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THE HORSE
ITS TREATMENT IN HEALTH AND DISEASE
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FARCY
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THE HORSE
!TS TREATMENT IN HEALTH AND DISEASE
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WITH A COMPLETE GUIDE TO BREEDING
TRAINING AND MANAGEMENT |
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Edited by
Prof. j. WORTLEY AXE, M.R.c.v.s.
j , , Ex-President of the Royal College of Veterinary Surgeons
te L<MU''er at the Royal Veterinary College, and at the Agricultural Colleges of Downton and Wye
Chief Veterinary Inspector to the Surrey County Council Consulting Veterinary Surgeon to the British Dairy Farmers' Association " Evnn ■ AlUh0r of ''The Mare and Foal" '' Abortion in Cattle " " Anthrax in Farm Stock "
minatl0n °f Horses as to Soundness " " Glanders, its Spread and Suppression " " Swme Fever
Uthotomy or the Removal of Stone from the Bladder of the Horse |
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VOLUME II
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LONDON
THE GRESHAM PUBLISHING COMPANY 34 SOUTHAMPTON STREET, STRAND
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CONTENTS
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VOLUME II
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Section IV.—HEALTH AND DISEASE {Continued)
Leases of the Respiratory Organs (continued)-
Diseases of the Lungs, Spasm of the Larynx, Cough, High Blowing
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20
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Constitutional Diseases ----- " "
Rheumatism, Lymphangitis - Weed, Purpura Hemorrhagica, Hemo-
globinuria Contagious Diseases ------- - - - 31
Influenza, Contagious Pneumonia, Glanders and Farcy, Strangles, Anthrax,
Horse-pox, Gloss-Anthrax, Rabies, Tetanus, Stomatitis Pustulosa Conta- giosa, Tuberculosis, Dourine (Maladie du Coit), South African Horse Sick- less, Epizootic Lymphangitis The Opr.,v -n .....65
"kgans of Reproduction -
A*ATOMY OF THE MALE ORGANS OF GENERATION
Anatomy of the Female Organs of Generation -
Leases of the Organs of Reproduction of the Horse -
Enclosure of the Penis, Paraphymosis, (Edema of the Sheath, Paralysis of
the Penis, Amputation of the Penis, Inflammation of the Testicles Leases of the Organs of Reproduction in the Female
Uterine Hemorrhage or Flooding, Inflammation of the Womb, Vaginitis,
Leucorrhcea, Mammitis, Parturient Fever, Inversion of the Uterus, Cystic Disease of the Ovary The Eye- - - - - " 103 'eases of the Eye and its Appendages - -
Examination of the Eyes, Diseases of the Eyelids, Laceration of the Eyelids
Entropium and Ectropium, Diseases of the Lachrymal Apparatus, Simple Ophthalmia, Inflammation of the Cornea, "Keratitis', Periodic or Ke- current Ophthalmia, Cutaneous - Piliferous Growth from the Cornea, .Cataract, Disease of the Optic Nerve—Amaurosis, Glaucoma |
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CONTENTS
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The Skin (Integument) and its Appendages - - - - - - 124
Uses of the Skin -----....... 127
Appendages op the Skin - - - ... - . . - 131
Diseases of the Skin - - -.......134
Classification, General Observations on the Subject of Diagnosis and
Treatment, Diagnosis, Etiology, Prognosis, The Principles of Treatment, Eruptions of the Acute Specific Diseases, Eruptions due to the Contact of Irritating Agents or to the Circulation of Specific Poisons in the Blood, Local Inflammations, Catarrhal Inflammation, Plastic Inflammations, Bullous Inflammation, Suppurative Inflammations, Squamous Inflammations, Hyper- trophies and Atrophies, New Formations, Hemorrhages, Neuroses, Mal- lenders and Sallanders, Haemophilia, Hsemorrhagic Diathesis, Bleeders Parasitic Diseases of the Horse - - -.....159
External Parasites of the Horse, Ringworm of the Horse, Parasites of the
Skin derived from the Animal Kingdom—Phthiriasis (Lousiness)—Acariasis (Mange)—Parasites of the Digestive System of the Horse Organs of Locomotion—Bones - -.......175
Composition of Bone, Structure of Bone, Classification of Bones, Growth of
Bones, Skeleton, Vertebral Column, Particular Vertebra?, Skull—Cranium, Bones of the Face; the Thorax or Chest, the Pelvis, the Fore Limb, Bones of the Hind Limb Diseases of Bones - .........205
Ring-Bone, Splint, Ostitis—Inflammation of Bone, Periostitis, Chronic
Periostitis, Acute Ostitis, Chronic Ostitis, Necrosis and Caries, Osteo-porosis —Big Head, Spavin, Bone-Spavin, Metacarpal Periostitis—Sore Shins Fractures 221
Fracture of the Bones of the Skull, Fracture of the Vertebrae, Fracture of
the Dorsal and Lumbar Vertebrae, Fracture of the Bones of the Face, Fracture of the Frontal Bone, Fracture of the Lower Jaw, Fracture of the Anterior Maxillary Bone, Fracture of the Bones of the Fore Extremity, Fracture of the Ribs, Fracture of the Pelvis, Fracture of the Bones of the Hind Extremity Articulations or Joints ---------- 262
Articulations of the Trunk, Articulations of the Head, Hyoidal Articula-
tions—Joints of the Tongue, Articulations of the Ribs, Articulations of the Head with the Neck, Scapulo-Humeral or Shoulder-Joint, Humero-Radial or Elbow-Joint, Articulations of the Carpus or Knee-Joint, The Metacarpo- Phalangial Articulation or Fetlock-Joint, First Inter-phalangial Articulation or Coronet-Joint, Second Inter-phalangial Articulation or Coffin-Joint, Coxo- Femoral Articulation or Hip-Joint, Femoro-Tibial Articulation or Stifle- joint, Tibio-Fibular Articulation, The Articulations of the Tarsus or Hock- Joint Diseases of the Joints, Tendons, and Ligaments - 279
The Local Origin of Joint Disease, Symptoms, Anchylosis, Synovitis—
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CONTENTS
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Inflammation of the Synovial Membrane, Loose Cartilages in the Joints,
Rheumatic Arthritis, Pysemic Arthritis, Bog-Spavin, Sprain or Strain, Sprain of the Flexor Brachii, Sprain of the Radial or Supra-Carpal Liga- ment, Spiain of the Check Ligament, Sprain of the Suspensory Ligament* Sprain of the Perfoians and Perforates Tendons, Sprain of the *etlock- J°i»t, Sprained Back, Sprain and Rupture of the Flexor Metatarsi, Curb, B(J»'ed Knees The Musom. a _ . - 305
muscular System --------
Muscles of the Face and Head, Muscles of the External Ear, Muscles of the
%oid Region, Muscles of the Tongue, Muscles of the Pharyngeal Region, Muscles of the Soft Palate, Muscles of the Larynx, Muscles of the JSecK, Muscles of the Back and Loins, Muscles of the Inferior Lumbar Region, Muscles of the Tail, Axillary Region, Muscles of the Fore Extremity, Muscles of the Ribs, Abdominal Muscles, the Abdominal Cavity or Cavity of the Belly, Muscles of the Croup, Muscles of the Hip and Thigh, Muscles of the Leg Diseases of the Joints, Muscles, Tendons, and Ligaments -
Dislocations, Sprain of the Back Sinews, Wind-Galls, Thoroughpin, Capped
Elbow, Capped Knee, Capped Hock, Filled Legs—(Edema Diseases of the Feet..... - - 365
Sand Crack, Shelly Feet, Seedy Toe, Keratoma-Horn Tumour, Thrush,
Corn, Laminitis-Fever in the Feet, Quittor, Canker, Chronic Viurtis, flicks a"d Wounds to the Sole and Frog, Side-Bones, Navicularthntis- ' aVlcular Disease, Contracted Feet Defective a,",., ~ - 395
action and Injuries Arising Out of It -
OS*1*' Interfering, Brushing, Cutting, Overreach, Forging, Speedy
Wounds and Their t» .... 402 -irtEIR IREATMENT.....
