed4 ,on the other hand1 all       
elasticity is lost as soon as the cast  
adapts itself to the contour of the     
extremity1 and because of this rigidity1
 it is doubtful if anything is gained by
 the incorporation of glue1 except in   
the way of added strength of the cast4  
,since the animal does not walk upon the
 broken leg1 it is possible to employ   
splints of suitable materials which are 
retained in position without glue and   
frequent readjustment of a part of the  

immobilizing apparatus is possible4     
,this is impossible with casts4  ,in    
compound fractures1 provision ought to  
be made for dressing the wound of the   
soft structures4 ,this entails adjusting
 the splints in such manner that one    
splint may be retained and others       
removed for dressing the wound and      
readjusted as often as wound dressing is
 necessary4   ,splints4  ,by this term  
is meant a condition where there exists 
an exostosis which involves usually the 
second 7inner small7 and third 7large7  
metacarpal bones4 ,while an exostosis   
involving any one of the splint bones1  
even when directly caused by an injury1 
is called a splint1 the term is employed
 here1 in reference to exostoses not due
 to direct injury such as in contusions4
  ,etiology and ,occurrence4--,this     
condition is one wherein there is       
osseous formation following a           
periostitis and the region of the upper 
portion of the second 7inner small7     
metacarpal bone is the usual site of the

 exostosis4 ,there is incited an        
inflammation of the periosteum at the   
site of the interosseous ligament which 
attaches the small to the large         
metacarpal bone4 ,this ligament is      
involved in the inflammatory process1   
and according to ,havemann1 whose view  
is supported by ,moller1 this           
inflammation is the origin of the       
trouble4  ,various theories attempting  
an explanation of the frequent affection
 of this one certain part so regularly  
involved have been offered1 but no proof
 of the correctness of any exists4 ,it  
follows1 however1 that splints occur in 
young animals2 that the affection seldom
 starts in subjects that are ten years  
of age or older1 and that when the      
exostosis has formed1 lameness usually  
subsides4 ,anything which will cause    
undue strain or irritation of the       
metacarpal bones in young animals1 is   
quite apt to result in a splint being   
formed4 ,concussion such as is caused by
 fast work on hard roads1 or work on    

rough or irregular road surfaces which  
cause unequal distribution of weight1   
will cause splint lameness and exostosis
 follows4  ,illustration3 ,fig4         
#af--,posterior view of radius 7right7  
illustrative of effects of splint4 ,note
 the extent of exostosis4               
,course4--,because of the peculiar      
manner in which the second and third    
metacarpal bones articulate in young    
animals1 until the bones become ossified
 and permanently joined1 the            
inflammation which attends the acute    
stage of this affection1 causes         
lameness4 ,later1 unless an unusually   
large exostosis is formed1 which may    
cause a constant irritation due to its  
size and juxtaposition to the carpus1   
lameness is discontinued4               
,symptomatology4--,lameness is usually  
the first manifestation of this         
disorder1 and the thing which           
characterizes splint lameness is its    
peculiar intermittence4 ,there is a     
mixed form of lameness which may not be 

in evidence when an affected animal is  
started on a drive1 but which is marked 
after the subject has gone some         
distance4 ,the animal may1 however1 go  
lame throughout the whole of a drive and
 continue to be lame for several days or
 weeks in some cases4 ,it is noticeable 
that lameness is augmented or produced  
when the subject travels on rough road  
surfaces and that little or no          
difficulty is encountered when roads are
 smooth4  ,the heavy brachial fascia is 
inserted in part to the head of the     
second metacarpal 7inner small7 bone    
together with the oblique digital       
extensor 7extensor metacarpi obliquus7  
and this explains the reason for pain   
being manifested during extension of the
 member4  ,before there is a visible    
exostosis1 supersensitiveness is readily
 recognized upon palpation of the parts1
 if careful comparison is made between  
the sound and unsound members4 ,however1
 frequently splints occur on both       
forelegs at the same time and in some   

instances exostoses are several in      
number upon each member affected4 ,in   
some instances1 the affection involves  
the outer splint bone and no evident    
involvement of the inner one exists4    
,treatment4--,at the onset complete rest
 should be provided and the local       
application of some good cataplasm is in
 order4 ,a stimulating liniment is      
beneficial when employed several times  
daily and massage is also quite helpful4
 ,later1 the application of a blistering
 ointment is good treatment4 ,the use of
 the actual cautery stimulates prompt   
resolution1 but there is seldom any     
resorption of products of inflammation  
following firing4 ,whereas1 in cases    
where other treatment is begun early1   
there usually follows considerable      
diminution in the size of the exostosis4
 ,a rest of four or five weeks is       
necessary and very young animals should 
not be put to work too soon1 if the     
character of the work is such as to     
induce a recurrence of the trouble4     

,many cases are treated successfully in 
draft types of animals 7where the       
subjects are not kept at work that      
occasions serious irritation to the     
affected parts7 by blistering the       
exostosis repeatedly and allowing the   
animals to continue in service4 ,in such
 cases1 it is unreasonable to expect to 
check the size of the exostosis and1 of 
course1 such methods are not employed   
where lameness causes distress to the   
subject4  ,firing usually causes prompt 
recovery from lameness and is a         
dependable manner of treating such cases
 but there remains more blemish         
following cauterization than where      
vesication is done4   ,,open ,,fetlock  
,,joint4  ,this condition1 because of   
the frequency with which it occurs may  
be taken as typal1 from the standpoint  
of treatment and results obtained       
therefrom4 ,while it serves to          
constitute a basis from which other     
joints1 when open1 are to be considered1
 due allowance must be made for the fact

 that1 as has been previously mentioned1
 some articulations when open constitute
 cause for grave consequences2 while    
with others an open capsule1 even when  
infected1 does not cause disturbance    
enough to be classed as difficult to    
handle4 ,moreover1 the fetlock joint is 
admirably suited1 anatomically1 to      
bandaging2 and when wounded1 is easily  
kept protected by means of surgical     
dressings4 ,this fact is of great       
importance in influencing the course and
 termination in any given case of open  
fetlock joint and should not be         
forgotten4  ,there is no logical reason 
for comparing the pedal joint with the  
pastern on the basis that it may also be
 completely and securely bandaged4 ,open
 navicular joint does not occur1 as a   
rule1 except by way of the solar surface
 of the foot1 and the introduction of   
active and virulent contagium is certain
 to happen2 consequently1 an acute      
synovitis quickly resulting in an       
intensely septic and progressively      

destructive arthritis soon follows in   
perforation of the capsule of the distal
 interphalangeal articulation4          
,etiology and ,occurrence4--,wounds of  
the fetlock region resulting in         
perforation or destruction of a part of 
the capsular ligament are caused by all 
sorts of accidents1 such as wire cuts1  
incised wounds occasioned by plowshares1
 disc harrows1 stalk cutters and other  
farming implements4 ,in runaways the    
joint capsule is sometimes punctured by 
sharp pieces of wood or other objects4  
,in horses driven on unpaved country    
roads the fetlock is occasionally       
wounded by being struck against the     
sharp end of some object1 the other end 
of which is firmly embedded in the      
ground4 ,in one instance the author     
treated a case wherein the fetlock joint
 was perforated by the sickle-guard of a
 self-binder4 ,in this case there       
occurred complete perforation causing   
two openings through the cul-de-sac of  
the joint4 ,such wounds are produced by 

implements which are1 to say the least1 
non-sterile1 and this perforation of the
 uncleansed skin conveys infectious     
material into the joint capsule4 ,yet in
 many instances1 especially in country  
practice1 no infectious arthritis       
results where cases are promptly cared  
for4  ,symptomatology4--,a difference in
 the character of symptoms is evidenced 
when dissimilar causes exist4 ,small    
penetrant wounds which infect the       
synovial membranes cause infectious     
arthritis in some cases1 whereas a wound
 of sufficient size to produce          
evacuation of all synovia will1 in many 
instances1 cause no serious distress to 
the subject1 even when not treated for  
several days4 ,if it is not evident that
 an open joint exists and the articular 
cavity is not exposed to view a positive
 diagnosis may be early established by  
carefully probing the wound4 ,in some   
cases where a small wound has perforated
 the joint capsule1 swelling and slight 
change of relation of the overlying     

tissues may preclude all successful     
exploratory probing4 ,in such instances 
it is necessary to await development of 
symptoms4 ,twenty-four hours after      
injury has been inflicted1 there is     
noticeable discharge of synovia which   
coagulates about the margin of the      
orifice1 where synovial discharge is    
possible4 ,particularly evident is this 
accumulation of coagulated synovia where
 wounds have been bandaged--there is no 
mistaking the characteristic            
straw-colored coagulum which1 in such   
cases1 is somewhat tenacious4  ,no      
difference exists between other symptoms
 in infectious arthritis caused by      
punctures1 and non-infectious arthritis1
 excepting the intensity of the pain    
occasioned1 the rise in temperature1    
circulatory disturbances1 etc42 all of  
which have been previously mentioned4   
,treatment4--,just as has been stated in
 discussions on the subject of open     
joint1 probing or other instrumentation 
is to be avoided until the exterior of  

the wound and a liberal area surrounding
 has been thoroughly cleansed--too much 
importance can not be placed on this    
preliminary measure4 ,in cases of open  
joint where ragged wound margins exist  
and the interior of the joint capsule is
 contaminated1 much time is required to 
thoroughly cleanse all soiled parts4 ,in
 some instances an hour's time is       
required for this cleansing process     
after the subject has been restrained   
and prepared4 ,in order to thoroughly   
cleanse these delicate structures       
without doing them serious injury1 one  
ought to be skillful and careful in all 
manipulations of the exposed parts of   
the joint capsule4  ,the general plan of
 treatment1 after preliminary cleansing 
has been accomplished1 has been outlined
 on page #ff in the consideration of    
scapulohumeral joint affections4 ,the   
injection of undiluted tincture of iodin
 in ounce quantities1 it must be        
remembered1 is not to be done unless    
there is provision for its free exit4   

,where good drainage from the joint     
cavity exists all infected wounds should
 be thus treated1 and this treatment may
 be repeated as conditions seem to      
require--until infection is checked4    
,if daily injections are necessary1     
dilution of the tincture of iodin with  
an equal amount of alcohol is advisable 
in order to avoid doing irreparable     
damage to the articular cartilages and  
synovial membranes4  ,an antiseptic     
powder composed of equal parts of boric 
acid and exsiccated alum is employed to 
protect the wound surfaces and the      
margins1 and the parts are then         
bandaged4 ,in bandaging wounds of this  
kind a liberal amount of cotton should  
be employed1 and after a large surface  
surrounding the wound has been          
thoroughly cleansed1 it must be so kept 
thereafter4 ,this is impossible1 if one 
uses a small amount of cotton1          
particularly if such meager quantity of 
dressing material is carelessly wrapped 
in position with an insufficient amount 

of bandage material4 ,mention1 without  
description of the elemental problem of 
applying cotton and bandages to a wound1
 would be sufficient1 were it not that  
this is a very important part of the    
handling of such cases1 and many        
practitioners are not only thoughtless  
in this part of their work1 but also    
apparently careless4 ,what does it      
profit to prepare a part and cleanse a  
wound with painstaking care and then    
neglect to take every possible          
precaution to prevent its subsequent    
contamination8  ,in the handling of open
 joint capsules where the perforation of
 the capsular ligament is small and     
discharge of synovia does not           
immediately follow1 there is presented a
 problem which is difficult to decide   
upon and that is the manner in which    
such wounds are to be handled4 ,one     
hesitates to enlarge such openings to   
drain or irrigate the capsule when there
 is no proof that serious trouble will  
follow because of infectious material   

which has probably been introduced at   
the time the wound was inflicted4 ,it is
 especially difficult to decide upon the
 manner of handling such cases where the
 tarsal joint is wounded1 although one  
hesitates to invade any joint to the    
extent of incising its capsule1 unless  
there is urgent need of so doing4       
,frost#ai offers the following          
suggestion in such instances3       ,the
 treatment recommended by us for open   
joints1 in which we wish      to prevent
 ankylosis1 is1 first1 to shave all hair
 from the area      surrounding the     
wound1 following with a thorough        
cleansing of the      skin and          
disinfection of the wound1 and then to  
inject a twenty per      cent ,lugol's  
solution in glycerin into the wound4    
,this should be      repeated two or    
three times a day1 each time enough of  
the solution      being injected to fill
 the joint capsule1 thereby securing the
      flushing effect4 ,as this solution
 does not cause irritation to the       

tissue and yet is a strong antiseptic1  
it serves to shorten the      period of 
congestion and inflammation and to      
overcome the infection      without     
causing a destruction of the secreting  
membrane until the      external wound  
has had time to heal4 ,the injection of 
this solution      seems to retard the  
excessive secretion of synovia4 ,the    
larger the      joint capsule and the   
smaller the external wound1 the longer  
our      antiseptic will remain in      
contact with the inflamed tissues as the
      glycerin1 being thick1 does not   
flow through a small opening4           
,after-care4--,following the initial    
cleansing and treatment of open joint1  
subsequent dressing is necessary as     
frequently as conditions demand4 ,if the
 parts are badly infected and profuse   
discharge of pus exists a daily change  
of dressings is necessary4 ,in the      
average instance1 however1 semi-weekly  
treatments are sufficient4 ,and in many 
instances where one is obliged to travel

 a considerable distance to handle the  
affected animal one weekly dressing of  
the wound will suffice after the second 
treatment4  ,the same general plan of   
treatment concerning the subject's      
comfort that has been previously        
mentioned in arthritis1 is carried out  
here4 ,a further and detailed           
consideration of the subject of handling
 of open joints follows4#bj       99 99 
99 ,such wounds may be classified in two
 general groups as      follows3 ,first1
 wounds in which the trauma has exposed 
the      articulation to view1 and      
second1 those the result of punctures1  
in      which the external wound is     
small and free drainage is lacking4     
,wounds in which the articulation is    
exposed to view have drainage           
either all ready provided for1 or it is 
established without      hesitancy      
surgically4 ,with free drainage thus    
established there is      little or no  
chance for the adjacent tissues to      
become infiltrated      with infected   

wound discharge4 ,this prevents an      
extension of the      injury and the    
establishment of a good field for the   
growth of      anaerobic bacteria4      
,open joints caused by punctures1 unless
 the puncture is aseptic1      produce a
 swelling which is more painful than is 
the open wound      which exposes the   
joint to view4 ,especially is this true 
if the      puncture is of small        
diameter1 allowing the tissues to       
partially      close the opening        
immediately after the wound has been    
made4 ,where      drainage is lacking   
there follows an exudation which        
congests the      tissues surrounding   
the injury and all factors favoring germ
 growth      are present4 ,it is perhaps
 advisable to establish good drainage in
      such cases as soon as a diagnosis 
is made4       ,it is not always an easy
 matter to recognize an open-joint1 when
      first made1 but twelve to         
twenty-four hours later there is no     
cause      for doubt4 ,the condition is 

then a very painful one2 lameness is    
excessive2 there is rise in temperature2
 acceleration of the pulse      and     
manipulation or palpation of the region 
affected1 occasions      great pain4    
,the treatment of open joints must be   
varied to suit the disposition      of  
the animal1 the nature and location of  
the injury1 the length of      time     
intervening between the infliction of   
the wound and the first      attention  
given1 and the surroundings in which the
 patient is kept4       ,in each and    
every case in which there exists an open
 wound the      surface surrounding the 
wound is cleansed thoroughly1 the hair  
is      shaved if possible1 and the     
margin of the wound is curretted and    
cleansed thoroughly with antiseptic     
solutions4       ,if there is evidence  
that the articulation contains infective
      material1 it is washed out with   
copious quantities of peroxide of       
hydrogen--usually as much as six or     
eight ounces4 ,this is followed      by 

injection of an ounce or two of tincture
 of iodin4 ,even though      the joint  
appears to be clean some tincture of    
iodin is used1 as it      checks the    
secretion of synovia and is1 in every   
way1 beneficial4      ,care is taken to 
apply the iodin also to the surface     
immediately      surrounding the wound4 
,the entire wound is then covered with a
      dusting powder composed of zinc   
oxide1 boric acid1 exsiccated alum1     
phenol and camphor4       ,this powder  
is used in abundance and the wound is   
then covered with      a heavy layer of 
absorbent cotton and well bandaged4     
,this bandage      is not disturbed for 
at least three days and may be left in  
place      for a week4 ,in cases in     
which it is necessary to keep the       
dressing      on for a week1 or in cases
 where the patient is1 through          
necessity1      kept in quarters that   
are wet or unclean1 the first bandage is
      covered with a layer of oakum     
which has been saturated in oil of      

tar and this in turn is held in place by
 means of several layers of             
bandages4 ,the bandages are also        
saturated with oil of tar4       ,in    
from one to two months wounds so        
treated1 unless they are                
foot-wounds1 will be ready to dress     
without being bandaged4 ,it is          
ordinarily unnecessary to dress         
foot-wounds oftener than every          
second week after the discharge of      
synovia has ceased4 ,when the      wound
 has filled with granulation1 a         
protective dressing is applied          
which is rendered water proof by the use
 of bandages covered with      oil of   
tar4 ,the patient can now be turned out 
for a month or six      weeks without   
disturbing the dressing4 ,after the     
removal of the      bandages1 the only  
treatment necessary is an occasional    
application      of some mildly         
antiseptic ointment4       ,except in   
nail pricks of the foot1 occasioned by  
punctures1 a five      per cent tincture

 of iodin is injected into open joints1 
if the      wound remains sufficiently  
open1 and this treatment is continued so
      long as there is a discharge of   
synovia4 ,surgical drainage is          
established if it is considered         
practicable and the remainder of        
the treatment is about the same as for  
wounds which are open4       ,open      
joints occur in horses at pasture and   
are sometimes not      discovered until 
several days or a week after the injury1
 and in      some instances the wounds  
are filled with maggots4 ,the only      
difference in the treatment of these    
cases is that more time and      care is
 taken in cleansing the wound1 more     
curetting is necessary1      and after  
cleansing the wound with peroxide of    
hydrogen1 the joint      is thoroughly  
washed out with equal parts of tincture 
of iodin and      chloroform4 ,this is  
followed by the injection of a quantity 
of      seventy-five percent alcohol and
 the wound is dressed and bandaged      

as already described4 ,at each          
subsequent dressing of infected         
wounds so treated less suppuration is   
noticed and the synovial      discharge 
usually ceases in from one to two       
months4       ,about ninety percent of  
all cases of open joint make complete   
recoveries1 about four per cent         
partially recover and six per cent      
are fatal4 ,among the fatal cases are   
the open joints with      complications 
as severed tendons1 those occasioned by 
calk wounds      in horses that are     
stabled1 and nail punctures of the feet4
 ,the      following report of twelve   
favorable cases is taken from a record  
of sixty-two cases4 ,the favorable ones 
are reported1 chiefly      because there
 are now enough reports on record of    
such cases which      have terminated   
fatally4       ,case #a4--;,a gray      
gelding used as a saddle pony received a
      horizontal wire cut laying        
completely bare the scapulohumeral      
articulation4 ,the margins of the wound 

were cleansed as heretofore             
described1 a drainage was provided      
surgically1 tincture of iodin      was  
injected and the wound was covered with 
equal parts of boric      acid and      
exsiccated alum4 ,the horse was kept    
tied and a diluted      tincture of     
iodin was injected into the wound once  
daily and the      powder applied often 
enough to keep the wound covered4 ,the  
case      made a complete recovery and  
the pony was again in service within    
sixty days4       ,case #b4--;,a        
twelve-hundred-pound bay mare with an   
open carpal      joint4 ,the wound was  
an open one about two and one-half      
inches in      length1 and made         
transversely and when the member was    
flexed the      articular surface of the
 carpal bones were presented to view4   
,an      ounce of tincture of iodin was 
injected into this joint after          
having cleansed the margin of the wound 
and the mare was cross-tied      in a   
single stall to keep her from lying     

down4 ,the owner was      instructed to 
keep the outside of the wound powdered  
with air      slaked lime and a very    
unfavorable prognosis was given4        
,i heard nothing further from this case 
until fifty-nine days from      the date
 of the injury1 when ,i met the owner   
driving this mare to a      buggy4 ,the 
wound had healed by first intention and 
at that time so      little cicatrix    
remained that it was difficult to find  
it4       ,case #c4--;,a brown mare with
 an open fetlock joint due to a         
spike-nail puncture4 ,lameness was      
excessive1 and joint greatly            
swollen4 ,tincture of iodin was injected
 into the wound and towels      dipped  
in hot antiseptic solutions were applied
 for several hours      daily until the 
acute stage had passed4 ,later the mare 
was turned      out to pasture and a    
vesicant was applied once or twice a    
month      until recovery was complete  
which was in about six months4          
,case #d4--;,a four-year-old bay mare   

having a wire-cut which opened      the 
tarsus joint was treated as heretofore  
described4 ,the wound was      kept     
bandaged for about two weeks and later  
it was dressed without      being       
bandaged4 ,in ninety days she had       
completely recovered4       ,case       
#e4--;,a twelve-year-old mare with an   
open fetlock joint due to      a        
puncture wound4 ,the margins of the     
wound were cleansed and the             
external wound enlarged to facilitate   
drainage4 ,tincture of iodin      was   
injected2 the wound was bandaged and    
dressed for a month in the      manner  
heretofore described1 when all discharge
 had stopped4 ,a      vesicant was      
applied2 the mare was put to pasture and
 within sixty      days from the date of
 the injury she was being driven on     
short      trips4       ,case #f4--;,a  
two-year-old brown gelding with a       
wire-cut on the left      front foot4   
,the wound extended down through the    
sole and opened the      navicular      

joint4 ,this colt was very wild and it  
was necessary to      tie it down each  
time the wound was dressed4 ,the wound  
was dressed      weekly for a month and 
less frequently thereafter4 ,it was     
handled      eight times2 the last      
dressing was left in place until worn   
out4      ,six months later the colt was
 practically well1 a very little        
lameness being shown when walking on    
frozen ground4       ,case #g4--;,a     
seven-year-old saddle-horse weighing    
eleven hundred      and fifty pounds    
received a wound of the tarsus1 laying  
bare the      articular surfaces of a   
part of the joint4 ,it was impossible to
      keep this wound bandaged because  
of the restless disposition of the      
subject4 ,injections of a dilute        
tincture of iodin were employed         
every second or third day for a month   
and the wound was kept      covered with
 the antiseptic dusting powder referred 
to heretofore4      ,in five months     
complete recovery had taken place1 with 

the      exception of a stubborn skin   
disturbance which was successfully      
treated six months after the wound was  
inflicted4 ,the horse is      still in  
use and is absolutely free from         
lameness4       ,case #h4--;,a          
two-year-old brown gelding with a       
wire-wound opening      the             
scapulohumeral joint4 ,this wound was   
large enough to expose to      view the 
articular portion of the humerus4 ,the  
same treatment as      that given case  
,no4 one was instituted and in ninety   
days the colt      was practically well4
       ,case #i4--;,a three-year-old bay
 filly was found at pasture with one    
fore foot badly injured4 ,the owner     
intended to destroy her1 but a          
neighbor prevailed upon him to have her 
treated4 ,apparently the      wound was 
of about a week's standing and in a very
 bad condition1      filled with maggots
 and dirt4 ,both the navicular and      
coronary      articulations were open4  
,this wound was cleansed in the usual   

manner and the owner cared for the case 
the balance of the time      because the
 distance from my office was too great  
to give her      personal attention4    
,she made an almost complete recovery in
 five      months4       ,case          
#aj4--;,at two-year-old mule with an    
open navicular joint due      to a      
barbed wire wound4 ,usual care was given
 this case and in five      months      
recovery was complete and little scar is
 to be seen4 ,this      case received   
seven treatments4       ,case #aa4--;,an
 eighteen-months-old colt at pasture was
 found down      and unable to rise     
without help4 ,in addition to several   
wounds of      lesser importance there  
was a large wound on the inner side of  
the      elbow1 the joint was open and  
the entire leg was greatly swollen      
and in a state of acute infectious      
inflammation4 ,the colt could not       
walk1 its temperature was #aje deg41    
pulse was rapid and respiration was     
a little hurried4 ,after advising the   

owner to put the poor animal      out of
 its misery ,i left the place4 ,four    
days later the owner came      to my    
office and asked if he could borrow some
 old shears to trim      off some loose 
hide from that colt4 ,he left the colt  
in the      pasture and all the care it 
received was the regular application of 
a proprietary dusting powder4 ,it made a
 complete recovery4       ,case         
#ab4--;,a family mare1 heavy in foal1   
received a vertical wound      of the   
fetlock joint inflicted by a            
disc-harrow4 ,the cul-de-sac      of the
 ligament of this joint was opened      
freely4 ,the wound was      dressed in  
the usual manner and again three days   
later when no      suppuration had taken
 place4 ,four days later the patient    
gave birth      to a colt and suckled it
 right along through her convalescence4 
,this wound healed by first intention   
and seventy-nine days from the      date
 of the injury the mare was driven to   
town1 two and one-half      miles       

distant1 and showed but little lameness4
   ,phalangeal ,exostosis 7,ringbone7   
,this term is applied to exostoses      
involving the first and second phalanges
 7suffraginis and corona71 regardless of
 their size1 extent or location4 ,it is 
a misnomer1 in a sense1 and the         
veterinarian is frequently obliged to   
spend considerable time with his clients
 in order to convince them that a       
spherodial exostosis of the proximal    
phalanx1 in certain cases1 is in reality
 ringbone1 even though there exists no  
exostosis which completely encircles the
 affected bone4  ,etiology and          
,occurrence4--,exostosis of the first   
and second phalanges is usually due to  
some form of injury1 whether it be a    
contusion1 a lacerated wound which      
damages the periosteum1 or periostititis
 and osteitis incited by concussions of 
locomotion1 or ligamentous strain4      
,practically the only exception is in   
the rachitic form of ringbone which     
affects young animals4  ,there are      

predisposing causes that merit          
consideration1 chief among which is the 
normal conformation of the coronet      
joint4 ,this proclivity is constant2 the
 normal interphalangeal articulation is 
an incomplete ginglymoid joint and while
 its dorso-volar diameter is great1 this
 in no wise compensates for its         
disproportionately narrow transverse    
diameter4 ,the pivotal strain which is  
sometimes thrown upon this articulation 
when an animal turns on one foot1 as    
well as the tension which is put on the 
collateral ligaments when the inner or  
the outer quarter of the foot rests in a
 depression of the road surface1 tends  
to detach the insertion of these        
ligaments or to cause fibrillary        
fractures of their substance4  ,short1  
upright1 pasterns receive greater       
concussion during fast travel on hard   
roads than do the longer more sloping   
and well formed extremities4 ,those who 
are advocates of the theory that this   
type of osteitis with its complications 

has its origin in the articular portion 
of the joint1 claim that the upright    
pastern constitutes an important        
tendency toward ringbone4 ,howbeit1     
ringbone is an active1 serious and      
frequent cause of lameness and it       
affects animals of all ages and occurs  
under various conditions4 ,horses having
 good conformation and kept at work     
wherein no great amount of strain is put
 upon these parts1 are occasionally     
victims of this affection4              
,classification4--,the arrangement      
employed by ,moller#ba is intensely     
practical and logical4 ,he considers    
ringbone as articular1 periarticular1   
rachitic and traumatic4 ,a mode of      
classification that is common and in a  
practical way1 good1 is1 high and low   
ringbone4 ,when prognosis is considered1
 for instance1 it is very convenient to 
state that the chances for recovery are 
much better in high ringbone than in low
 ringbone4 ,the classification of       
,moeller will be followed here4         

,illustration3 ,fig4 #ag--,phalangeal   
exostoses4  ,symptomatology4--,in all   
forms of incipient ringbone except      
rachitic1 the first manifestation of its
 existence1 or of injury to the         
ligaments in the region of the pastern  
joint which causes periostitis1 or      
affections of the articular portions of 
the proximal inter-phalangeal joint1 is 
lameness4 ,lameness which typifies      
ringbone is of the supporting-leg       
variety and by compelling the subject to
 step from side to side1 marked         
flinching is observed1 especially in    
periarticular ringbone2 causing the     
affected animal to turn abruptly on the 
diseased member1 using it as a pivot1   
likewise accentuates the manifestation4 
,in fact1 many subjects that exhibit no 
evidence of locomotory impediment while 
walking or trotting in a straight line  
on a smooth road surface1 will manifest 
the characteristic form of lameness from
 ringbone when the aforementioned side  
to side movement is performed4  ,when   

the manner in which pain is occasioned  
is considered1 it will be understood why
 lameness is intermittent in the early  
stages of this affection and may even be
 unnoticed by the driver4 ,an animal may
 travel on a smooth road without giving 
evidence of any inconvenience1 but as   
soon as a rough and irregular pavement  
or road surface is reached1 will limp4  
,as the subject is driven farther on    
level streets the lameness may          
disappear4 ,this intermittent type of   
lameness may continue until there is    
developed a large exostosis1 or until   
articular involvement causes so much    
distress during locomotion that lameness
 is constant4 ,on the other hand1       
resolution may occur during the stage of
 periosteal inflammation1 or1 an        
exostosis forms which causes no         
interference with function4             
,illustration3 ,fig4 #ah--,rarefying    
osteitis in chronic ringbone and        
ossification of lateral cartilages4     
,before there is evidence of an         

exostosis1 diagnosis of ringbone is not 
easy1 for it is then a problem of       
detecting the presence of a ligamentous 
sprain1 periostitis1 or osteitis4 ,the  
diagnostician should take note of local 
manifestations of hypersensitiveness1 or
 heat if such exist1 and1 in addition1  
other conditions must be excluded before
 definite conclusions are possible4  ,in
 articular ringbone as soon as there is 
developed an exostosis1 it occupies a   
position on the dorsal 7anterior7 part  
of the articulation and extends around  
the sides of the joint4  ,periarticular 
ringbone is characterized by exostoses  
which are situated on the sides of the  
phalanges and not extending around to   
the anterior part of the joint4 ,this   
type of ringbone as well as the         
articular may occur high or low4        
,illustration3 ,fig4 #ai--,phalangeal   
exostoses in chronic ringbone4 ,museum  
specimen of the ,kansas ,city           
,veterinary ,college4  ,with the        
traumatic form of ringbone1 all         

consequences1 as to the size and form   
the exostosis is to assume1 depend upon 
the nature and extent of the injury4    
,rachitic ringbone is frequently        
observed in some sections of the country
 and does not ordinarily cause much if  
any lameness4 ,it is a disease of colts 
and may affect one or all of the        
phalanges at the same time4 ,as the     
subject advances in age there is more or
 less diminution in the size of the     
enlargements4  ,treatment4--,rest is    
essential in the treatment of ringbone4 
,if diagnosed during its incipiency1    
remedial measures such as are usually   
employed to treat sprains1 are indicated
 and later the parts should be          
blistered4 ,when an exostosis has       
developed puncture firing is the remedy 
par excellence4 ,not that this method of
 treatment is infallible1 for to any    
thinking one who takes into             
consideration the pathological anatomy  
of this condition1 it is evident that no
 manner of treatment is beneficial in   

some cases4 ,if the exostosis is so     
situated that it does not mechanically  
interfere with function1 and is not so  
large that it may inhibit flexion and   
extension1 and where the articular      
portions of the joint are not eroded1   
good results attend the use of the      
actual cautery4  ,in firing1 after      
having anesthetized the extremity1 and  
prepared the surgical area1 the cautery 
is deeply inserted in numerous places1  
taking care1 however1 not to open the   
joint4 ,the parts are immediately       
covered with aseptic absorbent cotton   
and this dressing is left in position   
for forty-eight hours and if perchance  
there is evidence of synovial discharge1
 the parts are again aseptically dressed
 in order to prevent infection of the   
articulation4 ,if1 as is the case       
usually1 no perforation of the joint    
capsule exists1 the openings made by the
 cautery have been closed by the        
coagulation of serum and there is then  
little chance of infection causing      

trouble1 even though the member is left 
unbandaged4  ,in several instances1 the 
author has treated ringbone by this     
method where the periarticular type     
existed and lameness was marked1 and in 
three weeks the subjects were in service
 and not lame--this1 in one instance in 
a valuable polo pony where the subject  
continued in service for more than a    
year without any evidence of recurrence 
of the lameness4 ,the production of a   
deep-seated and acute inflammation with 
the actual cautery is preferable to any 
sort of counter-irritation which may be 
produced by vesicants4  ,there is no    
occasion for any difference in the      
treatment of either of the first three  
classes of ringbone1 but in the rachitic
 type where treatment is given1 the     
application of a vesicant is all that is
 required4 ,in most instances treatment 
is not necessary4  ,the affected animals
 require a month to three months' time  
for recovery to take place in the       
average favorable cases of ringbone4    

,median neurectomy is of service in many
 instances where lameness is not        
completely relieved by the use of the   
actual cautery and no bad results attend
 the performance of this operation even 
though no benefit is derived thereby4   
,plantar neurectomy is contraindicated  
in all cases where there exists much    
lameness4 ,if lameness is due to acute  
inflammation bad results such as        
sloughing and loss of the hoof may      
follow2 and if large exostoses          
mechanically interfere with function of 
the joint1 or where articular erosions  
exist1 no possible good can come from   
neurectomy4 ,careful discrimination     
should be employed in selecting cases   
for neurectomy for this operation2      
otherwise1 it is very likely to prove   
disappointing4   ,open ,sheath of the   
,flexors of the ,phalanges4  ,this      
condition does not differ from a like   
affection involving other tendons except
 that the function of these tendons is  
such that large synovial sheaths are    

necessary1 and when synovitis exists1   
the condition then becomes more serious4
  ,infectious synovitis involving these 
tendons in the fetlock region is of more
 frequent occurrence than a like        
affection of carpal or tarsal sheaths4  
,with the exception of the extent of the
 involvement and distress occasioned    
thereby1 synovitis the result of open   
tendon sheaths1 is similar wherever it  
occurs4  ,etiology4--,the same          
conditions which are responsible for    
open fetlock joint and other wounds of  
the pastern region1 cause open tendon   
sheaths of the flexor tendons4          
,symptomatology4--,because of the size  
and extent of this sheath and the       
different manner in which it is opened1 
there is manifested dissimilar symptoms 
in different cases4 ,a nail puncture    
which perforates the sheath in the      
pastern region and at the same time     
produces an infectious synovitis1 will  
cause a markedly different manifestation
 than will a wound which freely opens   

the sheath above the fetlock4 ,in the   
first instance1 the condition is much   
more painful2 swelling is intense in    
some cases2 and if the subject does not 
possess sufficient resistance so that   
spontaneous resolution promptly occurs1 
surgical evacuation of pus is usually   
necessary4 ,when these tendon sheaths   
are opened1 there follows a reaction    
which is quite analogous to that which  
exists in arthritic synovitis1 but      
instead of ankylosis1 adhesions with    
thecal obliteration occur4 ,rarely there
 result cartilaginous and osseous       
formations4  ,the constitutional        
disturbances which characterize this    
condition vary with the degree of       
distress occasioned4 ,as the infection  
is virulent and causes serious          
destruction of the affected parts1 so   
does evidence of malaise and finally    
distress appear4 ,detailed discussions  
of symptomatology in similar conditions 
have heretofore been given1 and further 
repetition is unnecessary4              

