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TREATISE

OH #9632;L'lIK

PRINCIPLES AND PEACTIOE

VETERINARY

MEDICINE amp; SURGERY.

BY WILLIAM HAYCOCK,

f Veterinary Surgeon, and M. K. C. V, S.)

PART I

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JOHN CHUECHILVSllW E�ELINGTON-STREET. 1858.

PREFACE.

A Book treating upon Wounds and Injuries of the Horse, and the severe consequences which occasionally result therefrom, has never appeared from the pen of any English Veterinary Surgeon, evincing that attention to the question, and that copiousness of detail which the subject requires. In commencing our labours in this particular department, it was our intention to devote not more than from eighty to one hundred pages to the entire subject; but as we proceeded, the result of such labour grew imperceptibly upon our hands, until we now find that a goodly sized octavo volume will be required before it is com�pleted in a satisfactory manner.

One portion of the subject treated upon in the the present part, may require some degree of expla�nation. We refer to the article on Inflammation. The majority of authors upon medicine who have treated upon Inflammation, generally com�mence their task by elucidating the theory of the disease. In this respect we have departed from

the usual course. We treat upon the theory of Inflammation towards the conclusion of our article; and we have done so from a conviction that the plan will tend to remove much of the ohscurity which invests this confessedly intricate department of pathology, quot;We have therefore at the commencement, concisely described facts, or the objective phenomena peculiar to the several kinds of Inflammation met with and encountered by the Veterinary surgeon in practice. quot;Whether this deviation will answer the purpose intended, the judgment and discrimination of the reader must determine for himself.

Throughout our laboius we have especially considered the wants and the requirements of the Veterinary Student. The young men who are almost daily going forth into the world of busy life, either to prepare for or practice as Veterinary Surgeons, must remember that the public have a right to expect from them the practical develop�ment of principles in the treatment of equine disease far in advance of those pursued by our forefathers. On the other hand, to instruct in such higher principles and advanced modes of practice, is without doubt the true province of every teacher, and of every writer upon Veterinary medicine. If we have failed in respect to these true essentials, we assure the reader such failure

does not arise from lack of industry, but from lack of ability botb to understand tbe ten dency of the age with regard to the former, regard to and the requirements of the pupil with the latter.

The present part, although announced as the first, is yet to be regarded as complete in itself inasmuch as it elucidates Inflammation and those general principles of treatment not only with respect to the severer types of idiopathic disease, but also in relation to the healing of wounds, and the more violent forms of systemic disturbance arising from the infliction of injuries of almost every degree of severity. To what extent the work will be carried, is at present unknown to ourselves. The process of production will neces�sarily be slow, arising from the multiplicity of labours in which we are engaged, as well as the time and care required in the production of the work. As we find its matter, however, to accu�mulate, and as such matter takes on form, order, and completeness, so will it be issued from the press. Every part which may be issued we hope to make complete in itself.

One important feature in medicine�a fea�ture recognised by many, and daily becoming patent to the thinking portion of medical men,�is

the fact, that the practice of medicine is becommg more simple in. character; and that we arc on the eve of a complete change. The hold which Homoeopathy has taken of the public mind; the remedial powers of cold and tepid water, when slcilfully applied to the organism for the cure both of acute and chronic disease; as well as the fact that the most eminent professors of the healing art not only abandon what is called orthodox practice, but openly avow their heresy and disgust at the same, are sufficiently indica�tive of what sooner or later will ensue. The compilers of ponderous Dictionaries on what is strangely denominated quot; practical medicine,quot; have, we suspect, fulfilled their mission in the world. They may not see the change, or, if they see it, may affect to disbelieve it. None of us are desirous of believing that which wo may consider destructive to our fame, or our supposed interests. Old men are wedded to the past; they desire repose. To the new school of Veterinary Surgeons which we believe must come, we trust that our work will be found, if not a pioneer in the change, at least an exponent of its principles.

The general views herein expressed upon the healinsr of flesh wounds, and the best mode of treatment to pursue in forwarding such healing in a manner the most economical to the life-

powers, may, or may not be regarded as new; nevertheless we can state with confidence, that the observations were made, and the conclusions upon them arrived at, upon entirely indepen�dent grounds. Neither are we aware of any Veterinary Surgeon having previously applied steam as a fomentation to wounds, or of having recommended it. The apparatus we recommend for the purpose we trust will be found fully adequate to the intent; in addition to which, it is equally adapted for domestic purposes. By unscrewing the pipe connected with the stop tap, plate xviii, figure iv, page 132, and screwing in its place the plug figure vi, the Digester is ready at once for cooking requirements.

In conclusion, we embrace this opportunity to thank our artist, Mr. J. Fountain, of Leeds, for the illustrations. To his care and artistic skill we acknowledge ourselves greatlv indebted.

Veterinary Institution, West Parade, Huddersfidd, April, 1858.

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YETEEINARY PRINCIPLES AND PRACTICE.

P A 11 T

INFLAMMATION.

Inflammation�From In�animo, to bum�is one of the most common forms of disease presented to the Veterinary Surgeon ; a form respecting which much has been written, and regarding which many erroneous opinions have prevailed. From causes of this nature, injurious and serious consequences have resulted. Indeed it will be evident to all who reflect, that sound medical practice must of necessity be based upon sound medical principles. Consequently, the more obscure our knowledge of healthy and diseased organic action, the more crude and barbarous will be our practice of the healing art.

Until very recently, every kind of disease was regarded as a form of Inflammation: and for its cure recourse was had either to local or systemic venesection, or both, together with numerous other measures, all more or less of a depletive nature. A less sanguinary system of practice, however, now prevails.

The manner too in which Inflammation has been written upon, has made it to the pupil, and also to the general reader, a subject perfectly bewildering. Its doctrines are so loaded with hypothetical formulai, and yet are so inseparably blended with

VOL. I.

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eveiything in actual practice, that the term, from necessity, is constantly associated in the thoughts of the pupil, but respecting which no idea of a very definite kind with regard to it, may for a long time occupy his mind. In the present article we shall attempt to rid the question of much of the obscurity in which it is involved, and endeavour to give a tolerably clear and definite account of what is meant and implied by the term, together with a perspicuous description of the numerous phenomena produced by, and associated with, the forms of the disease under discussion.

Before proceeding to treat upon Inflammation in detail, it will bo of advantage to sketch the line of our intended course : for by this means, the reader will be better prepared to comprehend the bearing of each separate part of the subject upon the whole : and he will also thereby learn the oneness of that, which otherwise might appear to be but a complication of terms, or a confused description of phenomena whose existence constitutes the very essence of the disturbance in question, and a clear understanding of which, is necessary to the success of all who claim to rank as Veterinary Surgeons, or who are passing through that probationary career so essential to the after course of the Veterinary Pupil.

In the Fiest place, then, it is proposed to define the term�Inflammation j�

Secondly, to treat upon its Terminations, or Common Consequences ;�

Thirdly, upon the various kinds of Inflammation;�

Fourthly, upon the nature of the Systemic Disturbance arising from Inflammation, whether such Inflam�mation be of a local or systemic character;�

..raquo; !

DEFINITION OF.nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp;�')

Fifthly, upon tiic State of the Blood in Inlhuu-mation;�

Sixthly, upon the Theory of lullamrmition;�and

Seventhly, upon the General Prmciples~of Cure to be pursued in the treatment of Inflammation.

L�DEFINITION OF THE TEEM.

To properly define what is implied by the term, Iiiliiimuuitiou, is a matter of considerable difficulty; particularly if such definition is to be at once brief, and yet fully meet, if not all at least the principal requirements of the case. Our definition, therefore, must only be regarded as an approximation to this. It must in fact be looked upon but as a text on which to found our disquisition; a text, however, which we trust the reader will hud fully elucidated in the context.

Inflammation, has been defined to be:�quot; An unnatural or perverted action, of, and in, the capillary blood-vessels of a part; attended with redness, throbbing, swelling, pain, heat, and disorder of function, with change in both its fluid and solid constituents, as well as with more or less general disturbance of the system.quot;'quot;'

The above definition as a whole is exemplified in Inflammation arising within structures which arc situate externally. If, for example, wo were to apply a strong blister to one of the limbs of a white horse, we should witness all the phenomena here specified. The limb would speedily swell. The skin instead of its usual pale flesh, tint, would present a deep red colour, arising from the congested state of its capillary vessels. The heat would also bo intense, the pain considerable, and the natural use of the limb

� Professor Miller.

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would for a tame be impaired. The phenomena witnessed under these circumstances, arc sucli as are present, to a greater or less degree, in any tissue which may take on the inflammatory process, some of the conditions being more strongly developed in certain tissues than in others. The extent to which structures in a state of Inflammation will swell, for example, varies considerably, and will be found to depend upon the vital and physical characters of the tissues involved. The more loose and soft the tissue, the greater the amount of swelling. The skin of the horse in the severe forms of Scarlatina presents a state of enormous distention�while on the other hand the pleuritic, the horny, and the cartilaginous tissues are seldom swollen when inflamed j but the pain is always of a severe character, arising from the distention or stretching of structures which are naturally unyielding. In acute Laminitis, or Inflammation of the feet, in acute Inflammation of the bowels and of the pleura, the pain is always of a highly severe character.

From the above definition it is evident that an assemblage of conditions, existing in intimate association, are necessary to constitute Inflammation,

In the first place, the capillary blood-vessels are the tissues or stractures wherein the morbid phenomena are seated; and by this it must be understood, not only the most minute of the arterial vessels, but the radicles of the veins also. Secondly, these capillary vessels take on an quot; unnatural or perverted action.quot; Thirdly, the usually attendant symptoms are�heat, pain, redness and swelling, with disorder of function, and more or less general disturbance of the system. Two or more of these conditions how�ever, be it distinctly understood, must exist in association; that is to say, neither pain alone within a part, nor redness alone, nor heat, nor swelling, nor mere disorder of function, will of itself constitute the disorder in question; but two or more of the above conditions must exist in association. Wc arc aware of the efforts of ore

iSraquo;i

rlaquo;*laquo;a

DEFCJITION OF.

or twu medical writers to give u wider deflnitios of the term, Inflammation, than the one here stated. These writers assert its occasional existence within tissues which are supposed to be destitute of blood-vessels, or nutritive vessels of any kind, such as the articular cartilages, and cornea of the eye. To refute state�ments of this nature would lead us fax into the arena of disputation, terminating probably in results of questionable value to the reader. The observations which may seem to favour such a view, are not only few, but are of an imperfect and isolated character; and even if they were true, they would not militate against the capillaries being considered, in the majority of instances, as the primary seat of the principal phenomena atten�dant upon, and manifested by, the inflammatory process. It matters not, then, where the Inflammation may be located, whether in the lungs, the bowels, the stomach, the bladder, the eyes, the joints, or within any structure capable of manifesting its presence�we must look upon it in all cases as having its seat within the capillary blood-vessels of the part involved. Seeing, then, that the disease is seated within these vessels, and knowing, as we do, that Inflammation within any part is frequently attended with consequences of a most disastrous nature�which con�sequences are not only numerous but highly important to be understood�we shall best comprehend the nature of the abnormal state in question, and more clearly understand the consequences to which we allude, if we, in the first instance, endeavour to obtain a clear comprehension of the natural functions of the capillary vessels. Indeed, without this, our knowledge of the nature and consequences of Inflammation must necessarily be not only confused, but imperfect and unsatisfactory in every respect.

Capillaries.�The blood is the pabulum from whence is elaborated the entire organism, as well as the source from whence is derived all the various secretions and excretions of the system; but in order that these purposes may be accomplished, it is necessary for the fluid in question to be circulated, through, or its materials

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brought in contact with, every tissue requiring fresh nutrition, as well as through the various secretory and excretory organs. To effectually accomplish this, we find a class of structures set apart and admirably adapted in every way to fulfil the purposes required. The first of these, is the heart itself : next come the large blood conduits, the arteries, which spring from the former, as a tree springs from the earth; while the arteries again, terminate in a series of vessels of wonderful minuteness, just as the boughs of a tree terminate in the twigs. These minute vessels are denominated Capillaries.

prnruE i.

Arrangement of the Capillaries of the air-cells of the Lung,

[After Dr. Carpenter.]

These Capillaries ramify, and arc placed in the most intimate relation with every tissue throughout the body, within whose substance reproduction and decay are in perpetual operation, as well as with those organs whose duty it is to furnish or separate the secretions and excretions already referred to. Each tissue selects from the common pabulum�the blood�thus sent to it, the peculiar principle it requires to support its own life and integrity. The bones select their own nutritive matter; the same with the muscles, nerves, skin, cellular tissue; and in short every tissue of the animal body; while the various secretory and excretory organs are found also to select, separate, and reject from the system those compounds which would prove injurious to the organism.

Li-M

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DEFINITION OF.nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; 7

Entering into the formation of the animal body, are structures called membraues, amongst which a wide difference is found to exist. Two or three of these, require a passing notice, inasmuch as this difference�which is one both of organisation, and function� gives rise to different phenomena, when manifesting any of those types of disease so common to the inflammatory process.

The membranes which principally interest our enquiry, are the serous and the mucous. The serous membranes are found within the cranium, the great cavities of the chest, and the abdomen, and also within the joints. From the tissues of the former is secreted a clear watery halitus, whose uses arc important in preventing consequences of a serious nature, when surfaces, opposite in position, arc brought into close contiguity, and act upon each other. One peculiarity of the serous membranes is, that they form shut sacs, or cavatics�impervious alike to the atmosphere and external agents of every kind; while the mucous membrane, or the membrane lining the mouth, the nostrils, the throat, trachea, bronchial tubes, stomach, intestinal canal, bladder, and other organs, is open at the extremities, and possesses properties and functions of a widely different nature from the serous membranes. A mucous membrane is more vascular than a serous one ; that is to say, more capillaries are found within it, and as a matter of course more blood than within the vessels of the serous tissues.

FIGURE H.

Distribulion of Capillaries around follicles of Mucous Membrane.

In addition to nutrition, secretion, and excretion, the organism is also constantly in a state of active disintegration. If

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new matter was being regularly added to the old, without a proportionate quantity of the old being removed, the body in a short time would increase to an enormous bulk. But the disintegration during health is equivalent, or nearly so, to repro�duction in an adult animal�and thus it is, that the balance is maintained. But the question very naturally arises, how is this disintegrated material removed, and finally expelled from the system 1 To effect this in part, another class of capillary vessels are provided, which are found to terminate in a manner altogether the reverse of the former. The arterial capillaries, are the terminating points of the arteries ; but the capillary veins commence at the termination of the arterial capillaries, and terminate in the smaller veins ; while the smaller veins terminate in the larger, and the larger in the liver and the heart, in which organs the disin�tegrated materials, to a great extent, are either immediately or mediately ejected from the body; or, at least, these organs materially aid in such ejection.

PIGURS m.

Capillary net-work of Muscle.

Such are the natural functions performed, in part at least, by the capillary system. The account we give is brief, and necessarily imperfect; but we trust it is sufficient to furnish the reader with a clear conception of the matter in hand, and in turn enable him to clearly comprehend that which is to follow.

We have thus endeavoured.

Firstly :�To define what is implied by the term Inflammation ; and in doing this, we have also

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endeavoured to shew that it is a process

essentially morbid.

Secondly :�To show, according to the definition given, that in whatever organ Inflammation may become manifest, whether in the stomach, lungs, or bowels, we must on all occasions regard it as having its seat within the capillary blood-vessels of the parts affected.

Thirdly :�That several conditions, such as heat, redness, swelling, and pain, are necessary to exist in association, to constitute Inflammation.

Fourthly:�That structures destitute of capillary blood-vessels, such as the hoofs and hair, cannot, from their nature, manifest Inflammation.

Fifthly :�That the natural functions of the capillary blood-vessels arc to convey blood to the most remote parts of the organism, in order to afford the tissues nutrition, to yield to the secretory and excretory organs those portions of the vital fluid required fur their purposes, and to remove the effete particles of the body and disperse them.

Having endeavoured to elucidate the above in a manner, wo trust, clear to the reader, we proceed to treat upon the termina�tions of Inflammation.

II.�TEEMINATIONS, OR COMMON CONSEQUENCES OF INFLAMMATION.

From the differences which exist between the serous and the mucous membranes, and between cither of those membranes and the

VOL. I.

INFLAMMATION,

osseous, muscular, and uervous tissues, wu might a jirlor't conclude that Inflammation must of necessity present different characters and different terminations, according to the peculiarities of the membranes, structures, or tissues involved. And such indeed we fi lid to be the fact to a very marked extent; so that, to use the language of an eminent authority:�quot; Inflammation may be of as many different species as there are kinds of tissues affected by it.quot; But we ought rather to regard Inflammation, after all, as being but one in kind�the difference for the most part depending, as we shall endeavour to prove, more upon its mode of termination� arising probably from the difference of vital endowment of the tissues affected�than upon any other peculiarity of a marked character.

It is usual to consider Inflanrnation as terminating in

a.�Resolution,�Perfect and Imperfect. u.�Mwtification, or Gangrene. C.�Sii/'/iiimtinK.�Abscess�Pus. D.� Ulcerafion. li.�Semorrhage. t'.�Effusion.

C.----J/lt;-jiillislt;ltiill.

u.�Ossification.

Iii/lammation, says Dr. Copland, quot; correctly speaking, terminates only in two ways: in Resolution, or the recovery of the healthy state of action; and in Gangrme, or the death of the inflamed part. The other morbid conditions, improperly ranked as terminations, are merely consequence of Inflammation; the morbid vascular action giving rise to them, still subsisting in most instances, in some one or other of its forms/'

i-M

TEEMINATIONS.

a..�Resolution.

The term Resolution is used to denote the state of the tissues after their recovery from the effects of lutlaramatioii. The defini�tion however which is usually given of the word in our uiedieal dictionaries, in relation to pathology, is this;�quot;the subsidence of injlammation, witliout the formation of abscess, ulceration, or termination in gangrene or induration;quot; but in the sense in which it is used by Dr. Copland and others, it possesses a far wider moaning�meaning in fact, the complete and entire restoration of the normal integrity of the tissues involved, both in structure and function; no matter whether such restoration takes place prior to, or after, the formation of abscess, ulceration, or induration.

Though such is avowedly the practical meaning of the term ; yet if it be regarded in its relation to the state of the tissues after the subsidence of cine or more of the effects named, it is not sufficiently descriptive of the different conditions and results.

Suppose, for example, we restrict the meaning of the word to denote the state of the tissues after the subsidence of Inllamma-lion, without the formation of abscess, ulceration, or indnration; what term shall we use to denote the state of the tissues, supposing inflammation to have progressed and assumed one or more of the states named, resulting in a permanent change of the tissues both in organization and function? li is clear the mere, word Resolution will not be correct. To meet the difficulties of the case, we propose to consider Resolution as naturally dividing itself into two kinds:�Perfect and Imperfect. By Perfect Resolution we mean the complete and entire restoration of the normal integrity of the tissues involved, both in structure and function; while by Imperfect Resolution we mean that state where the tissues originally involved are left permanently altered, but yet not so far altered as to destroy either vitally or mechanically their former usefulness.

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Examples of Perfect Resolution are seldom observed, save after attacks of Inflammation of the mildest character. They are occasionally seen after the subsidence of Strangles, and some other forms of abscess disease; also after recovery from certain injuries inflicted upon the feet, and ligamentous tissues; also after the subsidence of common or catarrhal Opthalmia.

Examples of Imperfect Resolution are far more common than the former. In numerous cases, Imperfect Resolution, practically speaking, is just as etfeetual as though the structures had been left perfect. Splint, in many of its forms, presents examples of this nature. It may appear superfluous to insist upon finely drawn distinctions of this nature, with regard to splints which are considered to be cured. The distinction, however, be it understood is not of our creating. It exists in nature.* When once Inflammation between the metacarpal and splint bones becomes established, Perfect Resolution, or a perfect restoration of the structures involved, is never obtained. The bones it is true in the majority of cases do not ultimately suffer to any considerable extent, neither is the animal less useful than before; but never�theless, the consequence of Inflammation in this part is, that the bones become permanently changed in their relation one to another. The two bones, which formerly were perfectly distinct, become united together by ossitic matter, whereby their natural action one upon the other, through the medium of an elastic tissue, is destroyed, affecting to some extent the natural springiness of the limb. As examples of the worst forms of Imperfect Resolution, we may instance Spavin, Ringbone, and Induration of the Lungs. In all these diseases, or rather consequences of disease, the structures involved become PEBMAKENTLY changed both in structure and function. The very worst types of Spavin and

* In ciiscs of this kintl, the reader must not misumlerstund the inclining, and consider that a Splint renders a horse for ever unsound. Imperfect Resolution in a great number of instances, as remarked above, is just as effectual, practically speaking, as the kinds of Resolution denominated pcifccl. The distinction drawn is to be understood only in a physiological sense.

L�raquo;1

TERMINATIONS.

l.T

Ringb�iie interfere materially with the natural usefulness of the animal, anil render him permanently unsoundj while in other types of the same diseases, the patients arc neither rendered permanently unsound, nor less useful than before. For these and many other pathological facts of a similar nature�facts which will readily present themselves to the practical reader�wc suggest the distinction above set forth, believing it to be founded in the reality of things.

B.�Gangrene, or Mortification.

Mortification, from mors death, and Jio to become; to become dead�is the second mode of termination, spoken of by Dr. Copland. When any part of a living animal loses its vitality, so that the circulation and all the other functions of the part entirely cease, that part is said to be in a state of Mortification. quot; Mortification is divided into acute and chronic. The former is also sometimes called humid, and the latter dry gangrene.'quot;'''

Chronic Gangrene is occasionally met with in old cows. The animal, affected in some instances for weeks or even months before death�will slowly sink in condition, and the appetite will partially fail; but beyond the lo?s of appetite and loss of flesh, little else may be observable. Tin; animal will in course of time drop down and quietly die. Examination of the body will shew that Gangrene of the peritoneum, also of the pleura, and even of the areolar tissues throughout the organism has taken place.

quot; The terms Gangrene and Mortification are often used synonymously; but gangrene properly signifies the state which immediately precedes mortification; while the complete mortifica�tion, or absolute death of a part, is called sphacelus. A part which has passed into the state of sphacelus, is called a dough. When a part becomes gangrenous, it loses its natural heat and

* Hooper.

INI'-LAMM A'l'lnN.

sensibility; it becomes livid, and vesications appear on its surface. Although this state generally leads to that of complete mortifica�tion, yet so long as it remains a degree of vitality also remains; and in some rare instances the circulation is re-established, and the part restored to health. When sphacelus has taken place, the part becomes black and putrid, it is entirely dead and disorganised, and the living system must either cast it ott', or sink from the effects of the absorption of putrid matter.quot;*

From the preceeding, it will be evident, that Inttammatiou can only terminate in Eesolution of a perfect or of an imperfect nature�or in Mortifiation, or death of the structures involved. Perfect Besolution then, of all other terminations, is the one to be sought for, and to attain which, every means should hi: employed which experience lias proved to be of real value in producing so desirable a result.

c.�Suppuration.

Suppuration is a very common result of Inflammation.

When Inflammation centres itself as it were amongst the softer structures, such as the skin, or the absorbent glands, or the areolar tissues, a collection of purulent matter frequently results, which receives the name of abscess. The submaxillary-tumour which forms in Strangles, is a familiar example of abscess. Abscesses may form in various parts, either in the deeper seated or internal structures of the frame, or upon structures near to the surface; the most common parts, being those within the sulnnaxillary space,�amongst the muscles of the poll; also at the point of the elbow, sometimes amongst the muscles of the breast, and also in and amongst the lymphatic glands of the hind limbs. Strangles is a purulent disease, in which the entire organism appears to acquire a tendency to secrete purulent matter. It is a mistake to suppose that in Strangles, the abscess which

* Hoop. r.

TEEMINATIONS.

usually fonns within thv submax�lary space, is eutirely the result of local mflammatory action. Tlie IMamiuation iraquo; systemic� its tendency in the general run of cases being to localise the ]Hinilent products withiji a limited area of tissue.

Abscess, although a common form of purulent deposit, is not the only condition under which pus is secreted. Certain structures, suck as the mucous membrane, the nasal channels, or within the larynx, and pharynx�whose surfaces possess a free communi�cation with the external air�when inliamed, secrete an abundance of purulent matter, winch is cast forth almost immediately upon its exudation. Inflammation in these parts is generally attended with considerable febrile disturbance and with acute local pain; but when Suppuration becomes fairly established, the patient comparatively speaking is safe.

Certain structures of the organism, when inflamed, manifest a far greater tendency to Suppuration than others under similar circumstances. The skin, muscles, and mucous membranes are structures of this character; while others, such as the serous membranes, manifest, when inflamed, a greater tendency to exude water and lymph; the difference depending upon the difference in the organism of the tissues themselves, and in the difference of their vital endowment. Nevertheless purulent matter is occasionally secreted from serous membranes; examples of which may sometimes be observed in Pleuritis, and also in cases of Inflammation within the lateral ventricles of the brain. The mucous membranes are more prone to take on inflammatory action than the serous membranes. The cause of this would appear to arise, first, from the former being more vascular than the latter, and secondly, because the former are more exposed to external agents, as effluvias of a poisonous nature co-mingled with the atmosphere, and also to irritating substances contained within the food, or by other accidental modes of introduction within the alimentary and respiratory organs. The tendency to

INFLAMMATION,

abscess-formation is mure common to the skin ami its snbtextures

than to other stmctuies. Did the mucous or tho serous membranes manifest a similar proneness to the same result, fatal consequences would more frequently occur than at present. The formation of an abscess within the mucous membrane of the trachea or the larynx, would be almost certain to terminate in the death of the patient. The abscess, if large, would etfectually block up the tracheal channel, preventing the ingress of air to the lungs, and suttbeation would be the natural consequence. In very few instances indeed during the life of the animal, should we be able to determine its precise scat, even if relief otherwise could be afforded. Abscess within the spongy textures of the lungs is rare, save in that form of Pneumonia which we have elsewhere designated Typhoid Pneumonia.quot;' In this form of Pneumonia, abscess within the substance of the lungs is common. In Sthenic Pneumonia however it is extremely uncommon. We have only witnessed it in two instances. In both these cases, the abscesses wore small, but immorous and perfectly distinct from each other. The largest of them did not exceed the size of a two shilling piece. They were round in form, and filled with clean yellow-coloured purulent matter. Professor Dick considers that abscesses within the lungs are generally of rapid formation; an opinion with which we entirely agree; for in neither of the cases to which wc allude, did the patients live until the close of tho third day from the commencement of the attack; and both animals were in perfect health within a very short time of being attacked, and tin disease becoming very active.

On the nature of purulent matter; it is necessary to offer a few remarks.

The peculiar conditions under which purulent matter is

� See the Author's quot;Contrihutions to the Pathology mid Practice of Veterinary Medicine,*' pablisbed in quot;The Veterinananquot; for 1849, page litl, article quot;Typhoid Pneumonia,quot; also his quot; Elements of Veterinary Homoeopathy,quot; page 150quot;,�London . Aylott and Co.

TKEMINATIOXS.

produced, are one thing�the product of sucb conditions is another. Pus is a product at all times the result or consequence of inflammatory action. It presents to notice several distinctive physical characters. The appearance of pus depends in some degree upon certain peculiarities of the structure whence it is secreted; and partly also upon the time which may elapse between its formation and evacuation. The pus which is secreted in Strangles, and this may be taken as a familiar example of pus in general, is of a pale yellow colour, of the consistence of cream, emitting occasionally a nauseous effluvia; and on other occasions, an effluvia of a sickly nature. If taken, in this state, and examined under the lens of a microscope, of sufficient magnifying power, it will be found to consist of globular, or granular portions similar to the forms in figure -1-, floating in a serous fluid. These corpuscles

FIGUBB IV.

I ^

Pus Granules magnified, .ibout 400 diameters.

present differences of form amongst themselves; some having a roughened scabby appearance, similar to the one in contiguity with the letter a; while others, comparitively speaking, are smooth as at B. If dilute acetic acid be added to the corpuscles while under view, they will be seen to change rapidly; the scabby roughened surface will disappear to a considerable extent. They will also become more transparent, and internal nuclei become developed, similar to the delineation marked c. When pus is allowed to remain, after its formation, for a considerable time, within

Pus Globules�magnified about 400 diameters,�a. Pus Corpuscle sliewinp tbe rnugliencd scabby appearance, so common,�b. another form,�c. Pus Corpuscle shewing Nucleoli.

VOL. I.

INFLAJIMATIOX,

a natural cavity of the body, it changes greatly in outward appearance. The fluid in which the corpuscles float is absorbed, and the corpuscles themselves become conglomerated into irregular formed lumps, or masses as shewn in figure (;;). Sometimes these

FIGURE V.

conglomerations are nearly as large as a pea. They may bo described as varying from the size, of a pea to that of a pin's head. Another peculiarity of purulent matter of this character is, that it is frequently destitute of smell.

Pus is altered fibrine. If recently secreted, its specific gravity varies from 1-3G to 1-45. It is insoluble, but yet readily mixes with water. It is neither acid nor alkaline, but neutral. Its corpuscles float in liquid; the latter being closely similar in chemical composition to the serum of the blood. If pus be absorbed into the system, it is generally considered a matter of serious importance. This, to a certain extent is true�but not to the extent generally believed. The purulent matter of glanders, however, is well known to be an excitant of the samo kind of disease in healthy animals-; and it is also equally virulent in its effects upon human beings. We are however of opinion� and this opinion is founded upon observation of numerous facts� that the absorption of non-specific purulent matter is not usually attended with those serious consequences which are attributed to it. The extensive purulent deposits, which arc occasionally found

Fioi-re (.^r).)�Gonglomerated masses of pus t.ikcn from an abscess, of six mohtli?' duration. The ahsccss was siiuate at the point of the elbow of a heavy draught horslaquo;:. The masses nro as shewn by a low magnifying power.

I. -

TERMINATIONS.

within the organism, and which are ascribed to InflammatioB of

the veins, in consequence of tlie supposed absorption of pus, are often due to other causes. Of this however more hereafter, when we come to treat upon Specific Fevers�such as Strangles and maladies of a similar nature.

The purulent matter such as we have described, is usually denominated quot; laudable pus,quot; in contradistinction to the other kinds which occasionally present themselves. The purulent matter found in abscess of the lung in asthenic, or Typhoid Pneumonia, differs widely in appearance from that which is commonly known as laudable pus. It is thinner in consistence, and of a dirty brown or yeasty colour. It is also generally mixed with small particles of coagulated lymph, and it passes far more rapidly into a state of putridity, and emits a most disgusting effluvia ; the effluvia in fact which is peculiar to all animal tissues when in a state of active decomposition. If subjected to microscopical examination, the corpuscles are found to be broken up and mixed with blood discs in various stages of decomposition; also with minute flake-like masses of lymph, epithelial scales, and with forms innumerable of the dead or decomposing structures. Purulent matter of this nature is also occasionally seen to exude from unhealthy and old ulcerated sores; from the skin in certain forms and stages of grease; from diseased thrushes, and from the ulcers which are found to affect the softer tissues of the foot in cases of canker.

The mode too in which pus is formed is another question of interest to the Veterinarian. It has been described by Dr. Carswell, Kaltenbrunner, and others; and is spoken of by Dr. Copland as follows:�quot; In the field of a microscope, the inflamed capillaries are seen uniformly red, and the circulation in them is retarded or has ceased. Serum and coagulable lymph are effused in the areolse of the tissue; and if the Inflammation is very intense, the exuded fluid is more or less coloured by the exudation of blood. The whole of the inflamed part is opaque.

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As soon as suppuration commences, the red colom begins to disappear in various points, giving place to a yellowish gTanular like matter in the capillaries and connecting cellular tissue. In the centre of the inflamed tissue, several of the capillary vessels, which were obscured by the accumulated blood, reappear�some containing red, others yellowish-grey, globules which gradually become more distinct, increase in number and size, begin to move slowly, and traversing the capillaries, arrive at the surface of the tissue, or at the edges of the wound, if this has occurred in the form of globules of pus.quot;

quot; Gendrin states that he has distinctly seen the globules of blood change into pus. The observations of Kaltenbrunner agree with those of Gendrin, as to the transformation of the blood globules into the globules of pus, and as to this taking place tvithin the capillaries; but they also seem to prove, what others have confirmed, that pus may be formed, tvithout as well as within the capillaries of an inflamed part, the fluid portion of the secretion consisting of the serum of the blood.quot;*

d.� Ulceration.

Ulceration is another consequence of Inflammation; and in the horse, as in the human being, we have the process manifested amongst various tissues, and under a variety of forms. We mt.y define an ulcer to be,

A solution of continuity of structure arising from loss of substance, caused by Inflammation.

In Quitter, Poll evil, Fistulous withers, and Canker of the feet, we have ulcers, which are denominated sinuous ox fistulous; sinuous, because the ulceration runs in various directions, literally eating its way under and through the surrounding tissues.

�Copland's quot; Medical Dktionary.quot;�Article�-'#9632; IntiammatUra.quot;

rEKMINATlONS.