Wounds, Healing 0f Wounds, General Treatment of Wounds, Special
treatment of Wounds, Disinfection of Instruments and Appliances, Sutures °5 Stotches, Antiseptics employed in the Treatment of Wounds Broken Knces' Cracked Heels, Ulcers, Sinus and Fistula, Fistulous Wounds Pirst Aid to the Sick and Injured - - - " ^
Medicines . _ ... 441
Introductory, Medicines and their Preparation, Medicines which Act upon
the Blood affecting the Nutrition of the Entire Body, Medicines which Act on Tissue Change, Drugs which Act on the Heart and Bloodvessels m§s which Act on the Stomach and Digestive System, Drugs which Act °n the Lungs and Air-Passages, Drugs which Act upon the Skin, Drugs Which Act upon the Kidneys, Bladder, and Generative Organs; Drugs which Act upon the Nervous System, Antiseptics, Miscellaneous Drugs |
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ILLUSTRATIONS
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VOLUME II
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FULL-PAGE PLATES
Parcy (colour) -...--- Fl Purpura Hemorrhagica -
Glanders (colour) --------
Horse-pox, Tuberculosis, and Endocarditis (colour) -
Stomatitis Pustulosa (colour) - nzootic Lymphangitis (colour) - THE Descent of the Testicles - Diseases of the Male Organs of Reproduction - Embolism of Lung and Variolous Eruption (colour)- Yorkshire Coach-Horse Mischief (colour) - External Parasites of the Horse - Skeletons of Horse and Man - €ERVICAL AND DORSAL VERTEBRAE
Gsteo-porosis—Fracture of the Sesamoid Bones -
Well-Shaped Foal—Foal with Bowed Legs - HE Superficial Muscles Exposed (colour)
Second Layer of Muscles Exposed (colour) LYDESDALE STALLION, HOLYROOD (colour) -
Deep Muscles of the Neck and Trunk -
Malformations of the Legs - - - " |
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x ILLUSTRATIONS
Dislocation of the Patella - - - - - . -352
Laminitis.....-■■■■--... 376
Arab Stallion, Mesaoud (colour)- - - - - - - . - 412
Chestnut Hunter Gelding, Artist (colour) ----_. 45g
Medicinal Plants—I - - - - --"*--.. 466
Medicinal Plants—II - - 470
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TEXT ILLUSTRATIONS
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Longitudinal Section of Horn -
Urticaria -
Eczema
Contagious Ecthyma, or American Boil
Ichthyosis -
Section of Wart -
Sallanders -
Mallenders
Ringworm -
Metamorphoses of the Bot-Fly -
Ascaris . .
Oxyurus of Horse - - '.
Tape-worms --..'.
Taenia perfoliata
T*nia plicata -
Taenia mamillana -
Liver Fluke -
Transverse Section of Bone
Longitudinal Section of Bone -
Cervical Vertebra -
Dorsal Vertebra
Lumbar Vertebra -
Sacrum
'Skull (Front Aspect) '. '.
Skull (Posterior Surface) -
™ (Side View) -
Lower Jaw
Hyoid Bone and Larynx - '. '.
sternum - Sternum and Costal Cartilages ~- '.
Pelvis and Sacrum -
Scapula (Outer Surface) 1
Scapula (Inner Surface) .
Humerus (Front Aspect) -
Humerus (Outer Aspect) -
J- he Forearm Carpus Fore-Leg from the Radius - - '-
Metacarpal Bones - . Os Suffraginis - Os Coronas and Os Naviculare - -
Os Pedis (Plantar Aspect) - - -
0s Pedis (Side View) - . . .
Os Femoris (Anterior Aspect) - -
p*^^0"8 (Posterior Aspect) - -
Tibia- ! ] ". "
Bones of the Hock separated - -
Klng-Bone - "High"Ring-Bone '-'.'.'.
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Splint - " ; '
Diagrammatic Transverse Section ot
Tibia and Fibula -
Acute Ostitis Rarefying Chronic Ostitis -
Chronic Ostitis - Osteo-porosis—Bones of the Face Osteo-porosis—Lower Jaw - Osteo-porosis—Metacarpals Bone-Spavin -
Fractures—Simple, Comminuted
Fractures—Tranverse, Oblique, Longi-
tudinal - " Principal Tendons and Ligaments of
the Fore-Limb Impacted Fracture of Femur
An Example of Compound Fracture -
Fracture of First Rib of Horse -
Bandaging a Fore-Leg
Bandaging a Fore-Leg (completed) -
Walker's Face-Cradle -
Tooth-Shears
Tooth-Rasp
Oblique Fracture of the Radius -
Iron Splint for Fractures of the Fore-
Limb Splint for Fracture of the Metacarpal
Bones
Oblique Fracture of Suffraginis - Oblique and Transverse Fractures of the Os Suffraginis -
Fracture of the Sesamoid Bones - Fracture of Navicular Bone Oblique Fracture of Rib - Fracture of the Pelvis Ligaments of Spine - Ligamentum Nucha? - Temporo-Maxillary Articulation - Articulation of the Ribs and Spine - Occipito-Atloid Articulation The Occipito-Atloid and Atlo-Axoid Articulations -
Capsular Ligament of Shoulder-Joint - Humero-radial or Elbow-Joint - The Carpus or Knee-Joint - Anterior View of Knee-Joint Ligaments of the Fetlock-Joint - Ligaments of the Pastern and Foot Articulation of the Hip-Joint - - Femoro-tibial Articulation or Stifle- joint |
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Posterior View of Stifle-Joint - - 277
External View of Hock-Joint - - 278
Loose Cartilages removed from the Capsule of a Stifle-Joint - - - 285
Bog-Spavin ----- 290
Bog-spavin Truss or Compress - - 291
The Flexor Brachii - - - - 293
The Check Ligament - - - 294
Sprain of the Perforans and Perforatus Tendons ----- 296
Rupture of the Flexor Metatarsi - 299
Curb ------- 301
Curb—Good hock with curb, Bad hock
without curb, Bad hock with curl) - 302
Muscles of Horse's Head - - - 307
Muscles of the Ear - - - - 311
Muscles of the Tongue, Soft Palate, and Larynx ----- 315
Muscles of the Lumbar and Pubio- Femoral Regions - - - - 325
The Diaphragm and Sub-Lumbar Mus- cles, seen from below - - - 337 The Patella and its relation to the other Bones of the Hind-Limb - 351
Dislocation of the Patella - - - 353
Shoe to prevent Contraction of the Back Sinews of the Leg after treat-
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of ligaments constituting " side
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groove in the pedal bone resulting
from pressure of Keratoma - - 372 Keratoma or Horn Tumour—Trans- |
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verse section of foot, showing Kera-
toma ------ 372 |
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Section IV.-HEALTH AND DISEASE-cw*»
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T. THE ORGANS OF RESPIRATION-Continued
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DISEASES OF THE LUNGS
General Considerations. — Under this general term are included
the disorders affecting the bronchial tubes, the lung tissue itself, and its investing membrane—the pleura. Although the diseases are considered separately and receive special names, they are frequently found to exist together. Nevertheless, it is common to find one particular structure So prominently affected as to warrant the use of a name identifying the disease. A compromise in nomenclature, where two principal structures afe at the same time affected, may be found in such terms as broncho- Pneumonia, pleuro-pneumonia, &c, at one time in exclusive use by the professions, but now generally understood by the public, who are aniiliarized in great part with medical terms through reading in the lay press accounts of the illnesses of eminent persons. BRONCHITIS
, Definition .—Bronchitis is an inflamed condition of the mucous mem-
ane iining the bronchial tubes. -It may occur as a primary disorder in which the larger bronchi are
leny involved, or it may follow upon or complicate other diseases. Two
rins of the malady are recognized—one sharp and of brief duration, known
acute bronchitis, and the other less severe but protracted, termed
chronic.
t-auses.—The predisposing causes are weakness, old age, and damp,
,? stables. A previous attack and the exhausting influence of other
iseases also increase the liability to a second seizure. Young horses in
c ose stables are more subject to it than others, if we except the worn-out
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HEALTH AND DISEASE
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2
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and exhausted. The disease may also be excited by the accidental intro-
duction of medicinal agents into the air-passages while administering draughts, exposure to easterly or north-easterly winds after exertion or fatigue, or it may complicate an attack of influenza or strangles, or arise out of an extension of inflammation from the larynx. Symptoms.—As a rule, but with notable exceptions, bronchitis com-
mences with shivering and the symptoms of a common cold; the first thing noted may be a cough and a rattling sound in breathing that in very marked cases can be heard at some distance. The breathing is somewhat quickened, the temperature raised, the appetite indifferent, and a general listlessness is observed as well as disinclination to movement. The pulse is increased in number and diminished in force, the ears and legs vary in temperature, being sometimes cold, sometimes warm. Thirst, too, is often noticed in the commencement of the disease. With the progress of the malady the cough occurs in paroxysms at frequent short intervals, and gives rise to very great distress. When the larger bronchi are chiefly affected it is louder and harsher than is the case when the small ramifications of the tubes become involved. Auscultation is here of much assistance, as by placing the ear on the chest at various points the peculiar sounds emitted will afford information as to the state and progress of the disease. Where the large bronchi are only or chiefly affected, a coarse, rough, or rattling sound will be heard plainly in the front and upper part of the chest; but if the smaller tubes are affected it may also be detected in a modified form by listening behind the shoulder-blade. Here the sound emitted is harsh as compared with normal breathing, and mixed up with it is a coarse or fine crepitation or crackling. The loud, harsh cough presently gives way to a softer one, attended with more or less copious expectoration of mucus, which varies considerably in thickness and tenacity. In these circumstances the chest sounds are quite altered, and the ear detects bubbling and wheezing in the tubes as the air passes through the accumu- lated matter within them. The patient's prospects of recovery would appear to depend largely upon the viscidity or otherwise of this matter and its possibility of removal. Treatment.—It is important that remedial measures should be applied
early, but too often the disease has gained a firm hold of the animal before professional assistance is called in or the gravity of the case is recognized. The severity of an attack may be mitigated by bold doses of anodynes, as chloral and iodide of potassium, with stimulants; but the disease, when fully established, cannot be cut short by any drastic measures, and the symptoms must be combated, the animal's strength maintained, and his general comfort attended to. The temperature of the stable should be |
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DISEASES OF THE LUNGS 3
to k a°out 55° Fahr., and outside it a convenient place may be chosen
the st\rater b°ilinS so tliat a Pail or two of hot water may be brought into
warml V t0 k66p the air moist' The legs should be banda§'ed and the bod>'
If y'i not heavily, clothed, a hood forming part of the suit worn. appli 1 1C 0at snows signs of soreness, counter-irritation should be
chest t *t0 Xt md al°n§ the front of tlie neck to tlie breast, and if tlie
Walls -ii *S severe' an application of turpentine liniment to the ehest- the desirable. Mustard should not be chosen for this purpose, as couo] ■ ^6nt' imitating vapour given off from it while on the skin provokes
swag and tends to add to existing distress,
sens „°USn we cannot induce the horse to expectorate in the ordinary facil'f word, yet we adopt those agents known as expectorants to can ' removal of mucus from the tubes, where its presence is
with to much annoyance. Electuaries of belladonna, in combination
a i mPhor and ipecacuanha, or tartarized antimony, will be preferred, ^ , P^ally where sore throat precludes the administration of draughts; riese cannot be given without distress to the patient, other remedies U1'e too volatile to enter into an electuary may be chosen. Of these, I net tincture of camphor (paregoric elixir), chlorodyne, aether, nitrous > carbonate of ammonia, and tincture of squills are among those re- sn l lcleo-; while the drinking water may be chosen as the vehicle for ' as chlorate or nitrate of potash, and the bicarbonates of potash
<Uld soda. i Usi n *10n °f steam, or rather, we should say, the vapour of hot water,
sin 11 ords relief, and may be made more potent by the admixture of a ni- moimt of friars' balsam, camphor, or eucalyptus oil. These may be
win ^0t bran *n a nose-bag, which should not be left on, but used an l Pendant is standing by for a few minutes at a time only. With
pr ' nient of the more distressing symptoms the cough in some cases ease 1 ° lnate and threatens to become chronic. Medicines may in such of t . 6 van*ageously administered in the form of bolus, and be composed be s 1 . ered squills, opium and gum ammoniacum, or for opium may time " Uted some other anodyne if it has already been given for some "» the course of the attack.
