Mair G ■>-HY ■'E OF ^ ^,-„-,. U. S. DEPARTMENT OF AGRICULTURE. BUREAU OF ANIMAL INDUSTRY. A. D. MELVIN, Chief of Bureau. SPECIAL REPORT ON DISEASES OF THE HORSE. BY Drs. PEARSON, MICHENER, LAW, HARBAUGH, TRUMBOWER, LIAUTARD, HOLCOMBE, HUIDEKOPER, STILES, MOHLER, AND ADAMS. REVISED EDITION. WASHINGTON: GOVERNMENT PRINTING OFFICE. 1907. \.c V (^ulAJT • ^* • • 4 » « ' L/ LEITI^R OF TRANSMriTAL. U. S. Department of Agriculture, Bureau of Animal Industry, Was/umjton, U. C, Aprils, 1907. Sir: I have the honor to transmit herewith a copy of the Special Report on Diseases of the Horse prepared for reprinting in accord- ance with the following resolution, approved March -i, 11)07: Resolved by the Senate and Howe of Repremitatives of the United States of America in Congress assembled, That there be printed and bound in cloth two hundred and fifty thousand copies of the special report on diseases of horses, with accompanying illus- trations, the same to be first revised and brought to date under the supervision of the Secretary of Agriculture, one hundred and seventy-five thousand for the use of the House of Representatives, sixty thousand for the use of the Senate, and fifteen thousand for the use of the Department of Agriculture. As the work was thoroughly revised in 1903, it has been found necessary to make only a slight revision at this time. A brief chapter on "Osteoporosis, or bighead," by Dr. John R. Mohler, Chief of the Pathological Division of this Bureau, has been added. This report was first issued in 1890 and was at once accorded a hearty reception ])y the horse owners of the country. The limited edition that the Department was able to publish was very soon exhausted, and the demand was then turned upon Members of Con- gress. As a result of the continuous demand Congress has ordered reprints from time to time until the total editions, including that provided for by the above resolution, approximate 900,000 copies. Very respectfullv, A. D. Melvin, Ch ief of Burea u. Hon. James Wilson, Seo'etary of Agriculture. risanss CONTENTS. The examination of a sick horse, Page. By Leonard Pearson, B. S., V. M. ^^ 9 Methods of administering medicines, By Ch. B. Michener, V. S 28 Diseases of the digestive organs, By Ch. B. Michener, V. S 34 Diseases of the urinary organs, By James Law, F. R. C. V. S 75 Diseases of the respiratory organs, By W. H. Harbaugh, V.. S , 104 Diseases of the generative organs, By James Law, F. "r. C. V. S 142 Diseases of the 7iervous system. By M. R. Tri-mbower, V. S 190 Diseases of the heart, blood vessels, and lympliatics, By M. R. Trumbower, V. S 225 Diseases of the eye. By James Law, F. R. C. V. S 251 Lameness, By A. LiAUTARD, M. D., V. S 274 Diseases of the fetlock, ankle, and foot, By A. A. Holcombk, D. Y. S 369 Diseases of the skin, By James Law, F. R. C. V. S 431 Woimds and their treatment, By Ch. B. M ichexer, V . S 459 General diseases. By Rush Shippen Huidekoper, ^L D., Vet 482 Surra, By Ch. AVardell Stiles, Ph. D 548 Osteoporosis or bighead, By John R. :\Ioni.i:K, V. M. D 554 Shoeing, By John W. Adams, A. B., V. .AL D 559 Index 583 5 ILLUSTRATIONS, PLATES. Plate I. Digestive apparatus ^^ II. Bots l^ III. Intestinal worms "^ IV. Longitudinal section through kidney 76 V. Microscopic anatomy of kidney 88 YI. Microscopic anatomy of kidney 88 VII. Calculi and instrument for removal 88 VIII. Position of the left lung 128 IX. Instruments used in ditticult labor 166 X. Normal presentations 166 XI. Abnormal presentations 166 XII. Abnormal presentations 166 XIII. Abnormal presentations 1'6 XIV. Abnormal presentations 176 XV. Anterior presentations 176 XVI. The nervous system 1 ^2 XVII. Interior of chest, showing position of heart and diaphragm 228 XVIII. Circulatory apparatus -28 XIX. Theoretical section of the horse's eye 2o6 XX. Skeleton of the horse 288 XXI. Superficial layer of muscles - 288 XXII. Splint 288 XXIII. Ringbone j^^"* XXIV. Various types of spavin 304 XXV. Bone spavin ^^6 XXVI. Bone spavin ^'^^ XXVII. Dislocation of shoulder and elbow, Bourgelat's apparatus 336 XX\'I11. The sling in use 336 XXIX. Anatomy of foot jjp XXX . Anatomy of foot ;^72 XXXI. Quarter crack and remedies -^^2 XXXII. Sound and contracted feet -^'2 XXXIII. Foundered feet •*16 XXXIV. Ringbone and navicular disease -^16 XXXV. Diseases of the skin "^•^2 XXXVI. Mites that infest the horse ■*'*8 XXXVII. General diseases. Inflammation 488 XXXVIII. General diseases. Inflammation '188 XXXIX. Glanders, nasal septum of horse, right side, showing acute lesions. 532 XL. Glanders, middle region of nasal septum, left side, showing ulcers. 532 XLI. Glanders, posterior half of nasal septum, right side, showing Cicatrices "^ 7 8 ... . IT.I.USTRATI01SrS. TEXT FIGURES. / . . :'. ',"'.','•'■ '■ ■'• ^*s^- Fig. 1. GroimJl'fiurface'of a right fore hoof of the ' ' regular ' ' form 566 2. Pair of fore feet of regular form in regular standing position 567 3. Pair of fore feet of base-wide form in toe- wide standing position 567 4. Pair of fore feet of base-narrow form in toe-narrow standing position. 568 5. Side view of an acute-angled fore foot, of a regular fore foot, and of a stumpy fore foot - 568 6. Side view of foot with the foot-axis broken backward as a result of too long a toe 570 7. Left fore hoof of a regular form, shod with a plain fullered shoe 574 8. Side view of hoof and fullered shoe 575 9. An acute-angled left fore hoof shod with a bar shoe 577 10. A fairly formed right fore ice shoe for a roadster 577 11. Left fore hoof of regular form shod with a rubber pad and "three- quarter ' ' shoe ■"•"^ 12. A narrow right fore hoof of the base-wide standing position shod with a plain " dropped crease" shoe 578 13. Hoof surface of a right hind shoe to prevent interfering 579 14. Ground surface of shoe shown in fig. 13 579 15. Side view of a fore hoof shod so as to quicken the "breaking over" in a " forger " 580 16. Side view of a short-toed hind hoof of a forger 580 17. A toe-weight shoe to increase the length of stride of fore feet 581 18. Most common form of punched heel-weight shoe to induce high action in fore feet ^^^ SPECIAL REPORT . ON DISEASES OF THE HORSE THE EXAMINATION OF A SICK HORSE. By Leonard Pearson, B. S., V. AI. D., Dean of the Veterinary Deparfninit, T'ltircr.siti/ of Pennsylvania, and State Veterinarian of Pcniisylvania. In the examination of a sick horse it is important to have a method, or system. If a definite plan of examination is followed one may feel reasonably sure when tlie examination is finished that no important point has been overlooked and that the examiner is in a position to arrive at an opinion that is as accurate as is possible for him. Of course, an experienced eye can see, and a trained hand can feel, slight alterations or variations from the normal that are not perceptible to the unskilled observer. A thorough knowledge of the conditions that exist in health is of the highest importance, because it is only by a knowledge of what is right that one can surely detect a condition that is wrong. A knoAvledge of anatomy, or of the structure of the body, and of physiology, or the functions and activities of the body, lie at the bottom of accuracy of diagnosis. It is important to remeuiber that animals of diiferent races or families deport themselves differ- ently under the influence of the same disease or pathological process. The sensitive and highly organized Thoroughbred resists cerebral depression more than does the lymphatic draft horse. Hence a de- gree of fever that does not produce marked dullness in a Thorough- bred may cause the most abject dejection in a coarsely bred heavy draft horse. This and similar facts are of vast importance in the diagnosis of disease and in the recognition of its significance. The order of examination, as given below, is one that has proved to be comparatively easy of application and sufficiently thorough for the purpose of the readers of this work. It is recommended by several writers. 9 10 DISEASES OF THE HORSE, HISTORY. It is important to know, first of all, something of the origin and development of the disease, therefore the canse should be looked for. The cause of a disease is important, not only in connection with diag- nosis, but also in connection with treatment. The character of food that the horse has had, the use to which he has been put, and the kind of care he has received should all be inquired into closely. It may be found by this investigation that the horse has been fed on damaged food, such as browser's grains or moldy silage, and this may be suffi- cient to explain the profound depression and weakness that are char- acteristic of forage poisoning. If it is learned that the horse has been kept in the stable without exercise for several days and upon full rations, and that he became suddenly lame in his back and hind legs, and finally fell to the ground from what appeared to be partial paralysis, this knowledge, taken in connection w^ith a few evident symptoms, will be enough to establish a diagnosis of azoturia. If it is learned that the horse has been recently shipped in the cars or has been through a dealer's stable, we have knowledge of significance in connection with the causation of a possible febrile disease, which is, under these conditions, likely to prove to be influenza, or edematous pneumonia. It is also important to know whether the particular horse that is under examination is the only one in the stable or on the premises that is similarly afflicted. If it is found that several horses are afflicted much in the same way, we have evidence here of a common cause of disease which may prove to be of an infectious nature. Another item of importance in connection with the history of the case relates to the treatment that the horse may have had before he is examined. It sometimes happens that medicine given in excessive quantities produces symptoms resembling those of disease, so it is important that the examiner shall be fully informed as to the medica- tion that has been employed. ATTITUDE AND GENERAL CONDITION. Before beginning the special examination attention should be paid to the attitude and general condition of the animal. Sometimes horses assume positions that are characteristic of a certain disease. For example, in tetanus, or lockjaw, the muscles of the face, neck, and shoulders are stiff and rigid, as well as the muscles of the jaw. This condition produces a peculiar attitude, that once seen is subse- quently recognized as rather characteristic of this disease. A horse with tetanus stands with his muscles tense and his legs in a somewhat bracing position, as though he were gathered to repel a shock. The neck is stiff' and hard, the head is slightly extended upon it, the face is drawn, and the nostrils are dilated. The tail is usually held up a little, and when pressed down against the thighs it springs back to its EXAMINATION OF A SICK HORSE. 11 j^revioiis position. In inflammation of the throat, as in pharyngo- hiryngitis, the head is extended upon the neck, and the angle between the jaw and the lower border of the neck is opened as far as possible to relieve the pressure that otherwise would fall upon the throat. In dumminess, or immobility, the hanging position of the head and the stupid expression are rather characteristic. In pleurisy, perito- nitis, and some other painful diseases of the internal organs, the rigid position of the body denotes an effort of the animal to avoid pressure upon and to protect the inflamed sensitive region. The horse may be down in the stall and unable to rise. This condi- tion may result from paraplegia, from azoturia, from forage poison- ing, from tetanus, or from painful conditions of the bones or feet, such as osteoporosis or founder. Lying down at unusual times or in unusual positions may indicate disease. The first symptom of colic may be a desire on the part of the horse to lie down at a time or place that is unusual or inappropriate. Sometimes disinclination to lie down is an indication of disease. Where there is difRcultj'^ in breath- ing, the horse knows that he can manage himself better upon his feet than upon his breast or his side. It happens, therefore, that in nearly all serious diseases of the respiratory tract the horse stands persist- ently, day and night, until recovery has commenced and breathing is easier, or until the animal falls from sheer exhaustion. Where there is stiffness and soreness of the muscles, as in rheumatism, inflamma- tion of the muscles from overwork, or of the bones in osteoporosis, or of the feet in founder, or where the muscles are stiff and beyond con- trol of the animal, as in tetanus, a standing position is maintained, because the horse seems to realize that when he lies down he will be unable to arise. Abnormal attitudes are assumed in painful diseases of the digestive organs (colic). A horse with colic nuiy sit upon his haunches, like a dog, or ma}' stand upon his hind feet and rest upon his knees in front, or may endeavor to balance himself upon his back, with all four feet in the air. These positions are assumed because they give relief from pain by lessening pressure, or tension, upon the sensitive structures. Under the general condition of the animal it is necessary to observe the condition, or state, of nutrition ; the conformation, so far as it may indicate the constitution; and the temperament. By observing the condition of nutrition one may be able to determine to a certain extent the effect that the disease has already had upon the animal and to esti- mate the amount of strength that remains and that will be available for the repair of the diseased tissues. A good condition of nutrition is shown by the rotundity of the body, the pliability and softness of the skin, and the tone of the liair. If the subcutaneous fat has disap- peared and the muscles are wasted, allowing the bony prominences to stand out ; if the skin is tight and inelastic and the coat dry and harsh, we have evidence of a low state of nutrition. This may have resulted 12 DISEASES OF THE HORSE. from a severe and long-continued disease or from lack of proper food and care. Where an animal is emaciated — that is, becomes thin — there is first a loss of fat and later the muscles shrink. By observing the amount of shrinkage in the muscles one has some indication as to the duration of the unfavorable conditions that the animal has lived under. By constitution we understand the innate ability of the animal to withstand disease or unfavorable conditions of life. The constitution depends largely upon the conformation. The type of construction that usually accompanies the best constitution is deep, broad chest, allowing plenty of room for the lungs and heart, indicating that these vital organs are well developed ; capacious abdomen, allowing sufficient space for well-developed organs of digestion; the loins should be short — that is, the space should be short between the last rib and the point of the hip; the head and neck should be well molded, without superfluous or useless tissue; this gives a clear-cut throat. The ears, eyes, and face should have an expression of alertness and good breeding. The muscular development should be good; the shoulders, forearms, croup, and thighs must have the appearance of strength. The withers are sharp, which means that they are not loaded with useless, superfluous tissue ; the legs are straight and their axes are parallel ; the knees and hocks are low, which means that the forearms and thighs are long and the cannons relatively short. The cannons are broad from in front to behind and relatively thin from side to side. This means that the bony and tendinous structures of the legs are well developed and well placed. The hoofs are compact, tense, firm structures, and their soles are concave and frogs large. Such a horse is likely to have a good constitution and to be able to resist hard work, fatigue, and disease to a maximum degree. On the other hand, a poor constitution is indicated by a shallow, narrow chest, small bones, long loins, coarse neck and head, with thick throat, small, bony, and muscular development, short thighs and forearms, small joints, long, round cannons, and hoofs of open texture with flat soles. The temperament is indicated by the manner in which the horse responds to external stimuli. When the horse is spoken to, or when he sees or feels anything that stimulates or gives alarm, if he responds actively, quickly, and intelligently, he is said to be of lively, or nerv^- ous, temperament. On the other hand, if he responds in a slow, sluggish manner, he is said to have a sluggish, or lymphatic, tempera- ment. The temperament is indicated by the gait, by the expression of the face, and by the carriage of the head and ears. The nature of the temperament shoidd be taken into consideration in an endeavor to ascertain the severity of a given case of illness, because the general expression of an animal in disease as well as in health depends to a large extent on the temperament. EXAMINATION OF A SICK HORSE. 13 THE SKIN AND THE VISIBLE MUCOUS MEMBRANES. The condition of the skin is a fair index to the condition of the animal. The effect of disease and emaciation upon the pliability of the skin have been referred to above. There is no part of the body that loses its elasticity and tone as a result of disease sooner than the skin. The practical herdsman or flockmaster can gain a great deal of information as to the condition of an animal merely by grasping the coat and looking at and feeling the skin. Similarly, the condition of the animal is shown to a certain extent by the appearance of the mucous membranes. For example, when the horse is anemic as a result of disease or of inappropriate food the mucous membranes become pale. This change in the mucous membranes can be seen most readily in the lining of the eyelids and in the lining of the nostril. For convenience of examination the eyelids can readily be everted. Paleness means weak circulation or poor blood. Increased redness occurs phj'siologically in painful conditions, excitement, and follow- ing severe exertion. Under such conditions the increase of circula- tion is transitory. In fevers there is an increased redness in the mucous membrane, and this continues so long as the fever lasts. Ix). some diseases red spots or streaks form in the mucous membrane. This usually indicates an infectious disease of considerable severity, and occurs in blood poisoning, purpura hemorrhagica, hemorrhagic septicemia, and in urticaria. When the liver is deranged and does not operate, or when the red-blood corpuscles are broken down, as in serious cases of influenza, there is a yellowish discoloration of the mucous membrane. The mucous membranes become bluish or blue when the blood is imperfectly oxidized and contains an excess of carbon dioxide. This condition exists in any serious disease of the respiratory tract, as pneumonia, and in heart failure. The temperature of the skin varies with the temperature of the body. If there is fever the temperature of the skin is likely to be increased. Sometimes, however, as a result of poor circulation and irregular distribution of the blood, the body may be warmer than normal, while the extremities (the legs and ears) may be cold. AMiere the general surface of the body becomes cold it is evident that the small blood vessels in the skin have contracted and are keeping the blood awav, as during a chill, or that the heart is weak and is unable to pump the blood to the surface, and that the animal is on the verge of collapse. The skin is moist, to a certain degree, at all times in a healthy horse. This moisture is not in the form of a perceptible sweat, but it is enough to keep the skin pliable and to cause the hair to have a soft, healthy feel. In some chronic diseased conditions and in fever, the skin becomes dry. In this case the hair has a harsh feel that is quite different from the condition observed in health, and from the fact of 14 DISEASES OF THE HORSE. its being so dry the individual hairs do not adhere to one another, they stand apart, and the animal has what is known as " a staring coat." Wlien, during a fever, sweating occurs, it is usually an indi- cation that the crisis is passed. Sometimes sweating is an indication of pain. A horse with tetanus or azoturia sweats profusely. Horses sweat freely wdien there is a serious impediment to respiration ; they sweat under excitement, and, of course, from the well-lmown physio- logical causes of heat and work. Local sweating, or sweating of a restricted area of the body, denotes some kind of nerve interference. Swellings of the skin usually come from wounds or other external causes and have no special connection with the diagnosis of internal diseases. There are, however, a number of conditions in which the swelling of the skin is a symptom of a derangement of some other part of the body. For example, there is the well-known " stocking," or swelling of the legs about the fetlock joints, in influenza. There is the soft swelling of the hind legs that occurs so often in draft horses when standing still and that comes from previous inflammation (lym- phangitis) or from insufficient heart power. Dropsy, or edema of the skin, may occur beneath the chest or abdomen from heart insuffi- ciency or from chronic collection of fluid in the chest or abdomen (hydrothorax, ascites, or anemia). In anasarca or purpura hemor- rhagica large soft swellings appear on any part of the skin, but usually on the legs, side of the body, and about the head. Gas collects under the skin in some instances. This comes from a local inoculation with an organism which produces a fermentation beneath the skin and causes the liberation of gas which inflates the skin, or the gas may be air that enters through a wound penetrating some air-containing organ, as the lungs. The condition here de- scribed is known as emphysema. Emphysema may follow the frac- ture of a rib when the end of a bone is forced inward and caused to penetrate the lung, or it may occur, when, as a result of an ulcerat- ing process, an organ containing air is perforated. This accident is more common in cattle than it is in horses. Emphysema is recog- nized by the fact that the swelling that it causes is not hot or sensi- tive on pressure. It emits a peculiar crackling sound when it is stroked or pressed upon. Wounds of the skin may be of importance in the diagnosis of internal disease. Wounds over the bony prominence, as the point of the hip, the point of the shoulder, and the greatest convexity of the ribs, occurs when a horse is unable to stand for a long time and, through continually lying upon his side, has shut off the circulation to the portion of the skin that covers parts of the body that carry the greatest weight, and in this way has caused them to mortify. Little, round, soft, doughlike swellings occur on the skin and may be scattered freely over the surface of the body when the horse is EXAMINATION OF A Sick HOKSE. 15 afflicted with urticaria. Similar eruptions, but distributed less gen- erally, about the size of a silver dollar, may occur as a symptom of dourine, or colt distemper. Hard lumps, from which radiate welt- like swellings of the lymphatics, occur in glanders, and blisterlike eruptions occur around the mouth and pasterns in horsepox. THE ORGANS OF CIRCULATION. The first item in this portion of the examination consists in taking the pulse. The pulse may be counted and its character may be de- termined at any point where a large artery occupies a situation close to t4ie skin and above a hard tissue, such as a bone, cartilage, or tendon. The most convenient place for taking the pulse of the horse is at the jaw. The external maxillary artery runs from between the jaws, around the lower border of the jawbone and up on tlie outside of the jawbone to the face. It is located immediately in front of the heavy muscles of the cheek. Its throb can be felt most distinctly just before it turns around the lower border of the jawbone. The balls of the first and second or of the second and third fingers should be pressed lightly on the skin over this artery when its pulsations are to be studied. The normal pulse of the healthy horse varies in frequency as follows : Stallion 28 to 32 beats per minute. Gelding 33 to 38 beats per minute. Mare 34 to 40 beats per minute. Foal 2 to 3 years old 40 to 50 beats per minute. Foal C to 12 months old 45 to 60 beats per minute. Foal 2 to 4 weeks old TO to 90 beats per minute. The pulse is accelerated by the digestion of rich food, by hot weather, exercise, excitement, and alarm. It is slightly more rapid in the evening than it is in the morning. Well-bred horses have a slightly more rapid pulse than sluggish, cold-blooded horses. The pulse should be regular ; that is. the separate beats should follow each other after intervals of equal length, and the beats should be of equal fullness, or volume. In disease, the pulse may become slower or more rapid than in health. Slowing of the pulse may be caused by old age, gi^eat exhaus- tion, or excessive cold. It may be due to depression of the central nervous system, as in dunnniness, or be the result of the administra- tion of drugs, such as digitalis or strophantus. A rapid pulse is almost always found in fever, and the more severe the infection and the weaker the heart the more rapid is the pulse. Under these con- ditions, the beats may rise to 80, 90, or even 120 per minute. "When the pulse is above 100 per minute the outlook for recovery is not promising, and especially if this symptom accompanies high tempera- 16 DISEASES OF THE HORSE. ture or occurs late in an infectious disease. In nearly all of the dis- eases of the heart and in anemia the pulse becomes rapid. The pulse is irregular in diseases of the heart, and especially where the valves are a.Sected. The irregularity may consist in varying inter- vals between the beats or tlie dropping of one or more beats at regu- lar or irregular intervals. The latter condition sometimes occurs in chronic diseases of the brain. The pulse is said to be weak, or soft, when the beats are indistinct, because little blood is forced through the artery by each contraction of the heart. This condition occurs when there is a constriction of the vessels leading from the heart and it occurs in certain infectious and febrile diseases, and is an indication of heart weakness. In examining the heart itself it is necessary to recall that it lies in the anterior portion of the chest slightly to the left of the median line and that it extends from the third to the sixth rib. It exends almost to the breastbone, and a little more than half of the distance between the breastbone and the backbone. In contracting, it rotates slightly on its axis, so that the point of the heart, which lies below, is pressed against the left chest wall at a place immediately^ above the point of the elbow. The heart has in it four chambers — two in the left and two in the right side. The upper chamber of the left side (left auri- cle) receives the blood as it comes from the lungs, passes it to the lower chamber of the left side (left ventricle), and from here it is sent with great force (for this chamber has A^ery strong, thick walls) through the aorta and its branches (the arteries) to all parts of the body. The blood returns through the veins to the upper chamber of the right side (right auricle), passes then to the lower chamber of the right side (right ventricle), and from this chamber is forced into the lungs to be oxidized. The openings between the chambers of each side and into the aorta are guarded by valves. If the horse is not too fat, one may feel the impact of the apex of the heart against the chest wall with each contraction of the heart by placing the hand on the left side back of the fifth rib and above the point of the elbow. The thinner and the better bred the horse is the more distinctly this impact is felt. If the animal is excited, or if he has just been exercised, the impact is stronger than when the horse is at rest. If the horse is weak, the impact is reduced in force. The examination of the heart w^ith the ear is an important matter in this connection. Certain sounds are produced by each contraction of the normal heart. It is customary to divide these into two, and to call them the first and second sounds. These two sounds are heard during each pulsation, and any deviation of the normal indicates some alteration in the structure or the functions of the heart. In making this examination, one may apply the left ear over the heavy muscles of the shoulder back of the shoulder joint, and just above the point of EXAMINATION OF A SK'K HORSE. 17 The elbow, or. if the sounds are not heard distinctly, the left fore leg may be drawn forward by an assistant and the right ear placed against the lower i)ortion of the chest wall that is exposed in this manner. The first sound of the heart occurs while the heart muscle is con- tracting and while the blood is being forced from the heart and the valves are rendered taut to j^revent the return of the blood from the lower to the upper chambers. The second sound follows quickly after the first and occurs during rebound of blood in the arteries, caus- ing pressure in the aorta and tensions of the valves guarding its open- ing into the left ventricle. The first sound is of a high pitch and is longer and more distinct than the second. Under the influence of disease these sounds may be altered in various ways. It is not profit- able, in a work sticli as this, to describe the details of these alterations. Those who are interested will find this subject fully discussed in the veterinary text-books. TEMPERATURE. The temperature of the horse is determined roughly by placing the fingers in the mouth or between the thighs or by allowing the horse to exhale against the cheek or liack of the hand. In accurate examina- tion, however, these means of determining temperature are not relied upon, but recourse is had to the use of the thermometer. The ther- mometer used for taking the temperature of a horse is a self-register- ing clinical thermometer, similar to that used by physicians, but larger, being from 5 to 6 inches long. The temperature of the animal is measured in the rectum. The normal temperature of the horse varies somewhat under differ- ent conditions. It is higher in the young animal than in the old, and is higher in hot weather than in cold. The Aveather and exercise de- cidedly influence the temj^erature physiologically. The normal tem- perature varies from 09.5° to 101° F. If the temperature rises to 102.5° the horse is said to have a low fever; if the teuij^erature reaches 104° the fever is moderate; if it reaches 100° it is high, and above this l^oint it is regarded as very high. In some diseases, such as tetanus or sunstroke, the temperature goes as high as 108° or 110°. In the ordinary infectious diseases it does not often exceed 100°. A tem- jierature of 107.5° and above is very dangerous and must be reduced promptly if the horse is to be saved. THE ORGANS OF RESPIRATION. In examining this system of organs and their functions it is custom- ary to begin by noting the fi-(Hpiency of the respiratory movements. This point can be determined by observing the motions of the nostrils or of the flanks: on a cohl day one can see the condensation of the moisture of the warm air as it comes from the lungs. The nornuil H. Doc. 795, 51)-2 2 18 DISEASES OF THE HORSE. rate of respiration for a healthy horse at rest is from 8 to 16 per min- ute. The rate is faster in young animals than in old, and is increased by work, hot weather, overfilling of the stomach, pregnancy, lying upon the side, etc. Acceleration of the respiratory rate where no physiological cause operates is due to a variety of conditions. Among these is fever ; restricted area of active lung tissue, from filling of por- tions of the lungs with inflammatory exudate, as in pneumonia ; com- pression of the lungs or loss of elasticity; pain in the muscles con- trolling the respiratory movements; excess of carbon dioxide in the blood ; and constriction of the air passages leading to the lungs. Difficult or labored respiration is known as dj'spnea. It occurs when it is difficult, for any reason, for the animal to obtain the amount of oxygen that it requires. This may be due to filling of the lungs, as in pneumonia ; to painful movements of the chest, as in rheu- jnatism or pleurisy; to tumors of the nose and paralysis of the throat, swellings of the throat, foreign bodies, or weakness of the respiratory jDassages, fluid in the chest cavity, adhesions between the lungs and chest walls, loss of elasticity of the lungs, etc. Where the difficulty is great the accessory muscles of respiration are brought into play. In great dyspnea the horse stands with his front feet apart, Avith his neck straight out, and his head extended upon his neck. The nostrils are widely dilated, the face has an anxious expression, the eyeballs j^rotrude, the up-and-down motion of the larynx is aggravated, the amplitude of the movement of the chest walls increased, and the flanks heave. The expired air is of about the temperature of the body. It con- tains considerable moisture, and it should come with equal force from each nostril and should not have an unpleasant odor. If the stream of air from one nostril is stronger than from the other, there is an in- dication of an obstruction in a nasal chamber. If the air possesses a bad odor, it is usually an indication of jDutrefaction of a tissue or secretion in some part of the respiratory tract. A bad odor is found where there is necrosis of the bone in the nasal passages or in chronic catarrh. An ulcerating tumor of the nose or throat may cause the breath to have an offensive odor. The most offensive breath occurs where there is necrosis, or gangrene, of the lungs. In some diseases there is a discharge from the nose. In order to determine the significance of the discharge it should be examined closely. One should ascertain whether it comes from one or both nostrils. If but from one nostril, it probably originates in the head. The color should be noted. A thin, watery discharge may be com- posed of serum, and it occurs in the earlier stages of coryza, or nasal catarrh. An opalescent, slightly tinted discharge is composed of mucus and indicates a little more severe irritation. If the discharge is sticky and pus-like, a deeper difficulty or more advanced irritation EXAMINATION OF A SICK HORSE, 19 is indicated. If the discharge contains flakes and chimps of more or less dried, agglutinated particles, it is probable that it originates within a cavity of the head, as the sinuses or guttural pouches. The discharge of glanders is of a peculiar sticky nature and adheres tenaciously to the wings of the nostrils. The discharge of pneumonia is of a somewhat red or reddish brown color, and, on this account, has been described as a prune- juice discharge. The discharge may contain blood. If the blood appears as clots or as streaks in the dis- charge, it probably originates at some point in the upper part of the respiratory tract. If the blood is in the form of a fine froth, it comes from the lungs. In examining the interior of the nasal passage one should remem- ber that the normal color of the mucous membrane is a rosy pink and that its surface is smooth. If ulcers, nodules, swellings, or tumors are found, these indicate disease. The ulcer that is characteristic of glanders is described fully in connection with the discussion of that disease. Between the lower jaws there are several clusters of lympathic glands. These glands are so small and so soft that it is difficult to find them by feeling through the skin, but when a suppurative dis- ease exists in the upper part of the respiratory tract these glands become swollen and easy to feel. They may become soft and break down and discharge as abscesses ; this is seen constantly in strangles. On the other hand, they may become indurated and hard from the proliferation of connective tissue and attach themselves to the jaw- bone, to the tongue, or to the skin. This is seen in chronic glanders. If the fflands are swollen and tender to pressure, it indicates that the disease causing the enlargement is acute ; if they are hard and insen- sitive, the disease causing the enlargement is chronic. The manner in which the horse coughs is of importance in diagno- sis. The cough is a forced expiration, following immediately upon a forcible separation of the vocal cords. The purpose of the cough is to remove some irritant substance from the respiratory passages, and it occurs when irritant gases, such as smoke, ammonia, sulphur vapor, or dust, have been inhaled. It occurs from inhalation of cold air if the respiratory passages are sensitive from disease. In laryngitis, bronchitis, and pneumonia, cough is very easily excited and occurs merely from accumulation of mucus and inflammatory product upon the irritated respiratory mucous membrane. If one wishes to deter- mine the character of the cough, it can easily be excited by pressing upon the larynx with the thumb and finger. The larynx should be pressed from side to side and the pressure removed the moment the horse commences to cough. A painful cough occurs in pleurisy, also in larvneitis. bronchitis, and bronchial pneumonia. Pain is shown by the efi'ort the animal exerts to repress the coiigh. The cough is not painful, as a rule, in the chronic diseases of the respiratory tract. 20 DISEASES OF THE HORSE. The force of the cough is considerable when it is not especially pain- ful and when the lungs are not seriously involved. Allien the lungs are so diseased that they can not be filled with a large volume of air, and in heaves, the cough is weak, as it is also in weak, debilitated animals. If mucus or pus is coughed out, or if the cough is accom- ])anied by a gurgling sound, it is said to be moist; it is dry when these characteristics are not present — that is, when the air in passing out passes over surface not loaded with secretion. In the examination of the chest we resort to fereussion and aus- cultation. "\A'lien a cask or other structure containing air is tapped upon, or percussed, a hollow sound is given forth. If the cask con- tains fluid, the sound is of a dull and of quite a different character. Similarly, the amount of air contained in the lungs can be estimated by tapping upon, or percussing, the walls of the chest. Percussion is practiced with the fingers alone or with the aid of a special percussion hammer and an object to strike upon known as a pleximeter. If the fingers are used, the middle finger of the left hand should be pressed firmly against the side of the horse and should be struck with the ends of the fingers of the right hand bent at a right angle so as to form a hammer. The percussion hammer sold by instrument makers is made of rubber or has a rubber tip, so that when the pleximeter, which is placed against the side, is struck the impact will not be accompanied by a noise. After experience in this method of exami- nation one can determine with a considerable degree of accuracy whether the lung contains a normal amount of air or not. If, as in pneumonia, air has been displaced by inflammatory product occupy- ing the air space, or if fluid collects in the lower part of the chest, the percussion sound becomes dull. If, as in emphysema or in pneu- mothorax, there is an excess of air in the chest cavity, the percussion sound becomes abnormally loud and clear. Auscultation consists in the examination of the lungs with the ear applied closely to the chest wall. As the air goes in and out of the lungs a certain soft sound is made which can be heard distinctly, especially upon inspiration. This sound is intensified by anything that accelerates the rate of respiration, such as exercise. This soft, rustling sound is known as vesicular murmur, and wherever it is heard it signifies that the lung contains air and is functionally active. The vesicular murmur is weakened when there is an inflammatory infiltration of the lung tissue or when the lungs are compressed by fluid in the chest cavity. The vesicular murmur disappears when air is excluded by the accumulation of inflammatory product, as in pneu- monia, and when the lungs are compressed by fluid in the chest cavity. The vesicular murmur becomes rough and harsh in the early stages of inflammation of the lungs, and this is often the first sign of the beginning of pneumonia. EXAMINATION OF A SICK HORSE. 21 By applying the ear over the lower part of the windpipe in front of the l3reastbone a somewhat harsh, blowing sonnd may be heard. This is known as the bronchial murmur and is heard in normal conditions near the lower part of the trachea and to a limited extent in the ante- rior portions of the lungs after sharp exercise. AAHien the bronchial murmur is heard over other portions of the lungs, it may signify that the lungs are more or less solidified by disease and the blowing bron- chial murmur is transmitted through this solid lung to the ear from a distant part of the chest. The bronchial murmur in an abnormal place signifies that there exists pneumonia or that the lungs are com- pressed by fluid in the chest cavity. Additional sounds are heard in the lungs in some diseased condi- tions. For example, when fluid collects in the air passages' and the air is forced through it or is caused to pass through tubes containing secretions or pus. Such sounds are of a gurgling or bubbling nature and are known as mucous rales. Mucous rales are spoken of as being large or small as they are distinct or indistinct, depending u]3on the quantity of fluid that is present and the size of the tube in which this sound is produced. Mucous rales occur in pneumonia after the selid- ified parts begin to break down at the end of the disease. They occur in bronchitis and in tuberculosis, where there is an excess of secretiou. Sometimes a shrill sound is heard, like the note of a whistle, fife, or flute. This is due to a dry constriction of the bronchial tubes and it is heard in chronic bronchitis and in tuberculosis. A friction sound is heard in pleurisy. This is due to the rubbing together of roughened surfaces, and the somid produced is similar to a dry rubbing sound that is caused by rubbing the hands together or by rubbing upon each other two dry, rough pieces of leather. THE EXAMINATION OF THE DIGESTIVE TRACT. The first point in connection with the examination of the organs of digestion is the appetite and the manner of takhig food and drink. A healthy animal has a good ai)petite. Loss of appetite does not point to a special diseased condition, but comes from a variety of causes. Some of these causes, indeed, may l)e looked upon as being physio- logical. Excitement, strange surroundings, fatigue, and hot weather may all cause loss of appetite. AVhere there is cerebral depression, fever, profound weakness, disorder of the stomach, or mechanical difficulty in chewing or swallowing, the appetite is diminished or destroyed. Sometimes there is an a])petite or desire to eat abnormal things, such as dirty bedding, roots of grass, soil, etc. This desire usually comes from a chronic disturbance of nutrition. Thirst is diminished in a good many mild diseases unaccompanied by distinct fever. It is seen where there is great exhaustion or depres- sion or profound l)rain disturbance. Thirst is increased after pro- 22 DISEASES OF THE HORSE. fuse sweating, in diabetes, diarrhea, in fever, at the crisis of infec- tions diseases, and when the month is dry and hot. Some diseases of the mouth or throat make it difficult for the horse to chew or swallow his food. Where difficulty in this respect is expe- rienced, the following-named conditions should be borne in mind and carefully looked for : Diseases of the teeth, consisting in decay, frac- ture, abscess formation, or overgrowth ; inflammatory conditions, or wounds or tumors of the tongue, cheeks, or lips ; paralysis of the mus- cles of chewing or swallowing; foreign bodies in upper part of the mouth between the molar teeth; inflammation of throat. Difficulty in swallowing is sometimes shown by the symptom known as " quid- ding." Quidding consists in dropping from the mouth well-chewed and insalivated boluses of food. A mouthful of hay, for example, after being ground and masticated, is carried to the back part of the mouth. The horse then finds that from tenderness of the throat, or from some other cause, swallowing is difficult or painful, and the bolus is then dropped from the mouth. Another quantity of hay is similarly prepared, only to be dropped in turn. Sometimes quidding is dwe to a painful tooth, the bolus being dropped from the mouth when the tooth is struck and during the pang that follows. Quid- ding may be practiced so persistently that a considerable pile of boluses of food accumulate in the manger or on the floor of the stall. In pharyngitis one of the symptoms is a return through the nose of fluid that the horse attempts to swallow. In some brain diseases, and particularly in chronic internal hydro- cephalus, the horse has a most peculiar manner of swallowing and of taking food. A similar condition is seen in hyperemia of the brain. In eating the horse will sink his muzzle into the grain in the feed box and eat for a while without raising the head. Long pauses are made while the food is in the mouth. Sometimes the horse will eat very rapidly for a little while and then slowly; the jaws may be brought together so forcibly that the teeth gnash. In eating hay the horse will stop at times with hay protruding from the mouth and stand stupidly, as though he has forgotten what he was about. In examining the mouth one should first look for swellings or for evidence of abnormal conditions upon the exterior: that is, the front and sides of the face, the jaws, and about the muzzle. By this means wounds, fractures, tumors, abscesses, and disease accompanied by eruptions about the muzzle may be detected. The interior of the mouth is examined by holding the head up and inserting the fingers through the interdental space in such a way as to cause the mouth to open. The mucous membrane should be clean and of a light-pink color, excepting on the back of the tongue, where the color is a yel- lowish gray. As abnormalities of this region, the chief are diffuse inflammation, characterized by redness and catarrhal discharge; local EXAMINATION OF A SICK HOESE. 23 inflammation, as from eruptions, ulcers, or Avounds; necrosis of the lower jawbone in front of the first back tooth; and swellings. For- eign bodies are sometimes found embedded in the mucous membrane lining of the mouth or lodged between the teeth. The examination of the pharynx and of the esophagus is made chiefly by pressing upon the skin covering these organs in the region of the throat and along the left side of the neck in the jugular gutter. Sometimes, when a more careful examination is necessary, an esoph- ageal tube or })robang is passed through the nose or mouth down the esophagus to the stomach. Vomiting is an act consisting in the expulsion of all or part of the contents of the stomach through the mouth or nose. This act is more difficult for the horse than for most of the other domestic animals, because the stomach of the horse is small and does not lie on the floor of the abdominal cavity, so that the abdominal walls in contracting do not bring pressure to bear upon it so directly and forcibly, as is the case in many other animals. Beside this, there is a loose fold of mucous membrane at the point where the esophagus enters the stom- ach, and this forms a sort of valve which does not interfere with the passage of food into the stomach, but does interfere with the exit of food through the esophageal opening. Still, vomiting is a symptom that is occasionally seen in the horse. It occurs when the stomach is very much distended with food or with gas. Distention stretches the mucous membrane and eradicates the valvular fold referred to, and also makes it possible for more pressure to be exerted upon the stom- ach through the contraction of the abdominal muscles. Since the distention to permit vomiting must be extreme, it not infrequently happens that it leads to rupture of the stomach walls. This has caused the impression in the minds of some that vomiting can not occur in the horse without rupture of the stomach, but this is incor- rect, since many horses vomit and afterwards Ix^come entirely sound. Aiter rupture of the stomach has occurred vomiting is impossible. In examination of the abdomen one should remember that its size depends largely upon the breed, sex, and conformation of the animal, and also upon the manner in which the animal has been fed and the use to which it has been put. A pendulous abdomen may l)e the result of an abdominal tumor or of an accumulation of fluid in the abdom- inal cavity; or, on the other hand, it may merely be an indication of pregnancy, or of the fact that the horse has been fed for a long time on bulkv and innutritions food. Pendulous abdomen occurring in a work horse kept on a concentrated diet is an abnormal condi- tion. The abdomen may increase suddenly in volume from accu- mulation of gas in tympanic colic. The abdomen becomes small and the horse is said to be " tucked up " from long-continued poor appe- tite, as in diseases of the digestive tract and in fever. This condi- 24 DISEASES OF THE HORSE. tioii also occurs in tetanus from the contraction of the abdominal walls and in diarrhea from emptiness. In applying the ear to the flank, on either the right or left side, certain bubbling sounds may be heard that are known as peristaltic sounds, because they are produced by peristalsis, or wormlike con- traction of the intestines. These sounds are a little louder on the right side than on the left on account of the fact that the large intes- tines lie in the right flank. Absence of peristaltic sounds is always an indication of disease, and suggests exhaustion or paralysis of the intestines. This may occur in certain kinds of colic and is an un- favorable symptom. Increased sounds are heard where the intes- tines are contracted more violently than in health, as in spasmodic colic, and also where there is an excess of fluid or gas in the intestinal canal. The feces show, to a certain extent, the thoroughness of digestion. They should show that the food has been well ground, and should, in the horse, be free from offensive odor or coatings of mucus. A coat- insf of mucus shows intestinal catarrh. Blood on the feces indicates severe inflammation. Very light color and bad odor may come from inactive liver. Parasites are sometimes in the dung. Rectal examination consists in examination of the organs of the pelvic cavity and posterior portion of the abdominal cavity by the hand inserted into the rectum. This examination should be attempted by a veterinarian only, and is useless except to one who has a good knowledge of the anatomj^ of the parts concerned. THE EXAMINATION OF THE NERVOUS SYSTEM. The great brain, or cerebrum, is the seat of intelligence, and it con- tains the centers that control motion in many parts of the body. The front portion of the brain is believed to be the region that is most important in governing the intelligence. The central and posterior portions of the cerebrum contain the centers for the voluntary motions of the face and of the front and hind legs. The growth of a tumor or an inflammatory change in the region of a center governing tlie motion of a certain part of the body has the effect of disturbing motion in that part by causing excessive contraction known as cramps, or inability of the muscles to contract, constituting the condition known as paralysis. The nerve paths from the cerebrum, and hence from these centers to the spinal cord and thence to the muscles, pass beneath the small brain, or the cerebellum, and through the medulla oblongata to the spinal cord. Interference with these paths has the effect of disturbing motion of the parts reached by them. If all of the paths on one side are interfered with, the result is paralysis of one side of the body. The small brain, or cerebellum, governs the regularity, or coordi- EXAMINATION OF A SICK HOESE. 25 nation, of movements. Disturbances of the cerebellum cause a totter- ing, uncertain gait. In the medulla oblongata, which lies between the spinal cord and the cerebellum, are the centers governing the circula- tion and breathing. The spinal cord carries sensory messages to the brain and motor impressions from the brain. The anterior portions of the cord con- tain the motor paths, and the posterior portions of the cord contain the sensory paths. Paralysis of a single member or a single group of muscles is known as monoplegia and results from injury to the motor center or to a nerve trunk leading to the part that is involved. Paralysis of one- half of the body is knoAvn as hemiplegia and results from destruction or severe disturbances of the cerebral hemisphere of the opposite side of the body or from interference with nerve paths between the cere- bellum, or small brain, and the spinal cord. Paralysis of the poste- rior half of the bod}^ is known as paraplegia and results from de- rangement of the spinal cord. If the cord is pressed upon, cut, or iujiu-ed, messages can not be transmitted beyond that point, and so the posterior part becomes paralyzed. This is seen when the back is fractured. Abnormal mental excitement may be due to congestion of the brain or to inflammation. The animal so afflicted becomes vicious, pays no attention to commands, cries, runs about in a circle, stamps with the feet, strikes, kicks, etc. This condition is usually followed by a dull, stupid state, in which the animal stands with his head down, dull and irresponsive to external stimuli. Cerebral depression also occurs in the severe febrile infectious diseases, in chronic hydrocephalus, in chronic diseases of the liver, in poisoning with a narcotic substance, and with chronic catarrh of the stomach and intestines. . Fainting is a symptom that is not often seen in horses. When it occurs it is shown by unsteadiness of gait, tottering, and, finally, in- ability to stand. The cause usually lies in a defect of the small brain, or cerebellum. This defect nuiy be merely in respect of the blood supply, to congestion, or to anemia, and in this case it is likely to pass aAvay and may never return, or it may be due to some jiernuinent cause, as a tumor or an abscess, or it may result from a hemorrhage, from a defect of the valves of the heart, or from poisoning. Loss of consciousness is known as conui. It is caused by hemor- I'hage in the bi-ain. by |)rofound exhaustion, or may result from a saturation of the system with the poison of some disease. Coma may follow upon cerebral dcjU'ession, which occurs as a secondary state of iuHannnation of the brain. AVhere the sensibility of a part is increased the condition is known as hyperesthesia, and where it is lost — that is, when; there is no feel- ing or knowledge of pain — the condition is known as anesthesia. The 26 DISEASES OF THE HORSE. former usually accompanies some chronic diseases of the spinal cord or the earlier stages of irritation of a nerve trunk. Hyperesthesia is difficult to detect in a nervous, irritable animal, and sometimes even in a horse of less sensitive temperament. An irritable, sensitive spot may be found surrounded by skin that is not sensitive to pressure. This is sometimes a symptom of beginning of inflammation of the brain. Anesthesia occurs in connection with cerebral and spinal paralysis, section of a nerve trunk leading to a part, in severe mental depression, and in narcotic poisoning. ITRIXARY AND SEXUAL ORGANS. In considering the examination of the urinary and sexual organs we may consider, at the beginning, a false impression that prevails to an astonishing extent. Many horsemen are in the habit of pressing upon the back of a horse over the loins or of sliding the ends of the fingers along on either side of the median line of this region. If the horse depresses his back it is at once said " his kidne3^s are weak."- Nothing could be more absurd or further from the truth. Any healthy horse — any horse with normal sensation and with a normally flexible back — will cause it to sink when manipulated in this way. If the kidneys are inflammed and sensitive, the back is held more rigidly and is not depressed under this pressure. To examine the kidneys by pressure the pressure should be brought to bear over these organs. The kidneys lie beneath the ends of tlie transverse processes of the vertebrae of the loins and beneath the hind- most ribs. If the kidneys are actually inflamed and especially sensi- tive, pressure or light blows applied here may cause the horse to shrink. The physical examination of the sexual and generative organs is made in large part through the rectum, and this portion of the exami- nation should be carried out by a veterinarian only. By this means it is possible to discover or locate cysts of the kidneys, urinary calculi in the ureters, bladder, or upper urethra, malformations, and acute inflammations accompanied by pain. The external genital organs are swollen, discolored, or show a discharge as a result of local disease or from disease higher in the tract. The manner of urinating is sometimes of considerable diagnostic importance. Painful urination is shown by frequent attempts, dur- ing which but a small quantity of urine is passed; by groaning, by constrained attitude, etc. This condition comes from inflammation of the bladder or urethra, urinary calculi (stones of the bladder or urethra), hemorrhage, tumors, bruises, etc. The urine is retained from spasms of the muscle at the neck of the bladder, from calculi, inflammatory growths, tumors, and paralysis of the bladder. The urine dribbles without control when the neck of the bladder is weakened or paralyzed. This condition is seen after the bladder is EXAMINATION OF A SICK HORSE. 27 Aveakened from long-continued retention and where there is a partial paralysis of the hind quarters. Horses usually void urine five to seven times a day, and pass from 4 to 7 quarts. Disease may be shown by increase in the number of voidings or of the quantity. P'requent urination indicates an irri- table or painful condition of the bladder or urethra or that the quan- tity is excessive. In one form of chronic inflammation of the kidneys (interstitial nephritis) and in polyuria the quantity may be increased to 20 or 30 quarts daily. Diminution in the quantity of urine comes from profuse sweating, diarrhea, high fever, weak heart, diseased and nonsecretine: kidnevs, or an obstruction to the flow. The urine of the healthy horse is a pale or at times a slightly red- dish yellow. The color is less intense when the quantity is large, and is more intense wlien the quantity is diminished. Dark-brown urine is seen in azoturia and in severe acute muscular rheumatism. A brownish-green color is seen in jaundice. Red color indicates admix- ture of blood from a bleeding point at some part of the urinary tract, usually in the kidneys. The urine of the healthy horse is not clear and transparent. It contains mucus, which causes it to be slightly thick and stringy, and a certain amount of undissolved carbonates, causing it to be cloudy. A sediment collects when the urine is allowed to stand. The urine of the horse is normally alkaline. If it becomes acid the bodies in sus- pension are dissolved and the urine is made clear. The urine may be unusually cloudy from the addition of abnormal constituents, but to determine their character a chemical or microscopic examination is necessary. Red or reddish flakes or clumps in the urine are always abnormal, and denote a hemorrhage or suppuration in the urinary tract. The normal specific gravity of the urine of the horse is about 1.040. It is increased when the urine is scanty and decreased when the quantity is excessive. Acid reaction of the urine occurs in chronic intestinal catarrh, in high fever, and during starvation. Chemical and microscopic tests and examinations are often of great importance in diagnosis, but require special apparatus and skill. Other points in the examination of a sick horse require more discus- sion than can be afforded in this connection, and require sj^ecial train- ing on the part of the examiner. Among such points may be men- tioned the examination of the organs of s])ecial sense, the examination of tlu> blood, the microscopic examination of the secretions and excre- tions, bacteriological examinations of the secretions, excretions, and tissues, specific reaction tests, and diagnostic inoculation. METHODS OF ADMINISTERING MEDICINES. By, Ch. B. Michener. V. S. [Revised in 1003 by Leonard Pearson, B. S., V. M. D.] Medicine msij enter the body through any of the following desig- nated channels: First, by the mouth; second, by the air passages; third, by the skin ; fourth, by the tissue beneath the skin (hypodermic methods) ; fifth, by the rectum; sixth, by the genito-urinary passages; and, seventh, by the blood (intravenous injections). (1) By the mouth. — Medicines can be given by the mouth in the form of solids, as powders or pills ; liquids, and pastes, or electuaries. Solids administered as jwicders should be as finely pulverized as possible, in order to secure rapid solution and absorption. Their action is in this way facilitated and intensified. Powders must be free from any irritant or caustic action upon the mouth. Those that are* without any disagreeable taste or smell are readily eaten with the feed or taken in the drinking water. When placed with the feed they should first be dissolved or suspended in water and thus sprinkled on the feed. If mixed dry the horse will often leave the medicine in the bottom of his manger. Nonirritant poAvders may be given in capsules, as balls are given. Pills, or "^«?Zs," when properly made, are cylindrical in shape, 2 inches in length and about three-fourths of an inch in diameter. They should be fresh, but if necessary to keep them some time they should be made up with glycerin, or some such agent, to prevent their becoming too hard. Very old, hard balls are sometimes passed whole with the manure without being acted upon at all. Paper is sometimes wrapped around balls when given, if they are so sticky as to adhere to the fingers or the balling gun. Paper used for this pur- pose should be thin but firm, as the tougher tissue papers. Balls are preferred to drenches when the medicine is extremely disagreeable or nauseating ; when the dose is not too large : when the horse is difficult to drench ; or when the medicine is intended to act slowly. Certain medicines can not or should not be made into balls, as medicines requiring to be given in large doses, oils, caustic substances, unless in small dose and diluted and thoroughly mixed with the vehicle, deli- quescent, or efflorescent salts. Substances suitable for balls can be made up by the addition of honey, sirup, soap, etc., when required 28 METHODS OF ADMINISTERING MEDICINES, 29 for immediate use. (ielatiii capsules of differeut sizes are now obtaiu- able and are a convenient means of giving- medicines in ball form. Liquids may be given as drenches Avhen the dose is large, or they may, when but a small quantity is administered, be injected into the mouth with a hard-rubber syringe or be poured upon the tongue from a small phial. Pastes, or electuaries^ are medicines mixed with licorice-root pow- der, ground flaxseed, molasses, or sirup to the consistency of honey, or a " soft solid." They are intended, chiefly, to act locally upon the mouth and throat. They are given by being spread upon the tongue, gums, or teeth with a wooden paddle or strong long-handled spoon. When balls are to be given we should observe the following direc- tions: In shape they shoidd be cylindrical, of the size above men- tioned, and soft enough to be easily compressed by the fingers. If made roinid or egg-shaped, if too long or too hard, they are liable to become fixed in the gullet and cause choking. Balls may be given with the '"balling gun" (obtainable at any veterinary instrument maker's) or by the hand. If given by the hand a mouth speculum or gag may be used to prevent the animal fi'om biting the hand or crush- ing the ball. Always loosen the horse before attempting to give a ball; if tied he may break his halter and injure himself or the one giving the ball. With a little practice it is much easier to give a ball Avithout the mouth gag, as the horse always fights more or less against having his mouth forced open. The tongue must be firmly grasped with the left hand and gently pulled forward ; the ball, slightly moist- ened, is then to be placed with the tips of the fingers of the right hand as far back into the mouth as possible: as the tongue is loosened it is drawn back into the mouth and carries the ball backward with it. The mouth should be kept closed for a minute or two. We should always have a pail of water at hand to offer the horse after balling. This precaution will often prevent him from coughing out the ball or its becoming lodged in the gullet. It is, very often, impossible to get balls properly made, or to induce owners or attendants to attempt to give them, and for these reasons medicines by the mouth are mostly given in the form of liquids. AMien medicine is to be given as a drench we must be careful to use enough water or oil to dissolve or dilute it thoroughly : more than this makes the drench bulky and is unnecesary. Insoluble medicines, if not irritant or corrosive, may be given simply suspended in water, the bottle to be well shaken immediately before giving the drench. The bottle used for drenching purposes should be clean, strong, and smooth about its neck; it should be without shoulders, taix^ring, and of a size to suit the amount to be given. A horn or tin lx)ttle may be better, because they are not so easily broken by the teeth. If the dose is a small one the horse's head may be held up by the left hand, while 30 DISEASES OF THE HORSE. the medicine is poured into the mouth by the right. The left thumb is to be placed in the angle of the lower jaw, and the fingers spread out in such a manner as to support the lower lip. Should the dose be large, the horse ugly, or the attendant unable to support the head as directed above, the head is then to be held up by running the tines of a long-handled wooden fork under the noseband of the halter or the halter strap or a rope may be fastened to the noseband and thrown over a limb, beam, or through a pulley suspended from the ceiling. Another way of supporting the head is to place a loop in the end of a rope, and introduce this loop into the mouth just behind the upper front teeth or tusks of the upper jaw, the free end to be run through a pulley, as before described, and held by an assistant. It is never to be fastened, as the horse might in that case do himself serious injury. The head is to be elevated just enough to prevent the horse from throwing the liquid out of his mouth. The line of the face should be horizontal, or only the least bit higher. If the head is drawn too high the animal can not swallow with ease or even with safety. (If this is doubted, just fill your mouth with water, throw back the head as far as possible, and then try to swallow.) The person giving the drench should stand on some object in order to reach the horse's mouth— on a level, or a little above it. The bottle or horn is then to be intro- duced at the side of the mouth, in front of the molar teeth, in an upward direction. This will cause the horse to open his mouth, when the base of the bottle is to be elevated, and about 4 ounces of the liquid allowed to escape on the tongue as far back as possible, care being taken not to get the neck of the bottle between the back teeth. The bottle is to be immediately removed, and if the horse does not swallow this can be encouraged by rubbing the fingers or neck of the bottle against the roof of the mouth, occasionally removing them. As soon as this is swallowed repeat the operation until he has taken all the drench. If coughing occurs, or if, by any mishap, the bottle should be crushed in the mouth, lower the head immediately. Do not rub, pinch, or pound the throat nor draw out the tongue when giving a drench. These processes in no way aid the horse to swallow and oftener do harm than good. In drenching, swallowing may be hastened by pouring into the nose of the horse, while the head is high, a few teaspoonfuls of clean water, but drenches must never he given through the nose. Large quantities of medicine given by pour- ing into the nose are liable to strangle the animal, or, if the medicine is irritating, it sets up an inflammation of the nose, fauces, windpipe, and sometimes the lungs. Cattle are easily drenched by holding them by the nose with the left hand, while the medicine is poured into the mouth with the right. Balls are not to be given to cattle, for they are likely to become METHODS OF ADMINISTERING MEDICINES. 31 embedded in the great mass of food in the stomach and act tardily if at all. (2) Medicines are administered to the lungs and upper air passages by insufflation, inhalation, injection, and nasal douche. • ' Insii-ffiatlon consists of blowing an impalpable powder directly into the nose. It is but rarely resorted to. Gaseous and volatile medicines are given by in halation^ as is also medicated steam, or vapor. Of the gases used there may be men- tioned, as the chief ones, sulphurous acid gas and, occasionally, chlo- rine. The animal or animals are to be placed in a tight room, where these gases are generated until the atmosphere is sufficiently impreg- nated with them. Volatile medicines — as the anesthetics (ether, chlo- roform, etc.) — are to be given by the attending surgeon only. Medi- cated vapors are to be inhaled by placing a bucket containing hot water, vinegar and water, scalded hay or bran, to which carbolic acid, iodine, creolin, compound tincture of benzoin, or other medicines have been added, in the bottom of a long grain bag. The horse's nose is to be inserted into the top of the bag, and he thus inhales the " medicated steam." Care must be taken not to have this hot enough to scald the animal. The vapor from scalding bran or hay is often thus inhaled to favor discharges in sore throat or " distemper." Injections are made into the trachea by means of a hypodermic syringe. This method of medication is used for the purpose of treat- ing local diseases of the trachea and upper bronchial tubes. It has also been used as a mode of administering remedies for their constitu- tional effect, but is now rarely used for this purpose. The naml douche is employed by the veterinarian in treating some local diseases of the nasal chambers. Special appliances and profes- sional knowledge are necessary when using liquid medicines by this method. It is not often resorted to, even by veterinary surgeons, since, as a rule, the horse objects very strongly to this mode of medi- cation. (3) By the skin. — Medicines are often administered to our hair- covered animals by the skin, yet care nuist be taken in applying some medicines — as tobacco water, carbolic-acid solutions, strong creolin solutions, mercurial ointment, etc. — over the entire body, as poison- ing and death follow in some instances from absorption through the skin. For the same reasons care must also be exercised and poisonous medicines not applied over very large raw or abraded surfaces. AVith domestic animals medicines are only to be applied by the skin to allay local pain or cure local disease. (4) By the TISSUE beneath the skin ( hypodermatic method). — Medicines are frexijuently given by the hypodermic syringe under the skin. It is not safe for any but medical or veterinary practitioners 32 DISEASES OF THE HORSE. to use this form of medication, since the medicines thus given are pow- erfnl poisons. There are many precautions to be observed, and a knowledge of anatomy is indispensable. One of the chief precautions has to do with the sterilization of the syringe. If it is not sterile an abscess may be produced. (5) By the rectu^i. — Medicines may be given by the rectum when they can not be given by the mouth, or when they are not retained in the stomach ; when we want a local action on the last gut ; when it is desired to destroy the small worms infesting the large bowels or to stimulate the peristaltic motion of the intestines and cause evacuation. Medicines are in such cases given in the form of suppositories or as liquid injections (enemas). Foods may also be given in this way. Sufpositories are conical bodies made up of oil of theobroma and opium (or whatever medicine is indicated in special cases), and are introduced into the rectuin or vagina to allay irritation and pain of these parts. They are not much used in treating horses. Enemas^ when given for absorption, should be small in quantity, neutral or slightly acid in reaction, and of a temperature of from 90° to 100° F. These, like foods given by the rectum, should be intro- duced only after the last boAvel has been emptied by the hand or by copious injections of tepid water. Enemas, or clysters, if to aid the action of physics, should be in quantities sufficient to distend the bowel and cause the animal to eject them. Simple Avater, salt and water, or soap and water, in quantities of a gallon or more, may be given every half hour. It is best that the horse retain them for some little time, as the liquid serves to moisten the dung and favor a pas- sage. Stimulating enemas^ as glycerin, should be administered after those already mentioned have emptied the last bowel, with the piu-- pose of still further increasing the natural motion of the intestines and aiding the purging medicine. Liquids may be thrown into the rectum by the means of a large syringe or a pump. A ver}^ good " irrigator " can be bought of any tinsmith at a trifling cost, and should be constantly at hand on every stock farm. It consists of a funnel about 6 inches deep and 7 inches in diameter, which is to be furnished with a prolongation to which a piece of rubber hose, such as small garden hose, 4 feet long may be attached. The hose, well oiled, is to be inserted gently into the rec- tum about '1 feet. The liquid to be injected may then be poured in the funnel and the i)ressure of the atmosphere will force it into the bowels. This appliance is better than the more complicated and expensive ones. Ordinary cold water or even ice-cold water is highly recommended by many as a rectal injection for horses overcome by the excessive heat of sunnner, and may be given by this simple pipe. METHODS OF ADMINISTERING MEDICINES. 33 (C.) By the genito-urinary passages. — This method of medication is especially nsefid in treating local diseases of the genito-nrinary organs. It finds its chief application in the injection and cleansing of the nterus and vagina. For this purpose a large syringe or the irrigator described above may be used. (7) By the blood. — Injections directly into veins are to be prac- ticed by medical or veterinary practitioners only, as are probably some other means of giving medicines — intratracheal injections, etc. H. Doc. 70,5, ,59-2 3 DISEASES OF THE DIGESTIVE ORGANS. By Ch. B. Michenek, V. S. [Revised in 1903 by Leonard Pearson, B. S., V. M. D.] It will not prove an easy task to write " a plain account of the common diseases, with directions for preventive measures, hygienic care, and the simpler forms of medical treatment," of the digestive organs of the horse. This study includes a careful consideration of the food and drink of our animals, their quality, quantity, analyses, etc. This, of itself, is material for a book. Being limited as to space, the endeavor must be made to give simply an outline — to state the most important facts — leaving many gaps, and continually check- ing the disposition to write anything like a full description as to cause, prevention, and modes of treatment of disease. These articles are addressed entirely to farmers and stock owners, and I must ask my professional brethren to bear this in mind when they are disposed to complain of a want of scientific treatment of the subjects. WATER. It is generally held, at least in practice, that any water that stock can be induced to drink is sufficiently pure for their use. This prac- tice occasions losses that would startle us if statistics were at hand. Water that is impure from the presence of decomposing organic mat- ter, such as is found in wells and ponds in close proximity to manure heaps and cesspools, is frequently the cause of diarrhea, dysentery, and many other diseases of stock, while water that is impregnated with different poisons and contaminated with specific media of con- tagion produces death in very many instances. Considering first the quantity of water required by the horse, it may be stated that when our animals have access to water continually they never drink to excess. Were the horse subjected to.ship voyages or any other circumstances where he must depend upon his attendant for the supply of water, it may be roughly stated that each horse requires a daily average of about 8 gallons of water. This will vary somewhat upon the character of his food; if upon green food, less water will be needed than when fed upon dry hay and grain. The time of giving water should be carefully studied. At rest, the horse should receive water at least three times a day ; when at work, more frequently. The rule should be to give in small quantities and often. There is a popular fallacy that if a horse is warm he should not be allowed to drink, many claiming that the first swallow of water 84 DISEASES OF THE DIGESTIVE ORGANS, 35 " founders '' the animal or produces colic. This is erroneous. No matter how warm a horse may be, it is always entirely safe to allow him from six to ten swallows of water. If this is given on going into the stable, he should be given at once a pound or two of hay and allowed to rest about an hour before feeding. If water be now offered him it will in many cases be refused, or at least he will drink but sparingly. The danger, then, is not in the " first swallow " of water, but is due to the excessive quantity that the animal will take when warm if he is not restrained. Water should never be given to horses when it is ice cold. It may not be necessary to add hot water, but we should be careful in placing water troughs about our barns to have them in such position that the sun may shine upon the water during the winter mornings. Water, even though it be thus cold, seldom produces serious trouble if the horse has not been deprived for a too great length of time. In reference to the jjurity of water, Smith, in his " Veterinary Hy- giene," classes spring water, deep-well water, and upland surface water as wholesome; stored rain water and surface water from culti- vated land, as suspicious; river water to which sewage gains access and shallow-well water, as dangerous. The water that is used for drinking purposes for stock so largely throughout some States can not but be impure. I refer to those sections where there is an imper- vious clay subsoil. It is the custom to scoop, or hollow out, a large basin in the pastures. During rains these basins become filled with water. The clay subsoil, being almost impervious, acts as a jug, and there is no escape for the water except by evaporation. Such water is stagnant, but would be kept comparatively fresh by subsequent rains were it not for the fact that much organic matter is carried into it by surface drainage during each succeeding storm. This or- ganic matter soon undergoes decomposition, and, as the result, we find diseases of different kinds much more prevalent where this water is drunk than where the water supply is wholesome. Again, it must not be lost sight of that stagnant surface water is much more certainly contaminated than is running water by one diseased animal of the herd, thus eudangering the remainder. The chief impurities of water may be classified as organic and inorganic. The organic impurities are either animal or vegetable substances. The salts of the metals are the inorganic impurities. Lime causes hardness of water, and occasion will be taken to speak of this when describing intestinal concretions. Salts of lead, iron, and copper are also frequently found in water, and will be referred to hereafter. About the only examination of water that can be made by the aver- age stock raiser is to observe its taste, color, smell, and clearness. Pure water is clear and is without taste or smell. 36 DISEASES OF THE HOESE. Chemical and microscopic examination will frequently be neces- sary in order to detect the presence of certain poisons, bacteria, etc., and can, of course, be conducted by experts only. FOODS AND FEEDING. In this place one can not attempt anything like a comprehensive discussion of the subject of foods and feeding, and I must content my- self with merely giving a few facts as to the different kinds of food, preparation, digestibility, proper time of feeding, quality, and quan- tity. Improper feeding and watering will doubtless account for over one-half of the digestive disorders met with in the horse, and hence the reader can not fail to see how very important it is to have some proper ideas concerning these subjects. KINDS OF FOOD. In this country horses are fed chiefly upon hay, grass, corn fodder, roots, oats, corn, wheat, and rye. Many think that they could be fed on nothing else. Stewart, in " The Stable Book," gives the following extract from Loudon's Encyclopedia of Agriculture, which is of interest at this point : In some sterile countries they [horses] are forced to subsist on dried fish, and even on vegetable mold ; in Arabia, on milk, flesh balls, eggs, broth. In India horses are variously fed. The native grasses are judged very nutritious. Few, perhaps no, oats are grown ; barley is rare, and not commonly given to horses. In Bengal a vetch, something like the tare, is used. On the western side of India a sort of pigeon pea, called gram {Cicer arietinum) , forms the ordinary food, with grass while in season, and hay all the year round. Indian corn or rice is seldom given. In the West Indies maize, guinea corn, sugar-corn tops, and sometimes molasses are given. In the Mahratta country salt, pepper, and other spices are made into balls, with flour and butter, and these are supposed to produce animation and to fine the coat. Broth made from sheep's head is sometimes given. In France, Spain, and Italy, besides the grasses, the leaves of limes, vines, the tops of acacia, and the seeds of the carob tree are given to horses. For information as to the nutritive value, chemistry, and classifica- tion of the different kinds of food, I will refer the reader to Jordan's or Armsby's book on feeding animals, or to " Smith's Veterinary Hygiene." We can not, however, leave aside entirely here a consideration of the digestibility of foods; and by this we mean the readiness with which foods undergo those changes in the digestive canal that fit them for absorption and deposition as integral parts of the animal economy. The age and health of the animal will, of course, modify the diges- tibility of foods, as will also the manner and time of harvesting, pre- serving, and preparing the foods. In the horse digestion takes place principally in the intestines, and here, as in all other animals and with all foods, it is found that a FOODS AND FEEDING. 37 certain part only of the provender is digested ; another portion is undigested. This proportion of digested and undigested food must claim passing notice at least, for if the horse receives too much food, or bulky food containing much indigestible waste, a large portion of food must pass out unused, entailing not only the loss of this unused food, but also calling for an unnecessary expenditure of vital force on the part of the digestive organs of the horse. It is thus that, in fact, too much food may make an animal poor. In selecting food for the horse we should remember the anatomical arrangement of the digestive organs, as well as the physiological functions performed In^ each one of them. Foods must be whole- some, clean, and sweet, the hours of feeding regular, the mode of preparation found b}^ practical experience to be the best must be adhered to, and cleanliness in preparation and administration must be observed. The length of time occupied by stomach digestion in the horse varies with the different foods. Hay and straw pass out of the stom- ach more rapidly than oats. It would seem to follow, then, that oats should be given after hay, for if reversed the hay would cause the oats to be sent onward into the intestines before being fuUv acted upon by the stomach, and as a result produce indigestion. Experi- ence confirms this. There is another good reason whv hav should be given first, particularly if the horse is very hungry or if exhausted from overwork, namely, it requires more time in mastication (insur- ing proper admixture of saliva) and can not be bolted, as are the grains. In either instance water must not be given soon after feed- ing, as it washes or sluices the food from the stomach before it is fitted for intestinal digestion. The stonuich begins to empty itself very soon after the commence- ment of feeding, and continues rapidly while eating. Afterwards the passage is slower, and several hours are required before the stom- ach is entireh' empty. The nature of the work required of the horse must guide us in the selection of his food. Rapid or severe labor can not be performed on a full stomach. For such labor food must be given in small quantity and about two hours before they go to work. Even horses intended for slow^ work must never be engorged with bulky, innutritions food immediately before going to labor. The small stonuich of the horse would seem to lead us to the conclusion that this animal should be fed in small quantities and often, which, in reality, should be done. The disproportion between the size of the stomach and the amount of water drank tells us plainly that the horse should always be watered before feeding. One of the common errors of feeding, and the one that produces more digestive disorders than any other, is to feed too soon after a hard dny''s iforl'. This must never be done. If n horse is completely jaded, it will be found 38 DISEASES OF THE HORSE. beneficial to give him an alcoholic stimulant on going into the stable. A small quantity of hay may then be given, but his grain should be withheld for one or two hours. These same remarks will apply with equal force to the horse that for any reason has been fasting for a long time. After a fast, feed less than the horse would eat; for if allowed too much the stomach becomes engorged, its walls paralyzed, and " colic " is almost sure to follow\ The horse should be fed three or four times a day. It will not answer to feed him entirely upon concentrated food. Bulky food must be given to detain the grains in their passage through the intestinal tract ; bulk also favors distention, and thus mechanically aids absorption. For horses that do slow work for the greater part of the time, chopped or cut hay fed with crushed oats, ground corn, etc., is the best manner of feed- ing, as it gives the required bulk, sav«s time, and half the labor of feeding. Sudden changes of diet are always dangerous. When desirous of changing the food, do so very gradually. If a horse is accustomed to oats, a sudden change to a full meal of corn will almost always sicken him. If we merely intend to increase the quantity of the usual feed, this also must be done gradually. The quantity of food given must always be in proportion to the amount of labor to be performed. If a horse is to do a small amount of work, or rest entirely from work for a few days, see that he receives a proportionate amount of feed. If this should be observed even on Saturday night and Sunday, there would be fewer cases of " Monday morning sickness," such as colics and lymphangitis. Foods should also be of a more laxative nature when the horse is to stand for some days. Musty or moldy foods. — Above all things, avoid feeding musty or moldy foods. These are very frequent causes of disease of different kinds. Lung trouble, such as bronchitis and " heaves," often follows the use of such food. The digestive organs always suffer from moldy or musty foods. Musty hay is generally considered to produce dis- order of the kidneys; and all know of the danger to pregnant ani- mals from feeding upon ergotized grasses or grains. It has often been said to produce that peculiar disease known variously as cere- bro-spinal meningitis, putrid sore throat, or choking distemper. Leaving these somewhat general considerations, I will refer briefly to the different kinds of foods : Hay. — The best hay for horses is timothy. It should be about one year old, of a greenish color, crisp, clean, fresh, and possessing a sweet, pleasant aroma. Even this good hay, if kept for too great a length of time, loses part of its nourishment, and, while it may not be positively injurious, it is hard, dry, and indigestible. New hay is difficult to digest, produces much salivation (slobbering) and occa- FOODS AND FEEDING. 39 sional purging and irritation of the skin. If fed at all, it should be mixed with old hay. Second crop^ or aftermath. — This is not considered good hay for horses, but it is prized by some farmers as a good food for milch cows, the claim being made that it increases the flow of milk. The value of hay depends upon the time of cutting, as well as care in the curing. Hay should be cut when in full flower, but before the seeds fall ; if left longer, it becomes dry and woody and lacks in nutrition. An essential point in making hay is that when the crop is cut it should remain as short a time as possible in the field. If left too long in the sun it loses color, flavor, and dries or wastes. Smith asserts that one hour more than is necessary in the sun causes a loss of 15 to 20 per cent in the feeding value of hay. It is impossible to state any fixed time that hay must have to cure, this depending, of course, upon the weather, thickness of the crop, and many other cir- cumstances ; but it is well known that, in order to preserve the color and aroma of hay, it should be turned or tedded frequently and cured as quickly as possible. On the other hand, hay spoils in the mow if harvested too green, or when not sufficiently dried. Moav- burnt hay produces disorder of the kidneys and bowels and causes tho horse to fall ofl^ in condition. The average horse on grain should be allowed from 10 to 12 pounds of good hay a day. It is a mistake of many to think that horses at light work can be kept entirely on hay. Such horses soon become pot-bellied, fall otf m flesh, and do not thrive. The same is true of colts; unless the latter are fed with seme grain the}^ grow up to be long, lean, gawky creatures, and never make as good horses as those accustomed to grain with, or in addition to, their hay. Straw. — The straws are not extensively fed in this country, and when used at all they should be cut and mixed with hay and ground or crushed grain. Wheat, rye, and oat straw are the ones most used, and of these oat straw is most easily digested and contains the most nourishment. Pea and bean straw are occasionally fed to horses, the pea being preferable, according to most writers. Chaff. — Wheat and rye chaff should never be used as a food for horses. The beards frequently become lodged in the mouth or throat and are productive of more or less serious trouble. In the stomach and intestines they often serve as the nucleus of the " soft concre- tions," which are to be described when treating of obstructions of the digestive tract. Oat chalf, if fed in small quantities and mixed with cut hay or corn fodder, is verv much relished by horses. It is not to be given in large quantities, as I have repeatedly witnessed a troublesome and sometimes fatal diarrhea following the practice of allowing horses or cattle free access to a pile of oat chaff. 40 DISEASES OF THE HOESE. Grains. — Oats take precedence of all grains as a food for horses, as the ingredients necessary for the complete nutrition of the body exist in them in the best proportions. Oats are, besides, more easily digested and a larger proportion absorbed and converted into the various tissues of the body. Care must be taken in selecting oats. According to Stewart, the best oats are one year old, plump, short, hard, clean, bright, and sweet. New oats are indigestible. Kiln- dried oats are to be refused, as a rule, for even though originally good this drying process injures them. Oats that have sprouted or fer- mented are injurious and should never be fed. Oats are to be given either whole or crushed — whole in the majority of instances; crushed to old horses and those having defective teeth. Horses that bolt their feed are also best fed upon crushed oats and out of a manger large enough to permit of spreading the grain in a thin layer. The average horse requires, in addition to the allowance of hay above mentioned, about 12 quarts of good oats daily. The best oats are those cut about one week before being fully ripe. Not only is the grain richer in nutritive materials at this time, but there is also less waste from " scattering " than if left to become dead ripe. Moldy oats, like hay and straw, not only produce serious digestive disorders, but have been the undoubted cause of outbreaks of that dread disease in horses, already referred to, characterized by inability to eat or drink, sudden paralysis, and death. Wheat and rye. — These grains are not to be used as food for horses except in small quantities, bruised or crushed, and fed mixed with other grains or hay. If fed alone, in any considerable quanti- ties, they are almost certain to produce digestive disorders, laminitis (founder), and similar troubles. They should never constitute more than one-fourth of the grain allowance, and should always be ground or crushed. Bran. — The bran of wheat is the one most used, and its value as a feeding stuff is variously estimated. It is not to be depended upon if given alone, but may be fed with other grains. It serves to keep the bowels open. "Sour bran is not to be given. It disorders the stomach and intestines and may even produce serious results. Maize (corn).— This grain is not suitable as an exclusive food for young horses, as it is deficient in salts. It is fed whole or ground. Corn on the cob is commonly used as the food for horses affected with " lampas." If the corn is old and is to be fed in this manner it should be soaked in pure, clean water for ten or twelve hours. Corn is bet- ter given ground, and fed in quantities of from 1 to 2 quarts at a meal mixed with crushed oats or wheat bran. Be very particular in giving corn to a horse that is not accustomed to its use. It must be commenced in small quantities and very gradually increased. I PREPARATION OF FOODS. 41 know of no grain more likely to produce what is called acute indiges- tion than corn if these directions are not observed. Linseed. — Ground linseed is occasionally fed with other foods to keep the bowels open and to improve the condition of the skin. It is of particular service during convalescence, when the bowels are slug- gish in their action. Linseed tea is very often given in irritable or inflamed conditions of the digestive organs. Potatoes. — These are used as an article of food for the horse in many sections. If fed raw and in large quantities they often produce indigestion. Their digestibility is favored by stea*ming or boiling. They possess, in common with other roots, slight laxative properties. Beets. — These are not much used as food for horses. Carrots. — These make a most excellent food, particularly during sickness. They improve the appetite and slightly increase the action of the bowels and kidneys. They possess also certain alterative prop- erties. The coat becomes smooth and gloss}' when carrots are fed. Some veterinary Avriters claim that chronic cough is cured by giving carrots for some time. The roots may be considered, then, as an adjunct to the regular regimen, and if fed in small quantities are highlv beneficial. Grasses. — Grass is the natural food of horses. It is composed of a great variety of plants, differing widely as to the amount of nour- ishment contained, some being almost entirely without value as foods and only eaten Avhen there is nothing else obtainable, while others are i^ositively injurious, or even poisonous. None of the grasses are suf- ficient to keep the horse in condition for work. Horses thus fed are " soft," sweat easily, purge, and soon tire on the road or when at hard work. To growing stack grass is indisjicmstible, and there is little or no doubt but that it acts as an alterative when given to horses accustomed to grain and hay. It must be given to such horses in small quantities at first. The stomach and intestines undergo rest, and recuperate if the horse is turned to grass for a time each j^ear. It is also certain that during febrile diseases grass acts almost as a medicine, lessening the fever and favoring recoveiy. Wounds heal more rapidly than Avhen the horse is on grain, and some chronic dis- orders (chronic cough, for instance) disappear entirely when at grass. In my experience, grass does more good when the horse crops it him- self. This may be due to the sense of freedom he enjoys at pasture, to the rest to his feet and limbs, and for many other similar reasons. "When cut for him it should be fed fresh or when but slightly wilted. preparation of foods. Foods are j^repared for feeding for any of the following reasons: To rendei- the food more easily eaten; to make it more digestible; to economize in amount; to give it some new property; and to pre- 42 DISEASES OF THE HORSE. serve it. We have already spoken of the preparation of drying, and need not revert to this again, as it only serves to preserve the different foods. Drying does, however, change some of the properties of food, i. e., removes the laxative tendency of most of them. The different grains are more easily eaten when ground, crushed, or even boiled. Rye or wheat should never be given whole, and even of corn it is found that there is less waste when ground, and, in common with all grains, it is more easily digested than when fed whole. Hay and fodder are economized w^ien cut in short pieces. Not only will the horse eat the necessary amount in a shorter time, but it will be found that there is less waste, and the mastication of the grains (whole or crushed) fed with them is insured. Reference has already been made to those horses that bolt their food, and we need only remark here that the consequences of such ravenous eating may be prevented if the grains are fed with cut hay, straw^, or fodder. Long or uncut hay should also be fed, even though a certain amount of hay or straw is cut and fed mixed with grain. One objection to feeding cut hay mixed with ground or crushed grains, and wetted, must not be overlooked during the hot months. Such food is apt to undergo fermentation if not fed directly after it is mixed ; and the mixing trough even, unless frequently scalded and cleaned, becomes sour and enough of its scrapings are given with the food to produce flatulent (wind) colic. A small amount of salt should always be mixed with such food. Bad hay should never be cut simply because it insures a greater consumption of it; bad foods are dear at any price and should never be fed. I have before spoken of the advantage of boiling roots. Not only does this render them less liable to produce digestive disorders, but it also makes them clean. Boiling or steaming grains is to be recom- mended when the teeth are poor, or when the digestive organs are weak. Of ensilage as a food for horses I have no experience, but am inclined to think that (and this opinion is based upon the imperfect manner in which the crop is often stored) disordered digestion would be more frequent were it extensively fed. DISEASES OF THE TEETH. Dentition. — This covers the period during which the young horse is cutting his teeth — from birth to the age of five years. With the horse more difficulty is experienced in cutting the second, or per- manent, teeth than with the first, or milk, teeth. There is a tendency among farmers and many veterinarians to pay too little attention to the teeth of young horses. Percivall relates an instance illustrative of this that is best told in his own words : I was requested to give my opinion concerning a horse, then in his fifth year, who had fed so sparingly for the last fortnight, and so rapidly declined in con- DISEASES OF THE TEETH. 43 ditioii ill c-unstMiueiice, that his owner, a veterinary surgeon, was undor no light apprehensions about his life. He had himself examined his mouth without having discovered any defect or disease, though another veterinary surgeon was of opinion that the difficulty or inability manifested in mastication, and the consequent cudding, arose from preternatural bluutness of the surfaces of the molar teeth, which were, in consequence, filed, but without beneficial result. It was after this that I saw the horse, and I confess I was, at my first examina- tion, quite as much at a loss to offer any satisfactory interpretation as others had been. While meditating, however, after my inspection, on the apparently extraordinary nature of the case, it struck me that I had not seen the tusks. I went back into the stable and discovered two little tumors, red and hard, in the situation of the inferior tusks, which, when pressed, gave the animal insuffer- able pain. 1 instantly took out my pocketknife and made crucial incisions through them l)oth. down to the coming teeth, from which moment the horse recovered his appetite and. by degrees, his wonted condition. The mouths of young horses should be examined from time to time to see if one or more of the milk teeth are not remaining too long, causing the second teeth to grow in crooked, in which case the first teeth should be removed with the forceps. Irregularities of teeth. — There is quite a fashion of late years, espe- cially in large cities, to have horses' teeth regularly "floated," or " rasped," by " veterinary dentists." In some instances this is very beneficial. Avhile in most cases it is entirely unnecessary. From the character of the food, the rubbing, or grinding, surface of the horse's teeth should be rougli. Still, we must remember that the upper jaw is somewhat wider than the lower, and that, from the fact of the teeth not being perfectly apposed, a sharp ridge is left unworn on the inside of the lower molars and on the outside of the upper, which may excoriate the tongue or cheeks to a considerable extent. This condi- tion can readily be felt by the hand, and these sharp ridges when found should be rasped down by a guarded rasp. In some instances the first or last molar tooth is unnaturally long, owing to the fact that its fellow in' the opposite jaw has been lost or does not close per- fectly against it. Should it be the last molar that is thus elongated, it will require the aid of the veterinary surgeon, who has the neces- sary forceps or chisel for cutting it. The front molar may be rasped down, if much patience is taken. In decay of the teeth it is quite common to find the tooth corresponding to the decayed one on the opposite jaw very much elongated, sometimes to such an extent that the mouth can not be perfectly closed. Such teeth must also be shortened by the tooth forceps, chisel, tooth saw, or rasp. In all instances where horses " quid " their food, where they are slobbering, or where they evince pain in mastication, shown by holding their head to one side Avhile chewing, the teeth should be carefully exam- ined. Horses whose teeth have undul}' sharp edges are likely to drive badly; they pull to one .side, do not bear on the bit, or bear on too hard and " big," toss the head, and start suddenly when a tender spot is touched. If, as is mostly the case, all the symptoms are referable 44 DISEASES OF THE HORSE. to sharp corners or projections of the teeth, these must be removed by the rasp. If decayed teeth are found, or other serious difficulty detected, or if the cause of the annoying symptoms is not discovered, an expert should be called. Toothache. — This is rare in the horse and is mostly witnessed where there is decay of a tooth or inflammation about its root. Toothache is to be discovered in the horse by the pain expressed by him while feeding or drinking cold water. I have seen horses affected with toothache that would suddenly stop chewing, throw the head to one side, and slightly open the mouth. They behave as though some sharp body had punctured the mouth. If upon examination there is no foreign body found, we must then carefully examine each tooth. If this can not be done with the hand in the mouth, we can, in most instances, discover the aching tooth by pressing each tooth from without. By tapping the teeth in succession with a hard object, such as a small hammer, the one that is tender may be located. The horse will flinch when the sore tooth is pressed or tapped upon. In most cases there is nothing to be done but extract the decayed tooth, and this, of course, is only to be attempted by the veterinarian. There is a deformity., known as parrot-mouth, that interferes with prehension, mastication, and, indirectly, with digestion. The upper incisors project in front of and beyond the lower ones. The teeth of both jaws become unusually long, as they are not worn down by fric- tion. Such horses experience much difficulty in grazing. Little can be done except to occasionally examine the teeth, and if those of the lower jaw become so long that they bruise the " bars " of the upper jaw, they must be shortened by the rasp or saw. Horses with this deformity should never be left entirely at pasture. MSEASES or THE MOUTH. Lampas. — Lampas is the name given to a swelling of the mucous membrane covering the hard palate and projecting in a more or less prominent ridge immediately behind the upper incisors. The hard palate is composed of spongy tissue that fills with blood when the horse is feeding, and this causes the ridges to become prominent, and they then help to keep food from dropping from the mouth. This swelling is entirelv natural and occurs in everv healthy horse. A^^iere there is some irritation in the mouth, as in stomatitis or durmg teeth- ing, the prominence of the hard palate may persist, due to the in- creased blood supply. In such cases the cause of the irritation should be sought for and removed. By way of direct treatment, slight scari- fication is the most that Avill be required. Burning the lampas is bar- barous and injurious, and it should never be tolerated. It is quite a common opinion among owners of horses and stable- men that lampas is a disease that very frequently exists. In fact whenever a horse fails to eat, and if he does not exhibit very marked DISEASES OF THE MOUTH. 45 symptoms of a >;evere illness, they say at once " he has the lampas," It is almost impossible to convince them to the contrary; yet it is not the case. It may be put clown, then, as an affliction of the stable- man's imagination rather than of the horse's mouth. Stomatitis. — This in an inflammation of the mucous membrane lining the mouth and is produced by irritating medicines, foods, or other substances. The symptoms are swelling of the mouth, which is also hot and painful to the touch; there is a copious discharge of saliva ; the mucous membrane is reddened, and in some cases there are observed vesicles or ulcers in the mouth. The treatment is simple, soft feed alone often being all that is necessary. A bucket of fresh cold water should be kept constantly in the manger so that the horse may drink or rinse his mouth at will. In some instances it may be advisable to use a Avash of chlorate of potash, borax, or alum, about one-half ounce to a pint of water. Hay, straw, or oats should not be fed unless steamed or boiled. A form of contagious stomatitis some- times occurs that is characterized by the formation within the mouth of small vesicles, or blisters. In this disease the horse should be isolated from other horses, and his stall, especially the feed box, and his bit should be disinfected. Glossitis, or inflammation of the tongue, is very similar to the above, and mostly exists with it and is due to the same causes. In- juries to the tongue may produce this simple inflammation of its covering menfbrane, or. if severe, may produce lesions much more extensive, such as lacerations, abscesses, etc. These latter would re- quire surgical treatment, but for the simpler forms of inflammation of the tongue the treatment recommended for stomatitis should bo followed. Plyalis:si. or salivation, consists in an abnormal and excessive se- cretion of saliva. This is often seen as a symptom of irregular teeth ; inflammation of the mouth or tongue, or of the use of such medicines as lobelia, mercury, and many others. Some foods produce this, such as clover, and particularly second crop ; foreign bodies, such as nails, vrheat chatf. and corncobs becoming lodged in the mouth. If the cause is removed no further attention is necessary, as a rule. Astrin- gent washes may be applied to the mouth as a gargle or by means of a sponge. PiiARvxGiTis is an inflammation of the mucous membrane lining of the pharynx or throat. It rarely exists unless accompanied by stomatitis or laryngitis, especially the latter. In those rare instances in which the inflammation is mostly confined to the pharynx are noticed febrile symptoms — difficulty of swallowing either liquids or solids; there is but little cough except when trying to swallow; there is no soreness on pressure over larynx (head of the windpipe). In- creased flow of saliva, difficulty of swallowing liquids in particular, 46 DISEASES OF THE HORSE. and congli only when attempting to swallow are the symptoms best marked in pharyngitis. In some cases the throat becomes gangrenous and the disease ends in death. For treatment wrap a wet sheet around the throat and cover this with rubber sheeting and a warm blanket. This should l^e changed three times daily ; or the region of the throat may be rubbed with mercurial ointment twice daily until the skin becomes irritated, but no longer ; chlorate of potash may be given in quantities of 2 drams four times daily, mixed with flaxseed meal or liquorice- root powder and honey, as an electuary. Soft foods should be given, and fresh water should be constantly before the horse. Paralysis of the pharynx, or, as it is commonly called, " paralysis of the throat," is a rare but very serious disease. The symptoms are as follows : The horse will constantly try to eat or drink, but will be unable to do so; if water be offered him from a pail he will appar- ently drink with avidity, but the quantity of water in the pail will remain about the same; he will continue trying to drink by the hour; if he can succeed in getting any fluid into the back part of the mouth it will come out at once through the nose. Foods also return through the nose, or are dropped from the mouth, quidded. An examination of the mouth by inserting the hand fails to find any obstruction or any abnormal condition. These cases go on from bad to worse ; the horse constantly and rapidly loses in condition, becomes very much emaciated, the eyes are hollow and lusterless, and death occurs from inanition. Treatment is very unsatisfactory. A severe blister should be ap- plied behind and under the jaw; the mouth is to be frequently swabbed out with alum or chlorate of potash, 1 ounce to a pint of water, by means of a sponge fastened to the end of a stick. Strych- nia may be given in 1-grain doses two or three times a day. This disease may be mistaken at times for foreign bodies in the mouth or for the so-called cerebro-spinal meningitis. It is to be dis- tinguished from the former, upon a careful examination of the mouth, by the absence of any offending body and by the flabby feel of the mouth; and from the latter by the animal api^earing in per- fect health in every particular except this inability to eat or drink. Abscesses.— Abscesses sometimes form back of the pharynx and give rise to symptoms resembling those of laryngitis ■ or distemper. Interference with breathing that is of recent origin and progression, Avithout an}'^ observable swelling or soreness about the throat, will make one suspect the formation of an abscess in this location. But little can be done by the owner in the way of treatment, save to hurry the ripening of the abscess and its discharge by steaming with hops, hay, or similar substances and by poulticing the throat. The opera- ation for opening an abscess in this region necessitates an intimate knowledge of the complex anatomy of the throat region. ^^ ' DISEASES OF THE GULLET. 47 DISEASES OF THE ESOPHAGUS, OR GULLET. It is rare to find diseases of this organ, except as a result of the introduction of foreign bodies too hirge to pass or to the administering of irritating medicines. Great care shonhl be taken in the administra- tion of irritant or canstic medicines that they be thoroughly diluted. If this is not done erosions and ulcerations of the throat ensue, and this again is prone to be followed by constriction (narrowing) of the gullet. The mechanical trouble of choking is quite common. It may occur when the animal is suddenly startled wdiile eating apples or roots, and we should be careful never to approach suddenly or put a dog after horses or cows that are feeding upon such substances. If left alone these animals very rarely attempt to swallow the object until it is sufficiently masticated. Choking also arises from feeding oats in a deep, narrow manger to such horses as eat very greedily or bolt their food. Wheat chaff is also a frequent cause of choke. This accident may result from the attempts to force eggs down without breaking or from giving balls that are too large or not of the proper shape. AVhatever object causes the choking, it may lodge in the upper part of the esophagus, at its middle portion, or close to the stomach, giving rise to the designations of pharyngeal^ eermcal., and thoracic choke. In some cases where the original obstruction is low we find all that part of the gullet above it to be distended with food. The symptoms vary somewhat according to the position of the body causing choke. In pharyngeal choke the object is lodged in the %ipj)er portion of the esophagus. The horse will present symptoms of great distress, hurried breathing, frequent cough, excessive flow of saliva, sweating, trembling, or stamping with the fore feet. The abdomen rapidly distends with gas. The diagnosis is completed by manipulating the upper part of the throat from without and by the introduction of the hand into the back part of the mouth, finding the body lodged here. In cervical choke (where the obstruction is situated at any point between the throatlatch and the shoulder) the protrusion caused by the object can be seen and the object can be felt. The symptoms here are not so severe; the horse wnll be seen occa- sionally to draAv himself up, arch his neck, and make retching movements as though he wished to vomit. The abdomen may be tympanitic. Should there be any question as to the trouble a con- clusion may be reached by pouring water into the throat from a bottle. If the obstruction is complete you can see the gullet become distended with each bottle of water by standing on the left side of the horse and watching the course of the esophagus, just above the wind- pipe. This is not always a sure test, as the obstruction may be an angular body, in which case liquids would pass it. Solids taken would show in these cases; but solids should not, however, be given, 48 DISEASES OF THE HOESE. as they serve to increase the trouble by rendering the removal of the body more difficult. In thoracic chol-e the symptoms are less severe. Food or water ma}^ be ejected through the nose or mouth after the animal has taken a few swallows. There will be some symptoms of distress, fullness of the abdomen, cough, and occasionally retching movements. Some- times a horse that is choking is heard to emit groans. The facial expression always denotes great anxiety and the eyes are bloodshot. The diagnosis is complete if, upon passing the probang (a flexible tube made for this purpose), an obstruction is encountered. Treatment. — If the choke is at the beginning of the gullet {pharyn- geal) an eifort must be made to remove the obstacle through the mouth. A mouth-gag, or speculum, is to be introduced into the mouth to protect the hand and arm of the operator. Then, while an assistant, with his hands grasped tightly hehind the object, presses it upward and forward with all his force, the operator must pass his hand into the mouth until he can seize the obstruction and draw it outward. This mode of procedure must not be abandoned with the first failure, as w^e may get the obstacle farther toward the mouth by continued efforts. If we fail with the hand, forceps may be intro- duced through the mouth and the object seized when it is just beyond the reach of the fingers. Should our efforts entirely fail, we must then endeavor to force the obstruction downward by means of the probang. This instrument, which is of such signal service in remov- ing choke in cattle, is decidedly more dangerous to use for the horse ; and I can not pass this point without a word of caution to those who have been known to introduce into the horse's throat such objects as whipstalks, shovel handles, etc. These are always dangerous, and more than one horse has been killed by such barbarous treatment. Cervical choke. — In this, as well as in thoracic choke, we must first of all endeavor to soften or lubricate the obstruction by pouring oil or mucilaginous drinks down the gullet. After this has been done endeavor to move the object by gentle manipulations with the hands. If choked with oats or chaff {and these are the objects that most fre- quently produce choke in the horse), begin by gently squeezing the lower portion of the impacted mass and endeavor to work it loose a little at a time. This is greatly favored at times if we apply hot fomentations immediately about the obstruction. Persist in these efforts for at least an hour before deciding to resort to other and more dangerous modes of treatment. If unsuccessful, however, the pro- bang may be used. In the absence of the regular instrument, use a piece of inch hose 6 feet long, or a piece of new three-quarter-inch manila rope well wrapped at the end with cotton twine and thor- oughly greased with tallow. The mouth is to be kept open by a gag of wood or iron and the head slightly raised and extended. The pro DISEASES OF THE STOMACH AND INTESTINES. 49 bang is then to be carefully guided by the hand into the upper i)art of the gullet and gently forced downward until the obstruction is reached. Pressure must then he gradual and firm. Do not at first attempt too much force, or the esophagus will be ruptured. Simply keep up this firm, gentle pressure until you feel the object moving, after which you are to follow it rapidly to the stomach. If this mode of treatment is unsuccessful, a veterinarian or physician is to be called in, who can remove the object by cutting down upon it. This should scarcely be attempted by a novice, as a knowledge of the anatomy of the parts is essential to avoid cutting the large artery, vein, and nerve that are closely related to the esophagus in its cervical portion. Thoracic choke. — Thoracic choke can be treated only by means of the introduction of oils and mucilaginous drinks, and the careful use of the probang. Stricture of the esophagus. — This is due to corrosive medicines, previous choking (accompanied by lacerations, which, in healing, nar- row the passage), or pressure on the gullet by tumors. In the major- ity of cases of stricture, dilatation of the gullet in front of the con- stricted portion soon occurs. This dilatation is due to the frequent accumulation of solid food above the constriction. Little can be done in either of these instances except to feed on sloppy or liquid food. Sacular DILATATION OF THE ESOPHAGUS. — Tliis follows chokiiig, and is due to stretching or rupture of the muscular coat of the gullet, allowing the internal, or mucous, coat to protrude through the lacer- ated muscular walls. Such a dilatation, or pouch, may gradually enlarge from the frequent imprisonment of food. When liquids are taken, the solid materials are partially washed out of the pouch. Symptovis. — The symptoms are as follows: The horse is able to swallow a few mouthfuls of food Avithout apparent difficulty; then he will stop feeding, paw, contract the muscles of his neck, and eject a portion of the food through his nose or mouth, or it will gradually work down to the stomach. As the diktation thus empties itself the symptoms gradually subside, only to reappear when he has again taken solid food. Liquids pass without any, or but little, inconven- ience. Should this dilatation exist in the rerneal region, surgical in- terference may sometimes prove effectual ; if in the thoracic por- tion, nothing can be done, and the patient rapidly passes from hand to hand by " swapping," until, at no distant date, the contents of the sac become too firm to be dislodged as heretofore, and the animal succumbs. DISEASES OK THE STOMACH AND INTESTINES. As a rule it is most difficidt to distinguish between diseases of the stomach and of the intestines of the horse. The reason for this is that the stomach is relatively small. It lies away from the abdominal IT. Doc. 705. .-.0-2 4 50 DISEASES OF THE HORSE, wall, and so pressure from without can not be brought to bear upon it to reveal sensitiveness or pain. Nor does enlargement, or disten- tion, of the stomach produce visible alteration in the form of the abdomen of the horse. Moreover, it is a rule to which there are few exceptions .that an irritant or cause of disease of the stomach acts likewise upon the intestines, so that it is customary to find them similarly deranged. For these reasons it is logical to discuss together the diseases of the stomach and intestines and to point out such localizations in one organ or another as are of importance in recog- nizing and treating the diseases of the digestive organs of the horse. It should be understood that gastritis signifies an inflammation of the stomach and enteritis an inflammation of the intestines. The two terms may be used together to signify a disease of the stomach and intestines, as gastro-enteritis. Colic. — The disease of the horse that is most frequently met with is what is termed " colic," and many are the remedies that are reputed to be " sure cures " for this disease. Let us discover, then, what the word " colic " means. This term is applied loosely to almost all diseases of the organs of the abdomen that are accompanied by pain. If the horse evinces abdominal pain, he is likely to be put down as suffering with colic, no matter whether the difficidty be a cramp of the bowel, an internal hernia, overloading of the stomach, or a painful disease of the bladder or liver. Since these conditions differ so much in their causation and their nature, it is manifestly absurd to treat them alike and to expect the same drugs or procedures to reliev^e them all. Therefore it is important that the various diseased states that are so roughly classed together as colic shall, so far as jjossible, be separated and individualized in order that appropriate treatments may be pre- scribed. With this object in view, colics will be considered under the following headings : (1) Engorgement colic, (2) obstruction colic, (3) tympanitic colic, (4) spasmodic colic, (5) worm colic. The general symptoms of abdominal pain, and therefore of colic, are restlessness, cessation of whatever the horse is about, lying down, looking around toward the flank, kicking with the hind feet upward and forward toward the belly, jerky switching of the tail, stretching as though to urinate, frequent change of position, and groaning. In the more intense forms the horse plunges about, throws himself down, rolls, assumes unnatural positions, as sitting on the haunches, and grunts loudly. Usually the pain is not constant, and during the inter- missions the horse may eat and appear normal. During the period of pain sweat is poured out freely. Sometimes the horse moves con- stantly in a circle. The respirations are accelerated, and usually there is no fever. (1) Engorgement colic. — This form of colic consists in an over- loading of the stomach with food. The horse may have been overfed DISEASES OF THE STOMACH AND INTESTINES. 51 or the food may have collected in the stomach through failure of this organ to digest it and pass it backward into the intestines. Even a normal amount of food that the horse is unaccustomed to may cause disease. Hence a sudden change of food may produce engorgement colic. Continued full rations while the horse is resting for a day or two or working too soon after feeding may serve as a cause. New oats, corn, or hay, damaged food, or food difficult of digestion, such as barley or beans, may incite engorgement colic. This disease may result from having fed the horse twice by error or from its having escaped and taken an unrestricted meal from the grain bin. (Jround feeds that pack together making a sort of dough may cause engorge- ment colic if they are not mixed with cut hay. Greedy eaters are predisposed to this disease. Symptoms. — The horse shows the general signs of abdominal pain, which may be long continued or of short duration. Retching or vom- iting movements are made; these are shown by labored breathing, upturned upper lip, contraction of the flank, active motion at the throat, and drawing in of the nose toward the breast, causing high arching of the neck. The horse may assume a sitting position on his haunches, like a dog. At times the pain is very great and the horse makes the most violent movements, as though mad. At other times there is profound mental depression, the horse standing in a sleepy, or dazed, way, with the head down, the eyes closed, and leaning his head against the manger or wall. There is, during the struggles, pro- fuse perspiration. Following retching, gas may escape from the mouth, and this may be followed by a sour froth and some stomach contents. The horse can not vomit except when the stomach is vio- lently stretched, and, if the accumulation of food or gas is great enough to stretch the stomach so that vomiting is possible, it may be great enough to rupture this organ. So it happens not infrequently that a horse will die from ruptured stomach after vomiting. But after the stomach ruptures vomiting is impossible. The death rate in this form of colic is high. Treatment. — The bowels should be stimulated to contraction by the use of clysters of lai-ge quantities of water and of glycerin. Veteri- narians use hypodermic injections of eserin or arecolin or intra- venous injections of barium chloride, but these have to be employed with great caution. It is not i)rofitable to give remedies by the stomach, for they can not be absorl^ed. But small doses of morphine (5 grains) or of the fluid extract of Indian hemp (2 drams) may be placed in the mouth and are absorbed in part, at least, without pass- ing to the stomacli. These drugs lessen pain and thus help to over- come the violent movements that are dangerous, because they uiay be the means of causing rupture of the diaphragm or stomach. If 52 DISEASES OP THE HOESE. facilities are available, relief may be afforded by passing an esoph- ageal tube through which some of the gaseous and liquid contents of the stomach may escape. Rupture of the stomach. — This mostly occurs as a result of en- gorged or tympanitic stomach (engorgement colic) and from the horse violently throwing himself when so affected. It may result from disease of the coats of the stomach, gastritis, stones, or calculi, tumors, or anything that closes the opening of the stomach into the intes- tines, and very violent pulling or jumping immediately after the animal has eaten heartilj'^ of bulky food. These or similar causes may lead to this accident. The symptoms of rupture of the stomach are not constant or ahvays reliable. Ahvays make inquiry as to what and how much the horse has been fed at the last meal. Vomiting may precede rupture of this organ, as stated above. This accident appears to be most likely to occur in heavy draft horses. A prominent symptom observed (though it may also occur in diaphragmatic hernia) is where the horse, if possible, gets the front feet on higher ground than the hind ones or sits on his haunches, like a dog. This position affords relief to some extent, and it will be maintained for some minutes ; it is also quickly regained when the horse has changed it for some other. Colicky symptoms, of course, are present, and these will vary much and pre- sent no diagnostic value. As the case progresses " the horse will often stretch forward the fore legs, lean backward and downward until the belly nearly touches the ground, and then rise up again with a groan, after Avhich the fluid from his nostrils is issued in increased quantity." The pulse is fast and weak, breathing hurried, body bathed in a clammy sweat, limbs tremble violently, the horse reels or staggers from side to side, and death quickly ends the scene. In the absence of any pathognomonic symptom w^e must take into account the history of the case ; the symptoms of colic that cease sud- denly and are succeeded by cold sweats and tremors ; the pulse quick and small and thready, growing weak and more frequent, and at length running down and becoming altogether imperceptible; looking back at the flank and groaning; sometimes crouching wath the hind quarters ; W' ith or without eructation and vomiting. There is no treatment that can be of any use whatever. Could we be sure of our diagnosis it would be better to destroy the animal at once. Since, however, there is always the possibility of a mistake in diagnosis, we may give powdered opium in 1-dram doses every two or three hours, w ith the object of keeping the stomach as quiet as possible. (2) Obstruction colic. — The stomach or bowels may be obstructed by accumulations of partly digested food (fecal matter), by foreign bodies, by displacements, by paralysis, or by abnormal growths. DISEASES OF THE STOMACH AND INTESTINES. 53 Impaction of the large intestines. — This is a very common bowel trouble and one which, if not promptly recognized and properly treated, results in deatli. It is caused by overfeeding, esi:>ecially of bulky food containing an excess of indigestible residue; old, dry, hard hay. or stalks when largely fed ; deficiency of secretions of the intesti- nal tracts; lack of water; want of exercise, medicines, etc. Si/mptom.s. — luijiaction of the large bowels is to be diagnosed by a slight abdominal pain, which may disai)pear for a day or two to reap- pear Avith more violence. The feces are passed somewhat more fre- quently, but in smaller (juantities and more dry; the abdomen is full, but not distended witli gas; the horse at first is noticed to paw and soon l)egins to look back at his sides. Probably one of the most char- acteristic symptoms is the position assumed when down. He lies flat on his side, head and legs extended, occasionally raising his head to look toAvard his flank; he remains on his side for from five to fifteen minutes at a time. Evidently this position is the one giving the most freedom from pain. He rises at times, walks about the stall, paws, looks at his sides, backs up against the stall, which he j^resses with his tail, and soon lies down again, assuming his favored position. The intestinal sounds, as heard by applying the ear to the flank, are dimin- ished, or there is no sound, indicating absence of motion of the bowels. The bowels may cease entirely to move. The pressure of the distended intestine upon the bladder may cause the horse to make frequent attempts to urinate. The pulse is but little changed at first, being full and sluggish; later,- if this condition is not overcome, it becomes' rapid and feeble. Horses ma}^ suffer from impaction of the bowels for a week, yet eventually recover, and cases extending two or even three weeks have ended favorably. As a rule, however, they sel- dom last over four or five days, many, in fact, dying sooner than this. The treatment consists of efforts to produce movement of the bowels and to prevent inflammation of the same from arising. A large cathartic is to be given as early as possible. Either of the follow- ing are recommended : Powdered Barbados aloes 1 ounce, calomel -2 drams, and powdered nux vomica 1 dram; or linseed oil 1 pint and croton oil 15 drops; or from 1 pint to 1 quart of castor oil may be given. Some favor the administration of Epsom or Glauber's salts, 1 pound, with one-quarter pound of common salt, claiming that this causes the horse to drink largely of water, and thus mechanically softening the impacted mass and favoring its expulsion. AVhichever physic is selected, it is essential that a full dose be given. This is nujch better than small and repeated doses. It must be borne in mind that horses require about twenty-four hours in which to respond to a physic, and under no circumstances are physics to be repeated sooner than this. If aloes has been given and has failed to operate at the proper time, oil or some different cathartic should then be adminis- tered. Allow the horse all the water he will drink. Calomel may be 54 DISEASES OF THE HOESE. administered in half-dram doses, the powder being placed on the tongue, one dose every two hours until four doses are given. Enemas of glycerin, 2 to 4 ouncas, are often beneficial. Rubbing or kneading of the abdominal walls and the application of stimulat- ing liniments or strong mustard water will also, at times, favor the expulsion of this mass. Walking exercise must occasionally be given. If this treatment is faithfully carried out from the start the majority of cases will terminate favorably. Where relief is not obtained in- flammation of the bowels may ensue, and death follow from this cause. Constifation., or costiveness. — This is often witnessed in the horse, and particularly in the foal. Many colts die every year from failure on the part of the attendant to note the condition of the bowels soon after birth. A¥lienever the foal fails to pass any feces, and in partic- ular if it presents any signs of colicky pains— straining, Qic— imme- diate attention must be given it. As a rule, it will only be necessary to give a few injections of soapy water in the rectum and to introduce the fineer through the anus to break down any hardened mass of dung found there. If this is not effective, a purgative must be given. Oils are the best for these young animals, and preferably castor oil, giving from 2 to 4 ounces. The foal should always get the first of the mother's milk, as this milk, for a few days, possesses decided laxative properties. If a mare, while suckling, is taking laudanum, morphine, atropia, or similar medicines, the foal should be fed during this time by hand and the mare milked upon the ground. Constipation in adult horses is often the result of long feeding on dry, innutritions food, deficiency of intestinal secretions, scanty water supply, or lack of exercise. If the case is not complicated with colicky symptoms, a change to light, sloppy diet, linseed gruel or tea. with plenty of exer- cise, is all that is required. If colic exists, a cathartic is needed. In very many instances the constipated condition of the bowels is due to lack of intestinal secretions, and when so due, may be treated by giving fluid extract of Ijelladonna three times a day in 2-dram doses, and handful doses daily of Epsom salts in the feed. It is always best, when possible, to overcome this trouble by a change of diet rather than by the use of medicines. For the relief of constipation such succulent foods as roots, grass, or green forage are recommended. Silage, however, should be fed sparingly, and not at all unless it is in the very best condition. Moldy silage may cause fatal disease. Foreign bodies (calculi (stones) in the stomach) .—There are prob- ably but few symptoms exhibited by the horse that will lead one to suspect the presence of gastric calculi, and possibly none by which we can unmistakably assert their presence. Stones in the stomach have been most frequently found in millers' horses fed sweepings from the mill. A depraved and capricious appetite is common in horses DISEASES OF THE STOMACH AND INTESTINES. 55 that have a stone forming in their stomach. There is a disposition to eat the woodwork of the stable, earth, and, in fact, ahnost any sub- stance within their reach. This symptom must not, however, be con- sidered as pathognomonic, since it is observed when calculi are not present. Occasional colics may result from these " stomach stones," and when these lodge at the outlet of the stomach they may give rise to symptoms of engorged stomach, already described. There is, of course, no treatment that will prove eflective. Give remedies to move the bowels, to relieve pain, and to combat inflammation. Intestinal concretions {calculi {stones) in the intestines). — These concretions are usually found in the large bowels, though they are occasionally met with in the small intestines. They are of various sizes, weighing from 1 ounce to 25 pounds; they may be single or multiple, and differ in composition and appearance, some being soft (composed mostly of animal or vegetable matter), while others are porous, or honeycombed (consisting of animal and mineral matter), and others are entirely hard and stonelike. The hair balls, so common to the stomach and intestines of cattle, are very rare in the horse. Intestinal calculi form around some foreign body, as a rule — a nail or piece of wood — whose shape they may assume to a certain extent. Layers are arranged concentrically around such nucleus until the sizes above spoken of are attained. These stones are also often found in millers' horses, as well also as in horses in limestone districts, \vhere the water is hard. A^Tien the calculi attain a sufficient size and become lodged or blocked in some part of the intestines, they cause obstruction, inflammation of the bowels, colicky symj^toms, and death. There are no certain signs or symptoms that reveal them. Recurring colics of the type of impaction colic, but more severe, may lead one to suspect the existence of this condition. Examination through the rectum may reveal the calculus. The symptoms will be those of obstruction of the bowels. Upon post-mortem examinations these stones will be discovered mostly in the large bowels; the intestines will be inflamed or gangrenous about the point of obstruction. Sometimes calculi have been expelled by the action of a physic, or they may be removed by the hand when found to occupy the rectum. As in concretions of the stomach, there can be but little done in the way of treatment more than to overcome spasm (if any exists), and to give physics with the hope of dislodging the stone or stones and carrying them on and outv/ard. I ntuss^isception^ or invagination. — This is the slipping of a portion of the intestine into another portion immediately adjoining, like a partially turned glove finger. This may occur at any part of the bowels, but is most frequent in the small guts. The invaginated por- tion may be slight — 2 or 3 inches only — or extensive, measuring as 56 DISEASES OF THE HORSE. many feet. In intussusception, the inturnecl bowel is in the direction of the anus. There are adhesions of the intestines at this laoint, con- gestion, inflammation, or even gangrene. This accident is most likely to occur in horses that are suffering from spasm of the bowel, or in those where a small portion of the gut is paralyzed. The natural wormlike or ringlike contraction of the gut favors the passage of the contracted or paralyzed portion into that immediately behind it. It may occur during the existence of almost any abdominal trouble, as diarrhea, inflannnation of the bowels, or from injuries, exposure to cold, etc. A fall or leaping may give the initial maldirection. Foals are most likely to be thus afflicted. /S'^/mpiJoms.— Unless the invaginated portion of the gut becomes strangulated, probably no symptoms Avill be appreciable, except con- stipation. Strangulation of the bowel may take place suddenly, and the horse die within twenty-four hours, or it may occur after several days — a week even — and death follow at this time. There are no symptoms positively diagnostic. Colicky pains, more or less severe and continuous, are observed, and there may he at first diarrhea fol- lowed by constipation. Severe straining occurs in some instances of intussusception, and this should be given due credit when it occurs. As death approaches the horse sweats profusely, sighs, presents an anxious countenance, the legs and ears become cold, and there is often freedom from pain immediately before death. In some rare in- stances the horse recovers, even though the invaginated portion of the gut has become strangulated. In this case the imprisoned portion sloughs away so gradually that a union has taken place between the intestines at the point where one portion has slipped into that behind it. The piece sloughing off is found passed with the manure. Such cases are exceedingly rare. Nonirritating laxatives, such as castor oil, sweet oil, or calomel in small doses should be given, and creolin in 2-dram doses in a pint of warm water. Soft feed and mucilag- inous and nourishing drinks should be given during these attacks. E. Mayhew Michener has operated successfully on a foal w^ith intus- susception by opening the abdomen and releasing the imprisoned gut. Volvulus, gut-tie, or twisting of the howels. — These are the terms applied to the bowels when twisted or knotted. This accident is rather a common one, and frequently results from the violent manner in which a horse throws himself about when attacked by spasmodic colic. The sympto77is are the same as those of intussusception and obstructions of the bowels; the same directions as to treatment are therefore to be observed. ; Paralysis of the intestine.— Th'isi occurs in old, debilitated animals that' have been fed on coarse innutritions fodder. This produces a condition of dilatation so pronounced as to make it impossible for the intestine to advance its contents, and so obstruction results. The symptoms are as in other forms of obstruction colic. The history of DISEASES OF THE STOMACH AND INTESTINES. 57 the case is of much service in diagnosing the trouble. The treatment consists in the administration of hixatives. One may give 1 quart of raw linseed oil and follow it the next day with 1 i)ound of Glauber's salts dissolved in a quart of warm water. Strychnia may be given in doses of 1 grain two or three times daily. If the stagnant mass of feces is in the rectum, it must be removed with the hand. Ahnorinal growths, such as tumors or fibrous tissue, producing contraction or stricture may be causes of obstruction. The colic caused by these conditions is chronic. The attacks occur at gradually shortening intervals and become progressively more severe. Relief is afforded by the use of purgatives that render the feces soft and thin and thus enable them to pass the obstruction, liut in time the con- tracted ])lace is likely to close so far that passage is impossible and the horse will die. (3) Flatulent colic (tympanitic colic, wind colic, or bloat). — Among the most frequent causes of this form of colic are to be men- tioned sudden changes of food, too long fasting, food then given Avhile tlie animal is exhausted, new hay or grain, large quantities of green food, food that has lain in the manger for some time and become sour, indigestible food, irregular teeth, crib-biting, and, in fact, any- thing that produces indigestion may produce flatulent colic. The symptoms of wind colic are not so suddenly developed uor so severe as those of cramp colic. At first the horse is noticed to be dull, paws slightly, and may or may not lie down. The pains from the start are continuous. The belly enlarges, and by striking it in front of the haunches a drumlike sound results. If not soon relieved the above symptoms are aggravated, and in addition there are noticed difficult breathing, bloodshot eyes, and red mucous membranes, loud tumultuous heart beat, profuse perspiration, treml)ling of front legs, sighing respiration, staggering from side to side, and. finally, plung- ing forward dead. The diagnostic symptom of flatulent colic is the distention of the bowels with gas, detected by the bloated appearance and resonance on ])ercussion. The treatment for wind colic differs very materially from lliat of cramp colic. Absorbents are of some service, and charcoal may be criven in any quantity. Relaxants and antispasmodics are also bene- ficial in this form of colic. Chloral hydrate not only possesses these qualities, but it also is an antiferment and a pain reliever. It is then particularly wi'U adapted to the treatment of wind colic, and should be given in the same-sized doses and in the manner directed for spas- modic colic. Diluted alcohol or whisky may be given, or aromatic spirits of anunonia in 1 -ounce doses at short intervals. A physic should always be given in flatulent colic as early as possi- ble, the best being Barbados aloes in the dose already mentioned. Injections, per rectum, of turpentine 1 to 2 ounces, linseed oil 8 ounces, may be given frequently to stimulate the peri'^taltic motion of the 58 DISEASES OF THE HORSE. bowels and favor the escape of wind. Blankets wrung out of hot water do much to afford relief; the}' should be renewed every five or ten minutes and covered with a dry woolen blanket. This form of colic is much more fatal than cramp colic, and requires prompt and persistent treatment. It is entirely unsafe to predict the result, some apparently mild attacks going on to speedy death, while others that appear at the onset to be very severe yielding rapidly to treatment. Do not cease j^our efforts until you are sure the animal is dead. In these severe cases puncturing of the bowels in the most prominent (distended) part by means of a small trocar and cannula or with a needle of a hypodermic syringe, thus allowing the escape of gas, has often saved life, and such punctures, if made with a clean, sharp in- strument that is not allowed to remain in the horse too long, are accompanied by little danger and do more to quickly relieve the patient than any other treatment. (4) Spasmodic, or cramp, colic. — This is the name given to that form of colic produced by contraction, or spasm, of a portion of the small intestines. It is produced by indigestible food ; large drinks of cold water when the animal is warm ; driving a heated horse through deep streams; cold rains; drafts of cold air, etc. Unequal distribu- tion of or interference with the nervous supply here produces cramp of the bowels, the same as external cramps are produced. Spasmodic colic is much more frequently met with in high-bred, nervous horses than in coarse, lymphatic ones. SymptoTns. — These should be carefully studied in order to diagnose this from other forms of colic requiring quite different treatment. Spasmodic colic always begins suddenly. If feeding, the horse is seen to stop abruptl}^ stamp impatiently, and probably look back. He soon evinces more acute pain, and this is shown by pawing, suddenly lying down, rolling, and getting up. During the period of pain the intestinal sounds, as heard by applying the ear over the flank, are louder than in health. There is then an interval of ease; he will resume feeding and appear to be entirely well. In a little while, how- ever, the pains return and are increased in severity, only to again pass off for a time. As the attack progresses these intervals of ease become shorter and shorter, and pain may be continuous, though even now there are exacerbations of pain. Animals suffering from this form of colic evince the most intense pain ; they throw themselves down, roll over and over, jump up, whirl about, drop down again, paw, or strike rather, with the front feet, steam and sweat, and make frequent attempts to pass their urine. Only a small amount of water is passed at a time, and this is due to the bladder being so frequently emptied. These attempts to urinate are often regarded by horsemen as symp- toms of trouble of the kidneys or bladder. In reality they are only one of the many ways in which the horse expresses the presence of SPASMODIC COLIC, 59 pain. As a matter of fact, diseases of the bladder or Ividneys of the horse are exceedingly rare. To recapitulate the symptoms of spasmodic colic : Keep in mind the history of the case, the type of horse, the suddenness of the attack, the increased intestinal sounds, the intervals of ease (which become of shorter duration as the case progresses) , the violent pain, the normal temperature and pulse during the intervals of ease, the frequent attempts to urinate, etc., and there i's but little danger of confounding this with other forms of colic. Treatment. — Since the pain is due to spasm, or cramp, of the bowels, medicines that overcome spasms — antispasmodics — are the ones indicated. Chloral hydrate may be used. This is to be given in a dose of 1 ounce in a pint of water as a drench. As this drug is irritant to the throat and stomach, it has to be well diluted. A com- mon and good remedy is sulphuric ether and laudanum; of each 2 ounces in a half pint of linseed oil. Another drench may be com- posed of 2 ounces each of sulphuric ether and alcohol in 8 ounces of water. If nothing else is at hand give whisky, one-half pint in hot Avater. Jamaica ginger is useful. If relief is not obtained in one hour from any of the above doses, they may then be repeated. The body should be warndy clothed and perspiration induced. Blankets dipped in very hot water to which a small quantity of turpentine has been added should be placed around the belly and covered with dry blankets, or the abdomen may be rubbed with stimulating liniments or mustard water. The difficulty, however, of applying hot blankets and keeping them in place forces us in most instances to dispense with them. If the cramp is due to irritants in the bowels, a cure is not complete until there is given a cathartic of 1 ounce of aloes or 1 pint of linseed oil. Injections into the rectum of warm soapy water or salt and water aid the cure. Rectal injections, clysters, or enemas as a rule should be lukewarm, and from 3 to 6 quarts are to be given at a time. They may be repeated every half hour if necessary. Great care is to be taken not to injure the rectum in giving such injections. A large syringe or a piece of rubber hose 4 or 5 feet long, with a funnel attached at one end, affords the l)est means by which to give them. The pipe of the svrinire or the hose introduced into the rectum nuist be blunt, rounded, and smooth. It is to be thoroughly oiled and then carefully pushed through the anus in a slightly upward direction. Much force must be avoided, for the rectum may be lacerated and serious complications or even death result. Exercise will aid the action of the bowels in this and similar colicky troubles, but severe galloping or trotting is to be avoided. If the horse can have a loose box or paddock, it is the best, as he will then t^ke what exercise he wants. If the patient be ev- tremely violent, it is often wise to restrain him by leading him with a 60 DISEASES OF THE HOESE. halter, since rupture of the stomach or displacement of the bowels may result and complicate the trouble. (5) Worm colic. — Parasites of many kinds reside in the intestinal canal of horses. There are three kinds of tapeworms, one long round- worm, and several kinds of smaller roundworms. Besides these are the bot-fly grubs and larvae. The intestinal worm most commonly seen is the long roundworm, known as Ascaris equorum. They are white or reddish in color and measure from 4 to 12 inches in length. In thickness they vary from the size of a? rye straw^ to that of a lady's little finger, being thickest at the middle and tapering at both ends. They are found singly or in groups or masses, and infest chiefly the small intestines. (See PI. III.) Of the smaller roundworms, there may be mentioned Spiroptera 7niscrostoma, which causes ulcers in the stomach; Cylichnostomnm tetraccmthum^ Strongylus equinus^ and Strongylus vulgaris^ which live in the large intestines. The larvse of the last named burrow in the walls of the great mesenteric artery, causing aneurisms. The tapeworms, once seen, are easily recognized. They are white, flat, thin, broad, and jointed. The head is found at the smaller end of the worm. Tapeworms of the horse measure from a few inches to a foot in length. S^jmptoms. — Symptoms of intestinal worms are not always ob- served, even when many parasites are present. If the infestation is extreme, there may be slight colicky pains at times, or there may only be switching of the tail, frequent passages of manure, and some slight straining, itching of the anus, and rubbing of the tail or rump against the stall or fences; the horse is in j^oor condition; does not shed his coat; is hidebound and potbellied; the appetite is depraved, licking the Avails, biting the wooden work of the stalls, licking parts of his body, eating earth, and being particularly fond of salt; the bowels are irregular, constipation or diarrhea being noticed. Some place much dependence upon the symptom of itching of the upper lip, as shown by the horse frequently turning it up and rubbing it upon the wall or stalls. Others again declare that whenever Ave see the adher- ence of a dried whitish substance about the anus, worms are present. The one symptom, however, that Ave should always look for, and cer- tainly the only one that may not deceive us, is seeing the worms or their eggs (by the use of a microscope) in the dung. Treatment. — Kemedies to destroy intestinal worms are much more efficient if given after a long fast, and then the worm medicine must be supplemented by a physic to carry out the worms. Among the best Avorm medicines may be mentioned santonin, turpentine, tartar emetic, creolin, infusion of tobacco, and bitt«r tonics. To destroy tapcAvorms, areca nut, malefern, and pumpkin seeds are the best. If a horse is passing the long roundworms, the plan of treatment is to INDIGESTION. 