,treatment4--,the same general plan of  
treatment which is employed for handling
 open joint is put in practice in these 
cases4 ,following the preoperative      
cleansing of the external wound and     
adjacent surfaces1 where liberal        
drainage exists1 tincture of iodin is   
injected into the sheath1 the parts     
covered with a suitable dressing powder1
 and the entire member is carefully     
dressed with cotton and bandages4       
,subsequent treatment is the same as has
 been outlined in the discussion of open
 fetlock joint on page #aab4 ,the same  
general plan of after-care is necessary4
 ,recovery1 however1 does not require so
 much time ordinarily1 yet punctures of 
the sheath occasioned by nails or other 
small implements make for long drawn out
 cases of infective synovitis4          
,luxation of the ,fetlock ,joint4       
,etiology and ,occurrence4--,the manner 
of construction of the fetlock joint is 
such that disarticulation without       
irreparable injury resulting1 is        

practically impossible4 ,logically1 this
 joint in the fore legs 7not so in the  
pelvic limbs7 should disarticulate in   
such manner that either all of the      
inhibitory apparatus 7flexor tendons and
 suspensory ligament7 must rupture or a 
lateral luxation is necessary4 ,lateral 
disarticulation must necessarily sever  
the attachment of one of the common     
collateral ligaments4 ,because of the   
width 7transverse diameter7 of the      
articulating surfaces of this joint1    
lateral luxation requires a great       
strain2 and a force that is sufficient  
to occasion this trauma usually causes  
serious additional injury4 ,therefore1  
the condition is considered one wherein 
prognosis is always unfavorable in so   
far as practical methods of treatment   
are concerned4  ,mr4 ,a4 ,barbier#bb    
reports a case of bilateral luxation of 
the fetlock joints of the hind legs in a
 horse4 ,this was done in jumping1 and  
the extensor tendon of each leg was     
ruptured and the anterior portion of the

 metatarsus was protruding through the  
skin4 ,profuse hemorrhage had taken     
place due to tearing of the blood       
vessels4  ,symptomatology4--,entire     
luxation of this joint when present is  
so evident that one cannot fail to      
recognize the condition4 ,complete      
disarrangement of normal relation occurs
 and there is either a breaking down of 
the inhibitory apparatus1 or if a       
lateral disarticulation exists1 the     
normally straight line formed by the    
bones of the front leg1 as viewed from  
the front or rear1 is broken at the     
fetlock4  ,often fracture of bones are  
concomitant and then1 of course1        
mobility is increased and not decreased 
as is the case in uncomplicated         
luxation4  ,such violence occurs at     
times1 when this joint is               
disarticulated1 that the joint capsule  
is also completely ruptured and the     
articular portion of the bones is       
exposed to view4  ,treatment4--,the     
condition being practically a hopeless  

one1 destruction of the subject is the  
thing which should be promptly done4 ,in
 valuable breeding animals1 owners may  
prefer that treatment be attempted when 
a lateral luxation and detachment of but
 one common ligament have permitted     
luxation without complete               
disarticulation and rupture of the joint
 capsule4 ,in such cases1 by            
immobilizing the affected parts as in   
fracture1 and confining the subject in a
 sling for about sixty days1 partial    
recovery may occur in some instances4   
,experience has shown that where        
luxation with detachment of a collateral
 ligament occurs1 recovery is slow and  
incomplete--there always results        
considerable exostosis at the site of   
injury4   ,sesamoiditis4  ,etiology and 
,occurrence4--,inflammation of the      
proximal sesamoid bones is caused by any
 kind of irritation which may involve   
this part of the inhibitory apparatus4  
,positioned as they are1 between the    
bifurcations of the suspensory ligament 

and the pastern joint1 they serve as    
fulcra and effectively assist in        
minimizing concussion which is received 
by the suspensory ligament4 ,the flexor 
tendons also1 in contracting1 exert     
strain upon the inter-sesamoidean       
ligament1 which has a similar effect    
upon the sesamoid bones as that which is
 produced by the suspensory ligament4   
,the condition occurs quite frequently1 
and because of the important function   
performed by these bones1 active        
inflammation of the sesamoids           
constitutes a serious affection4        
,because of the fact that these bones   
have proportionately large articular    
surfaces1 when they are inflamed to the 
extent that degenerative changes affect 
the articular cartilage1 complete       
recovery seldom results4  ,the same     
pathological changes occur here that are
 to be seen in any case of arthritis4   
,no special pathological condition      
characterizes sesamoiditis but this     
condition causes incurable lameness when

 the sesamoid bones are much inflamed4  
,symptomatology4--,in acute             
inflammation1 there exist all the       
symptoms which portray any arthritic    
inflammation of like character4 ,the    
parts are readily palpable and are found
 to be hot1 supersensitive1 and more or 
less infiltration of the tissues        
contiguous to the joint causes swelling4
 ,there is volar flexion of the         
phalanges when the subject is at rest4  
,lameness is intense2 in some acute     
inflammatory disturbances the subject is
 unable to bear weight on the affected  
member4  ,in chronic sesamoiditis1      
constant lameness is the one salient    
feature which marks the condition4      
,while it is possible for one sesamoid  
bone to become involved without its     
fellow being affected1 this is not      
usual4 ,considerable organization of    
tissue surrounding the joint is present 
and no particular evidence of           
supersensitiveness exists4 ,however1    
supporting weight brings sufficient     

pressure to bear upon the inflamed and  
more or less eroded bones so that pain  
is occasioned and lameness results4     
,treatment4--,during acute inflammation1
 absolute quiet is1 of course1 of first 
consideration4 ,cold packs are to be    
kept in contact with the parts until    
acute inflammatory symptoms subside4    
,the fetlock region is then enveloped   
with a poultice or an iodin and glycerin
 combination 7iodin one part to seven   
parts of glycerin7 is applied and a     
dressing of cotton is kept in contact   
with the inflamed region4 ,following    
this1 a vesicant is employed and the    
subject is allowed a month's rest4  ,in 
sub-acute cases1 the entire region      
surrounding the pastern is blistered or 
the actual cautery is used4 ,line-firing
 is preferable4 ,the subject is given a 
month or six weeks rest and one may be  
guided by the presence or absence of    
lameness as to whether improvement or   
recovery is taking place4  ,old chronic 
cases1 and particularly those where     

there are considerable induration and   
fibrous organization of tissue          
surrounding the joint1 are not to be    
benefited by treatment4  ,the chief     
consideration in handling sesamoiditis  
is checking inflammation as early as    
possible and preventing1 if this can be 
done1 the erosion of articular surfaces4
 ,if destruction of any part of the     
articular surfaces can be prevented and 
the patient allowed ample time for      
complete resolution of the affected     
parts to occur1 permanent relief is     
possible4   ,fracture of the ,proximal  
,sesamoids4  ,etiology and              
,occurrence4--,fracture of the proximal 
sesamoid bones is caused by violent     
strain when there exists fragilitas     
osseum1 or by contusions4 ,the author   
treated a case where fracture of one    
sesamoid was occasioned by a horse      
receiving a puncture wound wherein the  
sharp end of a steel bar was protruding 
from the ground where it was firmly     
embedded4 ,the subject in this case was 

injured while being driven along a      
country road4 ,frost#bc reports         
simultaneous fracture of all of the     
proximal sesamoids occurring in a       
sixteen-year-old pony4 ,the condition is
 of rather common occurrence in some    
countries because of the fragile        
condition of horses' bones4             
,symptomatology4--,if the parts can be  
examined before extravasation of blood  
and swelling mask the condition1        
crepitation may be detected4 ,in other  
instances1 it is possible to note a     
displacement of parts of the sesamoid   
bones--this in horizontal fracture4     
,there occurs more or less descent of   
the fetlock which must not be attributed
 to rupture of the superficial flexor   
tendon 7perforatus74 ,by outlining the  
course of this tendon with the fingers1 
when it is passively tensed sufficiently
 to follow its course1 one may exclude  
rupture of the superficial flexor4      
,finding the suspensory ligament intact 
from its origin to the sesamoid         

attachments1 one may also eliminate     
rupture of this structure as a cause of 
the trouble4 ,needless to say1 marked   
lameness and swelling of the fetlock    
soon take place4 ,the condition is      
painful1 and ordinarily1 recovery is    
impossible4  ,treatment4--,where        
treatment is attempted1 immobilization  
as in luxation is in order4 ,the        
patient's comfort is sought1 and if the 
fractured parts can be kept in close    
proximity1 their union may occur in     
time4 ,however1 chances for partial     
recovery 7which is the best to be hoped 
for7 are so remote that early           
destruction of the subject is the humane
 and economical thing to do4  ,where    
treatment is instituted1 it is found    
that there is required a long time for  
union of the fractured bones to occur   
7where union does take place7 and the   
cost of treatment together with the     
uncertainty of even partial recovery1   
makes for an unfavorable outcome4 ,when 
the best possible results succeed       

treatment1 a large callosity is formed  
and movement of the pastern joint is    
restricted4 ,lameness1 though not       
intense1 in the case referred to1 where 
one bone was broken1 was permanent and  
the subject was out of service for      
nearly a year4   ,inflammation of the   
,posterior ,ligaments of the ,pastern   
7,proximal ,interphalangeal7 ,joint4    
,anatomy4--,the ligaments here involved 
are the four volar ligaments described  
by ,sisson#bd as follows3 ,the volar    
ligaments 7,ligg ,volaria7 consist of a 
central pair and a lateral and medial   
bands which are attached below to the   
posterior margin of the proximal end of 
the second phalanx and its complementary
 fibro-cartilage4 ,the lateral and      
medial ligaments are attached above to  
the middle of the borders of the first  
phalanx1 the central pair lower down and
 on the margin of the triangular rough  
area4  ,this portion of the inhibitory  
apparatus is described by ,strangeways' 
,anatomy as two posterior ligaments     

which run each from three points on the 
sides of the os suffraginis to a piece  
of fibro cartilage1 described as the    
glenoid cartilage1 and attached to the  
postero-superior edge of the os coronae2
 between them is the insertion of the   
inferior sesamoidean ligament4          
,etiology and ,occurrence4--,everything 
tending to increase strain upon these   
ligaments is contributory to possible   
fibrillary fracture of these structures4
 ,excessive leverage as furnished by    
long toes1 long toe-calks and low heels 
increases the normal tension on the     
posterior ligaments of the pastern      
joint4 ,faulty conformation1 which      
throws an abnormal strain on these      
ligaments1 is a predisposing cause of   
inflammation of these structures4 ,hard 
pulling upon slippery and rough or      
frozen roads is a common exciting cause 
of this injury4 ,the condition is of    
comparatively frequent occurrence and is
 seen affecting draft horses frequently1
 in the hind legs4                      

,symptomatology4--,lameness is the first
 manifestation of this affection and    
weight bearing is painful in direct     
proportion to the extent of injury      
present4 ,volar flexion of the phalanges
 relieves tension on the parts2         
therefore1 this position is assumed     
while the subject is at rest4 ,when     
considerable tissue has been ruptured1  
and the condition is very painful1 the  
foot is held off the ground as in all   
painful affections of the extremity4    
,by palpation evidence of pain is       
discernible1 though very little swelling
 occurs4 ,pain is increased by manual   
tension of the parts which is done by   
grasping the toe of the foot and        
exerting traction on the flexor         
apparatus4 ,care must be taken in       
executing such manipulations1 and it is 
only by comparison of the affected      
member with the sound one and noting the
 difference in the manifestations of    
discomfort that we may arrive at the    
proper conclusion4  ,some hyperthermia  

is to be recognized in acute            
inflammation1 by comparing the          
extremities4 ,in the fore legs1         
navicular disease is differentiated by  
noting absence of contraction at the    
heel4 ,by use of the hoof testers one   
may recognize evidence of inflammation  
of the navicular apparatus4 ,in         
inflammation of the posterior ligaments 
of the pastern joint1 there is also     
absence of the characteristic stumbling 
which is seen in navicular disease4     
,treatment4--,rest is the first         
requisite1 and in addition every        
mechanical means possible to change the 
center of gravity in the phalangeal     
region1 is to be employed4 ,this is best
 accomplished by shortening the toe and 
paring the sole at the toe as much as   
conditions will permit4 ,the heel is    
raised by means of a shoe with          
moderately high heel calks4  ,the       
iodin-glycerin combination heretofore   
mentioned may be applied and the parts  
covered with cotton and bandage4        

,subjects require from three weeks to   
several months' rest and must be        
returned to work carefully1 lest the    
incompletely regenerated tissues suffer 
injury4  ,regeneration of tissue in such
 cases1 as has been pointed out1 is slow
 and sufficient time for complete       
recovery must be allowed or relapses    
will occur4   ,fracture of the ,first   
and ,second ,phalanges4  ,etiology and  
,occurrence4--,fractures of the first   
phalanx 7suffraginis7 occur with respect
 to frequency1 second to pelvic         
fractures4 ,often1 almost insignificant 
injuries cause phalangeal fractures4 ,on
 city streets1 horses shod with shoes   
having long calks get caught in frogs of
 street railways or by slipping on      
rails1 and phalangeal bones are often   
broken4 ,the author observed a case of  
comminuted fracture of both the first   
and second phalanges 7suffraginis and   
corona7 in a polo pony caused by making 
a sudden turn while in action in a      
contest on the turf4                    

,symptomatology4--,fracture of the      
phalanges is nearly always signalized by
 lameness1 and this is marked during the
 period of weight bearing4 ,lameness is 
usually intense and where the           
pathognomonic symptom 7crepitation7 is  
not recognized1 the intensity of the    
claudication1 when other causes are     
absent1 is indicative of fracture4 ,the 
subject does not bear weight upon the   
affected member and where pain is       
intense1 the foot is held in an elevated
 position and swung back and forth4 ,in 
hind legs the member is often flexed in 
abduction and held in this position for 
several minutes1 being rested on the    
ground only during short intervals4     
,when compelled to walk1 if pain is     
excruciating1 the animal hops with the  
sound leg1 no weight being supported by 
the fractured member4  ,when an         
examination of the subject is possible  
before the extremity is swollen1        
crepitation is usually found without    
great difficulty1 except in a           

subperiosteal break or in some cases of 
vertical or oblique fracture4 ,great    
care is necessary in handling the       
injured extremity in these cases1 and   
particularly in nervous subjects or in  
excited animals that have been recently 
injured in runaways1 is it necessary to 
be gentle in manipulating the extremity1
 if definite deductions are to be made4 
,as has been mentioned in the chapter on
 diagnostic principles1 if the condition
 is so painful that the subject does not
 relax the parts and crepitation is     
masked1 local anesthesia is necessary4  
,an anesthetic solution of cocain or    
novocain may be applied to the          
metacarpal or metatarsal nerves and an  
entirely satisfactory examination is    
then possible4  ,passive movement of the
 phalanges in all directions is         
practised in order to produce           
crepitation4 ,when rotation of the parts
 does not occasion crepitation1 gentle  
flexion and extension may do so4 ,and in
 many instances1 considerable           

manipulation of the phalanges is        
necessary before the pathognomonic      
symptom is to be recognized4  ,in cases 
where crepitation is not found and      
lameness is pronounced1 out of          
proportion with other possible existing 
causes1 one may by exclusion of other   
causes establish a diagnosis of fracture
 in the course of forty-eight hours4 ,in
 the meanwhile1 support is given the    
affected member by applying an effective
 leather splint1 so that pain may be    
diminished4 ,to combat inflammation1 a  
suitable cataplasm may be applied       
directly to the skin1 the extremity     
bandaged1 and the temporary immobilizing
 appliance may be secured over all4 ,in 
this manner one may make repeated       
examinations of the subject1 and if     
slings are used and every other         
necessary precaution taken to promote   
comfort for the subject1 no harm will   
result in delaying for several days the 
application of permanent                
immobilization--bandages and splints or 

casts4 ,in fact1 where much swelling    
exists at the time one is called to     
treat such cases1 it is advisable to    
delay the application of a permanent    
dressing or cast until inflammation has 
somewhat subsided4  ,course and         
,prognosis4--,where conditions are      
favorable1 the nature of the fracture   
one that will yield to treatment1 the   
subject not aged1 and facilities for    
giving good attention to the affected   
animal are ample1 fractures of the first
 and second phalanges recover completely
 in from six weeks to four months4 ,only
 simple fractures are considered curable
 from a practical and economical point  
of view1 excepting in foals1 where      
compound1 and even comminuted1 fractures
 may be so handled that animals may     
eventually become serviceable though    
blemished4  ,age retards the process of 
osseous regeneration1 but in one        
instance at the ,kansas ,city           
,veterinary ,college1 a very aged mare  
suffering from a multiple fracture of   

the first phalanx was treated and at the
 end of sixty days was able to walk into
 an ambulance4 ,large exostoses had     
developed and the subject remained lame1
 but union of the broken bone took place
 in a surprisingly prompt and effective 
manner1 when age of the subject and     
nature of the fracture are considered4  
,as a rule1 one is loath to recommend   
treatment1 even in a simple transverse  
fracture of the first phalanx1 in       
animals ten years of age or older4 ,the 
conditions which exist in any given     
locality that regulate the expense of   
caring for an animal during the period  
of treatment1 especially influence the  
course to be pursued in treating        
fractures4  ,treatment4--,for permanent 
immobilization of the phalanges in      
fracture1 materials which might adapt   
themselves to the irregular contour of  
the member and at the same time         
contribute sufficient rigidity to the   
parts without doing injury to the soft  
structures1 would constitute ideal means

 of treatment2 but no such materials    
have yet been devised1 and opinions are 
various as to the most efficient and    
practical method to employ4  ,after the 
fetlock has been shorn of hair and the  
ergot trimmed1 the skin is thoroughly   
cleansed and allowed to dry4 ,several   
thin layers of long fiber cotton are    
then wrapped around the                 
extremity--enough to pad well the       
member--and this is retained in position
 with a wide bandage4 ,gauze bandages   
are preferable to heavier bandages of   
cotton fabric because they are somewhat 
more elastic and yield to the irregular 
contour of the parts to a better        
advantage4 ,layers of three inch gauze  
bandages1 which are soaked with a cold  
starch paste are wound about the        
extremity4 ,strips of leather that are  
flexible and not more than an inch in   
width are placed in a vertical position 
around the leg and these are also       
covered with the starch and securely    
held in position with the bandages4 ,in 

this way1 one is able to provide a      
sufficient degree of rigidity and at the
 same time1 where the cast is carefully 
applied1 little if any injury is done   
the skin4 ,such a cast is not difficult 
to remove and is so inexpensive that it 
may be removed and reapplied at any time
 it should be thought preferable to do  
so4 ,of course1 this does not constitute
 an effective means of support if the   
parts are to be frequently and          
thoroughly soaked with water1 but       
animals undergoing this sort of         
treatment are usually kept sheltered4   
,the same after-care is necessary in    
such cases as is given in fractures of  
other bones4 ,two months after the      
injury has been done1 the application of
 a blistering ointment to the entire    
region is of benefit4  ,results4--,much 
depends on the nature of fractures as to
 the success one may attain in          
approximating the parts of a broken     
bone1 and in some cases of oblique      
fracture for instance1 complete recovery

 is impossible1 despite the most        
skillful and painstaking attention      
given4 ,on the other hand1 cases of     
simple transverse fractures make perfect
 recoveries in some instances4 ,all     
fractures are serious1 and in every     
instance the practitioner would best be 
careful to impress his client with the  
many difficulties which usually attend  
the treatment of fracture in horses4    
,tendinitis4  ,inflammation of the      
,flexor ,tendons4  ,one of the most     
common causes of lameness in light      
harness and saddle horses is tendinitis1
 and because of the character of the    
structure of tendons and because of     
their function1 an active inflammation  
of these parts is always serious4       
,being almost inelastic and not well    
supplied with blood1 tendinous tissue is
 slowly regenerated1 and so much time is
 required for complete recovery to take 
place in tendinitis1 that affected      
animals seldom fully recover before they
 are in service or vigorously exercising

 at will4 ,as a result1 complete        
recovery is delayed or prevented4  ,the 
extensor tendons1 because of the nature 
of their function1 are very seldom      
strained2 they are often bruised and    
occasionally divided1 but unlike this   
condition in the flexors1 tendinitis of 
the extensors is of rare occurrence4    
,for a concise discussion of this       
subject the most practical              
classification is one made on a         
chronological basis and we may then     
consider tendinitis as acute and        
chronic4   ,,acute ,,tendinitis4        
,etiology and ,occurrence4--,causes of  
tendinitis1 as in almost all diseases1  
may be considered under the heads of    
predisposing and exciting4 ,among the   
predisposing causes of tendinitis may be
 mentioned1 faulty conformation4        
,everything which has to do with        
increasing the strain upon tendons adds 
to the probability of their being       
over-taxed4 ,long1 sloping1 pastern     
bones2 disproportionate development of  

parts1 such as a heavy body and small1  
weak tendons and long hoofs1 are the    
principal factors which usually         
predispose to tendinous sprains4        
,degenerative changes which take place  
in tendons following constitutional     
diseases such as influenza may also be  
classed as a predisposing cause4        
,excessive strain when put upon tendons 
in any possible manner1 such as is      
occasioned in running and jumping2      
making missteps and catching up the     
weight of the body with one foot1 when  
the force thus thrown upon the          
supporting structure is great because of
 momentum gained at a rapid pace1 are   
exciting causes of tendinitis4          
,symptomatology4--,in all cases of acute
 tendinitis there is presented a        
characteristic attitude by the subject4 
,volar flexion in a sufficient degree to
 relax the inflamed structures is always
 evident4 ,the foot may be rested on the
 toe or placed slightly in advance of   
the one supporting weight1 but the      

fetlock is always thrown forward4 ,more 
or less swelling of the inflamed tendons
 is present4 ,where the deep flexor     
7perforans7 is involved swelling is     
marked and with swelling there is       
present the other symptoms of           
inflammation--heat and                  
supersensitiveness4  ,in manipulating   
tendons for the purpose of detecting    
supersensitiveness1 care must be taken  
so that no false conclusion be drawn1   
because of the aversion many horses have
 to submitting to palpation of the      
tendons even when they are in a normal  
condition4  ,supporting-leg-lameness is 
present and varies in degree with the   
intensity of the pain caused by weight  
bearing4 ,in many instances1 as soon as 
the subject has traveled a considerable 
distance1 lameness diminishes or        
discontinues4 ,as soon as the affected  
animal is permitted to stand long enough
 to cool out there is a return of the   
lameness1 which is then marked4  ,no    
difficulty is encountered in making a   

practical diagnosis in tendinitis2 that 
is1 one may fail to readily recognize   
the extent of the involvement as it     
affects the superficial flexor tendon1  
for instance1 but this has no practical 
bearing on the prognosis and treatment1 
when existing inflammation of the deep  
flexor is recognized4  ,the course of   
each tendon is readily outlined by      
palpation2 all parts are easily         
manipulated2 and with experience one may
 readily recognize the extent and degree
 of the inflammation4  ,treatment4--,in 
some cases of acute tendinitis1 pain is 
intense and the application of cold     
packs during this stage is very         
beneficial in that pain is controlled   
and inflammation subsides4 ,the         
extremity may be bandaged with a liberal
 quantity of absorbent cotton or with   
woolen material4 ,ice water is then     
poured around the bandaged member every 
fifteen minutes and this should be      
continued for about forty-eight hours4  
,in some cases this treatment is not    

necessary for more than twelve hours2 at
 the end of this length of time1 pain   
has subsided and the acute stage of     
inflammation has passed or its intensity
 has been diminished4  ,following the   
application of cold packs1 the use of a 
poultice such as some of the sterile1   
medicated muds1 is of marked benefit4   
,the author has made use of tincture of 
iodin and glycerin in the proportion of 
one part of iodin to seven parts        
glycerin1 with very satisfactory        
results4 ,this combination is           
hygroscopic1 anodyne and antiseptic and 
is easily applied4 ,a liberal quantity  
is directly applied all around the      
affected tendons and the leg covered    
with a heavy layer of cotton1 and this  
is snugly held in position with         
bandages4 ,the application may be used  
once or twice daily1 or if it is thought
 necessary1 an attendant may pour a     
quantity of the iodized-glycerin around 
the leg and under the bandage once daily
 without removing the cotton and        

bandage4 ,needless to say1 absolute rest
 is imperative4  ,when all evidence of  
acute inflammation has subsided         
vesication is indicated4 ,at this stage 
walking exercise is beneficial and the  
subject may be allowed the freedom of a 
paddock4  ,some practitioners are       
partial to the use of the actual cautery
 in these cases1 but it is doubtful if  
it is necessary to produce such a great 
degree of counter-irritation in cases   
where the subject is suffering the first
 attack of tendinitis4  ,as has been    
indicated1 ample time should be allowed 
for recovery and depending upon         
conditions1 it takes from three weeks to
 six months for complete recovery to    
become established4   ,chronic          
,tendinitis and ,contraction of the     
,flexor ,tendons4  ,etiology and        
,occurrence4--,acute inflammation of the
 flexor tendons may result in chronic   
tendinitis4 ,recurrent attacks in cases 
where insufficient time is allowed for  
complete recovery to result1 is followed

 by chronic inflammation and hypertrophy
 of the tendons4 ,again1 in subjects    
where conformation is faulty1 no amount 
of care will be sufficient to prevent a 
recurrence of the inflammation and the  
condition must become chronic4          
,symptomatology4--,on visual examination
 of the subject at rest1 one may note   
the hypertrophied condition of the      
affected tendons4 ,their transverse     
diameter is usually perceptibly         
increased and in many cases1 there is an
 increase in the antero-posterior       
diameter4 ,the latter condition causes a
 bulging of the tendon that is so       
noticeable1 because of the convexity    
thus formed1 it is commonly known as    
bowed tendon4  ,illustration3 ,fig4     
#bj--;,contraction of the superficial   
digital flexor tendon 7perforatus7 of   
the right hind leg1 due to tendinitis4  
,in chronic tendinitis there occurs     
repeated attacks of inflammation wherein
 lameness is pronounced and there exists
 in reality1 at such times1 acute       

inflammation of a hypertrophic          
structure1 where at no time does        
inflammation completely subside4        
,therefore1 in chronic tendinitis there 
is to be found at times the same        
conditions which characterize acute     
inflammation1 except that there is      
usually a variance of symptoms because  
of the difference in the degree of      
inflammation and pain4  ,the diagnosis  
of contraction of tendons is an easy    
matter because of the fact that         
relations between the phalanges are     
constantly changed with tendinous       
contraction4 ,if one bears in mind the  
attachments and function of the digital 
flexors1 no difficulty is encountered in
 recognizing contraction of either      
tendon4  ,contraction of the superficial
 digital flexor 7perforatus71 when      
uncomplicated1 is characterized by volar
 flexion of the pastern joint4 ,the foot
 is flat on the ground and the heel is  
not raised because the superficial      
flexor tendon does not have its         

insertion to the distal phalanx 7os     
pedis7 and therefore can not affect the 
position of the foot4  ,by causing the  
subject to stand on the affected member1
 one may outline the course of the      
flexor tendons by palpation1 and in this
 way recognize any lack of tenseness or 
contraction of tendons or of the        
suspensory ligament4  ,illustration3    
,fig4 #ba--;,contraction of the deep    
flexor tendon 7perforans7 of the right  
hind leg1 due to tendinitis4            
,contraction of the suspensory ligament 
would cause the pastern joint to assume 
the same position as is occasioned by   
contraction of the superficial digital  
flexor 7perforatus7 tendon1 but when the
 subject is bearing weight on the       
affected member1 it is easy to determine
 that no contraction of the suspensory  
ligament exists1 by noting an absence of
 abnormal tenseness of this structure4  
,and finally1 contraction of the        
suspensory ligament is of rare          
occurrence4  ,contraction of the deep   

flexor tendon 7perforans7 causes an     
elevation of the heel4 ,the foot can not
 set flat because the insertion of the  
deep flexor tendon to the solar surface 
of the distal phalanx 7os pedis7 causes 
when the tendon is contracted--a        
rotation of the distal phalanx on its   
transverse axis--hence the raised heel4 
,no other tendon has this same effect on
 the distal phalanx and the condition is
 correctly diagnosed without difficulty4
  ,illustration3 ,fig4 #bb--;,a chronic 
case of contraction of both flexor      
tendons of the phalanges4 ,in this case 
7presented at a clinic of the ,kansas   
,city ,veterinary ,college7 because of  
long continued contraction of the       
flexors1 which prevented weight being   
supported with any degree of comfort1   
there resulted a partial paralysis of   
the extensors1 and consequently the     
extremity was dragged on the ground4    
,course and ,complications4--,this      
condition may exist for years without   
causing the subject any serious         

inconvenience1 if the affected animal is
 kept at suitable work4 ,in other       
instances recurrent attacks of lameness 
are of such frequent occurrence that the
 subject is not fit for service4 ,many  
affected animals that are kept in       
service in spite of lameness 7and in    
some instances where no lameness is     
present71 soon become unserviceable     
because of contraction of the inflamed  
tendon4 ,this1 in fact1 is the condition
 which eventually becomes established in
 most instances4  ,treatment4--,where   
conformation is not too faulty so that  
recovery may be expected1 good results  
are obtained by line-firing the tendons 
and allowing the subject a few months'  
rest4 ,in some cases median neurectomy  
is advisable4 ,this is recommended by   
,breton#be as being productive of good  
results even where contraction of       
tendons exists and tenotomy is done4    
,illustration3 ,fig4 #bc--;,contraction 
of the superficial and deep flexor      
tendons 7perforatus and perforans7 of   

the left fore leg4  ,by shoeing with    
high heel-calks considerable strain is  
taken from the inflamed tendons because 
of the changed position of the foot     
which alters the distribution of weight 
on different parts of the leg4 ,rubber  
pads materially diminish concussion and 
should be made use of when the subject  
is returned to work1 if the character of
 the work is such as to occasion much   
concussion4  ,it is to be remembered1   
however1 that in sprains there occurs   
fibrillary fracture of soft structures  
and time is required for regeneration of
 tissue which has been injured or       
destroyed4 ,absolute rest is necessary  
where inflammation is acute and in      
sub-acute or chronic tendinitis         
avoidance of all work which causes      
irritation to the affected tendons is   
imperative4  ,illustration3 ,fig4       
#bd--;,contraction of superficial       
digital flexor and slight contraction of
 deep flexor tendon4  ,where contraction
 of tendons exists surgical treatment is

 necessary4 ,no good comes from         
appliances which are calculated to      
stretch the affected tendons2 in fact1  
they aggravate the inflamed condition   
and hasten complete loss of function of 
the affected member4 ,where there exists
 no articular or ligamentous diseases   
which would defeat the purpose1 tenotomy
 is the only remedy for contracted      
tendons4   ,contracted ,tendons of      
,foals4  ,etiology and                  
,occurrence4--,this condition is        
occasionally observed and no positive   
explanation of the reason for its       
existence can be given4 ,that           
mal-position en utero causes the        
metacarpal bones to develop in length so
 rapidly that the tendons are too short1
 is an explanation that is offered4 ,be 
that as it may1 in breeding sections of 
the country the general practitioner is 
obliged to handle these cases and       
successful methods of treatment are     
essential even though cause is not      
removable4  ,symptomatology4--,the      

superficial flexor tendon 7perforatus7  
alone1 is the one usually contracted1   
and while both flexors are at times     
involved1 this rarely occurs4 ,the      
condition is usually bilateral4  ,the   
degree of contraction varies greatly in 
different cases4 ,in some1 contraction  
exists to such extent that it is        
impossible for the colt to stand1 and   
because of continual decubitus where no 
relief is given1 the subject is lost    
because of gangrenous infection         
occasioned by bed sores4 ,otherwise the 
same symptoms are to be observed in this
 condition1 that exist in contraction of
 tendons of the mature animal4          
,treatment4--,wherever contraction is   
not too marked and weight is borne with 
the affected members1 and where the feet
 can be kept on the ground in a nearly  
normal position1 it is possible to      
correct the condition without doing     
tenotomy4 ,that is1 in cases where the  
subject is simply cock-ankled1 where    
volar flexion of the pastern joint      

exists but the foot is kept flat on the 
ground1 correction is possible without  
tenotomy4  ,in such instances the foal  
must be treated early--before the skin  
on the anterior pastern region has been 
badly damaged by knuckling over4 ,it is 
possible in many cases to stretch the   
flexor tendons by grasping the colt's   
foot with one hand1 and with the other  
hand one may push the pastern in the    
direction of dorsal flexion4 ,this may  
be tried and when a reasonable amount of
 force is employed1 no harm is done1    
even though no material benefit results4
 ,some veterinarians claim good results 
from this treatment alone and direct    
their clients to repeat the stretching  
process several times daily4  ,whether  
the tendons are manually stretched or   
not1 splints should be adjusted to the  
affected members4 ,the legs are padded  
with cotton and bandages and a suitable 
splint is applied on either side of the 
members and securely fixed in position  
by bandaging4  ,the splints are kept in 

position for four or five days and then 
removed for inspection of the affected  
parts4 ,if necessary1 they are reapplied
 and left in position for a week2       
however1 this is unnecessary in the     
average case that is treated in this    
manner4  ,where contraction exists to   
the extent that the subject can not     
stand and where no weight is borne by   
the feet1 it is necessary to divide the 
affected tendons surgically4 ,the same  
technic is put into practice that is    
employed in the mature subject but there
 is much greater chance for a favorable 
outcome in the foal4 ,further1 if       
necessary1 one may divide with impunity1
 both tendons on each leg1 at the same  
time4 ,in all cases this operation is   
done by observing strict aseptic        
precautions and the legs are1 of course1
 bandaged4 ,if both tendons are divided1
 splints should be employed and kept in 
position for ten days or two weeks4     
,primary union of the small surgical    
wound of the skin and fascia occurs in  

forty-eight hours4  ,the reader is      
referred to ,william's ,veterinary      
,surgical and ,obstetrical ,operations1 
for a complete description of this      
operation4       ,in veterinary         
literature there is occasionally        
described a      condition which affects
 young foals wherein symptoms similar to
      those of contraction of the       
flexors are manifested1 but upon        
examination it is found that rupture of 
the extensor of the digit      7extensor
 pedis7 exists4 ,this affection is      
briefly described by      ,cadiot but no
 complete treatise on this condition has
 been      published4       ,in parts of
 ,canada foals of from one to three days
 of age are found      affected in such 
manner that more or less interference   
with the      gait is to be seen in     
those moderately affected4 ,there is1 in
 some      subjects1 only a slight      
impediment in locomotion which is       
occasioned by inability to properly     
extend the digit4 ,in other             

subjects1 while able to stand and walk1 
great difficulty is      experienced    
because of volar flexion of the         
phalanges4 ,the more      seriously     
affected animals are unable to stand    
and1 in most      instances1 perish     
because of the effects of prolonged     
decubitus4       ,a local enlargement   
occurs at the anterior carpal region and
 the      mass is somewhat fluctuating1 
extravasated fluids becoming infected   
in many instances1 and necrosis of the  
skin and fascia provide      means for  
spontaneous discharge of the contents of
 the enlargement      if it is not      
opened4 ,the infection when it becomes  
generalized      causes a fatal         
termination in most cases that are not  
treated4  ,illustration3 ,fig4          
#be--;,fish knees4--,photo by ,thos4    
,millar1 ,m4,r4,c4,v4,s4       ,native  
stock owners of some parts of ,canada   
know this condition as      fish knees  
because of the presence of the ruptured 
end of the      extensor tendon which is

 found coiled in the cavity of the      
enlargements caused by the ruptured     
tendon4       ,local practitioners have 
treated the condition by incising the   
swollen mass and removing the part of   
tendon contained within such            
cavities4 ,treatment has not proved     
entirely satisfactory in the            
majority of instances1 perhaps because  
of tardy interference4       ,in a      
colt's leg sent the author by ,mr4      
,thomas ,millar1 ,m4,r4,c4,v4,s41       
of ,asquith1 ,saskatchewan1 a careful   
dissection of the carpal region         
revealed the fact that in this case the 
ruptured extensor tendon      was due to
 injury4 ,the colt may have been        
trampled upon by its dam      in such   
manner that the tendon was divided4 ,no 
noticeable evidence      of injury to   
the skin was to be seen on its outer    
surface1 but on      the fascial side a 
cyanotic congested area1 which was      
situated      immediately over the site 
of the ruptured tendon1 was very        

evident4       ,with the execution of a 
good surgical technic1 the ruptured     
tendon      might be sutured2 the wound 
of the tendon sheath as well as that of 
the skin carefully united by means of   
gut sutures1 the leg bandaged      and  
immobilized with leather splints and    
recovery follow in a      reasonable    
percentage of cases so treated4 ,these  
cases afford an      opportunity for the
 perfection of practical means of       
treatment by      those who frequently  
meet with this affection4   ,rupture of 
the ,flexor ,tendons and ,suspensory    
,ligament4  ,etiology and               
,occurrence4--,rupture of the flexor    
tendons or of the suspensory ligament is
 of rare occurrence4 ,frequently1 these 
structures are divided as the result of 
wounds2 but rupture1 due to strain1 is  
not frequent4  ,illustration3 ,fig4     
#bf--;,extreme dorsal flexion said to   
have resulted from an attack of         
distemper4 ,from ,amer4 ,j'n'l4 ,vet4   
,med41 ,vol4 ,,xi1 ,no4 #d4  ,in some   

cases in running horses1 or in animals  
that are put to strenuous performances1 
such as are jumpers1 rupture of tendons 
or of the suspensory ligament takes     
place4 ,however1 more frequently this   
follows certain debilitating diseases   
such as influenza or local infectious   
inflammation of the parts which results 
in degenerative changes and rupture     
follows4  ,the non-elastic suspensory   
ligament receives some heavy strains    
during certain attitudes which are taken
 by horses in hurdle jumping as is      
explained in detail by ,montane and     
,bourdelle#bf under the description of  
this ligament4 ,but in spite of the     
frequent and unusually heavy strains1   
which these structures receive1 complete
 rupture is not frequently seen4        
,symptomatology4--,when the anatomy and 
function of the flexor tendons and      
suspensory ligament is thoroughly       
understood1 recognition of rupture of   
either of these structures is easily    
recognized4 ,when one considers that in 

rupture1 a position directly opposite to
 that which is seen in contraction in   
either one of these structures1 is      
assumed1 a detailed description of each 
separate condition is needless          
repetition4  ,however1 it is pertinent  
to suggest that rupture of the deep     
flexor tendon 7perforans7 allows a      
turning up of the toe4 ,whether it be   
torn loose from its point of attachment 
or ruptured at some point proximal      
thereto1 the position is the same--heel 
flat on the ground1 toe slightly raised 
and this raising of the toe varies in   
degree as the subject moves about4      
,when the superficial flexor            
7perforatus7 is ruptured there is no    
change in the position of the foot but  
the fetlock joint is slightly lowered4  
,the pathognomonic symptom is the lax   
tendon during weight bearing1 which may 
be felt by palpation of the tendon along
 its course in the metacarpal region4   
,with complete rupture of the suspensory
 ligament there occurs a marked dropping

 of the fetlock joint and an abnormal   
amount of weight is then thrown upon the
 superficial flexor tendon 7perforatus71
 causing it to be markedly tensed4 ,this
 is readily recognized by palpation4 ,by
 palpating the suspensory ligament from 
its proximal portion down to and beyond 
its bifurcation1 while the affected     
member is supporting weight1 it is      
possible to diagnose rupture of one of  
its branches4  ,prognosis and           
,treatment4--,in rupture of the         
superficial flexor tendon 7perforatus7  
because of its comparatively less       
important function1 prognosis is        
favorable and recovery takes place when 
proper treatment is put into practice4  
,with rupture of the deep flexor tendon 
7perforans71 especially when it occurs  
at or near its point of insertion and   
sometimes following disease1 prognosis  
is unfavorable4  ,rupture of the        
suspensory ligament constitutes a       
condition which is1 as a rule1 hopeless1
 because of the impracticability of     

treating such cases4  ,the salient      
feature which characterizes any         
practical attempt at treatment of       
ruptured tendons or other portions of   
the inhibitory apparatus of the fetlock 
region1 is to retain the phalanges in   
their normal position for a sufficient  
length of time that the approximated    
ends of ruptured tendons or ligaments   
may unite4 ,the length of time required 
for this to occur1 together with the    
difficulties encountered in confining   
the affected extremities in suitable    
braces or supportive appliances1        
precludes all possibility of this       
condition's being practically amenable  
to treatment when the deep flexor tendon
 7perforans7 and suspensory ligament are
 simultaneously ruptured4 ,it does not  
follow1 even so1 that recovery does not 
succeed treatment in some of these      
unfavorable cases4  ,illustration3 ,fig4
 #bg--;,a good style of shoe for bracing
 the fetlock where tenotomy has been    
performed1 or in case of traumatic      

division of the flexor tendons4 ,an     
invention of ,dr4 ,g4,h4 ,roberts4      
,affected subjects are kept in slings as
 long as it seems necessary--until they 
learn to get up without deranging the   
braces worn4  ,several styles of braces 
are in use and each has its objections2 
nevertheless some sort of support to the
 affected member is necessary and steel 
braces which are connected with shoes   
are usually employed4  ,the principal   
difficulty which attends the use of     
braces is pressure-necrosis of the skin 
which is caused by the constant and firm
 contact of the metal support4 ,the     
practitioner's ingenuity is taxed in    
every case to contrive practical means  
of padding the exposed parts in order to
 prevent or minimize necrosis from      
pressure4 ,this is attempted--with more 
or less success--by frequent changing of
 bandages and the local application of  
such agents as alcohol or witch hazel4  
,needless to say1 the skin must be kept 
perfectly clean and the dressings free  

from all irritating substances4         
,illustration3 ,fig4 #bh--,showing the  
,roberts brace in operation4  ,the fact 
that tendons or ligaments which are     
ruptured1 do not regenerate as readily  
as in cases where traumatic or surgical 
division occurs1 must not be lost sight 
of1 and prognosis is given in           
accordance4   ,thecitis and ,bursitis in
 the ,fetlock ,region4  ,etiology and   
,occurrence4--,synovial distension of   
tendon sheaths and bursae in the region 
of the fetlock are caused by the same   
active agencies which produce this      
condition in other parts4 ,the fetlock  
region is exposed to more frequent      
injury than is the carpus and as a      
consequence is more often affected4 ,the
 same proportionate amount of irritation
 affects this part of the leg1 owing to 
strains1 as affect the carpus from a    
similar cause2 and synovitis from this  
cause1 is as frequent in one case as in 
the other4 ,therefore1 it is a natural  
sequence that the tendon sheaths of the 

metacarpophalangeal region are          
frequently distended because of chronic 
synovitis and thecitis4 ,these          
inflammations are usually non-infective 
in character4  ,the cul-de-sac of the   
capsular ligament of the fetlock joint  
which extends upward between the        
bifurcation of the suspensory ligament  
is the most frequently affected         
structure in this region4 ,when         
distended1 two spheroidal masses bulge  
laterally and anterior to the flexor    
tendons in a characteristic manner4     
,this condition is known among horsemen 
as wind-gall or fetlock-gall4  ,the     
sheath of the flexor tendons1 which     
begins about the middle portion of the  
lower third of the metacarpus1 and      
continues downward below the pastern    
joint is often distended4  ,excepting in
 cases of acute inflammation attending  
synovitis of these parts1 no lameness   
marks its existence and in chronic cases
 of synovial distension the service of  
affected animals is not interfered with4