result ^nnS the early days of the disease the bowels are constipated as a 8Pooi f°i febrile state, they may be regulated by soft food and a few aperi U S °f hnseed-oil given with it from day to day in preference to an
bowel 6 °^ medicine. Some glycerine may be introduced into the that f lT S°ap and warm water enemata employed. The extreme debility
listen °WS a severe attack may in some instances account for the per- y of the cough, and tonic treatment is then called for. |
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A fresh-made infusion of gentian, with small doses of carbonate of
ammonia or alcoholic stimulants, is worth trial. Rather large doses of quinine, with nux vomica, give just the necessary fillip sometimes when con- valescence is protracted. A considerable period of time should be allowed, with gentle and steadily increasing daily exercise, before the animal is allowed to return to his ordinary work, and the greatest care should be observed against exposure to wet or cold easterly winds. CHRONIC BRONCHITIS
Except as a sequel to acute bronchitis, the chronic form is seldom met
with. It differs from it in the absence of fever, the persistence of the cough, and the character of the matter coughed up. Slight causes are sufficient to aggravate the symptoms which are assumed to be due to the morbid irritability and lessened calibre of the small air-tubes by reason of the thickening of their lining membrane. The subjects of it are easily fatigued and their value much depreciated. Symptoms.—These are in some respects the same as in acute bron-
chitis, but modified in intensity, thick wind and premature fatigue being most noticeable under exertion. There is at the same time an inaptitude for putting on flesh and a want of bloom in the coat. The cough, although less frequent than in the acute form, is much increased in certain conditions of weather, as where cold and wet follow upon a period of dryness and sun- shine. It is also provoked by passing from a warm stable into the cold atmosphere without. Horses affected with chronic bronchitis are mostly heard to cough while feeding, and especially if the food is given dry. Treatment may ameliorate the symptoms, and, with care, the subject
of it may perform useful work; but it is seldom that anything like a radical cure is effected. Occasionally a young horse, under exceptionally favourable circumstances, will appear to grow out of it, but a trifling ail- ment is sufficient to bring it on again. Careful dieting with linseed and damp food should be observed, avoid-
ing all forage with the least suspicion of must or dustiness. The occasional but not habitual use of certain drugs has a beneficial effect. The agents most recommended are myrrh, soap, camphor, squills, carbonate of ammonia, digitalis, and tar in the form of bolus. Iodide of iron and arsenic are also employed with apparent good results. |
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CONGESTION OF THE LUNGS
eno, nnltlon.—By congestion of the lungs is meant an undue fulness or
con 5ernent °f the pulmonary vessels with blood, and especially those nu+ •.-n w*tn respiration as distinguished from others engaged in the two I, °n -°^ ^le orSans- It is convenient to consider this disease under The ain§s—A, as acute, and B, as passive or mechanical congestion, iect 1 m °^ tne an?ection is most frequently met with in horses sub- con • ° Severe exertion and distress. In the second form it arises in the
It j i Var^ous forms of disease, and especially obstructive heart disease, so a frequent and fatal accompaniment of the specific fevers, and niphcate acute inflammation of many of the organs of the body. ■Uses.—Congestion of the lungs follows upon a variety of disturb- Ql ln the health of the horse. 7 • acu-te form is frequently induced by excessive exertion without rin S a °iuate training or condition, hence the number of cases occur- wit-T c?nonS hunters and steeplechase horses pushed beyond their powers or +1 little previous preparation. Fat young horses fresh from grass wh 6T s °f the dealer are particularly prone to this disorder, especially
otl u§ht into town work and made to occupy badly-ventilated and con WlS6 ^~concutioned stables. The same causes that produce catarrh or
a 1 +1°n C0^ are liable to give rise to congestion of the pulmonary vessels, att I*6 rc^er is a frequent sequel to, or complication of, inflammatory Pre- S ctiQS other organs. As a mechanical congestion it is always jj niore or less in obstructive diseases of the valves of the heart, nial ^ ^' interrupted in its course through the last-named organ, is
the ° accumulate in the vessels of the lungs. Passive congestion of ticul ir^fns niostly arises in the course of exhausting diseases, and par- c y m that form of influenza termed " typhoid".
but f ™P 0Ins'—In acute cases the symptoms are very urgent. Eapid nost^'l W breathing, "blowing" as it is called among horsemen, dilated least ' oc^sn°t eyes, head depressed and commonly held in a corner the body " V* *"or obtaining a supply of fresh air. The muscles quiver, the of ti S 10t witb perspiration, and the ears and legs are icy cold. Bedness of acute°njUnCtiVal
membranes is not of that kind commonly seen in cases
anim 1 G "lflammation, but of a darker colour, as might be expected in an
rule tl Se blood is not receiving proper oxidation in the lungs. As a some 6 Se S° affectecl persistently stands, but there are exceptions, yain fl?PeannS to suffer acute pain and occasionally going down in a niore ^ t0 °'Dtairi ease> while others, and by far the majority, become less dull and stupid. The heart-sounds are loud, and the pulse, |
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which is at first moderately full, becomes weak and compressible, the
number being with difficulty counted owing to its rapidity and want of resistance to the touch. Auscultation yields a minute crepitating sound, besides a harsh bronchial noise in the place of the ordinary murmur of healthy respiration, and later there are areas in which the sounds are much subdued. Cases of pulmonary congestion from excessive exertion, although ex-
hibiting the severest distress, are more likely to recover than the so-called passive form when complicating diseases of a febrile and exhausting nature. Whether as a result of overtaxing the animal's capacity, or as a sequel to other affections, its course is rapidly fatal unless checked by treat- ment. Treatment.—In attempting any kind of treatment the object in view
is to relieve the overtaxed pulmonary vessels of their surplus blood, and to impart tone to them and to the embarrassed and enfeebled heart. If this can be done promptly the battle is half-fought. If the hunting man is horseman enough to recognize when his mount is "pumped out", he may accomplish it by pulling up with the horse's head to the wind, slacking out the girths, hand-rubbing the legs, pulling the ears, and giving the contents of his flask to the exhausted steed. Many a horse is thus saved by a judicious rider with that intelligent sympathy which every man should have who rides to hounds. Too many do not possess it, or assume that a hired horse must be in the pink of condition and have no weakness that shall curtail the pleasure of his rider; " the last ounce", as the phrase goes, is got out of the animal by whip and spur, and he finally comes to a stand- still, or a check occurs too late to save a high-spirited animal that will go till he drops. In such a situation the propriety of bleeding can hardly be called in question, but it is, comparatively speaking, a lost art among horsemen, who at one time were always ready to perform the operation with more zeal than judgment. The exhausted hunter, after first being allowed to recover himself, should be led to the nearest stable and put into the most airy box obtainable. The veterinary surgeon, when summoned, may not consider it too late to bleed, especially if the pulse is found fuller after a stimulant has been given. Every effort should be made to restore the circulation by friction, vigorous wisping of the body with straw, chafing the legs and ears, bandaging, and clothing. Alcoholic stimulants, such as gin or whisky, are mostly obtainable without much delay, and should be given at once or as soon as the animal has recovered his " wind ". Some authorities recommend carbonate of ammonia with digitalis, for which they claim the double advantage of increasing the power and diminishing the number of the heart's contractions. The doses, whether of alcohol or other |
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DISEASES OF THE LUNGS
chosen agents, should be moderate in amount and repeated hourly so long
as symptoms of distress continue. . f There is a general consensus of opinion in favour of the application ot
mustard to the sides of the chest, although a few dissentients of unquestion- able authority have thrown doubts upon the propriety of counter-irntation. The practice appears to have very marked and rapidly beneficial ettects in ^ny cases, and in our judgment should be promptly resorted to, but not water may be substituted where any special objection against mustard o strong liniments presents itself. The convalescent should receive unremitting fre, as there is much tendency to recurrence, as also a danger of Pneum0^ lowing the attack. Besides the importance of pure air and comfortable Editions generally, the state of the bowels must be made a matter 01 attention, and if a tendency to constipation exists which a axative diet is n°t sufficient to overcome, a small dose or two of linseed or castor oil °J sulphate of magnesia may be given, but in no case should aloes any drastic cathartic be employed. . , .. Post-Mortem Appearances.-Examination of an animal that has
dled of this disease shows the lungs to be very dark m colour; they are ^ertheless, compressible, and do not exhibit that solid,^*™ "f ^able texture common in inflammation of the lungs. Where the over barged vessels have given way, blackish red patches of lung are seen here and there infiltrated with escaped blood. INFLAMMATION OF THE LUNGS, PNEUMONIA