61 give tAvice dail}' for three or four days a drench composed of turpen- tine or creolin 1 ounce and linseed oil 2 or 3 ounces, to be followed on the fourth day by a physic of Barbados aloes 1 ounce, or one may give santonine 2 to 4 drams, with calomel 1 to 2 drams. This dose should not be repeated, and should be followed in six hours by 1 quart of lin- seed oil. If worms infesting the large bowels are present, injections into the rectum of infusions of tobacco, infusions of quassia chips, one-half poimd to a gallon of water, once or twice daily for a few days, and folloAv by a physios are most beneficial. It should be borne in mind that intestinal worms are mostly seen in horses that are in poor condition, and an essential part of treatment then is to improve the appetite and jiowers of digestion. This is best done by giving the vegetable tonics. One-half ounce of Peruvian bark, gentian, gin- ger, quassia, etc., is to be given twice a day in the feed or as a drench. To improve the general condition one may give artificial Carlsbad salts, 1 tablespoonful in each feed, and each dose to have added to it 3 to 5 grains of arsenious acid. Bot-fly larvae do not require special treatment unless they lodge in the rectum, in which case they may be dislodged by injecting tobacco water. If plenty of rock salt is allowed for horses to lick, they will thus be protected against intestinal parasites to a slight but useful degree. Indigestion or gastro-intestinal catarrh. — There is ample rea- son for considering these conditions together from the facts that they merere insensiblv into each other and usually occur simultaneously. This condition may be acute — that is, of sudden onset — or it may be chronic. The changes of structure produced by this disease occur in the mucous-membrane lining of the stomach and intestines. This membrane becomes red from increased blood supply or from hemor- rhage into it, it is swollen, and is covered by a coating of slimy mucus. In some especially severe cases the membrane is destroyed in spots, causing the appearance of ulcers or of erosions. The causes of indigestion are nnmerous, but nearly all are the residt of errors in feeding. Some horses are naturally endowed with weak digestive organs, and such are predisposed to this condition. Anythir.g that irritates the stomach or intestines may cause this disease. P'oods that the animal is unaccustomed to, sudden changes of diet, imperfectly cured, unripe, or damaged foods are all fruitful causes, and so are worms. In sucklinjr foals this condition may come from some disease of the dam that renders her milk indigestible or from overexertion or over- heating of the mare. Another prolific cause is bad teeth, making mastication imperfect, and thus causing the horse to swallow his food in a condition unfit for the action of the digestive juices. AVorking a horse too soon or too hard after feeding may cause either colic or 62 DISEASES OF THE HORSE. indigestion. Any condition that reduces the vitality of the horse, such as disease, overwork, poor food, or L^ck of care, may indirectly bring on indigestion by weakening the digestive organs. Symptoins. — Indigestion is characterized by irregular appetite; refusing all food at times, and at others eating ravenously ; the appe- tite is not only irregular, but is often depraved; there is a disposition on the part of the horse to eat unusual substances, such as wood, soiled bedding, or even his own feces ; the bowels are irregular to-day, loose and bad smelling, to-morrow bound ; grain is often passed whole in the feces, and the hay passed in balls or impacted masses, under- going but little change; the horse frequently passes considerable quantities of wind that has a sour odor. The animal loses flesh, the skin presents a hard, dry appearance and seems very tight (hide- bound). If the stomach is very seriously involved, the horse may yawn by stretching the head forward and upward and by turning outward the upper lip. There may be more or less colicky pain. In the chronic cases there is mental depression ; the horse is sluggish and dull. The abdomen gradually becomes small, giving a " tucked up " appearance, or, on the other hand, it becomes flaccid and pendulous. Treatment. — One should commence Avith the food — its quality, quantity, and time of feeding; examine the water supply, and see, besides, that it is given before feeding; then carefully observe the condition of the mouth and teeth ; and, continuing the observations as best we may, endeavor to locate the seat of the trouble. If the teeth are sharp or irregular they must be rasped down ; if any are decayed they must be extracted; if indigestion is due to ravenous eating or bolting, the feed must then be given from a large manger where the grain can be spread and the horse thus compelled to eat slowly. Any irritation, such as worms, undigested food, etc., that are operating as causes are to be removed by appropriate treatment, as advised elsewhere. If there is a tendency to distention of the stomach and bowels, with gas, during indigestion, the following may be used : Baking soda, powdered ginger, and powdered gentian, equal parts. These are to be thoroughly mixed and given in heaping tablespoonful doses, twice a day, before feeding. This powder is best given by dissolving the above quantity in a half pint of water and given as a drench. As a digestive tonic the following is good: Glauber's salts, 2 pounds; common salt, 1 pound; baking soda, one-half pound. Of this a heaping tablespoonful may be given in each feed. If diarrhea exists, the treatment advised below may be used. Diarrhea. — Diarrhea is due to indigestion or intestinal catarrh or to irritation of the bowels from eating moldy or musty food, drinking stagnant water, diseased condition of the teeth, eating irritating sub- stances, to being kept on low, marshy pastures, and exposure during SUPERPURGATION. 63 cold nights, or low, damp stables. Some horses are predisposed to scour and are called " washy " by horsemen ; they are those with long bodies, long legs, and narrow, fiat sides. Horses of this build are almost sure to scour if fed or watered immediately before being put to work. Fast or road work, of course, aggravates this trouble. Diar- rhea may exist as a complication of other diseases as pneumonia and influenza, for instance, and again during the diseases of the liver. The symptoms are the frequent evacuations of liquid stools, with or without pronounced abdominal pain, loss of appetite, emaciation, etc. Treatment is at times very simple, but requires the utmost care and iudement. If due to faulty food or water it is sufficient to change these. If it results from some irritant in the intestines, this is best gotten rid of by the administration of an oleaginous purge, for which nothing is better than castor oil, although raw linseed oil may be used if the case is not severe. The diarrhea often disappears with the ces- sation of the operation of the medicine. If, however, purging con- tinues, it may be checked by giving wheat flour in water, starch water, white-oak bark tea, chalk, opium, or half-dram doses of sul- phuric acid in one-half pint of water twice or thrice daily. Good results follow the use of powdered opium 2 drams and subnitrate of bismuth 1 ounce, repeated three times a day. It should be remem- bered in all cases to look to the water and feed the horse is receiving. If either of these is at fault it is at once to be discontinued. We should feed sparingly of good, easily digested foods. With that peculiar build of nervous horses that scour on the road but little can be done, as a rule. They should be watered and fed as long as possi- ble before iroinff on a drive. If there is much flatulencv accompany- ing diarrhea, baking soda or other alkaline medicines may effect a cure, while if the discharges have a very disagreeable odor, this can be corrected by 1 ounce of sulphite of soda or dram doses of creolin in water, repeated twice a day. Be slow to resort to either the vege- table or mineral astringents, since the majority of cases will yield to chansre of food and water or the administration of oils. Afterwards feed ujjon wheat-flour gruel or other light foods. The body should be warmly clothed. SuPERPT KOATioN. — This is the designation of that diarrhea, or flux from the l)()wels, that, at times, is induced by and follows the action of a physic. It is accompanied by much irritation or even inflamma- tion of the bowels and is always of a serious character. Although in rare instances it follows from a usual dose of physic and where every precaution has been taken, it is most likely to result under the follow- ing circumstances: Too large a dose of physic; giving physics to horses suffering from pneumonia, influenza, or other debilitating dis- eases; riding or driving a horse when purging: exposure or drafts of cold air; or giving large quantities of cold water while the physic is 64 DISEASES OF THE HORSE. operating. There is always danger of superpurgation if a physic is given to a horse suffering from diseases of the respiratory organs. Small and often-repeated phj^sics are also to be avoided, as they pro- duce debility and great depression of the system and predispose to this disorder. "\Mien a f)hysic is to be given one shoidd rest the horse and give him sloppy food until the medicine begins to oj^jerate; clothe the bod}^ with a w^arm blanket; keep out of drafts; give only warm water in small quantities. After a horse has purged from twelve to twenty-four hours it can mostly be stopped, or " set," as horsemen say, by feeding on dry oats and hay. Should the purging continue, however, it is best treated by giving demulcent drinks — linseed tea and oatmeal or wheat-flour gruel. After this the astringents spoken of for diarrhea may be given. Besides this the horse is to receive brandy in doses of from 2 to 4 ounces, with milk and eggs, four or rive times a day. Laminitis " founder '' is a frequent sequel of superpurgation and is to be guarded against by removing the shoes and standing the liorse on moist sawdust or some similar bedding. Dysentery. — This disease, sometimes called '' bloody flux," is an intestinal disease attended wdth fever, occasional abdominal pains, and fluid discharges mingled with blood. Discharges in dysentery are coffee colored or bloody, liquid, and very offensive in odor, and passed with much straining. It is rare in the horse, but is sometimes quite prevalent among foals. Causes. — Probably the most common cause is keeping young horses in particular for a long time on low, wet, marshy pastures, without other feed (a diarrhea of long standing sometimes terminates in dys- entery) ; exposure during cold, wet weather; decomposed foods; stag- nant w^ater that contains large quantities of decomposing vegetable matter; low, damp, and dark stables, particularly if crowded; the existence of some disease, as tuberculosis of the abdominal form. In suckling foals it may come from feeding the dam on irritant foods or from disease of the udder. In other foals it may be produced by exposure to cold and damp, to irritant food, or to w^orms. Symptoms. — The initial symptom is a chili, which probably escapes notice in the majority of instances. The discharges are offensive and for the most part liquid, although it is common to find lumps of solid fecal matter floating in this liquid portion; shreds of mucous mem- brane and blood may be passed, or the evacuations may be muco-puru- lent; there is much straining, and, rarel}^, symptoms of abdominal pain; the subject lies down a great deal; the pulse is quickened and the temperature elevated. Thirst is a prominent symptom. In the adult, death rarely follow^s under two to three weeks, but in foals the disease may end in death after a few days. Treatment. — This is most unsatisfactory, and I am inclined to place GASTRO-ENTERITIS. 65 more dependence upon the care and feed than any medication that may be adopted. First of all the horse must be phiced in a dry, warm, yet Avell-ventihited stable; the skin is to receive attention by frequent rubbin .5 56 DISEASES OF THE HORSE. make this chain of evidence complete, the poison may be discovered in the organs of the horse by chemical analysis. In nearly all cases of gastro-enteritis there is nervous depression. The poisons that are most irritant to the digestive tract are arsenic, corrosive sublimate, sugar of lead, sulphate of copper, sulphate or chloride of zinc, lye or other strong alkalies, mineral acids, and, among the vegetable poisons, tobacco, lobelia, and water hemlock. The treatment will depend upon the cause, but if this can not be detected, certain general indications may be observed. In all cases food should be given in small amounts and should be of the most soothing description, as oatmeal gruel, flaxseed tea, hay tea, fresh grass, or rice water. The skin should be well rubbed with wisps of straw and alcohol, to equalize the distribution of the blood ; the legs, after being rubbed until warm, should be bandaged in raw cotton or with woolen bandages. The horse should be warmly blanketed. It is well to apply to the abdomen blankets wrung out of hot water and frequently changed ; or mustard paste may be rubbed on the skin of the belly. Internally, opium is of service to allay pain, check secre- tion, and soothe the inflamed membrane. The dose is from 1 to 2. drams, mven everv three or four hours. If there is constipation, the opium should be mixed with 30 grains of calomel. Subnitrate ot bismuth may be given with the opium or separately in 2- dram doses. Stimulants, such as alcohol, aromatic spirits of ammonia, or camphor may be given in 2-ounce doses, mixed with warm water to make a drench. If putrid food has been consumed, creolin may be administered in doses of 2 drams, mixed with 1 pint of warm water or milk. If there is obstinate constipation and a laxative must be employed, it should be sweet or castor oil, from 1 pint to 1 quart. For the various poisons the remedies are as follows: Arsenic^ oxyhydrate of iron solution, 1 pint to 1 quart, or calcined magnesia one-half ounce in 1 pint of water; corrosive sublimate^ the whites of a dozen eggs or 2 ounces of flowers of sulphur ; sucjar of lead., Glauber's salts, 1 pound in 1 quart of warm water, to be followed with iodide of potash, 3 drams at a dose, in water, three times daily for five days ; sulphate of copper., milk, the whites of eggs, or reduced iron ; sulphate of chlo- ride of zinc, milk, the whites of eggs, or calcined magnesia ; lye or alkalies., as caustic potash or soda, vinegar, dilute sulphuric acid, and linseed tea, with opium, 3 drams; mineral acids, chalk, or calcined magnesia, or baking soda ; later give linseed tea and opium. HEMORRHoros, OR PILES. — Thcse are rare, comparatively, in horses. They are diagnosed by the appearance of bright-red irregular tumors after defecation, which may remain visible at all times or be seen only when the horse is down or after passing his manure. They are mostly due to constipation, to irritation, or injuries, or follow from the HERNIA, OR RUPTURE. 67 severe straining during- dysentery. I have observed them to follow from severe labor pam^ in the mare. Treatment. — Attention nuist be paid to the condition of the bowels; they should be soft, but purging is to be avoided. The tumors should be washed in warm water and thoroughly cleansed, after Avliich scarif}^ them and gently but firmly squeeze out the liquid that will be seen to follow the shallow incisions. After thus squeezing these tumors and before replacing through the anus, bathe the parts with some anodyne wash. For this purpose the glycerite of tannin and laudanum in equal parts is good. Mucilaginous injections into the rectum may be of service for a feW' days. Hekxia, ok rupture. — There are several diti'erent kinds of hernias that reipiire notice, not all of wdiich, however, produce serious symp- toms or results. Abdominal hernias, or mixtures, are divided into reducible, if^reducible, and strangulated, according to condition : and into inguinal, scrotal^ rentral, umbilical, and diaphragmatic, accord- ing to their situation. A hernia is reducible when the displaced organ can be returned to its natural location. It consists of a soft swelling, without heat, pain, or any uneasiness, generally larger on full feed, and decreases in size as the bowels become empty. An irreducible hernia is one that can not be returned into the abdomen, and yet does not cause any pain or uneasiness. Strang idated hernia is one where the contents of the sac are greatly distended, or where from pressure upon the blood vessels of the imprisoned portion the venous circula- tion is checked or stopped, thereby causing congestion, swelling, in- tlammation. and, if not relieved, gangrene of the part and death of the animal. According to the time or mode of origin, hernias may be congenital or acquired. Congenital .scrotal hernia. — Not a few foals are noticed from birth to have an enlarged scrotum, which gradually increases in size until about the sixth month, sometimes longer. Sometimes the scrotum of a six-months-old colt is as large as that of an adult stallion, and operative treatment is considered. This is unnecessary in the great majority of cases, as this enlargement often disappears by the time the colt has reached his second year. Any interference, medicinal or surgical, is worse than useless. If the intestine contained wathin the scrotum should at any time become strangulated, it must then be treated the same as in an adult horse. Scrotal hernia is caused by dilatation of the sheath of the testicle, combined with relaxation of the fibrous tissues surrounding the in- guinal ring, thus allowing the intestine to descend to the scrotum. At first this is intermittent, appearing during work and returning when the horse is at rest. For a long time this form of hernia may not cause the least uneasiness or distress. In course of time, however, the imprisoned gut becomes filled Avith feces, its return into the ab- 68 DISEASES OF THE HORSE. (lominal cavity is prevented, and it becomes strangulated. While the gut is thus filling the horse often appears dull, is disinclined to move, apj)etite is impaired, and there is rumbling and obstruction of the bowels. Colick^y symptoms now supervene. Strangulation and its consequent train of symptoms do not always follow in scrotal hf^rnia, for often horses have this condition without suffering incon- A^enience for years. InguiiKil Jiern'td is but an incomplete scrotal hernia, and, like the latter, may exist and cause no signs of distress, or, again, it may be- come strangulated and cause the death of the animal. Inguinal hernia is seen mostly in stallions, next in geldings, and very rarely in the mare. Bearing in mind that scrotal hernia is seen only in entire horses, we can proceed to detail the symptoms of both strangulated, inguinal, and scrotal hernia at the same time. \Vlien, during the existence of colicky symptoms, we find a horse kicking with his hind feet while standing or lying upon his back, we should look to the inguinal region and scrotum. If scrotal hernia exists the scrotum will be enlarged and lobulated ; by pressure we may force a portion of the contents of the gut back into the abdomen, eliciting a gurgling sound. If we take a gentle but firm hold upon the enlarged scrotum and then have an assistant cause the horse to cough, the swelling will be felt to expand and as quickly contract again. The history of these cases will materially aid us, as the owner can often assure us of j^receding attacks of " colic," more or less severe, that have been instantaneously relieved in some (to him) unaccounta- ble manner. The colicky symptoms of these hernias are not diagnos- tic, but, probably, more closely resemble those of enteritis than any other bowel diseases. The diagnosis can, in many cases, be made only by a veterinarian, when he has recourse to a rectal examination; the bowels can here be felt entering the internal abdominal ring. Treatment of inguinal hernia. — If the reader can be sure of the existence of hernia, he should secure the horse upon its back, and, with a hand in the rectum, endeavor to catch hold of the wandering bowel and pull it gently back into the cavity of the abdomen. Pres- sure should be made upon the scrotum during this time. If these means fail a veterinarian must be called to reduce the hernia by means of incising the inguinal ring, replacing the intestines, and castrate, using clamps and performing the " covered o^^eration." Ventral hernia. — In this form of hernia the protrusion is through some accidental opening or rupture of the abdominal wall. It may occur at any part of the belly except at the umbilicus, and is caused by kicks, blows, hooks, severe jumping or pulling, etc. Ventral hernia is most common in ])regnant mares, and is here due to the weight of the fetus or some degenerative changes taking place in the abdominal coats. It is recognized by the appearance of a swelling, HERNIA, OR RUPTURE. 69 at the base of which can be felt the opening or rent in the abdominal tunics, and from the fact that the swelling containing the intestines can be made to disappear when the animal is placed in a favorable j)osition. Treatment of central hernia. — In man}^ instances there is no occa- sion for treatment, and again, where the hernial sac is extensive, treat- ment is of no avail. If the hernia is small, a cure may be attempted by the methods to be described in treating of umbilical hernia. If one is fortunate enough to be present when the hernia occurs, and particularly if it is not too large, he may, by the proper api)lication of a pad and broad bandage, eifect a perfect cure. Umhilieal hernia is the passing of any portion of the bowel or omentum (" caul ") through the navel, forming a " tumor " at this point. This is often congenital in our animals, and is due to the im- perfect closure of the umbilicus and to the position of the body. Many cases of umbilical hernia, like inguinal and scrotal of the con- genital kind, disappear entirely by the time the animal reaches its second or third year. Advancing age favors cure in these cases from the fact that the omentum (swinging support of the bowels) is pro- portionally shorter in adults thafi in foals, thus lifting the intestines out of the hernial sac and allowing the opening in the walls to close. Probably one of the most frequent causes of umbilical hernia in foals is the i)ractice of keeping them too long from their dams, causing them to fret and worry, and to neigh, or cry, by the hour. The con- traction of the abdominal muscles and pressure of the intestines dur- ing neighing seem to open the umbilicus and induce hernia. Acci- dents may cause umbilical hernia in adults in the same manner as ventral hernia is produced, though this is very rare. Treatment of ximhilical hernia. — In the treatment of umbilical hernia it should be remembered that congential hernias are often removed with age, but probably congenital umbilical hernias less fre- quently than others. Among the uuiny plans of treatment are to be mentioned the application of a pad over the tumor, the pad being held in place by a broad tight bandage placed around the animal's body. The chief objection to this is the difficulty in keeping the pad in its place. Blisters are often applied over the swelling, and. as the skin hardens and contracts by the formation of scabs, an artificial bandage or pressure is produced that at times is successful. Another treatment that has gained considerable repute of late years consists in first clipping off the hair over the swelling. Nitric acid is then applied by a small brush, using only enough to moisten the skin. This sets up a deep-seated adhesive inflammation, which, in very many cases, closes the opening in the navel. Still another plan is to inject a solution of couuuon salt by means of the hypodermic syringe at three or four points about the base of the swelling. This acts in 70 DISEASES OF THE HORSE. the same manner as the preceding, but may cause serious injury if the syringe or solution is not sterile. Others, again, after keeping the animal fasting for a few hours, cast and secure it upon its back ; the bowel is then carefully returned into the abdomen. The skin over the opening is pinched up and one or two skewers are run through the skin from side to side as close as possible to the umbilical opening. These skewers are kept in place by passing a cord around the skin between them and the abdomen and securely tied. Great care must be taken not to draw these cords too tight^ as this would cause a speedy slough of the skin, the intes- tines would extrude, and death result. If properly applied, an adhe- sion is established between the skin and the umbilicus which effectually closes the orifice. Special clamps are provided for taking up the fold of the skin covering the hernial sac and holding it until the ad- hesion is formed. Diaphragmatic hernia. — This consists of the passage of any of the abdominal viscera through a rent in the diaphragm (midriff) into the cavity of the thorax. It is rather a rare accident and one often impossible to diagnose during life. Colicky symptoms, accompanied by great difficulty in breathing, and the peculiar position so often assumed (that of sitting upon the haunches) are somewhat character- istic of this trouble, though these symptoms, as we have already seen, may be present during diseases of the stomach or anterior portion of the bowels. Even could we pronounce, with certainty, this form of hernia, there is little or nothing that can be done. Leading the horse U13 a very steep gangway or causing him to rear up may possibly cause the hernial portion to return to its natural position. This is not enough, however ; it must be kept there. Peritonitis. — Peritonitis is an inflammation of the serous mem- brane lining the cavity of and covering the viscera contained within the abdomen. It is very rare to see a case of primary peritonitis. It IS, however, somewhat common as a secondary disease from extension of the inflammatory action involving organs covered by the perito- neum. Peritonitis is often caused by injuries, as punctured wounds of the abdomen, severe blows or kicks, or, as is still more common, fol- lowing the operation of castration. It follows strangulated hernia, invagination, or rupture of the stomach, intestines, liver, or womb. Symptoms. — Peritonitis is mostly preceded by a chill ; the horse is not disposed to move, and, if compelled to do so, moves with a stiff or sore gait ; he paws with the front feet and may strike at his belly wdth the hind ones; lies down very carefully; as the pain is increased while down, he maintains during most of the time the standing position ; he walks uneasily about the stall. Constipation is usually present. Pres- sure on the belly causes acute pain, and the horse will bite, strike, or kick if so disturbed; the abdomen is tucked up; the extremities are DROPSY OF THE ABDOMEN. 71 fine and cold. The temperature is higher than normal, reaching from 102° to 104° F. The pulse in peritonitis is rather characteristic; it is quickened, beating from seventy to ninety beats per minute, and is hard and wiry. This peculiarity' of the pulse occurs in inflammation of the serous membrane, and if accompanied by colicky 'symptoms, and, in particular, if following any injuries, accidental or surgical, of the peritoneum, there is reason to think that peritonitis is present. Peritonitis in the horse is mostly fatal when it is at all extensive. If death does not occur in a short time, the inflammation assumes a chronic form, in which there is an extensive effusion of w^ater in tlie cavity of the belly, constituting what is known as ascites^ and which, as a rule, results in death. The treatment of peritonitis is to be somewhat like that of enteri- tis. Opium in powder. 1 to '2 drams, with calomel, one-half dram, is to be given every two, three, or four hours, and constitute the main dependence in this disease. Extensive counterirritants over the belly, consisting of mustard j^lasters, applications of mercurial ointment, turpentine stupes, or even mild blisters, are recommended. Purga- tives must never be given during this complaint. Should we desire to move the bowels, it can be done by gentle enemas, though it is seldom necessary to resort even to this. Ascites, or dropsy of the abdomen. — This is seen as a result of subacute or chronic peritonitis, but may be due to diseases of the liver, kidneys, heart, or lungs. There Avill be found, on opening the cavity of the belly, a large collection of yellowish or reddish liquid ; from a few quarts to several gallons may be present. It may be clear in color, though generally it is yellowish or of a red tint, and contains numerous loose flakes of coagulable lymph. Symptomi^. — There is slight tenderness on pressure ; awkward gait of the hind legs; the horse is dull, and may have occasional very slight colicky })ains. shown by looking back and striking at the belly with the hind feet. Oftener, however, these colicky symptoms are absent. Diarrhea often precedes death, but during the progress of the disease the bowels are alternately constipated and loose. On percussing the abdominal walls we find that dullness exists to the same height on both sides of the belly : by suddenly pushing or striking the abdomen we can hear the rushing or flooding of water. If the case is an ad- vanced one, the horse is potbellied to the extreme, and dropsical swellings are seen under the belly and upon the legs. Treatment is, as a rule, unsatisfactory. Saline cathartics, as Ep- som or Glauber's salts, and diuretics, ounce doses of saltpeter, may be given. If a veterinarian is at hand he will withdraw the accumula- tion of water by tapping and then endeavor to prevent its recurrence (though this is almost sure to follow) by giving three times a day saltpeter, 1 ounce, and iodide of potash, 1 dram, and by the applica- 72 DISEASES OF THE HORSE. tioii of mustard or blisters over the abdominal walls. Tonics, min- eral and vegetable, are also indicated. Probably the best tonic is one consisting of powdered sulphate of iron, gentian, and ginger in equal parts ; a heaping tablespoonful of the mixture is given as a drench or mixed with the feed, twice a day. Good nutritious foods and gentle exercise complete the treatment. DISEASES OF THE I.lVER. This organ in the horse is, in the United States, but rarely the seat of disease, and when we consider how frequently the liver of man is a fleeted this can not but appear strange. The absence of the gall bladder may account to a certain extent for his freedom from liver diseases; as overdistention of this and the presence in it of calculi (stones) in man is a frequent source of trouble. In domestic animals, as in man. hot climates tend to produce diseases of the liver, just as in cold climates lung diseases prevail. Not only are diseases of the liver rare in horses in temperate climates, but they are also very obscure, and in many cases pass totally unobserved until after death. There are some symptoms, however, which, when present, should make us examine the liver as carefully as possible. These are jaundice (yellowness of the mucous membranes of the mouth, nose, and eyes) and the condition of the dung, it being light in color and pasty in appearance. Hepatitis, or inflammation of the li\t;r. — This disease may be general or local, and may assume an acute or chronic form. The symftoms of acute hepatitis are: Dullness; the horse is suffer- ing from some internal pain, but not of a severe type ; constipated and clay-colored dung balls ; scanty and high-colored urine ; and general febrile symptoms. If lying down, he is mostly found on the left side ; looks occasionally toward the right side, which, upon close inspection, may be found to be slightly enlarged over the posterior ribs, where pain upon pressure is also evinced. Obscure lameness in front, of the right leg mostly, may be a symptom of hepatitis. The horse, toward the last, reels or staggers in his gait and falls backward in a fainting fit, during one of which he finally succumbs. Death is sometimes due to rupture of the enveloping coat of the liver or of some of its blood vessels. Causes. Among the causes that lead to this disease we must men- tion first the stimulating effect of overfeeding, particularly during hot weather. Horses that are well fed and receive but little exercise are the best subjects for diseases of this organ. We must add to these causes the more mechanical ones, as injuries on the right side over the liver, worms in the liver, gallstones in the biliary ducts, for- eign bodies— as needles or nails that have been swallowed and in their wanderings have entered the liver — and, lastly, in some instances, the DISEASES OF THE LIVER. 73 extension of inflammation from neigliborin«>- parts, thus involving this organ. Acute hepatitis may terminate in chronic inflannnation, abscesses, rupture of the liver, or may disappear, leaving beliind no trace of disease whatever. Treatment. — This should consist, at first, of the administration of I ounce of Barbados aloes or other physic. General blood-letting, if had recourse to early, must prove of much benefit in acute inflamma- tion of the liver. The vein in the neck (jugular) must be opened, and from 4 to C quarts of blood may be drawn. Saline medicines, as Glauber's salts or the artificial Carlsbad salt, is indicated. These may be given with the feed in tablespoonful doses. The horse is to be fed sparingly on soft food, bran mashes chiefly. If treatment proves successful and recovery takes place, see to it that the horse afterwards gets regular exercise and that his food is not of a too highly nutritious character and not excessive. Jaundice, ictkrus, or the yelloavs. — This is a condition caused by the retention and absorption of bile into the blood. It was for- merly considered to be a disease of itself, but is now regarded as a symptom of disorder of the liver. " The yellows " is observed by looking at the eyes, nose, and mouth, Avhen it will be seen that these parts are yellowish instead of the pale-pink color of health. In white or light-colored horses the skin even may show this j'^ellow tint. The urine is saffron colored, the dung is of a dirty-gray color, and con- stipation is usually present. Jaundice may be present as a symptom of almost any inflammatory disease. We know that when an animal has fever the secretions are checked, the bile may be retained and absorbed throughout the system, and yellowness of the mucous mem- branes follows. Jaundice may also exist during the presence of simple constipation, hepatitis, biliary calculi, abscesses, hardening of the liver, etc. Treatment. — "When jaundice exists we must endeavor to rid the system of the excess of bile, and this is best accomplished by giving purgatives that act upon the liver. Calomel, 2 drams, with aloes, 7 drams, should be given. Glauber's salts in handful doses once or twice a day for a week is also effective. May apple, rhubarb, castor oil, and other cathartics that act upon the first or small bowels may be selected. AVe must be careful to see that the bowels are kept open by avoiding hard, dry, bulky foods. Rupture of the liver. — This is known to occur at times in the horse, most frequently in old fat horses and those that get but little exercise. Horses that have suffered from chronic liver disease for years eventually present symptoms of colic and die quite suddenly. Upon post-mortem examination we discover that the liver had rup- tured. The cicatrices, or scars, that are often found upon the liver indicate that th's organ may suffer small rupture and yet the horse 74 DISEASES OF THE HORSE. recover from it. This result can not obtain, however, if the rent or tear is extensive, since in such cases death must quickly follow from hemorrhage, or, later, from j)eritonitis. Enlarged liver is particu- larly liable to rupture. CaKSi'S. — The immediate causes of rupture appear to be excessive muscular exertion, as leaping a fence, a fall, a blow from a collision, a kick from a horse, or sudden distention of the abdomen with gas. The symptoms of rupture of the liver will depend upon the extent of the laceration. If slight, there will be simply the symptoms of abdominal pain, looking back to the sides, lying down, etc. ; if exten- sive, the horse is dull and dejected, has no appetite, breathing be- comes short and catching, he sighs or sobs, visible mucous mem- branes are pale, extremities cold, pulse fast, small, and weak or I'unning down. Countenance now shows much distress, he sweats profusely, totters in his gait, props his legs wide apart, reels, stag- gers, and falls. He may get up again, but soon falls dead. The rapid running-down pulse, paleness of the eyes, nose, and mouth, sighing, stertorous breathing, tottering gait, etc., are symptoms by which we know that the animal is dying from internal hemorrhage. Treatment. — But little can be done in the way of treatment. Opium in poAvder, in doses of 2 drams every two or three hours, may be given, with the idea of preventing as much as possible all movements of internal organs. If there is reason to suspect internal bleeding, we should give large and frequent doses of white-oak bark tea, dram doses of tannic or gallic acid, or the same quantity of sugar of lead, every half hour or hour. Fluid extract of ergot or tincture of the chloride of iron, in ounce doses, may be selected. Cold water dashed upon the right side or injected into the rectum is highly spoken of as a means of checking the hemorrhage. Biliary calculi, or gallstones. — These are rarely found in the horse, but may occupy the hepatic ducts, giving rise to jaundice and to colicky pains. There are no absolutely diagnostic symptoms, but should one find a horse that sulfers from repeated attacks of colic, accompanied by symptoms of violent pain, and that during or follow- ing these attacks the animal is jaundiced, it is possible that gallstones are present. There is little or nothing to be done except to give medicines to overcome pain, trusting that these concretions may pass on to the bowels, where, from their small size, they will not occasion any inconvenience. Diseases of the pancreas and spleen. — Diseases of the pancreas and spleen are so rare, or their symptoms so little understood, that it IS impossible to write anything concerning either of these organs and their simple diseases that will convey to the I'^ader information of practical value. < Oh -^- c^; o5 s> 'o ;o- ,.- oo" o,^ ^~ =:? 5> £2 ^^ ^' 50 !:; PLA.TEII. 77u' cutd/t . /jOg- j^'^:-^/^. 'I'/ic (iiiiifr IlilllK K.dl'l W OTS. I l{()ls ill till- sloiiiacli . '1 Hols in tlu' (iiHxIciiiiiii JULIUS BICN «,CO.NV PT. AT F rn. \ (J.ryunW t'l/iti. SlrongviiU''- ci/iiiuiis. Ascaris fquoruni Uaini-s dol IKTE STT NTAl. WO-R M S DISEASES OF THE URINARY ORGANS. By James Law, F. R. C. V. S.. Professor of Tctcrinanj Science, etc., in Cornell University. [Revised in 1903 by the author. 1 USES OF THE URINARY ORGANS. The urinary organs constitute the main channel through which are excreted the nitrogenous or albuminoid principles, whether derived directly from the food or from the muscular and other nitrogenized tissues of the body. They constitute, besides, the channel through which are thrown out most of the poisons, whether taken in by the mouth or skin or developed in connection with faulty or natural digestion, blood-forming, nutrition, or tissue destruction ; or, finally, poisons that are developed within the body, as the result of normal cell life or of the life of bacteria or other germs that have entered the body from without. Bacteria themselves largely escape from the body through the kidneys. To a large extent, therefore, these organs are the sanitary scavengers and purifiers of the system, and when their functions -are impaired or arrested the retained poisons quickly show their presence in resulting disorders of the skin and connective tissue beneath it, of the nervous system, or other organs. Nor is this influence one-sided. Scarcely an important organ of the body can suffer derangement without entailing a corresponding disorder of the urinary system. Nothing can be more striking than the mutual bal- ance maintained between the liquid secretions of the skin and kidneys during hot and cold weather. In summer, when so much liquid ex- hales through the skin as sweat, comparatively little urine is passed, whereas in winter, when the skin is inactive, the urine is correspond- ingly increased. This vicarious action of skin and kidneys is usually kept within the limits of health, but at times the draining oif of the water l)y the skin leaves too little to keep the solids of the urine safely in solution, and these are liable to crystallize out and form stone and gravel. Similarly the passage in the sweat of some of the solids that normally leave the body, dissolved in the urine, serves to irritate the skin and produce troublesome eruptions. PROMINENT CAUSES OF URINARY DISORDERS. A disordered liver contributes to the production, under different circumstances, of an excess of biliary coloring matter, which stains 75 76 DISEASES OF THE HORSE. the urine; of an excess of hippuric acid and allied products, which being less soluble than urea (the normal product of tissue change), favor the formation of stone, of taurocholic acid, and other bodies that tend, Avhen in excess, to destroy the blood globules and to cause irritation of the kidneys by the resulting hemoglobin excreted in the urine, and of glycogen too abundant to be burned up in the system, which induces saccharine urine (diabetes). Any disorder leading to impaired functional activity of the lungs is causative of an excess of hippuric acid and allied bodies, of oxalic acid, of sugar, etc., in the urine, which irritate the kidneys even if they do not produce solid deposits in the urinary passages. Diseases of the nervous system, and notably of the base of the brain and of the spinal cord, induce various urinary disorders, prominent among which are diabetes, chylous urine, and albuminuria. Certain aifections. with imperfect nutrition or destructive waste of the bony tissues, tend to charge the urine with phosphates of lime and magnesia, and endanger the forma- tion of stone and gravel. In all extensive inflammations and acute fevers the liquids of the urine are diminished, wliile the solids (waste products), which ^-hould form the urinary secretion, are increased, and the surcharged urine proves irritant to the urinary organs or the retained waste products poison the system at large. Diseases of the heart and lungs, by interfering with the free onward flow of the blood from the right side of the heart, tend to throw that liquid back on the veins, and this backward pressure of venous blood strongly tends to disorders of the kidneys. Certain poisons taken with the food and water, notably that found in magnesian limestone and those found in irritant diuretic plants, are especially injurious to the kidneys, as are also various cryptogams, whether present in musty hay or oats. The kidneys may be irritated by feeding green vege- tables covered with hoar frost or by furnishing an excess of food rich in phosphates (wheat bran, beans, pease, vetches, lentils, rape cake, cotton-seed cake) or by a privation of water, which entails a concen- trated condition and liigh density of the urine. Exposure in cold rain or snow storms, cold drafts of air, and damp beds are liable to further disorder an already overworked or irritable kidney. Finally, sprains of the back and loins may cause bleeding from the kidneys or inflammation. The right kidney, weighing 23^ ounces, is shaped like a French bean, and extends from the loins forward to beneath the heads of the last two ribs. The left kidney (Plate IV) resembles a heart of cards, and extends from the loins forward beneath the head of the last rib only. Each consists of three distinct parts— (a) the external (corti- cal), or vascular part, in Avhich the blood vessels form elaborate capillary networks within the dilated globular sacs which form the beginnings of the secreting (uriniferous) tubes and on the surface PLATE IV. '/ /, \ ^ t:. fl o (I iCor'ticfil (or \'<>\-ul.p.66'J. L()X(;iTri)lNAL SKCTIOX TH'ROI'GH KIDNKY. juuus BicN ft CO N y DISEASES OF THE URINARY ORGANS. 77 of the sinuous secreting- tubes leading from the sacs inward toward th? second, or mednUary, part of the organ; (b) the internal (medul- la '•) part, made up in the main of blood vessels, lym})hatics, and p ves extending between the notch on the inner border of the kid- 1 to and from the outer vascular portion, in which the secretion ' urine is almost exclusively carried on; and ((/) a large saccular '•eservoir in the center of the kidney, into which all nriniferous tubes pour their secretions and from which the urine is carried away through a tube (/ (ureter), which passes out of the notch at the inner border of the kidney and which opens by a valve-closed orifice into the roof of the bladder just in front of its neck. The bladder is a dilatable reservoir for the retention of the urine until the discomfort of its presence causes its voluntary discharge. It is kej^t closed by circu- lar muscular fibers surrounding its neck or orifice, and is emptied by looped muscular fibers extending in all directions forward from the neck around the blind anterior end of the sac. From the bladder the urine escapes through a dilatable tube (urethra) which extends from the neck of the bladder backward on the floor of the pelvis, and in the male through the penis to its free end, where it opens through a pink conical papilla. In the mare the urethra is not more than an inch in length, and is surrounded by the circular muscular fibers closing the neck of the bladder. Its opening may be found directly in tlie median line of the floor of the vulva, about 4^ inches from its external opening. GENERAI. SYMPTOMS OF DISEASE. These aj^ply especially to acute inflammations and the irritation caused by stone. The animal moves stiffly on the hind limbs, strad- dles, and makes frequent attempts to pass urine, which nuiy be in excess, deficient in amount, liable to sudden arrest in spite of the straining, passed in driblets, or entirely suppressed. Again, it may be modified in density or constituents. Difficulty in making a sharp turn, or in lying down and rising with or without groaning, drop- ping the back when mounted or when pinched on the loins is sugges- tive of kidney disease, and so to a less extent are swelled legs, dropsy, and diseases of the skin and nervous system. The oiled liand intro- duced through the rectum may feel the bladder beneath and detect any overdistention, swelling, tenderness, or stone. In ponies the kid- neys even may be reached. EXAMINATION OF THE URINE. In some cases the changes in the urine ar(» the sole sign of disease. In health the horse's urine is of a deep amber color and has a strong- odor. On a feed of grain and hay it may show a uniform transpar- 78 DISEASES OF THE HORSE. ency, Avhile on a green ration there is an abundant white deposit of carbonate of lime. Of its morbid changes the following are to be looked for: (1) Color: AMiite from deposited salts of lime; brown or red from blood clots or coloring matter; yellow or orange from bile or blood pigment; pale from excess of water; or varionsly colored from vegetable ingredients (santonin makes it red; rhubarb or senna, brown; tar or carbolic acid, green). (2) Density: The horse's urine may be 1.030 to 1.050, but it may greatly exceed this in diabetes and may sink to 1.007 in diuresis. (3) Chemical reaction., as ascertained by blue litmus or red test papers. The horse on vegetable diet has alkaline nrine turning red test papers blue, while in the sucking colt and the horse fed on flesh or on his own tissues (in starvation or ab- stinence during disease) it is acid, turning blue litmus red. (-4) Organic constituents., as when glairy from albumen coagulable by strong nitric acid and boiling, when charged with microscopic casts of the uriniferous tubes, with the eggs or bodies of worms, with sugar, blood, or bile. (5) In its salts, which may crystallize out spontane- ously, or on boiling, or on the addition of chemical reagents. Albuminous urine in the horse is usually glairy, so that it may be drawn out in threads, but its presence can always be tested as follows: If the liquid is opaque, it may be first passed through filter paper ; if very dense and already precipitating its salts, it may be diluted with distilled water; add to the suspected liquid acetic acid drop by drop until it reddens the blue litmus paper ; then boil gently in a test tube ; if a precipitate is thrown down, set the tube aside to cool and then add strong nitric acid. If the precipitate is not dissolved, it is albumen; if dissolved it was probably urate or hippurate of ammonia. Albu- men is normally present in advanced gestation ; abnormally it is seen in diseases in which there occurs destruction of blood globules (anthrax, low fevers, watery states of the blood, dropsies), in diseases of the heart and liver which prevent the free escape of blood from the veins and throw back venous pressure on the kidneys, in inflamma- tion of the lungs and pleurae, and even tympany (bloating), doubtless from the same cause, and in all congestive or inflammatory diseases of the kidneys, acute or chronic. Casts of the uriniferous tubes can only be seen by placing the sus- pected urine under the microscope. They are usually very elastic and mobile, waving about in the liquid when the cover-glass is touched, and showing a uniform clear transparency (waxy) or entan- gled circular epithelial cells or opaque granules or flattened red-blood globules or clear refrangent oil globules. They may be even densely opaque from crystals of earthy salts. Pus colls may be found in the urine associated with albumen, and are recognized by clearing up, when treated with acetic acid, so that each cell shows two or three nuclei. DISEASES OF THE URINARY ORGANS. 79 DIURESIS (polyuria, DIABETES INSIPIDUS, OR EXCESSIVE SECRETION OF urine). This consists in an excessive secretion of a clear, watery urine of a low specific gravity (1.007) with a correspondingly ardent thirst, a rapidly advancing emaciation, and great loss of strength and spirit. Causes. — Its causes may be any agent — medicinal, alimentary, or poisonous — which unduly stimulate the kidneys; the reckless admin- istration of diuretics, which form such a common constituent of quack horse powders; acrid diuretic plants in grass or hay; new oats still imperfectly cured; an excess of roots or other very watery food; a full allowance of salt to animals that have become inordinately fond of it; but, above all, feeding on hay, grain, or bran which has not been proi)erly dried and has become musty and permeated by fungi. Thus hay, straw, or oats secured in wet seasons and heating in the rick or stack is especially injurious. Hence this malady, like coma som- nolentinn (sleepy staggers), is widespread in wet seasons, and espe- cially in rain}^ districts. /Symptoms. — The horse drinks deep at every opportunity and passes urine on every occasion when stopped, the discharge being- pale, watery, of a low density, and inodorous; in short, it contains a great excess of water and a deficiency of the solid excretions. So great is the quantity passed, however, that the small amount of solids in any given specimen amounts in twenty-four hours to far more than the normal — a fact in keeping with the rapid wasting of the tissues and extreme emaciation. The flanks become tucked up, the fat disappears, the bones and muscles stand out prominently, the skin becomes tense and hidebound, and the hair erect, scurfy, and deiicient in luster. The eye becomes dull and sunken, the spirits are depressed, the animal is weak and sluggish, sweats on the slightest exertion, and can endure little. The subject may survive for months, or he may die early of exhaustion. In the slighter cases, or when the cause ceases to operate, he may make a somewhat tardy recovery. Treatment. — This consists in stopping the ingestion of the faulty drugs, poisons, or food, and supplying sound hay and grain free from all taint of heating or mustiness. A liberal sui)ply of boiled flaxseed in the drinking water at once serves to eliminate the poison and to sheath and protect the irritated kidneys. Tonics like sulphate or phosphate of iron (2 drams morning and evening) and ])owdered gentian or Peruvian bark (4 drams) help greatly by bracing the system and hastening repair. To these may be added agents calcu- lated to destroy the fungus and eliminate its poisonous products. In that form which de])ends on musty food nothing acts better than large doses of iodide of potassium (2 drams), while in other cases creosote, carbolic acid ( 1 dram), or oil of turpentine (4 drams) properly diluted, may be resorted to. 80 DISEASES OF THE HORSE. SACCHARINE IHABETES ( DIABETES MELLITUS, GLYCOSURIA, OR INOSURIa). This is primarily a disease of the nervous system or liver rather than of the kidneys, yet, as the most j^rominent symptom is the sweet urine, it ma}^ be treated here. Causes. — Its causes are varied, but resolve themselves largely into disorder of the liver or disorder of the brain. One of the most prominent functions of the liver is the formation of glycogen, a prin- ciple allied to grape sugar, and passing into it by further oxidation in the blood. This is a constant function of the liver, but in health the resulting sugar is burned up in the circulation and does not appear in the urine. On the contrary, when the supply of oxygen is defective, as in certain diseases of the lungs, the Avhole of the sugar does not undergo combustion and the excess is excreted by the kidneys. Also in certain forms of enlarged liver the amount of sugar produced is more than can be disposed of in the natural way, and it appears in the urine. A temporary sweetness of the urine often occurs after a hearty meal on starchy food, but this is due altogether to the super- abundant supply of the sugar-forming food, lasts for a few hours only, and has no pathological significance. In many cases of fatal glycosuria the liver is found to be enlarged, or at least congested, and it is found that the disorder can be produced experimentally by agencies which produce an increased circulation through the liver. Thus Bernard produced glycosuria by pricking the oblong medulla at the base of the brain close to the roots of the pneumogastric nerve, which happens to be also the nerve center (vaso-motor) which presides over the contractions of the minute blood vessels. The pricking and irritation of this center leads to congestion of the liver and the exces- sive production of sugar. Irritation carried to this point through the pneumogastric nerve causes saccharine urine, and. in keeping with this, disease of the pancreas has been found in this malady. The com- jilete removal of the pancreas, however, determines glycosuria, the organ having in health an inhibitive action on sugar production by the liver. The same result follows the reflection of irritation from other sources, as from different ganglia (corpora striata, optic thalami, pons, cerebellum, cerebrum) of the brain. Similarly it is induced by interruption of the nervous control along the vaso-motor tracts, as in destruction of the u])i)er or lower cervical sympathetic ganglion, by cutting the nervous branch connecting these two, in injury to the spinal marrow in the interval between the brain and the second or fourth dorsal vertebra, or in disease of the celiac plexus, which directly presides over the liver. Certain chemical poisons also cause saccharine urine, notal)ly woorarn. strychnia, morphia, phosphoric acid, alcohol, ether, quinia. chloroform, ammonia, arsenic, and ])hlorizin. Symptoms. — The symptoms are ardent thirst and profuse secretion SACCHARINE DIABETES (sWEET URINe). 81 of a pale urine of a high density (1.0(50 and upward), rapid loss of condition, scurfy, unthrifty skin, costiveness or irreguhirity of the bowels, indigestion, and the presence in the urine of a sweet princi- pk^ — grape-sugar or inosite, or both. This may be most promptly de- tected by touching the tip of the tongue with a drop. Sugar may be detected simply by adding a teaspoonful of liquid yeast to 4 ounces of the urine and keeping it lightly stopped at a temperature of 70° to 80° F. for twelve hours, when the sugar will be found to have been changed into alcohol and carbon dioxide. The loss of density will give indication of the amount of sugar transformed ; thus a density of 1.035 in a urine Avhich was formerly 1.060 would indicate about 15 grains of sugar to the fluid ounce. Inosite, or muscle sugar, frequently present in the horse's urine, and even replacing the glucose, is not fermentable. Its presence may be indicated by its sweetness and the absence of fermentation or by Gal- lois's test. Evaporate the suspected urine at a gentle heat almost to dryness, then add a drop of a solution of mercuric nitrate and evapo- rate carefully to dryness, when a yellowish residue is left that is changed on further cautious heating to a deep rose color, which dis- appears on cooling and reappears on heating. In advanced diabetes, dropsies in the limbs and under the chest and belly, puffy, swollen eyelids, cataracts, catarrhal inflammation of the lungs, weak, uncertain gait, and drow^siness may be noted. Treatment is most satisfactory in cases dependent on some curable disease of liver, pancreas, lungs, or brain. Thus, in liver diseases, a run at pasture in warm weather, or in winter a warm, sunny, well- aired stable, with sufficient clothing and laxatives (sulphate of soda, 1 ounce daily) and alkalies (carbonate of potassium, one-fourth ounce) may benefit. To this may be added mild blistering, cupping, or even leeching over the last ribs. Diseases of the brain or pancreas may be treated according to their indications. The diet should be mainly albuminous, such as wheat bran or middlings, pease, beans, vetches, and milk. Indeed, an exclusive milk diet is one of the very best remedial agencies. It may be given as skimmed milk or butter- milk, and in the last case combines an antidiabetic remedy in the lactic acid. Under such an exclusive diet recent and mild cases are often entirely restored, though at the expense of an attack of rheumatism. Codeia, one of the allciiloids of opium, is strongly reconnnended by Doctor Tyson. The dose for the horse would be 10 to 15 grains thrice daily. In cases in which there is manifest irritation of the brain, bromide of potassium, 4 drams, or ergot one-half ounce, may be re- sorted to. Salicylic acid and salicylate of sodium have proved useful in certain cases; also phosphate of sodium. Bitter tonics (especiallv nux vomica one-half dram) are useful in improving the digestion and general health. H. Doc. 70.1, .'">".)-2 6 82 DISEASES OF THE HORSE. BLOOOy URINE, OR HEMATURIA. Cause. — As seen in the horse, bloody urine is usually the direct result of mechanical injuries, as sprains and fractures of the loins, lacerations of the sublumbar muscles (psoas), irritation caused by stone in the kidney, ureter, bladder, or urethra. It may, however, occur with acute congestion of the kidney, with tumors in its sub- stance, or with papilloma or other diseased growth in the bladder. Acrid diuretic plants present in the food may also lead to the escape of blood from the kidney. The predisposition to this affection is, however, incomparably less than in the case of the ox or the sheep, the difference being attributed to the greater plasticity of the horse's blood in connection with the larger quantity of fibrin. The blood may be present in small clots or in more or less intimate admixture with the urine. Its condition may furnish some indication as to its source ; thus, if from the kidneys it is more likely to be uni- formly diffused through the urine, while as furnished by the bladder or passages clots are more likely to be present. Again, in bleeding from the kidney, minute cylindrical clots inclosing blood globules and formed in the uriniferous tubes can be detected under the micro- scope. Precision also may be approximated by observing whether there is coexisting fracture, sprain of the loins, or stone or tumor in the bladder or urethra. Treatment. — The disease being mainly due to direct injury, treat- ment will consist, first, in removing such cause whenever possible, and then in applying general and local styptics. Irritants in food must be avoided, sprains appropriately treated, and stone in bladder or urethra removed. Then give mucilaginous drinks (slippery elm, lin- seed tea) freely, and styptics (tincture of chloride of iron 3 drams, acetate of lead one-half dram, tannic acid one-half dram, or oil of turpentine 1 ounce). If the discharge is abundant, apply cold water to the loins and keep the animal perfectly still. HEMOGLOBINURIA (aZOTURIA, AZOTEMIA, POISONING BY ALBUMINOIDS). Like diabetes, this is rather a disease of the liver and blood-form- ing functions than of the kidney, but as prominent symptoms are loss of control over the hind limbs and the passage of ropy and dark- colored urine, the vulgar idea is that it is a disorder of the urinary organs. It is a complex affection directly connected with a plethora in the blood of nitrogenized constituents, with extreme nervous and muscular disorder and the excretion of a dense reddish or brownish urine. It is directly connected with high feeding, especially on highly nitrogenized food (oats, beans, pease, vetches, cotton-seed meal), and with a period of idleness in the stall under full rations. The disease is never seen at pasture, rarely under constant daily work, BLOODY URINE, OR HEMATURIA. 83 even though the feeding be high, and the attack is usually precipi- tated by taking the horse from the stable and subjecting it to exercise or work. The poisoning is not present when taken from the stable, as the horse is likely to be noticeably lively and spirited, but he will usually succumb under the first hundred yards or half mile of exer- cise. It seems as if the aspiratory power of the chest under the sudden exertion and accelerated breathing speedily drew from the gorged liver and abdominal veins (portal) the accumulated store of nitrogenous matter in an imperfectly oxidized or elaborated condi- tion, and as if the blood, surcharged with these materials, was unable to maintain the healthy functions of the nerve centers and muscles. It has been noticed rather more frequently in mares than horses, attributable, perhaps, to the nervous excitement attendant on heat, and to the fact that the unmutilated mare is naturally more excitable than the docile gelding. Lignieres has found in hemoglobinuria a streptococcus which pro- duced nephritis, bloody urine, and paraplegia in experimental ani- mals, including horses. Symptoins. — In the milder forms this affection may appear as a lameness in one limb, from indefinite cause, succeeding to some sud- den exertion and attended by a dusky^-brown color of the membranes of the eye and nose and some wdncing when the last ribs are struck. The severe forms come on after one or two days of rest on a full ration, when the animal has been taken out and driven one hundred paces or more. The fire and life with which he had left the stable suddenly give place to dullness and oppression, as shown in heaving flanks, dilated nostrils, pinched face, perspiring skin, and trembling body. The muscles of the loins or haunch become swelled and rigid, the subject moves stiffly or unsteadily, crouches behind, the limbs being carried semiflexed, and he soon drops, unable to support him- self. WTien down, the body and limbs are moved convulsively, but there is no power of coordination of movement in the muscles. The pulse and breathing are accelerated, the eyes red with a tinge of brown, and the urine, if passed, is seen to be highly colored, dark brown, red, or black, but it contains neither blood clots nor globules. The color is mainly due to hemoglobin and other imperfectly elabo- rated constituents of the blood. It may end fatally in a few hours or days, or a recovery may ensue, which is usually more speedy and perfect if it has set in at an early stage. In the late and tardy recoveries a partial paralysis of the hind limbs may last for months. A frequent sequel of these tardy cases is an extensive wasting of the muscles leading up from the front of the stifle (those supplied by the crural nerve) and a complete inability to stand. Prevention. — The prevention of this serious affection lies in re- 84 DISEASES OF THE HORSE. stricting the diet and giving daily exercise when the animal is not at work. A horse that has had one attack shonld never be left idle for a single day in the stall or barnyard. When a horse has been con- demned to absolute repose on good feeding he may have a laxative (one-half to 1 pound Glauber's salts), and have graduated exercise, beginning with a short walk and increasing day by day. Treatment. — The treatment of the mild cases may consist in a laxa- tive, graduated daily exercise, and a daily dose of saltpeter (1 ounce). Sudden attacks will sometimes promptly subside if taken on the in- stant and the subject kept still and calmed by a dose of bromide of potassium (4 drams) and sweet spirits of niter (1 ounce). The latter has the advantage of increasing the secretion of the kidneys. Iodide of potassium in one-half ounce doses every four hours has succeeded well in some hands. In severe cases, as a rule, it is desira- ble to begin treatment by a dose of aloes (4 to 6 drams) with the nbove-named dose of bromide of potassium, and this latter may be continued at intervals of four or six hours, as may be requisite to calm the nervous excitement. Fomentations with warm water over the loins are always useful in calming the excitable conditions of the spinal cord, muscles, liver, and kidneys, and also in favoring secre- tion from the two latter. On the second day diuretics may be re- sorted to, such as saltpeter one-half ounce, and powdered colchicum one-half dram, to be repeated twice daily. A laxative may be re- peated in three or four days shoidd the bowels seem to demand it, and as the nervous excitement disappears any remaining muscular weakness or paralysis may be treated by one-half dram doses of nux vomica twice a day and a stimulating liniment (aqua ammonia and sweet oil in equal proportions) rubbed on the torpid muscles. During the course of the disease friction to the limbs is useful, and in the advanced paralytic stage the application of electricity along the line of the affected muscles. When the patient can not stand he must have a thick, soft bed, and should be turned from side to side at least every twelve hours. As soon as he can be made to stand he may be helped up and even supported in a sling. ACUTE INFLAMMATION OF THE KIDNEYS, OR ACUTE NEPHRITIS. Inflammations of the kidneys have been differentiated widely, ac- cording as they w^ere acute or chronic, parenchymatous or tubal, sup- purative or not, with increased or shrunken kidney, etc. ; but in a work like the present utility will be consulted by classing all under acute or chronic inflamTrhation. Causes. — The causes of inflammation of the kidneys are extremely varied. Congestion occurs from the altered and irritant products passed through these organs during recovery from inflammations of other organs and during fevers. This may last only during the exist- INFLAMMATION OF THE KIDNEYS. 85 ence of its cause, or may persist and become aggravated. Heart dis- ease, throwing the blood pressure back on the veins and kidneys, is another cause. Disease of the ureter or bladder, preventing the escape of urine from the kidney and causing increased fullness and tension in its pelvis and tubes, will determine inflammation. Decom- position of the detained urine in such cases and the production of annnonia and other irritants must also be named. In elimination of bacteria through the kidney, the latter is liable t6 infection with con- sequent inflannnation. The advance of bacteria upward from the bladder to the kidneys is another cause. The consumption in hay or other fodder of acrid or irritant plants, including fungi, the absorp- tion of cantharidine from a surface blistered by Spanish flies, the reckless administration of diuretics, the presence of stones in the kidney, exposure of the surface to cold and wet, and the infliction of blows or sj^rains on the loins, may contribute to its production. Liver disorders which throw on the kidneys the work of excreting irritant products, diseases of the lungs and heart from which clots are car- ried, to be arrested in the small blood vessels of the kidney, and injuries and paralysis of the spinal cord, are additional causes. Symptoms. — The symptoms are more or less fever, manifest stiff- ness of the back and straddling gait with the hind limbs, difficulty in lying down and rising, or in walking in a circle, the animal sometimes groaning under the effort, arching of the loins and tucking up of the flank, looking back at the abdomen as if from colicky pain, and ten- derness of the loins to pinching, especially just beneath the bony processes 6 inches to one side of the median line. Urine is passed frequently, a small quantity at a time, of a high color, and sometimes mixed with blood or even j^us. Under the microscope it shows the microscopic casts referred to under general symptoms. If treated by acetic acid, boiling, and subsequent addition of strong nitric acid, the resulting and persistent precipitate indicates the amount of albumen. The legs tend to swell from the foot up, also the dependent joarts beneath the belly and chest, and effusions of liquid may occur within the chest or abdomen. In the male animal the alternate drawing up and relaxation of the testicles in the scrotum are suggestive, and in small horses the oiled hand introduced into the rectum may reach the kidney and ascertain its sensitiveness. Treatment demands, first, the removal of any recognized cause. Then, if the suffering and fever are high, 2 to 4 quarts of blood may be abstracted from the jugular vein; in weak subjects or unless in high fever this should be omitted. Next relieve the kidneys so far as possible by throwing their work on the bowels and skin. A ])int of castor oil is less likely than either aloes or salts to act on the kid- neys. To affect the skin a warm stall and heaA^ clothing may be supplemented by dram doses of Dover's j^owder. Pain may be 86 DISEASES OF THE HORSE. soothed by dram doses of bromide of potassium. Boiled flaxseed may be added to the drinking water, and also thrown into the rectum as an injection, and blankets saturated with hot water should be per- sistently applied to the loins. This may be followed by a very thin pulp of the best ground mustard made with tejDid water, rubbed in against the direction of the hair and covered up with paper and a blanket. This may be kept on for an hour, or until the skin thickens and the hair stands erect. It may then be rubbed or sponged off and the blanket reapplied. When the action of the bowels has been started it may be kept up by a daily dose of 2 or 3 ounces of Glauber's salts. During recovery a course of bitter tonics (nux vomica 1 scruple, ground gentian root 4 drams) should be given. The patient should also be guarded against cold, wet, and any active exertion for some time after all active symptoms have subsided. CHRONIC INFLAMMATION OF THE KIDNEYS. Causes. — Chronic inflammation of the kidneys is more commonly associated with albumen and casts in the urine than the acute form, and in some instances these conditions of the urine may be the only prominent symptoms of the disease. Though it may supervene on blows, injuries, and exposures, it is much more commonly connected with faulty conditions of the system — as indigestion, heart disease, lung or liver disease, imperfect blood formation, or assimilation; in short, it is rather the attendant on a constitutional infirmity than on a simple local injury. It may be associated with various forms of diseased kidneys, as shrinkage (atrophy), increase (hypertrophy), softening, red conges- tion, white enlargement, etc., so that it forms a group of diseases rather than a disease by itself. Symptoms. — The symptoms may include stiffness, weakness, and increased sensibility of the loins, and modified secretion of urine (increase or suppression), or the flow may be natural. Usually it contains albumen, the amount furnishing a fair criterion of the grav- ity of the affection, and microscopic casts, also most abundant in bad cases. Dropsy, manifested in swelled legs, is a significant symptom, and if the effusion takes place along the lower line of the body or in chest or abdomen, the significance is increased. A scurfy, unthrifty skin, lack-luster hair, inability to sustain severe or continued exer- tion, poor or irregular appetite, loss of fat and flesh, softness of the muscles, and pallor of the eyes and nose are equally suggestive. So are skin eruptions of various kinds. Any one or more of these symp- toms would warrant an examination of the urine for albumen and casts, the finding of which signifies renal inflammation. Treatment of these cases is not always satisfactory, as the cause is DISEASES OF THE KIDNEYS AND BLADDER. 87 liable to be maintained in the disorders of important organs else- where. If any such coincident disease of another organ or function can be detected, that should be treated first or simultaneously with this affection of the kidneys. In all cases the building up of the general health is important. Hence a course of tonics may be given (phosphate of iron 2 drams, nux vomica 20 grains, powdered geutian root 4 drams, daily) or 60 drops of sulphuric acid or nitromuriatic acid may be given daily in the drinking water. If there is any ele- vated temperature of the body and tenderness of the loins, fomenta- tions may be applied, followed by a mustard pulp, as for acute inflammation, and even in the absence of these indications the mus- tard may be resorted to with advantage at intervals of a few days. In suppression of urine, fomentations with warm water or with infu- sion of digitalis leaves is a safer resort than diuretics, and cupping over the loins may also benefit. To apply a cup, shave the skin and oil it; then take a narrow-mouthed glass, rarifs' the air within it by introducing a taper in full flame for a second, withdraw the taper and instantly apply the mouth of the glass to the skin and hold it closely applied till the cooling tends to form a vacuum in the glass and to draw up the skin, like a sucker. As in the acute inflammation, every attention must be given to secure warm clothing, a warm stall, and pure air. TUMORS OF THE KIDNEYS. Tumors, whether malignant or simple, would give rise to symptoms resembling some form of inflammation, and are not likely to be recog- nized during life. PARASITES. To parasites of the kidney belong the echinococcus^ the larval, or bladder worm, stage of the small echinococcus tapeworm of the dog; also the Ct/sticercu.s fiiitidaris, another bladder worm of an unknown tapeworm; in these there is the possibility of the passage with the urine of a detached head of the bladder worm or of some of its micro- scopic booklets, which might be found in the sediment of the urine and thus establish a diagnosis. Dioctophyme renale^ the largest of roundworms, has been found in the kidney of the horse. Its presence can only be certified by the passage of its microscopic eggs or of the entire worm. Immature stages of roundworms, either Strongylns eqi/ini/s or a related species, may be found in the renal artery or in the kidney itself. SPASM OF THE NECK OF THE BLADDER. This affection consists in spasmodic closure of the outlet from the bladder by tonic contraction of the circular muscular fibers. It may be accompanied by a painful contraction of the muscles on the body 88 DISEASES OF THE HORSE. of the bladder; or, if the organ is already unduly distended, these will be affected with temporary paralysis. It is most frequent in the horse, but by no means unknown in the mare. Causes. — The causes are usually hard and continuous driving with- out opportunity for passing urine, cold rainstorms, drafts of cold air when perspiring and fatigued, the administration of Spanish fly or the application of extensive blisters of the same, abuse of diuretics, the presence of acrid diuretic plants in the fodder, and the presence of stone in the bladder. ks> most mares refuse to urinate while in harness, they should be unhitched at suitable times for urination. Spasms of the bowels are always attended by spasm of the bladder, hence the free passage of water is usually a symptom of relief. Syni'ptoms.- — The symptoms are frequent stretching and straining to urinate, with no result or a slight dribbling only. These vain efforts are attended by pain and groaning. On resuming his natural IDOsition the animal is not freed from the pain, but moves uneasily, paws, shakes the tail, kicks at the abdomen w^ith his hind feet, looks back to the flank, lies doAvn and rises, arches the back, and attempts to urinate as before. If the oiled hand is introduced into the rectum the greatly distended bladder may be felt beneath, and the patient will often shrink when it is handled. It is important to notice that irritation of the urinary organs is often present in impaction of the colon with solid matters, because the impacted intestine under the straining of the patient is forced backward into the pelvis and presses upon and irritates the bladder. In such cases the horse stands with his fore limbs advanced and the hind ones stretched back beyond the natural posture, and makes fre- quent efforts to urinate, with varying success. Unpracticed observers naturally conclude that the secondary urinary trouble is the main and only one, and the intestinal impaction and obstruction is too often neglected until it is irremediable. In cases where the irritation has caused spasm of the neck of the bladder and overdistention of that organ, the mistake is still more easily made ; hence it is important in all cases to examine for the impacted bowel, forming a bend, or loop, at the entrance of the pelvis and usually toward the left side. The impacted intestine feels soft and doughy, and is easily indented with the knuckles, forming a marked contrast with the tense, elastic, resil- ient, overdistended bladder. It remains to be noted that similar symptoms maj^ be determined by a stone or sebaceous mass, or stricture obstructing the urethra, or in the newborn by thickened mucus in that duct and by the pressure of hardened, impacted feces in the rectum. In obstruction, the hard, impacted body can usually be felt by tracing the urethra along the lower and posterior surface of the penis and forward to the median line of the floor of the pelvis to the neck of the bladder. That part PI.A.TE "V 12 B A Stnicture of ihp Kidney. Diagramiiialic . a , Metlnllarv l/>l\inf/ t/ir nt'trrcnr vessel of the ffloiiierulii.s: c, AfTrrritt irw.sr'/ of't/ir e/(<>/nrru/e , d.Arf/Tv f/oinff di/erUy to the capHi/ir\- ple.^i/.v of the corfictd sufi.-jtancr ,- e., CapiUafy plea-iis : /,' Glomerulii.s . [ii'iiiil (HomcftilKs wilh its itlTpreiilwssi^ls fiiul (•"fforciils . ri ./'/•anr/i ot'rcntil aiicrvi h, Al'lcfrtil vca-^cI of'the (jloiiicfiilii.s ; c .Gtornerulius ; (t , Art'cffnt iv.v.ycV fjo iiitj into rorpn.vrU' r .of MtitpiM^' OI" KIDXI^^'. PL..\TK vri. Phtxsp/iadf c/Zci////.^-. i/flC t/r/a' ////c/t'tl.s. ^^T^o-^^j, -^.V '•-^'<.^t^ X 21. T Ca/cu/i/.s- or o.irilate of'litiu-. /fr/ui/ casf.v. Sof/lf rirpi-i\Titfif /(iini . Two fire dr'rrco/(>/\:f/ //y>/// f/ir ///fwr/irr uf'uraJfo/'sot/a. I) Slnt(f//if /h/-rose and give off ammonia, which dissolves the epithelial cells, exposing the 90 DISEASES OF THE HORSE. raw mucous membrane and causing the ^Yorst type of cystitis. Sup- pression and incontinence of urine are common also to obstruction of the urethra by stone or otherwise; hence this source of falhicy should be excluded by manual examination along the whole course of that duct. Treatment. — Treatment is only applicable in cases in which the de- termining cause can be abated. In remedial sprains of the back or disease of the spinal cord these must have appropriate treatment, and the urine must be drawn off frequently with a catheter to prevent overdistention and injury to the bladder. If the paralysis persists after recovery of the spinal cord, or if it continues after relief of spasm of the neck of the bladder, apply a pulp of mustard and water over the back part of the belly in front of the udder, and cover with a rug until the hair stands erect. In the male the mustard may be applied between the thighs from near the anus downward. Daily doses of 2 drams extract of belladonna or of 2 grains powdered Spanish fly may serve to rouse the lost tone. These failing, a mild current of electricity daily may succeed. INFLAMMATION OF THE BLADDER (CYSTITIS, OR UROCYSTITIS) . Cystitis may be slight or severe, acute or chronic, partial or general. It may be caused by abuse of diuretics, especially such as are irritat- ing (cantharides, turi^entine, copaiba, resin, etc.), by the presence of a stone or gravel in the bladder, the irritation of a catheter or other foreign body introduced from without, the septic ferment (bac- terium) introduced on a filthy catheter, the overdistention of the bladder by retained urine, the extrication of ammonia from retained decomposing urine, resulting in destruction of the epithelial cells and irritation of the raw surface, and a too concentrated and irritating urine. The application of Spanish flies or turpentine over a too ex- tensive surface, sudden exposure of a perspiring and tired horse to cold or wet, and the presence of acrid plants in the fodder may cause cystitis, as they may nephritis. Finally, inflammation may extend from a diseased vagina or urethra to the bladder. Sijnijjtomn. — The symptoms are slight or severe colicky pains; the animal moves his hind feet uneasily or even kicks at the abdomen, looks around at his flank, and may even lie down and rise frequently. More characteristic are frequently repeated efforts to urinate, result- ing in the discharge of a little clear, or red, or more commonly floc- culent urine, always in jets, and accompanied by signs of pain, which persist after the discharge, as shown in continued straining, groan- ing, and perhaps in movements of the feet and tail. The iDenis hangs from the sheath, or in the mare the vulva is frequently opened and closed, as after urination. The animal winces when the abdomen is pressed in the region of the sheath or udder, and the bladder is found DISEASES GF THE BLADDER. 91 to be sensitive and tender when pressed with the oiled hand intro- duced through the rectum or vagina. In the mare the thickening of the walls of the bladder may be felt by introducing one finger through the urethra. The discharged urine, which may be turbid or even oily, contains an excess of mucus, with flat shreds of membrane, with scaly epithelial cells, and pus corpuscles, each showing two or more nuclei when treated with acetic acid, but there are no microscoi)ic tubular casts, as in nepliritis. If due to stone in the bladder, that will be found on examination through rectum or vagina. Treatment implies, first, the removal of the cause, whether poisons in food or as medicine, the removal of Spanish flies or other blistering agents from the skin, or the extraction of stone or gravel. If the urine has been retained and decomposed it must be comj^letely evac- uated through a clean catheter, and the bladder thoroughly washed out with a solution of 1 dram of borax in a quart of water. This )nust be repeated twice dailv until the urine no longer decomposes, because so long as annnonia is develoijed in the bladder the protecting layer of epithelial cells will be dissolved and the surface kept raw and irritable. The diet must be light (bran mashes, roots, fresh grass), and the drink impregnated with linseed tea, or solution of slippery elm or marsh mallow. The same agents may be used to inject into the rectum, or they may even be used along with borax and opium to inject into bladder (gum arable 1 dram, opium 1 dram, tepid water 1 pint). Fomentations over the loins are often of great advantage, and these ma}' be followed or alternated wnth the appli- cation of mustard, as in paralysis ; or the mustard may be applied on the back part of the abdomen below or between the thighs from the anus downward. Finally, Avhen the acute symptoms have subsided. a daily dose of buchu 1 dram and nux vomica one-half dram will serve to restore lost tone. IRRITABLE BLADDKR. Some horses, and especially mares, show an irritability of the blad- der and nerve centers presiding over it by frequent urination in small quantities, thougli the urine is not manifestly changed in character and no more than the natural amount is passed in the twenty-four hours. The disorder appears to have its source quite as frequently in the generative or nervous system as in the urinary. A troublesome and dangerous form is seen in mares, which dash off and refuse all control by the rein if driven with a full bladder, but usually prove docile if the l)ladder has been emptied before hitching. In other cases tlie excitement connected with getting the tail over the reins is a pow- erful determining cause. The condition is marked in many mares during the period of " heaty An oleaginous laxative (castor oil 1 pint) will serve to remove any 92 DISEASES OF THE HORSE. cause of irritation in the digestive organs, and a careful dieting will avoid continued irritation by acrid vegetable agents. The bladder should be examined to see that there is no stone or other cause of irri- tation, and the sheath and jDenis should be washed with soapsuds, any sebaceous matter removed from the bilocular cavity at the end of the penis, and the whole lubricated with sweet oil. Irritable mares should be induced to urinate before they are harnessed, and those that clutch the lines under the tail may have the tail set high by cutting the cords on its lower surface, or it may be prevented getting over the reins by having a strap carried from its free end to the breeching. Those proving troublesome when " in heat " may have 4-dram doses of bro- mide of ]3otassium, or they may be served by the male or castrated. Sometimes irritability may be lessened by daily doses of belladonna extract (1 dram), or a better tone may be given to the parts by balsam copaiba (1 dram). DISEASED GROWTHS IN THE BLADDER. These may be of various kinds, malignant or simple. In the horse I have found villous growths from the mucous membrane especially troublesome. They may be attached to the mucous membrane by a narrow neck or by a broad base covering a great part of the organ. Symptoms. — The symptoms are frequent straining, passing of urine and blood with occasionally gravel. An examination of the bladder with the hand in the rectum will detect the new growth, which may be distinguished from a hard resistant stone. In mares, in which the finger can be inserted into the bladder, the recognition is still more satisfactory. The polypi attached by narrow necks may be removed by surgical operation, but for those with broad attachments treatment is eminently unsatisfactory. DISCHARGE OF URIXE BY THE NAVEL, OR PERSISTENT URACHUS. This occurs only in the newborn, and consists in the nonclosure of the natural channel (urachus), through which the urine is discharged into the outer water bag (allantois) in fetal life. At that early stage of the animal existence the bladder resembles a long tube, which is prolonged through the navel string and ojoens into the outermost of the two water bags in which the fetus floats. In this way the urine is prevented from entering the inner water bag (amnion), where it would mingle with the liquids, bathing the skin of the fetus and cause irritation. At birth this channel closes up, and the urine takes the course normal to extra-uterine life. Imperfect closure is more fi'e- quent in males than in females, because of the great length and small caliber of the male urethra and its consequent tendency to obstruction. In the female there may be a discharge of a few drops only at a time, while in the male the urine will l)e expelled in strong jets coincidently with the contractions of the bladder and walls of the abdomen. DISEASES OF THE BLADDER. 93 The first care is to ascertain if the urethra is pervious by passing a human catheter. Tliis determined, the open urachus may be firmly closed by a stout waxed thread, carried with a needle through the tis- sues back of the opening and tied in front of it so as to inclose as little skin as possible. If a portion of the navel string remains, the tying of that may be all sufficient. It is important to tie as early as possible so as to avoid inflammation of the navel from contact with the urine. In sunnner a little carbolic-acid water or tar water may be applied to keep off the flies. EVERSIOX OF THE BLADDER. This can only occur in the female. It consists in the turning of the organ outside in through the channel of the urethra, so that it appeai-s as a red, pear-shai^ed mass hanging from the floor of the vulva and protruding externally between its lips. It may be a mass like the fist, or it may swell up to the size of an infant's head. On examining its upper surface the orifices of the urethra may be seen, one on each side, a short distance behind the neck, with the urine oozing from them drop by drop. This displacement usually supervenes on a flaccid condition of the bladder, the result of paralysis, overdistention, or severe compression during a difficult parturition. The protruding organ may be washed with a solution of 1 ounce of laudanum and a teaspoonful of carbolic acid in a quart of water, and returned by pressing a smooth, rounded object into the fundus and directing it into the urethra, while careful pressure is made on the surrounding parts with the other hand. If too large and resistant it may be wound tightly in a strip of bandage about 2 inches broad to express the gi-eat mass of blood and exudate and diminish the bulk of the protruded organ so that it can be easily pushed back. This method has the additional advantage of protecting the organ against bruises and lacerations in the effort made to return it. After the return, straining may be kept in check by giving laudanum (1 to 2 ounces) and by applying a truss to press upon the lips of the vulva. (See E version of the womb.) The patient should be kept in a stall a few inches lower in front than behind, so that tlie action of gravity will favor retention, INFLAMMATION OF THE TRETHKA (URETHRITIS. OK GLEET ) . This affeclion belongs quite as much to the generative organs, yet it can not be entirely overlooked in a treatise on urinary disorders. It may be induced by the same causes as cystitis (which see) ; by the passage and temporary arrest of small stones^ or gravel ; by the irri- tation caused by foreigni bodies introduced from without ; by blows on the penis by sticks, stones, or by the feet of a mare that kicks while being served; by an infecting inflammation contracted from a mare 94 DISEASES OF THE HORSE. served in the first few days after parturition or one suffering from leucorrhea ; by infecting matter introduced on a dirty catheter, or by the extension of inflammation from an irritated bilocular cavity filled with hardened sebaceous matter, or from an uncleansed sheath. Symptoms. — The symptoms are swelling, heat, and tenderness of the sheath and penis ; difficulty, pain, and groaning in passing urine, which is liable to sudden temporary arrests in the course of micturi- tion, and later a whitish mucopurulent oozing from the papilla on the end of the penis. There is a tendency to erection of the penis, and in cases contracted from a mare the outer surface of that organ will show more or less extensive sores and ulcers. Stallions suffering in this way will refuse to mount, or having mounted will fail to com- plete the act of coition. If an entrance is effected infection of the mare is liable to follow. Treatment in the early stages consists in a dose of physic (aloes 6 drams) and fomentations of warm water to the sheath and penis. If there is reason to suspect the presence of infection,* inject the urethra twice daily with borax 1 dram, water 1 quart, using it tepid. AVliere the mucopurulent discharge indicates the supervention of the second stage, a more astringent injection may be employed (nitrate of silver 20 grains, water 1 quart), and the same may be applied to the surface of the penis and inside the sheath. Balsam of copaiba (1 dram daily) may also be given wdth advantage after the purulent discharge has appeared. Every stallion suffering from urethritis should be withheld from service, as should mares with leucorrhea. STRICTURE OF THE URETHRA. This is a permanent narrowing of the urethra at a given point, the result of previous inflammation, caused by the passage or arrest of a stone, or gravel, by strong astringent injections in the early nonsecret- ing stages of urethritis, or by contraction of the lining membrane occurring during the healing of ulcers in neglected inflammations of that canal. The trouble is shown by the passage of urine in a fine stream, with straining, pain, and groaning, and by frequent painful erections. It must be remedied by mechanical dilatation, with cathe- ters just large enough to pass with gentle force, to be inserted once a day, and to be used of larger size as the passage will admit them. The catheter should be kept perfectly clean, and washed in a borax solution and well oiled before it is introduced, URINARY CALCULI ( STONE, OR GRAVEl) . These consist iji some of the solids of the urine that have been pre- cipitated from the urine in the form of crystals, which remain apart as a fine powdery mass, or magma, or aggregate into calculi, or stones, of varying size. Their composition is therefore determined in differ- STONE, OE GRAVEL. 95 ent animals by the salts or other constituents found dissolved in the healthy urine, and by the additional constituents which may be thrown otl' in solution in the urine in disease. In this connection it is important to observe the following analysis of the horse's urine in health : Water 91S. 5 Urea t^- -I Uric acid and urates . 1 Ilippui-ic acid 2(). 4 Lactic acid aud lactates 1. 2 Mucus aud oi'gauic matter 22.0 Sulpliatos (alkaline) 1- 2 riiospliates (lime and soda) -2 Chlorides (sodium) 1.0 Carbonates (potash, magnesia, lime) IG. 0 lOOO. 0 The carbonate of lime, which is present in large amount in the urine of horses fed on green fodder, is practically insoluble, and therefore forms in the passages after secretion, and its microscopic rounded crystals give the urine of such horses a milky whiteness. It is this material which constitutes the soft, white, pultaceous mass that some- times fills the bladder to repletion and requires to be washed out. In hay-fed horses carbonates are still abundant, while in those mainly grain-fed they are replaced by hippurates and phosphates — the prod- ucts of the wear of tissues — the carbonates being the result of oxida- tion of the vegetable acids in the food. Carbonate of lime, therefore, is a verv common constituent of urinary calculi in herbivora, and in many cases is the most abundant constituent. Oxalate of lime, like carbonate of lime, is derived from the burning up of the carbonaceous matter of the food in the system, one impor- tant factor being the less perfect oxidation of the carbon. Indeed, Fiistenberg and Schmidt have demonstrated on man, horse, ox, and rabbit that, under the full play of the breathing (oxidizing) forces, oxalic acid, like other organic acids, is resolved into carbonic acid. In keeping with this is the observation of I:rain and hay, in those denied a sufficiency of water or that have water supplied irregularly, in those subjected to profuse perspiration (as in summer), and in those suffering from a watery diarrhea. On the whole, calculi are most commonly found in winter, because the horses are then on dry feeding, but such dry feeding is even more conducive to them ni summer when the condition is aggravated by the abundant loss of water by the skin. In the same way the extreme hardnCss of the water in certain dis- tricts must be looked upon as contributing to the concentration of the urine and correspondingly to the production of stone. The carbon- ates, sulphates, etc., of lime and magnesia taken in the Avater must be again thrown out. and just in proportion as these add to the solids of the urine they dispose it to i)recipitate its least soluble constituents. Thus, the horse is very obnoxious to calculi on certain limestone soils, as over the calcareous formations of central and western New York, Pennsylvania, and Ohio, in America ; of Norfolk, Suffolk, Derbyshire, Shropshire, and Gloucestershire, in England; of Poitou and Landes, in France : and ^Munich, in Bavaria. But the saturation of the urine from any or all of these conditions can only be looked on as an auxiliary cause, and not as in itself an efficient one, except on the rarest occasions. For a more direct and immediate cause we must look to the organic matter which forms a large proportion of all urinary calculi. This consists of mucus, albu- men, pus, hyaline casts of the uriniferous tubes, epithelial cells, blood, etc., mainly agents that belong to the class of colloid or noncrystalline bodies. A horse may live for months and years Avith the urine habit- \ially of a high density and having the mineral constituents in excess Avithout the formation of stone or gravel; and again one with dilute urine of low specific gravity Avill have a calculus, Rainey, Ord. and others furnish the explanation. They not only show that a colloid body, like mucus, albumen, pus. or blood, deter- mined the precipitation or the crystalline salts in the solution, but they determined the precipitation in. the form of globules, or spheres, capable of developing by further deposits into calculi. Heat intensi- fies this action of the colloids, and a colloid in a state of decomposition is specially active. The presence, therefore, of developing fungi and bacteria must be looked upon as active factors in causing calculi. In looking, therefore, for the immediate causes of calculi we must consider especially all those conditions which determine the presence of albumen, blood, and excess of mucus, pus, etc., in the urine. Thus diseases of distant organs leading to albuminuria, diseases of the kid- neys and urinary passages causing the escape of blood or the forma- H. Doc. T!)5, .^!>-2 7 98 DISEASES OF THE HORSE. tioii of mucus or pus, become direct causes of calculi. Foreign bodies of all kinds in the bladder or kidney have long been known as deter- mining causes of calculi and as forming the central nucleus. This is noAv explained by the fact that these bodies are liable to carry bacte- ria into the passages and thus determine decomposition, and they are further liable to irritate the mucous membrane and become enveloped in a coating of mucus, pus, and perhaps blood. The fact that horses appear to suffer from calculi, especially on the magnesian limestones, the same districts in which they suffer from goiter, may be similarly explained. The unknown poison which pro- duces goiter presumably leads to such changes in the blood and urine as will furnish the colloid necessary for precipitation of the urinary salts in the form of calculi. CLASSIFICATION OF URINARY CALCULI. These have been named according to the place where they are found, renal (kidney), uretral (ureter), vesical (bladder), urethral (urethra), and preputial (sheath, or prepuce). They have been otherwise named according to their most abundant chemical constit- uent, carbonate of lime, oxalate of lime, and phosphate of lime calculi. The stones formed of carbonates or phosphates are usually smooth on the surface, though they may be molded into the shape of the cavity in which they have been formed; thus those in the pelvis of the kidney may have two or three short branchlike prolongations, wdiile those in the bladder are round, oval, or slightly flattened upon each other. Calculi containing oxalate of lime, on the other hand, have a rough, open, crystalline surface, which has gained for them the name of mulberry calculi, from a supposed resemblance to that fruit. These are usually covered with more or less mucus or blood, produced by the irritation of the mucous membrane by their rough surfaces. The color of calculi varies from white to yellow and deep brow-n, the shades depending mainly on the amount of the coloring matter of blood, bile, or urine which they may contain. Renal calculi. — These may consist of minute, almost microscopic, deposits in the uriniferous tubes in the substance of the kidney, but more commonly they are large masses and lodged in the pelvis. The larger calculi, sometimes weighing 12 to 24 ounces, are molded in the pelvis of the kidney into a cylindroid mass, wdth irregular rounded swellings at intervals. Some have a deep brown, rough, crystalline surface of oxalate of lime, while others have a smooth, pearly white aspect from carbonate of lime. A smaller calculus, which has been called coralline, is also cylindroid, with a number of brown, rough, crystalline oxalate of lime branches and whitish depressions of car- bonate. These vary in size from 15 grains to nearly 2 ounces. Less frequently are found masses of very hard, brownish wdiite, rounded, STONE, OR GEAVEL. I 99 pealike calculi. These are smoother, but on the surface crystals of oxalate of lime may be detected with a lens. Some renal calculi are formed of more distinct layers, more loosely adherent to each other, and contain an excess of mucus, but no oxalate of lime. Finally, a loose aggregation of small masses, forming a very friable calculus, is found of all sizes within the limits of the pelvis of the kidney. These, too, are in tlie nuiin carbonate of lime (84 to 88 per cent) and without oxalate. /Sy/npfofns of renal calcvli are violent colicky pains, appearing sud- denly, very often in connection with exhausting work or the drawing of specially heavy loads, and in certain cases disappearing with equal suddenness. The nature of the colic becomes more manifest if it is associated with stitfness of the back and hind limbs, frequent passage of urine, and, above all, the passage of gravel with the urine, espe- cially at the time of the access of relief. The passage of blood and pus in the urine is equally significant. If the irritation of the kid- ney goes on to active inflammation, then the symptoms of nephritis are added. Uretnil calcuVi. — These are so called because they are found in the passage leading from the kidney to the bladder. They are simply small renal calculi which have escaped from the pelvis of the kidney and have become arrested in the ureter. They give rise to symjytoms almost identical with those of renal calculi, with this difference, that the colicky pains, caused by the obstruction of the ureter by the impacted calculus, are more violent, and if the calculus passes on into the bladder the relief is instantaneous and complete. If the ureter is completely blocked for a length of time, the retained urine may give rise to destructive inflammation in the kidney, which may end in the entire absorption of that organ, leaving only a fibrous capsule containing an urinous fluid. If both the ureters are similarly blocked, the animal will die of uremic poisoning. Treatment of renal and uretral calculi. — Treatment is unsatisfac- tory, as it is only the small calculi that can pass through the ureters and escape into the bladder. This may be favored by agents which will relax the walls of the ureters by counteracting their spasm and even lessening their tone, and by a liberal use of water and waterv fluids to increase the urine and the pressure upon the calculus from behind. One or 2 ounces of laudanum, or 2 drams of extract of bella- donna, may be given and repeated as it may be necessary, the relief of the pain being a fair criterion of the abating of the spasm. To the same end use warm fomentations across the loins, and these should be kept up persistently until relief is obtained. These act not alone by soothing and relieving the spasm and inflammation, but they also favor the freer secretion of a more watery urine, and thus tend to carry off the smaller calculi. To further secure this object give cool 100 ' DISEASES OF THE HORSE. ■water freely, and let the food be only such as contains a large propor- tion of liquid, gruels, mashes, turnips, beets, apples, pumpkins, ensilage, succulent grasses, etc. If the acute stage has passed and the presence of the calculus is manifested only by the frequent passage of urine with gritty particles, by stiffness of the loins and hind limbs, and by tenderness to pressure, the most promising resort is a long run at pasture where the grasses are fresh and succulent. The long- continued secretion of a watery urine will sometimes cause the break- ing downi of a calculus, as the imbibition of the less dense fluid bv the organic spongelike framework of the calculus causes it to sAvell and thus lessens its cohesion. The same end is sought by the long-con- tinued use of alkalies (carbonate of potassium), and of acids (muriatic), each acting in a different way to alter the density and cohesion of the stone. But it is only exceptionally that any of these methods is entirely satisfactory. If inflammation of the kidneys develops, treat as advised under that head. Stone in the hladder {vesical calculus^ or cystic calcvlus). — These may be of any size up to over a pound in weight. One variety is rough and crystalline and has a yellowish white or deep-brown color. These contain about 87 per cent carbonate of lime, the remainder being carbonate of magnesia, oxalate of lime, and organic matter. The phosphatic calculi are smooth and white and formed of thin concentric layers of great hardness extending from the nucleus out- ward. Besides the phosphate of lime these contain the carbonates of lime and mae-nesia and organic matter. In some cases the bladder contains and may be even distended by a soft pultaceous mass made up of minute round granules of carbonates of lime and magnesia. This, when removed and dried, makes a firm, white, and stony mass. Sometimes this magma is condensed into a solid mass in the bladder by reason of the binding action of the mucus and other organic matter, and then forms a conglomerate stone of nearly uniform con- sistency and Avithout stratification. Symptoms of stone in the hladder. — The symptoms of stone in the bladder are more obvious than those of renal calculu . The rough mull^erry calculi especially lead to irritation of the mucous membrane and frequent passing of urine in small quantities and often mingled with mucus or blood or containing minute gritty particles. At times the flow is suddenly arrested, though the animal continues to strain and the bladder is not quite emptied. In the smooth phosphatic variety the irritation is much less marked and may even be altogether absent. With the pultaceous deposit in the bladder there is incon- tinence of urine, which dribbles aAvay continually and keeps the hair on the inner side of the thighs matted with soft magma. In all cases alike the calculus may be felt by the examination of the bladder Avith the oiled hand in the rectum. The pear-shaped outline of the bladder STONE, OR GRAVEL ; i' ',,.'; •/?'','; 101 can be felt beneath, and within it the solid oval body. It is most easily recog'nized if the organ is half full of li(nud, as then it is not grasped by the contracting- Avails of the bladder, but n)ay be made to move from place to place in the liquid. If a pultaceous mass is present it has a soft, doughy feeling, and when pressed an indentation is left. In the mare the hard stone may be touched by the finger introduced through the short urethra. Treatment of stone in the bladder.— The treatment of stone in the bladder consists in the removal of the offending body. In the mare this is easily effected with the lithotomy forceps. These are slightly warmed and oiled, and carried forward along the floor of the i)assage of the vulva for 4 inches. Avhen the orifice of the urethra will be felt exactly in the median line. Through this the forceps are gradually pushed with gentle oscillating movement until they enter the bladder and strike against the hard surface of the stone. The stone is now grasped between the blades, care being taken to include no loose fold of the mucous membrane, and it is gradually withdrawn with tlie same careful oscillating motions as before. P^acility and safety in seizing the stone will be greatly favored by having the bladder half full of liquid, and if necessary one oiled hand may be introduced into the rectum or vagina to assist. The resulting irritation may be treated by an injection of laudanum, 1 ounce in a pint of tepid water. The removal of the stone in the horse is a much more difficult pro- ceeding. It consists in cutting into the urethra just beneath the anus and introducing the lithotomy forceps from this forAvard into the bladder, as in the mare. It is needful to distend the urethra with tepid water or to insert a sound or catheter to furnish a guide uj^on which the incision may be made, and in case of a large stone it may be needful to enlaige the passage by cutting in a direction upward and outward with a iM'obe-pointed knife, the back of which is slid along in the groove of a director until it enters the bladder. The horse may be operated upon in the standing position, being simply pressed against the wall l)y a pole passed from before back- ward along the other side of the body. The tepid water is injected into the end of the penis until it is felt to fluctuate under the pressure of the finger, in the median line over the bone just beneath the anus. The incision is then made into the center of the fluctuating canal, and from above downward. When a sound or catheter is used as a guide it is inserted through the ])enis until it can l)e felt through the skin at the point where the incision is to be made beneath the anus. The skin is then rendered tense by the thuml) and fingers of the left hand pressing on the two sides of the sound, while the i-ighl hand, armed Avith a scalpel, cuts downAvard onto the catheter. This A^ertical in- cision into the canal should escape Avounding any important blood W, •' 102/;. •:/:>*•. ■ )3i.gEAS.ES of the hoese. -^ •' vessel. It is in making the obliquely lateral incision in the subse- quent dilatation of the urethra and neck of the bladder that sucTi danger is to be apprehended. If the stone is too large to be extracted through the urethra it may be broken down with the lithotrite and extracted piecemeal with the forceps. The lithotrite is an instrument composed of a straight stem bent for an inch or more to one side at its free end so as to form an obtuse angle, and having on the same side a sliding bar moving in a groove in the stem and operated by a screw so that the stone may be seized between the two blades at its free extremity and crushed again and again into pieces small enough to extract. Extra care is required to avoid injury to the urethra in the extraction of the angular frag- ments, and the gravel or powder that can not be removed in this way must be washed out as advised below. When a pultaceous magma of carbonate of lime accumulates in the bladder it must be washed out by injecting water through a catheter by means of a force pump or a funnel, shaking it up with the hand introduced through the rectum and allowing the muddy liquid to flow out through the tube. This is to be repeated until the bladder is empty and the water comes away clear. A catheter with a double tube is sometimes used, the injection passing in through the one tube and escaping through the other. But the advantage is more ap- parent than real, as the retention of the water until the magma has been shaken up and mixed with it hastens greatly its complete evacu- ation. To prevent the formation of a new deposit any fault in feeding (dry grain and hay with privation of water, excess of beans, pease, wheat bran, etc.) and disorders of stomach, liver, and lungs must be corrected. Give abundance of soft drinking water, encouraging the animal to drink by a handful of salt daily ; let the food be laxa- tive, consisting largely of roots, apples, pumpkins, ensilage, and give daily in the drinking water a dram of carbonate of potash or soda. Powdered gentian root (3 drams daily) will also serve to restore the tone of the stomach and system at large. Urethral calfidus {stone ?n the urethra) .—This is less frequent in horses than in cattle and sheep, owing to the larger size of the urethra in the horse and the absence of the S-shaped curve and vermiform appendix. The calculi arrested in the urethra are never formed there, but consist of cystic calculi which have been small enough to pass through the neck of the bladder, but too large to pass through the whole length of the urethra and escape. Such calculi therefore are primarily formed either in the bladder or kidney, and have the chemical composition of the other calculi found in those organs. They may be arrested at any point of the urethra, from the neck of the bladder back to the bend of the tube beneath the anus, and from STONE, OR GRAVEL. 103 that point do^vn to the extremity of the penis. I have found them most frequently in the papiUa on the extreme end of the penis, and immediately behind this. Sijmptoms of urethral calculus. — The symptoms are violent strain- ing to urinate, but without any discharge, or with the escape of water in drops only. Examination of the end of the penis will detect the swelling of the papilla or the urethra behind it, and the presence of a hard mass in the center. A probe inserted into the urethra will strike against the gritty calculus. If the stone has been arrested higher up, its position may be detected as a small, hard, sensitive knot on the line of the urethra, in the median line of the lower surface of the penis, or on the floor of pelvis in the median line from the neck of the bladder back to the bend of the urethra beneath the anus. In any case the urethra between the neck of the bladder and the point of obstruction is likely to be filled with fluid, and to feel like a dis- tended tube fluctuating on pressure. Tveatmcitt of urethral calculus may be begun by an attempt to extract the calculi by manipulation of the papilla on the end of the penis. This failing, the calculus may be seized Avith a pair of fine- pointed forceps and withdrawn from the urethra; or, if necessary, a probe-pointed knife may be inserted and the urethra slightly dilated, or even laid open, and the stone removed. If the stone has been arrested higher up it must be extracted by a direct incision through the walls of the urethra and down upon the nodule. If in the free (protractile) portion of the penis, that organ is to be withdrawn from its sheath until the nodule is exposed and can be incised. If behind the scrotum, the incision must be made in the median line between the thiffhs and directlv over the nodule, the skin having been rendered tense by the fingers and thumb of the left hand. If the stone has been arrested in the intrapelvic portion of the urethra, the incision must be made beneath the anus and the calculus extracted with for- ceps, as in stone in tlic bladder. The wound in the urethra may be stitched up, and usually heals slowly but satisfactorily. Healing will be favored by washing two or three times daily with a solution of a teaspoonful of carbolic acid in a pint of water. Preputial calculus {calculus in the sheath, or hilocular car/ty). — These are concretions in the sheath, though the term has been also api^lied to the nodule of sebaceous matter which accumulates in the blind pouches (bilocular cavity) by the sides of the papilla on the end of the penis. AVithin the sheath the concretion may be a soft, cheesy- like sebaceous matter," or a genuine calculus of carbonate, oxalate, phosphate and sulphate of lime, carlwnate of magnesia, and organic matter. These are easily removed with the fingers, after which the sheath should be washed out with castile soap and warm water, and smeared with sweet oil. DISEASES OF THE RESPIRATORY ORGANS. By W. 11. Harbaugh, V. S. [Revised in 1903 by Leonard Pearson, B. S., V. M. D.] The organs pertaining to the respiratory function may be enu- merated in natural order as follows : The nasal openings, or nostrils ; the nasal chambers, through Avhich the air passes in the head; the sinuses in the head, communicating with the nasal chambers; the pharynx, common to the functions of breathing and swallowing; the huynx, at the top of the windpipe; the trachea, or windpipe; the bronchi (into which the windpipe divides), two tubes leading from the windpipe to the right and left lungs, respectively; the bronchial tubes, which penetrate and convey air to all parts of the lungs; the lungs. The pleura is a thin membrane that envelops the lung and lines the walls of the thoracic cavity. The diaphragm is a muscular structure, completely separating the contents of the thoracic cavity from those of the abdominal cavity. It is essentially a muscle of inspiration, and the principal one. Other muscles aid in the mechanism of respiration, but the diseases or injuries of them have nothing to do with the diseases under consideration. Just within the nasal openings the skin becomes gradually but per- ceptibly finer, until it is succeeded by the mucous membrane. Near the junction of the skin and membrane is a small hole, presenting the ajjpearance of having been made with a punch; this is the opening of the lachrymal duct, a canal that conveys the tears from the eyes. Within and above the nasal openings are the cavities, or fissures, called the false nostrils. The nasal chambers are completely separated, the right from the left, by a cartilaginous partition, the nasal septum. Each nasal chamber is divided into three continuous compartments by two thin, scrolllike turbinated bones. The nnicous membrane lining the nasal chambers, and in fact the entire respiratory tract, is much more delicate and more frequently diseased than the mucous membrane of any other part of the body. The sinu.ses of the head are compartments Avhich communicate with the nasal chambers and are lined with a continuation of the same membrane that lines the nasal chambers; their presence increases the volume and modifies the form of the head without increasing its weight. The horse, in a noi-mal condition, breathes exclusively through the nostrils. The organs of respiration are more liable to disease than 104 DISEASES OF THE EESPIKATOEY ORGANS. 105 tlie organs coimecleil ^villl uiiy other ruiiclion of the animal, and. as many of the causes can be avoided, it is both important and profitable to know and study the causes. CAUSES OF DISEASES OV RESriRATORV ORGANS. The causes of many of the diseases of these organs may be given under a connnon head, because even a simple cold, if neglected or badly treated, may run into the most complicated lung disease and terminate fatally. In the spring and fall, when the animals are changing their coats, there is a marked predisposition to contract disease, and consequently care should be taken at those periods to prevent other exciting causes. Badly ventilated stables are a frequent source of disease. It is a mistake to think that country stables necessarily have purer air than city stables. Stables on some farms are so faultily constructed that it is almost impossible for the foul air to gain an exit. All stables should have a sufficient supply of pure air, and be so arranged that strong drafts can not blow directly on the animals. In ventilating a stable, it is best to arrange to remove air from near the floor and admit it through numerous small openings near the ceiling. The reason for this is that the coldest and most impure air in the stable is near the floor while that which is Avarmest and purest, and therefore can least be spared is near the top of the room. In summer, top exits and cross currents should be jjrovided to remove excessive heat. Hot stables are almost always poorly ventilated, and the hot stable is a cause of disease on account of the extreme change of temperature that a horse is liable to when taken out, and extreme changes of tem- perature are to be avoided as certain causes of disease. A cold, close stable is invariably damp, and is to be avoided as much as the hot, close, and foul stable. Horses changed from a cold to a warm stable are more liable to contract cold than when changed from a Avarni to a cold stable. Pure air is more essential than warmth, and this fact should be especially remembered when the stable is made close and foul to gain the warmth. It is more econom- ical to keep the horse warm with blankets than to j)revent the ingress of ])ure air in order to make the stable Avarm. Stables should be well drained and kept clean. Some farmers allow large quantities of manure to accumulate in the stable. This is a pernicious practice, as the decomposing organic matter evolves gases that aic i^redisposing or exciting causes of disease. When a horse is overheated, it is not safe to allow him lo dry by evaporation; rubbing him drv and graduallv cooling him out is the wisest treat- ment. AVhen a horse is hot — covered with sweat — it is dangerous to allow him to stand in a draft; it is the best plan to walk him until his temperature moderates. In such cases a light blanket thrown over 106 DISEASES OF THE HORSE. the animal may prevent a cold. OverAvork or overexertion often causes the most fatal cases of congestion of the lungs. Avoid pro- longed or fast work when the horse is out of condition or unaccus- tomed to it. Animals that have been working out in cold rains should be dried and cooled out and not left to dry by evaporation. When the temperature of the weather is at the extreme, either of heat or cold, diseases of the organs of respiration are most frequent. It is not to be supposed that farmers can give their horses the par- ticular attention given to valuable racing and i^leasure horses, but they can most assuredly give them common-sense care, and this will often save the life of a valuable animal. If the owner properly con- siders his interests, he will study the welfare of his horses so that he may be able to instruct the servant in details of stable management. WOUNDS ABOUT THE NOSTRILS. Wounds in this neighborhood are common, and are generally caused by snagging on a nail or splinter or by the bite of another horse; or by getting " run into.'* or by running against something. Occasion- ally the nostril is so badly torn and lacerated that it is impossible to effect a cure without leaving the animal blemished for life, but in the majority of instances the blemish, or scar, is due to the w^ant of con- servative treatment. As soon as possible after the accident the parts should be brought together and held there by stitches. If too much time is alloAved to elapse, the swelling of the parts will considerably interfere. Never cut away any skin that may be loose and hanging, or else a scar will certainly remain. Bring the parts in direct apjjosi- tion and place the stitches from a quarter to a half inch apart, as cir- cumstances may demand. It is not necessary to have special surgeons' silk and needles for this operation ; good linen thread or ordinary silk thread will answer. The wound afterAvards only requires to be kept clean. For this purpose it should be cleansed and discharges washed away daily with a solution made of carbolic acid 1 part, in water 40 parts. If the horse is inclined to rub the wound against some object on account of the irritability, his head should be tied by means of two halter ropes attached to the opposite sides of the stall to prevent him rubbing the wound open. The head should be so tied about ten days, except when at work or eating. TUMORS WITHIN THE NOSTRILS. A small globular tumor is sometimes found within the false nostril, under that part of the skin that is seen to puff or rise and fall when a horse is exerted and breathing hard. These tumors contain matter of a cheesy consistency. Treatment. — If the tumor is well opened and the matter squeezed out, nature Avill perform a cure. If the opening is made from the out- COLD IN THE HEAD ( NASAL CATARRH ). 107 side throne:!! the skin, it shonid be at the most dependent part, bnt much tile best way to open the tumor is from the inside. Quiet the animal, i>:ently insert your finger up in the direction of the tumor, and you will soon discover that it is much larger inside than it appears to be on the outside. If necessary put a twitch on the ear of the horse to quiet him ; run the index finger of your left hand against the tumor; now. with the right hand, carefully insert the knife by running the back of the blade along the index finger of the left hand until the tumor is reached; with the left index finger guide the point of the blade (piickly and surely into the tumor; make the opening large. A little blood may flow for a Avhile, but it is of no consequence. Squeeze out the matter and keep the part clean. COLD IN THE HEAD, OR NASAL CATARRH. Catarrh is an inflammation of a mucous membrane. It is accom- panied by excessive secretion. In nasal catarrh the inflammation may extend from the membrane lining the nose to the throat, the in- side of the sinuses, and to the eyes. The causes are the general causes of respiratory disease enumerated above. It is especially common in voune: horses and in horses not acclimated. Si//Npfom.s. — The membrane at the beginning of the attack is dry, congested, and irritable; it is of a deeper hue than natural, pinkish red or red. Soon a watery discharge form the nostrils makes its appearance; the eyes may also be more or less affected and tears flow over the cheeks. The animal has some fever, which may be easily detected by means of a clinical thermometer inserted in the rectum or, roughly, by placing the finger in the mouth, as the feeling of heat conveyed to the finger will be greater than natural. To become somewhat expert in ascertaining the changes of temper- ature in the horse it is only necessary to place the finger often in the mouths of horses known to be healthy. After you have become accus- tomed to the warmth of the mouth of the healthy animal you will have no difficulty in detecting a marked increase of the temperature. The animal nuiy be dull: he sneezes or snorts, but does not cough unless the throat is atl'ected; he expels the air forcibly through his nostrils, very often in a manner that may be aptly called *' blowing his nose." A few days after the attack begins the discharge from the nostrils changes from a watery to that of a thick, mucilaginous state, of a yellowish white color, and may be more or less profuse. Often the appetitie is lost and the animal becomes debilitated. Treatment. — This disease is not serious, but inasmuch as neglect or bad treatment may cause it to lead to something worse or become chronic, it should receive proper attention. The animal should not be worked for a time. A few days of quiet rest, with pure air and good food, will be of greater benefit than most medication. The value of 108 DISEASES OF THE HORSE. pure air can not be overestimated, but drafts must be avoided. The benefit derived from the inhahition of steam is considerable. This is effected by holding the horse's head over a bucketful of boiling Avater, so that the animal Avill be compelled to inhale steam Avith every inhalation of air. Stirring the hot water with a wisp of hay causes the steam to arise in greater abundance. One may cause the horse to put his nose in a bag containing cut hay upon which hot water has been j^oured, the bottom of the bag being stood in a bucket, but the bag must be of loose texture, as gunny sack, or, if of canvas, holes must be cut in the side to admit fresh air. The horse may be made to inhale steam four or five times a day, about fifteen or twenty minutes each time. Particular attention should be paid to the diet. Give bran mashes, scalded oats, linseed gruel, and grass, if in season. If the horse evinces no desire for this soft diet, it is better to allow any kind of food he will eat, such as hay, oats, corn, etc., than to keep him on short rations. If the animal is constipated, relieve this symptom by injections (enemas) of warm water into the rectum three of four times a day, but do not administer purgative medicines, excepting of a mild character. For simple cases the foregoing is all that is required, but if the appetite is lost and the animal appears debilitated and dull, give 3 ounces of the solution of acetate of ammonia and 2 drams of pow- dered chlorate of potassium diluted with a pint of water three times a day as a drench. Be careful when giving the drench : do not pound the horse on the gullet' to make him swallow; be patient, and take time, and do it right. If the weather be cold, blanket the animal and keep him in a com- fortable stall. If the throat is sore, treat as advised for that ailment, to be described hereafter. If, after ten days or two weeks, the discharge from the nostrils con- tinues, give one-half dram of reduced iron three times a day. This may be mixed with damp feed. Common cold should be thoroughly understood and intelligently treated in order to prevent more danger- ous diseases. CHRONIC C^ATARRH (OR NASAL GLEET, OR COLLECTION IN THE SINUSES). This is a subacute or chronic inflammation of some part of the membrane affected in common cold, the disease just described. It is manifested by a persistent discharge of a thick white or yellowish white matter from one or both nostrils. The commonest cause is a neglected or badly treated cold, and it usually follows those cases where the horse has suffered exposure, been overworked, or has not received proper food, and, as a consequence, has become debilitated. CHRONIC CATARRH ( NASAL GLEET ). 109 Other but less frequent causes for this affection are: Fractures of the bones that involve the membrane of the sinuses, and even blows on the head over the sinuses. Diseased teeth often involve a sinus and cause a fetid discharge from the nostril. Violent coughing is said to have forced particles of food into the sinus, which acted as a cause of the disease. Tumors growing in the sinuses are known to have caused it. It is also attributed to disease of the turbinated liones. Absorption of the bones forming the Avails of the sinuses has been caused by the pressure of pus collecting in them and by tumors filling up the cavity. Symptoms. — Great caution must be exercised when examining these cases, for the horse may have glanders, while, on the other hand, horses have been condenmed as glandered when really there was nothing ailing them but nasal gleet. This affection is not contagious. It may stubbornly resist treatment and last for a long time. In most cases the discharge is from one nostril only, which may signify that the sinuses on that side of the head are affected. The discharge may be intermittent, that is, quantities may be discharged at times and again little or none for a day or so. Such an intermittent dis- charge usually signifies disease of the sinuses. The glands under and between the bones of the lower jaw may be enlarged. The pecul- iar ragged-edged ulcer of glanders is not to be found on the mem- brane within the nostrils, but occasionally^ sores are to be seen there. If there is any doubt about it, study well the symptoms of glanders to enable you to be at least competent to form a safe opinion. The eye on the side of the discharging nostril may have a peculiar appearance and look smaller than its fellow. There may be an enlargement, having the appearance of a bulging out of the bone over the part a fleeted, between or below the e^^es. The breath may be offensive, which indicates decomijosition of the matter or bones, or disease of the teeth. A diseased tooth is further indicated by the horse holding his head to one side when eating, or by drop})ing the food from the mouth after partly chewing it. When you tap on the bones between the eyes, below the eyes, and above the back teeth of the upper jaw. a hollow, drumlike sound is emitted, but if the sinus is filled with pus or contains a large tumor the sound emitted will be the same as if a solid substance were struck; by this means the sinus affected mav be located in some instances. The hair mav be rough over the affected part, or even the bone may be soft to the touch and the part give somewhat to pressure or leave an impres- sion where it is i:)ressed upon with the finger. Treatment. — The cause of the trouble must be ascertained before treatment is commenced. In the many cases where the animal is in poor condition (in fact, in all cases) he should have the most nutri- 110 DISEASES OF THE HOESE. tive food and regular exercise. The food, or box containing it, should be placed on the ground, as the dependent position of the head favors the discharge. The cases that do not require a surgical operation must, as a rule, have persistent medical treatment. Mineral tonics and local medica- tion are of the most value. For eight days give the following mix- ture: Reduced iron, 3 ounces; powdered nux vomica, 1 ounce. Mix and make into sixteen powders. Give one powder mixed with the food twice a day. Arsenious acid (white arsenic) in doses of from 8 to 6 grains three times dailv is a good tonic for such cases. Sulphur burnt in the stable while the animal is there to inhale its fumes is also a valuable adjunct. Care should be taken that the fumes of the burning sulphur are sufficiently diluted with air, so as not to suffocate the horse. Chloride of lime sprinkled around the stall is good. Also keep a quantity of the chloride under the hay in the manger, so that the eases, will be inhaled as the horse holds his head over the hay Avhile eating. Keep the nostrils washed, and keep the discharge cleaned away from the manger and stall. The horse may be caused to inhale creolin vapor or the vapor of compound tincture of benzoin by pouring 2 ounces of these drugs into hot water and fumigating in the usual way. If the nasal gleet is the result of a diseased tooth, the tooth must be removed. The operation of trephining is the best possible way to remove the tooth in such cases, as it immediately opens the cavity which can be attended to direct. In all those cases of nasal gleet where sinuses contain either collections of pus or tumors, the only relief is by the trephine ; and, no matter how thoroughly described, this is an operation that will be very seldom attempted by the non- professional. It would therefore be a waste of time to give the modus O'perondl. An abscess involving the turbinated bones is similar to the collection of pus in the sinuses, and must be relieved by trephining. THICKENING OF THE MEMBRANE. This is sometimes denoted by a chronic discharge, a snuffling in the breathing, and a contraction of the nostril. It is a result of common cold and requires the same treatment as prescribed for nasal gleet, namely, the sulphate of iron, sulphate of copper, iodide of potassium, etc. The membranes of both sides may be affected, but one side only is the rule; and the affected side may be easily detected by holding the hand tightly over one nostril at a time. AAlien the healthy side is closed in this manner, the breathing through the affected side will demonstrate a decreased caliber or an obstruction. TUMORS IN NOSE AND PHARYNX. Ill NASAL POLYPUS. Tumors with narrow bases (someAvhat pear-shaped) are occasion- ally found attached to the membrane of the nasal chambers, and are obstructions to breathing through the side in which they are located. They vary much in size; some are so small that their presence is not manifested, while others almost completely fill up the chamber, thereby causing a serious obstruction to the passage of air. The stem, or base, of the tumor is generally attached high up in the chamber, and usually the tumor can not be seen, but occasionally it increases in size until it can be observed within the nostril. Sometimes, instead of hanging down toward the nasal opening, it falls back into the phar- ynx. It causes a discharge from the nostril, a more or less noisy snutlling sound in breathing, according to its size, a discharge of blood (if it is injured), and sneezing. The side that it occupies can be detected in the same way as described for the detection of the affected side when the breathing is obstructed by a thickened mem- brane. The only relief is removal of the polypus, which, like all other operations, should be done by an expert when it is possible to secure one. The operation is performed by grasping the base of the tumor with suitable forceps and twisting it round and round until it is torn from its attachment, or by cutting it off Avith a noose of wire. The resulting hemorrhage is checked by the use of an astringent lotion, such as a solution of the tincture of iron, or by packing the nostrils with surgeon's gauze. PHARYNGEAL POLYPUS. This is exactly the same kind of tumor described as nasal polypus, the only difference being in the situation. Indeed, the stem of the tumor may be attached to the membrane of the nasal chamber, as before explained, or it may be attached in the fauces (opening of the back part of the mouth), and the body of the tmnor tlien falls into the pharynx. In this situation it may seriously interfere with breath- ing. Sometimes it droi)s into the larynx, causing the most alaruiing symptoms. The animal coughs, or tries to cough, saliva flows from the mouth, the breathing is performed with the greatest difficulty and accompanied by a loud noise; the aninuil appears as if strangled and often falls exhausted. When the tumor is coughed out of the larvnx the animal regains quickly and soon appears as if nothing was ailing. These sudden attacks and quick recoveries point to the nature of the trouble. The examination must be made by holding the aniuuiTs mouth open with a balling iron or speculum and running the hand l)ack into the mouth. If the tumor is within reach, it must be re- moved in the same manner as though it were in the nose. 112 DISEASES OF THE HOESE. BLEEDING FROM THE NOSE. This often occurs during the course of certain diseases, namely, influenza, bronchitis, purjjura liemorrhagica, glanders, etc. But it also occurs independent of other affections; and, as before mentioned, is a symptom of polypus, or tumor, in the nose. Injuries to the head, exertion, violent sneezing — causing a rupture of a small blood vessel — also induce it. The bleeding is almost inva- riably from one nostril only, and is never very serious. The blood escapes in drops (very seldom in a stream) and is not frothy, as when the hemorrhage is from the lungs. (See Bleeding from the lungs, p. 13G.) In most cases bathing the head and washing out the nostril with cold water are all that is necessary. If the cause is known, you will be guided according to circumstances. If the bleeding continues, i:)Our ice-cold water over the face, between the eyes and down over the nasal chambers. A bag containing ice in small pieces applied to the head is often efficient. If in spite of these measures the hemor- rhage continues, trj^ plugging the nostrils with cotton, tow, or oakum. Tie a string around the plug before it is pushed up into the nostril, so that it can be safely withdrawn after four or five hours. If both nostrils are bleeding, plug only one nostril at a time. If the hemor- rhage is profuse and persistent, give a drench composed of 1 dram of acetate of lead dissolved in 1 pint of Avater; or ergot, 1 ounce. INFLAMMATION OF THE PHARYNX, As already stated, the pharynx is common to the functions of both i^espiration and alimentation. From this organ the air passes into the larynx and thence onward to the lungs. In the posterior part of the pharynx is the superior extremity of the gullet, the canal through whicii the food and Avater pass to the stomach. Inflammation of the pharynx is a complication of other diseases — namely, influenza, strangles, etc. — and is probably always more or less complicated with inflammation of the larynx. That it may exist as an independent affection there is no reason to doubt, and it is discussed as such with the diseases of the digestive tract. SORE THROAT, OR LARYNGITIS. The larynx is situated in the space between the lower jawbones just back of the root of the tongue. It may be considered as a box (some- what depressed on each side), composed principally of cartilages and small muscles, and lined on the inside with a continuation of the respiratory mucous membrane. Posteriorly it opens into and is contin- uous with the windpipe. It is the organ of the voice, the vocal cords being situated within it : but in the horse this function is of little con- sequence. It dilates and contracts to a certain extent, thus regulating the volume of air passing through it. The mucous membrane lining SORE THROAT, OR LARYNGITIS. 113 it internally is so highly sensitive that if the smallest particle of food happens to drop into it from the pharynx violent coughing ensues instantly and is continued until the source of irritation is ejected. This is a provision of nature to prevent foreign substances gaining access to the lungs. That projection called Adam's apple in the neck of man is the promin(>nt i)art of one of the cartilages forming the larynx. Inflammation oi the larynx is a serious and sometimes a fatal dis- ease, and, as before stated, is usually complicated with inflammation of the pharynx, constituting what is popularly known as '* sore throat." The chief causes are chilling and exposure. Symptoms. — About the first symptom noticed is cough, followed by difficidty in swalloAving, which may be due to soreness of the mem- brane of the pharynx, over which the food or water must pass, or to the pain caused by the contraction of the muscles necessary to imi)el the food or water onward to the gullet ; or this same contraction of the muscles may cause a pressure on the larynx and produce pain. In many instances the difficulty in swallowing is so great that water, and in some cases food, is returned through the nose. This, however, does not occur from laryngitis alone, but only when the pharynx is involved in the inflammation. The glands between the lower jaw- bones and beloAv the ears may be swollen. Pressure on the larynx induces coughing. The head is more or less '' poked out," and has tlie appearance of being stiffly carried. The membrane in the nose becomes red. A discharge from the nostrils soon appears. As the disease advances, the breathing may assume a more or less noisy char- acter; sometimes a harsh rasping snore is emitted with every respira- tion, the breathing becomes hurried, and occasionally the animal seems threatened with suti'ocation. Treatment. — In all cases steam the nostrils, as has been advised for cold in the head. In bad cases cause the steam to be inhaled continu- ously for hours — until relief is afforded. Have a fresh bucketful of boiliuir water everv fifteen or twentv minntes. In each bucketful of water put a tablespoonful of oil of turpentine, or compound tincture of benzoin, the vapor of wdiich will be carried along with the steam to the affected parts and have a beneficial effect. In mild cases steaming the nostrils five, six, or seven times a day will suffice. The animal should be placed in a comfortable, dry stall (a box stall preferred), and should have a pure atmosphere to breathe. The body should be blanketed, and bandages applied to the legs. The diet should consist of soft food — bran mashes, scalded oats, linseed gruel, and. best of all. grass, if in season, which should be fresh. The man- ger, or trough, should not be too high nor too low. but a temporary one should be constructed at about the height he carries his head. II. !