In glanders, we have another form of ulcer, which presents to view a round shallow cavity, having ragged edges, with a tendency to spread superficially. This kind of ulcer is denominated Fhagedenic, from the greek word phago�I eat. All ulcers strictly speaking are phagedenicj but it is more common to apply the term to such ulcers as spread superficially. The Glanderous ulcer is of a destructive nature. It spreads rapidly�not unfrequently eating its way through a number of textures, even through the walls of large arteries�and the patient not unfrequently dies from hemorrhage. All structures capable of manifesting Inttammation, are of course liable to ulceration; some however more so than others. We behold its eft'ects upon diseased bone. It is common in navicular disease, and in many incurable forms of Spavin. The bones of the hock, in consequence of long continued infiammatory action, become softened; ulceration attacks the vascular structures; fresh bony matter is added, which not only replaces what the ulcerative process had removed, but an additional growth is added, which is not so firm in texture as the former, arising in a great measure from the absence of a sufficiency of organic matter within its substance. The very nature of Ulceration consists, first, of a softening of the structures diseased; and second, in the disappearance of such softened portions. Ulceration always commences at the surface of the part inflamed, or at the most extreme points of the capillary vessels. When ulcera�tion is about to manifest itself, we may observe a small red point or two, or an equal number of minute vesicles upon the surface of the part inflamed, and from under which exudes a watery fluid, or in some cases, a thin, grey-coloured, slimy lymph. We here allude to the ulcerative process as it may be seen upon the nasal membrane in Glanders, and upon the skin in Scarlatina Maligna. In a short time these vesicles break, and a corresponding number of small pit like cavities are exposed to view, whence is exuded a greater abundance of slimy lymph, intermixed with purulent matter. The ulcerative process may now be said to have fairly set in; particle after particle of the tissues as they become dead arc removed�

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every fresh removal of course adding to the size of the ulcer. As the sore becomes larger, its edges will appear more ragged-looking, and swollen, and not unfrequeutly a fungoid kind of flesh will rapidly arise from the sides and bottom of the cavity. Such growths are more particularly evident in glanderous ulcers.; and in ulcers of cankered feet, than in the common non-specific forms of the disease. The appearance of such fungoid growths is always indicative of great malignancy in the character of the Inliammation productive of these consequences.

Tiie disappearance of tissue under the effects of the ulcerative process has, from the time of Hunter until within a very recent period, been regarded as the result of absorption�an opinion now considered to be erroneous. The disappearance of tissue is found to result from its loss of vitality; and, under these conditions, it is cast forth along with the serous, or sero-purulcut exudation from the walls of the sore. Ulceration is indeed the result of limited sphacelus�the sphacelated portions constituting a portion of the sum total of the exudation from the ulcer itself. The commencement of resolution within the tissues contiguous to an ulcer, is marked by several changes. In the first place, they gradually acquire a state of greater natural firmness;�secondly, the exposed surface of the sore assumes a more healthy colour;� thirdly, the discharge which exudes from it acquires a thicker consistence, becoming of an albuminous, or albumiiio-puriform nature. This secretion gradually spreads itself over the ulcer, serving a double purpose; first, protecting the raw surface of the sore from external agents, and secondly, by gradually acquiring all the conditions necessary to heal the cavity.

E. �Hcmoi -rli age.

Another of the consequences of Inflammation, is that of Hemorrhage�a consequence not spoken of by any Veterinary writer upon Inflammation with whom we are acquainted; and

TEESHNATIONS.

2:5

yet it is not :i consequence by any moans of uncommou occurrence�being invariably present in every form of Purpura, as well as in all the severer forms of Scarlatina.

It may occur as a direct, or indirect, consequence of Infliim-mation. Direct, as in Purpura, and indirect, from Ulceration penetrating through the coats of an artery, as in Glanders.

Hemorrhage, as a consequence of Inflammation, varies in its intensity, from the slightest effusion to the most copious exudations. Such Hemorrhage may be subcutaneous�in which case it is always the most abundant; or it may occur within the deeper seated areolar tissues, as for example within tissues in immediate contiguity with the substance of the muscles. When present within the latter, the muscular substance immediately involved is invariably pale in colour, and greatly softened in texture, arising probably from the blood being effused, instead of going to the nutrition of the tissues themselves. The Hemorrhage in these cases, so far as our observations extend, is strictly confined to the areolar tissues of the body, and to the mucous membranes. The blood stains which are present within the substance of the muscles, do not arise from the effusion of blood within the muscular tissue itself, but from the areolar tissue immediately contiguous. The same is the case when effusion occurs within and amongst the folds of the intestinal tube. Hemorrhage is never present within the caucelli of the bones; nor within the ligamentous and tendinous structures.

r.�Effusion.

Effusion from the word effundo, to pour out. Effusion as a consequence of inflammation is made manifest under various conditions. Serous membranes, when inflamed, such as the pleura, exude large quantities of serous fluid into the cavity of the chest. A similar effect is occasionally manifested within the lateral

DfFLAMMATION,

vontricles of the brain, and also within the abdominal cavity. These are the common examples of effusion arising from inflam�mation invading the great serous cavities. In the lesser forms, the effect is of a more circumscribed and less dangerous nature. One of the limbs for example, receives a blow from a heavy body, or a kick from another horse. Inflammation within the tissues injured, is the result, and, as an accompaniment, swelling to a greater or less extent will exist. When effusion occurs amongst tissues or structures which are loose, it also gives rise to swelling or distention of the structures. It is important to understand the difference. The swelling, in the first instance, is the result of mvjestlon�in the second instance of effusion. The primary swelling�congestive swelling�is hard, hot, and painful. The secondary swelling�swelling from effusion�on the contrary is cool, not necessarily painful, is soft and pits from pressure.

Distention of the limbs from effusion is a common sequence to Pneumonia, Bronchitis, and epidemic fevers of various kinds, of an inflammatory or debilitating character. It is also a common sequence to Lymphatitcs and Scarlatina.

Ignorant pretenders of the Veterinary Art, when called upon to treat a horse whose limbs are swollen from effusion, generally give strong diuretics�and insert rowels and tents of tew beneath the skin, for the purpose of what they designate quot; drain�ing away the water.quot; Such treatment is in opposition to rational practice. The proper course to pursue is to give tone and vigour to the organism, by a careful attention to the diet of the animal, to the comfort of the stable, easy exercise, and the administration of China. The tincture of the muriate of iron, or arsenicum, and such medicines as tend to restore vigour to the organism.

Adhesion.

Adhesion, from adhaereo, to stick to. This term in pathology

TERMINATIONS.

implies the morbid union of parts by inflammation�which are naturally contiguous, but not adherent. It is another of the common consequences of inflammation, particularly in serous structures. It is a consequence in fact, all but exclusively con�fined to the structures in question, familiar examples of which are presented in the adhesion of the lungs to the pleura, also in the adhesion of muscles to each other and in the adhesion of tendons to their synovial sheaths in chronic states of inflammation. The mucous membranes on the other hand, when inrtamed, instead of their tissues becoming adherent, take on the suppurative process, and the secretion of purulent matter is the result. Did the mucous membranes under states of inflammation manifest a similar tendency to adhere to each other as the serous membranes when so involved, consequences of a fatal character would more frequently occur than at present. The tracheal channel, when its mucous membrane was inflamed, would in all probability, become speedily obliterated, and suffocation would ensue. Obliteration of the channels and cavities of the mucous surfaces lining the stomach and intestinal canal, or the mucous membrane of the bladder and uretha, would in like manner ensue.

In rare instances however, adhesion of mucous surfaces to each other does occur; and the natural canal or cavity which may exist is obliterated. In a case of (Esophagitis in a cow, which the writer attended, the internal surfaces of the organ, for more than five inches in length, became so firmly adherent as to totally obliterate its canal.*

The adhesion of structures, originally separate and distinct, or if originally united but separated by violence, as in flesh wounds, is effected by a substance denominated lymph. This substance is secreted from the capillary vessels of the inflamed tissue. The secretion at first is fluid and colourless, or nearly so; it soon however, coagulates, in which state it becomes opaque, and changes

Sec the Veterinarian, for 1843. page 319.

VOL.

IN'FL.aiMATlO.V,

to a pale straw colour. In the sthenic forms of inflammation tliirf coagulnm is firm and solid in its general appearance ; in tlic asthenic forms of inflammation, on the contrary, lymph is scantily supplied, and it exists in a scmicoagulated condition, having a sanious appearance, and readily passes into a state of putridity. Of the nature of this coagulahlo lymph effused from the exposed surface of a flesh wound and injuries of a like nature, and of the healing process, we shall treat more fully hereafter.

lt;:.�Hepatisation.

Hepatisation, from the Greek word Ifcpar�the liver, or liver-like. The term Hepatisation is applied to a morbid state manifested by the structures constituting the lungs, as a conse�quence of Inflammation. The respiratory organs, when inflamed, are affected in a manner similar to other structures of the softer kind; they swell, and become more solid than before; and this swelling, together with the increased solidity�such solidity arising from the deposition of lymph, within the air-cells, and small bronchial tubes of the organ diseased�constitute the peculiar morbid state in question, designated Hepatisation. The lung, in short, has become solid, or liver-like in its general condition.

'^:

Hepatisation was regarded by Lannec as the second stage of Pneumonia. But, if we strictly regard the phenomena of this disease as manifested in nature, Hepatisation will be the third stage of the morbid process; the first stage being that which marks the invasion, or commencement of the malady; the second, its full activity; and the third, when the lung has become hepatised. Of this however we shall treat more fully when specially treating upon Pneumonia. quot; The lungquot; in Hepatisation, says Lannec, quot; has entirely lost its erepitous feel under the finger, and has acquired a consistence and weight altogether resembling that of liver.quot;

LSWraquo;laquo;

TERMINATIONS.

Many medical writers describe two forms of Hepatisation� viz., the red and the yellow; the red form of the disease being due to the exudation of blood and serum within the inflamed tissues; and the yellow form as arising from the presence of purulent matter within the bronchial tubes, air-tells, and parenchyma of the organ. The phenomena of Hepatisation is presented in a very complete form in the lungs of cattle dying from what is called the lung disease, or Pleuro Pneumonia. Of the anatomical characters of Hepatisation and its associated peculiarities, we shall treat more fully when specially considering Pneumonia.

Thickening.

Thickening of tissue, as a consequence of Inflammation, is an effect frequently produced, particularly within structures where the disease has become chronic. Examples of thickening are common within fibrous structures, such as the flexor tendons, and metacarpal ligaments from sprain. A similar effect is produced within the pleura, from pleuritis. Kepeated blisters upon the skin will ultimately thicken it; similar effects also result from the use of the actual cautery. Examples in short of the thickening of structures as a consequence of Inflammatory action, are of such frequent occurrence, and are so well known and recognised, that further notice of the matter is unnecessary.

h.�Ossification.

Ossification, the literal meaning of the term Ossification is, os, a hone, and/acio to make�to make bone. Ossification is of two kinds, healthy, and morbid. We speak of course in the present instance of the latter only, of which in the equine class wc have numerous examples. Bone-spavin is one of the examples we allude to; another is the unition of the splint bone to the metacarpal bone, in the affection termed splint: the ossification of the

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lateral cartilages is a third; and Ring-boue, or ossification of the pasteru bones and fibrous structures contiguous thereto, is a fourth. The examples, however, of ossification as a con�sequence of Inflammation in the equine class, are so numerous, and their general characters so extensively recognised amongst Veterinary Surgeons and amateurs in horses, that we need not dwell longer upon the matter. The various forms of morbid ossification, we shall discuss in detail, when we come to treat upon them specially.

III.�KINDS OF INFLAMMATION.

Inflammation is of several varieties or kinds. Dr. Brown used the terms sthenic, and asthenic, to denote their existence under opposite states of the organism: sthenic, under a state where the vital powers are vigorous; asthenic, where enfeebled or debilitated. We have also chronic states of inflammation, and inflammations of a specific nature. These several kinds of inflammation come within the practical experience of most Veterinary Surgeons; but as the student and amatuer will probably be desirous to understand something of their nature, we shall concisely sketch the general characters of each.

Sthenic or Acute Inflammation.

Is the most common form in which the disease is manifested. It is, in the generality of cases, rapid in its attack, certain in its cause, quick in its course or in the development of its terminations or consequences, and strongly marked in its symptoms and attendant fever.

The most acute fonns of inflammation are seen in Laminitis, Enteritis, Lymphatitis, Sthenic Pneumonia, Pleuritis, and many other forms of chest and abdominal inflammations.

i ¹

TEU.MINATiONS.

Asthen ic Inflammation.

Is characterized by, and peculiar to, a feeble and debilitated state of the organism, by an uncertainty in many instances as to the real nature of its cause, by an insidiousness in its progress, by a want of that precise certainty in its symptoms, which is so characteristic a feature of the acute sthenic kinds, by its being attended with fever of a low typhoid nature, and by its greater proneuess in the generality of cases to spread to nearly all the soft tissues, and terminate in gangrene and death. The most common forms in which astheuie inflammation is manifested is that of Typhoid Pleuro Pneumonia; Purpura Hemorrhagica, and also in Scarlatina Maligna.

Specific Inflammation.

Specific from the French word Spedfique from the Latin species and facio, that which makes an object, or a state of organism, of the kind or species which it is.

The term specific in the present instance, is used to denote a form of inflammatory disease which is invariable in its scat, in the symptoms which characterize it, and in the consequences which result. Glanders, for example, is a specific inflammatory disease of this nature, the seat of its activity being principally limited to the mucous and dermal tissues. Scarlatina is a second instance, and Canker is a third.

Specific inflammatory diseases differ in many respects from the common, or non-specific inflammatory ones. Firstly, certain of the specific forms, are capable of reproducing themselves in other animals by contagion. Glanders is a specific inflammatory disease of this nature; it is a disease of the blood, arising from the presence of a morbid poison within the fluid itself, giving rise to the phenomena peculiar to this malady ; originating in causes of

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a local nature in the first instance, and spreading thence over the entire organism, until in the end, a disease is produced the virulence of which in the generality of cases, is not only sucli as hitherto to defy every effort of the Veterinary Surgeon to eradicate, but the secretions of which, possess the peculiar property, under circumstances of a favourable nature, of generating a disease equally virulent in other animals.

A specific inflammation may originate in common causes, as Glanders from common inflammatory catarrh; or the exciting causes of specific Opthalmia, in horses predisposed to the disease, may be such as in the general run lt; if animals would only induce Opthalmia of the common character, or perhaps not excite any derangement within the visual organs whatever. Other of the specific forms of inflammation appear to arise in a great measure from peculiarities of an hereditary nature, as in specific Opthalmia, the tendency to which is well known to be hereditary.

Kaviculartliritis and Spavin, are both specific forms of inflammation, which may originate from causes of a totally different nature, but are also known in numerous instances to have been transmitted from parent to ofispring.

A specific inflammatory disease may be contagious, or it may not. Glanders is known to be highly contagious, not only to the equine class, but to man also. Scarlatina, however, though another inflammatory disease of a specific nature, is not contagious. This malady is considered to be contagious in the human being; but notwithstanding the extraordinary statements made by Dr. Copland, in his Medical Dictionary on the authority of Percival, we deny the contagiousness of equine Scarlatina. It is epidemical, but not contagious. We never yet beheld two cases of the disease in the same stable; and we have had experience in the treatment of more than 100 eases, and have furnished the most complete account of the malady extant.

tsraquo;%

TERMINATIONS.

.'51

Chroi�i: Inflammation.

quot;Acute and Chronic Inflammationsquot; says Wharton Jones, quot;are so named from the most striking parts of their character; the former being distinguished by severity of symptons, the latter by long continuance. In the acute form of inflammation with severity of symptoms, there is combined rapidity of progress; and in the chronic form, long continuance is tempered by mildness of symptoms.

quot; These differences, it will be observed, are merely differences in degree and continuance. There does not appear to be any essential difference in nature between the acute and chronic forms of inflammation. In both there is congestion, in both exudation, and in both the exuded matter undergoes analagous changes. Moreover, it is to be observed, that between well marked acute and well marked chronic inflammation, aJl intermediate forms are met with.

quot; The conditions on which the striking parts of the character of acute and chronic inflammation will appear to depend, arc respectively the following:�In acute inflammation the congestion is greater; and if resolution, to which there is a tendency, does not soon ensue, exudation of lymph takes place more or less copiously�the result of which is adhesion, or abscess, or thick puriform discharge, as the case may be, after which the circulation may gradually be re-established, and so there is an end of the inflammation. In chronic inflammation, on the contrary, the congestion is less complete; there is but little tendency to resolution, and exudation is cither not so copious within a given time, or it is more watery. Moreover, the congestion persists, and the exudation still goes on; the result of which is permanent enlargement of substance, or chronic discharges, as the case may bo.

quot;Chronic inflammation may either succeed to acute inflam-

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mation, or come on slowly of itself,quot; (as for example in certain forms of spavin, and navicular disease,) quot;unpreceded by any acute stage. Acute in�ammatiou may supervene on chronic inflam�mation.*quot;

As examples of chronic forms of inflammation wc may instance Grease of long duration, old cases of Quittor, Canker in the feet, old cases of Spavin, thickening of the flexor tendons, Poll-evil, and many other maladies of a similar nature.

Metastastic Inflammation.

Metastasis, signifying to change, or to become translated from one part of the system to another, or as some writers denominate it, secondary inflammation; cannot, strictly speaking, be eon-sidered as essentially dittering in kind from cither the sthenic or the asfhenic varieties; it is simply to be regarded as a translation of the disease from one set of tissues to another, examples of which are not of nnfrequent occurrence in our class of patients.

Inflammatory attacks of this nature arc only observed amongst tissues of a certain character, and under conditions which are peculiar. Inflammation may arise within the stomach for example, and shortly afterwards become translated to the feet, and what is called Laminitis supervene; or, the gastric affection is translated to the skin, and the patient amongst other things becomes nearly denuded of hair, and foul spreading ulcerous sores, difficult of cure, are occasionally established upon the skin of the extremities. The former result, or the translation to the feet, frequently arises from the animal having partaken of wheat in a green or uncooked state�while the latter, more frequently arises from the animal having gorged itself w�th beans.

Metastasis is occasionally seen also in acute specific Opthalmia;

* Wharton Jones's Opthalmic Medicine.

KINDS OF.

the disease will suddenly leave one eye, and as suddenly appear in the other. We never observed Metastasis, however, from the urinary organs to the feet, nor from the feet to the urinary organs, and we may say very rarely from the lungs to the feet. We are of opinion that inflammation of the feet, arising from derangement of the stomach and digestive organs, is far more common than is generally suspected; indeed we have good grounds for believing, that the majority of cases of Laminitis have their cause in a morbid state of the above organs.

Metastatic inflammation is not so common, we believe, in the horse, as it is in the human being, and very rare indeed in the ox species.

In the Veterinarian, for 1849, page 495, will be found a case of Metastasis recorded by Mr. Boughton, of Hounslow. The subject of Mr. Boughtons case was a carriage horse, five years of age. In this case, the lungs became inflamed in con�sequence of superpurgation. The inflammation of the lungs set in on the 25th of August, 1849. On the evening of the 26th (the day following) the pneumonia was greatly ameliorated, but Laminitis was present, and continued until the afternoon of the 28th, when this also disappeared, and the animal became totally blind; the day following the patient died from exhaustion. Examination of the carcase after death shewed the intestines to be quot; pale internally; the mucous membrane of a dirty brown tinge;quot; the lungs inflamed, and within their tissues three large sized abscesses, containing thick purulent matter. Within the cranium was a copious effusion of serum; the lateral ventricles of the brain contained scrum; and the plexus ehoroides were congested with blood. Within the. feet quot;all the intervening substance connecting the fibro periosteum with the lamime had been destroyed, and its place had become filled with the partly decomposed periosteum and blood, which had been thrown out from the small vessels. All union between the periosteum VOL. i.nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; E.

olnbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; LVI'LA.MMATIUN',

and iaiuiiuf liinl disappeared, and an open space lay exposed to

view, nearly a quarter of an inch in size.quot;

Again, in the Veterinary Record, for 1850, page 38, is another case of Metastasis detailed by Mr. Cox, which in some respects is of a more extraordinary nature than the above. The subject of Mr. Cox's case, was a pony, the property of a horse dealer. The inflammation, as in the previous case, was caused by snperpurgation. The violent purging was checked by the owner, by whose orders the physic was given in the first instance, and immedi�ately upon its subsidence acute Opthalmia manifested itself in both eyes, for which the animal was bled, and more cathartic medicine given. On the 8th of September, (1850,) Mr. Cox was called in, when he found the Opthalmia to have nearly disappeared, but Laminitis had supervened in both fore feet. On the evening of the day following, (the Dth) the disease was translated from the fore to the hind feet. On the evening of the 10th, the fleam-wound in the neck began to inflame, and in the end suppuration was established, The patient ultimately recovered, and did well.

The proximate cause of Metastasis is to be sought for in the sympathy which exists between one set of tissues and another; as between the skin for example, and the mucous membranes. Metastasis never occurs except under states of debility.

Debility, as we have just intimated, being one of the essential conditions of its manifestation, it follows that if remedial measures are pursued, which tend more to lower the vital endowment of the system�such as bleeding and purging�the Metastasis will become of still greater intensity; while on the other hand, if such remedial measures be resorted to as tend to restore and give force to the vital endowment, the patient, if otherwise favourably circumstanced, may recover and do well; conclusions which are borne out by experience. In nearly every case of this nature the intensity of the translated disease wid

K1NPS OF.

be fouiul to fall or rise just in proportion as the vita! energies are exalted or lowered by the treatment pursued.

In addition to the form of secondary inflammation treated upon above, others are occasionally presented of a character equally interesting. We allude to the existence of secondary inflammations of a specific character, caused by the transmission of animal poisons from one part of the organism to another distantly situated with regard to the first. Forms of infiamniatory disease of this nature are now and then seen in Strangles, and more frequently in Glanders. In both maladies, the poisonous products are matured in one locality, and carried thence by the blood-current to another.

In Glanders the poisonous agent is carried into the absorbent system, and is developed as Farcy. On some occasions the whole of the denned lymphatics and their glands are more or less affected; in others the poison appears to confine its operations to the lymphatics of one of the hind limbs, the Symptoms of which are a swollen and indurated state of the whole of the tissues of the limb, the gradual appearance of small cord-like vessels�inflamed absorbents�miming in various directions beneath the skin; lame�ness of the limb, but not on all occasions of a severe character; small knot-like enlargements along the course of the lymphatics; the occasional bursting of these small abscesses; the discharge of purulent matter, and the appearance of chancreous ulcers in place of the small abscesses, and, finally, by a power resident within this purulent product of exciting by inoculation a disease of a precisely similar character in another animal. Such are the principal features of true Farcy; in contradistinction to a malady �Lymphatites�the symptoms of which are described by Percival as the symptoms of Farcy.*

We regard Farcy as a disease consecutive in the generality

* See Vol. 3 of rercirars Hi] popatliologv, first Edilion, pages 304-3 6 amp; 7-

INFLAMMATION,

of cases, of either developed or undeveloped Glanders. That Farcy may, and does in fact occur, prior to what is usually designated Glanders we admit. The poison, by inoculation or otherwise, may be taken into the organism, and there first developing its pernicious eft'ects within the dermal lymphatic sys�tem, give rise to a disease, to which the name of Farcy is given, but which after all is but a form of Glanders.

In other cases again, this poisonous purulent matter is con�veyed to the tissues of the lungs. There it originates a slow inflammatory disease, terminating in the formation of numerous pulmonary abscesses, and in extreme cases, in genuine tuberculous formations.

The occasional consecutive inflammatory att'ections of Stran�gles, are of a different character. The purulent matter of Strangles is sometimes absorbed into the system, giving rise to systemic Phlebitis, and also to the formation of abscesses in various localities of the body. The reader will find a veiy instructive case of this nature detailed in the Veterinarian, tor 1849, p. 245.

IV.�SYSTEMIC DISTURBANCE.

Symptomatic Inflammatory Fever: Febris, from ftrveo, I am hot. In the definition of Inflammation, we alluded to a more or less general disturbance of the organism, as an inevitable attendant and consequence of Inflammation. Systemic disturbance, as an effect of inflammatory action, is always present, the intensity of such disturbance depending upon the nature and intensity of its cause, and upon the natural susceptibility of the patient to the operation of such cause. This systemic disturbance receives the name of Symptomatic Inflammatory Fever. It is also usual to designate symptomatic fever with reference to the nature of its cause. Wien local inflammation is the result of mechanical violence, as in cases of fracture, open joint, and so

isaraquo;laquo;!

SYMPTOMATIC PEVEE.

forth, tkc attendant fever is designated Traumatic Inflaiuiuatory Fever, from the Greek word tmuma, a wound; meaning fever from local inflammation arising from mechanical violenee.

Symptomatic Fever, as its name implies, exists but as an effect of local disturbance. quot;Whatever irritates,quot; says Dr. Copland, quot;or stimulates the circulatory system to a stronger or more frequent action, or inflames a particular part, is productive of Symptomatic Fever. Its cause exists within the frame, as irritation, or inflam�mation of particular tissues; the presence of foreign bodies, or hurtful or acrid matters, or of contaminating secretions, surgical operations, external injuries, and violent exertion.quot;

The symptoms of Symptomatic Fever are acceleration of the pulse, increased respiration, increased heat of the skin, with occasional attacks of chilliness, glassiness of the eye, dryness of the mouth, general excitement of the system, restlessness, and thirst.

Symptomatic Fever is an index to organic peculiarities. Well-bred horses occasionally manifest it in a highly marked degree. The most severe forms of Symptomatic Fever are observed in Laminitis, Enteritis, Scarlatina, and in acute Opthalmia, both in its specific and common types; while its mildest forms are observed in some of the traumatic states of inflammation. Occasionally, however, the fever in this state is very severe. In simple flesh wounds, or simple fractures of the bones, the fever is seldom or ever violent; while in cases of open joint, particularly of the hock, the stifle, and the knee joints, the fever is frequently of a very severe character; the pulse on some occasions reaching as high as 10U beats per minute, or even more.

Perhaps Symptomatic Fever may be seen in the greatest intensity in acute Laminitis; the amount of disturbance it excites being occasionally most fearful, the pulse reaching perhaps 100,

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and tlio respiration 50 per minuta The eyes will be weeping

and blood-sliot. The body will bo bathed with hot steaming per�spiration, and from the hairs of the rnaue and tail it will literally run drop after drop in rapid successionj so great in fact, is the sympathetic disturbance on some of these occasions, that the entire organism appears as though it were in a state of acute inflammation.

Tiie Symptomatic Fever of asthenie inflammation is of a different character from the fever just described. In these cases of inflammation the pulse is feeble; in numerous instances thread-like in character. The skin is dry, warm, and cold, in patches; the fa3cal excretions arc scanty in some eases, in others watery and profuse; and at ail times emitting an effluvia more or less disagreeable. The symptoms, in short, are such as we should naturally expect to be present where the blood is loaded with impure and poisonous matters, and the organism debilitated from old age and excessive labour, and perhaps deficiency of food.

It must be understood, however, that fever in the horse may exist as an independent disease. When present in a primary form, it is designated Idiopathic Fever, from idios, peculiar, and p(dhos, disease; meaning fever which is primary, or not consecutive of any other malady. Of the nature of Idiopathic Fever, its symptoms, peculiarities, and causes, we shall treat hereafter.

V.�STATE OF THE BLOOD IN INFLAMMATION.

The Blood is a living fluid; and like all other substances and bodies endowed with life, it is influenced by changes and mutations from without.

Its life was possessed by other states and forms of matter prior to its existence in blood; so that blood may really be said to have its life independent of the organism in which it may exist, and whose pabulum it is.

Llaquo;M

BLOOB IN' liKAl.TII.

:?9

quot; The blood, as it eirculates, gives to each organ the means of repairing itself; first, by furnishing it with material of new growth ; secondly, by washing away from it in a dissolved state whatever elements of its tissues have become worn out and useless-It undergoes changes of its own�it undergoes a process of growth. In addition to receiving now matter from the food, and old matter from the tissues, in addition to feeding the several organs, and supplying the several excretions of the body, it under�goes progressive changes analogous to the growth of the solid tissues.quot;*

In severe inflammatory disease, it also undergoes changes of a character remarkable; changes with which the veterinary student should make himself acquainted. To enable him the more clearly to understand the nature of these changes, it will be of service to explain, in a brief manner, the constitution and. state of the blood in health.

The blood, as it exists in the body, is of two kinds, arterial and venous. Arterial blood, is of a bright red, or scarlet colour. It is what we may denominate the pure material, whence is built the entire animal body. Venous blood, is impure blood. It is of a dark purple colour, totally unfit for purposes of nutrition, being loaded with substances derived from the waste unceasingly going on within the organism.

The specific gravity of blood varies according to circumstances, sometimes being as low as 1.3^, in other cases as high as 1.8C, or 1.87. It will naturally vary in health to a considerable extent. In horses kept on poor diet and laboured severely, the blood will be poor also; while in young well-fed horses, the blood will be rich, and contain a great abundance of the nutritious elements.

Blood, when floating in the vessels of the body, is an

* Simnn's Lectures on PathologT.

#9632;W

INFLAMMATION',

homogeneous fluid, of a deep red colour, of a sickly odour, and of a sickly saltish taste; when abstracted from the body, it speedily loses its homogeneous character, and changes occur within it which require a brief notice. If the abstracted fluid be collected into a glass vessel, say eight or ten inches in depth, and three or four inches in diameter, the best form of vessel wherein to observe its changes, it will quickly assume a state of solidity; after which, a watery portion may bo seen slowly to separate itself, until at the end of from thirty to forty hours, the solid mass will become so reduced in bulk, and the watery exudations so abundant, that the solid portion will float, or nearly so, in the watery one. The watery portion is called serum�the sermn of the blood; the solid portion is its crassamentum, or clot.

The serum is of a pale yellow or amber colour; of a specific gravity varying from 1.22 to about 1.28. It is destitute of smell, and adhesive to the fingers. If a quantity of this be poured into a test tube, and heated over the flame of a spirit lamp, a certain portion will become precipitated and more solid. The substance precipitated is called albumen. It is similar in every respect to the white of an egg.

According to M�ller, 100 parts of equine serum contain upon the average about 9.9 of albumen to 90.1 of water. The water also contains carbonate of soda, chloride of sodium, and the phosphates of lime and magnesia, and small portions of fatty matter. The uses of albumen to the organism are highly important. quot; It exists in two states: fluid, being dissolved in the scram of the blood, and in some of the secretions; and solid, forming certain of the tissues, which are thence called albuminous tissues. These are the brain, spinal cord and nerves, and the mucous membranes; it also enters into the composition of the muscles, and of the aqueous and vitreous humours of the eye. It is also contained in the effusions of the serum and pus, which are the products of disease.

liLOOD IS HEALTH.

According to Mulder, this principle yields the fulluwing elements in one hundred parts :quot;*

Nitrogen ... Carbon Hydrogen Oxygen ... Pliosphorns Sulphur ...

15.83

54.84

7.09

31.23

0.33

0.68

100.00

It is the principal agent for supplying the new material required by the muscular and nervous tissues, in consequence of the waste perpetually going on within them. Albumen, in fact, is the pabulum of the greater part of the entire animal.

The Crassamentum, or clot, is a substance of threefold com�bination. It consists

1st.�Of Fibrinc;

2nd.�Eed Corpuscles; and

3rd.�Of White or Colourless Corpuscles.

The Fibrinc and the Red Corpuscles admit of being readily separated from each other. By gently washing the whole in water, the red particles disappear, and a tenacious substance is left of a yellowish grey colour. This is the fibrine, or one of the substances which give density to the vital fluid. Fibrine is the same, or nearly so, in chemical composition as the albumen; and it appears from the most recent investigations with regard to its general properties in relation to the organism, that it supplies new material to meet the waste going on within the fibrous tissues, such as the ligaments and tendons.

� Todd and Bowman's '' FfayBiological Anatomy and Physiology of Man,quot; Vol. 1. p. 37. VOL. I.nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp;F.

INFLAMMATION,

It is the principal agent alsu in checking tho flow of blood from wounded blood vessels, being that hi foot which coagulates, and by coagulating' completely plugs up the mouths of the injured vessels.

Blood Discs.

If we take a needle, and with its point pierce the blood-clot before it is washed, a small particle of the red colour will adhere to the metal. By spreading this particle upon a clean piece of glass, and placing it under a microscope of high power, we speedily observe this red particle resolve itself into numerous bodies of exceeding minuteness of a circular form, and having flat surfaces, similar to those shewn in the annexed engraving.

PJOORB V[.


	* *amp;)#**	fr
	% ^G	i

Blood DiPCS of the Horse, magnified aboul 3-500 iliamctcrs..

These are the Blood Discs, or by some called red corpuscles, the uses of which are to carry oxygon from the lungs to eve;quot;y part of the organism; and also, in association with albumen, to supply new material to the muscular and nervous tissues.

Some writers describe the red corpuscles as being quot;circular double concave lenses.quot;-' Their appearance, however, will vary according to circumstances, such as the arrangement of the light

* Toilrt and Boivman, Vol. 2, p. ��T.

BLOOD IN IlKALTI

when the ilisus are under the microscope, und also the density of the

rtuid in whiuli the corpuscles may float at the moment of examina�tion. The blood discs of the horse are less in size than those of the human being. The latter arc described as varying quot;from tjuVjj to .j�V� ^�f ^al1 i¹¹⁰'¹ 'u diameter�the average being from the ~~_3s¹_(gt;0~~

^lO TfTrTTn-

White or Colomiess Corpuscles.

quot; These particles are found in all kinds of blood. They are spherical bodies destitute of colour; in size they slightly exceed the red corpuscles; in mammalia, they are much fewer in number than the colourless discs; it is said they exist in the proportion of one colourless to fifty coloured.quot; The uses of the colourless corpuscles have nut been clearly ascertained. By some they are regarded as the pabulum whence the coloured discs have their origin. Dr. Carpenter and others regard them us the source of the fibrine of the blood.