 ,these distensions constitute unsightly
 blemishes and they are treated chiefly 
for this reason4  ,no difficulty is     
encountered in recognizing these        
conditions even where considerable      
organization of tissue overlying        
distended thecae occurs4 ,in such cases 
there may be only slight fluctuation of 
the enlargement1 but if necessary1 an   
aseptic exploratory puncture may be made
 with a suitable needle or trocar4      
,treatment4--,complete rest and the     
local application of cold packs are in  
order in acute synovitis when there is  
distension of tendon sheaths4 ,in the   
fetlock region1 because of the ease with
 which pressure may be employed1 the    
parts should be kept snugly wrapped with
 cotton1 and derby bandages are used to 
exert the desired amount of pressure    
over the affected region4 ,the          
pressure-bandages should be employed as 
soon as all acute and painful           
inflammation has subsided2 and then they
 should be continued1 day and night1 for

 ten days or two weeks4 ,the bandages   
should be removed morning and night4    
,after the skin of the leg has          
thoroughly dried off1 an infriction of  
alcohol or distilled extract of         
hamamelis is given the parts and the    
cotton and bandages are readjusted4 ,a  
good1 even and firm pressure in such    
cases is productive of satisfactory     
results4  ,illustration3 ,fig4          
#bi--;,distension of theca of the       
extensor of the digit 7extensor pedis74 
,in chronic distensions of tendon       
sheaths synovia may be aspirated and    
about five cubic centimeters of equal   
parts of tincture of iodin and alcohol  
is injected into the cavity4 ,this is   
not done1 however1 without usual aseptic
 precautions4 ,if no marked swelling    
results within forty-eight hours the    
entire fetlock region is thoroughly     
vesicated and1 as soon as the skin has  
recovered from the effects of the       
vesicant1 pressure bandages may be      
employed4 ,in these cases1 subjects may 

be put into service after all swelling  
which the injection or the vesicant has 
produced has subsided4 ,the pressure    
bandages are used at night or during the
 time that the horse is in its stall and
 they are not worn by the subject while 
at work4  ,where no marked swelling     
occurs within ten days1 as the result of
 the injection of iodin1 the injection  
may be repeated and1 if thought         
necessary1 the quantity may be          
materially increased4 ,if swelling does 
not occur it is indicative that no      
particular irritation has been caused4  
,some swelling is desirable and much    
swelling sometimes results and persists 
for weeks4 ,this is not in any way      
likely to cause permanent trouble2 and  
if the technic of injection is skilfully
 executed no infection will follow4  ,by
 persistent and careful use of suitable 
elastic bandages1 the support thus given
 the parts1 together with the absorption
 of products of inflammation which      
constant pressure occasions1 some       

chronic cases of synovial distension of 
tendon sheaths recover in two or three  
months and this without other treatment4
 ,such good results are not to be       
expected in aged subjects1 nor in horses
 having at the same time1 chronic       
lymphangitis4  ,where bandages of pure  
rubber are employed great care is       
necessary1 if one is not experienced in 
their use1 lest necrosis result4 ,where 
bandages are uncomfortably tight the    
subject will manifest discomfort1 and an
 attendant should observe the animal at 
intervals for a few hours 7where there  
may be some doubt as to the degree of   
pressure which is exerted by elastic    
bandages7 and readjustment made before  
any harm is done4   ,arthritis of the   
,fetlock ,joint4  ,anatomy4--,the       
anatomy of the metacarpophalangeal      
articulation is briefly reviewed on page
 #eh under the heading of               
,anatomo-,physiological ,review of      
,parts of the ,foreleg4  ,etiology and  
,occurrence4--,the chief causes of      

non-infective arthritis of the fetlock  
joint are irritations from concussion   
and contusions due to interfering4 ,the 
condition occurs in young animals that  
are over-driven in livery service or    
other similar exhausting work1 where    
they become so weary that serious injury
 is done these parts by striking the    
pasterns with the feet--interfering4 ,in
 these leg-weary animals1 that are      
always kept shod with fairly heavy      
shoes1 much direct injury is done at    
times by concussion due to              
self-inflicted blows4 ,in older animals1
 where there exists similar conditions1 
with respect to their being worn from   
fatigue and1 in addition1 periarticular 
inflammatory organizations1 arthritis is
 not of uncommon occurrence4            
,illustration3 ,fig4 #cj--,rarefying    
osteitis wherein articular cartilage was
 destroyed in a case of arthritis of    
fetlock joint4  ,symptomatology4--,in   
true arthritis there exists a very      
painful affection which is characterized

 by manifestations of distress4 ,the    
subject may keep the extremity moving   
about--where pain is great--suspended   
and swinging4 ,there is swelling which  
is more or less hot to the touch and    
compression of the parts with the       
fingers increases pain4 ,lameness is    
always pronounced and no weight is      
supported with the affected member in   
very acute and generalized arthritic    
inflammations4 ,there occurs the usual  
facial manifestations of pain--the tense
 condition of the facial muscles and the
 fixed eye and nostril are in evidence4 
,in cases where there exists a synovitis
 or where a very limited portion of the 
articulation is involved1 a somewhat    
different clinical picture is presented4
 ,then1 the disturbance causes less     
distress2 local swelling and evidence of
 supersensitiveness are not so          
pronounced and lameness is not intense1 
though weight-bearing is painful4       
,prognosis4--,there is a constant       
difference in the degree of pain        

manifested1 as well as the other        
symptoms of inflammation1 between true  
arthritis1 which involves much of the   
joint1 and synovitis2 or synovitis plus 
a small circumscribed area of joint     
involvement4 ,this difference is present
 in all joint affections of the         
extremities and1 in passing1 it is well 
to say that infection usually increases 
every manifestation of pain4 ,infection 
occasions more pronounced local symptoms
 of inflammation and1 because of the    
rapid progress of necrotic destruction  
of cartilage1 the course of the         
affection is usually rapid2 ankylosis is
 a frequent result and loss of the      
subject is often inevitable4 ,however1  
in non-infective arthritis of the       
fetlock joint1 prognosis is favorable4  
,treatment4--,the same general          
principles which are employed in        
arthritis of other joints are used here4
 ,rest and comfort for the patient is   
sought in every available manner4 ,if   
the subject remains standing too long1  

the sling should be used and a          
well-bedded box-stall will contribute   
much to the comfort of the patient4     
,pain and acute inflammation is         
diminished or controlled1 if possible1  
by using ice-cold packs4 ,in nervous1   
well-bred animals analgesic agents may  
be employed2 or small doses of morphin  
sulphate--one to two grains--given at   
intervals of three hours during the     
first stages of the affection is very   
beneficial4 ,this is especially         
indicated in infectious arthritis4  ,as 
inflammation subsides1 hot applications 
are used and finally counter irritants  
are employed4 ,their selection is a     
matter of choice with the practitioner4 
,the object sought is the same with     
every practitioner and while methods    
employed vary1 results are not markedly 
different except in so far as the degree
 of counter irritation which is produced
 varies in given cases4 ,where a great  
degree of counter irritation is thought 
necessary1 line-firing with the actual  

cautery is the remedy par excellence4   
,after-care4--,in the course of three or
 four weeks subjects may be allowed the 
run of a paddock and1 after a complete  
rest of six weeks at pasture1 they may  
be returned to work with care1 if the   
work is not of a nature to occasion     
concussion or other manner of irritation
 to the articulation4  ,neurectomy is   
not indicated even though there is a    
recurrence of lameness1 unless the      
lameness is not pronounced and          
inflammation is periarticular and no    
osseous enlargements mechanically       
interfere with function of the joint4   
,there are few cases then1 where        
neurectomy is materially helpful4       
,ossification of the ,cartilages of the 
,third ,phalanx4 7,ossification of the  
,lateral ,cartilages47  ,anatomy and    
,function of the                        
,cartilages4--,surmounting each wing of 
the distal phalanx 7os pedis7 is the    
irregularly-quadrangular cartilage4 ,the
 superior border of this cartilage is   

thin1 generally convex1 and perforated  
for vessels to pass to the frog2 the    
inferior border is attached to the wing 
of the third phalanx and posteriorly1 it
 is reflected inward and is continuous  
with the inferior surface of the        
sensitive frog4 ,the anterior border    
which is directed obliquely downward and
 backward becomes blended with the      
anterior lateral ligament of the coffin 
joint4 ,the fibrous expansion of the    
anterior digital extensor 7extensor     
pedis7 is united to the anterior borders
 of the lateral cartilages4             
,according to ,smith#bg3 ,these         
structures form an elastic wall to      
the sensitive foot1 and attachment to   
the vascular laminae2 they      also    
admit of increase in width occurring at 
the posterior part of      the foot     
without destroying the union of the two 
set of leaves4      ,further1 by their  
connection with the vascular system of  
the foot1      their elastic movements  
materially assist the circulation4 ,the 

primary use of the lateral cartilages is
 to render the internal      foot       
elastic1 and admit of its change in     
shape which occurs under      the       
influence of the weight of the body4    
,the alteration in the      shape of the
 foot is brought about by pressure on   
the pad1 which      widens and in       
consequence presses on the bars4 ,the   
pressure      received by the pad is    
also transmitted to the plantar cushion1
      which likewise flattens and       
spreads under pressure4 ,both of these  
factors force the cartilages slightly   
outwards4 ,when the posterior      wall 
recoils the cartilages are carried back 
to their original      position4 ,should
 the elastic cartilage under            
pathological      conditions become     
converted into bone1 its functions are  
destroyed1      and lameness may occur4 
,etiology and ,occurrence4--,the causes 
of ossification of these cartilages are 
several4 ,no doubt there exists a       
predisposition to this condition for it 

is of such frequent occurrence in heavy 
draft types of horses4 ,concussion plays
 an important role and1 according to    
,moeller's#bh theory1 which is sound1   
high heel calks prevent the frog from   
contacting the ground1 and as weight is 
placed upon the foot the lateral        
cartilages are subjected to a continuous
 inward and downward dragging strain4   
,illustration3 ,fig4 #ca--,ringbone and 
sidebone4  ,the condition affects the   
cartilages of the fore feet more        
frequently than those of the hind and   
the outer cartilage is more often       
ossified than is the inner4 ,this fact  
may be accounted for by its more exposed
 position2 it is also frequently injured
 by being trampled upon and otherwise   
contused or cut1 as in lacerated wounds 
of the quarter4                         
,symptomatology4--,ossification of the  
cartilages is known by grasping the free
 borders with the fingers and attempting
 their flexion2 the rigid inflexible    
ossified cartilage is thus easily       

recognized4  ,lameness during           
weight-bearing occurs in the majority of
 cases at some time4 ,much depends on   
the conformation of the foot and whether
 the involvement affects one or both    
cartilages as to the degree and duration
 of lameness which marks this affection4
 ,in narrow and contracted heels it is  
reasonable to expect more lameness than 
in well formed feet4 ,where only one    
cartilage is ossified1 the other being  
flexible1 there is less inconvenience   
experienced by the subject during       
weight-bearing1 because of the expansion
 of the heel which the one normal       
cartilage allows4  ,treatment4--,there  
is little if anything to be done in case
 the cartilage has become ossified      
except to shoe without high calks but   
preferably with rubber pads4 ,the hoof  
should be kept moist2 the wall at the   
quarter may be rasped thin and kept     
anointed4 ,firing is of no practical    
benefit in these cases1 and it is       
doubtful if vesication is helpful       

excepting where only a part of the      
cartilage is ossified4  ,subjects which 
continue somewhat lame1 because of      
complete ossification of both           
cartilages1 are best put to slow work on
 soft ground and not driven on          
pavements4   ,navicular ,disease4  ,this
 more or less ambiguous term has been   
applied to various diseases affecting   
the structures which make up the coffin 
joint4 ,we consider this name to be     
applicable to inflammatory involvement  
of the third sesamoid 7navicular bone71 
the deep flexor tendon 7perforans7 and  
the bursa podotrochlearis or navicular  
bursa4  ,etiology and ,occurrence4--,in 
#ahfd ,thomas ,greaves#bi wrote on the  
subject of navicular disease as follows3
 ,the opinion ,i entertain upon the     
subject of navicular disease is1 that in
 by far the greater majority 7if not    
all7 of these cases there exists in the 
animal affected a congenital tendency or
 predisposition1 that1 generally        
speaking1 it is the high stepper1 the   

good goer1 that becomes the victim to   
this disease2 and it is a fact well     
attested1 that it as frequently develops
 itself in the feet with wide frogs1    
bulbous heels1 shallow heels1 spread    
flattish feet1 as in the narrow upright 
feet4444 ,i have known foals1 born from 
defective parents1 in which this        
condition was so strongly developed1    
that all men would at once pronounce    
them affected with navicular disease1   
and such lameness was permanent4  ,often
 both fore feet are affected and this   
would point toward its being a disease  
wherein either conformation or          
congenital tendencies exists4 ,it is    
rare that hind feet are involved4       
,there are many theories regarding the  
possible exciting causes of navicular   
disease and1 when one has carefully     
considered the explanations as offered  
by ,peters1 ,moeller1 ,branell1         
,schrader and others1 he may conclude   
that navicular disease is a             
non-infectuous inflammatory affection of

 the third sesamoid 7navicular7 bone1   
deep flexor tendon 7perforans7 and      
adjoining structures4 ,whether it       
originates in the flexor tendon or      
whether the bone is the original part   
affected1 the disease is frequently met1
 and of all possible causes1 jars and   
irritation incident to concussion of    
travel1 are probably the principal      
causative agents4                       
,symptomatology4--,lameness is the      
primary indicator and a constant symptom
 which attends navicular disease        
wherever much structural change affects 
the infirm parts4 ,as the degree of     
intensity or extent varies1 so is there 
a dissimilarity in the character of the 
impediment4 ,incipient cases of         
bilateral involvement are more difficult
 to diagnose than are unilateral        
affections1 particularly when lameness  
is not marked4 ,there is manifested a   
supporting-leg-lameness which varies as 
to degree in the same subject at        
different times4 ,this may be noticed   

during the same trip in an animal that  
is being driven4 ,there is a tendency   
for the subject to stumble and1 of      
course1 where the affection is          
bilateral1 there is a stilted gait owing
 to shortened strides4  ,at rest the    
lame animal usually points with the     
affected member4 ,because of the fact   
that the distance is lessened between   
the origin and insertion of the deep    
flexor tendon 7perforans7 by this       
attitude1 one may readily understand the
 reason for the position assumed by the 
subject4 ,pressure on the navicular bone
 is diminished and tension on the flexor
 tendon is relieved by even slight volar
 flexion4  ,in acute inflammatory       
affections abnormal heat may be detected
 in the region of the heel4 ,by exerting
 tension on the flexor tendon1 by means 
of passive dorsal flexion of the member1
 evidence of hyperesthesia may be       
detected4 ,with the hoof testers one may
 determine supersensitivenss in most    
instances4 ,there occurs more or less   

contraction of the hoof in navicular    
disease1 but this is not to be taken as 
a cause of the affection1 but rather a  
sequence4  ,illustration3 ,fig4         
#cb--,pointing--the position assumed by 
horse having unilateral navicular       
disease4  ,in some cases of unilateral  
navicular disease there is a marked     
contrast in size between the sound and  
unsound foot4 ,however1 one must not be 
misguided in this particular1 for in    
some pairs of sound feet there exists   
considerable difference in size4        
,finally1 by a change from the normal   
position of the foot to one in which the
 heel is somewhat elevated 7as may be   
obtained by shoeing with high heel      
calks71 relief is evident1 and in the   
opposite position1 the condition is     
aggravated4 ,this experiment may be used
 for diagnostic purposes4               
,treatment4--,when the anatomy of the   
diseased parts is taken into            
consideration1 and an analysis of the   
lesions which occur in cases where      

considerable structural change is       
occasioned by this affection1 it is     
obvious that recovery is impossible4    
,only in cases where the inflammation is
 promptly checked before damage has been
 done the navicular bone or the flexor  
tendon1 is permanent recovery possible4 
,the disease is not frequently treated  
during this stage1 however1 and in the  
majority of instances the condition     
becomes chronic4  ,as soon as a         
diagnosis is made the shoes must be     
removed1 the toe shortened with the hoof
 pincers and rasp and the subject is put
 in a well bedded box-stall4 ,if the    
animal is very lame and the inflammation
 is acute1 ice-cold packs should be     
applied to the feet4 ,as soon as acute  
inflammation has subsided the foot may  
be so pared that all excess of sole and 
frog is removed without lowering the    
heels1 and the animal may be blistered  
about the coronet region4 ,the subject  
may be shod later1 with heel calks that 
raise the heel moderately and a         

protracted period of rest should be     
enforced4  ,in cases where no acute     
inflammatory condition exists1          
neurectomy is beneficial4 ,one must     
discriminate1 however1 between favorable
 and unfavorable subjects4 ,this is not 
a last resort expedient to be employed  
in cases where extensive lesions of the 
navicular structures exists4 ,with      
proper shoeing1 and by putting the      
subject at suitable work1 where         
concussion of fast travel on hard roads 
is not necessary1 the best results are  
obtainable4   ,laminitis4  ,this disease
 is primarily a non-infective           
inflammation of the sensitive laminae   
which very frequently affects the front 
feet4 ,often all four feet are affected1
 less frequently one foot 7when its     
fellow is unable to sustain weight7 and 
rarely the hind feet alone4             
,occurrence4--,probably a greater number
 of cases of laminitis occur in         
localities where horses that are worked 
on heavy transfer wagons are1 when in a 

state of perspiration1 allowed to stand 
exposed to sudden lowering of           
temperature and to stand in a cool or   
cold shower of rain such as occurs near 
the coast of the ,great ,lakes or the   
ocean in some parts of this country4    
,this disease occurs in connection with 
digestive disorders of various kinds    
and1 because of the frequent association
 of the two conditions1 the common term 
founder has long been employed to       
designate laminitis4 ,in cases of       
over-loading1 particularly when a large 
quantity of wheat has been eaten by     
animals that are unaccustomed to this   
diet1 laminitis almost constantly       
results4  ,large draughts of cold water1
 when drunk by animals that are         
overheated is often followed by         
laminitis4 ,concussion1 such as attends 
hard driving1 especially in unshod      
horses or on rough and hard roads1 is   
often succeeded by this affection4      
,likewise1 as has been stated1 injury   
such as is occasioned by long continued 

standing on the same foot is followed by
 laminitis4 ,some horses that are       
frequently shod1 suffer from this       
affection a few hours after shoes have  
been reset4 ,dr4 ,chas4 ,r4 ,treadway of
 ,kansas ,city reports the rather       
frequent occurrence of such conditions  
in horses that are in the fire          
department service in his city4  ,age in
 no way influences the occurrence of    
laminitis and the general condition of  
an animal with regard to its vigor or   
state of flesh has no apparent influence
 toward predisposing horses to this     
ailment4  ,etiology and                 
,classification4--,as it is with some   
other diseases1 one may unprofitably    
theorize on cause and readily enumerate 
many conditions which are apparently    
contributory toward producing the       
affection4 ,causes may well be grouped1 
however1 and a more definite            
understanding of laminitis is possible  
as a result4 ,such collocation would    
include conditions which directly or    

indirectly affect the digestion1 such as
 puerperal laminitis1 drinking of large 
quantities of cold water and exposure to
 cold and rain when the body is warm4   
,all of these various conditions might  
be said to affect the vaso-constrictor  
nerves in such manner that the natural  
tendency 7because of the peculiar       
structure of the sensitive laminae and  
their mode of attachment to the         
non-sensitive wall7 which solipeds have 
for this affection is indirectly due to 
this one cause--vaso-constriction4      
,according to ,dr4 ,d4,m4 ,campbell1 the
 effect of toxic materials1 which may be
 absorbed from the digestive tract or   
the uterus in parturient females1 upon  
the vaso-constrictor nerves1 is such    
that a passive congestion of the        
sensitive laminae occurs and laminitis  
is the result4 ,he believes that even   
the chilling of the surface of the body 
when very warm1 by a cold rain1         
constitutes a condition wherein the     
effect upon the vaso-constrictors is the

 same4  ,this grouping does not include 
the effect of direct injuries of any and
 all kinds to which the feet are        
subjected such as3 ,concussion in fast  
road work1 injuries occasioned by tight 
or ill fitting shoes1 contusions of any 
kind resulting in non-infectious        
inflammation of the sensitive laminae1  
as well as the causes which produce     
laminitis where weight is borne by one  
foot when its fellow is out of function4
  ,a classification which is practical  
is that of acute and chronic laminitis4 
,to the practicing veterinarian it is   
this manner of consideration that is    
essential in the handling of these      
cases4  ,symptomatology4--,in the acute 
attack the condition is so well         
described by ,dr4 ,r4,c4 ,moore#cj that 
we quote him in part as follows3        
,the acute form is generally ushered in 
very suddenly4 ,often a horse      that 
is perfectly free from symptoms of the  
disease is found a few      hours later 
so stiff and sore that he will scarcely 

move4 ,they      stand like they were   
riveted to the ground4 ,if forced to    
move the      evidence of pain subsides 
to some extent after they have gone a   
short distance1 to return more severe   
than ever after they have      been     
allowed to stand for a short time4 ,if  
the disease is confined      to the two 
front feet1 the hind feet are placed    
well under the      center of the body  
to support the weight and the front ones
 are      advanced in front of a        
perpendicular line so as to lessen the  
weight they must bear4 ,if they are made
 to move1 the same position      of the 
feet is maintained4 ,if made to turn in 
a small circle1 they      do so by using
 the hind feet as a pivot1 bringing the 
front parts      around by placing as   
little weight on them as possible4      
,placing the hind feet so far under the 
body1 arches the back and      often    
leads to errors in diagnosis1 the       
condition sometimes being      taken for
 diseases of the loins or kidneys4      

,if all four feet are involved1 the     
animal stands in the usual      position
 assumed in health1 but if urged to     
move1 the least effort      to do so    
usually brings on chronic spasms of the 
entire body4 ,in      very severe cases1
 a slight touch of the hand will develop
 the      spasms4 ,at times they are so 
severe1 and have such short             
intermissions1 that the disease has been
 mistaken for tetanus4      ,however1   
the clonic nature of the spasm should   
prevent such an      error4 ,if they are
 lying down1 it is difficult to get them
 to      arise1 and if they do so1 they 
show marked symptoms of pain for        
some time after rising4       ,if the   
disease is confined to the hind feet1   
they are placed well      forward to    
relieve the strain on the toe caused by 
the downward      pull of the perforans 
7deep flexor7 tendon1 but in place of   
the      front feet being kept in front 
of a perpendicular line1 as they are    
when the disease is confined to the     

front ones1 they are placed far         
back under the body1 so they will carry 
the maximum share of the      body      
weight of which they are capable4 ,the  
position of the feet is      of great   
importance and offers symptoms that     
should not be      overlooked4  ,when   
the subject is caused to walk1 symptoms 
of excruciating pain are manifested in  
all acute cases of laminitis4 ,in some  
cases where all four feet are affected1 
no reasonable amount of persuasion will 
cause the suffering animal to move from 
its tracks4  ,there is acceleration of  
the rate of heart action2 the pulse is  
full and in some cases1 bounding4 ,as   
the affection progresses the pulse      
becomes rather weak and irregular4 ,the 
character of the pulse in the region of 
the extremity is a reliable indicator2  
but one has to learn to make necessary  
discrimination because of the condition 
of the parts1 as in some cases of       
lymphangitis or where the skin is       
abnormally thick4 ,the characteristic   

throbbing pulse is1 however1 easily     
recognized in most cases4 ,temperature  
is variable1 though usually elevated    
from one to four degrees above normal4  
,this symptom varies with the type and  
stage of the affection4 ,in a subject   
that has been down1 unable to rise for  
several days1 where there is a          
suppurative and sloughing condition of  
the laminae1 the temperature is high4   
,whereas1 in some other and less        
destructive cases there may be little   
thermic disturbance after the first few 
hours have lapsed4  ,a constant symptom 
in bilateral affections of acute        
laminitis is the difficulty with which  
the subject supports weight with one    
foot4 ,it is this which causes the      
victim to stand as if rooted to the     
ground when all four feet are involved4 
,if one attempts to take up one foot1   
thus causing the subject to stand on the
 other1 there is much resistance and in 
many cases the animal refuses to give   
the foot4  ,when we consider that the   

sensitive parts of the foot are encased 
by a horny1 unyielding box and that1    
when the laminae are congested1 a great 
pressure is brought to bear upon the    
sensitive structures1 it is easy to     
understand why the condition is so      
painful4  ,chronic laminitis is a sequel
 of acute inflammation of the sensitive 
laminae4 ,it varies as to intensity and 
the exact manner of its manifestation   
depends upon preexisting disturbances4  
,in some mild cases of laminitis there  
are recurrent attacks wherein no        
particular structural change exists1 and
 diagnosis is established chiefly by    
noting the character of the pulse at the
 bifurcation of the large metacarpal 7or
 metatarsal7 artery just above the      
fetlock4 ,the same manifestation of pain
 is present when weight is supported by 
one foot1 though in a lesser degree4    
,there is less local heat to be detected
 by palpation than in the acute cases4  
,chronic laminitis as it occurs         
following acute attacks which have      

resulted in structural changes of the   
foot1 present the same symptoms just    
described and1 in addition1 the peculiar
 alterations in structure exist4 ,when1 
owing to acute inflammation of the      
sensitive laminae1 there has resulted   
necrosis of this sensitive tissue       
together with infiltration between the  
anterior surface of the distal phalanx  
7os pedis7 and the contacting hoof1 the 
lower portion of the distal phalanx is  
turned downward and backward 7rotated   
upon its transverse axis74 ,because of  
the traction which is exerted by the    
deep flexor tendon 7perforans71 as it   
attaches to the solar surface of the    
distal phalanx1 this rotation is        
facilitated4 ,with hyperplasia of       
lamina1 at the anterior portion of the  
distal phalanx1 there results a thick   
white line4 ,rotation of the distal     
phalanx necessitates a descent of its   
apical portion and there occurs a       
dropped sole4  ,in time1 partly because 
of excessive wear of hoof at the heel1  

owing to an altered condition in the    
normal antagonistic relation between the
 flexor and extensor tendons1 the toe   
makes an excessive growth1 and the      
concavity of the anterior line is       
accentuated owing to this abnormal      
length of hoof4 ,the hoof1 because of   
recurrent inflammatory attacks1 is      
corrugated--elevations of horn in       
parallel rings are usually present4     
,illustration3 ,fig4 #cc--,the hoof in  
chronic laminitis4 ,note the concavity4 
,this animal was serviceable for any    
work that could be performed at a walk4 
,animals that are so affected in        
traveling strike the heel first and the 
toe is later contacted with the ground  
surface4 ,rotation of the distal phalanx
 upon its transverse axis produces a    
condition1 with respect to this peculiar
 impediment1 that is equivalent to added
 and excessive length of the deep flexor
 tendon4  ,where there occurs           
suppuration1 by careful inspection of   
the coronary region1 one may early      

recognize detachment of hoof4 ,in such  
cases animals remain recumbent and1     
while the condition is not so painful at
 this stage1 the practitioner must not  
overlook the real state of affairs4     
,history1 if obtainable1 will be a      
helpful guide in such cases4 ,separation
 of hoof occurs as a rule in from four  
to ten days after the initial attack of 
acute laminitis4 ,needless to say these 
cases are hopeless1 when the economic   
phase of handling subjects is           
considered4  ,illustration3 ,fig4       
#cd--,showing the effects of laminitis4 
,by permission1 from ,merillat's        
,veterinary ,surgical ,operations4      
,treatment4--,much depends upon the     
concomitant disturbances 7or causes if  
one is justified in referring to them as
 such7 as to the manner in which        
laminitis is to be treated4 ,in all     
cases where digestive disturbances      
exist1 the prompt unloading of the      
contents of the alimentary canal is     
certainly indicated4 ,d4,m4 ,campbell#ca

 in a discussion of laminitis has the   
following to say regarding the treatment
 of such cases3       ,because          
superpurgation may be followed by       
laminitis1 the      advisability of     
using the active hypodermic cathartics  
is      questioned4 ,neither arecolin   
nor eserin can cause superpurgation4    
,the action of the former does not      
continue longer than an hour      after 
administration and of the latter not    
more than eight hours4      ,the action 
of either is mild after the first few   
minutes4       ,i do not think that     
anyone has recommended either arecolin  
or      eserin where there is severe    
purgation4 ,where the intestinal canal  
is fairly well emptied and its contents 
fluid1 ,i should be inclined      to    
rely upon intestinal antiseptics to hold
 in check harmful      bacterial growth4
       ,the use of alum in the treatment
 of laminitis is held to be without     
reason other than the empirical one that
 it is beneficial4 ,if      laminitis is

 due chiefly to an autointoxication1    
good and      sufficient reason for the 
administration of alum can be shown     
based      upon its known physiological 
action4 ,it is the most powerful        
intestinal astringent that ,i know of   
and has the fewest      disadvantages4  
,i have not noted constipation following
 its use nor      diarrhea1 nor a       
stopping of peristalsis1 nor            
indigestion1 and in      any case its   
action lasts at most only a few hours1  
and if it did      all these1 it could  
not much matter4 ,quitman says1 that it 
constricts the capillaries4 ,if this is 
true1 a thing of which ,i am      not   
certain1 is it not reasonable to suppose
 that as with other                     
vaso-constrictors1 e4g41 digitalis1     
there is a selective action on      the 
part of the capillaries 7not of the     
drug7 and those that need      it most1 
i4e41 those of the affected feet in     
laminitis1 are      constricted most8   
,all body cells exert this selective    

action in the      assimilation of food1
 the tissue needing most any particular 
kind      of food circulating in the    
blood1 gets it4       ,our first        
consideration in laminitis should be to 
remove the      cause--to stop the      
absorption of the toxin in the          
intestinal tract      that is producing 
the condition4 ,this we accomplish by   
partially      unloading it by the use  
of the active hypodermic cathartics and 
stopping absorption by the surest and   
most harmless of intestinal             
astringents4 ,whether the astonishingly 
prompt and certain action of      alum  
in this case is due wholly to its       
astringent action or whether      alum  
combines with the harmful bacterial     
products chemically and      forms an   
innocuous combination1 ,i can only      
surmise1 and it is      unimportant4 ,at
 any rate1 when alum is administered1   
the onslaught      of the disease is    
promptly stopped4 ,irreparable damage   
may already      have been done if the  

case is a neglected one1 but whether    
administered early or late in acute     
attacks1 the progress of the            
disease is stopped immediately4  ,the   
same authority may be profitably quoted 
in the matter of handling all cases     
wherein the revulsive effect of agents  
which diminish vascular tension are     
chiefly indicated or necessary as       
adjuvants4 ,in this connection1         
,campbell says3       ,the early and    
vigorous administration of aconitin in  
laminitis to      its full physiological
 effect1 is more logical4 ,assuming that
      laminitis is due to absorption of 
harmful products from the               
intestinal tract permitted through the  
deranged functioning of the      organs 
of digestion1 or assuming that it is due
 to an extension of      the            
inflammation from the mucosa to the     
sensitive lamina1 or that      it is a  
reflex from a sudden chilling of the    
skin1 we have in any      of these      
conditions a disturbed circulation1 and 

aconitin is the      first and foremost 
of circulation equalizers4 ,furthermore1
 in      laminitis there is an elevation
 of the temperature1 an almost          
invariable indication for aconitin4 ,a  
speedy return of the      temperature to
 normal1 a very marked diminution of the
 pain and      improved conditions      
generally1 appear coincident with the   
symptoms      of full physiological     
effect of aconitin when given in cases  
of      laminitis1 which constitutes    
assuredly an important part of its      
treatment4  ,illustration3 ,fig4        
#ce--;,inferior 7convex7 surface of     
,cochran shoe4  ,where lameness is not  
great as in cases wherein no marked     
structural change of the foot has       
occurred1 proper shoeing is very        
beneficial4 ,by keeping the heels as low
 as possible and shoeing without heel   
calks a more comfortable position is    
made possible4 ,thin rubber pads which  
do not elevate the heel are of service  
in diminishing concussion4  ,dr4 ,david 

,w4 ,cochran of ,new ,york ,city has    
attained unusual success in cases of    
chronic laminitis with dropped sole by  
the use of a specially designed shoe4   
,illustration3 ,fig4 #cf--,superior     
surface1 showing concavity or bowl1 as  
formed by the toe and branches of the   
shoe1 as designed by ,dr4 ,david ,w4    
,cochran4  ,cochran claims that1 not    
only are horses with dropped soles that 
would otherwise have to be put off the  
streets enabled to do a fair amount of  
work by means of this shoe1 but that    
continually wearing it1 meanwhile       
keeping the convexity of the front of   
the hoof rasped thin1 in time brings    
about a marked improvement1 and that    
after some months or years of use the   
animals are able to work with ordinary  
rubber-pad shoes1 provided they are     
arranged to facilitate breaking over4   
,from having been successfully used on  
some race horses of high value1 the     
,cochran shoe has attained considerable 
notoriety and is being used by a number 

of practitioners4 ,a disadvantage1      
however1 arises from the fact that few  
horseshoers other than ,doctor ,cochran 
seem able to make the shoe1 the peculiar
 shape of which offers considerable     
difficulty in forging4 ,concerning the  
application of the shoe ,cochran#cb     
says3       ,the most important primary 
procedure is the preparation of the     
foot to receive the shoe4 ,all excess of
 growth must be removed from      the   
anterior face of the hoof4 ,the outer   
face must be reduced at      the toe    
7not shortened71 but rasped down thin   
for the lighter the      top of the foot
 is1 the more chance the sole and coffin
 bone will      have of resuming their  
former normal position4 ,the pressure of
 the      wall at the toe upon the      
exudate between wall and coffin bone1   
tends to force the coffin bone and sole 
out of their normal      position4      
,leave the sole alone4 ,you can lower   
the excess of growth      at the heels4 
,there are many designs of shoes to     

relieve this condition4 ,a great        
deal depends on the judgment of the     
shoer to meet the conditions            
presented1 depending on the degree of   
the convexity and strength of      the  
sole4 ,in some cases we use a shoe that 
admits of a large amount      of sole   
room4 ,again1 we shoe with a shoe of    
wide cover4 ,in other      cases a shoe 
with even pressure over the whole sole4 
,in some cases      a high1 narrow shoe1
 resting only on the wall1 or the       
ordinary      plain shoe with side calks
 welded close to the outside edge and   
the      shoe dished well from these as 
a foundation4 ,then we have the air     
cushion pad designed after the model of 
the bowl shoe4  ,in cases when slight   
and persistent lameness interferes      
sufficiently to prevent using an animal 
at any sort of work on hard roads1      
median neurectomy will relieve all      
lameness in most instances4 ,this is a  
safe operation1 moreover1 in that no bad
 after effects are to be feared1 even   

though lameness were to continue4       
,calk ,wounds4 7,paronychia47  ,etiology
 and ,occurrence4--,injuries of various 
kinds are inflicted upon the coronary   
region but usually they are due to the  
foot being trampled upon4 ,when the foot
 that inflicts the injury happens to be 
unshod1 a contusion of the injured      
member is occasioned1 but in the        
majority of instances1 wounds that      
demand attention are the result of shoe 
calks which have penetrated the tissues 
in the region of the coronary band4     
,often calk wounds are self-inflicted4  
,when animals are excited and in turning
 crowd one another1 they often perform  
dancing movements which frequently      
result in deep calk wounds of the       
coronet4 ,some horses have a habit of   
resting the heel of one hind foot upon  
the anterior coronary region of the     
other4 ,while sleeping in this position1
 if they are suddenly awakened1 the     
weight is abruptly shifted to the       
uppermost foot and the one underneath is