><)(•. T'.ir., r.'.»-2 8 114 DISEASES OF THE HORSE. Having to reach too high or too low may cause so much pain that the animal would rather forego satisfying what little appetite he might have than inflict pain by craning his head for food or water. A sup- ply of fresh water should be before him all the time ; he will not drink too much, nor will the cold water hurt him. Constipation (if pres- ent) must be relieved by enemas of warm water, administered three or four times during the twenty- four hours. A liniment composed of 2 ounces of olive oil and 1 ounce each of solution of ammonia and tincture of cantharides, well shaken to- gether, may be thoroughly rubbed in about the throat from ear to ear, and about 6 inches down over the windpipe, and in the space be- tween the lower jaws. This liniment should be applied once a day for two or three days. If the animal is breathing with great difficulty, persevere in steam- ing the nostrils, and dissolve 2 drams of chlorate of potassium in every gallon of water he will drink ; even if he can not swallow much of it, and even if it is returned through the nostrils, it will be of some benefit to the pharynx as a gargle. An electuary of acetate of potash, 2 drams, honey, and licorice pow- der may be spread on the teeth with a paddle every few hours. If the pain of coughing is great, 2 or 3 grains of morphine maj'^ be added to the electuary. When the breathing begins to be loud relief is afforded in some cases by giving a drench composed of 2 drams of fluid extract of jaborandi in half a pint of water. If benefit is derived, this drench may be repeated four or five hours after the first dose is given. It will cause a free flow of saliva from the mouth. In urgent cases, when suffocation seems inevitable, the operation of tracheotomy must be performed. To describe this operation in words that would make it comprehensible to the general reader is a more difficult task than performing the operation, which, in the hands of the expert, is simple and attended with little danger. The operator should be provided with a tracheotomy tube (to be purchased from any veterinary instrument maker) and a sharp knife, a sponge, and a bucket of clean cold water. The place to be selected for opening the windpipe is that part which is found, upon examina- tion, to be least covered with muscles, about 5 or G inches below the throat. Kight here, then, is the place to cut through. Have an assistant hold the animal's head still. Grasp your knife firmly in the right hand, select the spot and make the cut from above to below directly on the median line on the anterior surface of the windpipe. Make the cut about 2 inches long in the windpipe; this necessitates cutting three or four rings. One bold stroke is usually sufficient, but if it is necessary to make several other cuts to finish the operation, do SORE THROAT, OR LARYNGITIS. 115 not hesitate. Your purpose is to make a hole in the windpipe suffi- ciently large to admit the tracheotomy tube. It is quickly manifested when the windpipe is severed; the hot air rushes out, and when air is taken in it is sucked in with a noise. A slight hemorrhage may result (it never amounts to much), which is easily controlled by wash- ing the wound with a sponge and cold water, but use care not to get any water in the windpipe. Do not neglect to instruct your assistant to hold the head down immediately after the operation, so that the neck will be in a horizontal line. This will prevent the blood getting into the w^indpipe and allow it to drop directly on the ground. If you have the self -adjustable tube, it retains its place in the wound without further trouble after it is inserted. The other kind requires to be secured in position b}^ means of two tapes or strings tied around the neck. After the hemorrhage is somewhat abated, sponge the blood aAvay and see that the tube is thoroughly clean, then insert it, directing the tube downward toward the lungs. The immediate relief this operation affords is gratifying to behold. The animal, a few minutes before on the verge of death from suffoca- tion, emitting a loud wheezing sound with every breath, with haggard countenance, body swaying, pawing, gasping, fighting for breath, now breaths tranquilly, and may be in search of something to eat. The tube should be removed once a day and cleaned with the car- bolic acid solution (1 to 20), and the discharge washed away from the wound with a solution of carbolic acid, 1 j^art to 40 parts water. Several times a day the hand should be held over the opening in the tube to test the animal's ability to breathe through the nostrils, and as soon as it is demonstrated that breathing can be performed in the natural way the tube should be removed, the wound thoroughly cleansed with the carbolic acid solution (1 to 40), and closed by in- serting four or five stitches through the skin and muscle. Do not include the cartilages of the windpipe in the stitches. Apply the carbolic acid solution to the wound three or four times a day until healed. When the tube is removed to clean it the lips of the wound may be pressed together to ascertain whether or not the horse can breathe through the larynx. The use of the tube should be discon- tinued as soon as possible. It is true that tracheotomy tubes are seldom to be found on farms, and especially when most urgently required. In such instances there is nothing left to be done but, with a strong needle, pass a wax end or other strong string through each side of the wound, including the cartilage of the windpipe, and keep the wound open by tying the strings over the neck. During the time the tube is used the other treatment advised must not be neglected. After a few days the discharge from the nostrils 116 DISEASES OF THE HORSE. becomes thicker and more profuse. This is a good symptom and sig- nifies that the acute stage has passed. At any time during the attack, if the horse becomes weak, give whisky or aromatic spirits of ammo- nia, 2 ounces in water. Do not be in a hurry to put the animal back to work, but give plenty of time for a complete recovery. Oentle and gradually increasing exercise may be given as soon as the horse is able to stand it. The food should bo carefully selected and of good qual- ity. Tonics, as iron or arsenic, ma}' be employed. If abscesses form in connection with the disease they must be opened to allow the escape of pus, but do not rashly plunge a knife into swollen glands; wait until you are certain the swelling contains pus. The formation of pus may be encouraged by the constant appli- cation of poultices for hours at a time. The best poultice for the purpose is made of linseed meal, with sufficient hot water to make a thick paste. If the glands remain swollen for some time after the attack, rub well over them an application of the following: Biniodide of mercury, 1 dram ; lard, 1 ounce ; mix well. This may be applied once every day until the part is blistered. Sore throat is also a symptom of other diseases, such as influenza, strangles, purpura hemorrhagica, etc., which diseases may be con- sulted under their proper headings. After a severe attack of inflammation of the larjmx the mucous membrane may be left in a thickened condition, or an ulceration of the part may ensue, either of which are liable to produce a chronic cough. For the ulceration it is useless to prescribe, because it can neither be diagnosed nor topically treated by the nonprofessional. If a chronic cough remains after all the other symptoms have dis- appeared, it is advisable to give 1 dram of iodide of potassium dis- solved in a bucketful of drinking water, one hour before feeding, three times a day for a month if necessary. Also rub in well the preparation of iodide of mercury (as advised for the swollen glands) about the throat, from ear to ear, and in the space between tb.e lower jaw bones. The application may be repeated every third day until the part is blistered. SPASM OF THE LARYNX. The symptoms are as follows: Sudden seizure by a violent fit of coughing; the horse may reel and fall, and after a few minutes re- cover and be as well as ever. The treatment recommended is this: Three drams of bromide of potassium three times a day, dissolved in the drinking water, or give as a drench in about a half pint of water for a week. Then give 1 dram of powdered nux vomica (either on the food or shaken with water as a drench) once a day for a few weeks. DISEASES OF THE THROAT, 117 CROUP AND DIPHTHERIA. Neither of these diseases affects the horse. But these names are sometimes wrongly applied to severe laryngitis or pharyngitis, or to forage ])oisoning. in which the throat is paralyzed and becomes exces- sively inflamed and gangrenous. THICK AVIND AND P.OARING. Horses that are ali'ected with a chronic disease that causes a loud unnatural noise in breathing are said to have thick. wind, or to be roarers. This class does not include those affected with severe sore throat, as in these cases the breathing is noisy only during the attack of the acute disease. Tliick wind is caused by an obstruction to the free passage of the air in some part of the respiratory tract. N|sal polypi, thickening of the membrane, pharyngeal polypi, deformed bones, paralysis of the wing of th.e nostril, etc., are occasional causes. The noisy breathing of horses after having been idje and put to sudden exertion is not due to any disease and is only temporary. Very often a nervous, excitable horse will make a noise for a short time Avhen started off, generally caused by the cramped position in which the head and neck are forced in order to hold him back. Many other causes may occasion temporary, intermitting, or per- manent noisy respiration, but chronic roaring is caused by paralysis of the muscles of the larynx ; and almost invariably it is the muscles of the left side of the larynx that are affected. In chronic roaring the noise is made Avhen the air is drawn into the lungs; and only when the disease is far advanced is a sound produced when the air is expelled, and even then it is not near so loud as during inspiration. In a normal condition the muscles dilate the aperture of the larynx by moving outward the cartilage and vocal cord, allowing a sufficient volume of air to rush through. But when the muscles are paralyzed the cartilage and vocal cord that are normally controlled by the affected nniscles lean into the tube of the larynx, so that when the air rushes in it meets this obstruction and the noise is produced. "When the air is expelled from the Ivnf/s its very force pushes the cartilage aiul vocal cords out, and consequently noise is not produced in the expiratory act. The paralysis of the muscles is due to derangement of the nerve that supplies them with energy. The muscles of both sides are not supplied by the same nerve; there is a right and a left nerve, each su]ii^l\ing its respective side. The reason why the muscles on the left side are the ones usually paralyzed is owing to the difference in 118 DISEASES OF THE HOESE. the anatomical arrangeiiieiit of the nerves. The left nerve is much longer and more exposed to interference than the right nerve. In chronic roaring there is no evidence of any disease of the larynx other than the wasted condition of the muscles in question. The disease of the nerve is generally located far from the larynx. Dis- ease of parts contiguous to the nerve along any part of its course may interfere with its proper function. Enlargement of lymphatic glands within the chest through which the nerve passes on its way back to the larynx is the most frequent interruption of nervous sup- ply, and consequently roaring. When roaring becomes confirmed, medical treatment is entirely useless, as it is impossible to restore the wasted muscle and at the same time remove the cause of the interrup- tion of the nervous supj)ly. Before roaring becomes permanent the condition may be benefited by a course of iodide of potassium, if caused by disease of the lymphatic glands. Electricity has been used with indifferent success'^ Blistering or firing over the larynx is, of course, not worthy of trial if the disease is due to interference of the nerve supply. The administration of strychnia (nux vomica) on the ground that it is a nerve tonic with the view of stimulating the af- fected muscles is treating only the result of the disease without con- sidering the cause, and is therefore useless. The operation of extir- pating the collapsed cartilage and vocal cord is believed to be the only relief, and, as this operation is critical and can only be per- formed by the skillful veterinarian, it will not be described here. From the foregoing description of the disease it will be seen that the name '' roaring," by which the disease is generally known, is only a symptom and not the disease. Chronic roaring is also in many cases accompanied by a cough. The best way to test whether a horse is a " roarer " is either to make him pull a load rajDidly up a hill or over a sandy road or soft ground ; or, if he is a saddle horse, gallop him up a hill or over soft ground. The object is to make him exert himself. Some horses require a great deal more exertion than others before the characteristic sound is emitted. The greater the distance he is forced, the more he w411 appear exhausted if he is a roarer; in bad cases the animal becomes utterly exhausted, the breathing is rapid and difficult, the nostrils dilate to the fullest extent, and the animal ajjpears as if suffocation was imminent. An animal that is a roarer should not be used for breeding pur- poses. The taint is transmissible in many instances. Grunting. — A common test used by veterinarians when examining " the wind " of a horse is to see if he is a " grunter.'" This is a sound emitted during expiration when the animal is suddenly moved, or startled, or struck at. If he grunts he is further tested for roaring. Grunters are not always roarers, but, as it is a common thing for a roarer to grunt, such an animal must be looked upon with suspicion CHRONIC BRONCHITIS. 119 until he is thoroughly tried by pulling a load or galloped up a hill. The test should be a severe one. Horses suffering with pleurisy, pleurodynia, or rheumatism, and other affections accompanied with much pain, will grunt when moved, or when the pain is aggravated, but grunting under these circumstances does not justify the term of " grunter " being applied to the horse, as the grunting ceases when the animal recovers from the disease that causes the pain. Hif/h hloiving. — This term is applied to a noisy breathing made by some horses. It is distinctly a nasal sound, and must not be con- founded with " roaring."' Tlie sound is produced by the action of the nostrils. It is a habit and not an unsoundness. Contrary to roaring, when the animal is put to severe exertion the sound ceases. An ani- mal that emits this sound is called a " high-blower." Some horses have, naturally, very narrow nasal openings, and they nuiy emit sounds louder than usual in their breathing when exercis'ed. Whistling is only one of the variations of the sound emitted by a horse called a " roarer," and therefore needs no further notice, except to remind the reader that a whistling sound may be produced during an attack of severe sore throat or inflammation of the larynx, which passes away with the disease that causes it. CHRONIC BRONCHITIS. This may be due to the same causes as acute bronchitis or it may follow the latter disease. An attack of the chronic form is liable to 6e converted into acute bronchitis by a very slight cause. This chronic affection in most instances is associated wnth thickening of the walls of the tubes. Its course is slower, it is less severe, and is not accompanied with as much fever as the acute form. If the animal is exerted, the breathing becomes quickened and he soon shows signs of exhaustion. In many instances the animal keeps up strength and appearances moderately well, but in other cases the appetite is lost, flesh gradually disaj:)pears. and he becomes emaciated and debilitated. It is accompanied by a persistent cough, which in some cases is husky, smothered, or muflled, while in other cases it is hard and clear. A whitish matter is discharged from the nose, which may be curdled in some instances. If the ear is placed against the chest behind the shoulder blade, the rattle of the air passing through the mucus can be heard within. Treatment. — Rest is necessary, as even under the most favorable circumstances a cure is difficult to effect. The animal can not stand e.xertion and should not be compelled to undergo it. The animal should have much the same general care and medical treatment pre- scribed for the acute form. Arsenious acid in tonic doses (3 to 7 grains) three times daily may be given. As arsenic is irritant, it must be mixed with a considerable bulk of moist feed and never given 120 DISEASES OF THE HORSE. alone. Arsenic may be given in the form of Fowler's solntion. 1 ounce three times daily in the drinking water. Xn application of nnistard applied to the breast is a beneficial adjunct. Tlie diet should be the most nourishina-. Avoid bulky food. Linseed mashes, scalded oats, and, if in season, grass and green-blade fodder are the best diet. THE LUNGS. The lungs are the essential organs of respiration. They consist of two (right and left) spongy masses, commonly called the "lights,'' situated entirely within the thoracic cavity. On account of the space taken up by the heart, the left lung is the smaller. Externally, they are completely covered by the pleura. The structure of the In.ng consists of a light, soft, but very strong and remarkably elastic tissue, which can only be torn with difficulty. Each lung is divided into a certain number of lobes, which are subdivided into numberless lobules (little lobes). A little bronchial tube terminates in every one of these lobules. The little tube then divides into minute branches which open into the air cells (])ulmonary vesicles) of the lungs. The air cells are little sacs having a diameter varying from one-seventieth to one tw^o-hundredth of an inch ; they have but one opening, tlie communication with the branches of the little bronchial tubes. Small blood vessels ramify in the walls of the air cells. The air cells are the consummation of the intricate structures forming the respiratory apparatus. They are of prime importance, all the rest being complementary. It is here that the exchange of gases takes l)lace. As before stated, the walls of the cells are very thin ; so, also, are the walls of the blood vessels. Through these walls escapes from the blood the carbonic acid gas that has been absorbed by the blood in its circulation through the different parts of the body ; and through these walls is absorbed by the blood, from the air in the air cells, the oxygen gas which is the life-giving element of the atmosphere. COMGESTION OF THE El'NGS. Congestion is essentially an excess of blood in the vessels of the parts affected. Congestion of the lungs in the horse, when it exists as an independent affection, is generally caused by overexertion when the animal is not in a fit condition to undergo more than moderate exercise. Very often what is recognized as congestion of the lungs is but a symptom of exhaustion or dilatation of the heart. The methods practiced by the trainers of running and trotting horses will give an idea of what is termed " putting a horse in condi- tion " to stand severe exertion. The animal at first gets walking exercises, then after some time he is made to go faster and farther each day; the amount of work is daily increased until the horse is CONGESTION OF THE LUNGS. 121 said to hv "in condition." An animal so prepared runs no risk of being affected with congestion of the hmgs, if he is otherAvise healthy. On the other hand, if the horse is kept in the stable for the ])urpose of laying on fat or for want of something to do, the nniscidar system becomes soft, and the horse is not in condition to stand the severe exertion of going fast or far, no niaUcr how healthy he may be in other respects. If such a horse be given a hard ride or drive, he may start off in high spirits, but soon becomes exhausted, and if he is pushed he will slacken his pace, show a desire to stop, and may stag- irer or even fall. Examination will show the nostrils dilated, the Hanks heaving, the countenance haggard, and the appearance of suf- focation. The heart and muscles w^ere not accustomed to the sudden and severe strain put upon them; the heart became unable to perform its work; the blood accumulated in the vessels of the lungs, which eventually became engrossed with the stagnated blood, constituting congestion of the lungs. The animal, after having undergone severe exertion, may not exhibit alarming symptoms until returned to the stable; then he will be noticed standing with his head down, legs spread out, the eyes Avildly staring or dull and sunken. The breathing is very rapid and almost gasping; the body is covered with perspiration in most cases, which, however, may soon evaporate, leaving the surface of the body and the legs and ears cold; the breathing is both abdominal and tho- racic; the chest rises and falls and the flanks are powerfully brought into action. If the pulse can be felt at all it will be found beating very frequently, one hundred or so to a minute. The heart may be felt tumultuously thumping if the hand is placed against the chest behind the left elbow, or it may be scarcely perceptible. The animal may tremble all over the body. If the ear is placed against the side of the chest a loud murmur will be heard and perhaps a fine crackling sound. One can scarcely fail to i-ecognize a case of congestion of the lungs when brought on by overexertion, as the history of the case indicates (he nature of the ailment. In all cases of suffocation the lungs are c(m<»ested. It is also seen in connection with other diseases. TrcatiiK'iit. — If the animal is attacked by the elisease while on the road, stop him immediately. Do not attempt to return to the stables. If he is in the stable, make arrangements at once to insure an unlim- ited supply of pure air. If the weather is warm, out in the open air is the best place, but if too cold let him stand with head to the door. Let him stand still : he has all he can do, if he obtains sufficient pure air to sustain life. If he is encumbered with harness or saddle, remove it at once and I'ub the body with cloths or wisps of hay or straw. 'J'his stimulates the circulation in the skin, and thus aids in relieving the lungs of the extra quantity of blood that is stagnated 122 DISEASES OF THE HORSE. there. If you have three or four assistants, let them rub the body and legs well until the skin feels natural; rub the legs until they are warm, if possible. When the circulation is reestablished, put band- ages on the legs from the hoofs up as far as possible. Throw a blan- ket over the body and let the rubbing be done under the blanket. Diffusible stimulants are the medicines indicated — brandy, whisky (or even ale or beer if nothing else is at hand), ether, and aromatic spirits of ammonia. Two ounces each of spirits of nitrous ether and alcohol, given as a drench diluted with a pint of water, every hour until relief is afforded, is among the best remedies. Or, give a quarter of a pint of whisky in a pint of water every hour, or the same quan- tity of brandy as often, or a quart of ale every hour, or 1 ounce of tincture of arnica in a pint of water every hour until five or six doses have been given. If none of these remedies is at hand, 2 ounces of oil of turpentine, shaken with a half pint of milk, may be given once, but not repeated. The animal may be bled from the jugular vein. Do not take more than 5 or 6 quarts from the vein, and do not repeat the bleeding. The blood thus drawn will have a tarry appearance. When the alarming symptoms have subsided active measures may be stopped, but care must be used in the general treatment of the ani- mal for several days, for it must be remembered that congestion may be folloAved by pneumonia. The animal should have a comfortable stall, where he will not be subjected to drafts or sudden changes of temperature ; he should be blanketed and the legs kept bandaged. The air should be pure, a plentiful supply of fresh cold water always in the stall, and a diet composed principally of bran mashes, scalded oats, and, if in season, grass. AA-lien ready for use again the horse should at first receive moderate exercise only, which may be daily increased until he may safely be put to regular work. PNEUMONIA, OR LUNG FEVER. Pneumonia is inflammation of the lungs. The chief varieties of pneumonia are catarrhal — already discussed in connection Avith bron- chitis, under the name of broncho-pneumonia — and the fibrinous or croupous variety. The latter form receives its name from the fact that the air spaces are choked with coagulated fibrin thrown out from the blood. This causes the diseased portions of the lungs to become as firm as liver, in which condition they are said to be hepatized. As air is excluded by the inflammatory product, the diseased lung will not float in water. The inflammation usually begins in the lower part of the lung and extends upward. The first stage of the disease consists of conges- tion, or engorgement, of the blood vessels, followed by leakage of serum containing fibrin from the blood vessels into the air passages. PNEUMONIA, OR LUNG FEVER. 123 The fluids thus escaping into the air cells and in the minute branches of the little bronchial tubes become coagulated. The pleura covering the affected parts may be more or less inflamed. A continuance of the foregoing phenomena is marked by a further escape of the constituents of the blood, and a change in the membrane of the cells, which become swollen. The exudate that fills the air cells and minute bronchial branches undergoes disintegration and softening when healing commences. The favorable termination of pneumonia is in resolution, that is, a restoration to health. This is gradually brought about by the exuded material contained in the air cells and lung tissues becoming broken down and softened and absorbed or expectorated through the nostrils. The l)lood vessels return to their natural state, and the blood circu- lates in them as before. In the cases that do not terminate so hap- pily the lung nuiy become gangrenous (or mortified), or an abscess mav form, or the disease may be merged into the chronic variety. Pneumonia may be directly induced by any of the influences named as general causes for diseases of the organs of respiration, but in many instances it is due to neglect. A common cold or sore throat may be followed by pneumonia if neglected or improperly treated. An animal may be debilitated by a cold, and when in this weakened state may be compelled to undergo exertion beyond his strength ; or he may be kept in bad quarters, such as a badly ventilated stable, where the foul gases are shut in and the pure air is shut out; or the stable may be so open that parts of the body are exposed to drafts of cold air. An animal is predisposed to pneumonia when debilitated by any constitutional disease, and especially during convalescence if exposed to any of the exciting causes. Foreign bodies, such as food, accidentally getting in the lungs by way of the windpipe, as well as the inhalation of irritating gases and smoke, ofttimes produce fatal attacks of inflammation of the lung and bronchial tubes. Pneumonia is frequently seen in connection with other diseases, such as influenza. ])iirpura hemorrhagica, strangles, glanders, etc. Pneumonia and l)leurisv are most common during cold, damp weather, and especially during the prevalence of the cold north and nortlieasterly winds. AVounds puncturing the thoracic cavity may cause pneumonia. SyTriptoms. — Pneumonia, when a primary disease, is ushered in by a chill, more or less prolonged. Avhich in many cases is seen neither by the owner nor the attendant, but is overlooked. The l)reathing becomes accelerated, and the animal hangs its head and has a very dull appearance. The mouth is hot and has a sticky feeling to the touch: the heat conveyed to the finger in the mouth demonstrates a fever: if the thermometer is j)laced in the rectum the temperature will be found to have risen to 103° F. or higher. The pulse is fre- quent, beating from fifty or sixty to eighty or more a minute. • There 124 DISEASES OF THE HORSE. is usually a dry cough from the beginning, which, however, changes in character as the disease advances; for instance, it may become moist, or if pleurisy sets in, the cough will be peculiar to the latter affection; that" is, cut short in the endeavor to suppress it. In some cases the discharge from the nostrils is tinged with blood, while in other cases it has the appearance of muco-pus. The appetite is lost to a greater or less extent, but the desire for water is increased, par- ticularly during the onset of the fever. The membrane within the nostrils is red and at first dry, but sooner or later becomes moist. The legs are cold. The bowels are more or less constipated, and what dung is passed is usually covered with a slimy mucus. The urine is passed in smaller (juantities than usual and is of a darker color. The animal prefers to have the head where the freshest air can be obtained. When affected Avith pneumonia a horse does not lie down, but persists in standing from the beginning of the attack. However, if pneumonia is complicated with pleurisy, the horse may appear rest- less and lie down for a few moments to gain relief from the pleuritic pains, but he soon rises. In pneumonia the breathing is rapid and difficult, but when the pneumonia is complicated with pleuris}^ the I'ibs are kept as still as possible and the breathing is abdominal; that is, the abdominal muscles are now made to do as much of the work as they can perform. If pleurisy is not present there is little pain. To the ordinary observer the animal may not appear dangerously ill, as he does not show the seriousness of the ailment by violence, as in colic, but a careful observer will discover at a glance that the trouble is something more serious than a cold. By percussion it will be shown that some portions of the chest are less resonant than in health, indicating exclusion of air. If the air is wholly excluded the percussion is quite dull, as that elicited by percussion over the thigh. By auscultation important information may be gained. When the ear is placed against the chest of a healthy horse, the respiratory murmur is heard more or less distinctly, according to the part of the chest that is beneath the ear. In the very first stage of pneumonia this murmur is louder and hoarser; and, also, there is heard a fine crackling sound something similar to that produced when salt is thrown in a fire. After the affected part becomes solid there is an absence of sound over that particular part. After absorption begins one may again hear sounds that are of a more or less moist character and resemble a bubbling or gurgling noise, which gradually change nntil the natural sound is heard announcing return to health. When a fatal termination is approaching all the symptoms become intensified. The breathing becomes still more rapid and difficult ; the flanks heave: the animal stares wildly about as if seeking aid to drive off the feeling of suffocation ; the body is bathed with sweat ; the horse staggers, but quickly recovers his balance; he may now, for the first PNEUMONIA, OR LUNG FEVER. 125 time during the attack, lie down; lie does so, however, in the hope of relief, which he fails to find, and with difficulty struggles to his feet; he pants; the nostrils flap; he staggers and sways from side to side and backward and forward, but still tries to retain the standing position, even by propping himself against the stall. It is no use, as after an exhausting fight for breath he goes doAvn ; the limbs stretch out and become rigid. In fatal cases death usually occurs in fr a / ■,/■■■' .•.^.>5'** ^'' O c DISEASES OF THE BEONCIITAT. TUBES. 129 BRONCHITIS AND BRONCHO-PNEUMONIA. Bronchitis is an inflannnation of the bronchial tubes. When this inflannnation extends to the air sacs at the termini of the smallest branches of the bronchial tubes, the disease is broncho-pneumonia. Bronchitis affecting- the larger tubes is less serious than when the smaller are involved. The disease may be either acute or chronic. The causes are generally much the same as for other diseases of the respiratory organs, noticed in the beginning of this article. The special causes are these: The inhalation of irritating gases and smoke and fluids or solids gaining access to the parts. Bronchitis is occa- sionalh' associated with influenza and other specific fevers. It also supervenes on connnon cold or sore throat. Symptoms. — The animal appears dull; the appetite is partially or Avholly lost; the head hangs; the breathing is quickened; the cough, at first dry, and having somewhat the character of a " barking cough," is succeeded in a fcAv days by a moist, rattling cough ; the mouth is hot ; the visible membranes in the nose are red ; the pulse is frequent, and during the first stage is hard and quick, but as the disease advances becomes smaller and more frequent. There is a discharge from the nostrils that is at first Avhitish, but later becomes creamy or frothy, and still later it is sometimes tinged with blood, and occasionally it ma}^ be of a brownish or rusty color. By auscul- tation, or placing the ear to the sides of the chest, unnatural sounds can now be heard. The air passing through the diseased tubes causes a wheezing sound when the small tubes are affected, and a hoarse, cooing, or snoring sound when the larger tubes are involved. After one or two days the dr}^ stage of the disease is succeeded by a moist state of the membrane. The ear now detects a different sound, caused by the bursting of the bubbles as the air passes through the fluid. Avhich is the exudate of inflammation and the augmented mu- cous secretions of the membrane. The mucus may be secreted in great abundance, which, by blocking up the tubes, may cause a col- lapse of a large extent of breathing surface. Usually the mucus is expectorated ; that is, discharged through the nose. The matter is coughed up. and when it reaches the larynx much of it may be swal- lowed, and some is discharged from the nostrils. The horse can not spit, like the human being, nor does the matter coughed up gain access to the mouth. If in serious cases all the symptoms become aggra- vated, the breathing is labored, short, and quick, it usually indicates that the inflammation has reached the breathing cells and that catar- rhal pneumonia is established. In this case the ribs rise and fall much more than natural. This fact alone is enough to exclude the idea that the animal nuiy be affected with pleurisy, because, in pleu- risy, the ribs are as nearh' fixed as in the power of the animal to do H. Doc. 705, 5!)-2 9 130 DISEASES OF THE HORSE. SO, and the breathing accomplished to a great extent bj^ aid of the abdominal muscles. The horse persists in standing throughout the attack. He prefers to stand with head to a door or window to gain all the fresh air possible, but may occasionally wander listlessly about the stall if not tied. The bowels most likely are constipated; the dung is covered with slimy mucus. The urine is decreased in quantity and darker in color than usual. The animal shows more or less thirst; in some cases the mouth is full of saliva. The discharge from the nose increases in quantity as the disease advances and in- flammation subsides. This is rather a good symptom, as it shows one stage has passed. The discharge then gradually decreases, the cough becomes less rasping, but of more frequent occurrence, until it grad- ually disappears with the return of health. Bronchitis, affecting the smaller tubes, is one of the most fatal diseases, while that of the larger tubes is never very serious. It must be stated, however, that it is an exceedingly difficult matter for a nonexpert to discriminate between the two forms, and, further, it may as well be said here that the nonexpert will have difficulty in discriminating between bronchitis and pneumonia. Treatment. — The matter of first importance is to insure a pure at- mosphere to breathe, and next to make the patient's quarters as com- fortable as possible. A well-ventilated box stall serves best for all purposes. Cover the body with a blanket, light or heavy, as the season of the year demands. Hand rub the legs until they are warm, then wrap them in cotton and apply flannel or Derby bandages from the hoofs to the knees and hocks. If the legs can not be made warm with hand rubbing alone, apply dry mustard. Rub in thoroughly and then put on the bandages. Also rub mustard paste well over the side of the chest, covering the space beginning immediately behind the shoulder blade and running back about eighteen inches, and from the median line beneath the breast to within ten inches of the ridge of the backbone. Repeat the application to the side of the chest about three days after the first one is applied. Compel the animal to inhale steam from a bucketful of boiling water containing a tablespoonful of oil of turpentine and spirits of camphor, as advised for cold in the head. In serious cases the steam should be inhaled every hour, and in any case the oftener it is done the g-reater will be the beneficial results. Three times a day admin- ister an electuary containing acetate of potash (2 drams), with lico- rice and molasses or honey. It is well to keep a bucketful of cold water before the animal all the time. If the horse is prostrated and has no appetite, give the following drench : Spirits of nitrous ether, 2 ounces; rectified spirits, 3 ounces; water, 1 pint. Repeat the dose every four or five hours if it appears to benefit. AVhen the horse is hard to drench, give the following: Pulverized carbonate of ammonia, PLEURISY. 131 3 drams ; linseed meal and molasses sufficient to make the whole into a stitf mass; wrap it with a small piece of tissue paper and give as a ball. This ball may be repeated every four or five hours. When giv- ing the ball care should be taken to prevent its breaking in the mouth, as in case of such accident it will make the mouth sore, which may prevent the animal from eating. If the bowels are constipated, give enemas of warm water. Do not give purgative medicines. Do not bleed the animal. If the animal retains an appetite, a soft diet is preferable, such as scalded oats, bran mashes, and grass, if in season. If he refuses cooked food, allow in small (pumtities anything he will eat. Hay, cob corn, oats, bread, apples, and carrots may all be tried in turn. Some horses will drink sweet milk when they refuse all other kinds of food, and especially is this the case if the drinking water is withheld for a while. One or '2 gallons at a time, four or five times a da}^, will support life. Bear in mind that when the disease is established re- covery can not occur in less than two or three weeks, and more time may be necessary. Good nursing and patience are required. "Wlien the symptoms have abated and nothing remains of the dis- ease except the cough and a white discharge from the nostrils, all other medicines should be discontinued and a course of tonic treat- ment pursued. Give the following mixture: Reduced iron, 3 ounces; powdered gentian, 8 ounces ; mix well together and divide into sixteen powders. Give a powder every night and morning mixed with bran and oats, if the animal will eat it, or shaken with about a pint of flax- seed tea and administered as a drench. If the cough remains after the horse is apparently well, give 1 dram of iodide of potassium dissolved in a bucketful of drinking water one hour before each meal for two or three weeks if necessary. Do not put the animal to work too soon after recovery. Allow ample time to regain strength. This disease is prone to become chronic and maj' run into an incurable case of thick wind. PLEURISY. The thoracic cavity is divided into two lateral comjiartments, each containing one lung and a part of the heart. Each lung has its sepa- rate pleural membrane, or covering. The pleura is the thin glisten- ing membrane that covers the lung and also completely covers the in- ternal walls of the chest. It is very thin, and to the ordinary ob- server appears to be part of the lung, which, in fact, it is for all practical purposes. The smooth, shiny surface of the lung, as well as the smooth, shiny surface so familiar on the rib, is the pleura. In health this surface is always moist. A fluid is thrown off by the pleura, which causes the surface to be constantly moist. This is to prevent the effects of friction between the lungs and tlie walls of the 132 DISEASES OF THE HOBSE. chest and other contiguous parts Avhich come in contact. It must be remembered that the kings are dihiting each time a breath is taken in, and contracting each time a breath of air is expelled. It may be readily seen that if it were not for the moistened state of the surface of the pleura the continual dilatation and contraction and the conse- quent rubbing of the parts against each other would cause serious friction. Inflammation of this membrane is called pleurisy. Being so closel}'' united with the lung, it can not always escape participation in the disease when the latter is inflamed. Pleurisy may be due to the same predisposing and exciting causes as mentioned in the beginning of this work as general causes for diseases of the organs of respiration, such as exposure to sudden changes of temperature, confinement in damp stables, etc. It may be caused by wounds that penetrate the chest, for it must be remembered that such wounds must necessarily pierce the pleura. A fractured rib may involve the pleura. The inflammation following such wounds may be circumscribed, that is, confined to a small area surrounding the wound, or it may spread from the wound and involve a large portion of the pleura. The ])leura may be involved secondarily when the heart or its membrane is the i^rimary seat of the disease. It ma}'' occur in conjunction with bronchitis, influenza, and other diseases. Diseased growths that interfere with the pleura may induce pleurisy. The most frequent cause of pleurisy is an extension of inflammation from adjacent dis- eased lung. It is a common complication of pneumonia. Pleurisy will be described here as an independent affection, although it should be remembered that it is very often associated with the foregoing diseases. The first lesion of jDleurisy is overfilling of the blood vessels that ramify in this membrane, and dryness of the surface. This is fol- lowed b}^ the formation of a coating of coagulated fibrin on the diseased pleura and the transudation of serum Avhich collects in the chest. This serum may contain flakes of fibrin and it may be straAV colored or red from an admixture of blood. The quantity of this accumulation may amount to several gallons. SyTuptoms. — When the disease exists as an independent affection it is ushered in bj'^ a chill, but this is usually overlooked. About the first thing noticed is the disinclination of the animal to move or turn round. AMien made to do so he grunts or groans Avith pain. He stands stiff"; the ribs are fixed, that is, the ribs move very little in the act of breathing, but the abdomen works more than natural, both the fore feet and elbows mav be turned out : during the onset of tlie attack the animal may be restless and act as if he had a slight colic; he may even lie down, but does not remain long down, for when he finds no relief he soon gets up. After effusion begins these signs of PLEURISY. 133 restlessness disappear. Every movement of the chest canses pain, therefore the coiio^h is peculiar; it is short and suppressed, and comes as near being no cough as the animal can make it in his desire to sup- press it. The breathing is hurried, the mouth is hot, the temperature being elevated from 10-2° or 108° to 105° F. The usual symptoms that accompany fever are present, such as costiveness, scanty dark- colored urine, etc. The i)ulse is frequent, perhaps 70 or more a minute, and is hard and wiry. 'Vho legs and ears are cold. Percussion is of valuable service in this affection. After effusion occurs, the sound produced by percussing over the lower part of the chest is dull. By striking different parts one may come to a spot of greater in the same manner as in health; it may possibly be done a little quicker than natural, but not enough to attract any notice. It is Avhen the act of expiration (or expelling the air from the lungs) is per- 138 . DISEASES OF THE HORSE. formed that the great change in the breathing is perceptible. It must be remembered that the hmgs have lost much of their elasticity, and, in consequence, of their power of contracting on account of the de- generation of the Avails of the air cells, and also on account of the paralysis of muscular tissue before mentioned. The air passes into them freely, but the jooAver to expel it is lost to a great extent by the lungs; therefore the abdominal muscles are brought into jolay. These muscles, especially in the region of the flank, are seen to contract, then pause for a moment, then complete the act of contracting, thus making a double bellowslike movement at each expiration, a sort of jerky motion with every breath. The double expiratory movement may also be detected by allowing the horse to exhale against the face or back of the hand. It w^ill be observed that the expiratory current is not continuous, but is broken into two jets. When the animal is exerted a wheezing noise accompanies the breathing. This noise may be heard to a less extent Avhen the animal is at rest if the ear be applied to the chest. As before remarked, indigestion is often present in these cases. The animal may have a depraved appetite, as shown by a desire to eat dirt and soiled bedding, which he often devours in preference to the clean food in the trough or manger. The stomach is liable to be overloaded with indigestible food. The abdomen may assume that form called '' potbellied." The animal frequently passes wind of a very offensive odor. When first put to work dung is passed fre- quenth^ ; the bowels are often loose. The animal can not stand much work, as the muscular system is soft. Round-chested horses are said to be predisposed to the disease, and it is certain that in cases of long standing the chest usually becomes rounder than natural. Certain individuals become very expert in managing a horse affected with heaves in suppressing the symptoms for a short time. They take advantage of the fact that the breathing is much easier when the stomach and intestines are empty. They also resort to the use of medicines that have a depressing effect. When the veterina- rian is examining a horse for soundness, and he suspects that the animal has been " fixed," he usually gives the horse as much water as he will drink and then has him ridden or driven rapidly up a hill or on a heavy road. This will bring out the characteristic breathing of heaves if the horse is so afflicted, but will not cause the symptoms of heaves in a healthy horse. All broken-winded horses have the cough peculiar to the affection, but it is not regular. A considerable time may elapse before it is heard and then it may come on in paroxysms, especially when first brought out of the stable into the cold air, or when excited by Avork, or after a drink of cold water. The cough is usually the first symptom of the disease. Tt'eatmerit.—\\\\^\\ the disease is established there is no cure for it. Proper attention paid to the diet will relieve the distressing symp- DISEASES OF THE LUNGS. 139 toms to a certain extent, but they will undoubtedly reappear in their intensity the first time the animal overloads the stomach or is al- lowed food of bad quality. Clover hay or bulky food which contains but little nutriment have nmch to do with the cause of the disease, and therefore should be entirely omitted when the animal is affected, as Avell as before. It has been asserted that the disease is unknown where clover hay is never used. The diet should be confined to food of the best (luality and in the smallest quantity. The bad effect of moldy or dusty hay, fodder, or food of any kind can not be over- estimated. A small quantity of the best hay once a day is sufficient. This should be cut and dampened. The animal should invariably be watered before feeding; never directly after a meal. The animal should not be worked innnediately after a meal. Exertion, when the stomach is full, invariably aggravates the symptoms. Turning on pasture gives relief. Carrots, potatoes, or turnips chopped and mixed with oats or corn are a good diet. Half a pint to a pint of thick, dark molasses with each feed is useful. Arsenic is efficacious in palliating the symptoms. It is best ad- ministered in the form of the solution of arsenic, as Fowler's solu- tion or as the white powdered arsenious acid. Of the former the dose is 1 ounce to the drinking water three times daily. Of the latter one may give 3 grains in each feed. These quantities may be cautiously increased as the animal becomes accustomed to the drug. If the bowels do not act regularly, a pint of raw linseed oil may be given once or twice a month, or a handful of Glauber's salt may be given in the feed twice daily, so long as necessary. It must, however, be borne in mind that all medical treatment is of secondary consideration ; careful attention paid to the diet is of greatest impor- tance. Broken-winded animals should not be used for breeding pur- poses. A predisposition to the disease may be inherited. CHRONIC COUGH. A chronic cough may succeed the acute diseases of the respiratory organs, such as pneumonia, bronchitis, laryngitis, etc. It accom- panies chronic roaring, chronic bronchitis, broken wind. It may succeed influenza. As previously stated, cough is but a symptom and not a disease in itself. Chronic cough is occasionally associated with diseases other than those of the organs of respiration. It may be a symptom of chronic indigestion or of worms. In such cases it is caused by a reflex nervous irritation. The proper treat- ment in all cases of chronic cough is to ascertain the nature of the disease of which it is a symptom, and then cure the disease if possible, and the cough will cease. The treatment of the affections will be found under their appro- priate heads, to which the reader is referred. 140 DISEASES OF THE HOESE. PLEURO-DYNIA. This is a form of rheumatism that affects the intercostal muscles; that is, the muscles between the ribs. The apparent symptoms are very similar to those of pleurisy. The animal is stiff and not in- clined to turn around : the ribs are kept in a fixed state as much as possible. If the head is pulled round suddenly, or the affected side struck with the hand, or if the spaces between the ribs are pressed wath the fingers, the animal w ill flinch and perhaps emit a grunt or groan expressible of much pain. It is distinguished from pleurisy by the absence of fever, cough, the friction sound, the effusion into the chest, and by the existence of rheumatism in other parts. The treatment for this affection is the same as for rheumatism affecting other parts. AVOUNDS PENETRATING THE WALLS OF THE CHEST. A wound penetrating the wall of the chest admits air into the tho- racic cavity outside of the lung. This condition is known as pneumo- thorax and may result in collapse of the lung. The wound may be so made that when the walls of the chest are dilating a little air is sucked in, but during the contraction of the wall the contained air presses against the torn part in such a manner as entirely to close the wound; thus a small quantity of air gains access with each in- spiration, Avhile none is allow^ed to escape until the lung is pressed into a very small compass and forced into the anterior part of the chest. The same thing may occur from a broken rib inflicting a wound in the lung. In this form the air gains access from the lung, and there may not even be an opening in the walls of the chest. In such cases the air may be absorbed, when a spontaneous cure is the result. But when the symptoms are urgent it is reconniiended that the air be removed by a trocar and canula or by an aspirator. It is evident that the treatment of wounds that penetrate the tho- racic cavity should l)e prompt. It should be quickly ascertained whether or not a foreign body remains in the wound, then it should be thoroughly cleaned with a solution of carbolic acid, 1 part in water 40 parts. The wound should then be closed immediately. If it is an incised wound, it shoidd be closed with sutures or with adhesive plas- ters; if torn or lacerated, adhesive plaster may be used or a bandage around the chest over the dressing. At all events, air must be pre- vented from getting into the chest as soon and as effectually as pos- sible. The after treatment of the wound should principally consist in keeping the parts clean with a solution of carbolic acid, and applying fresh dressing as often as required to keep the Avound in a healthy condition. Care should be taken that the discharges from the wound THUMPS. 141 have an outlet in the most dojiendent part. (See AVonnds and their treatment, p. 450.) If pleurisy suj)ervenes, it should be treated as advised under that head. THUMPS, OR SPASM OF THE DIAPHRAGM. *• Thumps "' is generally thought by the inexperienced to be a pal- pitation of the heart. "While it is true tliat palpitation of the heart is sometimes called ** thumi)s," it must not be confounded Avith the aflFection under consideration. In the beginning of this article on the diseases of the organs of respiration, the diaphragm was briefly referred to as the principal and essential muscle of respiration. Spasmodic or irregular contractions of it in man are manifested by what is familiarly known as hiccoughs. Thumps in the horse is similar to hiccoughs in man. although the peculiar noise is not made in the throat of the horse in all cases. There should l)e no difficultv in distino-uishina: this affection from l^alpitation of the heart. The jerky motion affects the whole body, and is not confined to the region of the heart. If one hand is placed on the body at about the middle of the last rib. while the other hand is placed over the heart behind the left elbow, it will be easily demon- strated that there is no connection between the thumping or jerking of the diaphragm and the beating of the heart. In fact, when the animal is affected with spasms of the diaphragm the beating of the heart is usually much Aveaker and less perceptible than natural. Thumps is produced by causes similar to those that produce conges- tion of the lungs and dilatation or palpitation of the heart, and ma}'^ occui- in connection Avith these conditions. If not relicA^'ed, death usually results from congestion or edema of the lungs, as the breath- ing is interfered Avith by the inordinate action of this important muscle of inspiration so much that proper aeration of the blood can not take place. The treatment should be as prescribed for congestion of the lungs, and. in addition, antispasmodics, such as 1 ounce of sulphuric ether in Avarm Avater or 3 drams of asafetida. RUPTURE OF THE DIAPHRAGM. Post-mortem examinations after colic or severe accident sometimes rcA'eal rupture of the diaphragm. This may take place after death, trom the generation of gases in the decomposing carcass, Avhich dis- tend the intestines so that the diaphragm is ruptured by the great pressure against it. The symptoms are intensely difficult respiration and great depression. There is no treatment. DISEASES OF THE GENERATIVE ORGANS. By James IjAW, F. K. C. V. S., Professor of Yeterinurii Science, etc., in Cornell University. I Revised in 1903 by tlie autlior.] CONGESTION AND INFLAMMATION OF THE TESTICLES, OR ORCHITIS. In the prime of life, in vigorons health, and on stimulating food, stallions are subject to congestion of the testicles, which become swollen, hot, and tender, but without any active inflammation. A reduction of the grain in the feed, the administration of 1 or 2 ounces of Glauber's salts daily in the food, and the bathing of the affected organs daily with tepid water or alum water will usually restore them to a healthy condition. When the factors producing congestion are extraordinarily potent, Avhen there has been frequent copulation and heavy grain feeding, when the weather is warm and the animal has had little exercise, and when the proximity of other horses or mares excite the generative instinct without gratification, this congestion may grow to actual inflammation. Among the other causes of orchitis are blows and pen- etrating wounds implicating the testicles, abrasions of the scrotum by a chain or rope passing inside the thigh, contusions and frictions on the gland under rapid paces or heavy draft, compression of the blood vessels of the spermatic cord by the inguinal ring under the same cir- cumstances, and, finally, sympathetic disturbance in cases of disease of the kidneys, bladder, or urethra. Stimulants of the generative functions, like rue, savin, tansy, cantharides, and damiana, may also be accessory causes of congestion and inflammation. Finally, certain specific diseases like maladie du coTt, glanders, and tuberculosis, local- ized in the testicles, will cause inflammation. Symptoms. — Apart from actual Avounds of the parts, the symptoms of orchitis are swelling, heat, and tenderness of the testicles, strad- dling Avith the hind legs alike in standing and walking, stiffness and dragging of the hind limbs or of the limb on the affected side, arching of the loins, abdominal pain, manifested by glancing back at the flank, with more or less fever, elevated body temperature, accelerated pulse and breathing, inappetence, and dullness. In bad cases the scanty urine mav be reddish and the swelling: mav extend to the skin and envelopes of the testicle, which may become thickened and doughy, pitting on pressure. The swelling may be so much greater in the convoluted excretory duct along the upper border of the testicle as to 142 DISEASES OF THE GENERATIVE ORGANS. 143 suggest the presence of a second stone. Even in tlie more violent attacks the intense suffering abates somewhat on the second or third day. If it hists longer it is likely to give rise to the formation of matter (abscess). In exceptional cases the testicle is struck Avith gangrene, or death. Improvement may go on slowly to comjilete recovery, or the malady may subside into a subacute and chronic form with induration. Matter (abscess) may be recognized by the presence of a soft spot, where i)ressure with two fingers will detect fluctuation from one to the other. When there is liquid exudation into the scrotum, or sack, fluctuation may also be felt, but the liquid can be made out to be around the testicle and can be pressed up into the abdomen through the inguinal canal. When abscess occurs in the cord the matter may escape into the scrotal sac and cavity of the abdo- men and pyemia ma}" follow. Treatment consists in perfect rest and quietude, the administration of a purgative (1 to 1^ pounds Glauber's salts), and the local appli- cation of an astringent lotion (acetate of lead 2 drams, extract of belladonna 2 drams, and water 1 quart) upon soft rags or cotton wool, kept in contact with the part by a suspensory bandage. This band- age, of great value for support, may be made nearly triangular and tied to a girth around the loins and to the upper part of the same sur- cingle by two bands carried backward and upward between the thighs. In severe cases scarifications one-fourth inch deep serve to re- lieve vascular tension. When abscess is threatened its formation may be favored by warm fomentations or poultices, and on the occurrence of fluctuation the knife may be employed to give free escape to the l)us. The resulting cavity may be injected daily with a weak car- bolic-acid lotion, or salol may be introduced. The same agents may be used on a gland threatened with gangrene, but its prompt removal by castration is to be preferred, antiseptics being applied freely to the resulting cavity. SARCOCELE. This is an enlarged and indurated condition of the gland, resulting from chronic inflannnation, though it is often associated with a specific deposit, like glanders. In this condition the natural struc- ture of the gland has given place to embryonal tissue (small round cells, with a few" fibrous bundles), and its restoration to health is very improbable. Apart from active inflammation, it may increase very slowly. The diseased testicle is enlarged, firm, nonelastic, and com- paratively insensible. The skin of the scrotum is tense, and it may be edenuitous (j^itting on ]:)ressure). as are the deeper envelopes and spermatic cord. If liquid is present in the sac. the symptoms are masked somewhat. As it increases it causes awkward, straddling, dragging movement of the hind limbs, or lameness on the affected side. The spermatic cord often increases at the same time with the 144 DISEASES OF THE HORSE. testicle, and the inguinal ring being thereby stretched and enlarged, a portion of intestine may escape into the sac, complicating the dis- ease with hernia. The only rational and effective treatment is castration, and even this may not succeed when the disease is specific (glanders, tuber- culosis). HYDROCELE, OR DROPSY OF THE SCROTUM. This may be merely an accompaniment of dropsy of the abdomen, the cavity of which is continuous Avith that of the scrotum in horses. It may be the result, however, of local disease in the testicle, sper- matic cord, or Avails of the sac. Symjytoms. — The symptoms are enlargement of the scrotum, and fluctuation under the fingers, the testicle being recognized as floating in Avater. By pressure the liquid is forced, in a slow stream and Avith a perceptible thrill, into tlie abdomen. Sometimes the cord or the scrotum is thickened and pits on pressure. Treatment may be the same as for ascites, yet Avhen the effusion has resulted from inflammation of the testicle or cord, astringent applica- tions (chalk and vinegar) may be applied to these. Then, if the liquid is not reabsorbed under diuretics and tonics, it may be draAvn oft' through the nozzle of a hypodermic sA^ringe Avhich has been first passed through carbolic acid. In geldings it is best to dissect out the sacs. A'ARICOCELE. This is an enlargement of the venous network of the spermatic cord, and giA^es rise to general thickening of the cord from the tes- ticle up to the ring. The same astringent dressings may be tried as in hydrocele, and, this failing, castration may be resorted to. ABNORMAL NUMBER OF TESTICLES. Sometimes one or both testicles are wanting; in most such cases, hoAveA^er, they are merely jiartially dcA^eloped, and retained in the inguinal canal or abdomen (crypt orchid). In rare cases there may be a third testicle, the animal becoming to this extent a double mon- ster. Teeth, hair, and other indications of a second fetus have like- Avise been found in the testicle or scrotum. DEGENERATION OF THE TESTICLES. The testicles may become the seat of fibrous, calcareous, fatty, carti- laginous, or cystic degeneration, for all of Avhich the appropriate treatment is castration. Thev also become the seat of cancer, glan- ders, or tuberculosis, and castration is requisite, though Avith less hope of arresting the disease. Finally, they may become infested Avith cystic tapcAvorms or larval stages of the armed roundAvorm {Strongylus equinus). DISEASES OF THE GENERATIVE ORGANS. 145 WARTS OX THE PENIS.' These are best removed by seizing them between the thumb and forefinger and twisting them off. Or they may be cnt oft' with scissors and the roots canterized with nitrate of silver. DEOENERATION OF PENIS (PAPILLOMA. OR EPITHELIOMA). The penis of the horse is subject to great caidiflower-like growths on its free end. which extend back into the substance of the orffan, obstruct the passage of urine, and cause very fetid discharges. Tlie only resort is to cut them off', together Avith whateA'er portion of the penis has become diseased and indurated. The operation, which should be performed by a veterinary surgeon, consists in cutting through the organ from its upper to its lower aspect, twisting or tying the two dorsal arteries, and leaving the urethra longer by half an inch to 1 inch than the adjacent structures. EXTRAVASATION OF BLOOD IN THE PENIS. As the result of kicks, blows, or of forcible striking of the yard on the thighs of the mare which it has failed to enter, the penis may become the seat of effusion of blood from one or more ruptured blood vessels. This gives rise to a more or less extensive swelling on one or more sides, followed by some heat and inflammation, and on recoA'ery a serious curving of the organ. The treatment in the early stages may be the application of lotions, of alum, or other astringents, to limit the amount of effusion and favor absorption. The penis should be suspended in a sling. PARALYSIS or THE PENIS. This results from blows and other injuries, and also in some cases from too frequent and exhausting service. The yard hangs from the sheath, flaccid, i)endu]ous, and often cold. The passage of urine occurs with lessened force, and especially without the final jets. In cases of local injury the inflammation should first be subdued by astringent and emollient lotions, and in all cases the system should be invigorated by nourishing diet, while 30-grain doses of nux vomica are given twice a day. Finally, a weak current of electricit}'^ sent through the penis from just beneath the anus to the free portion of the yard, continued for ten or fifteen minutes and rei)eated daily, may prove successful. SELF- ABUSE. OR IMASTITRBATION. Some stallions acquire this vicious habit, stimulating the sexual instinct to the discharge of semen by rubbing the penis against the belly or between the fore limbs. The only remedy is a mechanical 11. Doe. 795, 59-2 10 146 DISEASES OF THE HORSE. one, the fixing of a net under the penis in such fashion as will prevent the extension of the penis, or so prick the organ as to compel the animal to desist through pain. MALADIE DU COIT, OR DOURINE. This is propagated, like syphilis, by the act of copulation and affects stallions and mares. It has long been known in northern Africa, Arabia, and Continental Europe. It was imported into Illinois in 1882 in a Percheron horse. From one to ten days after copulation, or in stallions it may be after some weeks, there is irritation, swelling, and a livid redness of the external organs of generation, sometimes followed by the erup- tion of small blisters one-fifth of an inch across on the penis, the vulva, clitoris, and the vagina, and the consequent rupture of these vesicles and the formation of ulcers or small open sores. Vesicles have not been noticed in this disease in the dry climate of Illinois. In the mare there is frequent contraction of the vulva, urination, and the discharge of a watery and later a thick viscid liquid of a whitish, yellowish, or reddish color, which collects on and soils the tail. The SAvelling of the vulva increases and decreases alternately, affecting one part more than another and giving a distorted appearance to the opening. The affection of the skin leads to the appearance of circu- lar white spots, which may remain distinct or coalesce into extensive patches which persist for months. This, with the soiled tail, red, swollen, puckered, and distorted vulva, and an increasing weakness and paralysis of the hind limbs, serves to characterize the affection. The mare rarely breeds, but will take the male, and thus propagate the disease. The disease winds up with great emaciation and stu- pidity and death in four months to two years. In horses which serve few mares there may be only swelling of the sheath for a year, but with frequent copulation the progress is more rapid. The penis may be enlarged, shrunken, or distorted : the testicles are usually pendent and may be enlarged or wasted and flabby ; the skin, as in the mare, shows white spots and patches. Later the penis becomes partially paralyzed and hangs out of the sheath; swelling of the adjacent lymphatic glands (in the groin), and even of distant ones, and of the skin appears, and the hind limbs become weak and unsteady. In some instances the glands under the jaw swell, and a discharge flows from the nose, as in glanders. In other cases the itching of the skin leads to gnawing and extensive sores. Weakness, emaciation, and stupiditv increase until death, in fatal cases, yet the sexual desire does not seem to fail. A stallion without sense to eat, except when food was put in his mouth, would still neigh and seek to follow mares. In mild cases an apparent recovery may ensue, and through such animals the disease is propagated to new localities to be roused into CASTRATION OF STALLIONS. 147 activity and extension under the stimulus of service. The diseased nerve centers are the seat of cryptogamic growths. (Thannhoffer.) Treatment of the mahidy has proved eminently unsatisfactory. It belongs to the purely contagious diseases, and should be stamped out by the remorseless slaughter or castration of every horse or mare that has had sexual congress with a diseased animal. CASTRATION OF STALLIONS. This is usually done at one year old, but may be accomplished at a few weeks old at the expense of an imperfect development of the fore parts. The simplicity and safety of the operation are greatest in the young. The delay till two, three, or four years old will secure a better development and carriage of the fore parts. The essential part of castration is the safe removal or destruction of the testicle and the arrest or prevention of bleeding from the spermatic artery found in the anterior part of the cord. Into the many methods of accomplishing this limited space forbids us to enter here, so that the method most commonly adopted, castration by clamps, will alone be noticed. The animal having been thrown on his left side, and the right hind foot drawn up on the shoulder, the exposed scrotum, penis, and sheath are washed with soap and water, any concretion of sebum being carefully removed from the bilocular cavity in the end of the penis. The left spermatic cord, just above the testicle, is now seized in the left hand, so as to render the skin tense over the stone, and the right hand, armed with the knife, makes an incision from before backward, about three- fourths of an inch from and parallel to the median line between the thighs, deep enough to expose the testicle and long enough to allow that organ to start out through the skin. xVt the moment of making this incision the left hand must grasp the cord very firmly, otherwise the sudden retraction of the testicle by the cremaster muscle may draw it out of the hand and upwards through the canal and even into the abdomen. In a few seconds, when the struggle and retracticm have ceased, the knife is inserted through the cord, between its anterior and posterior portions, and the latter, the one which the muscle retracts, is cut completely through. The testicle will now hang limp, and there is no longer any tendency to retraction. It should be pulled down until it will no longer hang loose below the wound and the clamps applied around the still attached portion of the cord, close up to the skin. The clamps, which may be made of any tough wood, are grooved along the center of the surfaces opposed to each other, thereby fulfilling two important indications — {a) enabling the clamps to hold more securely and {}>) providing for the application of an antiseptic to the cord. For this puri)ose a dram of sulphate of copper may be mixed with an ounce of vaseline and 148 DISEASES OF THE HORSE. pressed jnto the groove in the face of each chimp. In applying the chimp over the cord it should be drawn so close with pincers as to press out all blood from the compressed cord and destroy its vitality, and the cord applied upon the compressing clamps should be so hard- twined that it will not stretch later and slacken the hold. When the clamp has been fixed the testicle is cut off one-half to 1 inch below it, and the clamp may be left thus for twenty-four hours; then, by cut- ting the cord around one end of the clamp, the latter may be opened and the stump liberated Avithout any danger of bleeding. Should the stump hang out of the wound it should be pushed inside with the finger and left there. The wound should begin to discharge white matter on the second day in hot weather or the third in cold, and from that time a good recovery may be expected. CONDITIONS FAVORABLE TO SITCCESSriTI. CASTRATION. The young horse suffers less from castration than the old, and very rarely perishes. Good health in the subject is all important. Castra- tion should never be attempted during the prevalence of strangles, influenza, catarrhal fever, contagious pleurisy, bronchitis, pneumonia, purpura hemorrhagica, or other specific disease, nor on subjects that have been kept in close, ill ventilated, filthy buildings, where the system is liable to have been charged wath putrid bacteria or other products. Warm weather is to be preferred to cold, but the fly time should be avoided or the flies kept at a distance by the application of a watery solution of tar. carbolic acid, or camphor to the wound. CASTRATION OF CRYPTORCHIDS (rIDGLINGS). This is the removal of a testicle or testicles that have failed to descend into the scrotum, but have been detained in the inguinal canal or inside the abdomen. The manipulation requires an accurate anatomical knowledge of the parts, and special skill, experience, and manual dexterity, and can not be made clear to the unprofessional mind in a short notice. It consists, however, in the discovery and removal of the missing gland by exploring through the natural chan- nel (the inguinal canal), or, in case it is absent, through the inguinal ring or through an artificial opening made in front and above that channel between the abdominal muscles and the strong fascia on the inner side of the thigh (Poupart's ligament). Whatever method is used, the skin, hands, and instruments should be rendered aseptic with a solution of mercuric chloride 1 part, water 2,000 parts (a car- bolic acid lotion for the instruments), and the spermatic cord is best torn through by the ecraseur. In many such cases, too, it is desirable to seAv up the external wound and keep the animal still, to favor healing of the wound by adhesion. CASTRATION OF STALLIONS. 149 PAIN AFTER CASTRATION. Some horses are pained and very restless for some hours after cas- tration, and this may extend to cramps of the bowels and violent colic. This is best kept in check by carefully rubbing- the patient dry when he rises from the operation, and then leading him in hand for some time. Tf the pain still persists a dose of laudanum (1 ounce for an adult) nuiy be given. BLEEDINO AFTER CASTRATION. Bleeding from the wound in the scrotum and from the little artery in the posterior portion of the spernuitic cord always occurs, and in warm weather may appear to be quite free. It scarcely ever lasts, however, over fifteen minutes, and is easily checked by dashing cold water against the part. Bleeding from the spermatic artery in the anterior part of the cord may be dangerous when due precaution has not been taken to prevent it. In such case the stump of the cord should be sought for and the artery twisted with artery forceps or tied with a silk thread. If the stump can not be found, pledgets of tow wet with tincture of muriate of iron may be stuffed into the canal to favor the formation of clot and the closure of the artery. STRANGULATED SPERMATIC CORD. If in castration the cord is left too long, so as to hang out of the wound, the skin wound in contracting grasps and strangles it, pre- venting the free return of blood and causing a steadily advancing swelling. In addition the cord becomes adherent to the lips of the wound in the skin, whence it derives an increased supply of blood, and is thereby stimulated to more rapid swelling. The subject walks stiffly, with straddling gait, loses appetite, and has a rapid pulse and high fever. Examination of the wound discloses the partial closure of the skin wound and the j^rotrusion from its lips of the end of the cord, red, tense, and varying in size from a hazelnut upward. If there is no material swelling and little i)rotrusion, the wound may be enlarged with the knife and the end of the cord broken loose from any connection with the skin and pushed up inside. If the swelling is larger, the mass constitutes a tumor and must be removed. (See below.) SWELLING OF THE SHEATH, PENIS, AND ABDOMEN. This occurs in certain unhealthy states of the system, in unhealthy seasons, as the result of operating without cleansing the sheath and penis, or of keejiing the subject in a filthy, imj^ure building, as the result of infecting the wound by hands or instruments bearing sceptic 150 DISEASES OF THE HORSE. bacteria, or as the result of premature closure of the wound, and imprisonment of matter. Pure air and cleanliness of groin and wound are to be secured. Antiseptics, like the mercuric chloride lotion (1 part to 2,000) are to be applied to the parts; the wound, if closed, is to be opened anew, any accumulated matter or blood washed out, and the antiseptic liquid freely applied. The most tense or dependent parts of the swelling in sheath or penis, or beneath the belly, should be pricked at intervals of 3 or 4 inches, and to a depth of half an inch, and anti- septics freely used to the surface. Fomentations with warm water may also be used to favor oozing from the incisions and to encourage the formation of Avhite matter in the original wounds, which must not be allowed to close again at once. A free, creamlike discharge im- plies a healthy action in the sore, and is the precursor of recovery. PHYMOSIS AND PARAPHYMOSIS. In cases of swelling, as above, the penis may be imprisoned within the sheath (phymosis) or protruded and swollen so that it can not be retracted into it (paraphymosis). In these cases the treatment indi- cated above, and especially the scarifications, will prove a useful pre- liminary resort. The use of astringent lotions is always desirable, and in case of the protruded penis the application of an elastic or simple linen bandage, so as to press out the blood and accumulated fluid, will enable the operator to return it. TUMORS ON THE SPERMATIC CORD. These are due to rough handling or dragging upon the cord in castration, to strangulation of unduly long cords in the external wound, to adhesion of the end of the cord to the skin, to inflammation of the cord succeeding exposure to cold or wet, or to the presence of infection {Staphylococcus hotriomyces) . These tumors give rise to a stiff, straddling gait, and may be felt as hard masses in the groin connected above with the cord. They may continue to grow slowly for many years until they reach a weight of 15 or 20 pounds, and contract adhesions to all surrounding parts. If disconnected from the skin and inguinal canal they may be removed in the same manner as the testicle, while if larger and firmly adherent to the skin and surrounding parts generally, they must be carefully dissected from the parts, the arteries being tied as they are reached and the cord finally torn through with an ecraseur. When the cord has become swollen and indurated up into the abdomen such removal is impos- sible, though a partial destruction of the mass may still be attempted by passing white-hot pointed irons upward toward the inguinal ring in the center of the thickened and indurated cord. CASTRATION OF THE MARE. 151 CASTRATION UY THE COVERED OPERATION. This is only required in case of hernia or protrusion of bowels or omentum into the sack of the scrotum, and consists in the return of the hernia and the application of the caustic clamps over the cord and inner walls of the inguinal canal, so that the walls of the latter become adherent above the clamps, the canal is obliterated, and further pro- trusion is hindered. For the full description of this and of the opera- tion for hernia in geldings, see remarks on hernia. CASTRATION OF THE :MARE. Castration is a much more dangerous operation in the mare than in the females of other domesticated quadrupeds and should never be resorted to except in animals that become unmanageable on the recur- rence of heat and that will not breed or that are utterly unsuited to breeding. Formerly the operation was extensively practiced in Europe, the incision being made through the flank, and a large pro- portion of the subjects i^erished. By operating through the vagina the risk can be largely obviated, as the danger of unhealthy inflam- mation in the wound is greatly lessened. The animal should be fixed in a trevis, with each foot fixed to a post and a sling placed under the body, or it may be thrown and put under chloroform. The manual operation demands special professional knowledge and skill, but it consists essentially in making an opening through the roof of the vagina just above the neck of the womb, then following with the hand each horn of the womb until the ovary on that side is reacl>ed and grasped between the lips of forceps and twisted oft'. It might be torn oft' by an ecraseur especially constructed for the purpose. The straining that follows the operation nuiy be checked by ounce doses of laudanum, and any risk of protrusion of the bowels may be obviated by applying the truss advised to prevent eversion of the woml). To further prevent the pressure of the abdominal con- tents against the vaginal wound the mare should be tied short and high for twenty-four or forty-eight hours, after which I have found it best to remove the truss and allow the privilege of lying down. Another important point is to give bran mashes and other laxative diet only, and in moderate quantity, for a fortnight, and to unload the rectum by copious injections of warm water in case it should threaten to become impacted. sTERii.rrv. Sterility may be in the male or in the female. If due to the stal- lion, then all the mares put to him remain barren; if due to the mare, she alone fails to conceive. 152 DISEASES OF THE HORSE. Ill the stallion sterility ma_y be due to the following causes: (a) Imperfect development of the testicles, as in cases in which the}^ are retained within the abdomen; (h) inflammation of the testicles, re- sulting in induration; (r) fatty degeneration of the testicles, in stal- lions liberally fed on starchy food and not sufficiently exercised; (d) fatty degeneration of the excretoiy ducts of the testicles {nasa defe- reritia) ; {e) inflammation or ulceration of these ducts; (/) inflam- mation or ulceration of the mucous membrane covering the penis; {g) injuries to the penis from blows (often causing paralysis) ; (A) warty groAvths on the end of the i)enis; (/) tumors of other kinds (largely pigmentary), affecting the testicles or penis; (/') nervous diseases which abolish the sexual appetite or that control the muscles Avhich are essential to the act of coition; (Z) azoturia with resulting weakness or paralysis of the muscles of the loins or the front of the thigh (above the stifle) ; (7) ossification (anchylosis) of the joints of the back or loins, which render the animal unable to rear, or mount ; {m) spavins, ringbones, or other painful affections of the hind limbs, the pain of which in mounting causes the animal to suddenly stop short in the act. In the first three of these only (c/, Z>, and c) is there real sterility in the sense of the nondevelopment or imperfect devel- opment of the male vivifying element (spermatozoa). In the other examples the secretion \nQ.y be i^erfect in kind and amount, l)ut as copulation is prevented it can not reach and impregnate the ovum. In the mare barrenness is equally due to a variety of causes. In a number of breeding studs the proportion of sterile mares has varied from 20 to 40 per cent. It may bo due to: {a) Imperfect develop- ment of the ovary and nonmaturation of ova; {h) cystic t)r other tumors of the ovary; {<■) fatty degeneration of the ovary in very obese, pampered mares; {d) fatty degeneration of the excretory tubes of the ovaries (Fallopian tubes) ; {e) catarrh of the womb, Avith mucopurulent discharge; (/) irritable condition of the Avomb, Avith profuse secretion, straining, and ejection of the semen; {) hybridity, Avhich in male and female alike usually entails sterility. STERILITY. 1 53 Trcatme)it. — The trecitnient of the majority of these conditions will be found dealt with in other parts of this work, so that it is only necessary here to name them as causes. Some, however, must be specially referred to in this place. Stallions with undescended testicles are beyond the reach of medicine, and should be castrated and devoted to other uses. Indurated testicles may sometimes be remedied in the early stages by smearing wnth a Aveak iodine ointment daily for a length of time, and at the same time invigorating the system by liberal feeding and judicious work. Fatty degeneration is best met by an albuminoid diet (wheat bran, cotton-seed meal, rape cake) and constant well-regulated work. Saccharine, starchy, and fatty food (potatoes, wheat, corn, etc.) are to be specially avoided. In the mare one diseased and irritable ovary should be removed, to do awav with the resulting excitability of the remainder of the generative organs. An irritable womb, with frequent strain- ing and the ejection of a profuse secretion, may sometimes be cor- rected by a restricted diet and full but well-regulated Avork. Even fatigue will act beneficially in some such cases, hence the i)ractice of the Arab riding his mare to exhaustion just before service. The perspiration in such a case, like the action of a purgative or the abstraction of blood just before service, benefits, by rendering the blood vessels less full, by lessening secretion in the womb and else- where, and thus counteracting the tendencj'^ to the ejection and loss of semen. If these means are ineffectual, a full dose of camphor (2 drams) or of salacin may at times assist. Low condition and anemia demand just the opposite kind of treatment — rich, nourishing, albumi- noid food, bitter tonics (gentian), sunshine, gentle exercise, liberal grooming, and supporting treatment generally are here in order. Spasmodic closure of the neck of the womb is common and is easily remedied in the mare by dilatation with the fingers. The hand, smeared with belladonna ointment and with the fingers drawn into the form of a cone, is introduced through the vagina until the projecting, romided neck of the womb is felt at its anterior end. This is opened by the careful insertion of one finger at a time, until the fingers have been passed through the constricted neck into tlie open cavity of the womb. The introduction is made Avith a gentle, rotary motion, and all precipitate violence is avoided, as abrasion, laceration, or other cause of irritation is likely to interfere with the retention of the semen and with impregnation. If the neck of the Avomb is rigid and unyielding from the induration Avhich follows in- flammation— a rare condition in the mare, though common in the eoAv — more force Avill lie re(piisite, and it may CA'en be needful to in- cise the neck to the depth of one-sixth of an inch in four or more opposite directions prior to forcible dilatation. The incision may be made Avith a jn'obe-pointed knife, and should be done by a profes- 154 DISEASES OF THE HORSE. eional man if possible. The subsequent dilatation may be best effected by the slow expansion of sponge or seaweed tents inserted into the narrow canal. In such cases it is best to let the wounds of the neck heal before putting to horse. An imperforate hymen may be freely incised in a crucial manner until the passage will admit the human hand. An ordinary knife may be used for this purpose, and after the operation the stallion may be admitted at once or only after the wounds have healed. INDICATIONS OF PREGNANCY. As the mere fact of service by the stallion does not insure preg- nancy, it is important that the result should be determined, to save the mare from unnecessary and dangerous work or medication when actually in foal and to obviate wasteful and needless precautions when she is not. The cessation and nonrecurrence of the symptoms of heat (horsing) are most significant though not an infallible sign of conception. If the sexual excitement speedily subsides and the mare persistently refuses the stallion for a month, she is probably pregnant. In very exceptional cases a mare w^ill accept a second or third service after wrecks or months, though pregnant, and some mares will refuse the horse persistently, though conception has not taken place, and this in spite of warm weather, good condition of the mare, and liberal feed- ing. The recurrence of heat in the pregnant mare is most likely to take place in hot weather. If heat merely persists an undue length of time after service, or if it reappears shortly after, in warm weather and in a comparatively idle mare, on good feeding, it is less signifi- cant, while the persistent absence of heat under such conditions may be usually accepted as proof of conception. An unwonted gentleness and docility on the part of a previously irritable or vicious mare, and supervening on service, is an excellent indication of pregnancy, the generative instinct which caused the excitement having been satisfied. An increase of fat, with softness and flabbiness of muscle, a loss of energy, indisposition for active work, a manifestation of laziness, indeed, and of fatigue early and easily induced, when preceded by service, will usually imply conception. Enlargement of the abdomen, especially in its lower third, with slight falling in beneath the loins and hollowness of the back are sig- nificant symptoms, though they may be entirely absent. Swelling and firmness of the udder, with the smoothing out of its wrinkles, is a suggestive sign, even though it appears only at intervals during ges- tation. A steady increase in weight (1^ pounds daily) about the fourth or fifth month is a useful indication of pregnancy. So is a swollen and red or bluish-red appearance of the vaginal mucous membrane. PREGNANCY. 155 From the seventh or eighth month onward the foal may be fek by the hand (pahn or knuckles) pressed into the abdomen in front of the left stifle. The sudden push displaces the foal toward the opposite side of the womb, and as it floats back its hard body is felt to strike against the hand. If the pressure is maintained the movements of the live foal are felt, and especially in the morning and after a drink of cold water or during feeding. A drink of cold water will often stimulate the fetus to movements that may be seen by the eye, but an excess of iced water may prove injurious, even to the causing of abortion. Cold water dashed on the belly has a similar effect on the fetus and equally endangers abortion. Examination of the uterus with the oiled hand introduced into the rectum is still more satisfactory, and if cautiously conducted no more dangerous. The rectum must be first emptied and then the hand car- ried forward until it reaches the front edge of the pelvic bones below, and pressed downward to ascertain the size and outline of the womb. Tn the unimj^regnated state the vagina and womb can be felt as a sin- gle rounded tube, dividing in front to two smaller tubes (the horns of the womb). In the pregnant mare not only the body of the womb is enlarged, but still more so one of the horns (right or left), and on compression the latter is found to contain a hard, nodular body, float- ing in a liquid, which in the latter half of gestation may be stimulated by gentle pressure to manifest spontaneous movements. By this method the presence of the fetus may be determined as early as the third month. If the complete natural outline of the virgin womb can not be made out, careful examination should always be made on the right and left side for the enlarged horn and its living contents. Should there still be difficulty the mare should be placed on an in- clined plane, with her hind parts lowest, and two assistants, standing on opposite sides of the body, should raise the low^er part of the abdomen by a sheet passed beneath it. Finally the ear or stethoscope applied on the wall of the abdomen in front of the stifle may detect the beating of the fetal heart (one hundred and twenty-five per minute) and a blowing sound (the uterine sough), much less rapid and corresponding to the number of the pulse of the dam. It is heard most satisfactorily after the sixth or eighth month and in the absence of active rumbling of the bowels of the dam. DFRATION OF PREGNANCY. Mares usually go about eleven months with young, though first pregnancies often last a year. Foals have lived when born at the three hundredth day, so with others carried till the four hundredth day. With the longer pregnancies there is a greater probability of male offspring. 156 DISEASES OF THE HORSE. HYGIENE OF THE PREGNANT MARE. The pregnant mare should not be exposed to teasing by a young and ardent stallion, nor should she be overworked or fatigued, par- ticularly under the saddle or on uneven ground. Yet exercise is bene- ficial to' both mother and offspring, and in the absence of moderate work the breeding mare should be kept in a lot where she can take exercise at will. The food should be liberal, but not fattening— oats, bran, sound hay, and other foods rich in the principles which form flesh and bone being especially indicated. All aliments that tend to indigestion are to be especially avoided. Thus rank, aqueous, rapidly growing grasses and other green food, partially ripe rye grass, millet, hun- garian grass, vetches, pease, beans, or maize are objectionable, as is overripe, fibrous, innutritions hay, or that which has been injured and rendered musty by wet, or that which is infested with smut or ergot. Food that tends to costiveness should be avoided. Water given often, and at a temperature considerably above freezing, will avoid the dangers of indigestion and abortion which result from taking too much ice-cold water at one time. Very cold or frozen food is objec- tionable in the same sense. Severe surgical operations and medicines that act violently on the womb, bowels, or kidneys are to be avoided as being liable to cause abortion. Constipation should be corrected, if possible, by bran mashes, carrots, or beets, seconded by exercise, and if a medicinal laxative is required it should be olive oil or other equally bland agent. The stall of the pregnant mare should not be too narrow, so as to cramp her when lying down or to entail violent effort, in getting up, and it should not slope too much from the front backward, as this throws the weight of the uterus back on the pelvis and endangers pro- trusions and eA^en abortion. Violent mental impressions are to be avoided, for though the majority of mares are not affected thereby, yet a certain number are so profoundly impressed that peculiarities "and distortions are entailed on the offspring. Hence, there is wisdom shown in banishing particolored or objectionably tinted animals, and those that show deformities or faulty conformation. Hence, too, the importance of preventing prolonged acute suffering by the pregnant mare, as certain troubles of the eyes, feet, and joints in the foals have been clearly traced to the concentration of the mother's mind on cor- responding injured organs in herself. Sire and dam alike tend to reproduce their individual defects which predispose to disease, but the dam is far more likely to perpetuate the evil in her progeny which was carried while she was individually enduring severe suffering caused by such defects. Hence, an active bone spavin or ringbone, PREGNANCY. 157 causing lameness, is more objectionable than that in Avhicli the in- flammation and lameness have both passed, and an active ophthalmia is more to be feared than even an old cataract. For this reason all active diseases in the breeding mare should be soothed and abated at as early a moment as ]-)ossil)le. EXTRA - 1 " T ERIN E GESTATION . It is rare in the domestic animals to find the fetus developed else- Avhere than in the womb. The exceptional forms are those in which the sperm of the male, making its \va\ through the womb and Fallo- pian tubes, impregnates the ovum prior to its escajje, and in which the now vitalized and growing ovum, b}'' reason of its gradually in- creasing size, becomes imprisoned and fails to escape into the womb. The arrest of the ovmn may be in the substance of the ovary itself (ovarian pregnancy), in the Fallopian tube (tubal pregnancy), or when by its continuous enlargement it has ruptured its envelopes so that it escapes into the cavity of the abdomen, it may become attached to any part of the serous membrane and draw its nourishment di- tlectly from that (abdominal pregnancy). In all such cases there is an increase and enlargement of the capillary blood vessels at the point to which the embryo has attached itself so as to furnish the needful nutriment for the growing offspring. All appreciable s^nnptoms are absent, unless from the death of the fetus, or its interference with normal functions, general disorder and indications of parturition supervene. If these occur later than the iiattiral time for parturition, they are the more significant. There may be general malaise, loss of appetite, elevated temperature, acceler- ated pulse, with or without distinct labor pains. Examination with the oiled hand in the rectum will reveal the womb of the natural unimpregnated size and shape and with both horns of one size. Fur- ther exjdoration may detect an elastic mass apart from the womb, and in the interior of which ma}' be felt the characteristic solid body of the fetus. If the latter is still alive and can be stimulated to move, the evidence is even more perfect. The fetus may die and be carried for years, its soft structures becoming absorbed so as to leave only the bones, or by pressure it may form a fistulous opening through the abdominal walls, or less frequently through the vagina or rectum. In the latter cases the best course is to favor the expulsion of the foal and to wash out the resulting cavity with a solution of carbolic acid 1 part to water 50 parts. This may be repeated daily. AVhere there is no spontaneous opening it is injudicious to interfere, as the danger from thr retention of the fetus is less than that from septic fermentation in the enormous fetal sac when that has been opened to tlie air. 158 DISEASES OF THE HORSE. MOLES, OR ANIDIAX MONSTERS. These are evidently products of conception, in which tlie impreg- nated ovum has failed to develop naturally, and presents only a cha- otic mass of skin, hair, bones, muscles, etc.. attached to the inner surface of the womb by an umbilical cord, which is itself often shriv- eled and w^asted. They are usually accompanied by a well-developed fetus, so that the mole may be looked upon as a twin which has under- gone arrest and vitiation of development. They are expelled by the ordinary process of parturition, and usually at the same time with the normally developed offspring. CYSTIC DISEASE OF THE WALLS OF THE WOMB, OR VESICULAR MOLE. This condition appears to be due to hypertrophy (enlargement) of the villi on the inner surface of the womb, which become greatly increased in number and hollowed out internally into a series of cysts, or pouches, containing liquid. Unlike the true mole, therefore, they appear to be disease of the maternal structure of the womb rather than of the product of conception. Rodet, in a case of this kind, which had produced active labor pains, quieted the disorder with ano- dynes and secured a recovery. AMiere this is not available attempts may be made to remove the mass Avith the ecraseur or otherwise, fol- lowing this up with antiseptic injections, as advised under the last heading. DROPSY OF THE WOMB. This appears as a result of some disease of the walls of the w^omb. Out has been frequently observed as the result of infection after sex- ual congress, and has, therefore, been confounded with pregnancy. The symptoms are those of pregnancy, but without any movements of the fetus and without the detection of any solid body in the woml) when examined with the oiled hand in the rectum. At the end of four or eight months there are signs of parturition or of frequent straining to pass urine, and after a time the liquid is discharged clear and watery, or muddy, thick, and fetid. The hand introduced into the womb can detect neither fetus nor fetal membrane. If the neck of the womb closes, the liquid may accumulate a second time, or even a third, if no means are taken to disinfect it or to correct the tendency. The best resort is to remove any diseased product that may be found attached to the walls of the womb, and to inject it daily with a warm solution of carbolic acid 2 drams, chloride of zinc one-half dram, water 1 quart. A course of bitter tonics (gentian 2 drams, sulphate of iron 2 drams, daily) shoulud be given, and a nutritious, easily digested, and slightly laxative diet allowed. DISEASES OF THE WOMB. 159 DROPSY OF THE A^INION. This differs from simple ((ropsy of the womb in that the fluid col- lects in the inner of the two water bags (that in which the foal floats) and not in the otherwise void cavity of the womb. This affection can occur only in the pregnant animal, while dropsy of the womb occurs in the unimpregnated. The blood of the pregnant mare con- tains an excess of water and a smaller proportion of albumen and red globules, and when this is still further aggravated by i)Oor feeding and other unhygienic conditions there is developed the tendency to liquid transudation from the vessels and dropsy. As the watery con- dition of the blood increases witli advancing pregnancy, so dropsy of the amnion is a disease of the last four or five months of gestation. The abdomen is large and pendulous, and the swelling fluctuates under pressure, though the solid body of the fetus can still be felt to strike against the hand pressed into the swelling. If the hand is introduced into the vagina, the womb is found to be tense and round, with the projecting rounded neck effaced, while the hand in the rectum will detect the rounded swollen mass of the womb so firm and tense that the body of the fetus can not be felt within it. The mare moves weakly and unsteadily on her limbs, having difficulty in sup- porting the great weight, and in bad cases there may be loss of appe- tite, stocking (dropsy) of the hind limbs, difficult breathing, and colicky pains. The tension may lead to abortion, or a slow, labo- rious parturition may occur at the usual time. Treatment consists in relieving the tension and accumulation by puncturing the fetal membrane Avith a canula and trocar introduced through the neck of the womb and the withdrawal of the trocar so as to leave the canula in situ. Or the membranes may be punctured with the finger and the excess of liquid allowed to escape. This may bring on abortion, or the wound may close and gestation continue to the full term. A course of tonics (gentian root 2 drams, sulphate of iron 2 drams, daily) will do much to fortify the system and counteract further excessive effusion. DROPSY OK THE LIMBS, PERINEUM, AND AROOATEX. The disposition to dropsy often shows itself in tlie hind and even in the fore limbs, around and beneath the vulva (perineum), and be- neath the abdomen and chest. The affected parts are swollen and pit on pressure, but are not especially tender, and subside more or less perfectly under exercise, hand rubl)ing, and bandages. In ob- stinate cases rubl)ing with the following liniment may be resorted to: Compound tincture of iodine, 2 ounces; tannic acid, one-half dram; water, 10 ounces. It does not last over a day or two after parturition. 160 DISEASES OF THE HORSE. CRAMPS OF THE HIND LIMBS. The pressure of the distended womb on the nerves and blood vessels of the pelvis, besides conducing to dropsy, occasionally causes cramps of the hind limbs. The limb is raised without flexing the joints, the front of the hoof being directed toward the ground, or, the spasms occurring intermittently, the foot is kicked violently against the o^round several times in rapid succession. The muscles are felt to be firm and rigid. The cramp may be promptly relieved by active rub- bing, or by walking the animal about, and it does not reappear after parturition. CONSTIPATION. This may result from compression by the gravid womb, and is best corrected by a graduated allowance of boiled flaxseed. PARALYSIS. The pressure on the nerves of the pelvis is liable to cause paralysis of the hind limbs, or in the mare of the nerve of sight. These are obstinate until after parturition, when they recover spontaneously, or under a course of nux A'omica and (locally) stimulating liniments. PROLONGED RETENTION OF THE FETUS (fOAL). In the mare, though far less frequently than in the cow, parturition may not be completed at term, and the foal may continue to be carried in the womb for a number of months, to the serious or even fatal injury of the mare. Hamon records one case in which the mare died after carrying the fetus for seventeen months, and Caillier a similar result after it had been carried twenty-two months. In these cases the fetus retained its natural form, but in one reported by Gohier, the bones only were left in the womb amid a mass of apparently purulent matter. Cause. — The cause may be any effective obstruction to the act of parturition, such as lack of contractile power in the womb, unduly strong (inflammatory) adhesions between the womb and the fetal membranes, wrong presentation of the fetus, contracted pelvis (from fracture or disease of the bones), or disease and induration of the neck of the womb. The mere prolongation of gestation does not necessarily entail the death of the foal; hence the latter has been born alive at the four hundredth day. Even when the foal has perished, putrefaction does not set in unless the membranes (water bags) have been ruptured and septic bacteria have been admitted to the interior of the womb. In the latter case a fetid decomposition advances rapidly, and the marc, usually perishes from poisoning Avith the putrid matters absorbed. At the natural period of parturition preparations are apparently made for that act. The vulva swells and discharges much mucus, the udder enlarges, the belly becomes more pendent, and the animal ABORTION. 161 strairs more or less. No progress is made, however; there is not even opening of the neck of the womb, and after a time the s3^mptoms subside. The mare usually refuses the male; j^et there are excei)ti()ns to this rule. If the neck of the womb has been opened and putrefy- ing changes have set in in its contents, the mare loses appetite and condition, pines, discharges an offensive matter from the generative passages, and dies of inflammation of the Avonib and putrid infection. In other cases there is a slow wearing out of the strength, and the mare finally dies of exhaustion. The treatment is such as will facilitate the expulsion of the fetus and its membranes and the subseciuent washing out of the womb with disinfectants. So long as the mouth of the womb is closed time should be allowed for its natural dilatation, but if this does not come about after a day or two of straining, the opening may be smeared with extract of belladonna, and the oiled hand, with the fingers and thumb drawn into the form of a cone, may be inserted by slow oscil- lating movements into the interior of the womb. The water bags may now be ruptured, any malpresentation rectified (see '•Difficult parturition''), and delivery effected. After removal of the mem- branes wash out the womb first with tepid water and then with a solu- tion of 2 ounces of borax in half a gallon of Avater. This injection may have to be repeated if a discharge sets in. The same course may be pursued even after prolonged retention. If the soft parts of the fetus have been absorbed and the bones only left, these must be carefully sought for and removed, and subsequent daily injections will be required for some time. In such cases, too, n course of iron tonics (sulphate of iron, 2 drams daily) will be highly bene- ficial in restoring health and vigoi-. ABORTION. Abortion is, strictly speaking, the expulsion of the impregnated ovum at any period from the date of impregnation until the foal can survive out of the womb. If the foal is advanced enough to live, it is premature parfiirifion, and in the mare this may occur as early as the tenth month (thi-ee hundi-edth day). The mare nuiy abort by reason of almost any cause that very pro- foundly disturbs the system. Hence very violent inflammations of important internal organs (l)owels, kidneys, bladder, lungs) may induce abortion. Profuse diarrhea, whether occurring from the reck- less use of purgatives, the consumption of irritants in the food, or a simple indigestion, is an effective cause. No less so is acute indiges- tion with evolution of gas in the intestines (bloating). The presence of stone in the kidneys, uterus, bladdei-. oi' invthi-a may induce so much sympathetic disorder in the wouil) as to induce abortion. In exceptional cases wherein mares come in heat during gestation, service H. Doc. 70."., .'-.0-2 11 162 DISEASES OF THE HORSE. by the stallion may cause abortion. Blows or pressure on the abdo- men, rapid driving or riding of the pregnant mare, especially if she ii' soft and out of condition from idleness, the brutal use of the spur or whip, and the jolting and straining of travel by rail or boat are prolific causes. Bleeding the pregnant mare, a painful surgical oper- ation, and the throwing and constraint resorted to for an operation are other causes. Traveling on heavy, muddy roads, slips and falls on ice, and jumping must be added. The stimulation of the abdom- inal organs by a full drink of iced water may precipitate a miscar- riage, as may exposure to a cold rainstorm or a very cold night after a warm day. Irritant poisons that act on the urinary or generative organs, such as Spanish flies, rue, savin, tansy, cotton-root bark, ergot of rye or other grasses, the smut of maize and other grain, and various fungi in musty fodder are additional causes. Frosted food, indigestible food, and, above all, green succulent vegetables in a frozen state, have proved effective factors, and filthy, stagnant water is dangerous. Low condition in the dam and plethora have in oppo- site ways caused abortion, and hot, relaxing stables and lack of exercise strongly conduce to it. The exhaustion of the sire by too frequent service, entailing debility of the offspring and disease of the fetus or of its envelopes, must be recognized as a further cause. The symptoms vary mainly according as the abortion is early or late in pregnancy. In the first month or tw^o of pregnancy the mare may miscarry without observable symptoms, and the fact only appears by her coming in heat. If more closely observed a small clot of blood may be found behind her, in which a careful search reveals the rudiments of the foal. If the occurrence is somewhat later in gestation, there will be some general disturbance, inappetence, neigh- ing, and straining, and the small body of the fetus is expelled, en- veloped in its membranes. Abortions during the later stages of pregnancy are attended w^ith greater constitutional disturbance, and the process resembles normal parturition, with the aggi-avation that more effort and straining is requisite to force the fetus through the comparatively undilatable mouth of the womb. There is the sw^elling of the vulva, with mucus or even bloody discharge; the abdomen droops, the flanks fall in, the udder fills, the mare looks at her flanks, paws with the fore feet and kicks with the hind, switches the tail, moves around uneasily, lies down and rises, strains, and, as in natural foaling, expels first mucus and blood, then the w^aters, and finally the fetus. This may occupy an hour or two, or it may be prolonged for a day or more, the symptoms subsiding for a time, only to reappear with renew^ed energy. If there is malpresentation of the fetus it w411 hinder progress until rectified, as in difficult parturition. Abortion may also be followed by the same accidents, as flooding, retention of the placenta, and leucorrhea. ABORTION. 1 63 The most important object in an impending abortion is to recog- nize it at as early a stage as possible, so that it may, if possible, be cut short and prevented. Any general indefinable illness in a preg- nant mare should lead to a close examination of the vulva as regards swelling, vascularity of its mucous membrane, and profuse nuicus secretion, and, above all, any streak or staining of blood; also the condition of the udder, if that is congested and swollen. Anj^ such indication, with colicky ])ains, staining, however little, and active movement of the fetus or entire absence of movement, are suggestive syni})toms and should be duly counteracted. The changes in the vulva and udder, with a soiled and bloody con- dition of the tail, may suggest an abortion already accom2:)lished, and the examination with the hand in the vagina may detect the mouth of the womb soft and dilatable and the interior of the organ slightly filled with a bloody liquid. Treatment should be preventive if possible, and would embrace the avoidance of all causes mentioned, and particularly of such as may seem to be particularly operative in the particular case. Where abor- tions have already occurred in a stud, the especial cause in the matter of food, water, exposure to injuries, overwork, lack of exercise, etc., may often be identified and removed. A most important point is to avoid all causes of constipation, diarrhea, indigestion, bloating, vio- lent purgatives, diuretics or other potent medicines, painful opera- tions, and slippery roads, unless well frosted. When abortion is imminent, the mare should be placed alone in a roomy, dark, quiet stall, and have the straining checked by some sedative. Laudanum is usually at hand and may be given in doses of 1 or 2 ounces, according to size, and repeated after two or three hours, and even daily if necessary. Chloroform or chloral hydrate, 3 drams, may be substituted if more convenient. These should be given in a pint or quart of water, to avoid burning the mouth and throat. Or Y Ihurnuni yrunifolinin^ 1 ounce, may be given and repeated if neces- sary to prevent straining. When all measures fail and miscarriage proceeds, all that can be done is to assist in the removal of the fetus and its membranes, as in ordinary parturition. As in the case of retention of the fetus, it may be necessary after delivery to employ antiseptic injections into the woml) to coTinteract putrid fermentation. This, however, is less I'equisite in the mare than in the cow, in which the prevalent con- tagious abortion must be counteracted by the persistent local use of antiseptics. After abortion a careful hygiene is demanded, especially in tlie matter of pure air and easily digestible food. The mare should not be served again for a month or longer, and in no case until after all discharge from tlie vulva luis ceased. 164 DISEASES OF THE HORSE. SYMPTOMS OF PARTURITION. As the period of parturition approaches, the swelling of the udder bespeaks the coming event, the engorgement in exceptional cases extending forward on the lower surface of the abdomen and even into the hind limbs. For about a \veek a serous fluid oozes from the teat and concretes as a yellow, waxlike mass around its orifice. About twenty-four hours before the birth this gives place to a whitish, milky liquid, Avhich falls upon and mats the hairs on the inner sides of the legs. Another symptom is enlargement of the vulva, with red- ness of its lining membrane, and the escape of glairy mucus. The belly droops, the flanks fall in, and the loins may even become de- pressed. Finally the mare becomes uneasy, stops feeding, looks anx- ious, whisks her tail, and may lie down and rise again. In many mares this is not repeated, but the mare remains down ; violent con- tractions of the abdominal muscles ensue; after two or three pains the water bags appear and burst, followed by the fore feet of the foal, with the nose between the knees, and by a few more throes the fetus is expelled. In other cases the act is accomplished standing. The whole act may not occupy more than five or ten minutes. This, to- o-ether with the disposition of the mare to avoid observation, renders the act one that is rarely seen by the attendants. The navel string, which connects the foal to the membranes, is ruptured when the fetus falls to the ground, or Avhen the mare rises, if she has been down, and the membranes are expelled a few minutes later. NATURAL PRESENTATION. Wlien there is a single foal, the common and desirable presentation is with the fore feet first, the nose between the knees, and with the front of the hoofs and knees and the forehead directed upward loward the anus, tail, and croup. (Plate X, fig. 1.) In this way the natural curvature of the body of the fetus corresponds to the curve of the womb and genital passages, and particularly of the bony pelvis, and the foal passes with much greater ease than if it were placed with its back downward toward the udder. When there is a twin birth the second foal usually comes with its hind feet first, and the backs of the legs, the points of the hocks, and the tail and croup are turned upward toward the anus and tail of the mare. (Plate X, fig. 2.) In this way, even with a posterior presentation, the curvature of the body of the foal still corresponds to that of the passages, and its expulsion may be quite as easy as in anterior presentation. Any presentation aside from these two may be said to be abnormal and will be considered under " Difficult parturition." diseasp:s of the generative organs. 165 DIFFICULT rARTlKITION. With natural presentation this is a rare occurrence. The great length of the fore limbs and face entail, in the anterior presentation, the formation of a long cone, which dilates and glides through the passages with comparative ease. Even Avith the hind feet first a simi- lar conical form is presented, and the ])rocess is rendered easy and quick. DiiKculty and danger arise mainly from the act being brought on prematurely before the passages are sufficiently dilated, from nar- rowing of the pelvic bones or other mechanical obstruction in the pas- sages, from monstrous distortions or duplications in the fetus, or from the turning back of one of the members so that the elongated conical or wedge-shaped outline is done aAvay with. But prompt as is the normal parturition in the mare, difficult and delayed parturitions are surrounded by special dangers and require unusual precautions and skill. From the proclivity of the mare to unhealthy infianmiations of the peritoneum and other abdominal organs, penetrating wounds of the womb or vagina are liable to prove fatal. The contractions of the womb and abdominal walls are so powerful as to exhaust and benumb the arm of the assistant, and to endanger penetrating wounds of the genital organs. By reason of the looser connection of the fetal mem- branes with the womb, as compared with those of ruminants, the violent throes early detach these membranes throughout their whole extent, and the foal, being thus separated from the mother and thrown on its own resources, dies at an early stage of any protracted parturi- tion. The foal rarely survives four hours after the onset of partu- rient throes. From the great length of the limbs and neck of the foal it is extremely difficult to secure and bring up limb or head which has been turned back when it should have been presented. When assist- ance must be rendered the operator should don a thick woolen under- .shirt with the sleeves cut out at the shoulders. This protects the body and leaves the whole arm free for manipulation. Before inserting the arm it should be smeared with lard. This protects the skin against se])tic infection, and favors the introduction of the hand and arm. The hand should be inserted with the thumb and fingers drawn to- gether like a cone. AVhether standing or lying, the mare should be turned with head downhill and hind parts raised as much as possible. The contents of the abdomen gravitating forward leave nuich more room for manipulation. Whatever part of the foal is presented (head, foot) should be secured with a cord and running noose before it is ])ushed back to search for the other missing parts. Even if a missing part is reached no attempt should be made to bring it up during a labor pain. Pinching the back will sometimes check the pains and allow the operator to secure and bring up the missing mem- ber. In intractable cases a large dose of chloral hydrate (1 ounce in 166 DISEASES OF THE HORSE. a quart of water) or the inhalation of chloroform and air (equal proportions) to insensibility may secure a respite, during which the missing members may be replaced. If the ^caters have been dis- charged and the mucus dried up, the genital passages and body of the fetus should be lubricated with lard or oil before any attempt at ex- traction is made. When the missing member has been brought up into i^osition and presentation has been rendered natural, traction on the fetus must be made only during a labor i^ain. If a mare is in- clined to kick, it may be necessary to apply hobbles to protect the operator. PREMATURE LABOR PAINS. These may be brought on by any violent exertion, use under the saddle, or in heavy draft, or in rapid paces, or in travel by rail or sea, blow\s, kicks, crushing by other animals in a doorway or gate. Ex- cessive action of jourgative or diuretic agents, or of agents that irritate the bowels or kidneys, like arsenic, jjaris green, all caustic salts and acids, and acrid and narcotico-acrid vegetables, is equally injurious. Finally, the ingestion of agents that stimulate the action of the gravid womb (ergot of rye or of other grasses, smut, various fungi of fodders, rue, savin, cotton root, etc.) may bring on labor pains prematurely. Besides the knowledge that parturition is not yet due, there will be less enlargement, redness, and swelling of the vulva, less mucous dis- charge, less filling of the udder, and less appearances of wax and probably none of milk from the ends of the teats. The oiled hand introduced into the vulva will not enter with the ease usual at full term, and the neck of the womb will be felt not only closed, but with its projecting papilla?, through which it is perforated, not yet flattened down and effaced, as at full term. The symptoms are in- deed those of threatened abortion, but at such an advanced stage of gestation as is compatible with the survival of the offspring. Treatment. — The treatment consists in the separation of the mare from all other animals in a quiet, dark, secluded place, and the free use of antispasmodics and anodynes. Opium in dram doses every two hours, or laudanum in ounce doses at similar intervals, will often suffice. When the more urgent symptoms have subsided these doses may be repeated thrice a day till all excitement passes off or until the passages have become relaxed and prepared for parturition. Vibamum prunifolium., in ounce doses, may be added if necessary. Should parturition become inevitable, it may be favored and any necessary assistance furnished. DIFFICULT PARTURITION FROM NARROW PELVIS. A disi)roportion between the fetus got by a large stallion and the pelvis of a small dam is a serious obstacle to parturition, sometimes PLATE IX. Sr/iancJi'S Tmction L orU. ^ S I I ■i b 4: 5- lo ^ I 5 r s y JX. Haines, del. oner Fleming. JULIUSBICNSCON^ INSTRUMENTS USED IN DrFFICtILT LABOR. PLATE X. after I'lemiiig Vertebra Sacral presentation Lumbo SacrtU pre.ientutiort . EUiines del JULIUS BieN fc CONY N (. ) U M A I . J » H !•: H K N'[ ATI () X S t: < Q, F T. z r\ 'w >-H h .1 <: 1 t^ 1^ z 1^ r^"» =--^ •^ X u: •§S ^ 1" •2 ~^ f^< ^■^ J ^ < k-4 " \ ^ :?- PLATK XII after Fleiiujig T}rnt^\'pj-se prescniaJion -Ljiper i-wm'. alter Kleniiii* Sin-no-nbfirmtj'itnl pr^esen/ntioT} -Hend and, Fket engaged . Ibiinps, after Fleming. ABNORMAL PRE SENTATIONS. JULIUS BIEN & CO NT •DISEASES OF THE GENERATIVE ORGANS. 167 seen in the mare. This is not the rule, however, as the foal up to birth usually accomuiodates itself to the size of the dam, as illustrated in the successful crossing of Percheron stallions on mustano- mares. If the disproportion is too great the only resort is embryotomy. FRACTURED II II' BONES. More commonly the obstruction comes from distortion and narrow- ing of the pelvis as the result of fractures. (Plate XV, fig. '2.) Fractures at any point of the lateral wall or floor of the pelvis are repaired with the formation of an extensive bony deposit bulging into the passage of the pelvis. The displacement of the ends of the broken bone is another cause of constriction, and between the two cou- ditions the passage of the fetus may be rendered impossible without embryotomy. Fracture of the sacrum (the continuation of the back- bone forming the croup) leads to the depression of the posterior part of that bone in the roof of the pelvis and the narrowing of the pas- sage from above downward by a bony ridge presenting its sharp edge forward. In all cases in which there has been injury to the bones of the pelvis the obvious precaution is to withhold the mare from breeding and to use her for work only. If a mare with a pelvis thus narrowed has got in foal inadvertently, abortion may be induced in the early months of gestation by slowly introducing the oiled finger through the neck of the womb and fol- lowing this by the other fingers until the whole hand has been intro- duced. Then the water bags may be broken, and with the escape of the liquid the womb will contract on the solid fetus and labor pains will ensue. The fetus being small wdll pass easily. TUMORS IN THE VAGINA AND PELVIS. Tumors of various kinds may form in the vagina or elsewhere within the pelvis, and when large enough will obstruct or prevent the passage of the fetus. Gray mares, which are so subject to black pig- ment tumors {melanosis) on the tail, anus, and vulva, are the most likely to suffer from this. Still more rarely the wall of the vagina becomes relaxed, and being pressed by a mass of intestines will jn'o- trude through the lips of the vulva as a hernial sac, containing a part of the bowels. Where a tumor is small it may only retard and not absolutely prevent parturition. A hernial protrusion of the wall of the vagina may be pressed back and emptied, so that the body of the fetus engaging in the passage may find no further obstacle. ^Y\\&n a tumor is too large to allow delivery the only resort is to remove it, but before proceeding it must be clearly made out that the obstruc- tion is a mass of diseased tissue, and not a sac containing intestines. 108 DISEASES OF THE HOESE. If the tumor bangs by a neck it can usually be most safely removed by the ecraseiir, the chain being- passed around the pedicel and gradu- ally tightened until that is torn through. HERNIA OF THE WOMB. The rupture of the musculo-fibrous floor of the belly and the escape of the gravid womb into a sac formed by the peritoneum and skin hanging toward the ground, is described by all veterinary obstetri- cians, yet it is very rarely seen in the mare. The form of the fetus can be felt through the walls of the sac, so that it is easy to recognize the condition. Its cause is usually external violence, though it may start from an umbilical hernia. When the period of parturition arrives, the first eftort should be to return the fetus within the proper abdominal cavitj^, and this can sometimes be accomplished with the aid of a stout blanket gradually tightened around the belly. This failing, the mare may be placed on her side or back and gravitation brought to the aid of manipulation in securing the return. Even after the hernia has been reduced the relaxed state of the womb and abdominal walls may serve to hinder parturition, in which case the oiled hand must be introduced through the vagina, the fetus brought into i)osition, and traction coincident with the labor pains employed to secure delivery. TWISTING OF THE NECK OF THE WOMB. This condition is very uncommon in the mare, though occasionally seen in the cow, owing to the greater laxity of the broad ligaments of the womb in that animal. It consists in a revolution of the womb on its own axis, so that its right or left side will be turned upward (quarter revolution), or the lower surface may be turned upward and the upper surface downward (half revolution). The effect is to throw the narrow neck of the womb into a series of spiral folds, turn- ing in the direction in which the womb has revolved, closing the neck and rendering distention and dilatation impossible. The period and pains of parturition arrive, but in spite of contin- ued efforts no progress is made, neither water bags nor liquids appear- ing. The oiled hand introduced into the closed neck of the womb will leadily detect the spiral direction of the folds on its inner surface. The method of relief Avhich I have successfully adopted in the cow may be equally happy in the mare. The dam is placed (with her head uphill) on her right side if the upper folds of the spiral turn toward the right, and on her left side if they turn toward the left, and the oiled hand is introduced through the neck of the womb and a limb or other part of the body of the fetus is seized and pressed against the wall of the womb, while two or three assistants turn the DISEASES OF THE GENERATIVE ORGANS. 169 animal over on her back toward the other side. The object is to keep the womb stationarv while the animal is rollinof. If success attends the effort, the constriction around the arm is suddenly relaxed, the spiral folds are effaced, and the water bags and fetus press forward into the passage. If the first attempt does not succeed it may be repeated again and again until success crowns the effort. Among my occasional causes of failure have been the prior death and decompo- sition of the fetus, with the extrication of gas and overdistention of the womb, and the supervention of inflammation and inflammatory exudation around the neck of the womb, whicli hinders untwisting. The first of these conditions occurs early in the horse from the detach- ment of the fetal membranes from the wall of the womb, and as the mare is more subject to fatal peritonitis than the cow, it may be con- cluded that both these sources of failure are more probable in the equine subject. When the case is intractable, though the hand may be easily intro- duced, the instrument shown in Plate IX, figure 7, may be used. Each hole at the small end of the instrument has passed through it a stout cord with a running noose, to be passed around two feet or other portion of the fetus which it may be possible to reach. The cords are then drawn tight and fixed around the handle of the instru- ment ; then, b}' using the cross handle as a lever, the fetus and w^omb may be rotated in a direction opposite to that causing the obstruction. During this process the hand must be introduced to feel when the twist has been undone. This method may be supplemented, if neces- sary, by rolling the mare as described above. ErFUSION OF BLOOD IX THE VAGINAIi WALLS. This is common as a result of difficult parturition, but it may occur from local injury before that act, and may seriously interfere with it. This condition is easilv recognized bv the soft, doughv swelling: so characteristic of blood clots, and by the dark-red color of the mucous membrane. I have laid open such swellings with the knife as late as ten days before parturition, evacuated the clots, and dressed the wound daily with an astringent lotion (sulphate of zinc 1 dram, carbolic acid 1 dram, water 1 quart). A similar resort might be had, if necessary, during parturition. CALCILI S (stone) and TUMOR IN THE BLADDER. The pressure upon the bladder containing a stone or a tumor may prove so painful that the mare will voluntarily suppress the labor pains. Examination of the bladder with the finger introduced through the urethra will detect the off'ending agent. A stone should be extracted with forceps. (See " Lithotomy.") The large papillary 170 DISEASES OF THE HOKSE. tumors which I have met with in the mare's bhidder have been inva- riably delicate in texture and could be removed piecemeal by forceps. Fortunately, mares affected in this way rarely breed. IMPACTION OF THE RECTUM WITH FECES. In some animals, with more or less paralysis or weakness of the tail and rectum, the rectum may become so impacted with solid feces that the mare is unable to discharge them, and the accumulation both by reason of the mechanical obstruction and the pain caused by pressure upon it will impel the animal to cut short all labor pains. The rounded swelling surrounding the anus will at once suggest the con- dition, when the obstruction may be removed by the well-oiled or well-soaped hand. SPASM OF THE NECK OF THE WOMB. This occurs in the mare of specially excitable temperament, or under particular causes of irritation, local or general. Labor pains, (hough continuing for some time, produce no dilatation of the neck of the womb, which will be found firmly closed so as to admit but one or two fingers, and this, although the projection at the mouth of the womb may have been entirely effaced, so that a simple round opening is left, with rigid margins. Treatment. — The simplest treatment consists in smearing this part with solid extract of belladonna, and after an interval inserting the hand with fingers and thumb drawn into the form of a cone, ruptur- ing the membranes and bringing the fetus into position for extrac- tion, as advised under " Prolonged retention of the fetus." Another mode is to insert through the neck of the womb an ovoid caoutchouc bag, empty, and furnished with an elastic tube 12 feet long. Carry the free end of this tube upward to a height of 8, 10, or 12 feet, insert a filler into it, and proceed to distend the bag with tepid or warm water. FIBROUS BANDS CONSTRICTINCx OR CROSSING THE NECK OF THE WOMB. These, occurring as the result of disease, have been several times observed in the mare. They may exist in the cavity of the abdomen and compress and obstruct the neck of the womb, or they may extend from side to side of the vagina across and just behind the neck of the Avomb. In the latter position they may be felt and quickly remedied by cutting them across. In the abdomen they can only be reached by incision, and two alternatives are presented: (1) To perform embry- otomy and extract the fetus piecemeal and (2) to make an incision into the abdomen and extract by the Csesarean operation, or simply to cut the constricting band and attempt delivery by the usual channel. DIFFICULT PARTURITION, 171 FIBROrS CONSTHU TION OF \A(;INA OU VILVA. This is probably always the result of direct inechanical injury and the fornuition of rigid cicatrices ^yhich fail to dilate with the re- mainder of the i)assages at the apjiroach of parturition. The pre- sentation of the fetus in the natural way and the occurrence of suc- cessive and active labor pains without any favorable result will direct attention to the rigid and unvielding cicatrices which may be incised at one, two, or more points to a depth of half an inch or more, after which the natural expulsive efforts will usually prove effective. The resulting wounds may be washed frequently with a solution of 1 ])art of carbolic acid to oO parts of water, or of 1 part of mercuric chloride to 1,000 parts of water. FETUS ADHERENT TO THE WALLS OF THE WOMB. In inflammation of the mucous membrane lining the cavity of the womb and im])licating the fetal membranes, the resulting embryonic tissue sometimes establishes a medium of direct continuity between the womb and fetal membranes ; the blood vessels of the one commu- nicate freely with those of the other and the fibers of the one are prolonged into the other. This causes retention of the membranes after bn-th, and a special risk of bleeding from the womb, and of septic poisoning. In exceptional cases the adhesion is more extensive and binds a portion of the body of the foal firmly to the womb. In such cases it has repeatedly been found impossible to extract the foal until such adhesions were broken down. If they can be reached with the hand and recognized, they may be torn through Avith the fingers or with a blunt hook, after which delivery may be attempted witli hope of success. EXCESSIVE SIZE OF THE FETUS. It would seem that a small mare may usually be safely bred to a large stallion, yet this is not always the case, and when the small size is an individual rather than a racial characteristic or the result of being very young, the rule can not be expected to hold. There is always great danger in breeding the young, small, and undeveloped female, and the dwarfed rej)resentative of a larger breed, as the off- spring tend to i;)artake of the large race characteristics and to show them even prior to birth. "\Mien imi)regnation has occurred in the very young or in the dwarfed female, there are two alternatives — to induce abortion or to wait until there are attempts at parturition and to extract by embryotomy if impracticable otherwise. CONSTIUCTIOX OF A MEMBER BY THE NAVEL STRING. In man and animals alike the winding of the umbilical cord around a member of the fetus sometimes leads to the amputation of the 172 DISEASES OF THE HORSE. latter. It is also known to get wound around the neck or a limb at birth, but in the mare this does not seriously impede parturition, as the looseh^ attached membranes are easily separated from the womb and no strangulation or retarding occurs. The foal may, however, die from the cessation of the placental circulation unless it is speedily delivered. WATER IN THE HEAD (HYDROCEPHALUS) OF THE FOAL. This consists in the excessive accumulation of liquid in the ventricles of the brain so that the cranial cavity is enlarged and constitutes a great projecting rounded mass occupying the space from the eyes upAvard. (See Plate XV, fig. 3.) With an anterior presentation (fore feet and nose) this presents an insuperable obstacle to progress, as the diseased cranium is too large to enter the pelvis at the same time with the forearms. With a posterior presentation (hind feet) all goes well until the body and shoulders have passed out, when progress is suddenly arrested by the great bulk of the head. In the first case, the oiled hand introduced along the face detects the enormous size of the head, which may be diminished by puncturing it Avith a. knife or trocar and cannula in the median line, evacuating the water and pressing in the thin bony walls. With a posterior presentation, the same course must be followed; the hand passed along the neck will detect the cranial swelling, which may be punc- tured with a knife or trocar. Oftentimes with an anterior presen- tation the great size of the head leads to its displacement backward, and thus the fore limbs alone engage in the passages. Here the first object is to seek and bring up the missing head, and then puncture it as above suggested. DROPSY OF THE ABDOMEN IN THE FOAL, OR ASCITES. The accumulation of liquid in the abdominal cavity of the fetus is less frequent, but when present it may arrest parturition as com- ])letely as will hydrocephalus. With an anterior presentation the foal may pass as far as the shoulders, but behind this all efiorts fail to secure a further advance. With a posterior presentation the hind legs as far as the thighs may be expelled, but at this point all progress ceases. In either case the oiled hand, passed inward by the side of the foal, Avill detect the enormous distention of the abdomen and its soft, fluctuating contents. The only course is to puncture the cavity and evacuate the licjuid. With the anterior presentation this may be done with a long trocar and cannula, introduced through the chest and diaphragm; or with a knife an incision may be made between the first two ribs and the lungs and heart cut or torn out, when the diaphragm will be felt projecting strongly forw^ard, and may be easily punctured. Should there not be room to introduce the hand DIFFICULT PARTURITION. 173 through the chest, the oiled hand may be passed along beneath the breast bone and the abdomen punctured. AVith a posterior presenta- tion the abdomen nuist be punctured in the same way, the liand, armed with a knife protected in its palm, being- passed along the side of the flank or between the hind limbs. It should be added that moderate dropsy of the abdomen is not incompatible with natural delivery, tho liquid being at first crowded back into the portion of the belly still engaged in the womb, and passing slowly from that into the ad- vanced portion as soon as that has cleared the narrow passage of the pelvis and passed out where it can expand. GENERAL DROPSY OF THE FETUS. In this case the tissues generally are distended with liquid, and the skin is found at all points tense and rounded, and pitting on pressure with the fingers. In some such cases delivery may be eilected after the skin has been punctured at narrow intervals to allow the escape of the fluid and then liberally smeared with fresh lard. More com- monly, however, it can not be reached at all points to be so punctured nor sufficiently reduced to be extracted whole, and resort must be had i to embryotomy. SWELLING OF THE FETUS AVITH GAS, OR EMPHYSEMA. I This has been described as occurring in a living fetus, but I have only met Avith it in the dead and decomposing foal after futile ; efforts have been made for several davs to effect deliverA\ These cases are very difficult ones, as the foal is inflated to such an extent that it is impossible to advance it into the passages, and the skin of the fetus and the walls of the womb and vagina have become so dry that it is impracticable to cause the one to glide on the other. The hair conies off any part that may be seized, and the case is rendered the more offensive and dangerous by the very fetid liquids and gases. The only resort is end)ryotomy. by Avhieh I have succeeded in saving , a valuable mare that had carried a colt in this condition for four days. contrac;tions <»f muscles. The foal is not ahvays develojjed symmetrically, but certain groups j of muscles are liable to remain short, or to shorten because of per- j sistent spasmodic contraction, so that even the bones become distorted I and twisted. This is most connnon in the neck. The bones of this part and even of the face are draAvn to one side and shortened, the ! head being held firmly to the flank and the jaws being twisted to the right or left. In other cases the flexor muscles of the fore limbs are contracted so that these members are strongly bent at the knee. In neither of these cases can the distorted part be extended and straight- ! 174 DISEASES OF THE HORSE. eiied, so that body or limbs must necessarily present double, and natural delivery is rendered impossible. The bent neck may some- times be straightened after the muscles have been cut on the side to which it is turned, and the bent limbs after the tendons on the back of the shank bone have been cut across. Failing to accomplish this, the next resort is embryotomy. TUMORS OF THE FETUS, OR INCLOSED OVUM. Tumors or diseased growths may form on any part of the foal, internal or external, and by their size impede or hinder parturition. In some cases what appears as a tumor is an imprisoned and undevel- oped ovum, which has grafted itself on the fetus. These are usually sacculated, and may contain skin, hair, muscle, bone, and other natural tissues. The only course to be pursued in such cases is to excise the tumor, or, if this is not feasible, to perforin embryotomy. MONSTROSITIES. Monstrosity in the foal is an occasional cause of difficult parturi- tion, especially such monsters as show excessive development of some part of the body, a displacement or distortion of parts, or a redun- dancy of i)arts, as in double monsters. Monsters may be divided into — (1) Monsters with absence of parts — absence of head, limb, or other organ. (2) Monsters with some part abnormally small — dwarfed head, limb, trunk, etc. (3) Monsters through unnatural division of parts — cleft head, trunk, limbs, etc. (4) Monsters through absence of natural divisions — absence of mouth, nose, eyes, anus, confluent digits, etc. (5) Monsters through fusion of parts — one central eye, one nasal opening, etc. (6) Monsters through abnormal position or form of parts — curved spine, face, limb, etc. (7) Monsters through excess of formation — enormous head, super- numerary digits, etc. (8) Monsters through imperfect differentiation of sexual organs — hermaphrodites. (9) Double monsters — double-headed, double-bodied, extra limbs, etc. Causes. — The causes of monstrosities appear to be very varied. Some monstrosities, like extra digits, absence of horns or tail, etc., run in families and are ])roduced almost as certainly as color or form. Others are associated with too close breeding, the powers of symmet- DIFFICULT PAKTUBITION. 175 rical development being- interfered with, just us in other cases a sex- ual incompatibility is developed, near relatives failing to breed with each other. Mere arrest of development of a part may arise from accidental disease of the embryo; hence vital organs are left out, or portions of organs, like the dividing walls of the heart, are omitted. Sometimes an older fetus is inclosed in the body of another, each having started independently from a separate ovum, but the one having become embedded in the semifluid mass of the other and hav- ing developed there simultaneously with it, but not so largely nor perfectly. In numy cases of redundance of parts, the extra part or member has manifestly developed from the same ovum and nutrient center with the normal member to which it remains adherent, just as a new tail will grow out in a newt when the former has been cut off. In the early embryo, with its great powers of development, this fac- tor can operate to far greater purpose than in the adult animal. Its influence is seen in the fact pointed out by St. Hilaire that such redundant parts are nearly always connected wnth the corresponding portions in the normal fetus. Thus superfluous legs or digits are attached to the normal ones, double heads or tails are connected to a common neck or rump, and double bodies are attached to each other by corresponding points, naval to naval, breast to breast, back to back. All this suggests the development of extra parts from the same primary layer of the impregnated and developing ovum. The effect of disturbing conditions in giving such wrong directions to the developmental forces is Avell shown in the experiments of St. Hilaire and Valentine in varnishing, shaking, and otherwise break- ing up the natural connections in eggs, and thereby determining the formation of monstrosities at will. So, in the nuimmal, blows and other injuries that detach the fetal membranes from the walls of the womb or that modify their circulation by inducing inflammation are at times followed by the development of a monster. The excitement, mental and physical, attendant on fright occasionally acts in a simi- lar way, acting probably through the same channels. The monstrous forms likely to interfere with parturition are such as, from contracted or twisted limbs or spine, must be presented double ; where supernumerary limbs, head, or body nuist approach the passages with the natural ones; where a head or other member has attained to an unnatural size; where the body of one fetus has become inclosed in or attached to another, etc. Extraction is sometimes possible by straightening the members and securing such a presentation as will reduce the presenting mass to its smallest and most wedgelike dimensions. To effect this it may be needful to cut the flexor tendons of bent limbs or the muscles on the side of a twisted neck or body; and one or more of the manipulations necessary to secure and bring up a missing member may be recjuired. 