Having enumerated the principal constituents of the blood, the reader, we trust, will now be better prepared to understand the condition of the vital fluid during the inflammatory process.

One of the earliest changes within the blood, is that of the fibrine becoming more abundant, and in the sthenic forms of the disease, more dense also. If blood be abstracted during the ex�istence of a severe inflammatory disease, and allowed to remain at rest, it will coagulate, and its serum will separate, but the clot will present a different appearance. This clot will be cupped, or concave, upon its superior surface; and instead of the mass pre�senting a red colour throughout, or nearly so, a portion only will be occupied by the red corpuscles; the corpuscles will congregate at the lower portion of the dot, taking up perhaps little more

� Todil and Bowman, Vol. i p. 397. I Ibid

#9632;

INFLAMMATION,

than half the depth of the coagi�um ; while the remaiuiug half, the superior half, will he of a clear pale yellow colour. This pale yellow coloured substance is the altered and more abundant fibrine ; a substance which is commonly called quot; huffy bloocT; or quot; the bufiy coat of the bloodquot;. In acute sthenic forms of inflammation, the clot always possesses great firmness and solidity; while in the asthenic forms, it is soft and lax; and as a matter of course less serum is exuded. The Red Corpuscles also undergo a marked change. Instead of retaining that clear round flat form, so characteristic when viewed under a good lens, they adhere more together in masses, as shewn in figures VII. and YIII.

Flit. YI1, is a microscopic view of a drop of inflammatory blood from the human being. In this Figure it will be seen the Pied Corpuscles have lost that well defined circular form so characteristic of these bodies, and the whole to have become adherent in the manner represented. The globular bodies are the White Corpuscles, they are represented as set apart from the rest. The above Engraving is copied from quot;Carpenter's Principles of Human Physiology,quot; p. 190.

koa

DISEASED BLOOD.

Fig. VIII, represents the Blood Discs in rolls, similar to a number of coins placed in immediate contact with each other.

The appearances however now treated upon, are not absolutely peculiar to inflammatory blood. Bufl'y blood, or rather blood having a buft'y appearance, is frequently seen in health.' The corpuscles also in health occasionally manifest a rolled appearance, similar to the bodies shewn in figure VIII. Butfy blood will also be found to exist when the organism is debilitated. During the prevalence of epidemic disease of a nature to involve the nervous system, and where debility as a consequence supervenes, the blood will always be found to present the buffy condition; thus proving to some extent the truth of the old proverb, viz, that quot; extremes in either way produce similar effects.quot; But there arc peculiar and well marked differences after all�differences which admit of an easy recognition. The buff of blood abstracted from the system during the time it is affected with some acute inflammatory disease, as, for example, in acute Rheumatism, Pleuritis, or acute Pneumonia, will be found, in the first place, to have the surface of its clot hollowed, or deeply concave. Second, to possess greater firmness. The clot in acute inflammatory diseases, is always exceedingly firm and solid. Third, the clot is more leathery, and v ot so clear in colour. Fourth, the bufl'y mass is always far more abundant; so abundant in fact is the butt', in some specimens of inflammatory blood, that frequently one half of the clot, or nearly

46nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; IM-'LA.MMATIO.V,

su, will be free from any red or corpuscular sediment. Of this we have from time to time witnessed numerous examples, particularly in cases of acute stlienic Pleuritis. Fifth, the red corpuscles are less numerous than in health. Sixth, the rolls or congregated discs of infiammatory blood are always more numerous both in the number of discs which may congregate into a mass, and in the number of masses also. Seventh, another difference in the latter state is, that the discs will thus accumulate while within the living vessels; but in health no such change within vessels is ever observed. In Scarlatina Maligna, the condition of the blood is greatly altered from its normal state. Its corpuscles undergo im�portant changes in form; vast numbers lose their well defined circularity, become broken, or elongated, shrunken and contorted in various ways.

The peculiarities and peculiar changes now described, arc present to a greater or less extent in the blood of the horse in every case of acute sthenic inflammatory disease; while in the asthenic states, the changes within the vital fluid arc of a similar character on some occasions, and different again in others. In the latter types, the blood seldom coagulates into a firm clot. It is also invariably less bright in colour; while on numerous occasions it will be found black or tar like, intermingled with patches of a blue colour, and passing far more readily into putridity.

Sometimes changes of a still more peculiar character, are observed, respecting which we are unable to give the reader any satisfactory explanation. In our remarks upon Bletastatic In-fiammation, we alluded to a case detailed in the quot;Veterinarianquot; for 18-11), page -t'J-J, by Mr. Bonghton. In that case the blood of the animal was found to present peculiarities which so far as we know are unique.

The surface of the blood withdrawn from the animal diseased

TI1FO�Y OF.

was quot;of a deep blue or purple colour.quot; So well marked in fact was the colour, that the pin was removed from the neck, and more blood was abstracted and caught in a tumbler glass, in order that the fluid might be better observed. quot;Here,quot; says the writer, quot;the mass assumed a dark nankeen (yellow) colour, the lower part gradually changing towards a blue; and by the time the serum had separated from the clot, the solid portion from a light blue, gradually deepened to a most beautiful purple, which ended at last in the most perfect black,quot; the observer (Mr. B.) ever saw blood exhibit. The blood retained the same appearance for days after it was abstracted. The animal died, and the blood within the body was found to present the same uncommon appearances.

VI.�THEORY OF INFLAMMATION.

Theory, from the Greek word theoreo, I behold, or contem�plate, quot;is,quot; says Richardson, in his admirable Dictionary, quot;a general collection of inferences drawn from facts, and compressed into principles.quot;

The term theory is one which is frequently misapplied, and that too by writers who should be more exact in their phraseology. It is frequently used as a term synonymous with the term hypofJicsk. Without entering into any elaborate analysis to shew the wide difference which exists with regard to the meaning of the two words, or rather perhaps which ought to exist, wc may remark, that wc regard the term hypothesis, as synonymous with conjecture, or mere speculation; while the term theory, we regard as relating to the rational explanation which science may afford upon any particular subject to which it may refer.

A theory of any particular art, for example, is the rational explanation which science may give to the facts of such art. The principles or laws of navigation constitute navigation a science.

48nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; INFLAMMATION,

To guide a ship across the Atlantic, is an art. Art relates to prac�tice, to manual operations. Theory, or science, is a thing of the mind. A theory then of inflammation, is the rational explanation which physiological science aftbrds of the phenomena of inflam�mation.

The world has been favoured with numerous hypothetical speculations regarding inflainniation; but we question if a theory complete in all essentials, or in other words, one which fully elucidates all the features peculiar to and developed by the inflam�matory process, yet exists. The facts of inflainniation are, that the part inflamed becomes red; that it throbs, swells, is painful, and hot j that the functions are disordered; that the blood under�goes changes, and the solid constituents of the part undergo changes also; and that the process is attended with more or less febrile disturbance of the system.

The facts now enumerated are the conditions of the inflam�matory process; and it is with regard to the natureoi this process, that the Theory of Inflammation will be found to relate.

The Redness is due to the accumulation of blood within the capillaries. Red Corpuscles are admitted in great numbers where previously few if any were admitted.

The Throbbing arises from the beating of these small blood�vessels ; more blood is passing through them in the same period of time than formerly, and every throb will be found synchronous, with the beating of the heart.

The Swelling is due to the turgesence of the capillary blood�vessels, and to the passive infiltration of serous fluid within the interstices of the tissues inflamed.

The Pain arises fivftu the stretching to which the sensitive

�^

THEORY OF.

nerves of the part are subject, or, it may also in part arise from the morbid change affecting the sensibility of the nervous tissue.

The Heat arises partly from the increased accumulation of blood, and partly from the increased action going on within the structures diseased. Action and heat arc inseparable. Hence, increased action within the capillaries of a part, will, as a matter of course, give rise to an increased temperature.

The Functions of the part are deranged. This is a natural consequence. Did the functions go on with the same regularity as before, the structures affected would be in a normal and an abnormal state at the same tune�a simple impossibility.

With regard to the other conditions, viz, changes in the blood, changes in the solids, and the febrile commotion of the system, we have treated upon them elsewhere, in a manner which we trust will prove sufficiently comprehensive to the reader.

One more observation or two upon this matter, and we dismiss this part of our inquiry.

The capillaries, when inflamed, become more numerous, par�ticularly under chronic states of inflammatory disease; and they also become greatly enlarged, examples of which may be seen in the limb of a horse affected with chronic Grease, and also in most other forms of inflammatory disease of a chronic nature.

State of the Capillaries.

We now arrive at the consideration of one of the most im�portant problems of the entire question; viz, the state of the Capillaries, at the commencement and during the existence of the inflammatory processes, in all their various stages and forms. It

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appears rational to believe that the state of the capillary vessels will vary as the inflammation itself may vary. Their state, for example, will be different in the sthenic, from what they are in the astheuic types. It is also equally rational to believe that they will be different at the commencement, or onset, of an inflammatory disease, from what they arc when the disease has become fairly established; but whether such differences be those of degree merely, or they are radically different during the existence and succession of these various stages and conditions, are questions of deep interest alike to the Pathologist and Veterinarian.

The forces which impel the blood over and through the organism, are of a vital and mechanical nature; the latter being dependent upon the entirety of the former for their power of active exertion during the life of the organism; so that the entire power of the organism to resist disease, centres itself in the vital power. The mechanical forces we allude to, arise from the impulse of the heart's action upon the vital fluid, and the pressure of the walls of the blood vessels upon the fluid within, caused by the elasticity and contractility of these vessels; but it must be clear to any one who reflects upon the question, that the first impulse received by the blood, arises, in the higher animals at least, from the living force resident within the heart and larger blood vessels; and although vital force and physical force exist in intimate association, yet, vital force is the force to which our cftorts in inflammation must in the main be directed to understand, and in our treatment to uphold.

The principal questions to understand, and if possible to solve, are

1.�What is the state of the arteries and capillaries immediately involved in the inflammatory pro�cess�locally in the sthenic, and locally and generally in the astheuic forms of the disease, 'I

ISraquo;laquo;

THfoRV OF.

�l

2.�What is tliu nature of the power which determines an abnormal amount of blood to a part when in-fiamed 1

3.�What are the causes which operate in inflammation,

in giving rise to an abnormal amount of the fibrine of the bluod #9632; and a decrease in the quan�tity of its red corpuscles ?

1.�With regard to the first question we may say it seems to be admitted, that the primary state of the arteries and capillaries immediately involved, in the inflammatory process, is that of dila�tation of their calibre ; and the state which immediately follows, is that of accumulation of blood, from the retardation of its motion. Upon close examination this appears to be partially true, but not wholly so. We do not think that dilatation of the blood vessels of a part taking on the inflammatory process, is the primary con�dition in all cases. It is the case in the asthenic forms of the malady, but not in the sthenic ones. In the latter forms, a state of constriction of the capillaries affected is the primary state ; and relaxation, dilatation, and turgescence, are secondary cfl'ects.

The character of the pulse under the two forms of inflamma�tion is very different at the onset; and such as to clearly warrant these conclusions. In the asthenic forms, as in Typhoid Pneumo�nia, the disease frequently commences so insidiously, that by the young practitioner its existence may not be suspected, until near the dissolution of the patient. The pulse from the first is soft and feeble, and easily compressed ; and the action of the heart evinces the want of that peculiar sensation to the hand, of power within the organ, so characteristic when the animal is in perfect vigour; while the pulse in the sthenic forms, is generally at the onset compressed, and hard in character. It resists the pressure of the finger upon the artery-�this is the period of its constriction :

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afterwards it becomes softer, more compressible, and more rapid. This we consider to mark its dilatation,and turgescence; or mother words, the second stage of the inflammatory process. The vital power of the circulatory organs, is not a power entirely indepen�dent of the other great organs and centres of life. Life is a whole, or a force which w^rorks from centre to peripheries, and from per-pheries back again to a centre. A cause of inflammation may also produce cft'ects of a morbid nature, in the same directions; and from the fact of this reverseness of origin in the operation of causes productive of inflammation, we, to some extent, account for the difference between the sthenic, and the asthenic forms of inflam�mation : the sthenic, as originating from the operation of causes acting upon the periphery of the tissues j the asthenic, from the operation of causes acting upon the centres of the life forces. Causes operating upon centres, will necessarily affect the entire system in a direct manner ; and this is precisely in accordance with the phenomena attending the asthenic forms of inflammation; while in the sthenic types, the inflammatory process is always at the onset limited in its direct effects to a locality. Some of these local inflammations we grant are of exceeding severity; so severe indeed, as to constitute common causes of death. But although the residt is so frequently fatal, yet the manner in which such result originates is different from the former.'

quot;We conclude, then with regard to this matter, by observing,

1.�That in the generality of cases of inflammation of the sthenic order in the horse, the proximate cause operates first in producing constriction of the vessels involved; while the second stage, is that of dilatation of their calibre, and consequent tur-gescence from the accumulation of blood.

2.�That this dilatation of the vesselraquo;, a dilatation from

THEORY OF.

relaxation, or loss of power within their tissues, is closely analogous in many respects to paralysis.

3.�That in inflammation of the true asthenic types, although the disease is destructive locally, yet the vascular system of the entire organism is more or less in the paralytic state.

The second question is, of what nature is the power or in�fluence, which determines more blood to a part when inflamed, than when in health'?

The above is a fact apparently of a simple nature; and yet it appears to greatly puzzle our best medical writers, in rationally accounting for it. It really seems, however, upon a close con-sideratiun of the question, that such writers have, of themselves, created many of the difficulties which are put forth as all but in�superable. Without stating these difficulties, and afterwards dis�cussing their validity, the usual practise in matters of this nature, we shall simply state our own views upon the question, leaving discussion to those who may possess a fondness, and a greater aptitude for controversial display, than we either have, or profess to claim.

The presiding powers of the organism are those which pertain to the nervous system. These powers are the supreme powers of the sensational, volitional, and organic spheres of the animal economy. The cerebro-spinal-nervons system, presides specially over the sen-sorial, and the volitional spheres; and the sympathetic, over the organic sphere. In other words, we regard the sympathetic ner�vous system, as the source of the vitality possessed by the arteries and capillaries of the organism; and that it also possesses the regulating power with respect to the functions of nutrition and growth of the tissues. Each ganglia we consider as a kind of

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bruin, or independeut nervous centre, tu which impressions arc conveyed as to the state of those tissues to which organic nervous filaments are distributed ; so that according to the nature of the impressions conveyed, will be the nature of the capillary action excited in return.

The heart is a muscular organ. The arteries possess three coats, one of which is muscular; and it is to this muscular coat that the contractility possessed by the arterial system is imme�diately due.

The organic nervous system is largely distributed to the heart, the arteries, and to the capillaries. quot; The nerves,quot; says Dr. Cop�land, quot; which supply the arteries and capillaries, are chiefly ganglial, or derived from the organic or sympathetic system. But filaments from adjacent parts of the cerebro-spmal system com-munieates with them. Ganglial nerves have been traced around the arteries as far as the interior of the cranium and the principal arteries of the extremities, by Weber and the author (Dr. Copland), in 181G and 1817, and more recently by Eibes and others ; and there can be uo doubt that they extend even to the capillaries, endowing these vessels with influence, and with properties evinced by them in health and disease.quot;

It is the power exercised by the organic-nervous system�a system of nerves inwoven within the tissues of the arteries and capillaries of every part�which, in our opinion, determines an abnormal amount of blood to a part when inflamed. If the sym�pathetic nervous system, inwoven as it is with every tissue and structure having to do with the organic sphere of animal life, and intimately connected, as it is, with the sensational and volitional spheres also, by means of an interchange of nervous filaments with the cerebro spinal system, be not the system which specially pre�sides over the organic functions, uniting such functions with the

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functions of the other spheres, for what other purposes, we ask, has the sympathetic nervous system been designed 1 We know of no other uses to which wo can assign it.

Assuming such to be the uses of the sympathetic nervous sys�tem, we regard the determining of an abnormal amount of blood to tissues when inflamed, as closely analagous to the manner in which sensational impressions are conducted by a sensational nerve to its centre, which sensation in turn, is productive of a motor influence. As the peripheral fibres of a sensational nerve convey sensitive im�pressions along the trunk of the nerve to its centre, thus making the centre acquainted with the state of its peripheral tissues, so do certain fibrilke of the organic nervous system, convey a know�ledge of the state of their peripheral capillaries, to the centres of organic nervous power; and a greater or less amount of blood is. determined to the peripheral capillaries accordingly.

The explanation now given may be objected to on the ground that no double set of fibres, possessing a double function in the organic nervous system, have up to this time been demonstrated anatomically ; to which we can only reply, that the central organs of life, are by some means or other, made acquainted with the state of the tissues remotely situated ; and that they regularly receive when in health a natural amount of nutrition ; and that, if such functions be not dependant upon the integrity of the organic nervous system, then we arc compelled to admit the existence of phenomena, the causes of which we are totally inadequate to explain.

We do not say that this transmitted knowledge as to the organic state of the tissues, is sensational, in the ordinary sense of the word; nor that the influence which determines an abnormal amount of blood to the part when inflamed, is motor influence, in the ordin�r;/ sense, implied by the word motor. We simply say.

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that such transmitted knowledge, and such doternmiiug inHucuco, are each transmitted in a manner clusely analagous to the sen�sational and motor influences.

Mr. Simon, in his excellent quot; Lectures on Pathology,quot; in refer�ence to the present question, expresses himself as of opinion, that this determining influence is independent of nervous influence ;� quot;that it occurs hy virtue of some law regulating the molecular growth of the invaded textures, and in immediate consequence of changes in their organic condition ; and that these changes, what�ever may be their method of operation, are competent to affect the stream of capillary circulation ; first, to quicken and narrow it; next, to widen and retard it; finally, to solidify and arrest it.quot; The opinion, that quot;it occurs by virtue oi some law,quot; amounts to an avowal of an entire ignorance as to the determining cause.

The third question, or, to what are we to ascribe the changes in the blood? these changes being first, an increase in the fibrine beyond its normal amount, and second, a decrease in the number of Eed Corpuscles; and not only is there present this increase and decrease, but the changes go on in the same direction, so long as the inflammatory state is upon the ascendant. To these questions we have given our earnest attention, and after all, we candidly confess our inability to afford a satisfactory solution of the difficul�ties involved. We arc strongly of opinion however, that the cause of these phenomena is somehow dependent upon, or insepa�rably associated with, that extensive disturbance in the functions cf the organism which is present during the existence of the inflam�matory disease. We are of opinion also, that what probably may fully account for the phenomena in one kind of inflammation, will not necessarily account for it iu another. Few if any, of the numerous authors who have written upon inflammation attempt fully to grapple with these questions, all admit the facts, but none afford a satisfactory solution as to the why and the wherefore.

k�JM

THEORY OF.

Physicians formerly attributed the proximate cause of inflam�mation to the blood, or quot;to a vitiated state of the fluids of the body, and of the blood in partioular.quot; But whether the exciting causes of inflammation operate upon the blood in the first instance and upon the solids consecutively, or upon both simultaneously, are questions of little or no importance, practically speaking. It is highly probable that the exciting causes operate by all the modes here specified. What wc really require to know is, how arc these states of the blood produced.

It is clear that the causes are to be sought for within the organism, and that, too, within a circumscribed area of causation.

We have spoken of these changes of the blood as somehow being associated with that general disorder of the functions so prominent in the severer forms of the disease.

The sentence, quot;more or less disorder of function,quot; admits of a wide latitude of expression. A great number of functions are performed within the organism of a horse. Within the lungs the most important changes occur with regard to the blood. The liver, secretes bile; the kidneys, urine; the stomach, gastric juice; certaiu glands within the duodenum and small intestines, secrete fluids of a peculiar nature; the pancreas, pancreatic juice; the skin secretes, and also exhales, what it secretes; while within the muscular and nervous tissues, molecular changes of a very peculiar and highly important nature arc every moment in operation; in fine, a vast number of changes arc perpetually occurring, arid will continue to occur, so long as life occupies its citadel. When wc speak, then, of quot;disorder of functionquot; as arising from inflammation, we mean neither more nor less than a derangement of the entire organism.

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It is difficult to satisfy ourselves with the belief that in de�rangements of so extensive a character, the immediate effect pro�duced, is simply mere suspension, or increased excitement of the functions enumerated. On the contrary, it does not appear irrational to believe that such extensive disturbance may in some way so direct or change the secretory functions, as to turn the force of the organism to the production of fibrine. Conjecture however is useless. Before this question can be settled, it is necessary to know the uses of fibrine, or the purposes of its existence; and it is also necessary to know the relation it holds to the other constituents of the vital fluid. These are matters which require to be fully understood, and until they are understood, it is mere labour in vain to attempt a solution of the problem.

Until very recently it was held as an article of belief amongst physiologists, that fibrine was the highest animalized constituent of the blood; that albumen was converted into fibrine, and while in the state of fibrine, it was seized upon by the muscular tissues, and appropriated as nutrition. Muscular tissue was analyzed, and the analysis compared with the analysis of fibrine. It was at first asserted that the two were identical. Closer observation, however, has led to the conviction that the two are not identical, but that fibrine holds a nearer relation to the fibrous tissues.

An accurate knowledge of physiology can alone enable us to obtain an accurate knowledge of pathology; and until we fully understand the physiology of fibrine, a correct theory of inflam�mation cannot be deduced.

VII.�TREATMENT OF INFLAMMATION.

The treatment proper to pursue with a sick horse,'is of a two-fold character:�viz, Medical treatment, and Hygienic treatment.

TREATMENT OF.

.59

Medical treatment comprises all that comes within the scope and duties of the Veterinary Surgeon; while Hygienic treatment comprises all that comes within the scope and duties of those having the immediate care and management of the animal, both in health and in periods of sickness. It is the duty of the Veterinarian, however, while he personally superintends the former, also at such times t3 direct the latter. Without the aid and con�stant care of a judicious and experienced groom, one who is really a nurse to the patient, the efforts of medicine and of the best Veterinary Surgeon may prove to be of little or no avail. For example, a horse labouring under acute Pneumonia requires the most careful and judicious hygienic management. Otherwise, of what avail would be the best specifics in such a case ? The animal also requires a comfortable stable; requires pure air, warmth, dryness, and a moderate quantity of light; requires comfortable clothing, nicely prepared food given to him in small quantities, and frequently; he also requires to be gone to gently and steadily, not shouted at, or pulled violently or hurriedly about. When all these advantages are absent; when the stable is foul, cold and damp; when the patient has little or no clothing; when ho obtains his food as it may chance, and that too perhaps of a bad quality; when in fact, as is too frequently the case, the patient is entrusted to any one who will take the trouble to do anything towards what may be required, we must expect the most skilful efforts of the medical attendant to meet with tjtal defeat. An ex�perienced nurse of a sick horse is of great importance to the success of therapeutical aid; audit behoves both the owner and the Veterinarian to observe with watchful eye those who may bo entrusted with the responsibility which necessarily attaches to these hygienic duties.

We purpose, then, to remark upon Medical *eatmcnt, and afterwards upon Hygienic treatment.

The principles of cure to be pursued in the treatment of

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inflamnmtiou demand the earnest attention of the Veterinary Surgeon. In the successful treatment of disease the value of the Veterinary practitioner to the community at large really centres. It matters not how accomplished he may be in scholastic attain�ments, how many modern languages he may be able to speak, how many colleges he may have visited or graduated at, or what amount of information he may possess of a general character; the chief question with those who employ him will be. Can he cure? It is one thing to understand principles of cure, it is another to apply them successfully. Sometimes the two are associated in one man. The combination of a knowledge of the principles of science in any of its branches, and a ready and efficient application of such principles to practice, are elements which go to constitute a great man.

The reader must not suppose that we are opposed to the acquirement of deep and extensive information. By no means are we to be so understood. On the contrary, we assert the reverse. Let the Veterinary Surgeon be educated to the highest degree possible; but at the same time we urge that the greatest attention be paid to what is really practical and useful. In the profession of the healing art, mere scholastic display is useless. Let those who possess knowledge strive to make it useful to the community.

quot; The highest object of medicine is to remove morbid phen�omena; or, in other words, to restore health in the safest, quickest, and most pleasant manner. A medical doctrine is of no value ex�cept in so far as it fulfils that end.quot;

In the present section upon the Treatment of Inflammation, we shall do little more than refer to general rules of practice, and to matters on which such rules are dependent for success; matters

TREATMENT OF.

which in many cases are either overlooked, or iyuorautly gone in opposition to.

The most important matter for the Veterinary Surgeon to fully comprehend�assuming that he understands the nature of the malady he may be called upon to treat�is a knowledge of the Law of Healing; that law being expressed as follows : �

Diseases are cured hy such medicines as have the IMioer of producing in healthy animals, symp�toms similar to those which characterise the diseases themselves.

We have on a former occasion explained this law.* Perhaps a closer explanation may be necessary on the present occasion. Diseases are cured, by remedies capable of producing similar effects. This to any one who may strictly regard the precise meaning of each word, will doubtless bo clear enough; but many parties, on this question especially, judge loosely, and quot;similar thingsquot; they understand to mean quot; the same things.quot; It must be distinctly understood we mean by similar not the same, hut having a resemblance to; and here another question arises, to what extent should tins similarity extend ? The law of similars is based in pathology; otherwise it is of no practical value to medicine. Mere similarity of objective symptoms is in itself veiy little. The medicine chosen must be such as if given to the patient in health, would affect the same organs or tissues in a manner closely similar to the disease sought to be cured. Every medicine is capable of producing certain effects of a direct or specific character upon one or more of the various organs and tissues of the body. This direct action may be limited to the mucous membranes, or to the serous structures. Other remedies again, have a direct action upon the brain only, or the spinal cord, or the sympathetic nervous

* See Introduction ilt;raquo; tht- Author's quot;Elements of Veterinary EXonucopatliy.quot;

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system. quot;Whatever organ or tissue, however, the primary action of a drug may be exerted upon, we must on all occasions expect to find secondary symptoms, or symptoms excited in other organs or tissues of a sympathetic nature. The sympathetic symptoms we may regard as closely analagous to sympathetic fever in inflam�mation ; while the primary action, may in like manner be regarded as the inflammation causing the sympathetic disturbance. In choosing a remedy then, strictly, in accordance with the law, attention must be directed to the prim�r)/ action of the drug. If, for example, a remedy be required whose primary action is exerted upon a serous membrane, it is of no use expecting aid from a remedy whose primary action is exerted upon a mucous membrane. A remedy in such a case must be chosen whose primary sphere of action is exerted upon the serous membranes, and the nature of which action is as closely similar as possible to the disease requiring to be removed. Such is the law; the truth of which becomes less and less questionable daily. We do not profess, however, to be the exclusive exponents of any one rigid course of practice or system of medical treatment. We claim for this law of cure the highest place at all times; but conditions arise, and morbid phenomena present themselves, which require aids of an auxiliary nature. The law is not at all times applicable, or rather, conditions occasionally arises which render it to a certain extent nugatory We cordially agree with Dr. Dudgeon, who says:�quot;cases do occur in which it is necessary to resort to other than Homoeopathic means for their cure; and he is the best practitioner who knows how and when to avail himself of all the aids and appliances nature and art have placed at our disposal for the cure of disease, or ir,s palliation when incurable.quot;* What these auxiliaries are, and under what circumstances w^Te are warranted in their use�we are warranted in the use of anything by which positive good can bo obtained�the reader will gather as he proceeds.

� Dudgeon's ^t; Lectures on Homccopatby,quot; page iJOO.

TREATMENT OF.

^33

It must be borne in mind, with regard to the proving of medicines upon the system of the healthy horse, that the Veterinary Surgeon, in a vast number of diseases which come under his care, has little else to guide him to the proper selection of a remedy, or one fully in accordance with the law of similars, than mere analogy; and at times this analogy is of so vague and unsatisfactory a character, as to totally debar any conscientious practitioner from strictly adhering to any one rigid rule. The duty of a practitioner when called to a patient, is plain. It is to cure the patient by the most certain and ready mode experience may enable him at the time to pursue.

Dr. John Hunter laid it down as a rule in practice, quot;that in curing disease, our efforts should be directed to allay morbid irritation, and at the same time give support to the vital energies.quot; This rale is a sound one; and if duly acted upon fewer butcheries would be perpetrated upon the lower animals than are perpetrated under the warrant and sanction of what is erroneously designated quot;Veterinary Science.quot;

A clear understanding, as to the nature of the law of similars, and a right use of it in practice, together with the use of such auxiliaries as necessity may require, will accomplish all that human skill can accomplish in fulfilling the conditions of cure em�braced in the Huuterian rule.

It is a fact greatly to be deplored, however, that numbers who practise the healing art seem incapable of rising to a full comprehension of the intrinsic value of a law. They appear to think that law, or no law, the healing art amounts to the same thing. It must be obvious, however, to those who reflect, that obedience to law means working to method�ivorhing to certainty. Where all the conditions under which a law operates are under�stood, and where all the obstacles to its free operation are known

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and admit of removal, the result is foreseen, expected, certain. Ent absence of law means confusion. Where the necessary con�ditions to the right action of a thing are not understood, all is dark and chaotic. Any one so practising the healing art, practises it empirically. The possession of a medical diploma docs not make that scientific, which in itself is not scientific. A law of cure can alone give to the practice of medicine a scientific character; can alone give that which is the most to be desired�certainty� as to what is done.

Let the Veterinary Surgeon then study the law of similars, and make himself practically conversant with its invaluable teachings, not only in so far as they relate to the curing of disease, but also as to the eftect of drugs upon the healthy organism of the animals he professes to treat;* a matter which ought to receive the special attention of the medical attendent.

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(Jauses.

Having dilated on the law of similars, and stated that tins law has its basis in pathology; having shewn its importance in a practical point of view to the Veterinary Surgeon; we next offer a few remarks with reference to the causes of inflammation.

The cause of inflammation must be removed in every case where practicable. In idiopathic inflammation, however, this in most instances will be found impracticable. In idiopathic Pneu�monia for example, the removal of its cause is out of our power. The disease may have arisen from exposing the animal to cold draughts of wind. All we can do in cases of this nature, is to remove the animal into more congenial circumstances, and cure the disease in the best mode available. In like manner we may remark

* For fintlicr infoimation upon this matter, see quot;Dudgeon's Lectures on Homoeo�pathy,*' '� Halinemanirs Organon,quot; or quot; Rau's Organon.quot;

TUEATMENT OF.

upon nearly every cause of disease of an idiopathic kiml. The search for, and removal of causes is most practicable in traumatic inflammation. Injury is inflicted upon a part endowed with life, but in what way does, or has the external agent produced the disturbance? Has the offending body injured the part by entering into the structures and there remaining ? as when a foot inflames, and lameness ensues from the entrance of a nail into its sole. If the injury be within a fleshy part, are splinters of wood, or pieces of metal, or pieces of glass within 1 Where practicable, the cause must be removed, and the patient so placed as to be in a position favourable to recovery; but where the removal of the former is impracticable, the latter will equally require attention.

Another condition necessary to be observed before a cure is to be expected, is, that the part inflamed must he jrfaced in a state of rest; and if absolute rest cannot be obtained, then a state as near to it as possible. The common sense of a rule like this will be evident. Hence the necessity for a loose box, in which the patient can be placed apart from excitement or dis�turbance of any kind.

Treatment of Stlienic Inflammation.

This order of inflammation presents so many forms, such as acute inflammation of the lungs, bowels, eyes, feet, lymphatics, and of the tissues in general, that in the present article we shall merely allude in a cursory way to the matter, leaving the details of treatment necessary to be pursued, until these several forms of disease are hereafter considered.

All remedies for the cure of disease, are applied either constitutionally, or localh/, or both. Without attempting to draw distinctions as to difference in action, between remedies applied

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constitutionally and locally, we shall simply consider tliem as they arise.

The Auxiliaries \vc propose to consider are Bleeding, Seda�tives, Stimulants, Counter Irritants, Tonics, Purgatives, and remedies locally applied.

Bleeding is a remedy which in former times was had recourse to for almost every ailment affecting the horse. Of late, however, its practise appears to have fallen into disrepute. For our own part, for a period of three years at a time, we have not found it necessary to bleed a single patient, although diseases of the most violent nature in one form or other, were constantly under treat�ment. It is very rarely indeed now that we abstract blood. It may, on some occasions be found of benefit, particularly in severe local inflammation, as in Laminitis, and in acute inflam�mation of the navicular joint; but we more than question its utility in such inflammatory diseases as Pneumonia, or Pleuritis. Why the abstraction of blood should prove beneficial in one case and not in the other, is, we think, obvious. In circumscribed local inflam�mation, the blood abstracted is withdrawn directly from the tissues inflamed, as in Laminitis for example, and a far less quantity suffices to make a direct impression upon the disease; while in such a disease as Pneumonia, before any impression can be made upon the part inflamed, the blood abstracted must be greater in quantity, because the abnormal quantity of blood which exists in the inflamed organ can only be lessened by an indirect process, i.e. by abstract�ing blood from the system at large; and this we find to injure the system and weaken its vital power, without conferring benefit locally equivalent to the injury inflicted upon the organism. In cases of this nature especial attention should be paid to the Hunterian rule�the economisin/j of vitcd force; and this can only be done by giving it every aid and support within our power. What shall we say then to directions such as the following?

KSi

TREATMENT OF.

quot;Under ordinary circumstances,quot; says Mr. Percival, quot;the abstrac�tion of a gallon of blood is reckoned a moderate bleeding. Under pressing disease I occasionally draw tlu'oe gallons: I have heard of four being taken.quot;* We have no hesitation in saying, that directions more atrociously destructive to animal life could not well be exceeded, unless they were such as to encompass the immediate death of the animal. quot;We used at one time to bleed patients frequently; but never during the most sanguinary days did we venture to abstract from any poor animal, three gallons of the vital fluid at one time!