Definition.-Inflammation of the true lung substance This may exist
as an independent disease or it may complicate an attack of bronchitis. A Causes are all such as induce catarrh, or inflammatory conditions ot ^ parts of the respiratory apparatus. It may arise as a sequel to fWary congestion, or be induced by direct irritation of the air-tubes *S ^hen medicines, in being given, "go the wrong way". It also follows ^bronchitis by a downward extension of the inflammation into the Stance of the lungs. Neglected colds and damp unhealthy stables are **°ng the most frequent of the many causes that contribute to this 'Usease- Influenza and strangles not unfrequently terminate m a lata fne^onia, and there is reason to believe that the disease is sometimes 'n itself specific and contagious. In this connection it has often been ^ed to spread from animal to animal in the entire absence of any 0bvious cause of a common cliaracter. Septic pneumonia, such as occurs ^the "joint ill" of foals, and other forms of blood-poisoning, is by eans an uncommon variety of this disease. |
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Symptoms.—There is a train of symptoms that may be called common
to all inflammatory disorders of the respiratory system, and only the expert can, with any degree of accuracy, distinguish between them. Following upon catarrh, it cannot be said precisely when pneumonia com- mences but there will be increased temperature and accelerated breathing, though in the latter connection not to the extent observed in acute pulmo- nary congestion. The mucous membranes exhibit a rusty or brick-red colour, and the pulse is small and irritable. The skin and extremities will be more or less cold, but scarcely with the icy coldness of acute congestion. nor will the sweating and trembling of that condition be present as a rule. There is very little appetite, a tendency to constipation, and the urine is highly coloured and small in quantity. While the cough of a common cold and of bronchitis is accompanied with a more or less considerable discharge of mucus from the nostrils, there is but little in pneumonia, and what there is is thin and frothy, but as the disease advances there is a foetid odour to the breath, and the matter expectorated is more or less reddened from admixture with spoilt blood and other decomposing material. If the chest sounds are listened to throughout an attack they will
at first be observed to be louder and harsher than in health, but as the air-tubes become charged with inflammatory products they undergo modifi- cation and give out minute crepitant or crackling sounds. When the air-cells and small tubes become actually filled with these products, and air is altogether excluded, crepitation ceases as a result of consolidation of the lung substance. The bronchial sounds in the upper part of the chest, however, are more or less exaggerated. Percussion applied to the chest by means of the fingers will enable us to make out with more or less accuracy the part of the lung which has undergone solidification, as there is an absence of resonance over the part where no air passes in or out. In speaking of congestion of the lungs, the rapid progress of the disease has been referred to, and in this it differs from pneumonia, which may take a week in reaching a crisis, and probably two or more weeks before the symptoms have quite disappeared, a high temperature being maintained for many days. Eelapses of a febrile character, at a time when considerable progress has been made, are not uncommon, and would seem to be due, in many instances, to infection of the blood with morbid matter, resulting from the disintegration of lung tissue. Treatment.—Before determining what method of treatment should
be adopted, it is well to consider the history of the individual and the circumstances that have led up to the illness. Also his condition, wdiether it is one of poverty and weakness—if the animal is an aged one or a |
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DISEASES OF THE LUNGS 9
ancTfth nd fulI"blooded creature fresh from the liberty of pasture. These
line °f16r Cllcumstances affecting individuals will materially influence the comm featment t0 be pursued. In the former case we should not re- might meaSU1'es of depletion of any kind, but in the latter these disea ^ advanfca8'e be sometimes employed. In dealing with this eondif m° n Practitioners attach much more importance to hygienic an e ^i? ° "^ t0 be the CaS6' G°°d nursing> tlie maintenance of
cleanp temPerature> both of the skin and stable atmosphere, scrupulous I'ecoo- -leSS' aml^e ventilation, and judicious feeding have now become
and gniZ6d as /"dispensable to successful treatment. Friction of the body freqn X .reni^es' the employment of suitable clothing and bandages, fuge ^ removed and replaced, are not less important. Saline febri- antl lT^ generaUv aPPi'Oved, and of these acetate of ammonia, nitrate arp +1 °rate °*" Potash, and sulphate of magnesia judiciously administered j*e most appropriate. ancj y °1 bland mucilaginous fluids, as linseed tea and barley-water,
the fk .Un m^ted quantity of drinking-water, should be allowed. When
has t 6 s^mPtoms nave abated, and extreme prostration or foetid breath Qui ' combated, there is benefit to be anticipated from the use of gonrl 1' tlie free use of alcoholic stimulants, as whisky, port-wine, or
the ' a ' a ^be anlmal's strength will be most speedily regained under
adm" • U6nee 0I" sucl1 things as beef-tea, eggs, and milk. The methods of of j • ennS the agents named will depend upon the presence or otherwise difB a y °^ the throat. Where this is great, with much cough and be I a n SWaH°wuigj electuaries may be chosen, unless the1 patient can d ecl to take them in drinking-water. In all pulmonary affections, ins. * require to be administered with the greatest care, and in some
ac[ must be altogether withheld. Where it is found necessary to be l •6. ^er course, spirit of wine in ounce or two-ounce doses may
^ai t nistered in the drinking water as often as may be required, and t] aPPetite after a severe illness of this kind is a troublesome feature, Pound • remedy of gentian, either in the form of powder or of com- afforl usi°n, with a mineral acid, as sulphuric or nitro-hydrochloric, <l the best results.
callei -erna^ Applications.—The efficacy of counter-irritation has been but t] fusion by men whose attainments should command respect, that tl are m a mm°rity, and most practical veterinarians are agreed Pi'om f §reatest benefit is often secured in a very short time by the °r ea tl a^p ca*l°n °f a mustard plaster, or a smart liniment of turpentine of x larides, to the sides of the chest. As an alternative to this mode 1 merit, heat and moisture to the surface may be applied by means |
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of rugs dipped in hot water and wrung out, or by the use of the hot pack,
great care being exercised in changing them to avoid a chill in the intervals. Where practicable, the employment of hot smoothing - irons is to be preferred. Here a hot rug is first placed on the sides of the chest, with a dry one over it, and flat-irons are applied first to one side and then to the other, or to both at the same time, as may be convenient. BLEEDING FROM THE LUNGS—HiEMOPTYSIS
Bleeding from the lungs and bronchial passages is not of common
occurrence in the horse, but sufficiently so to warrant a reference to it here. Causes.—The causes that bring it about are: (l) External violence,
as when the chest is punctured by a stake or other sharp instrument; (2) undue fulness of the vessels of the lungs or bronchial passages, as in bronchitis, pneumonia, and obstructive heart disease; (3) ulceration of the tracheal or bronchial mucous membrane, as in glanders and tuber- culosis, &c. Some cases come on during severe exertion and violent coughing without any other obvious reason. Symptoms.—Pulmonary, like nasal hemorrhage, is usually sudden
in its onset, and may be slight or severe. The blood is mainly discharged from the nostrils, but some also flows from the mouth. Bleeding from the lungs, when profuse, is invariably attended with outbursts of con- vulsive coughing, during which the blood, whipped into foam, is projected through the nose and mouth. Moreover, the bronchial tubes may become more or less blocked when the breathing becomes quick and embarrassed; the horse shakes his head, paws the ground, and manifests signs of distress. In slight cases, such as occur in pneumonia and some specific fevers, it appears in small amount as a blood-stained discharge from the nostrils. Treatment.-—Here, as in bleeding from the nose, the patient must
be placed in a cool, clean box and kept perfectly quiet. A little ice in the water will be of advantage in arresting the hemorrhage, but it is doubtful if the forcible administration of medicines is not rather mischievous than otherwise. A little ergotin injected beneath the skin, and free spong- ing of the face with cold water, is as much as can reasonably be clone. If in his water the patient can be induced to drink 4 ounces of sulphate
of magnesia on two successive days, benefit will result from a free action of the bowels. The body should be well clothed so as to keep the surface circulation active. |
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ASTHMA
by Pa ^0n °f Asthma.—This is a diseased state of the lungs, marked
ino. ysms of difficult breathing and distress, accompanied by a wheez-
bronch'. ' *S believed to be clue to spasmodic contraction of the
disarm UDes> and from the peculiar suddenness of its appearance and
ance it partakes of the character of a nervous disorder.
instari. . -^nese are very obscure, but seem to be connected in some the c t digestive disturbance, and by some authors are placed in may i *°r^ 0I" diseases of the digestive system. In susceptible animals it
and fk ^ breathing an atmosphere charged with irritating gases brono-1 •* lmPul'ities. Besides a vitiated atmosphere, it is sometimes
a f *nto existence by an attack of bronchitis, which is undoubtedly c 0r m its development.