176 DISEASES OF THE HORSE. In most cases of monstrosity by excess, however, it is needful to remove the superfluous parts, in which case the general principles employed for embryotomy must be followed. The Ca?sarean section, bv which the fetus is extracted through mi incision in the walls of the abdomen and womb, is inadmissible, as it practically entails the sacrifice of the mare, which should never be done for the sake of a monster. (See " Embryotomy," p. 182.) ENTRANCE OF TAVINS INTO THE PASSAGE AT ONCE. Twins are rare in the mare, and still more rare is the impaction of both at once into the pelvis. The condition would be easily recog- nized by the fact that two fore limbs and two hind would occupy the passage at once, the front of the hoofs of the fore feet being turned upward and those of the hind feet downward. If both belonged to one foal tliey would be turned in the same direction. Once recog- nized, the condition is easily remedied by passing a rope Avith a run- ning noose round each foot of the foal that is farthest advanced or that promises to be most easily extracted, and to push the members of the other fetus back into the depth of the womb. As soon as the one fetus is fully engaged in the passage it will hold its place and its delivery will proceed in the natural way. TABLE OF WRONG PRESENTATIONS. Anterior pres entatioiip. Fore limbs. Head . Flexor tendons short- Posterior pres entations. Incompletel)'^ extended, ened. Crossed over the neck. Bent back at the knee. Bent back from the shoulder. Bent downward on the neck. Head and neck turned back beneath the breast. Turned to one side. Turned upward and backwanl on the back. Hind limbs Hind feet engaged in the pelvis. Transverse Back of foal to side of pelvis. Inverted Back of foal to floor of pelvis. .,• ] ,- 1 (Bent on itself at the hock. Hmdlnubs JBent at the hip. Transverse Back of foal to side of pelvis. Inverted Back of foal to floor of pelvis. „ X .• f 1 1 (With back and loins presented. Transverse presentation of l'<'dy. ..j^yj^j^ ^^.^..^^^ .^^^^^ ,,^l,y presented. FORE I.TMBS INCOMPLETELY EXTENDED. In cases of this kind, not only are the back tendons behind the knee and shank bone unduly short, but the sinew extending from the front of the shoidder blade over the front of the elbow and down to the head of the shank bone is also shortened. The result is that the fore limb is bent at the knee and the elbow is also rigidly bent. The condition obstructs parturition by the feet becoming pressed against the floor of the pelvis or by the elbow pressing on its anterior brim. Relief is to be obtained by forcible extension. A rope with a running PLATE XIU. ~\' -\' "\ .7 .7 I .L-.:L- I _■ I ( - t Thigh, and croup presentafzoru after Flemin* . Ui/rrior prrsrnt/iO'on Hind -linih de\'iotioTL. Hdiui's dpi JULIUS ei£N i CO NV AB N ORMAI . I^RK S K NTATl OXS PLATE XIV. AnterwrpresentMtiorv.Hea/i turrved on si'Ae. Ante/'ior prtsentali/xn Ifr-od turned, on. back. Haines, del. JULIUS BlEN i CO NY AB XOH MAI, I'K K S K X'rA'rK)N S. V; : 4: ffi P C -JO > DIFFICULT PARTURITION. 177 rioose is passed arouiul each fetlock and a repeller (see Plate IX) ])lanted in the breast is pressed in a direction upward and backward while active traction is made on the ropes. If the feet are not thereby raised from the floor of the pelvis the palm of the hand may be placed beneath them to protect the mucous membrane until they have advanced sufficiently to obviate this danger. In the absence of a repeller, a smooth rounded fork handle may be employed. If the shortening is too great to allow of the extension of the limbs in this May. the tense tendons nuiy be cut across behind the shank bone and in front of the elbow, and the limb will be easily straightened out. This is most easily done with an embryotomy knife furnished with a ring for the middle finger, so that the blade may be protected in the l^alm of the hand. (See Plate XV, tig. 4.) ONE FORE I.mii CROSSED OVER THE BACK OF THE NECK. With the long fore limbs of the foal this readily occurs, and the resulting increase in thickness, both at the head and shoulder, otters a serious obstacle to progress. (See Plate XI, fig. '2.) The hand introduced into the passage detects the head and one fore foot, and farther back on the same side of the head the second foot, from whidi the limb may be traced obliquely across the back of the neck. If parturition continues to make progress the displaced foot may bruise and lacerate the vagina. By siezing the limb above the fetlock it may be easily pushed over the head to the proper side, when partu- rition will proceed normally. FORE LIMB BENT AT THE KNEE. The nose and one fore foot present, and on examination the knee of the missing fore limb is found farther back. (Plate XI, fig. 1.) First place a noose each on the presenting pastern and lower jaw, and push back the body of the fetus with a repeller, while the operator seizing the shank of the bent limb extends it so as to press back the knee and bring forward the fetlock and foot. As i)rogress is made little by little the hand is slid down from the region of the knee to the fetlock, and finally that is secured and brought up into the passage, when parturition will proceed without hindrance. If both fore limbs are bent back tlic licnd must be noosed and the limbs brought up as above, one after the other. It is usually best to employ the left hand for the right fore limb, and the right hand for the left fore liinb. FORE LIMB Tl'RNEI) BACK FHO^I THE .SIIOUI.DER. In this case, on exploration by the side of the head and presenting limb, the shoulder only can be reached at first. (Plate XI, fig. 4.) By noosing the head and presenting fore limb, these may be drawn forward into the pelvis, and the oiled hand being carried along the II. Doc. 705. 59-2 12 178 DISEASES OF THE HORSE. shoulder in the direction of the missing limb is enabled to reach and seize the forearm just below the elbow. The body is now pushed back by the assistants pressing on the head and presenting limb or on a repeller planted in the breast until the knee can be brought up into the pelvis, after which the procedure is the same as described in the last paragraph. HEAD BENT DOWN BETWEEN THE FORE LIMBS. This may be so that the poll or nape of the neck, with the ears, can be felt far back between the fore limbs, or so that only the upper border of the neck can be reached, head and neck being bent back beneath the body. With the head only bent on the neck, noose the two presenting limbs, then introduce the hand between them until the nose can be seized in the palm of the hand. Next have the assist- ants push back the presenting limbs, while the nose is strongly lifted upward over the brim of the pelvis. This accomj^lished, it assumes the natural position and parturition is easy. When both head and neck are bent downward it may be impossible to reach the nose. If, however, the labor has only commenced, the limbs may be drawn upon until the operator can reach the ear, by dragging on which the head may be so far advanced that the fingers ma}^ reach the orbit; traction upon this while the limbs are being pushed back may bring the head up so that it bends on the neck only, and the further procedure will be as described in the last paragraph. If the labor has been long in progress and the fetus is jammed into the pelvis, the womb emptied of the waters and firmly contracted on its solid contents, the case is incomparably more difficult. The mare may be chloroformed and turned on her back with hind parts ele- vated, and the womb may be injected with sweet oil. Then, if the ear can be reached, the correction of the malpresentation ma}^ be at- tempted as above described. Should this fail, one or more sharp hooks may be inserted in the neck as near the head as can be reached, and ropes attached to these may be dragged on, Avhile the body of the foal is pushed back by the fore limbs or by a repeller. Such repul- sion should be made in a direction obliquely upward toward the loins of the mother, so as to rotate the fetus in such a way as to bring the head up. As this is accomplished a hold should be secured nearer and nearer to the nose, with hand or hook, until the head can be straightened out on the neck. All means failing, it becomes necessary to remove the fore limbs (embryotomy) so as to make more space for bringing up the head. If, even then, this can not be accomplished, it may be jwssible to push the body backward and upward with the repeller until the hind limbs are brought to the passage, wdien they may be noosed and delivery effected with the posterior presentation. DIFFICULT PAETURITION. 179 HEAD TURNED BACK ON THE SHOULDER. Ill this case the fore feet present, and the oiled hand passed along the forearms in search of the missing head finds the side of the neck turned to one side, the head being perhaps entirely out of reach. (Plate XIV, fig. 1.) To bring forward the head it may be desirable to lay the mare on the opposite side to that to which the head is turned, and even to give chloroform or ether. Then the feet being noosed, the body of the ietus is pushed by the hand or repeller for- Avard and to the side opposite to that occuj^ied by the head until the head comes within reach, near the entrance of the pelvis. If such displacement of the fetus is difficult, it may be facilitated by a free use of oil or lard. \Anien the nose can be seized it can be brought into the passage, as when the head is turned down. If it can not be reached, the orbit may be availed of to draw the head forward until the nose can be seized or the low^er jaw noosed. In very difficult cases a rope may be passed around the neck by the hand or w^th the aid of a curved carrier (Plate IX), and traction may be made upon this while the body is being rotated to the other side. In the same Avay in bad cases a hook may be fixed in the orbit or even between the bones of the lower jaw to assist in bringing the head up into position. Should all fail, the amputation of the fore limbs may be resorted to as advised under the last heading. HEAD TURNED UPW^ARD ON Ti[E BACK. This differs from the last malpresentation only in the direction of the head, which has to be sought above rather than at one side, and is to be secured and brought forward in a similar manner. (Plate XIV, fig. 2.) If a rope can be passed around the neck it will prove most effectual, as it naturally slides nearer to the head as the neck is straightened and ends by bringing the head within easy reach. HIND FEET ENGAGED IN THE PELVIS. In this case fore limbs and head present naturally, but the hind limbs bent forward from the hip and the loins arched allow the hind feet also to enter the passages, and the further labor advances the more firmly does the bod}'' of the foal become wedged into the pelvis. (Plate XIII, fig. 2.) The condition is to be recognized by introduc- ing the oiled hand along the belly of the fetus, when the hind feet will be felt advancing. An attempt should at once be made to pusli them back, one after the other, over the brim of the pelvis. Failing in this, the mare may be turned on her back, head downhill, and the attempt renewed. If it is possible to introduce a straight rope car- rier, a noose passed through this may be put on the fetlock and the repulsion thereby made more effective. In case of continued failure 180 DISEASES OF THE HORSE. the anterior presenting part of the body may l)e skinned and cut oft' as far back toward the pelvis as possible (see " Embryotomy '") ; then nooses are placed on the hind fetlocks and traction is made upon these ^vhile the quarters are pushed back into the womb. Then the re- maining portion is brought away by the posterior presentation. ANTERIOR PRESENTATION WITH BACK TURNED TO ONE SIDE. The greatest diameter of the axis of the foal, like that of the pelvic passages, is from above downward, and when the fetus enters the pelvis with this greatest diameter engaged transversely or in the nar- row diameter of the pelvis, parturition is rendered difficult or impos- sible. In such a case the pasterns and head may be noosed, and the I^assages and engaged portion of the foal freely lubricated with lard, the limbs may be crossed over each other and the head, and a move- ment of rotation effected in the fetus until its face and back' are turned up toward the croup of the mother ; then parturition becomes natural. BACK OF THE FOAL TURNED TO THE FLOOR OF THE PELVIS. In a roomy mare thiis is not an insuperible obstacle to parturi- tion, yet it may seriously impede it, by reason of the curvature of the body of the foal being opposite to that of the passages, and the head and withers being liable to arrest against the border of the pelvis. Lubrication of the passage with lard and traction of the limbs and head will usually suffice with or without the turning of the mare on her back. In obstinate cases two other resorts are open: First, to turn the foal, pushing back the fore parts and bringing up the hind so as to make a posterior presentation, and, second, the amputation of the fore limbs, after which extraction will usually be easy. HIND PRESENTATION WITH LEG BENT AT HOCK. In this form the quarters of the foal with the hind legs bent up beneath them present, but can not advance through the pelvis by reason of their bulk. (Plate XI, fig. 3.) The oiled hand introduced can recognize the outline of the buttocks, with the tail and anus in tlie center and the sharp points of the hocks beneath. First pass a rope around each limb at the hock, then with hand or repeller push the buttocks backward and upward, until the feet can be brought up into the passages. The great length of the shank and pastern in the foal is a serious obstacle to this, and in all cases the foot should be ju-otected in the palm of the hand while being brought up over the brim of the pelvis. Otherwise the womb may be torn. When the pains are too violent and constant to allow eft'ective manipulation, DIFFICULT PARTURITION. 181 some respite laay be obtained b}^ the use of chloroform or morphia and by turning the mare on her back, but too often the operator fails and the foal must be sacrificed. Two courses are still open : First, to cut through the cords behind and above the hock and extend the upper part of the limb, leaving the hock bent, and extract in this way, and, second, to amputate the hind limbs at the hip joint and remove them separately, after Avhich the body may be extracted. H1M> I'RKSKNTATIOX Wmi LEGS BENT FORWARD FROM THE HIP. This is merely an aggravated form of the presentation last de- scribed. (Plate XIII, fig. 1.) If the nuire is roomy, a rope may be passed around each thigh and the body pushed upward and forward, so as to bring the hocks and heels uj^ward. If this can be accom- plished, nooses are placed on the limb farther and farther down until the feitlock is reached and brought into position. If failure is met Avith, then amputation at the hips is the last resort. HIND PRESENTATIONS WITH THE BACK TURNED SIDEWAYS OR DOWNWARD. These are the counterparts of similar anterior i:»resentatiop^ and are to be managed in the same Avav. PRESENTATION VV THE BACK. This is rare, yet not unknown, the foal being bent upon itself Avith the back, recognizable by its sharp roAv of spines, presented at the entrance of the pelvis and the head and all four feet turned back into the Avomb. (Plate XII, fig. 1.) The body of the fetus may be ex- tended across the opening transA^ersely, so that the head corresponds to one side (right or left), or it may be vertical, with the head aboA-e or below. In any such position the object should be to push the body of the fetus forAvard and iipwai'd or to one side, as may best promise to bring up the fore or hind extremities, and bring the latter into the passage so as to constitute a normal anterior or })ostcrior presentation. This turning of the fetus may be favored by a giA'en position of the mother, by tlie free use of oil or lard on the surface of the fetus, and by the use of a propeller. PRESENTATION OF BREAST AND ABDOMEN. This is the reverse of the back presentation, the foal being extended across in front of the pelvic opening, but Avith the belly turned toAvard the passages and Avith all four feet engaged in the passage. (Plate* XII, fig. 2.) The most promising course is to secure the hind feet Avitli nooses and then push the fore feet forAvard into the Avoinb. As 132 DISEASES OF THE HORSE. soon as the fore feet are pushed forward clear of the brim of the pelvis, traction is made on the hind feet so as to bring the thighs into the i^assage and prevent the reentrance of the fore limbs. If it prove difficult to push back the fore limbs a noose may be passed around the fetlock of each and the cord drawn through the eye of a rope carrier, by means of which the members may be easily pushed back. EMBRYOTOMY. This consists in the dissection of the fetus, so as to reduce its bulk and allow of its exit through the pelvis. The indications for its adop- tion have been furnished in the foregoing pages. The operation will vary in diU'erent cases according to the necessity for the removal of one or more parts in order to secure the requisite reduction in size. Thus it may be needful to remove head and neck, one fore limb or both, one hind limb or both, to remove different parts of the trunk, or to remove superfluous (monstrous) parts. Some of the simplest opera- tions in embryotomy (incision of the head in hydrocephalus, incision of the belly in dropsy) have already been described. It remains to notice the more difficult procedures which can be best undertaken by the skilled anatomist. Amputation of the head. — This is easy when both fore limbs are turned back and the head alone has made its exit in part. It is more difficult when the head is still retained in the passages or womb, as in double-headed monsters. The head is secured by a hook in the lower jaw, or in the orbit, or by a halter, and the skin is divided circularly around the lower part of the face or at the front of the ears, according to the amount of head protruding. Then an incision is made backward along the line of the throat, and the skin dissected from the neck as far back as possible. Then the muscles and other soft parts of the neck are cut across, and the bodies of two vertebrae (neck bones) are severed by cutting completely across the cartilage of the joint. The bulging of the ends of the bones wall serve to indi- cate the seat of the joint. The head and detached portion of the neck may now be removed by steady pulling. If there is still an obstacle, the knife may be again used to sever any obstinate connections. In the case of a double-headed monster, the whole of the second neck must be removed with the head. AVlien the head has been detached, a rope should be passed through the eyeholes, or through an artificial opening in the skin, and tied firmly around the skin, to be employed as a means of traction when the missing limbs or the second head have been brought up into position. Amputation of the hind limb. — This may be required when there are extra hind limbs or when the hind limbs are bent forward at hock or hip joint. In the former condition the procedure resembles that for removal of a fore limb, but requires more anatomical knowledge. DIFFICULT PARTURITION. 183 Having noosed the pastern, a circular incision is made through the skin around the fetlock, and a longitudinal one from that up to the groin, and the skin is dissected from the limb as high up as can be reached, over the croup, if possible. Then cut through the muscles around the hip joint, and, if possible, the two interarticular ligaments of the joint (pubio-femoral and round), and extract the limb by strong dragging. Amputation of the fore limbs. — This may usually be begun on the fetlock of the limb projecting from the vulva. An embryotomy knife is desirable. This knife consists of a blade with a sharp, slightly hooked point, and one or two rings in the back of the blade large enough to fit on the middle linger, while the blade is protected in the palm of the hand. (See Plate XV, fig. 4.) xA.nother form has the blade inserted in a mortise in the handle, from which it is pushed out by a movable button when wanted. First place a noose around the fetlock of the limb to be amputated, cut the skin circularly 3n- tirely around the fetlock, then make an incision on the inner side of the limb from the fetlock up to the breastbone. Next dissect the skin from the limb, from the fetlock up to the breastbone on the inner side, and as far up on the shoulder blade as possible on the outer side. Finally, cut through the muscles attaching the limb to the breast- bone, and employ strong traction on the limb, so as to drag out the whole limb, .shoulder blade included. The muscles around the upper part of the shoulder blade are easily torn through and need not be cut, even if that were possible. In no case should the fore limb be removed unless the shoulder blade is taken with it, as that furni.shes the greatest obstruction to delivery, above all when it is no longer advanced by the extension of the fore limb, but is pressed back so as to increase the already thickest posterior portion of the chest. The preservation of the skin from the Avhole limb is advantageous in various ways; it is easier to cut it circularly at the fetlock than at the shoulder; it covers the hand and knife in makincr the needful incisions, thus acting as a protection to the womb; and it affords a means of traction on the body after the limb has been removed. In dis.secting the skin from the limb the knife is not needful at all ]wints; much of it may be stripi^ed off' with the fingers or knuckles, or by a blunt iron spud pushed up inside the hide, which is mean- while held tense to render the spud effective. In case the limb is bent forward at the hock, a rope is passed round that and pulled so as to bring the point of the hock between the lips of the vulva. The hamstring and the lateral ligaments of the hock are now cut through, and the limbs extended by a rope tied round the lower end of the long bone above (tibia). In case it is still needful to remove the upper part of the limb, the further procedure is the same as described in the last paragraph. 184 DISEASES OF THE HORSE. In case the limb is turned forward from the hip, and the fetus so Avedged into the passage that turning is impossible, the case is very difficult. I have repeatedly succeeded by cutting in on the hip joint and disarticulating it, then dissecting tlie muscles back from the upper end of the thigh bone. A noose was placed around the neck of the bone and pulled on forcibly, Avhile any unduly resisting struc- tures were cut with the knife. Cartwright recommends to make free incisions round the hip joints and tear through the muscles when they can not be cut; then with cords round the pelvi-c bones, and hooks inserted in the openings in the floor of the pelvis to drag out the pelvic bones; then put cords around the heads of the thigh bones and extract them ; then remove the intestines; and finally, by means of the loose, detached skin, draw out the body with the remainder of the hind limbs bent forward beneath it. Reulf cuts his way into the pelvis of the foal, and wuth a knife separates the pelvic bones from the loins, then skinning the quarter draws out these pelvic bone.s by means of ropes and hooks, and along with them the hind limbs. The hind limbs having been removed by one or the other of these procedures, the loose skin detached from the pelvis is used as a means of traction and delivery is effected. If it has been a monstrosity with extra hind limbs, it may be possible to bring these up into the passage and utilize them for traction. Removal of the abdominal viscera. — In case the belly is unduly large, from decomposition, tumors, or otherwise, it may be needful to lay it open with the knife and cut or tear out the contents. Remoral of the thoracic viscera. — To diminish the bulk of the chest it has been found advisable to cut out the breastbone, remove the heart and lungs, and allow the ribs to collapse with the lower free ends overlapping each other. Dissection of the trunk. — In case it becomes necessary to remove other portions of the trunk, the general rule should be follow^ed of preserving the skin so that all manipulations can be made inside this as a protector, that it may remain available as a means of exercising traction on the remaining part of the body, and as a covering to l)rotect the vaginal w^alls against injuries from bones while such part is passing. FLOODING, OR BLEEDING rR0:\r THE WOMB. This is rare in the mare, but not unknown, in connection with a failure of the womb to contract on itself after parturition, or with eversion of the womb (casting the withers), and congestion or lacera- tion. If the blood accumulates in the flaccid womb, the condition may only be suspected by reason of the rapidly advancing weakness, DIFFICULT PARTURITION. 185 swaying, unsteady gait, hanging- head, paleness of the eyes and other mucous nienibranes, and Aveak, small, failing pulse. The hand in- troduced into the womb detects the presence of the blood parth^ clotted. If the blood escapes In- the vulva, the condition is evident. Treatment consists in evacuating the womb of its blood clots, giv- ing a large dose of powdered ergot of rye, and in the application of cold water or ice to the loins and external generative organs. Besides this, a sponge impregnated with a strong solution of alum, or, still better, with tincture of nuiriate of inm, may l)e introduced into the womb and s(|ueezed so as to bring the licjuid in contact with the walls generally. INVERSION OF THE AVOINIB. If the womb fails to contract after difficult parturition, the after- pains will sometimes lead to the fundus passing into the body of the organ and passing through that and the vagina imtil the whole inverted organ appears externally and hangs down on the thighs. The result is rapid engorgement and swelling of the organ, impaction of the rectum with feces, and distention of the bladder with urine, all of which conditions seriously interfere with the return of the mass. In returning the womb the standing is preferable to the recumbent position, as the abdomen is more pendent and there is less obstruc- tion to the return. It may, however, be necessary to put hobbles on the liind limbs to prevent the mare from kicking. A clean sheet should be held beneath the womb, and all filth, straw, and foreign bodies washed from its surface. Then with a broad, elastic (india rubber) band, or in default of that a long strip of calico 4 or 5 inches wide, wind the v.omb as tightly as possible, beginning at its^ most dependent part (the extremity of the horn). This serves two good ends. It squeezes out into the general circulation the enormous mass of blood which engorged and enlarged the organ, and it furnishes a strong protective covering for the now delicate friable organ, through which it may be safely manipulated without danger of laceration. The next. step may be the pressure on the general mass while those j)ortions next the vulva are gradually pushed in \\ith the hands; or the extreme lowest point (the end of the honi) may be turned within itself and pushed forward into the vagina by the closed list, the return being assisted by mani{)ulations by the other hand, and ev(Mi by those of assistants. By either mode the nianipulations may be nnide with almost perfect safety so long as the organ is closely wrapped in the bandage. Once a portion has been introduced into the vagina the rest will usually follow with increasing ease, and the operation should be comi)leted with the hand and arm extended the full length within the womb and nio\ed from point to point so as to straighten out all parts of the organ and insure that no 2)ortion still 186 DISEASES OF THE HORSE. remains inverted within another portion. Should any such partial inversion be left it will give rise to straining, under the force of which it will gradually increase until the whole mass will be protruded as l,)efore. The next step is to apply a truss as an effectual me- chanical barrier to further escape of the womb through the vulva. The simjDlest is made with two inch ropes, each about 18 feet long. These are each doubled and interwoven at the bend, as seen in Plate IX, figure 4. The ring formed by the interlacing of the two ropes is adjusted around the vulva, the two ends of the one rope are carried up on the right and left of the tail and along the spine, being wound round each other in their course, and are finally tied to the upper 2)art of the collar encircling the neck. The remaining two ends, belonging to the other rope, are carried downward and forward between the thighs and thence forward and upward on the sides of the belly and chest to be attached to the right and left sides of the col- lar. These ropes are drawn tightly enough to keep closely applied to the opening without chafing, and will fit still more securely when the mare raises her back to strain. It is desirable to tie the mare short so that she may be unable to lie down for a day or two, and she should be kept in a stall with the hind parts higher than the fore. Violent straining may be checked by full doses of opium (one-half dram), and any costiveness or diarrhea should be obviated by a suitable laxa- tive or binding diet. In some mares the contractions are too violent to allow of the return of the womb, and full doses of opium one-half dram, laudanum 2 ounces, or chloral hydrate 1 ounce, may be demanded, or the mare must be rendered insensible by ether or chloroform. RUPTURE, OR LACERATION, OF THE WOMB. This may occur from the feet of the foal during parturition, or from ill-directed efforts to assist, but it is especially liable to take l^lace in the everted, congested, and friable organ. The resultant dangers are bleeding from the wound, escape of the bowels through the opening and their fatal injury by the mare's feet or otherwise, and peritonitis from the extension of inflammation from the wound and from the poisonous action of the sej^tic liquids of the womb escaping into the abdominal cavity. The first object is to close the wound, but unless in eversion of the womb this is practically impossible. In the last-named condition the wound must be carefully and accurately sewed up before the womb is returned. After its return, the womb must be injected daily with an antiseptic solution (borax, one-half ounce, or carbolic acid, 3 drams to a quart of tepid water). If in- flammation threatens, the abdomen may be bathed continuously with hot Avater by means of a heavy woolen rag, and large doses of oj^ium (one-half dram) may be given twice or thrice daily. DIFFICULT PARTURITION. 187 RUPTURES OF THE VAGINA. These are attended by dangers similar to those belonging to rup- tnre of the womb, and in addition by the risk of protrusion of the bladder, which appears through the lips of the vulva as a red pyri- form mass. Sometimes such lacerations extend downward into the bladder, and in others upward into the terminal gut (rectum). In still other cases the anus is torn so that it forms one common orifice with the vulva. Too often such cases prove fatal, or at least a recovery is not at- tained, and urine or feces or both escape freely into the vagina. The simple laceration of the anus is easily sewed up, but the ends of the muscular fibers do not reunite and the control over the lower bowel is never fully reacquired. The successful stitching up of the wound communicating with the bladder or the rectum requires unusual skill and care, and though I have succeeded in a case of the latter kind, I can not advise the attempt by unprofessional persons. BLOOD CLOTS IN THE WALLS OF THE VAGINA. (See " Effusion of blood in the vaginal walls," p. 1G9.) INFLAMMATION OF THE WOMB AND PERITONEUM. These may result from injuries sustained by the womb during or after parturition, from exposure to cold or wet, or from the irritant infective action of putrid products within the womb. Under the inflammation the w^omb remains dilated and flaccid, and decomposi- tion of its secretions almost always occurs, so that the inflammation tends to assume a putrid character and general septic infection is likely to occur. Symptoms. — The symptoms are ushered in by shivering, staring coat, small rapid pulse, elevated temperature, accelerated breathing, inappetence, with arched back, stiff movement of the body, looking back at the flanks, and uneasy motions of the hind limbs, discharge from the vulva of a liquid at first watery, reddish, or yellowish, and later it may be whitish or glairy, and fetid or not in different cases. Tenderness of the abdomen shown on pressure is especially character- istic of cases affecting the peritoneum or lining of the belly, and is more marked lower down. If the animal survives, the inflammation tends to become chronic and attended by a whitish muco-purulent discharge. If, on the contrary, it })roves fatal, death is preceded by extreme prostration and weakness from the general septic poisoning. Tnuifmcnt. — In treatment the first thing to be sought is the removal of all offensive and irritant matters from the womb through a caout- chouc tube introduced into the womb, and into which a funnel is fitted. Warm water should be passed until it comes away clear. To 188 DISEASES OF THE HOESE. insure that all of the Avonib has been washed out, the oiled hand may be introduced to carry the end of the tube into the two horns successively. When the offensive contents have been thus removed, the womb should be injected with a quart of water holding in solu- tion 1 dram permanganate of potash, or, in the absence of the latter, 2 teaspoonfuls of carbolic acid. Repeat twice daily. Fomentation of the abdomen, or the application of a warm flaxseed poultice, may iireatly relieve. Acetanilid, in doses of half an ounce, repeated twice or thrice a day, or sulphate of quinia in doses of one-third ounce, may be employed to reduce the fever. If the great prostration indi- cates septic poisoning, large doses (one-half ounce) bisulphite of soda, or salicylate of soda, or sulphate of quinine may be resorted to. LEUCORKHEA. This is a white, glutinous, chronic discharge, the result of a contin- ued subacute inflannnation of the mucous membrane of the womb. Like the discharge of acute inflammation, it contains many forms of bacteria, by some of which it is manifestly inoculable on the penis of the stallion, producing ulcers and a specific gonorrheal discharge. Tveatiiund may consist in the internal use of tonics (sulphate of iron, 3 drams, daily) and the washing out of the womb, as described under the last heading, followed by an astringent antiseptic injection (carbolic acid 2 teaspoonfuls, tannic acid one-half dram, water 1 quart). This may be repeated two or three times a day. LAMINITIS, OR FOUNDER, FOLLOWING PARTURITION, This sometimes follows on inflammation of the womb, as it fre- quently does on disorder of the stomach. Its symptoms agree with those of the common form of founder, and treatment need not differ. DISEASES OF THE UDDER AND TEATS. CONGESTION AND INFLAMMATION OF THE UDDER. This is comparatively rare in the mare, though in some cases the udder becomes painfully engorged before parturition, and a doughy swelling, pitting on pressure, extends forward on the lower surface of the abdomen. AVhen this goes on to active inflammation, one or both of the glands become enlarged, hot, tense, and painful; the milk is dried up or replaced by a watery or reddish serous fluid, which at times becomes fetid ; the animal Avalks lame, loses appetite, and shows general disorder and fever. The condition may end in recovery, in abscess, induration, or gangrene, and in some cases may lay the foun- dation for a tumor of the gland. Treatment. — The treatment is simple so long as there is only con- gestion. Active rubbing with lard or oil, or, better, camphorated DISEASES OF THE UDDER AND TEATS. 189 nil, and the frequent drawing off of the milk, by the foal or with the hand, will usually bring- about a rapid improvement. When active intlannnation is present, fomentation with warm water may be kept uj) for an hour and followed by the application of the cam- plu)rated oil, to which has been added some carbonate of soda and extract of belladonna. A dose of laxative medicine (4 drams Bar- bados aloes) Avill be of service reducing fever, and one-half ounce saltpeter daily will >erve a similar end. In case the milk coagulates in the udder and can not be withdrawn, or when the licpiid becomes fetid, a solution of -20 grains carbonate of soda and 10 drops carbolic acid dissolved in an ounce of water should bo injected into the teat. In doing this it must be noted that the mare has three separate ducts opening on the summit of each teat and each must be carefully in- jected. To draw off the fetid product it may be needful to use a small milking tube, or spring teat dilator designed by the writer. (Plate VIII, figs. 2 and 3.) When pus forms and points externally and can not find a free escape by the teat, the spot where it fluctu- ates must be opened freely Avith the knife and the cavity injected daily with the carbolic-acid lotion. When the oland becomes hard and indolent, it may be rubbed daily with iodine ointment 1 part, vaseline (i j^arts. TUMORS OF THE UDDER. As the result of inflammation of the udder it may become the seat of an indurated dise^ised gi"owth, which may go on growing and seri- ously interfere with the movement of the hind limbs. If such swell- ings will not give way in their early stages to treatment by iodine, the only resort is to cut them out with a knife. As the gland is often implicated and has to be removed, such mares can not in the future suckle their colts and therefore .should not be bred. SORE TEATS, SCABS, CRACKS, WARTS. By the act of sucking, especially in cold weather, the teats are sub- ject to abrasions, cracks, and scabs, and as the result of such irrita- tion, or independently, warts sometimes grow and prove troublesome. The warts should be clipped off Avith sharp scissors and their roots burned with a solid pencil of lunar caustic. This is best done before parturition to secure healing before suckling begins. For sore teats use an ointment of vaseline 1 ounce, balsam of tolu 5 grains, and sulphate of zinc 5 grains. DISEASES OF THE NERVOUS SYSTEM. By M. R. Trumbower, V. S. [Revised in 1903 by Leonard Pearson. B. S.. V. M. D.] THE ANATOMY AND PHYSIOLOGY OF THE BRAIN AND NERVOUS SYSTEM. The nervous system may be regarded as consisting of two sets of organs, peripheral and central, the function of one being to establish a communication between the centers and the different parts of the body, and that of the other to generate nervous force. The whole may be arranged under two divisions: First, the cerebro-S'pinal system; second, the sympathetic^ or ganglionic system. Each is possessed of its own central and peripheral organs. In the first, the center is made up of two portions — one large and exj^anded (the brain) placed in the cranial cavity; the other elon- gated (spinal cord), continuous with the brain, and lodged in the canal of the vertebral column. The peripheral portion of this sys- tem consists of the cerebro-spinal nerves, which leave the axis in symmetrical pairs, and are distributed to the skin, the voluntary muscles, and the organs. In the second, the central organ consists of a chain of ganglia con- nected by nerve cords which extends from the head to the rump on each side of the spine. The nerves of this system are distributed to the involuntary muscles, mucous membrane, viscera, and blood vessels. The two sj^stems have free intercommunication, ganglia being at the junctions. Two substances, distinguishable by their color, enter into the forma- tion of nervous matter, namely, the wdiite or medullary, and the gray or cortical substance. Both are soft, fragile, and easily injured, in consequence of which the principal nervous centers are well protected by bony coverings. The nervous substances present two distinct forms — nerve fibers and nerve cells. An aggregation of nerve cells constitutes a nerve ganglion. The nerve fibers represent a conducting apparatus, and serve to place the central nervous organs in connection with peripheral end organs. The nerve cells, however, besides transmitting impulses, act as physiological centers for automatic, or reflex, movements, and also 190 DISEASES OF THE NERVOUS SYSTEM. 191 I for the sensory, perceptive, trophic, and secretory functions. A ' nerve consists of a bundle of tubular fibers, held together by a dense areolar tissue, and inclosed in a membranous sheath — the neurilemma. Nerve fibers possess no elasticity, but are very strong. Divided nerves do not retract. Nerves are thrown into a state of excitement when stimulated, and j are, therefore, said to possess excitable or irritable properties. The ' stimuli may be applied to, or may act upon, any part of the nerve. Nerves may be paralyzed by continuous pressure being applied. When the nerves divide into branches, there is never any splitting up of their ultimate fibers, nor yet is there ever any coalescing of | them; they retain their individuality from their source to their termination. Ner^'es which convey impressions to the centers are termed sensory, or centripetal, and those which transmit stimulus from the centers to organs of motion are termed motor, or centrifugal. The function of the nervous system may, therefore, be defined in the simplest terms, as follows : It is intended to associate the different parts of the body in such a manner that stimulus applied to one organ may excite or dojiross the activity of another. The brain is that portion of the cerebro-spinal axis wnthin the cra- nium, which may be divided into four parts — the medulla ohlongata, the cerehellum, the pons Varolii, and the cerehmm — ^and it is cov- ered by three membranes, called the meninges. The outer of these membranes, the dnra mater, is a thick, white, fibrous membrane which lines the cavity of the cranium, forming the internal periosteum of the bones ; it is continuous with the spinal cord to the extremity of the canal. The second, the arachnoid, is a delicate serous membrane, and \ loosely envelops the brain and spinal cord ; it forms two layers, leav- I ing between them the arachnoid space which contains the cerebro- I spinal fluid, the use of Avhich is to protect the spinal cord and brain from pressure. The third, or inner, the pia mater, is closely adher- i ent to the entire surface of the brain, but is much thinner and more ! vascular than when it reaches the spinal cord, which it also envelops, ! and is continued to form the sheaths of the spinal nerves. I The medulla ohlongata is the prolongation of the spinal cord, extciuliiig to the pons Varolii. This i)()rtion of \\\v brain is very large in the horse; it is pyramidal in shape, the narrowest part join- ing the cord. The pons Varolii is the transverse j^rojection on tlie base of the brain, betw^een the medulla oblongata and the peduncles of the cerebrum. The eerehclluyn is lodged in the posterior part of the cranial cavity, immediately above the medulla oblongata; it is globular or elliptical 192 DISEASES OF THE HOESE. ill shape, the transverse diameter being- oreatest. The body of the oerebelhim is composed of gray matter externally and of white matter in the center. The cerebellnm has the fnnction of coordinating move- ments; that is, of so associating them as to canse them to accomplish a definite purpose. Injuries to the cerebellnm cause disturbances of tli3 equilibrium, but do not interfere with the Avill power or intelligence. The cerebrum, or brain proper, occupies the anterior portion of the cranial cavity. It is ovoid in shape, Avith an irreg^ilar flattened base, and consists of lateral halves or hemispheres. The greater part of the cerebrum is composed of white matter. The hemispheres of the cerebrum are usually said to be the seat of all psychical activities. Only when they are intact are the process of feeling, thinking, and willing possible. After they are destroyed, the organism comes to be like a complicated machine, and its activity is only the expression of the internal and external stimuli which act upon it. The spinal cord, or spinal marrow, is that part of the cerebro- spinal system which is contained in the spinal canal of the backbone, and extends from the medulla oblongata to a short distance behind the loins. It is an irregularly cylindrical structure, divided into tAVo lateral symmetrical halves by fissures. The spinal cord terminates posteriorly in a pointed extremity, which is continued by a mass of nerve trunks — cauda equbup.. A transverse section of the cord reveals that it is composed of white matter externally and of gray matter internally. The spinal cord does not fill up the whole spinal canal. The latter contains, besides, a large venous sinus, fatty matter, the membranes of the cord, and the cerebro-spinal fluid. The spinal nerves, forty-two or forty-three in number, arise each by two roots, a superior, or sensory, and an inferior, or motor. The nerves originating from the brain are twenty-four in number, and arranged in pairs, which are named first, second, third, etc., counting from before backward. They also receive special names, according to their functions, or the parts to which they are distributed, viz : 1. Olfactory- T. Facial. 2. Optic. 8. Auditory. 3. Ociilo-motor. 9. Glosso-pharyngeal. 4. Pathetic. 10. Pneuniogastrie. 5. Trifacial. 11. Spinal-accessory. 0. Abduceus. 12. Hypoglossal. INFLAMMATION OF THE BRAIN AND ITS MEMBRANES. Inflammation may attack these membranes singly, or any one of the anatomical divisions of the nerve matter, or it may invade the whole at once. Practical experience, hoAvever, teaches us that primary inflammation of the dura mater is of rare occurrence, except in direct mechanical injuries to the head or diseases of the bones of the era- I w h < S r "^ 'A III f^ ^ i^ 'o iSi 'o <0" K' <«■ i n -s DISEASES OF THE BRAIN, 193 Ilium. Neither is the arachnoid often afi'ected with acute inflamma- tion, except as a secondary result. The pia mater is most commonly the seat of inflammation, acute and subacute, but from its intimate relation with the surface of the brain the latter very soon becomes involved in the morbid changes. Practically, we can not separate in- flannnation of the pia mater from that of the brain proper. Inflam- mation may. however, exist in the center of the great nerve masses — the cerebrum, cerebellum. ])ons Varolii, or medulla at the base of the brain — without involving the surface. AVhen, therefore, inflamma- tion invades the brain and its envelo])ing membranes it is properly called encephaUti.H; when the membranes alone are atfected, it is called meningitis ; or the brain substance alone, eerehritis. Since all of the conditions merge into each other and can scarcely be recognized separately during the life of the animal, thej'^ maj^ here be considered together. ENCEPHALITIS, MENINGITIS, AND CEBEBRITIS (INFLAMMATION OF THE BRAIN AND ITS MEMBRANES). Causes. — Exposure to extreme heat or cold, sudden and extreme changes of temperature, excessive continued cerebral excitement, over- feeding with nitrogenous foods, direct injuries to the brain, such as concussion, or from fracture of the cranium, overexertion, sometimes as sequelae to influenza, joj^emia, poisons having a direct influence upon the encephalic mass, extension of inflammation from neighboring structures, food poisoning, tumors, parasites, metastatic abscesses, etc. Symptoms. — The diseases here grouped together are accompanied by a variety of syiiiptoms almost none of which, however, are asso- ciated so definitely with a special pathological process as to point unmistakably to a given lesion. Usually the first symptoms indicate mental excitement, and these are followed by symptoms indicating depression. Acute encephalitis may be ushered in by an increased sensibility to noises, with more oi- less nervous excitability, contrac- tion of the pupils of the eyes, and a quick, hard ])ulse. In very acute attacks these synij^toms, however, ai-o not always noted. This condi- tion Avill soon be followed by muscular twitchings, convulsive or spasmodic movements, eyes wide open with shortness of sight. The animal becomes afraid to have his head handled. Convulsions and delirium will develop, with inability of muscular control, or stupor and coma may supervene. "Where the membranes are greatly implicated, convulsions and delirium with A'iolence may be expected, but where the brain substances are principally affected stupor and coma Avill be the prominent symptoms. In the former condition the pulse will be quick and hard: in the latter, soft or depressed with often a dila- tation of the pupils, and deep. slow, stertorous breathing. The II . I )n. •. 79.".. .-.!>-2 1 3 194 DISEASES OF THE HOESE. symptoms may follow one another in rapid succession, and the disease approach a fatal termination in less than twelve hours. In subacute attacks the symptoms are better defined, and the animal seldom dies before the third day. Within three or four days gradual improve- ment may become manifest, or cerebral softening with partial paral- ysis may occur. In all cases of encephalitis there is a marked rise in temperature from the very onset of the disease, with a tendency to increase until the most alarming symptoms develop, succeeded by a decrease when coma becomes manifest. The violence and character of the symptoms greatly depend upon the extent and location of the structures involved. Thus, in some cases there may be marked paral- ysis of certain muscles, while in others there may be spasmodic rigidity of muscles in a certain region. Very rarely the animal be- comes extremely violent early in the attack, and by rearing up, strik- ing with the fore feet, or falling over, may do himself great injury. Usually, however, the animal maintains the standing position, prop- ping himself against the manger or wall, until he falls from inability of muscular control or unconsciousness. Occasionally he may go through a series of automatic movements in his delirium, such as trotting or walking, and, if loose in a stall, will move around in a circle persistently. Early and persistent constipation of the bowels is a marked symptom in nearly all acute affections of the brain; re- tention of the urine, also, is frequently observed. Following these symptoms there are depression, loss of power and consciousness, lack of ability or desire to move, and usually fall of temperature. At this stage the horse stands with legs propped, the head hanging or resting on the manger, the eyes partly closed, and does not respond when spoken to or when struck with a whip. Chronic encephalitis or meningitis may succeed the acute stage, or may be due to stable miasma, blood poison, narcotism, lead poison- ing, etc. This form may not be characterized in its initial stages by excitability, quick and hard pulse, and high fever. The animal usually appears at first stupid ; eats slowly ; the pupil of the eye does not respond to light quickly ; the animal often throws up his head or shakes it as if suifering sudden twinges of pain. He is slow and sluggish in his movements, or there may be partial paralysis of one limb, one side of the face, neck, or body. These symptoms, with some variations, may be present for several days and then subside, or the disease may pass into the acute stage and terminate fatally. Chronic encephalitis may affect an animal for ten days or two weeks without much variation in the symptoms before the crisis is reached. If im- provement commences, the symptoms usually disappear in the reverse order in which they developed, with the exception of the paralytic effects, which remain intractable or permanent. Paralysis of certain sets of muscles is a very common result of chronic, subacute, and DISEASES OF THE BRAIN. 195 acute encephalitis, and is due to softening of the brain or to exuda- tion into the cavities of the brain or araclinoid space. Softening and abscess of the brain is one of the terminations of cerebritis. It may also be due to an insufficient supply of blood as a result of diseased cerebral arteries and of apoplexy. The symptoms are drowsiness, vertigo, or attacks of giddiness, increased timidity, or fear of familiar ol)jects, paralysis of one limb, hemiplegia, imperfect control of the limbs, and usually a weak, intermittent pulse. In some cases the symptoms are analogous to those of apoplexy. The char- acter of the sym])toms depends upon the seat of the softening or abscess within the brain. Cerebral sclerosis sometimes follows inflammation in the struct- ure of the brain atfecting the connective tissues, which eventually become hypertro])hied and press upon nerve cells and fibers, causing their ultimate disappearance, leaving the parts hard and indurated. This condition gives rise to a progressive paralysis and may extend along a certain bundle of fibers into the spinal cord. Complete j^aralysis almost invariably supervenes and causes death. Lesions. — On making post-mortem examinations of horses which have died in the first stages of either of these diseases we will find an excessive engorgement of the capillaries and small blood vessels, with correspondingly increased redness and changes in both the contents and the walls of the vessels. If death has occurred at a later period of the disease it will be found that, in addition to the redness and en- gorgement, an exudation of the contents of the blood vessels into the tissues and upon the surfaces of the inflamed parts has supervened. If the case has been one of encephalitis, there will usually be found more or less watery fluid in the ventricles (natural cavities in the brain), in the subarachnoid space, and a serous exudation between the convolutions and interstitial spaces of the gray matter under the membranes of t!ie brain. The amount of fluid varies in difl'erent cases. Exudations of a membranous character may be present and are found attached to the surface of the pia mater. In meningitis, especially in chronic cases, in addition to the serous effusion, there are changes which may be regarded as characteristic in the formation of a delicate and highly vascular layer or layers of membrane or organized structure on the surface of the dura mater, and also indications of hemorrhages in connection with the membra- nous formations. Hematoma, or blood tinnors, may be found em- bedded in this membrane. In some cases the hemorrhages are copious, causing paralysis or apoplexy, followed by speedy death. The menin- gitis may be suppurative. In this case, a puslike exudate is found between the membranes covering the brain. In cerebritis, or inflammation of the interior of the brain, there is a tendencv to softening and suppuration and the formation of 196 DISEASES OF THE HOESE. abscesses. In some cases the abscesses are small and numerous, sur- rounded with a softened condition of the brain matter, and some- times we may find one large abscess. In cases of recent development the walls of the abscesses are fringed and ragged and have no lining membrane. In older or chronic cases, the walls of the abscesses are generally lined with a strong membrane, often having the appearance of a sac, or cyst, and the contents have a very offensive odor. Treatment. — In all acute attacks of inflammation involving the membranes or cerebral masses, it is the pressure from the distended and engorged blood vessels and the rapid accumulation of inflamma- tory products that endangers the life of the animal in even the very earlv stae-e of the disease. The earlier the treatment is commenced to lessen the danger of fatal pressure from the engorged blood vessels, the less amount of inflammatory products and effusion we have to contend with later on. The leading object, then, to be accomplished in the treatment of the first stages of encephalitis, meningitis, or cere- britis is to relieve the engorgement of the blood vessels before a dan- gerous degree of effusion or exudation has taken place, and thereby lessen the irritation or excitability of the affected structures. If the attempt to relieve the engorgement in the first stage has been only partially successful, and the second stage with its inflammatory prod- ucts and exudations, whether serous or plastic, has set in, then the main objects in further treatment are to keep up the strength of the animal and hasten the absorption of the exudative products as much as possible. To obtain these results, when the animal is found in the initial stage of the disease, where there is unnatural excitability or stupor with increase of temperature and quickened pulse, we should apply cold to the head in the form of cold water or ice. For this pur- pose cloths or bags may be used, and they should be renewed as often as necessary. If the disease is still in its early stages and the animal is strong, bleeding from the jugular A^ein may be beneficial. Good results are to be expected only during the stage of excitement, while there is a strong, full pulse and the mucous membranes of the head are red from a plentiful supply of blood. The finger should be kept on the pulse and the blood allowed to flow until there is distinct -softening of the pulse. As soon as the animal recovers somewhat from the shock of the bleeding, the following medicine should be made into a ball or dissolved in a pint of Avarm water and be given at one dose: Barbados aloes, 7 drams; calomel, 2 drams; powdered ginger, 1 dram ; tincture of aconite, 20 drops. The animal should be placed in a cool, dark place, as free from noise as possible. When the animal becomes thirsty half an ounce of bromide of potash may be dissolved in his drinking water every six hours. Injections of warm water into the rectmn may facilitate the action of the purgative. Norwood's tincture of veratrum viride, in DISEASES OF THE BRAIN. 197 SO-drop doses, should bo given every hour and 1 dram of solid extract of belladonna every four hours until the symptoms become modified and the pulse regular and full. If this treatment fails to give relief, the disease will pass into the advanced stages, or, if the animal has been neglected in the early stages, the treatment must be supplanted with the hypodermic injec- tion of ergotin, in 5-grain doses, dissolved in 1 dram of water, every six hours. The limbs may be poulticed abov^e the fetlocks Avith mus- tard. Warm blanketing, to promote perspiration, is to be observed in all cases in which there is no excessive perspiration. If the disease becomes chronic (encephalitis or meningitis), we must place our reliance upon alteratives and tonics, with such incidental treatment as special symptoms may demand. Iodide of potassium in 2-dram doses should be given three times a day and 1 dram of calo- mel once a dav to induce absorption of effusions or thickened mem- branes. Tonics, in the form of iodide of iron in 1-dram doses, to which is added 2 drams of powdered hydrastis, may also be given every six or eight hours, as soon as the active fever has abated. After the disappearance of the acute symptoms, blisters (cantharides ointment) may be applied behind the poll. When paralytic effects remain after the disappearance of all other symptoms, sulphate of strychnia in 2-grain doses, in combination with the other tonics, may be given twice a day, and be continued until it produces muscular twitching. In some cases of paralysis, as of the lips or throat, bene- fit may be derived from the moderate use of the electric battery. Many of the recoveries will, however, under the most active and early treatment, be but partial, and in all cases the animals become predis- posed to subsequent attacks. A long period of time should be allowed to pass before the animal is exposed to severe work or great heat. When the disease depends upon mechanical injuries, they have to be treated and all causes of irritation to the brain removed. If it is due to stable miasma, uremic poisoning, pj'emia, influenza, rheumatism, toxic agents, etc., they should receive prompt attention for their removal or mitigation. Cerebral softening, abscess, and sclerosis are practically inaccess- ible to treatment, otherwise than such relief as may be afforded by the administration of opiates and general tonics, and. in fact, the diagnosis is largely presumj^tive. CONGESTION OF THE BRAIN, OR MEGRIMS. Congestion of the brain consists in an accumulation of blood in the vessels, also called hyperemia, or engorgement. It may be active or passive — active when there is an undue determination of blood or diminished arterial resistance, and passive when it accumulates in the vessels of the brain, owing to some obstacle to its return by the veins. 198 DISEASES OF THE HORSE. Causes. — Active cerebral congestion may be due to hypertrophy of the left ventricle of the heart, excessive exertion, the influence of extreme heat, sudden and great excitement, artificial stimulants, etc. Passive congestion may be produced by any mechanical obstruction which prevents the proper return of blood through the veins to thp heart, such as a small or ill-fitting collar, which often impedes the blood current, tumors or abscesses pressing on the vein in its course, and organic lesions of the heart with regurgitation. Extremely fat animals with short thick necks are peculiarly subject to attacks of cerebral congestion. Simple congestion, however, is merely a functional affection, and in a slight or moderate degree involves no immediate danger. Extreme engorgement, on the con- trary, may be followed by rupture of previously weakened arteries and capillaries and cause immediate death, designated then as a stroke of apoplexy. SyTnptoms. — Congestion of the brain is usually sudden in its mani- festation and of short duration. The animal may stop very suddenly and shake his head or stand quietly braced on his legs, then stagger, make a plunge, and fall. The eyes are staring, breathing hurried and stertorous, and the nostrils widely dilated. This may be followed by coma, violent convulsive movements, and death. Generally, however, the animal gains relief in a short time, but he may remain weak and giddy for several days. If it is due to organic change of the heart or to disease of the blood vessels in the brain, then the symptoms may be of slow development manifested by drowsiness, dimness or im- perfect vision, difficulty in voluntary movements, diminished sensi- bility of the skin, loss of consciousness, delirium, and death. In milder cases effusion may take place in the arachnoid spaces and ventricles of the brain, followed by paralysis and other complications. Pathology. — In congestion of the brain the cerebral vessels are loaded with blood, and the venous sinuses distended to an extreme degree, and the pressure exerted upon the brain constitutes actual compression, giving rise to the symptoms just mentioned. On post- mortem examinations this engorgement is found universal through- out the brain and its membranes, which serves to distinguish it from inflammations of these structures, in which the engorgements are confined more or less to circumscribed portions. A prolonged con- gestion may, however, lead to active inflammation, and in that case we will find serous and plastic exudations in the cavities of the brain. In addition to the intensely engorged condition of the vessels we find the gray matter of the brain redder in color than natural. In cases where several attacks have occurred the blood vessels are often found permanently dilated. Treatment. — Prompt removal of all mechanical obstructions to the circulation. If it is due to venous obstruction by too tight a collar, SUNSTROKE. 199 tlie loosening of the collar will give innnecliate relief. The horse should be bled freely from the jugular vein. If due to tumors or abscesses, a surgical operation becomes necessary to afford relief. To revive the aninuil if he becomes partially or totally unconscious, cold water should be dashed on the head. Give a purge of Glauber's salts. If the limbs are cold, tincture of capsicum or strong mustard water should be applied to them. If symptoms of paralysis remain after two or three days, an active cathartic and iodide of potassa will be indicated, to be given as prescribed for inflammation of the brain. Prerent'ion. — AVell-adjusted collar, with strap running from the collar to the girth, to hold down the collar when pulling upgrade; regular feed and exercise, Avithout allowing the animal to become ex- cessively plethoric; moderate checking, allowing a free-and-easy movement of the head; well-ventilated stabling, proper cleanliness, pure water, etc. SUNSTROKE. HEAT STROKE. OR HEAT EXHAUSTION. The term sunstroke is applied to affections occasioned not exclu- sively l)y exposure to the sun's rays, as the word signifies, but by the action of great heat combined generally with humid atmosphere. Exhaustion produced by a long-continued heat is often the essential factor, and is called heat exhaustion. Horses on the race track un- dergoing protracted and severe w^ork in hot weather often succumb to heat exhaustion. Draft horses exposed to the direct rays of the sun for many hours, which do not receive projjer care in w^atering, feeding, and rest in shady places, suffer very frequently from sun- stroke. Sym ptomf<. — Sunstroke is manifested suddenly. The animal stops, drops his head, begins to stagger, and soon falls to the ground uncon- scious. The breathing is marked with great stertor, the pulse is very slow and irregular, cold sweats break out in patches on the surface of the bodv, and the animal often dies without recoverinxr consciousness. The temperature becomes very high, reaching 105° to 109° F. In heat exhaustion tht^ animal usually requires urging for some time previous to the appearance of any other symptoms, generally perspiration is checked, and then he becomes Aveak in his gait, the breathing hurried or ]:)anting, eyes watery or bloodshot, nostrils dilated aiul highly reddened, assuming a dark, j)urple color; the pulse is rapid and weak, the heart bounding, followed by unconsciousness and death. If recovery takes place, convalescence extends over a long period of time, during which incoordination of movement may persist. Pnthology. — Sunstroke, virtually active congestion of the brain, often accompanied by effusion and blood extravasation, characterizes this condition, with often raj^id and fatal lowering of all the vital 200 DISEASES OF THE HORSE, functions. The death ma}' be due in many instances to the complete stagnation in the circidation of the brain, inducing anemia, or want of nourishment -of that organ. In other cases it may be directly due to the excessive compression of the nerve matter controlling the heart's action, and cause paralysis of that organ. There are also changes in the composition of the blood. Treatment. — Under no circumstances is bloodletting permissible in sunstroke. Ice or very cold water should be applied to the head and along the spine, and half an ounce of carbonate of ammonia or 6 ounces of whisky should be given in 1 pint of water. Cold water should be showered upon the body of the horse from the hose or otherwise. This should be continued until the temperature is dow^n to 103° F. Brisk friction of the limbs and the application of spirits of camphor often yield good results. The administration of the stim- ulants should be repeated in one hour if the pulse has not become stronger and slower. In either case, when reaction has occurred, preparations of iron and general tonics may be given during conva- lescence: Snljohate of iron, 1 dram; gentian, 3 drams; red cinchona bark, 2 drams; mix and give in the feed morning and evening. Pretention. — In very hot weather horses should have wet sponges or light sunshades on the head when at work, or the head may be sponged with cold water as many times a day as possible. Proper attention should be given to feeding and watering, never in excess. During the warm months all stables should be cool and well ven- tilated, and if an animal is debilitated from exhaustive Avork or disease he should receive such treatment as will tend to build up the system. Horses should be permitted to drink as much water as they want while they are at Avork during hot weather. An animal which has been affected with sunstroke is very liable to have subsequent attacks when exposed to the necessary exciting causes. APOPLEXY, OR CEREBRAL HEMORRHAGE. Apoplexy is often confounded with cerebral congestion, but true apoplexy always consists in rupture of cerebral blood vessels, with blood extravasation and formation of blood clot. Causes. — Two causes are involved in the production of apoplexy, the predisposing and the exciting. The ^predisposing cause is degen- eration, or disease which weakens the blood vessel; the exciting cause is anv one which tends to induce cerebral congestion. Symptoms. — Apoplexy is characterized by a sudden loss of sensa- tion and motion, profound coma, and stertorous and difficult breath- ing. The action of the heart is little disturbed at first, but soon be- comes sloAver, then qincker and feebler, and after a little time ceases. If the rupture is one of a small artery and the extravasation limited, DISEASES OF THE BRAIN. 201 sudden paralj'sis of some part of the body is the result. The extent and location of the paralysis depend upon the location -within the brain which is functionally deranged by the pressure of the extrava- sated blood; hence these conditions are very variable. In the absence of any premonitory symptoms or an increase of tem- perature in the early stage of the attack, Ave may be reasonably certain in making the distinction between this disease and congestion of the brain, or sunstroke. Pathology. — In apoplexy there is generally found an atheromatous condition of the cerebral vessels, with weakening and degeneration of their walls. AMien a large artery has been ruptured it is usually fol- lowed by immediate death, and large rents may be found in the cere- brum, with great destruction of brain tissue, induced by the forcible pressure of the liberated blood. In small extravasations producing local paralysis without marked general disturbance, the animal may recover after a time: in such cases gradual absorption of the clot takes place. In large clots atrophy of the brain substances ma}' follow, or softeniner and abscess from want of nutrition mav result, and render the animal worthless, ultimately resulting in death. Treatment. — Place the animal in a quiet, cool place and avoid all stimulating food. Administer, in his drinking water or feed, 2 drams of the iodide of potassa twice a day for several weeks if necessary. Medical interference with sedatives or stimulants is more apt to be harmful than of benefit, and bloodletting in an apoplectic fit is extremely hazardous. From the fact that cerebral apoplexy is due to diseased or weakened blood vessels, the animal remains subject to subsequent attacks. COIMPRESSTOX OF THE BRAIX. Causes. — In injuries from direct violence a piece of broken bone may press upon the brain, and, according to its size, the brain is robbed of its normal space within the cranium. It may also be due to an extravasation of blood or to exudation in the subdural or arach- noid spaces. Death from active cerebral congestion results through compression. The occurrence may sometimes be traced to the direct cause, which will give assurance for the correct diagnosis. Symptotns. — Impairment of all the special senses and localized paralysis. All the symptoms of lessened functional activity of the brain are manifested to some degree. The paralysis remains to be our miide for the location of the cause, for it will be found that the paralysis occurs on the opposite side of the body from the location of the injury, and the parts suffering paralysis will denote, to an expert veterinarian or physician, the part of the brain which is suffering compression. Treatment. — Trephining, by a skillful operator, for the removal of 202 DISEASES OF THE HORSE. the cause when due to depressed bone or the presence of foreign bodies. When the symptoms of compression follow other acute diseases of the brain, apoplectic fits, etc., the treatment must be such as the exigencies of the case demands. CONCUSSION OF THE BRAIN. Causes. — This is generally caused by an animal falling over back- ward and striking his poll, or perhaps falling forward on his nose; by a blow on the head, etc. Train accidents during shipping often cause concussion of the brain. Symptoms. — Concussion of the brain is characterized by giddiness, stupor, insensibility, or loss of muscular power, succeeding imme- diately upon a blow or severe injury involving the cranium. The animal may rally quickly or not for hours ; death may occur on the spot or after a few days. When there is only slight concussion or stunning, the animal soon recovers from the shock. When more severe, insensibility may be complete and continue for a considerable time; the animal lies as if in a deep sleep; the pupils are insensible to light ; the pulse fluttering or feeble ; the surface of the body cold, muscles relaxed, and the breathing scarcely perceptible. After a variable interval partial recovery may take place, which is marked by paralysis of some parts of the body, often of a limb, the lips, ear, etc. Convalescence is usually tedious, and frequently permanent im- l^airment of some organs remains. Pathology. — Concussion produces laceration of the brain, or at least a jarring of the nervous elements, which, if not sufficiently severe to produce sudden death, may lead to softening or inflammation, with their respective symptoms of functional derangement. Treatment. — The first object in treatment will be to establish reac- tion or to arouse the feeble and weakening heart. This can often be accomplished by dashing cold water on the head and body of the ani- mal ; frequent injections of weak ammonia water, ginger tea, or oil and turpentine should be given per rectum. In the majority of cases this will soon bring the horse to a state of consciousness. In more severe cases mustard poultices should be applied along the spine and above the fetlocks. As soon as the animal gains partial consciousness stimulants, in the form of whisky or capsicum tea, should be given. Owing to severity of the structural injury to the brain or the pos- sible rupture of blood vessels and blood extravasation, the reaction may often be followed by encephalitis or cerebritis, and will then have to be treated accordingly. For this reason the stimulants should not be administered too freely, and they must be abandoned as soon as reaction is established. There is no need for further treatment unless complications develop as a secondary result. Bleed- ing, wiiich is so often practiced, proves almost invariably fatal in DISEASES OF THE BRAIN. 203 this form of brain affection. We should also remember that it is never safe to drench a horse with lar animal suddenly staggers: the muscles become (•ranii)ed; the jaws nuiy be spasmodically opened and closed, and the tongue be- 208 DISEASES OF THE HOESE. come lacerated between the teeth; he foains at the mouth and falls down in a siDasm. The nrine flows away involuntarily, and the In-eathing may be temporarily arrested. The paroxysm soon passes off, and the animal gets on his feet in a few minutes after the return of consciousness. Treatment. — Dashing cold water on the head during the paroxysm. After the recovery, 1 dram of oxide of zinc may be given in his feed twice a day for several weeks, or benefit may be derived from the tonic prescribed for chorea. PARALYSIS, OR PALSY. Paralysis is a weakness or cessation of the muscular contraction, by diminution of loss of the conducting poAver or stimulation of the motor nerves. Paralytic affections are of two kinds, the complete and the incomplete. The former includes those in which both motion and sensibility are affected ; the latter those in which only one or the other is lost or diminished. Paralysis may be general or partial. The latter is divided into hemiplegia and paraplegia. W[\e\\ only a small portion of the body is affected, as the face, a limb, the tail, it is desig- nated by the term local paralysis. A^Tien the irritation extends from the periphery of the center it is termed reflex paralysis. Causes. — They are very varied. Most of the acute affections of the brain and spinal cord may lead to paralysis. Injuries, tumors, disease of the blood vessels of the brain, etc., all have a tendency to produce suspension of the conducting motive power to the muscular structure's. Pressure upon, or the severing of, a nerve causes a paralysis of the parts to which such a nerve is distributed. Apoplexy may be termed a general paralysis, and in nonfatal attacks is a frequent cause of the various forms of palsy. General paralysis. — This can not take place Avithout producing immediate death. The term is, hoAvever, usually applied to paralysis of the four extremities, Avhether any other portions of the body are involved or not. This form of palsy is due to compression of the brain by congestion of its vessels, large clot formation in apoplexy, concussion, or shock, or any disease in Avhich the Avhole brain structure is involved in functional disturbance. Hemiplegia., or paralysis of one side., or half., of the body. — Hemi- plegia is frequently the result of a tumor in the lateral A'entricles of the brain, softening of one hemisphere of the cerebrum, pressure from' extravasated blood, fracture of the cranium, or it may be due to poi- sons in the blood or to reflex origin. When hemiplegia is due to or the result of a prior disease of the brain, especially of an inflamma- tory character, it is seldom complete; it may affect only one limb and one side of the head, neck, or muscles along the back, and may pass off in a fcAV days after the disappearance of all the other evidences of the PARALYSIS. 209 ]:)riinary affection. Tn the majority of cases, however, hemiplegia arises from emboli obstructing one or more blood vessels of the brain, or the rupture of some vessel the wall of which had become weakened by degeneration and the extravasation of blood. Sensibility in most cases is not impaired, but in some there is a loss of sensibility as well as of motion. In some cases the bladder and rectum are involved in the paralysis. .Symptoms. — In hemiplegia the attack may be very sudden, and the animal fall down powerless to move one side of the body, one side of the lips will be relaxed; the tongue may hang out on one side of the mouth; the tail curved around sideways; an inability to swallow food or water nuiy be present, and often the urine dribbles away as fast as it collects in the bladder. Sensibility of the affected side may be entirely lost or only partial; the limbs may be cold and sometimes unnaturally warm. In cases wherein the attack is not so severe the animal may be able to maintain the standing position, but will have great difficulty in moving the affected side. In such cases the animal may recover from the disability. In the more severe, where there is complete loss of power of movement, recoveries are rare. Paraplegia, or transverse paralysis of the hind extremities. — Pa- ralysis of the hind extremities is usually due to some injury or inflam- mation affecting the spinal cord. (See '' Spinal meningitis,'' p. 211, and ''Myelitis, p. 213.) It may also be due to a reflex irrigation from disease of peripheral nerves, to spinal irritation or congestion caused by blood poisons, etc. Symptoms. — When due to mechanical injury of the spinal cord, from a broken back or spinal hemorrhage, it is generally progressive in its character, although it may be sudden. When it is caused by agents in the blood, it mav be intermittent or recurrent. Paraplegia is not difficult to recognize, for it is characterized by a weakness and imperfect control of the hind legs and powerless tail. The urine usually dribbles away as it is formed and the manure is pushed out, ball by ball, without any voluntary effort, or the passages may cease entirely. When paraplegia is complete, large and ill- conditioned sores soon form on the hips and thighs from chafing and bruising, which have a tendency to quickly Aveaken the animal and necessitate his destruction. Locomotor ataxia., or incoordination of movement. — This is charac- terized by an inability to control ])roperly the movement of the limbs. The animal appears usually perfectly healthy, but Avhen he is led out of his stall his legs have a wobbly movement, and he will stumble or stagger, especially in turning. When this is confined to the hind parts it may be termed a modified form of paraplegia, but often it may be seen to affect nearly all the voluntary nniscles when they are H. Doc. 795, 51V2 14 210 DISEASES OF THE HORSE. called into play, and must be attributed to some pressure exerted on the base of the brain. Local paralysis. — This is frequently met with in horses. It may- affect many parts of the body, even vital organs, and it is very frequently overlooked in diagnosis. Facial paralysis. — This is a frequent type of local paralysis, and is due to impairment of function of the motor nerve of the facial muscles, the portio dura. The cause may exist at the base of the brain, compression along its course after it leaves the medulla oblon- gata, or to a bruise after it spreads out on the great masseter muscle. Symptoms. — A flaccid condition of the cheek muscles, pendulous lips, inability to grasp the food, often a slow and weak movement in chewing, and difficulty and slowness in drinking. Laryngismus paralyticus., or roaring. — This condition is character- ized by roaring, and is usually caused by an inflamed or hypertro- phied bronchial gland pressing against the left recurrent laryngeal nerve, which interferes with its conducting power. A similar con- dition is occasionally induced in acute pleurisy, where the recurrent nerve becomes involved in the diseased process or compressed by plastic exudation. Paralysis of the rectum and tail. — This is generally the result of a blow or fall on the rump, which causes a fracture of the sacrum bone and injury to the nerves supplying the tail and part of the rectum and muscles belonging thereto. This facture would not be suspected were it not for the loss of motion of the tail. Intestinal paralysis. — Characterized by persistent constipation; frequently the strongest purgatives have no effect whatever on the movement of the bowels. In the absence of symptoms of indigestion, or special diseases implicating the intestinal canal, torpor of the bowels must be attributed to deficient innervation. This condition may depend upon brain affections or be due to reflex j^aralysis. Sud- den checks of perspiration may induce excessive action of the bowels or paralysis. Paralysis of the hladder. — This usually affects the neck of the blad- der, and is characterized by incontinence of urine; the urine dribbles away as fast as it is secreted. The cause may be of reflex origin, disease of the rectum, tumors growing within the pelvic cavity, injury to the spinal cord, etc. Paralysis of the optic nerve, or amaurosis. — A paralysis of eyesight may occur very suddenly from rupture of a blood vessel in the brain, acute local congestion of the brain, the administration of excessive doses of belladonna or its alkaloid atropia, etc. In amaurosis the pupil is dilated to its full extent, the eye looks clear, but does not respond to light. SPINAL MENINGITIS. 211 Paralysis of hearing, of the external ear, of the eyelid, partial paralysis of the heart and organs of respiration, of the blood vessels from injury, to the vaso-motor nerves of the esophagus, or loss of deglutition, palsy of the stomach, all may be manifested when the supply of nervous influence is impaired or suspended. Treatment for jmralyds. — In all paralytic affections there may be anesthesia^ or impairment of sensibility, in addition to the loss of motion, or there may be hyperesthesia^ or increased sensibility, in connection with the loss of motion. These conditions may call for special treatment in addition to that for loss of motion. Where hyperesthesia is well marked local anodynes may be needed to relieve suffering. Chloroform liniment or hypodermic injections of from 3 to 5 grains of sulphate of morphia will allay local pain. If there is marked anesthesia, or loss of sensibility, it may become necessary to secure the animal in such a way that he can not suffer serious injury from accidents which he can not avoid or feel. In the treat- ment of any form of paralysis we must always refer to the cause, and attempt its removal if it can be discovered. In cases where the cause can not be determined we have to rely solely upon a general external and internal treatment. Externally, fly blisters or strong irritant liniments may be applied to the paralyzed parts. In hemi- plegia they should be applied along the bony part of the side of the neck ; in paraplegia, across the loins. In some cases hot-water cloths will be beneficial. Internally, it is well to administer 1 dram of powdered nux vomica or 2 grains of sulphate of strychnia twice a day until twitching of some of the voluntary muscles occurs; then discontinue it for several days, and then commence again with a smaller dose, gradually increasing it until twitching recurs. Iodide of potash in 1 to 2 dram doses two or three times daily may be em- ployed with the hope that it will favor the absorption of the clot or obstruction to the nervous current. In some cases Fowler's solution of arsenic in teaspoonful doses twice a day in the drinking water proves beneficial. Occasionally benefit may be derived from the application of the electric current, especially in cases of roaring, facial paralysis, paralysis of the eyelid, etc. Nutritious but not too bulky food, good ventilation, clean stabling, moderate exercise if the animal is capable of taking it, good grooming, etc., should be observed in all cases. SPINAL MENINGITIS, OR INFLAMMATION OF THE MEMBRANES ENVELOPING THE SPINAL GORD. Canses. — This may be induced by the irritant properties of blood poisons, exhaustion and exposure, spinal concussion, all forms of injury to the spme, tumors, caries of the vertebra^, rheumatism, etc. Symptoms. — A chill may be the precursor, a rise in temperature, or 212 DISEASES OF THE HORSE. a general Aveakness and shifting of the legs. Soon a painful, convul- sive twitching of the muscles sets in, followed by muscular rigidity along the spine, in Avhich condition the animal will move very stiffly and evince great pain in turning. Evidences of paralysis or para- plegia develop, retention or incontinence of urine, and oftentimes sexual excitement is present. The presence, of marked fever at the beginning of the attack, associated with spinal symptoms, should lead us to suspect spinal meningitis or myelitis. These two conditions usually appear together, or myelitis follows inflammation of the meninges so closely that it is almost impossible to separate the two; practically it does not matter much, for the treatment will be about the same in both cases. Spinal meningitis generally becomes chronic, and is then marked principally by paralysis of that portion, or parts of it, posterior to the seat of the disease. Pathology. — In spinal meningitis we will find essentially the same condition as in cerebral meningitis ; there Avill be an effusion of serum between the membranes, and often a plastic exudation firmly adherent to the pia -rnatev serves to maintain a state of paralysis for a long time after the acute symptoms have disappeared by compressing the cord. Finally, atrophy, softening, and even abscess may develop within the cord. Unlike in man, it is usually found localized in horses. Treatment. — Bags filled with ice should be applied along the spine, to be followed later on by strong blisters. The fever should be con- trolled as early as possible by giving 20 drops of Norwood's tincture of veratrum viride every hour until the desired result is obtained. One dram of the fluid extract of belladonna, to control pain and vas- cular excitement of the spinal cord, may be given every five or six hours until the pupils of the eyes become pretty w^ell dilated. If the pain is very intense 5 grains of sulphate of morphia should be injected hypodermically. The animal nnist be kept as free from excitement as possible. If the urine is retained in the bladder it must be drawn off every four or six hours. In very acute attacks the disease gener- ally proves fatal in a few days. If, however, the animal grows better some form of paralysis is apt to remain for a long time, and the treatment will have to be directed then toward a removal of the exuda- tive products and a strengthening of the system and stimulation of the nervous functions. To induce absorption, iodide of potassa in 2-dram doses may be given, dissolved in the drinking water, twice a day. To strengthen the system, iodide of iron 1 dram twice a day and 1 dram of nux vomica once a day may be given in the feed. Electricity to the paralyzed and weakened muscles is advisable; the current should be weak, but be continued for half an hour two or three times daily. If the disease is due to a broken back, caries of the vertebrae, or some other irremediable cause, the animal should be destroyed at once. DISEASES OFv THE SPINAL CORD. 213 MYELITIS. OR INFLAMMATION OF THE SUBSTANCE OF THE SPINAL CORD. This is a rare disease, except as a secondary result of spinal menin- o-itis or injuries to the spine. Poisoning by lead, arsenic, mercury, phosphorus, carbonic-acid gas, etc., has been known to produce it. Myelitis mav be confined to a small spot in the cord or may involye the ^yhole for a yariable distance. It may lead to softening, abscess, or degeneration. Symptoms. — The attack may begin with a chill or convulsions; the muscles twitch or become cramped yery early in the disease, and the bladder usually is affected at the outset, in which there may be either ivtention or incontinence of urine. These conditions are followed by complete or partial paralysis of the muscles posterior to the locality of the inflamed cord, and the muscles begin to waste away rapidly. The paralyzed limb becomes cold and dry, due to the suspension of proper circulation; the joints may swell and become edematous; vesicular eruptions appear on the skin; and frequently gangrenous sloughs form on the paralyzed parts. It is exceedingly seldom that recovery takes i^lace. In a few instances it may assume a chronic type, when all the symptoms become mitigated, and thus continue for some time, until septicemia, pyemia, or exhaustion causes death. Pathology. — The infiammation may involve nearly the wdiole length of the cord, but generally it is more intense in some places than others ; when due to mechanical injury, the inflammation may remain con- fined to a small section. The cord is swollen and congested, reddened, often softened and infiltrated with pus cells, and the nerve elements are degenerated. Treatment, — Similar to that of spinal meningitis. SPINAL CONGESTION. This condition consists in an excess of blood. As the blood vessels of the pia mater are the principal source of supply to the spinal cord, peremia of the cord and of the meninges usuall}^ go together. The symptoms are, therefore, closely allied to those of spinal meningitis and congestion. AVhen the pia mater is diseased, the spinal cord is almost invariably affected also. Cause. — vSudden checking of the perspiration, \-iolent exercise, blows, and falls. Symptoms. — The symptoms may vary somewhat with each case, and closely resemble the first symptoms of spinal meningitis, spinal tumors, and myelitis. First, some disturbance in movement, lower- ing of the temperature, and partial loss of sensibility posterior to the seat of the congestion. If in the cervical region, it may cause inter- ference in breathing and the action of the heart. "When in the region of the loins, there may be loss of control of the bladder. When the 214 DISEASES OF THE HORSE. congestion is snfficient to produce comj^ression of the cord, paraplegia may be complete. Usually fever, spasms, muscular twitching, or muscular rigidity are absent, which will serve to distinguish spinal congestion from spinal meningitis. Treatment. — Hot-water applications to the spine, 1-dram doses fluid extract of belladonna repeated everj^ four hours, and tincture of aconite root 20 drops every hour until the symptoms become amel- iorated. If no inflammatory products occur, the animal is likely to recover. SPINAL ANEMIA. This may be caused b}^ extreme cold, exhausting diseases, spinal embolism or plugging of a spinal blood vessel, an interference with the circulation through the abdominal aorta, from compression, thrombosis, or aneurism of that vessel ; the spinal vessels may be caused to contract through vaso-motor influence, a result of periph- eral irritation of some nerve. Syni'ptoms. — Spinal anemia causes paralysis of the muscles used in extending the limbs. AVhen the bladder is affected, it precedes the weakness of motion, while in spinal congestion it follows, and in- creased sensibility, in place of diminished sensibility, as in spinal con- gestion, is observed. Pressure along the spine causes excessive pain. Treatment. — If the exciting cause can be removed, the animal re- covers ; if this fails, the spinal cord may undergo softening. SPINAL COMPRESSION. A\lien caused by tumors or otherwise, when pressure is slight, it produces a paralysis of the muscles used in extending a limb and con- traction of those which flex it. Wlien compression is great it causes complete loss of sensibility and motion posterior to the compressed part of the cord. Compression of a lateral half of the cord produces motor paralysis, disturbance of the circulation, and difficulty of movement, an in- creased sensibility on the side corresponding to the compressed sec- tion, and a diminished sensibility and some paralysis on the opposite side. Treatment. — When it occurs as a sequence of a preceding inflam- matory disease, iodide of potassa and general tonics are indicated. When due to tumors growing within the spinal canal, or to pressure from displaced bone, no form of treatment will result in any benefit. SPINAL HEMORRHAGE. This may occur from changes in the wall of the blood vessels, in connection with tumors, acute myelitis, traumatic injuries, etc. The blood may escape through the pia mater into the subarachnoid cavity, and large clots be formed. DISEASES OF THE SPINAL CORD. 215 Symptoms. — The syinptoms are largely dependent upon the seat and extent of the hemorrhage, as they are principally due to the com- pression of the cord. A large clot may produce sudden paraplegia, accompanied by severe pain along the spine; usually, however, the paralysis of both motion and sensation is not very marked at first; on the second or third day fever is apt to appear, and increased or diminished sensibility along the spine posterior to the seat of the clot. When the bladder and rectum are involved in the symptoms it indi- cates that the spinal cord is c(mi])ressed. Treatment. — In the occurrence of injuries to the back of a horse, whenever there is any evidence of paralysis, it is always advisable to apply bags of ice along the spine to check or prevent hemorrhage or congestion, and 2 drams of the fluid extract of ergot and 20 drops of tincture of digitalis may be given every hour until three doses have been taken. Subsequently tincture of belladonna in half-ounce doses may be given three times a day. If there is much pain, 5 grains of sulphate of morphia, injected under the skin, will afford relief and lessen the excitability of the animal. In all cases the animal should be kept perfectly quiet. SPINAL CONCUSSION. This is rarely observed in the horse, and unless it is sufficiently severe to produce well-marked symptoms it would not be suspected. It may occur in saddle horses from jumping, or it may be produced by falling over an embankment, or a violent fall upon the haunches may produce it. Concussion may be follow^ed by partial paralysis or spinal hemorrhage: generally, however, it is confined to a jarring and some disturbance of the nerve elements of the cord, and the paralytic effect which ensues soon passes off. Treatment consists in rest until the animal has completely recovered from the shock. If secondary effects follow from hemorrhage or compression, they have to be treated as heretofore directed. SPINAL TUMORS. Within the substance of the cord glioma or the mixed gliosarco- mata are found to be the most frequent, tumors may form from the meninges and the vertebra^, being of a fil)rous or l)ony nature, .".nd affect the spinal cord indirectly by compression. In tiie meninges we may find glioma, cancers, and psammoma, fibromata; and aneurisms of the spinal arteries have been discovered in the spinal canal. Symptoms. — Tumors of the spinal canal cause symptoms of spinal irritation or compression of the cord. The gradual and slow develop- ment of symptoms of paralysis of one or both hind limbs or certain muscles may lead to a suspicion of spinal tumoi's. The jiaralysis induced is progressive, but not usually nuirked with atrophy of the 216 DISEASES OF THE HORSE. jimscles or increased sensibility along the spine. When the tumor is within the spinal cord itself all the symptoms of myelitis may be present. Treatment. — General tonics and 1-dram doses of mix vomica may be given; iodide of iron or iodide of potassa in 1-dram doses, three times a day in feed, may, in a very few cases, give some temporary benefit. Usually the disease progresses steadily until it proves fatal. NEURITIS, OR INFLAMMATION OF A NERVE. This is caused by a bruise or wound of a nerve or by strangulation in a ligature when the nerve is included in the ligation of an artery. The changes in an inflamed nerve are an enlargement, reddening of the nerve sheath, spots of extr^vasated blood, and sometimes an infil- tration of serum mixed with pus. Symptoms. — Acute pain of the parts supplied by the nerve and ^fcbsence of swelling or increased heat of the part. Treatment. — Hypodermic injections of from 3 to 5 grains of mor- phia to relieve pain, hot fomentations, and rest. If it is due to an inclusion of a ligature, the nerve should be divided above and below the ligature. NEUROMA, OR TUMOR OF A NERVE. Neuroma may be from enlargement of the end of a divided nerve or due to fibrous degeneration of a nerve which has been bruised or wounded. Its most fi'equent occurrence is found after the operation of neurotomy for foot lameness, and it may appear after the lapse of months or even years. Neuroma usually develops within the sheath of the nerve wdth or without implicating the nerve fibers. It is oval, running lengthwise with the direction of the nerve. Symptoms. — Pain of the affected limb or part is manifested, more especially after resting a Avhile, and when pressure is made upon the tumor it causes extreme suffering. Treatment. — Excision of the tumor, including part of the nerve above and below, and then treat it like any other simple wound. INJURIES TO NERVES. These may consist in wounding, bruising, laceration, stretching, compression, etc. The symptoms which are produced will depend upon the extent, seat, and character of the injurv. Recovery may quickly take place, or it may lead to neuritis, neuroma, or spinal or cerebral irritation, which may result in tetanus, paralysis, and other serious derangements. In all diseases, Avhether produced by some form of external violence or intrinsic causes, the ner^^es are necessa- rily involved, and sometimes it is to a primary injury of them that the principal fault in movement or change of nutrition of a part is due. FORAGE POISONING. 217 It is often difficult or imi)ossible to discover that an injury to a nerve has been inflicted, but whenever this is possible it may enable us to remedy that which otherwise would result in permanent evil. Treat- ment should consist in relieving compression, in hot fomentations, the application of anodyne liniments, excision of the injured part, and rest. FORAGE POISONING, OR SO-CALLED CEREBRO-SPINAL MENINGITIS. This disease prevails among horses in nearly all parts of the United States. It is most connnon in Maryland, Delaware, Virginia, North Carolina, New Jersey, l^ennsylvania. New York, Kansas, Missouri, Illinois, Indiana, and Ohio. Certain localities are visited by it almost every year. This condition consists in a poisoning and de- pression of the nervous system from eating or drinking food or water containing poison generated by mold or bacteria. It has been shown to be due to eating damaged ensilage, corn, brewers' grains, oats, etc., or to drinking stagnant pond water or Avater from a w^ell contami- nated by surface drainage. Horses at pasture may contract this dis- ease when the growth of grass is so profuse that it mats together and the lower part dies and ferments or becomes moldy. In England a similar disease has been called "' grass staggers," due to eating rye grass when it is ripening or when it is cut and eaten while it is heating and undergoing fermentation. In eastern Penn- sylvania it was formerly known by the name of " putrid sore throat " and " choking distemper."' A disease similar in many respects, which is very prevalent in Virginia, especially along the eastern border, is commonly known by the name of '* blind staggers," and in manj^ of the Southern States this has been attributed to the consumption of worm-eaten corn. Horses of all ages and mules are subject to this disease. Symptoms. — The symptoms which typify sporadic, or epidemic, cerebro-spinal meningitis in man are not witnessed among horses, namely, excessive pain, high fever, and early muscular rigidity. In the recognition of the severity of the attack we may divide the symp- toms into three grades. In the most rapidly fatal attacks the animal may first indicate it by weak, staggering gait, partial or total inabil- ity to swallow solids or liquids, impairment of eyesight ; twitching of the muscles, and slight cramps may be observed. As a rule, the tem- perature is not elevated — indeed, it is sometimes below normal. This is soon followed by a paralysis of the whole body, inability to stand, delirium in which the animal sometimes goes through a series of auto- matic movements as if trotting or running; the delirium may become very violent and the animal in his unconsciousness may bruise his head in his struggles very seriously, but usually a deep coma renders him quiet until he expires. Death in these cases usually takes ])lace in 218 DISEASES OF THE HORSE. from four to twenty-four hours from the time the first symptoms be- come manifest. The pulse is variable during the progress of the dis- ease; it may be almost imperceptible at times, and then again very rapid and irregular; the respirations generally are quick and catch- ing. In the next form in which this disease may develop it first be- comes manifest by a difficulty in swallowing and slowness in mastica- tion, and a weakness which may be first noticed in the strength of the tail ; the animal will be unable to switch it or to offer resistance when we bend it up over the croup. The pulse is often a little slower than normal. There is no evidence of pain ; the respirations are unchanged, and the temperature little less than normal ; the bowels may be sonie- Avhat constipated. These symptoms may remain unchanged for two or three days and then gradual improvement take place, or the power to swallow may become entirely lost and the weakness and uncertainty in gait more and more perceptible ; then sleepiness or coma may ap- pear; the pulse becomes depressed, slow, and weak, the breathing stertorous, and paroxysms of delirium develop, with inability to stand, and some rigidity of the spinal muscles or partial cramp of the neck and jaws. In such cases death may occur in from six to ten days from the commencement of the attack. In many cases there is no evidence of pain, spasm, or fever at any time during the progress of the disease, and finally profound coma develops and death fol- lows, painless and without a struggle. In the last or mildest form the inability of voluntary control of the limbs becomes but slightly marked, the power of swallowing never entirely lost, and the animal has no fever, pain, or unconscious move- ments. Generally the animal will begin to improve about the fourth day and recovers. In a few cases the spinal symptoms, manifested by paraplegia, may be the most prominent symptoms ; in others they may be altogether absent and the main symptoms be difficulty in mastication and swal- lowing ; rarely it may affect one limb only. In all cases where coma remains absent for six or seven days the animal is likely to recover. ^\Tien changes toward recovery take place, the symptoms usually leave in the reverse order in which they developed, but local paralysis may remain for some time, rarely persistent. One attack does not give immunity, for it may recur at some later time and prove fatal. Horses have been known to pass through three attacks, being affected for a week or longer each time. Treatment. — In the worst class of cases treatment is very seldom successful, and it is dangerous to attempt the administration of medi- cine by the mouth, on account of the inability of the animal to swal- low. If the condition of the animal will admit of a drench, give 4 to G ounces of whisky in 2 pints of milk; the inhalation of ammonia TETANUS, OR LOCKJAW. 219 vapor from a sponge saturated with dilute acjua annnonia may arouse consciousness. In the second class of cases a purge should always be given, and the further treatment recommended is to give strychnia in 2-grain doses twice or three times daily. If there is twitching of the shoulder muscles or gnashing of the teeth, this shouhl be discontinued. The strength of tlie heart should be kept up with carbonate of ammonia or whisky. When the animal is unable to swallow, one-fourth-grain doses of sulphate of atropia may be injected under the skin every four, six, or eight hours, as the case may deuuind. The atropia is a heart stimulant, increases capillary circulation, and quiets pain and excitability. When the most prominent symptoms abate give such food as they may be able to eat, and keep fresh, cool water constantly before them, supporting them in slings if necessary; clean stabling and plenty of fresh air are of the utmost importance. Pathology. — Post-mortem examination reveals, in some cases, more or less congestion of the blood vessels at the base of the brain and effusion in the ventricles and in the subarachnoid space, both in the cranial and the spinal cavities. The brain and cord appear softened in some cases where the greatest evidence of inflammatory action existed. In other cases the post-mortem examination is entirely negative, no gross lesions being visible. Hygienic Tneasures needful. — Whenever this disease appears in a stable all the animals should be removed as soon as possible. They should be provided w^ith clean, well-ventilated, and well-drained stables, and each animal should receive a laxative and be fed food and given water from a new, clean source. The abandoned stable should be thoroughly cleansed from all waste matters, receive a coat of whitewash containing 4 ounces of carbolic acid to the gallon of water, and should have time to dry thoroughly before the horses are replaced. A complete change of food is of the very greatest im- portance, on account of the belief that the cause resides in diseased grain, hay, and grass. TETANUS, OR LOCKJAW. This disease is characterized by spasms affecting the muscles of the face, neck, body, and limbs, and of all the muscles supplied by the cerebro-spinal nerves. The spasms or muscular contractions are rigid and persistent, yet mixed with occasional more intense con- tractions of convulsive violence. Causes. — This disease is caused by a bacillus that is often found in the soil, in manure and in dust. This germ grows only in the ab- sence of oxygen. It produces a powerful nerve poison, which causes the symptoms of tetanus. The germ itself multiplies at the point 220 DISEASES OF THE HORSE. where it is introduced, but its poison is absorbed, and is carried by the blood to all parts of the body, and thus the nervous system is poisoned. Deep wounds infected by this germ are more dangerous than superficial wounds, because in them the germ is more remote from the oxygen of the air. Hence, nail pricks, etc., are especially dangerous. In the majority of instances the cause of tetanus can be traced to wounds, especially pricks and wounds of the feet or of tendinous structures. It sometimes follows castration, docking, the introduction of setons, inclusion of a nerve in a ligature, etc. It may come on a long time after the wound is healed — three or four months. In some countries where tetanus appears to be enzootic the presump- tion is that it is due to a specific germ. Horses with a nervous, ex- citable disposition are more predisposed than those of a more slug- gish nature. Stallions are more subject to develop tetanus as the result of wounds than geldings, and geldings more than mares. SymjytoTns. — The attacks may be acute or subacute. In an acute attack the animal usually dies within four days. The first symptoms which attract the attention of the owner is clifKcultv in chewing and swallowing, an extension of the head and protrusion over the inner part of the eye of the membrana nictitans, or haw. An examination of the mouth will reveal an inability to open the jaws to their full extent, and the endeavor to do so Avill produce great nervous excita- bility and increased spasm of the muscles of the jaw and neck. The muscles of the neck and along the spine become rigid and the legs are moved in a stiff manner. The slightest noise or disturbance throws the animal into increased spasm of all the affected muscles. The tail is usually elevated and held immovable; the bowels become consti- pated early in the attack. The temperature and pulse are not much changed. These symptoms in the acute type become rapidly aggra- vated until all the muscles are rigid — in a state of tonic spasm — with a continuous tremor running through them ; a cold perspiration breaks out on the body; the breathing becomes painful from the spasm of the muscles used in respiration; the jaws are completely set, eyeballs retracted, lips drawn tightly over the teeth, nostrils di- lated, and the animal presents a picture of the most extreme agony until death relieves him. The pulse, which at first was not much affected, will become quick and hard, or small and thready when the spasm affects the muscles of the heart. In the subacute cases the jaws may never become entirely locked; the nervous excitability and rigid- ity of the muscles are not so great. There is, however, always some stiffness of the neck or spine manifest in turning; the haw is turned over the eyeball when the nose is elevated. It is not uncommon for owners to continue such animals at their work for several days after the first symptoms have been observed. All the symptoms may grad- ually increase in severity for a period of ten days, and then gradually TETANUS, OR LOCKJAW. 221 diminish under judicious treatment, or they may reach the stage Avherein all the characteristics of acute tetanus become developed. In some cases, however, Ave find the nuiscular crami)s almost solely con- fined to the head or face, perhaps involving those of the neck. In such cases we have complete trismus (lockjaw), and all the head symptoms are acutely developed. On the contrary, w^e may find the head almost exempt in some cases, and have the body and limbs per- fectly rigid and incapable of movement without falling. Tetanus may possibly be confounded with spinal meningitis, but the character of the spasm-locked jaw, retraction of the eyeballs, the difficulty in swallowing due to spasms of the muscles of the pharynx, and above all, the absence of paralysis, should serve to make the distinction. Pi-ei^ntion. — AVhere a valuable horse has sustained a wound that it is feared may be followed by tetanus, it is well to administer a dose of tetanus antitoxin. This is injected beneath the skin with a hypoder- mic syringe. A very high degree of protection may in this way be afforded. Treatment. — The animal should be placed in a box stall w^ithout bedding, as far away as possible from other horses. If in a country district, the animal should be put into an outbuilding or shed, where the noise of other animals will not reach him; if the place is moder- ately dark it is all the better; in fly time he should be covered with a light sheet. The attendant must be very careful and quiet about him, to prevent all unnecessary excitement and increase of spasm. Teta- nus antitoxin appears to be useful as a remedy in some cases, if given in very large quantities early in the disease; otherwise it is useless. Subcutaneous injections of carbolic acid in glycerin and water (car- bolic acid 80 grains, glycerin and water each 1 ounce) appear to be useful in some cases. Injections shovild be given twice daily. A cathartic, composed of Barbados aloes 6 to 8 drams, witli which may be mixed 2 drams of the solid extract of belladonna, should be given at once. This is best given in a ball form ; if, however, the ani- mal is greatly excited by the attempt or can not swallow, the ball may be dissolved in 2 ounces of olive oil and thrown on the back of the tongue with a syringe. If the jaws are set, or nearly so, an attempt to administer medicine by the mouth should not be made. In such cases one-quarter of a grain of atropia, with 5 grains of sulphate of morphia, should be dissolved in 1 dram of pure w^ater and injected under the skin. This should be repeated sufficiently often to keep the animal continually under its effect. This will usually mitigate the severity of the spasmodic contraction of the affected muscles and lessen sensibility to pain. Good results may be obtained sometimes by the injection per rectum of the fluid extract of belladonna and of cannabis indica, of each 1 dram, every four or six hours. This may 222 DISEASES OF THE HORSE. be diluted with a quart of milk. When the animal is unable to swal- low liquids, oatmeal gruel and milk should be given by injection per rectum to sustain the strength of the animal. A pailful of cool water should be constantly before him, placed high enough for him to reach it without special effort ; even if he can not drink, the laving of the mouth is refreshing. Excellent success frequently may be obtained by clothing the upper part of the head, the neck, and greater part of the body in woolen blankets kept saturated with very warm water. This treatment should be continued for six or eight hours at a time. It often relaxes the cramped muscles and gives them rest and the ani- mal almost entire freedom from pain ; but it should be used every day until the acute spasms have permanently subsided in order to be of any lasting benefit. Recently subcutaneous injections of brain emulsion have been rec- ommended. It is thought that the tetanus toxin will attach itself to the brain cells so injected and thus free the system of this poison. ^Y[\en it is due to a wound, the wound should be thoroughly cleaned and disinfected with carbolic acid. If from a wound which has healed, an excision of the cicatrix may be beneficial. In all cases it is not uncommon to have a partial recovery followed by relapse when the animal becomes excited from any cause. RABIES, HYDROPHOBIA, OR MADNESS. This disease does not arise spontaneously among horses, but is the result of a bite from a rabid animal — generally a dog or cat. The development of the disease follows the bite in from three weeks to three months — very rarely in two weeks. (See also page 545.) Symptoms. — The first manifestation of the development of this dis- ease may be an increased excitability and viciousness; very slight noises or the approach of a person incites the animal to kick, strike, or bite at any object near him. Very often the horse will bite his own limbs or sides, lacerating the flesh and tearing the skin. The eyes appear staring, bloodshot; the ears are on the alert to catch all sounds; the head is held erect. In some cases the animal will con- tinually rub and bite the locality of the wound inflicted by the rabid animal. This symptom may precede all others. Generally the bowels become constipated and he makes frequent attempts at urina- tion, which is painful, and the urine very dark colored. The furious symptoms appear in paroxysms; at other times the animal may eat and drink, although swallowing appears to become painful toward the latter stage of the disease, and may cause renewed paroxysms. The muscles of the limbs or back may be subject to intermittent spasms, or spasmodic tremors; finally, the hind limbs become para- lyzed, breathing very difficult, and convulsions supervene, followed LEAD POISONING. 223 by death. The pulse and respirations are increased in frequency from the outset of the attack. Rabies may possibly be mistaken for tetanus. In the latter disease we find tonic spasms of the muscles of the jaws, or stiffness of the neck or back very early in the attack, and evidence of viciousness is absent. Treatment. — As soon as the true nature of the disease is ascertained the animal should be killed. Prevention. — \Alien a horse is known to have been bitten by a rabid animal, immediate cauterization of the wound with a red-hot iron may possibly destroy the virus before absorption of it takes place. PLUMBISM, OR LEAD POISONING. This disease is not of frequent occurrence. It may be due to habit- ually drinking water which has been standing in leaden conductors or in old paint barrels, etc. It has been met with in enzootic form near smelting works, where, by the fumes arising from such works, lead in the form of oxide, carbonate, or sulphate was deposited on the grass and herbage which the horses ate. Symptoms. — Lead poisoning produces derangement of the func- tions of digestion and locomotion, or it may affect the lungs princi- pall}'. In whatever system of organs the lead is deposited mostly there w'ill we have the symptoms of nervous debility most manifest. If in the lungs, the breathing becomes difficult and the animal gets out of breath very quickly when he is compelled to run. Roaring, also, is very frequently a symptom of lead poisoning. When it affects the stomach, the animal gradually falls away in flesh, the hair becomes rough, the skin tight, and colicky symptoms develop. When the deposit is principally in the muscles, partial or complete paralysis gradually develops. When large quantities of lead have been taken in and absorbed, symptoms resembling epilepsy may result, or coma and delirium develop and prove fatal. In lead poisoning there is seldom any increase in temperature. A blue line forms along the gums of the front teeth, and the breath assumes a peculiarly offensive odor. Lead can always be detected in the urine by chemical tests. Treatment. — The administration of 2-dram doses of iodide of potassa three times a day. This will form iodide of lead in the sys- tem, which is rapidly excreted by the kidneys. If much muscular weakness or paralysis is present, sulphate of iron in 1-dram doses and strichnia in 2-grain doses may be given twice a day. In all cases of suspected lead poisoning all utensils which have entered into the supply of feed or water should be examined for the presence of soluble lead. If it occurs near lead works, great care must be given to the supply of uncontaminated fodder, etc. 224 DISEASES OF THE HORSE. T^REMIA. Uremic poisoning may affect the brain in nephritis, acute albumi- nuria, or when, from any cause, the functions of the l<:idneys become impaired or suppressed and urea (a natural product) is no longer eliminated from these organs, causing it to accumulate in the system and give rise to uremic poisoning. Symptoms. — Uremic poisoning is usually preceded by dropsy of the limbs or abdomen; a peculiar fetid breath is often noticed; then drowsiness, attacks of diarrhea, and general debility ensue. Sud- denly extreme stupor or coma develops; the surface of the body becomes cold; the pupils are insensible to light; the pulse slow and intermitting; the breathing labored, and death supervenes. The temperature throughout the disease is seldom increased, unless the disease becomes complicated with acute inflammatory disease of the brain or respiratory organs, which often occur as a result of the urea in the circulation. Albumen and tube casts may frequently be found in the urine. The disease almost invariably proves fatal. Treatment. — This must be directed to a removal of the cause. ELECTRIC SHOCK. Electric shock, from coming in contact with electric wires, is becom- ing a matter of rather frequent occurrence, and has a similar effect upon the animal system as a shock from lightning. Two degrees of electric or lightning shock may be observed, one producing temporary contraction of muscles and insensibility, from which recovery is pos- sible, the other killing directly, by producing a condition of nervous and general insensibility. In shocks which are not immediately fatal the animal is usually insensible, the respiration slow, labored, or gasp- ing, the pulse slow, feeble, and irregular, and the pupils dilated and not sensitive, or they may be contracted and sensitive. The tempera- ture is lowered. There may be a tendency to convulsions or spasms. The predominating symptoms are extreme cardiac and respiratory depression. Treatm,ent. — Sulphate of atropia should be given hypodermically in one-quarter grain doses every hour or two hours until the heart beats are invigorated, the number and fullness of the respirations increased, and consciousness returns. Stimulating injections per rectum may also be useful in arousing the circulation; for this purpose whisky or ammonia water may be used. DISEASES OF THE HEART, BLOOD VESSELS, AND LYMPHATICS. By M. K. Triimbower, V. S. [Uevised in liKl.? by Leonard Pearson, U. S., V. M. D.] ANATOMY AND I'll VSK )L<)(;V OF THE IlEAUT AND BLOOD VESSELS. The heart is a hollow, muscular organ, situated a little to the left of tiie center of the chest. Its impulse is felt on the left side on account of its location and from the rotary movement of the organ in action. It is cone-shaped, with the base upward ; the apex points dow nward, backward, and to the left side. It extends from about the third to the sixth ribs, inclusive. The average weight is about 7 to 8 pounds. In horses used for speed the heart is relatively larger, according to the weight of the animal, than in horses used for slow work. It is suspended from the spine by the large blood vessels, and held in posi- tion below by the attachment of the pericardium to the sternum. It is inclosed in a sac, the pericardium, which is composed of a dense fibrous membrane lined by a delicate serous membrane, which is reflected over the heart ; the inner layer is firmly adherent to the heart, the outer to the fibrous sac, and there is an intervening space, known as the pericardial space, in which a small amount of serum — a thin translucent liquid — is present constantly. The heart is divided by a shallow fissure into a right and left side ; each of these is again subdivided by a transverse partition into two compartments which communicate. Thus there are four cardiac cavities — the superior, or upper, ones called the auricles; the inferior, or lower, ones the ventricles. These divisions are marked on the out- side by grooves, which contain the cardiac blood vessels, and arc generallv filled with fat. The right side of the heart may be called the venous side, the left the arterial side, named from the kind of blood which passes through them. The auricles are thin-walled cavities placed at the base, and are connected with the great veins — the venae cava) and pulmonary veins — through which they receive blood from all parts of the body. The auricles comnumicate with the ventricles each by a large aper- ture, the avricnlo-venty'iculai' orifice, which is furnished with a remarkable mechanism of valves, allowing the transmission of blood from the auricles into the ventricles, but preventing a reverse course. The ventricles are thick-walled cavities, forming the more massive portion of the heart toward the apex. They are separated by a par- tition, and are connected with the great arteries — the pulmonary artery and the aorta — by which they send blood to all parts of the II. Doe. 71)5, r)!>-2 15 225 226 DISEASES OF THE HORSE. body. At the mouth of the aorta and at the mouth of the pulmonary urteiy is an arrangement of valves in each case which prevents the reflux of blood into the ventricles. The auriculo-ventricular valves in the left side are composed of two flaps, hence it is called the bicuspid valve; in the right side this valve has three flaps and is called the tricuspid valve. The flaps which form these valves are connected with a tendinous ring between the auricles and ventricles; and each flap of the auriculo-ventricular valves is supplied with tendinous cords, which are attached to the free margin and under- surface, so as to keep the valves tense when closed — a condition which is produced by the shortening of muscular pillars with which the cords are connected. The arterial oj)enings, both on the right and on the left side, are provided with three-flapped semilunar-shaped valves, to prevent the regurgitation of blood when the ventricles contract. The veins emptying into the auricles are not caj)able of closure, but the posterior vena cava has an imperfect valve at its aperture. The inner surface of the heart is lined by a serous membrane, the endocardium, which is smooth and firmly adherent to the muscular structure of the heart. This membrane is continuous with the lining membrane of the blood vessels, and it enters into the formation of the valves. The circulation through the heart is as follows: The venous blood is carried into the right auricle by the anterior and posterior vense cavse. It then passes through the right auriculo-ventricular opening into the right ventricle, thence through the pulmonary artery to the lungs. It returns by the pulmonary veins to the left auricle, then is forced through the auriculo-ventricular opening into the left ven- tricle, which propels it through the aorta and its branches into the system, the veins returning it again to the heart. The circulation, therefore, is double, the pulmonary, or lesser, being performed by the right side, and the systemic, or greater, by the left side. As the blood is forced through the heart by forcible contractions of its muscular walls, it has the action of a force pump, and gives the impulse at each beat, wdiich we call the pulse — the dilatation of the arteries throughout the system. The contraction of the auricles is quickly followed by that of the ventricles, and then a slight pause occurs ; this takes place in regular rhythmical order during health. The action of the heart is governed and maintained by the pneumo- gastric nerve (tenth pair of cranial nerves) ; it is the inhibitory nerve of the heart, and regulates, slows, and governs its action. When the nerve is cut, the heart-beats increase rapidly, and in fact the organ works without control. When the nerve is unduly irritated the hold- back, or inhibitory force, is increased, and the heart slows up in the same measure. The left cavities of the heart, the pulmonary veins. ANATOMY OF THE HEART. 227 and the aorta, or systemic artery, contain red or florid blood, fit to cir- culate through the body. The right cavities of the heart, with the vena' cava\ or systemic veins, and pulmonary artery, contain dark blood, which must be transmitted through the lungs for renovation. The arteries, commencing in tAvo great trunks, the aorta and the pulmonary artery, undergo division, as in the branching of a tree. Their branches mostly come off at acute angles, and are commonly of uniform diameter in each case, but successively diminish after and in consequence of division, and in this manner gradually merge into the capillary system of blood vessels. As a general rule, the combined area of the branches is greater than that of the vessels from which they emanate, and hence the collective capacity of the arterial system is greatest at the capillary vessels. The same rule applies to the veins. The effect of the division of the arteries is to make the blood move more slowly along their branches to the capillary vessels, and the effect of the union of the branches of the veins is to accelerate the speed of the blood as it returns from the capillary vessels to the venous trunks. In the smaller vessels a frequent running together, or anastomosis, occurs. This admits of a free communication between the currents of blood, and must tend to promote equability of distribution and of pressure, and to obviate the effects of local interruption. The arteries are highly elastic, being extensile and retractile both in length and breadth. During life they are also contractile, being provided with muscular tissue. ^\^ien cut across they present, although empty, an open orifice; the veins, on the other hand, collapse. In most parts of the body the arteries are inclosed in a sheath formed of connective tissue, but are connected so loosely that, when the vessel is cut across, its ends readily retract some distance within the sheath. Independently of this sheath, arteries are usually de- scribed as being formed of three coats, named, from their relative positions, external, middle, and internal. This applies to their struc- ture so far as it is discernible by the naked eye. The internal, serous, or tunica intima, is the thinnest, and is continuous with the lining membrane of the heart. It is made up of two layers — an inner, con- sisting of a layer of epithelial scales, and an outer, transparent, Avhitish, highly elastic, and perforated. The middle coat, tunirti media, is elastic, dense, and of a yellow color, consisting of nonstriated muscular and elastic fibers, thickest in the largest arteries and be- coming thinner in the smaller. In the smallest vessels it is almost entirely muscular. The external coat, tunica adventitia, is com- posed mainly of fine and closely woven bundles of white connective tissue, which chiefly iMin diagonally or obliquely round the vessel. In tliis coat the nutrient vessels, the vasa t.'asorum, form a capillary network, from which a few penetrate as far as the muscular coat. 228 DISEASES OF THE HORSE. The veins differ from arteries in possessing thinner walls, less elastic and muscular tissue, and for the most part a stronger tunica adventitia. They collapse Avhen cut across or when they are empty. The majority of veins are provided with valves; these are folds of the lining membrane, strengthened by fibrous tissue. They favor the course of the blood and prevent its reflux. The nerves which supply both the arteries and the veins come from the sympathetic system. The smaller arteries terminate in the system of minute vessels known as the capillaries, which are interposed between the termination of the arteries and the commencement of the veins. Their average diameter is about one three-thousandth of an inch. DISEASES or THE HEART AND BLOOD VESSELS. In considering diseases of the heart we meet with many difficulties, depending much upon the position which this organ occupies in the animal. The shoulders cover so much of the anterior portion of the chest, and often in very heavy-muscled horses the chest walls are so thick that a satisfactory examination of the heart is attended with difficulty. Diseases of the heart are not uncommon among horses; the heart and its membranes are frequently involved in diseases of the respiratory organs, diseases of the kidneys, rheumatism, influenza, etc. Some of the diseases of this organ are never suspected by the ordinary observer during life, and are so difficult to diagnose with any degree of certainty that we will have to confine ourselves to a general outline, giving attention to such symptoms as may serve to lead to a knowledge of their existence, with directions for treatment, care, etc. Nervous affections often produce promment heart symptoms by causing functional disturbance of that organ, which, if removed, will leave the heart restored to perfect vigor and normal action. Organic changes involving the heart or valves, however, usually grow worse and eventually prove fatal. Therefore it is necessary that we arrive at an appreciation of the true nature and causes, so that we may be able to form a true estimate of the possibilities for recovery or en- couragement for medical treatment. Disease of the heart may occur at any age, but it is witnessed most frequently in young horses, which, when being trained for fast work, are often subjected to excessive hardship and fatigue. Nervous or timid animals also suffer from such diseases more frequently than those of a sluggish disposition. Any cause which induces a violent or sudden change in the circulation may result in injury to the heart. Symptoms which may frequently denote disease of the heart are diffi- cult breathing or short-windedness, dropsies of the limbs, habitual coldness of the extremities, giddiness or fainting attacks, inability to stand work, although the general appearance would indicate strength and ability, etc. > ■i9^r^.--- < Q < ^r frT ■*"" 'I" ^" K' o o u > ■^ 5 K k' ■53 . 1 li G ^ 1 •c; 5 ?5 2 -^ '■^ a 5 > C55 5 ■5 <^ § 2 C i •Ci c ?'^ ■3 5JS .V N. N. =1 o •^ a ■>- 'Ci: i C -a S" r ^ ^ f -r DISEASES OF THE HEART. 229 INFLAMMATORY DISEASES OE THE HEART. This will embrace myocarditis, endocarditis, and pericarditis. MYOCAUniTIS, OK INKI.AM M ATION OK TIIK MITSCTLAU STRUCTURE OF THK HEART. The heart muscle sometimes becomes inflamed as a complication or result of the existence of general or febrile and of infectious diseases. Severe influenza or infectious pneumonia is not infrequently followed by myocarditis. By extension of inflammation of the endocardium or pericardium the muscle of the heart may become involved. Over- exertion or especially hard work continued for a long time may cause this muscle to become inflamed. Symptoms. — Inflamnuition of the heart muscle is shown by inabil- ity to contract forcibly; this results in a rapid but weak, soft pulse and irregular heart sounds. The pulse may be quite irregular as a result of the irregular, tumultuous action of the heart. There is great general weakness, shortness of breath, and rapid respiratory movements. In some cases, wdiere the muscle is very much softened and weakened, or, perhaps when an abscess forms in the wall of the heart, the course of the disease is very rapid and terminates suddenly from paralysis or rupture of the heart. Alterations. — The heart muscle has a brownish or yellowish, boiled ai)pearance, and is so brittle that it tears easily. There may be a spotted appearance of the muscle from the intense changes in struc- ture in snudl areas; these small areas may be due to suppuration, in which case they have the characteristics of small abscesses. This last condition is seen in pyemia (blood poisoning). If the disease is of long duration, the fibrous tissue in the wall of the heart may increase to such an extent as to produce an unnatural hardness of the wall. Treatment.— li\ this disease the nutrition and strength of the heart should be kept up as much as possible with good food, good care, and heart tonics and stimulants. The horse should be tempted to eat such foods as he will take; \w should be kept in an airy box stall; his legs should be well rubbed as often as necessary to keep them warm and bandaged loosely with flannel bandages. Internally, the horse may have strychnia in 2-grain doses twice daily, whisky in 4-ounce doses every two to four hours, digitalis in the form of the tincture in doses of 1 dram every three to six hours. Artificial Carlsbad salts in heaping tablespoonful doses in the feed may be given three times daily for a couple of Aveeks. Kest is of the greatest importance and should be allowed for a few weeks after recovery seems to be complete. ENDOCARDITIS. OR INFI.AMMATION OF THE LINING MEMBRANE OF THE HEART, USUALLY INVOLVING THE MUSCULAR STRUCTURE. Endocarditis frequently occurs as a complication of rheumatism, some of the specific or zymotic fevers, specific poisoning, etc. This is a more frequent disease among horses than is generally known, 230 DISEASES OF THE HORSE. and often gives rise to symptoms which, at first, are obscure and unnoticed. In influenza we may find the heart becoming involved in the dis- ease, in consequence of the morbid material conveyed through the heart in the blood stream. In view of the fact that many affections, in even remote portions of the body, may be traced directly to a primary endocardial disease, we shall feel justified in inviting special attention to this disease. Endocarditis may be acute, subacute, or chronic. In acute inflam- mation we find a thickening and a roughened appearance of the endo- cardium throughout the cavities of the heart. This condition may be followed by a coagulation of fibrin upon the inflamed surface, which adheres to it, and by attrition soon becomes worked up into shreddy- like granular elevations; this may lead to a formation of fibrinous clots in the heart and sudden death early in the disease, the second or third day. Subacute endocarditis, which is the most common form, may not become appreciable for several days after its commencement. It is characterized by being confined to one or more anatomical divisions of the heart, and all the successive morbid changes follow each other in a comparatively slow process. Often we w^ould not be led to sus- pect heart affection were it not for the distress in breathing, which it generally occasions Avhen the animal is exercised, especially if the valves are much involved. When coagula or vegetations form upon the inflamed membrane, either in minute shreds or patches, or when formation of fibrinous clots occurs in the cavity affected, some of tlies>' materials may be carried from the cavity of the heart by the blood current into remote organs, constituting emboli that are liable to sud- denly plug vessels and thereby interruj^t important functions. In the great majority of either acute or subacute grades of endocarditis, whatever the exciting cause, the most alarming symptoms disappear in a week or ten days, often leaving, however, such changes in the interior lining or valvular structures as to cause impairment in the circulation for a much longer j^eriod of time. These changes usually consist of thickening or induration of the inflamed structures. But while the effects of the inflammation in the membrane lining the walls of the ventricles may subside to such a degree as to cause little or no inconvenience, or even wholly disappear, yet after the valvular structures have been involved, causing them to be thicker, less flexible than normal, they usually remain, obstructing the free passage of the blood through the openings of the heart, thereb}^ inducing secondary changes, Avhich take place slowly at first, but ultimately serioiisly im- pair the animal's usefulness. AVliat was but a slight obstruction to the circulation during the first few weeks after the subsidence of the cardiac inflammator}^ attack becomes in process of time so much in- DISEASES OF THE HEART. 231 creased as to induce increased growth in the muscidar structure of the heart, constituting hypertrophy of the walls of the ventricles, more particularly of the left, with corresponding fullness of the left, auricle and pulmonary veins, thereby i)roducing fullness of the cap illaries in the lungs, pressure upon the air cells, difficult or asth- matic breathing — greatly increased in attempts to work — until in a few months many of these cases become entirely disabled for work. Sometimes, too, dropsical effusions in the limbs or into the cavities of the body result from the irregular and deficient circulation. De- rangement of the urinary secretion, with passive congestion of the kidneys, may also appear. Endocardial inflamnuition is seldom fatal in its early stages, but in many cases the recovery is incomplete, for a large proportion is left with some permanent thickening of the valves, which constitutes the beginning of valvular disease. SymptomH. — Endocarditis may be ushered in by a chill, with sud- den and marked rise in temperature. The pulse rapidly decreases in strength or may become irregular, while the heart beats more or less tumultuously. In the early stages soft-blowing sounds may be heard by placing the ear over the heart on the left side, which correspond in number and rhythm to the heart's action. Excessive pain, though not so great as in acute pleuritis, is manifested when the animal is compelled to trot; very often difficulty in breathing, or shortness of breath, on the slightest exertion develops early in the attack. AMien the valves are involved in the inflammatory process the visible mucous membranes become either very pale or very dark colored, and fainting may occur when the head is suddenly elevated. When the valves of the right side are affected we may find a regurgitant pulsation in the jugular vein. Occasionally it happens that the heart contracts more frequently than the pulse beats — that is, there may be twice as many contractions of the heart in a minute as there are pulse waves in the arteries. The pulse is always very fast. In some cases we find marked lameness of the left shoulder, and when the animal is turned short to the left side he may groan with pain, and the heart's action become violently excited, although pressure against the chest <\all will not produce i)ain unless roughly applied. The animal is not disposed to eat or drink much ; the surface of the body and legs is cold — rarely excessively hot — and frequently the body of the ani- mal is in a subdued tremor. In nearly all cases there is partial sup- pression of the urinary secretion. The symptoms may continue with very little modification for three or four days, sometimes seven days, without any marked changes. If large fibrinous clots form in the heart the change will be sudden and quickly prove fatal unless they become loosened and are carried away in the circulation; then apoplexy may result from the plugging of arteries too small to give 232 DISEASES OF THE HORSE. further transmission. If the animal manifests symptoms of im- provement, the changes usually are slow and steady until he feels apparently as well as ever, eats well, and moves freely in his stall or yard. When he is taken out, however, the seeming strength often proves deceptive, as he may quickly weaken if urged into a fast gait, the breathing becomes quickened with a double flank movement as in heaves, and all the former symptoms reappear in a modified degree. An examination at this stage may reveal valvular insufficiency, car- diac hypertrophy, or pulmonary engorgement. In fatal cases of endocarditis death often occurs about the fourth day, from the formation of "heart clot or too great embarrassment of the circulation. Endocarditis may be suspected in all cases where plain symptoms of cardiac affection are manifested in animals af- fected with influenza, rheumatism, or any disease in Avhich the blood may convey septic matter. Acute endocardial inflammation may be distinguished from pleu- ritis by the absence of any friction rnurmur, absence of pain when the chest wall is percussed, and the absence of effusion in the cavity of the chest. It may be distinguished from pericarditis by the absence of the friction sounds and want of an enlarged area of dullness on percussion. Treatment. — The objects to be attained by treatment will be to remove or mitigate as much as possible the cause inducing the disease ; to find a medicine which will lessen the irritability of the heart with- out weakening it; and, last, to maintain a free urinary secretion and prevent exudation and hypertrophy. So long as there is an increase of temperature, with some degree of scantiness of the urine, it may be safe to believe that there is some degree of inflammatory action exist- ing in the cardiac structures, and as long as any evidence of inflam- matory action remains, however moderate in degree, there is a ten- dency to increase or hypertrophy of the connective tissue of the heart or valves, thereby rendering it almost certain that the structural changes will become permanent unless counteracted by persistent treatment and complete rest. The tincture of digitalis, in 20-drop doses, repeated every hour, is perhaps the most reliable agent we know to control the irritability of the heart, and this also has a decided influence upon the urinary secretion. After the desired impression upon the heart is obtained the dose may be repeated every two or three hours, or as the case may demaml. Tincture of strophanthus, in 2-dram doses, will quiet the tumultuous action of the heart in some cases where the digitalis fails. Bleeding, blistering, and stimulating applications to the chest should be avoided. They serve to irritate the animal and can do no possible good. Chlorate of potassa, in 2-dram doses, may be given in the drinking water every four hours for the first five or six days, and then DISEASES OF TTIE HEART. 