Aconite is an excellent remedy. In numerous cases of acute Inflammation, such as acute Eheumatism, Pleurodyuia, Lymphatitis, Pleuritis, and Inflammation of the Bowels, it will be found a medicine of the highest value. In acute Lymphatites, Aconite may also be applied externally with benefit, using four drachms of the tincture to about a pint of tepid water, and bathing the swollen glands and distended lymphatic vessels. It is better to apply the lotion topically, immediately after fomenting the limb with hot water. We have known four or five doses of this remedy, given at intervals of from four to six hours, remove acute Eheumatism, and acute Pleurodyuia, even when these maladies were associated with a smart attack of fever.

Aconite acts upon the nervous system, and upon the tissues composing the capillary blood-vessels. It produces within the horse, a state closely analagous to inflammatory fever; in addition to which, it produces a specific effect upon the pharynx and glottis. We have, on numerous occasions, witnessed the distressing effects of this drug produced by the administration of an over-dose. The state is, and the symptoms produced are, that the vital force of the animal is severely prostrated; the respirations are disturbed; tliey become quick, short, and panting; the skin becomes suftused #9632;with a copious

* '#9632; Percival's Ilippfniatholngy,quot; Vol. 1, Second Edition, pagt y.5.

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perspiration; the pulse is quick ami soft; while a peculiar click frequently occurs in the region of the pharynx, and on some occasions the animal appears as though excited to vomit; the eyes have a dull and exceedingly depressed appearance; and the con�junctiva in the generality of cases, is copiouly injected.*

After death, when poisoned with this drug, serum has been found effused within the lateral ventricles of the brain. There has also been copious venous congestion of the lungs, congestion within the pleura, and of the serous and mucous tissues generally; and also congestion of the vessels of the investing tissues of the spinal cord.

We have not found this remedy to produce that marked effect in traumatic states of inflammation, which it does in the idiopathic forms. This is not greatly to be wondered at, when we consider that traumatic fever is wholly dependent upon an outward cause, or is a mere effect of a reflex nature, which disappears as the wound recovers. Neither is Aconite of that marked value in Pneu�monia and Bronchitis which might be anticipated. Nevertheless, cases of this nature do occur in which Aconite produces a well marked beneficial effect. It is of value in acute Opthalmia, bcth when given internally, and when applied topically, freely diluted with water; also in Gastritis, whether the disease exists alone, or is associated with Laminitis. It is moreover of value in incipie.it Glanders. Other remedies suitable to the sthenic forms of'inflam�mation could bo enumerated; but as we only here treat upon matters of a general character in relation to this brauch of the question, we refrain from specialities, until a more befitting occasion, merely indicating those remedies in this place which are considered the most suitable, viz :�Arsenicum, Belladonna, Bromine, Nux Vomiea,

* Wc have observed the symptoms here detailed, supervene on nnmerous occasions, from the administration of from twent;- to forty drops of the tincture of Aconite, made from the root of the plant.

TEKATMENT OF.

Mereurius, Bryonia, Phosphorus, Hyoscyamus, Ehus Toxiuodendron. Veratrum and Sulnhur.

Sedatives, Sedati'vus; from Sedo, to ease or assuage, quot;are medicinesquot; says Thompson quot;which directly depress the energy of the nervous system, diminishing motion in animal bodies, without inducing previous excitement. Regarded in a remedial point of view, they are powers intended to diminish preternaturally increased action in animal bodies. This increased action may display itself chiefly in the circulating system, and only in the nervous system as it is connected with the circulatory; or it may appear in the muscular system, and may affect the circulatory only in a secondary and transitory manner. Whatever may be the cause of this increased action, whether irritating matters introduced into the bod}⁷, or some state of its own economy, the substances which directly lessen this preternatural action may be considered as Sedatives; and this they effect by depressing the nervous power, and by diminishing the energy of the brain and that of the spinal marrow.quot;*

Auxiliary medicines, of this class, are frequently of good service, in the more violent forms of inflammation, such as Enteritis, and also in severe spasmodic attacks of bowel disease, and in the chronic forms of Diarrhoea and Dysentery. In maladies of this nature, we have again, and again, witnessed the benefits supervening upon the administration of a full dose of the Tincture of Opium, or a liberal dose of Chloroform given in gruel. The use of sedatives, however, at the onset of such diseases, would be productive in the generality of cases of far more injury than benefit. A closely observing practitioner, will discover the time when to administer his remedies; the time ult;hen they may be given with a probability of their acting with success. This is a matter particularly to bo observed both in acute and snbacute maladies of a similar nature. � Xhomiison'a quot;Materia Medica.*'

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With a proviso that our statements are not to be taken in a very extreme sense, or, in a sense which is absolute upon all occasions, it may with safety be affirmed, that disease once estab�lished, will, in spite of every effort to the contrary, run a certain, and in many cases, a well marked course. The tendency in acute intiammatory disease in many instances, is to pass into the sub-acute and the chronic forms; and to remain in the latter an indefinite period, unless prevented by judicious treatment. We do not assert that all acute diseases will become chronic; on the contrary, they may be cured without necessarily becoming chronic. What we mean is, that inflammatory diseases cannot be cut down as it were at a blow. If acute, they will, in spite of treatment, run a certain course; or if subacute, the same; or, if either the acute or subacute becomes chronic, the tendency of the chronic malady, if left alone, is to remain chronic for an indefinite period. The proper course to pursue, is, first to control, if possible, the violence of the disease; and second, to afford every aid we can to the vital energies. Perhaps for a time it may not be within our power to afford direct or positive aid to the vital energies; but if direct aid cannot at all times be afforded, good may result by refrmnhvj from the abstraction of hmje quantities of blood, and the adminis�tration of enormous doses of medicine, either at the onset, or during any subsequent stage of the malady. Let the reader select for observation any inflammatory disease he may choose, and study its phenomena; and he will learn the truth of what is now stated. Take a case of epidemic catarrh of an inflammatory character; watch its progress, and it will be found, in spite of all which may be done, the disease for a time will resist every effort, and every remedy to eradicate it. The patient we will suppose to be feverish, and the temperature of the body unequal; presently the throat will manifest unequivocal signs of soreness. The Homoeopath, in such a case, may give his Belladonna, or his Mercurius, together with Aconite, or other remedies of a suitable nature; or, the Allopath, may resort to his routine Blister to the neck, and region

Eftlaquo;

TEEATMENt OF.

of the throat, and his Tartar Emetic, and Camphur Balls; but in spite of all, for a time the throat will become more inflamed, and the patient more feverish, until suppuration is freely established from the diseased mucous membranes; when the patient, in all probability, if carefully treated, will speedily exhibit signs of amendment. Then is the time for the Belladonna and Mercurius, or for Mustard embrocations to be applied to the region of the throat. It would appear as though every power within the organ�ism, up to the time of suppuration being established, had either re�mained quiescent, or was directed to the production of a copious and free suppuration, to rid the system of some morbid product detri�mental to its welfare. To bring all our therapeutical force then to bear upon a disease at its onset, is bad practise. At this time our efforts, to be beneficial, should only be directed to obtain control of the malady; and while striving to acquire this control, we must be prepared to act with efficiency when the proper oppor�tunity presents itself. We have on numerous occasions had proof of the truth of these observations. During the period of our faith in time-honoured modes of medical practise, we have again and again remarked upon the inertness of opium, and of drugs of every kind, when given in large doses at the onset of attacks of this kind; while we have again and again, in similar attacks of similar intensity, witnessed their marked effect, when given at a later period. The practitioner should not only know what is the most proper thing to do when recpiired, but he should also know the most proper time to do it. Common sense will teach any one who reflects, that when a disease is violently acute, severe depletive measures cannot be the best to commence with. Should the disease continue with its original, or with a gradually increasing violence, we have nothing left to fall back upon; and if copious bleedings have been resorted to, and large doses of pur�gative medicines given, the former will certainly have debilitated the system to a severe extent, and the latter will have aided still more in the same direction.

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Lest it may be supposed that we arc overstating the practise usually pursued in cases of severe inflammatory disease, we will quote the directions relative to inflammation of the bowels, given by Mr. Percival, late V. S. to the 1st. Life Guards, whose work is one of the latest, and by the majority of the profession, considered the best veterinary treatise extant. quot;The treatment,quot; says this writer, quot;of a case of inflammation of the bowels requires on the part of the practitioner, no less promptitude than judgement. Without the one, the other will, indeed, avail but little. Tlie^/w'si and grand thing to he done, is to let hlood from the jugular vein to the utmost extent the patient lolll hear. The blood-can ought not to be taken from the neck, until evident signs of prostration demand it. Should this come on prematurely, should the horse stagger, and appear faint from loss of blood, although but a few pints have flowed, pin up the vein, and administer to him his drench, and an injection; and then, should his strength seem revived, have recourse once more to the fleam; foe blood he must lose, and in large quantities too, since upon that mainly depends his recovery.quot; The writer next prescribes a drench, containing Solution of Aloes one pint, powdered Opii ^l, and water half-a-pmt.* He next directs an injection of soap and water; then an Aloetic injection; quot;or, in case of emergency,quot; an injection of tobacco smoke. But if these should prove to be of no benefit, quot;the Prussic Acid Enema, made by mixing from one to two ounces of the acid with a gallon of water, may be made trial of, if thought prudent.quot;

He next directs that quot;hot flannels, wrung out from boiling water, may be attempted to be applied to the belly; or a sack, or bag filled with hay, and dipped in scalding hot water, may be bound up close against it; or a sheep skin but just flayed is a good application, providing it can be conflned upon the surface; but

* The Solution of Aloes ho does not give the formnla? of, hut we presume it is according to the formnhe of the London Veterinary College. If so, a pint of t'.ie solution of Aloes will contain over two ounces of Aloes dissolved.

E�f

TREATMENT OF.

unfortunately there is generally much difficulty in fixing these soothiny remedies ; and sometimes considerable danger to the per�sons engaged in their application. A mustard embrocation, made by pouring boiling vinegar slowly over the mustard, and stirring them together to a proper consistence, can at all times be rubbed on; and I am not certain that it is not, in the end, more ser�viceable than temporary heat. A Turpentine tincture of Can-tharides, made by steeping an ounce of bruised Cantharides in half a pint of spirits of Turpentine, in a stopper bottle, and kept ready for use, may be employed instead of the mustard. It is calculated to relieve not only as a blister, but as an instantaneous counter-irritant. Some dash boiling water upon the belly. The late Professor Peall used to recommend that the surface be cauterized with a broad flat firing iron. Mr. Hales, of Owestry, lias a warming pan full of hot coals passed over the belli/. Mr. Atchcrly used the actual-cautery to the abdomen, in the form of a large shovel made red hot, in the last stage, with success. Three or four hours after the first blood-letring, should no change or abatement take place, a second bleeding, though not to the same depressing extent as before, followed by the exhibition of an opiate drench, will probably be called for ; and a couple of hours after that, even a third repetition of the opium.quot;

It might be supposed that Mr. Percival would now, should the case not progress favourably, strive to assist the vital energies. No such thing. The life force must be lowered still more. quot; A demier remedy,quot; he continues, quot; we still possess,quot; provided, as he significantly remarks, quot; the case proves protracted enough to admit of its trial.quot; This dernier remedy is, two scruples of Calomel, and one of powdered Opium, to be made into a ball, and given to the patient. The ball to be repeated every four hours. quot; Under its administration quot; we are told, quot; the mouth will require watching. The first sign of its entering the system will be tainted or fetid breath; the next, reddening of the gumsquot; and so forth. quot;As for

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fooil, tlio horse will take nemo; mid even wnre ho so inclined, he should iiigt;t be allowed any. Ho may be suffered to drink as much gruel, or white water, or even plain, provided it be chilled, as lie pleases: fluids assist in bringing on purgation.quot; *

Wo cannot but express amazement, that directions of the character here given should have emanated from Mr. Percival. They are barbarous in the extreme, and display an amount of savage recklessness, which wo could scarcely have thought possible. We cannot bo supposed to entertain invidious feelings towards the author, for we never saw or were in any way in contact with him. Neither do we place this treatment in juxtaposition with Homoeo�pathy, to cry down one system of medical practice at the expense of another. Imagine a poor animal, after a severe day's labour, attacked with Inflammation of the Bowels�and the disease frequently manifests itself at snoli a time. A Veterinary Surgeon is called in, who believes the course of treatment recommended above, to be the best which can be pursued. The animal is at once bled, until ho reels and staggers. The orifice is then made secure, and a drench given containing two ounces, by weight, of Aloes in solution, one of the most powerful purgatives we possess. Bleeding is resorted to a second time, which is succeeded by an injection containing from one to two ounces of Prussic Acid. The practitioner next applies boiling water, ad lihitmn, to the abdomen and sides; he uses severe irritating blisters; he burns the abdomen with red hot irons ! or with a warming pan filled with red hct coals! or with a red hot fire shovel; and finally, we are told, as a dernier remedy, quot;should the case prove protracted enough to admit of its trialquot;, he gives a ball every four hours, containing two scruples of Calomel, until the gums are affected�the patient all the while not having one particle of food, nor anything in fact but white water or thin gruel. With remedies of the nature

� PercivoTs ' Hippopathology/' Vol. 2. part 3, pase? 335 and 336. Ncsv Edition, London; Longman and Co, 1355,

TREATMENT OF.

described, and applied as recommended, we perfectly agree with Mr. Percival that quot;the duratiou of Enteritis cannot but be short,quot; as, under the circumstances, neither the part affected, quot;nor the constitution, can v/ithstand it long.quot;

We are aware of the anxiety which a Veterinary Surgeon must occasionally feel when called to a patient suffering under acute inflammatory disease, particularly if the animal be of high value, say from one to two hundred pounds. The disease, wo will suppose to be one of those very acute attacks of Inflammation of the Bowels, which occasionally present themselves. Perhaps the veterinary attendant may be young and inexperienced, and the owner, in consequence, not over confident of his ability. The horse is plunging about. Knowing grooms are also present, who will, as opportunity may present itself, detail their experience; and to crown all, every one but the Veterinary Surgeon may be clamorous for blood. We are aware that such a position is a most anxious one. We have experienced it; and we know that a strong resolution is required to hold firm to convictions, which may be in opposition to notions entertained by others. Timid men are afraid of a small amount of violence, and are not fit to be placed in circumstances of this nature.

At all times bearing in mind the hnlt; of cure and the Hunterian rule of healing, the practitioner need not embarrass himself as to the general course he should pursue. The difficulty, when difficulty there is, will be as to the special, or particular thing necessary to bo done at the time. Violent forms of Inflam�mation cannot be left alone. Something must bo attempted; although of the alternative, it would, for the majority of patients, be preferable to leave them alone rather than pursue the course recommended by Percival. What is required at the onset of acute Inflammation is, the adoption of such measures as will, if possible, have a beneficial effect, and yet failing this, may not be

INFLAMMATION,

productive of harm. By the adoption of measures of this nature, the practitioner will not commit himself. Large doses of medicine cannot bo administered at any stage of a disease, without either good or bad as a sequence. Medicine, unless poured into a dead animal, cannot remain inert. The multiplicity of actions per�petually going on within the living structure, are certain to become affected by the drug, either for good or ill; so that it may be laid down as a rule, that a drug once given, if given in large quantities, if it does not operate to the good of the patient, will work to its injury. The course of the practitioner, until he is perfectly clear upon the matter, is at the onset, to use remedies the action of which will tend to the good of the ixitient, without the possi�bility of producing harm. We possess remedies of this nature; remedies which we venture to designate neutral, or non-medicinal. Hot and cold water are non-medicinal; and yet they are capable of producing effects upon the living body when diseased, which formerly were considered as belonging to medicines only.

Hot water, we therefore class us a neutral remedy; or a remedy of the nature indicated; and it may in the generality of

Body Sacking.

cases, be resorted to with benefit; or, at least, with a certainty of harm not resulting, unless from scalding the patient�a conse-

TREATMENT OF.

quence at all times to be prevented with ordinary care. It can bo given in moderate quantities internally, and applied almost ad lihitmn externally. The application of hot water topically in Pleurodyuia, Pleuritis, Pneumonia, and in Acute Inflammation of the Bowels, may bs readily affected by means of an article similar to the one portrayed in figure IX, of which every Veterinary Surgeon should have two or throe sizes in stock, ready for use at a moment's notice.

This article is made of strong sacking, to which is firmly attached a number of leather straps, each strap having a buckle fixed to one end. The length of the sacking should be eight or ten inches more than the circumference of the body of a large sized horse, the purpose of the article being to hold to the body and sides of the patient, a large woollen rug saturated with hot water. The rug having been placed close to, and around the animal, the body sacking is to be placed under, and below the rug, and made secure by firmly buckling it along the top of the back. By this simple contrivance, hot water can be readily applied, and firmly retained to the abdomen and sides, without fear of displacement, however violent the patient.

In procuring the body sacking, observe the following essen�tials in its construction:�

1st.�It should be made to fit the body of the horse.

2nd.�It should be eight or ten inches longer than the cir�cumference of the body of a large-sized horse, to afford sufticient space for the wet rug, when applied to the body of the patient.

3rd.�The straps should be two, or two-and-a-half inches in width, and of considerable strength.

INFLAMMATION,

4th.�The straps should traverse the entire length of the sacking, being stitched thereto a little over half their length. The straps should have so much freedom of cud, as to allow of the ends of the body-sacking folding over, should the patient be a small sized animal; by which means it can be as tightly buckled as though it were fixed to a large bodied patient. Six straps are figured in the engraving; but seven or eight may be fixed to the article, if necessary. The straps should not be more than three inches apart.

Countee Irritants frequently prove of great value, if applied at a proper time, and arc managed with care, in acute inflammat�ry diseases affecting the larynx, trachea, bronchial tubes, lungs, and pleura, and other organs internally situate. Counter Irritants we also consider of a neutral character. The remedy which we apply more frequently than any other, as a topical counter irritant, is Mustard. Its advantages are many. It does not require the removal of the hair previous to its appli�cation. It produces a smart effect, which is of short duration, if applied to a reasonable extent; and it leaves no blemish of a permanent nature.

The best mode to apply it topically, is to freely wet the hair of the part it is intended to cover, with hot water,�the mustard also to be mixed with hot water,�and, while the hair is wet and the embrocation hot, rub it in with vigour. Should the mustard work dry, gather hot water in the hand, and proceed as before. A little Spt. of Ammonia added to the mustard will considerably increase its action. Mustard seldom produces any effect the first or second time of its application. It should be applied four, five, or even six times, in succession, at intervals of one or two hours. Mix the mustard fresh upon each occasion, and apply hot water to the hair previously. The principal indication of the remedy having acted sufficiently, is to be gathered from the swollen state

TRE.VTMEN'T OF.

of the skin upon which it may have been applied. Tins swelling-wo always consider a favourable indication�decisive; evidence in fact of the safety of the patient. When mustard is applied to the sides of a patient, the hot water rug may also be applied, in the manner previously directed. The hot water, in this case, is retained at a high temperature for a considerable period; it also percolates into the hair. The hair retains it, and the mustard in consequence is rendered doubly active, and its activity greatly prolonged.

Stimulants and Toxics are remedies of a somewhat similar character. Stimulants excite the vital powers, producing their effects immediately; such effects, generally speaking, being in excess; that is the organic activity, is excited beyond its regular state. Tonics also act by exciting the vital powers; but their action is slow, their effects cumulative, and, if such effects be aided by a judicious hygienic treatment, they are, if we may so express ourselves, carried forward, and become permanent. Horses, and also animals of the bovine class, succumb more readily to acute disease than the human being. Hence the administration of a Diffusible Stimulant to a patient will frequently prove of essential service, when the vital powers manifest a tendency to fail. Diffusible Stimulants are necessary to patients affected with the Epidemical forms of Broncho-Pneumony; or Broncho-Pleuro-Pneumony�forms of disease which at their commencement are marked by peculiar states of debility, which readily pass into the typhoid state, even in animals naturally strong and robust. To prevent this typhoid state, Diffusible Stimulants judiciously ap�plied, will be found of great value.

Of Stimulants and Tonics we have a numerous variety. The principal of which are�Wine, Rum, Whiskey, Spirits of Nitre, Sulphuric Ether, Camphor, Carbonate of Ammonia, Acetate of Ammonia, and the Aromatic Spirit of Ammonia, which perhaps.

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for the generality of cases, will prove the best of them all. The symptoms indicating the necessity for Diffusible Stimulants, are, feebleness of the heart's action, and of the pulse; irregular temperature of the body and limbs; pallid state of the nasal membranes, and evidence of feebleness when the patient is made to walk. In Epidemic Bronchitis, these indications will, in the generality of cases, become strongly marked about the third day after the commencement of the attack;�sometimes earlier, but generally about the time stated. When the pidse is feeble, and boating about seventy or seventy-five times per minute, for forty or fifty hours in succession, together with the presence of symptoms such as enumerated above, Diflusible Stimulants are required, and their use had better be persevered with. It is frequently necessary to give large sized draught horses six or eight drachms of the Aromatic Spirit of Ammonia every four hours; and in these cases the remedy should be persevered with, until improvement is fairly established. The signs of improvement are�the tempera�ture of the body becomes more genial and regular, the hair more glossy, and the pulse rounder, or rounder and intermittent.

Diffusible Stimulants are not so much required in the Sthenio, as in the Asthenic states of Inflammation, or where the former manifest a tendency to insidiously pass into the latter. They are sometimes of use in the former states, if given during the convalescent stages. It is seldom their use is indicated at the beginning of an acute attack.

Tonics are as before stated slowly acting stimulants. quot;By the term Tonics,quot; says Thompson, quot;we are to understand those medi�cinal agents which restore the strength and vigour of the body.quot; Strictly speaking, this definition, although one which expresses the opinion of medical writers in general respecting the word tonic, is not correct. Neither stimulants nor tonics will answer the purpose intended, or act in the manner stated above, unless

TREATMENT OF.

nutrition can be got into the animal as well. Stimulants and Tonics excite the system to action. Food does the same, with this difference: the action excited by stimulants, is that of the organ�ism upon itself; while food excites the organism to act, but instead of the organism acting merely upon itself, it acts upon the food and appropriates it. When the action of a stimulant, or a tonic is exhausted, the system, unless nutrition bo taken as well, is left worse than before. The additional action causes additional waste; and the least additional waste within a frame already debilitated, cannot but weaken it more, unless material be afforded equivalent to the amount lost. Waste is produced within the organism from the action of the digestive organs upon the food; but such waste is replaced by material of a like nature, and in quantity fully equivalent to the quantity lost. Hence the reason why neither stimulants nor tonics can of themselves restore the strength and vigour of the body when weakened or relaxed. They excite action, and produce waste in consequence; but they are incapable of affording an equivalent in return. Food alone can do that. We give Iron, for example, when the organism is enfeebled from disease. Iron is one of the elements entering into the com�position of the blood. It is present in the red corpuscles. These corpuscles are carriers of oxygen, and the Iron is the medium by which this is effected. Oxygen is the prime agent in destroying the old tissues of the organism; so that by increasing the amount of Iron in each corpuscle, and increasing the number of corpuscles also, we increase the number of oxygen carriers, and consequently the amount and rapidity of the waste; and this, in turn, increases the demand for food. All Tonics do not produce their effect in the manner here described. Some of them produce their effect upon the nervous system at large; some upon the nerves of the stomach merely; and some upon one set of tissues, and some upon others. Be the medium of their action however what it may, the result in the end is the same�they increase the action of the organism, and not only excite within it a greater demand for food,

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but the food is more vigorously acted upon and more perfectly assimilated. The tonics in general use amongst Veterinary Sur�geons are�Gentian, Capsicum, Nux Vomica, Sulphate of Iron, Sulphate of Copper, Arsenic, Muriate of Baryta, Iodide of Iron, Muriate of Iron, Chlorate of Potassa, Carbonate of Iron, Bark, and several othere. It is highly probable that most of the pre�parations of Iron act upon the system in the manner already described.

Pcegatives are a class of medicines the nature of which is moderately well understood. The stomach and intestines are organs whose functions strictly relate to the digestive process. It is the sole function, in fact, of these organs to digest the food, and evacuate the refuse. To enable the stomach and intestines to perform this duty efficiently, they secrete peculiar fluids adapted for the purpose; and they possess, or rather manifest, a motion of a peculiar character. The principal fluids are the gastric juice, the bile, and the pancreatic juice. The motion we allude to is the peristaltic motion. The fluids are solvents of the food; while the motion enables the food, which is passive, to traverse the intestinal canal, and thus freely expose the digested mass to the action of the absorbent vessels, whose function it is to secure and conduct the prepared fluids away, to serve the wants of the organism. Purgatives arc a class of medicines, which if freely brought into contact with the internal surface of the intestinal tube, excite within it a twofold effect: first, its secretions are considerably augmented; and second, the peristaltic motion is increased. Purgatives have not only been overrated as to their value in veterinary practice, but they arc frequently recommended where they cannot but prove injurious. Percival, as the reader will remember, recommends them in Inflammation of the Bowels. We believe if given in this disease, they will in the generality of cases prove injurious. In our present mode of practice we do not (rive Purgatives in Enteritis: and we are satisfied that more of

TREATMENT OF.

our Enteric patients recover, than when we resorted to Purgatives. Purgatives excite tlie intestines to increased action; and in Enteritis the intestines are already too much excited. Granting, for the sake of argument, that Purgatives are of value if given in Enteritis, it is incumbent upon those who advocate their use to shew at what stage of the malady they afford relief, or in what manner they afibrd it. If beneficial results are to be expected from the fact of purgation being produced, and we cannot tell what other effects are expected even by their most strenuous supporters, it is certain that a Purgative cannot act in less than twelve or sixteen hours after its administration; and in severe cases, the patient before the expiration of that time, will be either relieved, or in a state beyond the power of medicine to relieve; so that in either case the Purgative hypothesis cannot be supposed to possess any particular merit or demand our acceptance, in preference to the modes of treatment and the remedies here recommended. Patients soon after recovery from Enteritis, when the intestines have to a great extent recovered their normal tone, may then have Purgatives given with every probability of their acting beneficially.

Purgatives are of use in local inflammatory diseases of the ex�tremities of an idiopathic nature, such as Grease in its acute form, and also in inflammatory attacks of the skin, as in acute Pmrigo. On some occasions, a Purgative is of value in acute chronic Opthalmia, whether of the specific or common varieties. In these cases, a Purgative, particularly if the patient be in a gross state of body, acts as a clearer of the system, and prepares it for the action of remedies whose effects answer to the law of the case. Sometimes we are called to a patient, which all at once manifests disease of a character difficult to define or even name; but having once seen a case of the kind it is easy to understand. The symptoms are, the extremities swell, the heels crack, the skin becomes rough and scabby, and the hair loses its gloss. The

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animal also loses llesh. The appetite on sume oceasions is good, in others ravenous, in others bad. The patient coughs, the dung-is diy, and resembles balls of wax; the mucous membranes have a yellow appearance, and occasionally the patient is attacked vrith colic. Here the entire system appears deranged, and acute local attacks of inflammation supervene. The numerous functions of the organism have lost their balance, to restore which a Purgative will be found indispensable. It rids the system of something offensive and detrimental to its well doing. Of the numerous Purgatives which might be enumerated, Barbadoes Aloes is alone worthy of the attention of the Veterinary Surgeon.

Of the value of Purgatives in other forms of disease we shall treat more fully hereafter. Local remedies we have to some extent treated upon already in our observations upon Enteritis, Pleuritis, Pleurodynia, and Pneumonia. The external application of hot water is local; also that of Mustard, Blisters, stimulating Linameuts, and others of a like nature. As we shall of necessity be required to treat in the present volume upon local remedies in the practical sections of the work, we forego any further remarks upon them in this place.

Treatment of Asthenic Inflammation.

The nature of Asthenic Inflammation, and the peculiarities by which it is distinguished from the sthenic types, the reader will find at pages 29 and 32.

Asthenic, means weak or debilitated. It is a prefix used in the present case, to signify a form of inflammation associated with a state of debility or exhaustion of the vital powers. Strictly speaking, this may be said of all idiopathic disease, otherwise how could disease become manifest ? The fan- deduction is, that all idiopathic disease is in part the result of debility. The objectiju

TKEATMENT OF.

8:5

wc arc bound to admit, is to a certain extent correct; but to say that it expresses what is implied by the terms Asthcuic Inflam�mation, would be incorrect. The difference can be best explained by an illustration. Two horses, we will suppose, belong to one establishment, one six or eight years of age, the other aged. They are alike exposed to influences of a pernicious character. Both animals suffer in consequence. Both are treated alike. The younger animal speedily recovers, but the aged animal gradually becomes worse. He slowly succumbs to the operation of an enemy, which, in spite of medicine or medical skill, destroys the life of the patient. Examination after death reveals the fact that the lungs, the trachea, the bronchial tubes, the pleura, and the mucous membranes generally, are in a state of gangrene, the animal having died from inflammatory disease, which had taken on this peculiar character, in consequence of a thoroughly enfeebled state of the vital power. The debility which existed within the younger animal, and which favoured the development of the disease, was merely temporary, and only of a partial character. In the other case it was general and permanent. The disease reigned supreme and unchecked, and death ensued as an inevitable consequence.

In Asthenic Inflammation of every form, the principal chances of cure lay in detecting the malady at the commencement, and in energetically adopting that course of treatment, which tends to the conservation of the vital power. More than usual attention must be paid to the ventilation of the stable or loose box in which the animal may be placed; also to a proper degree of warmth within the place in cold weather, and its coolness in a season of oppressive heat.

The medicines indicated are Stimulants and Tonics, such as are enumerated at Page 82. Counter irritants of mustard may be applied to the sides of the chest, in case the organs within arc

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affected. It must be remembered however, that Tonics and Stimulants alone will not effect much, unless food be also taken by the patient, or material of some kind be supplied of a nature calculated to restore the waste of the organism, and impart fresh power, in addition to stimulating the old. Port Wine, of good quality, will be found of value in every form, and in almost every stage of Asthenic Inflammation, especially if the disease has taken on the typhoid state. Wine is best given diluted with cold water. The proper quantity for a dose will depend upon the size, breed, and quality of the patient. We frequently give in these cases, a pint of the best old Port we can procure, in a pint of spring water; and in some cases repeat the dose twice a day. AVc arc aware that in recommending Port Wine, we recommend an expensive stimulant; but where the state and symptoms clearly denote the disease to be not only asthenic, but typhoid, and the patient valuable, a few bottles of Wine may be freely allowed, and profitably used.

Treatment of Jletasiatic Inflammation.

The last form of Asthenic Inflammation wc shall notice in the present section, with reference to medical treatment, is the Metastatic. We notice it more fully than otherwise we might have done, simply because every author upou veterinary medicine with whose writings we are acquainted, has omitted to give any definite instructions upon a subject which is of the utmost im�portance, not only to the owner of horses, but to the Veterinary Surgeon.

The Metastatic form of Inflammation, is certainly not common, on which account it becomes highly necessary to under�stand, not only on account of its rarity, but that we may be fully prepared to combat it when it does appear. The clear-thinking and right-acting Veterinary Surgeon will as seldom as possible allow

TREATMEVT OF.

himself to be taken by surprise. He will be prepared to meet consequences of the -vrorst nature. He will anticipate their appearance, and bo prepared to meet them remedially, so far as known modes of cure will enable him to do so. By holding him�self in readiness to combat to the utmost of his power, the worst results, short of death, he will certainly be prepared for the best. In cases of this nature, as in the kind last treated upon, our re�medial measures, will, in the main, have to he directed to the vital energies of the patient,

Metastatic Inflammation is occasionally manifested in attacks of Specific Opthalmia. The disease will disappear from one eye, and as suddenly appear in the other. In Pneumonia, the disease will remove from the lungs to the feet; or from the lungs to the eyes; or from the eyes to the lungs; from the bowels to the eyes; from the fore feet to the hinder feet; or from the skin and sub-tissues, to the digestive organs; as in Scarlatina and Purpura Hannorrhagica, of which we have seen numerous examples of a very severe nature.

It will be best to consider the treatment of Metastatic Inflammation, with reference to the organs named, and in the order enumerated. Where the cause of the disease arises from excessive purging, as in the cases recorded by Mr. Boughtou and Mi-. Cox, the first thing is to check the purging. To effect this, it may be necessary to give a full dose of sedative medicine, such as Tincture of Opium, or Chloroform. Should the patient be a large sized animal, and manifest excessive debility, commence at once with the following

Port Wine Tincture of Opium Thick Flour Gruel

3x11.

giiss. one pint.

INFLAMMATION,

Mix together, and give the whole at a dose. Sometimes a single dose of the above named remedies fail in effectually checking the purging; in which case, repeat them to some extent; that is, less of each ingredient should be employed in the repetition according to the circumstances of the case. Chloroform is an excellent remedy to allay violent purging, particularly if it be attended with pain of a severe nature. Where the application of Chloroform is considered necessary, give the remedy in cold flour gruel, three drachms by measure for a dose. A second dose may be required in six or eight hours after the first. Camphor is another excellent remedy in superpurgation. It requires to be powdered at the time of using. Give it in drachm doses, mixed with warm flour gruel. A second, and even a third dose may be necessary, at intervals of six or eight hours.