 7because of the pain attending its     
being wounded7 quickly drawn out from   
under its fellow4 ,in this way deep cuts
 may divide the coronary band and       
inflict extensive injury to the         
sensitive lamina as well4  ,an          
infectious type of coronary inflammation
 occurs in some localities during the   
winter months1 wherein the condition is 
enzootic4  ,symptomatology4--,depending 
upon the manner in which the injury has 
been produced1 the appearance of the    
wound varies and likewise lameness is   
more or less pronounced4 ,if the tissues
 are not divided and the wound is       
chiefly of the subsurface structures1   
there will not immediately occur        
pronounced local evidence of the        
existence of injury2 but as soon as the 
lame animal is made to move1 the        
peculiar character of the impediment    
7supporting-leg lameness with the       
affected foot kept well in advance of   
its normal position7 directs attention  
to the extremity and all of the symptoms

 of acute inflammation are discovered4  
,where a wound is inflicted which       
divides1 in some manner1 the surface    
structures 7skin1 coronary band1 or the 
hoof wall7 one's attention is at once   
called to the existence of the wound4   
,because of the fact that there is every
 facility for the production of a       
sub-coronary and podophylous infection1 
these wounds should receive prompt      
attention4 ,in some instances1 the      
pastern joint is opened by calk wounds  
and then1 of course1 an infectious      
arthritis succeeds the injury4          
,treatment4--,in all contused wounds of 
the coronary region the parts need      
thorough cleansing2 the hair1 if long is
 clipped and a cataplasm is applied4 ,or
 preferably1 an iodin-glycerin          
combination of one part of iodin to four
 parts of glycerin is poured on a layer 
of cotton1 and this is confined in      
contact with the inflamed parts by means
 of a bandage4  ,where normal resistance
 to infection obtains1 the subject      

usually suffers no suppurative          
disturbance when the surface structures 
are not broken2 and daily applications  
of the antiseptic lotion above referred 
to stimulates complete resolution4 ,this
 may be expected in from four to ten    
days depending upon the extent of the   
injury4  ,if a calk wound has been      
inflicted1 the adjoining surface        
structures are freed of hair and the    
parts cleansed in the usual manner1     
7which in wounds recently inflicted1    
should be done without employing        
quantities of water7 and after painting 
the wound surface with tincture of iodin
 and saturating its depths with the same
 agent1 the wound is cleansed1 if it    
contains filth1 by means of a small     
curette4 ,by using a small and sharp    
curette1 one is enabled to cleanse the  
average wound quickly and almost        
painlessly4  ,in such cases1 equal parts
 of tincture of iodin and glycerin are  
employed4 ,the wound is filled with this
 preparation and a quantity of it is    

poured upon a suitable piece of aseptic 
gauze or cotton and this is contacted   
with the wound4 ,the extremity is       
carefully bandaged and this dressing is 
left in position for forty-eight hours  
unless there occurs1 in the meanwhile1  
evidence of profuse suppuration--which  
is unusual4  ,one is to be guided as to 
the progress made by the degree of      
lameness present4 ,if little or no      
lameness develops1 it is reasonable to  
expect that infection has been checked2 
that the wound is dry and redressing    
every second day is sufficiently        
frequent4  ,where cases progress        
favorably1 recovery 7unless infectious  
arthritis results7 should occur in from 
ten days to three weeks4 ,where         
extensive sub-coronary fistulae result1 
either from lack of prompt or proper    
attention1 the condition is then one    
requiring a radical operation to        
establish drainage and to disinfect if  
possible1 the suppurating tissues4      
,corns4  ,etiology and ,occurrence4--,in

 horses1 because of a tendency toward   
contraction of the heel in some         
subjects1 together with work on hard    
roads and pavements1 where the feet     
become dry and brittle1 and because of  
neglect of the matter of shoeing1 this  
affection is of frequent occurrence4    
,unshod horses are rarely affected4 ,if 
conformation is faulty and too much     
weight is borne on the inner or the     
outer quarter1 and the hoof wall at the 
quarter tends to turn inward1 corns are 
usually present4 ,they occur more       
frequently on the inner quarters of the 
front feet1 though the outer quarters   
are occasionally also affected and in   
rare instances corns are found at the   
toes4 ,they do not often affect the hind
 feet4  ,as soon as injury by pressure1 
such as is supposed to cause the        
formation of corns1 is brought to bear  
on the sensitive sole1 an extravasation 
of blood occurs4 ,in time when the cause
 remains active1 this discoloration is  
evident in the substance of the         

insensitive sole and consists in a red  
or yellowish spot which varies in       
size--this is ordinarily termed dry     
corn4  ,in some cases where infection of
 this extravasation of blood and serum  
occurs1 instead of desiccation and      
discoloration of the insensitive parts1 
there is1 in time1 manifested a         
circumscribed area of destruction of the
 insensitive sole and the abscess may1  
where no provision for drainage exists1 
burrow between sensitive and insensitive
 laminae and perforate the tissues at   
the coronet4 ,if the suppurative        
material discharges readily by way of   
the sole1 no disturbance of the heel or 
quarters occurs above the hoof4         
,symptomatology4--,a                    
supporting-leg-lameness characterizes   
this condition2 and this lameness in    
most instances varies in degree with the
 amount of distress which is occasioned 
by pressure upon the inflamed parts4 ,by
 an examination of the sole after having
 removed all dirt1 and exposed the horny

 sole to view1 no difficulty is         
encountered in locating the cause of the
 trouble4  ,treatment4--,before         
suppuration has taken place and in the  
cases where suppuration does not occur1 
the horse-shoer's method of paring out  
the diseased tissue affords a means of  
temporary relief2 but unless frequently 
done1 in many cases1 lameness results   
within about three weeks after such     
treatment has been given4 ,in other     
instances temporary relief is not to be 
gotten in this manner for any great     
length of time or until a more rational 
mode of treatment becomes necessary so  
that the subject may experience a       
cessation of the inconvenience or       
distress4  ,the general plan which meets
 with the approval of most practitioners
 consists in careful leveling of the    
foot and removing enough of the wall and
 sole at the quarters to make possible  
frog pressure by means of a bar shoe4   
,with frog pressure1 expansion of the   
heel follows in time1 and permanent     

relief is obtainable in this manner4    
,thinning the wall of the quarter is    
advocated by many practitioners and is  
undoubtedly beneficial in chronic cases 
where marked contraction has taken      
place4 ,the wall must be thinned with a 
rasp until it is readily flexible by    
compressing with the thumbs4  ,there are
 instances1 however1 where corns and    
contraction of the heel have existed so 
long that they do not yield to          
treatment4 ,such cases are found in old 
light-harness or saddle-horses that have
 been more or less lame for years and   
where there exists marked contraction of
 the heels1 rough hoof walls1 and hard  
and atrophied frogs4  ,suppurating corns
 require surgical attention in the way  
of removal of the purulent necrotic mass
 and making provision for drainage4 ,dry
 dressings1 such as equal parts of zinc 
sulphate and boric acid1 may be employed
 to pack the cavity4 ,after the         
infectious condition has been           
controlled1 and the wound is dry1 the   

same plan of treatment is indicated that
 is employed in the non-suppurating     
corn4 ,ample time is allowed1 however1  
for the surgically invaded tissues to   
granulate and1 if the subject is to be  
put in service1 a leather pad1 under    
which there has been packed oakum and   
tar1 affords good protection4           
,quittor4  ,this name is employed to    
designate an infectious inflammation of 
the lateral cartilage and adjoining     
structures4 ,the disease is             
characterized by a slowly progressive   
necrosis and by a destruction of more or
 less of the cartilage and by the       
presence of fistulous tracts4  ,etiology
 and ,occurrence4--,the disease is due  
to the introduction of pus producing    
organisms into the subcoronary region of
 the foot under conditions which favor  
the retention of such contagium and     
extension of infection into contiguous  
tissues4  ,morbific material is         
introduced into the region of the       
lateral cartilage by means of calk      

wounds and other penetrant injuries of  
the foot4 ,a sub-coronary abscess which1
 because of lack of proper care or      
because of virulency of the contagium or
 low vitality of the subject1 is quite  
apt to result in cartilaginous affection
 and its perforation by necrosis        
follows4  ,symptomatology4--,quittor is 
readily diagnosed on sight in many      
instances4 ,where there is dependable   
history or other evidence of the        
chronicity of an infectious inflammation
 of the kind1 quittor is easily         
identified4 ,if no positive evidence of 
the disease exists1 by means of careful 
exploration of sinuses with the probe1  
one may distinguish between true        
cartilaginous quittor and superficial   
abscess formation that is often         
accompanied by hyperplasia4  ,lameness  
depends upon the extent of the          
involvement as it affects the structures
 contiguous to the cartilage4 ,a        
variable degree of lameness is          
manifested in different cases4          

,treatment4--,two general plans of      
handling this disease are in vogue4     
,one1 the more popular method1 consists 
in the injection of caustic solutions of
 various kinds into the fistulous       
openings with the object of causing     
sloughing of necrotic tissue and the    
stimulation of healthy granulation of   
such wounds4 ,the other mode consists in
 either complete surgical removal of the
 cartilage or its remaining portions1 or
 removal of the diseased parts of       
curettage4  ,when quittor has not       
extensively damaged the foot and the    
lateral cartilage is not partly ossified
 as it is in some old chronic cases1 the
 complete removal of the lateral        
cartilage by means of the ,bayer        
operation or a modification thereof is  
indicated4 ,a complete description of   
the ,bayer operation as well as         
,merillat's operation for this disease  
7the latter consisting in part1 in the  
removal of diseased cartilage with the  
curette7 are given in ,volume three of  

,merillat's ,veterinary ,surgical       
,operations4  ,treatment by injection of
 caustic solutions has many advocates   
and because of the fact that1 in many   
instances the condition is such that    
they are not desirable surgical cases   
and also because some animals may be put
 in service before treatment is         
completed1 the injection method is      
popular4  ,the mode of treatment        
advocated by ,joseph ,hughes1           
,m4,r4,c4,v4,s41 constitutes a very     
successful manner of handling quittor   
and we can do no better than quote ,dr4 
,j4,t4 ,seeley#cc on his manner of using
 this particular treatment4             
,illustration3 ,fig4 #cg--;,hyperplasia 
of right fore foot1 due to chronic      
quittor4       ,preparation4--,first    
remove the shoe1 have the foot pared    
very      thin and balanced as nicely as
 possible4 ,moreover1 all loose         
fragments of horn must be detached and  
all crevices cleaned      thoroughly4   
,next1 have the leg brushed and hair    

clipped from the knee or hock      to   
the foot and scrubbed with ethereal soap
 and warm water1 after      which the   
foot must be scrubbed in like manner4   
,the foot is then      placed in a      
bichlorid bath several hours daily1 for 
from two to      five days1 depending   
upon whether or not soreness is shown4  
,the      bichlorid solution is #a to   
#a1jjj strength4       ,on removing the 
horse from the bath a liberal layer of  
gauze is      soaked in #a to #a1jjj    
bichlorid solution and placed so as to  
cover      the entire foot4 ,on         
discontinuing the bath1 cover the foot  
with      gauze saturated with a #a to  
#a1jjj bichlorid solution4 ,this is to  
be      covered with absorbent cotton   
and a gauze bandage1 and over all is    
placed an oil cloth or silk covering4   
,this pack is kept moist with           
bichloride solution for forty-eight     
hours4 ,the foot is then ready      for 
injection4  ,illustration3 ,fig4        
#ch--;,chronic quittor1 left hind foot4 

,showing position assumed because of    
painfulness of the affection4           
,preparation of the ,injection          
,fluids4--,have on hand a pint of a     
one per cent aqueous solution of        
formaldehyd made under cleanly          
conditions1 even to a clean bottle and  
cork1 and a clean container      when   
ready to use the liquid4 ,prepare also a
 bichlorid of mercury      solution as  
follows3 ,hydrarg4 ,chlor4 ,corros4     
#c;,,iv2 ,acid ,hydrochlor4             
#c;,iss42 ,aqua ,bulliens1 ,oij4 ,this  
should be thoroughly triturated1        
and then filtered into a clean bottle1  
when it is ready for use4               
,injection4--,the patient should be laid
 on a table1 if one is      available1  
or cast1 and the foot securely fixed4   
,then1 with an      ordinary one-ounce  
hard rubber syringe1 with a good plunger
 7tried      first to note whether or   
not any fluid works around between the  
barrel and the plunger71 introduce one  
syringe full of the      formaldehyd    

solution1 then thoroughly probe the     
quittor to      determine the number of 
sinuses4 ,this done1 inject each sinus4 
,if      two sinuses open on the        
surface1 close one with cotton while    
filling the other so that if there is a 
connection the solution      will come  
in contact with all tissues involved4   
,irrigate with the      full pint of    
formaldehyd solution first1 then follow 
with six or      eight ounces of the    
bichlorid solution4 ,never probe the    
foot nor      allow it to be tampered   
with except in the manner prescribed4   
,after-,treatment4--,put on a pack      
saturated with a solution of            
bichlorid of mercury #a to #a1jjj and   
let it remain two days4 ,remove         
pack1 and once daily afterwards wipe off
 with cotton the secretion      which   
accumulates on the outside1 and apply a 
dry dressing or      healing oil        
composed of phenol1 camphor gum and     
olive oil4       ,when ,dangerous to    
,inject4--,never inject a quittor in the

 acute      stage4 ,never inject a      
quittor if considerable lameness is     
present4      ,on injecting a solution  
of formalin1 hold cotton tightly around 
the      nozzle of the syringe1 when the
 plunger is down1 then withdraw the     
syringe gently and note particularly if 
the fluid returns through      the      
opening2 if none returns cease          
operations at once1 as it is            
dangerous to proceed farther1 it        
indicates that the sinus is not         
well defined and the fluid retained will
 cause much trouble and      often the  
death of the patient4  ,experience has  
taught that1 if extensive destructive   
changes of the foot exist1 the ,bayer   
operation is not indicated4 ,in the     
country1 where quittors are not so      
frequently met as in urban practice1 the
 ,merillat operation is preferable in   
all cases4 ,however1 the cost of the    
protracted period of idleness1 which    
convalescent surgical patients require1 
renders the ,hughes method more         

satisfactory in the hands of the general
 practitioner1 especially in the city4  
,nail ,punctures4  ,nail punctures1 as  
herein considered1 embrace all penetrant
 wounds of the solar surface of the     
horse's foot due to trampling upon      
street nails4 ,this does not include    
accidental nail pricks occasioned in    
shoeing4 ,in city practice1 in some     
stables1 these cases are of frequent    
occurrence2 and1 generally speaking1    
nail punctures are observed more        
frequently in urban horses than in      
animals that are kept in the country4   
,occurrence and ,method of              
,examination4--,this condition1 then1 is
 a rather common cause of lameness and  
in no case1 where cause of the          
claudication is not obvious1 is the     
practitioner warranted in concluding his
 examination without careful search for 
the possible existence of nail puncture 
of the solar surface of the foot4       
,illustration3 ,fig4 #ci--,skiagraph of 
foot4 ,the ,x-ray offers very limited   

possibilities in the diagnosis of       
lameness4 ,the location of a gravel or a
 nail that had worked its way some      
distance from the surface1 or of an     
abscess of some proportion1 deep in the 
tissues1 might be facilitated under some
 circumstances by the aid of the ,x-ray4
 ,its use in the detention of fractures 
is very limited1 owing to the difficulty
 encountered in getting a view from the 
right position--many trials being       
necessary in most cases4 ,the case shown
 above was diagnosed clinically as      
incipient ringbone4 ,the ,x-ray revealed
 no lesions4 7,photo by ,l4             
,griessmann47  ,in occasional instances 
there co-exists an obvious cause for    
supporting-leg-lameness and an occult   
cause--a nail puncture4 ,where such     
complications are met1 the practitioner 
is not necessarily guilty of neglect or 
carelessness when the nail puncture is  
not discovered at once1 nevertheless1 an
 examination is not complete until      
practically every possible cause of     

lameness has been located or excluded in
 any given case4  ,in a search for nail 
puncture it is necessary to expose to   
view every portion of the sole and frog 
in such manner that the existence of the
 smallest possible wound will be        
revealed4 ,this necessitates removal of 
the shoe1 if1 after a preliminary       
examination1 a puncture is not found1   
when there is good reason to suspect its
 presence4 ,however1 where it is readily
 possible to locate and care for a wound
 without removal of the shoe1 allowing  
the shoe to remain materially           
facilitates retaining dressings in      
position and relieves the solar surface 
of contact with the ground4 ,if         
extensive injury or infection exists1 it
 is of course necessary to remove the   
shoe and leave it off4 ,by removing a   
superficial portion of all of the sole  
and frog1 thus carefully and completely 
exposing to view all parts of the solar 
surface of the foot1 and with the aid of
 hoof-testers one is enabled to         

positively determine the existence of   
nail punctures4 ,because of the tendency
 of puncture wounds of the foot to      
close1 and since the superficial portion
 of the solar structures are usually    
soiled1 it is absolutely necessary to   
conduct examinations of this kind in a  
thorough manner4  ,symtomatology4--,not 
all cases of nail puncture cause        
lameness during the course of the       
disturbance and in many instances no    
lameness is manifested for some time    
after the injury has been inflicted--not
 until infection has been the means of  
causing considerable inflammation of    
sensitive structures4 ,nevertheless1    
this lack of manifestation occurs only  
in cases where serious injury has not   
taken place and the degree of lameness  
is a constant and reliable indicator of 
the character and extent of nail        
punctures within twenty-four hours after
 injury has been inflicted4  ,the       
position assumed by the affected animal 
inconstantly varies with the location   

and nature of the injury and is not of  
particular importance in establishing a 
diagnosis4 ,the subject may support some
 weight with the affected member and    
stand base-wide or base-narrow1 or no   
weight may be borne with the foot or the
 animal may point or keep the extremity 
in a state of volar flexion4 ,in cases  
where extensive injury has been         
inflicted1 and great pain exists1 the   
foot is kept off the ground much of the 
time and it may be swung back and forth 
as in all painful affections of the     
extremity4  ,nail punctures cause       
typical supporting-leg-lameness and in  
some cases certain peculiarities of     
locomotory impediment are worthy of     
notice4 ,punctures of the region of the 
heel1 which directly affect or involve  
the deep tendon sheath1 cause a type of 
lameness wherein pain is augmented1 when
 dorsal flexion of the extremity occurs 
as well as when weight is borne4 ,wounds
 in the region of the toe of the hind   
feet sometimes cause the subject to     

carry the extremity considerably in     
advance of the point where it is planted
 and1 just before placing the foot on   
the ground1 it is carried backward a    
little way--ten or twelve inches4       
,however1 diagnosis of nail puncture is 
based on the finding of the             
characteristic wound or resultant local 
changes4  ,course and ,prognosis4--,the 
nature of the progress and the manner of
 termination of these cases are         
variable4 ,if the coffin joint has been 
invaded1 and a septic arthritis exists1 
the condition is at once grave4 ,an open
 and infected tendon sheath1 while not  
so serious1 constitutes a condition     
which is distressing1 and recovery is   
slow even under the most favorable      
conditions4 ,where a heavy1 rigid and   
sharp nail enters the foot1 in such     
manner that fracture of the third       
phalanx 7os pedis7 occurs1 this         
complication makes for a protraction of 
the condition4 ,experience teaches that 
the natural course and termination in   

these cases are modified by the location
 and depth of the injury1 virulency of  
the contagium and resistance of the     
subject to such infection4              
,prevention4--,in all horses which are  
kept at such work that exposure to nail 
punctures is frequent1 a practical means
 of prevention of such injuries consists
 in the employment of heavy sole leather
 or suitable sheet metal to cover the   
sole of the foot and1 at the same time1 
confine oakum and tar in contact with   
the solar surface to prevent the        
introduction of foreign material between
 the foot and such protecting           
appliances4 ,further1 if drivers and    
owners could be impressed with the      
serious complications which so          
frequently attend wounds of this kind1  
undoubtedly many cases which are now    
lost1 because of ignorance or neglect on
 the part of the teamsters or           
proprietors of horses1 would be saved by
 prompt and rational treatment4         
,treatment4--,the treatment of this     

condition falls so largely within the   
dominion of surgery that we can give    
little more than an outline here4  ,in  
cases where there exists no evidence of 
open joint or open tendon sheath as     
judged by the site of the puncture and  
degree of lameness present 7after having
 thoroughly cleansed the solar surface  
of the foot and enlarged the opening in 
the nonsensitive sole7 a little phenol  
is introduced into the wound4 ,in such  
cases1 where it is possible for the     
antiseptic to contact every part of     
wound surface to the extreme depths of  
the puncture1 infection is prevented    
when such treatment is promptly         
administered4 ,this may be considered as
 first aid1 or emergency care1 and is   
indicated in all wounds of the foot     
whether the injury be serious or almost 
insignificant4  ,subsequently one of two
 general courses may be pursued in the  
treatment of cases of nail puncture4    
,one1 by the employment of means to keep
 the wound patent and injection of      

suitable antiseptics1 or agents that are
 more or less caustic in conjunction    
with strict observance of asepsis and   
wound protection4 ,the other method     
consists in prompt establishment of     
drainage by surgical means and includes 
exploration and curettage4  ,the first  
method is better adapted to the use of  
the average general practitioner and he 
would do well to keep the opening in the
 nonsensitive structures patent4 ,by    
introducing equal parts of tincture of  
iodin and glycerin daily1 good results  
will follow in most instances4 ,the     
wound is protected in unshod horses1    
either by completely bandaging the foot 
and retaining1 in contact with the      
wound1 cotton that is saturated with    
iodin and glycerin1 or1 if a minor      
injury exists1 the moderately enlarged  
opening in the nonsensitive sole or     
frog1 which has been moistened with the 
antiseptic1 is packed with a very small 
quantity of cotton4 ,a little practice  
in this mode of closing benign puncture 

wounds will enable the practitioner to  
successfully protect the sensitive parts
 in the treatment of such cases in      
unshod country horses4  ,when the       
condition progresses favorably the wound
 may be dressed every second day or     
twice weekly1 and in the course of from 
two to six weeks recovery should be     
complete4  ,if the practitioner is      
somewhat proficient as a surgeon1 and   
has at his command facilities for doing 
surgery1 the second method is preferable
 in many cases4 ,by using a local       
anesthetic on the plantar nerves and    
confining the subject on an operating   
table1 restraint should be perfect4 ,the
 solar surface of the foot is first     
thoroughly cleansed1 the puncture wound 
is enlarged in the nonsensitive         
structures and the parts are then       
moistened with phenol or other suitable 
antiseptics4 ,by means of a small probe 
the puncture is explored and1 depending 
on the character of the wound and the   
structures involved1 surgical           

intervention is varied to suit the case4
 ,if necessary1 all of the insensitive  
frog is removed1 and in wounds affecting
 the region of the heel the tissues may 
be incised from the puncture outward    
dividing all of the tissues outward and 
backward to the surface4 ,a suitable    
surgical dressing is then applied4  ,if1
 on the other hand1 the puncture extends
 into the navicular bursa1 the radical  
operation is perhaps indicated1 though  
not until one is sure that infection of 
the bursa and serious consequences are  
to follow if this operation is not      
performed4 ,detailed description of the 
technic of this operation belongs to the
 realm of surgery and a good discussion 
of it is to be found in ,william's work 
on veterinary surgical and obstetrical  
operations4  ,one may summarize the     
discussion of treatment of nail puncture
 by saying that emergency care as herein
 described is of first consideration4   
,in every case an immunizing dose of    
anti-tetanic serum should be given4     

,subsequently1 the method employed must 
suit the character of the wound1        
existing facilities for handling the    
subject and the skill and aptitude of   
the practitioner4  ,,footnotes3         
,footnote #e3 ,manual of ,veterinary    
,physiology1 by ,major-,general ,f4     
,smith1 page #eij4  ,footnote #f3       
,manual of ,veterinary ,physiology by   
,major-,general ,f4 ,smith1 page #ehi4  
,footnote #g3 ,regional ,veterinary     
,surgery and ,operative ,technique1     
,jno4 ,a4,w4 ,dollar1 ,m4,r4,c4,v4,s41  
,f4,r4,s4,e41 ,m4,r4,i41 page #gfe4     
,footnote #h3 ,dr4 ,roscoe ,r4 ,bell in 
the ,proceedings1 ,n4,y4 ,state         
,veterinary ,medical ,society1 #ahii4   
,footnote #i3 ,american ,veterinary     
,review1 ,vol4 #ce1 ,p4 #def4  ,footnote
 #aj3 ,radial ,paralysis and ,its       
,treatment by ,mechanical ,fixation of  
,knee and ,ankle1 ,geo4 ,h4 ,berns1     
,d4,v4,s4 ,proceedings of the ,american 
,veterinary ,medical ,association1      
#aiab1 p4 #bai4  ,footnote #aa3 ,as     

quoted by ,berns1 in ,radial ,paralysis1
 etc41 ,proceedings of the ,a4,v4,m4,a41
 #aiab4  ,footnote #ab3 ,veterinary     
,surgical ,operations1 by ,l4,a4        
,merillat1 ,v4,s41 p4 #ejg4  ,footnote  
#ac3 ,a paper presented before the      
,illinois ,veterinary ,medical ,assn4 by
 ,dr4 ,h4 ,thompson of ,paxton1 ,ill41  
,american ,veterinary ,review1 ,vol4    
#ae1 p4 #acd4  ,footnote #ad3 ,fractures
 in ,foals1 by ,dr4 ,wilfred ,walters1  
,m4,r4,c4,v4,s41 ,american ,journal of  
,veterinary ,medicine1 ,vol4 #h1 p4     
#ffi4  ,footnote #ae3 ,american         
,veterinary ,review1 ,vol4 #bf1 p4      
#ajfh4  ,footnote #af3 ,fractures1 by   
,h4 ,thompson1 ,paxton1 ,ill41 ,american
 ,veterinary ,review1 ,vol4 #ae1 p4     
#acd4  ,footnote #ag3 ,veterinary       
,surgical ,operations1 by ,l4,a4        
,merillat1 ,vol4 #c1 p4 #aih4  ,footnote
 #ah3 ,wilfred ,walters1 ,american      
,journal of ,veterinary ,medicine1 ,vol4
 #h1 p4 #fjf4  ,footnote #ai3 ,j4,n4    
,frost1 assistant professor of ,surgery1

 ,veterinary ,dept41 ,cornell           
,university1 in ,wound ,treatment1 page 
#aei4  ,footnote #bj3 ,open ,joints and 
,their ,treatment in my practice1 by    
,j4,v4 ,lacroix1 ,american ,journal of  
,veterinary ,medicine1 ,vol4 #e1 page   
#bjc4  ,footnote #ba3 ,regional         
,veterinary ,surgery ,moeller--,dollar1 
page #fje4  ,footnote #bb3 ,extract from
 ,receuil de ,medecine ,veterinaire in  
,ameircan ,veterinary ,review1 ,vol4    
#bc1 p4 #hic4  ,footnote #bc3 ,fracture 
of ,all the ,sesamoid ,bones1 by ,r4,f4 
,frost1 ,m4,r4,c4,v4,s41 ,a4,v4,d41     
,rangoon1 ,burmah1 in ,american         
,veterinary ,review1 ,vol4 #e1 p4 #cfb4 
,footnote #bd3 ,the ,anatomy of the     
,domestic ,animal1 by ,septimus ,sisson1
 ,s4,b41 ,v4,s4  ,footnote #be3 ,traite 
,de ,therapeutique ,chirurgicale ,des   
,animaux ,domestique1 par ,p4,j4 ,cadiot
 et ,j4 ,almy1 ,tome ,second1 page #edg4
  ,footnote #bf3 ,anatomie ,regionale   
,des ,animaux ,domestique1 page #fie4   
,footnote #bg3 ,manual of ,veterinary   

,physiology1 by ,major-,general ,f4     
,smith1 ,c4,b41 ,c4,m4,g41 page #fgh4   
,footnote #bh3 ,moeller's ,regional     
,veterinary ,surgery1 by ,dollar1 page  
#fcj4  ,footnote #bi3 ,edinburgh        
,veterinary ,review1 ,vol4 ,,vi1 page   
#faf4  ,footnote #cj3 ,equine ,laminitis
 or ,pododermatitis1 by ,r4,c4 ,moore1  
,d4,v4,s41 ,american ,journal of        
,veterinary ,medicine1 ,vol4 ,,xi1 page 
#bhd4  ,footnote #ca3 ,american ,journal
 of ,veterinary ,medicine1 ,vol4 ,,xi1  
page #cah4  ,footnote #cb3 ,the ,shoeing
 of a ,dropped ,sole ,foot by ,dr4      
,david ,w4 ,cochran1 ,new ,york ,city1  
,the ,horse ,shoers ,journal1 ,march1   
#aiae4  ,footnote #cc3 ,quittor and ,its
 ,treatment by the ,hughes ,method1     
,j4,t4 ,seeley1 ,m4,d4,c41 ,seattle1    
,washington1 ,chicago ,veterinary       
,college ,quarterly ,bulletin1 ,vol4 #i1
 page #bg4     ,,section ,,iv4          
,,lameness ,,in ,,the ,,hind ,,leg4     
,anatomo-,physiological ,consideration  
of the ,pelvic ,limbs4  ,the pelvic     

bones as a whole constitute the analogue
 of the scapulae with respect to their  
function as a part of the mechanism of  
locomotive and supportive apparatus of  
the horse4 ,the manner of attachment or 
connection between the ilia and the     
trunk is materially different from that 
of the scapulae1 however1 and the angles
 as formed by the long axes of the ilia 
in relation to the spinal column are    
maintained by two functionally          
antagonistic structures--the            
sacrosciatic ligaments1 and the         
abdominal muscles by means of the       
prepubian tendon4 ,the sacro-iliac      
articulations are such that a very      
limited amount of movement is possible2 
free movement1 however1 is unnecessary  
because of the enarthrodial 7ball and   
socket7 femeropelvic joint4  ,the       
various muscles which exert their effect
 upon the pelvis in changing their      
relationship between the long axes of   
the ilia and spinal column1 are         
concerned but little more in propulsion 

and weight bearing than are the pectoral
 muscles4 ,a general treatise on the    
subject of lameness does not properly   
include such structures any more than it
 does the various affections of the     
dorsal1 lumbar and sacral vertebrae or  
inflammation of the abdominal parietes4 
,involvement of such parts cause        
manifestations of lameness but the      
matter of establishing a diagnosis is   
difficult in many instances and in some 
cases impossible4  ,the femeropelvic    
articulation is formed by the           
hemispherical head of the femur and the 
acetabulum2 the latter constituting a   
cotyloid cavity which is deepened by the
 cotyloid ligament4  ,the round ligament
 7ligamentum teres7 is the principal    
binding structure of the hip joint and  
it arises in a notch in the head of the 
femur and is attached in the subpubic   
groove close to the acetabular notch4   
,another ligament1 peculiar to          
,equidae--the accessory                 
7pubiofemoral7--is attached to the head 

of the femur near the round ligament and
 passes through the cotyloid notch and  
along the under side of the pubis4 ,it  
is inserted or blends with the prepubic 
tendon4 ,this ligament prevents extreme 
abduction of the leg4 ,the joint capsule
 encompasses the articulation and is    
attached to the brim of the acetabulum  
and the edge of the head of the femur4  
,illustration3 ,fig4 #dj--,sagital      
section of right hock4 ,the section     
passes through the middle of the groove 
of the trochlea of the tibial tarsal    
bone4 #a and #b4 ,proximal ends of      
cavity of hock joint4 #c4 ,thick part of
 joint capsule over which deep flexor   
tendon plays4 #d4 ,fibular tarsal bone  
7sustentaculum74 ,a large vein crosses  
the upper part of the joint capsule 7in 
front of #a74 7,from ,sisson's ,anatomy 
of the ,domestic ,animals47             
,illustration3 ,fig4 #da--,muscles of   
right leg2 front view4 ,the greater part
 of the long extensor has been removed4 
#a1 #b1 #c4 ,stumps of patellar         

ligaments4 #d4 ,tuberosity of tibia4    
7,from ,sisson's ,anatomy of the        
,domestic ,animals47  ,the stifle joint 
is analagous to the knee joint of man   
and is to be considered an atypical     
ginglymus 7hinge7 articulation formed by
 the femur1 tibia and patella4 ,the     
ligaments are femerotibial1             
femeropatellar and capsular4  ,in       
addition to the usual provision for     
articulation of bones there are situated
 cartilaginous menisci between the      
condyles of the femur and the head of   
the tibia4 ,these discs surround the    
tibial spine and are otherwise shaped to
 fit perfectly between the articular    
portions of the femur and tibia4        
,collateral ligaments 7internal and     
external lateral7 pass from the distal  
end of the femur to the proximal portion
 of the tibia4 ,the mesial 7internal7   
arises from the internal condyle of the 
femur and is attached to a rough area   
below the margin of the medial          
7internal7 condyle of the tibia4 ,the   

lateral 7external71 shorter and thicker1
 arises from the depression on the      
lateral epicondyle and inserts to the   
head of the fibula4  ,the crucial or    
interosseus1 anterior and posterior1 are
 situated between the femur and tibia1  
and according to ,smith1#cd the crucial 
ligaments are necessary to properly join
 the two bones1 because of the character
 of the structure of the articular ends 
of the femur and tibia4  ,the           
femeropatella ligaments are two thin    
bands which reinforce the capsular      
ligament4 ,they arise from the lateral  
aspects of the femur1 just above the    
condyles and are inserted to the        
corresponding surfaces of the patella4  
,the patellar ligaments are three strong
 bands which arise from the             
antero-inferior surface of the patella1 
and are inserted to the anterior aspect 
of the tuberosity of the tibia4  ,taken 
as a whole1 the tarsal bones1           
interarticulating and articulating with 
the tibia and metatarsal bones form the 

hock joint and this articulation is     
analagous to the carpus4 ,as with the   
carpus1 there is less movement in the   
inferior portion of the joint than in   
the superior part of the articulation4  
,the chief articulating parts are the   
tibia with the tibial tarsal bone       
7astragulus74  ,illustration3 ,fig4     
#db--,muscles of lower part of thigh1   
leg and foot2 lateral view1 o'1 ,fascia 
lata2 q1 q'1 q1 biceps femoris2 r1      
semitendinosus2 #ba'1 lateral condyle of
 tibia4 ,the extensor brevis is visible 
in the angle between the long and       
lateral extensor tendons4 7,after       
,ellenberger-,baum1 ,anat4 fuer         
,kuenstler47 7,from ,sisson's ,anatomy  
of the ,domestic ,animals47  ,the       
capsular ligament is attached around the
 margin of the articular surfaces of the
 tibia1 to the tarsal bones1 the        
collateral ligaments 7internal and      
external lateral7 and to the metatarsus4
  ,illustration3 ,fig4 #dc--,right      
stifle joint2 lateral view4 ,the        

femoro-patellar capsule was filled with 
plaster-of-,paris and then removed after
 the cast was set4 ,the femoro-tibial   
capsule and most of the lateral patellar
 ligament are removed4 ,m4 ,lateral     
meniscus4 7,from ,sisson's ,anatomy of  
the ,domestic ,animals47  ,the common   
ligaments of the tarsal joint are the   
collateral1 the plantar                 
7calcaneo-metatarsal and c4 cuboid7 and 
dorsal ligaments 7oblique74  ,the medial
 7internal lateral7 ligament serves to  
join the medial 7internal7 tibial       
malleolus with tibial tarsal            
7astragalus7 and other tarsal bones4    
,the lateral 7external lateral7 ligament
 is inserted to the lateral 7external7  
tibial malleolus and its distal portions
 are attached to the tibial tarsal      
7astragalus71 fibular tarsal 7calcaneum7
 bone1 fourth tarsal 7cuboid7 and       
metatarsus bones4  ,illustration3 ,fig4 
#dd--,left stifle joint2 medial view4   
,the capsules are removed4 7,from       
,sisson's ,anatomy of the ,domestic     