Sy "f PtOms. — The attacks may come on so suddenly that warning andPi°mS ai6 brief' if at a11 observed. The breathing is at once difficult spir t" ressinS> arjd the duration of the attack altogether uncertain. In- with j 1S ^6SS difficult than expiration, the latter being accomplished jerk 0UDle action of the flank, and the whole body receiving a distinct . c tiie end of the movement. As compared with broken wind, which ac , e respects it resembles, the symptoms are more paroxysmal and Ran ' 6 *S a^SO Sreater distress, as evidenced by the anxious counte- ehok'' a tbe sb°rt irritable cough, which returns again and again in
fesnlt to Paroxysms. The discharge of small quantities of mucus as a 0f coughing, and more or less elevation of temperature and loss apD l e' a^so serve to distinguish asthma from broken wind. Its sudden
after ^ 1S &S remarkable as its rapid subsidence, but in some cases, djSe ePeated attacks, it passes imperceptibly into that form of lung prPH 6' nown popularly as "broken wind". The subject of asthma is ,_, ie ota recurrence of the affection at no very distant date.
first ^tnieHt.—An oily aperient, preferably linseed-oil, may be given
as 'i \ C to"Owed at short intervals with fairly large doses of such sedatives
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as nit yne' or camphor and belladonna, combinations of stimulants,
to ci i S ^tber and valerian, and failing early relief a change of sedatives is eSn -i anC* tbe bromides of potassium and ammonium. Chlorodyne in e«. v useful, and rather bold doses are found to be safe and speedy alime t ' ^r^ anc* dusty food should be removed, and no bulky and u vecb Linseed, boiled or scalded, is found to be the best food,
and scallUbtedly haS a medicinal effect alsa This' with a littIe bran
anin, i& G °ats' should be given in small quantities, and often. Different "uais arp. rK#v,— ^i «.?-,, , . -,... n . ____: |
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ence relief in a moist air, while others are benefited by dryness. Cold
air is always prejudicial. In dealing with this disease the effect of warm vapour should always be tried, either by means of a nose-bag containing moist bran or by allowing a pail of steaming hay to stand near the patient's head. To guard against a recurrence of the disease the dietary should be carefully regulated, and an oleaginous aperient administered every few weeks, according to the state of the bowels. Severe exertion and fatigue, exposure to wet and cold and badly-
ventilated unwholesome stables, by lowering the standard of health and irritating the air-passages, favour a return of the disease. EMPHYSEMA OF THE LUNGS—BROKEN WIND
Definition.—This is a disease in which the air-cells of the lungs are
abnormally dilated; the lungs themselves are consequently enlarged or ruptured and their elasticity impaired, as a result of which breathing is carried on with much difficulty and distress. Causes.—-While the proximate causes are not known with certainty,
the remote or contributory ones are generally agreed upon. Hereditary predisposition no doubt conduces to its origin. It is observed to affect heavy or coarse-bred animals more frequently than the better-bred ones. This may be in part due to the fact that the former are more likely to live and work under conditions conducive to the development of the disease than those more carefully housed and fed and maintained for pleasure and sport. It frequently originates in the excessive use of coarse innutritious bulky
food, and especially in connection with greedy feeders. The exclusive use of damaged fodder contributes largely towards bringing about this disease, more particularly in the case of old animals. It is of common occurrence in ponies leading a life of idleness while receiving a superabundance of nutritious and bulky food. All these facts go to show the disease to be, in a great measure at least,
the result of dietetic causes. Symptoms.—The cough is characteristic and different from any other
in its prolongation—a double effort in expiration, which is easily seen in a well-developed case but may in others be mistaken for the quick breath- ing induced by exertion and excitement. When the patient is at rest and subjected to no excitement the cough is rarely heard, but it often occurs at the time of feeding, or follows a full meal and copious draughts of water. The chest sounds are very variable, but in nearly all cases those of the trachea and larger bronchi are exaggerated, and over different areas there |
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DISEASES OF THE LUNGS 13
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In ad CrePltus as well as an increased sound or resonance on percussion.
ejectel f cases flatulency is a marked symptom, and wind is frequently the li °m bind in the act of coughing. As the disease progresses, and seque S U,n r§° expansion, the walls of the chest become rounded in con- attend r^S De*ng forced outward. Premature distress invariably work i ^°n exert*on> and the capacity for work is much abridged. Where laro-p,. +i orced the body shrinks, while the abdomen becomes perceptibly ^r than normal. judici ^eE[t0—In no disease can so much be done for a horse by
usefn] feting as in broken wind. Many a subject of it will perform nian +i, without undue distress for years in the care of a good horse- 0f ' LSanie animal being practically useless when transferred to the care;
these ° no^ PrePare and administer the food secundem artem. In ailc} es Jt is especially desirable to give nutritious food in small bulk
nou • , ^omParatively short intervals, so that the patient may be well
from fh never distended. Every particle of dust should be separated ni corn by the sieve or other means, and no hay with a suspicion of
alwa .0Wec*' an(i even the best should only be given in small amount and
°Tind' m ^°im °^ c^ia^" previously damped in order to ensure proper o-iVe ^ the corn. Long hay may be dispensed with altogether, or, if
to e t • ^ 0ccasi°nal treat, should be first steamed and the animal allowed after * &* n^nt or at a time when his services will not be required soon ancj , 8" Linseed is the food par excellence for a broken-winded horse, djffe, 0uSn it is found that many tire of it, it must be dished up in eook' Wa^S anc* a taste ^or ** cultivated. It is often spoiled in the novi ' o allowed to cake in the bottom of the saucepan, and the Wrv' nVariaHy putting too much linseed in proportion to water and
may i § . ne process. Linseed-oil and cod-liver-oil in small quantities Q°rse l111156^ w^tn the food once or twice daily, or every other day; some 't- W-+ieC°me Very fonc* of ^oth' ancl show a distaste for their food without when 1" re§arc^ to medicinal agents, these should be reserved for occasions The i conditions or other causes have induced unusual distress. disord a ^ a»ents recommended for asthma may be resorted to in this
tive sv + and usua% result in abatement of the symptoms, but the diges- which em mUSt ^e 0ur Prineipal care, and those agents should be chosen c°nstit if-6 m°St ^e^v t° disencumber the bowels, restore tone, and increase benefi ■ ]° vigour. An occasional dose of aperient medicine has a most §ress nf i,6 *" rebeving the embarrassed breathing, retarding the pro- digest- ^ disease, and the same may be said of allowing ample time for
bitters D tween feeding and working. The mineral acids and vegetable le especially employed for this purpose, and for allaying the difli- |
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culty in breathing much benefit is often obtained from a course of nux
vomica and arsenic, the latter being given in solution and in combination with bicarbonate of potash. The good effects of arsenic are apt to cease with its discontinuance, and it is well to resume it again as occasion requires at suitable intervals. PLEURISY, PLETJRITIS
Definition.—Inflammation of the serous membrane that invests the
lungs and lines the cavity of the chest. It may exist as a distinct disorder or complicate an attack of lung disease. One side only or both may suffer. Causes.—Sudden chills, as exposure to cold draughts and cutting
winds when the animal is overheated, swimming under like conditions when following hounds, invasion from contiguous structures, as in in- flamed lungs. It may also come about by direct injury from external violence to the walls of the chest, or result from morbid growths. As a sequel to ohter diseases, as influenza and various forms of blood-poisoning, it is not uncommon. Symptoms.—Marked rigors or shivering fits usually usher in the
disease, and the temperature of the body shows a considerable rise. The respiration is quick, short, and painful, the animal manifesting acute pain as soon as the lungs are half inflated. Movement, especially turning, is extremely painful, and is demonstrated by a grunt or groan, and the same result follows the application of pressure between the ribs, and also percussion with the knuckles. The belly marks a peculiarity of inspiration in this disease, which is
diagnostic of pleurisy, especially noticeable during the act of expiration, when a ridge appears along the ends of the ribs, extending from the back of the brisket to the flank, which is not present at other times. Ausculta- tion is a valuable aid in the diagnosis of pleurisy; the ear will detect in the early stage a very distinct friction sound as of two roughened surfaces passing over one another. This sound becomes louder and more distinct until the ordinary breathing murmur is overwhelmed in it, or is too weak to be detected. With the progress of the disease, water is effused into the chest when the rubbing or friction sounds cease. If the fluid accumu- lates it gives rise to various sounds, as the splashing of rain-drops, a subdued tinkling, or the dropping of water. The amount of fluid accumu- lated is sometimes very great, and it may for some time remain unaltered, but must eventually be either absorbed or by pressing on the lungs cause suffocation and death. Dropsical swellings here and there mark the advance of the disease. The loose tissues under the skin along the breast and bell/ |
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DISEASES OF THE LUNGS 15
8ame caus ^r^ Wlth fluid' and tIle slieath becomes enlarged from the
and haaff ,\ °S ^ more or ^ess> tne countenance becomes worn of exPiratio ^^ extremities cold' and the bell7 drawn UP at eac]l act
Tl
is effuseJU -Se 1S at firSt hard and of increased frequency, but as the fluid as ^el] a ° tne cIiest it; becomes softened and smaller in volume, Persistentl ^^ ^ irreSuIar> and the Pain is less severe. The patient and contryf-StandS With Protruded head and dilated nostrils, which open Pleu ■act In a jerky, spasmodic manner.