Having succeeded in checking the excessive action of the bowels, and allowed a sufficiency of time to elapse afterwards, the next thing to do if possible, is to restore the organs to their normal condition. The proper remedies for this purpose, are Nux Vomica, Ammonia, Citrate of Iron. Arsenicum, China, and Sulphur.

Nux Vomica. Use this remedy of the first dilution. Give thirty or forty drops for a dose, in two or three ounces of water, at intervals of three or four hours.

China is good for the debility which may remain after the pain and fever have subsided to some extent. Use the #9632;copy;#9632; Tincture of the remedy in 5iv doses, mixed with a little water. It may be given either alone, or in alternation with the Nux Vomica.

Arsenicum, will sometimes prove a better remedy than either Nux Vomica or China. If resorted to, use it alone, and of the third dilution. Give it in thirty drop doses, at intervals of four or five hours between each dose.

TREATMENT OF.

Ammonia Citrate of Iron, is invaluable where the debility is excessive. Give it in gy doses, dissolved in water. It may be alternated with any of the remedies named above.

Sulphur, will prove of benefit as a last or concluding remedy, when convalescence may be regarded as established. Give the remedy in drachm doses of the first trituration, once or twice a day.

In addition to medicine, nutrition must be got into the patient. Solid food in such a case is out of the question. It might be productive of far more injury than benefit. The system may be too much debilitated to allow the digestive organs to operate upon solid food. The food might remain within the stomach, and aggravate the secondary inflammation. One of the best forms to exhibit nutrition in such cases, is to beat up three or four Eggs in a mass, together with one drachm of common Salt; dilute the mass with over a pint of cold water, and administer it to the patient as a draught. The Eggs in this case afford albumen in a state perfectly fitted to the wants of the enfeebled organism, without the stomach having 'previously to digest it. Precaution must be excorcised in not repeating the albumen too frequently. Avoid glutting the patient. Having recognised the state of the organism, and given to it all the aid which the circumstances of the case permit, the state of the tissues, or parts locally suffering, must next engage our careful attention. If the eyes are the organs affected, shade them with a thick linen cover, and darlcen the box. By securing a thick fold of linen over the forehead of the patient, it acts in a twofold manner; it excludes the light from the inflamed organs, and by wetting the linen with cold Lotion, the eyes are kept cool, and thus a degree of comfort is yielded to the patient worth the trouble. A Lotion for the purpose may be made as follows:�

Belladonna ... Spring Water ...

vol. r.

IN FLAMM ATIOK,

Mix together, and apply when necessary. Sometimes Aconite �copy;#9632; in the same proportion, may be substituted with advantage in place of the Belladonna.

The best remedies in general for Metastatic Opthalmia, for internal use, are Aconite, Belladonna, Arsenicum, Mercurius Corrosivus, and Sulphur. Use the Aconite and Belladonna of the first dilution. The Arsenicum and Mercurius Corrosivus, each of the third dilution. Sulphur the same as before directed.

The best remedies in general for Metastatic Laminitis, arc Nux Vomica, Rims Toxicodendron, Arnica, Arsenicum, and Sulphur.

Use the Nux Vomica, and the Rhus Toxicodendron, each of the first dilution, and in alternation. The dose, from one to two drachms. Arsenicum the same. China -e- in four drachm doses, may also be occasionally given with advantage.

Keep the feet wet with warm Arnica Lotion, which may bo freely applied to the hoofs by means of felted cloth, cut to the form and size of the feet, and secured around the coronet by means of a strap and buckle, or a piece of broad tape. Woollen bandages dipped in hot water, may also be folded around the limbs, extending from the knees or the hocks, as the case may be, down to the hoofs. Should the case be a severe one, place the patient in slings, unless rest be obtained by the animal lying down.

The best remedies in general for Metastatic Pneumonia, are Aconite, Bryonia, and Spirit of Ammonia Aromaticus. Use the Aconite as previously directed. Give Bryonia of the first dilution, in two drachm doses. The Aromatic Spirit in four or six drachm doses. The two last named may be given in alternation. Use mustard embrocations to the chest, in the manner directed at

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page 78. Look to the vital energies of the patient. If the weather be cold, clothe the animal so that it may be comfortable.

HYGIENIC TREATMENT.

The duties comprised in the Hygienic treatment of the diseased animal, may bo arranged under three heads:

1.�The Housing of the Patient. 2.�Clothing. 3.�Dieting.

These will be: found to include all that is necessary.

1.�Housing of the Patient.�If the patient be attacked with disease of an acute, or sub-acute nature, as Inflammatiou of the Bowels, or Inflammation of the Lungs, or Epidemic Catarrh j it is better that the animal be placed in a box, which should have as many of the following advantages as possible: it should

be ROOMY, MODERATELY WELL LIGHTED, PERFECTLY CLEAN, WELL VENTILATED, OF A COMFORTABLE TEMPERAT�RE, AND WELL LITTERED WITH CLEAN DRY STRAW.

It is always best to separate diseased animals from those which are healthy, for the following reasons: If the disease be of an infectious nature, it may prevent it from spreading. The animal is not disturbed by other horses going out, or coming into the stable. The temperature of a loose box can be maintained at a more equable rate; and lastly, if the disease bo of a violent nature, as Inflammation of the Bowels, the patient if allowed to remain in a regular sized stall, would probably severely injure and bruise himself, destroy the wood-work, and perhaps inflict injuries upon the limbs of other horses.

While upon the subject of Housing, we will offer a few

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observations upon cleansing the box. If the disease be of an acute nature, and the patient likely to remain in the box for two or three weeks, the litter which the animal will make, and the old straw at the bottom of the bed, must either be removed at least once every day, or not at all until recovery is established. If the old straw is removed once every two or three days, the urine and dung with which it will in places be saturated, will have decom�posed, and upon turning it up, a powerful effluvia will be emitted, and if taken away, the temperature of the place will fall con�siderably, which, in cold damp weather, may be productive of a bad effect. If allowed to remain without being disturbed, and fresh dry straw spread over the old, no such result probably will follow, if the ventilation be good. The best plan to pursue, is to gather up the dung, and allow all the straw to remain until the patient is recovered j or else to remove the old litter at least once every day. The straw supplied to diseased patients, should be chopped or cut into lengths of about six or eight inches. The advantages gained by this will be evident. The patient can move its limbs with greater freedom. The box can be cleaned with greater facility, and the urine will be more readily absorbed.

2.�Clothing.�The kind, the quantity, and the way of clothing the sick patient, will depend upon a variety of circum�stances; upon the season of the year, upon the nature of the disease, and the breed of the patient; upon the kind of box and its position; and upon the previous habits to which the animal may have been inured. If the box bo in an exposed position, in a situation facing the North, or the West, and not sheltered by other buildings, and if the season of the year be unfavourable to the patient, and the disease be of an acute nature affecting the respiratory organs, the clothing will require to be plentiful, and of a very comfortable kind. But if the season be warm and open; if the box faces the South, and be well sheltered by other buildings, the clothing need only be light, or perhaps, with the exception of a linen sheet, or a light cotton rug, none whatever.

TREATMENT OF.

If the habitation be comfortable, we are not advocates for much clothing. For coarse bred horses, we seldom use more than a single woollen rug thrown evenly over the body of the animal, and fastened lightly with a surcingle. With high bred horses, it may at times he necessary to have a hood, a breast cloth, and woollen bandages for the limbs in addition, and perhaps an additional rug as well. The best criterion however to judge by, is the state of the coat of the patient. If the hair rises upon the skin, and the animal becomes chilly, clothe more heavily- but if the hair remains glossy, the temperature of the body equable, and the animal appears comfortable, it is all that is required. In some diseases it is impossible to clothe the patient, as in Inflam�mation of the Bowels. The very violence of the animal will prevent it. But when recovery has commenced, and the violence disappeared, it is then necessary to clothe well, in order to assist the restorative powers as far as we can. It is impossible however, to lay down rules to meet the exigencies of every case. Experience is necessary in this as in most other matters connected with the management of the horse.

If the patient be clothed too heavily, an uncomfortable state of excitement is produced; while too little clothing is also pre�judicial. The skin is the index, which if closely noted, will at all times prove a sure guide in this matter.

The temperature of the box or stable containing a sick horse, should range from G2deg; to 64deg; Fahrenheit, during the Winter season. In Summer it should be maintained at a similar tem�perature. Loose boxes at some establishments are perfect pests. They are exposed to the full glare of the sun ; and closely con�tiguous to them, are very frequently large heaps of half rotted manure. This in Summer, attracts thousands of flies, which swarm into the box, and irritate the poor animal beyond measure. If a more retired situation cannot be had, the manure should bo removed, and the doors and windows fitted with gauze wire

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blinds to admit the cool air, and yet to prevent the ingress of the flies.

3.�Diet.�The Dieting of a sick horse is at times a matter of nicety. Two extremes in practice are to be avoided; that is, neither to give the animal too much, nor too little food. Some people encourage the appetite too eagerly, while others are almost afraid to allow a sick horse to even look at food. During the early stage of the most acute maladies, it is seldom the patient will partake of food. No anxiety need be manifested on this account. Loss of appetite is but an effect of the disease; and if the disease can be subdued, the desire for food will gradually return. When it does return, encourage it by the allowance of small quan�tities of food at a time ; and let it be of a nature which is at once nutritious, and easy of digestion. If cooked food is resorted to, it should be cooked with the greatest care, and given at a temperature agreeable to the animal.

Avoid huge scalding hot mashes, made of bran, oats, or linseed, �a mess fitter for an Hippopotamus than a horse, having a languid stomach, and a frame weakened by acute disease. The common articles of diet for the sick patient arc bran, boiled oats, boiled barley, gruel, boiled linseed, hay, carrots, turnips, green clover and rye grass when in season.

Bean may either be given alone as a mash, or it may be mixed with boiled oats, or boiled barley. Some horses will not eat boiled oats, either alone or mixed with bran, but will partake of a mash composed of bran and oatmeal. The bran should be clear in colour, perfectly sweet, and coarse in its scales. Fine bran is unfit for sick horses. Oats and barley require boiling until they are soft or pulpy. They may be given to the patient alternately, or the oats may be given for a few times, and then the Barley in lieu of them. A change of diet will be found both agreeable and beneficial to

TBEATMENT OF.

9rgt;

the patient. But when one or the other are used, bran must be mixed with them.

Gruel is a very suitable article of diet, when properly pre�pared. It should be made of the best oatmeal, and boiled over a slow fire for at least an hour before it is required for use. It may either be given alone, or mixed with an equal quantity of fresh made linseed gruel. It should bo given thiuish, and about blood-heat in temperature.

A mixture composed of equal portions of oatmeal gruel, and linseed gruel, forms a diet in every way suitable to a sick animal. The generality of our patients are fond of it. It should always be given thin, otherwise it disgusts the animal.

Hay is sometimes a proper article of diet, but at other times not so. It is very improper to give hay in those low typhoid states of the system, so common during the prevalence of Epidemic Catarrh. It is not indicated, when the pulse is quick and irritable; when the digestive organs are in a foul state, which state is known by a soapy condition of the tongue, with clamminess, and bad smell of the mouth; when the temperature of the body varies consider�ably, and when the nasal membranes are pallid, or of a dull leaden hue. Hay is a diet at such times highly improper ; and yet it is not unlikely that the animal will prefer and even manifest an avidity for it, and an aversion for every other kind of food. When hay is allowed to a diseased patient, it should be sparingly given, and selected with care. Bad hay is injurious at all times. Mow burnt hay is bad food. Good horse-hay is known by a sweet open smell, by its handling perfectly clean and crisp, and possessing a clear surface. Some horses relish hay-tea, which is made by pouring boiling water upon a quantity of hay in a bucket, and allowing the whole to stand, until it is cold, when it is ready for use.

INFLAMMATION,

Carrots are excellent fodder for the horse, both when the animal is in health and in sickness, when in season they may be liberally used. They are a very nutritious vegetable, and there are few horses but will partake of them, when most other kinds of food would either be injurious or distasteful. They are usually given to the sick animal when convalescence has set in. It is better to wash them clean before they are given. Swede turnips are sometimes preferred to carrots. These may be given in small quantities, cut into slices. They are not so good a diet for sick horses. They are heavy, wateiy, and far less nutritious than the carrot.

ill

Green clover, rye grass, and food of a similar kind, fre�quently proves of marked benefit to a sick horse. Care however, should be exercised in their use, otherwise they may not only injure the animal, by aggravating the disease, but colic in some instances may supervene, and the worst consequences speedily follow. It is better to mix the green fodder with a little hay, and give small portions of this at a time. Lints and oats, or tares, are a heavy, cold, and watery diet.

PART II.

FLESH-WOUNDS,

WOUNDS OP THE TENDONS, INJURIES

OP A MISCELLANEOUS CHARACTER,

AND THEIR TREATMENT.

SECTION I.

PEELIMINARY REMARKS.

In the present section wc come more to the practical depart�ment of our labour, and in doing so, propose to divide Part II into numerous sections, in which will be considered the greater division of such wounds and injuries as the horse hitherto has been found liable. Under the terms wound, injury, are comprised a variety of states, both of a simple and complicated nature. Injuries are of every kind, grade, and degree; that is, from a slight swelling upon the skin caused by the stroke of a whip, to a fracture of one or more of the bones.

The position occupied by the horse, as a useful and domesti�cated animal, necessarily subjects him to a variety of accidents, the nature, general course, consequences, and proper treatment of which will constitute the matter of the present part. Before entering upon a special account of each particular form of injury, a few remarks in relation to the causes which are productive of injury to the Horse, may prove of advantage. Perhaps it may be considered out of place to write with regard to causes of this character, simply because injury to horses is of daily occurrence,

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from the operation of tilings the most trivial and insignificant in themselves. Causes productive of disturbance to, and -within the animal economy, such as are now implied, admit of being arranged into two orders, Mechanical and Chemical. The principal mechan�ical causes are kicks, blows, punctures, striking one limb against the other during the act of locomotion, falls, concussions, injuries from shoeing, and a hundred others, of a similar character. Chemical Causes, are of a very limited class, that is, so far as this class of causes are allowed to operate perniciously upon the horse. Occasionally a Veterinary Surgeon is called upon to afford assistance to one of the equine class, which by some means or other, seldom veiy clearly ascertained, may have fallen into a wet lime pit, or upon whose limbs a carboy of Nitric or Sulphuric Acid, may have been spilt. Beyond an occasional case of this nature, one rarely however hears, of horses suffering violently from the operation of chemical causes of a direct character.

Mechanical Causes. For the convenience of pointing out certain causes of injury, of this class, it is proposed to have a more limited classification, or rather, it is proposed to divide this class of causes into sub-classes; the object in doing so is, that we may the more efiiciently point out defects which are not only numerous, but are the most fruitful source of accidents, falling under the cognizance of the Veterinary Surgeon; and if by pursuing this course, we are the means of inducing those who are the owners of, or the attendants upon these animals, to become more vigilant �',nd circumspect, and thus not only prevent suffering, loss of labour, and even at times the life of a valuable animal, our task will have been performed to a good purpose. It is not possible at all times for the most careful of men, to avoid every cause of accident; but it is more than probable, that numbers of casualities which have happened, might have been avoided, and others of daily occurrence may in like manner be prevented.

Horses used for the purposes of Society, or which are

CAUSES OF.

intended for such purposes, are found in three states of existence, viz, in the Stable, at Work, and at Grass; so that Mechanical causes of injury very naturally arrange themselves into three classes, viz: Such as may happen to the animal ivithinthe Stable; such as may happen, to the animal ivhen at Worh ; and such as may happen to the animal while at PasUire.

Class i.�Or such as happen within the Stable,

Comprises : 1st, Horses getting loose in the stable, and fighting with each other; 2nd, Slips upon the pavement of the stable; 3rd, Injuries from the timber and iron work used in the construction and division of the stalls; 4th, Injuries from the animal being cast in a stall, or loose box; 5th, Injuries from improperly fastening the head of the animal; Gth, Injuries from the feet of the animal becoming fast in a loose urine grate, or an open space which may exist between the sets constituting the floor of the stalls; 7th, Injuries from improperly constructed stall posts; 8th, Injuries from hooks and nails in connection with the mangers and racks; 9th, Injuries to the feet and tendons of the animal, from forks and other tools used within the stable; 10th, Injuries to the feet of the animal from shoeing; 11th, Injuries inflicted upon the head, hips, ribs, shoulders and other parts of the animal, from lowncss of the stable, narrowness of the stalls, or from low and narrow doorways to stables.

We hold it as a rule, that accidents having once occurcd, similar accidents under similar circumstances, are liable to occur again. Of the causes above enumerated, let us examine a little more in detail, at the same time, we beg of the reader, if he be the owner of a horse, to go at once, and thoroughly examine his own stable, with an eye to the prevention of consequences such as we shall presently treat upon. Accidents are sooner prevented than remedied, and quot;the eye of a master,quot; it is said, quot;maketh diligent.quot; Causes of injury arising from circumstances numbered

100

WOUNDS AND INJUEXES,

1st, 2nd, 3rtl, 4th, 10th, aucl 11th, are the most common sources of injury to horses while within the stable.

1st.�Becoming loose in the Stahle, and fighting with each other. This is generally done during the night. A horse by suddenly jerking his head, or from restlessness, pulls and stretches the head collar shank, or what is more probable, what ought to be the shank; the fastening breaks, and the animal finds himself loose, when he at once begins to wander about the stable. This excites alarm amongst the other horses, and presently the row begins; and unless some one be at hand to restore order, the owner may consider himself a fortunate individual, if no worse injuries are inflicted, than a few cuts and bruises. Sometimes however, they break the limbs of one another, or a jaw bone is broken, or a joint is laid open, and months elapse before the animal injured is again fit for service. Stablemen are often careless, and for weeks or months before the grand melee comes off, every animal in the stable may have been tied to the manger in a most insecure manner, probably with old halters, or old neck straps without buckles, and with a piece of old hempen cord for a shank, half untwisted, and more than half rotten.

2nd.�Slvps on the Pavement of the Stahle. The majority of stables are ill constructed; few are rightly constructed in every essential. From the pavement being too steep, or greasy from the accumulation of dirt, horses slip, and sometimes severely injure themselves. Broken knees, and even fractures, occur from causes of this nature.

3rd.�Injuries from the Timber and Iron Work, used in the construction and division of the Stalls. The necessity for attend�ing to causes of this nature, will be exemplified the best, by the short account of a case of injury, which resulted in death as a consequence of that carelessness so common in these matters. Without stating lengthy details, we may relate, that in order to

CAUSES 01'.

101

strengthen a stall post, a strong flat piece of iron, thin at the top end, and eight or ten inches in length, was let into a large stone at the bottom end of the stall post. The iron was let into the stone at its lower end to the depth of about three inches. Down the flat surface of the iron, a number of small holes were bored, through which were passed an equal number of screws into the wooden post immediately behind the hon; so far all very well. In course of time however, the screws fell out, and the post dropt as before, to one side, and left the iron standing alone. As usual in such cases, the matter was not noticed, until one morning a servant man, on entering the stable, found one of the horses lying dead. Upon removing the horse the iron in question, was found within its body. The animal in lying down, had dropt upon the projecting iron, which had pierced the skin and muscles in the region of the flank, had torn open the large vein situate immediately contiguous to the spinal column, and the horse had bled to death, without again rising from the ground. It is perhaps needless to say, that attention was given to the projecting metal after this, and that the stall post was made secure forthwith.

4th.�Injuries from the animal being cast in the Stall, or loose Box. It is seldom that horses are severely injured from being cast in the stall. It appears as though some horses had a fondness for this sort of thing; they will be found cast so fre�quently, and in places where it cannot be said to arise from want of room. If after removing the animal into another stall or box, having more room than the one it was taken out of, and the casting is repeated, it may be fairly set down as an item of vice, and perhaps the best mode of cure in such cases, is to try the effect of a whip upon the animal before righting him. We know that this remedy has succeeded in more instances of the kind than one. Injuries from causes numbered 5, 6, 7, 8, and 9, are of less frequent occurence.

yth.�Injuries from improperly fastening the head of the

102

WOUNDS AND INJ�EIES.

animal. Chains and ropes arc the common articles by which horses are secured to the manger; and weights of lead, iron, or wood, are also common articles for suspending to the end of the tie. Very frequently this is neglected, and the loose end is merely secured by tieing it to the ring at the front of the manger. If a shank so secured bo very long, the horse when eating hay from the ground�a common habit with many horses�may easily have one of his limbs become entangled, and before the limb is liber�ated, he may injure himself to a serious extent. The author once attended a case of this nature, where the flexor tendons of the near fore leg, were exposed for more than three inches in length. The injury arose from the limb being entangled in a chain. Similar accidents may result where the tie is too long, and the weight too light. On other occasions the shank will become twisted tightly around the neck, and the poor animal will be found half strangled, and the head enormously swollen in con�sequence.'quot;quot;

7th.�Injuries to the animal from vm/properly constructed stall posts. A stall post may be too low, or too high. If too high the horse is liable to strike his head against it when stopping quickly round in the stall. When made too low, horses may kick them�selves across the post. Accidents of this nature have occurred, enormous abdominal rapkues have been caused thereby, and death to the animal resulted. The proper height for a stall post, is about five feet five or six inches.

Class ii.�Causes of Injury to the Animal while at Woek.

These are also a numerous class of causes. They may occur to the animal in the form of falls, violent concussions j or they

� To determine the proper length of the tie or the collar shank, observe the follow�ing rule :�Bring the chin of the horse to the edge of the nmngcr, pass the loose end of the tic through the ring at the bottom of the manger, and that part of the loose end which lies upon the yyoiind, if any, is more of the tie than is recpiired. All addi�tional length of tic is dangerous. The clog at the end, should be from two to tnree pounds in weight.

CAUSES OP.

103

may arise from an exhibition of vice, such as kicking, or bolting in harness, and overturning the vehicle. Draught horses when heavily loaded, and travelling down hill, are liable to suffer injury from the breaking of the slipper chain, or in ccnsequcnce of neglect in not putting on the slipper; also from the gathering of nails within its feet; striking of the shoe of one limb against the opposite limb, arising either from a faulty conformation of the limbs, or from fatigue, or bad construction of the shoe, or all these causes acting in association. Also from slips of the animal in winter during the prevalence of frost; also from ill fitting, and badly constructed harness, and gears. The harness or gears may be too large, or too small, or too heavy. These and many other causes of a like nature, occur so frequently, and are moreover of so palpable a nature, that further remark upon them is un�necessary.

Class hi.�Injuries aeising to Animals while at Grass.

In treating upon this class of injuries, the reader should understand that we allude not only to adult animals, but to young animals unbroken. The majority of injuries which occur to horses while at grass, arises from kicking, galloping, and leaping. They kick each other at times, in a most savage manner. In galloping, they frequently sprain themselves, or are severely injured from falls, or violent concussions. In leaping walls and hedges, they are frequently bruised and staked. They are also liable to suffer from injuries inflicted purposely by malicious people. It is bad practice to turn horses to grass where a footpath crosses the pasturage, particularly if near a large town, or contiguous to the banks of a river. Vagabonds are always wandering about such localities, accompanied with vicious dogs, under pretence of rat hunting. Now and then these wretches take it into their heads to pitch at a mark with stones, and on some occasions, instead of hitting the mark, they hit the eye of some poor animal. Accidents from causes of this nature, are sadly too common, as many who

104

WOUNDS AND INJURIES.

own young stock, know to their cost. Turning young horses and horned cattle together into the same pasture, is not a practice to be approved of. Sometimes a young horse will delight in racing and tormenting young cattle, and this sort of game frequently ends by the latter becoming goaded to desperation, when a battle ensues, in which the former not unfrequently receives its death-blow; or the horn of the beast inflicts an extensive flesh wound; or the cavity of the chest is entered; or the abdomen is penetrated, and the bowels protrude. We could relate many accidents of this nature, some of them of a very singular character.

The parts of the animal most frequently injured from the operation of causes such as we have enumerated, are the thighs, the hocks, both upon their outer and inner surfaces. The patella joints, the ischium, and the fleshy region immediately contiguous thereto; also the knees, the breast, and the feet. We have attended upon scores of eases of this nature, and by far the greater number were injured in one or more of the parts named. When a Veterinary Surgeon receives an order to attend upon a case of injury, he should go prepared to combat consequences of the worst character. The most formidable injuries are fractures of one or more of the bones; penetration of the cavities of the chest, or the abdomen, by large bodies such as the pole of a coach, or the end of a gig shaft, attended with injury to the large blood vessels, or protrusion of the bowels, and division or laceration of one or more of the larger arteries, or veins. The next in importance, are open joints, after which we may rank flesh wounds, such e,s are extensively torn, lacerated, jagged or contused. For the former class of injuries, bandages, splints of wood, and gutta percha, may be required. For the second class. Collodion and cotton wool; and for the latter, perhaps a few carpet pins, a portion of soft string, Tincture of Calendula and Tincture of Arnica. The consequences to be anticipated, or which may prove inevitable results to the severer forms of injury, are. Hemorrhage, so profuse as to destroy the life of the animal, unless discovered

INSTRUMENTS.

105

and arrested. Limited, but permanent rupture of the bowels; permanent lamenessj permanent blemishes; Traumatic Fever, or Traumatic Tetanus.

The Instruments most commonly required in cases of injury, will generally be comprised amongst the following:�

For Flesh Wounds and Wounded Blood-Vessels:

1nbsp; nbsp;Twitch.

2nbsp; Side Line.

3nbsp; Large and small sized Pins, Carpet Pins.�Fig. 11, page 107.

4nbsp; Soft string, for twisted Sutures.

5nbsp; Pin Directors.�Fig. 13, page 107.

6nbsp; Zinc Wire, and Needle for ditto.�Figs. 12 amp; 15, page 107.

7nbsp; Wire-cutting Pliers, to cut Pins and Zinc wire.�Fig. 10, page 107.

8nbsp; Liston's Forceps, and Bull Dog Forceps, to secure bleeding

arteries.

9nbsp; Strong Silk, to tie arteries.

10nbsp; Needle for Interrupted Suture.�Fig. 14, page 107.

11nbsp; nbsp;Scissors, to remove torn skin, and lacerated muscle.

12nbsp; Large Syringe, to clear away dirt and sand from wounds.�

Fig. 16, page 108.

13nbsp; Sponge, two or three large pieces�soft.

14nbsp; Tincture of Calendula

15nbsp; Tincture of Arnica

For Open Joints, and Divided Tendons.

1nbsp; nbsp;Sulphuric Ether.

2nbsp; Gun Cotton.

3nbsp; Cotton Wool�dry.

4nbsp; Quick Lime.

5nbsp; Gutta Percha.

6nbsp; Cotton Bandages.

7nbsp; Zinc Wire.

8nbsp; Needle to use Zinc Wire.

9nbsp; nbsp;Slings.

lot]

WOUNDS AND INJOMES,

Por Fractures.

1nbsp; nbsp;Splints, of various sizes.

2nbsp; Large pieces of Gutta Pereha.

3nbsp; nbsp;Bandages, botli Linen and

Woollen.

4nbsp; nbsp;Flue Tow.

5 Tape. G Slings.

7nbsp; nbsp;Starch Gruel, or Paste.

8nbsp; nbsp;Hot Water.

The Twitch, is an instrument so useful in the restraining-, for a time at least, the vicious propensities of a horse, and its uses are so well known, that it would be waste of time to say more about it. By its aid, with the use of a side line, and the holding up of a fore leg, the worst tempered horses may, ou most occa�sions, be dealt with easily.

Laege Sized Pins and Pin Dieectoe.�When a wound is extensive and open, it will be greatly improved by closing it with sutures. The most preferable mode of doing this, in the generality of cases, is by means of the twisted suture. Tlds re�quires a pin, and the best for the purpose, where the wound is large, the structures heavy, and great strength of material is necessary, is the large sized Carpet pin, similar to the one shewn at figure 11, in the annexed plate.

Pin Dieectoe.�The Pin Director, is of great value to the operator, in affording guidance to the pin. The instrument shewn in the annexed engraving, figure 13, is of a new form. The old form of Director is objectionable in one or two respects. In the first place, the blade of the instrument and its handle, are fixed in a continuous line, so that when the blade is passed through the lips of a wound, it is frequently very difficult, when the pin is slid through the groove, to withdraw the Director, in consequence of the top part of the pin being held tight between the handle of the instrument and the skin. This, when operating upon a high spirited or vicious animal, we frequently foim:l a

#9632;

108

WOTTNDS AND INJURIES,

I¹-''.

preventative to the progress of the operation; to obviate which, the form of instrument shewn in figure 13, was procured. By having the Director with an elbow, the pin can be slid along the groove formed in the blade, and the Director can be withdrawn with the greatest facility; and thus a source of danger and annoyance to the operator is avoided. By adopting the form of Director here recommended, the operator will find it advantageous to have two instruments, one where the elbow of the instrument is directed to the left, the other to the right. The way to use the Director will be fully described hereafter.

Laege Syeinge.�This instrument is recommended in preference to any other, to cleanse away dirt and fine sand, which are prone to collect in the loose tissues of a wound, in such injuries as broken knees, and others of a similar nature. The force with which warm water may be injected from the Syringe into a wound, will be found of great advantage in washing the finer particles of dirt and sand away. We have found the Syringe the best instrument for the purpose.

Tikctuee of Calendula, is one of the best remedies which can be used as an outward apphcation to flesh wounds of any kind. Use it as a lotion, mixed as follows :

Tincture of Calendula -e-......gj

Soft Water ............ jxvj

#9632;#9632;#9632;I

EBMEDIES FOE.

109

Tincture of Arnica, is the proper remedy to be used to injured tendons and fibrous tissues in general, whether such injury be of the nature of sprain, cut, or braise. Use it as a lotion, mixed as follows :

Tincture of Arnica Soft quot;Water ...

#9632;5J 5^XVJ

Tincture of Calendula and Tincture of Arnica may be pro�cured through any respectable Homoepathic Chemist.

Calendula Lotion, is allowed the first rank as an outward applicant to flesh wounds. Arnica Lotion, is considered the best for external use to wounds of the tendinous and fibrous tissues. Lotion applied to either class of wounds will produce a quicker result, if used warm. This may be easily effected by keeping the bottle containing the Lotion upon the hod, a short distance from the fire. In this situation, it will keep warm, and be ready for immediate use. Two drachm doses of Arnica 1, in two ounces of water, should also be given to the patient, two or three times a day, as an internal remedy, unless Traumatic Fever of a serious character should necessitate other treatment of a nature to be fully described hereafter.

Sulphuric Ether and Gun Cotton, are the well-known substances from which the article Collodion is made. Fresh made Collodion is preferable to old; and for this simple reason we name the ingredients, and recommend it to be made at the time required in preference to keeping it in the Surgery ready made. Collodion is invaluable when used with cotton wool, to close open Joints, or openings made into the theca, or bursae of tendons. But of this we shall have more to say when speaking upon the in�juries in question and of the proper mode of treatment. We propose to arrange the matter of the present division into three parts, viz:�

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1st. Part�Flesh Wounds, Wounds of the Tendons, Injuries of a miscellaneous nature, and their Treatment. 2nd.�Open Joint and its treatment. 3rd.�Fractures, Dislocations, and their Treatment.

Prior to entering upon the specialities of our work, we may premise such by the statement of certain general facts and obser�vations, which the experience of others will doubtless confirm.

Fiest :�Wounds heal with greater rapidity in warm, than in cold weather.

Second:�-Wounds inflicted upon the front region of a fore limb above the knee,�extensor metacarpi muscle�or at the back of a fore limb, above the knee,�flexor metacarpi externus and intcrnus�or in the front region of a hind limb, above the hock joint,�extensor pedis and flexor mctarsi muscles�or upon the posterior region of a hind limb, above the hock,�gastrocnemii muscles�or upon the shoulder, above and below the shoulder joint,�flexor brachii muscle�or upon the muscles and integuments of the back, are always difficult of cure. The former, from the fact of their being almost constantly in a state of exertion; the latter,�the muscles and integuments of the back,�from the position of the parts. The great length of time required for the cure of a simple saddle gall is familiar to most horsemen. The same remarks apply to wounds and injuries upon, and within, the arti�culations, more especially of the articulation of the upper and lower jaws ; also upon the fleshy prominence of the cheek,�massctter muscles� or amongst the tendons of the fore and hind limbs,�flexor and extensor tendons.

fIKNERAI. 0BS1EVATI0NS UPON.

Ill

Third;�Wounds in the region of the ischium, or upon the muscular tissues, between the ischium and the point of the hock,�semitendinosus

muscle in particular�are extremely prone to produce tetanus, or lockjaw; also if inflicted upon the hock, or the structures contiguous thereto, either upon its outer, inner, front or back surfaces;�also from injuries inflicted upon the hind feet;�also from injuries inflicted upon the knees, and upon the muscles situated in the region of the shoulder joint. The reason is, because the parts and muscles named, are the most vascular, and the most copiously supplied with nervous fibrilla, and consequently, the most prone to manifest disease, particularly from causes of a mechanical nature.

Foueth :�The best fomentation to wounds and external local injuries of every kind, where fomentation is necessary, is steam.

Fifth :�The dressing of wounds and injuries, with digestives so called, hot stimulating oils, and linaments of the same nature; or astringent washes, and powders, for the purpose of what is called quot;getting the wound to heal,quot; or quot;the destruction of proud flesh,quot; are practices of a most pernicious kind; not only unnecessary, but injurious in every way.

Sixth :�Wounds upon the posterior region of the hock, above the joint,�gastrocnemii muscles� also in the front region above the joint,� extensor pedis muscle,�also in front of the fore limb, above the knee,�metacarpi magnus mus-

ll:!'