233 be superseded by the nitrate of potassa, in half-ounce doses, for the following week, or until the ui'inary secretion becomes abnormally profuse. Where the disease is associated with rheumatism, '2-dram doses of salicylate of soda may be substituted for the chlorate of potassa. To guard against chronic induration of the valves, the iodide of i)otassa, in 1 to 2 dram doses, should be given early in the disease, and may be repeated two or three times a day for several weeks. When chronic etl'ects renuiin after the acute stage has passed this drug becomes indispensable. When dropsy of the limbs develops, it is due to weakened circula- tion or functional impairment of the kidneys. When there is much weakness in the action of the heart, or general debility is nuirked, the iodide of inm, in 1-dram doses, combined with hydrastis, 8 drams, may be given three times a day. Arsenic, in 5-grain doses twice a (lav, will o-ive excellent results in some cases of weak heart associated with dirticult breathing. In all cases absolute rest and warm stabling, with comfortable clothing, become necessary, and freedom from work should be allowed for a long time after all symptoms have dis- appeared. PERICARDITIS. OR INFLAMMATION OF THE SAC INCLOSING THE HEART. Causes. — Pericarditis may be induced by cold and damp stabling, exposure and fatigue, from wounds caused by broken ribs, etc. Gen- erally, however, it is associated with an attack of influenza, rheuma- tism, pleuritis, etc. Symptoms. — Usually the disease manifests itself abruptly by a brief stage of chills coincident with pain in moving, a short jiainful cough, i-apid and short breathing, and high temperature, with a rapid and hard pulse. In the early stages of the disease the pulse is regular in beat; later, when there is much exudation present in the pericardial sac, the heart-beat becomes muffled, and may be of a double or rebounding character. By placing the ear against the left side of the chest behind the elbow a rasping sound may be heard, cor- responding to the frequency of the heart-beat. This is known as a friction sound. Ik'tween the second and fourth days this sound nuiy disappear, due to a distension of the pericardium by an exudate or serous eflusion. As soon as this effusion partly fills the pericardium, percussion will reveal an abnormally increased area of (hiUiiess over the region of the heart, the heart-beats become less perceptible than in health, and in some cases a splashing or flapping sound may become audible. If the effusion becomes absorbed, the friction sound usually recurs for a short time; this friction may often be felt by applying the hand to the side of the chest. In a few cases clonic spasms of the muscles of the neck may be present. In acute pericarditis, when the effusion is rapid and excessive, the animal may die in a few days or 234 DISEASES OF THE HORSE. recovery may begin equally as early. In snbacnte or in chronic cases the effusion may slowly become augmented until the pressure upon the lungs and interference with the circulation becomes so great that death will result. \\^iether the attack is acute, subacute, or chronic, the characteristic symptoms which will guide us to a correct diagnosis are the friction sound, wdiich is always synchronous with the heart's action, the high temperature with hard, irritable pulse, and, in cases of pericardial effusion, the increased area of dullness over the cardiac region. AMien the disease is associated with influenza or rheumatism, some of the symptoms may be obscure, but a careful examination will reveal sufficient evidence upon which to base a diagnosis. AYhen pericarditis develops as a result of or in connection with pleuritis, the distinction may not be very clearly definable, neither will many recover. When it results from a wound or broken rib, it almost in- variably proves fatal. Pathology. — Pericarditis may at all times be regarded as a very serious affection. At first we will find an intense injection or accu- mulation of blood in the vessels of the pericardium, giving it a red and swollen appearance, during which we have the friction sound. In twenty-four to forty-eight hours this engorgement is followed by an exudation of sero-fibrinous fluid, the fibrinous portion of which Ti\?ij soon form a coating over the internal surface of the pericardial sac, and may ultimately form a union of the opposing surfaces. Generally this adhesion will only be found to occupy a portion of the surfaces. As the serous or watery portion of this effusion is ab- sorbed, the distinctness of the friction sound recurs, and may remain perceptible in a varied degree for a long time. When the serous effusion is very great, the pressure exerted upon the heart weakens its action, and may produce death soon ; when it is not so great, it may cause dropsies of other portions of the body. When the adhesions of the pericardial sac to the body of the heart are extensive, they gen- erally lead to increased growth, or hypertrophy, of the heart, with or Avithout dilatation of its cavities ; when they are but slight, they may not cause any inconvenience. Treatment. — In acute or subacute pericarditis the tincture of digi- talis may be given in 20 to 30 drop doses every hour until the pulse and temperature become reduced. Whisky or carbonate of ammonia may be given regularly as stimulants. Bandages should be applied to the legs; if the legs are very cold, tincture of capsicum should be first applied; the body should be warmly clothed in blankets, to pro- mote perspiration. When the suffering from pain is very severe, 10 grains of morphine may be given by the mouth once or tw^ice a day; nitrate of potassa, half an ounce, in drinking water, every six hours; after the third day, iodide of potassa, in 2-dram doses, may be sub- stituted. Cold packs to the chest in the early stages of the disease DISEASES OF THE HEART. 235 niiiy give marked relief, or, late in the disease, smart blisters may be a])plied to the sides of the chest with benefit. If the disease becomes chronic, iodide of iron and gentian to support the strength will be indicated, but the iodide of potassa, in 1 or 2 dram doses, two or three times a day, must not be abandoned so long as there is an evidence of effusion or plastic exudate accumulating in the pericardial sac. Where the effusion is great and threatens the life of the patient, tap2)ing by an expert veterinarian may save the animal. VALVULAR DISEASE OF THE HEART. Acute valvular disease can not be distinguished from endocarditis, and chronic valvular affections are generally the result of endocar- dial inflannnation. The valves of the left side are the most subject — the bicusi^id or mitral and the aortic or semilunar. The derange- ment may consist of mere inflammation and swelling, or the edges of the valves may become covered by the organization of the exudation, thus narrowing the passage. Valvular obstruction and adhesions may occur or the tendinous cords may be lengthened or shortened, thus obstructing the orifices and permitting the regurgitation of blood. In protected cases the fibrous tissue of the valves may be transformed into fibro-cartilage or bone, or there may be deposits of salts of lime beneath the serous membrane, which may terminate in ulceration, rupture, or fissures. Sometimes the valves become cov- ered by fibrinous, fleshy, or hard vegetations, or excrescences. In cases of considerable dilatation of the heart there may be atrophy and shrinking of the valves. Symptoms. — Valvular disease may be indicated by a venous pulse, jerking pulse, intermittent pulse, irregular pulse; palpitation; con- stant abnormal fullness of the jugular veins; difficulty of breathing when the animal becomes excited or is urged out of a walk or into a fast trot; attacks of vertigo; congestion of the brain; dropsical swell- ing of the limbs. A blowing, cooing, or bubbling murmur may some- times be heard by placing the ear over the heart on the left side of the chest. Hypertrophy, or dilatation, or both, usually follow valvular disease. Treatment. — When the pulse is irregular or irritable, tonics, such as preparations of iron, gentian, and ginger, may be given. When the action of the heart is jerking or violent, 20 to 30 drop doses of tincture of digitalis or of veratruni viride may be given until these symptoms abate. As the disease nearly always is the result of endo- carditis, the iodide of potassa and general tonics, sometimes stimu- lants, when general debility supervenes, may be of temporary benefit. Very few animals recover or remain useful for any length of time after once marked organic changes have taken place in the valvular structure of the heart. 236 DISEASES OF THE HORSE. ADVENTITIOUS GROWTHS IN THE HEART. Fibrous^ cartilaginous^ and hony formations have been observed in some rare instances in the muscular tissue. Isolated calcareous masses have sometimes been embedded in the cardiac walls. Fihrino^is coagxda and polypous concretions may be found in the cavities of the heart. The former consist of coagulated fibrin, separated from the mass of blood, of a whitish or yellowish white color, translucent, of a jellylike consistence, and having a nucleus in the center. They may slightly adhere to the surface of the cavity, from which they can easily be separated without altering the structure of the endocardium. They probably result from an excess of coagulability of fibrin, which is produced by an organization of the lymph during exudation. They are usually found in the right auricle and ventricle. Polypous concretions are firmer than in the preceding, more opaque, of a fibrous texture, and may be composed of successive layers. In some instances they are exceedingly minute, while in others they almost fill one or more of the cavities. Their color is usually white, but occasionally red from the presence of blood. They firmly adhere to the endocardium, and when detached from it give it a torn appear- ance. Occasionally, a vascular communication seems to exist between them and the substance of the heart. They may be the result of fibrinous exudation from inflammation of the inner surface of the heart or the coagulation of a portion of the blood Avhich afterwards contracts adhesion with the heart. These concretions prove a source of great inconvenience and often danger, no matter how formed. They cause a diminution in the cavity in which they are found, thus narrowing the orifice through which the blood passes, or preventing a proper coaptation of the valves, which may produce most serious valvular disease. Symptoms. — These are frequently uncertain; they may, however, be suspected when the action of the heart suddenly becomes embar- rassed with irregular and confused pulsations, great difficulty of breathing, and the usual signs dependent \\\)o\\ the im])erfect arterial- ization of the blood. Treatment. — Stimulants, whisky, or carbonate of ammonia may be of service. PALPITATION OF THE HEART. This is a tumultuous and usually irregular beating of the heart. It may be due to a variety of causes, both functional and organic. It may occur as a result of indigestion, fright, increased nervousness, sudden excitement, excessive speeding, etc. (See " Thumps," pp. 141,205.) Symptoms. — The heart may act with such violence that each beat may jar the whole body of the animal; very commonly it may be DISEASES OF THE HEART. 237 heard at a short distance away from the animal. It can usually be traced very readily to the excitin per cent solution of creolin or other good antiseptic. Tracheotomy may be necessary. Complications, when th^y arise, must be treated with proper circumspection. DISEASES OF THE LYMPHATIC SYSTEM. 249 DISEASES OF THE LYMPHATIC SYSTEM!. The h^mphatic, or absorbent, system is connected witli the blood- vascular system, and consists of a series of tubes which absorb and convey to the blood certain fluids. These tubes lead to lymphatic glands, through which the fluids pass to reach the right lymphatic vein and thoracic duct, both of which enter the venous system near the heart. Tlirough the excessively thin walls of the capillaries the fluid part of the blood transudes to nourish the tissues outside the capillaries; at the same time fluid passes from the tissues into the blood. The fluid, after it passes into the tissues, constitutes the lymph, and acts like a stream irrigating the tissue elements. Much of the surplus of this lymph passes into the lymph vessels, which in their commencement can hardly be treated as independent structures, since their walls are so closely joined with the tissues through which they T:)ass, beine: nothinof more than spaces in the connective tissue until they reach the larger lymph vessels, which finally empty into lymph glands. These lymph glands are structures so placed that the lymph flowing toward the larger trunks passes through them, undergoing a sort of filtration. From the fact of this arrangement lymph glands tire subject to inflammatory diseases in the vicinity of diseased struc- tures, because infective material being conveyed in the lymph stream lodges in the glands and produces irritation. LOCAL INFLAMMATION AND ABSCESS OF LYMPHATIC GLANDS. Acute inflammation of the lymph glands usually occurs in connec- tion with some inflammatory process in the region from which its lymph is gathered. Several or all of the glands in a cluster may become affected, as in strangles, nasal catarrh, or nasal gleet, diseased or ulcerated teeth, the lymph glands between the branches of the lower jaw almo.st invariably become affected, which may lead to sup- puration or induration. Similar results obtain in other portions of the body; in pneumonia the bronchial glands become affected; in pharyngitis, the postpharyngeal glands lying above the trachea be- come a fleeted, etc. Symptoms. — The glands swell and become painful to the touch, the connective tissue surrounding them becomes involved, suppuration usually takes ])lace, and one or more abscesses form. If the inflam- mation is of a milder type, resolution may take ]dace and the swelling recede, the exudative material being absorbed, and the gland restored without the occurrence of suppuration. In the limbs a wdiole chain of the glands along the lymphatic vessels may become affected, as in farcy, phlebitis, or septic poisoning. Treatment. — Fomentation with hot water and the application of camphorated soap liniment or camphorated oil may jn-oduce a revul- 250 DISEASES OF THE HORSE. sive action and prevent suppuration. If there is any indication of abscess forming, poultices of linseed meal and bran made into a paste with hot water should be applied, or a mild blistering ointment rubbed in over the swollen gland. As soon as fluctuation can be felt a free opening must be made for the escape of the contained pus. The wound may subsequently be washed out with a solution of chlo- ride of zinc, 5 grains to the ounce of water, three times a day. LYMPHANGITIS. Specific inflammation of the lymphatic structures usually affects the hind legs ; very seldom a fore leg. This disease is very sudden in its attack, exceedingly painful, accompanied by a high temperature and great general disturbance. Causes. — Horses of lymphatic, or sluggish, temperament are pre- disposed to this affection. It usually attacks well-fed animals, and in such cases may be due to an excess of nutritive elements in the blood. Sudden changes in work or in the habits of the animal may induce an attack. Symjytoms. — It is usualh^ usiiered in by a chill, rise in temperature, and some uneasiness; in a very short time this is followed by lame- ness in one leg and swelling on the inside of the thigh. The swelling gradually surrounds the whole limb and continues on downward until it reaches the foot. The limb is excessively tender to the touch, the animal perspires, the breathing is accelerated, i^ulse hard and quick, and the temperature may reach 106° F. The bowels early become constipated and the urine scanty. The symptoms usually are on the increase for about two days, then they remain stationary for the same length of time; the fever then abates: the swelling recedes and be- comes less painful. It is very seldom, though, that all the swelling leaves the leg; generally it leaves some permanent enlargement, and the animal becomes subject to recurrent attacks. Occasionally, the inguinal lymphatic glands (in the groin) undergo suppuration, and pyemia may supervene and prove fatal. In severe cases the limb be- comes denuded of hair in patches, and the skin remains indurated with a fibrous growth, which is known by the name of elephantiasis. Treatment. — The parts should be bathed freely and frequently with water as hot as the hand can bear and then fomented with vinegar and water, equal parts, to which add 2 ounces of nitrate of potassa for each gallon. This should be applied frequently, after the hot water for the first day. Afterwards, the leg may be dried with a woolen cloth and bathed with camphorated soap liniment. Inter- nally, administer artificial Carlsbad salts in 2 to 4 ounce doses three times daily. Feed lightly and give complete rest. This treatment, if instituted early in the attack, very frequenth^ brings about a re- markable change within twenty-four hours. DISEASES OF THE EYE. By James Law, F, R. C. V. S., Professor of Veterinary Science, etc., Cornell University. [Revised lu lOO:^ by the author.] We can scarce!}' overestimate the value of sound eyes in the horse, and hence all diseases and injuries 'which seriously interfere with vision are matters of extreme gravity and apprehension, for should they prove permanent they invariably depreciate the selling price to a considerable extent. A blind horse is always dangerous in the sad- dle or in single harness, and he is scarcely less so when, with partially impaired vision, he sees things imperfectly, in a distorted form or in a wrong place, and when he shies or avoids objects which are com- monplace or familiar. \Mien we add to this that certain diseases of the eyes, like recurring inflammation (moon blindness), are habitu- ally transmitted from parent to offspring, we can realize still more fully the importance of these maladies. Again, as a mere matter of beauty, a sound, full, clear, intelligent eye is something which must always add a high value to our equine friends and servants. THE EYEBALL. A full description of the structure of the eye is incompatible with our prescribed limits, and yet a short description is absolutely essen- tial to the clear understanding of what is to follow. The horse's eye is a spheroidal body, flattened behind, and with its posterior four-fifths inclosed by an opaque, white, strong fibrous membrane (the sclerotic), on the inner side of which is laid a more delicate friable memlirane, consisting mainly of blood vessels and pigment cells (the choroid), and that in its turn is lined by the ex- tremely delicate and sensitive expansion of the nerve of sight (the retina). The anterior fifth of the globe of the eye bulges forward from what would have been the direct line of the sclerotic, and thus forms a segment of a much smaller sphere than is inclosed by the sclerotic. Its walls, too, have in health a perfect translucency from which it has derived the name of transparent cornea. This trans- parent coat is composed, in the main, of fibers with lymph interspaces, and it is to the condition of these and their condensation and com- pression that the translucency is largely due. This may be shown by compressing with the fingers the eye of an ox which has just been killed, when the clear transparent cornea will suddenly become 251 252 DISEASES OF THE HORSE. clouded over with a whitish bhie opacity, and this will remain until the compression is interrupted. The interior of the eye contains three transparent media for the refraction of the rays of light on their way from the cornea to the visual nerve. Of these media the anterior one (aqueous humor) is liquid, the posterior (vitreous humor) is semisolid, and the intermediate one (crystalline lens) is solid. The space occupied by the aqueous humor corresponds nearly to the portion of the eye covered by the transparent cornea. It is, however, divided nuu two chambers, anterior and posterior, by the iris, a contractile curtain with a hole in the center (the pupil), and vvhich may be looked on as in some sense a projection inward of the vascular and pigmentary coat from its anterior margin at the point Avhere the sclerotic or opaque outer coat becomes continuous with the cornea or transparent one. This iris, or curtain, besides its abun- dance of blood vessels and pigment, possesses two sets of muscular fibers, one set radiating from the margin of the pupil to the outer border of the curtain at its attachment to the sclerotic and choroid, and the other encircling the pupil in the manner of a ring. The action of the two sets is necessarily antagonistic, the radiating fibers dilating the pupil and exposing the interior of the eye to view, Avhile the circular fibers contract this opening and shut out the rays of light. The form of the pupil in the horse is ovoid, with its longest diameter from side to side, and its upper border is fringed by several minute black bodies (corpora nigra) projecting forward and serving to some extent the purpose of eyebrows in arresting and absorbing the excess of rays of light which fall upon the eye from above. These pigmentary projections in front of the upper border of the pupil are often mistaken for the products of disease or injury, in place of the normal and beneficent protectors of the nerve of sight which they are. They may, like all other parts, become the seat of disease, but so long as they and the iris retain their clear, dark aspect, without any tints of brown or yellow, they may be held to be healthy. The vitreous or semisolid refracting medium occupies the posterior part of the eye — the part corresponding to the sclerotic, choroid, and retina — and has a consistency corresponding to that of the white of an egg, and a power of refraction of the light rays correspondingly greater than the aqueous humor. The third or solid refracting medium is a biconvex lens, with its convexity greatest on its posterior surface, which is lodged in a depres- sion in the vitreous humor, while its anterior surface corresponds to the opening of the pupil. It is inclosed in a membranous covering (capsule) and is maintained in position by a membrane (suspensory ligament) which extends from the margin of the lens outward to the sclerotic at the point of junction of the choroid and iris. This liga- ment is, in its turn, furnished with radiating muscular fibers, which DISEASES OF THE EYE. 253 change the form or position of the lens so as to adapt it to see with equal clearness objects at a distance or close by. Another point which strikes the observer of the horse's eye is that in tile darkness a bright bluish tinge is reflected from the widely dilated pupil. This is owing to a comparative absence of pigment in the choroid coat inside the upper part of the eyeball, and enables the animal to see and advance with security in darkness where the human eye would be of little use. The lower part of the cavity of the horse's eye, into which the dazzling rays fall from the sky, is furnished with an intensely black lining, by which the rays penetrating the inner nervous layer are instantly absorbed. MUSCLES OF THE EYE. These consist of four straight muscles, two oblique and one re- tractor. The straight muscles pass from the depth of the orbit forward on the inner, outer, upper, and lower sides of the eyeball, and are fixed to the anterior portion of the fibrous (sclerotic) coat, so that in contracting singly they respectively turn the eye inward, outward, upward, and downward. When all act together they draw the eyeball deeply into its socket. The retractor muscle also consists of four muscular slips, repeating the straight muscles on a smaller scale, but as they are only attached on the back part of the eyeball they are less adapted to roll the eye than to draw it down into its socket. The two oblique muscles rotate the eye on its own axis, the upper one turning its outer surface upward and inward, and the lower one turning it downward and inward. THE HAW (the WINKING CARTILAGE, OR CARTILAGO NICTITANS). This is a structure, which, like the retractor muscle, is not found in the eye of man, but it serves in the lower animals to assist in remov- ing foreign bodies from the front of the eyeball. It consists, in the horse, of a cartilage of irregular form, thickened inferiorly and pos- teriorly where it is intimately connected with the muscles of the eye- ball and the fatly material around them, and expanded and flattened anteriorly where its upper surface is concave, and, as it were, molded on the lower and inner surface of the eyeball. Externally it is cov- ered by the mucous membrane which lines the eyelids and extends over the front of the eye. Tn the ordinary restful state of the eye the edge of this cartilage should just appear as a thin fold of membrane at the inner angle of the eye, but when the eyeball is drawn deeply into the orbit the cartilage is pushed forward, outward, and upward over it until the entire globe may be hidden from siglit. This protrusion of the cartilage, so as to cover the eye, may be induced in the healthy eye by pressing the finger and thumb on the upper and lower lids, so as to cause retraction of the eyeball into the socket. When foreign 254 DISEASES OF THE HORSE. bodies, such as sand, dust, and chaff, or other irritants have fallen on the eyeball or eyelids, it is similarly projected to push them off, their exj^ulsion being further favored by a profuse flow of tears. This is seen, to a lesser extent, in all painful inflammations of the eye, and to a very marked degree in lockjaw, wdien the spasm of the muscles of the eyeball draws the latter deeply into the orbit and pro- jects forward the masses of fat and the cartilage. The brutal practice of cutting off this apparatus, whenever it is projected, necessitates this explanation which, it is hoped, may save to many a faithful serv- ant a most valuable appendage. That the cartilage and membrane may become the seat of disease is undeniable, but so long as its edge is thin and even, and its surface smooth and regular, the mere fact of its projection over a portion or the whole of the eyeball is no evidence of disease in its substance, nor any warrant for its removal. It is usually but the evidence of the presence of some pain in another part of the eye, wdiich the suffering animal endeavors to assuage by the use of this beneficent provision. For the diseases of the cartilage itself, see " Ence]3haloid cancer." LACHRYMAL APPARATUS. This consists, first, of a gland for the secretion of the tears, and, second, of a series of canals for the conveyance of the superfluous .tears into the cavity of the nose. The gland is situated above the outer part of the eyeball, and the tears which have flowed over the eye and reached the inner angle are there directed by a small conical pajDilla (lachrymal caruncle) into two minute orifices, and thence by two ducts (lachrymal) to a small pouch (lachrymal sac) from w^hich a canal leads through the bones of the face into the nose. This opens in the lower part of the nose on the floor of the passage and a little outside the line of union of the skin which lines the false nostril with the mucous membrane of the nose. In the ass and mule this opening is situated on the roof instead of the floor of the nose, but still close to the external oi^ening. EXAMINATION OF THE EYE. To avoid unnecessary repetition the following general directions are given for the examination of the eye: The eye, and to a certain extent the mucous membrane lining the eyelids, may be exposed to view by gently parting the eyelids with the thumb and forefinger pressed on the middle of the respective lids. The pressure, it is true, causes the protrusion of the haw over a portion of the lower and inner part of the eye, but by gentleness and careful graduation of the pressure this may be kept within bounds, and oftentimes even the interior of the eye can be seen. As a rule it is best to use the right hand for the left eye, and the left hand for the right, the finger in each case being DISEASES OF THE EYE. 255 pressed on the upper lid while the thumb depresses the lower one. In cases in which it is desirable to examine the inner side of the eyelid further than is possible by the above means, the upper lid may be drawn down by the eyelashes with the one hand and then everted over the tip of the forefinger of the other hand, or over a probe laid flat against the middle of the lid. Where the interior of the eye must be examined it is useless to make the attempt in the open sunshine or under a clear sky. The worst cases, it is true, can be seen under such circumstances, but for the slighter forms the horse should be taken indoors, where all light from above wall be shut oif, and should be placed so that the light shall fall on the eye from the front and side. Then the observer, placing himself in front of the animal, will receive the reflected rays from the cornea, the front of the lens and the back, and can much more easily detect any cloudiness, opacity or lack of transparency. The examination can be made much more satisfactory by placing the horse in a dark chamber and illuminating the eye by a lamp placed forward and outward from the eye which is to be exam- ined. Any cloudiness is thus easily detected, and any doubt may be resolved by moving the lamp so that the image of the flame may be passed in succession over the whole surface of the transparent cornea and of the crystalline lens. Three images of the flame will be seen, the larger one upright, reflected from the anterior surface of the eye ; a smaller one upright, reflected from the anterior surface of the lens; and a second small one inverted from the back surface of the lens. So long as these images are reflected from healthy surfaces they will be clear and perfect in outline, but as soon as one strikes on an area of opacity it will become difi'used, cloudy, and indefinite. Thus, if the large upright image becomes hazy and imperfect over a partic- ular spot of the cornea, that will be found to be the seat of disease and opacity. Should the large image remain clear, but the small upright one become diffuse and indefinite over a given point, it indi- cates opacity on the front of the capsule of the lens. If both upright images remain clear while the inverted one becomes indistinct at a given point, then the opacity is in the substance of the lens itself or in the posterior part of its capsule. If in a given case the pupil remains so closely contracted that the deeper parts of the eye can not be seen, the eyelids may be rubbed with extract of belladonna, and in a short time the pupil will be found widely dilated. DISEASES OF THE EYELIDS. Congenital disorders. — Some faulty conditions of the eyelids are congenital, as division of an eyelid in two., after the manner of hare- lip, abnormally small ojyening between the lids., often connected with imperfect development of the eye, and closure of the lids by adhesion. 256 DISEASES OF THE HORSE. The first is to be remedied by paring the edges of the division and then bringing them together, as in torn lids. The last two, if reme- diable at all, require separation by the knife, and subsequent treat- ment with a cooling astringent of eyewash. Nervous disorders. — Spasm of eyelids may be owing to consti- tutional susceptibility, or to the presence of local irritants (insects, chemical irritants, sand, etc.) in the eye, to wounds or inflammation of the mucous membrane, or to disease of the brain. When due to local irritation, it may be temporarily overcome by instilling a few drops of a 4 per cent solution of cocaine into the eye, when the true cause may be ascertained and removed. The nervous or constitu- tional disease must be treated according to its nature. Drooping eyelids., or ptosis. — This is usually present in the upper lid, or is at least little noticed in the lower. It is sometimes but a symptom of paralysis of one-half of the face, in which case the ear, lips, and nostrils on the same side will be found soft, drooping, and inactive, and even the half of the tongue may partake of the palsy. If the same condition exists on both sides, there is difficult snuffling breathing, from the air drawing in the flaps of the nostrils in inspira- tion, and all food is taken in by the teeth, as the lips are useless. In "both there is a free discharge of saliva from the mouth during masti- cation. This paralysis is a frequent result of injury, by a poke, to the seventh nerve, as it passes over the back of the lower jaw. In some cases the paralysis is confined to the lid, the injury having been sustained by the muscles which raise it, or by the supraorbital nerve which emerges from the bone just above the eye. Such injury to the nerve may have resulted from fracture of the orbital process of the frontal bone above the eyeball. The condition may, however, be due to spasm of the si^hincter muscle, which closes the lids, or to inflammation of the upper lid, usually a result of blows on the orbit. In the latter case it may run a slow course with chronic thickening of the lid. The paralysis due to the poke may be often remedied, first, by the removal of any remaining inflammation by a wet sponge worn be- neath the ear and kept in place by a bandage ; second,, when all in- flammation has passed, by a blister on the same region, or by rubbing it daily with a mixture in equal proportions of olive oil and strong aqua ammonia. Improvement is usually slow, and it may be months before complete recovery ensues. In paralysis from blows above the eyes the same treatment may be applied to that part. Thickening of the lid may be treated by painting with tincture of iodine, and that failing, by cutting out an elliptical strip of the skin from the middle of the upper lid and stitching the edges together. PL, AT R XTX. Theoretical Section of the Horse's Eye. a. Optic n rive : b, Sc/cf-ot/r : cCAoroid / (/,Rettnu ; e. Cornea , f'.lrix; f/.h, Ciliary circle, (orlignmefit j and proce.vAc^s- f/iven oCCby the c/ioroid , thoiiff/i representee/ as isoUUecl from, it, in ordi-r to indiratc t/ieir limits more clearly! i, Insertion of the diirtry proceAne.s on Ifir crystalline le/isi J, Crystalline lens ! k.Crystcdlinc capsule , LMtreoiis body: ni.n,ArUerior (ind posterior chanthers,- u.Tlieoreti cat indication of the nt'Cfnlircuie of the u(/ncons hanioiir: p.p.Tiwsi ,- q,r/, fibrous membran/^ of the cyelAd^- ; r. Elevator muscle of the upper eyelid , .%s. Orbicularis rnuscie of the neltds: t.t.Shin of the eyelids; u,Conju/iel/va. , \: A'pierior rectus nutscle : x.,IrU('rior rccttis muscle; v%; J'lbrous slirtUli of the orbit (or or-bit^d nienihra/ie I . lii'n.Nhiix il('l..'illei' l).\rl>(>\'cil.p .'' / 1. JULIUS BIEN i CO NT DIAGRAMMATlf N'KimC.U- SECTION THROl'tVH V'.W:. DISEASES OF THE EYELIDS. 257 INFLAMMATION OF THE EYELIDS. The eyelids suffer more or less in all severe inflammations of the eye, whether external or internal, but inasmuch as the disease some- times starts in the lids and at other times is exclusively confined to them, it deserves independent mention. Among the causes may be named : Exposure to drafts of cold air, or to cold rain or snow storms; the bites or stings of mosquitoes, flies, and other insects; snake bites, pricks with thorns, blows of whip or club; accidental bruises against the stall or ground, especially during the violent struggles of colic, enteritis, phrenitis (staggers), and when thrown for operations. It is also a result of infecting inoculations, as of erysipelas, anthrax, boil, etc., and is noted by Leblanc as espe- cially prevalent among horses kept on low marshy pastures. Finally, the introduction of sand, dust, chaff, beards of barley and seeds of the finest grasses, and the contact with irritant chemical powders, liquids, and gases (ammonia from manure or factory, chlorine, strong sulphur fumes, smoke, and other products of combustion, etc.) may start the inflammation. The eyelids often undergo extreme inflammatory and dropsical swelling in urticaria (nettlerash, sur- feit) and in the general inflammatory dropsy known as purpura hemorrhagica. The affection will, therefore, readily divide itself into (1) inflam- mations due to constitutional causes; (2) those due to direct injury, mechanical or chemical ; and (3 ) such as are due to inoculation with infecting material. (1) Inflammations due to constitutional causes are distinguished by the absence of any local wound, and the history of a low, damp pasture, exposure, indigestion from unwholesome food, or the pres- ence elsewhere on the limbs or body of the general doughy swellings of purpura hemorrhagica. The lids are swollen and thickened; it may be slightly or it may be so extremely that the eyeball can not be seen. If the lid can be everted to show its mucous membrane, that is seen to be of a deep-red color, especially along the branching lines of the blood vessels. The part is hot and painfvd, and a profuse flow of tears and mucus escapes on the side of the face, causing irritation and loss of the hair. If improvement follows, this discharge becomes more tenacious, and tends to cause adhesion to the edges of the upper and lower lids and to mat together the eyelashes in biuidles. This gradually decreases to the natural amount, and the redness and con- gested appearance of the eye disappears, but swelling, thickening, and stiffness of the lids may continue for a length of time. There may be more or less fever according to the violence of the inflamma- tion, but so long as there is no serious disease of the interior of the eye or of other vital organ this is usually moderate. H. Doc. 795, .59-2 17 258 DISEASES OF THE HOESE. The local treaUnent consists in astringent, soothing lotions (sugar of lead 30 grains, laudanum 2 teaspoonfuls, rain water — boiled and cooled — 1 pint), applied with a soft cloth kept wet with the lotion, and hung over the eye by tying it to the headstall of the bridle on the two sides. If the mucous membrane lining of the lids is the seat of little red granular elevations, a drop of solution of 2 grains of nitrate of silver in an ounce of distilled water should be applied with the soft end of a clean feather to the inside of the lid twice a day. The patient should be removed from all such conditions (pasture, faulty food, exposure, etc.) as may have caused or aggravated the disease, and from dust and irritant fumes and gases. He should be fed from a manger high enough to favor the return of blood from the head, and should be kept from work, especially in a tight collar which would prevent the descent of blood by the jugular veins. His diet should be laxative and nonstimulating (grass, bran mashes, carrots, turnips, beets, potatoes, or steamed hay), and any costiv^eness should be corrected by a mild dose of raw linseed oil (1 to 1^ pints). In cold weather warm blanketing may be needful, and even loose flannel bandages to the limbs, but heat should never be sought at the expense of pure air. (2) In inflammations due to local irritants of a noninfective kind a careful examination will usually reveal their presence, and the first step must be their removal with a pair of blunt forceps or the point of a lead pencil. Subsequent treatment will be in the main the local treatment advised above. (3) In case of infective inflammation there will often be found a prick or tear by which the septic matter has entered, and in such case the inflammation will for a time be concentrated at that point. A round or conical swelling around an insect bite is especially character- istic. A snake bite is marked by the double prick made by the two teeth and by the violent and rapidly spreading inflammation. Ery- sipelas is attended with much swelling, extending beyond the lids and causing the mucous membrane to protrude beyond the edge of the eyelid (chemosis). This is characterized by a bright, uniform, rosy red, disappearing on pressure, or later by a dark, livid hue, but wdth less branching redness than in noninfecting inflammation and less of the dark, dusky, brow^nish or yellowish tint of anthrax. Lit- tle vesicles may appear on the skin, and pus may be found without any distinct limiting membrane, as in abscess. It is early attended by high fever and marked general weakness and inappetence. An- thrax of the lids is marked by a firm swelling, surmounted by a blis- ter, with bloody serous contents, which tends to burst and dry up into a slough, while the surrounding parts become involved in the same way. Or it may show as a diffuse dropsical swelling, with less of the hard central sloughing nodule, but, like that, tending to spread DISEASES OF THE EYELIDS. 259 quickly. In both cases alike the inucons nieinl>rane and the skin, if white, assume a dusky brown or yellowish brown hue, which is largely characteristic. This may pass into a black color by reason of extravasation of blood. There appears early great constitutional disturbance, Avith much prostration and weakness and generalized anthrax symptoms. Treatment. — The treatment of these will vary according to the severity. Insect bites may be touched with a solution of equal parts of glycerin and aqua ammonia, or a 10 per cent solution of carbolic acid in water. Snake bites may be bathed with aqua ammonia, and the same agent given in doses of 2 teaspoonfuls in a quart of water. Or alcohol nuiy be given in pint or quart doses, according to the size of the aninuil. In erysipelas the skin may be painted with tincture of muriate of iron, or with a solution of 20 grains of iodine in an ounce of carbolic acid, and one-half an ounce of tincture of muriate of iron may be given thrice daily in a bottle of water. In anthrax the sAvelling should be painted with tincture of iodine, or of the mixture of iodine and carbolic acid, and if very threatening it may have the tincture of iodine injected into the SAvelling with a hypodermic syringe, or the hard mass may be freely incised to its depth with a sharp lancet and the lotion applied to the exposed tissues. Internally, iodide of potassium may be given in doses of 2 drams thrice a day, or tincture of the muriate of iron every four hours. STY, OR FURUNCLE (bOIl) OF THE EYELID. This is an inflammation of limited extent, advancing to the forma- tion of matter and the sloughing out of a snuill mass of the natural tissue of the eyelid. It forms a firm, rounded swelling, usually near the margin of the lid,which suppurates and bursts in four or five days. Its course may be hastened by a poultice of camomile flowers, to which have been added a few drops of carbolic acid, the whole applied in a very thin muslin bag. If the swelling is slow to open after having become yellowish white, it may be ojiened by a lancet, the incision being made at right angles to the margin of the lid. ENTROPION AND ECTROPION, OR INVERSION AND EVERSION OF THE EYELID. These are respectively caused by wounds, sloughs, ulcers, or other causes of loss of substance of the mucous membrane on the inside of the lid and of the skin on the outside; also of tumors, skin diseases, or paralysis which leads to displacement of the margin of the eyelid. As a rule, they require a surgical operation, with removal of an ellip- tical portion of the mucous membrane or skin, as the case may be, but which requires the skilled and delicate hand of the surgeon. 260 DISEASES OF THE HORSE. TRICHIASIS, This consists in the turning in of the eyelashes so as to irritate the front of the eye. If a single eyelash, it may be snipped off with scis- sors close to the margin of the eyelid or pulled out by the root with a pair of flat-bladed forceps. If the divergent lashes are more numer- ous, the treatment may be as for entropion, by excising an elliptical portion of skin opposite the offending lashes and stitching the edges together, so as to draw outward the margin of the lid at that point. WARTS AND OTHER TUMORS OF THE EYELIDS. The eyelids form a favorite site for tumors, and al)ove all, warts, which consist in a simple diseased overgroAvth (hypertrophy) of the surface layers of the skin. If small, these may be snipped off with scissors or tied around the neck with a stout waxed thread and left to drop off, the destruction being completed, if necessary, by the daily application of a piece of sulphate of copper (blue vitriol), until any unhealthy material has been removed. If more widely spread, the wart may still be clipped off with curved scissors or knife, and the caustic thoroughly aj^plied day by day. A bleeding wart, or erectile tumor, is more liable to bleed, and is best removed by constricting its neck with the waxed cord or rubber band, or if too broad for this it may be transfixed through its base by a needle armed with a double thread, which is then to be cut in two and tied around the two portions of the neck of the tumor. If still broader, the armed needle may be carried through the base of the tumor at regular intervals, so that the whole may be tied in moder- ately sized sections. In gray and in white horses black pigmentary tumors (melanotic) are common on the black portions of skin, such as the eyelids, and are to be removed by scissors or knife, according to their -^ize. In the horse these do not usually tend to recur when thoroughly removed, but at times they prove cancerous (as is the rule in man), and then they tend to reappear in the same site or in internal organs with, it may be, fatal effect. Encysted, honeylike (melicerous), sebaceous, and fibrous tumors of the lids all require removal with the knife. TORN EYELIDS OR WOUNDS OF EYELIDS. The eyelids are torn by attacks with horns of cattle, or with the teeth, or by getting caught on nails in stall, rack, or manger, on the point of stumps, fences, or fence rails, on the barbs of wire fences, and on other pointed bodies. The edges should be brought together as promptly as possible, so as to secure union without the formation of matter, puckering of the skin, and unsightly distortions. Great care is necessary to bring the two edges together evenly without twisting DISEASES OF THE EYELIDS. 261 or puckering. The simplest mode of holding them together is by a series of sharp pins passed through the lips of the wound at intervals of not over a third of an inch, and held together by a thread twisted around each pin in the form of the figure 8, and carried obliquely from pin to pin in two directions, so as to prevent gaping of the wound in the intervals. The points of the pins may then be cut off with scissors, and the wound may be wet twice a day with a weak solution of carbolic acid. TUMOR OF THE HAAV, OR CARIES OF THE CARTILAGE. Though cruelly excised for alleged "" hooks,"' when itself perfectly healthy in the various diseases which lead to retraction of the eye into its socket, the haw may, like other bodily structures, be itself the seat of actual disease. The pigmentary black tumors of white horses and soft (encephaloid) cancer may attack this part primarily or extend to it from the eyeball or eyelids ; hairs have been found growing from its surface; and the mucous membrane covering it becomes inflamed in common with that covering the front of the eye. These inflamma- tions are but a phase of the inflannnation of the external structures of the eye, and demand no particular notice nor special treatment. The tumors lead to such irregular enlargement and distortion of the haw that the condition is not to be confounded with the simple pro- jection of the healthy structure over the eye when the lids are pushed apart with the finger and thumb, and the same remark applies to the ulceration, or caries, of the cartilage. In the latter case, besides the swelling and distortion of the haw, there is this peculiarity, that in the midst of the red inflamed mass there appears a white line or mass formed by the exposed edge of the ulcerating cartilage. The animal having been thrown and properly fixed, an assistant holds the eyelids apart while the operator seizes the haw with forceps or hook and care- fully dissects it out with blunt-pointed scissors. The eye is then covered with a cloth, kept wet with an eyewash, as for external ophthalmia. OBSTRUCTION OF THE LACHRYMAL APPARATUS, OR WATERING EYE. The escape of tears on the side of the cheek is a symptom of exter- nal inflammation of the eye, but it may also occur from any disease of the lachrymal apparatus which interferes with the normal prog- ress of the tears to the nose. Hence, in all cases when this symptom is not attended by special redness or swelling of the eyelids, it is well to examine the lachrymal apparatus. In some instances the orifice of the lachrymal duct on the floor of the nasal chamber and close to its anterior outlet will be found blocked by a portion of dry muco-pniu- lent matter, on the removal of which tears may begin to escape. This implies an inflannnation of the canal, which may be helped by occa- 262 DISEASES OF THE HORSE. sional sponging out of the nose with warm water, and the application of the same on the face. Another remedy is to feed warm mashes of wheat bran from a nosebag, so that the relaxing effects of the water vapor may be secured. The two lachrymal openings, situated at the inner angle of the eye, may fail to admit the tears by reason of their deviation outward in connection with eversion of the lower lid, or by reason of their con- striction in inflammation of the mucous membrane. The lachrymal sac, into which the lachrymal ducts open, may fail to discharge its contents by reason of constriction or closure of the duct leading to the nose, and it then forms a rounded swelling beneath the inner angle of the eye. The duct leading from the sac to the nose may be com- pressed or obliterated by fractures of the bones of the face, and in disease of these bones (osteosarcoma, so-called osteoporosis, diseased teeth, glanders of the nasal sinuses, abscess of the same cavities). The narrowed or obstructed ducts may be made pervious by a fine silver probe passed down to the lachrymal sac, and any existing inflammation of the passages may be counteracted by the use of steam- ing mashes of wheat bran, by fomentations or wet cloths over the face, and even by the use of astringent eyewashes and the injection of similar liquids into the lachrymal canal from its nasal opening. The ordinary eyewash may be used for this purpose, or it may be injected after dilution to half its strength. The fractures and diseases of the bones and teeth must be treated according to their special demands when, if the canal is still left pervious, it may be again rendered useful. EXTERNAL OPHTHALMIA, OR CONJUNCTIVITIS. In inflammation of the outer parts of the eyeball the exposed vas- cular and sensitive mucous membrane (conjunctiva) which covers the ball, the eyelids, the haw, and the lachrymal apparatus, is usually the most deeply involved, yet adjacent parts are more or less implicated, and when disease is concentrated on these contiguous parts it consti- tutes a phase of external ophthalmia which demands a special notice. These have accordingly been already treated of. Causes. — The causes of external ophthalmia are mainly those that act locally — blows with whips, clubs, and twigs, the presence of for- eign bodies like hay seed, chaff', dust, lime, sand, snuff, pollen of plants, flies attracted by the brilliancy of the eye, wounds of the bridle, the migration of the scabies (mange) insect into the eye, smoke, ammonia rising from the excretions, irritant emanations from drying marshes, etc. Road dust containing infecting microbes is a common factor. A very dry air is alleged to act injuriously by drying the eye as well as by favoring the production of irritant dust; and the undue exposure to bright sunshine through a window in front of the DISEASES OF THE EYE. 263 stall, or to the reflection from snow or water, is undoubtedly injurious. The unprotected exposure of the eyes to sunshine through the use of a very short overdraw check is to be condemned, and the keeping of the horse in a very dark stall from w^hich it is habitually led into the glare of full sunlight, intensified by reflection from snow or white limestone dust, must be set down among the locally acting causes. But exposed to cold and wet, to wet and snow storms, to cold drafts and wet lairs must also be accepted as causes of conjunctivitis, the general disorder which they produce affecting the eye, if that happens to be the weakest and most susceptible organ of the body, or if it has been subjected to any special local injury, like dust, irritant gases, or excess of light. Again, external ophthalmia is a constant con- comitant of inflammation of the contiguous and continuous mucous membranes, as those of the nose and throat. Hence the red, watery eyes that attend on nasal catarrh, sore throat, influenza, strangles, nasal glanders, and the like. In such cases, however, the affection of the eye is subsidiary and is manifestly overshadowed by the pri- mary and predominating disease. Symptoms. — The symptoms are watering of the eye, swollen lids, redness of the mucous membrane exposed by the separation of the lids — it may be a mere pink blush with more or less branching red- ness, or it may be a deep, dark red, as from effusion of blood — and a bluish opacity of the cornea, which is normally clear and translucent. But except when resulting from w^ouncls and actual extravasation of 'blood, the redness is seen to be superficial, and if the opacity is con- fined to the edges, and does not involve the entire cornea, the aque- ous humor behind is seen to be still clear and limpid. The fever is always less severe than in internal ophthalmia, and only runs high in the w^orst cases. The eyelids may be kept closed, the eyeball retracted, and the haw protruded over one-third or one-half of the ball, but this is due to the pain only and not to any excessive sensibility to light, as shown by the comparatively widely dilated pupil. In internal oph- thalmia, on the contrary, the narrow contracted pupil is the measure of the pain caused by the falling of light on the inflamed and sensitive optic nerve (retina) and choroid. If the affection has resulted from a Avound of the cornea, not only is that the point of greatest opacity, forming a white speck or fleecy cloud, but too often blood vessels begin to extend from the adjacent vascular covering of the eye (sclerotic) to the white spot, and that portion of the cornea is rendered permanently opaque. Again, if the wound has been severe, though still short of cutting into the anterior layers of the cornea, the injury may lead to ulceration that may pene- trate more or less deeply and leave a breach in the tissue which, if filled up at all. is repaired by o])a(|ue filn-ous tissue in place of the transparent cellular structure. Pus may form, and the cornea assumes 264 DISEASES OF THE HORSE. a yellowish tinge and bursts, giving rise to a deep sore which is liable to extend as an ulcer, and may be in its turn followed by bulging of the cornea at that point (staphyloma) . This inflammation of the con- junctiva may be simply catarrhal, with profuse muco-purulent dis- charge; it may be granular, the surface being covered with minute reddish elevations, or it may become the seat of a false membrane (diphtheria). Treatment. — In treating external ophthalmia the first object is the removal of the cause. Remove any dust, chaff, thorn, or other for- eign body from the conjunctiva, purify the stable from all sources of ammoniacal or other irritant gas; keep the horse from dusty roads, and, above all, from the proximity of a leading wagon and its attend- ant cloud of dust; remove from pasture and feed from a rack which is neither so high as to drop seeds, etc., into the eyes nor so low as to favor the accumulation of blood in the head; avoid equally excess of lio-ht from a sunny window in front of the stall and excess of darkness from the absence of windows; preserve from cold drafts and rains and wet bedding, and apply curative measures for inflammation of the adjacent mucous membranes or skin. If the irritant has been of a caustic nature, remove any renmant of it by persistent bathing with tepid water and a soft sponge, or with water mixed with white of egg, or a glass filled wnth the liquid may be inverted over the eye so that its contents may dilute and remove the irritant. If the suffering is very severe, a lotion with a few grains of extract of belladonna or of morphia in an ounce of water may be applied, or if it is available, a few drops of 4 per cent solution of cocaine may be instilled into the eye. In strong, vigorous patients benefit will usually be obtained from a laxative, such as 2 tablespoonfuls of Glauber's salts daily, and if the fever runs high from a daily dose of half an ounce of saltpeter. As local applications astringent solutions are usually the best, as 30 grains of borax or of sulphate of zinc in a quart of water, to be ap- plied constantly on a cloth, as advised under " Inflannnation of the eyelids." In the absence of anything better, cold water may serve every purpose. Above all, adhesive and oily agents (molasses, sugar, fats) are to be avoided, as only adding to the irritation. By way of suggesting agents that may be used with good effect, salt and sulphate of soda may be named, in solutions double the strength of sulphate of zinc, or 7 grains of nitrate of silver may be added to a quart of dis- tilled water, and will be found especially applicable in granular con- junctivitis, diphtheria, or commencing ulceration. A cantharides blister (1 part of Spanish fly to 4 parts lard) may be rubbed on the side of the face 3 inches below the eye, and washed off next morning with soapsuds and oiled daily till the scabs are dropped. DISEASES OF THE EYE. 265 M'lIITE SPECKS ANl) ( LOliDlNESS OF THE CORNEA. As a result of external ophthalmia, opaque specks, clouds, or hazi- ness are too often left on the cornea and require for their removal that they be daily touched with a soft feather dipped in a solution of 3 grains nitrate of silver in 1 ounce distilled water. This should be applied until all inHammation has subsided, and until its contact is comparatively painless. It is rarely successful Avith an old thick scar following an ulcer, nor Avith an opacity having red blood vessels running across it. ULCERS OF THE CORNEA. These may be treated with nitrate of silver lotion of twice the strength used for opacities. Powdered gentian, one-half ounce, and sulphate of iron, one-fourth ounce daily, may improve the general health and increase the reparatory power. INTERNAL OPHTHALMIA (iRITIS, CHOROIDITIS, AND RETINITIS). Although inflammations of the iris, choroid, and retina — -the inner, vascular, and nervous coats of the eye — occur to a certain extent inde- pendently of each other, yet one usually supervenes upon the other, and, as the s3'mptoms are thus made to coincide, it will be best for our present purposes to treat the three as one disease. Causes. — The causes of internal ophthalmia are largely those of the external form only, acting with greater intensity or on a more suscep- tible eye. Severe blows, bruises, punctures, etc., of the eye, the penetration of foreign bodies into the eye (thorns, splinters of iron, etc.), sudden transition from a dark stall to bright sunshine, to the glare of snow or water, constant glare from a sunny window, abuse of the overdraw checkrein, vivid lightning flashes, drafts of cold, damp air; above all, when the animal is perspiring, exposure in cold rain and snow storms, swimming cold rivers; also certain general diseases like rheumatism, arthritis, influenza, and disorders of the digestive organs, may become complicated by this affection. From the close relation between the brain and eye — alike in the blood ves- sels and nerves — disorders of the first lead to affections of the second, and the same remark applies to the persistent irritation to which the jaws are subjected in the course of dentition. So potent is the last agency that we dread a recurrence of ophthalmia so long as dentition is incomplete, and hope for immunity if the animal completes its dentition without any permanent structural change in the eye. Symptoms. — The symptoms will vary according to the cause. If the attack is due to direct physical injury, the inflammation of the eyelids and superficial structvu'es may be quite as marked as that of the interior of the eye. If. on the other hand, from general causes, or as a complication of some distant disease, the affection may be largely 266 DISEASES OF THE HORSE. confined to the deeper structures, and the swelling, redness, and ten- derness of the superficial structures will be less marked, ^^^len the external coats thus comparatively escape the extreme anterior edge of the white, or sclerotic, coat where it overlaps the border of the trans- parent cornea is in a measure free from congestion, and, in the absence of the obscuring dark pigment, forms a whitish ring around the cornea. This is partly due to the fact that a series of arteries (cili- ary) passing to the inflamed iris penetrate the sclerotic coat a short distance behind its anterior border, and there is therefore a marked difference in color between the general sclerotic occupied between these congested vessels and the anterior rim from which they are absent. Unfortunately, the pigment is often so abundant in the anterior part of the sclerotic as to hide this symptom. In internal ophthalmia the opacity of the cornea may be confined to a zone around the outer margin of the cornea, and even this mav be a bluish haze rather than a deep fleecy white. In consequence it becomes possible to see the interior of the chamber for the aqueous humor and the condition of the iris and pupil. The aqueous humor is usually turbid, and has numerous yellowish white flakes floating on its substance or deposited in the lower part of the chamber, so as to cut off the view of the lower portion of the iris. The still visible portion of the iris has lost its natural, clear, dark luster, which is replaced by a brownish or yellowish sere-leaf color. This is more marked in proportion as the iris is inflamed, and less so as the inflammation is confined to the choroid. The amount of flocculent deposit in the chamber of the aqueous humor is also in direct ratio to the inflamma- tion of the iris. Perhaps the most marked feature of internal oj)hthal- mia is the extreme and painful sensitiveness to light. On this account the lids are usually closed, but when opened the pupil is seen to be narrowly closed, even if the animal has been kept in an obscured stall. Exceptions to this are seen when inflammatory effu- sion has overfilled the globe of the eye, and by pressure on the retina has paralyzed it, or when the exudation into the substance of the retina itself has similarly led to its paralysis. Then the pupil may be dilated, and frequently its margin loses its regular ovoid outline and becomes uneven by reason of the adhesions which it has con- tracted with the capsule of the lens, through its inflammatory exu- dations. In the case of excessive effusion into the globe of the eye that is found to have become tense and hard so that it can not be indented with the tip of the finger, paralysis of the retina is apt to result. With such paralysis of the retina, vision is heavily clouded or entirely lost ; hence, in spite of the open pupil, the finger may be approached to the eye without the animal becoming conscious of it until it touches the surface, and if the nose on the affected side is gently struck and a feint made to repeat the blow the patient makes DISEASES OF THE EYE. 267 no effort to evade it. Sometimes the edo-es of the contracted pupil become adherent to each other by an intervening plastic exudation, and the opening becomes virtually abolished. In severe inflamma- tions pus may form in the choroid or iris, and escaping into the cavity of the aqueous humor show as a yellowish white stratum below. In nearly all cases there is resulting exudation into the lens or its capsule, constituting a cloudiness or opacity (cataract), which in severe and old-standing cases appears as a white fleecy mass behind a widely dilated pupil. In the slighter cases cataract is to be recog- nized by examination of the eye in a dark chamber, with an oblique side light, as described in tlie introduction to this article. Cataracts that appear as a simple haze or indefinite fleecy cloud are usually on the capsule (capsular) , while those that show a radiating arrangement are in the lens (lenticular), the radiating fibers of which the exudate follows. Black cataracts are formed by the adhesion of the pigment on the back of the iris to the front of the lens, and by the subsequent tearing loose of the iris, leaving a portion of its pigment adherent to the capsule of the lens. If the pupil is so contracted that it is impossible to see the lens, it may be dilated by applying to the front of the eye with a feather some drops of a solution of 4 grains of atropia in an ounce of water. Treatment. — The treatment of internal ophthalmia should embrace, first, the removal of all existing causes or sources of aggravation of the disease, which need not be here repeated. Special care to protect the patient against cold, wet, strong light, and active exertion must, however, be insisted on. A dark stall and a cloth hung over the eye are important, while cleanliness, warmth, dryness, and rest are equally demanded. If the patient is strong and vigorous, a dose of 4 drams of Barbados aloes may be given, and, if there is any reason to suspect a rheumatic origin, one-half a dram powdered colchicuni and one-half ounce salicylate of soda may be given daily. Locally, the astringent lotions advised for external ophthalmia may be resorted to, especially when the superficial inflammation is well marked. More important, however, is to instill into the eye, a few drops at a time, a solution of 4 grains of atropia in 1 ounce of distilled water. This may be effected with the aid of a soft feather, and may be repeated at inter- vals of ten minutes until the pupil is widely dilated. As the horse is to be kept in a dark stall, the consequent admission of light will be harmless, and the dilation of the pupil prevents adhesion between the iris and lens, relieves the constant tension of the eye in the effort to adapt the pupil to the light, and solicits the contraction of the blood vessels of the eye and the lessening of congestion, exudation, and in- traocular pressure. Shoidd atropia not agi-ee with the case, it may be replaced by morphia (same strength) or cocaine in 4 per cent solution. Another local measure is a blister, Avhich can usually be aiii)lied to 268 DISEASES OF THE HORSE. advantage on the side of the nose or beneath the ear. Spanish flies may be used as for external ojihthalmia. In very severe cases the parts beneath the eye may be shaved and three or four leeches applied. Setons are sometimes beneficial, and even puncture of the eyeball, but these should be reserved for professional hands. The diet throughout should be easily digestible and moderate in quantity — bran mash, middlings, grass, steamed hay, etc. Even after the active inflammation has subsided the atrof)ia lotion should be continued for some weeks to keep the eye in a state of rest in its still weak and irritable condition, and during this period the patient should be kept in semidarkness, or taken out only with a dark shade over the eye. For the same reason heavy drafts and rapid paces, which would cause congestion of the head, should be carefully avoided. RECURRENT OPHTHALMIA (PERIODIC OPHTHALMIA, OR MOONBLINDNESS) . This is an inflammatory affection of the interior of the eye, inti- mately related to certain soils, climates, and systems, showing a strong tendency to recur again and again, and usually ending in blindness from cataract or other serious injury. Causes. — Its causes may be fundamentally attributed to soil. On damp clays and marshy grounds, on the frequently overflowed river bottoms and deltas, on the coasts of seas and lakes alternately sub- merged and exposed, this disease prevails extensively, and in many instances in France (Reynal), Belgium, Alsace (Zundel, Milten- berger), Germany, and England it has very largely decreased under land drainage and improved methods of culture. Other influences, more or less associated with such soil, are potent causative factors. Thus damp air and a cloudy, wet climate, so constantly associated with wet lands, are universally charged with causing the disease. These act on the animal body to produce a lymphatic constitution with an excess of connective tissue, bones, and muscles of coarse open texture, thick skins and gummy legs covered with a profusion of long hair. Hence the heavy horses of Belgium and southwestern France have suf- fered severely from the affection, while high dry lands adjacent, like Catalonia, in Spain, and Dauphiny, Provence, and Languedoc, in France, have in the main escaped. The rank aqueous fodders grown on such soils are other causes, but these again are calculated to undermine the character of the nervous and sanguineous temperament, and to superinduce the lymphatic. Other foods act by leading to constipation and other disorders of the digestive organs, thus impairing the general health ; hence in any ani- mal predisposed to this disease, heating, starchy foods, such as maize, wheat, and buckwheat, are to be carefully avoided. It has been widely charged that beans, pease, vetches, and other Leguminosse are danger- DISEASES OF THE EYE. 269 ous, but a fuller iiuiuir.v contradicts this. If these are well grown they invigorate and fortify the system, while, like any other fodder, if grown rank, aqueous, and deficient in assimilable principles, they tend to lower the health and open the way for the disease. The period of dentition and training is a fertile exciting cause, for though the malady may appear at any time from birth to old age, yet the great majority of victims are from two to six years old, and if a horse escapes the affection till after six there is a reasonable hope that he will continue to resist it. The irritation about the head during the eruption of tlie teeth, and while fretting in the unwonted bridle and collar, the stimulating grain diet and the close air of the stable all combine to rouse the latent tendency to disease in the eye, while direct injuries by bridle, Avhip, or hay seeds are not without their influence. In the same way local irritants, like dust, severe rain and snow storms, smoke, and acrid vapors are contributing causes. It is evident, however, that no one of these is suiRcient of itself to produce the disease, and it has been alleged that the true cause is a microbe, or the irritant products of a microbe, which is harbored in the marshy soil. The prevalence of the disease on the same damp soils which produce ague in man and anthrax in cattle has been (pioted in support of this doctrine, as also the fact that the malady is always more prevalent ccetei'is panbus in basins surounded by hills where the air is still and such products are concentrated, and that a forest or simple belt of trees will, as in ague, at times limit the area of its prevalence. Another argument for the same view is found in the fact that on certain farms irrigated by town sewage this malady has become extremely prevalent, the sewage being assumed to form a suitable nidus for the growth of the germ. But on these seAvage farms a fresh crop may be cut every fortnight, and the i)roduct is precisely that aqueous material which contributes to a lymphatic structure and a low tone of health. The presence in the system of a definite germ has not yet been proven, and in the present state of our knowledge we are only warranted in charging the disease to the deleterious emanations from the marshy soil in which bacterial fer- ments are constantly producing them. Heredity is one of the most potent causes. The lymj^hatic constitu- tion is of course transmitted and with it the proclivity to recurring ophthalmia. This is notorious in the case of both parents, male and fenuile. The tendency appears to be stronger, however, if either parent has already suffered. Thus a nuire may have borne a number of sound foals, and then fallen a victim to this malady, and all foals subsequently borne have likewise suffered. So with the stallion. Reynal even quotes the appearance of the disease in alternate gen- erations, the stallion offspring of blind parents remainijig sound through life and yet producing foals which furnish numerous victims 270 DISEASES OF THE HORSE. of recurrent ophthalmia. On the contrary, the offspring of diseased l^arents removed to high, dry regions and furnished with wholesome, nourishing rations will nearly all escape. Hence the dealers take colts that are still sound or have had but one attack from the affected low Pyrenees (France) to the unaffected Catalonia (Spain), with confidence that they will escape, and from the Jura Valley to Dau- phiny with the same result. Yet the hereditary taint is so strong and pernicious that intelligent horsemen everywhere refuse to breed from either horse or mare that has once suffered from recurrent ophthalmia, and the French (lovern- ment studs not only reject all unsound stallions, but refuse service to any mare which has suffered with her eyes. It is this avoidance of the hereditary predisj)osition more than anything else that has reduced the formerly wide prevalence of this disease in the European countries generally. A consideration for the future of our horses would demand the disuse of all sires that are unlicensed, and the refusal of a license to any sire which has suffered from this or any other communicable constitutional disease. Other contributing causes deserve passing mention. Unwholesome food and a favdty method of feeding undoubtedly predisposes to the disease, and in the same district the carefully fed will escape in far larger proportion than the badly fed. But it is so with every other condition which undermines the general health. The presence of worms in the intestines, overwork, and debilitating diseases and causes of every kind weaken the vitality and lay the system more open to attack. Thierry long ago showed that the improvement of close, low, dark, damp stables, where the disease had previously pre- vailed, practically banished this affection, Wliatever contributes to strength and vigor is protective; whatever contributes to weakness and poor health is provocative of the disease in the predisposed subject. Symptoms. — The symptoms vary according to the severity of the attack. In some cases there is marked fever, and in some slighter cases this may be almost altogether wanting, but there is always a lack of vigor and energy, bespeaking general disorder. The local symptoms are in the main those of internal ophthalmia, with, in many cases, an increased hardness of the eyeball from effusion into its cavity. The contracted pupil does not expand much in darkness, nor even under the action of belladonna. Opacity advances from the margin, over a part or whole of the cornea, but so long as it is trans- parent there may be seen the turbid, aqueous humor with or without flocculi, the dingy iris robbed of its clear black aspect, the slightly clouded lens and a greenish yellow reflection from the dejDth of the eye. From the fifth to the seventh day the flocculi precipitate in the lower part of the chamber, exposing more clearly the iris and lens, DISEASES OF THE EYE. 271 and absorption commences, so that the eye may be cleared up in ten or iifteen days. The characteristic of the disease is, however, its recurrence again and again in the same eve until blindness results. The attacks mav follow each other at intervals of a month, more or less, but they show no relation to any particular phase of the moon as might be inferred from the familiar name, but are determined rather by the weather, the health, the food, or by some periodicity of the system. From five to seven attacks usually result in blindness, and then the second eye is liable to be attacked until it also is ruined. In the intervals between the attacks some remaining synii^toms betray the condition, and these become more marked after each suc- cessive access of disease. Even after the first attack there is a bluish ring round the margin of the transparent cornea. The eye seems smaller than the other, at first because it is retracted in its socket, and often after several attacks because of actual shrinkage (atrophy). The upper eyelid, in place of presenting a uniform, continuous arch, has about one-third from its inner angle an abrupt bend, caused by the contraction of the levator muscle. The front of the iris has exchanged some of its dark, clear brilliancy for a lusterless yellow, and the depth of the eye presents more or less of the greenish j^ellow shade. The pupil remains a little contracted, except in advanced and aggravated cases, when, with opaque lens, it is widely dilated. If one eye only has suffered, as is common, the contrast in these respects with the sound eye is all the more characteristic. Another feature is the erect, attentive carriage of the ear, to compensate to some extent for the waning vision. The attacks vary greatly in severity in different cases, but the recur- rence is characteristic, and all alike lead to cataract and intraocular effusion, with pressure on the retina and abolition of sight. Prevention. — The prevention of this disease is the great object to be aimed at. and this demands the most careful breeding, feeding, housing, and general management, as indicated under " Causes." Much can also be done by migration to a high, dry location, but for this and malarious affections the improvement of the land by drainage and good cultivation should be the final aim. T reatment is not satisfactory, but is largely the same as for com- mon internal ophthalmia. Some cases, like rheumatism, are benefited by scruple doses of powdered colchicum and 2-dram doses of salicylate of soda twice a day. In other cases, with marked hardness of the globe of the eye from intraocular effusion, aseptic puncture of the eye, or even the excision of a portion of the iris, has helped. During recovery a course of tonics (2 drams oxide of iron, 10 grains nux vomica, and 1 ounce sulphate of soda daily) is desirable to invigorate the system and help to ward off another attack. The vulgar resort to 272 DISEASES OF THE HORSE, knocking out the wolf teeth and cutting out the haw can only be con- demned. The temi^orary recovery would take place in one or two weeks, though no such thing had been done, and the breaking of a small tooth, leaving its fang in the jaw, only increases the irritation. CATARACT. The common result of internal ophthalmia, as of the recurrent type, may be recognized as described under the first of these diseases. Its offensive appearance may be obviated by extraction or depression of the lens, but as the rays of light would no longer be properly refracted, perfect vision would not be restored, and the animal would be liable to prove an inveterate shyer. If perfect blindness continued by reason of pressure on the nerve of sight, no shying would result. PALSY or THE NERVE OF SIGHT, OR AMAUROSIS. Causes. — The causes of this affection are tumors or other disease of the brain implicating the roots of the optic nerve, injury to the nerve between the brain and eye, and inflammation of the optic nerve within the eye (retina), or undue pressure on the same from dropsical or inflammatory efi'usion. It may also occur from overloaded stom- ach, from a profuse bleeding, and even from the pressure of the gravid womb in gestation. Sym'ptoins. — The symptoms are wide dilatation of the pupils, so as to expose fully the interior of the globe, the expansion remaining the same in light and darkness. Ordinary eyes when brought to the light have the pupils suddenly contract, and then dilate and contract alternately until they adapt themselves to the amount of light. The horse does not swerve when a feint to strike is made unless the hand causes a current of air. The ears are held erect and turn quickly toward any noise, and the horse steps high to avoid stumbling over objects which it can not see. Treatment is only useful when the disease is symptomatic of some removable cause, like congested brain, loaded stomach, or gravid womb. When recovery does not follow the termination of these con- ditions, apply a blister behind the ear and give one-half dram doses of mix vomica daily. TUMORS OF THE EYEBALL. A variety of tumors attack the eyeball— dermoid, papillary, fatty, cystic, and melanotic — but perhaps the most frequent in the horse is encephaloid cancer. This may grow in or on the globe, the haw, the eyelid, or the bones of the orbit, and is only to be remedied, if at all, by early and thorough excision. It may be distinguished from the less dangerous tumors by its softness, friability, and great vascularity, bleeding on the slightest touch, as well as by its anatomical structure. DISEASES OF THE EYE. 273 STAPHYLOMA. This consists in a bulging forward of the cornea at a given point by the saccuhir yielding and distention of its coats, and it may be either transparent or opaque and vascular. In the last form the iris has become adherent to the back of the cornea, and the whole struc- ture has become Hlled with blood vessels. In the first form the bulg- ing cornea is attenuated; in the last it may be thickened. The best treatment is by excision of a portion of the rise so as to relieve the intraocular pressure. PARASITES IN THE EYE. Acari in the eye have been incidentally alluded to under inflamma- tion of the lids. Filai'ia palpehralh is a white w^orm, one-half to 1 inch long, which inhabits the lachrymal duct and the underside of the eyelids and haw in the horse, producing a verminous conjunctivitis. The first step in treatment in such cases is to remove the worm with forceps, then treat as for external inflammation. Filaria equina is a delicate, white, silvery-looking worm, which I have repeatedly found 2 inches in length (a length as great as 5 inches has been reported). It invades the aqueous humor, where its constant active movements make it an object of great interest, and it is fre- quently exhibited as a " snake in the eye." It is found also in other internal cavities of the horse, to which it undoubtedly makes its Avay from the food, and especially the water swallowed, and its prevention is therefore to be sought mainly in the supply of pure water from closed, deep wells. When present in the eye it causes inflammation and has to be removed through an incision made Avith the lancet in the ui)per border of the cornea r cavity, accurately adapted to complete, by their coaptation, the ball and socket joint. The articulation of the arm and shoulder is an example of the first 278 DISEASES OF THE HORSE. kind, while that of the hip with the thigh bone is a perfect exhibition of the hitter. The structure whose office is to retain the articulating surfaces in place is the ligament. This is usually a white, fibrous, inelastic tissue; sometimes, however, it is elastic in character and yellowish. In some instances it is funicular shaped or corded, serving to bind more firmly together the bones to which its extremities are attached; in others it consists of a broad membrane, wholly or partially sur- rounding the broad articulations, and calculated rather for the pro- tection of the cavity from intrusion by the air than for other security. This latter form, known as cajjsular.^ is usually found in connection Avith joints which possess a free and extended movement. The capsular and funicular ligaments are sometimes associated, the cap- sular appearing as a membranous sac wholly or partially inclosing the joint; the fimicular, here known as an inter articular ligament, occupying the interior, and thus securing the union of the several bones more firmly and effectively than would be 230ssible for the cap- sular ligament unassisted. The universal need which pertains to all mechanical contrivances of motion has not been forgotten while providing for the perfect working of the interesting piece of living machinery which performs the function of locomotion, as we are contemplating it, and nature has consequently provided for obviating the evils of attrition and friction, and insuring the easy play and smooth movement of its parts, by the establishment of the secretion of the synovia^ the vital lubricant of which we have before spoken, as a yellow, oily, or rather glairy secretion, which performs the indispensable office of facilitating the play of the tendons over the joints and certain given points of the bones. This fluid, which is deposited in a containing sac, the lining (serous) membrane of which forms the secreting organ, is of an excessively sensitive nature, and while it lines the inner face of the ligaments, both capsular and fascicidar, is attached only upon the edges of the bones without extending upon their length, or between the layers of cartilage which lie between the bones and their articular surfaces. Our object in thus partially and concisely reviewing the structure and condition of the essential organs of locomotion has been rather to outline a sketch which may serve as a reference chart of the gen- eral features of the subject than to offer a minute description of the parts referred to. Other points of interest will receive due attention as we proceed with the illustration of our subject and examine the matters which it most concerns us to bring under consideration. The foundation of facts which we have thus far prepared will be found sufficiently broad, we trust, to include whatever may be necessary to insure a ready comprehension of the essential matters which are to DEFINITION OF LAMENESS. 279 follow as our review is carried forward to completion. What we have said touching these elementary truths will })rohably be sufficient to facilitate a clear understanding of the requirements essential to the perfection and regularity which characterize the normal perform- ance of the various movements which result in the accomplishment of the action of locomotion. So long as the bones, the muscles and their tendons, the joints with their cartilages, their ligaments and their synovial structure, tlie nerves and the controlling influences which they exercise over all, with the blood vessels which distribute to every part, however minute, the vitalizing fluid which sustains the whole fabric in being and activity — so long as these various constituents and adjuncts of aninuil life preserve their nonnal exemption from disease, traumatism, and pathological change, the function of locomotion will continue to be performed with perfection and efficiency. But on the other hand, let any element of disease become implanted in one or several of the parts destined for combined action, any change or irregularity of form, dimensions, location, or action occur in any portion of the apparatus — any obstruction or misdirection of vital power take place, any interference with the order of the phenomena of normal nature, any loss of harmony and lack of balance be be- trayed— and we have in the result the condition of lameness. DEFINITION or LAMENESS. Physiology. — Comprehensively and universally considered, then, the term lameness signifies any irregularity or derangement of the function of locomotion, irrespective of the cause which produced it or the degree of its manifestation. However slightly or severely it may be exhibited, it is all the same. The nicest observation may be demanded for its detection, and it may need the most thoroughly trained j^owers of discernment to identify and locate it, as in cases where the animal is said to be fainting, tender, or to go sore. On the contrary, the patient may be so far affected as to refuse utterly to use an injured leg, and under compulsory motion keej) it raised from the ground, and prefer to travel on three legs rather than to bear any por- tion of his weight upon the afflicted member. In these two extremes, and in all the intermediate degrees, the patient is simply lame — l)athognomonic minutia? being considered and settled in a place of their own. This last condition of disal:»led function — lameness on three legs — and many of the lower degi'ees of simple lameness are very easy of detection, but the first, or mere tenderness or soreness, may be very difficult to identify, and at times very serious results have followed from the obscurity which has enveloped the early stages of the malady. For it may easily occur that in the absence of the treatment which an early correct diagnosis would have indicated, an insidious ailment 280 DISEASES OF THE HORSE. may so take advantage of the lapse of time as to root itself too deeply into the economy to be subverted, and become transformed into a disabling chronic case, or possibly one that is incurable and fatal. Hence the impolicy of (fepreciating early symptoms because they are unaccompanied by distinct and pronounced characteristics, and from a lack of threatening appearances inferring the absence of danger. The possibilities of an ambush can never be safely ignored. An extra caution costs nothing, even if wasted. The fulfillment of the first duty of a practitioner, when introduced to a case, is not always an easy task, though it is too frequently expected that the diagnosis, or " what is the matter " verdict, will be reached by the quickest and surest kind of an " instantaneous process," and a sure prognosis, or " how will it end,'' guessed at instanter. Usually the discovery that the animal is becoming lame is compar- atively an easy matter to a careful observer. Such a person will readily note the changes of movements which will have taken place in the animal he has been accustomed to drive or ride, unless they are indeed slight and limited to the last degree. But what is not always easy is the detection, after discovering the fact of an existing irregularity, of the locality of its point of origin, and ^diether its seat be in the near or off leg, or in the fore or the hind part of the body. These are questions too often wrongly answered, notwith- standing the fact that with a little careful scrutiny the point may be easily settled. The error, which is too often committed, of pronounc- ing the leg upon which the animal travels soundly as the seat of the lameness, is the result of a misinterpretation of the physiology of locomotion in the crippled animal. Much depends upon the gait with which the animal moves while under examination. The act of walk- ing is unfavorable for accurate observation, though, if the animal w^alks on three legs, the decision is easy to reach. The action of gal- loping will often, by the rapidity of the muscular movements and their quick succession, interfere with a nice study of their rhythm, and it is only under some peculiar circumstances that the examination can be safely conducted wdiile the animal is moving with that gait. It is Avhile the animal is trotting that the investigation is made with the best chances of an intellige-nt decision, and it is while moving with that gait, therefore, that the points should be looked for which must form the elements of the diagnosis. Our first consideration should be the physiology of normal or healthy locomotion, that from thence we may the more easily reach our conclusions touching lameness, or that which is abnormal, and by this process w^e ought to succeed in obtaining a clew to the solution of the first problem, to Avit, in which leg is the seat of the lameness? A word of definition is here necessary, in order to render that which follows more easily intelligible. In veterinary nomenclature each DEFINITION OF LAMENESS. 281 two of the legs, as referred to in pairs, is denoniimUod a biped. Of the four points occupied by the feet of the animal while standing at rest, forming a scpiare, the two fore legs are known as the anterior biped ; the two hinder, the posterior; the two on one side, the lateral; and one of either the front or hind biped with the opposite leg of the hind or front biped will form the diagonal biped. Considering, as it is proper to do, that in a condition of health each separate biped and each individual leg is required to perform an equal and uniform function and to carry an even or equal jiortion of the weight of the body, it will be readily appreciated that the result of this distribution will be a regular, evenly balanced, and smooth displacement of the body thus supported by the four legs, and that therefore, according to the rapidity of the motion in dill'erent gaits, each single leg will be required at certain successive moments to tear the weight which had rested upon its congener while it was itself in the air, in the act of moving; or, again, two different legs of a biped may be called upon to bear the weight of the two legs of the opposite biped while also in the air in the act of moving. To simplify the matter by an illustration, the weight of an animal may be placed at 1,000 pounds, of which each leg, in a normal and healthy condition, supports while at rest 250 pounds. When one of the fore legs is in action, or in the air, and carrying no weight, its 250 pounds share of the weight Avill be thrown upon its congener, or part- ner, to sustain. If the two legs of a biped are both in action and raised from the ground, their congeners still resting in inaction, will carry the total weight of the other two, or 500 pounds. And as the succession of movements continues, and the change from one leg to another or from one biped to another, as may be ree produc- tive of the evil, and among these may be mentioned the overstraining of an immature organism by the imposition of excessive labor upon a young animal at a too early period of his life. The bones which enter into the formation of the cannon are three in number, one large and two smaller, which, during the youth of the animal, are more or less articulated, with a limited amount of mobility, but which become in maturity firmly joined by a rigid union and ossification of their interarticular surface. If the inmiature animal is compelled, then, to perform exacting tasks beyond his strength, the inevitable result will follow in the muscular straining, and perhaps tearing asunder of the fibers which unite the bones at their points of juncture, and it is difficult to understand how inflammation or periostitis can fail to develop as the natural consequence of such local irritation. If the result were deliberately and intelligently designed, it could hardly be more effectually accomplished. The splint is an object of the commonest occurrence — so common, indeed, that in large cities a horse which can not exhibit one or more specimens upon some portion of his extremities is one of the rarest of spectacles. Though it is in some instances a cause of lameness, and its discovery and cure are sometimes beyond the ability of the shrewd- est and most experienced veterinarians, yet as a source of ^dtal danger to the general equine organization, or even of functional disturbance, or of practical inconvenience, aside from the rare exceptional cases which exist as mere samples of possibility, it can not be considered to belong to the category of serious lesions. Tlie worst stigma that at- taches to it is that in general estimation it is ranked among eyesores and continues indefinitely to be that and nothing different. The infiunnnation in which they originated, acute at first, either subsides or assumes the chronic form, and the bony growth becomes a perma- nence— more or less established, it is true, but doing no positive harm and not hindering the animal from continuing his daily routine of labor. All this, however, requires a proviso against the occurrence of a subsequent acute attack, when, as with other exostoses, a fresh access of acute symptoms may be followed by a new pathological 288 DISEASES OF THE HORSE. iiotivity, which shall again develop, as a natural result, a reappear- ance of the lameness. Treatment. — It is, of course, the consideration of the comparative harmlessness of splints that suggests and justifies the policy of non- interference, except as they become a positive cause of lameness. And a more positive argument for such noninterference consists in the fact that any active and irritating treatment may so excite the parts as to bring about a renewed pathological activity, which may result in a reduplication of the phenomena, with a second edition, if not a second and enlarged volume, of the whole story. For our part, our faith is firm in the impolicy of interference, and this faith is founded on an experience of many years, during which our practice has been that of abstention. Of course, there will be exceptional conditions which will at times indicate a different course. These will become evident when the occa- sions i)resent themselves, and extraordinary forms and effects of inflammation and growth in the tumors offer special indications. But our conviction remains unshaken that surgical treatment of the oper- ative kind is usually useless, if not dangerous. We have little faith in the method of extirpation except under very special conditions, among which that of diminutive size has been named, which seems in itself to constitute a sufficient negative argument. But even in such a case a resort to the knife or the gouge could scarcely find a justifi- cation, since no operative procedure is ever without a degree of haz- ard, to say nothing of the considerations which are always forcibly negative in any question of the infliction of pain and the unnecessary use of the knife. If an acute periostitis of the cannon bone has been readily discov- ered, the treatment we have already suggested for that ailment is at once indicated, and the astringent lotions may be relied upon to bring about beneficial results. Sometimes, however, preference may be given to a lotion possessing a somewhat different quality, the alter- ative consisting of tincture of iodine applied to the inflamed spot several times daily. If the lameness persists under this mild course of treatment, it must, of course, be attacked by other methods, and we must resort to the cantharides ointment or Spanish-fly blister, as we have before recommended. Besides this, and producing an analogous effect, the compounds of biniodide of mercury are favored by some. It is prepared in the form of an ointment, consisting of 1 dram of the biniodide to 1 ounce of either lard or vaseline. It forms an excellent blistering and alterative application, and is of special advantage in newly formed or recently discovered exostosis. It remains a pertinent query, however, and one which seems to be easily answered, Mdiether a tumor so diminutive in size that it can only be detected by diligent search, and which is neither a disfigure- 3 w i c ^*f<- o , J< ~ i 0 I g I y. I 3 EINGBONES. 289 nient nor an obstruction to the motion of the limb, need receive any recognition whatever. Other modes of treatment for splints are rec- onnneiided and i)racticed Avhicli belong strictly to the domain of oper- ative veterinary surgery. Among these are to be reckoned actual cauterization, or the application of the fire iron and the operation of periosteotomy. These are frequently indicated in the treatment of si^lints which have resisted milder means. The mode of the development of their growth; their intimacy, greater or less, with both the large and the small cannon bones ; the possibility of their extending to the back of these bones under the sus- pensory ligament ; the dangerous complications which may follow the rough handling of the parts, wnth also a possibility, and indeed a probability, of their return after removal — these are the considera- tions which have influenced our judgment in discarding from our practice and our approval the method of removal by the saw or the chisel, as recommended by certain European veterinarians. EINGBONES. This t^rm forms the designation of the exostosis which is found on the coronet and in the digital and phalangeal regions. The name is appropriate, because the growth extends quite around the coronet, which it encircles in the manner of a ring, or perhaps because it often forms upon the back of that bone a regular osseous arch, through which the back tendons obtain a passage. The places where these gi'owths are usually developed have caused their subdivision and classification into three varieties, with the designations of high, middle^ and low, though much can-not be said as to the importance of such distinction. It is true that the ringbone or phalangeal exostosis may be found at various points on the foot, in one case forming a large bunch on the upper part and quite close to the fetlock joint ; in another around the upper border of the hoof, or perhaps on the extreme front or on the very back of the coronet. The shape in which they commonly appear is favorable to their easy discovery, their form when near the fetlock usually varying too much from the natural outlines of the part wdien compared with those of the opposite side to admit of error in the matter. (See also page 413.) A ringbone when on the front of the foot, even when not very largely developed, assumes the form of a diil'used convex swelling. If situated on the lower part, it will form a thick ring, encircling that portion of the foot innnediately above the hoof ; when found on the posterior part, a small, sharp osseous growth somewhat project- ing, sometimes on the inside and sometimes on the outside of the coronet, may comprise the entire manifestation. Cause. — As wnth splints, ringbones may result from severe labor in early life, before the process of ossification has been fully perfected ; II. Doc TD.^t, .'')'. >-L> 19 290 DISEASES OF THE HORSE. • or they may be referred to bruises, blows, sprains, or other violence; or injuries of tendons, ligaments, or joints may be among the account- able causes. It is certain that they may commonly be traced to diseases and traumatic lesions of the foot, and their aj^pearance may be reason- ably anticipated among the sequelae of an abscess ot the coronet; or the cause may be a severe contusion resulting from calking, or a deep-punctured wound from picking up a nail or stepping upon any hard object of sufficiently irregular form to penetrate the sole. Moreover, a ringbone may originate in heredity. This is a fact; of no little importance in its relation to questions connected with the extensive interests of the stock breeder and purchaser. That the hereditary transmission of constitutional idiosyncrasies is an active cause with regard to diseases in general, it would be absurd to claim, but we do claim that a predisposition to contract ringbone due to faulty conformation, such as long, thin pasterns with narrow joints and steep fetlocks, may be inherited in many cases, and in a smaller proportion of cases this predisposition may act as a secondary cause in the formation of ringbone. The importance of this point when considered in reference to the policy which should be observed in the selection of breeding stock is obvious, and, as the whole matter is within the control of the own- ers and breeders, it will be their own fault if the unchecked trans- mission of ringbones from one equine generation to another shall bo allowed to continue. It is our belief that among the diseases which are known for their tendency to perpetuate and repeat themselves by individual succession, those of the bony structures stand first, and the inference from such a fact which would exclude every ani- mal of doubtful soundness in its osseous apparatus from the stud list and the brood farm is too plain for argument. Symptoms. — Periostitis of the phalanges is an ailment requiring careful exploration and minute inspection for its discovery, and is quite likely to result in a ringbone of which lameness is the result. The mode of its manifestation varies according to the state of de- velopment of the diseased growth as affected by the circumstances of its location and dimensions. It is commonly of the kind which, in consequence of its intermittent character, is termed lam,eness when cool., having the peculiarity of exliibiting itself when the animal starts from the stable and of diminishing, if not entirely disappearing after some distance of travel, to return to its original degree, if not indeed a severer one, when he has again cooled off in his stable. The size of the ringbone does not indicate the degree to which it cripples the patient, but the position may, especially Avhen it inter- feres with the free movement of the tendons which pass behind and in front of the foot. While a large ringbone will often interfere SIDEBONES. 291 but little with the motion of the limb, a smaller growth, if situated under the tendon, may become the cause of considerable and con- tinued pain. A ringbone is doubtless a worse evil than a splint. Its growth, ils location, its tendency to increased development, its exposure to the influence of causes of renewed danger, all tend to impart an unfavor- able cast to the prognosis of a case and to enij)hasize the impor- tance and the value of an early discovery of its presence and possible growth. Even when the discovery has been made, it is often the case that the truth has come to light too late for effectual treatment. Months may have ehipsed after the first manifestation of the lauio- ness before a discovery has been made of the lesion from which it has originated, and there is no recall for the lapsed time. And by the. uncompromising seriousness of the discouraging prognosis must the energy and severity of the treatment and the promptness of its administration be measured. The periostitis has been overlooked ; any chance that might have existed for preventing its advance to the chronic stage has been lost; the osseous formation is established; tho ringbone is a fixed fact, and the indications are urgent and pressing. Treatment. — The preventive treatment consists in keeping colts well nourished and in trimming the hoof and shoeing to properly bal- ance the foot, and thus prevent an abnormal strain on the ligaments. Even after the ringbone has developed, a cure may sometimes be occa- sioned by proper shoeing directed toward straightening the axis of the foot as viewed from the side by making the wall of the hoof from the coronet to the toe continuous with the line formed by the front of the pastern. As long as inflammation of the periosteum and liga- ments remains, a sharp blister of biniodide of mercury and canthari- des may do good if the animal is allowed to rest for four or five weeks. If this fails, some success may be accomi)lished by point firing in two or three lines over the ringbone. It is necessary to touch the hot iron well into the bone, as superficial firing does little good. When all these measures have failed to remove the lameness, or when the animal is not worth a long and uncertain treatment, a comi)etent veterinarian should be engaged to perform double neurectomy, liigli or low, of the plantar nerves, or neurectomy of the median nerve as indicated by the seat of the lesion. SIDEBONES. On each side of the bone of the hoof — the coffinbone — there are nornuilly two supplementary organs which are called the carttlayes of the foot. They are soft, and though in a degree elastic, yet somewhat resisting, and are implanted on the lateral wings of the coffinbcme. Evidently their office is to assist in the elastic expansicm and contrac- tion of the posterior part of the hoof, and their healthy and normal 292 DISEASES OF THE HORSE. action doubtless contributes in an important degree to the perfect per- formance of the functions of that part of the leg. These organs are, however, liable to undergo a process of disease which results in an entire change in their properties, if not in their shape, by wdiich they acquire a character of hardness resulting from the deposit of earthy substance in the intimate structure of the cartilage, and it is this change, when its consummation has been effected, that brings to our cognizance the diseased growth which has received the designation of sidehones. They are situated on one or both sides of the leg, bulging above the superior border of the hoof in the form of two hard bodies composed of ossified cartilage, irregularly square in shape and un- yielding under the pressure of the fingers. Cause. — Sidebones may be the result of a low inflammatory condi- tion or of an acute attack as well, or may be caused by sprains, bruises, or blows; or they may have their rise in certain diseases affecting the foot proper, such as corns, quarter cracks, or quittor. The deposit of calcareous matter in the cartilage is not always uniform, the base of that organ near its line of union with the cofRnbone being in some cases its limit, w^hile at other times it is diffused throughout its sub- stance, the size and prominence of the growth varying much in consequence. Symptoms. — It would naturally be inferred that the amount of interference with the proper functions of the hoof which must result from such a pathological change would be proportioned to the size of the tumor, and that as the dimensions increased, the resulting lame- ness would be the greater in degree. This, however, is not the fact. A small tumor, while in a condition of acute inflammation during the formative stage, may cripple a patient more severely than a much larger one in a later stage of the disease. In any case the lameness is never wanting, and Avith its intermittent character may usually be detected when the animal is cooled off after labor or exercise. The class of animals in which this feature of the disease is most frequently witnessed is that of the heavy draft horse, and others similarly em- ployed. There is a wide margin of difference in respect to the degrees of severity which may characterize different cases of sidebone. While one may be so slight as to cause no inconvenience, another may de- velop elements of danger which may involve the necessity of severe surgical interference. Treatment. — The curative treatment should be similar to the pro- phylactic, and such means should be used as would tend to pre\ent the deposit of bony matters by checking the acute inflammation which causes it. The means recommended are the free use of the cold bath ; frequent soaking of the feet, and at a later period treatment with iodine, either by painting the surface with the tincture several times daily or bv applying an ointment made by mixing 1 dram of the SPAVIN. 293 crystals with 2 ounces of vaseline, rubbed in once a day for several days. If this proves to be ineffective, a Spanish fly blister, to which a few grains of biniodide of mercury have been added, will, in a majority of cases, efi'ect the desired result and remove the lameness. If, hnaily, this treatment is inetfcctual, the case must be relegated to the surgeon for the operation of neurectomy, or the free and deep application of the firing iron. SPAVIN. This aft'ection, popularly termed hone spavin^ is an exostosis of the hock joint. The general impression is that in a spavined hock the bony growth should be seated on the anterior and internal part of the joint, and this is partially correct, as such a growth will constitute a spavin in the most correct sense of the term. But an enlargement may appear on the upper part of the hock also, or possibly a little below the inner side of the lower extremit}^ of the shank bone, form- ing what is known as a likjh spavin; or, again, the growth may form just on the outside of the hock and become an outside^ or external^ spavin. And, finally, the entire under surface may become the seat of the osseous deposit, and involve the articular face of all the bones of the hock, and this again is a hone spavin. There would seeui, then, to be but little difficulty in comprehending the nature of a bone spavin, and there would be none but for the fact that there are similar affections which might confuse one if the diagnosis is not very care- fully made. But the liock may be " spavined," while to all outward observation it still retains its perfect form. With no enlargement perceptible to sight or touch the animal may yet be disabled by an occult spavin, an anchvlosis in fact, which has resulted from a union of several of the bones of the joint, and it is only those who are able to realize the importance of its action to the perfect fulfillment of the function of locomotion by the hind leg who can comprehend the gravity of the only prognosis which can be justified by the facts of the case — a prog- nosis wliicli is essentially a sentence of serious import in respect to the future usefulness and value of the animal. For no disease, if we excej)t those acute iuflaunnatory attacks upon vital organs to Avhich the jjatient succumbs at once, is more destructive to the useful- ness and value of a horse than a confirmed spavin. Serious in its inception, serious in its progress, it is an ailment which, when once established, becomes a fixed condition which there is no known means of dislodging. Cause. — The periostitis, of which it is nearly always a termination, is usually the effect of a traumatic cause operatiug upon the compli- cated structure of the hock, such as a sprain which has torn a liga- mentous iusertion and lacerated some of its fibers; or a violent effort in jumping, galloping, or trotting, to which the victim has been com- pelled by the torture of whip and spur Avhile in use as a gambling 294 DISEASES OF THE HORSE. implement by a sporting owner, under the pretext of " improving his breed ; " or the extra exertion of starting an inordinately heavy load ; or an effort to recover his balance from a misstep ; or slipping upon an icy surface; or sliding with worn shoes upon a bad pavement, and other kindred causes. And we can repeat here what we have before said concerning bones, in respect to heredity as a cause. From our own experience we know of equine families in which this condition has been transmitted from generation to generation, and animals otherwise of excellent conformation rendered valueless by the mis- fortune of a congenital spavin. Symptoms. — The evil is one of the most serious character for other reasons, among which may be specified the slowness of its develop- ment and the insidiousness of its growth. Certain indefinite phenom- ena and alarming changes and incidents furnish usually the only portents of approaching trouble. Among these signs may be men- tioned a peculiar posture assumed by the patient while at rest, and becoming at length so habitual that it can not fail to suggest the action of some hidden disorder. The posture is due to the action of the adductor muscles, the lower part of the leg being carried inward, and the heel of the shoe resting on the toe of the opposite foot. Then an unwillinjjness mav be noticed in the animal to move from one side of the stall to the other. When driven he will travel, but stiffly, and with a sort of sidelong gate between the shafts, and after finishing his task and resting again in his stall will pose with the toe pointing for- ward, the heel raised, and the hock flexed. Some little heat and a considerable amount of inflammation soon appear. The slight lame- ness which appears when backing out of the stall ceases to be notice- able after a short distance of travel. A minute examination of the hock may then reveal the existence of a bony enlargement which may be detected just at the junction of the hock and the cannon bone, on the inside and a little in front, and tangible both to sight and touch. This enlargement, or hone spavin, grows rapidly and persistently and soon acquires dimensions Avhich render it impossible to doubt any longer its existence or its nature. Once established, its development continues under conditions of prog- ress similar to those to which we have before alluded in speaking of other like affections. The argument advanced by some that because these bony deposits are frequently found on both hocks they are not spavins is fallacious. If they are discovered on both hocks, it proves merely that they are not confined to a single joint. The characteristic lameness of bone spavin, as it affects the motion of the hock joint, presents two aspects. In one class of cases it is most projiounced when the horse is cool, in the other when he is at work. The first is characterized by the fact that when the animal travels the toe first touches the ground, and the heel descends more SPAVIN. 295 slowly, the motion of flexion at the hock taking place stittl}', and accompanied by a dropping of the hip on the opposite side. In the other case the peculiarity is that the lameness increases as the horse travels; that when he stops he seeks to favor the lame leg, and when he resumes his work soon after he steps much on his toe, as in the first variety. As with sidebones, though for a somewhat different reason, the dimensions of tlie spavin and the degree of the lameness do not seem to bear any determinate relation, the most ])r()nouncod symptoms at times accompanying a very diminutive growth. But the distinction between the t^^'() varieties of cool and wann may easily be determined by remembering the fact that in a majority of cases the first, or cool, is due to a simple exostosis, while the second is generally connected with disease of the articulation, such as ulceration of the articular surface — a condition which, as we proceed further, will meet our attention when we reach the subject of stringhalt. An excellent test for spavin lameness, wdiich may be readily ap- plied, consists in lifting the affected leg off the ground for one or two minutes and holding the foot high so as to flex all the joints. X\\ assistant, with the halter strap in his hand, quickly starts the animal off in a trot, when, if the hock joint is affected, the lameness will be so greatly intensified as to readily lead to a diagnosis. Prognosis. — Having thus fully considered the history of bone spavin, we are prepared to give due weight to the reasons which exist for the adverse prognosis which we must usually feel compelled to pronounce when encountering it in practice, as well as to realize the importance of early discovery. It is but seldom, however, that the necessary advantage of this early knowledge can be secured, and Avhen the true luiture of the trouble has become apparent it is usually too late to resort to the remedial measures w^hich, if duly forewarned, a skillful practitioner might have employed. We are fully persuaded that but for the loss of the time wasted in the treatment of purely imaginary ailments very many cases of bone spavin might be arrested in their incipiency and their victims preserved for years of comfort for themselves and valuable labor to their owners. Treatment. — To consider a hypothetical case: An early discovery of lameness has l>een made; that is. the existence of an acute inflam- nuition — of periostitis — has been detected. The increased tempera- ture of the parts has been observed, with the stiffened gait and the characteristic pose of the limb, and the question is proposed for solu- tion, What is to be done? Even with only these comparatively doubtful symptoms — doubtful with the nonexpert — we should dircn-t our treatment to the hock in preference to any other joint, since of all the joints of the hind leg it is this which is most liable to be attacked, a natural result from its peculiarities of structure 'and 296 DISEASES OF THE HORSE. function. And in answer to the query, What is the first treatment indicated? We should answer rest — emphatically, and as an essential condition, rest. Whether only threatened, suspected, or positively diseased, the animal must be wholly released from labor, and it must be no partial or temporary quiet of a few days. In all stages and conditions of the disease, whether the spavin is nothing more than a simple exostosis, or whether accompanied by the complication of arthritis, there must be a total suspension of effort until the danger is over. Less than a month's quiet ought not to be thought of— the longer the better. Good results may also be expected from local applications. The various lotions which cool the parts, the astringents which lower the tension of the blood vessels, the tepid fomentations which accelerate the circulation in the engorged capillaries, the liniments of various composition, the stimulants, the opiate anodynes, the sedative prepa- rations of aconite, the alterative frictions of iodine— all these are recommended and prescribed by one or another. We prefer counter- irritants, for the simple reason, among many others, that they tend by the promptness of their action to prevent the formation of the bony deposits. The lameness will often yield to the blistering action of cantharides, in the form of ointment or liniment, and to the alter- ative preparations of iodine or mercury. And if the OAvner of a " spavined " horse really succeeds in removing the lameness, he has accomplished all that he is justified in hoping for; beyond this let him be well persuaded that a " cure " is impossible. For this reason, moreover, he will do well to be on his guard against the patented " cures " which the traveling horse doctor may urge upon him, and withhold his faith from the circular of the agent who will deluge him with references and certificates. It is possible that nostrums may in some exceptional instances prove serviceable, but the greater number of them are capable of producing only injurious effects. The removal of the bony tumor can not be accomplished by any such means, and if a trial of these unknown compounds should be followed by complications no worse than the establishment of one or more ugly, hairless cicatrices, it will be well for both the horse and his owner. Rest and counterirritation, with the proper medicaments, consti- tute, then, the prominent points in the treatment designed for the relief of bone spavin. Yet there are cases in which all the agencies and methods referred to seem to lack effectiveness and fail to produce satisfactory results. Either the rest has been prematurely inter- rupted or the blisters have failed to rightly modify the serous infil- tration, or the case in hand has some undiscernible characteristics which seem to have rendered the disease neutral to the agencies employed against it. An indication of more energetic means is then FEACTURES. 297 presented, aiul free cauterization ^vith the firing iron becomes necessary. At this point a Avord of explanation in reference to this operation of firing may be appropriate for the satisfaction of any among our readers Avho may entertain an exaggerated idea of its severity and possible cruelty. The operation is one of simplicity, but is nevertheless one which, in order to secure its benefits, must be reserved for times and occa- sions of which only the best knowledge and highest discretion should be allowed to judge. It is not the mere application of a hot iron to a given part of the body which constitutes the operation of firing. It is the methodical and scientific introduction of heat into the structure with a view to a given effect upon a diseased organ or tissue by an expert surgeon. The first is one of the degrees of mere burning. The other is scientific cauterization, and is a surgical manipulation which should be committed exclusively to the practiced hand of the veter- inary surgeon. Either firing alone or stimulation with blisters is of great efficacy for the relief of lameness from bone spavin. Failure to produce relief after a few applications and after allowing a sufficient interval of rest should be followed by a second, or, if needed, a third firing. In case of further failure there is a reserve of certain special oper- ations which have been tried and recommended, among which those of cunean tenotomy, periosteotomy, the division of nervous branches, etc., may be mentioned. These, however, belong to the peculiar domain of the veterinary practitioner, and need not now engage our attention. FRACTURES. In technical language a fracture is a '' solution of continuity in the structure or substance of a bone." It ranks among the most serious of the lesions to which the horse — or any animal — can be subject. It is a subject of special interest to veterinarians and horse owners in view of the fact that it occurs in such a variety of forms and sub- jects the patient to much loss of time, resulting in the susj)ension of his earning capacity. Though of less serious consequence in the horse than in man, it is always a matter of grave import. It is always slow and tedious in healing, and is frequently of doubtful and unsatisfactory result. This solution of continuity may take place in two principal ways. In the most numerous instances it includes the total thickness of the bone and is a complete fractur<>. In other cases it involves a portion only of the thickness of the bone, and for that reason is described as rncoinplete. If the bone is divided into two separate portions, ana the soft parts have received no injury, the fracture is a simple one; or 298 DISEASES OF THE HORSE. it becomes compound if the soft parts have suffered hiceration, and comminuted if the bones have been crushed or ground into fragments, many or few. The direction of the break also determines its further classification. Broken at a right angle it is transverse ; at a different angle it becomes oblique, and it may be longitudinal, or lengthwise. In a complete fracture, especially of the oblique kind, there is a con- dition of great importance in respect to its effect upon the ultimate result of the treatment in the fact that from various causes, such as muscular contractions or excessive motion, the bony fragments do not maintain their mutual coaptation, but become separated at the ends, which makes it necessary to add another descriptive term — uy'ith displacement. And these words again suggest the negative, and introduce the term without displacement, when the facts justify that description. Furthermore, a fracture may be intra-articular or extra- articular, as it extends into a joint or otherwise, and once more, intra- periosteal, when the periosteum remains intact. Finally, there is no absolute limit to the use of descriptive terminology in the case. The condition of displacement is largely influential in determining the question of treatment and as affecting the final result of a case of fracture. This, however, is dependent upon its location or whether its seat be in one or more of the axes of the bone, in its length, its breadth, its thickness, or its circumference. An incomplete fracture may also be either simple or comminuted. In the latter case the frag- ments are held together by the periosteum when it is intact, and the fracture in that case belongs to the intraperiosteal class. At times, also, there is only a simple fissure or split in the bone, making a con- dition of much difficulty of diagnosis. Causes. — Two varieties of originating cause may be recognized in cases of fracture. They are the predisposing and the occasional. As to the first, different species of animals differ in the degree of their liability. That of the dog is greater than that of the horse, and in horses the various questions of age, the mode of labor, the season of the 5'^ea'r, the portion of the body most exposed, and the existence of ailments, local and general, are all to be taken into account. Among horses, those employed in heavy draft work or that are driven over bad roads are more exposed than light-draft or saddle horses, and animals of different ages are not equally liable. Dogs and young horses, with those which have become sufficiently aged for their bones to have acquired an enhanced degree of frangibility, are more liable than those which have not exceeded the time of their adult prime. The season of the year is undoubtedly, though in an incidental way, an important factor in the problem of the etiology of these accidents, for though they may be observed at all times, it is during the months when the slippery condition of the icy roads ren- ders it difficult for both men and beasts to keep their feet that they FRACTURES. 299 occur most frequently. The long bones, those especially which belong to the extremities, are most frequently the seat of fractures, from the circumstance of their superficial position, their exposure to contact and collision, and the violent muscular efforts involved both in their constant rapid movement and their labor in the shafts or at the i:)ole of heavy and heavily laden carriages. The relation between sundry idiosyncrasies and diatheses and a lia- bility to fractures is too constant and weU-established a jjathological fact to need more than a passing reference. The history of rachitis, of melanosis, and of osteoporosis, as related to an abnormal frangi- bility of the bones, is a part of our common medical knowledge. There are few persons who have not known of cases among their friends of frequent and almost spontaneous fractures, or at least of such as seem to be produced by the slightest and most inadequate vio- lence, and there is no tangible reason for doubting an analogous con- dition in individuals of the equine race. Among local predisposing causes mention must not be omitted of such bony diseases as caries, tuberculosis, and others of the same class. Exciting, occasional, or " efficient " causes of fracture are in most instances external traumatisms, as violent contacts, collisions, falls, etc., or sudden muscular contractions. These external accidents are various in their character, and are usually associated with quick mus- cular exertion. A violent, ineffectual effort to move too heavy a load ; a semispasmodic bracing of the frame to avoid a fall or resist a pres- sure; a quick jump to escape a blow; stopping too suddenly after speeding; struggling to liberate a foot from a rail, perhaps to be thrown in the effort — all these are familiar and easy examples of acci.- dents happening hourly by which our equine servants become suffer- ers. We may add to these the fracture of the bones of the vertebrae, occurring when casting a patient for the purpose of undergoing a surgical operation, quite as much as the result of muscular contrac- tion as of a preexisting diseased condition of the bones. A fracture occurring under these circumstances may be called with propriety indirect, whik» one which has resulted from a blow or a fall differ- ently caused is of the direct kind. Symptoms. — We now return to the first items in our classification of the varieties of fractures for the purpose of bringing them in turn under an orderly review, and our first examination will include those which l)elong to the first category, or the complete kind. Irregu- larity in the performance of the functions of the apparatus to which the fractured bone belongs is a necessary consequence of the existing lesion, and this is Jmnencstf<. Tf the broken bone belongs to one of the extremities, the impossil)ility of the performance of its natural func- tion in sustaining the weight of the body and contributing to the act of locomotion is usually complete, though the degree of disability 300 DISEASES OF THE HORSE. will vary according to the kind of fracture and the bone which is injured. For example, a fracture of the cannon bone without dis- placement, or of one of the phalanges, which are surrounded and sus- tained by a complex fibrous structure, is, in a certain degree, not incompatible with some amount of resting on the foot. But, on the contrar}^ if the shank bone, or that of the forearm be the implicated member, it would be very difficult for the leg to exercise any agency whatever in the support of the body. And in a fracture of the lower jaw it would be obviously imreasonable to expect it to contribute materiall}' to the mastication of food. A fracture seldom occurs which is not accompanied with a degree of deformity, greater or less, of the region or the leg affected. This is due to the exudation of the blood into the meshes of the surround- ing tissues and to the displacement which occurs between the frag- ments of the bones, with subsequently the swelling which follows the inflammation of the surrounding tissues. The character of the deformity will mainly depend upon the manner in which the dis- placement occurs. In a normal state of things the legs perform their movements with the joints as their only centers or bases of action, with no participa- tion of intermediate points, while with a fracture the flexibility and motion which will be observed at unnatural i)oints are among the most strongly characteristic signs of the lesion. No one need be told that Avhen the shaft of a limb is seen to bend midway between the joints, with the lower portion swinging freely, that the leg is broken. But there are still some conditions where the excessive mobility is not easy to detect with certainty. Such are the cases where the fracture exists in a short bone, near a movable joint, or in a bone of a region where several short and small bones are united in a group, or even in a long bone where its situation is such that the muscular covering jDrevents the visible manifestation of the symptom. If the situation of a fracture precludes its discovery by means of this abnormal flexibility, other modes of detection remain. There is one method which is absolute and positive and which can be applied in by far the most, though not in all cases. This is crepitation^ or the peculiar effect which is produced by the friction of the fractured sur- faces one against another. Though discerned by the organs of hear- ing it can scarcely be called a sound, for the grating of the parts as the rubbing takes place is more felt than heard ; however, there is no mistaking its import in cases favorable for the application of the test. The conditions in which it is not available are those of incomplete fracture, in which the mobility of the part is lacking, and those in which the whole array of phenomena are usually obscure. To obtain the benefit of this pathognomonic sign requires deliberate, careful, and gentle manipulation. Sometimes the slightest of movements will FRACTURES. 301 be sufficient for its development, after much rougher handling has failed to discover it. Perhaps the failure in the latter case is due to a sort of defensive spasmodic rigidity caused by the pain resulting from the rude interference. More or less. reactive fever is a usual accompaniment of a fracture. Ecchymoses in the parts is but a natural occurrence, and is more easily discovered in aninuils possessing a light-colored and delicate skin than in those of the opposite character. There are difficulties in the way of the diagnosis of an incomplete fracture, even sometimes when there is a degree of impairment in the function of locomotion, with evidences of pain and swelling at the seat of lesion. There should then be a careful examination for evi- dences of a blow or other violence sufficient to account for the frac- ture, though very often a suspicion of its existence can only be con- verted into a certainty by a minute history of the patient if it can be obtained up to the moment of the occurrence of the injury. A diag- nosis ought not to be hastily pronounced, and where good ground for suspicion exists it ought not to be rejected upon any evidence less than the best. Serious and fatal complications are too often recorded of the results following careless conclusions in similar cases, among which we may refer to one instance of a complete fracture manifesting itself in an animal during the act of rising up in his stall after a decision had been pronounced that he had no fracture at all. Fractures are of course liable to complications, especially those which are of a traumatic character, such as extensive lacerations, tear- ing of tissues, punctures, contusions, etc. Unless these are in com- munication with the fracture itself the indication is to treat them sim- ply as independent lesions upon other parts of the body. A traumatic emphysema will at times cause trouble, and abscesses, more or less deep and diffused, may follow. In some cases small bony fragments from a comminuted fi-acture. becoming loose and acting as foreign bodies, give rise to troublesome fistulous tracts. A frequent compli- cation is hemorrhage, which often becomes of serious consequence. A fracture in close proximity to a joint may be accompanied by dan- gerous inflammations of important organs, and induce an attack of pneumonia, pleurisy, arthritis, etc., especially if situated near the chest ; it may also cause luxations, or dislocations. Gangrene^ as a conse- quence of contusions or of hemorrhage or of an. impediment to the circulation, caused by unskillfully applied apparatus, nuist not be overlooked among the occasional incidents; nor must loc/r/dw, which is not an unconnnon occurrence. Even founder, or laminitis, has been met with as the result of forced and long-continued immobility of the feet in the standing posture, as one of the involvements of unavoidably protracted treatment. 302 DISEASES OF THE HORSE, When a simple fracture has been properly treated and the broken ends of the bone have been securely held in coaptation, one of two things Avill occur. Either — and this is the more common event — -there will be a union of the two ends by a solid cicatrix, the callus, or the ends will continue separated or become only partially united by an intermediate fibrous structure. In the first instance the fracture is consolidated, or united; in the second there is a false articulation, or pse udarthrosis. The time required for a firm union or true consolidation of a frac- ture will vary with the character of the bone affected, the age and constitution of the patient, and the general conditions of the case. The union will be perfected earlier in a young than in an adult ani- mal, and sooner in the latter than in the aged, and a general healthy condition is, of course, in every resj^ect, an advantage. The mode of cicatrization, or method of repair in lesions of the bones, has been a subject of much study among investigators in i:)athology, and has elicited various expressions of opinion from those high in authority. But the weight of evidence and preponderance of opinion are about settled in favor of the theory that the law of repa- ration is the same for both the hard and the soft tissues. In one case a simple exudation of material, with the proper organization of newly formed tissue, will bring about a union by the first intention, and in another the work will be accompanied by suppuration, or union by the second intention, a process so familiar in the repair of the soft struc- tures by granulation. Considering the process in its simplest form, in a case in which it advances without interruption or complication to a favorable result, it may probably be correctly described in this wise: On the occurrence of the injury an effusion of blood takes place be- tween the ends of the bone. The coagulation of the fluid soon fol- lows, and this, after a few days, undergoes absorption. There is then an excess of inflammation in the surrounding structure, wdiich soon spreads to the bony tissue, when a true ostitis is established, and the compact tissue of the bone becomes the seat of a new vascular organi- zation, and of a certain exudation of plastic lymph, appearing be- tween the i^eriosteum and the external surface of the bone, as well as on the inner side of the medullary cavity. After a few^ days the ends of the bone thus surrounded by this exudate become involved in it, and the lymph, becoming vascular, is soon transformed into cartilag- inous, and in due time into bony, tissue. Thus the time required for the consolidation of the fractured seg- ments is divisible into two distinct periods. In the first they are sur- rounded by an external bony ring, and the medullary cavity is closed by a bony plug or stopper, constituting the period of the provisional callus. This is followed by the period of permanent callus, during FRACTURES. 303 which the process is going forward of converting the cartihiginous into the osseous form. The restorative process is sooner completed in the carnivorous than in tlie herbivorous tribes. In the former the temporary callus may attain sufficient fineness of consistency for the caref id use of the limb within four weeks, but with the latter a period of from six weeks to two months is not too long to allow before removing the supporting apparatus from the limb. Tliis, in general terms, represents the fact when the resources of nature have not been thwarted by untoward accidents, such as a want of vigor in the constitution of the patient or a lack of skill on the part of the practitioner, and especially when, from any cause, the bony fragments have not been kept in a state of perfect immobility and the constant friction has prevented the osseous union of the two portions. Failures and misfortunes are always more than possible, and instead of a solid and practicable bony union the sequel of the accident is sometimes a false joints composed of mere flexible carti- lage, a j3oor pseudarthrosis. The explanation of this appears to be that, first, the sharp edges of the ends of the bone disappear by becoming rounded at their extremities b}"- friction and polishing against each other. Then follow^s an exudation of a plastic nature Avhich becomes transformed into a cartilaginous layer of a rough articular aspect. In this bony nuclei soon appear, and the lymph secreted between the segments thus transformed, instead of becoming truly ossified, is changed into a sort of fibro-cartilaginous jjouch, or capsular sac, in which a somewhat albuminous secretion, or pseudo- synovia, permits the movement to take place. Most commonly, how- ever, in our animals, the union of the bony fragments is obtained wholly through the medium of a layer of fibrous tissue, and it is because the union has been accomplished by a ligamentous formation only that motion becomes practicable. Prognosis. — The prognosis in a case of fracture in an animal is one of the gravest vital import to the patient, and therefore of serious pecuniary concern to his owner. The period has not long elapsed when to have received such a hurt w^as quite equivalent to undergoing a sentence of death for the suffering animal, and perliaps to-day a similar verdict is pronounced in many cases in which the exercise of a little mechanical ingenuity, with a due amount of careful nurs- ing, might secure a contrary result and insure the return of the patient to his former condition of soundness and usefulness. TreatTnent. — Considered, jter se^ a fracture in an animal is in fact no less amenable to treatment than the same description of injury in any other living being. But the question of the propriety and exj)odiency of tivatment is dependent uj)on certain specific points of collateral consideration. 304 DISEASES OF THE HORSE. First. The nature of the lesion itself is a point of paramount im- jiortance. A simple fracture occurring in a bone where the ends can be firmly secured in coaptation presents the most favorable con- ditions for successful treatment. If it be that of a long bone, it will be the less serious if situated at or near the middle of its length than if it were in close proximity to a joint, from the fact that perfect immobility can rarely, in the latter case, be secured without incurring the risk of subsequent rigidity of the joint. A simple is always less serious than a compound fracture. A com- minuted is always more dangerous than a simple, and a transverse break is easier to treat than one which is oblique. The most serious are those which are situated on parts of the body in which it is diffi- cult to secure perfect immobility, and especially those which are accompanied by severe contusions and lacerations in the soft parts; the protrusion of fragments through the skin : the division of blood vessels by the broken ends of the bone; the existence of an articula- tion near the point to which inflammation is likely to extend; the luxation of a fragment of the bone; laceration of the periosteum; the presence of a large number of bony particles, the result of the crushing of the bone — all these are circumstances which discourage a favorable prognosis, and weigh against the hope of saving the patient for future usefulness. Fractures which may be accounted curable are those which are not conspicuously visible, as those of the ribs, where displacements are either very limited or do not occur, the parts being kept in situ by the nature of their position, the shape of the bones, the articulations they form with the vertebra, the sternum, or their cartilages of prolonga- tion; those of transverse processes of the lumbar vertebra; those of the bones of thfe face ; those of the ilium ; and that of the coffinbones. To continue the category, the following are evidently curable when their position and the character of the patient contribute to aid the treatment : Those of the cranium, in the absence of cerebral lesions ; those of the jaws; of the ribs, with displacement; of the hip; and those of the bone of the leg in movable regions, but where their vertical position admits of perfect coaptation. On the contrary, a compound, complicated, or comminuted frac- ture, in whatever region it may be situated, may be counted incurable. In treating fractures time is an important element and " delays are dangerous." Those of recent occurrence unite more easily and more regularl}' than older ones. Second. As a general rule, fractures are less serious in animals of the smaller species than in those of more bulky dimensions. This influence of species will be readily appreciated when we realize that the difficulties involved in the treatment of the latter class have hardly any existence in connection Avith the former. The difference in ^1 5;^ ;*~-« •^c^ ■^4 - z £ 1— t 1 > < tZ n '■5 H^ 0 'Sj a. y. ■ i 0 50 5 1.1 r.. r.!>-L' 120 306 DISEASES OF THE HORSE. he is carried, it must be by means of a AA'agon, a truck, or an ambu- lance ; the latter, being designed and adapted to the purpose, would, of course, be the preferable vehicle. As a precaution which should never be overlooked, a temporary dressing should first be aj)plied. This may be so done as for the time to answer all the purpose of the permanent adjustment and bandaging. Without thus securing the patient, a fracture of an inferior degree may be transformed to one of the severest kind, and, indeed, a curable changed to an incurable injury. We recall a case in which a fast trotting horse, after running away in a fright caused by the whistle of a locomotive, was found on the road limping with excessive lameness in the off fore leg, and walked with comparative ease some 2 miles to a stable before being seen by a surgeon. His immediate removal in an ambulance was advised, but before that vehicle could be procured the horse lay down, and upon being made to get upon his feet was found with a well- marked comminuted fracture of the os suffraginis, with considerable displacement. The patient, however, after long treatment, made a comparatively good recovery and though with a large bony deposit, a ringbone, was able to trot among the forties. The two obvious indications in cases of fracture are reduction, or replacement, and retention. In an incomplete fracture, where there is no displacement, the necessity of reduction does not exist. With the bone kept in place by an intact periosteum, and the fragments secured by the unin- jured fibrous and ligamentous structure which surrounds them, there IS no dislocation to correct. Reduction is also at times rendered impossible by the seat of the fracture itself, by its dimensions alone, or by the resistance arising from muscular contraction. This is illustrated even in small animals, as in dogs, by the exceeding diffi- culty encountered in bringing the ends of a broken femur or humerus together, the muscular contraction being even in these animals suffi- ciently forcible to renew the* displacement. It is generally, therefore, only fractures of the long bones, and then at points not in close proximity to the trunk, that may be con- sidered to be amenable to reduction. It is true that some of the more superficial bones, as those of the head, of the pelvis, and of the thoracic walls, may in some cases require special manipulations and appliances for their retention in their normal positions, hence the treatment of these and of a fractured leg can not be the same. The methods of accomplishing reduction vary with the features of each case, the manipulations being necessarily modified to meet dif- ferent circumstances. If the displacement is in the thickness of the bone, as in transverse fracture, the manipulation of reduction con- sists in applying constant pressure upon one of the fragments, while the other is kept steady in its place, the object of the pressure being FRACTURES. 