Skater ^ 1S dlstmguished from other inflammatory chest diseases by C°ugh \vfrh' rder pu]se' eatcny breathing, and the short occasional SoUnds a !} Patient endeavours to suppress, as also by the friction Treat SPeater sensibility of the chest to external pressure,
irritation t " ^ ^S disease benefit may be expected from counter mterven^ °h ^^ °f tlie cll6St' Heie We haVe but little substance
fieial in ng between the skin and inflamed part, and if mustard is bene- pleuritis °r^T lnflammator7 diseases of the chest it is doubly so in
altoo-etne nough bleeding is not so generally practised as formerly, and Pate ben fi nSUlted to tne great majority of cases, there is reason to antici- tlle disea6 °Ial rGSults from a hberal blood-letting at the commencement of an acute 6' where the patient is in plethoric condition and the attack is of harmful .~laiacter- But even here it will be of no use, and probably hleediu j f a^ed t0 an advanced stage of the attack. In advocating tlle Weal ^ Unsy ** is not at any time to be employed on the aged or the onr^ ' n°r sh0ldd it be resorted to where pleurisy follows upon any of
^ontagxous fevers. v J l should be" JU att6ntion should be given to the patient's surroundings, which
ai'd Well-i>°m a^le and witb ever7 inducement to rest. A roomy, dry, lll0Vement1 ^ b°X iS t0 be Provided> so that no restraint be placed on ri'e Iegs sh i ample ventilati°n should be allowed both night and day. the interv ] ^ kept Wami by W00llen bandages frequently changed, and ^rarm cjoa,S emPIo7ed in hand-rubbing or wisping them with hay or straw. °hject of t ln? m tbe form of ruSs and hoods is most essential, with the *hus aidi aeeping UP tbe circulation on the surface and extremities, and See Catarrh "* ^ reduction of inflammation in the affected part. For diet tlle chest i aild "Pneumonia- The application of moist heat to the sides of being diPrjS f .g^ advocated by some authorities, woollen clothes or rugs baodages^thVh ^ Water ^ appIied to the chest hy
means of rollers or
Possible } 6 * be*nS retained and evaporation prevented as much as
The r/ja Slleet °f oiled siIk or gutta-percha, or a dry rug. icines to be chosen are those most calculated to reduce tem-
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16
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HEALTH AND DISEASE
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perature and steady the heart's action in the first instance, and for this
purpose alternate doses of aconite and belladonna are in repute. Salines, as the salicylates of soda, and glauber salts, sulphate of magnesia, nitrate of potash, and acetate of ammonia, are recommended as for pneumonia and other inflammatory disorders of the respiratory apparatus. To allay the acute_pain which marks the majority of cases at the onset, such anodynes as opium and cannabis indicus may be employed. The latter is perhaps tne greatest of pam-killers for horses, nor does it leave the depression which has been noted
in the human subject. Subcutaneous injec- tions of morphia may be employed for the same purpose, when objections exist to balls or draughts. The cases that most often end unfavour- ably are those which are said to "hang fire". They make very good progress up to a certain point, the temperature falls two or three degrees and then obsti- |
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rie-208-Tapping the Chest
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nately remains, and
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patient goes
it is then |
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the
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good treatment to reneat rtQ i- „ ^^^^^^— ——
mended at first 1• ■ aPPllcatlon of mustard to the chest as recom-
linseed-meal in whlh^S °f Cantharides ma7 be used> or poultices of
day and a nUt or Zl *"**** k mked' m^ be aPPHed for a
the conrv W • a- ntllnlmprovement is noted. Where the disease takes
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will ZZ 11 'i Cat6d'
s foUowT ^^ t0 d° ^
|
good nourishment with stimulants and tonics
agents recommended for such |
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|
as follow the more common course. ^^^^^^^^^^_
In convalescence alcnhnliV. ■,+• i
gentian, and iodide of iron m ^ " «* °V ^kj> ^ ^^ improvement, a C allt J/T -ii61^ ^^n^g general
the chest and refuse for a Wh f *• SOmetimes P^istently remain in iron, and those drug omlnlv tT" '° T^° ^^ ^ °f
8 mmonly known as diuretics, are best calculated to |
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SPASM OF THE LARYNX l7
fluicMf .abs°rption- In some cases, however, it is necessary to remove the
very X°m the °hest hodilJ by means of an operation. A liberal diet and have m°derate exercise should be allowed when the urgent symptoms Wppk passed> but nothing amounting to work should be imposed for several eeks at least. |
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|
SPASM OF THE LARYNX
We h
which - aVe S6en' in sPeaking of roaring and whistling, that the muscles thrown 6SUlate the size of the °Pening into the larynx are liable to become noticed th* °f USe aS the result of Paral7sis- In the disease now t0 be differe t Same narrowing of the orifice takes place, but in an entirely of a manner. In the one case it is the result of a paralysed state the othrtain SCt °f muscles (abductors) which open the larynx, while in
anoth ^ ** aris6S 0ut of abnormal action or a spasmodic contraction of set (adductors), whose natural purpose it is to close it.
vi0i USes-~^Spasm of the larynx may result from any sudden and irritahl Untation> and from milder stimulation when the larynx is in an agenat Ie ^ndition. The accidental entrance of food or other foreign of the sometimes bring it about, and especially when the sensibility irritati ^^ ^ heiShtened in the course of an attack of inflammatory in th °n" ■ ^°me °f the most severe and dangerous cases, however, arise they c 6Qtlre absence of any such condition, and from the manner in which the aT^ and g° lt is clear tliat they have a nervous origin; but whether larynx t SCat °f the disorder be in the brain or in the nerV6S °f the
* themselves cannot well be determined. oneoi[mi;)toms-~It is seldom that any premonitory indications mark the
genei-c Tf °f ^ disease- Horses who suffer from it usually enjoy good variabl th' and are mostly in fair condition. The attack almost in- gali0 -Y Comes on suddenly, and, with few exceptions, while trotting or
a sta ig' • ^bile moving along, the horse is noticed to come suddenly to is pineh ?1L The head is raised and m°Ved fr°m 8kle t0 Skle' the feCe
after ° v &nd wears an anxious expression, the nostrils are dilated, and insPirat• arreSt in the breathing a lopd shrill noise is heard with each gait b 10n' In severe cases the horse breaks out in patchy sweat, the
is gene°TeS unsteady> the breathing gasping and troubled, and the body Vera% eonvulsed. |
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Th
is cause paroxysm may quickly pass away only to return when the animal interval t0 m°Ye' or [t ma7 be renewed from time to time at varying
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little
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-vthe worse for ^ troubl&
|
n it disappears, leaving the patient but
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36
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18
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HEALTH AND DISEASE
|
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|
Treatment.—At the outset of the seizure the horse should be brought
to a stand-still at once and allowed to remain in a state of quiet until the paroxysm abates, when he may be removed to the nearest stable. The body should now be well rubbed down and plenty of fresh air pro- vided for. A draught, consisting of 2 ounces of tincture of opium in water, or, what is better, a subcutaneous injection of morphia, is to be administered and repeated in two hours if the symptoms do not abate. Hot bandages to the throat after an application of glycerine and bella- donna will be found useful, with inhalations of warm vapour, and a dose of physic should be administered when the spasm has disappeared. An animal having suffered one attack is frequently the victim of a
second, and sometimes a succession of seizures may follow the first at varying intervals of days, weeks, or months. Where this is the case the greatest care should be observed to guard against overfeeding, severe exertion, and, as far as possible, against the inhalation of dust and irritat- ing gases, and to avoid exposure to such sudden and extreme changes of temperature as are met with in passing from hot, foul stables into the cold air. COUGH
A cough is a more or less violent expiratory effort, indicating irritation
of some part of the breathing organs. The act is commenced by a deep inspiration, during which the lungs are distended with air. The larynx or entrance to the windpipe is then momentarily closed, after which it is forcibly opened by the contraction of the muscles of the chest and abdomen, when the contained air is expelled, carrying with it any offend- ing matter to which the cough may be due. lhe irritation by which coughing is induced may be direct or sym-
pathetic, i.e. it may result from something brought into direct contact with some part of the respiratory tube, as cold air, dust, irritating gases, or it may be a sense of irritation transmitted by nervous influence from some other organ, as in the case of cough arising out of stomach derangement, worms in the bowels, teething, &c, &c. The sensibility of the respira- tory passages is greatly enhanced when any part of them suffers from active disease, hence coughing is always present in such ailments as laryn- gitis, bronchitis, and pneumonia. Cough, moreover, is frequently associated with heart disease, especially with those forms that interfere with the pul- monary circulation and keep up a certain degree of congestion of the lungs. As a means of diagnosis, much importance is to be attached to the
character of the cough: (l) as to whether it is short and hacking, as in stomach and intestinal derangements, or long drawn out, as in chronic lung |
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|
HIGH BLOWING 19
chitis8e;/o^ Aether it is occasional, as in pleurisy, or frequent, as in bron-
in brok Wlletller ^ is moist, as in catarrh of the air passages, or dry, as SuPPresei!qWind; ^ whether it is free> as in common cold' or Painful and
disease &S in laryngitis. Cough, it will be seen, is a mere symptom of disordersand n0t a disease in itself; and although usually associated with