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clo,�when healed to all appearance, are prone to again become inflamed; and from time to time, discharge purulent matter.

Seventh :�To the generality of wounds, or injuries of a severe character, consequences of one or more of the following nature are to be expected under the most favourable circumstances. The first and most simple, is blemish without deterioration either in the value or the usefulness of the animal. Second, deterioration of value, without necessary deterioration of usefulness. Thirdly, deterioration of both usefulness and value.

Eighth :�Sutures are of value in clean cut, or incised wounds. The twisted suture is the one to be preferred in the generality of cases.

Ninth :�Whether sutures be inserted or not, the time required for healing the wound is much the same in either case. Still sutures are valuable under certain conditions, which will be fully explained as we proceed.

Tenth :�Injury may be inflicted upon a bone with sufficient force to break without separating the broken portions, in which state it may remain until discovered, and further consequences of an injurious nature prevented. From ignorance, or the committal of further violence upon the part, the broken portions may become separated, and the fracture made palpable. A fracture of this nature Surgeons denominate quot;green stick fracture.quot;

VAEIETIES OF.

113

Eleventh :�After the infliction of a wound of a severe nature upon any part of a living animal, certain phenomena are developed, which may be limited to the tissues injured; or the local injury may develope other phenomena within the organism while the injury is unhealed; or the part locally injured may to all appearance recover, and yet effects of a character most destructive to the life of the patient may become manifest as a sequence to the local injury. The phenomena limited to the tissues, are such as pertain to the healing process. The phenomena developed by the organism while the injury is unhealed, are com�prised in the state designated Traumatic Fever; while under the third state, we may have Traumatic Tetanus, or Traumatic Tetanus may be associated with Traumatic Fever.

SECTION II.

VARIETIES OF FLESH WOUNDS.

It is usual to arrange Flesh Wounds into five varieties, viz,

1st.�Incised Wounds. 27id.�Lacerated Wounds. 3rd.�Jagged Wounds, ith.�Punctured Wounds, and 5th.�Contused Wounds.

In describing wounds, it is proper to name them with reference to

the region in which they may exist; as, for example, abdominal

wounds, wounds of the neck, ischium, and so forth. They art

vol. i.nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp;r

114

WOUNDS AN^TD INJUillES,

also described with reference to their direction, viz, whether they bo transverse, oblique, or perpendicular.

1st.�Incised Wounds. An incised wound is one where the skin and subtextures present surfaces which are cleanly cut. Such wounds, if inflicted purposely, or by malicious people, are generally made with sharp instruments; or if they arise from accident, and are caused by a blunt instrument, the wound is effected with considerable power, and with great rapidity of movement of the instrument causing it. AVe lately inspected an incised wound inflicted upon a valuable two year old filly, by a young bull. The bull inflicted the wound with its left horn, which was short and exceedingly blunt, and yet it had passed through the skin and subtissues at the bottom of the neck, cutting the whole as clean and straight as though a sharp knife had done it.

2nd. and 3rd.�Lacerated and Jagged Wounds are such as where the skin and subtextures present a torn and jagged ap�pearance. These varieties of injury are always the result of severe mechanical violence, which violence is generally of more than usual continuance in its operation.

4th.�Functured Wounds are such as arc caused by small but pointed instruments penetrating the skin and subtextures, and leaving little or no external trace of the injury. Of all the variety of wounds enumerated, the punctured wound is the most to be dreaded with regard to after consequences. The reasons why this variety of wound is the most dangerous, will be fully explained hereafter.

5th.�Contused Wouiid is an injury inflicted upon the softer textures of the body, without any perceptible break or division of the skin. This variety of wound though mentioned by one or two veterinary writers, is not treated upon with that attention which the subject merits. Contused wounds arc certainly not of

VAIUETIES OF.

115

such frequent ooeurrencc as tlie incised or lacerated varieties, but great difficulty is at times experienced in bringing this form of wound to a successful issue. A horse is brought to us after having received a violent blow upon some part of his body, or he has suddenly slipped down upon a very uneven surface and received a severe contusion the consequences of which are, injury to a number of small blood vessels, and effusion of blood and serum behind the skin of the part injured. Wounds of this kind are common to draught horses employed in the construction of railways. They are also of frequent occurrence to horses during the prevalence of frost. The symptoms are, swelling, heat, and tumefaction of the parts injured, with tenderness upon pressure. The swelling in some cases, when only slight, may subside without treatment. In other cases it will increase to a considerable extent; serum will be effused day after day for several days in succession; and if the tissues injured are situate in a dependent position, so as to allow the accumulating fluid to stretch the skin, or for the effused serum to gravitate to parts below the injury, epiantities of fluid may collect, even to the amount of gallons. Occasionally a contused wound, to all appearance of a simple character, produces the death of the animal injured. We lately saw a case of this nature, and as it was an instructive one we deem the facts worthy of publication. An aged gelding was contused upon the back, a little to the left of the spinal column. Fomentations were applied to the injury. On the third day succeeding the injury, the part was freely opened, and a quantity of dirty coloured serum liberated. On the fifth day, the abdomen appeared larger, and a second portion of dirty coloured serum, emitting a putrid odour, was removed from the cavity on the back by means of a sponge. On the eighth day the abdomen was greatly increased in size, incisions were made into its walls in several places, and the scram which escaped also possessed the putrid odour. The strength of the patient began to fail, stimulants and tonics were given, and various measures resorted to, to improve the life force, but to no avail. The animal died nn the twelfth day after the accident. Examination

11�nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp;WOUNDS AND INJURIES,

of tlie carcase shewed that portions of the panniculus muscle in�vesting the sides of the abdomen were in a state of gangrene. Great quantities of putrid senun were also liberated. The proper treatment to pursue with contused wounds, we shall fully describe

hereafter.

SECTION III.

OF THE HEALING PROCESS, AND GENERAL REMARKS UPON THE TREATMENT OF WOUNDS.

Many erroneous notions prevail with regard to the treatment of wounds. Authors have written, and continue to write, as though the natural powers of the living animal were incapable of repairing wounds and injuries. We are alike taught by veterinary authors and the generality of veterinary teachers, that medicated fomentations, stimulating oils, liuaments, decoctions, and astringent washes of almost every variety, and even at times the application of red hot iron, are all necessary to cure a wound, or keep down exuberant granulations, or what is commonly called quot; proud flesh.quot;

The healing process is described as consisting of stages, viz. quot;union by the first and second intentionsquot;; the quot;first intentionquot; consisting of adhesion of the divided surfaces by means of a glutinous fluid called lymph, the parts being in fact united to one another by a species of glueing; while the quot; second intention,quot; the granulating or suppurating process, consists in the fleshy chasm being filled up by the gradual deposition of fleshy grain-like particles, superimposed one upon another. In the healing of wounds, the chief care of the practitioner should be directed to the attainment of union by the first intention. The suppurating process is not one to be desired, and in the majority of instances

HEALING OF.

117

where it occurs, it will be found to arise more from the maltreat�ment of the wound than from any natural tendency of the tissues when injured to manifest such a change. We are told that union by the first intention is very rarely to be accomplished, especially with large sized wounds, or with such as are jagged, torn, or lacerated. In ail that we do in the treatment of disease in general, or in the treatment of wounds and injuries in particidar, one im�portant rule should determine our remedial course, viz. to assist the natural efforts of the organism. This is a statement which every one claiming to understand the treatment of equine disease, from the properly educated Veterinary Surgeon down to the most ignorant pretender, will at once assent to; but then arises the very natural query, since each will claim this rule to be the one which invariably guides him in practice, viz. by what means are we to determine that we do aid the natural eiforts of the organism ? We purpose to examine this question with regard to the treatment of wounds; and in doing so, it is taken for granted we require first to know, whether the organism is capable, by its own efforts, of restoring injuries in the muscular tissue, and if it be, by what pccidiar process is such repair effected? or, secondly, if the organism be not so capable, to what extent is foreign aid necessary ? So far as we profess an acquaintance with veterinary literature, we are not aware of any veterinary writer having solved these questions. On the contrary, they appear either to have escaped their attention, or they have not deemed them worthy of notice. At any rate, they have not enlightened the prevailing obscurity upon the matter.

The healing process may be briefly described as follows :* A wound of the flesh when first inflicted, is generally succeeded by more or less bleeding, which if not interfered with, or a large blood vessel is not divided, and the animal is allowed to remain at rest, will shortly stop. Blood is effused, and a

* It must b^ distinctly understood, that wc are here treating upon flesh wounds left entirely alone, where the constitutional energies arc vigorous, and where the patient is not put to labour.

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clot is formed upon the exposed surfaces which speedily plugs the open mouths of the bleeding vessels. This is the first process. The second is, the drying of the blood clot, and tumefaction not only of the parts injured, but of the parts con�tiguous thereto. About the third clay, and in some cases even as early as the second day after the accident, the dried blood will crack, and at the bottom of the cracks lymph will appear. The cracks of the blood-clot and the appearance of lymph are constantly associated phenomena � but the two may be hastened or retarded by the weather. When the weather is hot, as in the months of June, July and August, wounds will speedily present a moist appearance. If the weather be cold and frosty, wounds will present a dry appearance for some time, and the formation of lymph bo consequently delayed. So dry in fact will a flesh wound frequently become in cold weather, and continue so for days, that any one not acquainted with the cause, might conclude the injured tissues were taking on a permanent leathery state. About the fourth day, all circumstances being favourable, the cracks will in the generality of cases become wider, and the lymph more abundant, and more dense. The formation of lymph may now be said to have become established, and its secretion will go on until the fleshy chasm and all its irregularities become filled to a level with the skin. Finally, the lymph will harden and dry, and the wound become what in surgical language is termed cicatrized. When the lymph-secreting process is fairly established, the swelling and tumefaction will rapidly disappear, until long before the healing process is complete the tissues immediately contiguous to the wound will have become as free from swelling as though not involved with the #9632;wounded tissues. Such are the processes by which the vital powers repair a -wound, or a breach of con�tinuity in the flesh. They arc simple and thoroughly effectual.

In connection with the operation we may call attention to one or two significant facts. First: If the process of healing be allowed to pursue its natural course, we never behold purulent

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119

matter. If purulent matter appears, it generally results cither from improper treatment, or an milicaltby state of tlic system. Second : We never observe those exuberant granulations, commonly known by the name of quot; jnvud �eshquot;�productions which we believe in all cases to originate entirely from improper treatment.

From the facts above set forth, it will be clear that if the mode of treatment pursued retard the natural operations, it is not a mode which aids the vital energies, but on the contrary perverts their ends and intentions. Let us examine a little further into these teachings of nature. Of what use is the blood-clot ? The blood-clot performs a double service, each of which are essential to the success of the healing process. In the first place it plugs the mouths of the bleeding vessels, and thus puts an effectual stop to all further hemorrhage; and secondly, it affords a most effectual protection to those vessels whose duty it now becomes to secrete lymph to repair the injury. These vessels, if exposed to the atmosphere, would, from their delicacy, be extremely liable to irritation, from the lodgement of dirt and other substances of a foreign nature; any of which would have an injurious effect, and materially interfere with the reparativc function. When lymph is secreted in quantity sufficient to cover and protect the secreting vessels, then the blood-clot cracks. These cracks widen as the lymph becomes inoro abundant, until in the end the cover of dried blood is cast off, as no longer necessary for the healing process. The lymph in fact, is now sufficiently abundant to perform not only the duty of the blood-clot, but the wound being freed from the pressure the clot exerted, the healing goes on more rapidly than before. Again, the interval which occurs between the completion of the first process, or the drying of the blood-clot, and the appearance of lymph, is just the period when the parts injured and the structures contiguous thereto begin to swell, and in fact attain their full extent of swelling in healthy horses. It is also the period when the natural energies arc engaged in forming the lymph; and in order to effect this,

120

WOUNDS AND IXJUEIE�,

more blood than ordinary is determined to the region, and swelling and tension result as natural consequences. In cases where the injury is of an extensive nature, the system will sympathise considerably, the pulse will increase in the number of its beats, and the respiration will become quickened; in short, what is called Inflammatory Fever will present itself in a greater or less degree� the degree of course depending upon the nature and extent of the wound, upon the condition of the animal, and upon its natural susceptibility. It is also the period during which, under the sanction of what is usually designated quot; Medical Science,quot; excessive bleedings are resorted to, as well as the routine administration of purgatives, the dressing of the wound with stimulating oils and linaments, for the purpose, it is alleged quot;of keeping down in�flammation,quot; and quot;bringing the sore into a more healthy con�ditionquot;; until in the end, nature is so far perverted or driven from her original intentions, that purulent matter becomes secreted instead of lymph; and all those alarming symptoms, respecting which wo have heard and read so much, disappear, and so called scientific medical practitioners claim the credit of having effected quot;a wonderful cure;quot; having, in all probability, quot;snatched a valuable animal from the very jaws of death.

The reader we trust, is now furnished with data, by means of which he can examine for himself into the value of those modes of treating flesh wounds which up to this hour are reverently believed in by the ignorant, and extensively practised throughout the kingdom. These modes we shall not further notice here. To criticise them fully would swell the present section beyond reasonable bounds. We shall therefore do little more than state our own directions, trusting that common sense will in the end direct practitioners to the proper course.

When called in to treat a wound, the Veterinary Surgeon should take cognizance of its state. By this we mean, he should note whether it be a small, large, lacerated, contused, or punctured

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121

wound. Is it deep or superficial ? Does it Weed profusely ? Is it associated with fracture of one or more of tlic bones 1 To -wlrat depth does it extend, and in what direction does it run? Is there within it any foreign body, such as a piece of stone, a splinter of wood, particles of sand, or a piece of broken glass ? All these and many more, are matters to determine, and arc comprised in what we term t7ie state of the injury.

Should the hemorrhage be copious, the bleeding vessel must at once be got at, and made secure by tying a strong ligature of silk around it. The colour of the blood, and the manner it issues forth, will be sufficient to determine the character of the vessel injured. If the blood be of a bright scarlet colour, and if it issues in partially interrupted jets, the vessel injured will be an artery; while the size of the current will afford some indication of its calibre. In searching for a blood vessel, a large soft sponge is necessary to dab upon the part where the bleeding vessel may be.

Having secured the bleeding vessel, the next duty is to remove any extraneous substance which may bo present. Foreign bodies may be taken away with the common forceps; but to remove sand and small grit, the best instrument is a powerful syringe, similar to the one shewn at fig. XVI, which fill with tepid water, and send the contents forcibly upon any part where the grit may lodge, the object being to wash it away by the force of the current. The practitioner should next clip away all fragments of loose tissue, no matter whether it be skin, muscle, or tendon. These fragments cannot unite again, therefore remove them, and save nature the trouble by a process far more tedious and uncertain.

We have now arrived at that stage of the business, when almost every one who professes to understand the matter would exclaim, quot;now stitch up the wound.quot; Whether this should oe done however, will depend upon circumstances. Sutures are advan-

i^a

122

WOUNDS AXraquo; OTJUEIES,

tageous iu some cases, and not in otliers. The general error with regard to sutures is in supposing tlieir application necessary to every wound of the incised, torn, or lacerated varieties. We propose, therefore, to discuss the matter, and determine so far as experience will permit, not only the proper cases in which to use them, but also the proper kind of suture best adapted for flesh wounds.

Sutures arc of several kinds. The Veterinary Surgeon however, need concern himself but with three, viz, the Twisted, the Detached or Interrupted, and the MetaUic Suture.

Twisted Suture and the Interrupted Suture.nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; ,

The Twisted Suture, where sutures are required, will in the majority of cases bo found the best. They hold the divided structures the most securely together. They do not readily cut through the skin after being inserted, and thus allow the wound to re-open; neither are they destroyed by any purulent discharge, which may flow from the injury.

The best kind of pin for the purpose, especially for large sized wounds, is that known by the name of Carpet Pin, see fig. XI, page 107. To insert these with facility, an instrument called a Pin Director is essential, see flg. XIII, page 107.

SUTURES.

12.deg;)

The mode in which the Twisted Suture is made, is as follows : The operator first takes hold of the divided skin with the thumb and forefinger of the left hand, at the part where the suture is to be fixed. The Pin Director being held in the right hand, is made to pass rapidly through the skin from tvithout, inwards, and close to the point held. The process is repeated, with the opposite lip of the wound, only the Director must be forced through the skin from u'ithin, outwards. During the passage of the Director through the skin, the animal by its motions will eviiice the degree of pain which it suffers. The Director however must be held firmly, and as firmly pushed forward; and when the violence has subsided, place the point of the pin in the groove of the Director, and push it onwards until its point passes the point of the Director; the latter may then be withdrawn, leaving the pin fixed in the skin. The edges of the wound are then gently pressed together by an assistant, and there held until the operator passes a piece of soft string under, over, and around the pin, as shewn in fig. XYII. When the twisting of the string is com�pleted, the pin may be pushed a little further, and about an inch of its pointed end may be removed with the Wire Cutting Pliers, fig. X, page 107. The ordinary sized pin will be the most suitable for small wounds, and wounds in peculiar situations, such as those inflicted upon the eyelids, nostrils, ears, and other parts of a similar nature,

The Detached Suture, see fig. XVII, by some called the Interrupted Suture, quot; is,quot; says Druitt, quot; thus made : a needle armed with a single ligature is passed through the skin on one side of the wound from v.'ithout, inwards; then at a corresponding part through tho other lip from within, outwards. Then the ends of the ligature�which may bo made of silk or stout hempen thread well waxed�are to be drawn together, without however, any great straining, and are to be tied tightly in a double reef knot. As many of these stitches are to be made as are necessary; half or three-quarters of an inch is a proper interval.quot; * This

* Dn�tt's Surgeon's Vadc-Mcciun. page 1-1.

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fonn of suture answers well, when it can be got to hold sufficiently; but the secretion from the wound frequently destroys the silk, or thread, or the suture cuts through the skin; and the wound in either case is opened afresh, and the cure is rendered more tedious in consequence. For the proper form and size of needle best {jnbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp;adapted for making the Interupted Suture, see fig. XIV, page 107.

The Metallic Suture is made with zinc wire, instead of thread or silk. The wire, which is manufactured on purpose, can be obtained at the surgical instrument makers, of varying thickness and lengths. It is very pliable, and can be readily applied to any part of the animal body. To use it, a needle made for the pur�pose is required. It is of the size and form shewn at fig. XII, jnbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp;page 107. At the top end of the needle a deep groove is cut in

the metal; in this groove the wire, after threading it through the eye of the instrument, is laid flat. Without the groove, great difficulty would occur in drawing the wire through the skin, on account of the additional thickness. The Metallic Suture is simply another form of Interrupted Suture, the only difference between the two being in the difference of material used. For the proper mode of making this suture see the preceding paragraph. The thickness of wire best adapted for the generality of cases, is shewn at fig. XV, page 107. Instead of tying the wire as we should tie the thread or silk in the interrupted suture, the ends of the wire are simply brought close to each other and twisted together. The remaining length is then cut from the twisted part with the Cutting Pliers. In the generality of cases, where sutures arc required, we do not recommend the Metallic Suture. The largo needle, which we are compelled to use with the Zinc Wire, inflicts upon the patient very severe pain, from the operator being com�pelled to take a deep hold of the skin and subtextures contiguous to the wound. The Metallic Suture will nevertheless be found of use to wounds in particular localities, and of a particular kind. They will be found useful to wounds which may be inflicted across a joint; as for example, across the front of the hock or the fetlock

SUTURES.

12.3

joints, or the back of the knee-joints, or tlie front of the elbow joint. The skin and. subtextures at these parts are much dis�turbed during the act of locomotion. The Interrupted Suture under this condition of wound does not answer well, while the Twisted Suture would perhaps act more injuriously than otherwise. The bending of the injured limb bends the pin, and the pin cannot be bent without its lower end receding from the lower border of the wound. This of course will cause a partial re-opening of the wound. As the pin becomes bent, the borders of the wound will recede, until the lower border will slip entirely from the pin, and matters become as they were. Under these peculiar circumstances the Metallic Suture will be found of decided advantage. The motion of the li:iib injured, will not displace the wire, while its flexibility will adapt it to the requirements of the case.

Having described the three kinds of suture, we purpose to describe the conditions under which sutures may prove useful, and also lay down certain rules to be observed by the operator when manipulating. The cleaner a wound is cut, the more perfect the cure, providing the wound be rationally treated. Sutures to such wounds are proper; but where wounds are jagged and torn, the skin torn, or the muscular fibre broken or ploughed deeply into; or where foreign substances are lodged within the part injured, and cannot bo entirely removed, it is better not to insert sutures, but to cut away the loose bits of skin and flesh, to remove all the dirt which can be removed, and give the wound the most finished appearance possible under the circumstances.

In wounds which are large and deep, and where pieces of skin and flesh hang loose, and away from the surface line of the uninjured parts, sutures will be found of good service. They will effectually fix the loose parts, and give a proper direction to the healing force.

Unless great care is exercised in placing the injured parts

#9632;

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straight, and afterwards keeping tkem so, unsightly blemishes arc certain to remain.

Before sutures are inserted, look well to the wound with regard to its size, form, and direction. The most common form of wound is that of a triangle.

In fixing sutures, place them so as to secure the divided parts as exact to each other as possible. The best way to do this is to commence by securing the wound at its most conspicuous parts, by which means accuracy of adjustment throughout, will be more readily eflected. If the injury be of a triangular form, it is best for the operator to commence with his sutures at the highest point of the triangle; by this mode the sides of the wound are placed straight against each other.

The distance at which sutures should be fixed apart from each other, will depend upon circumstances. One inch however may be set down as the average distance.

In fixing sutures, avoid forcing the skin into folds or corrugations. The wounded parts ivill he found to grow together in the way they are set. In like manner, where sutures are not used, the skin must be attended to in this respect, otherwise the part when healed will present an ugly blemish. To the want of care in this respect, may in general be attributed the ugly blemishes which remain after the healing of wounds. It is seldom the skin requires to be forced from its adhesions more than once to prevent this.

Whatever kind of suture is resorted to, the operator must secure firm hold of the skin and make the sutures no tighter than what suffices to hold the divided edges properly in contact.

The lowest part of a wound must be left more open than any

!'I

SUTURES.

127

other, to allow free exit to any serous exudation which may collect, SiiL-h exudation not unfrequcntly carries away particles of dirt, or other foreign bodies of a minute kind.

When sutures are properly fixed, let them remain until the wound is thoroughly healed. It has been taught that sutures excite unnecessary inflammation, and that in consequence they should be removed as speedily as circumstances will permit. This is an error. On the contrary, they excite little or no inflammation. Sutures, unless loose and frequently disturbed, are all but inert. quot; It must be remembered,quot; says Percival, quot; although sutures are employed to produce adhesion or -union hi/ the first intention, yet they, being foreign bodies, will soon become sources of irritation, and require removal. Generally speaking, sutures should be removed on the third day : cases do occur, however, in which they can be allowed to remain until the fifth and even the sixth day. It is seldom that we succeed in accomplishing perfect adhesion. Commonly, about the third or fourth day, the exterior of the wound becomes tumid, stretching the stitches, and oozing an acrid matter : this is the signal for the withdrawal of the sutures. When union by the first intention is effected, the parts, though warmer than natural, and somewhat tumid, remain perfectly diy, and free from any discharge. The sutures being removed quot; he continues quot; the sides of the ivound are a'jain open, and ive behold a large sore, which has to heal hy the tedious process of granulation. This operation will have time. When once estab�lished, the Veterinary Surgeon can do little towards promoting it, beyond freeing the wound from bandages and coverings of all descriptions, leaving it perfectly exposed, keeping it clean, and attending to the general health. Should there appear any indis�position in the v.vund to suppurate kindly, toe may empjloy digestives, as they are called.quot; He then enumerates certain quot; digestives,quot; one of which is composed of Spts. of Turpentine, Sulphuric Acid, and Olive Oil; but in case this should not cause the wound to quot;suppurate kindly,quot; Oil of Tar is recommended.

128

wounds and iNJimrea,

and Wound Stone Lotion, quot;which according to the popular recipe, is made by reducing to a fine powder 1J pounds of Sul�phate of Iron, 1 ditto of Alum, 2 oz. of Verdigris, and 1 oz. of Sal. Ammoniac. These are to be boiled together; afterwards allow the mixture to cool, when it will become solid and hard, and fit for use. A piece of the magnitude of a walnut is to be dissolved in a quart of water, and the wound by means of bandages, kept wet with the lotion.quot; *

The above may be described as the mode usually pursued in the treatment of flesh wounds. Suppuration we have already shewn to be a bad process. Wien purulent matter appears in flesh #9632;wounds, it is, in the generality of cases, to be attributed to bad treatment. In proof of this we could scarcely adduce evidence of a more direct or stronger character, than that contained in the above quotation. Why, for example, remove the sutures ? The reason given by the author is absurd to a degree. He advises their re�moval, because quot;the exterior of the wound becomes tumid, stretching the stitches, and oozing an acrid matter;quot; and these symptoms we are told, quot;is the signal for the withdrawal of the sutures.quot; How, in the name of common sense could the author expect a wound to heal ? What he calls the signal for the re�moval of sutures, is a necessary stage in the healing process, the direct intention of nature being to unite the divided surfaces ; but by cutting away the sutures we remove the bonds which hold the divided surfaces in close contiguity, and thus prevent the intention of nature. Every one familiar with flesh wounds is aware that the muscular substance when cut, separates; the separation necessarily causing a cavity or open space, to obliterate which, or, in other words, to restore the tissues to their normal state, is the aim of the Veterinary Surgeon. This can only be done by one or two modes : either by a gradual effusion of lymph, until the cavity is filled up�the process of healing when sutures are not used�or by the use of sutures; thus fixing the parts

* Tcrcivars quot; Hippopathology,quot; Vol. I, rP- Iquot;³.- 174, and I7-^!gt;, 1855.

SUTURES.

129

separated, closely together, and holding them so fixed, until union is effected. In both eases lymph is the bond, or medium of union. The former we may denominate, mediate union ; the latter, immediate. Farther reflection will enable us to perceive that the divided parts cannot be securely united until the uniting substance, the lymph, becomes sufficiently firm to hold the fleshy surfaces securely together; and until this is effected sutures are of essential service, inasmuch as they constitute a temporary bond of union until the permanent one is complete. Consequently to re�move these temporary bonds, before the permanent one is capable of doing what is required, is just to trifle with the vital powers, and inflict useless torture upon the patient. Mr. Percival, however, is not content with this. He gives directions, which, if pursued, must defeat the direct intention of the animal economy. He recommends, after the sutures are withdrawn, to apply to the open sore a corrosive mixture composed of Sulphuric Acid and Spts. of Turpentine, also Wound Stone Lotion, and other noxious and offen�sive modes of procedure, with the gentle intention of inducing quot; the wound to suppurate kindly.quot; In opposition to this we say, let the sutures remain until the healing process is perfected, and the structures are securely united, then the sooner the sutures are re�moved the better. A few remarks as to the state of the wound before sutures are inserted, and we close this part of our subject. Before sutures are inserted, the injured vessels should have ceased to bleed; or the operator should be certain that a clot of blood ia not enclosed between the surfaces of the injury. A clot of blood so enclosed, would act as a foreign body, and produce inflam�mation, and necessitate the removal of the sutures. It is better, therefore, to wait until hemorrhage ceases, and until the exposed surfaces put on a glazed appearance; when the operator having previously removed all foreign bodies, and loose shreds of tissue, is, with a soft sponge, to gently remove what blood may be deposited at the bottom of the wound, and proceed without delay to insert the sutures of the kind necessity may require, and according to the directions already given.

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Ha ml ages.

Bandages in numerous cases of wound will be found excellent auxiliaries to a successful issue. The /best kind for the purpose, are linen. Linen fabric is cooler than woollen. Bandages for wounds should be from four to five inches wide, and of a length suitable to the circumstances of the case. They are procurable from every saddler, of a kind purposely made for stable use. Hom'c-madc bandages are objectionable, unless the borders are secured; raw edges, as housewives call them, are a nuisance; the loose threads become entangled amongst the sutures, where sutures are used, or, they become insinuated into the sore, and thus excite unnecessary irritation. Bandages will be found of value to incised wounds inflicted upon the lower part of a limb. Their application will prevent undue swelling of the limb; but at the same time they have the disadvantage, particularly to wounds not sutured, of causing it to remain raw longer than it would if left alone. The advantages however, must be placed against the disadvantages, and the balance decided accordingly. When applied to a wounded limb, bandages should always be put on wet; the hah- should be wet also. Wet bandages keep their position better than dry ones. They should be put on with caution, the operator taking care to make them secure. To bandage a limb properly requires practice. The bandage should fit easy, it should also press equally upon every part to which it may be applied; and so arranged that ordinary motion of the limb, so long as the patient remains in a stable or a loose box, will be unable to work it loose.

Fomenlations.

Fomentations are also valuable in promoting the cure of wounds. Fomentations relax the tension of the swollen tissues, and thus promote a greater freedom of circulation within the part wounded, and a more rapid exudation of lymph. We have found, from numerous experiments, that steam is by far the best

FOMENTATIONS.

131

agent to apply as a fomentation to wounds of the softer tissues. Water by its weiglit and quantity, if applied to wounds not sutured, washes away the lymph, and thus what aid it renders in one direction is more than counterbalanced in another. Hot water forms the best fomentation where the skin is unbroken, or to apply to limbs when acutely inflamed from internal disease, as in Ljnn-phatitis, Pleuritis, Sprain of the Flexor Tendons, Acute Grease, and maladies of a similar character; but Steam is the best agent to foment injuries of a limited nature inflicted amongst the softer tissues. Steam does not wash the lymph away from the wound, nor in fact disturb it. It can be applied in a more direct manner than water, and such directness can be maintained without inter�ruption, so long as the operator may desire. Its operation will be found both gentle and uniform. It is more genial to the patient in cold weather than hot water. It does not deluge with wet any other part than the one injured; and where straw is scarce, the patient severely injured, and dryness of the stable or loose box desirable, it will be found preferable to water in every way.

The question may naturally be put, how is steam to be readily procured, particularly in localities where steam engines, and large boilers to generate steam, are not to be found ? In answer to this, wo submit a simple mode, which may be readily put in operation.

Before describing the apparatus represented at fig. XVIII, it will be well to describe certain indispensables necessary for the apparatus in question to possess, before it can be used, with facility and safety to the operator. First : The apparatus for generating steam should be portable. Second : The vessel in which the steam is prepared, should hold at least, for large veterinary establishments, four or five gallons of water, as water subject to great heat evaporates rapidly, particularly where the evaporating surface is large. Third : The apparatus should be provided with

132

WOUNDS AND INJ��lK-;,

a safety valve, otherwise, persons using it, nut acquaintecl with the power of steam, when unduly confmecl, might be seriously

ik:

injured, from the bursting of the Steam Producer. Fourth : Narrow flexible tubing will be required, to con�duct the steam from the Steam Producer to the wound.nbsp; nbsp; nbsp; nbsp; nbsp;Fifth:

The flexible tubing-must bo of a nature to resist the action of steam, or hot water.

The apparatus represented in fig. XVIII, will be found to meet every requirement of the case. The Steam Producer is simply a common pat jut

digester, an appara-

STEAM FOMENTING APPAEATUS.

1, Safety-valve. 2, 2, Patent Di^c-ster. ;*, ripe connection screwed Into Cover of Digester. 4, Stop Tap, 5. Begnlating-tap and Stuim-nozzlc. (!, ring to stop up aperture in Digester, vrben pipe is unscrewed therefrom.

tus which can be readily procured

from any respecta�ble ironmonger. The price of the whole, as figured above, will not exceed 3.5s. or 40s. The lid of the digester is securely held in its place by a sort of bayonet joint. Upon the lid is a safety valve to let oft' superfluous steam. By weighting this valve a greater pressure of steam can be obtained if desirable.

STEAM PHODL'CER.

13:3

Near to the safety valve is a stop cock, | of an iuch diameter; or wider if necessary, to which can be attached a flexible pipe to conduct the steam from the digester. At the loose end of the flexible pipe is a tube made of brass or wood, according to the fancy of the owner; this the operator can take hold of, and direct the steam to the parts injured. The flexible pipe proper for the purpose, is mineralized India rabber tubing. This tubing should not be less than half an inch diameter, nor more than three quarters. The tubing should be what is called quot; double ply.quot; It will cost from eightpence to tenpence per foot. A smal�ler apparatus might easily be made, and arranged similar to a tea urn. Boiling water could be poured into the Steam Producer in the first instance, and afterwards kept at the same temperature by means of iron heaters, dropt into a tube surrounding the water. The portable fire grate might also be dispensed with, by heating the large Steam Producer over a regular fire, and where practicable, taking the patient into the same apartment.

Hot Fomentations may be applied to the limbs or any part of the organism externally, by means of bandages, or Spongio Piline; to the back and loins, by means of a large woollen rug dipped in hot water, and spread over the part, with a dry woollen rug to cover the wet one.

Foult ices.

Poultices are remedies of a nature which act similar to fomen�tations. Poultices are of value in cases of severe injury to the feet and lower part of the limbs.

Bran is the best substance to make poultices of, not only on account of its lightness, and cleanliness but with the addition of hogs lard, it will retain heat equal to any other substance used for poultices. Lard or oil should always be added, at the time hot water is poured upon the bran; it prevents the bran from

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becoming dry. The way to fix poultices upon a part injured is a matter so well understood by every one having the care of a horse, as to require no further notice on our part.