307 the reestablishment of the exact coincidence of the two bony surfaces. If the disphicenient has taken place at an angle it will be .sufficient in order to effect the reduction to press upon the summit, or apex, of the angle until its disappearance indicates that the parts have been brought into coaptation. This method is often practiced in the treat- ment of a fractured rib. In a longitudinal fracture, or when the fragments are pressed together by the contraction of the muscles to which they give insertion until they so overlap as to correspond by certain points of their circumference, the reduction is to be accom- plished by effecting the movements of extension, counter extension, and coaptation. Extension is accomplished by making traction upon the lower portion of the limb. Counter extension consists in firmly holding or c(mfining the upper or body portion in such a manner that it shall not be affected by the traction applied to the lower part. In other words, the operator, grasping the limb below the fracture, draws it down or away from the trunk, while he seeks not to draw aAvay, but simply to hold still the upper portion until the broken ends of bone are brought to their natural relative positions, when the coaptation, which is thus effected, has only to be made permanent by the proper dressings to perfect the reduction. In treating fractures in small animals the strength of the hand is usually sufficient for the required manipulations. In the fracture of the forearm of a dog, for example, while the upper segment is firmly held by one hand the lower may be grasped by the other and the bone itself made to serve the purpose of a lever to bring about the desired coaptation. In such a case that is sufficient to overcome the muscular contraction and correct the overlapping or other malposition of the bones. If, however, the resistance can not be overcome in this mode, the upper segment may be committed to an assistant for the manage- ment of the counter extension, leaving to the operator the free use of both hands for the further manipulation of the case. But if the reduction of fractures in small animals is an easy task, it is far from being so when a large animal is the patient, whose mus- cular force is largely greater than that of several men combined. In such a case resort must be had not only to superior numbers for the necessary force, but in many cases to mechanical aids. A reference to the mode of proceeding in a case of fracture with displacement of the forearm of a horse will illustrate the matter. The patient is first to be carefully cast, on the uninjured side, with ropes, or a broad leather strap about 18 feet long, passed under and around his body and under the axilla of the fractured limb and secured at a point opposite to the animal and toward his back. This will form the mechanical means of counter extension. Another rope will then be placed around the inferior part of the leg beh)w the point of frac- ture, with wliicli to produce extension, and this will sometimes be 308 DISEASES OF THE HORSE. furnished with a block and pulleys, in order to augment the power when necessary; and there is, in fact, always an advantage in their use, on the side of steadiness and uniformity, as well as of increased power. It is secured around the fetlock or the coronet, or, what is better, above the knee and nearer the point of fracture, and is com- mitted to assistants. The traction on this should be firm, uniform, and slow, without relaxing or jerking, while the operator carefully watches the process. If the bone is superficially situated he is able to judge l)y the eye of any changes that may occur in the form or length of the parts under traction, and discovering, at the moment of its happening, the restoration of synnnetry in the disturbed region, he gently but firmly manipulates the place until all appearance of severed continuity has vanished. Sometimes the fact and the instant of restoration are indicated by a peculiar sound, or " click," as the ends of the bone slip into contact, to await the next step of the restorative procedure. The process is the same when the bones are covered with thick muscular masses, excepting that it is attended with greater difficulties, from the fact that the finger nuist be substituted for the eye, and the taxis nnist take the place of the sight. It frequently happens that perfect coaptation is prevented by the interposition between the bony surfaces of substances, such as a small fragment of detached bone or a clot of blood, and sometimes the extreme obliquity of the fracture is the opposing cause, by permit- ting the bones to slip out of place. These are difficulties which can not always be overcome, even in small-sized animals, and still it is only when they are mastered that a correct consolidation can be looked for. Without it the continuity between the fragments will be by a deformed callus, the union will leave a shortened, crooked, or ano;ular limb and a disabled animal. If timely assistance can be obtained, and the reduction accom- plished immediately after the occurrence of the accident, that is the best time for it. But if it can not be attended to until inflanunation has become established and the parts have become swollen and pain- ful, time must be allowed for the subsidence of these symptoms before attempting the operation. A spasmodic muscular contraction which sometimes interposes a difficulty may be easily overcome by subjecting the patient to general anesthesia, and need not, therefore, cause any loss of time. A tendency to this may also be overcome by the use of sedatives and antiphlogistic remedies. The reduction of the fracture having been accomplished, the prob- lem which follows is that of retention. The parts which have been restored to their natural position must be kept there, without dis- turbance or agitation, until the perfect formation of a callus, and it is here that ample latitude exists for the exercise of ingenuity and FRACTURES. 309 •skill by tlu' surgeon in the contrivance of the neee.ssary apparatus. One of the most important of the conditions which are avaihible by the surgeon in treating luiman patients is denied to the veterinarian in the management of those which belong to the animal tribes. This is position. The intelligence of the human patient c()oi)erat«s with the instructions of the surgeon, but with the animal sufferer there is a continual antagonism between the parties, and the forced exten- sion and fatiguing position which must for a considerable period be maintained as a condition of restoration require special and effective appliances to insure successful results. To obtain complete inniio- bility is scarcely possible, and the surgeon must be content to reach a point as near as possible to that which is unattainable. For this reason, as Avill subsequently be se^n. the use of slings and the re- straint of patients in very narrow stalls is much to be preferred to the practice sometimes reconmiended of allowing entire freedom of motion by turning them loose in box stalls. Temporary and movable apparatus are not nsnally of difficult use in veterinary practice, but the restlessness of the patients and their unAvillingness to submit quietly to the changing of the dressings render it obliga- tory to have recourse to permanent and inmiovable bandages, which should be retained without disturbance until the process of consolida- tion is complete. The materials composing the retaining apparatus consist of oakum, bandages, and splints, with an agglutinating compound wdiich forms a species of cement by which the different constituents are blended into a consistent mass to be spread upon the surface covering the locality of the fracture. Its components are black pitch, rosin, and Venice turpentine, blended by heat. The dressing may be applied directly to the skin, or a covering of thin linen may be interposed. A putty made with powdered chalk and the white of Q^g is recom- men<]ed for small animals, though a mixture of sugar of lead and burnt alum Avith the albumen is preferred l)y others. Another formula is spirits of camphor, Goulard's extract, and albumen. Another rec- ommendation is to saturate the oakum antl bandages with an adhesive solution formed with gum arabic, dextrin, flour jjaste, or starch. This is advised particu.larly for small animals, as is also the silicate of soda. Dextrin mixed, while warm, with burnt alum and alcohol cools and solidifies into a stony consistency, and is preferable to jjlaster of Paris, which is less friable and has less solidity, besides beiu": heavier and requiring constant additions as it becomes older. Starch and plaster of Paris form another good compound. In applying the dressing the leg is usually padded with a cushion of oakum, thick and soft enough to equalize the irregularities of the surface and to form a bedding for the protection of the skin fnmi dialing. Over this the splints are placed. The material for these is, 310 DISEASES OF THE HORSE. variously, pasteboard, thin wood, bark, laths, gutta percha, strips of thin metal, as tin or perhaps sheet iron. These should be of sufficient length not only to cover the region of the fracture, but to extend sufficiently above and below to render the immobility more complete than in the surrounding joints. The splints, again, are covered with cloth bandages, linen preferably, soaked in a glutinous mixture. These bandages are to be carefully applied, with a perfect condition of lightness. They are usually made to embrace the entire length of the leg, in order to avoid the possibility of interference with the cir- culation of the extremity, as well as for the prevention of chafing. ^They should be rolled from the lower part of the leg upward, and carefully secured against loosening. In some instances suspensory bandages are recommended, but excepting for small animals our experience does not justify a concurrence in the recommendation. These permanent dressings always need careful watching with ref- erence to their immediate effect upon the region they cover, especially during the first days succeeding that of their application. Any mani- festation of pain, or any appearance of swelling above or below, or any odor suggestive of suppuration should excite suspicion, and a thorough investigation should follow without delay. The removal of the dressing should be performed with great care, and especially so if time enough has elapsed since its application to allow of a probability of a commencement of the healing process or the existence of any points of consolidation. With the original dressing properly applied in its entirety in the first instance, the entire extremity will have lost all chance of mobility, and the repairing process may be permitted to proceed without interference. There will be no necessity and there need be no haste for removal or change except under such special con- ditions as have jiist been mentioned, or when there is reason to judge that solidification has become perfect, or for the comfort of the ani- mal, or for its readaptation in consequence of the atrophy of the limb from want of use. Owners of animals are often tempted to remove a splint or bandage prematurely at the risk of producing a second frac- ture in consequence of the failure of the callus properly to consolidate. The method of applying the splints which we have described refers to the simple variety only. In a compound case the same rules must be observed, with the modification of leaving openings through the thickness of the dressing, opposite the wound, in order to permit the escape of pus and to secure access to the points requiring the applica- tion of treatment. FRACTURE OF DIFFERENT BONES. CRANIAL BONES. Causes.— Yractnres of these bones in large animals are compara- tively rare, though the records are not destitute of cases. When they occur, it is as the result of external violence, the sufferers being FRACTURES OF BONES IN THE HEAD. 311 usually runaways which have come in collision with a wall or a tree or other obstruction ; or it may occur in those which in pulling upon the halter have broken it with a jerk and been thrown backward, as might occur in rearing too violently. Under these conditions we have witnessed fractures of the parietal, of the frontal, and of the sphenoid bones. These fractures may be of both the complete and the incomplete kind, which indeed is usually the case with those of the flat bones, and they are liable to be complicated with lacerations of the skin, in consequence of which they are easily brought under observation. But when the fact is otherwise and the skin is intact, the diagnosis becomes difficult. Symptoms. — The incomplete variety may be unaccompanied by any special symptoms, but in the complete kind one of the bony plates may be so far detached as to press upon the cerebral substance with sufficient force to produce serious nervous complications. When the injury occurs at the base of the cranimn, hemorrhage may be looked for, with paralytic symptoms, and when these are present the usual termination is death. It may happen, however, that the symptoms of an apparently very severe concussion may disappear, resulting in an early and complete recovery, and the surgeon will therefore do well to avoid undue haste in venturing upon a prognosis. In frac- tures of the orbital or the zygomatic bones the danger is less pressing than with injuries otherwise located about the head. Treatment. — The treatment of cranial fractures is simple, though involving the best skill of an experienced surgeon. Whew incomplete, hardly any interference is needed ; even plain bandaging may usually be dispensed with. In the complete variety the danger to be com- bated is compression of the brain, and attention to this indication must not be delayed. The means to be employed are the trephining of the skull over the seat of the fracture and the elevation of the depressed bone or the removal of the portion which is causing the trouble. Fragments of bone in connninuted cases, bony exfoliations, collections of fluid, or even protruding portions of the brain substance must be carefully cleansed away, and a simple bandage so applied as to facilitate the application of subsequent dressings. FKACTliRES OV THE BONES OF THE FACE. In respect to their origin — usuall)^ traumatic — these injuries rank with the preceding, and are connnonly of the incomplete variety. They may easily be overlooked and may even sometimes escape recog- nition until the reparative process has been well established and the discovery of the wound becomes due to the prominence caused by the presence of the provisional callus which marks its cure. When the fracture is complete it will be marked by local deformity, mobility of the fragments, and crepitation. Nasal hemorrhage, roaring, frequent sneezing, loosening or loss of teeth, difficulty of mastication, and in- 312 DISEASES OF THE HOESE. flammation of the cavities of the sinuses are varying complications of these accidents. The object of the treatment should be the restora- tion of the depressed bones as nearly as possible to their normal position, and their retention in place by protecting splints, which should cover the entire facial region. Special precautions should be observed to prevent the patient from disturbing the dressing by rub- bing his head against surrounding objects^ such as the stall, the manger, the rack, etc. Clots of blood in the nasal passages must be washed out, collections of pus must be removed from the sinuses, and if the teeth are loosened and likely to fall out they should be removed. If roaring is threatened, tracheotomv is indicated. FRACT'^JEES OF THE PREMAXILLARY BONE. These are mentioned by continental authors. They are usually encountered in connection with fractures of the nasal bone, and may take place either in the width or the length of the bone. The deformity of the upper lip, which is drawn sidewise in this lesion, renders it easy of diagnosis. The abnormal mobility and the crepitation, with the pain manifested by the patient when under^i^oing examination, are concurrent symptoms. Looseness of the teeth, abundant salivation, and entire inability to grasp the food complete the symptomatology of these accidents. In the treatment, splints of gutta-percha or leather are sometimes used, but they are of difficult application. Our own judgment and practice are in favor of the union of the bones by means of metallic sutures. FRACTURES OF THE LOWER JAW. A fracture here is not an injury of infrequent occurrence. It involves the body of the bone, at its symphysis, or back of it, and includes one or both of its branches, either more or less forward, or at the posterior part near the temporo-maxillary articulation, at the coronoid process. Falls, blows, or other external violence, or powerful muscular con- tractions during the use of the speculum, may be mentioned among the causes of this lesion. The fracture of the neck, or that portion formed by the juncture of the two opposite sides, and of the branches in front of the cheeks, causes the lower jaw, the true dental arch, to drop, without the ability to raise it again to the upper, and the result is a peculiar and characteristic physiogiiomy. The prehension and mastication of food become impossible ; there is an abundant escape of fetid and sometimes bloody saliva, especially if the gums have been wounded ; there is excessive mobility of the lower end of the jawbone ; and there is crepitation, and frequently paralysis of the under lip. Although an animal suffering with a complete and often compound and comminuted fracture of the submaxilla presents at times a serious FRACTURES OF VERTEBRA. 313 aspect, the pro<;nosis of the case is comparatively favoral)le, and recovery is usually only a question of time. The severity of the lesion corresponds in degree with that of the violence to which it is due, also with the resulting complications and the situation of the wound. It is simple when at the symphysis, l)ul becomes more serious when it affects one of the branches, and most aggravated when both are involved. Fracture of the coronoid process becomes important prin- cipally as an evidence of the existence of a morbid diathesis, such as osteoporosis, or the like. The particular seat of the injury, with its special features, will, of course, determine the treatment. For a simple fracture, without displacement, j^rovided there is no laceration of the periosteum, an ordinary su})porting bandage will usually be sufficient; but when there is displacement the reduction of the fracture must first be accom- plished, and for this special splints are necessary. In a fracture of the symphysis or of the branches the adjustment of the fragments by securing them with metallic sutures is the first step necessary, to be followed l)y the application of supports, consisting of splints of leather or sheets of metal, the entire front of the head being then covered with bandages prepared with adhesive mixtures. During the entire course of treatment a special method of feeding becomes necessary. The inability of the patient to appreciate the situation, of course, necessitates a resort to an artificial mode of introducing the necessary food into his stomach, and it is accomplished by forcing between the commissures of the lips, in a liquid form, by means of a syringe, the milk or nutritive gruels selected for his sustenance until tiie consolidation is sufficiently advanced to permit the ingestion of food of a more solid consistency. The callus will usually be suffi- ciently hardened in two or three weeks to allow of a change of diet to mashes of cut hay and ^scalded grain, until the removal of the dressing restores him to his old habit of mastication. FRACTURES OK VERTKBR.E. These are not very common, but when they do occur the bones most frequently injured are those of the back and loins. Causes.— The ordinary causes of fracture are responsible here as elsewhere, such as heavy blows on the spinal column, severe falls while convoying heavy loads, and especially violent efforts in resisting the process of casting. Although occurring more or less frequently under the latter circumstances, the accident is not always attributable to carelessness or error in the management. It may, of course, some- times result from such a cause as a badly i)repared bed, or the acci- dental presence of a hard body concealed in the straw, or to a heavy iall when the movements of the patient have not been sufficiently controlled by an effective apjiaratus and its skillful adaptation, but it 314 DISEASES OF THE HORSE. is quite as likely to be caused by the violent resistance and the con- sequent powerful muscular contraction by the frightened patient. The simple fact of the overarching of the vertebral column, with excessive pressure against it from the intestinal mass, owing to the spasmodic action of the abdominal muscles, may account for it, and so also may the struggles of the animal to escape from the restraint of the hobbles Avhile frantic under the pain of an operation without anesthesia. In these cases the fracture usually occurs in the body or the annular part, or both, of the posterior dorsal or the anterior lumbar vertebra. When the transverse processes of the last-named bones are injured, it is probably in consequence of the heavy concus- sion incident to striking the ground when cast. The diagnosis of a fracture of the body of a vertebra is not always easy, especially when quite recent, and more especially when there is no accompanying displacement. Symptoms. — There are certain peculiar signs accompanying the occurrence of the accident while an operation is in progress which should at once excite the suspicion of the surgeon. In the midst of a violent struggle the patient becomes suddenly quiet ; the movement of a sharp instrument, which at first excited his resistance, fails to give rise to any further evidence of sensation; perhaps a general trembling, lasting for a few minutes, will follow, succeeded by a cold, profuse perspiration, particularly between the hind legs, and fre- quently there will be micturition and defecation. Careful examina- tion of the vertebral column may then detect a slight depression or irregularity in the direction of the spine, and there may be a diminu- tion or loss of sensation in the posterior part of the trunk, while the anterior portion continues to be as sensitive as before. In making an attempt to get upon his feet, however, upon the removal of the hobbles, only the fore part of the body will respond to the effort, a degree of paraplegia being present, and while the head, neck, and fore part of the body will be raised, the hind quarters and hind legs will remain inert. The animal may perhaps succeed in rising and probably may be removed to his stall, but the displacement of the bone will follow, converting the fracture into one of the complete kind, either through the exertion of walking or by a rencAved attempt to rise after another fall before reaching his stall. By this time the paralysis is complete, and the extension of the meningitis, which has become established, is a consummation soon reached. To say that the prognosis of fracture of the body of the vertebra is always serious is to speak very mildly. It would be better, perhaps, to say that occasionally a case may recover. Fractures of the trans- verse processes are less serious. Treatment. — Instead of stating the indication in this class of cases as if assuming them to be amenable to treatment, the question natur- PRACTUKES OF THE RIBS. 315 ally would be: Can any treatment be recommended in a fracture of the body of a vertebra? The only indication in such a case, in our opinion, is 'to reach the true diagnosis in the shortest possible time and to act accordin<>ly. If there is displacement, and the existence of serious lesions may be inferred from the nervous symptoms, the destruction of the suffering animal appears to suggest itself as the one conclusion in which considerations of policy, humanity, and science at once unite. If, however, it is fairly evident that no displacement exists; that pressure upon the spinal cord is not yet present; that the animal with a little assistance is able to rise upon his feet and to walk a short dis- tance— it may be well to experiment upon the case to the extent of placing the patient in the most favorable circumstances for recovery and allow nature to operate without further interference. This may be accomplished by securing immobility of the whole body as much as possible, and especially of the suspected region, by placing the patient in slings, in a stall sufficiently narrow to preclude lateral motion, and covering the loins with a thick coat of agglutinative mixture. Watch and wait for developments. FRACTURE OF THE RIBS. The different regions of the chest are not equally exposed to the violence to which fractures of the ribs are due, and they are therefore either more common or more easily discovered during life at some points than at others. The more exposed regions are the middle and the posterior, while the front is largely covered and defended by the shoulder. A single rib may be the seat of fracture, or a number may be involved, and there may be injuries on both sides of the chest at the same time. It may take place lengthwise, in any part of the bone, though the middle, l)eing the most exposed, is the most frequently hurl. Incomplete fractures are usually lengthwise, involving a por- tion only of the thickness or one or other of the surfaces. The com- plete kind may be either transverse or oblique, and are most com- monlv denticulated. The fracture may be comminuted, and a sino-le bone may show one of the complete and one of the incomplete kind at different points. The extent of surface presented by the thoracic region, with its complete exposure at all points, explains the liability of the ribs to suffer from all the forms of external violence. St/f/iptoms. — In many instances fractures of these bones continue undiscovered, especially the incomplete variety, without displace- ment, though the evidences of local pain, a certain amount of swelling, and a degi-ee of disturbance of the respiration, if noticed during the examination of a patient, may suggest a suspicion of their existence. Abnormal mobility and crepitation are difficult of detection, even when present, and they ai-c iu)t always present. When there is dis- placement the deformity which it occasions will betray the fact, and 316 DISEASES OF THE HOESE. Avhen such an injury exists the surgeon will, of course, become vigi- lant, in view of possible and probable complications of thoracic trouble, and prepare himself for an encounter with a case of trau- matic pleuritis or pneumonui. Fatal injuries of the heart are re- corded. Subcutaneous emphysema is a common accompaniment of broken ribs, and I recall the death from this cause of a patient of my own wliich had suft'ered a fracture of two ribs in the region of the withers, under the cartilages of the shoulder, and of which the diag- nosis was only made after the fatal ending of the case. These hurts are not often of a very serious character, though the union is never as solid and complete as in other fractures, the callus being usually imperfect and of a fibrous character, with an amphiar- throsis formation. Still, complications occur which may impart gravity to the prognosis. Treatment. — Fractures with but a slight or no displacement need no reduction. All that is necessary is a simple application of a blis- tering nature as a preventive of inflammation or for its subjugation when present, and in order to excite an exudation which will tend to aid in the support and immobilization of the parts. At times, how- ever, a better effect is obtained by the application of a bandage placed firmly around the chest, although, while this limits the motion of the ribs, it is apt to render the respiration more labored. If there is displacement, with much accompanying pain and evident irritation of the lungs, the fracture must be reduced without delay. The means of effecting this vary according to whether the displace- ment is outward or inward. In the first case the bone may be straightened by pressure from without, while in the second the end of the bone must be raised by a lever, for the introduction of which a small incision through the skin and intercostal spaces will be neces- .sary. AVhen coaptation has been effected it must be retained by the external application of adhesive mixture, with splints and bandages around the chest. FRACTURES OF THE BONES OF THE PELVIS. These fractures will be considered under their separate denomina- tions, as those of the sacrum and the os innominatum, or hip, which includes the subdivisions of the ilium, the pubes, and the ischium. The sacrum. — Fractures of this bone are rarely met with among solipeds. Among cattle, however, it is of connnon occurrence, being attributed not only to the usual varieties of violence, as blows and other external hurts, but to the act of coition and violent efforts in parturition. It is generally of the transverse kind and may be recog- nized by the deformity which it occasions. This is due to the drop- ping of the bone, with a change in its direction and a lower attachment of the tail, which also becomes more or less paralyzed. The natural and spontaneous relief which usually interposes in these cases has FRACTURES OF HIP BONES. 317 doubtless been observed by the extensive cattle breeders of the West, and their practice and example fully establish the inutility of inter- ference. Still, cases may occur in which reduction may be indicated, and it then becomes a matter of no difficulty. It is effected by the introduction of a round, smooth piece of wood into the rectum as far as the fra^iinent of bone and using it as a lever, resting upon another as a fulcrum placed under it outside. The bone, having been thus returned, may be kept in place by the ordinary external means in use, Tlie vii to the fet- lock. Place the animal in a roomy box stall well provided with bed- ding so that he can lie down, to prevent founder. FRACTURE Ol' THK FEMUK. The protection which this bone receives from the large mass of muscles in which it is enveloped does not suffice to invest it with immnnitv in regard to fractures. Cause. — It contributes its share to the list of accidents of this description, sometimes in consequence of external violence and some- times as the result of muscular contraction; sometimes it takes place at the upper extremity of the bone; sometimes at the low^er; some- times at the head, when the condyles become implicated ; but it is principally found in the body or diaphysis. The fracture may be of any of the ordinary forms, simple or compound, complete or incom- plete, transverse or oblique, etc. A case Qf the comminuted variety is recorded in which eighty-five fragments of bone were counted and removed. The thickness of the muscular covering sometimes renders the diagnosis difficult by interfering with the manipulation, but the crepi- tation test is readily available, even when the swelling is considerable, and which is likely to be the case as the result of the interstitial hem- orrhage which naturally follows the laceration of the blood vessels of the region involved. Symptoms. — If the fracture is at the neck of the bone the muscles of that region (the gluteal) are firmly contracted and the leg seems to be shortened in consequence. Locomotion is imi:>ossible. There is intense pain and violent sweating at first. Crepitation may in some cases be discerned by rectal examination, with one hand resting over the coxo-femoral (hip) articulation. Fractures of the tuberosities of the upper end of the bone, the great trochanter, may be identified by the deformity, the swelling, the impossibility of rotation, and the dragging of the leg in walking. Fracture of the body is always accompanied by disj^la cement, and as a consequence a shortening of the leg, which is carried forward. The lameness is excessive, the foot being moved, both when raising it from the ground and when setting it down, very timidly and cautiously. The manipulations for the dis- covery of crepitation always cause much pain. Lesions of the lower end of the bone are more difficult to diagnosticate with certainty, though the manifestation of pain while making lieavy j)ressure upon the condyles will be so marked that only crepitation will be needed to turn a suspicion into a certainty. Treatment. — The question as to treatment in fractures of this description resolves itself into the query whether any treatment can be suggested that \\ ill avail anything })ractically as a curative meas- ure; whether, upon the hypothesis of reduction as an accomplished 324 DISEASES OF THE HORSE. fact, any permanent or efficient device as a means of retention is within the scope of human ingenuity. If the reduction were success- fully performed, would it be jjossible to keep the parts in place by any known means at our disposal ? At the best the most favorable result that could be anticipated would be a reunion of the fragments, with a considerable shortening of the bone, and a helpless, limping, crippled animal to remind us that for human achievement there is a " thus far and no farther.'' In small animals, however, attempts at treatment are justifiable, and we are convinced that in many cases of difficulty in the applica- tion of splints and bandages a patient may be placed in a condition of undisturbed quiet and left to the processes of nature for " treat- ment " as safely and with as good an assurance of a favorable result as if he had been subjected to the most heroic secundum artem doctor- ing known to science. As a case in point, mention may be made of the case of a pregnant bitch which suffered a fracture of the upper end of the femur by being run over by a light wagon. Her " treat- ment " consisted in being tied up in a large box and let alone. In due time she was delivered of a family of puppies, and in three weeks she was running in the streets, limping very slightly, and nothing the worse for her accident. FRACTURE OF THE PATELLA. This, fortunately, is a rare accident and can only result from direct violence, as a kick or other blow. The lameness which follows it is accompanied with enormous tumefaction of the joint, pain, inability to bear weight upon the foot, and finally disease of the articulation. Crepitation is absent, because the hip muscles draw away the upper part of the bone. The prognosis is unavoidably adverse, destruction being the only termination of this incurable and very painful injury. Most of the reported cases of cures are based upon a wrong diagnosis. FRACTURES OF THE TIBIA. Of all fractures these are probably more frequently encountered than any others among the class of accidents we are considering. As with injuries of the forearm of a like character, they may be complete or incomplete; the former when the bone is broken in the middle or at the extremities, and transverse, oblique, or longitudinal. The incomplete kind are more common in this bone than in any other. Synipto7ns. — Complete fractures are easy to recognize, either with or without displacement. The animal is very lame, and the leg is either dragged or held up clear from the ground by flexion at the stifle, while the lower part hangs down. Carrying weight or moving back- ward is impossible. There is excessive mobility below the fracture, and well-marked crepitation. If there is much displacement, as in an oblique fracture, there will be considerable shortening of the leg. FRACTURE OF THE TIBIA. 325 While incomplete fractures can not be recognized in the tibia with any greater degree of certainty than in any other bone, there are some facts associated with them by which a diagnosis may be justified. The hj'^pothetical history of a case may serve as an illustration : An animal has received an injury by a blow or a kick on the inside of the bone, perhaps Avithout showing any mark. Becoming very lame immediately afterwards, he is allowed a few days' rest. Being then taken out again, he seems to have recovered his soundness, but within a day or two he betrays a little soreness, and this increasing he becomes very lame again, to be furlouglied once more, with the result of a temporary im})rovement, and again a return to labor and again a relapse of the lameness; and this alternation vseems to be the rule. The leg being now carefully examined, a local periostitis is readily discovered at the point of the injury, the part being warm, swollen, and painful. What further proof is necessary? Is it not evident that a fracture has occurred, first superficial — a mere split in the bony structure, which, fortunatelj^, has been discovered before some extra exertion or a casual misstep had developed it into one of the complete kind, possibly with complications? What other infer- ence can such a series of symptoms thus repeated establish ? The prognosis of fracture of the tibia must, as a rule, be unfavor- able. Treatment. — The difficulty of obtaining a union without shortening, and consequentl}'^ without lameness, is proof of the futility of ordi- nary -attempts at treatment. But though this may be true in respect to fractures of the complete kind, it is not necessarily so with the incomplete variety, and Avith this class the simple treatment of the slings is all that is necessary to secure consolidation. A few weeks of this confinement will be sufficient. With dogs and other small animals there are cases which nuiy be successfully treated. If the necessary dressings can be successfully applied and retained, a cure will follow. FRACTURES OF THE HOCK. Injuries of the astragalus have been recorded which had a fatal tei-- mination. Fractures of the os calcis have also been observed. l)ut never with a favorable prognosis, and attempts to induce recovery have, as might have been anticipated, proved futile. FRACTIRES OF THE CANNON BONES. Whether these occur in the fore or hind legs, they appear either in the body or near their extremities. If in the body, as a rule the three metacarjial or metatarsal bones are affected, and the fracture is generally transverse and obIi(|ue. On account of the absence of soft tissue and tightness of the skin, the broken bones pierce the skin and render the fracture a complicated one. The diagnosis is easy when all 326 DISEASES OF THE HORSE, the bones are completely broken, but the incomplete fracture can only be suspected. Sy?nptoms. — There is no displacement, but excessive mobility, crep- itation, inability to sustain weight, and the leg is kept off the ground by the flexion of the upper joint. No region of the body affords better facilities for the application of treatment, and the prognosis is, on this account, usually favorable. We recall a case, however, which proved fatal, though under excep- tional circumstances. The patient was a valuable stallion of highly nervous organization, with a compound fracture of one of the cannon bones, and his unconquerable resistance to treatment, excited by the intense pain of the wound, precluded all chance of recovery, and ultimately caused his death. Treatment. — The general form of treatment for these lesions will not differ from that which has been alread}^ indicated for other frac- tures. Reduction, sometimes necessitating the casting of the patient; coaj^tation, comparatively easy by reason of the subcutaneous situa- tion of the bone; retention, by means of splints and bandages — applied on both sides of the region, and reaching to the ground as in fractures of the forearm — these are always indicated. We have obtained excellent results by the use of a mold of thick gutta-percha, composed of two sections and made to surround the entire lower part of the leg as in an inflexible case. FRACTURE OF THE FIRST PHALANX. The hind extremity is more liable than the fore to this injury. It is usually the result of a violent effort, or of a sudden misstep or twisting of the leg, and may be transverse, or, as has usually been the case in our experience, longitudinal, extending from the upper artic- ular surface down to the center of the bone, and generally oblique and often connninuted. The symptoms are the swelling and tender- ness of the region, j^ossibly crepitation ; a certain abnormal mobility ; an excessive degree of lameness, and in some instances a dropping back of the fetlock, with j^erhaps a straightened or upright condi- tion of the pastern. The difficulty of reduction and coaptation in this accident, and the probability of bony deposits, as of ringbones, resulting in lameness, are circumstances which tend to discourage a favorable prognosis. The treatment is 'that which has been recommended for all frac- tures, so far as it can be applied. The iron splint which has been mentioned gives excellent residts in many instances, but if the frac- ture is incomplete and without displacement, a form of treatment less energetic and severe should be attempted. One case is within our knowledge in which the owner lost his horse by his refusal to subject the animal to treatment, the post-mortem revealing only a simple fracture with very slight displacement. FRACTURES OF BONES OF THE FOOT. 327 KRACTURES OF THE SECOND rUALA.NX (COROXET). Thouo:h these are generally of the coniniimited kind, there are often conditions associated with them which justify the surgeon in attempt- ing their treatment. Though crepitation is not always easy to detect, the excessive lameness, the soreness on pressure, the inability' to carry weight, the difHculty experienced in raising the foot, all these suggest, as the solution of the question of diagnosis, the fracture of the.coronet, Avith the accompanying realization of Uie fact that there is yet, by rea- son of the situation of the member, innnobilized as it is by its struc- ture and its surroundings, room left for a not unfavorable prognosis. Only a slight manipulation will be needed in the treatment of this lesion. To render the innnobility of the region more fixed, to support the bones in their position by bandaging, and to establish forced innnobility of the entire body with the slings is usually all that is re- quired. Ringbone, being a common sequela of the reparative process, must receive due attention subsequently. One of the severest com- plications likely to be encountered is an immobile joint (anchylosis). Neurectomy of the median nerve may relieve lameness after a frac- ture of the phalanges. FRACTURES OF THE THIRD PHALANX (OS PEDIS). These lesions may result from a penetrating street nail, or follow plantar or median neurectomy. In the latter instance it is caused by the animal setting the foot down carelessly and too violently, and partly due to degeneration of bone tissue which follow^s nerving. Though these fractures are not of A'^ery rare occurrence, their recog- iiition is not easy, and there is more of speculation than of certainty pertaining to their diagnosis. The animal is very lame and spares the injured foot as much as possible, sometimes resting it upon the toe alone and sometimes holding it suspended in the air. The foot is very tender, and the exph)ring pinchers of the examining surgeon causes nnich pain. During the first twenty-four hours there is no increased pulsation in the digital and i)lantar arteries, but on the second day this symptom is apparent. There is nothing to encourage a favorable prognosis, and a not unusual termination is an anchylosis with either the navicular bone or the coronet. No method of treatment needs to be suggested here, the hoof per- forming the office of retention unaided. Local treatment by baths and fomentations will do the rest. It may be months before there is any mitigation of the lameness. An ultimate recovery depends to a great extent upon whether the other foot can support the weight during the healing process without causing a drop sole in the supporting foot. 328 DISEASES OF THE HORSE. FRACTURE OF THE SESAMOID BONES. This lesion has been considered by veterinarians, erroneously, ^ve think, one of rare occurrence. We believe it to be more frequent than has been supposed. Many observations and careful dissections have convinced us that fractures of these little bones have often been mistaken for specific lesions of the numerous ligaments that are implanted upon their superior and inferior parts, and which have been described as a '"' giving way " or "" breaking down " of these ligaments. In my post-mortem examinations I have always noted the fact that when the attachments of the ligaments were torn from their bony connections minute fragments of bony structure were also separated, though we have failed to detect any diseased process of the fibrous tissue composing the ligamentous substance. Cause. — From Avhatever cause this lesion may arise, it can hardly" be considered as of a traumatic nature, no external violence having any apparent agency in producing it, and it is our belief that it is due to a peculiar degeneration or softening of the bones themselves, a theory which acquires plausibility from the consideration of the spongy consistency of the sesamoids. The disease is a peculiar one, and the suddenness with which different feet are successively attacked, at short intervals and without any obvious cause, seems to prove the existence of some latent, morbid cause Avhich has been unsuspectedly incubating. It is not peculiar to any jDarticular class of horses, nor to any special season of the year, having fallen under our observation in each of the four seasons. Symptoms. — The general fact is reported in the history of a majority of cases that it makes its appearance without premonition in animals wdiich, after enjoying a considerable period of rest, are first exercised or put to work, though in point of fact it may manifest itself while the horse is still idle in his stable. A hypothetical case, in illustration, will explain our theory : An animal which has been at rest in his stable is taken out to work, and it will be presently noticed that there is something unusual in his movement. His gait is changed, and he travels with short, mincing steps, without any of his accustomed ease and freedom. This may continue until his return to the stable, and then, after being placed in his stall, he will be noticed shifting his weight from side to side and from one leg to another, continuing the movement until rupture of the bony structure takes place. But it may happen that the lameness in one or more of the extremities, anterior or posterior, suddenly increases, and it becomes evident that the rupture has taken ]:)lace in consequence of a misstep or a stumble while the horse is at work. Then, upon com- ing to a standstill, he will be found with one or more of his toes turned up; he is unable to place the affected foot flat on the ground. The fetlock has dropped and the leg rests upon this part, the skin of DISEASES OF JOINTS. 329 which may liave reinaiiKHl intact or may have been more or less exten- sively lacerated. It seldom haj^pens that more than one toe at a time will turn up, yet still the lesion in one will be followed by its occurrence in another. Commonly two feet, either the anterior or posterior, are affected, and we recall one case in which the two fore ■ and one of the hind legs were included at the same time. The acci- dent, however, is quite as likely to happen while the horse is at rest in his stall, and he may be found in the morning standing on his fetlocks. One of the earliest of the cases occuring in my own expe- I'ience had been under care for several weeks for suspected disease of the fetlocks, the nature of which had not been made out, when, apparently, improved by the treatment which he had undergone, the patient was taken out of the stable to be walked a short distance into the country, but had little more than started when he was called to a halt by the fracture of the sesamoids of both fore legs. While there are no positive premonitory symptoms known of these fractures, we believe that there are signs and symptoms which come l)ut little short of being so, and the appearance of which will always justify a strong susj^icion of the truth of the case. These have been indicated when referring to the soreness in standing, the short min- cing gait, and the tenderness betrayed when pressure is made over the sesamoids on the sides of the fetlock, with others less tangible and definable. Prognosis. — These injuries can never be accounted less than seri- ous, and in our judgment will never be other than fatal. If our theory of their i^athology is the correct one, and the cause of the lesions is truly the softening of the sesamoidal bony structure and independent of any changes in the ligamentous fibers, the possibility of a solid osseous union can hardly be considered admissible. Treatment. — In respect to the treatment to be recommended and instituted it can only be employed with any rational hope of benefit during the incubation, and with the anticipatory purpose of preven- tion. It must be suggested by a suspicion of the verities of the case, and applied before any rupture has taken place. To prevent this and to antagonize the causes which might precipitate the final catastro- phe— the elevation of the toes — resort must be had to the slings and to the application of firm bandages or splints, perhaps of plaster of Paris, with a high shoe, as about the only indications which science and nature are able to offer. "\Mien the fracture is an occurred event, and the toes, one or more, are turned up, any further resort to treat- ment will be futile. DISEASES or .TOTXTS. Three classes of injury will be considered under this head. These are, affections of tlic synovial sacs: those of the joint structures, oi- of 330 DISEASES OF TAE HORSE. the bones and their articular surfaces, and those forms of solution of continuity known as dislocations or luxations. DISEASES OF THE SYNOVIAL SACS. Two forms of affection here present themselves, one being the result of an abnormal secretion which induces a dropsical condition of the sac without any acute inflammatory action, while the other is characterized by excessive inflammatory symptoms, with their modi- fications, constituting synovitis. . SYNOVIAL DROPSIES. We have already considered in a general way the presence of these peculiar oil bags in the joints, and in some regions of the legs where the passage of the tendons takes place, and have noticed the similarity of structure and function of both the articular and the tendinous bursa^, as well as the etiology of their injuries and their pathological history, and we now proj^ose to treat of the affections of both. WINDGALLS. This name is given to the dilated bursse found at the posterior part of the fetlock joint. They have their origin in a dropsical condition of the bursae of the joint itself, and also of the tendon which slides behind it, and are therefore further known by the designations of articular and tendinous windgalls, or puffs. (See also page 375.) They aj^pear in the form of soft and somewhat symmetrical tumors, of varying dimensions, and generally well defined in their circumfer- ence. They are more or less tense, according to the amount of secre- tion they contain, a^^parently becoming softer as the foot is raised and the fetlock flexed. Usually they are painless and only cause lameness imder certain conditions, as when they begin to develop themselves under the stimulus of inflammatory action, or when large enough to interfere with the functions of the tendons, or again where they have undergone certain pathological changes, such as calcification, which is among their tendencies. Cause. — Windgalls ma}^ be attributed to external causes, such as severe labor or strains resulting from heavy pulling, fast driving, or jumping, or they may be among the sequelae of internal disorders, huch as strangles or the resultants of a pleuritic or pneumonic attack. An unnecessary amount of anxiety is sometimes experienced respect- ing these growths, with much questioning touching the expediency of their removal, all of which might be spared, for, while they constitute a blemish, their unsightliness will not hinder the usefulness of the animal, and in any case they rarely fail to show themselves easily amenable to treatment. Treatment. — AVhen in their acute stage, and when the dropsical condition is not excessive, the inflammation mav be checked during DISEASES OF JOINTS. 331 the day by continuous cold water irrigation by means of a hose or soaking tub and at night by applying a moderately tight roller band- age. Later absorption may be promoted by a Priessnitz bandage," pressure by roller bandages, sweating, the use of liniments, or if neces- sary by a sharp blister of biniodide of mercur3\ This treatment should subdue the inflanmiation, abort the soreness, absorb the excess of secretion, strengthen the walls of the sac, and finally cause the windgalls to disappear, provided the animal is not too quickly re- turned to labor and exposed to the same factors that occasioned them at first. But if the infiammation has become chronic, and the enlargement has been of considerable duration, the negative course will be the wiser one. If any benefit results from treatment it will be of only a transient kind, the dilatation returning when the patient is again sub- jected to labor, and it will be a fortunate circumstance if inflamma- tion has not supervened. But notwithstanding the generally benignant nature of the swelling there are exceptional cases, usually when it is probably undergoing certain pathological changes, which may result in lameness and dis- able the animal, in which case surgical treatment will be indicated, especially if repeated blisters have failed to improve the symptoms. Line firing is then a preeminent suggestion, and many a useful life has received a new lease as the result of this operation timely per- formed. Another method of firing, which consists in emptying the sac by means of punctures through and through, made with a red-hot needle or Avire, and the subsequent injection into the cavity of cer- tain irritating and alterative compounds, designed to effect its closure by exciting adhesive inflammation, such as tincture of iodine, may be commended. But thev are all too active and energetic in their effects and require too much special attention and intelligent management to be trusted to any hands other than those of an expert veterinarian. nr,ooi) SPAVIN, iuk; spavin, and thokoughpin. The blood spavin is situated in front and to the inside of the hock and is merely a varicose or dilated condition of the saphena vein. It occurs directly over the point where the bog spavin is found, and has thus been frequently confused with the latter. The complicated arrangement of the hock joint, and the powerful tendons which pass on the posterior part, are lubricated with the product of secretion from one tendinous synovial and several articular oThis l>;iinliifx(' consists of a doth (Ircnclied in warm water or a drippiiiij band- age laid aronnd the diseased part, then covered b.v >several layers of woolen lilanket or chttli. wliieh is in turn covered by i)arclnnent paper, rubber cloth, or other impervious material. Heat, moisture, and |)ressure is obtained by such a bandage if water is iK)ured upon it several times daily. 332 DISEASES OF THE HOKSE. synovial sacs. A large articular sac contributes to the lubrication of the shank bone (the tibia) and one of the bones of the hock (the astrag- alus). The tendinous sac lies back of the articulation itself and extends upward and downward in the groove of that joint through which the flexor tendons slide. The dilatation of this articular syno- A'ial sac is what is denominated bog spavin, the term thoroughpin being applied to the dilatation of the tendinous capsule. The bog spavin is a round, smooth, well-defined, fluctuating tumor situated in front and a little inward of the liock. On jDressure it disappears at this point to reappear on the outside and just behind the hock. If pressed to the front from the outside it will then appear on the inside of the hock. On its outer sui'face it presents a vein which is quite prominent, running from below upward, and it is to the preternatural dilatation of this blood vessel that the term blood sjjavin is applied. The thoroughpin is found at the back and on the top of the hock in that part known as the " hollows,'' immediately behind the shank bone. It is round and smooth, but not so regularly formed as the bog spavin, and is most apparent when viewed from behind. The swelling is usually on both sides and a little in front of the so-called hamstring, but may be more noticeable on the inside or on the outside. In their general characteristics bog spavins and thoroughpins are similar to windgalls, and one description of the origin, symptoms, pathological changes, and treatment will serve for all equally, except that it is possible for a bog spavin to cause lameness, and thus to involve a verdict of unsoundness in the patient, a circumstance which will, of course, justify its classification by itself as a severer form of a single type of disease. We have already referred to the subject of treatment and the means employed — rest^ of course — with liniments, blisters, etc., and what Ave esteem as the most active and beneficial of any, early^ deep^ and well-performed cauterization. There are, besides, commendatory reports of a form of treatment by the application of pressure pads and peculiar bandages upon the hocks, and it is claimed that the removal of the tumors has been effected by their use. But our expe- rience with this apparatus has not been accompanied by such favorable results as would justify our indorsement of the flattering representations which have sometimes apj^eared in its behalf. OPEN JOINTS, BROKEN KNEES, SYNOVITIS, AND ARTHRITIS. The close relationship whicli exists among these several affections, their apparently possible connection as successive developments of a similar, if not an essentially identical, origin, together with the advantage gained by avoiding frequent- repetitions in the details of symptoms, treatment, etc., are our reasons for treating under a single head the ailments we have grouped together in the present section. DISEASES OF JOINTS. 333 Cause. — The great, comprehensive, coiiiinon cause of, sometimes permanent, sometimes only transient, disability of the horse is exter- nal traumatism. Blows, bruises, hurts by nearly every known form of violence, falls, kicks, lacerations, punctures — we may add compulsory speed in racing and cruel overloading of draft animals — cover the entire ground of causation of the diseases and injuries of the joints now receiving our consideration. In one case, a working horse making a misstep stumbles, and fall- ing on his knees receives a hurt, variously severe, from a mere abra- sion of the skin to a laceration, a division of the tegimient, a slough, mortification, and the escape of the synovial fluid, with or without exposure of the bones ami their articular cartilages. In another case, an animal, from one cause or another, perhaps an impatient temper, has formed the habit of striking or pawing his manger with his fore feet until inflammation of the kneejoint is induced, first as a little swelling, diffused, painless; then as a perios- titis of the bones of the knee ; later as bony deposits, then lameness, and finally the implication of the joint, with all the various sequelae of chronic inflammation of the kneejoint. In another case, a horse has received a blow wnth a fork from a careless hostler on or near a joint, or has been kicked by a stable companion, Avith the result of a punctured wound, at first mild- looking, painless, apparently without inflammation, and not yet caus- ing lameness, but which, in a few hours, or it may be only after a few days, becomes excessively painful, grows Avorse, the entire joint swells, presently discharges, and at last a case of suppurative synovitis is presented, witli perhaps disease of the joint proper, and arthritis as a climax. The sym]>toms of articular injuries vary not only in the degrees of the hurt, but in the nature of the lesion. Or the condition of hroken k/wes, resulting as w^e have said, may have for its starting point a mere abrasion of the skin — a scratch, apparently, which disappears without a resulting scar. The injury may. however, have been more severe, the blow heavier, the fall aggra- vated by occurring ui)on an irregular surface, or sharp or rough ob- ject, with tcniiiig <»!• cutting of the skin, and this laceration may re- main. A more serious case than (he first is now brought to our notice. Another time, inunediately following the accident, or j)ossibly as a sequel of the traumatism, the tentlinous sacs may be opened, with the escape of the synovia ; or worse, the tendons which pass in front of the knee are torn, the inflannnation spreads, the joint and leg are swollen, the animal is becoming very lame; synovitis has set in. With this the danger becomes very great, for soon suppuration will be established, then the external coat of tlic articulation proix'i- becomes ulcerated, if it is not already in that state, and we find ourselves in 334 DISEASES OF THE HORSE. the presence of an open, 'joint with suppurative synovitis — that is, with the worst among the conditions of diseased processes, because of the liability of the suppuration to become infiltrated into ever}^ part of the joint, macerating the ligaments and irritating the cartilages, soon to be succeeded by their ulceration, with the destruction of the articular surface — or the lesion of ulcerative arthritis, one of the gravest among all the disorders known to the animal economy. But ulcerative arthritis and suppurative synovitis may be devel- oped otherwise than in connection with open joints; the simplest and apparenth^ most harmless punctures may prove to be cause sufficient. For example, a horse may be kicked, perhaps, on the inside of the hock; there is a mark and a few drops of blood to indicate the spot, he is put to work, apparently free from pain or lameness, and per- forms his task with his usual ease and facility. But on the following morning the hock is found to be a little swollen and there is some stiff- ness. A little later on he betrays a degree of uneasiness in the leg, and shrinks from resting his weight upon it, moving it up and doAvn for relief. The swelling has increased and is increasing, the pain is severe, and, finally, there is an oozing, at the spot where the kick imi^inged, of an oily liquid mixed with whitish drops of suppuration. The mischief is done; a simple, harmless, punctured womid has ex- panded into a case of ulcerative arthritis and suppurative synovitis. Prognosis. — From ever so brief and succinct description of this traumatism of the articulations, the serious and important character of these lesions, irrespectiA^e of which particular joint is affected, will be readily understood. Yet there will be modifications in the prog- nosis in different cases, in accordance with the peculiarities of struc- ture in the joint specially involved, as, for example, it is obvious that a better result may be expected from treatment when but a single joint, with only its plain articular surfaces, is the place of injury, than in one which is composed of several bones, united in a complex formation, as in the knee or hock. As severe a lesion as suppurative synovitis always is, and as frequently fatal as it proves to be, still cases arise in which, the inflammation assuming a modified character and at length subsiding, the lesion terminates favorably and leaves the animal with a comparatively sound and useful joint. There are cases, however, which terminate in no more favorable a result than the union of the bones and occlusion of the joint, to form an anchylo- sis, which is scarcely a condition to justify a high degree of satisfac- tion, since it insures a permanent lameness with very little capacity for usefulness. Appreciating now the dangers associated with all wounds of articu- lations, however simple and apparently slight, and how serious and troublesome are the complications which are likely to arise during their progress and treatment, we are prepared to understand and DISEASES OF JOINTS. 335 realize the necessity and the vahie of early and prompt attention upon their discovery and dia1,^V1K. XXAai. I Brcvce for dislocation of the elboM- cLpplted to the horse. I a,. The same brace seen alona. 2, Brace for disJornlion of fetlock- 2a, The same brace applied t^ the horse. jsBf^BS<' y ■ ijhoce fui .-iproin'ut. nr dJslMfUted vhontder, .'tti.J'he same broi-e applied to the shoulder. Haines, dri.ut tPi- Ppucli uiiU Tuussiunl JULIUS BIEN ti CO N.r. l)lSi.< )( Vl ioN (»!• SHOTLDKH AND I'J.HOW IJomc'f'lat's a))paralus I'l.Aii-: xwiii "y^x. Hainps del after Rflvnders TIN-: siJN(. IN rsi« DISLOCATIONS. 337 fractured bones: however, it must be remembered that in a disloca- tion two or three days old the inflammatory changes around the joint may give rise to a crackling sensation similar to that in fracture; (3) as a rule, in luxations, if the ligamenous and muscular tissues about the joint are not badly torn, the displacement^ when reduced^ does not recur. Prognosis. — The prognosis of a luxation is comparatively less seri- ous than that of a fracture, though at times the indications of treat- ment may prove to be so difficult to apply that complications may arise of a very severe character. Treatment. — The treatment of luxations must, of course, be similar to that of fractures. Reduction, naturally, will be the first indication in both cases, and the retention of the replaced parts must follow. The reduction involves the same steps of extension and counter exten- sion, performed in the same manner, with the patient subdued by anesthetics. The difference between the reduction of a dislocation and that of a fracture consists in the fact that in the former the object is simply to restore the bones to their true normal position, with each articular surface in exact contact with its companion surface, the apparatus necessary afterwards to keep them in situ being similar to that which is employed in fracture eases, and which will usually require to be retained for a period of from forty to fifty days, if not longer, before the ruptured retaining ligaments are sufficiently firm to be trusted to perform their office unassisted. A variety of manipulations are to be employed by the surgeon, consisting in pushing, pulling, pressing, rotating, and indeed whatever movement may be necessary, until the bones are forced into such relative positions that the muscular qjow- traction. operating in just the right directions, pulls the opposite matched ends together in true coaptation — a head into a cavity, an articular eminence into a trochlea, as the case may be. The " setting *' is accompanied by a peculiar snapping sound, audible and significant, as well as a visible return of the surface to its normal synnnetry. Special dislocations. — "While all the articulations of the body are liable to this form of injury, there are three in the large animals which may claim a special consideration, viz : THE SHOULDER JOINT. We mention this displacement without intending to imply the prac- ticability of any ordinary attt'mpt at treatment, which is usually unsuccessful, the animal whose mishap it has In^en to become a victim to it being disabled for life. The su|)erior head of the arm bone as it is received into the lower cavity of the shouldci- blade is so situated as to be liable to be forced out of place in four directions. It may eseai^e from its socket, according to the manner in which the violence affects 11. Doc. TO.'j. ,')!>-2 22 338 DISEASES OF THE HORSE. it — outward, inward, backward, or forward — and the deformity which results and the effects which follow will correspondingly differ. We have said that treatment is generally unsuccessful. It may be added that the difficulties which interpose in the way of reduction are nearly insurmountable, and that the application of means for the retention of the parts after reduction would be next to impossible. The prognosis is sufficiently grave from any point of view for the luckless animal with a dislocated shoulder. THE HIP JOINT. This Joint partakes very much of the characteristics of the humero- scapular articulation, but is more strongly built. The head of the thigh bone is more separated, or prominent and rounder in form, and the cuplike cavity, or socket, into which it fits is much deeper, form- ing together a deep, true ball-and-socket joint, which is, moreover, reenforced by two strong cords of funicular ligaments, which unite them together. It will be easily comprehended, from this hint of the anatomy of the region, that a luxation of the hip joint must be an accident of comparatively rare occurrence. And yet cases are recorded in which the head of the bone has been affij-med to slip out of its cavity and assume various positions — inward, outward, forward, or backward. The indications of treatment are those of all cases of dislocation. When the reduction is accomplished the surgeon will be apprised of the fact by the peculiar snapping sound usually heard on such occasions. PSEUDO-LUXATIONS OF THE PATELLA. This is not a true dislocation. The stifle bone is so peculiarly articulated with the thigh bone that the means of union are of suffi- cient strength to resist the causes which usually give rise to luxations. Yet there is sometimes discovered a peculiar pathological state in the hind legs of animals, the effect of which is closely to simulate the manifestation of many of the general symptoms of dislocations. This peculiar pathological condition originates in muscular cramps, the action of which is seen in a certain change in the coaptation of the articular surfaces of the stifle and thigh bone, resulting in the exhibi- tion of a sudden and alarming series of symptoms which have sug- gested the phrase of " stifle out " as a descriptive term. Symptoms. — The animal so affected stands quietly and firmly in his stall, or perhaps with one of his hind legs extended backAvard, and resists every attempt to move him backward. If urged to move for- ward he will either refuse or comply with a jump, with the toe of the disabled leg dragging on the ground and brought forward by a second effort. There is no flexion at the hock and no motion at the stifle, while the circular motion of the hip is quite free. The leg- appears to be much longer than the other, owing to the straightened DISLOCATIONS. 339 position of the thigh bone, whicli forms ahiiost a straight line with the tibia from the hip joint down. The stifle joint is motionless, and the motions of all the joints below it are more or less interfered with. External examination of the muscles of the hip and thigh reveals a certain amount of rigidity, with perhaps some soreness, and the stifle bone may be seen projecting more or less on the outside and upper part of the joint. This state of things may continue for some length of time and until treatment is applied, or it may spontaneously and suddenly terminate, leaving evervthing in its normal condition, but perhaps to return again Cause. — Pseudo-dislocation of the patella is likely to occur under many of the conditions which cause actual dislocation, and yet it may often occur in animals wdiich have not been exposed to the ordinary causes, but which have remained at rest in their stables. Sometimes these cases are assignable to falls in a slippery stall, or perhaps slip- ping wdien endeavoring to rise ; sometimes to weakness in convalescing patients; sometimes to lack of tonicity of structure and general de- bility; sometimes to relaxation of tissues from want of exercise or use. A straight leg, sloping croup, and the young are predisposed to this dislocation. Treatment. — The reduction of these displacements of the patella is not usually attended with difficulty. A sudden jerk or spasmodic action will often be all that is required to spring the patella into place, when the flexion of the leg at the hock ends the trouble for the time. But this is not always sufficient, and a true reduction may still be indicated. To effect this the leg must be drawn well forward by a rope attached to the lower end, and the patella, grasped with the hand, forcibly pushed forward and inward and made to slip over the outside border of the trochlea of the femur. The bone suddenly slips into position, the excessive rigor of the leg ceases with a spasmodic jerk, and the animal may walk or trot away without suspicion of lameness. But though this may end the trouble for the time, and the restoration seem to be perfect and permanent, a repetition of the entire transaction may subsequently take place, and perhaps from the loss of some proportion of tensile power which would naturally fol- low the original attack in the muscles involved the lesion might become a habitual weakness. Warm fomentations and douches with cold water will often pro- mote permanent recovery, and liberty in a box stall or in the field will in many cases insure constant relief. The use of a high-heeled shoe is recommended by European veterinarians. The use of stimu- lating liniments, with frictions, charges, or even severe blisters, may be resorted to in order to prevent the repetition of the difficulty by strengthening and toning up the parts. 340 DISEASES OF THE HORSE, DISEASES OF MUSCLES AND TENDONS. SPRAINS. This term expresses a more or less complete laceration or yielding of the fibers of the muscles, tendons, or the sheaths surrounding and supporting them. The usual cause of a sprain is external violence, such as a fall or a powerful exertion of strength, with following symptoms of soreness, heat, swelling, and a suspension of function. Their termination varies from simple resolution to suppuration, and commonly fibrinous exudation difficult to remove. None of the muscles or tendons of the body are exempt from liability to this lesion, though naturally from their uses and the exposure of their situation the extremities are more liable than other regions to become their seat. The nature of the prognosis will be determined by a consideration of the seat of the injury and the complications likely to arise. Treatment. — The treatment will resolve itself into the routine of local applications, including warm fomentations, stimulating lini- ments, counterirritation by blistering, and in some cases even firing. Rest, in the stable or in a box stall, will be of advantage by promoting the absorption of whatever fibrinous exudation may have formed, or absorption may be stimulated by the careful and persevering applica- tion of iodine in the form of ointments of various degrees of strength. There are many conditions in which not only the muscular and ten- dinous structures proper are affected by a strain, but, by contiguity of parts, the periosteum of neighboring bones may become involved, with a complication of periostitis and its sequela?. LAMENESS OF THE SHOULDER. The frequency of the occurrence of lameness in the shoulder from sprains entitles it to precedence of mention in the present category. For, though so well covered with its muscular envelope, it is often the seat of injuries which, from the complex structure of the region, become difficult to diagnosticate with satisfactory precision and facility. The flat bone which forms the skeleton of that region is articuiated in a comparatively loose manner with the bone of the arm, but the joint is, notw^ithstanding, rather solid, and is powerfully strengthened by tendons passing outside, inside, and in front of it. Still, shoulder lameness or sprain may exist, originating in lacera- tions of the muscles, the tendons or the ligaments of the joint, or perhaps in diseases. of the bones themselves. " Slip of the shoulder " is a phrase frequently applied to such lesions. The identification of the particular structures involved in these lesions is of much importance, in view of its bearing upon the ques- tion of prognosis. For example, while a simple superficial injury of the spinatus muscles, or of the muscles by which the leg is attached to SHOULDER LAMENESS. 341 the trunk, may not be of serious import and may readily yield to treatment, or even recover spontaneously and without interference, the condition is quite changed when a case of tearing of the flexor brachii, or of its tend(ms as they pass in front of the articulation, occurs, or, what is still more serious, if there is inflammation or ulceration in the groove over which this tendon slides, or upon the articular surfaces or their surroundings, or periostitis at any point adjacent. Causes. — The frequency of attacks of shoulder lameness is not diffi- cult to account for. The superficial and unprotected position of the part, and the numerous movements of which it is capable, and which in fact it performs, render it both subjectively and objectively preemi- nently liable to accident or injur^^ It would be difficult, nor would it materially avail, to enumerate all the forms of violence by which the shoulder may be crippled. A fall, accompanied by powerful con- cussion; a violent muscular contraction in starting a heavily loaded vehicle from a standstill ; a misstep following a quick muscular efi'ort ; a jump accompanied by miscalculated results in aligliting; a slip on a smooth, icy road; balling the feet with snow; colliding with another horse or other object — indeed, the list might be indefinitely extended, but it would be without profit or utility. Symptoms.. — Some of the symptoms of shoulder lameness are pecul- iar to themselves, and yet the trouble is frequently mistaken for other affections — navicular disease more often than any other. The fact that in both affections there are instances when the external symptoms are but imperfectly defined, and that one of them espe- cially is very similar in both, is sufficient to mislead careless or inexperienced observers, and to occasion the error which is sometimes committed of applying to one disease the name of the other, erring both ways in the interchange. The true designation of i^athological lesions is very far. at times, from being of certain and easy accom- plishment, and, owing to the massive structure of the parts we are considering, this is especially true in the present connection. And still there are many cases in which there is really no reasonable excuse for an error in diagnosis by an average practitioner. Shoulder lameness will of course manifest itself by signs and apjjearances more or less distinct and pronounced, according to the nature of the degree and the extent of the originating cause. We sunnnarize some of these signs and appearances: Tiie lameness is not intermittent but continued, the disturbance of motion frauofins: the severity of the lesion and its extent. It is more marked when the bones are diseased than when the nniscles alone are affected. Wlien in motion the two upper bony h'vers — the shouklei* blade and the bone of the upper arm — are reduced to nearly complete immobility and the walking is performed by the complete displace- ment of the entire mass, which is dragged forward without either 342 DISEASES OF THE HORSE. flexion or extension. The action of the joint below, as a natural con- sequence, is limited in its flexion. In many instances there is a cer- tain amount of swelling at the point of injury — at the joint, or more commonly in front of it, or on the surface of the spinatus muscle. Again, instead of swelling there will be muscular atrophy, though while this condition of loss of muscular power may interfere with perfect locomotion, it is not in itself usually a cause of shoulder lame- ness. " Sweenied " shoulders are more often due to disease below the fetlock than to affections above the elbow. During rest the animal often carries his leg forward, somewhat analogous to the " pointing " position of navicular disease, though in some cases the painful member drops at the elbow in a semiflexed position. The backing is sometimes typical, the animal when per- forming it, instead of flexing his shoulder, dragging the whole leg without motion in the upper segment of the extremity. The peculiar manner in which the leg is brought forward in the air for another step in the act of walking or trotting is in some instances characteristic of injuries of the shoulder. The lameness also mani- fests itself in bringing the leg forward with a circumflex swinging motion and a shortening in the extension of the step. The foot is carried close to the ground and stumbling is frequent, especially on an inieven road. With the utmost scrutiny and care the vagueness and uncertainty of the symptoms will contribute to perplex and discredit the diagnosis and embarrass the surgeon, and sometimes the expedient is tried of aggravating the symptoms by way of intensifying their significance, and thus rendering them more intelligible. This has been sought by requiring the patient to travel on hard or very soft ground and compelling him to turn on the sound leg as a pivot, with other motions calculated to betray the locality of the pain. Treatment. — It is our conviction that lameness of the shoulder will in many cases disappear with no other prescription than that of rest. Provided the lesions occasioning it are not too severe, time is all that is required. But the negation of letting alone is seldom accepted as a means of doing good, in the place of the active and the positive forms of treatment. This is in accordance with a trait of human nature which is universal, and is unlimited in its applications. Hence there must be something done. In mild cases of shoulder lameness, then, the indications are water, either in the cold douche or by showering, or by warm fomentations. Warm wet blankets are of great service; and in addition, or as alternative, anodyne lini- ments, camphor, belladonna, either in the form of tincture or the oils, are of benefit, and at a later period stimulating friction with suitable mixtures, sweating liniments, blistering compounds, sub- cutaneous injections over the region of the muscle of 1^ grains of SPRAIN OF ELBOW MUSCLES. 343 veratrin (the variety insoluble in water) mixed in 2 drams of water, etc., will find their place, and tinally, when necessity demands it, the firing iron and the seton. The duration of the treatment must be determined by its effects and the evidence that may be offered of the results following the action of the reparative process. But the great essential condition of cure, and the one without which the possibility of relapse will always remain as a menace, is, as we have often reiterated in analogous cases, re«#, imperatively rest, irrespective of any other prescriptions with which it may be associated. SPRAIN OF THE ELBOW MUSCLES. Causes. — This injury, which fortunately is not very common, is mostly encountered in cities, among heavy draft horses or rapidly driven animals which are oblip^ed to travel, often smooth shod, upon slipi:)ery, icy, or greasy pavements, where they are easily liable to lose their foothold. The region of the strain is the posterior part of the shoulder, and the muscles which are affected are those which occupy the space between the posterior border of the scapula and the pos- terior face of the arm. It is the muscles of the olecranon which give way. Symptoms. — The symptoms are easily recognized, especially when the animal is in action. While at rest the attitude may be normal, or by close scrutiny a peculiarity may perhaps be detected. The leg may seem to drop; the elbow may appear to be lower than its fellow, with the knee and lower part of the leg flexed and the foot resting on the toe, with the heel raised. Such an attitude, however, may be occasionally assumed by an animal without having any special signifi- cance. But when it becomes more pronoimced on putting him in motion the fact acquires a symptomatic value, and this is the case in the present instance. A rapid gait becomes quite impossible, and the walk, as in some few other diseases, becomes sufficiently characteristic to warrant a diagnosis even when observed from a distance. An entire dropping of the anterior part of the trunk becomes manifest, and no weight is carried on the disabled side, in conscMpience of the loss of action in the suspensory muscles. There are often heat, pain, and swelling in the nuiscular mass at the elbow, though at times a hollow, or depression, nuiy be observed near the posterior border of the scapula, which is probably the seat of injury. These lnirt> aic of various degrees of importance, varying from mere minor casualties of quick recovery to lesions which are of suffi- cient severity to render an animal useless and valueless for life. Tveatinrnt. — The prime elements of treatment, which should be strictly observed, are rest and (juiet. Prescriptions of all kinds, of course, have their advocates. Among them are ether, chloroform, 344 DISEASES OF THE HORSE. camphor, alcoholic frictions, warm fomentations, blisters, setons, etc. But unless the conclusions of experience are to be ignored, my own judgment is decisive in favor of rest, judiciously applied; and my view of what constitutes a judicious application of rest has been more than once presented in these pages. There are degrees of this rest. One contemplates simple immobility in a narrow stall. Another means the enforced mobility of the slings and a narrow stall as well. Another a box stall, with ample latitude as to posture and space, and option to stand up or lie down. As wide as this range may appear to be, radical recovery has occurred under all of these modified forms of letting our patients alone. HIP I>AMENESS. The etiology of injuries and diseases of the hip is one and the same with that of the shoulder. The same causes operate and the same results follow. The only essential change, with an important excep- tion, which Avould be necessary in passing from one region to the other in a description of its anatomy, its physiology, and its pathol- ogy, would be a substitution of anatomical names in reference to certain bones, articulations, muscles, ligaments, and membranes con- cerned in the injuries and diseases described. It would be only a use- less repetition to cover again the ground over which we have so recently passed in recital of th-e manner in which certain forms of external violence (falls, blows, kicks, etc.) result in other certain forms of lesion (luxation, fracture, periostitis, ostitis, etc.), and to recapitulate the items of treatment and the names of the medicaments proper to use. The same rules of diagnosis and the same indications and prognosis are applicable equally to every portion of the organ- ism, with only such modifications in applying dressings and appa- ratus as may be required by differences of conformation and other minor circumstances, which must suggest themselves to the judgment of every experienced observer when the occasion arrives for its exercise. There is an exception to be made, while considering the subject in connection with the region now under advisement, in respect to the formidable affection known as morbus coxarius, or hip-joint disease; and leaving the detail of other lesions to take their place under other heads, that relating to the shoulder, for instance, we turn to the hip joint and its ailments as the chief subject of our present consid- eration. Symptoms. — In investigating for morbus coxarius, let the ob- server first examine the lame animal by scanning critically the out- lines of the joint and the region adjacent for any difference of size or disturbance of symmetry in the parts, any prominence or rotundity, and on both sides. The lame side will probably be warmer, more developed and fuller, both to the touch and to the eye. Let him then SPRAIN OF LIGAMENTS OF FEET. 345 gi'asp the lower part of the leg (as he would in examining a case of shoulder lanieneiss) and endeavor to })roduce excessive passive mo- tion. This will probably cause pain when the leg is made to assume a given j)osition. Let him ])usli the thigh forcibly against the hip bone, and the contact Avill again j)robably cause a manifestation of pain. If the horse is trotted, the limited action of the hip joint proper and the excessive dropping and rising of the hip of the oppo- site side will be easily recognized. Usually the aninuil dtx^s not extend the foot as far as customarily and i)icks it up nnich sooner. The abductive or circumlUx motion obsci'ved in shoulder lameness is also present in hij) lameness, but under special conditions, and the test of the difticulty, either by traveling on soft ground or in turning the horse in a circle, may here also contribute to the diag- nosis, as in testing for lameness in the anterior extremity. Prognosis. — The jirognosis of hip lameness is at times quite seri- ous, not only on account of the long duration of treatment required to effect good results, and because of the character which, may be assumed by the disease, but of the ]:)ermanence of the disability re- sulting from it. PLxostosis and ulcerative arthritis are sequeht? which often resist every form of treatment. Treatment. — As before intimated, this is little more tlian a repetition of the remarks upon the lameness of the shoulder, with slight modifi- cations occasioned by the muscular structure of the hip, and we are limited to the same recommendations of treatment. The advantaires of rest must be reaffirmed, with local ai)plications, of which, however, it may be said that they are more distinctly indicated and likely to be more effective in their results than in shoulder lameness, and nuiy be more freely employed, whether in the form of liniments, blisters (singly or repeated), firing, or setoning. SPRAINS OF SUSPENSORY LIGAMENTS AND OF THE FLEXOR TENDONS OR THEIR SHEATH. The fibrous structure situated behind the cannon bones, both in the fore and hind legs, is often the seat of lacerations or sprains resulting from violent efforts or sudden jerks. Cause. — The injury may be considered serious or trilling, according to the circumstances of each case as iudired bv its own historv. Amouir the predisi^osing causes are a long thin fetlock and a narrow knee or hock as viewed from the side, with the flexor nmscles tied in just below the joint. 'J'he longer and more oblique the pastern the greater is the straiu on the flexor tendons and suspensory ligaments, hence a low quart<>r. a toe calk, and ii(» liccl cjilks. or a thin calk })laced at the tip under the toe. and leaving the quarters long abnormally stretches the back tendons and causes a great strain upon them just before the ■weight is shifted from the foot in locomntion. In runners and hunters the disease is apt to be periodic. In dri\ iiig horses it is most connnon 346 DISEASES OF THE HORSE. ill well-bred animals of nervous teniperament. Draft horses suffer most frequently in the hind legs. Symptoms. — The injury is readily recognized by the changed aspect of the region and the accompanying local symptoms. The parts, which in health are well defined, wnth the outlines of the tendons and ligaments well marked, become the seat of a swelling, more or less developed, from a small spot on the middle of the back of the tendon to a tumefaction reaching from the knee down to and even involving the fetlock itself. It is always characterized by heat, and it is vari- ously sensitive, ranging from a mere tenderness to a degree of soreness which shrinks from the lightest touch. The degree of the lameness varies, and it has a corresponding range with the soreness, sometimes showing only a slight halting and at others the extreme of lameness on three legs, with intermediate degrees. The lameness is always worse when the weight is thro^/n on the foot, and is most marked toward the end of the phase of contact with the ground. Either passive irritation of the leg or turning the ani- mal in a circle causes pain as in diseases of the joints. Sometimes the horse likes to get the heels on a stone or some elevation so as to relieve the weight from the flexor tendons. Finally, in cases of long stand- ing, a shortening of the tendons occurs, resulting in the abnormal flexion of the foot known by horsemen as " broken down," or a more upright position of the foot may follow, producing perhaps knuck- ling or the so-called clubfoot. Prognosis. — It may be safely assumed on general principles that a leg which has received such injuries very seldom returns to a perfect condition of efficiency and soundness, and that as a fact a certain abso- lute amount of thickening and deformity will remain permanent, even when the lameness has entirely disappeared. Treatm,ent. — The injured member should receive the earliest atten- tion possible, not only when the inflammatory condition is present, but when it is subsiding and there is only the thickening of the ligaments, the tendons, or the sheath. The most important remedy is rest, and the shoes should always be removed. During the first three days cold in the form of immersion or continuous irrigation is indicated. Then warm moisture and con- tinuous pressure are advised. The latter is best applied by placing two padded splints about the thickness of the thumb along the two sides of the tendon and binding them in place with even pressure by bandage. Frequent bathing with warm soap suds is also beneficial. The absorption of the exudate may be promoted and the work of restoration effected by frictions with alcohol, tincture of soap, spirits of camphor, mild liniments, strong sweating liniments, and blisters. An excellent ointment to apply with massage consists of equal parts of blue ointment and green soap, with double the quantity of vaseline. KNUCKLING OF FETLOCK. 347 The action of blisters in these cases depends chiefly upon the massage used in applying them and upon the continuous pressure of the swol- len skin on the inflamed tendons. In old cases more beneficial results will follow line firing. In these cases shoeing is very inii^ortant. Leave the quarters long, shorten the toe, give the shoe rolling motion, and either put short heel calks on the branches or thicken the branches. Although this line of treatment is efficacious in many cases, there are others in which the thickening of the tendons refuses to vield and the changed tissues remain firmlv organized, leavinjj: them in the form of a thick mass resting ui)on the back part of the cannon bone. KNUCKLING OF FETLOCK. As a consequence of the last-mentioned lesion of the tendons, a new condition presents itself in the articular disposition, constituting the deformity known as the knuckling fetlock. (See also page 374.) By this is meant a deformity of the fetlock joint by which the nat- ural angle is changed from that which pertains to the healthy articu- lation. The first pastern, or suffraginis, loses its oblique direction and assumes another, wdiich varies from the upright to the oblique, from before backward, and from above downward; in other words, form- ing an angle with its apex in front. Causes. — This condition, as we have seen, may be the result of chronic disease producing structural changes in the tendons, and it may also occur as the result of other affections or some peculiarity independent of this and situated below the fetlock, such as ringbones, sidebones, or traumatic disease of the foot proper. Animals are sometimes predisposed to knuckling, such, for example, as are natur- ally straight in their pasterns, or animals which are compelled to labor when too young. The hind legs are more predisposed than the fore to this deformity, in consequence of the greater amount of labor they are required to perform as the propelling levers of the body. Sy?npto7ns. — The symptoms of knuckling are easil)-^ recognized. The changes in the direction of the bones vary more or less with the degree of the lesion, sometimes assuming such a direction that it almost becomes a true dislocation of the pastern. The effect of knuckling upon the gait also varies according to the degree of the deformity. As the different degi*ees of the shortening of the leg affect the motion of the fetlock, the lameness may be very slight or quite extreme. Another consequence of this shortening is such a change in the position of the foot that the heels cease to come in contact with the ground and assume a greater elevation, and the final result of this is soon witnessed in the development of a clubfoot. Treatvient. — To whatever cause the knuckling may be ascribed, it is always a severe infirmity, and there is but little room for hoping to overcome it unless it be during the v^k first stages of the trouble, 348 DISEASES OF THE HORSE. and the hope dwindles to still smaller dimensions when it is secondary to other diseases below the fetlock. If it is caused by overworking the animal, the first indication will, of course, be rest. Line firing has proved very efficacious in these cases. The animal must be turned loose and left unemployed. Careful attention should be given to the condition of his feet and to the manner of shoeing, while time is allowed for the tendons to become restored to their normal state and the irritation caused by excessive stretching has subsided. A shoe with a thick heel will contribute to this. But if no improvement can be obtained and the tendons though retracted have yet been relieved of much of their thickening, the case is not a desperate one, and may yet be benefited by the operation of tenotomy, single or double — an operative expedient which must be committed to the experienced surgeon for its performance. SPRUNG KNEES. Though not positively the result of diseases of the tendons acting upon the knees, we venture to consider this deformity in connection with that which we have just described. It consists in such an alter- ation in the direction and articulation of the bones which form the various carpal joints that instead of forming a vertical line from the lower end of the forearm to the cannon bone they are so united that the knee is more or less bent forward, presenting a condition due to the retraction of two of the principal muscles by which the cannon bone is flexed. Cause. — This flexion of the knee may be a congenital deformity and have continued from the foaling of the animal ; or, like clubfoot, it may be the result of heavy labor which the animal has been compelled to perform at too early an age. It may also be due to other diseases existing in jjarts below the kneejoint. Sytnptojns. — This change of direction largely influences the move- ment of the animal by detracting from its firmness and practically weakening the entire frame, even to the extent of rendering him inse- cure on his feet and liable to fall. This condition of weakness is some- limes so pronounced that he is exposed to fall even when standing at rest and unmolested, the knees being unable even to bear the portion of the mere Aveight of the frame which bekmgs to them. This results in another trouble — that of being unable to keep permanently upright. He is apt to fall on his knees, and by this act becomes presently a sufferer fi-om the lesion known by the t^rm of hrokcn knees. Treatment. — Whatever may be the originating cause of this imper- fection, it detracts very largely from the usefulness and value of a horse, disqualifying him for ordinary labor and wholly unfitting him for service under the saddle Avithout jeopardizing the safety of his lider. If, hoAvever, the trouble is known from the start, and is not the result of congenital de^^'mity or Aveakness of the kneejoint, or CURB. 349 secondary to other diseases, rest, with fortifying frictions, may some- times aid in strengtliening the joints; and the application of blisters on the posterior part of the knee, from a sliort distance above to a point a little below the joint, may be followed by some satisfactory results; but with this trouble, as with knuckling fetlocks, the danger of relapse must be kept in mind as a contingency always liable to occur. CURB. This lesion is the bulging backward of the posterior part of the hock, where in the normal state there should be a straight line, extend- ing from the upper end of the point of the hock down to the fetlock. Cause. — The cause may be a sprain of the tendon which passes on the posterior part of the hock, or of one of its sheaths, or of the strong ligament situated on the posterior border of the os calcis. Hocks of a certain conformation seem to possess a greater liability to curb than others. They are overbent, coarse, and thick in appear- ance, or may be too narroAv from front to back across the lower por- tion. This condition may therefore result as a sequence to congeni- tal malformation, as in the case of horses that are saber-legged. It often occurs, also, as .the result of violent etforts, of heavy pulling, of high jumping, or of slipping; in a word, it may result from any of the causes heretofore considered as instrumental in producing lacera- tions of muscular, tendinous, or ligamentous structure. Symptoms. — A hock affected with curb will, at the outset, present a swelling more or less diffuse on its posterior portion, with varying degrees of heat and sortness, and these will be accompanied by lame- ness of a permanent character. At a later period, however, the swell- insr will become better defined, the deformitv more characteristic, the prominent curved line readily detected, and the thickness of the infil- trated tissue easily determined by the fingers. At this time, also, there may be a condition of lameness, varying in degree, while at others, again, the irregularity of action at the hock will be so slight as to escape detection, the animal betraying no ai)pearance of its existence. A curb constitutes, by a strict construction of the term, an '" un- soundness," since the hock thus affected is less able to endure severe labor, and is more liable to give way with the slightest effort. And yet the prognosis of a curb can not be considered to be serious, since it srenerallv yields to treatment, or nt least the lameness it mav occasion is generally easily relieved, (hougli the loss of contour caused by the bulging will always constitute a blemisji. Treatment. — On the first appearance of a cuib. Avhen it exhibits the signs of an acute inflammation, the first indication is to suMue this by the use of cold ap})lications as intermittent or constant in-iga- tion or an ice poultice; but when these have exhausted their effect 350 DISEASES OF THE HOKSE. and the swelling has assumed better defined boundaries, and the infil- tration of the tendons or of the ligaments is all that remains of a morbid state, then every eff'ort must be directed to the object of effect- ing its absorption and reducing its dimensions by pressure and other methods. The medicaments most to be trusted are blisters of can- tharides and frictions with ointments of iodine, or, jjreferabl}', biniodide of mercury. Mercurial agents alone, by their therapeutic properties or by means of the artificial bandages which they furnish by their incrustations when their vesicatory effects are exhausted, will give good results in some instances by a single application, and often by repeated applications. The use of the firing iron must, however, be frequently resorted to, either to remove the lameness or to stimulate the absorption. We believe that its early application ought to be resorted to in preference to waiting until the exudation is firmly organized. Firing in dull points or in lines will prove as beneficial in curb as in any other disease of a similar nature. LACERATED TENDONS. This form of injury, whether of a simple or of a compound char- acter, may become a lesion of a very serious nature, and will usually require long and careful treatment, which may yet prove unavailing in consequence either of the intrinsically fatal character of the wound itself or the complications which have rendered it incurable. Cause. — Like all similar injuries, these are the result of traumatic violence, such as contact with objects both blunt and sharp ; a curb- stone in the city ; in the country, a tree stump or a fence, especially one of wire. It may easily occur to a runaway horse when he is '' whipped " with fragments of harness or " flogged " by fragments of splintered shafts " thrashing " his legs, or by the contact of his legs with the wagon he has overturned and shattered with his heels while disengaging himself from its wreck. Symptoms. — It is not always necessary that the skin should be involved in this form of injury. On the contrary, the tegument is frequently left entirely intact, especially when the injury follows infectious diseases or occurs during light exercise after long periods of rest in the stable. Yet, again, the skin may be cut through and the tendons nearly severed. A point a little above the fetlock is usually the seat of the injury. But irrespective of this, and whether the skin is or is not implicated, the symptoms very much resemble those of a fracture. There is excessive mobility, at least more than in a normal state, with more or less inability to carry weight. There may be swelling of the parts, and on passing the hands care f idly along the tendon to the point of division the stumps of the divided structure will be felt more or less separated, perhaps wholly divided. The position of the animal while at rest and standing is peculiar and characteristic. While the heels are well placed on the ground, the LACERATED TENDONS. 351 toe is correspondingly elevated, with a tendency to turn up — a form of breaking down which was described when speaking of the fracture of the sesamoids. Carrying weight is done only with considerable difficulty, but with comparatively little pain, and the animal will unconsciously continue to move the leg as if in great suffering, not- withstanding the fact that his general condition may be very good and his appetite unimpaired. The ert'ect u})()n the general organism of compound lacerated wounds of tendinous structures, or those which are associated with injuries of the skin, are different. The wound becomes in a short time the seat of a high degree of inflanmiation with abundant suppuration, filling it from the bottom; and the tendon, wdiether as the result of the bruise or of the laceration, or of maceration in the accunnilated pus, undergoes a process of softening, and necrosis and sloughing ensue. This comjjlicates the case, and probably some form of tendi- nous synovitis follows, running into suppurative arthritis, to end, if close to a joint, with a fatal result. Prognosis. — The prognosis of lacerated tendons should be very con- servative. Under the most favorable circumstances a period of from six weeks to two months will be necessary for the treatment, before the formation of the cicatricial callus and the establishment of a firm union between the tendinous stumps. Treatment. — As with fractures, and even in a greater degree, the necessity is imperative, in the treatment of lacerated tendons, to se- cure as perfect a state of immobility as can be obtained compatibly with the disposition of the patient; the natural opposition of the animal, sometimes ill-tempered and fractious at best, under the neces- sary restraint, causing at times much embarrassment to the practi- tioner in applying the necessary treatment. Without the necessary inunobility no close connection of the ends of the tendons can be secured. To fulfill this necessary condition the posterior part of the foot and the fetlock must be supported and the traction performed by them relieved, an object which can be obtained by the use of the high-heeled and bar shoe, or possibly better accomplished with a shoe of the same kind extending about 2 or 2i inches back of tlie heels. The perfect immobility of the legs is obtained in the same way as in the treatment of fracture, with splints, bandages, iron appa- ratus, plaster of adhesive mixtures, and similar means. So long as the dressings remain in place undisturbed, and no chafing or other evidence of pain is present, the dressings may be continued without changing, the |)atient being kept in the slings for a period sufficient to insure the perfect union of the tendons. But for a compound lesion, when there is laceration of the skin, some special care is necessary. The wound must be carefully watched and the dressings removed at intervals of a few days, or as often as may be needful, all of which 352 DISEASES OF THE HORSE. additional manipulation and extra nursing, however indispensable, still adds to the gravity of the case and renders the prognosis more and more serious. When the tendons have sloughed in threads of various dimensions, or if in the absence of this process of mortification healthy granulations should form and fill up the wound, still very careful attention will be required, the granulating ends of the tendons having a tendency to bulge between the edges of the skin and to assume large dimensions, forming bulky excrescences or growths of a warty or cauliflower appearance, the removal of which becomes a troublesome matter. The union of the tendons will at times leave a thickening of vary- ing degree near the point of cicatrization, the absorption of which becomes an object of difficult and doubtful accomplishment,, but Avhich may be. promoted by moderate blistering and the use of alter- ative and absorbent mixtures or perhaps the fire iron. A shoe with heels somewhat higher than usual will prove a comfort to the animal and aid in moderating and relieving the tension of the tendons. RUPTURE OF THE FLEXOR METATARSI. This is a muscle of the anterior part of the shank. It is situated in front of the tibia, and is of peculiar formation, being composed of a muscular portion with a very powerful tendon, which are at first distinct and separate, to be intimately united lower down, and termi- nating at the lower end by a division into four tendinous bands. It is a powerfid muscle of the hinder shank bone, and also acts as a strong means of support for the stifle joint, that is, of the articulation of the thigh and shank bone, in front and outside of which it passes. Its situation and its use cause it to be liable to severe stretching and straining, and a rupture of some of its fibers is sometimes the consequence. Cause. — This injury may be the result of a violent effort of the animal in leaping over a high obstacle ; in missing his foothold and suddenly slipping backward while powerfully grasping the ground with the feet in striving to start a heavily loaded vehicle ; or in mak- ing a violent effort to prevent a probable fall; or in attempti.ig to lift the feet from miry ground. Symptovis. — The accident is immediately folloAved by disability which will vary according to the true seat of the injury and the period of its duration. This rupture will not prevent the horse from standing perfectly and firmly on his feet when kept at rest, and Avhile no muscular efforts are required from him there is no appear- ance of any lesion or unsoundness. An attempt to move him back- ward, however, will cause him to throw all his weight upon his hind quarters, and he will refuse to raise his foot from the ground. If compelled to do so, or required to move forward, the hock being no longer capable of flexion, the muscle which effects that movement LACERATED TENDONS. 353 being the injured one. the opposite muscles, the extensors, acting freely, the entire lower part of the leg, from the hock down, will l)e suddenly, with a jerk, extended on the tibia or shank bone, and simultaneously with this the tendo-Achillis, the cord of the hock, the tendons of the extensors of the hock will be put in a wrinkled and relaxed condition. The leg is behind the animal and the toe rests on the ground. Examination of the fore paH of the shank from the stifle down to the hock may reveal soreness, and possibly some swelling and heat at the seat of the lesion. Treatment. — Our experience with injuries of this form satisfies us that, generally speaking, they are amenable to treatment. Very few instances have come to our knowledge in which radical recovery has not been obtained, ]n-ovided a sufficient time has been allowed for union to take place. The more flexed the leg can be kept, the quicker will it heal. In these cases, as in those already considered of simple laceration of tendons, the indications resemble those which apply in the treatment of fractures; as near as coaptation of the lacerated ends is possible, Avith immobility, being the necessary conditions to secure. The first is a matter of very difficult accomplishment, by bandaging alone, and some have recommended instead the application of charges or blisters in order to compel the animal to keep more quiet. To secure the necessary immobility the animal should be placed in slings snugly applied, and kept in a narrow stall. He should also be tied short, and restrained from any backward movement by ropes or boards, and he should, moreover, be kept in as quiet a temper as pos- sible by the exclusion of all causes of irritation or excitement. Weeks must then elapse, not less, but frequently more than six, often eight, before he can be considered out of danger and able to return to his labor, which should for a time be light and easy, and gradually, if ever, increased to the measure of a thoroughly sound and strong ani- mal. If he is used too soon the newly formed tissue between the ends of the muscle will be apt to stretch and leave the flexor muscle too long and permanently displaced. SUNDKV ADOrnONAL AFFECTIONS OF THE EXTREMITIES. Among tliese there are three which will principally occupy our attention, and these may be considered as forming a single group. In some parts of tlie legs may be found certain peculiar little structures of a saclike formation, containing an oily substance designed for the lubrication of tlie parts ii])()ii wliidi (liey are placed for the i)urpose of facilitating the movements of the tendons which pass over them. These little sacs or inuco-synoN ial capsules are liable under peculiar conditions of traumatism to l>ocome subject to a disea.sed process, n. I)*-'4 (Mie v/frcl ol' lintirtcr I'rtir/; . UPS del QUAHTKR-rR^CK AND H >: M KD 1 K S. 1.2 nnd 3, Sound foot oftyyoreo.^ old PLATh: xxxn. — X a, iVa-il properly driven b. Nail improperly driven. Con.tracteart, and the lameness may last a long time. In these cases the joint should be kept completely at rest; and this condition is best secured by the application of the plaster of Paris bandages, as in cases of fracture. As a rule, patients take kindly to this bandage, and may be given the freedom of a roomy box or yard while wearing it. If they are disposed to tear it off, or if sufficient rest can not otherwise be secured, the patient must be kept in slings. In the majority of instances the plaster bandage should remain on from two to four weeks. If the lameness returns when the bandage is removed, a new one should be put on. The swelling, which always remains after the other evidences of the disease have disappeared, may be largely dissipated and the joint strengthened by the use of the firing iron and blisters. A joint once injured bj^ a severe sprain never entirely regains its original strength, and is ever after particularly liable to a repetition of the injury. RUPTURE OF THE SUSPENSORY L-IGAMENT. Sprain with or without rupture of the suspensory ligament may ha])pen in either the fore or hind legs, and is occasionally seen in horses of all classes and at all ages. Old animals, however, and espe- cially hunters, runners, and trotters, are the most subject to this injury, and with these classes the seat of the trouble is nearly always in one or both the fore legs. Horses used for heavy draft are more liable to have the ligament of the hind legs affected. When the strain upon the suspensory ligament becomes too great, one or both of the branches may be torn from the sesamoid bones, one or both of the branches may be torn completely across, or the liga- ment may rupture above the point of division. Symjjtoms. — The most common injury to the suspensory ligament is sjDrain of the internal branch in one of the fore legs. The trouble is proclaimed by lameness, heat, swelling, and tenderness of the affected branch, beginning just above the sesamoid bone and extend- ing obliquely downward and forward to the front of the ankle. If the whole ligament is involved, the swelling comes on gradually, and is found above the fetlock and in front of the flexor tendons. The patient stands or walks upon the toe as much as possible, keeping the fetlock joint flexed so as to relieve the ligament of tension. When both branches are torn from their attachments to the sesa- moids, or both are torn across, the lameness comes on suddenly and is most intense; the fetlock descends, the toe turns up, and, as the animal attempts to walk, the leg has the ai)pearance of being broken off at the fetlock. These symptoms, foUowiHl by heat, pain, and 378 DISEASES OF THE HORSE. swelling of the parts at the point of injury, will enable anyone to make a diagnosis. Treatment. — Sprain of the suspensory ligament, no matter how mild it may be, should always be treated by enforced rest of at least a month, and the application of cold douches and cold-water bandages, firmly applied until the fever has subsided, when a cantharides blister should be put on and repeated in two or three weeks if necessary. When rupture has taken place, the patient should be put in slings, and a constant stream of cold water allowed to trickle over the seat of injury until the fever is reduced. In the course of a week or ten days a plaster of Paris splint, such as is used in fractures, is to be applied and left on for a month or six weeks. When this is taken off, blisters may be used to remove the remaining soreness; but it is use- less to expect a removal of all the thickening; for, in the process of repair, new tissue has been formed which will always remain. In old cases of sprain the firing iron may often be used with good results. As a rule, severe injuries to the suspensory ligament inca- pacitate the subject for anything but slow, light work. OVERREACH. An overreach is where the shoe of the hind foot strikes and injures the heel or quarter of the fore foot. It rarely happens except when the animal is going fast, hence is most common in trotting and run- ning horses. In trotters the accident generally happens when the animal breaks from a trot to a run. The outside heels and quarters are most liable to the injury. Synij)toms. — The coronet at the heel or quarter is bruised or cut, the injury in some instances involving the horn as well. Where the hind foot strikes well back on the heel of the fore foot — an accident known among horsemen as " grabbing " — the shoe may be torn from the fore foot or the animal may fall to its knees. Horses accustomed to overreaching are often " bad breakers," for the reason that the pain of the injury so excites them that they can not readily be brought back to the trotting gait. Treatment. — If the injury is but a slight bruise, cold-water bandages applied for a few days will remove all of the soreness. If the parts are deeply cut, more or less suppuration will follow, and, as a rule, it is well to poultice the parts for a day or two, after which cold baths may be used, or the wounds dressed with tincture of aloes, oakum, and a roller bandage. Wlien an animal is known to be subject to overreaching, he should never be driven fast without quarter boots, which are specially mode for the protection of the heels and quarters. If there is a disposition to " grab " the forward shoes, the trouble may be remedied by having the heels of these shoes made as short as CALK WOUNDS AND FROSTBITES. 379 possible, while the toe of the hind foot should project well over the hind shoe. When circumstances will permit of their use, the fore feet may be shod with the " tips " instead of the common shoe, as described in treatment for contracted heels. CALK WOUNDS. Horses wearing shoes with sharp calks are liable to wounds of the coronary re<>;ion, either from tramplinti^ on themselves or on each other. These injuries are most common in heavy draft horses, especially on rough roads and slijipery streets. The fore feet are more liable than the hind ones, and the seat of injury is commonly on the quarters. In the hind feet the wound often results from the animal resting- with the heel of one foot set directly over the front of the other. In these cases the injury is generally close to the horn, and often involves the coronary band, the sensitive laminie, the extensor tendon, and even the coffin bone. Treatment. — Preventive measures include the use of boots to pro- tect the coronet of the hind foot, and the use of a blunt calk on th.^ outside heel of the fore shoe, since this is generally the ofl'ending instrument where the fore feet are injured. If the wound is not deep, and the soreness slight, cold-water bandages and a light protective dressing, such as carbolized cosmoline, will be all that is needed. "NMiere the injury is deep, followed by inflammation and suppuration of the coronary band, lateral cartilages, sensitive laminR% etc., active measures must be resorted to. Cold, astringent baths, made by adding 2 ounces of sulphate of iron to 1 gallon of water, should be used, followed by poultices if it is necessary to hasten the cleansing of the wound by stinndating the sloughing process. Where the wound is deep between the horn and skin, especially over the anterior tendon, the horn should be cut away so that the injured tissues may be exposed. The subsequent treatment in these cases should follow the directions laid down in the article on toe cracks. • FROSTBITES. Excepting the ears, the feet and legs arc about the only parts of the liorse liable to become frostbitten. The cases most commonly seen are found in cities, especially among car horses, where salt is used for the purpose of melting the snow on cui-ves and switches. This mixture of snow and salt is splashed over the feet and legs, rapidly lowering the temperature of the parts to the freezing point. In mountainous districts, where the snowfall is heavy and the cold often intense, frostbites are not uncommon even among animals running at large. Symptoms. — When the frosting is slight the skin becomes pale and bloodless, followed soon after by intense redness, heat, pain, and 380 DISEASES OF THE HORSE. swelling. In these cases the hair may fall out and the epidermis peel o&, but the inflammation soon subsides, the swelling disappears, and only an increased sensitiveness to cold remains. In cases more severe irregular patches of skin are destroyed and after a few days slough aw^ay, leaving slow-healing ulcers behind. In the cases produced by low temperatures and deep snow the coronary band is the part most often atfected. In many instances there is no destruction of the skin but simply a temporary suspension of the horn-producing function of the coronary band. The fore feet are more often affected than the hind ones, and the heels and quarters are less often involved than the front part of the foot. The coronary band becomes hot, swollen, and painful, and after tAvo or three days the horn separates from the band and slight suppuration follows. For a few days the animal is lame, but as the suppuration disapjDears the lameness subsides. New horn, often of an inferior quality, is produced by the coronary band, and in time the cleft is grown off and complete recovery is effected. The frog is occasionally frostbitten and may slough off, exposing the soft tissues ])eneath and causing severe lameness for a time. Treatment. — Simple frostbites are best treated by cold fomentations followed by applications of a 5 per cent solution of carbolized oil. When portions of the skin are destroyed, their early separation should be hastened by warm fomentations and poultices. Ulcers are to be treated by the application of stimulating dressings, such as carbolized oil, a 1 per cent solution of nitrate of silver or of chloride of zinc, with pads of oakum and flannel bandages. In many of these cases recovery is exceedingly slow. The new tissue by which the destroyed skin is replaced always shrinks in healing, and, as a consequence, unsightly scars are unavoidable. Where the coronary band is in- volved it is generally advisable to blister the coronet over the seat of injury as soon as the suppuration ceases, for the purpose of stimulat- ing the srrow^th of new horn. Where a crevasse is formed between the old and new horn no serious trouble is likely to be met with until the cleft is nearly grown out, when the soft tissues may be exposed by a breaking off of the partly detached horn. But even where this acci- dent happens final recovery is secured by poulticing the foot until a sufficient growth of horn protects the parts from injury. QUITTOR. Quittor is a term applied to various affections of the foot wherein the tissues which are involved undergo a process of degeneration that results in the formation of a slough folloAved by the elimination of the diseased structures by means of a more or less extensive suppuration. For convenience of consideration quittors may be divided into four QUITTOE. 381 classes, as suggested by Girard : (1) Cutaneous quittor, which is known also as simple quittor, skin quittor, and carbuncle of the coro- net; (2) tendinous quittor; (3) subhorny quittor; and (4) cartilagi- nous quittor. CUTANE017S QUITTOR. Simple quittor consists in a local inflammation of the skin and sub- cutaneous connective tissue on some part of the coronet, followed by a slough and the fonnation of an ulcer which heals by suppuration. It is an extremely' painful disease, owing to the dense character of the tissues involved ; for in all dense structures the swelling which accompanies inflanunation always produces intense pressure. This pressure not only adds to the patient's suffering but may at the same time endanger the life of the affected parts by strangulating the blood vessels. It is held by some writers that simple quittor is most often met with in the hind feet, but in my experience more than tAvo- thirds of the cases have developed in the fore feet. While any part of the coronet may become the seat of attack, the heels and quarters are undoubtedly most liable. Causes. — Bruises and other wounds of the coronet are often the cause of cutaneous quittor; yet there can be no question but that in the great majority of cases the disease develops without any known cause. For some reason, not yet satisfactorily explained, most cases happen in the fall of the year. One explanation of this fact has been attempted in the statement that the disease is due to the injuri- ous action of cold and mud. This claim, however, seems to lose force when it is remembered that in many parts of this country the most mud, accompanied by freezing and thawing weather, is seen in the early springtime Avithout a corresponding increase of quittor. Furthermore, the serious outbreaks of this disease in the mountainous regions of Colorado, AVyoming, and Montana are seen in the fall and winter seasons, when the weather is the driest. It may be claimed, and perhaps with justice, that during these seasons, when the water is Ioav, animals are compelled to wade through more mud to drink from lakes and pools than is necessar}'^ at other sea- sons of the year, Avhen these lakes and pools are full. Add to these conditions the further fact that much of this mud is impregnated Svith alkaline salts, which, like the mineral sul)stances always found in the mud of cities, are more or less irritating, and it seems fair to conclude that under certain circumstances mud may become an im- portant factor in the production of quittor." aA recent outbreak of quittor near Cheyenne. Wyo., which came under the author's observation, was caused by the mud tlu-oujjh which the horses had to wade to reach the watering troughs. These troughs were furnished with water by windmills, and the iimd iiolcs wore caused by the waste water. More than fifty cases developed inside of two months, or during September and 382 DISEASES OP THE HORSE. "\Miile this disease attacks any and all classes of horses, it is the large, common breeds, with thick skins, heavy coats, and coarse legs ' that are most often aifected. Horses well groomed and cared for in stables seem to be less liable to the disease than those running at large | or than those which are kept and worked under adverse circumstances. ' Symptoins. — Lameness, lasting from one to three or four daj^s, ! nearly always precedes the development of the strictly local evidences \ of quittor. The next sign is the appearance of a small, tense, hot, j and painful tumor in the skin of the coronary region. If the skiri of the affected foot is white, the inflamed portion will present a dark-red or even a purplish ajjpearance near the center. Within a few hours ' the ankle, or even the whole leg as high as the knee or hock, becomes much swollen. The lameness is now so great that the patient refuses j to use the foot at all, but carries it in the air if compelled to move. i As a consequence, the opposite leg is required to do the work of both, and if the animal persists in standing a greater part of the time it, too, becomes swollen. In many of these cases the suffering is so in- tense during the first few days as to cause general fever, dullness, loss of appetite, and increased thirst. Generally the tumor shows signs of suppuration within forty-eight to seventy-two hours after its first appearance; the summit softens, a fluctuating fluid is felt be- neath the skin, which soon ulcerates completely through, causing the discharge of a thick, yellow% bloody pus, containing shreds of dead tissue which have sloughed awa3\ The sore is now converted into an open ulcer, generally deep, nearly or quite circular in outline, and with hardened base and edges. In exceptional cases large patches of skin, varying from 1 to 2i inches in diameter, slough away at once, leaving an ugly superficial ulcer. These sores, especially when deep, suppurate freely, and if there are no complications they tend to heal raj)idly as soon as the degenerated tissue has softened and is entirely removed. When suppuration is fully established, the lameness and general symptoms subside. Where but a single tumor and abscess form, the disease progresses rapidly, and recovery, under proper treatment, may be effected in from two to three weeks ; but when two or more tumors are developed at once, or where the formation of one tumor is rapidly succeeded by another for an indefinite time, the suf- ferings of the patient are greatly increased, the case is more difficult to treat, and recovery is more slow and less certain. October. In these fifty cases all forms of the disease and all possible compli- cations were presented. During the rainy season at Leadville, Colo., outbreaks of quittor are common, and the disease is so virulent that it has long been known as the " Leadville foot rot." The soil being rich in mineral matters is no doubt the cause of the outbreaks. In the city of Montreal quittor is said to be very common in the early springtime, when the streets are muddy from the melting snow and ice. QUITTOR. 383 This form of quittor is often complicated Avith the tendinous and subhorny quittors by an extension of the slough in*;- process. Treatment. — The first step in the treatment of an outbreak of quit- tor should be the removal of all exciting causes. Crowding animals into small corrals and stables, where injuries to the coronet are likely to happen from trampling, especially among unbroken range horses, must be avoided as nuich as possible. Watering i)laces accessible without having to wade through mud are to be supplied. In towns, where the mud or dust is largely impreg- nated with mineral products, it is not possible to adopt complete pre- ventive measures. Much can be done, however, by careful cleans- ing of the feet and legs as soon as the animal returns from work. Warm water should be used to remove the mud and dirt, after which the parts are to be thoroughly dried with soft cloths. The means which are to be adopted for the cure of cutaneous quit- tor vary with the stage of the disease at the time the case is presented for treatment. If the case is seen early — that is, before any of the signs of suppuration have developed — the affected foot is to be placed under a constant stream of cold water, with the object of arresting a further extension of the inflammatory process. To accomplish this, put the patient in slings in a narrow stall having a slat or open floor. Bandage the foot and leg to the knee or hock, as the case may be, with flannel bandages loosely applied. Set a tub or barrel filled with cold water above the patient, and by the use of a small rubber hose of suf- ficient length make a siphon which will carry the water from the bot- tom of the tub to the leg at the top of the bandages. The stream of water should be quite small, and is to be continued until the inflamma- tion has entirely subsided or until the presence of pus can be detected in the tumor. AVhen suppuration has conunenced, the process should be aided by the use of warm baths and poultices of linseed meal or boiled turnips. If the tumor is of rapid gi'owth, accompanied by intense pain, relief is secured and sloughing largely limited by a free incision of the parts. The incision should be vertical and deep into the tumor, care being taken not to entirely divide the coronary band. If the tumor is large, more than one incision may be necessary. The foot should now be placed in a warm bath for half an hour or longer and then poulticed. The hemorrhage produced by the cutting and encouraged by the warm bath is generally very copious and soon gives relief to the overtension of the parts. In otlier cases it will be found that suppuration is well under way, so that the center of the tumor is soft when the patient is first pre- sented for treatment. It is always good surgery to relieve the tumor of pus whenever its presence can be detected; hence in these cases a free incision must be uuide into the softened parts, the pus evacuated, and the foot poulticed. 384 DISEASES OF THE HORSE. By surgical interference the tumor is now converted into an open sore or ulcer, which, after it has been well cleaned b}' warm baths and poultices applied for two or three days, needs to be protected by proper dressings. The best of all protective dressings is made of small balls, or pledgets, of oakum, carefully packed into the wound and held in place by a roller bandage 4 yards long, from 3 to 4 inches wide, made of common bedticking and skillfully applied. The remedies which may be used to stimulate the healing process are many, and, as a rule, they are applied in the form of solutions or tinctures. In my own practice I prefer a solution of bicliloride of mercury 1 part, water 500 parts, with a few drops of muriatic acid or a few grains of muriate of ammonia added to cause the mercury to dissolve. The balls of oakum are wet with this solution before they are applied to the wound. Among the other remedies which may be used, and perhaps with equally as good results, Avill be noted the sulphate of copper, iron, and zinc, 5 grains of either to the ounce of water ; chloride of zinc, 5 grains to the ounce; carbolic acid, 20 drops dissolved in an equal amount of glycerin and added to 1 ounce of water ; nitrate of silver, 10 grains to the ounce of water; and creolin, pure or diluted. If the wound is slow to heal, it will be found of advantage to change the remedies every few days. If the Avound is pale in color, the granulations transparent and glistening, the tincture of aloes, tincture of gentian, or the spirits of cami:)hor may do best. When the sore is red in color and healing rapidly, an ointment made of 1 part of carbolic acid to 40 parts of cosmoline or vaseline is all that is needed. If the granulations continue to grow until a tumor is formed which projects beyond the surrounding skin, it should be cut off w^ith a sharp, clean knife, and the foot poulticed for twenty-four hours, after which the wound is to be well cauterized daily with lunar caustic and the bandages applied with great firmness. The question as to how often the dressings should be renewed must be determined by the condition of the wound, etc. If the sore is sup- purating freely it will be necessary to renew the dressing every twenty-four or forty-eight hours; if the discharge is small in quan- tity and the patient comfortable, the dressing may be left on for several daj'^s ; in fact, the less often the wound is disturbed the better, in so long as the healing process is healthy. When the sore com- mences to skin over, the edges should be lightly touched with lunar caustic at each dressing. The patient may now be given a little exercise daily ; but the bandages must be kept on until the wound is entirely healed. QUITTOR. ' 385 TENDINOUS QUITTOR. This form of quittor differs from the cutaneous in that it not only affects the skin and subcutaneous tissues, but involves, also, the ten- dons of the leg, the ligaments of the joints, and, in many cases, the bones of the foot as well. Fortunately this form of quittor is less common than the preced- ing; yet any case beginning as simple cutaneous quittor may at any time d\iring its course become complicated by the death of some part of the tendons, by gangrene of the ligaments, sloughing of the coro- nary band, caries of the bones, or inflannnation and suppuration of the synovial sacs and joints, thereby converting a simple quittor into one which will, in all probability, either destroy the patient's life or maim him for all time. Causes. — Tendinous quittor is caused by the same injuries and influ- ences that produce the simple form. Zundel believes it to be a not infrequent accompaniment of distemper. In my own experience I have seen nothing to verify this belief, but I am satisfied that young- animals are more liable to have tendinous quittor than older ones, and that they are much more likely to make a good recovery. Symptoms. — When a case of simple quittor is transformed into the tendinous variety the change is announced by a sudden increase in the severity of all the symptoms. On the other hand, if the attack primarily is one of tendinous quittor, the earliest sjnnptom seen is a well-marked lameness. In those, cases due to causes other than in- juries this lameness is at first very slight, and the animal limps no more in trotting than in walking; but later on, generally during the next forty-eight hours, the lameness increases to such an extent that the patient often refuses to use the leg at all. An examination made during the first two daj^s rarely discloses any cause for this lameness; it may not be possible even to say with certainty that the foot is the seat of the trouble. On the third or fourth day, sometimes as late as the fifth, a doughy-feeling tumor will be found forming on the heel or quarter. This tumor grows rapidly, feels hot to the touch, and is extremely painful. As the tumor develops, all the other symptoms increase in intensity; the pulse is rapid and hard; the breathing quick; the temperature elevated three or four degrees; the appetite is gone; thirst increased, and the lameness so great that the foot is carried in the air if locomotion is attempted. At this stage of the disease the patient generally seeks relief l)y lying upon the broad side, with outstretched legs; the coat is bedewed with a clammy sweat, and every respiration is accompanied by a moan. The leg soon swells to the fetlock; later this swelling gradually extends to the knee or hock, and in some cases reaches the body. As a lule, several days elapse before the disease develops a well-defined abscess, for, owing H. Doc. 795, 59-2 25 386 DISEASES OF THE HORSE. to the dense structure of the bones, ligaments, and tendons, the sup- purative process is a slow one, and the pus is prevented from readily collecting in a mass. Recently I made a post-mortem examination on a typical case of this disease, where the animal had died on the fourth day after being found on the range slightly lame. The suffering had been intense; yet the only external evidences of the disease consisted in the shed- ding of the hoof from the right fore foot and a limited swelling of the leg to the knee. The sloughing of the hoof took place two or three hours before death, and w^as accompanied with but little suppu- ration and no hemorrhage. The skin from the knee to the foot was thickened from watery infiltration (edema), and on the inside quarter three holes, each about one-half inch in diameter, were found. All had ragged edges, while but one had gone deep enough to perforate the coronary band. The loose connective tissue beneath the skin was distended, with a gelatinous infiltration over the whole course of the flexor tendons and to the fetlock joint over the tendon in front. The soft tissues covering the coffin bone were loosened in patches by col- lections of pus which had formed beneath the sensitive lamina". The coffin and pastern joints were inflamed, as were also the coffin, navicu- lar, and coronet bones, while the outside toe of the coffin bone had become softened from suppuration until it readily crumbled between the fingers. The coronary band was largely destroyed and completely separated from the other tissues of the foot. The inner lateral carti- lage was gangrenous, as w^as also a small spot on the extensor tendon near its point of attachment on the coffinbone. Several small collec- tions of pus were found deep in the connective tissue of the coronary region; along the course of the sesamoid ligaments; in the sheath of the flexor tendons; under the tendon just below the fetlock joint in front, and in the coffiji joint. But all cases of tendinous quittor are by no means so complicated as this one was. In rare instances the swelling is slight, and after a few days the lameness and other symjitoms subside, without any dis- charge of pus from an external opening. In most cases, however, from one to half a dozen or more soft points arise on the skin of the coronet, open, and discharge slowly a thick, yellow, fetid, and bloody matter. In other cases the suppurative process is largely confined to the sensitive lamina? and plantar cushion, M^hen the suffering is intense until the pus finds an avenue of escape by separating the hoof from the coronary band, at or near the heels, without causing a loss of the whole horny box. When the flexor tendon is involved deep in the foot, the discharge of pus usually takes place from an opening in the hollow of the heel ; if the sesamoid ligament or the sheath of the flexors are affected, the opening is nearer the fetlock joint; although in most of these cases the suppuration spreads along the course of the QUITTOR. 387 tendons until the navicular joint is involved, and extensive sloughing of the deeper parts follows. Treatment. — The treatment of tendinous quittor is to he directed toward the saving of the foot. First of all an effort must be made to prevent suppuration ; and if the patient is seen at the beginning, cold irrigation, recommended in the treatment for cutaneous quittor, is to be resorted to. Later on, when the tumor is forming on the coronet, the knife must be used, and a free and deep incision made into the swelling. Whenever openings appear from wdiich pus escapes, they should be carefully probed ; in all instances these fistulous tracts lead down to dead tissue which nature is trying to remove by the process of sloughing. If a counter opening can be made, which will enable a more ready escape of the pus, it should be done at once ; for instance, if the probe shows that the discharge originates from the bottom of the foot, the sole must be pared through over the seat of trouble. ^Mienever suppuration has commenced the process is to be stimulated by the use of warm baths and poultices. The pus which accumulates in the deeper parts, especially along the tendons, around the joints, and in the hoof, is to be removed by pressure and injections made with a small syringe, repeated two or three times a day. As soon as the discharge assumes a healthy character and diminishes in quantity, stimulating solutions are to be injected into the open w^ounds. Where the tendons, ligaments, and other deeper parts are affected, a strong solution of carbolic acid — 1 to 4 — should be used at first. Or strong solutions of tincture of iodine, sulphate of iron, sulphate of copper, bichloride of mercury, etc., may be used in place of the carbolic ; after which the remedies and dressings directed for use in simple quittor are to be used. In those cases where the fistulous tracts refuse to heal it is often necessary to burn them out with a saturated solution of caustic soda, equal parts of muriatic acid and w^ater; or, better still, with a long, thin iron, heated white hot. But no nuitter what treatment is adopted, a large percentage of the cases of tendinous quittor fail to make good recoveries. Where the entire hoof sloughs away, the growth of a new, but soft and imper- fect, hoof may be secured b}^ carefull}^ protecting the exposed tissues with proper bandages. When the joints are opened by deep slough- ing, recovery may eventually take place, but the joint remains immov- able ever after. If caries of a small part of the coffin bone takes place, it may be removed by an operation ; but if much of the bone is affected, or if the navicular and coronet bones are involved in the carious proc- ess, the only hope for a cure is in the amputation of the foot. This operation is advisable only where the animal is valuable for breeding purposes. In all other cases where there is no hope for recovery the patient's suffering should be relieved by death. In tendinous quittor much thickening of the coronary region, and sometimes of the ankle 388 DISEASES OF THE HORSE. and fetlock, remains after suppuration has ceased and the fistulous tracts have healed. To stimulate the reabsorption of this new and unnecessary tissue, the parts should be fired with the hot iron, or, in its absence, repeated blistering with the biniodide of mercury oint- ment may largely accomplish the same result. SUBHORNY QUITTOB. This is the most common form of the disease. It is generally seen in but one foot at a time, and more often in the fore than in the hind feet. It nearly always attacks the inside quarter, but may affect the outside quarter, the band in front, or the heel, where it is of but little consequence. It consists in the inflammation of a small part of the coronary band and adjacent skin, followed by sloughing and suppura- tion, which in most cases extends to the neighboring sensitive lamina?. Causes. — Injuries to the coronet, such as bruises, overreaching, and calk wounds, are considered as the common causes of this disease. Still cases occur in which there appears to be no existing cause, just as in the other forms of quittor, and it seems fair to conclude that subhorny quittor may also be produced by internal causes. Sy'nipto7ns. — At the outset the lameness is always severe, and the patient often refuses to use the affected foot. Swelling of the coronet close to the tojD of the hoof causes the quarter to protrude beyond the wall. This tumor is extremely sensitive, and the whole foot is hot and painful. After a few days a small spot in the skin, over the most elevated part of the tumor, softens and opens or the hoof sepa- rates from the coronary band at the quarter or well back toward the heel. From this opening, wherever it may be, a thin, watery, offensive discharge escapes, often dark in color, at times mixed with blood, and always containing a considerable j^ercentage of pus. Probing will now disclose a fistulous tract leading to the bottom of the diseased tissues. If the ojDening is small, there is a tendency upon the part of the suppurative process to spread downw^ard; the pus gradually separates the hoof from the sensitive laminae until the sole is reached, and even a jiortion of this may be undermined. As a rule, the slough in this form of quittor is not deep, and if the case receives early and proper treatment complications are generally avoided; but if the case is neglected, and, occasionally, even in sjjite of the best of treatment, the disease spreads until the tendon in front, the lateral cartilage, or the coffin bone and joint as well are involved. In all cases of subhorny quittor much relief is experienced Avhen the slough comes away, and rapid recovery is made. If, however, after the lapse of a few days, the lameness remains and the wound continues to discharge a thin unhealthy matter, the probabilities are that the disease is spreading, and pus collecting in the deeper parts of the foot. In Zundel's opinion, if the use of the probe now detects a QUITTOR. 389 pus cavity below the opening, a cartilaginous quittor is in the course of development. Treatment. — Hot baths and poultices are to be used until the pres- ence of pus can be determined, Avhen the tumor is to be opened with a knife or sharp-pointed iron heated white liot. The hot baths and poultices are now continued for a few days or until the entire slough has come away and the discharge is diminished, when dressings recommended in the treatment for cutaneous quittor are to be used •until recovery is completed. In cases where the discharge comes from a cleft between the upper border of the hoof and the coronar}^ band, always pare away the loosened horn, so that the soft tissues beneath are fully exposed, care being taken not to injure the healthy parts. This operation permits of a thorough inspection of the dis- eased parts, the easy removal of all gangrenous tissue, and a better application of the necessary remedies and dressings. The only objec- tion to the operation is that the patient is prevented from being early I'eturned to work. When the probe shows that pus has collected under the coffin bone the sole must be pared through, and if caries of the bone is present the dead parts cut away. After either of these operations the wovmd is to be dressed with the oakum balls, saturated in the bichloride of mercury solution, as previously directed, and the bandages tightl}' applied. Generally the discharge for the first two or three days is so great that the dressings need to be changed every twenty-four hours; but when the discharge diminishes, the dressing may be left on from one to two weeks. Before the patient is returned to work, a bar shoe should be applied, since the removed quarter or heel can only be made perfect again by a new growth from the coronary band. Tendinous or cartilaginous complications are to be treated as directed under those headings. CARTILAGINOUS QUITTOR. This form of quittor nuiy commence as a primary inflammation of the lateral cartilage, but in the great majority of cases it appears as a sequel to cutaneous or subhorny quittor. It may affect either the fore or hind feet, but is most commonly seen in the former. As a rule, it attacks but one foot at a time, and but one of the cartilages, generally the inner one. It is always a serious affection for the reason that, in manj^ cases, it can only be cured by a surgical operation, requiring a thorough knowledge of the anatomy of the parts involved and much surgical skill. Causes. — Direct injuries to the coronet, such as trampling, pricks, burns, and the blow of some heavy falling object which uuiy puncture, bruise, or crush the cartilage, are the conunon direct causes of carti- laginous quittor. Besides being a sequel to the other forms of quittor. 