impulSesS °f tne respiratory apparatus, it is sometimes induced by nervous remedySf6Xcited in remote organs. The remedy for coughing is the must tb ^ the Particular ailment out of which it arises, and every case allay t] erefore be dealt with on its merits. The treatment necessary to ing fr COu§'n of laryngitis would have no beneficial effect in that result- be^"1 lnte8tinal irritation, for, while in the former case sedatives would most 1Cat6d' in the latter aperients and perhaps a vermifuge would be Particuir°miSing of access. In the matter of treatment, therefore, the the natar medicines and applications to be employed will be governed by Ure of the cause to which the cough is due, HICxH BLOWING
breath6 S°Und to which this term is aPPlied is Produced in the aCt °f
respil "?g Wllile the air is being expelled from the lungs during forced and\ Xt is most marked while the horse is d°ing a brisk Cante1'
starting01068 ksS audible in the galloP- Xt is alwayS m°St PronouncedJf
degre 8'/Ud is recognized as a fluttering or loud vibrating noise. I he sol, 6 vibration differs in different animals, and it is distinctly more |
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|
^■]| , '" some than in others. ^^^^HH^^B
ana s? n Ving is essentially a nasal sound, and although sometimes loud eraitt T ** bears no comparison in point of quality with the noise It as the result of laryngeal disease in roarers and whistlers,
nostril ^ m°re esPeciallj observed in horses with thin skins, whose false In th ^ l0°Se and caPacious, and in animals of excitable temperament, of thee W"ter's experience high blowers are conspicuous for the soundness practi6lr atning organs and endurance under exertion, and in a large remJrt m the examination of horses of every description he does not ina er to nave found roaring to be associated with this peculiar breath- reLf ? Increased nasal resonance or noisy breathing is sometimes the Pinch a that tyPe of conformation in which the face presents a narrow and SonJi apPearance across the region of the nose. In this condition tlie intens-fTd" ^ ^^ °f that ordinarily heard in resPiratl°n' m"
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s JtVS fadUy distinguishable from roaring, and is not to be regarded
ot unsoundness. |
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as
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20 HEALTH AND DISEASE
8. CONSTITUTIONAL DISEASES
RHEUMATISM
Dennition.—Rheumatism is a specific constitutional disease, sometimes
assuming an acute febrile character. It is specially marked by local mani- festations of pain of varying degrees of intensity, with a tendency to shift from place to place, and to recur periodically. Horses of all ages are liable to it, but it is most prevalent in the aged. Causes.—Heredity is undoubtedly a factor in the causation of
rheumatism, and, as in gout, the disease would appear to be due to some incomplete elaboration of the nutrient elements of the food, whereby a rheumatic poison is generated in the body and brought into activity by certain extraneous causes. Among these may be mentioned unsanitary surroundings, cold, damp, and vitiated stables, and damaged fodder. Any condition tending to reduce an animal's vitality or bring him below par increases his susceptibility to attack. Seasonal influences, as ex- posure to the biting east winds of spring and autumn, are often account- able tor attacks of this disease in susceptible subjects. Horses brought irom a hot stable and then, while heated, compelled to stand without clothing exposed to wet and cold, readily contract the disease. Animals from the t0 habltUal exP°sure> but without those sudden alternations ,. ,, ^he stable to the draughty street corner, are much stables t0 C°ntraCt the diS6aSe than the ammals Hvin§ in h0t Stuffy
, , f . ln lts acute febrile form not infrequently complicates an
attack ol influenza, strangles, or pneumonia, or follows upon it in the
course of convalescence. Symptoms.--Rheumatism may present itself as an acute fever with
mamiestations of local ™»in ™ •/ r iJdm' or it may assume a chronic and less severe tutionalthdisturrr **** ^ ^^ Sh°WS marked indications of GOnsti'
l +v *&w T-06' nota% a high temperature, quick pulse, increased breaking hot skin injected eyes, inappetence, and constipation of the ooweis. Really, the disease may centre itself in one or another of the joints of the extremities, or in the tendons and ligaments of the limbs, or m the muscles. Whichever structure is involved, the part becomes more or less swollen, hot, and intensely painful, so much so that the up- right posture is mamtained with difficulty, and only at the expense of considerable suffering. The disease may be confined to one extremity |
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|
RHEUMATISM 21
°f th ^^ m&Y involve two or more- In the chronic or sub-acute form
the l<\ ase there is seldom any obvious disturbance of the system, is u Pr S6' breatning, and temperature remain normal, and the appetite Plicat r,Urbed' The disease mostly attacks the limbs, but may also im- Thea ° muscles of the loins, producing lumbar rheumatism or lumbago, and t8eat °f attack ma7 or may not be enlarged, but more or less heat tureg enderness is generally observed in it. When swelling of the struc- painS appears it is usually firm, and seldom altogether disappears. The shift fn(i lameness is liable to vary in severity from day to day, and to may br°m Part to part, and from limb to limb, so that the lame leg to-day With ttlle sound one to-morrow, and vice versa. An animal once affected eurre atism seldom escapes a second attack, and the liability to re- lar&enCe of the disease becomes greater as time goes on. Many of those
rheu SWellin§s found on the limbs of horses involving the bones are of the r^10 °riSin' as are also others seen in the tendons and ligaments of enlarS The Joints of horses are frequently found to become gradually § V repeated attacks of the disease.
atta:featment.-The reduction of temperature in those sudden and acute be J? °f rheumatism referred to is of first importance, and this should saliovl Pt6d ^ the administration of successive doses of sahcme. Ihe yiate of Soda is perhaps the most useful salt in rheumatic affections, is w I8'8 of 4 to 8 drams are not considered excessive. If the heart less and t0° easil7 depressed, salicylic acid may be preferred as having a m.af10n uPon that organ. This treatment may be accompanied by 0r Ud aperient, preferably of a saline nature, as sulphate of magnesia e octa, and if the gymptoms do not rapidly abate salicylates may be in t ,§'ed for iodide of potassium, with bicarbonate of potash or soda alio dnnkirig-water. The diet should not be stimulating, and if the Whe °e °f COrn has been ful1 [t sh0uld be considerabl7 recluCe,
pati"6 VeiT acute Pain is evinced it may be desirable to place the sWo]1nt m slings, and to employ anodynes both internally and to the to tl .Parts (see section on anodynes). Hot fomentations and bandages a*d iodlnflamed Parts> friction with the hand, aided by liniments of soap lne, also afford considerable relief.
tlle eCUrrent rheumatism at particular periods, as in moulting and during of J?ValenCe °f east winds, may be combated in advance by a course the „ f* P°tash and a laxative dose of medicine a little while before beddi tlme 0f attack- ^od drainage, a dry stable, and plenty of dry subie? are Particularly desirable for horses that have been previously J ct to rheumatism. |
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HEALTH AND DISEASE
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22
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LYMPHANGITIS—WEED
Definition.—A constitutional disorder, with local manifestations of
an inflammatory nature, affecting the lymphatic glands and vessels of the limbs. It is usually confined to one hind extremity, but occasionally involves both, and sometimes attacks a fore one. Causes.—Predisposition to this disease is especially marked in heavy
coarse-bred draught horses with a thick skin, round fleshy legs, and lym- phatic temperament. It may, however, and occasionally does, attack the lighter breeds, but this is of comparatively rare occurrence. Lymphangitis seldom appears before the adult period of life has been reached. Animals out on grass enjoy an immunity from it, and it is only when they are housed and liberally fed on highly stimulating food in the course of active work that the disease presents itself. Under these conditions the disorder appears to be excited by in-
sufficient exercise or a temporary respite from work; hence it is sometimes termed "Monday morning disease", from the fact of its frequent occur- rence after Sunday's rest. The intimate cause of the malady cannot be clearly stated, but it would seem to have its origin in some vitiated state of the blood, either resulting from imperfect assimilation of the food or the too tardy elimination from the system of the waste products of the wear and tear of the body. Symptoms.—Two groups of symptoms are clearly manifested in this
disorder; one group has reference to the diseased limb, and the other to the general system. In respect of the former it is observed to become suddenly enlarged, hot, and painful. The swelling commonly extends from the foot to the stifle, but may be less extensive in the milder forms of attack. The animal shows intense lameness, and will sometimes hold the leg suspended in the air as evidence of pain. The glands in the groin are swollen, and in the more severe cases an oozing of a straw- coloured fluid appears upon the skin. The constitutional symptoms are ushered in by rigors or shiverings,
an accelerated pulse, and hurried breathing. The temperature rises two or three degrees above the normal standard. The mouth is hot and clammy, the bowels constipated, and the urine thick, and somewhat dark in colour, and loaded with solid matters. Under judicious manage- ment the fever symptoms subside in thirty-six to forty-eight hours, and the local symptoms show signs of abatement. Treatment.—As a rule to which there are but few exceptions, a bold
dose of aloes in the form of a ball should be promptly administered, and |
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|
93
LYMPHANGITIS-WEED rndletllWaitinS for its effects relief may be afforded by warm fomentation
anodv eJplo^ment of soothing emollients to the swollen limb. The and i tS °f warm water maJ be increased by the addition of opium ^ution of the acetate of lead, and the emollient chosen may be
improved by the addi-
tion of extract of bella- donna or cocaine. Diuretic agents may
here be employed with great promise of success, as they stimulate the kidneys to carry off the morbid material in the blood. Nitrate and bi- carbonate of potash is a convenient form in which to give diuretic drugs. Sometimes benefit re- sults by a free scarifica- tion of the swollen limb, i.e. making a number of small punctures through the skin with a fine lancet.