,animals47  ,the plantar ligament       
7calcaneo-cuboid7 is a strong flat band 
which is attached to the plantar surface
 of the fibular and fourth tarsal bones 
7calcaneum and cuboid7 and the head of  
the lateral metatarsal 7external small7 
bone4  ,the dorsal 7oblique7 ligament is
 attached above to the distal tuberosity
 on the inner side of the tibia4 ,it is 
inserted below to the central 7cuneiform
 magnum7 and third 7c4 medium7 tarsal   
bones1 to the proximal ends of the large
 and outer small metatarsal bones4  ,the
 tarsus is a true hinge joint and       
because of the great strain which it    
sustains1 is subject to frequent injury4
 ,about seventy-five percent of cases of
 lameness affecting the hind leg may be 
said to arise from disease of the hock4 
,as members of locomotion the legs      
receive strains of two kinds3 those of  
concussion and weight-bearing and       
strains of propulsion2 the latter are   
the greater4 ,in the horse as a work    
animal1 the hind legs are probably      

subjected to greater strains than are   
the front but the manner of construction
 of the various parts of the pelvic     
limbs with the possible exception       
7according to some authorities7 of the  
tibial tarsal joint1 offsets this       
condition4  ,the femur may be considered
 analagous to the humerus in that it    
bears a similar relationship to the     
ilium1 that exist between the humerus   
and scapula4 ,further flexion during    
repose is prevented chiefly by the      
glutens medius 7maximus7 muscle and its 
tendons4 ,the larger tendon inserts to  
the summit of the trochanter major of   
the femur and corresponds to the biceps 
brachii in the action of the latter on  
the scapulohumeral joint1 except that   
the gluteus medius1 in attaching to the 
femoral trochanter1 exerts its effect as
 a lever of the first class4 ,because of
 the relationship between the long axes 
of the femur and iliac shaft it is      
evident that the angle formed by these  
two bones is maintained chiefly by the  

gluteus muscles during weight bearing4  
,contraction of muscular fibers of the  
gluteus medius causes extension of the  
femur and muscular strain is prevented  
to a great degree by the inelastic      
portion of this muscle4 ,the chief      
physiological antagonistics of the      
glutei are the quadriceps femoris and   
tensor fascia lata4  ,while the leg is  
supporting weight the stifle joint is   
fixed in position mainly by the         
quadriceps femoris group of muscles     
which are attached to the patella4      
,tendinous fibres intersect this        
muscular mass and relieve muscular      
strain during weight bearing4 ,because  
of the manner in which the patella      
functionates with the trochlea of the   
femur1 comparatively little energy is   
required to prevent further flexion of  
the stifle joint4 ,the patella1         
according to ,strangeways1 may be       
considered a sesamoid bone4             
,illustration3 ,fig4 #de--,left stifle  
joint2 front view4 ,the capsules are    

removed4 #a4 ,middle patellar ligament4 
#b4 ,stump of fascia lata4 #c4 ,stump of
 common tendon of extensor longus and   
peroneus tertius4 7,from ,sisson's      
,anatomy of ,domestic ,animals47  ,the  
quadriceps group of muscles is assisted 
by the anterior digital extensor        
7extensor pedis7 peroneus tertius and   
tibialis anticus 7flexor metatarsi7     
muscles4 ,the latter pair 7flexor       
metatarsi1 muscular and tendinous       
portions1 because of their attachment to
 the external condyle of the femur and  
to the metatarsal bone7 are enabled to  
automatically flex the tarsal joint when
 the stifle is flexed4  ,the hock is    
kept fixed in position by the           
gastrocnemius and the superficial       
digital flexor 7perforatus74 ,the latter
 structure1 which is chiefly tendinous1 
originates in the supracondyloid fossa  
of the femur and has an insertion to the
 summit of the fibular tarsal 7calcis7  
bone4 ,it relieves the gastrocnemius of 
muscular strain during weight bearing4  

,smith#ce styles the function of the    
stifle and hock joints a reciprocating  
action1 and we quote from this authority
 the following3       ,from what has    
been said1 it is evident that flexion   
and extension      of stifle and hock   
are identical in their action4 ,when the
 stifle      is extended1 the hock is   
automatically extended1 nor can it under
      any circumstances flex without the
 previous flexion of the stifle4        
,there is no parallel to this in the    
body4 ,the two joints1 though      far  
apart1 act as one1 and they are locked  
by the drawing up of the      patella1  
and in no other way4 ,the so-called     
dislocation of the      stifle in the   
horse is a misnomer4 ,that the patella  
is capable of      being dislocated is  
beyond doubt1 but the ordinary condition
      described under that term1 when   
the stifle and hock are rigid while     
the foot is turned back with its wall on
 the ground1 is nothing      more than  
spasm of the muscles which keeps the    

patella drawn up4      ,the moment they 
relax the previously immovable limb and 
useless      foot have their function   
restored as if by magic1 but are        
immediately thrown out of gear in the   
course of a few minutes as a            
recurrence of the tetanus of the        
petallar muscle takes place4 ,the       
fascia of the thigh1 like that of the   
arm1 is a most potent factor      in    
giving assistance to the constant strain
 imposed on the muscles      of the     
limbs during standing4       ,below the 
hock the hind limb is arranged like that
 of the fore1 the      deep flexor      
7perforans7 receiving its additional    
support from the      check ligament1 as
 in the fore leg4       ,the natural    
attitude of standing adopted by the     
horse is to rest on      three legs--one
 hind and two fore4 ,if he is alert1 he 
stands on all      four limbs2 but if   
standing in the ordinary manner1 he     
always rests      on one hind leg4 ,he  
does not remain long in this position   

without      changing to the other4     
,hour by hour he stands1 shifting his   
weight      at intervals from one to the
 other hind leg1 and resting its fellow 
by flexing the hock and standing on the 
toe4 ,he never spares his               
fore-limbs in this manner in a state of 
health1 but always stands      squarely 
on them4   ,hip ,lameness4              
,fortunately1 because of the heavy      
musculature which goes to form a part of
 the locomotive apparatus of the rear   
extremity1 hip lameness is comparatively
 rare4 ,while the term is in itself     
ambiguous and signifies nothing more    
definite than does shoulder lameness1   
yet diagnosis of almost any condition   
that may be classed under the head of   
hip lameness is not easy except in cases
 where the cause is obvious1 as in      
wounds of the musculature and certain   
fractures4 ,to the complexity which the 
gait of the quadruped contributes1      
because of its being four-legged1 there 
is added the complicated manner of      

articulation of the bones of the hind   
leg4 ,this involves the hip in the      
manner of diagnostic problems and       
because of the inaccessibility of       
certain parts1 owing to the bulk of the 
musculature of these parts1 diagnosis of
 some hip ailments becomes an intricate 
problem4 ,consequently1 in some         
instances1 before one may arrive at     
definite and enlightening conclusions1  
repeated examinations are necessary as  
well as a knowledge of reliable history 
and recorded observations of the subject
 over a considerable period4  ,rheumatic
 affections1 when present1 usually cause
 recurrent attacks of lameness2 myalgia1
 due to subsurface injury occasioned by 
contusion1 generally produces an        
ephemeral disturbance2 and while these  
are examples of cases where occult      
causes are active1 they are by no means 
unprecedented4 ,in cases where the cause
 of lameness is not definitely located1 
and when by the process of exclusion one
 is enabled to decide that the seat of  

trouble is in the hip1 a tentative      
diagnosis of hip lameness is always     
appropriate4  ,in one instance a        
,shetland pony evinced a peculiar form  
of intermittent lameness which affected 
the left hip1 and repeated examinations 
did not disclose the cause of the       
trouble4 ,after about a year there was  
established spontaneously an opening    
through the integument overlying the    
region of the attachment of the psoas   
major 7magnus71 through which pus       
discharged4 ,with the occurrence of this
 fistula1 lameness almost entirely      
disappeared1 but the emission of a small
 amount of pus persisted for more than a
 year4 ,the subject was not observed    
thereafter and the outcome in this case 
is not a matter of record4 ,whether     
there existed a psoic phlegmon due to   
metastatic infection or necrosis of a   
part of a lumber or dorsal vertebra is a
 matter for speculation4 ,thus the      
presence of some anomalous conditions   
which affect the pelvic region and cause

 lameness may be discovered1 yet both in
 hip and shoulder regions causes may not
 be definitely located by means of      
practical methods of examination4       
,injuries of all kinds are the more     
frequent causes of hip lameness4 ,in    
such cases1 lameness may result directly
 and resolution be prompt1 or the       
claudication become aggravated in time1 
due to muscular atrophy or degenerative 
changes affecting the hip joint or      
nerves4 ,rheumatism or metastatic       
infection may be the cause of hip       
lameness as well as affections of the   
pelvic bones1 lumbar and sacral         
vertebrae4 ,hip lameness may also be    
provoked by melanotic or other tumors4  
,in the diagnosis of hip lameness1 one  
is guided in a general way by the       
character of the impediment manifested4 
,swinging-leg lameness is often present 
and the impediment is more accentuated  
when the animal is caused to step       
backward4 ,in many cases lameness is    
mixed1 being about equally noticeable   

during weight bearing and while the     
member is being swung4 ,by exclusion of 
causes which might affect other parts2  
one may definitely locate the cause of  
the trouble or determine that a certain 
region is affected4  ,the sudden        
manifestation of lameness is indicative 
of injury2 thermic disturbances may     
signalize metastatic infection2 history1
 if dependable1 is always helpful4      
,repeated observations1 taking into     
account the course which the affection  
assumes during a period of a few days1  
often serve to afford a means of        
establishing a diagnosis in baffling    
cases4   ,fractures of the ,pelvic      
,bones4  ,the os innominatum may be so  
fractured that the pelvic girdle is     
broken1 as in fracture of the iliac     
shaft1 or in a manner that the girdling 
continuity of the innominate bones is   
not interrupted4 ,it naturally follows  
that greater injury is done when the    
pelvic girdle is broken than when it is 
not1 except in cases where the          

acetabulum is involved and its brim not 
completely divided4  ,etiology and      
,occurrence4--,pelvic fractures are     
usually caused by falls or other manner 
of contusion4 ,cases are reported where 
it would seem that fracture of the iliac
 angle resulted from muscular           
contraction1 but it is certain that most
 fractures of this kind are due to      
collisions with door jambs or similar   
injuries4 ,in old horses especially1    
fracture of pelvic bones occurs         
frequently4 ,this form of injury is of  
more frequent occurrence in animals of  
all ages that work on paved streets4    
,the country horse is not subjected to  
the uncertain footing of the slippery   
pavement1 nor to injuries which compare 
with those caused by contusions         
sustained in falling upon asphalt or    
cobble-stones4  ,symptomatology4--,while
 in many cases of pelvic fracture       
lameness or abnormal decumbency are the 
salient manifestations1 yet the         
pathognomic symptoms are crepitation or 

palpable evidence which may be obtained 
by rectal or vaginal examination4 ,in   
fractures of the angle of the ilium and 
the ischial tuberosity1 perceptible     
evidence always exists4  ,in cases where
 fracture of some portion of the pelvic 
girdle is suspected and the subject is  
able to walk1 crepitation is sought by  
placing one hand on an external angle of
 the ilium and the other on the ischial 
tuberosity and the animal is then made  
to walk4 ,or1 by placing the hands as   
just directed1 an assistant may grasp   
the horse's tail and by alternately     
exerting traction on the tail and       
pushing against the hip in such manner  
that weight is shifted from one leg to  
the other1 crepitation may be detected4 
,fracture of the pubis near its         
symphysis constitutes a grave injury1 as
 there is danger of the bladder becoming
 caught in the fissure and perforation  
of its wall may result4 ,such a case is 
reported by ,bauman#cf wherein a        
three-year-old gelding bore the history 

of having been lame for ten days4 ,upon 
rectal examination the bladder was found
 to be hard and tumor-like and about the
 size of a baseball4 ,the body of the   
ischium in this case was fractured and a
 rent in the bladder was caused by a    
sharp projecting piece of bone4 ,autopsy
 revealed1 in addition to the fracture  
and rent of the bladder wall1 a large   
quantity of urine in the peritoneal     
cavity4  ,in other instances hemorrhage 
caused death and not infrequently       
infection was responsible for a fatal   
issue4 ,moller1#cg quoting ,nocard1     
describes a case where fracture occurred
 through the region of the foramen ovale
 and paralysis of the obturator nerve   
followed4  ,fractures which include the 
acetabular bones cause great pain4 ,this
 is manifested by marked lameness1 both 
during weight bearing and when the      
member is swung4 ,such cases terminate  
unfavorably--complete recovery is       
impossible4  ,where small portions of   
the angle of the ilium are broken1 and  

the skin is left intact1 there exists   
the least troublesome class of pelvic   
fracture4 ,if large portions of the     
ilium are fractured1 considerable       
disturbance results4 ,there eventually  
occurs more or less displacement in such
 cases1 if such displacement does not   
take place at the time of injury4 ,the  
same may be said of fracture of the     
tuber ischii1 but when these bones are  
fractured a more serious condition      
results4  ,treatment4--,when a case is  
found to be uncomplicated1 that is1 if  
the fracture is such that recovery seems
 possible and after having determined   
that treatment may be practicable1 the  
first consideration is that of confining
 the subject in suitable slings4 ,in    
many cases of pelvic fracture1 the      
affected animal will need to be kept in 
slings from six weeks to three months1  
and it becomes a difficult problem to   
minimize the distress during this long  
period of confinement in the peculiar   
manner required for favorable outcome4  

,the pattern of sling employed should be
 the best that is obtainable and the    
matter of its adjustment is quite       
important lest unnecessary chafing or   
even necrosis of skin result4 ,frequent 
readjustment may be necessary1 and time 
is well spent in this manner since this 
contributes materially toward a         
favorable termination by encouraging the
 subject to remain quiet so that        
coaptation of the broken bones may be   
maintained4 ,aside from slings1         
mechanical appliances that are helpful  
in the treatment of these cases are not 
yet in use4  ,a regimen that is         
nutritive and at the same time laxative 
is essential and in some cases          
cathartics and enemata are necessary4   
,also1 during the first few days1 if    
there is retention of urine1            
catheterization is imperative4 ,in a    
word1 the handling of such cases        
consists largely in keeping the subject 
inactive1 as comfortable as possible1   
and giving attention to suitable diet4  

,simple fracture of the external iliac  
angle needs no particular attention1    
except that the subject is kept quiet   
until lameness subsides4 ,in all cases  
where much of the bone is broken1 the   
animal is blemished1 but interference   
with function does not follow4 ,if      
infection results because of a compound 
fracture1 loose pieces of bone must be  
removed surgically and drainage provided
 for4  ,in fracture of the ischial      
tuberosity1 infection is more apt to    
result than in like injury of the ilium1
 and greater displacement of bone       
occurs4 ,this displacement1 due to      
contraction of the attached muscles1 is 
in some instances a contributing cause  
to the infection which often follows in 
these cases4 ,in females where the body 
of the ischium is fractured1 lacerations
 of the vagina may be present1 and this 
constitutes a serious complication which
 usually terminates fatally4            
,after-care in fracture of the pelvic   
girdle consists principally in allowing 

a protracted period of rest before      
subjects are put to work4   ,fractures  
of the ,femur4  ,etiology and           
,occurrence4--,this is a comparatively  
rare injury in the horse because of the 
protection afforded the femur by the    
heavy musculature4 ,fragilitas of the   
bone probably exists in many cases when 
fracture of its diaphysis occurs4 ,it is
 generally conceded that the neck of the
 femur is rarely broken because of a    
lack of constriction in this part1 but  
fracture of the trochanters has been    
recorded rather frequently4 ,however1   
,lienaux and ,zwanenpoete#ch state that 
fracture of the neck of the femur is of 
frequent occurrence in ,belgian colts4  
,tapley#ci reports in the ,veterinary   
,journal 7,english7 fracture of the head
 and internal trochanter of the femur   
and patellar luxation occurring         
simultaneously affecting a mule4 ,in    
this case the mule was found decumbent  
on a concrete floor4 ,after three weeks1
 the subject was destroyed and autopsy  

revealed rupture of the left            
pubiofemoral ligament1 tearing with it a
 portion of the articular surface of the
 femur4 ,the internal trochanter was    
also fractured in four small pieces4 ,in
 this case it is fair to suppose that   
the mule in trying to regain footing on 
a slippery floor violently abducted the 
legs and fracture resulted4 ,it is      
possible also that a temporary luxation 
of the patella took place first and     
caused the animal to struggle in such   
manner that fracture followed4          
,illustration3 ,fig4 #df--,oblique      
fracture of the femur of a #a1ejj       
six-year-old draft horse4 ,showing      
shortening of bone1 owing to a lateral  
approximation of the diaphysis because  
of muscular contraction4 ,photo by ,dr4 
,edward ,merillat4                      
,symptomatology4--,according to ,cadiot 
and ,almy1#dj regardless of the location
 of femoral fractures1 the subject is   
usually intensely lame1 the animal      
frequently walking on three             

legs--fractures of the diaphysis are    
characterized by an abnormal mobility4  
,as a rule1 crepitation is to be        
recognized in fractures of the shaft of 
the bone1 by passively moving the leg to
 and from the medial plane 7adduction   
and abduction74  ,fracture of the       
trochanter major is signalized by local 
swelling and evidence of pain2 the      
forward stride is shortened because this
 movement tenses the tendon of the      
gluteus major 7maximus7 which is        
attached principally to the trochanter4 
,illustration3 ,fig4 #dg--,same bone as 
in ,fig4 #df after about six months'    
treatment4 ,in this case ,dr4 ,merillat 
employed a weight to counteract muscular
 contraction4 ,it is noticeable that    
very little provisional callus has      
formed in this case1 and in spite of    
unusual ingenuity and good facilities   
for caring for the subject1 union of    
bone did not occur4                     
,treatment4--,reduction of femoral      
fracture in the horse is practically    

impossible1 and retaining the broken    
bones in coaptation is not possible by  
means of mechanical appliances4         
,consequently1 prognosis is unfavorable 
in fracture of the body of the femur4   
,when union of bone occurs1 there       
results shortening of the leg and       
animals are rendered permanently lame4  
,if the immediate region of the head of 
the bone is involved as well as in case 
of fracture of the condyles1 an         
incurable arthritis ensues4  ,where the 
trochanters are broken1 chronic lameness
 and muscular atrophy is the result4    
,therefore1 it is evident that1 because 
of the manner of function of the femur1 
the leverage afforded by its great      
trochanter and its heavy muscular       
attachments1 fractures of this bone in  
the horse do not terminate favorably4   
,luxation of the ,femur4  ,etiology and 
,occurrence4--,uncomplicated femoral    
luxation is of less frequent occurrence 
in the horse than in the other domestic 
animals4 ,the deep cotyloid cavity      

renders disarticulation difficult and   
luxation does not often take place4     
,complications that usually occur are   
rupture of the round 7coxofemoral7      
ligament or fracture of the neck of the 
femur4 ,falls or violent strains are    
necessary to produce this luxation4     
,goubaux is quoted by ,cadiot and       
,almy#da as having observed the head of 
the femur in an instance wherein        
luxation had long existed4 ,in this case
 autopsy revealed the fact that the     
inner portion 7two-thirds7 of the head  
of the femur had completely disappeared4
  ,luxation of the femur is observed in 
old emaciated animals that are worked on
 slippery pavements4 ,occasionally1     
evidence of chronic luxation of the     
femur is observed in the anatomical     
laboratory4 ,the chronicity of the      
condition is obvious when one notes the 
well formed articulation which ,nature  
provides for the head of the femur1     
where fracture or other serious         
complications are not present4          

,symptomatology4--,in every case there  
must exist either restriction of        
movement or an evident abnormal position
 of the leg1 or both conditions may     
exist at once4 ,also1 the leg may be    
markedly shortened4 ,manifestation of   
this affection varies1 depending upon   
the character of the luxation 7position 
of the head of the humerus with relation
 to the acetabulum74 ,lusk#db cites a   
case of a mule which had suffered       
femoral luxation4 ,the animal was       
destroyed and on autopsy the head of the
 femur found to be contained within a   
false articular cavity situated about   
four inches above the acetabulum4 ,in   
,dr4 ,lusk's case as he states it1 the  
following symptoms were presented3 ,limb
 shortened and fixed in a position of   
adduction4 ,while standing the affected 
limb hung directly across and in front  
of the opposite one2 upper trochanter   
very prominent2 skin over hip joint very
 tense4 ,the mobility of the limb was   
very limited1 especially in the forward 

direction4  ,being very prominent when  
there is an upward luxation and less    
perceptible in downward displacement1   
the location of the trochanter major is 
an indicator of the character of the    
luxation with respect to the position of
 the head of the femur4 ,this variation 
of position causes abnormal tenseness or
 looseness of the skin over the region  
of the trochanter major4 ,rectal        
examination is of aid in locating the   
head of the humerus4  ,treatment4--,when
 it is evident that a subject should be 
given treatment and not destroyed1 the  
animal must be cast and completely      
anesthetized4 ,with complete relaxation 
thus secured by rotation of the limb1   
using the hip joint region as a pivot1  
reduction may be effected4 ,traction is 
exerted in the same direction from the  
acetabulum that the head of the femur is
 situated and by pressing over the      
joint1 the displaced bone may be        
returned in position4 ,if luxation is   
downward1 traction on the extremity will

 tend to dislodge the head of the femur 
from the inferior acetabular margin     
making reduction possible4  ,the same   
general plan which is ordinarily        
employed in correcting luxation is      
indicated here1 but because of the heavy
 musculature of the hip1 complete       
anesthesia is imperative in all such    
manipulations4   ,gluteal               
,tendo-,synovitis4  ,the glutens medius 
7g4 maximus7 muscle is inserted chiefly 
by means of two tendons2 one to the     
summit of the trochanter major of the   
femur and the other passing over the    
anterior part of the convexity of the   
trochanter1 and being attached to the   
crest below it4 ,the trochanter is      
covered with cartilage1 and a bursa 7the
 trochanteric7 is interposed between the
 tendon and the cartilage4  ,etiology   
and ,occurrence4--,this affection is    
probably caused in most instances by    
direct injury to the parts1 such as may 
be occasioned by being kicked1 falling  
on pavement1 or being struck by the body

 of a heavy wagon4 ,strains in pulling  
or in slipping are undoubtedly causative
 factors and in draft horses such       
strains may result in involvement of    
this synovial apparatus4                
,symptomatology4--,if pain be severe and
 inflammation acute1 weight may not be  
borne with the affected member4 ,there  
is some local manifestation of the      
condition in acute cases4 ,swelling of  
the tissues contiguous to the bursa is  
present and pain is evinced upon        
manipulation of the parts4 ,a           
characteristic gait marks inflammation  
of the trochanteric bursa1 and as       
,gunther has put it1 the subject        
generally moves or trots as does the    
dog--the sound member being carried in  
advance of the affected one and the     
forward stride of the diseased leg is   
shortened4 ,in some chronic cases       
crepitation is discernible by holding   
the hand on the trochanter while the    
subject walks4  ,treatment4--,in the    
first stages of an acute affection      

absolute quiet must be enforced2 local  
antiphlogistic applications are         
beneficial4 ,later1 vesication of a     
liberal area surrounding the trochanter 
major is indicated4 ,where the condition
 has become chronic in horses that are  
to be kept at heavy draft work there is 
little chance for complete recovery4    
,and1 naturally1 one is not to expect   
resolution in cases where there exist   
erosion and ossification of             
cartilage--where crepitation is         
discernible4   ,paralysis of the ,hind  
,leg4  ,aside from paraplegic conditions
 due to disease of the cord or the      
lumbosacral plexus1 and monoplegic      
affections resultant from disturbances  
of this plexus1 paralysis of certain    
nerves are occasionally encountered4    
,anatomy4--,the lumbosacral plexus      
results substantially from the union of 
the ventral branches of the last three  
lumbar and the first two sacral nerves1 
but it derives a small root from the    
third lumbar nerve also4 ,the anterior  

part of the plexus lies in front of the 
internal iliac artery1 between the      
lumbar transverse processes and the     
psoas minor4 ,it supplies branches to   
the iliopsoas#dc 7designated by ,girard1
 the iliacomuscular nerves74 ,the       
posterior part lies partly upon and     
partly in the texture of the            
sacrosciatic ligament4 ,from the plexus 
are derived the nerves of the pelvic    
limb 7,sisson74   ,paralysis of the     
,femoral 7,crural7 ,nerve4              
,anatomy4--,the femoral nerve 7crural7  
is derived chiefly from the fourth and  
fifth lumbar nerves4 ,it runs ventrally 
and backward1 at first between the psoas
 major and minor1 then crosses the deep 
face of the tendon of the latter and    
descends under cover of the sartorious  
over the terminal part of the iliopsoas4
 ,it innervates the psoas major         
7magnus71 psoas minor 7parvus71         
sartorious1 rectus femoris1 vastus      
lateralis 7interims74 ,branches supply  
the stifle and the adductor and         

pectineus muscles4  ,etiology and       
,occurrence4--,while paralysis of the   
femoral nerve1 also known as dropped    
stifle occurs as a result of local      
injuries and melanotic tumors in gray   
horses1 most cases are due to azoturia4 
,so-called crural paralysis or hip      
swinney is occasionally observed but    
this is not a condition wherein the     
nerve is affected in the manner that    
characterizes the marked atrophy of     
quadriceps femoris 7crural7 muscles in  
some cases of hemaglobinuria4 ,this form
 of paralysis according to ,hutyra and  
,marek is due primarily to diffuse      
degeneration of the muscles4            
,symptomatology4--,when muscular atrophy
 is not extensive no particular evidence
 of this condition may be manifested    
while the subject is at rest1 but where 
muscular waste has occurred1 the nature 
of the ailment is at once recognized4   
,since the femoral nerve supplies the   
quadriceps femoris muscles1 it follows  
that when the psoic portion of this     

nerve becomes diseased1 the stifle loses
 its support1 and in a unilateral       
involvement when the subject attempts to
 walk on the affected member1 the stifle
 sinks down for want of support and the 
leg collapses unless weight is caught up
 with the other leg4 ,often1 following  
azoturia1 a bilateral affection is to be
 observed4  ,treatment4--,horses may be 
restrained in the standing position1 and
 in the average instance1 a twitch and  
hood are all the restraining appliances 
necessary4  ,in cases where the disease 
is unilateral and atrophy is not of too 
long standing1 recovery is possible in  
vigorous subjects4 ,all affections1     
however1 wherein degenerative changes   
involve the nerve trunk1 whether due to 
diffuse myositis or pressure from       
malignant tumors1 will not yield to     
treatment4  ,the same general plan of   
treatment is indicated that is described
 on page #gd in the consideration of    
atrophy of the scapular muscles4 ,it is 
especially important to provide for the 

subject to be exercised when there is   
atrophy of the quadriceps muscles       
following azoturia4  ,in addition to the
 foregoing1 good results have attended  
the use of intramuscular injections of  
oxygen4 ,the technic of the operation   
consists in preparing the area of skin  
which covers the atrophied muscles as   
for any operation4 ,the hair is clipped 
over five or six or more circular areas 
of about an inch in diameter2 the skin  
is cleansed and then painted with       
tincture of iodin4  ,a long heavy       
sterile needle1 which is connected with 
an oxygen tank by means of six feet of  
rubber tubing1 is thrust into the depths
 of the affected muscles and the gas is 
gently introduced into the tissues4 ,one
 needs exercise extreme care that the   
gas enter slowly because great pain is  
produced by the sudden injection of the 
oxygen4 ,likewise too much of the gas   
must not be introduced at one place4    
,when the oxygen is slowly introduced it
 may be allowed to enter the tissues    

until the subject gives evidence of     
experiencing considerable pain1 or if   
the parts are not particularly          
sensitive1 a reasonable amount 7enough  
to cause a mild degree of diffuse       
inflammation7 is introduced at each one 
of five or six points4 ,in large animals
 more points of injection may be used4  
,no infection or other bad results will 
follow the execution of a good technic  
and the treatment may be repeated every 
three or four weeks until either marked 
regeneration of tissue is evident or the
 case is obviously proved hopeless4     
,paralysis of the ,obturator ,nerve4    
,anatomy4--,the obturator nerve1        
situated at first under the peritoneum1 
accompanies the obturator artery through
 the obturator foramen and gaining the  
muscles on the internal face of the     
thigh1 terminates in the obturator      
externus1 adductors1 pectineus and      
gracilis1 also giving twigs to the      
obturator internus 7,strangeways74      
,etiology and ,occurrence4--,this       

condition occurs upon rare occasions as 
the result of injury such as falls which
 cause extreme abduction of the legs1 or
 in pelvic fracture where the nerve is  
directly injured1 or when melanotic     
tumors or other new growths compress the
 nerve in such manner that its function 
is suspended4 ,paralysis of the         
obturator nerve or nerves is met with   
rather frequently1 notwithstanding1 in  
mares1 following dystocia4 ,the nerves  
7one or both7 may become bruised at the 
brim of the obturator foramen by being  
caught between the pelvis and the body  
of the fetus in some cases of protracted
 labor4  ,symptomatology4--,in a        
unilateral affection there may be little
 evidence of the trouble while the      
subject is standing2 or there is to be  
seen some abduction2 or the affected    
member may present abduction of the     
stifle and stand toe outward4 ,if the   
animal is walked there will be          
manifested more or less abduction and   
the character of the impediment varies  

according to the nature of the          
involvement4  ,following protracted     
cases of labor in some instances where  
only a unilateral paralysis exists1     
walking is performed with difficulty2   
the subject may be unable to support    
weight with the affected member and is  
obliged to hop on the one sound hind    
leg4 ,in bilateral affections1 they are 
unable to rise4 ,if the condition is    
severe the sling is required to keep the
 subject standing1 and with this care1  
recovery will follow4  ,treatment4--,if 
new growths or callosities or similar   
conditions affect the nerve1 little1 if 
any1 hope for recovery exists4 ,in young
 and vigorous subjects where cause is   
not definitely known1 a course of       
strychnin may be given4 ,good nursing1  
providing for the subject's comfort and 
allowing moderate exercise1 constitute  
rational treatment4 ,stimulating        
embrocations on the abductor muscles    
resorted to in cases during the         
incipient stage may prove helpful4      

,when paralysis of the obturator nerve  
occurs as a post-partum complication1   
and other conditions are favorable1 the 
subject should be raised to its feet    
without unnecessary delay4 ,if the mare 
is unable to assist in regaining her    
feet1 a sling is required4 ,usually     
little else is necessary and after a few
 days in the sling the subject can get  
about unassisted4 ,in the meanwhile the 
well-being of the affected animal is to 
be considered just as in any other case 
where the patient is so confined4 ,the  
foal in such instances constitutes a    
source of some trouble1 but the average 
mare offers no serious resistance to the
 confinement occasioned by the sling4   
,good hygienic care1 a suitable diet and
 full physiological doses of strychnin  
are indicated4 ,cadiot and ,almy        
recommend vaginal douches of cold water 
and counterirritation of the region of  
the inner thigh in these cases4         
,paralysis of the ,sciatic ,nerve4      
,anatomy4--,the great sciatic nerve     

leaves the pelvis in company with the   
gluteal nerves1 through the great       
sciatic foramen 7notch71 passing        
downward along the posterior face of the
 femur4 ,near the stifle it passes      
between the two heads of the            
gastrocnemius muscle and continues as   
the tibial4 ,branches supply the        
following muscles--obturator1           
semimembranosus 7adductor magnus71      
biceps femoris 7triceps abductor        
femoris71 semitendinosus 7biceps rotator
 tibialis71 lateral extensor 7peroneus7 
and the tibial nerve1 its continuation1 
innervates the digital flexors4         
,etiology and ,occurrence4--,paralysis  
of the great sciatic nerve may be caused
 by central disorders1 injury in        
falling1 fractures and new growths4     
,because of its protected position1 this
 nerve does not often suffer injury1 and
 paralysis of the sciatic nerve is      
recorded in a few instances owing to its
 rarity4  ,symptomatology4--,when       
consideration is given the number of    

muscles that are supplied by the sciatic
 nerve and the function of these        
muscular structures1 it is obvious that 
the leg cannot be used in sciatic       
paralysis4 ,however1 the limb is capable
 of sustaining weight when it is fixed  
in position1 but this is done without   
exertion of muscular fibers which are   
supplied by the great sciatic nerve4    
,trotting is impossible and flexion of  
the affected member is also likewise    
precluded4 ,the foot is dragged when the
 subject is caused to advance4  ,under  
the heading sciatica1 ,scott#dd has     
described a case of acute sciatic       
affection wherein a pacing horse        
manifested evidence of great pain of a  
nervous character4 ,there were muscular 
twitchings and the leg was held off the 
floor and moved about convulsively4     
,breathing was very much accelerated1   
pulse #he per minute1 the temperature   
was #ajc deg4 and manipulation of the   
hips augmented the pain4  ,this was not 
a paralytic condition and recovery      

resulted1 yet undoubtedly this was a    
case which1 if not properly cared for1  
might have terminated unfavorably4      
,treatment4--,prognosis is decidedly    
unfavorable in paralysis of the great   
sciatic nerve4 ,if treatment is         
attempted1 it is to be conducted along  
the same general lines as in femoral    
paralysis4 ,particular attention should 
be given to conditions which will make  
for the patient's comfort1 and as soon  
as it is evident that the affection is  
not progressing favorably1 the subject  
should be humanely destroyed4   ,iliac  
,thrombosis4  ,this condition is        
undoubtedly of more frequent occurrence 
than we are wont to grant when one      
considers the comparatively small number
 of cases that are actually recognized  
in practice4 ,it does not follow1       
however1 that iliac thrombosis rarely   
exists4 ,probably in the majority of    
instances there is insufficient         
obstruction of the lumina of vessels to 
provoke noticeable inconvenience4 ,or1  

if circulation is hampered to the extent
 that function is impaired and          
manifestations are observed by the      
driver1 the subject may be permitted to 
rest a few days and partial resolution  
occurs1 so that further trouble is not  
noticeable4  ,as judged by lesions of   
the aorta and iliac arteries in         
dissecting subjects1 the conclusion that
 arteritis and resultant disorders are  
of rather frequent occurrence1 is       
logical4  ,etiology4--,inflammation of  
the vessel walls and resultant          
prolifieration of tissue together with  
the accumulation of clotted blood       
becoming organized1 serve to obstruct   
the lumen of the affected artery4 ,the  
cause of arteritis is unknown in many   
instances1 but parasitic invasion and   
contiguous involvement of vessels in    
some inflammatory injuries are          
etiological factors4                    
,symptomatology4--,a characteristic type
 of lameness signalizes iliac thrombosis
 and the following brief abstract from a

 contribution on this subject by ,drs4  
,merillat#de1 clearly portrays the chief
 symptoms3  ,illustration3 ,fig4        
#dh--;,exposure of aorta and its        
branches1 showing location of thrombi in
 numerous places4 ,in this case 7same as
 ,fig4 #di7 ,dr4 ,l4,a4 and ,dr4 ,edward
 ,merillat found the cause of the       
condition to be due to sclerastomiasis4 
,the seizures are accompanied with      
profuse sudation1 tremors1      dilated 
nostrils1 accelerated respirations and  
other symptoms of      pain and         
distress1 all of which1 together with   
the lameness1      disappear as rapidly 
as they had developed1 leaving the      
animal in      an apparently perfect    
state of health1 ready to fall with     
another      attack of precisely the    
same kind1 as soon as enough exercise is
      forced upon it4 ,the rectal       
explorations may reveal a pulseless     
state of one or more of the iliac       
arteries and a hardness and             
enlargement of the aortic               

quadrifurcation1 but sometimes this     
palpation fails to disclose any         
perceptible diminution of the      blood
 current of these vessels4 ,the         
obturation being incomplete1 it      may
 be impossible by palpation to decide   
that thrombosis really      exists4 ,in 
this event and1 in fact1 in all eases1  
the clinical      symptoms are          
sufficiently characteristic to make a   
diagnosis      without reservation4 ,it 
cannot be mistaken for any other        
disease1      once properly             
investigated4 ,any given seizure may    
easily be      mistaken for azoturia1 at
 first1 but a better examination soon   
excludes that disease4  ,illustration3  
,fig4 #di--;,illustrative of thrombosis 
of the aorta1 iliacs and branches4      
,photo by ,dr4 ,l4,a4 ,merillat4        
,prognosis and ,treatment4--,in the     
majority of instances1 when      there  
is occasioned serious inconvenience1 the
 outcome is not      likely to be       
favorable1 according to ,moeller4       

,detachment of a      portion of the    
thrombus1 according to ,hoare1 may      
result in the      lodgment of an       
embolus in the brain or kidneys4 ,the   
latter      authority also states that  
muscular atrophy may occur owing to lack
      of blood supply in some of these  
cases4 ,moeller states that             
moderate exercise or work stimulates the
 establishment of      collateral       
circulation4 ,massage per rectum is     
condemned as      dangerous by ,cadiot4 
,fracture of the ,patella4  ,etiology   
and ,occurrence4--,patellar fractures   
are rarely met with in the horse but may
 be caused by falls and heavy           
contusions4 ,violent muscular           
contraction1 it is said1 may also bring 
about the same condition4               
,symptomatology4--,fracture may be      
transverse or vertical1 and depending on
 the manner in which the bone is broken1
 prognosis is either at once rendered   
favorable or unfavorable4 ,the patella  
performs a function which is in a way   

similar to that of the sesamoids and    
when fractured1 complete recovery is    
improbable in the average instance4     
,when complete1 transverse fractures    
permit of separation of the parts of    
bone4 ,tension on the straight ligaments
 below and contraction of the quadriceps
 above usually cause insuperable        
difficulty in the handling of this type 
of fracture in the horse4  ,compound    
fractures as well as multiple or        
comminuted fractures occasionally occur 
and these constitute injuries which are 
generally considered fatal1 although    
,andrien1 according to ,cadiot and      
,almy1 succeeded in obtaining complete  
recovery in a case of compound fracture 
of the patella and the horse was in     
service and almost free from lameness   
two months after treatment was begun4   
,no difficulty is encountered in        
recognizing the fracture of the patella 
because of the exposed position of the  
bone4 ,crepitation1 and in some cases   
fissures1 may be easily detected4       

,treatment4--,in simple fracture1 when  
treatment is thought advisable1 the     
subject is put in a sling and kept as   
nearly comfortable as possible4 ,if     
little inflammation exists1 the         
application of a vesicant two or three  
weeks after the injury has been         
inflicted will be helpful and serve to  
hasten repair4  ,bandages or mechanical 
appliances are of no practical use in   
the handling of these cases4   ,luxation
 of the ,patella4  ,etiology and        
,occurrence4--,this1 the most common    
luxation met with in the equine subject1
 has been described by writers as       
existing in many forms4 ,patellar       
disarticulation may be more practically 
considered as momentary and fixed1      
regardless of the position taken by the 
patella4 ,described under the title of  
false luxation are recorded cases       
wherein the quadriceps 7crural7 muscles 
become contracted in such manner that a 
condition simulating true               
disarticulation of the patella obtains4 

,also1 some practictioners report cases 
of patellar luxation and refer to       
pseudo-luxations1 without clearly       
defining the conditions which constitute
 pseudo-luxation4 ,this has contributed 
to the extant cause of misconception as 
to actual differences between luxation  
and conditions simulating dislocation4  
,luxation of the patella is a condition 
wherein the articular portions of the   
femur and patella assume abnormal       
relations whether such displacement of  
the patella be momentary and capable of 
spontaneous reduction1 or fixed and     
requiring corrective manipulation4      
,spasmodic contraction of the crural    
muscles which sometimes retains the     
patella in such position that the leg is
 rigidly extended1 does not in itself   
constitute luxation of the patella2 and 
unless this bone becomes lodged on the  
upper portion of a femoral condyle or   
laterally displaced out of its femoral  
groove1 luxation cannot be said to exist
 in the horse4 ,these are sub-luxations4