390 DISEASES OF THE HORSE. it sometimes develoi:>s as a complication in suppurative corn, canker, grease, laminitis, and punctured wounds of the foot. Animals used for heavy draft, and those with flat feet and low heels, are more liable to the disease than others, for the simple reason that they are more exposed to injury. Bough roads also predispose to the disease by increasing liability to injury. Symptoms. — When the disease commences as a primary inflamma- tion of the cartilage, lameness develops with the formation of a swell- ing on the side of the coronet over the quarter. The severity of this lameness depends largely upon the part of the cartilage which is dis- eased, for if the disease is situated in that part of the cartilage nearest the heel, where the surrounding tissues are soft and spongy, the lame- ness may be very slight, especially if the patient is required to go no faster than a walk; but when the middle and anterior parts of the cartilage are diseased, the pain and consequent lameness are much greater, for the tissues are less elastic and the coffin joint is more likely to become affected. Except in the cases to be noted hereafter, one or more fistulous openings finally appear in the tumor on the coronet. These openings are surrounded by a small mass of granulations which are elevated above the adjacent skin and bleed readily if handled. A probe shows these fistulous tracts to be more or less sinuous, but always leading to one point — the gangrenous cartilage. "V^-lien cartilaginous quittor hapi^ens as a complication of suppurative corn, or from punctured wounds of the foot, the fistulous tract may open alone at the point of injury on the sole. The discharge in this form of quittor is generally thin, watery, and contains enough \)\\s to give it a pale yellow color; it is offensive to the sense of smell, due t-o the detachment of small flakes of cartilage which have become gangrenous and are seen in the discharge as small greenish colored particles. In old cases it is not unusual to find some of the fistulous openings heal at the surface; this is followed by the gradual collection of pus in the deeper parts, forming an abscess, which in a short time opens at a new point. The wall of the hoof, over the affected quarter and heel, in very old cases becomes rough and wrinkled like the horn of a ram, and generally it is thicker than the corresponding quarter, owing to the stimulating effect which the disease has upon the coronary band. Complications may arise by an extension of the disease to the lat- eral ligament of the coffin joint, to the joint itself, to the plantar cushion, and by caries of the coffin bone. Treatment. — Before recovery can take place all of the dead cartilage must be removed. In rare instances this is effected by nature without assistance. Usually, however, the disease does not tend to recovery, and active curative measures must be adopted. The best and sim- THRUSH. 391 plest treatment, in a majority' of cases, is the injection of strong caustic solutions, which destroy the diseased cartilage aijd cause its discharge, along with the other products of suppuration. In favor- able cases these injections will secure a healing of the wound in from two to three weeks. While the saturated solution of sulphate of copper, or a solution of 10 parts of bichloride of mercury to 100 parts of water, has given the best results in my hands, equally as favorable success has been secured by others from the use of caustic soda, nitrate of silver, sulphate of zinc, tincture of iodine, etc. But no matter which one of these remedies may be selected, it must be used at least twice a day for a time. The solution is injected into the vari- ous openings with enough force to drive it to the bottom of the wound, after which the foot is to be dressed with a pad of oakum, held in place by a roller bandage tightly applied. While it is not always necessary, it is often of advantage to relieve the pressure on the parts by rasping away the hoof over the seat of the cartilage ; the coronary band and laminae should not be injured in the operaticm. If the caustic injections prove successful, the discharge will become healthy and gradually diminish, so that by the end of the second week the fistulous tracts are closing up, and the injections are made with much difficulty. If, on the other hand, there is but little or no improvement after this treatment has been used for three weeks, it may reasonably be concluded that the operation for the removal of the lateral cartilage must be resorted to for the cure of the trouble. As this operation can be safely undertaken only by an expert surgeon, it will not be described in this connection. THRUSH. Thrush is characterized by an excessive secretion of unhealthy mat- ter from the cleft of the frog. A^^lile all classes of horses are liable to this aflection, it is more often seen in the common draft horse than in any other breed — a fact due to the conditions of servitude and not to the fault of the breed. Country horses are much less subject to the disease, except in wet, marshy districts, than are the horses used in cities and towns. Causes. — The most common cause of thrush is the filthy condition of the stable in which the animal is kept. Mares are more liable to contract the disease in the hind feet when the cause is duo to filth, while the gelding and stallion are more likely to develop it in the fore feet. Hard work on rough and stonv roads mav also induce the disease, as may a change from dryness to excessive moisture. The latter cause is often seen to operate in old track horses, whose feet are constantly soaked in the batli tul) for the purpose of relieving soreness. Muddy streets and roads, especially wliere mineral substances are plentiful, excite this abnormal condition of the frog. Contracted heels, 392 DISEASES OF THE HORSE. scratches, and navicular disease predispose to thrush, Avhile by some a constitutional tendency is believed to exist among certain animals which otherwise present a perfect frog. Sym/ptortis. — At first there is simply an increased moisture in the cleft of the frog, accompanied by an offensive smell. After a time a considerable discharge takes place — thin, watery, and highly offen- sive, changing gradually to a thicker puriform matter, which rapidly destro3'S the horn of the frog. Only in old and severe cases is the patient lame and the foot feverish — cases in which the whole frog is involved in the diseased process. Treatment. — Thrushes are to be treated by cleanliness, the removal of all exciting causes, and a return of the frog to its normal condition. As a rule, the diseased and ragged portions of horn are to be pared away and the foot poulticed for a day or two with boiled turnips, to Avhich may be added a few drops of carbolic acid or a handful of pow- dered charcoal to destroy the offensive smell. The cleft of the frog and the grooves on its edges are then to be cleaned and w^ell filled with dry calomel and the foot dressed Avith oakum and a roller bandage. If the discharge is profuse, the dressing should be changed daily ; otherwise it may be left on two or three days. A^Tiere a constitu- tional taint is supposed to exist, with sAvelling of the legs, grease, etc., a purgative, followed by dram doses of sulphate of iron, repeated daily, may be prescribed. In cases where the growth of horn seems too slow a Spanish-fly blister applied to the heels is often followed by good results. Feet in which the disease is readily induced may be protected in the stable with a leather boot. If the thrush is but a sequel to other diseases, a permanent cure may not be possible. CANKER. Canker of the foot is due to the rapid reproduction of a vegetable parasite. It not only destroys the sole and frog, but, by setting up a chronic inflammation in the deeper tissues, prevents the growth of a healthy horn by which the injury might be repaired. Heavy cart horses are more often affected than those of any other class. Causes. — The essential element in the production of canker is the parasite ; consequently the disease may be called contagious. But, as in all other diseases due to specific causes, the seeds of the disorder must find a suitable soil in which to grow before they are reproduced. It may be said, then, that the conditions which favor the preparation of the tissues for a reception of the seeds of this disease are simply predisposing causes. The condition most favorable to the development of canker is dampness— in fact, dampness seems indispensable to the existence and growth of the parasite ; for the disease is rarely, if ever, seen in high, dry districts, and is much more common in rainy than in dry seasons. Filthy stables and muddy roads have been classed among the causes CANKER. 393 of canker; but it is very doublful if these conditions can do more than favor a preparation of the foot for the reception of the disease germ. All injuries to the feet may, by exposing the soft tissues, render the animal susceptible to infection; but neither the injury nor the irrita- tion and inflammation of the tissues which follow are sufficient to induce the disease. For some unknown reason horses with lymphatic temperaments — thick skins, fiat feet, fleshy frogs, heavy hair, and particularly with white feet and legs — are especially liable to canker. Symptoms. — ITsually, canker is confined to one foot; but it may attack two, three, or all of the feet at once; or, as is more commonly seen, the disease attacks first one then another, until all may have been successively affected. "NA^hen the disease follows an injury which has exposed the soft tissues of the foot, the wound shows no tendency to heal, but instead there is secreted from the inflamed parts a profuse, thin, fetid, watery discharge, which gradually undermines and de- stroys the surrounding horn, until a large part of the sole and frog is diseased. The living tissues are swollen, dark colored, and covered at certain points with particles of new, soft, j-ellowish, thready horn, which are constantly undergoing maceration in the abundant liquid secretion by which they are immersed. As this secretion escapes to the surrounding parts, it dries and forms small, chees}^ masses com- posed of partly dried horny matter, exceedingly offensive to the sense of smell. When the disease originates independently of an injury, the first evidences of the trouble are the offensive odor of the foot, the liquid secretion from the cleft and sides of the frog, and the rotting away of the horn of the frog and sole. In the earlier stages there is no interference with locomotion, but later the foot becomes sensitive, particularly if the animal is used on rough roads, and, finally, when the sole and frog are largely destroyed the lameness is severe. Treatment. — Since canker does not destroy the power of the tissues to produce horn, but rather excites them to an excessive production of an imperfect horn, tlie indications for treatment are to restore the parts to a normal condition, when healthy horn may again be secreted. In my experience, limited though it has been, the old practice of strip- ping off the entire sole and deep cauterization, Avith either the hot iron or strong acids, is not attended with uniformly good results. I am of the opinion that recovery can generally l)e effected as surely and as speedily with measures which are less heroic and much less painful. True, the treatment of canker is likely to exhaust the patience, and sometimes the resources, of the attendant; but after all success depends more on the persistent apjilication of simple remedies and great cleanliness than on the special virtues of any particular drug. 394 DISEASES OF THE HORSE. First, then, clean the foot with warm baths and apph' a poultice containing powdered charcoal or carbolic acid. A handful of the charcoal or a tablespoonful of the acid mixed with the j)Oultice serves to destroy much of the offensive odor. The diseased portions of horn are to be carefuU}^ removed with sharp instruments, until only healthy horn borders the affected parts. The edges of the sound horn are to be pared thin, so that the swollen soft tissues may not overlap their borders. With sharp scissors cut off all the prominent points on the soft tissues, shorten the walls of the foot, and nail on a broad, plain shoe. The foot is now ready for the dressings, and any of the many stimulating and drying remedies may be used; but it will be necessary to change frequently from one to another, until finally all m.ay be tried. The list from which a selection may be made comprises wood tar, gas tar, petroleum, creosote, phenic acid ; sulphates of iron, copper, and zinc; chloride of zinc, bichloride of mercury, calomel, caustic soda, nitrate of silver, chloride of lime ; carbolic, nitric, and sulphuric acids. In practice I prefer to give the newly shod foot a bath for an hour or two in a solution of the sulphate of iron, made by adding 2 ounces of the powdered sulphate to a gallon of cold water. "V^^ien the foot is removed it is dressed with oakum balls dipped in a mixture made of Barbados tar 1 part, oil of turpentine 8 parts, to which is slowly added 2 parts of sulphuric acid, and the mixture well stirred and cooled. The diseased parts being well covered with the balls, a pad of oakum, sufficiently thick to cause considerable pressure, is placed over them, and all are held in place by pieces of heavy tin fitted to slip under the shoe. The whole foot is now incased in a boot or folded gunny sack, and the patient turned into a loose, dry box. The dressings are to be changed daily or even twice a day, at first. When they are removed, all pieces of new horny matter which are now firmly adherent must be rubbed off with the finger or a tent of oakum. As the secretion diminishes, dry powders may prove of most advantage, such as calomel, sulphates of iron, copper, etc. The sul- phates should not be used pure, but are to be mixed w^ith powdered animal charcoal in the proportion of one of the former to eight or ten of the latter. When the soft tissues are all horned over, the dress- ings should be continued for a time, weak solutions being used to jDrevent a recurrence of the disease. If the patient is run down in condition, bitter tonics, such as gentian, may be given in 2-dram doses, twice a day, and a liberal diet of grain allowed. CORNS. A corn is an injury to the living horn of the foot, involving the soft tissues beneath, whereby the capillary blood vessels are ruptured and a small amount of blood escapes, which, by jDcrmeating the horn coKNs. 395 ill the immediate neighborhood, stains it a dark color. If the injury is continuously repeated, the horn becomes altered in character, and the soft tissues may suppurate or a horny tumor develop. Corns always appear in the sole in the angle between the bar and the outside wall of the hoof. In many cases the laminae of the bar, of the wall, or of both are involved at the same time. Three kinds of corns are commonly recognized — the dry, the moist, and the suppurative — a division based solely on the character of the conditions which follow the primary injury- The fore feet are almost exclusively the subjects of the disease, for two reasons : First, because they support a greater part of the bodj' ; secondly, because the heel of the fore foot during progression is first placed upon the ground, whereby it receives much more concussion than the heel of the hind foot, in which the toe first strikes the ground. Causes. — It may be said that all feet are exposed to corns, and that even the best feet may suffer from them when conditions necessary to the production of the peculiar injury are present. The heavier breeds of horses generally used for heavy work on rough roads and streets seem to be most liable to this trouble. Mules rarely have corns. Among the causes and conditions which predispose to corns may be named high heels, which change the natural relative position of the bones of the foot and thereby increase the concussion to which these parts are subject; contracted heels, which in part destroy the elas- ticity of the foot, increase the pressure uj^on the soft tissues of the heel, and render lacerations more easy; long feet, which by removing the frog and heels too far from the ground deprive them of necessary moisture, which, in turn, reduces the elastic properties of the horn and diminishes the transverse diameter of the heels; and weak feet, or those in which the horn of the wall is too thin to resist the tendency to spread, whereby the soft tissues are easily lacerated. AA^'ide feet with low heels are always accompanied by a flat sole whose posterior wings either rest upon the ground or the shoe, and as a consequence are easily bruised ; at the same time the arch of the sole is so broad and flat that it can not support the weight of the body, and in the dis- placement which happens Avhen the foot is rested upon the ground the soft tissues are liable to become bruised or torn. It is universally conceded that shoeing, either as a direct oi' predis- posing cause, is most prolific in producing corns. One of the most serious as well as the most common of the errors in shoeing is to be found in the preparation of the foot. Instead of seeking to maintain the integrity of the arch, the first thing done is to weaken it l)y freely ])aring away the sole; nor does the mutilation end here, for the frog, which is nature's main support to the branches of the sole and the heels, is also largely cut away. This not only permits of an excessive 396 DISEASES OF THE HORSE. downward movement of the contents of the horny box, bnt it at the same time removes the one great means by which concussion of the foot is destroyed. As adjuncts to the foregoing errors must be added the faults of construction in the shoe and in the way it is adjusted to the foot. An excess of concavity in the shoe, extending it too far back on the heels, high calks, thin heels which permit the shoe to spring, short heels with a calk set under the foot, and a shoe too light for the animal wearing it or for the work required of him, are all to be avoided as causes of corns. A shoe so set as to press upon the sole or one that has been on so long that the hoof has overgrown it until the heels rest upon the sole and bars become a direct cause of corns. Indirectly the shoe becomes the cause of corns when small stones, hard, dry earth, or other objects collect between the sole and shoe. Lastly, a rapid gait and excessive knee action, especially on hard- roads, predisjjose to this disease of the feet. Symptoms. — Ordinarily a corn induces sufficient pain to cause lame- ness. It may be intense, as seen in suppurative corn, or it may be but a slight soreness, such as that wdiich accompanies dry corn. It is by no means unusual to see old horses having chronic corns apparently so accustomed to the slight pain which they suffer as not to limp at all; but these animals are generall}^ very restless ; they paw their bedding behind them at night, and often refuse to lie down for any lengthened rest The lameness of this disease, however, can hardly be said to be characteristic, for the reason that it varies so greatly in intensity ; but the posilion of the leg while the patient is at rest is generally the same in all cases. The foot is so advanced that it is relieved of all weight, and the fetlock is flexed until all pressure by the contents of the hoof is removed from the heels. In suppurative corn the lameness subsides or entirely disappears as soon as the abscess opens. When the injured tissues are much inflamed, as may happen in severe and recent cases, the heel of the affected side, or even the whole foot, is hot and tender to pressure. In dry corn, and in most chronic cases, all evidences of local fever are often wanting. It is in these cases that the patient goes well W'hen newly shod, for the smith cuts away the sole over the seat of injury until all pressure by the shoe is remoA^ed, and lowers the heels so that concussion is reduced to a minimum. If a corn is susj^ected the foot should be examined for increased sensibility of the inside heel. Tapping the heel of the shoe with a hammer and grasping the wall and bar between the jaws of pincers, Avith moderate pressure, will cause more or less flinching, if the dis- ease is present. For further evidence the shtje is removed and the heel cut away with the drawing knife. As the horn is pared out, not only the sole in the angle is found discolored, but in many instances the insensible laminae of the bar and wall adjacent are also stained CORNS. 397 Avith the escaped blood. In moist and suppurative corns this discolor- ation is less marked than in dry corn and may be entirely wanting. In these cases the horn is soft, often white, and stringy or mealy, as seen in pumiced sole resulting from founder. AVhcn the whole thick- ness of the sole is discolored and the horn dry and brittle, it is gen- erally evidence that the corn is an old one and that the exciting cause has existed continuously. A moist corn dilfers from the dry corn in that the injury is more severe; the parts atfected are more or less inllamed, and the horn of the sole in the angle is undermined by a citron-colored fluid, which often jiermeates the injured sole and lamina?, causing the horn to become somewhat spongy. A suj^purative corn differs from others in that the inflammation ends in suppuration. The pus collects at the point of injury and finally escapes by working its way between the sensitive and insensi^ ble laminae to the top of the hoof, where an opening is made between the wall and coronary band at or near the heels. This is the most serious form of corns, for the reason that it may induce gangrene of the plantar cushion, cartilaginous quittor, or caries of the coffin bone. Treatment. — Since a diversity of opinion exists as to what measures must be adopted for the radical cure of corns, the author will advise the use of those which have proven most efficient in his hands. As in all other troubles, the cause must be discovered, if possible, and removed. In the great majority of cases the shoeing will be at fault. A^iile sudden changes in the method of shoeing are not advis- able, it may be said that all errors, either in the preparation of the foot, in the construction of the shoe, or in its application may very properly be corrected at any time. Circumstances may at times make it imperative that shoes shall be worn which are not free from objec- tions; as, for instance, the shoe with a high calk; but in such cases it is considered that the injuries liable to result from the use of calks are less serious than those which are sure to happen for the want of them. For a sound foot perfectly formed, a flat shoe, with heels less thick than the toe, and which rests evenly on the Avail proper, is the best. In flat feet it is often necessary to concave the shoe as much as possi- ble on the upper surface, so that the sole may not be pressed upon. If the heels are very low the heels of the shoe may be made thicker. If the foot is very broad and the wall light toward the heels, a bar shoe resting upon the frog will aid to prevent excessive tension upon the soft tissues when the foot receives the weight of the body. A piece of leather placed between the foot and shoe serves largely to destroy concussion, and its use is absolutely necessary on some ani- mals to enable them to work. Last among the preventive measures may be mentioned those whicli serve to maintain the suppleness of the hoof. The dead horn upon 398 DISEASES OF THE HORSE. the surface of the sole not only retains moisture for a long time, but protects the living horn beneath from the effects of evaporation ; for this reason the sole should be pared as little as possible. Stuffing the feet with flaxseed meal, wet clay, or other like substances, or damp dirt floors or damp bedding of tanbark, greasy hoof ointments, etc., are all means which may be used to keep the feet from becoming too dry and hard. As to the curative measures which are to be adopted much will depend upon the extent of the injury. If the case is one of chronic dry corn, with but slight lameness, the foot should be poulticed for a day or two and the discolored horn pared out, care being taken not to injure the soft tissues. The heel on the affected side is to be lowered until all pressure is removed and, if the patient's labor is required, the foot must be shod with a bar shoe or with one having stiff heels. Care must be taken to reset the shoe before the foot has grown too long, else the shoe Avill no longer rest on the wall, but on the sole and bar. I believe in cutting moist corns out. If there is inflammation present, cold baths and poultices should be used ; when the horn is well softened and the fever allayed, pare out all of the diseased horn, lightly cauterize the soft tissues beneath and poultice the foot for two or three days. Wlien the granulations look red, dress the wound with oakum balls saturated in a weak solution of tincture of aloes or spirits of camphor and apply a roller bandage. Change the dressing every two or three days until a firm, healthy layer of new horn covers the wound, when the shoe may be put on, as in dry corn, and the patient returned to work. In suppurative corns the loosened horn must be removed, so that the pus may freely escape. If the pus has worked a passage to the coronary band and escapes from an opening between the band and hoof, an opening must be made on the sole, and cold baths made astringent with a little sulphate of iron or copper are to be used for a day or two. Wlien the discharge becomes healthy, the fistulous tracts may be injected daily with a weak solution of bichloride of mercury, nitrate of silver, etc., and the foot dressed as after operation for moist corns. When complications arise, the treatment must be varied to meet the indications; if gangrene of the lateral cartilage takes place it must be treated as directed under the head of cartilaginous quittor; if the velvety tissue is gangrenous, it must be cut away ; if the coffin bone is necrosed, it must be scraped, and the resulting wounds treated on general principles. After any of the operations for corns have been performed, in which the soft tissues have been laid bare, it is best to protect the foot by a sole of soft leather set beneath the shoe when the animal is returned to work. Only in rare instances are the complications of corns so serious as to destroy the life or usefulness of BRUISE OF THE FROG. 399 the patient. It is the wide, Hat foot with low heels and thin wall which is most liable to resist all efforts toward effecting a comjjlete cure. BRUISE OF THE FROG. When the frog is severely bruised, the injury is followed by suppu- ration beneath the horn, and at times by partial gangrene of the plantar cushion. Causes. — A bruise of the frog generally happens from stepping on a rough stone or other hard object. It is more apt to take place when trotting, running, or jumping than when at a slower pace. A stone wedged in the shoe and pressing on the frog or between the sides of the frog and the shoe, if it remains for a time, produces the same results. A cut through the horny frog with some sharp instrument or a punctured wound by a blunt pointed instrument may also cause suppuration and gangrene of the plantar cushion. Broad, flat feet with low heels and a fleshy frog are most liable to these injuries. ISymptonis. — Lameness, severe in proportion to the extent of the bruise and the consequent suppuration, is always an early symptom. Wlien the animal moves, the toe only is placed to the ground or the foot is carried in the air and the patient hobbles along on three legs. WTien he is at rest, the foot is set forward w^ith the toe on the ground and the leg flexed at the fetlock joint. As soon as the pus finds its wa}^ to the surface the lameness improves. If the frog is examined early the injured spot may usually be found; later, if no opening exists, the pus may be discovered working its way toward the heels. The horn is loosened from the deeper tissues, and, if pared through, a thin, yellow, watery and offensive pus escapes. In other cases a ragged opening is foimd in the frog, leading down to a mass of der.d, sloughing tissues, which are pale green in color if gangrene of the plantar cushion has set in. In rare cases the coffin bone may be in- volved in the injury and a small portion of it become carious. Treatment. — If the injury is seen at once, the foot should be placed in a bath of cold water to prevent suppuration. If suppuration has already set in, the horn of the frog, and of the bars and branches of the sole, if necessary, is to be pared thin so that all possible pressure may be removed, and the foot poulticed. AVhen the pus has loosened the horn, all the detached portions are to be cut away. If the pus is discharging from an opening near the hair, the whole frog, or one- half of it, will generally be found separated from the plantar cushion, and is to be removed with the knife. After a few days the gangre- nous portion of the cushion will slough off from the effects of the poultice; under rare circumstances only should the dead parts be removed by surgical interference. AVhen the slough is all detached, the remaining wound is to be treated with simple stimulating dress- 400 DISEASES OF THE HORSE. iiigs, such as tincture of aloes or turpentine, oakum balls, and band- ages as directed in punctured wounds. When the lameness has sub- sided, and a thin layer of new horn has covered the exposed parts, the foot ma}^ be shod. Cover the frog with a thick pad of oakum, held in place by pieces of tin fitted to slide under the shoe, and return to slow work. A^^iere caries of the coffin bone, etc., follow the injury, the treatment recommended for these complications in punctured wounds of the foot must be resorted to. PUNCTURED WOUNDS OF THE FOOT. Of all the injuries to which the foot of the horse is liable, none are more common than punctured wounds, and none are more serious than these may be when involving the more important organs contained within the hoof. A nail is the most common instrument by which the injury is inflicted, yet wounds may happen from sharp pieces of rock, glass, wire, knives, etc. A wound of the foot is more serious when made bj^ a blunt-pointed instrument than when the jDoint is sharp, and the nearer the injury is to the center of the foot the more likely are disastrous results to fol- low. Wounds in the heel and in the posterior parts of the frog are attended with but little danger, unless they are so deep as to injure the lateral cartilages, when quittor may follow. Punctured wounds of the anterior i3arts of the sole are more dangerous, for the reason that the coffin bone may be injured, and the suppuration, even wdiere the wound is not deep, tends to sj^read and always gives rise to intense suffering. The most serious of the punctured wounds are those which happen to the center of the foot, and which involve, in pro- portion to their depth, the plantar cushion, the plantar aponeurosis, the sesamoid sheath, the navicular bone, or the coffin joint. Punctured wounds are more likely to be deep in flat or convex feet than in well-made feet, and, as a rule, recovery is neither so rapid nor so certain. These wounds are less serious in animals used for heavy draft than in those required to do faster work; for the former may be useful, even if complete recovery is not effected. Lastly, punctured wounds of the fore feet are more serious than of the hind feet, for the reason that in the former the instrument is apt to enter the foot in a nearly perpendicular line, and, consequently, is more likely to injure the deeper structures of the foot; in the hind foot, the injury is generally near the heels and the wound oblique and less deep. SyTnptoins. — A nail or other sharp instrument may penetrate the frog and remain for several days without causing lameness; in fact, in many cases of punctured wound of the frog the first evidence of the injury is the finding of the nail or the appearance of an opening where the skin and frog unite, from which more or less pus escapes. Even when the sole is perforated, if the injury is not too deep, no PUNCTURED WOUNDS OF FOOT. 401 lameness develops until suppnration is established. In all cases of foot lameness, especially if the cause is obscure, the foot should be examined for evidence of injury. The lameness from punctured wounds, accompanied by suppura- tion, is generally severe, the patient often refusing to use the aft'ected member at all. The pain being lancinating in character, he stands with the injured foot at rest or constantly moves it back and forth. In other cases the patient lies down most of the time with the feet outstretched ; the breathing is rapid, the pulse fast, the temperature elevated, and the body covered with patches of sweat. When the plantar aponeurosis is injured, the pus escapes with diffi- culty and the wound shows no signs of healing; the whole foot is hot and very painful. If the puncture involves the sesamoid sheath, the synovial fluid escapes. At first this fluid is pure, like joint Avater, but later becomes mixed with the products of suppuration and loses its clear amber color. Suppuration generally extends up the course of the flexor tendon, an abscess forms in the hollow of the heel, and finally opens somewhere below the fetlock joint. The whole coronet is more or less swollen, the discharge is profuse and often mixed with blood, yet the suffering is greatly relieved from the moment the abscess opens. If the puncture reaches the navicular bone the lameness is intense from the beginning; but the only certain v:?.y to determine the exist- ence of this complication is by the use of the probe, and unless there is a free escape of synovia it must be used Avitli the greatest of care, else the coffin joint may be opened. If the coffin joint has been penetrated, either by the offending in- strument or by the process of suppuration, acute inflammation of the joint follows, accomi^anied by high fever, loss of appetite, etc. The ankle and coronet are now greatly swollen, and dropsy of the leg to the knee or hock, or even to the body, often follows. If the j^rocess of suppuration continues, small abscesses appear at intervals on dif- ferent parts of the coronet, the patient rapidly loses flesh, and may die from intense suffering and blood poisoning. In other cases the suppuration, soon disappears, and recovery is effected by the joint becoming stiff (anchylosis). When the wound is forward, near the toe, and deep enough to injure the coffin bone, caries always results. The j)resence of the dead pieces of bone can be determined by the use of the i)robe; the bone feels rough and gritty. Furthermore, there is no disposition upon the part of the wound to heal. Besides the complications above mentioned, others ex|ually as seri- ous may be met with. The tendons may soften and ru]:)ture, the hoof may slough off, quittors develop, or sidebones and ringbones grow. II. Dnr. 7!tr>. ^0-2 2(> 402 DISEASES OF THE HORSE. Finally, laminitis of the opposite foot may happen if the patient per- sists in standing, or lockjaw may cause early death. Treatment. — In all cases the horn around the seat of injury should be thinned down, a free opening made for the escape of the products of suppuration, and the foot placed in a poultice. If the injury is not serious, recovery takes j^lace in a few days' time. Wliere the wound is deeper, it is better to put the foot in a cold bath or under a stream of cold water, as advised in the treatment for quittor. If the bone is injured, cold baths, containing about 2 ounces each of sulphate of copper and sulphate of iron, may be used until the dead bone is well softened, when it should be removed by an opera- tion. The animal must be cast for this operation. The sole is pared aw^ay until the diseased bone is exposed, when all the dead particles are to be removed with a drawing knife, and the wound dressed with creolin or a 5 per cent solution of carbolic acid, oakum balls, and a roller bandage. AVounds of the bone which are made by a blunt-pointed instrument, like the square-pointed cut nail, in which a portion of the surface is driven into the deeper parts of the bone, always progress slowly, and should be operated upon as soon as the conditions are favorable. Even wounds of the navicular bone, accompanied by caries, may be operated on and the life of the patient saved ; but the most skillful surgery is required and only the experienced operator should under- take their treatment. If there is an escape of pure synovial fluid from a wound of the sole, without injury to the bone, a small pencil of corrosive sublimate should be introduced to the bottom of the wound and the foot dressed as directed above. The other comj^lications are to be treated as directed under their ptoper headings. After healing of the wounds has been effected, lameness, with more or less SAvelling of the coronary region, may remain. In such cases the coronet should be blistered or even fired with the actual cautery, and the patient turned to pasture. If the lameness still persists, and is not due to a stiff joint, unnerving may be resorted to ; in many cases with very good results. If the joint is anchylosed, no treatment can relieve it, and the patient must either be put to very sIoav work or kept for breeding purposes only. '"''Prick in shoeing " is an injury wdiich should be considered under the head of punctured wounds of the foot. The nails by which the shoe is fastened to the hoof may jjroduce an injur}" followed by inflammation and suppuration in two days, by penetrating the soft tissues directly or by being driven so deep that the inner layers of the horn of the wall are pressed against the soft tissues with such force as to crush them. In either case the animal generally goes lame soon CONTRACTED HEELS, OR HOOF-BOUND. 403 after shoeing unless the injury is at the toe, when the first evidence of the troubk^ may be the dischar<>e of pus at the coronet. When hnneness follows close upon the setting of the shoes, without other appreciable cause, each nail should be lightly struck with a hammer, when the one at fault will be detected by the flinching of the animal. Treatment consists in drawing the nail, and if the soft tissues have been penetrated or suppuration has commenced, the horn must be pared away until the diseased parts are exposed. The foot is now to be poulticed for a day or two, or until the lameness and suppuration have ceased. If the discharge of pus from the coronet is the first evi- dence of the disease, the oti'ending jiail must be found and removed, the horn pared out, and creolin or a weak solution of carbolic acid injected at the coronet until the fistulous tract has healed. (OX'l'KACTKI) TIEELS, OR IIOOF-BOUND. Contracted heels, or hoof-bound, is a common disease among horses kept on hard floors in dry stables, and in such as are subject to much saddle work. It consists in an atrophy, or shrinking, of the tissues of the foot, whereby the lateral diameter of the heels is diminished. It affects the fore feet principally; but it is seen occasionally in the hind feet, where it is of less importance for the reason that the hind foot first strikes the ground with the toe, and, consequently, less expan- sion of the heels is necessary than in the fore feet, where the weight is first received on the heels. Any interference with the expansibility of this part of the foot interferes wnth locomotion and ultimately irives rise to lameness. Usually but one foot is affected at a time; but when both are diseased the change is greater in one than in the other. Occasionally but one heel, and that the inner one, is contracted; in these cases there is less likely to be lameness and permanent impair- ment of the animal's usefulness. According to the opinion of some of the French veterinarians, hoof-bound should be divided into two classes — total contraction^ where the whole foot is shrunken in size; and (Oiifnirtioii of tlir Iicr/s, when the trouble extends only from the quarters backward. (Plate XXXIV, figs. 4 and 7.) Causes. — Animals raised in wet or marshy districts, when taken to towns and kei)t on dry floors, are liable to have contracted heels, not alone because the horn becomes dry, but because fever of the feet and wasting away of the soft tissues result from the change. Another common cause of contracted heels is to be found in faulty shoeing, such as rasping the wall, cutting away the frog, heels, and bars; high calks and the use of nails too near the heels. Contracted heels may happen as one of the results of other diseases of the foot ; for instance, it often accompanies thrush, sidebones, ringbones, canker, navicular disease, corns, sprains of the flexor tendons, of the sesamoid and sus- pensory ligaments, and from excessive knuckling of the fetlock joints. 404 DISEASES OF THE HORSE. Symptoms. — In contraction of the heels the foot has lost its circular shape, and the Avails from the quarters backward approach to a straight line. The ground surface of the foot is now smaller than the coronary circumference; the frog is pinched between the inclosing lieels, is much shrunken, and at times is affected with thrush. The sole is more concave than natural, the heels are higher, and the bars are long and nearly perpendicular. The whole hoof is dry, and so hard that it can scarcely be cut; the parts toward the heels are scaly and often ridged like the horns of a ram, while fissures, more or less deep, may be seen at the quarters and heels following the direction of the horn fibers. (Plate XXXIII, fig. 10.) When the disease is well advanced, lameness is present, while in the earlier stages there is only an uneasiness evinced by frequent shifting of the affected foot. Stumbling is common, especially on hard or rough roads. In most cases the animal comes out of the stable stiff and inclined to walk on the toe, but after exercise he may go free again. He wears his shoes off at the toe in a short time, no matter whether he works or remains in the stable. If the shoe is removed and the foot pared in old cases, a dry, mealy horn will be found where the sole and Avail unite, ex- tending upward in a narroAv line toAvard the cjuarters. Treatment. — First of all, the preA^entiA^e measures must be consid- ered. The feet are to be kept moist and the horn from drying out by the use of damp saAvdust or other bedding; by occasional poultices of boiled turnips, linseed meal, etc., and greasy hoof ointments to the sole and Avails of the feet. The Avail of the foot should be spared from the abuse of the rasp; the frog, heels, and bars are not to be mutilated Avith the knife, nor should calks be used on the shoe except Avhen absolutely necessary. The shoes should be reset at least once a month, to prevent the feet from becoming too long, and daily exer- cise must be insisted on. As to curative measures, a diversity of opinion exists. A number of kinds of special shoes have been invented, having for an object the sj^reading of the heels, and perhaps any of these, if properly used. Avould eventually eft'ect the desired result. But a serious objection to most of these shoes is that they are expensive and often difficult to make and apply. The method of treatment Avhich I haA^e adopted is not only attended Avith good results, but is inexpensiA^e, if the loss of the patient's services for a time is not considered a part of the ques- tion. It consists, first, in the use of jjoultices or baths of cold Avater until the horn is thoroughly softened. The foot is noAv prepared for the shoe in the usual way, except that the heels are loAvered a little, and the frog remains untouched. A shoe, called a " tip," is made by cutting off both branches at the center of the foot and drawing the ends doAvn to an edge. The tapering of the branches should begin at the toe, and the shoe should be of the usual Avidth, Avith both the upper SAND-CRACKS. 405 and lower surfaces flat. This tip is to be fastened on with six or eight small nails, all set well forward, two being in the toe. With a com- mon foot rasp begin at the heels, close to the coronet, and cut away the horn of the wall until only a thin layer covers the soft tissues beneath. Cut forward until the new surface meets the old 2^ or 3 inches from the heel. The same sloping shai)e is to be observed in cutting downward toward the bottom of the foot, at which point the wall is to retain its nornud thickness. The foot is now blistered all around the coronet with Spanish-fly ointment ; when this is well set, the patient is to be turned to i)asture in a damp field or meadow. The blister should be repeated in three or four weeks, and, as a rule, the patient can be returned to work in two or three months' time. The object of the tip is to throw the weight on the frog and heels, which are readily spread after the horn has been cut away on the sides of the wall. The internal structures of the foot at the heels, being relieved of excessive pressure, regain their normal condition if the disease is not of too long standing. The blister tends to relieve any inflammation which may be present, and stimulates a rapid growth of healtliy horn, which, in most cases, ultimately forms a wide and nor- mal heel. In old, chronic cases, with a shrunken frog and increased concavity of the sole, accompanied by excessive wasting of all the internal tissues of the foot, satisfactory results can not be expected and are rarely secured. Still, much relief, if not an entire cure, may be effected by these measures. When thrush is present as a complication, its cure must be sought by measures directed under that heading. If sidebones, ringbone^ navicular disease, contracted tendons, or other diseases have been the cause of contracted heels, treatment will be useless until the cause is removed. . SAXD-CRACKS. A sand-crack is a fissure in the horn of the wall of the foot. These fissures are quite narrow, and, as a general rule, they follow the direc- tion of the horny fibers. They may occur on any part of the wall, but ordinarily are only seen directly in front, when they are called toc- craehs; or on the lateral parts of the walls, when they are known as quarter-cracks. (Plate XXXIII.) Toe-cracks are most common in the hind feet, while quarter-cracks nearlv always affect the fore feet. The inside quarter is more liable to the injury than the outside, for the reason that this quarter is not only the thinner, but during locomotion receives a greater part of the weidit of the body. A sand-crack may be superficial, involving only the outer parts of the wall, or it may be deep, involving the whole thickness of the wall and the soft tissues beneath. The toe-crack is most likely to be complete— that is, extending from 406 DISEASES OF THE HORSE. the coronary band to the sole — while the quarter-crack is nearly always incomj^lete, at least when of comparatively recent origin. Sancl-cracks are most serious when they involve the coronary band in the injury. They may be complicated at any time by hemorrhage, inflammation of the laminae, suppuration, gangrene of the lateral cartilage and of the extensor tendon, caries of the coffin bone, or the growth of a horny tumor known as a keraphyllocele. Causes. — Relative dryness of the horn is the j^rincipal predisposing cause of sand-cracks. Excessive dryness is perhaps not a more pro- lific cause of cracks in the horn than alternate changes from damp to dry. It is even claimed that these injuries are more common in ani- mals working on wet roads than those w^orking on roads that are rough and dry ; at least these injuries are not common in mountainous countries. Animals used to running at pasture when transferred to stables Avith hard, dry floors are more liable to quarter-cracks than those accustomed to stables. Small feet, with thick, hard hoofs, and feet which are excessively large, are more susceptible to sand-cracks than those of better proportion. A predisposition to quarter-cracks exists in contracted feet, and in those where the toe turns out or the inside quarter turns under. Heavy shoes, large nails, and nails set too far back toward the heels, together with such diseases as canker, quittor, grease and sup- purative corns, must be included as occasional predisposing causes of sand-cracks. Fast work on hard roads, jumping, and blows on the coronet, together with calk wounds of the feet, are accidental causes of quar- ter-cracks in particular. Toe-cracks are more likely to be caused by heavy pulling on slippery roads and pavements or on steep hills. Symptoms. — The fissure in the horn is ofttimes the only evidence of the disease ; and even this may be accidentally or purposely hidden from casual view by mud, ointments, tar, wax, putty, gutta-percha, or by the long hairs of the coronet. Sand-cracks sometimes commence on the internal face of the wall, involving its whole thickness excepting a thin layer on the outer surface. In these cases the existence of the injury may be suspected from a slight depression, which begins near the coronary band and follows the direction of the horny fibers; but the trouble can only be positively diagnosed by paring away the outside layers of horn until the fissure is exposed. In toe-cracks the walls of the fissure are in close apposition when the foot receives the weight of the body, but w^hen the foot is raised from the ground the fissure opens. In quar- ter-crack the opposite is true.; the fissure closes when the weight is removed from the foot. As a rule, sand-cracks begin at the coronary band, and as they become older they not only extend downward, but they also grow deeper. In old cases, particularly in toe-crack, the SAND-CRACKS. 407 horn on the borders of the fissure h)ses its vitality and scales off, sometimes thr()u<::h the o^reater part of its thickness, leaving behind a rough and irregular channel extending from the coronet to the end of the toe. In many cases of quarter-crack, and in some cases of toe-crack as well, if the edges remain close together, with but little motion, the fissure is dry; but in other cases a thin, offensive discharge issues from the crack and the ulcerated soft tissues, or a funguslike growth protrudes from the narrow opening. When the cracks are deep, and the motion of their edges consider- able, so that the soft tissues are bruised and pinched with every move- ment, a constant inflammation of the parts is maintained and the lameness is severe. Ordinarily the lameness of sand-crack is slight when the patient walks; but it is greatly aggravated when he is made to trot, and the harder the road the worse he limps. Furthermore, the lameness is greater going down hill than up, for the reason that these conditions are favorable to an increased motion in the edges of the fissure. Lastly, more or less hemorrhage accompanies the inception of a sand- crack when the whole thickness of the wall is involved. Subsequent hemorrhages may also take place from fast work, jumping, or a misstep. Treatment. — In so far as preventive measures are concerned, but little can be done. The suppleness of the horn is to be maintained by the use of ointments, damp floor, bedding, etc. The shoe is to be pro- portioned to the weight and work of the animal; the nails holding it in place are to be of proper size, and not driven too near the heels; sufficient calks and toe-pieces must be added to the shoes of horses working on slippery roads; and the evils of jumping, fast driving, etc., are to be avoided. When a fissure has made its appearance, means are to be adopted which will prevent it from growing longer or deeper; and this can only be done by arresting all motion in the edges. The best and simplest artificial appliance for holding the borders of a toe-crack together is the Vachette clasp. These clasps and the instruments necessary for their application can be had of any prominent maker of veterinary instruments. (Plate XXXIII.) These instruments com- prise a cautery iron with which two notches are burned in the wall, one on each side of the crack, and forceps with which the clasps are closed into place in the bottom of the notches and the edges of the fissure brought close together. The clasjis, being made of stiff steel wire, are strong enough to prevent all motion in the bdrders of the crack. Before these clasps are applied the fissure should be thoroughly cleansed and dried, and. if the injury is of recent origin, the crack may be filled with a putty made of 2 parts of gutta-percha and 1 pan 408 DISEASES OF THE HORSE. of glim ammoniac. The number of clasps to be used is to be deter- mined by the length of the crack, the amount of motion to be arrested, etc. Generally the clasps are from one-half to three-quarters of an inch apart. The clasps answer equally as well in quarter-crack if the wall is suiRciently thick and not too dry and brittle to withstand the strain. In the absence of these instruments and clasps a hole may be drilled through the horn across the fissure and the crack closed with a thin nail made of tough iron, neatly clinched at both ends. A plate of steel or brass is sometimes fitted to the parts and fastened on with short screws; while this appliance may prevent much gaping of the fissure, it does not entirely arrest motion of the edges, for the simple reason that the plate and screw can not be rendered immobile. If, for any reason, the above measures fail or can not be used, recourse must be had to an operation. The horn is softened by the use of warm baths and poultices, the patient cast, and the walls of the fissure entirely removed with the knife. The horn removed is in the shape of the letter Y with the base at the coronet. Care must be taken not to injure the coronary band and the laminae. The Avound is to be treated with mild stimulant dressings, such as creolin, a weak solu- tion of carbolic acid, tincture of aloes, etc., oakum balls, and a roller bandage. After a few days the Avound will be covered Avith a iieAv, white horn, and the oakum and bandages only Avill be needed. As the neAV quarter groAvs out the lameness disapi^ears, and the patient may be shod Avith a bar shoe and returned to Avork. In all cases of sand-crack the groAvth of horn should be stimulated by cauterizing the coronary band or by the use of blisters. In simple quarter-crack recoA^ery Avill often take place if the coronet is blistered, the foot shod Avith a *■' tip," and the patient turned to pasture. The shoe in toe-crack should have a clip on each side of the fissure and should be thicker at the toe than at the heels. The foot should be low^ered at the heels by paring, and spared at the toe, except directly imder the fissure, Avhere it is to be pared away until it sets free from the shoe. When any of the complications referred to above arise, special measures must be resorted to. For the proper treatment of gangrene of the lateral cartilage and extensor tendon and caries of the coffin bone reference may be had to the articles on quittors. If the horny tumor, knoAvii as keraphyllocele, should develop, it is to be removed by the use of the knife. Since this tumor develops on the inside of the horny box and may invoh^e other important organs of the foot in disease, its removal should only be undertaken by a skillful surgeon. INFLAMMATION OF NAVICULAR BONE. 409 NAVICULAR- DISEASE. Navicular disease is an inflammation of the sesamoid sheath, in- duced by repeated bruising or laceration, and complicated in many cases by inflammation and caries of the navicular bone. In some instances the disease undoubtedly begins in the bone, and the ses- amoid sheath becomes involved subsequently by an extension of the inflammatory process. (Plate XXXII, fig. 5.) The thoroughbred horse is more commonly affected than any other, yet no class or breed of horses is entirely exempt. The mule, how- ever, seems rarely, if ever, to suffer from it. For reasons which Avill appear Avhen considering the causes of the disease, the hind feet are not liable to be affected. Usually but one fore foot suffers from the disease, but if both should be attacked the trouble has become chronic in the first before the second shows signs of the disease. Causes. — To comprehend fully how navicular disease may be caused by conditions and usages common to nearly all animals, it is neces- sary to recall the peculiar anatomy of the parts involved in the process and the functions which they perform in locomotion. It must be remembered that the fore legs largely support the weight of the body wlien the animal is at rest, and that the faster he moves the greater is the shock which the fore feet must receive as the body is thrown forward by the propelling force of the hind legs. This shock could not be withstood by the tissues of the fore feet and legs were it not that it is largely dissipated by the elastic muscles which bind the shoulder to the body, the ease Avith Avhich the arm closes on the shoulder blade, and the spring of the fetlock joint. But even these means are not sufficient within themselves to protect the foot from injury ; so nature has further supplemented them by placing the coffin joint on the hind part of the coffin bone instead of directly on top of it, whereby a large part of the shock of locomotion is dispersed before it can reach the vertical colmnn represented by the cannon, knee, and arm bones. A still further provision is made by placing a soft, clastic pad — the frog and plantar cushion— at the heels to receive the sesamoid expansion of the flexor tendon as it is forced downward by the pressure of the coronet bone against the navicular. Extraordinary as these means may appear for the destruction of shock, and ample as they are when the animal is at a slow pace or unweighted by rider or load, they fail to relieve completely the ])arts from concussion and ex- cessive pressure Avhenever the o])i)osite conditions are jn-esent. The result, then, is that the coronet bone forces the navicular hard against the flexor tendon, which, in turn, presses firndy against the navicular as the force of the contracting nuiscles lifts the tendon into place. It is self-evident, then, that the more rapid the pace and the greater the load, the greater must these contending forces be. and the greater the 410 DISEASES OF THE HORSE. liability to injury. For the same reason horses with excessive knee action are more likely to suffer from this disease than others, concus- sion of the foot and intense pressure on the tendon being common among such horses. Besides the above exciting causes must be considered those which predispose to the disease. Most prominent among these is heredity. It may be claimed, however, that an inherited predisposition to navic- ular disease consists not so much in a special susceptibility of the tissues which are involved in the process as in a vice of conformation which, as is well known, is likely to be transmitted from parent to off- spring. The faults of conformation most likely to be followed by the development of navicular disease are an insufficient planter cushion, a small frog, high heels, excessive knee action, and contracted heels. Finally, the environments of domestication and use, such as dry stables, heavy jjulling, bad shoeing, punctured wounds, etc., all have their influence in developing this disease. Syinjytoms. — In the early stages of navicular disease the symptoms are generally very obscure. AVlien the disease begins in inflammation of the navicular bone, the animal while at rest points the affected foot a time before any lameness is seen. AYhile at work he apparently travels as well as ever, but when placed in the stable one foot is set out in front of the other, resting on the toe, with fetlock and knee flexed. After a time, if the case is closely w^atched, the animal takes a few lame steps Avhile at work, but the lameness disappears as sud- denly as it came, and the driver doubts if the animal was really lame at all. Later on the patient has a lame spell which may last during a greater part of the day, but the next morning it is gone ; he leaves the stable all right, but goes lame again during the day. In time he has a severe attack of lameness, which may last for a week or more, when a remission takes jilace and it may be weeks or months before another attack supervenes. Finally, he becomes constantly lame, and the more he is used the greater the lameness. In the lameness from navicular disease the affected leg always takes a short step, and the toe of the foot first strikes the ground; so the shoe is most worn at this point. If the patient is made to move back- ward, the foot is set down with exceeding great care, and the weight rests upon the affected leg but a moment. \Vlien exercised he often stumbles, and if the road is rough he may fall on his knees. If he is lame in both feet the gait is stilty, the shoulders seem stiff, and, if made to work, sweats profusely from intense pain. Early in the development of the disease a careful examination will reveal some increased heat in the heels and frog, particularly after w^ork; as the disease progresses this becomes more marked, until the whole foot is hot to the touch. At the same time there is an increased sensibility of the foot, for the patient flinches from the percussion of a hammer SIDEBONES. 411 lightly iipplied to the frog and heels or from the precsiire of the smith's pincers. The frog is generally shrunken, often of a pale-red color, and at times is aifected with thrush. If the heels are pared away so that all the weight is received on the frog, or if the same re- sult is attained by the application of a bar shoe, the animal is excess- ively lame. The muscles of the leg and shouhler shrink away, and often tremble as the animal stands at rest. After months of lameness j the foot is found to be shrunken in its diameter and apparently j lengthened ; the horn is dry and brittle and has lost its natural gloss, while circular ridges, developed most toward the heels, cover the i u{)})er part of the hoof. AMien both feet are aft'ected. the animal points first one foot, then the other, and stands with the hind feet well forward beneath the body, so as to relieve the fore feet as much as ! possible from bearing weight. In old cases the wasting of the muscles and the knuckling at the fetlock become so great that the leg can not be straightened; and locomotion can scarcely be performed. The ' disease generally makes a steady progress without inclining to recov- ery the remission of symptoms in the earlier stages should not be interpreted as evidence that the process has terminated. The compli- cations usually seen are ringbones, sidebones, thrush, contracted heels, quarter-cracks, and fractures of the navicular, coronet, and pastern | bones. Treatment. — But few cases of navicular disease recover. In the early stages the wall of the heels should be rasped away, as directed in tiie treatment for contracted heels, until the horn is quite thin; the coronet should be well blistered with Spanish-fly ointment, and the patient turned to grass in a damp field or meadow. After three or four weeks the blister should be repeated. This treatment is to be continued for two or three months. Plane shoes are to be put on when the patient is returned to work. In chrri Sesaunoids. SrrtaZL Cannon . {'oronary. ,y(rvir,uJn.r ,Cofrui Fore nrni . Kncr. Splint bone. - Can/itin Oo/ir. Sri.s/frns(>fy[ U'(/n/nerU . | Fetlock . Flrxor pcrtiiriins. \ Flt'Xor- /ff'rt'oratlis. l-'ool. Anat(>rn\ ■ of t/>f tool . after Haubner. Buru:.\ ol the foot aft t-r Chajiveaji FTJ-Aor 5 tericU/rc- tlunes.Uel. Side Iion,e.f. aAor StoneKoTiic . yaviaxlar Disease,, after SUin£l\en^c . JULIUS BIEN a CO NT HIN(V HONE .VND NAVICULAR DISEASK. LAMINITIS, OR FOUNDER. 417 some manner dependent upon the food for its inception. Barley, wheat, and sometimes corn are the grains most apt to cause this dis- ease. With some horses there ai)pears to be a particuhir suscepti- bility to this influence of corn, and the use of this grain is followed by inflammation of the feet, lasting from a few days' to two weeks' time. In these animals, to all appearances healthy, the corn neither induces colic, indigestion, nor purging, and apparently no irritation whatever of the alimentary canal. (G) Fortunately i)urgative medicines rarely cause inflammation of the laminse. That it is, then, the result of symi)athetic action is no doubt more than hypothetical, for when there is no derangement of the alimentary canal a dose of cathartic medicine will at times brins: on severe laminitis. (T) Most all the older authorities were agreed that metastatic lami- nitis is a reality. In my opinion metastatic laminitis is nothing more nor less than concurrent laminitis, and presents little in any way pecul- iar outside the imperfectly understood exciting cause. The practi- tioner who allows the acute symptoms of the laminitis to mislead him, simjDly because their severity has overshadowed those of the primary disease, may lose his case through unguarded subsequent treatment. This form of laminitis is by no means commonly met with. It may be found in conjunction with pneumonia, according to Youatt with inflammation of the bowels and eyes, and according to Law and Williams sometimes with bronchitis. Symptoms. — Laminitis is characterized by a congregation of symp- toms so well marked as scarcely to be misinterpreted by the most casual observer. They are nearly constant in their manifestations, modified by the number of feet affected, the cause which has induced the disease, the previous condition of the patient, and the various other influences which o})erate in all diseases to some extent. They may be divided into general symptoms, which are concomitants of all cases of the disease, subject to variations in degree only, and special symptoms, or those which serve to determine the feet aifected and the complications which may arise. General sym^ptoms. — Usually, the first symptoms is the interfer- ence with locomotion. Occasionally the other symptoms are j^re- sented first. As the lameness develops the jjulse becomes accelerated, full, hard, and strikes the finger strongly ; the temperature soon rises .several degrees above the normal, reaching sometimes 100° F. ; it generally ranges between 102.5° and 105° F. The respirations are rapid and panting in character, the' nostrils widely dilated, and the mucous membranes highly injected. The facial expression is anxious and indicative of the most acute suffering, while the body is more or less bedewed with sweat. At first there may be a tendency to diar- H. Doc. 795, 50-2 27 418 DISEASES OF THE HORSE. rhea, or it may appear later as the result of the medicines used. The urine is high colored, scant in quantity, and of increased specific gravity, owing to the water being eliminated by the skin instead of the kidneys. The appetite is impaired, sometimes entirely lost, but thirst is greatly increased. The affected feet are hot and dry, and are relieved as much as possible from bearing weight. Rapping them with a hammer, or comj>elling the animal to stand upon one affected member, causes intense pain. The artery at the fetlock throbs heneath the finger. Special syTYiptoms.- — Liability to affection v^aries in the different feet according to the exciting cause. Any one or more of the feet may become the subject of this disease, although it appears more often in the fore feet than in the hind ones. This is due to the difference of function, i. e., that the fore feet are the bases of the columns of support, receiving nearly all of the body weight during progression and consequently most of the concussion, while the hind feet become simply the fulcra of the levers of progression, and are almost exempt from concussion. One foot. — Injuries and excessive functional performance are the causes of the disease in only one foot. The general symptoms, as a rule, are not severe, there being often no loss of appetite and no unu- sual thirst, while the pulse, temperature, and respiration remain about normal. The weight of the body is early throw^n upon the opposite foot, and the affected one is extended, repeatedly raised from the floor, and then carefully replaced. When made to move forward the lame foot is either carried in the air while progression is accomplished by hojoping with the healthy one, or else the heel of the first is placed upon the ground and receives little weight while the sound limb is quickly advanced. Progression in a straight line is more easy than turning toward the lame side. Both fore feet. — When both fore feet are affected the symptoms are well marked. The lameness is excessive and the animal almost im- movable. When standing the head hangs low down, or rests upon the manger as a means of support and to relieve the feet; the fore feet are well extended so that the weight is thrown upon the heels, where the tissues are least sensitive, least inflamed, and most capable of relief by free effusion. The hind feet are brought forward beneath the body to receive as much weight as possible, thereby relieving the diseased ones. If progression is attempted, which rarely happens voluntarily during the first three or four days, it is accomplished with very great pain and lameness at the starting, which usually subsides to an extent after a few minutes' exercise. During this exercise, if the animal happens to step upon a small stone or other hard substance, he stumbles painfully and is excessively lame in the offended member for a number of steps, owing to the acute pain which pressure upon LAMINITIS, OR FOUNDER. 419 the sole causes in the tissues beneath. The manner of the progression is pathognomonic of the comphiint. Sometimes the affected feet are simultaneousl}'^ raised from the ground (the liind ones sustaining the weight), then advanced a short distance and carefully replaced; at almost the same moment the hind ones are quickly shuffled forward near to the center of gravitation. In other instances one foot at a time is advanced and placed with the heel upon the ground in the same careful manner, all causes of concussion being carefully avoided. In attempting to back the ani- mal he is found to be almost stationary, simply swaying the body backward on the haunches and elevating the toes of the diseased feet as they rest upon their heels. In attempting to turn either to the right or left he allows his head to be drawn to the one side to its full extent before moving, then makes his hind feet the axis around which the forward ones describe a shuffling circle. In a majority of cases of laminitis in the fore feet the animal per- sists in standing until he is nearly recovered. In other cases he as persistently lies, standing only when necessity seems to compel it, and then for as short a time as possible. If the recumbent position is once assumed, the relief experienced tempts the patient to seek it again; and so we often find him down a greater part of the time. But this is not true of all cases ; sometimes he will make the experi- ment, then cautiously guard against a repetition. Even in cases of enforced recumbency, he ofttimes takes advantage of the first opportunity and gets upon his feet, doggedly remaining there until again laid upon his side. How to explain this diversity of action I do not know ; theoretically the recumbent position is the only ap- propriate one, except when complications exist, and the one which should give the most comfort, yet it is rejected by very many patients and, no doubt, for some good reason. It has been suggested as an explanation that when the animal gets upon his feet after lying for a time the suffering is so greatly augmented that the mem- ory of this experience deters him from an attempted repetition. If this were true, the horse with the first attack must necessarily make the experiment before knowing the after effects of lying down, yet many remain standing Avithout even an attempt at gaining this experimental knowledge. The most-favored position of the animal when down is on the broadside, with the feet and legs extended, ^\^lile in this position the general symptoms greatly subside; the respirations and pulse be- come almost nornuil ; the temperature falls and the perspiration dries. It is with difficulty that he is made to arise. When he attempts it he gets up rapidly and " all of a heap," as it were, shifting quickly from one to the other foot until they become accustomed to the weight 420 DISEASES OF THE HORSE. thrown upon them. Occasionally a })atient Avill get up like a cow, rising upon the hind feet first. Although enforced exercise relieves to some extent the soreness, it is but temporary, for after a few minutes' rest it returns Avith all its former severity. Both hind feet. — AMien only both hind feet are atfected, they are, while standing, maintained in the same position as when only the fore ones are the subjects of the disease, but with an entirely different object in view. Instead of being there to receive Aveight, they are so advanced that the heels only may receive what little weight is neces- sarily imposed on them; the fore feet at the same time are placed well back beneath the body, where they become the main supports; the animal standing, as Williams describes it, " all of a heap." Progression is even more difficult now than when the disease is confined to the anterior extremities. The fore feet are dubiously advanced a short distance and the hind ones brought forward with a sort of kangaroo hop, that results in an aj^parent loss of equilibrium which the animal is a few moments in regaining. The general symp- toms, or, in other words, the degree of suffering, seem more severe than where the disease affects the fore feet alone. The standing posi- tion is not often maintained, the patient seeking relief in recumbency. This fact is easily understood when we consider how cramped and unnatural is the position he assumes while standing and, if it were maintained for any considerable length of time, would, no doubt, excite the disease in the fore feet, as explained by D'Arboval. All four feet. — Laminitis of all four feet is but imcommonly met with. The author has seen but three such cases. In all these the posi- tion assumed was nearly normal. All the feet were slightly advanced, and first one, then another, momentarily raised from the ground and carefully replaced, this action being kept up almost continually dur- ing the time the animal remained standing. - The suffering is most acute, the appetite lost, and, although the patient lies most of the time, the temiDerature remains too high. The pidse and respirations are greatly accelerated, the body covered with sweat, and bed sores are unpleasant accompaniments. Course. — The course which laminitis takes varies greatly in differ- ent cases, being influenced more or less by the exciting cause, the animal's previous condition, the acuteness of the attack, and the sub- sequent treatment. The first symptoms rarely exhibit themselves while the animal is at his work, although we occasionally see the gait impaired by stumbling, the body covered with a profuse sweat, and the respirations become blowing in character as premonitions of the oncoming disease ; but, as a rule, nothing is noted amiss with the ani- mal until he has stood for some time after coming in from work, when, in attempting to move him, he is found very stiff. Like all conges- tions, the early symptoms usually develop rapidly; yet this is not LAMINITIS, OR FOUNDER. 421 always the case, for often there appears to be no well-defined period of congestion, the disease seemingly commencing at a point and gradually spreading until a large territory is involved in the morbid process. Simple congestion. — Those cases of simple congestion of the laminae, which we erroneously call laminitis, are rapidly developed, the symp- toms are but moderately severe, and but one to three days required for recovery. There are no structural changes and but a moderate exudate. This is rapidly reabsorbed, leaving the parts in the same condition as they were previous to the attack. If the congestion has been excessive, a i-upture of some of the capillaries will be found, a condition more apt to obtain where the animal is made to continue Avork after a development of symptoms has begun. True, the majority of these last-described cases prove to be the lam- initis in fact, yet the congestion may pass away and the extravasated blood be absorbed without inflammation sufficient to warrant calling it laminitis. The seat of greatest congestion will always be found in the neighborhood of the toe, because of the increased vascularity of that part, and, although at times it is limited to the podophyllous tissue aloQe, any or all parts of the keratogenous membrane may be affected by the congestion and followed finally by inflammation. Acute. — In the acute form of laminitis the symptoms may all de- velop rapidly, or it ma}^ commence by the appearance of a little sore- ness of the feet which in twenty-four or forty-eight hours develops into a well-marked case. This peculiarity of development is due to one of two causes. Either the congestion is general, but takes place slowly, or else it begins in one or more points and gradually spreads throughout the lamina?. These acute cases generally run their course in from one or two weeks. Usually a culmination of the symptoms is reached, if the patient is properly treated, in from three to five days; then evidences of recovery are discernible in favorable cases. The lameness improves, the other s3'mptoms gradually subside, and eventually health is regained. It is in these cases that a strong tend- ency to disorganization of a destructive character exists, hence it is we see so many recover imperfectly with marked structural changes permanently remaining. Subacute. — Subacute laminitis is most often seen as a termination of the acute form, although it may exist independent of or precede an acute attack. It is characterized by the mikhiess of its symptoms, slow course, and moderate tissue changes. It may be ])resent a long time before any patliological lesions result other than those found in the acute form, and when these changes do take place they should rather be viewed as complications. Chronic. — Chronic laminitis is a term used by many to designate any of the sequela? of the acute and subacute forms of this disease. 422 DISEASES OF THE HORSE. Pure chronic inflammation of the lammse is not very commonly met with, but is most frequent in horses that have long done fast track work. They have " fever in the feet " at all times and are continually sore, both conditions being aggravated by work. Like chronic in- flammation of other parts, there is a strong tendency to the develop- ment of new connective tissue, which, by its pressure upon the blood vessels, interferes with nutrition. Wasting of the coffin bone and in- flammation of its covering with caries is not unusual. The continued fever and impaired function of secretion result in the production of a horn deficient in elasticity, somewhat spongy in character, and in- clined to crumble. In some cases of " soreness " in horses used to hard or fast work, there is evident weakness of the coats of the ves- sels, brought on by repeated fimctional exhaustion. Here slight worii brings on congestion, which results in serous effusion and temporary symptoms similar to those of chronic laminitis. C omplications. — Complications concurrent with or supervening upon laminitis are frequent and varied, and are often dependent upon causes not fully understood. Excessive jyurgation is one of the simplest of these, and not usually attended with dangerous consequences. It rarely occurs unless in- duced by a purgative, and the excessive action of the medicine is prob- ably to be explained upon the theory that the mucous membrane symj)athizes with the diseased laminae, is irritable, and readily be- comes overexcited. The discharges are thin and watery, sometimes offensively odorous, and occasionally persist in spite of treatment. It may prove disastrous to the welfare of the patient by the rapid exhaustion which it causes, preventing resolution of the laminitis, and may even cause death. Septicemia and pyemia. — Septicemia and pyemia are unusual com- plications and are seen only in the most severe cases, where bed sores are present or suppuration of the laminae results. They die, as a rule, within three days after showing signs of the complication. Pneumonia — the so-called metastatic — needs no special considera- tion, for in its lesions and symptoms it does not differ from ordinary pneumonia, although it may be overlooked entirely by the practi- tioner. Examinations of the chest should be made every day, so as to detect the disease at its onset and render proper aid. Sidehones. — A rapid development of sidebones is one of the compli- cations, or, perhaps better, a sequel of laminitis not often met with in practice. Here the inflammatory process extends to the lateral carti- lages, with a strong tendency to calcification. The deposition of the lime salts is sometimes most rapid, so that the " bones " are developed in a few weeks ; in other instances they are deposited slowly and their growth is not noted until long after the subsidence of the laminitis, so that the exciting cause is not suspected. This change in the car- LAMINITIS, OR FOUNDER. 423 tilages may commence as early as the first week of the laminitis ; and although the trouble in the laminae is removed in the course of a fort- night the symptoms do not entirely subside, the animal retains the shuffling gait, the sidebones continue to grow, and the patient usually remains quite lame. This alteration of the cartilages generally pre- vents the i^atient recovering his natural gait, and the practitioner receives unjust censure for a condition of affairs he could neither foresee nor prevent. The laminitic process occasionally extends to the covering of the coronet bone, or at least concurrent with and subsequent to laminitis the development of " low ringbone " is seen, and it is apparently dependent upon the disease of the lamina? for its exciting cause. The impairment of function and consequent symptoms are much less marked here than in sidebones. The coronet remains hot and sensi- tive and somewhat thickened after the laminitis subsides, and a little lameness is present. This lameness persists and the deposits of new bone may readily be detected. Suppuration of the sensitive membrane is a somewhat common complication, and even when present in its most limited form is always a serious matter ; but when it becomes extensive, and especially where the suppurative process extends to the periosteum, the results are apt to be fatal. When suppuration occurs the exudation does not appear to be excessive. It is rich in leucocytes and seems to have caused detachment of the sensitive tissues from the horn prior to the formation of pus in some instances; in others the tissues are still attached to the horn and the suppuration takes place in the deeper tissues. Limited suppuration may take place in any part of the sensitive tissues of the foot during laminitis, and may ultimately be reabsorbed instead of being discharged upon the surface, but generally the process l)egins in the neighborhood of the toe and spreads backward and upward toward the coronet, finally separating the horn from the coronary band at the quarters. At the same time it spreads over the sole and eventually the entire hoof is loosened and sloughs away, leaving the tissues beneath entirely unprotected. In other instances, and these are generally the cases not considered unusually severe, the suppuration begins at the coronary band; it extends but a short dis- tance into the tissues, yet destroys the patient by separating the hoof from the coronary band, upon which it depends for support and growth. This form of the suppurative process usually begins in front ; for it is this part of the coronary band that is always most actively affected with inflammation, and conse(iuently it is here that impairments first occur. Suppuration of the sensitive sole is more common than of the sensi- tive lamina? and coronary band. It is present in the majority of cases 424 DISEASES OF THE HORSE. where there is a dropping of the coffin bone, and in other instances where the eifusion at this point is so great as to arrest the production of horn and uncover the sensitive tissues. Except when the result of injury it begins at the toe and spreads backward, and, if not relieved by opening the sole, escapes at the heel. Suppuration of the sole is much less serious than in other parts of the foot. If the acute constitutional symptoms developed from sloughing of the foot do not result in death, a new hoof of very imperfect horn may be developed after a time; but unless the animal is to be kept for breeding purposes alone the foot will ever be useless for work and death should relieve the suffering. When only the sole sloughs recovery takes place with proper treatment. Peditis. — This is the term that Williams applies to that serious complication of laminitis where not only the laminae, but the perios- teum and coffin bone also are subjects of the inflammatory proess. Neither is this all ; for in some of these cases of peditis acute inflam- mation of the coffin joint is present, and occasionally suppuration of the joint. A mild form of periostitis, in which the exudation is in the outer layer of the periosteum only, is a more common condition than is recognized by practitioners generally. Intimate contiguity of structures is the predisposing cause, for the disease either spreads from the original seat or the complication occurs as one of the primary results of the exciting cause. In the severer cases where the exudate separates the periosteum from the bone, suppuration, gangrene, and superficial caries are common results. If infiltration of the bone tissues is rapid the blood supply is cut off by pressure upon the vessels and death of the coffin bone follows. Grave constitutional symptoms mark these changes, which soon prove fatal. In the mild cases of periostitis it is by no means easy to determine its presence positively, for there are no special symptoms by which it may be distinguished from pure, laminitis. In a majority of acute cases, though, which show no signs of improvement by the fifth to seventh day, it is safe to suspect periostitis, particularly if the coro- nets are very hot, the pulse full and hard, and the lameness acute. In the fortunatel}^ rare cases where the bone is affected with inflam- mation and suppuration, the agony of the patient is intense ; he occu- pies the recumbent position almost continually, never standing for more than a few minutes at a time; suffers from the most careful handling of the affected feet; maintains a rapid pulse and respiration, high temperature, loss of appetite, and great thirst. It is in these cases the patient continually grows worse, and the appearance of sup- puration at the top of the hoof in about two weeks after the inception of the disease proves the inefficienc}'^ of any treatment which may have been used and the hopelessness of the case. These patients die usually LAMINITIS, OR FOUNDER. 425 between the tenth and twentieth days either from exhaustion or pyemic infection. Gangrene occurs in the periosteum as the result of excessive detach- ment from the bone and compression due to excessive exuchition. Other parts of the sensitive tissues are subject to the same fate occa- sionallv, and at times hirge territories will be found dead. PuTniced sole is that condition in which the horny sole in the neigh- borhood of the toe readily crumbles away and leaves the sensitive tissues more or less exposed. It is not a complication of laminitis only, for it is seen under other conditions. AVilliams has described the horny tissue of pumiced sole as " weak, cheesy, or spongy, like macerated horn, or even grumous." This crumbling horn, Avhen critically examined, shows almost an entire absence of the cohesive matter which unites the healthy fibers, while the fibers themselves are irregidar and granular in appearance. Pumiced sole depends upon an impairment of the horn-secreting powers of the sensitive sole, or upon a separation of the horny from the soft tissues which maintain its vitalitv. Punctured wounds of the foot, accompanied by any considerable destruction of the soft tissues, present the same peculiarities of horn in the immediate neighborhood of the injury. Bruises of the sole are followed by this change when the exudation has been excessive and has separated the horn from the living tissues. True, in these cases we rarely see the soft tissues laid bare, for the reason that new horn is constantly secreted and replaces that undergoing disintegration. Laminitis presents three different conditions under which pumiced sole may appear : First, where free exudation separates the horn from the other tissues, or where the process of inflammation arrests the production of horn by impairing or destroying the horn-secreting membrane; secondly, where depression of the coffin bone causes pres- sure upon and arrests the formation of horn; and, thirdly, where the elevation of the sole compresses the soft tissues against the pedal bone and induces the same condition. Pumiced sole, from simple exudation and separation of tissues, is of little importance, for the reason given above in connection v»'ith bruises; but when suppuration occurs in restricted portions of the foot in conjunction with laminitis, it always lays bare the tissues beneath and impairs the aninuil's value temporarily. Recovery takes place after a few weeks by the tissues horning over, as in injuries attended by the same process. Depression of the coffin bone is not sufficient within itself to cause pumiced sole; for, if the relative change in the bone takes place slowly, or if the horn is thin, the sole becomes convex from gradual pressure, and the soft tissues adapt themselves to the change without having their function materially 426 DISEASES OF THE HOKSE. impaired. But when the dropping is sudden and the soft tissues are destroyed, the horn rapidly crumbles away and the toe of the bone comes through. In many of these cases the soft tissues remain uncovered for months. When they are eventually covered it is with a thin, slightly adherent hom that stands but little or no wear. The sole being now convex, the diseased tissues bear unusual weight by coming in contact with the ground, and hence it is that these animals are generally incurable cripples. In the majority of cases where the sole is raised to meet the pedal bone and pumiced sole occurs, it is due not to pressure of the bone from within (for the tissues are capable of adapting themselves to the gradual change), but to impaired vitality of the sensitive tissues from the inflammation and to the constant concussion and pressure applied from without during progression. To this is to be added the paring away of the horn by the smith when applying the shoe, thereby keep- ing the sole at this point too thin. Turning up of the toe. — In many cases of laminitis which have become chronic it is found that the toe of the foot turns up ; that the heels are longer than natural ; while the hoof near the coronary band is circled with ridges like the horn of a ram. Even in cases where recovery has taken place, and in other diseases than laminitis, these ridges may be found in the wall of the foot. But in such cases the ridges are equally distant from each other all around the foot, while in turning up of the toe the ridges are wide apart at the heels and close together in front, as seen in the figure (Plate XXXI, fig. 4). These ridges are produced by periods of interference with the growth of horn alternating with periods during which a normal or nearly normal gi'owth takes place. When the toe turns up it is because the coronary band in front produces horn very slowly, while at the heels it grows much faster, causing marked deformit}^ Animals so affected always place the abnormally long heel first upon the ground, not alone because the heel is too long, nor as in acute or subacute laminitis to relieve the pain, but for the simple reason that the toe is too short and lifted away from its natural position. To bring the toe to the ground the leg knuckles at the fetlock joint. The pain and impairment of function in these cases always result in marked atrophy of the muscles of the forearm and shoulder, and to some extent of the pectorals, while the position of the fore legs advances the shoulder joints so far forward as to cause a sunken appearance of the breast, which the laity recognize as " chest founder." The lesions of turning up of the toe are permanent, and are the most interesting pathologically of all the complications of laminitis. Treatment. — The treatment of laminitis is probably more varied LAMINITIS, OR FOUNDER. 427 than in any other disease, and jet a large number of cases recover for even the poorest practitioner. Prevention. — To guard against and prevent disease, or to render an unpreventable attack less serious than it otherwise would be, is the highest practice of the healing art. In a disease so prone to result from the simplest causes, especially when the soundest judgment may not be able to determine the extent of the disease-resisting powers of the tissues which are liable to be affected, or of what shall in every instance constitute an overexcitement, it is not strange that horse owners find themselves in trouble from unintentional transgression. If the disease was dependent upon specific causes, or if the stability of the tissues were of a fixed or more nearly determinate quality, some measures might be instituted that would prove generally preventive. But the predisposing causes are common conditions and often can not be remedied. That which is gentle work in one instance may incite disease in another. That which is food to-day may to-morrow prove disastrous to health. Finally, necessary medical interference, no mat- ter how judicious, may cause a more serious complaint than that which are being treated. Notwithstanding these difficulties there are some general rules to be observed that will in part serve to prevent the development of an unusual number of cases. First of all the predis- posing causes must be removed where possible ; when this is impossi- ble unusual care must be taken not to bring into operation an exciting- cause. Fat animals should, under no circumstances, have hard work. If the weather is warm or the variation of temperature great, all horses should have but slow, gentle labor until they become inured to it, the tissues hardened, and their excitability reduced to a minimum. Green horses should have moderate work, particularly when taken from the farm and dirt roads to city pavements; for increased con- cussion, changed hygienic conditions, and artificial living readily become active causes of the disease under these circumstances. Army horses just out of winter (juarters, track horses with insufficient prep- aration, and farmers' horses put to work in the spring are among the most susceptible classes, and must be protected by work that is easy and gradual. If long marches or drives are imperative, the in- cumbrances must be as light as possible and the journey interspersed with frequent rests, for this allows the lamina? to regain their iuipaired functional activity and to withstand much more work with- out danger. Furthermore, it permits early detection of an attack, and prevents working after the disease begins, which renders subse- quent medication more efi'ective by cutting the process short at the stage of congestion. All animals when resting immediately after work should be pro- tected from cold air or drafts. If placed in a stable that is warm 428 DISEASES OF THE HORSE. and without draft, no covering is necessary ; under opposite conditions blankets should be used until the excitement and exhaustion of labor have entirely passed away. It is still better that all animals coming in warm from work be " cooled out " by slow walking until the per- spiration has dried and the circulation and respiration are again normal. Animals stopped on the road even for a few moments should always be protected from rapid change of temperature by appropriate clothing. If it can be avoided, horses that are working should never be driven or ridden through w^ater. If unavoidable, they should be cooled off before passing through, and then kept moving until com- pletely dried. The same care is to be practiced with washing the legs in cold Avater when just in from work, for occasionally it proves the cause of a most acute attack of this disease. Unusual changes in the manner of applying the shoes should not be hastily made. If a plane shoe has been worn, high heels or toes must not be substituted at once; but the change, if necessary, should gradually be made, so that the different tissues may adapt themselves to the altered conditions. If radical changes are imperative, as is sometimes the case, the work must be so reduced in quantity and quality that it can not excite the disease. Laminitis from the effects of purgatives can scarcely be guarded afi-ainst. I can not determine from the cases in which I have seen this result that there are any conditions present that would warn us of danger. The trouble does not seem to depend upon the size of the purgative, the length of time before purgation begins, or the activity and severity with which the remedy acts. Medicines known to have unusual irritating effects on the alimentary canal should be used only when necessity demands it, and then in moderate doses. Experience alone will determine what animals are liable to suffer from this disease through the use of foods. When an attack can be ascribed to any particular food it should be withheld, unless in small quantities. Horses that have never been fed upon Indian corn should receive but a little of it at a time, mixed with bran, oats, or other food, until it has been determined that no danger exists. Corn is less safe in warm than in cold weather, and for this reason it should always be fed with caution during spring and summer months. When an animal is excessively lame in one foot the shoe of the oppo- site member should be removed, and cold water frequently applied to the well foot. At the same time use the slings if the subject remains standing. Horses should under no circumstances be overworked; to guard against this, previous work, nature of roads, state of weather, and various other influences must be carefully considered. Watering while warm is a pernicious habit, and, unless the animal is accustomed to it, is apt to result in some disorder, ofttimes in laminitis. lAMINITIS, OR FOUNDER. 429 Curative measures. — In cases of simple congestion of the laminae the body should be warmly clothed and warm drinks administered. The feet should be placed in a warm bath to increase the return flow of blood. In course of an hour the feet may be changed to cold water and kept there until recovery is completed. If the constitutional symptoms demand it, diuretics should be given. Half-ounce doses of saltpeter, three times a day in the water, answer the purpose. In cases of active congestion the warm footbaths should be omitted and cold ones used from the commencement. vSubacute laminitis demands the same treatment, with laxatives if there is constipation, and the ad- dition of low-heeled shoes. The diuretics may need to be continued for some time and their frequency increased. Regarding acute lami- nitis, what has been called the " American treatment " is simple and efficient. It consists solely in the exhibition of large doses of nitrate of potash and the continued application to the feet and ankles of cold water. Three to -i ounces of saltpeter in a pint of water, repeated every six hours, is the proper dose. The laminitis frequently subsides within a week. These large doses may be continued for a week with- out danger ; under no circumstances have I seen the kidneys irritated to excess or other unfavorable effects produced. The feet should be kept in a tub of wat^r at a temperature of 45° to 50° F., unless the animal is lying down, when swabs are to be used and wet everv half hour with the cold water. The water keeps the horn soft and moist and acts directly upon the inflamed tissues by re- ducing the temperature. Cold maintains the vitality and disease- resisting qualities of the soft tissues, tones up the coats of the blood vessels, diminishes the supply of blood, and limits the exudation. Furthermore, cold has an anesthetic effect upon the diseased tissues and relieves the pain. Aconite rnay be given in conjunction with the niter where the heart is £rreatlv excited and beats strongly. Ten-drop doses, repeated every two hours for twenty-four hours, are sufficient. The use of cathartics is dangerous, for they may excite superpurgation. Usually the niter will relieve the constipation, yet if it should prove obstinate, laxatives may be carefully given. Bleeding, both general and local, should be guarded against. The shoes must be early removed and the soles left unpared. Paring of the soles presents two objections: First, while it may' temporarily relieve the pain by relieving })ressure, it favors greater exudation, which may more than counterbalance the good effects. Secondly, it makes the feet tender and subject to bruises when the animal again goes to work. The shoes should be replaced when con- valescence sets in and the animal is ready to take exercise. Exercise 430 DISEASES OF THE HORSE. should never be enforced until the inflammation has subsided; for although it temporarily relieves the pain and soreness, it maintains the irritation, increases the exudation, and postpones recovery. If at the end of the fifth or sixth day prominent symptoms of recovery are not apparent, apply a stiff blister of cantharides around the coronet and omit the niter for about forty -eight hours. When the blister is well set, the feet may again receive wet swabs. If one blister does not remove the soreness it may be repeated, or the actual cautery applied. The same treatment should be adopted where sidebones form or inflammation of the coronet bone follows. Wlien the sole breaks through, exposing the soft tissues, the feet must be carefully shod with thin heels and thick toes where there is a tendency to walk on the heels, and the sole must be well protected with appropriate dressings and pressure over the exposed parts. When there is turn- ing up of the toe, blistering of the coronet, in front only^ sometimes stimulates the growth of horn, but as a rule judicious shoeing is the only treatment that will enable the animal to do light, slow work. \Vliere suppuration of the laminae is profuse, it is better to destroy your patient at once and relieve his suffering ; but if the suppuration is limited to a small extent of tissue, especially of the sole, treatment, as in acute cases, may induce recovery and should always be tried. If from bed sores or other causes septicemia or pyemia is feared, the bisulphite of soda, in half -ounce doses, may be given in conjunction with tonics and such other treatment as is indicated in these diseases. As to enforced recumbency I doubt the propriety of insisting on it in the majority of cases, for I think the patient usually assumes what- ever position gives most comfort. No doubt recumbency diminishes the amount of blood sent to the feet, and may greatly relieve the pain, so that forcing the patient to lie down may be tried, yet should not be renewed if he thereafter persists in standing. Where the animal persistently stands, or where constant lying indi- cates it (to prevent extensive sores), the patient should be placed in slings. When all four feet are affected it may be impossible to use slings, for the reason that the patient refuses to support any of his weight and simply hangs in them. Lastly, convalescent cases must not be returned to work too early, else permanent recovery may never be effected. DISEASES OF THE SKIN. By James Law, F. R. C. V. S., Professor of Veterinary Science, etc., Cornell University. [Revised in 1&03 by the author.] As we find them described in systematic works, the diseases of the skin are very numerous and complex, which may be largely accounted for by the fact that the cutaneous covering is exposed to view at all points, so that shades of difference in inflammatory and other diseased processes are easily seen and distinguished from one another. In the horse the hairy covering serves to some extent to mask the symptoms, and hence the nonprofessional. man is tempted to apply the term " mange " to all alike, and it is only a step further to apply the same treatment to all these widely different disorders. Yet even in the hairy quadruped the distinction can be made in a way which can not be done in disorders of that counterpart and prolongation of the skin — the mucous membrane, which lines the air passages, the digest- ive organs, the urinary and generative apparatus. Diseased processes, therefore, which in these organs it might be difficult or impossible to distinguish from one another, can usually be separated and recognized when appearing in the skin. Nor is this differentiation unimportant. The cutaneous covering presents such an extensive surface for the secretion of cuticular scales, hairs, horn, sebaceous matter, sweat, and other excretory matters, that any extensive disorder in its functions may lead to serious internal disease and death. Again, the intimate nervous sympathy of differ- ent points of the skin with particular internal organs renders certain skin disorders causative of internal disease and certain internal dis- eases causative of affections of the skin. The mere painting of the skin with an impermeable coating of glue is speedily fatal; a cold draft striking on the chest causes inflammation of the lungs or pleura ; a skin eruption speedily follows certain disorders of the stomach, the liver, the kidneys, or even the lungs; simple buuns of the skin cause inflammations of internal organs, and inflanuuations of such or- gans cause in their turn eruptions on the skin. The relations — nervous, secretory, and absorptive — between the skin and internal organs are most extensive and varied, and therefore a visible disorder in the skin may point at once and specifically to a particular fault in diet, to an injudicious use of cold water when the system is heated, to a fault in drainage, ventilation, or lighting of the stables, to indiges- tion, to liver disease, to urinary disorder, etc. 431 432 DISEASES OF THE HOESE. STRUCTURE OF THE SKIN. The skin consists primarily of two j^arts: (1) The superficial non- vascular (without blood vessels) layer, the cuticle, or epidermis: and (2) the deep vascular (with blood vessels) layer, the corium, dermis, or true skin. The cuticle is made up of cells placed side by side and more or less modified in shape by their mutual compression and by surface evapo- ration and drying. The superficial stratum consists of the cells dried in the form of scales, which fall off continually and form dandruff. The deep stratum (the mucous layer) is formed of somewhat rounded cells with large central nuclei, and in colored skin containing numer- ous pigment granules. These cells have prolongations, or branches, by which they communicate with one another and with the superficial layer of cells in the true skin beneath. Through these prolongations they receive nutrient liquids for their growth and increase, and pass on liquids absorbed by the skin into the vessels of the true skin beneath. The living matter in the cells exercises an equally selective power on Avhat they shall take up for their own nourishment and on what they shall admit into the circulation from without. Thus, cer- tain agents, like iodine and belladonna, are readily admitted, whereas others, like arsenic, are excluded by the sound, unbroken epidermis. Between the deep and superficial layers of the epidermis there is a thin translucent layer (septum lucidum) consisting of a double stratum of cells, and forming a medium of transition from the deep spheroidal to the superficial scaly cuticle. The true skin, or dermis, has a framework of interlacing bundles of white and yellow fibers, large and coarse in the deeper layers, and fine in the superficial, where they approach the cuticle. Between the fibrous bundles are left interspaces which, like the bundles, become finer as they approach the surface, and inclose cells, vessels, nerves, glands, gland ducts, hairs, and in the deeper layers fat. The superficial layer of the dermis is formed into a series of minute conical elevations, or papilla, projecting into the deep portion of the cuticle, from which they are separated by a very fine transparent membrane. This papillary layer is very richly supplied with capil- lary blood vessels and nerves, and is at once the seat of acute sensa- tion and the point from which the nutrient liquid is supplied to the cells of the cuticle above. It is also at this point that the active changes of inflammation are especially concentrated; it is the im- Descriptiou of Fig. 1, Plate XXXV : e. Epidermis, d. Derma. 1. Horny layer of the epidermis. 2. Stratum mucosum. 3. Papillary layer of the derma. 4. Excretory duct of a sudoriparous gland. 5. Glomerule of a sudoriparous glaud. 6. Hair follicle. 7. Sebaceous gland. 8. Internal sheath of the hair follicle. 9. Bulb of the hair. 10. Mass of adipose tissue. Pl.ATl": XX w \er(ical section through shin. aftfi- Hiaiiv-pau . Hiiii- diseased t\\' 't'richnph y txin Ton.siiiuui.s ;lt't<'l- Mi'ouili J^m-'^^ W '^1 Hair diseased h\ Achorion Sehon leini Micixts/ioinit .IdoiLitdi /'rorii Pa/rtsrfif Pi/vr/ffsis in tjie At>r.\(' Ifaines. dfl . JULIUS Bit'. i)isi:asf. s oi'- riii': skix. STRUCTURE OF THE SKIN. 433 mediately superposed cell layers (mucous) that become morbidly increased in the earlier stages of inflammation; it is on the surface of the papillary layer that the liquid is thrown out which raises the cuticle in the form of a blister, and it is at this point mainly that pus forms in the ordinary pustule. The fibrous bundles of the true skin contain plain muscular libers, which are not controlled by the wnll, but contract under the influence of cold and under certain nervous influences, as in some skin dis- eases and in the chill of a fever, and lead to contraction, tightening, or corrugation of the skin, contributing to produce the " hidebound " of the horseman. Other minute muscular filaments are extended from the surface of the dermis to the hair follicle on the side to wdiich the hair is inclined, and under the same stnnulating influences pro- duce that erection of the hair which is familiarly known as " staring coat,"' Besides these, the horse's skin is furnished with an expansion of red voluntary muscle, firmly attached to the fibrous bundles, and l)y which the animal can not only dislodge insects and other irritants, but even shake off the harness. This fleshy envelope covers the sides of the trunk and the lower portions of the neck and head, the parts unprotected by the nume and tail, and serves to throw the skin of these pi^.rts into puckers, or ridges, in certain irritating skin diseases. The hairs are cuticular products growing from an enlarged papilla lodged in the depth of a follicle or sac, hollowed out in the skin and extending to its deepest layers. The hair follicle is lined by cells of epidermis, which at the bottom are reflected on the papilla and become the root of the hair. The hair itself js formed of the same kind of cells firmly adherent to each other by a tough intercellular substance, and overlapping each other like slates on a roof in a direction toward the free end. The sebaceous glands are branching tubes ending in follicles or sacs and opening into the hair follicles, lined by a very vascular fibrous network representing the dermis, and an internal layer of cells repre- senting the mucous layer of the cuticle. The oily secretion gives gloss to the hair and prevents its becoming dry and brittle, and keeps the skin soft and supple, protecting it at once against undue exhalation of water and undue absorj)tion when immersed in that medium. Besides those connected Avith the hair follicles there are numerous isolated sebaceous glands, opening directly on the surface of the skin, produ- cing a somewhat thicker and more odorous secretion. These are found in large numbers in the folds of the skin, whej-e chafing w^ould be likely if the surface w^ere dry,, as on the sheath, scrotum, mammary glands, and inner side of ihe thigh, around the anus and vulva, in the hollow of the heel, beneath the fine horn of the frog, on the inner side H. Doc. 795, 50-2 28 434 DISEASES OF THE HORSE. of the elbow, on the lips, nostrils, and eyelids. ^'^Hien closed by dried secretion or otherwise these glands may become distended so as to form various-sized swellings on the skin, and when inflamed they may throw out offensive liquid discharges, as in " grease," or produce red, tender fungous growths (" grapes "). The sioeat glands of the horse, like those of maii, are composed of simple tubes, which extend down through the cuticle and dermis in a spiral manner, and are coiled into balls in the deeper layer of the true skin. In addition to their importance in throwing offensive waste products out of the system, these glands tend to cool the skin and the entire economy of the animal through the evaporation of their watery secretion. Their activity is therefore a matter of no small moment, as besides regulating the animal heat and excreting impurities, they influence largely the internal organs through the intimate sympathy maintained between them and the skin. Diseases of the skin may be conveniently divided, according to their most marked features, into — - (1) Those in which congestion and inflaTnmation are the most marked features, varying according to the grade or form into (a) congestion with simple redness, dryness, and heat, but no eruption {erythema) ; (6) infamination with red-pointed elevations, but no blisters {papnles) ; (osing green food, brewers' grains, or kitchen garbage. The excitement in the skin, caused by shedding the coat, lack of grooming, hot weather, hot boiled or steamed food, 438 DISEASES OF THE HORSE. conduces to the eruption. Lastly, any sudden change of food may induce it. The blisters may in part go on to suppuration so that vesicles and j)ustules often appear on the same patch, and when raw from rubbing the true nature of the eruption may be completely masked. In high- fed horses, kept in close stables with little work, eczema of the limbs may last for months and years. It is a very troublesome affection in draft stallions. Treatment. — This disease is so often the result of indigestion that a laxative of 1 pound Glauber's salts, in 3 or 4 quarts w^ater or 1^ pints olive oil, is often demanded to clear away irritants from the alimen- tary canal. Following this, in recent and acute cases, give 2 drams of acetate or bicarbonate of potash twice a day in the drinking water. If the bowels still become costive, give daily 1 ounce sulphate of soda and 20 grains powdered nux vomica. In debilitated horses combine the nux vomica with one-half ounce powdered gentian root. As a wash for the skin use 1 dram bicarbonate of soda and 1 dram carbolic acid in a quart of water, after having cleansed the surface with tepid water. Employ the same precautions as regards feeding, stabling, and care of harness as in simple congestion of the skin. In the more inveterate forms of eczema more active treatment is required. Soak the scabs in fresh sweet oil, and in a few hours remove these with tepid water and Castile soap ; then apply an oint- ment of sulphur or iodide of sulphur day by day. If this seems to be losing its effect after a week, change for mercurial ointment or a solution of sulphide of potassium, or of hyposulphite of soda, 3 drams to the quart of water. In these cases the animal may take a course of sulphur (1 ounce daily), bisulphite of soda (one-half ounce daily), or of arsenic (5 grains daily) mixed with 1 dram bicarbonate of soda. INFLAMMATION WITH PUSTULES. In this affection the individual elevations on the inflamed skin show in the center a small sac of white, creamy pus, in place of the clear liquid of a blister. They vary in size from a millet seed to a hazelnut. The pustules of glanders (farcy buds) are to be distin- guished by the watery contents and the cordlike swelling, extending from the pustules along the line of the veins, and those of boils by the inflammation and sloughing out of a core of the true skin. The hair on the pustule stands erect, and is often shed with the scab which results. When itching is severe the parts become excoriated by rubbing, and, as in the other forms of skin disease, the character of the eruption may become indistinct. Old horses suffer mainly at the root of the mane and tail and about the heels, and suckling foals around the mouth, on the face, inside the thighs, and under the tail. Pustules like eczema are esj^ecially liable to result from unwhole- some food and indigestion, from a sudden change of food — above all. BOILS, OR FURUNCLES. 439 from dry to green food. In foals it may result from overheating of the mare and allowing the first milk after she returns, or by milk rendered unwholesome by faulty feeding of the dam. If a foal is brought up by hand the souring and other decompositions in the milk derange the digestion and cause such eruption. Vetches and other plants affected with honeydew and buckwheat have been the cause of these eruptions on white portions of the skin. Disorders of the kidneys or liver are connnon causes of this ati'ection. Treatment. — Apply soothing ointments, such as benzonated oxide of zinc, or vaseline with 1 dram oxide of zinc in each ounce. Or a wash of 1 dram sugar of lead or 2 drams hyposulphite of soda in a quart of water may be freely applied. If the skin is already abraded and scabby, smear thickly wdth vaseline for some hours, then wash with soapsuds and apply the above dressings. When the excoriations are indolent they may be painted with a solution of lunar caustic, 2 grains to 1 ounce of distilled water. Internally counteract costive- ness and remove intestinal irritants by the same means as in eczema, and follow this with one-half ounce doses daily of hyposulphite of soda, and one-half ounce doses of gentian. Inveterate cases may often be benefited by a course of sulphur, bisulphite of soda, or arsenic. In all, the greatest care must be taken with regard to food, feeding, watering, cleanliness, and work. In wet and cold seasons predisposed animals should, so far as possible, be protected from wet, mud, snow, and melted snow — above all, from that wiiich has been melted by salt. BOILS, OR FURUNCLES. These may appear on any part of the skin, but are especially com- mon on the lower parts of the limbs, and on the shoulders and back where the skin is irritated by accumulated secretion and chafing wnth the harnes?. In other cases the cause is constitutional, or attended by unwholesome diet and overwork with loss of general health and condition. They also follow on weakening diseases, notably strangles, in which irritants are retained in the system from overproduction of poisons and effete matters during fever, and imperfect elimination. There is also the presence of a pyogenic bacterium, by which the disease may be maintained and propagated. While boils are pus-producing, they differ from simple j^ustule in affecting the deepest layers of the true skin, and even the superficial layers of the connective tissues beneath, and in the death and slough- ing out of the central part of the inflamed mass (core). The depth of the hard, indurated, painful swelling, and the formation of this central mass or core, which is bathed in pus and slowly separated from surrounding parts, serve to distinguish the boil alike from the pustule, from the farcy bud, and from a superficial abscess. 440 DISEASES OF THE HORSE. Treatment. — To treat very painful boils a free ,inci8ion with a lancet in two directions, followed by a dressing w^ith one-half an ounce carbolic acid in a pint of water, bound on with cotton wool or lint, may cut them short. The more common course is to apply a warm poultice of linseed meal or wheat bran, and renew daily until the center of the boil softens, when it should be lanced and the core pressed out. If the boil is smeared with a blistering ointment of Spanish flies and a poultice put over it, the formation of matter and separation of the core is often hastened. A mixture of sugar and soap laid on the boil is equally good. Cleanliness of the skin and the avoidance of all causes of irritation are important items, and a teaspoonful of bicar- bonate of soda once or twice a day will sometimes assist in warding off a new crop. NETTLERASH ( SURFEIT, OR URTICARIA). This is an eruption m the form of cutaneous nodules, in size from a hazelnut to a hickory nut, transient, with little disposition to the formation of either blister or pustule, and usually connected with shedding of the coat, sudden changes of weather, and imwholesome- ness or sudden change in the food. It is most frequent in the spring and in young and vigorous animals (good feeders). The swelling embraces the entire thickness of the skin and terminates by an abrupt margin in place of shading off into surrounding parts. When the individual swellings run together there are formed extensive patches of thickened integument. These may appear on any part of the body, and may be general; the eyelids may be closed, the lips rendered immovable, or the nostrils so thickened that breathing becomes difficult and snuffling. It may be attended by constipation or diarrhea or by colicky pains. The eruption is sudden, the whole skin being sometimes covered in a few hours, and it may disappear with equal rapidity or persist for six or eight days. Treatment. — This consists in clearing out the bowels by 5 drams Barbados aloes, or 1 pound Glauber's salts, and follow the operation of these by daily doses of one-half ounce poAvdered gentian and 1 ounce Glauber's salts. A weak solution of alum may be applied to the swellings. SCALY SKIN DISEASE, OR PITYRIASIS. This affection is characterized by an excessive production and detachment of dry scales from the surface of the skin (dandruff). It is usually dependent on some fault in digestion and an imperfect secretion from the sebaceous glands, and is most common in old horses with spare habit of body. Williams attributes it to food rich in sac- ERUPTIONS OF THE SKIN. 441 charine matter (carrots, turnips) and to the excretion by the skin of oxalic acid. He has found it in horses irreguhirly worked and well fed, and advises the administration of pitch for a length of time, and the avoidance of saccharine food. Otherwise the horse may take a laxative followed by dram doses of carbonate of potash, and the affected parts may be bathed with soft tepid water and smeared with an ointment made with vaseline and sulphur. In obstinate cases sulphur may be given daily in tlie food. NERVOI'S IRRITATIOX OK THE SKIN, OR PRURITUS. This is seen in horses fed to excess on grain and hay, kept in close stables, and worked irregidarly. Though most common in summer, it is often severe in hot, close stables in winter. Pimples, vesicles, and abrasions may result, but as the itching is quite as severe on other parts of the skin, these may be the result of scratching merely. It is especially common and inveterate about the roots of the mane and tail. Treatnient consists in a ^jurgative (Glauber's salts, 1 pound), re- stricted, laxative diet, and a wash of water slightly soured with oil of vitriol and rendered sweet by carbolic acid. If obstinate, give daily 1 ounce of sulphur and 20 grains nux vomica. If the acid lotion fails, 2 drams carbonate of potash and 2 grains of cyanide of potas- sium in a quart of water will sometimes benefit. If due to pinworms in the rectum, the itching of the tail mav be remedied bv an occasional injection of a quart of water in which chips of quassia wood have been steeped for twelve hours. HERPES. This name has been applied to a disease in which there is an eruji- tion of minute vesicles in circular groups or clusters. Avith little tendency to burst, but rather to dry up into fine scabs. If the vesicles break thev exude a slight gumniv discharge which concretes into a small, hard scab. It is apparently noncontagious and not appreciably connected with any disorder of internal organs. It sometimes accom- panies or follows specific fevers, and is, on the Avhole, most frequent at the seasons of changing the coat — spring and autumn. It is seen on the lips and pastern, but may appear on any part of the body. The duration of the eruption is two weeks or even more, the tendency being to spontaneous recovery. The affected part is very irritable, causing a sensitiveness and a disposition to rub out of proi:)ortion to the extent of the eruption. Treatment. — It may be treated by oxide of zinc ointment, and to relieve the irritation a solution of opium or belladonna in water, or of sugar of lead or oil of peppermint. A course of bitters (one-half an ounce Peruvian bark daily for a week) may be serviceable in brac- ing the system and producing an indisposition to the eruption. 442 DISEASES OF THE HORSE. BLEEDING SKIN ERUPTIONS, OR DERMATORRHAGIA PARASITICA. In China, Hungary, Spain, and other countries horses frequently suffer from the presence of a threadworm {Filaria hcemorrhagica, Railliet; F. muUipapillosa^ Condamine and Drouilly) in the subcuta- neous connective tissue, causing effusions of blood under the scurf skin and incrustations of dried blood on the surface. The eruptions, which ai^pear mainly on the sides of the trunk, but may cover any part of the body, are rounded elevations about the size of a small pea, containing blood which bursts through the scurf skin and concretes like a reddish scab around the erect, rigid hairs. These swellings appear in groups, which remain out for several days, gradually diminishing in size; new groups appear after an interval of three or four weeks, the manifestation being confined to three or four months of spring and disappearing in winter. A horse will suffer for several years in succession, and then permanently recover. A fatal issue is not unknown. To find the worm the hair is shaved from the part where the elevations are felt, and as soon as a bleeding point is shown ihe superficial layer is laid open with the knife, when the parasite will be seen drawing itself back into the parts beneath. The worm is about 2 inches long and like a stout thread, thicker toward the head than toward the tail, and with numerous little conical elevations (papillae) around the head. The young worms are numerous in the body of the adult female w^orm. The worm has become common in given localities, and probably enters the system with food or water. TreatTnent is not satisfactory, but the affected surface should be kept clean by sponging, and the pressure of harness on any affected part must be avoided. Thus rest may become essential. The part may be frequently washed with a strong solution of sulphide of potassium. SUMMER SORES FROM FILARIA IRRITANS. Tlie summer sores of horses {^Dermatitis granulosa^ boils) have l^een traced to the presence in the skin of another parasite, 3 milli- meters in length and extremely attenuated {Filaria irntans Railliet). The sores may be seen as small as a millet seed, but more frequently the size of a pea, and may become an inch in diameter. They may jtppear on any point, but are especially obnoxious where the harness ])resses or on the lower parts of the limbs. They cause intense and insupi^ortable itching, and the victim rubs and bites the part until extensive raw surfaces are produced. Aside from such friction the sore is covered by a brownish-red, soft, pulpy material with cracks (»r furrows filled with serous pus. In the midst of the softened mass are small, firm, rounded granulations, fibrinous, and even caseated, and when the soft pultaceous material has been scraped off, the sur- face bears a resemblance to the fine yellow points of miliary tubercu- CRACKED HEELS. 443 losis in the lung. The worm or its debris is found in the center of such masses. These sores are very obstinate, resisting treatment for months in summer, and even after apparent recovery during the cold season they may appear anew the following summer. In bad cases the rubbing and l)iting may cause exposure of synovial sacs and tendons, and cause irremediable injury. Even in winter, however, when the diseased process seems arrested, there remain the hard, firm, resistant patches of the skin with points in which the diseased product has become softened like cheese. The apparent subsidence of the disease in winter is attributed to the coldness and comparative bloodlessness of the skin, whereas in sum- mer, with high temperature, active circulation, and rapid cell growth, inflammation is increased, itching follows, and from the animal rub- bing the part the irritation is persistently increased. The hotter the climate the more troublesome the disease. The life history of the parasite is unknown, but it j)robably enters the system with the food or water. Treatment consists, first, in placing the animal in a cool place and showering the surface with cold water. The parasite may be de- stroyed by rubbing the surface of the wound with iodoform and covering it with a layer of collodion, and repeating the applications every twenty-four hours for fifteen days, or until the sores heal up. Eiher or chloroform may be used in place of iodoform, being poured on cotton wool and applied to the sore for two minutes before jjaint- ing it with collodion. CRACKED HEELS ( SCRATCHES, OR CHAPS ON KNEE AND HOCk). This usually sets in with swelling, heat, and tenderness of the hol- low of the heel, with erections of the hairs and redness (in white skins), with stiffness and lameness, wiiich may be extreme in irritable horses. Soon slight cracks appear transversely, and may gain in depth and width, and may even suppurate. More frequently they become covered at the edges or throughout by firm incrustations re- sulting from the drying of the liquids thrown out, and the skin be- comes increasingly thick and rigid. A similar condition occurs behind the knee and in front of the hock (malanders and salanders), and may extend from these points to the hoof, virtually incasing that side of the limb in a pernument incrusting sheath. Causes. — Besides a heavy lyuiphatic constitution, which predisposes to this affection, the causes are overfeediug on grain, unwholesome fochlcr, close, hot, dirty stables, constant contact with dung and urine and their emanations, working in deep, irritant mud ; above all, in limestone districts, irritation by dry limestone or sandy dust in dry weather on dirt roads; also cold drafts, snow and freezing mud, washing the legs with caustic soap, wrapping the wet legs in thick 444 DISEASES OF THE HORSE. Avoolen bandages which soak the skin and render it sensitive when exposed next day, clipping the heels, weak heart and circulation, natural or supervening on overwork, imperfect nourishment, impure air, lack of sunshine, chronic exhausting, or debilitating diseases, or functional or structural diseases of the heart, liver, or kidneys. These last induce dropsical swelling of the limbs (stocking), weaken the parts, and induce cracking. Finally the cicatrix of a preexist- ing crack, weak, rigid, and unyielding, is liable to reopen under any severe exertion, hence rapid paces and heavy draft are active causes. Treatment. — In treatment the first step is to ascertain and remove the cause whenever possible. If there is much local heat and inflam- mation, a laxative (5 drams aloes or 1 pound Glauber's salts) may be given, and for the pampered animal the grain should be reduced or replaced altogether by bran mashes, flaxseed, and other laxative, non- stimulating food. In the debilitated, on the other hand, nutritious food and bitter tonics may be given, and even a course of arsenic (5 grains arsenic with 1 dram bicarbonate of soda daily). When the legs swell, exercise on dry roads, hand rubbing, and evenly applied bandages are good, and mild astringents, like extract of witch-hazel, may be applied and the part subsequently rubbed dry and bandaged. If there is much heat but unbroken skin, a lotion of 2 drams sugar of lead to 1 quart of water may be applied on a thin bandage, covered in cold weather with a dry one. The same may be used after the cracks appear, or a solution of sulphurous acid 1 part, glycerin 1 part, and Avater 1 part, applied on cotton and w^ell covered by a bandage. In case these should prove unsuitable to the particular case, the part may be smeared \\\i\\ vaseline 1 ounce, sugar of lead 1 dram, and carbolic acid 10 drops. inflammation of the heels w^ith sebaceous secretion ( grease, or ^ canker). This is a specific affection of the heels of horses usually associated w ith the growth of a parasitic fungus, an offensive discharge from the numerous sebaceous glands, and, in bad cases, the formation of red, raw excrescences (grapes) from the surface. It is to be distinguished (1) from simple inflammation in wdiich the special fetid discharge and the tendency to the formation of " grapes " are absent ; (2) from horsepox, in w-hich the abundant exudate forms a firm yellow in- crustation around the roots of the hair, and is embedded at intervals in the pits formed by the individual pocks, and in which there is no vascular excrescence; (3) from foot scabies (mange), in which' the presence of an acarus is distinctive; (4) from lymphangitis, in which the swelling appears suddenly extending around the entire limb as high as the hock, and on the inner side of the thigh along the line of the vein to the groin, and in which there is active fever, and (5) from GREASE, OR CANKER. 445 erysipelas, in which there is active fever (wanting in grease), the implication of the deeper layers of the skin and of the parts beneath giving a boggy feeling to the parts, the absence of the fetid, greasy discharge, and finally a tendency to form pus loosely in the tissues without any limiting membrane, as in abscess. Another distinctive feature of grease is its tendency to implicate the skin which secretes the bulbs or heels of the horny frog and in the cleft of the frog, con- stituting; the disease known as canker. Causes. — The predisposing causes of grease are essentially the same as those of simple infiannnation of the heel, so that the reader may consult the preceding article, and though a specific fungus and bac- teria of different kinds are present, they tend mainly to aggravation of the disease, and are not proved to be essential factors in causation. Symptoms. — The symptoms vary according to Avhether the disease comes on suddenly or more tardily. In the first case there is a sudden swelling of the skin in the heel, with heat, tenderness, itching, and stiffness, which is lessened during exercise. In the slower forms there is only seen a slight swelling after rest, and with little heat or inflam- mation for a week or more. Even at this early stage a slight serous oozing may be detected. As the swelling increases, extending up toward the hock or knees, the hairs stand erect, and are bedewed by moisture no longer clear and odorless, but grayish, milky, and fetid. The fetor of the discharge draws attention to the part whenever one enters the stable, and the swollen pastern and wet, matted hairs on the heel draw attention to the precise seat of the malady. If actively treated, the disease may not advance further, but if neglected the tense, tender skin cracks open, leaving open sores from which vascular bleeding growths grow up, constituting the '' grapes." The hair is shed, and the heel may appear but as one mass of rounded, red, angry excrescences Avhich bleed on handling and are covered with the now repulsively fetid decomposing discharge. During this time there is little or no fever, the animal feeds well, and but for its local trouble it might continue at work. When the malady extends to the frog, there is a fetid discharge from its cleft or from the depressions at its sides, and this irraduallv extends to its whole surface and ui)on the adjacent parts of the sole. The horn meanwhile becomes soft, whitish, and fleshy in aspect, its constituent tubes being greatly enlarged and losing their natural cohesion: it grows rapidly above the level of the surrounding horn, and when pared is found to be penetrated to an unusual depth by the secreting papilla\ and that at intervals these have bulged out into a vascular fungous mass comparable to the " grapes." Treatment. — In treatment hygienic measures occupy a fi-ont rank, but are in themselves insufficient to establish a cure. All local and general conditions which favor the prodiu'tion and persistence of the 446 DISEASES OF THE HORSE. disease must be guarded against. Above all, cleanliness and purity of the stable and air must be secured ; also nourishing diet, regular exercise, and the avoidance of local irritants — septic, muddy, chilling, etc. At the outset benzoated oxide of zinc ointment may be used with advantage. A still better dressing is made with 1 ounce vaseline, 2 drams oxide of zinc, and 20 drops iodized phenol. If the surface is much swollen and tender, a flaxseed poultice may be applied over the surface of which has been poured some of the following lotion : Sugar of lead, one-half ounce; carbolic acid, 1 dram; water, 1 quart. All the astringents of the pharmacopoeia have been employed with more or less advantage, and some particular one seems to suit particular cases or patients. To destroy the grapes, they may be rubbed daily with strong caustics (copperas, bluestone, lunar caustic), or each may be tied round its neck by a stout waxed thread, or, finally and more speedily, they may be cut off by a blacksmith's shovel heated to red- ness and applied with its sharp edge toward the neck of the excres- cence, over a cold shovel held between it and the skin to protect the skin from the heat. The cold shovel must be kept cool by frequent dipping in water. After the removal of the grapes the astringent dressing must be persistently applied to the surface. AVhen the frog is affected, it must be pared to the quick and dressed with dry caustic powders (quicklime, copperas, bluestone) or carbolic acid and sub- jected to pressure, the dressing being renewed every day at least. ERYSIPELAS. This is a specific contagious disease, characterized by spreading dropsical inflammation of the skin and subcutaneous tissues, attended by general fever. It differs from most specific diseases in the absence of a definite period of incubation, a regular course and duration, and a conferring of immunity on the subject after recovery. On the con- trary, one attack of erysipelas predisposes to another, partly, doubt- less, by the loss of tone and vitality in the affected tissues, but also, perhaps, because of the survival of the infecting germ. Cause. — It is no longer to be doubted that the microbes found in the inflammatory product are the true cause of erysipelas, as the disease can be successfully transferred from man to animals and from one animal to another by their means. This transition may be direct or through the medium of infected buildings or other articles. Yet from the varying severity of erysipelas in different outbreaks and localities it has been surmised that various different microbes are operative in this disease, and a perfect knowledge of these might perhaps enable us to divide erysipelas into two or more distinct affections. At present we must recognize it as a specific inflammation due to a bacterial poison and closely allied to septicemia. Erysipelas was formerly ERYSIPELAS. 447 known as surgical when it spread from a wound (throngli which the germ had gained access) and medical, or idiopathic, when it started independently of any recognizable lesion. Depending as it does, how- ever, upon a germ distinct from the body, the disease must be looked upon as such, no matter by what channel the germ found an entrance. Erysipelas which follows a wound is usually much more violent than the other form, the difference being doubtless partly due to the lowered vitality of the wounded tissues and to the oxidation and septic changes which are invited on the raw, exposed surface. As apparently idiopathic cases may be due to infection through bites of insects, the small amount of poison inserted may serve to moderate the violence. This affection may attack a w^ound on any part of the horse's body, while apart from wounds it is most frequent about the head and the hind limbs. It is to be distinguished from ordinary inflammations by its gradual extension from the point first attacked, by the abun- dant liquid exudation into the affected part, by the tension of the skin over the affected part, by its soft boggy feeling, allowing it to be deeply indented by the finger, by the abrupt line of limitation between the diseased and healthy skin, the former descending suddenly to the healthy level instead of shading off slowly toward it, by the tendency of the inflammation to extend deeply into the subjacent tissues and into the muscles and other structures, by the great tendency to death and sloughing of portions of skin and of the structures beneath, by the formation of pus at various different points throughout the diseased parts without any surrounding sac to protect the surround- ing structures from its destructive action, and without the usual dis- position of pus to advance harmlessly toward the surface and escape ; and, finally, by a low prostrating type of fever, with elevated tem- perature of the body, coated tongue, excited breathing, and loss of appetite. The pus when escaping through a lancet wound is grayish, brownish, or reddish, with a heavy or fetid odor, and intermixed with shreds of broken-down tissues. The most destructive form, however, is that in which pus is deficient and gangrene and sloughing more speedy and extensive. Treatment resolves itself mainly into the elimination from the system of the poisonous products of the bacteria by laxatives and diuretics, the sustaining of the failing vitality by tonics and stimu- lants, above all those of the nature of ant i ferments, and the local application of astringent and antiseptic agents. Internal treatment may consist in 4 drams tincture of muriate of iron and one-half dram muriate of ammonia or chlorate of potash, given in a pint of water every two hours. To this may be added, liberally, whisky or l)randy when the prostration is very marked. Locally a strong solution of iron, alum, or of sulphate of iron and laudanum may be used ; or the 448 DISEASES OF THE HORSE. a fleeted part may be painted Avitli tincture of muriate of iron or with iodized phenol. In mild cases a lotion of 4 drams sugar of lead and 2 ounces laudanum in a quart of water may be applied. It is desir- able to avoid the formation of wounds and the consequent septic action, yet when pus has formed and is felt by fluctuation under the linger to be approaching the surface it should be freely opened with a clean, sharp lancet, and the wound thereafter disinfected daily with carbolic acid 1 part to water 10 parts, with a saturated solution of hyposulphite of soda, or with powders of iodoform or salol. HORSEPOX, ANTHRAX, AND CUTANEOTLTS GLANDERS (fARCy). These subjects will come more properly under the head of conta- gious diseases. CALLOSITIES. These are simple thickening and induration of the cuticle by reason of continued pressure, notably in lying down on a hard surface. Be- ing devoid of hair, they cause blemishes; hence smooth floors and good bedding should be secured as preventives. HORNY SLOUGHS ( SITFASTS) , OR SLOUGHING CALLOSITIES. These are circumscribed sloughs of limited portions of the skin, the result of pressure by badly fltting harness or by irritating masses of dirt, sweat, and hairs under the harness. They are most common under the saddle, but may be found under collar or breeching as well. The sitfast is a piece of dead tissue which, would be thrown off but that it has formed firm connections with the fibrous skin beneath, or even deeper with the fibrous layers (fascia) of the muscles, or with the bones, and is thus bound in its place as a persistent source of irri- tation. The hornlike slough may thus involve the superficial part of the skin only, or the whole thickness of the skin, and even of some of the structures beneath. The first object is to remove the dead irri- tant by dissecting it off with a sharp knife, after which the sore may be treated with simple wet cloths or a weak carbolic-acid lotion, like a common wound. If the outline of the dead mass is too indefinite, a linseed-meal poultice will make its outline more evident to the opera- tor. If the fascia or bone has become gangrenous, the dead portion must be removed with the hornlike skin. During and after treat- ment the horse must be kept at rest or the harness must be so adjusted that no pressure can come near the affected parts. (See also page 470.) WARTS. These are essentially a morbid overgrowth of the superficial papil- lary layer of the skin and of the investing cuticular layer. They are PI. All'. XXW'I. ? Sarcopte.s scabiei , \ai: Equi . Chovioples sptilh i ferim '^^\ M ' '^' / \ \ P.soro/jle-'i loiufirosln.s, var Eqni . Dernui n \ ■ssu.s qaWnar . Hiiine&.ilfl.aflei-Meeimi . JULIUS BIEN t CO N-r Mni-:s 'in.vr ixfi-jst riri-; hoiisi-;. PARASITES OF THE SKIN. 449 mostly seen in young horses, about the lips, eyelids, cheeks, ears, beneath the belly, and on the sheath, but may develop anywhere. The smaller ones may be clipped off with scissors and the raw surface cauterized with bluestone. The larger may be sliced off with a sharp knife, or if with a narrow neck they may be twisted off and then cau- terized. If very vascular they may be strangled by a wax thread or cord tied around their necks, at least three turns being made round and the ends being iixed by passing them beneath the last preceding turn of the cord, so that they can be tightened day by day as they slacken by shrinkage of the tissues. If the neck is too broad it may be transfixed several times with a double-threaded needle and then be tied in sections. Very broad warts that can not be treated in this w^ay may be burned down to beneath the surface of the skin with a solder- ing bolt at a red heat, and any subsequent tendency to overgrowth kept down by bluestone. BLACK PIGMENT TUMORS, OR >IELANOSIS. These are common in gray and in white horses on the naturally black parts of the skin at the root of the tail, around the anus, vulva, udder, sheath, eyelids, and lips. They are readily recognized by their inky-black color, which extends throughout the whole mass. They may appear as simple pealike masses, or as multiple tumors aggre- gating many pounds, especially around- the tail. In the horse these are usually simple tumors, and may be removed with the knife. In exceptional cases they prove cancerous, as they usually are in man. EPITHELIAL CANCER, OR EPITHELIOMA. This sometimes occurs on iho Up^ at the angle of the mouth and elsewhere in the horse. It begins as a small Avartlike tumor,, which grows slowly at first, but finally bursts open, ulcerates, and extends laterally and deeply in the skin and other tissues, destroying them as it advances (rodent ulcer) . It is made up of a fibrous framework and numerous round, ovoid, or cylindrical cavities, lined with masses of epithelial cells, which may be squeezed out as a fetid caseous material. The most successful treatment is early and thorough removal with the knife. VEGETABLE PARASITES OF THE SKIN. Par.