High Heeled Shoe,

In certain cases of injury to the extremities, of a nature to be specified hereafter, it is necessary to relax as far as possible, the natural tension of the parts injured while the animal is stand�ing in the stall or loose box. Injuries upon the point, and posterior parts of the hock joint, require thus relaxing ; also the structures situate at the back part of the hind limbs, between the hock joint and the root of the tail; also in cases of injury upon the Flexor Tendons, both of the fore and hind limbs; and also, when injury is inflicted upon the muscles at the back of the fore limb above the knee, or immediately behind the knee joint. The best mode to effect this relaxation, is by the use of the High Heeled Shoe, of a form similar to the one represented at figure XIX.

High Heeled Shoe.

The caulkens of the shoe represented, are made high; tnA, reaching from one caulkcn to the other, for the latter to rest upon, is a stout bar of iron. The purpose of the cross-bar is to give a more uniform pressure to the foot when upon the ground, and also to prevent the shoe from being entangled amid the straw. If the patient bo turned to grass, it will also prevent the heel from sink�ing deep into soft ground. The caulkens should be made not only of extra length, but should project backwards. When so constructed, the foot is not thrown up so suddenly, nor pitched so much upon the toe. The length of the support, including the

LOOSE BOX, EXCEECISE, amp;C.

135

cross bar, should be from one to two inches. Of course the length of the support need not be so great, if the caulkens are not inclined backwards. See fig. XIX, as it is a matter of some importance.

Loose Box.

The wounded patient should be placed in a comfortable loose box ; and if the weather be cold, well clothed in addition. If the weather be warm, the clothing may be dispensed with, but the doors and windows of the box should be guarded by gauze, or thin canvass blinds, to entirely shut out flies. Flies are a dreadful pest to a wounded horse. They annoy the animal to excess. For further directions with regard to loose box, see page 91.

Exercising the Patient.

Exercise may, in the milder cases of injury, be resorted to, particularly if the patient has not the liberty of a loose box. It is a matter, however, of no great importance to give directions upon. The state of the patient, including the extent of the wound, the state of the weather, and other matters of a trifling character, of which the owner of the patient, or the attendant, will be fully competent to judge upon, should determine how far exercise may be resorted to

TEEATMENT OP PUNCTUEED WOUNDS.

We have spoken of this variety of wound as the most dan�gerous. quot;Punctured Wounds,quot; says Draitt, in his admirable work on Surgery, quot; are justly esteemed the most dangerous of all.quot;

First.�quot; Because from their depth they are liable to impli�cate blood-vessels, nerves, viscera, and other deep seated parts of importance.

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Second.�quot; Because tlie parts which they traverse are stretched and torn, and consequently arc disposed to inflame and suppurate.

Third.�quot; Because matter when formed has no free exit, and is liable to burrow extensively.

Fourth.�quot; Because foreign bodies may be carried in to great depths without being suspected, and create long continued irrita-tation.

Fifth.�quot; Because they are most liable to be followed by Tetanus.quot;

The locality in which the puncture may occur, will, to a con�siderable extent, determine the course to be pursued. Should the puncture be inflicted within a fleshy part, pass a small director, if possible, to the bottom of the wound, and then with a straight probe-pointed bistoury, cut it freely open. Make it in fact, an open wound. The danger will thereby become lessened to some extent, and the whole will be exposed to view. After the wound is laid open, carefully remove any foreign matter which may be observed, either with the forceps or the large syringe; after which leave it alone for some time, then apply a few twisted sutures, and treat the wound according to the rules already laid down. Dress with the Calendula lotion, give Arnica internally, and keep the animal upon a cooling diet.

The puncture, however, may be inflicted within structures which, to lay freely open, would be likely in the end to destroy the patient. It may occur, for example, within a joint, or amongst the tendons of a limb. It is clear in cases of this nature, such a proceeding as laying the wound freely open is altogether inadmis�sible. The course, under these circumstances, is, if possible, to carefully inspect the instrument which inflicted the puncture, and

TREATMENT OF.

137

from its appearance judge as to the depth it may have penetrated, and whether it has left any foreign matter within the injury, such as rust of iron or splinters of wood.

In treating a punctured Flexor Tendon, we must if possible prevent suppuration of the injured tissues. The burrowing of purulent matter amongst the tendons is at all times a serious affair, and to prevent it recourse must be had to many expedients. In the first place, after having determined the extent of the punc�ture, place upon the foot a high heeled shoe, apply a lotion of Arnica freely to the surface of the part injured, then keep the limb well secured with cold water bandages, and imme�diately over the seat of the injury, both upon the inner and outer side of the tendons, place a small roll of wet linen, each roll about three or four inches in length, and about the thickness of the thumb. These rolls must be placed within the folds of the bandage, and pressed with moderate firmness to the limb; the object being, by pressure and cold, to limit the inflammatory action which may ensue. If suppuration has set in before medical aid was sought, the pus must be liberated, when the course of treatment will still be very similar. Should matter have gravi�tated to the fetlock, it must of course be evacuated; but the operator had better proceed with caution, lest he should make an incision into the cavity of the joint. To avoid doing this, force the skin to one side, when making the incision, so that the external opening will not correspond to the one passing through the subtissues. After the matter is evacuated, recourse must be had to bandages and to the linen rolls; only in this case, the rolls will require to be larger than those described above, or more numerous; and they must be carefully applied in a direction parallel to the length of the tendons. In this manner, we have succeeded on many occasions, in bad punctures of this nature, in restoring the parts to health without the least blemish in the end being perceptible.

C^?

138

CONTUSED WOUNDS,

:#9632;#9632;:

We recommend the use of linen rolls. At times however, their use is prejudicial. This is the case now and then with horses of an excitable nature. The best substitute in such cases is wet sponge ; it would, in fact, be the best upon every occasion of the kind, but it is expensive; so that where rolls of linen or wash leather will answer the purpose, the expense of sponge is saved. Sponge of a proper form, can be selected, or clippings can be made of lengths suitable to the requirements of the practitioner. The advantages of wet sponge-rolls are their softness and elasticity.

{{I

Above all things avoid blisters, and the application of hot stimulating oils in these cases. By the aid of a high heeled shoe, such as shewn at fig. XIX, page 134, with Arnica 1, in two drachm doses administered to the patient; with Arnica Lotion externally; with cold water bandages, linen rolls, or wet sponge, together with a cooling diet; this treatment will, if steadily persevered in, effect all that is desirable.

TREATMENT OF CONTUSED WOUNDS;

Before the practitioner begins to treat what may be considered a contused wound, he should in the first place determine whether it really be of that variety. On two occasions we have known serious consequences to result from Hernia being mistaken for this variety of wound. Such a mistake is not likely to occur with a man of even ordinary penetration; but inasmuch as it has occurred, it may occur again.

A contused wound we have defined to be quot; an injury inflicted upon the softer textures, without any perceptible break or division of the skin.quot; A contused wound may be produced amongst the soft tissues constituting the walls or sides of the abdomen, or the contusion may be of so severe a nature, as to cause Hernia ; and as the appearance of the two, to a common observer, would be much the same, it will be well that we enumerate the characters

TREATMENT OF.

139

by which the one is to be distinguished from the other. The chief characters by which abdominal Hernia is to be distinguished from a contused wound of the same region, are as follows :�

In Hernia, the temperature of the skin covering the enlarge�ment is the same as the skin immediately contiguous.

In Hernia, the swelling is highly elastic, and can be made by steady pressure, entirely to disappear.

In Hernia, the swelling cannot be made to pit upon pressure.

In Hernia, during the act of breathing, the swelling moves as the contiguous parts move, viz. with perfect freedom.

In a contused wound the skin covering the part injured, is generally warmer thun the skin contiguous.

In a contused wound the swelling will on many occasions be found elastic, but it cannot be made to disappear by pressure.

In a contused wound the swelling will pit upon pressure.

In contused wound, the swelling maintains the same circumscribed appearance during the respiratory action; and the action is not performed so freely.

A contused wound will generally require to be freely opened. Its contents usually consist either of serum wholly, or clots of blood and serum, both of which must be removed. Afterwards, treat it as an ordinary incised wound. Sometimes these cases prove obstinate. The sac may be opened, and its contents liber�ated, but it will fill and refill many times in succession. The best plan to pursue, is not to open the sac at once; that is, if the practitioner be called in to a case of the kind soon after the accident, but to foment the injury several times a day, for several days in succesiou, until the diseased action has had time to exhaust itself, when the swelling may be freely opened, and its contents evacuated. After the part is opened, should the situation of the

TRAUMATIC FEVEB,

cavity permit, pressure may be applied. It will hasten the cure by preventing a further effusion of serum. But if pressure cannot be applied, and the sac refills if left alone, enlarge the opening previously made, inject Arnica #9632;copy;#9632; freely within, and leave a tent of tow in the orifice for twelve or fourteen hours, at the end of which time the lips of the opening will bo found swollen, and purulent matter will issue therefrom. All that now remains to be done, is to encourage for a time such purulent discharge until a new action is thoroughly established ; then remove the tent from the orifice, and dress daily with warm Arnica, or warm Calendula Lotion, of the strength described at page 109.

TEAUMATIC FEVER.

We have now to treat upon the principal phenomena of a constitutioiial nature which occasionally becomes manifest as a sequence to wounds and injuries of every variety, and of almost every degree of severity, save those of a most trivial character. To early recognise and successfully combat two forms of systemic disturbance of the traumatic class, will require every care, and at times the highest skill, on the part of the Veterinary Surgeon. The first is. Traumatic Fever; the second. Traumatic Tetanus.

Traumatic Fever may terminate in Traumatic Tetanus ; or Traumatic Tetanus may supervene, without any perceptible inter�vention of Traumatic Fever, or, the two may be associated.

In wounds of a severe character, from the second to the fifth day after the inflietion of the injury, the system begins to manifest sympathy towards the part injured. This manifestation of sympathy, when presenting symptoms of a kind presently to be described, is denominated Sympathetic Fever, Acute Inflam�matory Fever, Traumatic Fever, and other names which we need not enumerate. It is a state which is generally spoken of in terms of alarm, as though it was something greatly to be dreaded, and

SYMPTOMS OF.

141

requiring the practitioner to apply measures of the most urgent nature, for its dispersal, otherwise the results are regarded as cer�tain to be fatal. Now we unhesitatingly assert, that such alarm in the generality of cases is entirely groundless. Traumatic Fever is easy to control, save in those cases where vitally important viscera, such as the lungs, the abdominal organs, or the brain, are exten�sively injured. The period when cicatrization occurs in wounds of the Ischium, or in broken knees, is far more to be dreaded than the inflammatory fever which supervenes upon the occurrence of a wound in the general run of cases. One important fact must be borne in mind, viz, that Traumatic Fever is to be regarded as an inevitable consequence in wounds and injuries of a severe char�acter; and that, being inevitable, instead of attempting in ex�treme cases to ward it off, or seeking to suddenly check it when developed, we ought rather to carefully watch its progress, and endeavour if possible to keep it within bounds, until its cause becomes so far modified as to allow of the subsidence of the fever, ludccd, this is all we can hope to accomplish ; for as one of our eminent writers upon Surgery observes, when speaking of a similar state in the human being: quot; it cannot be cut short, although its undue violence may be abated.quot;

Symptoms.

The animal from the occurrence of the accident to the com�mencement of acute fever, may not have thoroughly rallied from the shock; so that the Veterinary Surgeon ought to be fully alive to what may follow, and by judicious treatment from the first, endeavour to do that which will modify its effects accordingly. Usually about the third day the pulse of the patient will manifest disturbance of the system. It will increase in the number of its beats, reaching on some occasions as high as 75, 80, 85, or 90 per minute. The respiratory process will also be found to participate. The respirations may become from 30 to 45 per minute, and be of a short and superficial

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character. The skin at one time will be hot, and the breath hot, at another time the skin will manifest chillness and the hair become elevated. The urine will be scanty and high coloured, and the bowels what is called constipated. In addition to this, the patient will be exceedingly restless, and if the injury be amongst the muscles of a limb, the limb will be frequently shifted. The injured parts will also become exceedingly tender, swollen, angry looking, hot, and dry in appearance in some cases, and in others moist, from the exudation of a watery secretion. In this state the patient may continue two or three days, at the end of which time, should the case progress favoura�bly, the surface of the wound will present a less tender and angry appearance. The pidse will have become softer, and the skin of a more genial temperature. In short, the state of the animal will be found to gradually improve, as the exudation of lymph becomes more abundant; until finally, the swelling will disperse, and the animal will soon become thoroughly restored.

Treatment.

The natural indications presented to notice, for our especial guidance, are twofold. First: To control the violence of the fever; and Second: To aid to the utmost, the free exudation of lymph. In promoting the latter, we at the same time are relieving the former.

The proper treatment to pursue, locally, we have indicated already,�see remarks from page 116 to 135. The best remedies in general, are. Purgatives, Aromatic Spt. of Ajmmokia, Nux Vomica, Rhus Toxicodendkon, Calendula, Aconite, and Fomentations.

Purgatives. Where the patient is in a high state of health, a hunter, for example, in perfect condition, or, in a gross state of body, a purgative will prove highly beneficial,

TREATMENT OF.

143

unless the animal be suffering from excessive loss of blood, in which case purgatives are to be avoided. The best purgative is Barbadoes Aloes ; the dose of which, will depend upon the size of the patient and its constitutional energies. Six drachms by weight of the drug, however, is usually considered sufficient for the most powerful horse. Aloes is best given in a ball.

Aromatic Spt. of Ammonia is indicated in cases where the pulse is feeble, and easily compressed, and where the vital powers are depressed. Sometimes it proves of essential service if given to the animal when under excitement from the immediate effects of the injury. Horses of a very excitable nature will on some occasions, after receiving an injury, tremble severely and breathe rapidly for hours afterwards. A diffusible stimulant given to the patient upon such occasions, will be found of value. Administer the medicine as follows:

Aromatic Ammonia, from Water (Cold).........

3Jvtovj 3^xiJ

Arnica 1, in two drachm doses, given in a little water, is an excellent remedy to be used in alternation with the Aromatic Ammonia. Two, or at most three, doses of Ammonia, at intervals of five or six hours, will generally prove sufficient.

Nux Vomica. Should the administration of a purgative be deemed necessary, Nux Vomica is a remedy valuable to resort to, after the action of the purgative has subsided. It will assist in keeping the bowels in a well regulated state. Give the remedy of the 1st dilution in forty drop doses, every eight or ten hours, in a little water.

Ehus Toxicodendeon is a valuable remedy to apply either as a lotion, or to give internally. Used as a lotion, it is good for wounds and injuries of the tendons and ligamentous tissues. Mix as follows, and apply the lotion warm :

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Rims Toxicodendron #9632;copy;- ............ 3I

Water ..................... gxvi

If resorted to for internal use, it may either be given alone, or in alternation with Nux Vomica. Use the first dilution in two drachm doses, in a little water.

Calendula is a remedy to use to flesh wounds locally. Of Calendula we have treated previously,�see page 108.

Aconite will frequently be found an excellent remedy to apply externally, especially when the patient is severely pained. Make the lotion as follows :�

Aconite -6- .................. 3i^v

Water........................ gxij

Mix the two together, and apply the lotion warm to the part injured.

Fomentations we have treated upon previously. Steam is the best as a fomentation. Where the patient is severely pained, apply the steam freely. Examine the wound also for the lodge�ment within it of foreign bodies. If purulent matter is pent up, liberate it freely, and at once. If steam cannot be obtained for purposes of fomentation, apply hot water, not so much iqwn the part injured, as immediately around where the injury may be situate.

TRAUMATIC TETANUS.

Two varieties of Tetanus or Lock Jaw are described by Veterinary writers : viz., Idiopathic and Traumatic. Of the Traumatic form of Lock Jaw, or Lock Jaw arising fron a wound, we shall treat on the present occasion.

SYSIPTOMS OF.

145

Traumatic Tetanus is more common than the Idiopathic form of the disease, and it is also more fatal. The Traumatic is a form, generally speaking, of the very worst nature, not only with regard to the amount of suffering which it entails upon the patient, but in numerous instances from the uncontrolable nature of its course. It is also more prone to occur from wounds and injuries seemingly of a trifling nature, in old than in young horses. It is also more prone to occur from wounds and injuries inflicted upon the hind limbs than upon the fore limbs. Injuries inflicted upon the hind feet, and upon the muscles situate in the region of the ischium, are exceedingly liable to cause the disorder; and that too of a veiy unmanageable nature.quot; The period ft-om the infliction of the injury to the appearance of the disease, may be called its period of incubation. Not unfruquently a wound or an injury causing Tetanus, may to all appearance be healed before the disorder is observed. On the other hand, it may arise within a few hours after the occurrence of the accident, and run its course to a fatal result with exceeding rapidity, and with a degree of violence fearful to observe. Wounds so quickly induc�ing Tetanus, are usually of the variety called punctured ivounds.f Old horses seldom recover from the complaint. The more rapid its manifestation, the more acute in the generality of cases is the malady, and the more destructive are its results. The period of its duration in fatal cases, is from a few hours to fourteen, or even twenty-one days. When recovery takes place, its duration is generally from four to six weeks. In cases of Tetanus, where the jaws become firmly locked, recovery from the disease is exceedingly rare. Fever is not a necessary attendant upon Tetanus. In many of the worst forms of the disorder, we have found the pulse scarcely disturbed, unless the patient was unduly excited. Tetanus is a remittent disease. In cases which tend to a favourable result, the paroxysms of spasm less and less frequently occur, and are less and less severe, until in the end they entirely cease, and the patient recovers.

* For Ischium, see Engraving of Skeleton, t Sec Punctured Wounds pages 135-6, VOL. I.nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; I

14 Cnbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp;TRAUMATIC TETANUS.

During the existence of the disease however, the patient is never entirely free from spasm. It subsides slowly and regularly. Where the pulse is much disturbed at the commencement, it is seldom or ever recovery takes place.

The disease is presented in acute, sub-acute, and chronic states. It is from the sub-acute and chronic forms that the greatest number of Tetanic cases recover.

For the convenience of description, and for the better illustra�tion of our subject, the symptoms of Tetanus may be arranged into three classes. First: symptoms of the early or incipient stage of the malady. Second : of the middle or sub-acute stage ; and Third : of the acute, or last stage. In every case of Tetanus which ends fatally, the most acute stage of the disease is the last. The patient is generally in the end destroyed from its excessive active violence. The most acute stage may set in at once, or follow so quickly upon the first, as to have prevented the first from being noticed. Should the first stage of the disease continue for any length of time, the animal will be observed to manifest a peculiarity of gait; presenting, in fact, a degree of stiffness and disinclination to move altogether uncommon to behold. One of the earliest symptoms, and perhaps one more clearly indicating what is about to supervene than any other, is the pro�jection of the Membrana Mctitans over the front of the eye_iA degree of stiffness in the gait may arise from other causes, such as recent exposure of the animal to cold and wet, or from severe labour. By lifting up the head of the patient, however, and observing if the haw, as it is commonly called, suddenly projects over the front of the eye, accompanied with a reluctance and a starting back on the part of the patient to submit to the operation, we may at once decide that the case is one of Tetanus. The jaws may not be closed, nor the animal present anything peculiar to the ordinary observer; but the projection of the haw, together with the general hardness of the muscles of the body are symptoms sufficiently 'ndicative of the malady.

SYMPTOMS OF.

As the disease advances, or passes into the second stage, the general stiffness becomes more confirmed. The head, neck, body, and limbs lose their suppleness. The patient when made to turn round, does so as stiffly as a beam of wood. The general appear�ance of the animal at this time is well represented in fig. XX.

Tetanic Hor*c, after Youatt.

The muscles situate at the junction of the head and neck, present a state of tightness peculiar to the disease. The ears are cocked and firm, as though attentive to sound. The hind limbs are placed wide apart; the patient straddles and walks exceedingly slow. The tail is constantly elevated, and possesses a peculiar quivering motion. The muscles of the belly are cramped. The pulse is seldom disturbed, but the respirations are quicker than ordinary. The haw projects more or less over the eye con�tinually. The temperature of the body will be natural. Should the patient be able to eat, food will be sought with even more than usual avidity. For a few days at first, the bowels will be torpid, and the urine high coloured; but as the system becomes accustomed to the shock undergone, unless prevented from the drugging so commonly pursued in this malady, the functions of the

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digestive and urinary organs will resume, to a considerable extent, their wonted state. The disease being a remittent one the spasm and general excitement of the system becomes increased, and afterwards declines. The patient perspires freely, the muscular system becomes more rigid, and the respirations are also increased. This remittent character of Tetanus is of constant occurrence. An increase of the general spasm may come on once every twelve or twenty-four hours, for many days in succession, and continue for a long time, with a similar degree of force ; then slowly abate both in intensity and in regularity, until it disappears and leaves the patient convalescent; or the third stage may supervene, and destroy the animal.

The third and last stage of this fearful malady is marked by the spasmodic attacks presenting as it were a cumulative character. They appear with increased force; they are of longer duration, and they succeed each other with greater rapidity, until in the end the limbs become so rigid that the patient is no longer able to balance himself. He falls to the ground, a heap of cramp and distortion. The limbs will become inflexible. The neck will be drawn towards the back with a force that threatens to crush the bones of the cervical and dorsal vertebrae into fragments. The nostrils will be dilated, and the body suffused with perspira�tion. The respirations will have become more rapid and harsh in sound, until at last one spasm more dreadful in intensity r^han any former one seizes the poor animal, and death mercifully closes the painful scene.

I'roijuosia.

The Prognosis of Traumatic Tetanus should at all times be guarded. The patient may die as late as the twenty-first, or even twenty-third day, from the commencement of the malady. When the malady however does not pass beyond the second, or sub-acute stage : when the jaws are not rigidly closed, the pulse not dis-

PATHOLCXiY OF.

149

turbed, and the animal can partake of food; when the disease does not increase in severity, but if anything appears relieved from the remedies used and the course pursued, a favourable result may be looked for. But when the jaws remain rigidly closed, the pulse greatly disturbed, the respirations quick and hoarse in sound, from partial spasm of the glottis; when the general stiffness is excessive, and the spasmodic fits succeed each other with greater rapidity and greater force, a fatal result may be prognosticated.

Appearances after Death.

We have carefully dissected tiie carcases of more than twenty cases of Traumatic Tetanus; and in all -we found congestion of the superficial veins; in eight cases congestion of the tissues of the part injured; in six cases congestion, and consequent effusion, of the membranes of the spinal cord; in one of which, the membranes were darkened considerably. In one there was effusion of serum within the lateral ventricles of the brain. The congested appearance of the membranes of the spinal cord, varied from a slight blush, to darkish coloured stains. In every case, we found extensive laceration of the muscular tissues, and effusion of blood and serum within the areolar and connecting tissues. In three, laceration and rupture of the diaphragm; and in every case, what might be expected, viz, congestion of the lungs, and dryness of the mucous membranes the entire length of the intestinal canal.

Pathology.

The following remarks on the pathology of Tetanus by Druitt, are so excellent in themselves, and bear so closely upon this malady when affecting the horse, that no apology is needed for extracting them :�quot; The spasms of Tetanus, affecting as they do all the voluntary muscles, must evidently depend upon some morbid condition of those central organs, the spinal cord and medulla

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oblongata, from which all the voluntary muscles are supplied with nerves. This morbid condition may depend on centric causes; that is on causes affecting the spinal marrow itself; or on eccentric causes ; that is to say, irritation of some other part of the body, which irritation is conveyed to the spinal cord, by the sentient nerves.

quot; With respect to the nature of this morbid condition, it cannot be regarded as essentially inflammatory, because the quot;spinal cord is often found after death without a trace of vascularity, and because Tetanus may be established during a state of depression and collapse that would be quite incompatible with inflammation. It must be concluded, therefore, that Tetanus is merely a manifest�ation of functional disorder in one department of the nervous system, and that the nearest approach we can make to a correct pathological definition is to say, that it consists in an unnatural excitability of the spinal cord, through which it produces spasm of the voluntary muscles ; a spasm that is aggravated by the slightest impression on the sentient nerves.quot; *

Causes.

The proximate cause of Traumatic Tetanus as already stated, is dependent upon a peculiar change within the whole, or part, of the nervous centres, while the exciting cause originates in mechanical violence.

The mechanical causes of Tetanus are numerous ; and many of them are seemingly so simple as to appear inadequate to the production of such violent and terrific effects. Simple punctures and mere scratches upon the skin have been known to induce the malady. Mr. Dickens, of Kimbolton, relates in the Veter�inarian, for 1857, page 689, the case of a young horse having received a slight scratch upon his side, by coming in contact

* Druitt's Surgeons Vade-Mecum, p.p. 12 and 13. Seventh Edition.

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with a nail. Ten days afterwards the animal was seized with Tetanus of so violent a character, as to destroy its life in a few hours. Pricks in the foot at the time of shoeing, or from the shoe being forced awry, and the stumps entering the sole ; punc�tures near to the ischium; docking too close to the rump; (this operation independently of going too close to the rump, is very likely to induce Tetanus, if the animal operated upon be old); broken knees; kicks from another horse, inflicted upon parts con�tiguous to the joints, particularly the hock joints; castration, particularly if the animal be exposed to cold and wet afterwards ; Saddle-galls and injuries of almost every grade of triviality are suflioient, at times, to cause the worst forms of Tetanus.

The time at which Tetanus may appear after the infliction of an injury, varies from a few hours to even three weeks. From three to ten days, however, appears to be the average period.

Treatment.

In the treatment of Tetanus we place comfort to the animal in the first rank. By comfort, must be understood good quarters to the patient in housing, clothing, and feeding, where food can be taken. Upon the discovery of the disease, the animal should be placed at once in a comfortable box, entirely away from every source of annoyance. Repose and a low degree of light are prime essentials to recovery. The straw in the box should be plentiful and chopped, in the way recommended at page 92; and as the disease will cause the animal to perspire abundantly, plenty of dry clothing should be at hand to use in place of that it may be necessary to remove. The quantity and kind of clothing will of course depend upon the season and the kind of weather which may prevail at the time. See page 92.

With regard to medical treatment, we could say much in condemnation of the modes usually pursued. Numbers of horses

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we doubt not, die from the disease. Numbers endowed with constitutional vigour sufficient for a time to conquer almost any�thing, recover in spite of both disease and treatment, whilst others are without doubt destroyed by the treatment pursued.

The treatment, to be rational, must be directed to three ends. First :�To the external comfort of the animal. Second : To the state of the part locally injured ; and Third ; to control the violence of the disease, by giving all the aid wc can to the vital powers. The nature of the attention to be directed to the comfort of the animal, the reader will find amply treated upon from page 91 to 96.

Local Teeatment. Supposing the injury, in the first instance, to have occurred to the foot, remove the shoe, and pare the foot. Thin it at the sides with a rasp, and thin the sole, until it springs from the application of gentle pressure. Afterwards im�merse the foot in a large poultice, made of bran and hot Arnica Lotion�the lotion to be made as directed at page 109. The poultice should be renewed twice or thrice a day. The attendant in going about the patient should do so with all possible gentleness. If the injury be a flesh wound, a large soft sponge dipped in warm Arnica Lotion, and fixed to the part injured, will be proper to apply. Should a difficulty be experienced in fixing the sporge to the wound, pursue the following plan. Procure a few slips of linen of sufficient length, half an inch wide in the middle, and one inch wide or more at the ends. Place the sponge in close contact with the wound, and let an assistant hold it there until the ends of the linen straps are secured to the skin, by means of thick glue, or collodion. Collodion will set the quickest, but glue will hold the best. Place the ends of the linen straps so that the lotion, which may drain out of the sponge, cannot drain upon the glue, otherwise the straps will fall off. By this process, the sponge can be held to the wound, and fresh lotion poured upon it when desirable. The Arnica Lotion may be changed for a Lotion of Belladonna, or Tincture of Aconite.

TREATMENT OF.

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Belladonna -e-Water

Mix together and apply warm. Where Aconite is chosen in preference, mix it of the strength directed for the Arnica or Belladonna mixture.'quot;'

In cases of Tetanus, where a wound situate upon a fleshy-part is the exciting cause, if the skin contiguous be tight, hot, and tender, make two transverse incisions, one about an inch above, and another an inch below the wound. Make the incisions with a clean sharp scalpel. Make them freely, and allow them to bleed as long as they will. Then clean away what blood may adhere to the limb, and apply the Aruica, or the Belladonna Lotion as directed. In two cases of Tetanus arising from wounds situate upon the semi-tendinosus muscle, a few inches below the ischium, two incisions to each ease, and of the kind recommended, were made with the best results. In both the cases alluded to, the skin was hot, tightly stretched, and exceedingly tender upon pressure. In wounds presenting the character described, it may be the best plan, when practicable, to entirely remove the tissues originally injured, from the tissues contiguous. Such removal could be readily affected in muscular parts ; but in the region of a joint or amongst tendinous structures, it would be impracticable.

Wounds and injuries causing Tetanus should always be ex�amined with care, as foreign bodies may lodge or purulent matter may be pent within. Where a sinus exists, its depth and direction shoidd be ascertained, and, if practical, opened freely to the bottom. A contused wound when associated with Tetanus, should also be

� A better article than glue for holding the linen straps to an injured part, will be found in a Cement made as follows;�Take Black Pitch two ounces, Gutta Pcrcha cut into thin slices, an ounce. Place the two together in a thick brown earthenware tcsscI, which put upon a slow burning fire. Carefully and repeatedly sfir the mixture, until the ingredients are thoroughly melted and incorporated. A little of this made warm and put upon the ends of the linen straps and held a few moments to the hair, will speedily set and remain fixed, even if wet by the lotion.

1/54

TEAUMATIC TETANUS.

freely opened, and its contents removed; but where wounds are healthy in appearance, the skin not stretched, nor the tissues tender, we are of opinion that isolating the wound, or resorting to incisions above and below the injury will not benefit the patient. The hair must be removed from the back along its entire length, to the depth of three or four inches on each side of the spine, and by the aid of Spongio Piline, the part can be kept constantly wet with the warm Belladonna Lotion. In three cases of Tetanus, we have had the hair shaved from the back, to the extent directed, and the exposed skin freely rubbed with the extract of Belladonna, and afterwards the warm lotion regularly applied. Two cases out of the three recovered.

Systemic Treatment. Tetanus, it may be said resembles to some extent, a heap of combustibles ; the least violent inter�ference with the disease, and the whole animal is at once in a state of fearful commotion. The administration of large doses of pur�gative medicine, such as Calomel, or Aloes, or the Farina of Croton, are very likely in patients naturally excitable, to heighten the disease.

Many authors upon Tetanus, manifest alarm at what has been called, quot;that fearful state of constipation so common to Tetanus.quot; Now this said, quot; fearful state of constipation,quot; is, to a great extent mythical. When disease of a severe character of any kind invades the system, all the natural secretions and excretions, are for a time more or less suspended; but so soon as the organism recovers its force, or becomes accustomed to the change, the more important functions are resumed. We have witnessed this over and over again in Tetanus, particularly with regard to the digestive functions. For three or four days after the commencement of the attack, we have seldom observed the bowels to act; but if at the expiration of the time named, these organs have not resumed their proper functions, we have had recourse to one or two warm injections of soap and water, and may

TEEATMENT OF.

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be, clearing the rectum of its contents, after which we have seldom found it necessary to repeat the process, and never to give purga�tive medicine. It is true that in post-mortem examinations of horses which have died from Tetanus, we have found the contents of the intestinal canal to be somewhat dry. This, however, is easily accounted for, if we reflect upon the large amount of watery fluid which is cast off by the skin, during those excessive attacks of perspiration we have previously alluded to. This watery exuda�tion is yielded by the excretory vessels of the skin, which vessels derive it from the general mass of blood within the organisin On the other hand, the rapid disappearance of the watery portion of the blood excites a general absorption of all the loose fluid throughout the body; hence wc can readily explain why the con�tents of the bowels should, after the death of the patient, be in a state of dryness.

Perhaps the best course to pursue, after giving all necessary attention to the comfort of the patient, and to the local treatment, is simply to refrain from giving medicine of any kind, beyond a few doses of Arnica 1, for two or three days at the commencement. If the animal can partake of food, feed with mashes, containing boiled turnips, or boiled carrots, and a little oatmeal. Allow the patient to drink a mixture consisting of equal parts of linseed and oatmeal gruel. Occasionally administer a warm injection of soap and water; and if at the end of the second or third day, the bowels have not responded, back-rakc with all the care which can be exercised, as the least additional excitement will increase the general spasm. The best remedies in general for Tetanus are Arnica, Strychnia, Nux Vomica, Belladonna, Muriate of Morphia, Chloro�form, Extract of Indian Hemp, and the Steam Bath. Other remedies of a general character we shall enumerate at last.

Arnica. Use this remedy of the first dilution. Give it in two drachm doses, by measure, either alone or in alternation with Nux Vomica of the first dilution. The medicine is best ministered in a little water.

156

TEAUMATIC TETANUS,

Steychnta, is one of the most valuable remedies for Tetanus, but it requires to be used with the greatest caution. It should not be used lower than the fifth trituration. We have ex�perimented largely with this drug upon tetanic patients, and we are satisfied that it cannot be used with safety for four or five days in succession, of a lower trituration than the fifth. A trituration lower than the fifth, will produce colic, a disease which in Tetanus is disastrous in the extreme. Give the modi-cine, then, in scruple doses, at intervals of five or six hours. It may be given in a little wet flour upon the tongue. It is best to use Strychnia alone ; That is, not alternated with any other remedy. As the patient improves, supply the medicine less fre�quently.

Nfx Vomica. This remedy may be supplied in alternation with the Arnica. Give twenty drops for a dose in a little water. Administer them every four hours turns about. Nux Vomica is valuable in promoting the action of the bowels.