  ,occasionally one may observe in      
suckling colts outward luxation of the  
patella wherein there is history of     
navel infection and no marked evidence  
of rachitis is present4 ,some of these  
cases recover4 ,in a unilateral         
involvement of this kind in a           
three-month-old mule colt1 the author   
observed a case wherein an unfavorable  
prognosis was given and destruction of  
the subject advised1 because of the     
extreme dislocation of the patella4     
,this colt1 however1 was not destroyed  
and in three weeks had apparently       
recovered4 ,no treatment was given in   
this instance2 the colt was allowed the 
run of a small pasture with its dam and 
in time it matured1 becoming a sound and
 serviceable animal4                    
,classification4--,two forms of true    
patellar luxation in the horse may be   
considered2 one which is due to the     
patella becoming fixed upon the internal
 trochlear rim of the femur and the     
other when the patella slips over the   

outer rim of the trochlea4  ,the first  
form is known as upward luxation and is 
made possible by rupture of the mesial  
7internal7 femeropatellar ligament4     
,according to ,cadiot and ,almy1 it is  
only by the rupture of this             
ligament--the femeropatellar--that      
upward luxation may occur4 ,this type of
 luxation is rarely observed and is     
usually due to violent strain and       
abnormal extension of the stifle joint4 
,the second class1 outward luxation1    
occurs in colts and is1 in many         
instances1 congenital4 ,this form of    
luxation is also the one usually seen   
following debilitating diseases such as 
influenza and pneumonia4  ,upward       
luxation of the patella is characterized
 by the stiff-extended position of the  
leg4 ,when the patella is situated upon 
the inner trochlear rim1 the tibia must 
be extended because of the traction     
exerted by the straight ligaments4      
,since the stifle and hock joints extend
 and flex in unison1 there is presented 

also an extension of the tarsus4        
,extension of the stifle joint would    
increase the distance between the       
femoral origin of the gastrocnemius and 
its insertion to the summit of fibular  
tarsal bone 7calcis7 were it not for the
 gastrocnemius and superficial flexor   
7perforatus74 ,extension of the hock in 
upward luxation of the patella1 permits 
of flexion of the phalanges4 ,in upward 
luxation1 then1 the leg is extended as  
if too long1 but the phalanges may be in
 a state of moderate flexion4 ,if the   
foot rests on the ground when the       
extremity is not flexed1 it is almost   
impossible for the subject to step      
backward4 ,because of immobilization of 
the stifle and hock joints in upward    
luxation1 the subject can walk only by  
hopping on the sound leg and then the   
extremity is flexed1 allowing the       
anterior portion of the fetlock to drag 
on the ground4  ,in some cases          
practitioners are called to attend young
 animals that are reported to be stifled

 7often in young mules that have made a 
rapid growth7 and upon arrival the only 
noticeable symptom of preexisting       
luxation is the soiled condition of the 
anterior fetlock region--evidence of its
 having been dragged4 ,such cases may be
 styled momentary luxation1 whether they
 are due to a weakened condition of the 
patellar ligaments or spasmodic         
contraction of the crural muscles4  ,in 
upward luxation1 reduction is effected  
by attempting further extension of the  
stifle joint and at the same time the   
patella is pulled outward1 off the      
internal rim of the trochlea4 ,this is  
attempted by securing the subject in a  
standing position2 the sound side is    
kept against a wall if possible and a   
rope is tied to the extremity of the    
affected leg4 ,traction is exerted upon 
the rope and at the same time force is  
directed against the stifle joint to    
produce further extension if possible1  
so that the straight patellar ligaments 
may relax sufficiently to allow the     

patella to be dislodged from its        
position upon the inner trochlear lip4  
,failing in this manner of procedure1   
the affected animal is to be cast and   
anesthetized with chloroform4 ,the      
relaxation which attends surgical       
anesthesia will permit of reduction of  
the dislocated bone and manipulations   
such as have just been outlined may be  
employed4  ,following reduction in the  
average case it is essential that the   
subject be given vigorous exercise for a
 few minutes4 ,reduction having been    
affected1 the application of a vesicant 
over the whole patellar region is       
customary4  ,in cases of habitual       
luxation1 unless the ligaments are so   
lax that the patella may be displaced   
laterally over the inner as well as the 
outer trochler rims1 division of the    
inner straight patellar ligament will   
correct the condition4 ,this desmotomy  
has been advocated by ,bassi1 and good  
results in appropriate cases have been  
reported by ,cadiot1 ,merillat and      

,schumacher4 ,this operation has been   
found a corrective in cases of outward  
luxation as well as those of upward     
dislocation of the patella when resorted
 to before the trochleae are worn from  
frequent luxation4  ,outward luxation of
 the patella is occasioned by a lax     
condition of the internal femeropatellar
 ligament or a rupture of the same so   
that the patella slips over the outer   
femoral trochlear rim and permits of an 
abnormal flexion of the stifle joint4   
,the outer trochlear rim being the      
smaller of the two1 inward luxation does
 not occur in the horse4 ,with the      
patella disarticulated in this manner1  
the action of the quapriceps femoral    
group of muscles has no effect on the   
stifle joint and1 therefore1 flexion of 
this articulation occurs as soon as the 
subject attempts to sustain weight and  
the leg collapses unless weight is at   
once taken up by the other member if    
sound4  ,as a rule1 the reduction of    
this form of luxation is not difficult4 

,the patella may be pushed inward and   
into position without manipulation of   
the leg4 ,retention of the patella in   
position is a difficult problem4        
,bandaging is considered impractical and
 is not ordinarily done in this country4
 ,benard1 according to ,cadiot and      
,almy1 recommends bandaging with a heavy
 piece of cloth in which an opening is  
made through which the patella is       
allowed to protrude1 and by turning such
 a bandage snugly about the stifle      
several times1 the patella is held in   
position4 ,this bandage should be kept  
in place for about ten days4  ,in young 
and rachitic animals outdoor exercise   
and a good nutritive ration for the     
subject are indicated4 ,hypophosphites  
in assimilable form may be beneficial1  
and vesication of the patellar region   
contributes to recovery4  ,where extreme
 luxation is present in both stifles1   
the prognosis is unfavorable4 ,in such  
cases1 degenerative changes may exist   
and in some instances the ligaments are 

so diseased and elongated that          
regeneration is impossible4 ,williams#df
 reports a case where bilateral floating
 7outward7 luxation was present and     
extensive degeneration changes affected 
the articulation4  ,in subjects         
suffering frequent dislocation of the   
patella 7habitual luxation7 it is       
possible in some cases1 to prevent its  
occurrence or at least to minimize the  
distress occasioned by momentary        
luxation1 by keeping the animals in wide
 stalls so that backing is unnecessary4 
,in some nervous subjects that seem to  
be suffering from cramp of the crural   
muscles1 the difficulty and pain of     
their being backed out of narrow stalls1
 accentuates the nervousness4 ,sudation 
and restlessness are manifested and the 
subject presents a clinical picture of  
distress and fear of a painful ordeal4  
,in some cases of this kind1 complete   
recovery takes place by the time animals
 are five or six years of age4 ,one     
should avoid keeping such subjects in   

narrow stalls4 ,preferably patellar     
desmotomy should be performed that      
relief may be obtained at once4         
,luxations attending some cases of      
influenza recover promptly when subjects
 are kept comfortably confined in roomy 
box-stalls4 ,the administration of      
stimulative medicaments such as nux     
vomica and the application of an active 
blistering agent to the patella serve to
 hasten recovery4 ,dislocations in such 
cases are often bilateral and they are  
usually momentary4 ,reduction occurs    
spontaneously1 as a rule1 and the       
subjects are not occasioned much        
distress if they are kept quiet for a   
few days4   ,chronic ,gonitis4          
,etiology and ,occurrence4--,chronic    
inflammation of the stifle joint is met 
with following acute synovitis due to   
strains and concussion4 ,it is an       
ailment which affects heavy horses and  
particularly animals that are kept at   
work on paved streets1 but this does not
 explain its existence in animals that  

are not subjected to work likely to     
cause concussion4 ,berns#dg considers   
rheumatism a probable cause of gonitis  
and1 as he states1 the dropsical form of
 affection of this joint is not         
ordinarily attended with manifestations 
of inconvenience to the subject4        
,gonitis is often bilateral and its     
onset is insidious in many instances4   
,symptomatology4--,in unilateral gonitis
 weight is not borne by the affected    
member4 ,there is noticeable distension 
of the joint capsule--a characteristic  
pendant pouching protrusion4 ,when both 
stifles are affected the subject        
frequently shifts the weight from one   
limb to the other4 ,lameness comes on   
gradually and during the incipient      
stages may be intermittent but it       
progressively increases so that in time 
affected animals become useless4 ,in    
bilateral affections animals drag the   
toes because of the pain incident to    
flexing the stifles4 ,this is           
particularly evident when the subject is

 made to trot4 ,as the disease          
progresses1 atrophy of the quadriceps   
femoris muscles becomes pronounced and  
as destructive changes involving the    
articular cartilages take place4 ,the   
subject becomes more lame and eventually
 is rendered incapable of service4      
,upon manipulation of the patellar      
region1 one is impressed with the fact  
that hyperesthesia does not exist in    
proportion to the pain manifested during
 locomotion4 ,in some cases a gelatinous
 swelling is present and may be detected
 by palpating between the straight      
ligaments of the patella4 ,williams1    
,hughes1 ,merillat1 ,hadley and others  
have directed attention to the existence
 of floating masses 7corpora oryzoidea7 
in the synovial capsule of this joint in
 gonitis1 and as with all cases of      
arthritis1 irreparable damage is often  
done the articular cartilages during the
 course of the ailment4  ,illustration3 
,fig4 #ej--;,chronic gonitis4 ,the      
knuckling which results from long       

continued inactivity of the crural      
muscles in chronic cases is marked in   
this instance4 ,photo by ,dr4 ,l4,a4    
,merillat4  ,treatment4--,no effective  
method is as yet known which will       
control this condition during its       
incipiency4 ,the disease progresses1 and
 more or less damage is done the        
affected parts in the course of months  
or even years in some cases before      
subjects are rendered hopelessly        
crippled4 ,when recognized early 7before
 chronic gonitis exists7 aspiration of  
the synovia and the injection of diluted
 tincture of iodin might prove          
beneficial in cases of synovial         
distension4 ,chronic gonitis is         
considered an incurable affection and as
 soon as subjects manifest evidence of  
distress from this condition they should
 by all means be taken from work4       
,firing and vesication have not been    
productive of beneficial results4       
,illustration3 ,fig4 #ea--;,gonitis4    
,showing position assumed in such cases 

because of pain occasioned4 ,photo by   
,dr4 ,c4,a4 ,mc,killip4   ,open ,stifle 
,joint4  ,anatomy of the ,joint         
,capsule4--,this joint capsule is thin  
and very capacious4 ,on the patella it  
is attached around the margin of the    
articular surface1 but on the femur the 
line of attachment is at a varying      
distance from the articular surface4 ,on
 the medial side it is an inch or more  
from the articular cartilage2 on the    
lateral side and above1 about half an   
inch4 ,it pouches upward under the      
quadriceps femoris for a distance of two
 or three inches1 a pad of fat          
separating the capsule from the muscle4 
,below the patella it is separated from 
the patellar ligaments by a thick pad of
 fat1 but inferiorly it is in contact   
with the femerotibial capsules4 ,the    
joint cavity is the most extensive in   
the body4 ,it usually communicates with 
the medial sac of the femerotibial joint
 cavity by a slit-like opening situated 
at the lowest part of the medial ridge  

of the trochlea4 ,a similar1 usually    
smaller1 communication with the lateral 
sac of the femerotibial capsule is often
 found at the lowest part of the lateral
 ridge4 7,sisson's ,anatomy47  ,thus it 
is seen that because of its frequent    
communication with the other parts of   
this large synovial membrane1 a wound   
which opens the external portion of the 
femerotibial capsule may be the cause of
 contamination and resultant infectious 
arthritis of the whole stifle joint4    
,because of the distance between the    
most dependent part of the femerotibial 
articulation and the summit of the      
patella1 one may misjudge the exact     
location of the lowermost part of this  
portion of the capsular ligament of the 
stifle joint and thereby fail at once to
 appreciate the seriousness of calk     
wounds in this region4  ,etiology and   
,occurrence4--,wounds to the patellar   
region are of rather frequent           
occurrence1 and because of the          
comparatively unprotected position of   

these structures1 the capsular ligaments
 of the stifle joint may be perforated  
as a result of violence in some form4   
,calk wounds which penetrate the tissues
 in the immediate region of the lower   
portion of the external part of the     
femerotibial capsule sometimes result in
 open joint because of tissue necrosis  
resulting from the introduction of      
infection4 ,contused wounds sometimes   
destroy the skin and fascia over large  
areas on the lateral patellar region and
 because of subsequent sloughing of     
tissue due to infection as well as to   
the manner in which such wounds are     
inflicted1 septic arthritis subsequently
 occurs4 ,penetrant wounds1 such as may 
be caused by a fork tine may not result 
in infection2 if infectious material is 
introduced an infectious arthritis does 
not necessarily follow1 though such     
cases should be considered as serious   
from the outset4  ,symptomatology4--,the
 pathognomonic symptom of open stifle   
joint is the profuse escape of synovia1 

indicating perforation of the synovial  
capsule2 by means of a probe the wound  
may be explored in a way that will      
clearly reveal the nature of the injury4
  ,after a few days have elapsed in     
cases where considerable infection has  
taken place1 there is manifestation of  
pain as in all cases of infective       
arthritis4 ,hughes#dh gives an excellent
 description of the clinical aspect of  
arthritis which applies here3           
,acute arthritis begins like an ordinary
 attack of synovitis4 ,in      joints   
other than the pedal and pastern1 there 
is sudden and      extensive swelling1  
which at first is intra-articular1      
succeeded by      extra-articular       
tumefaction1 and accompanied by violent 
lameness4      ,the pain soon becomes   
intense and agonizing4 ,there is severe 
constitutional disturbance1 the         
temperature ranging from #ajd to #ajf   
degrees and the pulse from #fj to #gb4  
,painful convulsions of the      limb   
occur1 shown by involuntary spasmodic   

elevations due to reflex      irritation
 of the muscles4 ,there is loss of      
appetite1 rapid      emaciation1 the    
flank is tucked up and the back arched4 
,in from      three to six days1 the    
tumefaction around the joint tends to   
soften      at a particular place1 and  
bursts1 and a discharge that is         
sometimes of a sanious character1 mixed 
with synovia1 escapes4      ,great      
exhaustion at times supervenes1 and if  
the joint is an      important one1 the 
horse lies or falls and is unable to    
rise4  ,treatment4--,in small puncture  
wounds the immediate application of a   
vesicating ointment has given good      
results1 but when infection has taken   
place to such extent that the animal    
manifests evidence of intense pain1 and 
lameness is marked and local swelling   
and hyperesthesia are great1 vesication 
is contraindicated4 ,in such instances  
the exterior of the wound and its       
margins should be prepared as in similar
 affections of other joints4 ,a quantity

 of synovia is then aspirated by means  
of a small trocar and care should be    
taken to observe all due aseptic        
precautions4 ,subsequently the injection
 of from four to six ounces of a mixture
 of tincture of iodin1 one part to ten  
parts of glycerin1 and gentle massage of
 the joint immediately after the        
injection has been made1 serves to check
 the infective process in some cases4   
,the subject should be cared for as has 
been previously suggested in arthritis  
proper provisions for comfort being     
made4 ,good nursing is always essential 
to a successful issue4 ,however1 the    
author cannot view cases of open stifle 
joint with the same optimism concerning 
their course and outcome that is        
expressed by a number of writers on this
 subject4 ,it is a grave condition      
wherein the prognosis should be given   
advisedly4   ,fracture of the ,tibia4   
,etiology and ,occurrence4--,because of 
its exposed position to kicks1 and its  
lack of protection by heavy musculature 

7especially on its inner surface71 there
 is afforded ample opportunity for      
frequent injury to the tibia4 ,fractures
 are complete and varying as to nature1 
or incomplete4 ,the heavy tibial fascia 
affords sufficient protection so that   
fissures without entire solution of     
continuity of the bone may occur from   
violence to which this part is often    
subjected4 ,moeller classes tibial      
fracture as ranking second in           
frequency--pelvic fracture being more   
often met with in horses4 ,this does not
 apply in our country as phalangeal and 
metacarpal and even metatarsal fractures
 are observed in more instances than are
 such injuries to the tibia4 ,the tibia 
is occasionally broken at its middle and
 lower thirds1 but malleolar fractures  
are not common4  ,symptomatology4--,when
 fracture is complete and all support is
 removed1 the leg dangles1 and the      
nature of the injury is so obvious that 
there is no mistaking its identity4     
,however1 in case of incomplete fracture

 one needs to base all conclusions upon 
the history of the case1 evidence of    
injury1 or other knowledge of the       
character of violence to which this bone
 has been exposed4 ,for without the     
presence of crepitation 7even by        
excluding other possible causes for the 
pronounced lameness which characterizes 
some of these cases7 we can only resort 
to the knowledge which experience has   
taught that fracture may be deemed      
probable in many injuries to the tibial 
region4 ,consequently1 we are to look   
upon all injuries that affect the tibia 
as being fractures of some sort when    
there is either local evidence of the   
infliction of violence or whenever      
marked lameness attends such injuries1  
unless there is positive indication that
 no fractures exist4  ,a careful        
examination of parts of the tibia1 i4e41
 noting the amount and painfulness of   
swellings1 exploration with the probe1  
and observations of the course taken in 
any given case1 will determine the exact

 nature of injuries4 ,such examination  
needs to extend over a period of a week 
or in some instances two or three weeks 
may pass before the true state of       
affairs is apparent4 ,in the meanwhile1 
cases are to be handled as though tibial
 fracture certainly existed4            
,prognosis4--,prediction of the outcome 
in tibial fracture is somewhat          
presumptuous1 but in the majority of    
cases in mature subjects fatality       
results4 ,cadiot#di1 however1 views this
 condition with more optimism than have 
,american practitioners4 ,while he      
considers the condition grave1 in citing
 case reports of successful treatment by
 d',arboval1 ,duchemin1 ,leblanc1 and   
others1 his conclusion is that many     
practitioners erroneously consider      
fractures of the tibia as incurable4    
,the method of handling these cases by  
,leblanc is as follows3 ,the subject is 
placed in a sling2 a pit is excavated   
below the affected member so that a     
heavy weight may be attached to the     

extremity2 splints are applied to each  
side of the leg1 which is padded with   
oakum1 and this is kept in position by  
means of bandages covered with pitch4   
,the outer splint extends from the hoof 
to the stifle and the inner one from the
 hoof to the upper third of the leg4    
,this method in the hands of ,leblanc   
has been successful in several          
instances1 according to ,cadiot4  ,in a 
foal the author has in one instance     
succeeded in obtaining complete recovery
 in a simple fracture of the lower third
 of the tibia where the only support    
given the broken bone was a four-inch   
plaster-of-paris bandage which was      
adjusted above the hock4 ,below the     
tarsus a cotton and gauze bandage was   
applied to prevent swelling of the      
extremity4 ,in this instance 7an        
emergency case in which materials that  
are not to be recommended were          
necessarily employed7 recovery took     
place within thirty days4  ,as has been 
mentioned in the consideration of radial

 fractures1 heavy leather is better     
suited for immobilization of these parts
 than a cast or other rigid splint      
materials4 ,mature animals may be       
expected to resist the immobilization of
 the hind legs because of the normal    
manner of flexion of the tarsal and     
stifle joints in unison4 ,therefore1 the
 application of rigid splints to the leg
 and including the hock is productive of
 disastrous results in some cases4  ,the
 application of cotton and bandages to  
pad the member and the adjusting of     
heavy leather splints on either side of 
the leg1 and retaining them in position 
with four-inch gauze bandages will prove
 more nearly satisfactory than some     
other methods employed4 ,prognosis is   
unfavorable1 however1 in most cases of  
compound fracture and recovery is       
improbable when the upper portion of the
 tibia is broken4   ,rupture and ,wounds
 of the ,tendo ,achillis4  ,etiology and
 ,occurrence4--,cases are recorded by   
,uhlrich in which rupture has followed  

degenerative changes affecting the tendo
 ,achillis4 ,not infrequently1 the      
result of a trauma1 division of the     
tendo ,achillis occurs4 ,moeller states 
that rupture of this tendon may be due  
to jumping1 in riding horses and in     
draught horses1 in their efforts to     
avoid slipping4 ,in runaways1 it        
sometimes occurs where sharp-edged      
implements are bounced against the legs 
in such fashion that division of the    
tendon results4  ,symptomatology4--,with
 division of the tendo ,achillis or of  
the musculature of the gastroenemii and 
the superficial flexor 7perforatus71    
there remains nothing to inhibit tarsal 
flexion except the deep flexor tendon   
7perforans7 and this does not support   
the leg4 ,when attempt is made to       
sustain weight with the affected member1
 abnormal flexion of the tarsus takes   
place and the hock sinks almost to the  
ground4 ,the symptoms are so            
characteristic that recognition is      
always easy even in case no wound of the

 skin exists4  ,prognosis4--,spontaneous
 recoveries occur and such cases are    
reported by ,bouley who is quoted by    
,cadiot as having observed division of  
the tendo ,achillis due to a sword wound
 wherein at the end of four months      
recovery was complete4 ,division of this
 tendon in brood mares has been         
practiced by the early settlers of parts
 of the ,united ,states for the purpose 
of preventing their straying too far    
from home4 ,in such instances one leg   
only was so mutilated and in most       
instances1 it is reported that          
spontaneous recovery took place4  ,in   
unilateral involvement without          
complications1 the prognosis is not     
unfavorable if provisions for giving    
necessary attention are available4      
,treatment4--,the subject is to be      
confined in a sling and the member      
bandaged and supported by means of      
leather splints4 ,immobilization as for 
fracture is not necessary but1          
nevertheless1 movement is to be         

restricted as much as possible4 ,in case
 of open wounds1 the exposed tissues are
 cared for along general surgical lines4
 ,where the divided parts of the tendon 
are maintained in fairly close and      
constant relation1 granulation of       
tissue1 sufficient to sustain weight    
takes place in from six weeks to three  
months4   ,spring-,halt4                
7,string-,halt47  ,occurrence4--,this   
condition is a myoclonic affection of   
the hind leg which is discussed in works
 on theory and practice under the head  
of neuroses1 but the cause or causes    
have not been established4 ,theories    
that heredity is responsible have their 
supporters and advocates of hypotheses  
attributing it to disease of the sciatic
 nerve1 patellar subluxation1 fascial   
contraction of various muscles1 dry     
spavin 7tarsal arthritis71 iliac        
exostoses1 disease of the foot and      
contraction of the hoof1 are on record  
in veterinary literature4 ,this ailment 
affects old horses more frequently than 

it does young and is seen in all breeds 
of animals including mules4             
,illustration3 ,fig4 #eb--,spring-halt4 
,symptomatology4--,this disease develops
 slowly1 and progressively increases in 
severity as a rule1 but does not        
ordinarily constitute cause for         
rendering an animal unserviceable4      
,while the affection is sometimes       
bilateral 7occasionally affections of   
the forelegs are reported7 and the      
extreme flexion of the legs in the      
spasmodic manner which characterizes    
spring-halt1 cause great waste of energy
 during locomotion1 yet such cases are  
rare4 ,usually the ailment is markedly  
evinced when subjects are first taken   
from the stable1 but as they are        
exercised the manifestation diminishes1 
and in many instances it completely     
subsides4 ,the condition is generally   
more noticeable when the subject is made
 to step backward4 ,in some animals     
there is marked abduction at the time   
flexion occurs and in singular instances

 the spasmodic contraction is so violent
 that the subject falls to the ground as
 a result of the peculiar flexion of the
 leg4  ,in severe cases of scratches or 
chemical irritation of the extremity1   
the legs are abnormally flexed in a     
manner which simulates spring-halt1 but 
because of the evident injury of the    
parts this is not likely to confuse4    
,since all facts concerning etiological 
agencies are surrounded with so much    
obscurity1 classification does not lend 
any particular assistance in the        
consideration of this ailment4          
,prognosis4--,one cannot intelligently  
give a prognosis in these cases if      
forecast is expected to state the exact 
course following treatment4 ,however1 in
 a general way1 cases of recent         
affection are thought more favorable    
than are those of long standing or in   
old animals where myositis and other    
muscular and fascial affections exist   
owing to years of hard service4         
,treatment4--,no known line of medicinal

 treatment is of service1 nor is any    
particular surgical operation to be     
considered dependable for obtaining     
relief4 ,operations of almost every     
conceivable nature have been tried with 
the hope of securing recovery in        
spring-halt but under no condition can  
the practitioner as yet be reasonably   
certain of effecting permanent relief in
 any case4 ,treatment is1 therefore1    
entirely empirical4  ,neurectomies have 
been performed and recoveries following 
were attributed thereto2 fascial        
divisions in the crural region have been
 done with good results and this manner 
of treatment has its favorers4          
,advocates of tenotomies1 likewise1 are 
to be found4 ,consequently1 one may     
summarize thus3 ,spring-halt is a       
disease of unknown origin--the exact    
cause has not been determined2          
therefore1 all treatment is1 in a way1  
experimental4 ,the recommendation of any
 given procedure in handling cases must 
then be a matter of opinion based either

 upon practical experience or knowledge 
of the experiences of others4 ,divisions
 of the lateral digital extensor        
7peroneus7 below the tarsus near its    
point of insertion to the extensor of   
the digit is recommended here because it
 is followed by a percentage of         
recoveries that is as large as in any   
other method of treatment and the       
operation is not difficult to perform   
nor is its performance fraught with any 
dangerous complications4 ,in selected   
subjects about fifty per cent of cases  
recover in from two to six weeks        
following this operation4               
,illustration3 ,fig4 #ec--,lateral      
7external7 view of tarsus showing       
effects of generalized tarsitis4   ,open
 ,tarsal ,joint4  ,like the tibia the   
hock is exposed to frequent injuries and
 in some cases wounds perforate the     
joint capsule4 ,when due to calk wounds 
where horses are kicked1 the injury is  
often on the side of the tarsus 7medial 
or lateral7 and such wounds not         

infrequently result in infectious       
arthritis4 ,horses sometimes jump over  
wire fences and wounds are inflicted    
which constitute extensive laceration of
 the joint capsule4 ,in firing for bone 
spavin1 where a deep puncture is made   
very near the tibial tarsal             
7tibioastragular7 joint if infection    
gains entrance1 serious and generalized 
infection of the open joint cavity      
supervenes in some cases4               
,symptomatology4--,there is no marked   
difference in the constitutional        
disturbances which are occasioned in    
this condition and those encountered in 
other cases of septic arthritis         
7previously considered herein7 except   
that there is a difference in the degree
 of resultant derangement and local     
tissue changes4 ,chiefly1 because of the
 difficulty encountered in keeping the  
hock joint in an aseptic condition or   
securely bandaged1 open tarsal joint    
constitutes a more serious condition    
than a similar affection of the fetlock4

 ,otherwise1 a very similar condition   
obtains and the same diagnostic         
principles serve here that have been    
described on page #aaj in considering   
open fetlock joint4  ,treatment4--,the  
same plan that is described in detail   
for treatment of similar conditions     
affecting the fetlock joint is indicated
 in this affection4 ,exceeding care must
 be exercised in bandaging the hock1    
however1 lest the animal be so irritated
 that in the extreme flexion of the     
tarsus which is often caused by         
bandaging1 the wound dressings may be   
completely deranged4 ,a wide gauze      
bandage material is most satisfactory2  
cotton of long fiber is separated in    
thin layers and wound about the hock1   
extending from the site of injury to a  
point about six inches proximal to the  
summit of the os calcis4 ,by using an   
abundance of cotton in this way1 it will
 not be found necessary to apply the    
bandages very snugly2 with a four-inch  
gauze bandage material1 which is        

supported above the cap of the hock and 
brought across the anterior face of the 
tarsus in a diagonal manner1 a          
comfortable and very serviceable        
protective dressing is provided for4    
,animals so treated will not ordinarily 
resist because of pressure from the     
bandages4 ,pressure is unavoidable in   
the use of adhesive dressings or where  
careful attention is not given the      
manner of applying cotton to the parts4 
,such methods are sure to result        
disastrously4 ,but if subjects are kept 
quiet after the parts have been properly
 bandaged1 no difficulty is encountered 
in maintaining asepsis in an uninfected 
wound4 ,recovery takes place in         
favorable cases in from three weeks to  
three months1 depending on the nature   
and extent of injuries inflicted4       
,fracture of the ,fibular ,tarsal ,bone 
7,calcaneum47  ,etiology and            
,occurrence4--,this condition though    
rarely met with in the horse1 is the    
result of violent strain upon the os    

calcis by the gastrocnemius and         
superficial flexor tendons in efforts   
put forth by animals in attempts to     
regain a footing when the hind feet slip
 forward under the body1 or in jumping  
and in falls or direct contusion by     
heavy bodies4 ,hoare#ej reports a case  
of a mare that had produced fracture in 
jumping4  ,fracture of the other tarsal 
bones are very seldom observed but may  
be occasioned by contusions wherein     
multiple or comminuted fractures are    
produced1 such as are to be seen in     
small animals4 ,fracture of the tibial  
tarsal bone 7astragalus7 is to be       
observed as a complication in luxations 
of the tarsal joint and1 according to   
,cadiot1 the other tarsal bones may     
likewise suffer fracture in luxations of
 the hock4  ,symptomatology4--,great    
pain attends this accident according to 
the observations given in recorded      
cases4 ,in the case cited by ,hoare the 
animal evinced great pain and           
uneasiness2 the hock was unduly flexed2 

the calcaneum was displaced forward2 and
 marked crepitation was present4 ,a     
portion of the body of the calcaneum was
 protruding through the perforated skin4
 ,the animal was destroyed and the bone 
was found broken in three pieces4       
,illustration3 ,fig4 #ed--,right hock   
joint4 ,viewed from the front and       
slightly laterally after removal of     
joint capsule and long collateral       
ligaments4 ,t4t41 ,tibial tarsal bone   
7distal tuberosity74 ,t4c41 central     
tarsal bone4 ,t4#c4 ,ridge of third     
tarsal bone4 ,t4f4 ,fibular tarsal bone 
7distal end74 ,t4#d4 ,fourth tarsal     
bone4 ,mt4 ,,iii1 ,mt4 ,,iv4 ,metatarsal
 bones4 ,arrow points to vascular canal4
 7,from ,sisson's ,anatomy of the       
,domestic ,animals47  ,since the support
 for the tendo ,achillis is removed in  
such fracture and no leverage on the    
metatarsus obtains1 it naturally follows
 that any attempt to sustain weight must
 result in extreme flexion of the hock  
and descent of this part in a manner    

similar to cases of rupture or division 
of the ,achilles' tendon4 ,the two      
conditions should not be confused1      
however1 as the parts may be definitely 
outlined by palpation and the slack     
condition of the tendon and displaced   
summit of the calcaneum1 which          
characterize fracture of the fibular    
tarsal bone1 are easily recognized4     
,treatment4--,prognosis is unfavorable  
in the majority of cases1 but should    
attempts at treatment be undertaken in  
young and quiet mares which might prove 
valuable for breeding purposes in case  
of imperfect recovery1 they should be   
put in slings and the member is to be   
immobilized as in tibial fracture4      
,authorities are agreed that prognosis  
is entirely unfavorable in mature       
animals1 when the case is viewed from an
 economic standpoint4   ,tarsal         
,sprains4  ,etiology and                
,occurrence4--,the hock joint is often  
subjected to great strain because of the
 structural nature of this part and its 

relation to the hip as well as the      
manner in which the tarsus functionates 
during locomotion4 ,that ligamentous    
injuries owing to sprain frequently     
occur and attendant periarticular       
inflammations with subsequent           
hypertrophic changes follow1 is a       
logical inference4 ,fibrillary fracture 
of the collateral ligaments may take    
place in falls or when animals make     
violent efforts to maintain their       
footing on slippery streets4 ,in        
expressing opinions concerning the      
frequency with which the hock is found  
to be the seat of trouble in lameness of
 the pelvic members1 different writers  
place the percentage of hock lameness at
 from seventy-five to ninety per cent4  
,and when one considers the possibility 
that a goodly proportion of cases of    
tarsal exostis are the outcome of       
sprains1 the occurrence of tarsal       
sprains may be more generally admitted4 
,symptomatology4--,a mixed type of      
lameness is present and the nature of   

the impediment varies1 depending upon   
the location of the injury4 ,sprains of 
the mesial tarsal ligaments cause       
lameness somewhat similar to that of    
spavin4 ,however1 in establishing a     
diagnosis1 local evidence in these cases
 is of greater significance than the    
manner of locomotion4 ,during the acute 
stage of inflammation there is to be    
detected local hyperthermia1 some       
hyperesthesia and a little swelling4    
,later1 when resolution is not prompt1  
considerable swelling 7or perhaps       
correctly speaking1 an indurated        
enlargement7 variable in size is        
developed4 ,in some cases the entire    
tarsal region becomes greatly enlarged  
and this swelling is very slowly        
absorbed in part or completely4 ,such   
sub-acute cases are observed during the 
winter season and particularly where    
subjects are kept in tie stalls without 
exercise for weeks at a time4           
,treatment4--,attention should be       
directed toward relief for the animal in

 all acute inflammations4 ,local        
applications of heat are helpful and1 of
 course1 rest is essential4 ,towels that
 are wrung out of hot water and held in 
position by means of a few turns of a   
loose bandage and this covered with an  
impervious rubber sheet1 will serve as a
 practical means of application of      
hydrotherapy4 ,following this when      
conditions improve1 as in the handling  
of all similar cases1 counterirritation 
is indicated4  ,when proper care is     
given at the onset and where injury does
 not involve too much ligamentous       
tissue1 recovery takes place in a few   
weeks but in some cases which occur     
during the winter season in farm horses1
 complete recovery does not result until
 several months have passed4   ,curb4   
,the hock is said to be curbed when the 
normal appearance1 viewed from the side1
 is that of bulging posteriorly at any  
point between the summit of the         
calcaneum and the upper third of the    
metatarsus4 ,among some horsemen a hock 

is said to be curby whenever there      
exists an enlargement of any kind on the
 posterior face of the tarsus whether it
 be due to sprain1 exostosis or         
proliferation of tissue as a result of  
contusion4  ,french veterinarians       
consider under the title of courbe1 an  
exostosis situated on the mesial side of
 the distal end of the tibia4 ,cadiot   
and ,almy state that this condition     
7courbe7 is of rare occurrence4         
,percivall defines curb as a prominence 
upon the back of the hind leg1 a little 
below the hock1 of a curvilinear shape1 
running in a direct line downwards and  
consisting of infusion into1 or         
thickening of1 the sheath of the flexor 
tendons4 ,moeller's version of true curb
 is a thickening of the plantar ligament
 7calcaneocuboid or calcaneometatarsal74
 ,hughes and ,merillat consider curb as 
a synovitis having for its seat the     
synovial bursa which is situated between
 the superficial flexor tendon          
7perforatus7 and the plantar ligament4  