\site: Trichophyton tonsurcms. Malady: Tinea tonsurans, or Circinate ringworm. — This is especially common in young horses coming into training and work, in low-conditioned colts in winter and spring after confinement indoors and during molting, in lymphatic rather than nervous subjects, and at the same time in several animals that have herded together. The disease is common to man, and H. Doc. 795, 50-2 29 450 DISEASES OF THE HORSE. among the domestic animals to horse, ox, goat, dog, cat, and in rare instances to sheep and swine. Hence it is common to find animals of different species and their attendants suffering at once, the diseases having been propagated from one to the other. Symptoms. — In the horse the symptoms are the formation of a cir- cular scurfy patch where the fungus has established itself, the hairs of the affected spot being erect, bristly, twisted, broken, or split up and dropping off. Later the spot first affected has become entirely bald, and a circular row of hairs around this are erect, bristly, broken, and split. These in turn are shed and a new row outside passes through the same process, so that the extension is made in more or less circular outline. The central bald spot, covered with a grayish scurf and sur- rounded by a circle of broken and split hairs, is characteristic. If the scurf and diseased hairs are treated with caustic potash solution and put under the microscope the natural cells of the cuticle and hair will i3e seen to have become transparent, while the groups of spherical cells and branching filaments of the fungus stand out prominently in the substance of both, dark and unchanged. The eruption usually appears on the back, loins, croup, chest, and head. It tends to spontaneous recovery in a month or two, leaving for a time a dappled coat from the spots of short, light-colored hair of the new growth. The most effective way of reaching the parasite in the hair follicles is to extract the hairs individually, but in the horse the mere shaving of the affected part is usually enough. It may then be painted with tincture of iodine twice a day for two weeks. Germs about the stable may be covered up or destroyed by a whitewash of freshly burned quicklime, the harness, brushes, etc., may be washed with caustic soda, and then smeared with a solution of corrosive sublimate one-half dram and water 1 pint. The clothing may be boiled and dried. Parasite: Achorion schonleini. Malady: Faims, or Hoiieycomh ringworm. — Megnin and Goyau, who describe this in the horse, say that it loses its characteristic honeycomb or cup-shaped appearance, and forms only a series of closely aggregated, dry, yellowish crusts the size of hemp seed on the trunk, shoulders, flanks, or thighs. They are accompanied by severe itching, especially at night. The cryptogam, formed of spherical cells with a few filaments only, grows in the hair follicles and on the cuticle, and thus a crust often forms around the root of a hair. Like the other cryptogams, their color, as seen under the microscope, is unaffected by acetic acid, alcohol, ether, or oil of turpentine, while the. cells are turned bluish by iodine. For treatment, remove the hair and apply tincture of iodine or corrosive sublimate lotion, as advised under the last para- graph. Parasite: Microsporon furfur. Malady: Parasitic pityriasis. — This attacks the horse's head where the harness presses, and leads to PARASITES OF THE SKIN. 451 dropping of the hair, leaving bald patches covered with a branlike scurf, without any eruption, heat, tenderness, swelling, or rigidity of the skin. A lotion of carbolic acid 1 dram and water 2] ounces is usually applied to ett'ect a cure. ANIMAL PARASITES OF THE SKIN. Acariasis, or rnange. — This affection is due to the irritation of the skin caused by the presence of nearly microscopic acarus, or mite. The disease varies, however, according to the species of acarus which infests the skin, so that we must treat of several different kinds of acariasis. Parasite: Sareoptes seaUei equi. Malady: Sarcoptic acariasis. — This is the special Sarcoptes of the horse, but under favorable condi- tions it can be transmitted to ass and mule, and even to man, and may live indefinitely on the human skin. The mite is nearly microscop- ical, but may be detected with a magnifying lens among moving scurf taken from the infected skin. Like all Sarcoptes, it burrows little galleries in and beneath the scurf skin, where it hides and lays its eggs and where its young are hatched. It is therefore often difficult to find the parasite on the surface, unless the skin has been heated by a temporary exposure to the sun or in a warm room. Even then it may be needful to tie the scab on the human arm till a pricking is felt, when the acarus will be found in the center of a minute papule caused by its bite. Like other acari, this is wonder- fully prolific, a ncAV generation of fifteen individuals being possible every fifteen days, so that in three months the offspring of a single pair may produce generations aggregating 1,500.000 young. The Sarcoptes have less vitality than the nonburrowing acari, as they die in an hour when kept apart from the skin in dry air at a heat of 145° F. They live twelve to fourteen days apart from the skin in the damp air of a stable. On a piece of damp hide they lived till the twenty-fourth day, when they began to die, and all were dead on the twenty-eighth. Symptoms. — The symptoms are an incessant, intolerable, and in- creasing itching of some part of the skin (head, mane, tail, back, etc.), the horse inclining himself toward the hand that scratches him, and moving his lips as if himself scratching. The hairs may be broken and rubbed off, but the part is never entirely bald, as in ring- worm, and there may be papules or any kind of eruption or open sores from the energy of the scratching. Scabs of any thickness may form, but the special features are the intense itching and the discovery of the acarus. Treatment consists in the removal of the scabs by soapsuds, and, if necessary, a brush and the thorough application of tobacco 1^ ounces and water 2 pints, prepared by boiling. This may be applied more 452 DISEASES OF THE HORSE. than once, and should always be repeated after fifteen days, to destroy the new brood that may have been hatched in the interval. All har- ness and stable utensils should be similarly treated; blankets and rubbers may be boiled, and the stalls should be covered with a white- wash of quicklime, containing one-fourth pound of chloride of lime to the gallon. Parasite: Sarcoptes mutans. Malady: Sarcoptic acariasis of fowls. — This parasite belongs to chickens, but can live on the skin of the fox and horse as well. A troublesome mange may therefore at times be traceable to the proximity of a chicken roost. The general symptoms and treatment are essentially the same as for Sarcoptes scahiei equi. Parasite: Psoroptes equi {Dermatocoptes equi, Dermatodectes equi). Malady: Psoroptic acariasis. — This produces the most fre- quent mange in horses, and as the parasite only bites the surface and lives among the crusts under the shelter of the hair, it is very easily discovered. It reproduces itself with equal rapidity and causes simi- lar s3'mptoms to those produced by the Sarcoptes. The same treat- ment will suffice and is more promptly effectual. The purifjdng of the stable must be more thorough, as the Psoroptes will survive twenty to thirty days in the moist atmosphere of a stable, and may even revive after six or eight weeks when subjected to moist warmth. Infested pastures will therefore prove dangerous to horses for that length of time, and, with rubbing posts, etc., should not be used. Parasite: Cliorioptes hovis {SymMotes equi, Dermatophagus equi, Chorioptes spathiferus) . Malady: Foot mange. — This acarus at- tacks the heels and lower parts of the legs, especially the hind ones, and may be present for years without extending upon the body. Like the Psoroptes, it lives on the surface, on the hairs, and among the scabs. It gives rise to great itching, stamping, rubbing of the one leg with the other, and the formation of papules, wounds, ulcerous sores, and scabs. The intense itching will always suggest this i^ara- site, and the discovery of the acarus will identify the disease. The treatment is the same as for the Sarcoptes, but may be confined to the legs and the parts with which they come in contact. Parasite : Dermanyssus gallina', or chicken, acari. Malady : Poul- try acariasis. — This is a large-sized acarus, though usually miscalled " hen louse," and the disease " poultry-lousiness." The mite lives in the hen manure and adjacent woodwork, but temporarily passes on to the skin of man and of the horse and other quadrupeds, when occasion serves. It causes much irritation, with the eruption of papules or vesicles and the formation of sores and scabs. The ex- amination of the skin is usually fruitless, as the attacks are mostly made at night and the effects only may be seen during the day. The proximity of hen manure swarming with the acari explains the PARASITES OF THE SKIN. 453 trouble, and the removal of this and a whitewashing with qnioklinie, with or without chloride of lime, will prevent future attacks. The skin may still require bland ointments or lotions, as for congestion. Parasite: Larva of a Tromhidhim^ Leptits americanus^ or harrest hag, misnamed jigger {chigoe). Malady: Aiitamn mange. — This parasite is a brick-red acarus, visible to the naked eye on a dark ground, and living on green vegetation in many localities. It attacks man, and the horse, ox, dog, etc., burrowing under the skin and giving rise to small papules and intolerable irritation. This continues for two or three days only if no fresh acari are received, but will last until cold weather sets in if a fresh colony is received every day. Horses at pasture suffer mainly on the lower part of the face. If kept indoors the disease will disappear, or if left at pasture a weak tar-water or solution of tobacco may be applied to the face. Parasites : Gamarus pteroptoides and Cheyletus live in musty fod- ders and are found on the horse. ticks. The wood ticks are familiar to inhabitants of uncultivated lands, and prove troublesome parasites to man and beast alike. The tick lives on bushes, and attaches itself to the mammal only to secure a feast of blood, for when gorged it drops off to sleep off its debauch on the soil. The tick produces great irritation by boring into the skin with its armed proboscis. If pulled out, the head and thorax are often left in the skin. They may be covered with oil to shut out the air from their breathing pores, or by touching them with a hot penknife they will be impelled to let go their hold. GRUBS IX SKIN. Parasite: Uypoderma linenta. Malady: Larva" {gruhs) under the skhi. — The larva} of a fly (probabl}' Uypoderma Uneafa, whose larva? in the skin of cattle are commonly known as " warbles ") are occasionally found in little sacs beneath the skin of horses. The mature larva escapes in early summer and develops into a fly. In districts where they exist the grubs should be pressed out of the skin in the course of the winter and destroyed. LAKWK ((JRIBS) OX THE SKIN, OK KLVULOW. The following flies, among others, deposit their eggs on open sores or on wet, filthy parts of the skin, where their larva? or gi-ubs give rise to serious troul)le: L.vcilia casar (bluei)ottle), Luc'dia Jiomhd- vorax (screwworm fly). Miisca vomitona (meat fly), and Sarcophaga carnaria (flesh fly). To prevent their attacks, wet, filthy hair should be removed and wounds kept clean and rendered antiseptic by a lotion of carbolic acid 1 part, water 50 i^arts, or by a mixture of 1 454 DISEASES OF THE HOKSE. ounce oil of tar in 20 ounces sweet oil, or by some other antiseptic. If the grubs are already present they should be picked off and one of these dressings freely applied. FLIES A number of flies attack horses and suck their blood, producing great annoyance, and in some instances death. These insects not only suck the blood, but also often ins' ill an acid poison into the skin, and in exceptional cases transfer infectious germs from animal to animal by inoculation. Various devices are resorted to to jDrevent the attacks, as to sponge the skin with a decoction of walnut or elder leaves, of tobacco, to dust with Persian insect powder, to keei3 a light blanket or fly net on the horse, to close doors and windows with fine screens and destroy by pyrethrum any flies that have gained admission, to remove all manure heaps that would prove breeding places for flies, to keep the stalls clean, deodorize by gypsum, and to spread in them trays of dry chlo- ride of lime. For the poisoned bites apply ammonia, or a solution of 1 part of carbolic acid in 20 parts of sweet oil or glycerin, or one- fourth ounce bicarbonate of soda and 1 dram of carbolic acid in a quart of water may be used. STINGS OF BEES, WASPS, AND HORNETS. These are much more irritating than the bites of flies, partly be- cause the barbed sting is left in the wound, and partly because of the amount and quality of the venom. When a swarm attacks an animal the result may prove fatal. Treatment consists in the application of wet clay, or of a lotion of soda or ammonia, or of carbolic acid, or permanganate of potash, 2 grains to the ounce, or of sugar of lead 2 drams, laudanum 1 ounce, and water 1 pint. The embedded stings should be extracted with fine forceps or even with the finger nails. FLEA, OR PULEX. The flea of man and those of the dog and cat, when numerous, will bite the horse and give rise to rounded swellings on the skin. To dis- j)ose of them it is needful to clear the surroundings of the grublike larva3 as well as to treat the victim. The soil may be sprinkled with quicklime, carbolic acid, coal tar, or petroleum ; the stalls may be deluged w4th boiling water and afterwards painted with oil of tur- pentine and littered with fresh pine sawdust, and all blankets should be boiled. The skin may be sponged with a solution of 1 part carbolic acid in 60 parts of water. Dogs, cats, and pigs should be dressed with the same lotion, or, better, removed from the vicinity of the stable. DISEASES OF THE SKIN. 455 The chigoe {Pulex penetrans) of the Gulf coast is still more injuri- ous, because it burrows under the surface and deposits its eggs to be hatched out sloAvly with much irritation. The tumor formed by it should be hiid open and the parasite extracted. If it bursts so that its eggs escape into the wound, they may be destroyed by introduc- ing a wire at a red heat. LICE, OR PEDICULI. Two kinds of lice attack the horse, one of which is furnished with narrow head and a proboscis for perforating the skin and sucking the blood, and the other — the broad-headed kind — with strong mandibles, by which it bites the skin only. Of the bloodsuckers, one is common to horse and ass and another to horse and ox, while of the nonsucking lice one species attacks horse and ox and a second ox and ass. The poor condition, itching, and loss of hair should lead to suspicion, and a close examination will detect the lice. They may be destroyed by rubbing the victim with sulphur ointment, or with sulphuret of potas- sium 4 ounces, water 1 gallon, or with tar water, or the skin may be sponged with benzine. The application should be repeated a week later to destroy all lice hatched from the nits in the interval. Build- ings, clothes, etc., should be treated as for fleas. TARANTULA AND SCORPION. The bite of the first and the sting of the second are poisonous, and may be treated like other insect venom, by carbolated glycerin, or a strong solution of ammonia, or permanganate of potash. SNAKE BITES. These are marked by the double incision caused by the two fangs, by the excessive doughy (dark red) swelling around the wounds, and in bad cases by the general symptoms of giddiness,* weakness, and prostration. They are best treated by enormous doses of alcohol, whisky, or brandy, or by aqua ammonia very largely diluted in water, the object being to sustain life until the poison shall have spent its power. As local treatment, if the wound is in a limb, the latter may have a handkerchief or cord tied around it above the injury and drawn tiffht bv a stick twisted into it. In this wav absorption may be checked until the poison can be destroyed by the application of a hot iron or a piece of nitrate of silver or other caustic. A poultice of tobacco leaves is a favorite remedy, and may be used to soothe the sore after cauterization. BURNS AND SCALDS. For scalds the surface may be bathed with a solution of bicarbonate of soda, sweetened or not by carbolic acid, or a weak solution of sugar 456 DISEASES OF THE HORSE. of lead may be used ; or the surface may be dusted thickly with starch or flour aud covered with the cotton wool, or oil of turpentine may be applied over the scalded skin. Burns are well treated by liniment made of equal parts of lime Avater and linseed oil (Carron oil). For both kinds of injuries cosmoline 10 parts, and carbolic acid 1 part, proves an excellent dressing. Blisters should be pricked with a needle and emptied to prevent their ru^Dture and exposures of the raw surface. Severe burns, leading to destruction of very extensive patches of skin, usually render a horse useless by reason of the contraction of the resulting scar. Hence the treatment of such is rarely advisable, unless followed by a skillful plastic operation. In other cases a skillful transplanting of epidermis, shaved from a healthy surface with a sharp razor, will secure the healing of a granulating wound which has proved obstinate to all other measures. In cases of burns with mineral acids (sulphuric, nitric, or hydrochloric) avoid water, as that will develop heat, and cover the surface with dry whiting or chalk, and only when eifervescence has ceased wash off with water. When the caustic has been a salt (coj^peras, bluest one, chloride of zinc, etc.) apply limewater or white of egg. If the irritant has been caustic potash, soda, or ammonia, vinegar should be the first application. If sores result they may be treated like ordinary wounds. WOUNDS OF THE SKIN. These are divided into incised (clean cut) wounds, lacerated {to7m) wounds, and contused (bruised) and punctui^ed wounds. Incised wounds are the simplest, and the sharper the instrument, and the cleaner the cut the greater the hope of speedy healing. Something, however, depends on the seat and direction of the wound ; thus, one running from before backward on the body, or from above downward in the limb, will not tend to be drawn open and gape as would one running transversely on the body or limb. Again, a wound on a joint and running across the limb will gaj^e when the joint is bent. Again, a clean-cut wound which has not been exposed to the air, and which lodges no foreign body and no septic nor infecting germ, will heal readily by simple adhesion, whereas those that have been exposed and contain matter foreign to the tissues will have healing delaj^ed or prevented by the disturbing action of such bodies. Healing in wounds may be said to take place by these modes : (1) By primary adhesioii^ in which case the spherical (embryonic) cells, and the stellate connective tissue cells thrown out on the surface of the wound rapidly multiply and form a bond of union between the divided lips. Union by this means may be effected within WOUNDS OF THE SKIN. 457 twenty-four hours after the wound has been inflicted. Of all do- mestic animals, however, the horse is the least prone to sucli union, being more disposed to the formation of pus. (2) By granulation^ which is the common form of healing in raw, exposed sores, in those containing foreign bodies and septic and in- fecting ferments; also in torn and contused wounds. In this form the wound becomes covered with a layer of embryonic cells, of which the superficial ones degenerate into pus cells, and thus the surface is kept moist by a layer of whitish, creamy pus. Tn the deeper layer of cells minute loops of capillary blood vessels start up, causing the small rounded elevations known as granulations. In this wa}'^ the deeper layer of cells receiving a blood supply is transformed into connective tissue, and from its surface new loops of blood vessels start into the layer above, and thus layer after layer of new tissue is formed, and the breach caused by the wound is gradually filled up. The new tis- sue as formed undergoes a steady contraction, drawing in the ad- jacent skin over the wound, and hence large wounds healed in this way have the skin more or less puckered around them. (3) By secondary adhesion^ in which, two granulating lips of a wound having been brought together and kept in apposition, union takes place through the medium of the cells, as in primary adhesion. (4) By scahhing^ in which the exudation on the surface of the wound dries up into a firm scab, under which the process of rejiair goes on by the development of tissue from the deeper cells, as in ad- hesion. Treatment. — In treating clean, incised wounds, attempts should be made to secure healing by primary adhesion, even in the horse. Bleeding should first be arrested, or nearly so, by applying a cold or hot sponge, or by tying bleeding vessels, and the lips of the wound should then be closed accurately, without any twisting or overlap- j)ing. In small wounds pieces of sticking ])laster may be used, the lips of the wound having first been smoothly shaved, so that they may adhere finnly. In larger wounds the wound ma}'^ be sewed with a curved surgical needle and a silk thread dipped in a solution of carbolic acid. The stitches may be continued from end to end of the wound and the thread prevented from slipping and loosening by a knot at each end ; or the stitches may be independent, the two ends being tied together across the wound. In such cases they may be one-quarter to one-third inch apart ; or the lips of the Avound may be pinned together, the pins in a simple skin wound being inserted one-eighth inch fi'om the edge, and when both lips have been trans- fixed in this way a thread (or hair) carried successively around the two ends of the pin and made to describe a figure 8 will hold the wound close. "When the stitching is not continuous from end to end 458 DISEASES OF THE HOKSE. of the wound the apposition of the edges will be rendered more per- fect by the application of strips of sticking plaster in the intervals. AMien efforts at i)rimary union have failed and pus has formed, or fermentative changes have occurred on the raw surfaces and the lips gape more or less, some antisej)tic dressing wall be required, as in the case of lacerated and contused wounds. In cases where an incised wound has had foreign bodies or septic ferments introduced into it these should first be removed. A current of water that has been boiled and cooled is one of the best methods of cleansing a wound, and there is no objection to the addition of one- twentieth of its amount of carbolic acid, as this will tend to destroy any germ life that might otherwise prove fatal to the healing process. Then the w'ound may be stitched up as if it had been clean, and a daily dressing of carbolic acid 1 part and sweet oil 10 parts may be aj^plied. For a w^ound on the convex surface of a joint, where stitches are not sufficient to keep the lips accurately applied to each other, the movement of the joint may be temporarily abolished by the applica- tion of a splint and bandage, and in any such case the bandage should be applied uniformly from the hoof upward, as otherwise the limb below the bandage is liable to sAvell or even die. The treatment of contused., punctured., and lacerated wounds de- mands cleansing and antiseptic applications as for an incised wound, but as primary adhesion is next to impossible, the same accurate appo- sition of the lips by stitching is not so essential. If portions of skin or other tissue are so detached or crushed that they can not possibly live, they may be cut off, but if there is any doubt on this matter the injured portion should be left and every attempt should be made to preserve it. Such portions of the w'ound as are free from such fatally injured parts may be disinfected by the carbolic lotion referred to above and stitched up like a clean wound. The severely injured parts may be left open to discharge, and the whole may be dressed daily with the carbolized oil or with a solution of 1 part of mercuric chlo- ride in 1,000 of water. Granulating wounds may be irrigated with the mercuric chloride solution, and if the granulations become inflamed (soft, flabby, exu- berant, rising above the edges of the wound), they may be touched lightly with a stick of lunar caustic, so as to leave them covered with a white film. In all wounds that fail to heal by primary union an elaborate anti- septic treatment is desirable, but the difficulty of applying this suc- cessfully to the horse in an ordinary stable would seem to forbid a lengthy description in a book of this kind. WOUNDS AND THEIK TllEATMENT. By Ch. B. Muhknkk. \'. S. [Revised in 100:i by .Tolin I{. Mo1i1(M-, V. M. D.. A. M.] DESCRIPTION OF WOUNDS. A Avound is an injury to iiny part of the body involving a solution of continuity or disruption of the affected parts and is caused by violence, with or without laceration of the skin. In accordance with this definition we have the following varieties of wounds: Incised, punctured, contused, lacerated, gunshot, and poisoned. They may further be classified as superficial, deep, or penetrating, and also as unclean, if hair, dirt, or splinters of wood are present; as infected, when contaminated with germs; and as aseptic, if the wound does not contain germs. An incised wound is a simple cut made with a sharp body, like a knife, producing merely a division of the tissues. The duller the body, the more force is required, the more tissues destroyed, and a greater time will be required for healing. In a cut wound the edges are even and definite, while those of a lacerated wound are irregular and torn. Three conditions are present as a result of an incised wound: (1) Pain, (2) hemorrhage, (3) gaping of the wound. The first pain is due to the crushing and tearing of the nerve fibers. In using a sharp knife and by cutting quickly, the animal suffers less pain and healing occurs more rapidly. The secondary pain is usu- ally due to the action of the air and inflammatory processes. AVhen air is kept from the wound pain ceases soon after the lesion is pro- duced. Hemorrhage is absent only in wounds of nonvascular tissues, as the cornea of the eye, the cartilage of joints, and other similar structures. Bleeding may be from the arteries, veins, or capilhiries. In the latter form of bleeding the blood oozes from the part in drops. Hemorrhage from the veins is dark red and issues in a steady stream without spurting. In arterial bleeding tlie l)lood is briglit red and spurts with each heart Ix'at. This latter variety of hemorrhage is the most dangerous, and should be stopped at once before attempting any further treatment. Bleeding from small veins and capillaries ceases in a short time spontaneously, while larger vessels, especuilly arteries, require some form of treatment to cause complete stoppage of the hemorrhage. 459 460 DISEASES OF THE HORSE. HEIVIOSTASIA. By this term is meant the checking of the flow of blood. It may be accomplished by several methods, such as compress bandages, torsion, hot iron, and ligatures. The heat from a hot iron will cause the im- mediate clotting of the blood in the vessels, and this clot is further supported by the production of a scab, or crust, over tlie portion seared. The iron should be at a red heat. If at a white heat, the tissue is charred, which makes it brittle and the bleeding is apt to be re- newed. If the iron is at a black heat, the tissue will stick to the iron and will pull away from the surface of the wound. Cold water and ice bags quickly stop capillary bleeding, wdiile hot water is preferable in more excessive hemorrhages. Some drugs, called styptics, possess the power of contracting the walls of blood vessels and also of clot- ting the blood. A solution of the chloride of iron placed on a wound alone or by means of cotton drenched in the liquid produces a rapid and hard clot. Tannic acid, alum, acetic acid, alcohol, and oil of tur- pentine are all more or less active in this respect. To check bleeding from large vessels compression may be adopted. When it is rapid and dangerous and from an artery, the fingers may be used for press- ing between the wound and the heart (digital compression), but if from a vein, the pressure should be exerted on the other side of the wound. Tourniquet may also be used by passing a strap around the part and tightening after placing a pad over the hemorrhage. The rubber ligature has now replaced the tourniquet and is bound tightly around the limb to arrest the bleeding. Tampons, such as cotton, tow, or oakum, may be packed tightly in the wound and then seAved up. After remaining there for twenty-four or forty-eight hours they are removed. Bleeding ma^^ sometimes be easily checked by passing a pin under the vessel and by taking a horsehair and forming a figure 8 by running it above and below the pin, thus causing pressure on the vessel. Torsion is the twisting of the blood vessel until the walls come together and form a barrier to the flow of blood. It may be ac- complished by the fingers, forceps, or by running a pin through the vessel, turning it several times, and then running the i^oint into the tissue to keep it in a fixed position. Ligation is the third method for stopping a hemorrhage. Seize the blood vessel with the artery forceps, pass a clean thread of silk around it, and tie about one-half inch from its end. The silk should be sterilized by placing it in an antiseptic solution so as not to impede the healing process or cause blood poisoning or lockjaAv, which often follow^s the ligation of a vein with unsterilized material. Sometimes it will be impossible to reach the bleeding vessel, so it is necessary to pass the ligature around a mass of tissue Avhich includes the blood vessel. Ligation is the most useful method of arresting hemorrhage, WOUNDS AND THEIR TREATMENT. 461 since it disturbs healing least and gives the greatest security against secondary luMiiorrhage. SUTURES. After the bleeding has been controlled and all foreign bodies removed from the wound, the gaping of the wound is noticeable. It is caused by the contraction of the nuiscles and clastic fibers, and its degree depends on the extent, direction, and nature of the cut. This o-apiug will hinder the healing process so that it must be overcome by briiiiiing the edges together by some sort of sutures or pins, or by a bandage applied from below upward. As suture material, ordinary cotton thread is good if well sterilized, as is also horsehair, catgut, silk, and various kinds of wire. If the suture is made too tight, the subsequent swelling may cause the stitch to tear out. In order to make a firm suture the depth of the stitch should be the same as the distance the stitch is from the edge of the wound. The deeper the suture the more tissue is embraced and the fewer the number of stitches required. In tying a sutiu'e use the square or reef knot. Closure of wounds by means of adhesive plaster, collodion, and metal clamps is not practiced to any great extent in veterinary practice. PROCESS OF lIEALINfi. In those cases where perfect stoppage of bleeding, perfect coapta- tion of the edges of the wound, and perfect cleanliness are obtained, healine occurs within three davs, without the formation of granula- tions, pus, or proud flesh, by what is termed frst intention. If wounds do not heal in this manner they will gap somewhat and become Avarm and ])ainful. Healing then occurs by granulation or suppuration, which is termed healing by second intentioN. The sides of the wound become covered Avith granulation tissue wdiich may fill the wound and sometimes overlap the lips, forming a fungoid growth called proud flesh. Under favorable conditions the edges of the wound appear to grow together by the end of the first week, and the Avhole surface gradually becomes dry, and finally covered w^ith pigmented skin, when the wound is healed. The cause of pus formation in wounds is usually due to the presence of germs. For this reason the utmost care slK)Hld be adopted to keep clean wounds aseptic, or free from germs, and to make unclean womids antiseptic by using antiseptic fluids to kill the microbes present in the wound. The less the injurious action of this fluid on the wound, and the greater its power to kill germs, the more valuable it becomes. All antiseptics are not equally destructive, and some germs are more susceptible to one antiseptic than to another. The most important are (1) bichloride of mercury, Avhich is to be pre- ferred on horses. It becomes weakened in its action if placed in a wooden pail or on an oily or greasy surface. It is used in the strength 462 DISEASES OF THE HORSE. of 1 part of bichloride to 1,000 to 5,000 parts of water, according to the delicacy of the tissue to which it is applied. (2) Carbolic acid in from 2 to 5 per cent solution is used on infected wounds and for clean- ing instruments, dressings, and sponges. It unites well with oil and is preferred to the bichloride of mercury on a greasy surface. A 5 per cent solution in oil is often used under the name of carbolized oil. (3) Aluminum acetate is an efficient and cheap antiseptic, and is com- posed of 1 part alum and 5 parts acetate of lead, mixed in 20 parts of water. (4) Boracic acid is good in a 2 to 4 per cent solution to cleanse wounds and wash eyes. Creolin and lysol may be used in a 2 to 5 per cent solution in water. Iodoform is one of the most used of the anti- septics and it also acts as an anodyne, stimulates granulation, and checks wound secretion. A very efficacious and inexpensive powder is made by taking 5 parts of iodoform and 95 parts of sugar, making what is called iodoform sugar. Tannic acid is a useful drug in the treatment of wovmds, in that it arrests hemorrhage, checks secre- tion, and favors the formation of a scab. A mixture of 1 part tannic acid and 3 joarts iodoform is good in suppurating wounds. lodol, white sugar, ground and roasted coffee, and powdered charcoal are all used as prqtectives and absorbents on sujjpurating surfaces. More dej^ends on the care and the method of application of the drug than on the drug itself. On aseptic wounds use only those antiseptics that do not irritate the tissue. If care is used in the application of the anti- septic, corrosive sublimate or carbolic acid is to be recommended, but in the hands of irresponsible parties lysol or creolin is safer. In order to keep air from the wound and to absorb all wound secretions rapidly, a dressing should be applied. If the wound is aseptic, the dressing should be likewise, such as cotton gauze, sterile cotton, oakum, or tow. This dressing should be applied with uniform pres- sure at all times and secured by a bandage. Allow it to remain for a week or ten days if the wound is aseptic or if the dressing does not become loose or misplaced or become drenched with secretions from the wound, or if pain, fever, or loss of appetite does not develop. The dressing should then be removed, the wound treated antiseptically, and a sterilized dressing applied. HEALING UNDER A SCAB. This often occurs in small superficial wounds that have been kept aseptic. In order for a scab to form, the wound must not gap, secrete freely, or become infected with germs. The formation of scab is favored by astringents and styptics, such as tannic acid, iodoform, and 6 per cent solution of zinc chloride. In case of large hollow wounds that can not be dressed, such as fistulous withers, open joints, etc., antisepsis may be obtained by warm water irrigation with or without an antiseptic fluid. It should continue day and night, and LACERATED AND CONTUSED WOUNDS. 463 never be interrupted for more than eight hours, for germs will then have gained headway and will be difficult to remove. Four or five days of irrigation will be sufficient, for granulations will then have formed and pus will remain on the outside if it forms. For perma- nent irrigation the stream should be very small, or drop by drop, but should play over the entire surface of the wound. It is always better to heal an infected wound under a scab, or treat it as an open wound, than it is to suture the wound, thus favoring the growth of the in- closed germs and retarding ultimate healing. In the latter case pus may develop in the wound, form pockets by sinking into the tissues, and cause various complications. Such pockets should be well drained, either through incisions at the bottom or by drainage tubes or setons. They should then be frequently syringed out or continuously irrigated. In case proud flesh appears it should be kept down either by pressure or by caustics, as powdered bluestone, silver nitrate, chloride of antimony, or by astringents, such as burnt alum. If they prove resistant to this treatment they may be removed by scissors or the knife or by searing with the hot iron. The following rules for the treatment of wounds should be followed: (1) See that the wound is clean, removing all foreign bodies. (2) For this purpose use a clean finger rather than a probe. (3) Arrest all hemorrhage before closing the wound. (4) Antiseptics should only be used if you suspect the wound to be infected. (5) When pus is present treat w^ithout closing the wound. (6) This may be accomplished by drainage tubes, absorb- ent dressings, setons, or continuous irrigations. (7) Protect the wound against infection while Ijealing. LACERATED AND CONTUSED WOUNDS. Lacerated and contused wounds may be described together, althouirh there is, of course, this difference, that in contused wounds there is no break or laceration of the skin. Lacerated wounds, how- ever, are, as a rule, also contused — the surrounding tissues are bruised to a greater or lesser extent. While such wounds may not appear at first sijrht to be as serious as incised wounds, thev are commonly very much more so. Lacerations and contusions, when extensive, are always to be regarded as dangerous. Many horses die from septic mfection or mortification as a result of these injuries. We find in severe contusions an infiltration of blood into the surrounding tissues; disorganization and mortification follow, and involve often the deeper seated structures. Abscesses, single or multiple, may also result and call for special treatment. In wounds that are lacerated the amount of hemorrhage is mostly inconsiderable; even very large blood vessels may be torn apart with- out inducing a fatal result. The edges of the wound are ragged and uneven. These wounds are produced by barbed wire or some blunt 464 DISEASES OF THE HOESE. object, as where a horse runs against fences, board piles, tlie corners of bniklings, or where he is struck by the pole or shafts of another team, falling on rough irregular stones, etc. Contused Avounds are caused by blunt instruments moving with sufficient velocity to bruise and crush the tissues, as running against objects, kicks, or falling on large, hard masses. Treatment. — In lacerated wounds great care must at first be exer- cised in examining or probing to the very bottom of the rent or tear, to see if any foreign body be present. Very often splinters of wood or bits of stone or dirt are thus lodged, and miless removed prevent the wound from healing; or if it should heal the wound soon opens again, discharging a thin, gluey matter that is characteristic of the presence of some object in the part. After a thorough exploration these wounds are to be carefully and patiently fomented with warm water, to which has been added carbolic acid in the j)roportion of 1 j^art to 100 of water. Rarely, if ever, are stitches to be inserted in lacerated wounds. The surrounding tissues and skin are so weakened in vitality and structure by the contusions that stitches will not hold ; they only irritate the parts. It is better to endeavor to secure coap- tation by means of bandages, plasters, or collodion. One essential in the treatment of lacerated wounds is to secure a free exit for the pus. If the orifice of the wound is too high, or if pus is found to be bur- rowing in the tissues beneath the opening, we must then make a counter opening as low as jDossible. This will admit of the wound being thoroughl}^ washed out, at first with warm water, and after- wards injected with some mild astringent and antiseptic wash, as chloride of zinc, 1 dram to a pint of water. A dependent opening must be maintained until the wound ceases to discharge. Repeated hot fomentations over the region of lacerated wounds afford much relief and should be persisted in. BRUISES.. Bruises are nothing but contused wounds where the skin has not been ruptured. There is often considerable solution of con- tinuity of the parts under the skin, subcutaneous hemorrhage, etc., which may result in local death (mortification) and slough of the bruised parts. If the bruise or contusion is not so severe, many cases are quickly cured by constant fomentation with hot water for from tAvo to four hours. The Avater should be allowed about this time to gradually become cool and then cold. Cold fomentation must then be kept up for another hour or two. Dry the parts thoroughly and quickly and bathe them freely with camphor 1 ounce, sweet oil 8 ounces, or with equal jjarts of lead water and laudanum. A dry, light bandage should then be applied, the horse allowed to rest, and if necessary the treatment may be repeated each day for two or PUNCTURED WOUNDS, 465 three days. If, however, the wound is so severe that sloughing must ensue, we should encourage this by poultices made of linseed meal, wheat bran, turnips, onions, bread and milk, or hops. Charcoal is to be sprinkled over the surface of the poultice when the wound is bad smelling. After the slough has fallen off the Avound is to be dressed with warm antiseptic washes of carbolic acid, chloride of zinc, permanganate of potash, etc. If granulating (hlling up) too fast, use burnt alum or air-slaked lime. Besides this local treatment, we find that the constitutional symptoms of fever and inflammation call for measures to prevent or control them. This is best done by placing the injured animal on soft or green food. A physic of Bar- bados aloes, 1 ounce, should be given as soon as possible after the accident. Sedatives, such as tincture of aconite root, 15 drops, three times a day, or ounce doses of saltpeter every four hours, may also be administered. When the symptoms of fever are abated, and if the discharges from the wound are abundant, the strength of the patient must be supported by good food and tonics. One of the best tonics is as follows : Powdered sulphate of iron, powdered gen- tian, and powdered ginger, of each 4 ounces. Mix thoroughly and give a heaping tablespoonful twice a day, on the feed or as a drench. PUNCTURED AVOUNDS. Punctured wounds are produced })y the penetration of a sharp or blunt pointed substance, such as a thorn, fork, nail, etc., and the orifice of these wounds is always small in proportion to their depth. In veterinary practice punctured wounds are much more comuKm than the others. They involve the feet most frequently, next the legs, and often the head and face from nails protruding through the stalls and trough. They are not only the most frequent, but they are also the most serious, owing to the difficulty of obtaining thorough disinfection. Another circumstance rendering them so is the lack of attention that they at first receive. The external wound is so small that but little or no importance is attached to it, yet in a short time swelling, pain, and acute inflammation, often of a serious character, are manifested. Considering the most common of the punctuivd wounds, we nnist give precedence to those of the feet. Horses worked in cities, about iron works, around building ])laces, etc., are most likely to receive '' nails in the feet." The aninuil treads upon nails, pieces of iron or screws, and forces them into the soles of the feet. If the nail, or whatever it is that has punctured the foot, is fast in some large or heavy body, and is withdrawn as the horse lifts his foot, lameness may last for only a few steps; l)ut unless properly attended to at once he will be found in a day or two to be very lame in the injured II. Doc. 79.5, 59-2 30 466 DISEASES OF THE HORSE. member. If the foreign body remains in the foot, he gradually grows worse from the time of puncture until the cause is discovered and removed. If, when shoeing, a nail is driven into the " quick " (sensi- tive laminae) and allowed to remain, the horse gradually evinces more pain from day to day ; but if the nail has at once been removed by the smith, lameness does not, as a rule, show itself for some days; or, if the nail is simply driven " too close," not actually pricking the horse, he may not show any lameness for a week or even much longer. At this point it is due the blacksmith to say that, considering how thin the walls of some feet are, the uneasiness of many horses while shoe- ing, the ease with which a nail is diverted from its course by striking an old piece of nail left in the wall, or from the nail itself splitting, the wonder is not that so many horses are pricked or nails driven " too close," but rather that many more are not so injured. It is not always carelessness or ignorance on the part of the smith, by any means, that is to account for this accident. Bad and careless shoers we do meet with, but let us be honest and say that the rarity of these accidents points rather to the general care and attention given by these much-abused mechanics. From the construction of the horse's foot (being incased in an im- permeable horny box) , and from the elasticity of the horn closing the orifice, punctured wounds of the feet are almost always productive of lameness. Inflammation results, and as there is no relief afforded by swelling and no escape for the product of inflammation, this mat- ter must and does burrow between the sole or wall and the sensitive parts within it until it generally opens " between hair and hoof." We can thus see why pain is so much more severe, why tetanus (lock- jaw) more frequently follows wounds of the feet, and why, from the extensive, or at times complete, separation and " casting " of the hoof, these wounds must always be regarded with grave apprehension. Symptoms and treatment. — A practice which, if never deviated from — that of picking up each foot, cleaning the sole, and thoroughly examining the foot each and every time the horse comes into the stable — will enable us to reduce the serious consequences of punctured wounds of the feet to the minimum. If the wound has resulted from pricking, lameness follows soon after shoeing; if from the nails being driven too close, it usually appears from four to five days or a week after receiving the shoe. We should always inquire as to the time of shoeing, examine the shoe carefully, and see whether it has been par- tially pulled and the horse stepped back upon some of the nails or the clip. The pain from these wounds is lancinating; the horse is seen to raise and lower the limb or hold it from the ground altogether; often he points the foot, flexes the leg, and knuckles at the fetlock. Swelling of the fetlock and back tendons is also frequently seen and WOUNDS OF JOINTS. 467 is apt to mislead ns. The foot must be carefully examined, and this can not be properly done without removing the shoe. The nails should be drawn separately and carefully examined. If there is no escape of pus from the nail holes, or if the nails themselves are not moist, we must continue our examination of the foot by carefully pinching or tapping it at all i)arts. With a little practice we can de- tect the spot where pain is the greatest or discover the delicate line or scar left at the point of entrance of the foreign body. The entire sole is then to be thinned, after which we are to carefully cut down upon the point where pain is greatest upon pressure, and, finally, through the sole at this spot. AVhen the matter has escaped, the sole, so far as it was undermined by pus, is to be removed. The foot must now be poulticed for one or two days and afterwards dressed with a com- press of oakum saturated with carbolic-acid solution or other anti- septic dressing. If we discover a nail or other object in the foot, the principal direc- tion, after having removed the otfending body, is to cut away the sole, in a funnel shape, down to the sensitive parts beneath. This is imperative, and if a good free opening has been made and is main- tained for a few days, hot fomentations and antiseptic dressings applied, the cure is mostly easy, simple, quick, and permanent. The horse should be shod with a leather sole under the shoe, first of all applying tar and oakum to prevent any dirt from entering the wound. In some instances nails may puncture the flexor tendons, the coffin bone, or enter the coffin joint. Such injuries are always serious, their recovery slow and tedious, and the treatment so varied and difficult that the services of a veterinarian will be necessary. PUNCTURED WOUNDS OF JOINTS, OR OPEN JOINTS. These wounds are more or less frequent. They are always serious, and often result in anchylosis (stiffening) of the joint or death of the animal. The joints mostly punctured are the hock, fetlock, or knee, though other joints may, of course, suffer this injury. As the symp- toms and treatment are much the same for all, only the accident as it occurs in the hock joint will be described. Probably the most com- mon mode of injury is from the stab of a fork, but it may result from the kick of another horse that is newly shod, or in many other ways. At first the horse evinces but slight pain or lameness. The owner discovers a small wound scarcely larger than a pea, and pays but little attention to it. In a few days, however, the pain and lameness be- come excessive; the horse can no longer bear any weight upon the injured leg; the joint is very much swollen and painful upon pres- sure; there are well-marked symptomsof constitutional disturbance — quick pulse, hurried breathing, high temperature, 103° to 106° F., the 468 DISEASES OF THE HORSE. appetite is lost, thirst is present, the horse reeks with sweat, and shows by an anxious countenance the pain he suffers. He may lie down, though mostly he persists in standing, and the opposite limb becomes greatly swollen from bearing the entire weight and strain for so long a time. The wound, which at first appeared so insignifi- cant, is now constantly discharging a thin whitish or yellowish fluid — joint oil or water, Avhich becomes coagulated about the mouth of the Avound and adheres to the part in clots like jelly, or resembling some- Avhat the white of an egg. Not infrequently the joint opens at dif- ferent places, discharging at first a thin bloody fluid that soon as- sumes the character above described. Treatment of these wounds is most difficult and unsatisfactory. We can do much to prevent this array of symptoms if the case is seen early — within the first twenty-four or forty-eight hours after the injury ; but Avhen inflammation of the joint is once fairly estab- lished the case becomes one of grave tendencies. Whenever a punc- tured Avound of a joint is noticed, even though apparently of but small moment, we should, without the least delay, apply a strong cantharides blister over the entire joint, being even careful to fill the orifice of the wound with the blistering ointment. This treatment is almost always effectual. It operates to perform a cure in two ways — first, the swelling of the skin and tissues underneath it completely closes the wound and prevents the ingress of air; second, by the superficial inflammation established it acts to check and abate all deep-seated inflammation. In the great majority of instances, if pursued soon after the accident, this treatment performs a cure in about one week, but should the changes described as occurring later in the joint have already taken place, we must then treat by cooling lotions and the application to the wound of chloride of zinc, 10 grains to the ounce of water, or a paste made up of flour and alum. A bandage is to hold these applications in place, which is only to be removed when swelling of the leg or increasing febrile symptoms demand it. In the treatment of open joints our chief aim must be to close the orifice as soon as possible. For this reason repeated prob- ing or even injections are contraindicated. The only probing of an open joint that is to be sanctioned is on our first visit, when we should carefully examine the Avound for foreign bodies or dirt, and after removing them the probe must not again be used. The medicines used to coagulate the synovial discharge are best simply applied to the surface of the Avound, on pledgets of toAV, and held in place b}^ bandages. Internal treatment is also indicated in those cases of open joints Avhere the suffering is great. At first Ave should admin- ister a light physic and follow this up Avith sedatives and anodynes, as directed for contused Avounds. Later, hoAvever, Ave should give quinine, or salicylic acid in 1-dram doses two or three times a day. WOUNDS AND THEIR TREATMENT. 469 WOUNDS OF THE TENDON SHEATHS. Wounds of tendon sheaths are simihir to open joints in that there is an escape of synovial lluid, '' sinew waiter." Where the tendons are simply punctured by a thorn, nail, or fork, we must, after a thorough exploration of the wound for any remaining foreign substance, treat with the flour-and-alum paste, bandages, etc., as for open joint. Should the skin and tendons be divided the case is even more serious and often incurable. There is always a large bed of granulations (proud flesh) at the seat of injury, and a thickening more or less pro- nounced remains. AVhen the back tendons of the leg are severed we should api>ly at once a high-heel shoe (which is to be gradually lowered as healing advances) and bandage firmly with a compress moistened with a 10-grain chloride of zinc solution. When proud flesh appears this is best kept under control by repeated applications of a red-hot iron. Mares that are valuable as brood animals and stock horses should always be treated for this injury, as, even though blemished, their value is not seriously impaired. The length of time required and the expense of treatment will cause us to hesitate in attempting a cure, if the subject is old and comparatively valueless. GUNSHOT WOUNDS. These wounds vary in size and character, depending on the size and quality of the projectile and also the tissue injured. They are so seldom met with in our animals that an extended reference to them seems unnecessary. If a wound has been made by a bullet a careful examination should be made to ascertain if the ball has passed through or out of the body. If it has not we must then probe for the ball, and if it can be located it is to be cut out when practicable to do so. Oftentimes a ball may be so lodged that it can not be removed, and it then may become encysted and remain for years Avithout giving rise to any inconvenience. It is often difficult to locate a bullet, as it is verv readilv deflected bv resistances met with after entering the body. The entering wound is the size of the projectile, the edges are inverted and often scorched. The wound produced in case of the bullet's exit is larger than the projectile, the edges are turned out and ragged. A bidlet heated by the friction of the barrel or air often softens and becomes flattened on striking a bone or other tissue. Modern bullets that have an outer steel layer may pass through bone without splintering it. Leaden bullets may split, producing two exit womids. Spent bullets may only produce a bruise. Should bones be struck by a ball they are sometimes shattered and splintered to such an extent as to warrant us in having the animal destroyed. A gun- shot wound, when irreparable injury has not been done, is to be 470 DISEASES OF THE HOESE. .treated the same as punctured wounds, i. c, stop the hemorrhage, remove the foreign body if possible, and a^jply hot fomentations or poultices to the wound until suppuration is fairly established. Anti- septic and disinfectant injections may then be used. Should pus accunnilate in the tissues, openings must be made at the most depend- ing parts for its escape. Wounds from shotguns fired close to the animals are serious. They are virtually lacerated and contused wounds. Remove all the shot possible from the wound, and treat as directed for contusions. AVlien small shot strike the horse from a distance they stick in the skin or only go through it. The shot grains must be picked out, but as a rule this " peppering " of the skin amounts to but little. POISONED WOUNDS. These injuries are the result of bites of snakes, rabid dogs, stings of bees, w^asps, etc. A single sting is not dangerous, but an animal is often stung by a swarm of insects, when the chief danger occurs from the swelling produced. If stung about the head, the nostrils may be closed as a result of the swelling, causing labored breathing and pos- sibly asphyxiation. Intoxication may be produced by the absorption of this poison and is manifested by staggering gait, spreading of the legs, paralysis of the muscles, difficult respiration, and a rise of tem- perature. Death may follow in five to ten hours. Treatment. — Douse animal with cold water and aj^ply any alkaline liquid, such as soapsuds, bicarbonate of soda, or weak solution of ammonia. Internally give alcohol, ether, or camphor to strengthen the heart. In case of bites by rattlesnakes, moccasin, or other poi- sonous snakes, a painful swelling occurs about the bitten part, which is followed by labored breathing, weakness, retching, fever, and death from collapse. The animal usually recovers if it can be kept alive over the third day. In treating the animal, a tight ligature should be passed about the part above the wound to keep the poison from entering the general circulation. Wash out the wound thor- oughly with antiseptics and then apply a caustic, such as silver ni- trate, or burn with a hot instrument. A subcutaneous injection of one-fourth dram of 1 per cent solution of chromic acid above the wound is also beneficial. Cold water may be applied to the wound to combat the inflammation. Bites of rabid dogs produce an infected wound, and the virus of rabies introduced in this manner should be removed or destroyed in the wound. Therefore produce considerable bleeding by incising the wound, wash out thoroughly with 10 per cent solution of zinc chloride, and then apply caustics or the actual cautery. HARNESS GALLS (SITFASTS). Wounds or abrasions of the skin are frequently caused by ill-fitting harness or saddles. Wlien a horse has been resting from steady work SITFASTS, BURNS, AND SCALDS. 471 for some time, particularly after being kept idle in a stable on a scanty allowance of grain, as in winter, he is soft and tender and sweats easily when put to work again. In this condition he is apt to sweat and chafe under the harness, especially if it is hard and poorly fitted. This chafing is likely to cause abrasions of the skin, and tlius pave the way for an abscess, or for a chronic blemish, unless attended to very promptly. Besides causing the animal considerable pain, chafing, if long continued, leads to the formation of a callosity. This may be superficial, involving only the skin, or it may be deep- seated, involving the subcutaneous fibrous tissue and sometimes the muscle and even the bone. This causes a dry slough to form, which is both inconvenient and unsightly. Sloughs of this kind are com- monly called " sitfasts " and, Avhilo they occur in other places, are most frequently found under the saddle. (See also page 448.) Treatment. — Abrasions are best prevented by bringing the animal gradually into working shape after it has had a prolonged rest, in order that the muscles will be hard and the skin tough. The harness should be well fitted, neither too large nor too small, and it should be cleaned and oiled to remove all dirt and to make it soft and pliable. Saddles should be properly fitted so as to prevent direct pressure on the spine, and the saddle blankets should be clean and dry. Parts of the horse where chafing is likely to occur, as on the back under the saddle, should be cleaned and brushed free of dirt. The remedies for simple harness galls are numerous. Among them may be mentioned alcohol, 1 pint, in which are well shaken the whites of two eggs ; a solution of nitrate of silver, 10 grains to the ounce of water: sugar of lead or sulphate of zinc, 20 grains to an ounce of water; carbolic acid, 1 part in 15 parts of glycerin, and so on almost without end. Any simple astringent wash or powder will effect a cure, provided the sores are not irritated by friction. If a sitfast has developed, the dead hornlike slough must be care- fully dissected out and the wound treated carefully with antiseptics. During treatment it is always best to allow the animal to rest, but if this is inconvenient care should be taken to prevent injury to the abraded or wounded surface by padding the harness so that chafing can not occur. BURNS AND SCALDS. These wounds of domestic animals are fortunately of rare occur- rence; however, when they do occur, if at all extensive, they prove quite troublesome and in many cases are fatal. According to the severity of the burn we distinguish three degrees: First degree, where there is a simple reddening of the skin; second degree, where there is a formation of vesicles, or blisters; third degree, where there is a complete destruction of vitality of the tissues, such as would occur in charring from direct contact v;ith fiames or from escaping 472 DISEASES OP THE HORSE. steam. Besides the burns caused by flames and steam, there are other causative agents, such as chemicals (caustic alkalis and acids), light- ning stroke, and occasionally the broken trolley wires of electric rail- ways. When a large surface of the skin is burned or scalded, the ani- mal (if he does not die at once from shock) will soon show signs of fever — shivering, coldness of the extremities, weakness, restlessness, quick and feeble pulse, and labored breathing. Xo matter which agent is a factor in the j^roduction of burns, the lesions are practi- cally of the same nature. The extent and site of the burn should lead one in the determination and course of treatment. Burns of the shoulder and those about the region of the elbow or other parts where there is much movement of the tissues are grave, and, if at all extensive, treatment should not be attempted, but the immediate destruction of the animal is advised. A burn of the third degree, where there is a destruction of the vitality of large areas of tissue, even on parts not subject to much motion, is extremely tedious to treat ; in fact, it is questionable whether the treatment and keep of the animal will ever be compensated for, even though recovery does take place, Avhich, in any event, will require at least six or eight weeks. Those due to lightning stroke and trolley wires are likely to occur in irregular lines, and, unless death occurs at once, they are not likely to prove serious. Treatment, — Treatment should be prompt and effective. If the burns are extensive the constitutional symptoms should be combated with whisky and milk and eggs, or ammonia carbonate, strychnine, caffein, and other stimulants to prevent slwck. In the local treat- ment, to alleviate the pain, the application of cold water in some form and the hypodermic injection of morphine are to be recommended. In burns of the first degree, where there is only a superficial inflam- mation, lead carbonate (white lead) ointment is very good. Carron oil (limewater and linseed oil, equal parts) is a standard remedy, but a modification of it known- as Stahl's liniment is perhaps better; this liniment is composed of linseed oil and limewater each 200 parts, bicarbonate soda 100 parts, and thymol 1 part. This liniment should be applied freely to the scorched surface and covered with a layer of borated gauze or absorbent cotton to protect it from the air. Re- new the application frequently. Carbolated vaseline may be used in jDlace of the above. In case the burn is more extensive, the fol- lowing solution may be used: Picric acid 2 parts, alcohol 40 parts, water 400 parts. The lesion should be thoroughly cleansed with this solution used on absorbent cotton. The vesicles., if any appear, should be opened with a clean needle, allowing the skin to remain. Strips of gauze or absorbent cotton saturated with the solution should now be applied and renewed only occasionally. In burns of the sec- ond and third degrees more satisfactory results may be obtained with GANGRENE, OR MORTIFICATION. 473 nonpoisonoiis dry dressing powder, such as is used in ordinary open wounds, as tannic acid 8 parts and iodoform 1 part, or a salve made of this powder and a sufficient quantity of vaseline. When slough- ing of the tissues takes place the wounds should be cleansed with a warm '^ per cent solution of carbolic acid, all loose fragments of tissue removed, and either a di-y antiseptic dressing powder or carbolated vaseline ointment applied to exclude the air. Granulation tissue (proud flesh) should be controlled by the application of silver nitrate in the form of a caustic pencil. Burns due to mineral acids may be first treated by flushing the parts with a copious quantity of cold w^ater or by the application of whiting or chalk. Either use a large quantity of water at the start or use the chalk first, then wash with water. If the irritant has been a caustic alkali, such as potash, lye, ammonia, or soda, then vinegar should be the first application. StahFs liniment is probably the best general application for all burn? for the first week; then this should be followed by the ordinary antiseptic wound dressings. GANGRENE. Gangrene, or mortification, denotes the death of the affected part, and is mostly found attacking soft tissue near the surface of the body. Gangrenous areas may occur as a result of shutting off their blood supply. Constitutional diseases, such as ergotism, anthrax, and septicemia, predispose to gangrene. As external causes we have acids and alkalies, freezing and burning, contusions and continuous pres- sure that interrupt the circulation. There are two forms of gan- ori-ene — dry and moist. Dry gangrene is most often seen in horses from continuous lying down (decubitus) or from uneven pressure of some portion of the harness. Symptoms. — There is a lack of sensation due to the death of nerves. In diy gangrene the skin is leathery and harsh, while in moist gan- grene the tissues are soft, wrinkled, and friable; the hair is dis- turbed, and the skin is usually moist and soapy and sometimes cov- ered with ])lebs. The tissue surrounding the moist gangrenous patch is usually inflamed, swollen, and hot, but this is less noticeable in the case of dry gangrene. Moist gangrene often spreads and involves deeper tissue, sheaths of tendons and joints producing septic syno- vitis or septic arthritis leading to pyemia and death. Dry gangrene is seldom dangerous, but the rapidity of its spread will indicate its virulence. Treatment. — The preventive treatment consists in avoiding all the influences that tend to disturb the nutrition of the tissues, such as excessive cold or heat or continuous jiressure. Gangi-ene following decubitus may be prevented by using soft bedding and frequently turning the animal from one side to the other. In dry gangrene moist 474 DISEASES OF THE HORSE. heat in the form of poultices or anointing the tissue with oils and fats will be found beneficial in hastening the dead tissue to slough off. AVhen the outer skin begins to suppurate, seize it with a pair of pincers and draw it away. After this treat the patch as an open wound. In moist gangrene the tissue should be thoroughly disin- fected with creolin, lysol, or particularly an alcoholic tincture of cam- phor. Continuous irritation with antiseptic fluids prevents the accu- mulation and absorption of j^oisonous liquids. Incisions into the dead tissue may be made, and when sloughing commences the tissue should be removed with forceps and the resulting wound treated as in dry gangrene. ULCERATION. An ulcer is a circumscribed area of necrosis occurring on the skin or mucous membrane and covered with granulation tissue. It is a process of destruction, and when this process is going on faster than regeneration can take place, we have a gnawing, or eating, ulcer. When such an ulcer increases rapidly in size it is termed a phagedenic ulcer. A fungoid ulcer is one in which the bottom of the ulcer pro- jects beyond the edge of the skin. These ulcers secrete milky or bloody-white liquid called ichor. When the ulcer is of an ashen or leaden color, with the bottom and sides formed of dense, hard con- nective tissue which gives but little discharge and is not sensitive, it is termed callous, torpid, or indolent ulcer. Causes. — As in the case of gangrene, disturbances of circulation are among the most frequent causes. A w^ound to a tissue with slight recuperative power may be followed by ulceration, as in tumors. Certain germs may produce ulcers, as the glanders bacilli, which cause the ulcerations on the nasal septum in glanders. Treatment. — This consists in removing at once the exciting cause. The secretions of the ulcer should be washed off with antiseptic solu- tions and the formation of granulation tissues stimulated by antisep- tic salves, such as carbolated vaseline, lead ointment, or by dressings of camphor. Air should be kept from the ulcer by occlusive dress- ings. AVhere the ulcers are inflamed, warm lead water or lead water and laudanum will be found efficacious. Callous ulcers are best re- moved by a curet, knife, or hot iron and then treated like a common wound. Mechanical irritation should be avoided. ABSCESSES. These consist of accumulations of pus within circumscribed walls, at different parts of the body, and may be classed as acute, and cold, or chronic, abscesses. When an abscess occurs about a hair follicle it is called a boil or furuncle; when several hair follicles are involved, resulting in the ABSCESSES. 475 formation of more than one exit for the inflammatory prodiicts, it is called a carbuncle. ACUTE ABSCESSES. Acute abscesses follow as the result of local inflammation in glands, muscular tissue, or even bones. They are very common in the two former. The abscesses most commonly met with in the horse (and the ones which will be here described) are those of the salivary glands, occurring during the existence of " strangles," or " colt distemper." The glands behind or under the jaw are seen to slowly increase in size, becoming firm, hard, hot, and painful. At first the swelling is uniformly hard and resisting over its entire surface, but in a little while becomes soft — fluctuating — at some portion, mostly in the center. From this time on the abscess is said to be " pointing," or " coming to a head," which is shown by a small elevated or projecting prominence, which at first is dry, but soon becomes moist with trans- uded serum. The hairs over this part loosen and fall off, and in a short time the abscess opens, the contents escape, and the cavity grad- ually fills up — heals by granulations. Abscesses in muscular tissue are usually the result of bruises or injuries. In all cases where abscesses are forming we should hurry the ripening process by frequent hot fomentations and poultices. When they are very tardy in their development a blister over their surface is advisable. It is a common rule with surgeons to open an abscess as soon as pus can be plainly felt, but this practice can scarcely be recommended to owners of stock indiscriminately, since this little operation frequently requires an exact knowledge of anat- omy. It will usually be found the better plan to encourage the full ripening of an abscess and allow it to open of itself. This is impera- tive if the abscess is in the region of joints, etc. When open, we must not squeeze the walls of the abscess to any extent. They may be very gently pressed with the fingers at first to remove the clots — inspissated pus — but after this the orifice is simply to be kept open by the introduction of a clean probe, should it be disposed to heal too soon. If the opening is at too high a level another should be made into the lowest portion of the abscess so as to permit the most com- plete drainage. Hot fomentations or poultices are sometimes required for a day or two after an abscess has opened, and are particularly indicated when the base of the abscess is hard and indurated. The cavity should be thoroughly washed with stimulating anti- septic solutions, such as 3 per cent solution of carbolic acid, 3 to 5 per cent solution of creolin. 1 to 1,000 I)ichloride of mercury, or 1 per cert permanganate of potash solution. If the abscesses are foul and bad smelling, their cavities should first be syringed with 1 part of hydrogen peroxide to 2 parts of water and then followed by the injection of any of the above-montioned antiso]4ics. 476 DISEASES OF THE HOESE. COLD ABSCESSES. Cold abscess is the term applied to those large, indolent swellings that are the result of a low, or chronic, form of inflammation, in the center of which there is a small collection of pus. They are often seen near the point of the shoulder, forming the so-called breast boil. The swelling is diifuse and of enormous extent, but slightly hotter than surrounding parts, and not very painful upon pressure. There is a pronounced stiffness, rather than pain, evinced upon moving the animal. Such abscesses have the appearance of a hard tumor, sur- rounded by a softer edematous swelling, involving the tissues to the extent of a foot or more in all directions from the tumor. This dif- fused swelling gradually subsides and leaves the large, hardened mass somewhat well defined. One of the characteristics of cold abscesses is their tendency to remain in the same condition for a great length of time. There is neither heat nor soreness ; no increase nor lessening in the size of the tumor; it remains statu quo. If, how^ever, the ani- mal should be put to work for a short time the irritation of the collar causes the surrounding tissues to again assume an edematous condi- tion, which after a few" days' rest disappears, leaving the tumor as before or but slightly larger. Upon careful manipulation w^e may discover what appears to be a fluid deep seated in the center of the mass. The quantity of matter so contained is verj^ small — often not more than a tablesjjoonful — and for this reason it can not, in all cases, be detected. Cold abscesses are mostly, if not always, caused by the long-con- tinued irritation of a loose and badly fitting collar. There is a slow inflammatory action going on, which results in the formation of a small quantity of matter inclosed in very thick and but partially organized walls, that are not as well defined as is the circumference of fibrous tumors, which they most resemble. Treatment. — The means recommended to bring the acute abscess " to a head " are but rarely effectual with this variety ; or, if successful, too much time has been occupied in the cure. We must look for other and more raj^id methods of treatment. These consist, first of all, in carefully exploring the tumor for the presence of pus. The incisions must be made over the softest part and carried deep into the tumor (to its ver}' bottom if necessary), and the matter allowed to escape. After this, and whether we have found matter or not, we must induce an active inflammation of the tumor in order to promote solution of the thick walls of the abscess. This may be done by inserting w^ell into the incision a piece of oakum or cotton saturated with turpentine, carbolic acid, tincture of iodine, etc., or w^e may pack the incision with powdered sulphate of zinc and keep the orifice plugged for tw^enty- four hours. These agents set up a destructive inflammation of the walls. Suppuration follows, and this should now be encouraged by ABSCESSES AND FISTULAS. 477 hot fomentations and poultices. The orifice must be kept open, and should it be disposed to heal we must again introduce some of the asrents above described. A favored treatment with many, and it is probably the best, is to plunge a red-hot iron to the bottom of the incision and thoroughly sear all parts of the walls of the abscess. This is to be repeated after the first slough has taken place, if the walls remain thickened and indurated. It is useless to waste time with fomentations, poultices, or blisters in the treatment of cold abscesses, since, though apparently removed by such methods, they almost invariably return when the horse is put to work. Extirpation by the knife is not practicable, as the walls of the tumor are not sufficiently defined. If treated as above directed, and properly fitted with a good collar after healing, there will not remain any track or trace of the large, unsightly mass. FISTULAS. De-ftmiion. — The word fistula is applied to any ulcerous lesion upon the external surface of the body which is connected by ducts, or passages, with some internal cavity. Because of this particular formation the term fistulous tract is often used synonymously with the word fistula. Fistulas may exist in any part of the body, but the name has come to be commonly accepted as applicable only to such lesions when found upon the withers. Poll evil is a fistula upon the poll, and in no sense differs from fistulous withers except in location. The description of fistula will apply, then, in the main, to poll evil equally well. Quittor presents the characteristic tubular passages of a fistula and may therefore be considered and treated as fistula of the foot. Fistulous passages may also be developed upon the sides of the face, through which saliva is discharged instead of flowing into the mouth, and are called salivarv fistulas. A dental fistula mav arise from the necrosis of the root of a tooth. Again, a fistula is sometimes noted at the umbilicus associated with hernia, and recto-vaginal fistulas have been developed in mares, following difficult parturition. Fistulas may arise from wounds of glandular organs or their ducts, and thus we have the so-called nunnmary, or lachrymal, fistulas. Fistulous tracts are lined with a false, or adventitious, membrane and show no disposition to heal. They constantly afford means of exit to the pus oi- ichorous material discharged l)y ihe unhealthy parts below. They are particularly liable to develop at the withers or poll because of the exposed positions which these parts occupy, and, having once become located there, they usually assert a tend- ency to further extension, because the vertical and laminated forma- tion of the muscles and tendons of these parts allows the forces of gravitation to assist the pus in gaining the deeper-lying structures and also favors its retention among them. 478 DISEASES OF THE HOKSE. Causes. — Fistulas follow as a result of abscesses, bruises, wounds, or long-continued irritation by the harness. Among the more com- mon causes of fistula of the poll (poll evil) are chafing by the halter or heavy bridle ; blows from the butt end of the whip ; the horse striking his head against the hayrack, beams of the ceiling, low doors, etc. Fistulous withers are seen mostly in those horses that have thick necks as well as those that are very high in the withers; or, among saddle horses, those that are very low on the withers, the saddle here riding forward and bruising the parts. They are often caused by bad-fitting collars or saddles, by direct injuries from blows, and from the horse rolling upon rough or sharp stones. In either of these locations ulcers of the skin, or simple abscesses, if not prop- erly and punctually treated, may become fistulas. The pus burrows and finds lodgment deep down between the muscles, and escapes only when the sinus becomes surcharged or when, during motion of the parts, the matter is forced to the surface. Sytnptoms. — These, of course, will vary according to the progress made by the fistula. Following an injury we may often notice sore- ness or stiffness of the front legs, and upon careful examination of the Avithers we will see small tortuous lines running from the point of irritation downward and backward over the region of the shoulder. These are superficial lymphatics, and are swollen and painful to the touch. In a day or two a swelling is noticed on one or both sides of the dorsal vertebrae, which is hot and painful and rapidly enlarging. The stiffness of the limbs may disappear at this time, and the heat and soreness of the parts may become less noticeable, but the swelling remains and continues to enlarge. A fistulous ulcer of the poll may be first indicated by the opposition which the animal offers to the application of stable brush or bridle. At this time the parts are so sore and sensitive that there is some danger that the patient will acquire disagreeable stable habits unless handled with the greatest care. The disease in its early stages may be recognized as a soft, fluctuating tumor surrounded by inflammatory swelling, with the presence of enlarged hanphatic vessels and stiffness of the neck. Later the inflammation of the surrounding tissues may disappear, leaving a prominent tumor. The swelling, whether situ- ated upon the head or the withers, may open and form a running ulcer, or its contents may diy up and leave a tumor which gradually develops the common characteristics of a fibrous tumor. When the enlargement has opened we should carefully examine its cavity, as upon its condition w^ill wholly depend our treatment. Treatment. — In the earliest stage, when there is soreness, enlarged lymphatics, but no well-marked swelling, the trouble may frequently be aborted. To do this requires both general and local treatment. A physic should be given, and the horse receive 1 ounce of pow^dered FISTULAS. 479 saltpeter three times a day in his water or feed. If the fever runs high, 20-drop doses of tincture of aconite root every two hours may be administered. The local application of cold water to the inflamed spot for an hour at a time three or four times a day has often proved very beneficial, and has afforded great relief to the patient. Cooling lotions, muriate of ammonia, or saltpeter and water; seda- tive washes, such as tincture of opium and aconite, chloroform lini- ment, or camphorated oil, are also to be frequently applied. Should this treatment fail to check the progress of the trouble, the formation of pus should be hastened as rapidly as possible. Hot fomentations and poultices are to be constantly used, and as soon as the presence of piis can be detected, the abscess wall is to be opened at its lowest point. In this procedure lies our hope of a speedy cure. As with any simple abscess, if drainage can be so provided that the pus will run off as fast as formed without remaining within the interstices of the tissues, the healing which follows will be rapid and satisfactory. Attention is again called to the directions given above as to the necessity of probing the cavity when opened. If upon a careful ex- amination with the probe we find that there are no pockets, no sin- uses, but a simple, regular abscess wall, the indication for treatment is to make an opening from below so that the matter must all escape. Rarely is anything more needed than to keep the orifice open and to bathe or inject the parts with some simple antiseptic wash that is not irritant or caustic. A low opening and cleanliness constitute the essential and rational treatment. If the abscess has already opened, giving vent to a quantity of pur- ulent matter, and the pipes and tubes leading from the opening are found to be extensive and surrounded with thick fungoid membranes, there is considerable danger that the internal ligaments or even some of the bones have become affected, in which case the condition has assumed a serious aspect. Or, on the other hand, if the abscess has existed for some time without a rupture, its contents will frequently be found to consist of dried purulent matter, firm and dense, and the walls surrounding the mass will be found greatly thickened. In such a case we must generally have recourse to the application of caustics which will cause a sloughing of all of the unhealthy tissue, and will also stimulate a rapid increase of healthy organized material to re- place that destroyed in the course of the development and treatment of the disease. Threads or cords soaked in gum-arabic solution and rolled in jiowdered corrosive sublimate may be introduced into the canal and allowed to remain. The skin on all parts of the shoulder and leg beneath the fistula should be carefully greased with lard or oil, as this will prevent the discharge that comes from the opening after the caustic is introduced from irritating or blistering the skin over which it flows. In obstinate cases a piece of caustic potash 480 DISEASES or THE HOUSE, (fused) 1 to 2 inches in length may be introduced into the opening and should be covered with oakum or cotton. The horse should then be secured so that he can not reach the part with his teeth. After the caustic plug has been in place for twenty-four hours, it may be re- moved and hot fomentations applied. As soon as the discharge has become again established the abscess should be opened from its lowest extremity, and the passage thus formed may be kept open by the in- troduction of a seton. If the pipes become established in the deep tissues beneath the shoulder blade or among the spines of the ver- tebral column, it will often be found impossible to provide proper drainage for the abscess from below, and treatment must consist of caustic solutions carefully injected into all parts of the suppurating sinuses. A very effective remedy for this purpose consists of 1 ounce of chloride of zinc in half a pint of water, injected three times during a week, after which a weak solution of the same may be occasionall}' injected. Injections of Villate's solution or alcoholic solution of cor- rosive sublimate, strong carbolic acid, or possibly oil of turpentine will also prove beneficial. Pressure should be applied from below, and endeavors made to heal the various pipes from the bottom. Should the swelling become general, without forming a well-defined tumor, the placing of 20 to 30 grains of arsenious acid, wrapped in a single layer of tissue paper, in a shallow incision beneath the skin Avill often produce a sloughing of the affected parts in a v>'eek or ten days, after which the formation of healthy tissue follows. The surrounding parts of the skin should be protected from any damage from escaping caustics by the aj^plication of lard or oil, as previously suggested. Although the successful treatment of fistulas requires iime and patience, the majority of cases are curable. The sinuses must be opened at their lowest extremity and kept open. Caustic applications must be thoroughly used once or twice, after which mild astringent antiseptic washes should be persistently used until a cure is reached. It sometimes happens that the erosions have burrowed so deeply or in such a direction that the opening of a drainage passage becomes impracticable. In other cases the bones may become attaclted in some inaccessible location, or the joints maj^ be affected, and in these cases it is often best to destroy the horse at once. The reappearance of the fistula after it has apparently healed is not uncommon. The secondary attack in these cases is seldom serious. The lesion should be carefully cleansed and afterwards injected with a solution of zinc sulphate, 20 grains to the ounce of water, every sec- ond or third day until a cure is effected. In fistula of the foot we see the same tendency toward the burrow- ing of pus downward to loAver structures, cr in some cases upward toward the coronet. Prior to the development of a quit tor there is always swelling at the coronet, accompanied by heat and pain. FISTULAS. 481 Every effort should now be made to prevent the formation of an abscess at the point of injury. AVounds caused by nails, gravel, or any other foreign body Avhich may have become lodged in the sole of the foot should be opened at once from below so as to allow free exit to all purulent discharges. Should the injury have occurred directly to the coronet the application of cold fomentations may prove efficient in preventing the formation of an abscess. When a quittor becomes fully established it sliould be treated pre- cisely as a fistula situated in any other part of the body ; that is, the sinuses should all be opened from their lowest extremities so as to afford constant drainage. All fragments of diseased tissue shoidd be irinnned away, antiseptic solutions injected, and, after covering the wound with a pad of oakum saturated with sor.ie good antiseptic wash, the whole foot may be carefully covered with clean bandages, which will afford valuable assistance to the healing process by exclud- ing all dirt from the affected part. H. Doc. 795, 59-2 31 GENERAL DISEASES. By Rush Shippen Huidekopek, M. D., Vet. [Revised in 1903 by Leonard Pearson, B. S., V. M. D.] ANIMAL TISSUES. The nonprofessional reader may regard the animal tissues, which are subject to inflammation, as excessively simple structures, as simi- lar, simple, and fixed in their organization as the joists and boards which frame a house, the bricks and iron coils of pipe which build a furnace, or the stones and mortar which make the support of a great railroad bridge. Yet while the principles of structure are thus sim- ple, for the general understanding by the student who begins their study the complete appreciation of the shades of variation, which differentiate one tissue from another, which define a sound tendon or a ligament from a fibrous band — the result of disease filling in an old lesion and tying one organ with another — is as complicated as the nicest jointing of Chinese woodwork, the building of a furnace for the most difficult chemical analysis, or the construction of a bridge which will stand for ages and resist any force or weight. All tissues are composed of certain fundamental and similar ele- ments which are governed by the same rules of life, though they may appear at first glance to be widely different. These are (a) amor- phous substances, (h) fibers, and (c) cells. (a) Amorphous substances may be in liquid form, as in the fluid of the blood, which holds a vast amount of salts and nutritive matter in solution ; or they may be in a semiliquid condition, as the plasma which infiltrates the loose meshes of connective tissue and lubricates the surface of some membranes ; or they may be in the form of a glue or cement, fastening one structure to another, as a tendon or muscle end to a bone; or, again, they hold similar elements firmly together, as in bone, where they form a stiff matrix which becomes impreg- nated with lime salts. Amorphous substances, again, form the pro- toplasm or nutritive element of cells or the elements of life. (h) Fibers are formed of elements of organic matter which have only a passive function. They can be assimilated to little strings, or cords, tangled one with another like a mass of waste yarn, woven regularly like a cloth, or bound together like a rope. They are of two kinds — white connective tissue fibers, only slightly extensible, pliable, and very strong, and yellow elastic fibers, elastic, curly, ramified, and very dense. These fibers once created require the constant presence of fluids around them in order to retain their functional condition, as 482 DESCKIPTION OF THE TISSUES. 483 a piece of lijirness leather demands continual oiling to keep its strength, but they undergo no change or alteration in their form until destroyed by death. (c) Cells, which may even be regarded as low forms of life, are masses of protoplasm or amorphous living matter, with a nucleus and frequently a nucleolus, which are capable of assimilating nutriment or food, propagating themselves either into others of the same form or into fixed cells of another outward appearance and diiferent function but of the same constitution. It is simply in the mode of grouping of these elements that we have the variation in tissues, as (1) loose connective tissue, (2) aponeurosis and tendons, (3) muscles, (4) cartilage, (5) bones, (6) epithelia and endothelia, (7) nerves. (1) Loose connective tissue forms the great framework, or scaf- folding, of the body, and is found under the skin, between the muscles surrounding the bones and blood vessels, and entering into the structures of almost all of the organs. In this the fibers are loosely meshed together like a sponge, leaving spaces in which the nutrient fluid and cells are irregularly distributed. This tissue we find in the skin, in the spaces between the organs of the body wdiere fat accumu- lates, and as the framework of all glands. (2) Aponeurosis and tendons are structures which serve for the termination of muscles and for their contention, and for the attach- ment of bones together. In these the fibers are more frequent and dense, and are arranged with regularity, either crossing each other or lying parallel, and here the cells are found in minimum quantity. (3) In the muscles the cells lie end to end, forming long fibers which have the power of contraction, and the connective tissue is in small quantity, serving the passive purpose of a band around the con- tractile elements. (4) In cartilage a mass of firm amorphous substance, with no vas- cularity and little vitality, forms the bed for the chondroplasts, or cells of this tissue. (5) Bone differs from the above in having the amorphous matter impregnated with lime salts, which gives it its rigidity and firmness. (G) Epithelia and endothelia, or the membranes which cover the body and line all of its cavities and glands, are made up of single or stratified and multijole layers of cells bound together by a glue of amorphous substance ami resting on a layer composed of fibers. When the membrane serves for secreting or excreting purposes, as in the salivary glands or the kidneys, it is usually siuijile; when it serves the mechanical purpose of protecting a jiart, as over the tongue or skin, it is invariably multiple and stratified, the surface wearing away while new cells replace it from beneath. (7) In nerves, stellate cells are connected by their rays to each other, or to fibers which conduct the nerve impressions, or they act as 484 DISEASES OF THE HOESE. receptacles, storehouses, and transmitters for them, as the switch- board of a telephone system serves to connect the various wires. All of these tissues are supplied with blood in greater or less quan- tity. The vascularity depends upon the function which the tissue is called upon to perform. If this is great, as in the tongue, the lungs, or the sensitive part of the hoof, a large amount of blood is required ; if the labor is a passive one, as in cartilage, the membrane over the withers, or the tendons of the legs, the vessels only reach the periph- ery, and nutrition is furnished by imbibition of the fluids brought to their surface by the blood vessels. Blood is brought to the tissues by arterioles, or the small termina- tions of the arteries, and is carried off from them by the veinlets, or the commencement of the veins. Between these two systems are small delicate networks of vessels called capillaries, which subdivide into a veritable lacework so as to reach the neighborhood of every element. In health the blood passes through these capillaries with a regular current, the red cells or corpuscles floating rapidly in the fluid in the center of the channel, while the white or ameboid cells are attracted to the walls of the vessels and move very slowly. The supply of blood is regulated by the condition of repose or activity of the tissue, and under normal conditions the outflow compensates exactly the sup- ply. The caliber of the blood vessels, and consequently the amount of blood which they carry, is governed by nerves of the sympathetic system in a healthy body with unerring regularity, but in a diseased organ the flow may cease or be greatly augmented. In health a tissue or organ receives its proper quantity of blood ; the nutritive elements are extracted for the support of the tissue and for the product, which the function of the organ forms. The force required in the achieve- ment of this is furnished by combustion of the hydrocarbons and oxygen brought by the arterial blood, then by the veins this same fluid passes off, less its oxygen, loaded with the waste products, which are the result of the worn-out and disintegrated tissues, and of those which have undergone combustion. The above brief outline indi- cates the process of nutrition of the tissues. Hypernutrition, or excessive nutrition of a tissue, may be normal or morbid. If the latter, the tissue becomes congested or inflamed. CONGESTION. Congestion is an unnatural accumulation of blood in a part. Ex- cessive accumulation of blood may be normal, as in blushing or in the red face which temporarily follows a violent muscular effort, or, as in the stomach or liver during digestion, or in the lungs after severe work, from which, in the latter case, it is shortly relieved by a little rapid breathing. The term congestion, however, usually indicates a morbid condition, with more or less lasting effects. Congestion is CONGESTION. 485 active or passive. The former is produced by an increased sup- ply of blood to the part, the latter by an obstacle preventing the escape of blood from the tissue. In either case there is an increased supply of blood, and as a result increased combustion and augmented nuti'ition. ACTIVE CONCJESTION. Active congestion is caused by — (1) FunctionaJ ((ctlvHij. — Any organ wliich is constantly or exces- sively used is habituated to hold an unusual quantity of blood; the vessels become dilated; if overstrained the walls become weakened, lose their elasticity, and any sudden additional amount of blood en- gorges the tissues so that they can not contract, and congestion results. Example : The lungs of a race horse, after an unusual burst of speed or severe work, in damp weather. (2) Irritants.— Yi^^i and cold, chemical or mechanical. Any of these, by threatening the vitality of a tissue, induce immediately an augmented flow of blood to the part to furnish the means of repair — a liot iron, frostbites, acids, or a blow. (3) Nerve influence. — This may produce congestion either by act- ing on the part reflexly or as the result of some central nerve dis- turbance affecting the branch which supplies a given organ. (4) Plethora and sanguinary temperament. — Full-blooded animals are much more predisposed to congestive diseases than those of a lymphatic character or those in an anemic condition. The circula- tion in them is forced to all parts with much greater force and in larger quantities. A well-bred full-blooded horse is nnich more sub- ject to congestive diseases than a common, coarse, or old worn-out animal. (5) Fevers. — In fever the heart works more activelj'^ and forces the current of blood more rapidly; the tissues are weakened, and it requires but a slight local cause at any part to congest the structures already overloaded Avith blood. Again, in certain fevers, we find alteration of the blood itself, rendering it less or more fluid, which interferes with its free passage through the vessels and induces a local predisposition to congestion. (6) Warm climate and summer heat. — AVarmth of the atmosphere relaxes the tissues; it demands of the animals less blood to keep up their own body temperature, and the extra quantity accumulates in the blood-vessel system. It causes sluggishness in the performance of the organic functions, and in this way it induces congestion, especially of the internal organs. So we find founders, congestive colics and staggers more frequent in sunnner than in winter. (7) Previous conqcstion. — Whether the previous congestion of any organ has been a continuous normal one — that is, a i-epeated func- tional activity — or has been a morbid temporary overloading, it al- 486 DISEASES OF THE HORSE. ways leaves the walls of the vessels weakened and more predisposed to recurrent attacks from accidental causes than are perfectly healthy tissues. Thus a horse which has had a congestion of the lungs from a severe drive is apt to have another attack from even a lesser cause. The alterations of congestion are distention of the blood vessels, accumulation of the cellular elements of the blood in them, and effu- sion of a portion of the liquid of the blood into the fibrous tissues which surround the vessels. Where the changes produced by conges- tion are visible, as in the eye, the nostril, the mouth, the genital organs, and on the surface of the body in white or unpigmented ani- mals, the part appears red from the increase of blood; it becomes swollen from the effusion of liquid into the spongelike connective tissues ; it is at times more or less hot from the increased combustion ; the part is frequently painful to the animal from pressure of the effu- sion on the nerves, and the function of the tissue is. interfered with. The secretion or excretion of glands may be augmented or diminished. Muscles may be affected with spasms or may be unable to contract. The eyes and ears may be affected with imaginary sights and sounds. PASSIVE CONGESTION. Passive congestion is caused by interference with the return of the current of blood from a part. Old age and debility weaken the tissues and the force of the circu- lation, especially in the veins, and retard the movement of the blood. We then see horses of this class with stocked legs, swelling of the sheath of the penis or of the milk glands, and of the under surface of the belly. We find them also with effusions of the liquid parts of the blood into the lymph spaces of the posterior extremities and organs of the pelvic cavity. Tumors or other mechanical obstructions, by pressing on the veins, retard the flow of blood and cause it to back up in distal parts of the body, causing passive congestion. The alterations of passive congestion, as in active congestion, con- sist of an increased quantity of blood in the vessels and an exudation of its fluid into the tissues surrounding them, but in passive conges- tion we have a dark thick blood which has lost its oxygen, instead of the rich combustible blood rich in oxygen which is found in active congestion. The termination of congestion is by resolution or inflammation. In the first case, the choked-up blood vessels find an outlet for the exces- sive amount of blood and are relieved ; the transuded serum or fluid of the blood is reabsorbed, and the part returns almost to its normal condition, with, however, a tendency to weakness predisposing to fu- ture trouble of the same kind. In the other case further alterations take place, and we have inflammation. GENERAL DISEASES. , 487 INFLAMMATION. [Synonyms: Inflammatio, Latin, from inflammare, to flame, to burn; phleg- niasia (pXeyiiaSta, Greek ; inflammation, French: inflammazione, Italian; In- flamacion, Spanish; Entzilndung, German.] Inflammation is a hypernutrition of a tissue. It is described by Doctor Agnew, the surgeon, as " a double-edged sword, cutting either way for good or for evil." The increased nutrition may be iiioderate and cause a growth of new tissue, a simple increase of quantity at first ; or it may j^roduce a new grow^th differing in quality ; or it may be so great that, like luxuriant, overgrown weeds, the elements die from their very haste of growth, and we have immediate destruction of the part. According to the rapidity and intensity of the process of structural changes which takes place in an inflamed tissue, inflam- mation is described as acute or chronic^ with a vast number of inter- mediate forms. "When the phenomena are marked it is termed sthenic; when less distinct, as the result of a broken-down and feeble constitution in the animal, it is called asthenic. Certain inflamma- tions are specific, as in strangles, the horsepox, glanders, etc., where a characteristic or sj^ecific cause or condition is added to the origin, character of phenomena, or alterations which result from an ordinary inflammation. An inflammation may be circumscribed or limited, as in the abscess on the neck caused by the pressure of a collar, in pneumonia, in glanders, in the small tumors of a splint or a jack; or it may be diffuse, as in severe fistulas of the withers, in an extensive lung fever, in the legs in a case of grease, or in the spavins which affect horses with poorl}' nourished bones. The causes of inflamma- tion are practically the same as those of congestion, which is the initial step of all inflannnation. The temperament of a horse predisposes the animal to inflamma- tion of certain organs. A full-blooded animal, whose veins show on the surface of the body, and which has a strong, bounding heart pumping large quantities of blood into the vascular organs like the lungs, the intestines, and the lamina^ of the feet, is more apt to have pneumonia, congestive colics, and founder, than lymphatic, cold- blooded animals which have })leurisies, inflannnation of the bones, spavins, ringbones, inflammation of the glands of the less vascular skin of the extremities, greasy heels, thrush, etc. Young horses have inflammation of the membranes lining the air passages and digestive tract, while older animals are more subject to troubles in the closed serous sacs and in the bones. ' The work to which a horse is put (saddle or harness, speed or draft) will influence the predisposition of an animal to inflammatory diseases. As in congestion, the functional activity of a part is an important factor in localizing this form of disease. Given a group of horses exposed to the same draft of cold air or other exciting 488 DISEASES OF THE HORSE. cause of inflammation, the one which has just been eating will be at- tacked with an inflammation of the bowels; the one that has just been w^orking so as to increase its respiration will have an inflamma- tion of the throat, bronchi, or lungs; the one that has just been using its feet excessively will have a founder or inflammation of the laminae of the feet. The direct cause of inflammation is usually an irritant of some form. This may be a pathogenic organism — a disease germ — or it may be mechanical or chemical, external or internal. Cuts, bruises, injuries of any kind, parasites, acids, blisters, heat, cold, secretions, such as an excess of tears over the cheek or urine on the legs, all cause inflammation by direct injury to the part. Strains or wrenches of joints, ligaments, and tendons cause trouble by laceration of the tissue. Inflammations of the internal organs are caused by irritants as above, and by sudden cooling of the surface of the animal, which drives the blood to that organ which at the moment is most actively supplied with blood. This is called repercussion. A horse which has been worked at speed and is breathing rapidly is liable to have pneumonia if suddenly chilled, while an animal wdiich has just been fed is more apt to have a congestive colic if exposed to the same in- fluence, the blood in this case being driven from the exterior to the intestines, while in the former it was driven to the lungs. Symptoms. — The symptoms of inflammation are, as in congestion, change of color, due to an increased supply of blood ; swelling, from the same cause, with the addition of an effusion into the surrounding tissues ; heat, owing to the increased combustion in the part ; pain, due to pressure on the nerves, and altered function. This latter may be augmented or diminished, or first one and then the other. In addition to the local symptoms, inflammation always produces more or less constitutional disturbance or fever. A splint or small spavin will cause so little fever that it is not appreciable, while a severe spavin, an inflamed joint, or a pneumonia may give rise to a marked fever. The alterations in an inflamed tissue are first those of congestion, distention of the blood vessels, and exudation of the fluid of the blood into the surrounding fibers, with, however, a more complete stagna- tion of the blood ; fibrin, or lymph, a plastic substance, is thrown out as well, and the cells, which we have seen to be living organisms in themselves, no longer carried in the current of the blood, migrate from the vessels and, finding proper nutriment, proliferate or mul- tiply with greater or lesser rapidity. The cells which lie dormant in the meshes of the surrounding fibers are awakened into activity by the nutritious lymph which surrounds them, and they also multiply. Whether the cell in an inflamed part be the white ameboid cell of PLATE XXXVII. lUrtiriflcune^lwingoftJie bat. :i? Inf'la/ned wi/iff of (/ir Ixtt . Hiuiies, nfter A^pw JUUUSBItH 8C0 N Y' lKFLAM:Nr^TIOJSr. PLATt: xxx\nu. 1- Xon-ifi/IoTned mesentery of'the fro^.-tOO dzameters, redMced !^:a,a, Veiujle. wi/Ji red anxl n-7u/« corpiiscteS; b,b, Gelatinous n-erve fibre,- c.CapfJlary,- d,d, /JfiJ-k- bordered nerve fibre ,- e,e, Conner/ive- icssu.e witft connective tissue corpuscles avid leucocytes sca.tte/-ed^ spnjsely thj-ou,i i/uilc fil/ed witfi red and white rorpascles,- fJic red i/t tfie centre and file white crnwdi/if/ alortfj fjie walL^j c, c. f'npillary distended nit/i red and white cor- puscles, na/ii her of' tile white ninrh decre//sed.- d ,d,Connertive tissw between \-enute o/id cupiUnny til-led with niir/nLfed leucocytes; e-.e., Coruiective tissue. with l-ess inllltratiDit; l^ Dtu-k-fiori/ered nerve fibre,; ^, XujnJ)er ol'n-ucleL in . a se(pu'l, the volume of it which is carried to the point of inflannnation; it diminishes the body temperature or fever; 492 DISEASES OF THE HORSE. it numbs the nervous system, which phiys an important part as a con- ductor of irritation in diseases. Blood-letting is the most rapid means, and frequently acts like a charm in relieving a commencing inflammatory trouble. One must remember, however, that the strength of the body and repair depend on the blood. Hence blood-letting should be practiced only in full- blooded, well-nourished animals and in the early stages of the disease. CatJiartics act by drawing off a large quantity of fluid from the blood through the intestines, and have the advantage over the last remedy of removing only the watery and not the formed elements from the circulation. The blood cells remain, leaving the blood as rich as it was before. Again, the glands of the intestines are stimu- lated to excrete much waste matter and other deleterious material which may be acting as a poison in the blood. Diuretics operate through the kidneys in the same way. Diaphoretics aid depletion of the blood by pouring water in the form of sweat from the surface of the skin and stimulating the dis- charge of waste material out of its glands, which has the same effect on the blood pressure. Antipyretics are remedies to reduce the temperature. This may be accomjjlished by depressing the center in the brain that controls heat production. Some coal-tar products are very effective in this way, but they have the disadvantage of depressing the heart, which should always be kept as strong as possible. If they are used it must be with knowledge of this fact, and it is well to give heart tonics or stimu- lants with them. The temperature of the body may be lowered by cold packs or by showering witli cold water. This is a most useful procedure in many diseases. Depressants are drugs which act on the heart. They slow" or weaken the action of this organ and reduce the quantity and force of the cur- rent of the blood which is carried to the point of local disease ; they lessen the vitality of the animal, and for this reason are now used much less than formerly. Anodynes quiet the nervous system. Pain in the horse, as in the man, is one of the important factors in the production of fever, and the dulling of the former often prevents, or at least reduces, the latter. Anodynes produce sleep, so as to rest the patient and allow recupera- tion for the succeeding struggle of the vitality of the animal against the exhausting drain of the disease. The diet of an animal suffering from acute inflammation is a factor of the greatest importance. An overloaded circulation can be starved to a reduced quantity and to a less rich quality of blood by reducing the quantity of food given to the patient. Foods of easy digestion do not tire the already fatigued organs of an animal with a torpid diges- tive system. Nourishment will be taken by a suffering brute in the FEVERS. 493 form of slops and coolino; drinks where it would be totall)^ refused if oifered in its ordinary form, as hard oats or dry hay, requiring the labor of grinding between the teeth and swalloAving by the weakened muscles of the jaws and throat. Tonics and stimulants are remedies Avhich are used to meet special indications, as in the case of a feeble heart, and Avhich enter into the after treatment of inflannnatory troubles as well as into the acute stages of thorn. They brace up weakened and torpid glands; they stimulate the secretion of the necessary fluids of the body, and hasten the excretion of the waste material produced by the inflannnatory process; they regulate the action of a weakened heart; they promote healthy vitality of diseased parts, and aid the chemical changes needed for returning the altered tissues to their normal condition. FEVERS. [Synonyms: Febris, Latin; pyrexia, Greek; fidvre, French; fieber, German; fcbbrc, Italian; calentura, Spanish.] The etymology of the word " fever,"' from the Latin fevere, to boil or to burn, and of pyrexia, from the Greek word irvp, fire, defines in a general way the meaning of the term. Fever is a general condition of the animal body in which there is an elevation of the animal bod}^ temperature, which may be only a de- gree or two or may be 10° F. The elevation of the body temperature, which represents tissue change or combustion, is accompanied by an acceleration of the heart's action, a quickening of the respiration, and an aberration in the functional activity of the various organs of the body. These organs may be stimulated to the performance of exces- sive work, or they may be incapacitated from carrying out their allotted tasks, or, in the course of a fever, the two conditions may both exist, the one succeeding the other. Fever as a disease is usually preceded by chills as an essential symptom. Fevers are divided into essential fevers and symptomatic fercrs. In symptomatic fever some local disease, usually of an inflammatory character, develops first, and the constitutional febrile phenomena are the result of the primary point of combustion irritating the whole body, either through the nervous system or directly by means of the waste material which is carried into the circulation and through the blood vessels, and is distributed to distal j)arts. Essential fevers are those in which there is from the outset a general disturbance of the whole economy. This may consist of an elementary alteration in the blood or a general change in the constitution of the tissues. Fevers of the latter class are usually due to some infecting agent and belong, therefore, to the class of infectious diseases. Essential fevers are subdivided into ephemeral fevers, which last but a short time and terminate by critical phenomena ; intermittent 494 DISEASES OF THE HORSE. fevers, in which there are aherations of exacerbations of the febrile symptoms and remissions, in which the body returns to its normal condition or sometimes to a dej^ressed condition, in which the func- tions of life are but badly performed; and continued fevers, which include contagious diseases, such as glanders, influenza, etc., the septic diseases, such as pyemia, septicemia, etc., and the eruptive fevers, such as variola, etc. "^Miether the cause of the fever has been an injury to the tissues, such as a severe bruise, a broken bone, an inflamed lung, or excessive work, which has surcharged the blood with the waste products of the combustion of the tissues, which were destroyed to produce force, or the toxins of influenza in the blood, or the presence of irritating ma- terial, either in the form of living organisms or of their products, as in glanders or tuberculosis — the general train of symptoms are much the same, varying as the amount of the irritant differs in quantity, or when some special quality in them has a specific action on one or another tissue. There is in fever at first a relaxation of the small blood vessels, which may have been preceded by a contraction of the same if there was a chill, and as a consequence there is an acceleration of the cur- rent of the blood. There is, then, an elevation of the jjeripheral temperature, followed by a lowering of tension in the arteries and an acceleration in the movement of the heart. These conditions may be produced by a primary irritation of the nerve centers of the brain from the effects of heat, as is seen in thermic fever, or sunstroke, or by the entrance into the blood stream of disease-producing organisms or their chemical products, as in anthrax, rinderpest, influenza, etc. There are times when it is difficult to distinguish between the exist- ence of fever as a disease and a temporary feverish condition which is the result of excessive work. Like the condition of congestion of the lungs, which is normal up to a certain degree in the lungs of a race horse after a severe race, and morbid when it produces more than temf)orary phenomena or when it causes distinct lesions, the tem- perature may rise from physiological causes as much as four degrees, so fever, or, as it is better termed, a feverish condition, may follow any work or other employment of energy in which excessive tissue change has taken place; but if the consequences are ephemeral, and no recognizable lesion is apparent, it is not considered morbid. This condition, however, may predispose to severe organic disturbance and local inflammations which will cause disease, as an animal in this condition is liable to take cold and develop lung fever or a severe enteritis, if chilled or otherwise exposed. Fever in all animals is characterized by the same general phe- nomena, but we find the intensity of the symptoms modified by the species of animals affected, by the races which subdivide the species. FEVERS. 495 by the families which form groups of the races, and by certain condi- tions in individuals themselves. For example, a pricked foot in a Thoroughbred may cause intense fever, while the same injury in the foot of a Ch'desdale may scarcely cause a visible general symptom. In the horse, fever produces the following symptoms: The normal body temperature, which varies from 99° to 100° F., is elevated from 1° to 9°. A temperature of 102° or 103° F. is mod- erate fever, 104° to 105° F. is high, and 106° F. and over is excessive. The temperature is accurately measured by means of a clinical ther- mometer inserted in the rectum. This elevation of temperature can readily be felt by the hand placed in the mouth of the animal, or in the rectum, and in the cleft between the hind legs. It is usually appreciable at any point over the surface of the body and in the expired air emitted from the nos- trils. The ears and cannons are often as hot as the rest of the body, but are sometimes cold, which denotes a debility in the circulation and irregular distribution of the blood. The pulse, which in a healthy horse is felt beating about 42 to 48 times in the minute, is increased to GO, TO, 90, or even 100. The respirations are increased from 14 or 16 to 24, 30, 36, or even more. With the commencement of a fever the horse usually has its appetite diminished, or it may have total loss of appetite if the fever is excessive. There is, however, a vast difference among horses in this regard. With the same amount of elevation of temperature one horse may lose its appetite entirely, while others, usually of the more common sort, will eat at hay throughout the course of the fever, and will even continue to eat oats or other grains. Thirst is usually increased, but the animal desires only a small quantity of water at a time, and in most cases of fever a bucket of water should be kept standing before the patient, which may be allowed to drink ad libitum. The skin becomes dry and the hairs stand on end. Sweating is almost unknown in the early stage of fevers, but frequently occurs later in their course, when an out- break of warm sweat is often a most favorable symptom. The mu- cous membranes, which are most easily examined in the conjunctivae of the eyes and inside of the mouth, change color if the fever is an acute one; without alteration of blood the mucous membranes become of a rosy or deep-red color at the outset: if the fever is attended with distinct alteration of the blood, as in influenza, and at the end of two or three days in severe cases of pneumonia or other extensive inflam- matory troubles the mucous membranes are tinged with yellow, which may even become a deep ocher in color, the result of the decomposi- tion of the blood corpuscles and the freeing of their coloring matter, Avhich acts as a stain. At the outset of a fever the various glands are checked in their secretions, the salivary glands fail to secrete the saliva, and we find the surface of the tongue and inside of the cheeks 496 DISEASES OF THE HOKSE. dry and covered with a brownish, bad-smelling deposit. The excre- tion from the liver and intestinal glands is diminished and produces an inactivity of the digestive organs which causes a constipation. If this is not remedied at an early period, the undigested material acts as an irritant, and later we may have it followed by an inflamma- tory process, producing a severe diarrhea. The excretion from the kidneys is sometimes at first entirely sup- pressed. It is always considerably diminished, and what urine is passed is dark in color, undergoes ammoniacal change rapidly, and deposits quantities of salts. At a later period the diminished excre- tion may be replaced by an excessive excretion, which aids in carrying oil waste products and usually indicates an amelioration of the fever. While the ears, cannons, and hoofs of a horse suffering from fever are usually found hot, they may frequently alternate from hot to cold, or be much cooler than they normally are. This latter condition usually indicates great weakness on the part of the circulatory system. It is of the greatest importance, as an aid in diagnosing the gravity of an attack of fever and as an indication in the selection of its mode of treatment, to recognize the exact cause of a febrile condition in the horse. In certain cases, in very nervous animals, in which fever is the result of nerve influence, a simple anodyne, or even only quiet with continued care and nursing, will sometimes be sufficient to dimin- ish it. When fever is the result of local injury, the cure of the cause produces a cessation in the constitutional symptoms. Wlien fever is the result of a pneumonia or other severe parenchymatous inflamma- tion, it usually lasts for a definite time, and subsides with the first improvement of the local trouble, but in these cases w^e constantly have exacerbations of fever due to secondary inflammatory processes, such as the formation of small abscesses, the development of secondary bronchitis, or the death of a limited amount of tissue (gangrene). In specific cases, such as influenza, strangles, and septicemia, there is a definite poison contained in the blood-vessel system, and carried to the heart and to the nervous system, which produces a peculiar irritation, usually lasting for a specific period, during which the tem- perature can be but slightly diminished by any remedy. In cases attended with complications, the diagnosis becomes at times still more difficult, as at the end of a case of influenza which becomes complicated with pneumonia. The high temperature of the simple inflammatory disease may be grafted on that of the specific trouble, and the determination of the cause of the fever, as between the two, is therefore frequently a difficult matter but an important one, as upon it depends the mode of treatment. Any animal suffering from fever, whatever the cause, is much more susceptible to attacks of local inflammation, which become compli- cations of the original disease, than are animals in sound health. In FEVERS. 497 fever we have (he tissues and the walls of the blood vessels weakened, we have an increased current of more or less altered blood, flowin*; through the vessels and stagnating in the cainllaries, which need but an exciting cause to transform the passive congestion of fever into an active congestion and acute inflammation. These conditions be- come still more distinct when the fever is accompanied by a decided deterioration in the blood itt^elf, as is seen in influenza, septicemia, and at the termination of severe pneumonias. Fever, with its symptoms of increased temperature, acceleration of the pulse, acceleration of respiration, dry skin, diminished secretions, etc., must be considered as an indication of organic disturbance. This organic disturbance may be llie result of local inflammation or other irritants acting through the nerves on nerve centers; altera- tions of the blood, in which a poison is carried to the nerve centers, or direct irritants to the nerve centers themselves, as in cases of heat stroke, injury to the brain, etc. The treatment of fever depends upon its cause. One of the im- portant factors in treatment is absolute quiet. This may be obtained b}' placing a sick horse in a box stall, away from other animals and extraneous noises, and sheltered from excessive light and drafts of air. Anodynes, belladonna, hyoscyamus, and oi:)ium act as antipy- retics simply by quieting the nervous system. As an irritant exists in the blood in most cases of fever, any remedy which Avill favor the excretion of foreign elements from it will diminish this cause. We therefore employ diaphoretics to stimulate the sweat and excretions from the skin ; diuretics to favor the elimination of matter l)v the kidneys; cholagogues and laxatives to increase the action of the liver and intestines, and to drain from these important organs all the waste material which is aiding to choke up and congest thfii- rich plexuses of blood vessels. The heart becomes stinndated to increased action at the outset of a fever, but (his does not indicate increased strength; on the contrary, it indicates the action of an irritant to the heart that will soon weaken it. It is therefore irrational to further depress the heart by the use of such drugs as aconite. It is better to strengthen the heart and to favor the elimination of the substance that is irritating it. The increased blood pressure throughout the body may be diminished by lessening the quantity of l)lood. This is obtained in some cases with advantage where the disease is l)Ut starting and the animal is plethoric by direct abstraction of blood, as in bleeding from the jugular oi- otlier veins; or I)y derivatives, such as mustard, turpentine, or blisters ai)plied to the skin; or b}' setons, Avhich draw to the surface the fluid of the blood, thereby lessening is volume, without having the disadvantagi' of impoverish- ing the elements of the blood found in bleeding. Antipyretics given H. Doc. 79.U, r>0-2 .32 498 DISEASES OF THE HORSE. by the mouth and cokl applied to the skin are most useful in many cases. When the irritation which is the cause of fever is a specific one, either in the form of bacteria (living organisms), as in glanders, tuberculosis, influenza, septicemia, etc., or in the form of a foreign element, as in rheumatism, gout, hemaglobinuria, and other so-called diseases of nutrition, we emjDloy remedies which have been found to have a direct specific action on them. Among the specific remedies- for various diseases are counted quinine, carbolic acid, salic^dic acid, antipyrine, mercury, iodine, the empyreumatic oils, tars, resins, aro- matics, sulphur, and a host of other drugs, some of which are of known effect and others of which are theoretical in action. Certain remedies, like simple aromatic teas, vegetable acids, such as vinegar, lemon juice, etc., alkalines in the form of salts, sw^eet spirits of niter, etc., which are household remedies, are always useful, because they act on the excreting organs and ameliorate the effects of fever. Other remedies, which are to be used to influence the cause of fever, must be selected Avith judgment and from a thorough knowledge of the nature of the disease. INFLUENZA. [Synonyms: Plnkeiic typhoid fever, epizoiity, epihippic fever, hepatic fecer, MUous fever, etc.; fi^vre typhoide, grippe, French; pferdestaube, German; gastro-enteritis of Vatel and d'Arboval ; fcbris erysipelatodes, Zundel ; typhun of Delafond.] Definition. — Influenza is a contagious and infectious specific fever of the horse, ass, and mule, with alterations of the blood, stu})efac- tion of the brain and nervous system, great depression of the vital forces, and frequent inflammatory complications of the important vascular organs, especially of the lungs, intestines, brain, and lamina? of the feet. One attack usually protects the animal from future ones of the same disease, but not always. An apparent complete recovery is sometimes followed by serious sequelae of the nervous and blood-vessel systems. The disease is very apt, under certain condi- tions of the atmosphere or from unknown causes, to assume an epi- zootic form, with tendency to complications of especial organs, as, at one period, the lungs, at another the intestines, etc. The first description of influenza is given by Laurentius Rusius in 1301, when it spread over a considerable portion of Italy, causing great loss among the war horses of Rome and the surrounding district. Later, in 1648, an epizootic of this disease visited Germany and spread to other parts of Europe. In iTll, under the name of " epi- demica equorum,^'' it followed the tracks of the great armies all over Europe, causing immense losses among the horses, while the rinder- pest was scourging the cattle of the same regions. The two diseases were confounded with each other, and Avere, by the scientists of the INFLUENZA. 499 day, allied to llie typluin, Avhich was a phii^ue to llic liumaii race at the same time. We lind the first advent of this disease to the British Islands in an epizootic among the horses of London and the sonthern counties of England, in 1732, which is described by Gibson. In 1758, Eobert AVhytt recounts the devastation of the horses of the north of Scotland from the same trouble. Throughout the eighteenth century a number of epizootics occurred in Hanover and other portions of Germany and in France, which were renewed early in the present century, with complications of the intestinal tract, which obtained for it its name of orastro-enteritis. In 17G0 it lirst attacked the horses in North America, but is not described as. again occurring in a severe form until 1870-1872, when it spread over the entire country, from Canada south to Ohio, and then eastward to the Atlantic and west- ward to California. It is now a permanent disease in our large cities, selecting for the continuance of its virulence young or especially sus- ceptible horses which pass through the large and ill-ventilated and unclcaned stables of dealers, and assumes from time to time an en- zootic form, when from some reason its virulence increases. It as- sumes this form also when, from reasons of rural economy and com- merce, large numbers of young and more susceptible animals are exposed to its contagion. Etiology. — As one attack is self-protective, numbers of old horses, having had an earlier attack, are not capable of contracting it again ; but, aside from this, young horses, especially those about four or five years of age, are much more predisposed to be attacked, while the older (mes, even if they have not had tlie disease, are less liable to it. Again, the former age is that in Avhich the horse is brought from the farm, where it has been free from the risk of exposure, and is sold to pass through the stables of the country taverns, the dirty, infected railway cai-s, and the foul stockyards and damp stables of dealers in our large cities. Want of training is a predisposing cause. Overfed, fat, young horses which have just come through the sales stables are much more susceptible to contagion than the same horses are after a few months of steady work. Pilger, in 1805, was the first to recognize infection as the direct cause of the disease. Roll and others stutlied the ccmtagiousness of influenza, and, finding it so much more virulent and permanent in old stables than elsewhere, classed it as a "stall miasm." The at- mosphere is the most conmion carrier of the infection from sick ani- mals to healthy ones, and through it may be carried for a considerable distance. The ccmtagion will remain in the straw bedding and droppings of the animal and in the feed in an infected stable for a considerable time, and if these are removed to other localities it may be carried in them. It may 1k> carried in the clothing of those who have been in attendance on horses suffering from the disease. The 500 DISEASES OF THE HORSE. drinking water in troughs and even running water may hold the virus and be a means of its communication to other animals, even at a distance. The studies of Dieckerhotf, in 1881, in regard to the con- tagion of influenza were especially interesting. He found that dur- ing a local enzootic, produced by the introduction of horses suffering from influenza into an extensive stable otherAvise perfectly healthy, the infection took place in what at first seemed to be a most irregular manner, but which was shown later to be dependent on the ventilation and currents of air through the various buildings. His experiments showed that the virus of influenza is excessively diffusible, and that it will spread rapidly to the roof of a building and pass by the apertures of ventilation to others in the neighborhood. The writer has seen cases that have appeared to spread through a brick wall and attack animals on the opposite side before others even in the same stable ■were affected. Brick walls, old woodwork, and the dirt which is too frequently left about the feed boxes of a horse stall will all hold the contagion for some days, if not weeks, and communicate it to susceptible animals when placed in the same locality. A four-year- old colt, belonging to the writer, stood at the open door of a stable where two cases of influenza had developed the day before, fully 40 feet from the stall, for about ten minutes on two successive mornings, and in six days developed the disease. On the morning when the trouble in the colt w^as recognized it stood in an infirmary with a dozen horses being treated for various diseases, but was immediately isolated ; within one week two-thirds of the other horses had con- tracted the disease. Symptoms. — After the exposure of a susceptible horse to infection a period of incubation of from four to seven days elapses, during which the animal seems in perfect health, before any sjanptom is visible. When the sjmiptoms of influenza develop they may be in- tense or they may be so moderate as to occasion but little alarm, but the latter condition frequently exposes the animal to use and to the danger of the exciting causes of complications which would not have happened had the animal been left quietly in its stall in place of being worked or driven out to show to prospective purchasers. The disease may run a simple course as a specific fever, with alterations only of the blood, or it may become at any period complicated by local inflammatory troubles, the gravity of which is augmented by developing in an animal with an impoverished blood and already irritated and rapid circulation and defective nutritive and reparative functions. The first symptoms are those of a rapidly developing fever, which becomes intense within a very short period. The animal becomes dejected and inattentive to surrounding objects; stands Avith its head down, and not back on the halter as in serious lung diseases. It has INFLUENZA. 501 chills of the flanks, the luiiscles of llio croiij), and the nniscles of the shoulders, or of the entire body, lasting from fifteen to thirty min- utes, and frequently a grinding of the teeth which warns one that a severe attack may be expected. The hairs become dry and rough and stand on end. The l)ody temperature increases to 104°, 104.5°, and 105° F., or even in severe cases to 107° F., within the first twelve or eighteen hours. The horse becomes stupid, stands inunobile with its head hanging, the ears listless, and it pays but little attention to the surrounding attendants or the crack of a whi[). The stui)()r becomes rapidly more marked, the eyes become pufl'y and swollen with ex- cessive lachrymation, so that the tears run from the internal canthus of the eye over the cheeks and may blister the skin in its course. The respiration becomes accelerated to twenty-five or thirty in a minute, and the pulse is quickened to seventy, eighty, or even one hundred, moderate in volume and in force. There is great depression of mus- cular force; the animal stands limp, as if excessively fatigued. There is diminution, or in some cases total loss, of sensibility of the skin, so that it may be pricked or handled without attracting the attention of the animal. On movement, the horse staggers and shows a want of coordination of all of the muscles of its limbs. The senses of hearing, sifi-ht, and taste are diminished, if not entirely abolished. The visible • • • 1 mucous membranes (as the conjunctiva), from Avliich it is known as the pinkeye, and the mouth and the natural openings become of a deep saffron, ocher, or violet-red color. This latter is especially noticeable on the rim of the gums and is a condition not found in any other disease, so that it is an almost diagnostic symptom. In some outbreaks there is much more swelling of the lids and weeping from the eyes than in others. If the animal is bled at this period the blood is found more coagulable than normal, but at a later ])eriod it be- comes of a dark color and less coagulable. There is great diminution or total loss of appetite with an excessive thirst, but in many cases in cold-blooded horses the animal may retain a certain amount of appetite, eating slowly at its hay, oats, or other feed. There is some irritation of the mucous membrane of the resjiiratory tract as shown by discharge of mucus from the nose, and by cough. Pregnant mares are apt to abort. We have, following the fever, a tumefaction, or edema, of the sub- cutaneous tissues at the fetlocks, of the under surface of the belly, and of the sheath of the penis, which may be excessive. The infiltration is noninflammatory in character and produces an insensibility of the skin like the excessive stocking which we see in (l("l)ilitated animals after exposure to cold. In ordinary cases the temperature has reached its maximum of 105° or 10(;° F. in from twenty-four to forty-eight hours from the origin of the fever. It remains stationary for a period of from three to four davs without so much variation between morn- 502 DISEASES OF THE HORSE. ing and evening temperature as we have in pneumonia or other seri- ous diseases of the kings. At the termination of the specific course of the disease, which is generally from six to ten days, the fever abates, the swelling of the legs and under surface of belly diminishes, the ap- petite returns, the strength is rapidly regained, the mucous mem- branes lose their yellowish color, which they attain so rapidly at the commencement of the disease, and the animal convalesces promptly to its ordinary good condition and health, and rapidly regains the large amount of weight which it lost in the early part of the disease, a loss which frequently reaches 30, 50, or even 75 pounds each twenty- four hours. For the first three days of the high tempei*ature there is a great tendency to constipation, which should be avoided if possible by the use of the means recommended below, for, if it has been marked, it may be followed by a troublesome diarrhea. T eliminations. — The termination of simple influenza may be death by extreme fever, with failure of the heart's action ; from excessive coma, due generally to a rapid congestion of the brain ; to the poison- ous effects of the debris of the disintegrated blood corj^uscles and the toxin of the disease; to an asphyxia, following congestion of the lungs ; or the disease terminates by subsidence of the fever, return of the appetite and nutritive functions of the organs, and rapid con- valescence; or, in an unfortunately large number of cases, the course of the disease is complicated by local inflammatory troubles, whose gravity is greater in influenza than it is when they occur as sporadic diseases. Complications. — The complications are congestions, followed by inflammatory phenomena in the various organs of the body, but they are most commonly located in the intestines, lungs, brain, or vascular laminae of the feet. Atmospheric influence or other surrounding influences of unknown quality seem to be an important factor in the determination of the local lesions. At certain seasons of the year, and in certain epizootics, we find 40 and 50 per cent or even a greater percentage of the cases rendered more serious by complication of the intestines; at other seasons of the year, or in other epizootics, we find the same percentage of cases complicated by inflammation of the lungs, while at the same time a small percentage of them are com- plicated by troubles of the other organs; inflammatory changes of the brain, of the laminae, more rarely commence in epizootic form, but are to be found in a certain small percentage of cases in all epizootics. Exciting causes are important factors in complicating individual cases of influenza, or in localizing special lesions either during enzo- otics or epizootics. These exciting or determining causes act much as they would in sporadic inflammatory diseases, but in this case Ave find the animal much more susceptible and predisposed to be acted upon INFLUENZA. 503 llian ordinary healthy animals. "With a temperature alread}' ele- vated, with the heart's action driving the blood in increased quantity into the distended blood vessels, which become dihited and lose their contractility, Avith a con<2;esti()n of all of the vascular organs already established, it takes but little additional irritation to carry the con- gestion one step further and i)roduce inflannnation. Compliration of the 'intestines. — When any cause acts as an irritant to the intestin.al tract during the course of this specific fever it may produce inliammation of the organs belonging to it. This cause may be constipation, which can find relief only in a congestion which oH'ers to increase the function of the glands and relieve the inertia caused by a temporary cessation of activity; or irritant medicines, esj^ecially any increased use of antimony, turpentine, or the more active reme- dies; the taking of indigestible food, or of food in too great quantities, or food altered in any way by fungus or other injurious alterations; the swallowing of too cold water; or anv other in-itant may cause congestion. This complication is ushered in by colics. The animal paws with the fore feet and evinces a great sensibility of the belly ; it looks Avith the head from side to side, and may lie down and get up, not with violence, but with care for itself, perfectly protecting the sur- face of the belly from any violence. At first we find a decided con- stipation; the droj^pings if passed are small and hard, coated with a viscous varnish or even with false membranes. In from thirty-six to forty hours the constipation is followed by diarrhea. The alimen- tary discharge becomes mixed with a seronuicous exudation, Avhich is followed by a certain amount of suppurative matter. The animal be- comes rapidly exhausted and unstable, staggers on movement, losing the little appetite which may have remained, and has exacerbations of fever. The pulse becomes softer and weaker, the respiration becomes gradually more rapid, the temperature is about 1° to 1.5° F. higher. If a fatal result is not produced by the extensive diarrhea the dis- charge becomes arrested in from five to ten days and a rapid recovery takes place. Complieation of the lungs. — If at any time during the course of the fever the animal is exposed to cold or drafts of air, or in any other way to the causes of repercussion, the lungs may become afl'ected. In the majority of cases, however, after three, four, or five days of the fever, congestion of the lungs commences without any exposure or apparent exciting cause. Unless this congestion of the hmgs is soon relieved it is followed by an inflannnation constituting ])neumo- nia. This pneimionia, while it is in its essence the same, ditl'ers from an ordinary ])neumonia at the connnencement by an insidious course. The animal conmwnces to l)reathe heavily, which becomes distinctly visible in the heaving of the Hanks, the dilatation of the nostrils, and frequently in the swaying movement of the unsteady body. The res- 504 DISEASES OF THE HORSE. l^iratioiis increase in number, what little appetite remained is lost, the temperature increases from 1° to 2°, the pulse becomes more rapid, and at times, for a short period, more tense and full, but the previous poisoning of the specific disease has so weakened the tissues that it never becomes the characteristic full, tense j^ulse of a simple pneu- monia. On percussion of the chest dullness is found over the inflamed areas; on auscultation at the base of the neck over the trachea a tubu- lar murmur is heard. The crepitant rales and tubular murmurs of pneumonia are heard on the sides of the chest if the pneumonia is peripheral, but in pneumonia complicating influenza the inflamed portions are frequently disseminated in islands of variable size and are sometimes deep seated, in which case the characteristic auscultory symptoms are sometimes wanting. From this time on the symptoms of the animal are those of an ordinary grave pneumonia, rendered more severe by occurring in a debilitated animal. The cough is at first hacky and aborted ; later, more full and moist. There is dis- charge from the nostrils, which may be mucopurulent, purulent, or hemorrhagic. As in simple pneumonia, in the outset this discharge may be " rusty," due to capillary hemorrhages. We find that the blood is thoroughly mixed with the matter, staining it evenly, instead of being mixed with it in the form of clots. At the commencement of the complication the animal may be subject to chills, which may again occur in the course of the disease, in which case, if severe, an unfa- vorable termination by gangrene ma}^ be looked for. If gangrene occurs it is shown by preliminary chills, a rapid elevation of tempera- ture, a tumultuous heart, a flaky discharge from the nostrils, and a fetid breath ; the symptoms are identical with those which occur in gangrene complicating other diseases. C 07nplieation of the hrain. — At any time during the course of the disease congestion of the brain may occur; at an early period if the fever has been intense from the outset, but in ordinary cases more frequently after three or four days. The animal, which has been stupid and immobile, becomes suddenly restless, wuilks forAvard in the stall until it fastens its head in the corner. If in a box stall and it be- comes displaced from its position, it follows the wall with the nose and eyes, rubbing it along until it reaches the corner and again fastens itself. It may become more violent, and rear and plunge. If dis- turbed by the entrance of the attendant or any loud noise or bright light, it Avill stamp with its fore feet and strike with its hind feet, but is not definite in fixing the object which it is resisting, which is a diagnostic point between meningitis and rabies and which renders the animal with the former disease less dangerous to handle. If fas- tened by a rope to a stake or post, the animal will wander in a circle INFLUENZA. 505 at the end of the rope. It Avaiulers ahnost invariably in one direelion. The pupils may be dihited or contracted, or we may find one condition in one eye and the opposite in the other. The period of excitement is followed by one of profound coma, in which the animal is immobile, the head hangin