Belladonna, is a remedy of the highest value in Tetanus. The dose proper to supply, varies from two drachms by measure of the first dilution, to two drachms by weight of the extract of the drug. It is better to resort to Belladonna after the disease has existed for some time. Its use should be steadily persevered in for a week or ten days in succession. If the animal be large-�ized, minister two drachms by weight of the extract night and morning. Administer it mixed with wet flour upon the tongue. It is better first to make thin the extract with a little Spirits of Wine, before combining it with flour. So long as the patient improves under the administration of the drug, continue its use. Many practioncrs report highly of the curative properties of Belladonna in Tetanus.

Mueiate of Moephia. Another capital remedy to admin�ister in this disease. Four or five grains may be given at a dose, give it in wet flour. It is an excellent remedy to resort to

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157

after the bowels have resumed their natural functions. These organs, however, require watching under its influence, otherwise constipation may ensue. As Morphia is the active principle of Opium, the latter may perhaps be selected in preference, on account of the price. If so, use the Opium in drachm doses, night and morning. Give it in wet flour. AVe have more faith in Bella�donna as a curative agent in Tetanus, than in Morphia or Opium.

Chloeofoem is another pre-eminent remedy to resort to when the disorder has become chronic, and Belladonna ceased to act with decided benefit. Sometimes a remedy acts well for a time, and then fails to produce any further change. It is occasionally so with Belladonna in cases of Tetanus. Chloroform is best given in cold flour gruel. The gruel should be well boiled, and used thin. Mix in the following proportions :�

Chloroform ......

Cold Flour Gruel, thin,

gij by measure. 1 pint.

Before mixing the two together, the gruel must be cold. Place the mixture when not used away from the light, and supply the whole at four times, at intervals of six or eight hours between each dose. We have witnessed the best results from Chloroform ministered as directed. If resorted to at the commencement of the disease, we question if its effects would prove as well marked, as if given in six or eight days afterwards.

The Steam Bath should be resorted to in Tetanus more frequently than it is. To do so is not difficult, especially by the aid of the steam generating apparatus figured at page 132. With this apparatus it may be effected by a process at once simple, cheap, and efficient.

Proceed as follows. Procure two light wooden Trusscls, seven feet in length and about four feet six inches in height, Along the

l^fl

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top of each Trassel,bore six holes, each hole half an inch in diameter. Bore them at equal distances from each other, and at corresponding distances in each Trussel. Place the Trussels four feet apart, and parallel to each other in the box or stable where the patient is to be operated upon. Lead the animal between the Trussels; then from one Trussel to the other, fix bent rods, of half inch iron, or of hoop wood; each rod passing over the patient as an arch; then over the whole draw a waggon cover. The cover must be large enough to cover the iron arches, the Trussels, and to fall to the ground behind and on each side the patient. In front, fix a smaller piece of tarpauling ; fix it under the neck, and in front of the breast. The head of the patient must be outside, but every other portion of the body must be within, with the tarpauling so closely secured as to prevent the escape of steam. Let the whole apparatus be prepared with as little noise and as little excitement to the animal as possible, and when all arrangements are complete, and the outer door closed, turn in the steam near to the ground and under the belly of the patient. Continue it for twenty minutes or half an hour, or longer if the process be agreeable. After the bath, great care must be excerciscd, otherwise injurious effects may ensue. The animal must be briskly scraped, then clothed with hood, breast-cloth, woollen rugs of an extra size, and woollen bandages to the limbs, after which allow the patient to drink freely of gruel. The animal may then be left alone for several hours. Should the steam bath prove beneficial, it may be repeated every three or four days, until convalescence is fully established.

Fomemtatioxs. In addition to the steam bath as recom�mended above, it may prove advantageous to apply hot water fomentations along the spine. To effect this, procure a thick woollen rug, which saturate with hot water and place upon the back and immediately above it, place a dry rug folded three or four times lengthways ; then over the whole fix the article called Body Sacking, such as pourtrayed at fig. IX, page 76. By this simple

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process, hot fomentations can be firmly secured to the spine, readily changed when necessary, and retained so long as they may prove beneficial.

Traumatic Tetanus is a disease which in many instances the practitioner must expect to fail in his efforts to cure ; and the rea�son tvhy he must expect to fail appears simple. The direct cause of the tetanic state is evidently of a continuous character, and where the cause is of a continuous nature, unless it can be destroyed, or its operation prevented, our curative efforts are certain to prove abortive, no matter whether the disorder be Tetanus, or in fact disease of any other kind.

Of all remedies at present known for the disease, that which according to the law of similars is the best adapted to cure it, is Strychnia. This drug is pre-eminently the remedy for Tetanus; but of what avail will be either Strychnia or any other substance if given to a disease, the direct cause of which, is continuous in its operation! It is desirable, however, upon all occasions to know the essential remedy to use for the cure of a disease; but it is equally desirable to fully understand the impediments to its action. When such impediments are known, and their nature fully understood, our efforts will at once be directed to their proper centre of operation, and though we should, from a peculiarity and combination of circumstances, fail to cure our patient, yet our dis�appointment at the result, will neither be so bitter, nor perhaps so hopeless with regard to cases of such a nature as may happen in the future. If it be not however within the power of the practi�tioner to do good at all times, it certainly ought to be within his power to refrain from the infliction of injury, and by this we moan, to refrain from bleeding, and sweating with sheepskins The administration of enormous doses of drastic purgatives, and when opportunity offers, the indiscriminate forcing into the system of drug after drug, without regard either to its suitability to the case, or the injurious effects which it may produce. Medicine,

ILA

160

TRAUMATIC TETANUS.

unless given under the enlightened guidance of a law, is a dan�gerous game of hazard. In no other disease will the Veterinary Surgeon find a greater necessity to carry out the Hunterian rule than in Tetanus : viz, quot; to allay morhid irritation, and give support to the vital energies.quot;

The following is a summary of what, in the generality of cases, will be necessary to be done : If the disease arises from pricks in the foot, inflicted in shoeing, or from the gathering of a nail in the foot, remove the shoe ; pare well the part injured and thin the sole j evacuate purulent matter; remove foreign bodies of any kind which may be present; apply large poultices of Bran made hot with boiling Arnica or Aconite Lotions, not only to the part injured, but to the spine as wdl. Make transverse incisions above and below a flesh wound, when the structures involved are hot, stretched, and tender, while Steam Baths and Fomen�tations of hot water medicated with Tincture of Arnica or Tincture of Aconite, may prove valuable if occasionally used, either to the part locally injured, or to the system at large.



	1

	YETEEINARY PRINCIPLES AND PRACTICE.

	P A 11 T

	INFLAMMATION. Inflammation�From In�animo, to bum�is one of the most common forms of disease presented to the Veterinary Surgeon ; a form respecting which much has been written, and regarding which many erroneous opinions have prevailed. From causes of this nature, injurious and serious consequences have resulted. Indeed it will be evident to all who reflect, that sound medical practice must of necessity be based upon sound medical principles. Consequently, the more obscure our knowledge of healthy and diseased organic action, the more crude and barbarous will be our practice of the healing art. Until very recently, every kind of disease was regarded as a form of Inflammation: and for its cure recourse was had either to local or systemic venesection, or both, together with numerous other measures, all more or less of a depletive nature. A less sanguinary system of practice, however, now prevails.

	The manner too in which Inflammation has been written upon, has made it to the pupil, and also to the general reader, a subject perfectly bewildering. Its doctrines are so loaded with hypothetical formulai, and yet are so inseparably blended with

	VOL. I.



	8nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp;INFLAMMATION. new matter was being regularly added to the old, without a proportionate quantity of the old being removed, the body in a short time would increase to an enormous bulk. But the disintegration during health is equivalent, or nearly so, to repro�duction in an adult animal�and thus it is, that the balance is maintained. But the question very naturally arises, how is this disintegrated material removed, and finally expelled from the system 1 To effect this in part, another class of capillary vessels are provided, which are found to terminate in a manner altogether the reverse of the former. The arterial capillaries, are the terminating points of the arteries ; but the capillary veins commence at the termination of the arterial capillaries, and terminate in the smaller veins ; while the smaller veins terminate in the larger, and the larger in the liver and the heart, in which organs the disin�tegrated materials, to a great extent, are either immediately or mediately ejected from the body; or, at least, these organs materially aid in such ejection. PIGURS m.



	Capillary net-work of Muscle. Such are the natural functions performed, in part at least, by the capillary system. The account we give is brief, and necessarily imperfect; but we trust it is sufficient to furnish the reader with a clear conception of the matter in hand, and in turn enable him to clearly comprehend that which is to follow. We have thus endeavoured.

	Firstly :�To define what is implied by the term Inflammation ; and in doing this, we have also



	TEEMINATIONS. a..�Resolution.	11
	The term Resolution is used to denote the state of the tissues after their recovery from the effects of lutlaramatioii. The defini�tion however which is usually given of the word in our uiedieal dictionaries, in relation to pathology, is this;�quot;the subsidence of injlammation, witliout the formation of abscess, ulceration, or termination in gangrene or induration;quot; but in the sense in which it is used by Dr. Copland and others, it possesses a far wider moaning�meaning in fact, the complete and entire restoration of the normal integrity of the tissues involved, both in structure and function; no matter whether such restoration takes place prior to, or after, the formation of abscess, ulceration, or induration.

	Though such is avowedly the practical meaning of the term ; yet if it be regarded in its relation to the state of the tissues after the subsidence of cine or more of the effects named, it is not sufficiently descriptive of the different conditions and results.

	Suppose, for example, we restrict the meaning of the word to denote the state of the tissues after the subsidence of Inllamma-lion, without the formation of abscess, ulceration, or indnration; what term shall we use to denote the state of the tissues, supposing inflammation to have progressed and assumed one or more of the states named, resulting in a permanent change of the tissues both in organization and function? li is clear the mere, word Resolution will not be correct. To meet the difficulties of the case, we propose to consider Resolution as naturally dividing itself into two kinds:�Perfect and Imperfect. By Perfect Resolution we mean the complete and entire restoration of the normal integrity of the tissues involved, both in structure and function; while by Imperfect Resolution we mean that state where the tissues originally involved are left permanently altered, but yet not so far altered as to destroy either vitally or mechanically their former usefulness.



	TERMINATIONS.	l.T

	Ringb�iie interfere materially with the natural usefulness of the animal, anil render him permanently unsoundj while in other types of the same diseases, the patients arc neither rendered permanently unsound, nor less useful than before. For these and many other pathological facts of a similar nature�facts which will readily present themselves to the practical reader�wc suggest the distinction above set forth, believing it to be founded in the reality of things.

	B.�Gangrene, or Mortification. Mortification, from mors death, and Jio to become; to become dead�is the second mode of termination, spoken of by Dr. Copland. When any part of a living animal loses its vitality, so that the circulation and all the other functions of the part entirely cease, that part is said to be in a state of Mortification. quot; Mortification is divided into acute and chronic. The former is also sometimes called humid, and the latter dry gangrene.'quot;''' Chronic Gangrene is occasionally met with in old cows. The animal, affected in some instances for weeks or even months before death�will slowly sink in condition, and the appetite will partially fail; but beyond the lo?s of appetite and loss of flesh, little else may be observable. Tin; animal will in course of time drop down and quietly die. Examination of the body will shew that Gangrene of the peritoneum, also of the pleura, and even of the areolar tissues throughout the organism has taken place.

	quot; The terms Gangrene and Mortification are often used synonymously; but gangrene properly signifies the state which immediately precedes mortification; while the complete mortifica�tion, or absolute death of a part, is called sphacelus. A part which has passed into the state of sphacelus, is called a dough. When a part becomes gangrenous, it loses its natural heat and * Hooper.



		22nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; INI-LAM.MATIOX, every fresh removal of course adding to the size of the ulcer. As the sore becomes larger, its edges will appear more ragged-looking, and swollen, and not unfrequeutly a fungoid kind of flesh will rapidly arise from the sides and bottom of the cavity. Such growths are more particularly evident in glanderous ulcers.; and in ulcers of cankered feet, than in the common non-specific forms of the disease. The appearance of such fungoid growths is always indicative of great malignancy in the character of the Inliammation productive of these consequences. Tiie disappearance of tissue under the effects of the ulcerative process has, from the time of Hunter until within a very recent period, been regarded as the result of absorption�an opinion now considered to be erroneous. The disappearance of tissue is found to result from its loss of vitality; and, under these conditions, it is cast forth along with the serous, or sero-purulcut exudation from the walls of the sore. Ulceration is indeed the result of limited sphacelus�the sphacelated portions constituting a portion of the sum total of the exudation from the ulcer itself. The commencement of resolution within the tissues contiguous to an ulcer, is marked by several changes. In the first place, they gradually acquire a state of greater natural firmness;�secondly, the exposed surface of the sore assumes a more healthy colour;� thirdly, the discharge which exudes from it acquires a thicker consistence, becoming of an albuminous, or albumiiio-puriform nature. This secretion gradually spreads itself over the ulcer, serving a double purpose; first, protecting the raw surface of the sore from external agents, and secondly, by gradually acquiring all the conditions necessary to heal the cavity.

	E. �Hcmoi -rli age. Another of the consequences of Inflammation, is that of Hemorrhage�a consequence not spoken of by any Veterinary writer upon Inflammation with whom we are acquainted; and



2G		IN'FL.aiMATlO.V,

to a pale straw colour. In the sthenic forms of inflammation tliirf coagulnm is firm and solid in its general appearance ; in tlic asthenic forms of inflammation, on the contrary, lymph is scantily supplied, and it exists in a scmicoagulated condition, having a sanious appearance, and readily passes into a state of putridity. Of the nature of this coagulahlo lymph effused from the exposed surface of a flesh wound and injuries of a like nature, and of the healing process, we shall treat more fully hereafter.

	lt;:.�Hepatisation. Hepatisation, from the Greek word Ifcpar�the liver, or liver-like. The term Hepatisation is applied to a morbid state manifested by the structures constituting the lungs, as a conse�quence of Inflammation. The respiratory organs, when inflamed, are affected in a manner similar to other structures of the softer kind; they swell, and become more solid than before; and this swelling, together with the increased solidity�such solidity arising from the deposition of lymph, within the air-cells, and small bronchial tubes of the organ diseased�constitute the peculiar morbid state in question, designated Hepatisation. The lung, in short, has become solid, or liver-like in its general condition.
'^:

Hepatisation was regarded by Lannec as the second stage of Pneumonia. But, if we strictly regard the phenomena of this disease as manifested in nature, Hepatisation will be the third stage of the morbid process; the first stage being that which marks the invasion, or commencement of the malady; the second, its full activity; and the third, when the lung has become hepatised. Of this however we shall treat more fully when specially treating upon Pneumonia. quot; The lungquot; in Hepatisation, says Lannec, quot; has entirely lost its erepitous feel under the finger, and has acquired a consistence and weight altogether resembling that of liver.quot;

LSWraquo;laquo;



	TEU.MINATiONS. Asthen ic Inflammation.	20

	Is characterized by, and peculiar to, a feeble and debilitated state of the organism, by an uncertainty in many instances as to the real nature of its cause, by an insidiousness in its progress, by a want of that precise certainty in its symptoms, which is so characteristic a feature of the acute sthenic kinds, by its being attended with fever of a low typhoid nature, and by its greater proneuess in the generality of cases to spread to nearly all the soft tissues, and terminate in gangrene and death. The most common forms in which astheuie inflammation is manifested is that of Typhoid Pleuro Pneumonia; Purpura Hemorrhagica, and also in Scarlatina Maligna. Specific Inflammation. Specific from the French word Spedfique from the Latin species and facio, that which makes an object, or a state of organism, of the kind or species which it is. The term specific in the present instance, is used to denote a form of inflammatory disease which is invariable in its scat, in the symptoms which characterize it, and in the consequences which result. Glanders, for example, is a specific inflammatory disease of this nature, the seat of its activity being principally limited to the mucous and dermal tissues. Scarlatina is a second instance, and Canker is a third.

	Specific inflammatory diseases differ in many respects from the common, or non-specific inflammatory ones. Firstly, certain of the specific forms, are capable of reproducing themselves in other animals by contagion. Glanders is a specific inflammatory disease of this nature; it is a disease of the blood, arising from the presence of a morbid poison within the fluid itself, giving rise to the phenomena peculiar to this malady ; originating in causes of



	TERMINATIONS.	.'51

	Chroi�i: Inflammation. quot;Acute and Chronic Inflammationsquot; says Wharton Jones, quot;are so named from the most striking parts of their character; the former being distinguished by severity of symptons, the latter by long continuance. In the acute form of inflammation with severity of symptoms, there is combined rapidity of progress; and in the chronic form, long continuance is tempered by mildness of symptoms. quot; These differences, it will be observed, are merely differences in degree and continuance. There does not appear to be any essential difference in nature between the acute and chronic forms of inflammation. In both there is congestion, in both exudation, and in both the exuded matter undergoes analagous changes. Moreover, it is to be observed, that between well marked acute and well marked chronic inflammation, aJl intermediate forms are met with. quot; The conditions on which the striking parts of the character of acute and chronic inflammation will appear to depend, arc respectively the following:�In acute inflammation the congestion is greater; and if resolution, to which there is a tendency, does not soon ensue, exudation of lymph takes place more or less copiously�the result of which is adhesion, or abscess, or thick puriform discharge, as the case may be, after which the circulation may gradually be re-established, and so there is an end of the inflammation. In chronic inflammation, on the contrary, the congestion is less complete; there is but little tendency to resolution, and exudation is cither not so copious within a given time, or it is more watery. Moreover, the congestion persists, and the exudation still goes on; the result of which is permanent enlargement of substance, or chronic discharges, as the case may bo.

	quot;Chronic inflammation may either succeed to acute inflam-



	BLOOD IN IlKALTI	43

	when the ilisus are under the microscope, und also the density of the rtuid in whiuli the corpuscles may float at the moment of examina�tion. The blood discs of the horse are less in size than those of the human being. The latter arc described as varying quot;from tjuVjj to .j�V� ^�f ^al1 i¹¹⁰'¹ 'u diameter�the average being from the ~~_3s¹_(gt;0~~ ^lO TfTrTTn-

	White or Colomiess Corpuscles. quot; These particles are found in all kinds of blood. They are spherical bodies destitute of colour; in size they slightly exceed the red corpuscles; in mammalia, they are much fewer in number than the colourless discs; it is said they exist in the proportion of one colourless to fifty coloured.quot; The uses of the colourless corpuscles have nut been clearly ascertained. By some they are regarded as the pabulum whence the coloured discs have their origin. Dr. Carpenter and others regard them us the source of the fibrine of the blood. Having enumerated the principal constituents of the blood, the reader, we trust, will now be better prepared to understand the condition of the vital fluid during the inflammatory process.

	One of the earliest changes within the blood, is that of the fibrine becoming more abundant, and in the sthenic forms of the disease, more dense also. If blood be abstracted during the ex�istence of a severe inflammatory disease, and allowed to remain at rest, it will coagulate, and its serum will separate, but the clot will present a different appearance. This clot will be cupped, or concave, upon its superior surface; and instead of the mass pre�senting a red colour throughout, or nearly so, a portion only will be occupied by the red corpuscles; the corpuscles will congregate at the lower portion of the dot, taking up perhaps little more � Todil and Bowman, Vol. i p. 397. I Ibid



	76	INFLAMMATION,

	productive of harm. By the adoption of measures of this nature, the practitioner will not commit himself. Large doses of medicine cannot bo administered at any stage of a disease, without either good or bad as a sequence. Medicine, unless poured into a dead animal, cannot remain inert. The multiplicity of actions per�petually going on within the living structure, are certain to become affected by the drug, either for good or ill; so that it may be laid down as a rule, that a drug once given, if given in large quantities, if it does not operate to the good of the patient, will work to its injury. The course of the practitioner, until he is perfectly clear upon the matter, is at the onset, to use remedies the action of which will tend to the good of the ixitient, without the possi�bility of producing harm. We possess remedies of this nature; remedies which we venture to designate neutral, or non-medicinal. Hot and cold water are non-medicinal; and yet they are capable of producing effects upon the living body when diseased, which formerly were considered as belonging to medicines only. Hot water, we therefore class us a neutral remedy; or a remedy of the nature indicated; and it may in the generality of



	Body Sacking. cases, be resorted to with benefit; or, at least, with a certainty of harm not resulting, unless from scalding the patient�a conse-



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	BIBUOTHEEK UNIVERSITEIT UTRECHT

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	PART II. FLESH-WOUNDS, WOUNDS OP THE TENDONS, INJURIES OP A MISCELLANEOUS CHARACTER, AND THEIR TREATMENT.

	SECTION I.

	PEELIMINARY REMARKS.

	In the present section wc come more to the practical depart�ment of our labour, and in doing so, propose to divide Part II into numerous sections, in which will be considered the greater division of such wounds and injuries as the horse hitherto has been found liable. Under the terms wound, injury, are comprised a variety of states, both of a simple and complicated nature. Injuries are of every kind, grade, and degree; that is, from a slight swelling upon the skin caused by the stroke of a whip, to a fracture of one or more of the bones.

	The position occupied by the horse, as a useful and domesti�cated animal, necessarily subjects him to a variety of accidents, the nature, general course, consequences, and proper treatment of which will constitute the matter of the present part. Before entering upon a special account of each particular form of injury, a few remarks in relation to the causes which are productive of injury to the Horse, may prove of advantage. Perhaps it may be considered out of place to write with regard to causes of this character, simply because injury to horses is of daily occurrence, VOL. I.nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp;n



INSTRUMENTS.		105

and arrested. Limited, but permanent rupture of the bowels; permanent lamenessj permanent blemishes; Traumatic Fever, or Traumatic Tetanus. The Instruments most commonly required in cases of injury, will generally be comprised amongst the following:� For Flesh Wounds and Wounded Blood-Vessels: 1nbsp; nbsp;Twitch. 2nbsp; Side Line. 3nbsp; Large and small sized Pins, Carpet Pins.�Fig. 11, page 107. 4nbsp; Soft string, for twisted Sutures. 5nbsp; Pin Directors.�Fig. 13, page 107. 6nbsp; Zinc Wire, and Needle for ditto.�Figs. 12 amp; 15, page 107. 7nbsp; Wire-cutting Pliers, to cut Pins and Zinc wire.�Fig. 10, page 107. 8nbsp; Liston's Forceps, and Bull Dog Forceps, to secure bleeding arteries. 9nbsp; Strong Silk, to tie arteries. 10nbsp; Needle for Interrupted Suture.�Fig. 14, page 107. 11nbsp; nbsp;Scissors, to remove torn skin, and lacerated muscle. 12nbsp; Large Syringe, to clear away dirt and sand from wounds.� Fig. 16, page 108. 13nbsp; Sponge, two or three large pieces�soft. 14nbsp; Tincture of Calendula 15nbsp; Tincture of Arnica For Open Joints, and Divided Tendons.

1nbsp; nbsp;Sulphuric Ether. 2nbsp; Gun Cotton. 3nbsp; Cotton Wool�dry. 4nbsp; Quick Lime. 5nbsp; Gutta Percha.	6nbsp; Cotton Bandages. 7nbsp; Zinc Wire. 8nbsp; Needle to use Zinc Wire. 9nbsp; nbsp;Slings.



lot]	WOUNDS AND INJOMES, Por Fractures.

1nbsp; nbsp;Splints, of various sizes. 2nbsp; Large pieces of Gutta Pereha. 3nbsp; nbsp;Bandages, botli Linen and Woollen. 4nbsp; nbsp;Flue Tow.		5 Tape. G Slings. 7nbsp; nbsp;Starch Gruel, or Paste. 8nbsp; nbsp;Hot Water.

The Twitch, is an instrument so useful in the restraining-, for a time at least, the vicious propensities of a horse, and its uses are so well known, that it would be waste of time to say more about it. By its aid, with the use of a side line, and the holding up of a fore leg, the worst tempered horses may, ou most occa�sions, be dealt with easily. Laege Sized Pins and Pin Dieectoe.�When a wound is extensive and open, it will be greatly improved by closing it with sutures. The most preferable mode of doing this, in the generality of cases, is by means of the twisted suture. Tlds re�quires a pin, and the best for the purpose, where the wound is large, the structures heavy, and great strength of material is necessary, is the large sized Carpet pin, similar to the one shewn at figure 11, in the annexed plate.

Pin Dieectoe.�The Pin Director, is of great value to the operator, in affording guidance to the pin. The instrument shewn in the annexed engraving, figure 13, is of a new form. The old form of Director is objectionable in one or two respects. In the first place, the blade of the instrument and its handle, are fixed in a continuous line, so that when the blade is passed through the lips of a wound, it is frequently very difficult, when the pin is slid through the groove, to withdraw the Director, in consequence of the top part of the pin being held tight between the handle of the instrument and the skin. This, when operating upon a high spirited or vicious animal, we frequently foim:l a



	VAEIETIES OF.	113

	Eleventh :�After the infliction of a wound of a severe nature upon any part of a living animal, certain phenomena are developed, which may be limited to the tissues injured; or the local injury may develope other phenomena within the organism while the injury is unhealed; or the part locally injured may to all appearance recover, and yet effects of a character most destructive to the life of the patient may become manifest as a sequence to the local injury. The phenomena limited to the tissues, are such as pertain to the healing process. The phenomena developed by the organism while the injury is unhealed, are com�prised in the state designated Traumatic Fever; while under the third state, we may have Traumatic Tetanus, or Traumatic Tetanus may be associated with Traumatic Fever.

	SECTION II. VARIETIES OF FLESH WOUNDS. It is usual to arrange Flesh Wounds into five varieties, viz, 1st.�Incised Wounds. 27id.�Lacerated Wounds. 3rd.�Jagged Wounds, ith.�Punctured Wounds, and 5th.�Contused Wounds.

	In describing wounds, it is proper to name them with reference to the region in which they may exist; as, for example, abdominal wounds, wounds of the neck, ischium, and so forth. They art vol. i.nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp;r



	11�nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp;WOUNDS AND INJURIES, of tlie carcase shewed that portions of the panniculus muscle in�vesting the sides of the abdomen were in a state of gangrene. Great quantities of putrid senun were also liberated. The proper treatment to pursue with contused wounds, we shall fully describe hereafter.

	SECTION III. OF THE HEALING PROCESS, AND GENERAL REMARKS UPON THE TREATMENT OF WOUNDS. Many erroneous notions prevail with regard to the treatment of wounds. Authors have written, and continue to write, as though the natural powers of the living animal were incapable of repairing wounds and injuries. We are alike taught by veterinary authors and the generality of veterinary teachers, that medicated fomentations, stimulating oils, liuaments, decoctions, and astringent washes of almost every variety, and even at times the application of red hot iron, are all necessary to cure a wound, or keep down exuberant granulations, or what is commonly called quot; proud flesh.quot; The healing process is described as consisting of stages, viz. quot;union by the first and second intentionsquot;; the quot;first intentionquot; consisting of adhesion of the divided surfaces by means of a glutinous fluid called lymph, the parts being in fact united to one another by a species of glueing; while the quot; second intention,quot; the granulating or suppurating process, consists in the fleshy chasm being filled up by the gradual deposition of fleshy grain-like particles, superimposed one upon another. In the healing of wounds, the chief care of the practitioner should be directed to the attainment of union by the first intention. The suppurating process is not one to be desired, and in the majority of instances



	m I2inbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp;WOUNDS AND INJURIES, fonn of suture answers well, when it can be got to hold sufficiently; but the secretion from the wound frequently destroys the silk, or thread, or the suture cuts through the skin; and the wound in either case is opened afresh, and the cure is rendered more tedious in consequence. For the proper form and size of needle best {jnbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp;adapted for making the Interupted Suture, see fig. XIV, page 107. The Metallic Suture is made with zinc wire, instead of thread or silk. The wire, which is manufactured on purpose, can be obtained at the surgical instrument makers, of varying thickness and lengths. It is very pliable, and can be readily applied to any part of the animal body. To use it, a needle made for the pur�pose is required. It is of the size and form shewn at fig. XII, jnbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp;page 107. At the top end of the needle a deep groove is cut in the metal; in this groove the wire, after threading it through the eye of the instrument, is laid flat. Without the groove, great difficulty would occur in drawing the wire through the skin, on account of the additional thickness. The Metallic Suture is simply another form of Interrupted Suture, the only difference between the two being in the difference of material used. For the proper mode of making this suture see the preceding paragraph. The thickness of wire best adapted for the generality of cases, is shewn at fig. XV, page 107. Instead of tying the wire as we should tie the thread or silk in the interrupted suture, the ends of the wire are simply brought close to each other and twisted together. The remaining length is then cut from the twisted part with the Cutting Pliers. In the generality of cases, where sutures arc required, we do not recommend the Metallic Suture. The largo needle, which we are compelled to use with the Zinc Wire, inflicts upon the patient very severe pain, from the operator being com�pelled to take a deep hold of the skin and subtextures contiguous to the wound. The Metallic Suture will nevertheless be found of use to wounds in particular localities, and of a particular kind. They will be found useful to wounds which may be inflicted across a joint; as for example, across the front of the hock or the fetlock



	I3inbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; nbsp; WOUN�S AND INJUIUES, becoming dry. The way to fix poultices upon a part injured is a matter so well understood by every one having the care of a horse, as to require no further notice on our part. High Heeled Shoe, In certain cases of injury to the extremities, of a nature to be specified hereafter, it is necessary to relax as far as possible, the natural tension of the parts injured while the animal is stand�ing in the stall or loose box. Injuries upon the point, and posterior parts of the hock joint, require thus relaxing ; also the structures situate at the back part of the hind limbs, between the hock joint and the root of the tail; also in cases of injury upon the Flexor Tendons, both of the fore and hind limbs; and also, when injury is inflicted upon the muscles at the back of the fore limb above the knee, or immediately behind the knee joint. The best mode to effect this relaxation, is by the use of the High Heeled Shoe, of a form similar to the one represented at figure XIX.



	High Heeled Shoe. The caulkens of the shoe represented, are made high; tnA, reaching from one caulkcn to the other, for the latter to rest upon, is a stout bar of iron. The purpose of the cross-bar is to give a more uniform pressure to the foot when upon the ground, and also to prevent the shoe from being entangled amid the straw. If the patient bo turned to grass, it will also prevent the heel from sink�ing deep into soft ground. The caulkens should be made not only of extra length, but should project backwards. When so constructed, the foot is not thrown up so suddenly, nor pitched so much upon the toe. The length of the support, including the



	uo	TRAUMATIC FEVEB,

	cavity permit, pressure may be applied. It will hasten the cure by preventing a further effusion of serum. But if pressure cannot be applied, and the sac refills if left alone, enlarge the opening previously made, inject Arnica #9632;copy;#9632; freely within, and leave a tent of tow in the orifice for twelve or fourteen hours, at the end of which time the lips of the opening will bo found swollen, and purulent matter will issue therefrom. All that now remains to be done, is to encourage for a time such purulent discharge until a new action is thoroughly established ; then remove the tent from the orifice, and dress daily with warm Arnica, or warm Calendula Lotion, of the strength described at page 109.

	TEAUMATIC FEVER. We have now to treat upon the principal phenomena of a constitutioiial nature which occasionally becomes manifest as a sequence to wounds and injuries of every variety, and of almost every degree of severity, save those of a most trivial character. To early recognise and successfully combat two forms of systemic disturbance of the traumatic class, will require every care, and at times the highest skill, on the part of the Veterinary Surgeon. The first is. Traumatic Fever; the second. Traumatic Tetanus. Traumatic Fever may terminate in Traumatic Tetanus ; or Traumatic Tetanus may supervene, without any perceptible inter�vention of Traumatic Fever, or, the two may be associated.

	In wounds of a severe character, from the second to the fifth day after the inflietion of the injury, the system begins to manifest sympathy towards the part injured. This manifestation of sympathy, when presenting symptoms of a kind presently to be described, is denominated Sympathetic Fever, Acute Inflam�matory Fever, Traumatic Fever, and other names which we need not enumerate. It is a state which is generally spoken of in terms of alarm, as though it was something greatly to be dreaded, and



	TREATMENT OF.	157

	after the bowels have resumed their natural functions. These organs, however, require watching under its influence, otherwise constipation may ensue. As Morphia is the active principle of Opium, the latter may perhaps be selected in preference, on account of the price. If so, use the Opium in drachm doses, night and morning. Give it in wet flour. AVe have more faith in Bella�donna as a curative agent in Tetanus, than in Morphia or Opium. Chloeofoem is another pre-eminent remedy to resort to when the disorder has become chronic, and Belladonna ceased to act with decided benefit. Sometimes a remedy acts well for a time, and then fails to produce any further change. It is occasionally so with Belladonna in cases of Tetanus. Chloroform is best given in cold flour gruel. The gruel should be well boiled, and used thin. Mix in the following proportions :�

	Chloroform ...... Cold Flour Gruel, thin,	gij by measure. 1 pint.

	Before mixing the two together, the gruel must be cold. Place the mixture when not used away from the light, and supply the whole at four times, at intervals of six or eight hours between each dose. We have witnessed the best results from Chloroform ministered as directed. If resorted to at the commencement of the disease, we question if its effects would prove as well marked, as if given in six or eight days afterwards. The Steam Bath should be resorted to in Tetanus more frequently than it is. To do so is not difficult, especially by the aid of the steam generating apparatus figured at page 132. With this apparatus it may be effected by a process at once simple, cheap, and efficient. Proceed as follows. Procure two light wooden Trusscls, seven feet in length and about four feet six inches in height, Along the

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