,occurrence4--,certain predisposing     
factors seem to favor the occurrence of 
curb4 ,a malformation of the inferior   
part of the tarsus so that its          
antero-posterior diameter is            
considerably less than normal is a      
contributing cause4 ,such hocks are     
known as tied-in4 ,another fault in     
conformation is the existence of a weak 
hock that is set low down on a crooked  
leg1 especially when such a member is   
heavily muscled at the hip4 ,given such 
conformation in an excitable horse1 and 
curb is usually produced before the     
subject is old enough for service4 ,it  
is certain that in cases where          
conformation is bad1 greater strain is  
put upon the plantar ligament4 ,this    
structure serves to bind the tibial     
tarsal 7calcis7 bone to the metatarsus2 
traction exerted upon its summit by the 
tendo ,achillis is great when animals   
run1 jump or rear and also at heavy     
pulling4 ,in animals having curby hocks1
 sprain is likely to result and curb    

supervenes4  ,symptomatology4--,the     
characteristic swelling which marks curb
 may develop quickly and lameness occur 
suddenly or the enlargement comes on    
gradually and slowly1 causing little    
lameness4 ,lameness is not proportionate
 to the size of the swelling and in all 
cases whether subacute or chronic1 the  
condition improves with rest1 but       
lameness is again manifested upon       
exertion4 ,a horse which throws a curb  
will go lame until the acute            
inflammatory condition subsides and     
depending upon treatment received and   
conformation of the hock1 this requires 
from three days to two or three weeks4  
,the character of the swelling varies2  
in some cases it is not large but rather
 dense and lacking in evidence of heat  
and hyperesthesia2 in other cases there 
is considerable swelling1 which is hot  
and doughy1 somewhat painful to the     
touch but not necessarily productive of 
much lameness4 ,in any event1 whether   
the swelling or enlargement is big or   

little1 its location makes it           
conspicuous when viewed in profile4  ,in
 most cases after the acute inflammatory
 period has passed1 lameness is slight1 
if at all present1 and in time no       
interference with the subject's         
usefulness is occasioned because of the 
curb1 but the animals often remain      
blemished--complete resorption of       
inflammatory products being unusual when
 much disturbance has existed4          
,treatment4--,the handling of curb      
during the acute inflammatory stage is  
along the same lines as in sprain--local
 applications of cold and heat4         
,subjects must be kept quiet until all  
inflammation has subsided1 for there are
 no cases wherein a little brisk        
exercise is more likely to cause a      
recurrence of lameness before recovery  
is complete than in curb4 ,vesication is
 in order in a week or ten days after   
the affection has set in2 in old        
stubborn cases that have resisted       
ordinary treatment for a few months1 the

 use of the actual cautery 7line firing7
 is to be recommended4  ,illustration3  
,fig4 #ee--,spavin4   ,spavin4 7,bone   
,spavin47  ,this term is applied to an  
affection of the tarsus which is usually
 characterized by the existence of an   
exostosis on the mesial and inferior    
portion of the hock4 ,there is also     
included under this name1 articular     
inflammation wherein no external        
evidence is shown4 ,spavin lameness has 
long been recognized and much has been  
written upon this subject4 ,since       
authorities are agreed that most cases  
of lameness in the hind leg are due to  
hock affection1 and because the majority
 of cases of lameness which have the    
tarsal region as the seat of trouble are
 instances of spavin lameness1 this     
disease merits all the attention it has 
received4  ,etiology and                
,occurrence4--,causes may well be       
classified as predisposing and exciting1
 for there are many etiologic factors to
 be reckoned with in spavin1 some of    

which are widely different in nature4   
,considered as predisposing causes1     
hereditary influences play an important 
role and may1 owing to faulty           
conformation1 subject an animal to      
affections of this kind because of      
disproportionate development of parts   
7weak and small joints and heavy        
muscular hips72 or as a consequence of  
inherited traits1 a subject may manifest
 susceptibility to degenerative bone    
changes which are signalized by the     
formation of exostoses of different     
parts on one or more of the legs4       
,hereditary predispositions make for the
 presence of spavin in a large          
percentage of the progeny of sires so   
affected4 ,this fact has been repeatedly
 demonstrated in this country as well as
 elsewhere according to ,quitman1       
,dalrymple and ,merillat4#ea ,a number  
of states have passed stallion          
inspection laws stipulating that animals
 having such exostoses as spavin and    
ringbone cannot be registered except as 

unsound4  ,asymmetrical conformation1   
particularly where the hock is obviously
 small and weak as compared with other  
parts of the leg1 constitutes a         
noteworthy predisposing cause4  ,peters'
 theory is plausible that the screw-like
 joint between the tibia and the tibial 
tarsal 7astragulus7 bones causes these  
structures to functionate in a manner   
not in harmony with the provisions      
allowed by the collateral ligaments of  
the tarsus1 permitting movement only in 
a direction parallel with the long axis 
of the body4  ,because of the quality of
 their temperaments1 nervous animals    
possessing no particular congenital     
structural defects of the hock and      
having no history of spavined           
progenitors1 are subject to spavin when 
kept at work likely to produce tarsal   
sprain4 ,spavin usually develops early  
in such subjects and examples of this   
kind may be frequently observed in      
agricultural sections of the country4   
,where spavin develops in unshod colts  

at three and four years of age1 shoeing 
is not an influencing agency when       
animals are not worked on pavements4    
,exciting causes of spavin are sprain   
and concussion4 ,various hypotheses are 
recorded as to how sprains are          
influenced and among others may be      
mentioned that of ,mc,donough#eb1 which 
is that the foot is robbed of its normal
 manner of support by the ordinary      
three-calked shoe4 ,with such a shoe1   
little support is given the sides of the
 foot2 hence1 undue strain is put upon  
the collateral ligaments of the tarsus4 
,moreover1 the shoe with its calks      
increases the length of the leg and adds
 to the leverage on the hock1 by virtue 
of such added length4 ,this makes for   
greater strain upon the mesial or       
lateral tarsal ligaments whenever the   
foot bears upon a sloping ground        
surface1 so that one side 7inner or     
outer7 is higher or lower than the      
other4 ,but according to ,mc,donough's  
theory 7a good one concerning horses    

that work on pavements71 the chief error
 in shoeing lies in that the foot is    
deprived of its normal base or support  
on the sides--the three-calked shoe     
being an unstable support--and that this
 manner of shoeing city horses working  
on pavements is an inhumane practice1 a 
diabolical method4  ,whether spavin has 
its point of origin within the          
articulation as a rarefying ostitis of  
the cancellated structure of the lower  
tarsal bones as suggested by ,eberlein2 
or1 as ,diekerhoff asserts1 that the    
cunean bursa may be the initial point of
 affection1 is unsettled2 but it is     
reasonable to consider occult spavin as 
having its origin within the            
articulation1 and that cases readily    
yielding to cunean tenotomy are         
primarily due to affection of the cunean
 bursa4  ,symptomatology4--,where a     
visible exostosis exists1 the presence  
of spavin is easily detected1 yet       
exostoses that extend over large areas  
may constitute cause for serious trouble

 and still be difficult of detection4   
,by observing the internal surface of   
the hock from various suitable angles1  
such as from between the forelegs or    
directly behind the subject1 one may    
note the presence of any ordinary       
exostosis4  ,the position assumed by the
 spavined horse is often characteristic4
 ,more or less knuckling is usually     
present 7,liautard1 ,mc,donald74 ,there 
is abduction of the stifle in some      
cases1 or the toe may be worn in unshod 
horses so that it presents a straight   
line at the surface4 ,this is manifested
 to a great degree in some animals and  
in others the foot is not dragged and   
there is no wearing of the hoof at the  
toe4  ,spavin lameness is so distinctive
 that one trained and experienced in the
 examination of horses that are         
spavined1 should correctly diagnose the 
condition in practically every instance 
without recourse to other means than    
noting the peculiar character of the    
gait of the subject4 ,lameness develops 

gradually in the majority of instances1 
and an important feature in spavin      
lameness is that it disappears after the
 subject has gone a little way1 to      
return again as soon as the animal has  
rested for a variable length of         
time--from a half hour to several hours4
 ,this warming out is marked during the 
incipient stage1 but less pronounced in 
most chronic cases4 ,a complete         
disappearance of lameness is observed in
 some instances1 while in others only   
partial subsidence is evident4 ,because 
of the fact that pain is occasioned both
 during weight bearing and while the leg
 is being flexed and advanced1 there is 
manifested the characteristic mixed     
lameness and exaggerated hip action     
which typifies spavin4 ,by throwing the 
hips upward with the sound member it is 
possible to advance the affected leg    
with less flexion1 hence less pain is   
experienced in this manner of           
locomotion4 ,when made to step aside in 
the stall1 a spavined horse will flex   

the affected member abruptly and when   
weight is taken on the diseased leg1    
symptoms are evinced of pain1 and weight
 is immediately shifted to the sound    
limb4 ,this is marked during the        
incipient stages of spavin4 ,lameness   
usually precedes the formation of       
exostosis1 though cases are observed    
wherein an exostosis is present and no  
lameness is manifested and no history of
 the previous existence of lameness is  
available4  ,the spavin test is of value
 as a diagnostic measure when it is     
employed with other means of            
examination1 though reaction to this    
test is seen in some cases in old crampy
 horses that have experienced hard      
service4 ,the test consists in flexing  
the affected leg 7elevating the foot    
from the ground twelve to twenty-four   
inches7 and holding the member in this  
position for a minute1 whereupon the    
animal is made to step away immediately 
at a trot4 ,during the first few steps  
taken directly thereafter1 the subject  

shows pronounced lameness and this      
constitutes a reaction to the spavin    
test4  ,where no exostosis is present it
 becomes necessary to exclude other     
causes for lameness but the             
characteristic spavin lameness is to be 
relied upon to a greater extent in such 
cases than are other means of           
examination4 ,such cases are known as   
occult spavin and may be present for    
months before any external changes in   
structure are observable4 ,in some      
instances no extoses form even during   
the course of years4 ,the spavin test is
 of aid in establishing a diagnosis here
 but the marked warming out peculiar to 
spavin is not so pronounced in such     
cases4  ,prognosis4--,an animal having  
hereditary predisposition to spavin is  
not likely to recover completely whether
 this predisposition be due to faulty   
conformation or susceptibility to bone  
changes4 ,in predicting the outcome1 the
 temperament of the subject is to be    
taken into account1 as well as the      

character of service the animal is      
expected to perform4 ,and finally1 a    
very important feature to be noted1 is  
the location of the exostosis4 ,if      
situated rather high and extending      
anterior to the hock1 there is less     
likelihood of recovery resulting than   
where an exostosis is confined to the   
lower row of tarsal bones4 ,when        
situated anterior to the tarsus a large 
exostosis may by mechanical interference
 to function1 cause lameness when all   
other causes are absent4 ,in making     
examinations one must not be deceived by
 the inconspicuous and seemingly        
insignificant exostosis which has a     
broad base4 ,in some cases of this kind1
 dealers style the condition as rough in
 the hock when as a matter of fact1 in  
some instances1 incurable spavin        
lameness develops4  ,treatment4--,many  
incipient cases of spavin yield to      
vesication and a protracted period of   
rest4 ,results depend primarily upon the
 nature of the affection4 ,however1 in  

every instance if there is involvement  
of the tibial tarsal 7astragalus7 bone1 
complete recovery is highly improbable4 
,when the disease is confined to the    
lower tarsal bones1 lameness subsides as
 soon as the degenerative changes are   
checked and ankylosis occurs4  ,the use 
of the actual cautery when properly     
employed constitutes an excellent method
 of treatment4 ,the auto-cautery when   
equipped with a point of about          
one-eighth of an inch in diameter and   
about three-fourths of an inch in length
 is well suited for this particular     
operation4 ,before deciding to          
cauterize1 it is necessary to ascertain 
the extent of area affected4 ,the       
nearness of the exostosis to the        
tibiotarsal articulation can be         
definitely determined by palpation4 ,the
 hair over the entire surgical field is 
clipped and the cautery at white heat is
 pushed through the overlying soft      
tissues and into the central part of the
 exostosis4 ,care is taken to keep the  

cautery-point away from the articular   
margin of the tibial tarsal bone about  
three-fourths of an inch4 ,no danger    
will result from cauterizing to a depth 
of three-fourths of an inch in the      
average case4 ,two or three 7and not    
more7 centrally located points for      
penetration with the cautery are        
sufficient4 ,experience has shown that  
several 7five or six or more7 punctures 
are not productive of good results4     
,when considerable cicatricial tissue is
 present1 due to the action of          
depilating vesicants or other chemicals1
 sloughing of tissue is very apt to     
follow deep cauterization1 if one is not
 careful to keep the punctures at least 
one-half inch apart when three are made4
 ,it is best1 in such cases1 to make but
 two deep penetrations with the cautery 
but additional superficial punctures may
 be made if kept about three-fourths of 
an inch distant and not nearer than this
 to one another4 ,sloughing of tissue is
 not necessarily productive of bad      

results but there is occasioned an open 
wound which usually becomes infected and
 necrosis of tissue may extend into the 
articulation4 ,no benefit results from  
sloughing and it should be avoided4 ,in 
small horses1 one deep point of         
cauterization is sufficient if the      
osseous tissues are penetrated to a     
proper depth so that an active          
inflammation is induced4 ,the cautery   
may1 if necessary1 be reintroduced      
several times4 ,when the field of       
operation has been properly prepared and
 it is thought advisable 7as where      
subjects are kept in the hospital for a 
time71 the hock may be covered with     
cotton and bandaged and no chance for   
infection will occur4  ,after           
cauterization the subject should be kept
 quiet in a comfortable stall for three 
weeks2 thereafter1 if the animal is not 
too playful1 the run of a paddock may be
 allowed for about ten days and a       
protracted rest of a month or more at   
pasture is best4 ,it is unwise in the   

average case to put an animal in service
 earlier than two months after having   
been fired4  ,where cases progress      
favorably1 lameness subsides in about   
three weeks after cauterization and     
little if any recurrence of the         
impediment is manifested thereafter4    
,however1 because of violent exercise   
taken in some instances when subjects   
are put out after being confined in the 
stall1 a return of lameness occurs and  
it may remain for several days or in    
some cases become permanent4 ,no good   
comes from the use of blistering        
ointments immediately after             
cauterization4 ,the actual cautery is a 
means of producing all necessary        
inflammation and it should be so        
employed that sufficient reactionary    
inflammation succeeds such firing4 ,the 
use of a vesicating ointment subsequent 
to cauterization invites infection      
because of the dust that is retained in 
contact with the wound4 ,the employment 
of irritating chemicals in a liquid form

 following firing is needless and cruel4
  ,in many instances lameness is not    
relieved and subjects show no           
improvement at the end of six weeks time
 and it then becomes a question of      
whether or not recovery is to be        
expected even with continued rest and   
treatment4 ,as a rule1 such cases are   
unfavorable4 ,in one instance the author
 employed the actual cautery three times
 during the course of six months and    
lameness gradually diminished for a     
year4 ,in this case the spavin was of   
nearly one year's standing when         
treatment was instituted4 ,the subject  
was a nervous and restless but          
well-formed seven-year-old gelding4     
,recovery was not complete2 recurrent   
intervals of lameness marked this case1 
but the horse limped so slightly that   
the average observer could not detect   
its existence after the animal had been 
driven a little way4  ,cunean tenotomy  
has been advocated and practiced by     
,abildgaard1 ,lafosse1 ,peters1         

,herring1 ,zuill and others and good    
results have followed in many cases so  
treated4  ,considering results1 the     
employment of chemicals of various kinds
 for the purpose of relieving spavin    
lameness does not compare favorably with
 firing4 ,moreover1 so many animals have
 been tortured and needlessly blemished 
in the attempted cure of spavin that    
agents which are not of known value1 the
 use of which are likely to result in   
extensive injury to the tissues1 are    
only to be condemned4  ,when spavin is  
bilateral and lameness is likewise      
affecting both members1 prognosis is at 
once unfavorable4 ,such cases are often 
benefited by cauterization but only one 
leg at a time should be treated4        
,bossi's double tarsal neurectomy       
7division of the anterior and posterior 
tibial nerves7 has undoubtedly been of  
decided benefit in many cases1 but is   
not at present a popular method of      
treatment in this country4 ,this        
operation has its indications1 however1 

and may be recommended in chronic       
lameness where no extensive exostosis   
exists which may mechanically interfere 
with function4   ,distension of the     
,tarsal ,joint ,capsule4 7,bog ,spavin47
  ,distension of the capsular ligament  
of the tibial tarsal 7tibioastragular7  
joint with synovia is commonly known as 
bog spavin4 ,this condition is separate 
and distinct from that of distension of 
the sheath of the deep flexor tendon    
7perforans7 though not infrequently the 
two affections coexist4  ,etiology and  
,occurrence4--,following strains from   
work in the harness or under the saddle1
 horses develop an acute synovitis of   
the hock joint1 which often results in  
chronic synovial distension4            
,debilitating diseases favor the        
production of this affection in some    
animals4 ,it is also frequently observed
 in young horses and in draught colts of
 twelve to eighteen months of age4 ,this
 condition occurs while the subjects are
 at pasture and often spontaneous       

recovery results by the time the animals
 are two years of age4  ,illustration3  
,fig4 #ef--;,bog spavin4 ,showing point 
of view which may be most advantageously
 taken by the diagnostician in examining
 for distension of the capsular ligament
 of the tarsal joint4                   
,symptomatology4--,bog spavin is        
recognized by the distended condition of
 the joint capsule which is prominent   
just below the internal tibial malleolus
 and this affection is characterized by 
a fluctuating swelling which varies     
considerably in size in different       
subjects4 ,except in cases of acute     
synovitis1 lameness is not present and  
in chronic distension of the capsule of 
the tarsal joint1 no interference with  
the subject's usefulness occurs4 ,in the
 majority of instances1 the             
disfigurement which attends bog spavin  
is the principal objectionable feature4 
,the condition is bilateral in many     
instances1 and in such cases the        
subjects have a predisposition to this  

condition or it follows attacks of      
strangles or other debilitating         
ailments4 ,because of a rapid and       
unusual growth1 bilateral affections are
 of frequent occurrence in some animals4
  ,treatment4--,the most practical      
method of handling bog spavin consists  
in aspiration of synovia and injection  
of tincture of iodin4 ,discretion should
 be employed in selecting subjects for  
treatment1 regardless of the manner in  
which such cases are to be handled4     
,where there exists chronic distension  
of the joint capsule of several years'  
standing in old or weak subjects1       
needless to say1 recovery is not likely 
to result4 ,when animals are vigorous   
and two or three months' time is        
available1 treatment may be begun with  
reasonable hope for success4  ,the      
average subject is handled standing and 
can be restrained with a twitch1        
sideline and hood4 ,aspirating needles  
and all necessary equipment must be in  
readiness 7sterile and wrapped in       

aseptic cotton or gauze7 so that no     
delay will occur from this cause when   
the operation has been started4 ,the    
central or most prominent part of the   
distended portion of the capsule is     
chosen for perforation and an area of an
 inch and a half in diameter is shaved4 
,the skin is cleansed and then painted  
with tincture of iodin4 ,the sterile    
aspirating needle is pushed through the 
tissues and into the capsule with a     
sudden thrust4 ,with a large and sharp  
needle 7fourteen gauge71 synovia can be 
drawn from the cavity in most instances 
and the subject usually offers no       
resistance4 ,by compressing the         
distended capsule and surrounding       
structures with the fingers1            
considerable synovia may be evacuated4  
,in singular instances1 no synovia is to
 be aspirated with the needle1 and in   
such cases the amount of iodin injected 
needs be increased1 possibly twenty-five
 per cent41 as experience will indicate4
 ,from two to five cubic centimeters of 

,u4,s4,p4 tincture of iodin is injected 
through the aspirating needle into the  
synovial cavity of the joint1 and the   
exterior of the parts are vigorously    
massaged immediately after injection to 
stimulate distribution of the iodin     
throughout the synovial cavity4 ,where a
 bilateral affection exists1 two or     
three weeks' time should intervene      
between the treatments of each leg4 ,a  
sterile metal syringe equipped with a   
slip joint for the needle is well       
adapted to this operation4 ,lubrication 
of the plunger with heavy sterile       
vaseline or glycerin will prevent the   
syringe from being ruined by the iodin4 
,following the injection1 the subject is
 kept in a stall or in a suitable       
paddock1 so that conditions may be      
observed for four or five days4 ,the    
object sought by the introduction of    
iodin is not only for a local effect    
upon the synovial membranes in checking 
secretions1 but the production of an    
active inflammation and great swelling1 

which will remain from four weeks to    
three months subsequent to the          
injection4 ,this periarticular swelling 
should produce and maintain a constant  
pressure over the entire affected parts 
for a sufficient length of time until   
normal tone is re-established4  ,in some
 cases1 swelling does not develop as the
 result of a single injection of iodin4 
,when marked swelling has not taken     
place within five days1 none will occur 
and a repetition of the injection may be
 made within ten days after the first   
treatment has been given4 ,one may      
safely increase the amount of iodin at  
the second injection in such cases by   
one-fourth to one-third4  ,in ,europe   
this method of treating bog spavin has  
been employed by ,leblanc1 ,abadie1     
,dupont and others according to ,cadiot2
 but ,bouley1 ,rey1 ,lafosse and        
,varrier used it with bad results4      
,where a perfect technic is executed    
7and no other is excusable in this      
operation71 no infection will occur if a

 reasonable amount of iodin is injected4
 ,the dilution of iodin with an equal   
amount of alcohol has been practised by 
the author in many cases1 but later this
 was found unnecessary4  ,other methods 
of treatment have been used with        
success4 ,perhaps the most heroic       
consists in opening the joint capsule   
with a bistoury or with the actual      
cautery4 ,such practice is too hazardous
 for general use and is not to be       
recommended1 although good results      
should follow the employment of such    
methods if infectious arthritis does not
 occur4  ,line firing over the distended
 capsule is a practical method of       
treatment4 ,this is attended with good  
results in young animals in many cases1 
but considerable blemish is caused when 
sufficient irritation is produced to    
stimulate resolution4  ,vesication also 
is successfully employed in some        
instances4 ,however1 only cases of      
recent origin in young animals--colts of
 two years or younger--yield to         

blistering1 and in some affected colts  
no doubt recovery would have been       
spontaneous had no treatment been       
instituted4  ,ligation of the saphenous 
vein at two points1 one above and the   
other below the distended ligamentous   
capsule1 is an old operation1 which has 
undoubtedly given good results in some  
cases1 although it does not seem to be a
 rational procedure4                    
,after-,care4--,after swelling has fully
 developed--which occurs within a       
week--the subject is turned to pasture  
and no attention is necessary           
thereafter4 ,a gradual subsidence of the
 swelling occurs and in the average     
instance1 this completely resolves      
within six or eight weeks4  ,complete   
recovery succeeds the                   
aspiration-and-injection-treatment in   
about seventy-five per cent of cases as 
the result of one operation1 and        
subjects may be gradually and carefully 
returned to work in about sixty days    
after treatment has been given4         

,distension of the ,tarsal ,sheath of   
the ,deep ,digital ,flexor4             
7,thoroughpin47  ,the terms thoroughpin 
or throughpin are translations from the 
,french vessignon cheville and have the 
same significance4 ,they are so named   
because of the diametrically opposed    
distensions of the sheath of the deep   
flexor tendon in such manner that the   
distensions appear to be due to a       
supporting peg4  ,anatomy4--,the theca  
through which the deep digital flexor   
7perforans7 plays in the tarsal region1 
begins about three inches above the     
inner tibial malleolus and extends about
 one-fourth of the way down the         
metatarsus4 ,the posterior part of the  
capsular ligament of the hock joint is  
very thick in its most dependent        
portions and is in part cartilaginous1  
forming a suitable groove for the       
passage of the deep flexor tendon4      
,illustration3 ,fig4 #eg--,thoroughpin4 
,showing distension of the sheath of the
 deep flexor tendon as it protrudes     

antero-externally to the fibular tarsal 
bone 7calcaneum74  ,etiology and        
,occurrence4--,strains and sequellae to 
debilitating diseases constitute the    
usual causes of this affection4 ,as a   
result of acute synovitis a chronic     
synovial distension of the tarsal sheath
 occurs4 ,bog spavin is often present in
 case of thoroughpin but the two        
conditions are separate and distinct    
excepting in that both may occur        
simultaneously and as the result of the 
same cause4 ,some animals are           
undoubtedly predisposed to disease of   
synovial structures4 ,the average horse 
that has been subjected to hard service 
on pavements or hard roads at fast work 
suffers synovial distension of bursae1  
thecae or of joint capsules4 ,some of   
the well bred types such as the         
thoroughbred horses may be subjected to 
years of hard service and still remain  
clean limbed and free from all          
blemishes4 ,thus it seems that subjects 
of rather faulty conformation1 animals  

having lymphatic temperaments and the   
coarse-bred types1 are prone to synovial
 disturbances such as thoroughpin1 bog  
spavin1 etc41 sometimes having both legs
 affected4  ,illustration3 ,fig4        
#eh--;,fibrosity of tarsus as a         
complication in chronic thoroughpin4    
,symptomatology4--,thoroughpin is       
characterized by a distended condition  
of the tarsal sheath which is manifested
 by protrusions anterior to the tendo   
,achillis4 ,however1 where but moderate 
distension of the sheath exists1 there  
is little1 if any1 bulging on the mesial
 side of the hock and but a small       
hemispherical enlargement is presented  
on the outer side of the tarsus1        
anterior to the summit of the os calcis4
 ,in some instances the protruding parts
 assume large proportions1 but always1  
because of the relationship between the 
fibular tarsal bone 7calcaneum7 and the 
tendon sheath1 the larger protrusion is 
situated mesially4  ,during the acute   
inflammatory stage there is marked      

lameness present but this soon subsides 
when local antiphlogistic agents are    
applied to the parts4 ,in fact1         
spontaneous relief from lameness usually
 results in the course of ten days' time
 following the appearance of            
thoroughpin4 ,no lameness marks the     
advent of this affection when it        
develops as the result of continuous    
strain and concussion occasioned by hard
 service1 and local changes tend to     
remain in status quo4  ,illustration3   
,fig4 #ei--;,another view of same case  
as illustrated in ,fig4 #eh4            
,treatment4--,rest and the local        
application of heat or cold will suffice
 to promote resolution of acute         
inflammation and lameness when present  
will subside within two weeks4 ,in      
chronic affections1 however1 the matter 
and manner of effecting a correction of 
the condition--distended tarsal         
sheath--merit careful consideration4    
,while drainage of distended thecae and 
bursae by means of openings made with   

hot irons was practiced by the ,arabs1  
centuries ago1 and good results have    
attended such heroic corrective         
measures1 nevertheless the occasional   
serious complications which result from 
infection likely to be introduced in    
following such procedures1 cause the    
prudent and skilful practitioner to     
employ safer methods of treatment4  ,the
 application of blistering agents is of 
no value in stimulating resorption of an
 excessive amount of synovia in chronic 
cases and the actual cautery when       
employed without perforation of the     
synovial structure1 is of little        
benefit4 ,trusses or mechanical         
appliances for the purpose of           
maintaining pressure upon the distended 
parts are of no practical value because 
of the great difficulty of keeping such 
contrivances in position4 ,they usually 
cause so much discomfort to the subject 
that they are not tolerated4  ,a very   
practical and fairly successful method  
of treatment consists in the aspiration 

of a quantity of synovia and injecting  
tincture of iodin4 ,cadiot recommends   
the drainage of synovia with a suitable 
trocar and cannula and injecting a      
mixture consisting of tincture of iodin1
 one part1 to two parts of sterile      
water1 to which is added a small        
quantity of potassium iodid4 ,the latter
 agent is added to prevent precipitation
 of the iodin4 ,this authority 7,cadiot7
 further advocates the removal of       
practically all of the synovia that will
 run out through the cannula and the    
immediate introduction of as much as one
 hundred cubic centimeters of the above 
mentioned iodin solution4 ,this solution
 is allowed to remain in the synovial   
cavity a few minutes and by compressing 
the tissues surrounding the tendon      
sheath1 the evacuation of as much of the
 contents of the synovial cavity as is  
practicable1 is effected4 ,subsequently 
the subject is allowed absolute rest and
 more or less inflammatory reaction     
follows4 ,in some cases there occur     

marked lameness and some febrile        
disturbance1 but where a good technic is
 carried out1 no bad results follow4 ,at
 the end of four weeks' time1 horses so 
treated may be returned to service1 but 
the full beneficial effect of such      
treatment is not experienced until      
several months' time have elapsed4      
,where good facilities for executing a  
careful technic in every detail are at  
hand1 incision of the tarsal sheath1    
evacuation of its contents and uniting  
its walls again by means of sutures and 
providing for drainage with a suitable  
drainage tube1 may be practiced4 ,this  
manner of treatment has been            
satisfactory in the hands of a number of
 surgeons4   ,capped ,hock4             
,enlargements which occur upon the      
summit of the os calcis1 whether        
hypertrophy of the skin and subcuticular
 fascia1 the result of injury or        
repeated vesication1 distension of the  
subcutaneous bursa or injury to the     
superficial flexor tendon 7perforatus7  

or its sheath1 are generally known as   
capped hock4 ,however1 the term should  
be restricted to use in reference to    
distensions of synovial structures of   
that region4  ,etiology and             
,occurrence4--,usually there occurs a   
hygromatous involvement of the          
subcutaneous bursa due to contusion4 ,as
 in bog spavin1 following certain       
infectious diseases 7influenza1 purpura 
hemorrhagica1 etc47 there remains a     
distended condition of the subcutaneous 
bursa1 after swelling of the member has 
subsided4 ,in feeding pens where numbers
 of young mules are kept in crowded     
quarters many cases may be observed4 ,in
 some instances where violent contusions
 result from kicking cross-bars of wagon
 shafts 7by nymphomaniacs or in habitual
 kickers where there is opportunity for 
doing such injury7 the superficial      
flexor tendon and its synovial apparatus
 are injured and a more serious         
condition may result4                   
,symptomatology4--,in acute and         

extensive inflammation of the parts1    
lameness is present1 but in the average 
case no inconvenience to the subject    
results4 ,the prominent site of the     
affection is cause for an unsightly     
blemish4 ,this is undesirable1          
particularly in light-harness or saddle 
horses4 ,these affections are           
characterized by a fluctuating mass     
which has a thin wall and in all cases  
of long standing the condition is       
painless4  ,by careful palpation one may
 readily distinguish between a          
hygromatous condition of the superficial
 bursa and involvement of the underlying
 structures4 ,affection of the expanded 
portion of the flexor tendon and        
contiguous structures makes for an      
organized mass of tissue which is       
somewhat dense and in some instances    
painful to the subject when manipulated4
 ,this is particularly noticeable in    
cases where the parts are regularly and 
repeatedly injured as in habitual       
kickers4  ,illustration3 ,fig4          

#fj--;,capped hock4 ,distension of the  
bursa over the summit of the os calcis4 
,treatment4--,in acute inflammation1    
antiphlogistic applications are         
indicated and the subject must be kept  
quiet4 ,the matter of bandaging the hock
 is a difficult problem in some cases   
and needs be done with care4 ,as has    
been previously stated in this volume1  
the tarsus needs to be well padded with 
cotton before the bandages are applied  
and only a moderate degree of tension is
 employed in applying the bandages lest 
anemic-necrosis result from pressure4   
,in distension of the superficial bursa1
 after clipping the hair over a liberal 
area and preparing the skin by          
thoroughly cleansing and painting with  
tincture of iodin1 the capsule is       
incised with a bistoury4 ,an incision   
about an inch in length1 situated low   
enough to provide drainage1 is made     
through the tissues and the contents are
 evacuated4 ,tincture of iodin is       
injected into the cavity and the parts  

are covered with cotton and bandaged4   
,no after-care is necessary except to   
retain the dressing in position1 which  
is not difficult in the average case if 
the subject is kept tied4 ,if much      
resistance is exhibited1 such as extreme
 flexion of the bandaged hock1 the      
animal may be put in a sling and little 
if any objection to the bandage will be 
offered thereafter4 ,the wound may be   
dressed at the end of forty-eight hours 
and no redressing will be necessary in  
the average instance if infection is not
 present4 ,but slight local disturbance 
and little distress to the subject      
result in cases so treated even when    
infection occurs1 but a good technic is 
possible of execution in most instances 
and no infection should take place4     
,the surgical wound heals in two or     
three weeks and inflammation gradually  
subsides4 ,bandages are retained one or 
two weeks1 as the case may require1 and 
subsequently a good wound lotion may be 
employed several times daily4 ,a good   

lotion for such cases as well as in many
 others has long been employed with     
success by ,dr4 ,a4 ,trickett of ,kansas
 ,city4 ,it consists of approximately   
equal parts of glycerin1 alcohol and    
distilled extract of witch hazel1 to    
which is added liquor cresolis          
compositus1 two percent1 and coloring   
matter q4s4  ,complete resolution does  
not occur in the average case4 ,there   
remains some hyperplastic tissue and    
even where the enlargement is slight1   
the prominent situation of the affection
 precludes its being unnoticed4  ,in    
disease of the flexor tendon and its    
bursa where contiguous inflammation of  
tissue is present1 the parts are        
blistered or fired4 ,line firing is     
beneficial in such instances but in all 
cases the cause is to be removed if     
possible4   ,rupture and ,division of   
the ,long ,digital ,extensor 7,extensor 
,pedis74  ,etiology and                 
,occurrence4--,because of the fact that 
the long digital extensor is the only   

extensor of the phalanges of the pelvic 
limb1 its rupture or division           
constitutes a troublesome condition1    
which in some cases does not readily    
respond to treatment4  ,rupture of this 
tendon may occur during work on rough   
and uneven roads1 particularly in range 
horses that are ridden over ground that 
is burrowed by gophers or prairie dogs2 
in such cases1 horses are apt to        
suddenly and violently turn the foot in 
position of volar flexion1 thereby      
causing undue strain to the digital     
extensor and its rupture sometimes      
follows4 ,in foals of one or two days of
 age1 this tendon is sometimes found    
parted or ruptured and the condition may
 be bilateral4  ,as the result of       
accidents1 the digital extensor may be  
divided and when the wound becomes      
contaminated1 as it does because of the 
marked volar flexion 7knuckling7 which  
occurs during the course of this        
affection1 regeneration of tissue is    
checked and recovery is tardy4          

,symptomatology4--,there is no          
interference with ability to sustain    
weight in such cases1 when the foot is  
placed in normal position2 but          
immediately upon attempting to walk1 the
 toe is dragged1 and if weight is borne 
with the affected member1 it comes upon 
the anterior face of the fetlock4 ,the  
flexors are not antagonized and if there
 be an open wound the parts soon become 
contaminated2 or1 in rupture1 if animals
 travel about very much1 there soon     
occurs necrosis of the tissues of the   
anterior fetlock region and the         
condition is rendered incurable4 ,cases 
are reported of animals that have       
suffered rupture of the long digital    
extensor and the subjects learned to    
throw the member forward during         
extension1 substituting for the extensor
 tendon the pendulum-like momentum which
 the foot affords when so employed2 and 
a walking and even a trotting pace was  
possible without doing injury to the    
fetlock region4  ,where a subcutaneous  

division exists as in rupture1 the      
divided ends of the tendon may be       
definitely recognized by palpation4     
,treatment4--,subjects are best put in  
slings and kept so confined until       
regeneration of tendinous structures has
 been completed4 ,this requires from six
 weeks to two months' time4 ,in         
addition1 the extremity is kept in a    
state of extension by means of suitable 
splints and shoes1--a shoe equipped with
 an extension at the toe and perforated 
so that a steel brace may be hooked into
 the perforation and the brace fashioned
 to be buckled to the upper metatarsal  
region4 ,when braces are placed in front
 of the foot1 great care is necessary in
 properly padding the member with cotton
 lest sloughing from pressure occurs at 
the coronet2 but this does not apply in 
rupture of extensors so much as where   
flexors are ruptured4  ,open wounds are 
treated along general surgical lines1   
dressed as frequently as occasion       
demands1 and recovery will be complete  

in a few months' time unless much of the
 tendon has been destroyed4 ,in one     
instance1 the author had occasion to    
observe such a condition1 which1 because
 of the extensive destruction of tendon 
and lack of facilities for giving proper
 attention to the subject1 results were 
so unfavorable that it was deemed       
necessary to destroy the animal4        
,wounds ,from ,interfering4  ,when1     
during locomotion1 injury is inflicted  
upon the mesial side of an extremity by 
the swinging foot of the other member1  
the condition is termed interfering4    
,etiology and ,occurrence4--,faulty     
conformation1 bad shoeing and over-work 
are the principal causes of interfering4
 ,horses that are base narrow or that   
have crooked legs are quite apt to      
interfere4 ,shoes that are put on a foot
 that is not level or applied in a      
twisted position1 or shoes wide at the  
heel will often cause interfering and   
injury4 ,animals that are driven at fast
 work until they become nearly exhausted

 may be expected to interfere4 ,such    
cases are frequently observed in young  
horses that are driven over rough roads1
 particularly when so nearly exhausted  
or weakened from disease or inanition   
that the feet are dragged forward rather
 than picked up and advanced in the     
normal manner4                          
,symptomatology4--,wounds inflicted by  
striking the extremities in this manner 
present various appearances and occasion
 dissimilar manifestations4 ,the hind   
legs are almost as frequently affected  
as the front and the fetlock region is  
most often injured1 though wounds may be
 inflicted to the coronet4 ,in front1   
the carpus is sometimes the site of     
injury4  ,when only an abrasion is      
caused1 little if any lameness occurs1  
but where interfering is continued and  
nerves are involved or subfascial       
infection and extensive inflammation    
succeed such abrasions1 marked lameness 
and evidence of great pain are          
manifested4 ,frequently1 in chronic     

cases affecting the hind leg1 the       
fetlock assumes large proportions1 and  
at times during the course of every     
drive the subject strikes the inflamed  
part1 immediately flexing and abducting 
the injured member1 and the victim hops 
on the other leg until pain has somewhat
 subsided4  ,interfering is much more   
serious in animals that are used at fast
 work than in draft horses4 ,in         
light-harness or saddle horses1 it may  
render the subject practically valueless
 or unserviceable if the condition      
cannot be corrected4                    
,treatment4--,wherever possible1 cause  
is to be removed and if animals are     
properly used1 ordinary interfering     
wounds will yield to treatment4 ,if the 
shoeing is faulty1 this should be       
corrected1 the foot properly prepared   
and leveled before being shod and       
suitable shoes applied4 ,in young       
animals that become leg-weary from      
constant overwork1 rest and recuperation
 are necessary to enhance recovery4 ,in 

such cases it will be found that very   
light shoes1 frequently reset1 will tend
 to prevent injury to the fetlock region
 such as characterizes these injuries of
 hind legs4  ,palliative measures of    
various kinds are employed where cause  
is not to be removed and a degree of    
success attends such effort4 ,in draft  
horses or animals that are used at a    
slow pace1 shields of various kinds are 
strapped to the extremity and protection
 is thus afforded4 ,or1 large encircling
 pads of leather1 variously constructed1
 serve to cause the subject to walk with
 the extremities apart4  ,interfering   
shoes of different types are of material
 benefit in many instances4 ,often the  
principle upon which corrective shoeing 
is based is that the mesial 7inner7 side
 of the foot is too low2 the foot is    
consequently leveled and the inner      
branch of the shoe is made thicker than 
the outer1 altering the position of the 
foot in this way4 ,this is productive of
 desirable results4 ,however1 much      

depends upon the manner in which the    
foot in motion strikes the              
weight-bearing member as to the         
corrective measures that are indicated4 
,this belongs to the domain of          
pathological shoeing and the reader is  
referred to works on this subject for   
further study of this phase of lameness4
   ,lymphangitis4  ,excluding glanders1 
in the majority of instances1           
lymphangitis in the horse1 such as      
frequently affects the hind legs1 is due
 to the local introduction of infectious
 material into the tissues as a result  
of wounds4 ,however1 one may observe in 
some instances an acute lymphangitis    
which affects the pelvic limbs of horses
 and no evidence of infection exists4   
,consequently1 lymphangitis may be      
considered as infectious and            
non-infectious4   ,,infectious          
,,lymphangitis4  ,etiology and          
,occurrence4--,traumatisms of the legs  
frequently result in infection and when 
such injuries are near lymph glands1    

even though the degree of infection be  
slight1 more or less disturbance of     
function of the muscles in the vicinity 
of such glands occurs and lameness      
follows4  ,the prescapular1 axillary and
 cubital lymph glands when in a state of
 inflammation1 cause lameness of the    
front leg1 and the superficial inguinal 
and deep inguinal lymph glands not      
infrequently become involved also4      
,because of the location of these lymph 
glands1 they are subject to             
comparatively frequent injury and       
inflammation1 causing lameness more     
often than other lymph-gland-affections4
  ,small puncture wounds in the region  
of the elbow are often met with4 ,these 
may be inflicted when horses lie down   
upon sharp stumps of vegetation or      
shoe-calk injuries may be the means of  
introducing contagium1 and an infectious
 inflammation results4 ,abscess         
formation1 the result of strangles or   
other infection in the prescapular      
glands1 may be observed at times4       

,following castration1 the inguinal     
lymph glands may become involved in an  
infectious inflammation and locomotion  
is impeded to a marked degree4 ,horses  
running at pasture sometimes become     
injured by trampling upon pieces of     
wood1 causing one end of these or of    
various implements to become embedded in
 the soft earth and the other end to    
enter at the inguinal region and even   
penetrate the tissues to and through the
 skin and fascia just below the perineal
 region4  ,nail punctures resulting in  
infection frequently cause an infectious
 lymphangitis and a marked and painful  
swelling of the legs supervenes4        
,illustration3 ,fig4 #fa--;,chronic     
lymphangitis4 ,showing hypertrophy of   
the left hind leg1 due to repeated      
inflammation4                           
,symptomatology4--,lameness1 mixed or   
swinging-leg1 signalizes the presence of
 acute lymphangitis4 ,there is always   
more or less swelling present and       
manipulation of the affected parts gives

 pain to the subject4 ,depending upon   
the character of the infection and its  
extent1 there is presented a varying    
degree of constitutional disturbance4   
,there may be a rise in temperature of  
from two to five degrees1 and in such   
instances there is an accelerated pulse4
 ,where much intoxication is present1   
anorexia and dipsosis are to be noticed4
  ,swelling may increase gradually and  
in time discharge of pus may take place 
spontaneously without drainage being    
provided for1 if the character of the   
infection does not cause early death4   
,in these cases lameness is pronounced  
and the cause of the disturbance is to  
be sought1 particularly if the condition
 be due to a nail puncture4             
,illustration3 ,fig4                    
#fb--;,elephantiasis4                   
,treatment4--,location of the site of   
injury is advisable in all cases and in 
some instances provision for drainage1  
as in puncture wounds1 is helpful4      
,locally1 curettage and the application 

of suitable antiseptics are indicated4  
,hot fomentations are beneficial and    
should be continued for several days if 
necessary1 to stimulate resolution4 ,a  
brisk purge should be admintered at the 
onset and strychnin1 because of its     
indirect stimulative effect upon the    
circulation together with its tonic     
effect upon the musculature1 is         
beneficial4  ,in all such cases rational
 treatment1 good hygiene and careful    
nursing are the principal factors which 
stimulate recovery4 ,individual         
resistance or lowered vitality has a    
marked influence on the course of this  
affection4   ,,non-,,infectious         
,,lymphangitis4  ,this type of          
lymphangitis is associated with1 or the 
result of1 a derangement of digestion4  
,it affects heavy draft horses1 rarely  
other types of animals1 and involves one
 or both hind legs4  ,occurrence4--,in  
healthy and well nourished horses       
irregularly used1 this affection may    
suddenly manifest itself4 ,it occurs in 

singular instances in mares that are in 
advanced pregnancy even when such       
animals are at pasture4 ,usually1       
however1 this malady is found in heavy  
draft horses that have been kept stabled
 from one to three days4                
,symptomatology4--,at the outset in     
severe cases1 there is elevation of     
temperature1 labored breathing1         
accelerated pulse1 anorexia and more or 
less swelling of the affected members4  
,swelling is very painful and when the  
affected legs are palpated1 pain is     
manifested by flinching4 ,the inguinal  
lymph glands are often swollen but in   
some cases they are not affected in any 
perceptible degree4 ,in the average case
 suppuration does not occur and when    
conditions are favorable1 resolution is 
complete within ten days4 ,the extent of
 the involvement and the intensity of   
the affection vary materially in        
different cases and a chronic           
lymphangitis may succeed the acute      
attacks and finally in some instances1  

elephantiasis results4  ,treatment4--,an
 active purgative should be given at    
once and in the ordinary case1          
stimulants are indicated4 ,if marked    
distress is present1 morphin is given   
and where there is much rise of         
temperature1 cold drinking water is     
offered in abundance and catharsis is   
enhanced by enemata4 ,locally1 hot      
applications are of benefit4 ,hot towels
 or cotton held in position by bandages 
and kept soaked with warm water will    
relieve pain and stimulate resolution4  
,diuretics may be of benefit and anodyne
 applications are to be employed with   
profit in some cases4 ,walking exercise1
 if not indulged in to excess1 is       
helpful as soon as acute inflammation   
has subsided4 ,by giving careful        
attention to the regimen and providing  
regular exercise for susceptible        
subjects1 this type of lymphangitis is  
often forestalled4  ,,footnotes3        
,footnote #cd3 ,manual of ,veterinary   
,physiology4 ,page #faj4  ,footnote #ce3

 ,manual of ,veterinary ,physiology1    
page #fja4  ,footnote #cf3 ,case report 
at meeting of the ,iowa ,state          
,veterinary ,medical ,association1      
,jan41 #aijd1 by ,dr4 ,s4,h4 ,bauman1   
,birmingham1 ,ia4  ,footnote #cg3       
,regional ,veterinary ,surgery and      
,operative ,technique1 by ,john ,a4,w4  
,dollar1 ,m4,r4,c4,v4,s41 ,f4,r4,s4,e41 
,m4,r4,i41 page #gcc4  ,footnote #ch3   
,as quoted by ,a4 ,liautard1 ,m4,d41    
,v4,m41 ,american ,veterinary ,review1  
,vol4 #cg1 page #ffg4  ,footnote #ci3   
,quoted by ,prof4 ,liautard1 ,american  
,veterinary ,review1 ,vol4 #cc1 page    
#aij4  ,footnote #dj3 ,traite de        
,therapeutique ,chirurgical des ,animaux
 ,domestique par ,p4,j4 ,cadiot et ,j4  
,almy1 ,tome second1 page #dfj4         
,footnote #da3 ,traite de ,therapeutique
 ,chirurgical1 ,tome second1 page #dfe4 
,footnote #db3 ,luxation of the ,femur1 
by ,wm4 ,v4 ,lusk1 ,veterinary ,surgeon1
 ,u4,s4 ,cavalry1 ,american ,veterinary 
,review1 ,vol4 #ba1 page #bed4          

,footnote #dc3 ,because of the intimacy 
of the psoas major 7p4 magnus7 and the  
iliacus they are sometimes called       
iliopsoas4  ,footnote #dd3 ,dr4 ,john   
,scott1 ,peoria1 ,ill41 in ,the         
,american ,veterinary ,review1 ,vol4    
#af1 page #af4  ,footnote #de3          
,annotation on ,surgical ,items1 by     
,drs4 ,l4,a4 and ,edward ,merillat1     
,american ,veterinary ,review1 ,vol4    
#ca1 page #ceh4  ,footnote #df3 ,w4,l4  
,williams in ,american ,veterinary      
,review1 ,vol4 #ba1 page #deb4          
,footnote #dg3 ,geo4 ,h4 ,berns1        
,d4,v4,s41 report1 ,american ,veterinary
 ,medical ,association1 #aiab1 page     
#bch4  ,footnote #dh3 ,joseph ,hughes1  
,m4,r4,c4,v4,s41 in the ,chicago        
,veterinary ,college ,quarterly         
,bulletin1 ,vol4 #aj1 page #ae4         
,footnote #di3 ,traite de ,therap4      
,chir4 ,cadiot et ,almy1 ,tome second1  
page #dhj4  ,footnote #ej3 ,e4 ,wallis  
,hoare1 ,f4,r4,c4,v4,s41 ,american      
,veterinary ,review1 ,vol4 #bg1 page    

#aahi4  ,footnote #ea3 ,discussions on  
paper entitled ,the ,spavin ,group of   
,lamenesses1 by ,w4,l4 ,williams1 ,carl 
,w4 ,fisher and ,d4,h4 ,udall1          
,proceedings of ,american ,veterinary   
,medical ,association1 #aije4  ,footnote
 #eb3 ,hock-,joint ,lameness1 by ,dr4   
,james ,mc,donough1 ,proceedings of the 
,a4,v4,m4,a41 #aiac1 page #ede4         
,,index   ,a  ,acetabulum1 #ahe  ,acute 
arthritis1 #fe  ,acute laminitis1 #afb  
,acute tendinitis1 #ace  ,affections of 
blood vessels1 #ca  ,affections of      
bursae and thecae1 #bg  ,affections of  
the feet1 #cd  ,affections of ligaments1
 #bj  ,affections of lymph vessels and  
glands1 #cb  ,affections of muscles and 
tendons1 #bh  ,affections of nerves1 #cj
  ,anamnesis1 #ch                       
,anatomo-physiological review of parts  
of fore leg1 #ee  ,anatomo-physiological
 consideration of the pelvic limbs1 #ahe
  ,anatomy of the joint capsule1 #bbj   
,annular ligament1 #eh  ,antea-spinatus 
muscle1 #fe  ,anterior brachial region1 

wounds of1 #ij  ,anterior digital       
extensor muscle1 #aic  ,arteritis1 #bji 
,artery 7brachial71 thrombosis of the1  
#ha  ,arthritis1 #bb1 #hd  ,arthritis1  
acute1 #fe  ,arthritis1 chronic1 #fe    
,arthritis1 infectious1 #ff  ,arthritis1
 metastatic1 #be  ,arthritis of the     
fetlock joint1 #aeb  ,arthritis1        
rheumatic1 #bf  ,arthritis1             
scapulohumeral1 #fe  ,arthritis1 tarsal1
 #bbe  ,arthritis1 traumatic1 #bb       
,articular ringbone1 #aba               
,articulation1 femeropelvic1 #ahe       
,articulation1 metacarpophalangeal1 #eh 
,articulation1 scapulohumeral1 #ee      
,aspiration-and-injection treatment of  
bog spavin1 #bdd                        
,aspiration-and-injection treatment of  
capped hock1 #beb                       
,aspiration-and-injection treatment of  
thoroughpin1 #bej  ,astragalus1 #aij    
,astragalus1 fracture of the1 #bcj      
,attitude of the subject1 #da  ,atrophy 
of the quadriceps muscles1 #bje         
,atrophy1 shoulder1 #gc   ,b  ,biceps   

brachii1 #eh1 #fe1 #fh1 #fi  ,bicipital 
bursa1 inflammation of1 #fh  ,blood     
vessels1 affections of1 #ca  ,bog       
spavin1 #bdb  ,bog spavin1              
aspiration-and-injection treatment of1  
#bdd  ,bog spavin1 line firing for1 #bdf
  ,bog spavin1 vesication for1 #bdf     
,bone spavin1 #bce  ,bones1 degenerative
 changes in1 #af  ,bones1 tarsal1 #aij  
,bossi's double tarsal neurectomy1 #bdb 
,brachial artery1 thrombosis of the1 #ha
  ,brachial paralysis1 #gg  ,bursa      
intertubercularis1 #fb1 #fi  ,bursa     
podotrochlearis1 inflammation of the1   
#aeg  ,bursae1 affections of1 #bg       
,bursitis1 #bg1 #ajd  ,bursitis1        
infectious1 #bh  ,bursitis in the       
fetlock region1 #aej  ,bursitis         
intertubercularis1 #fh  ,bursitis1      
noninfectious1 #bh   ,c                 
,calcaneo-cuboid ligaments1 #aij        
,calcaneo-metatarsal ligaments1 #aij    
,calcaneum1 fracture of the1 #bcj  ,calk
 wounds1 #agj  ,capped hock1 #bea       
,capped hock1 aspiration-and-injection  

treatment of1 #beb  ,capsular ligament1 
#aij  ,caput muscles1 #ga  ,carpal      
bones1 fracture of the1 #if  ,carpal    
bones1 luxation of the1 #if  ,carpal    
flexors1 contraction of the1 #ic        
,carpal flexors1 inflammation of the1   
#ic  ,carpal joint1 #eh  ,carpal joint1 
open1 #ajj  ,carpitis1 #ih  ,carpus1    
inflammation of the1 #ih  ,cartilage1   
lateral1 inflammation of1 #agd          
,cartilages of the third phalanx1       
ossification of the1 #aee  ,chronic     
arthritis1 #fe  ,chronic gonitis1 #bag  
,chronic laminitis1 #afd  ,chronic      
tendinitis1 #acg  ,cochran shoe for     
dropped soles1 #afi  ,collateral        
ligaments1 #aij  ,comminuted fractures1 
#ag  ,compound fractures1 #ag           
,contracted tendons of foals1 #adc      
,contraction of the carpal flexors1 #ic 
,contraction of the flexor tendons1 #acg
  ,contusions of the triceps brachii1   
#ga  ,contusive wounds1 #he             
,coracoradialis1 #eh  ,corns1 #agb      
,coronary region1 wounds of the1 #agj   

,corpora oryzoidea1 #bah  ,cotyloid     
ligament1 #ahe  ,courbe1 #bcc           
,crepitation1 false1 #dh  ,crepitation1 
true1 #dg  ,crucial ligaments1 #ahh     
,crural nerve1 paralysis of the1 #bjd   
,cunean bursa1 #bcg  ,cunean tenotomy1  
#bdb  ,cuneiform magnum1 #aia           
,cuneiform medium1 #aia  ,curb1 #bcc    
,d  ,deep digital flexor1 distension of 
the tarsal sheath of1 #bdf  ,deep flexor
 tendon 7perforans71 #fj  ,degenerative 
changes in bones1 #af  ,diagnosis by    
exclusion1 #ec  ,diagnosis by use of the
 ,x-ray1 #agi  ,diagnostic principles1  
#cg  ,disease1 navicular1 #aeg          
,dislocations1 #ba  ,distension of the  
tarsal joint capsule1 #bdb  ,distension 
of the tarsal sheath of the deep digital
 flexor1 #bdf  ,division of long digital
 extensor1 #bec  ,dorsal ligaments1 #aij
  ,dropped elbow1 #ga1 #hj  ,dropped    
soles1 shoe for1 #afi  ,dropped stifle1 
#bje  ,dry spavin1 #bbe   ,e  ,elbow1   
dropped1 #ga1 #hj  ,elbow1 inflammation 
of the1 #hd  ,elbow joint1 #eh          

,elephantiasis1 #cd  ,etiology1 general 
discussion of1 #ae  ,examination by     
palpation1 #dc  ,examination1 special   
methods of1 #ec  ,examination1 visual1  
#ci  ,exclusion1 diagnosis by1 #ec      
,exostosis of splint bones1 #ajg        
,exostosis1 phalangeal1 #aah  ,extensor 
7long digital7 rupture and division of1 
#bec  ,extensor of the digit1 rupture   
of1 #ade  ,extensor pedis1 #fj          
,extensor pedis1 rupture of1 #ade       
,extensor pedis1 rupture and division   
of1 #bec   ,f  ,false crepitation1 #dh  
,feet1 affection of the1 #cd  ,femoral  
nerve1 paralysis of the1 #bjd           
,femeropatella ligaments1 #ahh          
,femeropelvic articulation1 #ahe        
,femur1 #ahe1 #aib  ,femur1 fracture of 
the1 #aii  ,femur1 luxation of the1 #bja
  ,fetlock joint1 #eh  ,fetlock joint1  
arthritis of the1 #aeb  ,fetlock joint1 
luxation of the1 #abe  ,fetlock joint1  
open1 #aaj  ,fetlock region1 thecitis   
and bursitis in1 #adh  ,fetlock1 shoe   
for bracing the1 #aha  ,fibular tarsal  

bone1 fracture of the1 #bcj  ,firing1   
treatment of ringbone by1 #abc  ,first  
phalanx1 #ei  ,fish knees1 #ade  ,fixed 
luxations1 #ba  ,fixed patellar         
disarticulation1 #bac  ,flexor brachii1 
#eh1 #fh1 #fi  ,flexor carpiradialis1   
#ic  ,flexor carpiulnaris1 #ic  ,flexor 
metacarpi externus1 #id  ,flexor        
metacarpi internus1 #ic  ,flexor        
metacarpi medius1 #ic  ,flexor          
metatarsi1 #aic  ,flexor1 superficial   
digital1 #aid  ,flexor tendons1         
contraction of the1 #acg  ,flexor       
tendons1 inflammation of the1 #ace      
,flexor tendons1 rupture of1 #adf       
,flexors of phalanges1 open sheath of1  
#abd  ,foals1 contracted tendons of1    
#adc  ,forearm1 wounds of1 #ij  ,fore   
leg1 lameness in the1 #ee  ,fracture of 
the carpal bones1 #if  ,fracture of the 
femur1 #aii  ,fracture of the fibular   
tarsal bone1 #bcj  ,fracture of first   
and second phalanges1 #aca  ,fracture of
 humerus1 #hb  ,fracture of the ilium1  
#aih  ,fracture of the ischial          

tuberosity1 #aii  ,fracture of the      
metacarpus1 #ajf  ,fracture of the      
patella1 #bab  ,fractures of the pelvic 
bones1 #aif  ,fracture of the proximal  
sesamoids1 #abh  ,fracture of the pubis1
 #aig  ,fracture of the radius1 #hg     
,fracture of the scapula1 #fb  ,fracture
 of the tibia1 #bbb  ,fracture of the   
tibial tarsal bone1 #bcj  ,fracture of  
the ulna1 #hf  ,fractures1 #af          
,fractures1 comminuted1 #ag  ,fractures1
 compound1 #ag  ,fractures1 green stick1
 #ah  ,fractures1 impacted1 #ai         
,fractures1 longitudinal1 #ah           
,fractures1 multiple1 #ah  ,fractures1  
multiple longitudinal1 #ai  ,fractures1 
oblique1 #ah  ,fractures1 simple1 #ag   
,fractures1 simple transverse1 #ah      
,fractures1 transverse1 #ah             
,fragilitas1 #aii  ,fragilitas osseum1  
#abh   ,g  ,gait1 observing character   
of1 #dh  ,gastrocnemius1 #aid  ,gluteal 
tendo-synovitis1 #bjc  ,gluteus medius  
muscle1 #aib1 #bjc  ,gonitis1 chronic1  
#bag  ,green stick fractures1 #ah   ,h  

,hind leg1 lameness in the1 #ahe  ,hind 
leg1 paralysis of the1 #bjd  ,hip       
lameness1 #aie  ,hip swinney1 #bje      
,hock1 capped1 #bea  ,hock joint1 #ahh  
,hoof testers1 #ec  ,humeroradioulnar   
joint1 #eh  ,humerus1 fracture of1 #hb  
,i  ,iliac thrombosis1 #bji  ,iliopsoas1
 #bjd  ,ilium1 fracture of the1 #aih    
,impacted fractures1 #ai  ,infectious   
arthritis1 #ff  ,infectious bursitis1   
#bh  ,infectious inflammation of the    
lateral cartilage1 #agc  ,infectious    
lymphangitis1 #beg  ,infectious         
synovitis1 #abd  ,inflammation of the   
bicipital bursa1 #fh  ,inflammation of  
the bursa podotrochlearis1 #aeg         
,inflammation of the carpal flexors1 #ic
  ,inflammation of the carpus1 #ih      
,inflammation of the elbow1 #hd         
,inflammation of the flexor tendons1    
#ace  ,inflammation of posterior        
ligaments of pastern1 #abi              
,inflammation of proximal sesamoid      
bones1 #abg  ,inflammation of third     
sesamoid and deep flexor tendon1 #aeg   

,inflammation of the trochanteric bursa1
 #bjd  ,infraspinatus muscle1 #fe       
,injection of fluids for quittor1 #agg  
,injuries to scapulohumeral joint1 #ff  
,interfering1 shoeing for1 #bef         
,interfering1 wounds from1 #bee         
,ischial tuberosity1 fracture of the1   
#aii   ,j  ,joint capsule1 anatomy of   
the1 #bbj  ,joint1 carpal1 #eh  ,joint1 
elbow1 #eh  ,joint1 fetlock1 #eh  ,joint
 capsule1 tarsal1 distension of the1    
#bdb  ,joint1 fetlock1 arthritis of the1
 #aeb  ,joint1 fetlock1 luxation of1    
#abe  ,joint1 hock1 #ahh  ,joint1       
humeroradioulnar1 #eh  ,joint1 open1 #fg
  ,joint1 open carpal1 #ajj  ,joint1    
open fetlock1 #aaj  ,joint1 pastern     
proximal interphalangeal1 #abi  ,joint1 
shoulder1 #ee  ,joint1 stifle1 open1    
#bbj  ,joint1 tarsal1 open1 #bbi   ,l   
,lameness1 hip1 #aie  ,lameness1 mixed1 
#di  ,lameness in the fore leg1 #ee     
,lameness in the hind leg1 #ahe         
,lameness1 shoulder1 #fa  ,lameness1    
supporting-leg1 #di  ,lameness1         

swinging-leg1 #di  ,laminitis1 #afj     
,laminitis1 acute1 #afb  ,laminitis1    
chronic1 #afd  ,lateral cartilage1      
infectious inflammation of the1 #agd    
,lateral cartilages1 ossification of1   
#aee  ,ligaments1 affections of1 #bj    
,ligament1 capsular1 #aij  ,ligaments1  
collateral1 #aij  ,ligament1 cotyloid1  
#ahe  ,ligaments1 crucial1 #ahh         
,ligaments1 dorsal1 #aij  ,ligaments1   
femeropatella1 #ahh  ,ligament1 medial1 
#aij  ,ligaments1 mesial tarsal1 sprains
 of the1 #bcb  ,ligaments of pastern    
proximal interphalangeal joint1         
inflammation of1 #abi  ,ligaments1      
patellar1 #ahh  ,ligaments1 plantar1    
#aij  ,ligament1 pubiofemoral1 #ahe     
,ligament1 superior check1 #eh          
,ligament1 suspensory1 rupture of1 #adf 
,ligaments1 volar1 #abi  ,ligament1     
volar-carpal or annular1 #eh  ,ligation 
of the saphenous vein1 #bdf  ,line      
firing for bog spavin1 #bdf             
,longitudinal fractures1 #ah            
,lumbosacral plexus1 #bjd  ,luxation of 

the carpal bones1 #if  ,luxation of the 
femur1 #bja  ,luxation of fetlock joint1
 #abe  ,luxation of the patella1 #bac   
,luxation of the patella1 outward1 #bae 
,luxation of the patella1 upward1 #bad  
,luxation of scapulohumeral joint1 #fg  
,luxations1 #ba  ,luxations1 fixed1 #ba 
,luxations1 temporary1 #ba  ,lymph      
vessels and glands1 affections of1 #cb  
,lymphangitis1 #cb  ,lymphangitis1      
infectious1 #beg  ,lymphangitis1        
non-infectious1 #bfj   ,m  ,medial      
ligament1 #aij  ,median neurectomy1 #abd
  ,mesial tarsal ligaments1 sprains of  
the1 #bcb  ,metacarpophalangeal         
articulation1 #eh  ,metacarpus1 fracture
 of the1 #ajf  ,metastatic arthritis1   
#be  ,mixed lameness1 #di  ,momentary   
patellar disarticulation1 #bac          
,movements1 passive1 #dg  ,multiple     
fractures1 #ah  ,multiple longitudinal  
fractures1 #ai  ,muscles1 affections of1
 #bh  ,muscle1 antea-spinatus1 #fe      
,muscle1 anterior digital extensor1 #aic
  ,muscle1 biceps brachii1 #eh  ,muscle1

 caput1 #ga  ,muscle1 gluteus medium1   
#aib1 #bjc  ,muscle1 infraspinatus1 #fe 
,muscle1 peroneus tertius1 #aic         
,muscle1 postea-spinatus1 #fe  ,muscles1
 quadriceps1 #aic  ,muscles1 quadriceps1
 atrophy of the1 #bje  ,muscle1         
subscapularis1 #fe  ,muscle1            
supraspinatus1 #fe  ,muscle1 tibialis   
anticus1 #aic  ,muscle1 triceps brachii1
 #eh  ,myalgia1 #aie   ,n  ,nail        
punctures1 #agh  ,navicular disease1    
#aeg  ,nerves1 affections of1 #cj       
,nerve1 femoral1 paralysis of the1 #bjd 
,nerve1 obturator1 paralysis of the1    
#bjf  ,nerve1 sciatic1 paralysis of the1
 #bjh  ,nerve1 7suprascapular7 paralysis
 of the1 #ge  ,non-infectious           
lymphangitis1 #bfj  ,non-infectious     
bursitis1 #bh  ,neurectomy1 ,bossi's    
double tarsal1 #bdb  ,neurectomy1       
median1 #abd  ,neurectomy1 plantar1 #abd
   ,o  ,oblique fractures1 #ah          
,observing character of gait1 #dh       
,obturator nerve1 paralysis of the1 #bjf
  ,occurrence1 general discussion of1   

#ae  ,omphalophlebitis1 #be  ,open      
carpal joint1 #ajj  ,open fetlock joint1
 #aaj  ,open joint1 #fg  ,open sheath of
 flexors of phalanges1 #abd  ,open      
stifle joint1 #bbj  ,open tarsal joint1 
#bbi  ,os corona1 #fj  ,ossification of 
cartilages of the third phalanx1 #aee   
,ossification of the lateral cartilages1
 #aee  ,os innominatum1 #aif  ,os       
suffraginis1 #ei  ,osteitis1 rarefying1 
#af  ,outward luxation of the patella1  
#bae   ,p  ,palpation1 examination by1  
#dc  ,paralysis1 brachial1 #gg          
,paralysis of the femoral nerve1 #bjd   
,paralysis of the hind leg1 #bjd        
,paralysis of the obturator nerve1 #bjf 
,paralysis of the sciatic nerve1 #bjh   
,paralysis of the suprascapular nerve1  
#ge  ,paralysis1 radial1 #gg            
,paronychia1 #agj  ,passive movements1  
#dg  ,pastern proximal interphalangeal  
joint1 inflammation of ligaments of1    
#abi  ,patella1 #ahh  ,patella1 fracture
 of the1 #bab  ,patella1 luxation of    
the1 #bac  ,patella1 outward luxation of

 the1 #bae  ,patella1 upward luxation of
 the1 #bad  ,patellar disarticulation1  
fixed1 #bac  ,patellar disarticulation1 
momentary1 #bac  ,patellar ligaments1   
#ahh  ,pelvic bones1 fractures of the1  
#aif  ,pelvic limbs1                    
anatomo-physiological consideration of  
the1 #ahe  ,penetrative wounds1 #he     
,periarticular ringbone1 #abb  ,peroneus
 tertius muscle1 #aic  ,phalangeal      
exostosis1 #aah  ,phalanges1 fracture of
 first and second1 #aca  ,phalanges1    
open sheath of flexors of1 #abd         
,phalanx1 first1 #ei  ,phalanx1 second1 
#fj  ,phalanx1 third1 ossification of   
cartilages of1 #aee  ,plantar ligaments1
 #aij  ,plantar neurectomy1 #abd        
,polyarthritis1 #be  ,postea-spinatus   
muscle1 #fe  ,principles1 diagnostic1   
#cg  ,proximal sesamoid bones1          
inflammation of1 #abg  ,proximal        
sesamoids1 fracture of1 #abh            
,pubiofemoral ligament1 #ahe  ,pubis1   
fracture of the1 #aig  ,punctures1 nail1
 #agh   ,q  ,quadriceps muscles1 #aic   

,quadriceps muscles1 atrophy of the1    
#bje  ,quittor1 #agd  ,quittor1         
injection of fluids for1 #agg   ,r      
,rachitic ringbone1 #abb  ,radial       
paralysis1 #gg  ,radius1 fracture of    
the1 #hg  ,rarefying osteitis1 #af      
,rheumatic arthritis1 #bf  ,rheumatism1 
#aif  ,ringbone1 #aah  ,ringbone1       
articular1 #aba  ,ringbone1             
periarticular1 #abb  ,ringbone1         
rachitic1 #abb  ,ringbone1 traumatic1   
#abb  ,ringbone treated by firing1 #abc 
,roberts shoe for bracing the fetlock1  
#aha  ,rupture of the extensor pedis1   
#ade  ,rupture of flexor tendons and    
suspensory ligament1 #adf  ,rupture of  
long digital extensor1 #bec  ,rupture of
 the tendo archillis1 #bbd   ,s         
,saphenous vein1 ligation of the1 #bdf  
,scapula1 fracture of the1 #fb          
,scapulohumeral articulation1 #ee       
,scapulohumeral joint1 injuries to1 #ff 
,scapulohumeral joint1 luxation of1 #fg 
,scapulohumeral joint1 wounds of1 #fg   
,scapulohumeral arthritis1 #fe          

,sciatica1 #bjh  ,sciatic nerve1        
paralysis of the1 #bjh  ,second phalanx1
 #fj  ,sesamoid bones1 #ei  ,sesamoid1  
third1 inflammation of the1 #aeg        
,sesamoids1 proximal1 fracture of1 #abh 
,sesamoiditis1 #abg  ,setons1 #ge       
,sheath of flexors of phalanges1 open1  
#abd  ,sheath 7tarsal7 of the deep      
digital flexor1 distension of the1 #bdf 
,shoe for dropped soles1 #afi  ,shoeing 
for interfering1 #bef  ,shoulder        
atrophy1 #gc  ,shoulder joint1 #ee      
,shoulder lameness1 #fa  ,simple        
fractures1 #ag  ,simple transverse      
fractures1 #ah  ,soles1 dropped1 shoe   
for1 #afi  ,spavin1 bog1 #bdb  ,spavin1 
bone1 #bce  ,spavin1 dry1 #bbe  ,spavin 
test1 #bci  ,special methods of         
examination1 #ec  ,sprains of the mesial
 tarsal ligaments1 #bcb  ,sprains1      
tarsal1 #bcb  ,splints1 #ajg            
,spring-halt1 #bbe  ,stifle1 dropped1   
#bje  ,stifle joint1 open1 #bbj         
,strangles1 #be  ,streptococcus equi1   
#be  ,string-halt1 #bbe  ,subject1      

attitude of the1 #da  ,subscapularis    
muscle1 #fe  ,supporting-leg-lameness1  
#di  ,suprascapular nerve1 paralysis of 
the1 #ge  ,supraspinatus muscle1 #fe    
,superficial digital flexor1 #aid       
,superior check ligament1 #eh           
,suspensory ligament1 rupture of1 #adf  
,sweeny1 #gc  ,swinging-leg-lameness1   
#di  ,swinney1 #gc  ,swinney1 hip1 #bje 
,synovial distension of tendon sheaths1 
#ajd  ,synovitis1 #be  ,synovitis1      
infectious1 #abd   ,t  ,tarsal          
arthritis1 #bbe  ,tarsal bones1 #aij    
,tarsal joint capsule1 distension of    
the1 #bdb  ,tarsal joint1 open1 #bbi    
,tarsal sheath of the deep digital      
flexor1 distension of the1 #bdf  ,tarsal
 sprains1 #bcb  ,tarsus1 #aib           
,temporary luxations1 #ba  ,tendinitis1 
#ace  ,tendinitis1 acute1 #ace          
,tendinitis1 chronic1 #acg  ,tendo      
achillis1 rupture and wounds of the1    
#bbd  ,tendon1 deep flexor1 inflammation
 of the1 #aeg  ,tendon1 deep flexor     
7perforans71 #fj  ,tendon1 extensor1    

rupture of1 #ade  ,tendon1 flexor1      
rupture of1 #adf  ,tendons of foals1    
contracted1 #adc  ,tendon sheaths1      
synovial distension of1 #ajd  ,tendons1 
affections of1 #bh  ,tendons1 flexor1   
contraction of the1 #acg  ,tendons1     
flexor1 inflammation of the1 #ace       
,tendo-synovitis1 gluteal1 #bjc         
,tenotomy1 cunean1 #bdb  ,tensor fascia 
lata1 #aib  ,test1 spavin1 #bci         
,testers1 hoof1 #ec  ,thecae1 affections
 of1 #bg  ,thecitis1 #bg1 #ajd          
,thecitis in the fetlock region1 #aej   
,thoroughpin1 #bdf  ,thoroughpin1       
aspiration-and-injection treatment of1  
#bej  ,thrombosis1 iliac1 #bji          
,thrombosis of the brachial artery1 #ha 
,tibia1 #ahh  ,tibia1 fracture of the1  
#bbb  ,tibial tarsal bone1 fracture of  
the1 #bcj  ,tibialis anticus muscle1    
#aic  ,tibioastragular joint1 distension
 of the1 #bdb  ,transverse fractures1   
#ah  ,traumatic arthritis1 #bb          
,traumatic ringbone1 #abb  ,treatment of
 bog spavin by aspiration and injection1

 #bdd  ,treatment of capped hock by     
aspiration and injection1 #beb          
,treatment of ringbone by firing1 #abc  
,treatment of thoroughpin by aspiration 
and injection1 #bej  ,triceps brachii1  
#eh  ,triceps brachii1 contusions of1   
#ga  ,triceps extensor brachii1 #ga     
,trochanteric bursa1 inflammation of    
the1 #bjd  ,true crepitation1 #dg   ,u  
,ulna1 fracture of the1 #hf  ,ulnaris   
lateralis1 #id  ,upward luxation of the 
patella1 #bad   ,v  ,vein1 saphenous1   
ligation of the1 #bdf  ,vesication for  
bog spavin1 #bdf  ,vessignon cheville1  
#bdf  ,visual examination1 #ci          
,volar-carpal ligament1 #eh  ,volar     
ligaments1 #abi   ,w  ,wounds1 calk1    
#agj  ,wounds1 contusive1 #he  ,wounds  
from interfering1 #bee  ,wounds of      
anterior brachial region1 #ij  ,wounds  
of coronary region1 #agj  ,wounds of    
scapulohumeral joint1 #fg  ,wounds of   
tendo achillis1 #bbd  ,wounds1          
penetrative1 #he   ,x  ,x-ray diagnosis1
 #agi      ,,authorities ,,cited        

,almy1 ,j41 #ada1 #bjj1 #bjb1 #bjh1     
#bab1 #baf1 #bad1 #bcc  ,bassi1 #bae    
,bauman1 ,s4,h41 #aig ,bell1 ,roscoe    
,r41 #fi ,benard1 #baf ,berns1 ,geo4    
,h41 #gg1 #bah ,bouley1 #bbe ,bourdelle1
 #adg  ,cadiot1 ,p4,j41 #gh1 #ada1 #bjj1
 #bjb1 #bjh1 #bab1 #bad1 #baf1 #bbc1    
#bbe1 #bcc1 #bde1     #bej ,campbell1   
,d4,m41 #afb1 #aff1 #afg ,castagne1 #hd 
,cochran1 ,david ,w41 #afi1 #agj        
,diekerhoff1 #bcg ,dollar1 ,jno4 ,a4,w41
 #fh1 #aih  ,eberlein1 #bcg  ,fisher1   
,carl ,w41 #bcf ,frost1 ,j4,n41 #aac    
,frost1 ,r4,f41 #abh  ,greaves1 ,thomas1
 #aeg  ,hoare1 ,e4 ,wallis1 #be1 #baa1  
#bcj ,hughes1 ,joseph1 #agf1 #bba       
,hutyra and ,marek1 #bje  ,law1 ,james1 
#cc ,leblanc1 #bbc ,liautard1 ,a41 #hd1 
#aii1 #bch ,lusk1 ,wm4 ,v41 #bjc        
,mc,donough1 ,james1 #bcg ,merillat1    
,edward1 #baj ,merillat1 ,l4,a41 #hj1   
#if1 #age1 #baj ,millar1 ,thomas1 #ade  
,moeller1 ,h41 #aai1 #aef1 #baa1 #bbb   
,montane1 #adg ,moore1 ,r4,c41 #afb     
,roberts1 ,g4,h41 #aha  ,schumacher1    

#bae ,scott1 ,john1 #bjh ,seeley1       
,j4,t41 #agf ,sisson1 ,septimus1 #abi1  
#bjd1 #bbj ,smith1 ,f41 ,major ,general1
 #ef1 #fj1 #aee1 #ahh1 #aid             
,strangeways1 #aic  ,taylor1 ,henry1 #ga
 ,thompson1 ,h41 #hc1 #hg ,trickett1    
,a41 #bec  ,udall1 ,d4,h41 #bcf         
,uhlrich1 #bbd  ,walters1 ,wilfred1 #hc1
 #ig ,williams1 ,w4,l41 #bag1 #bcf      
,transcriber's notes3     ,accented     
words3 ,the following spelling          
differences have been    maintained3    
,moller _/ ,moeller       ,montane _/   
,montane       ,traite _/ ,traite4      
,hyphenation3 ,the following hyphenation
 differences have been    maintained3   
bilateral _/ bi-lateral                 
calcaneocuboid _/ calcaneo-cuboid       
calcaneometatarsal _/                   
calcaneo-metatarsal                     
counterirritation _/ counter-irritation 
counterirritating _/ counter-irritating 
foreleg _/ fore-leg                     
interphalangeal _/ inter-phalangeal     
noninfectious _/ non-infectious         

nonsensitive _/ non-sensitive           
overwork _/ over-work                   
posteaspinatus _/ postea-spinatus       
ringbone _/ ring-bone       subacute _/ 
sub-acute       subcoronary _/          
sub-coronary       subfascial _/        
sub-fascial       subperiosteal _/      
sub-periosteal     ,typographical       
errors3        sub-facial         for   
sub-fascial       ,at two-year-old  for 
,a two-year-old       ,ameircan         
for  ,american       ,symtomatology     
for  ,symptomatology       extoses      
for  exostoses       admintered         
for  administered