Movement during the
first two or three days is very painful, and although a reduction of the swell- ing and greater mobility of the limb is the im- mediate result, it appears to increase the inflam- matory action afterwards. |
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*%• 209
|
With the first subsidence
|
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-Lymphangitis
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of pain and swelling,
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J
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iabiiu"~*a 'dl Sequent intervals may be recommended as reducing tie
Uli% to r,------ . ,., . „.J ..._•_ ____™iKr impaired at |
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fir
|
y to Perffianent thickening. The appetite is generally impaired at
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durin! i Sh°uld not be indulged immediately when it returns; a low diet
i . ° . . ,, • -_-l_„j. ;„ +hc. matter oi |
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|
^tmJ^ Peri0d of convalescence being all-important in the matter o
^Ppbel •, °raSS and 7°™g vetches or other green food should be PPlled' rf obtainable, and corn withheld until a good deal of exercise can |
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|
24 HEALTH AND DISEASE
be taken. In the absence of green fodder, bran mashes, carrots, and a
moderate amount of hay should be given. It invariably results that more or less permanent thickening remains after the acute symptoms have sub- sided especially m the more depending parts of the limb. This, however, maybe m some measure obviated by repeatedly subjecting the limb to brisk rubbing with a straw wisp and afterwards to a course of massage. In- r ase susceptibility usually follows the first attack. Animals so pre- disposed require special attention and management. In this connection walking exercise should be given whenever a rest-day comes round, and tiie tood ration should be diminished. An aperient dose of medicine, given every three or four months, will greatly assist in warding off an attack. PURPURA HEMORRHAGICA
KP l efinitl0n-7;A disease Evolving the entire system, and believed to
leadTnTt 7 ^^ in the comPosition and character of the blood,
and patch ^'l °* ^ Sm&U V6SSels and the develoPment of blood gPots
OTWq C16S m skm' tlle mucous membrane of the eyelids, the nose, and various parts and organs of the body. Examination of the blood,
Z,Lfl death' sllow the white cells or corpuscles to be in
m ! ^ATmal am°Unt' and the red corpuscles to be very soft and
iLtW 1 7 adhere t0Sether in ^gular masses, instead of arrang- MoreovTr * T? "* ^ ^ °ther aS *"* are Seen to do in healtS"
with granulaHebris ^ C°rpU8deS "* "^ UP' fiUing the bl°°d
hnt^Ztruly'XTr^said r ?the piw cause °f ^™>
ss£ rr^tsM rugh rdiso-drg th;^
|
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acter—as influenza stm^l anions oi a aeomtatin^
in animals ^1^1^°^ ^ P^.-** it also occurs
Bad ventilation and ind HW^*? 7 *"" * & P^0™ C°nditi^
concerned in tU • j 'neient drainage are suspected of being sometimes t i milt iUCtl0D °f *" di8ease' but ^ow or in what measure
sZXms Th °Ur PreSent WledSe' t0 dete™
^^ri^is sometimes very sudden'and
The first sic™ SIT the V1Ctims are ^-blooded or plethoric.
2L2WC ri;r"?w; £lips or a triekli,,g of bl00d-
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■J 3
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PURPURA HEMORRHAGICA
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25
PURPURA HEMORRHAGICA becomes generally enlarged and unsightly, and the ^f^^^Zml
mterfered with. In many instances attention is first directed v g ^ent of one or more of the legs, or to a soft doughy swelling
the belly. , es The lining membrane of the eyelids, or the nostrils, or both ecom^
spotted over with extravasated blood, and in some cases b ooa - ^ fluid oozes from the skin at numerous points. The urine also ■discoloured by admixture with blood. . vflrvin2 Purpura is always attended with a good deal of prostration, a va yj
^ount of fever, and general constitutional disturbance. In ca ^ the swelling is considerable, and the disease protracted, sloug^
ln the region of the lips, or from the heels, is not unlikely to c* ^ „ Treatment.-Good sanitation and hygiene are matters o ^ importance in dealing with this affection. A roomy, well-ventii ^ box with efficient drainage should be provided for the P*« „
floor should be strewn daily with carbolic solution, or some other q,
•efficient disinfectant. The body is to be well clothed and bandages, app t0 the legs with the object of keeping up the surface circu a tion at the same time a free and plentiful supply of air is allowed ™b J *» d day. The strength of the animal should be supported ^«°°V ^ food, suitably prepared by boiling and scalding, as well as by gg ,^ ^ tea> &c. Stimulants, in the form of whisky or gin, will ^ materially in supporting the powers of life and g^din§ ^ of iron Phcations. As to drugs, turpentine with tincture of Perc*T and re- ^ generally employed with the object of arresting hemorilia < ^ st°ring the integrity of the red corpuscles. One ounce ol eac» d of ^Y be given in a pint of gruel morning and evening. ^ featment which has been attended with marked success, botn i .
*7 and on the Continent, is that of injecting into the trachea ov ^
J Weak solution of iodine in iodide of potassium. *oui g ^ f r*er to 8 or 10 of the latter, dissolved in an ounce ol wate ,
tor a close. be given . Should the bowels be constipated, a little linseed-oil may j^
111 ^e food twice a day until a better condition is ^^7' not on any account be carried to the extent of exciting P*« ^ be . ^ere sloughing of skin takes place the wounds will i q ^ 1^7 and repeatedly disinfected with one or another of the ag
0nly used for this purpose. times Joes, it is
, When this disease appears in a mild form, as it son
***«1 by some scarlatfnPa. There is, however, no diseaso *hu* ^ any way resembles scarlatina, either clinically or patholog |
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HEALTH AND DISEASE
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S6
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H^MO-GLOBINURIA
Definition.—HfBmo-globinuria is an acute blood disease characterized
by sudden and severe lameness in one hind-limb, general paralysis, and dark discoloration of the urine, which is loaded with albumen. IMS disease used to be called hysteria, because first observed m mares.
is found, however, to be equally prevalent in geldings, and stallions are
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"$* f
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Fig. 210.—Horse Suffering from Hfemo-globinuria
also sometimes affected by it. It usually comes on after work following
upon a short period of rest. Horses in high condition who receive large rations of highly nutritious food are specially liable to it. The late Professor "Williams described the deposit thrown down on the
addition of an acid to the urine as nitrate of urea. In 1883 Professor Axe combated the view enunciated by "Williams and others who regard the disease as the outcome of an immoderate accumulation of urea in the blood, and he adduced a large amount of chemical and pathological evi- dence in support of his contention. In regard to the condition of the urine the Professor showed by a,
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JELEMO-GLOBINUBIA 27
the1^ 1^ .Cllemical analyses:—1. That the precipitate thrown down on
and a of nifcric acicl and subsequent boiling is essentially albumen, ^n not urea as was stated by Williams. 2. That the discoloration is
Jie to the colouring matter of the blood. 3. That while the amount urea contained in the urine varies in different cases, it cannot be said exist in any abnormal proportion. He further stated that the simple Presence of urea in the serum of the blood, as referred to by Williams, ^ no indication of its being the disease-producing agent, inasmuch as rea is normally present in it. As to the specific gravity of the urine, had ~T0feSSOr observe(i that in none of the cases to which his attention a been directed had any marked increase been observed. In respect the composition of the urine, he had noticed a considerable diminution n the amount of the calcium carbonate, and a notable increase in the amnionio-magnesium phosphates. In speaking of the condition of the tissues after death he dwelt on
^le general septicaemic character of the changes, and specially referred ^° their oedematous condition. In a case recently brought under his ^°tice the amount of fluid contained in the muscular and hepatic tissues as estimated and compared with that contained in the same structures n health, with the result stated below. Estimation of Moisture in Muscle Tissue of Horse suffering from
zoturia".— !. From the psoas muscles 8 ounces or 3840 grains of flesh ^ ei'e removed and correctly weighed. 2. On some of the fluid being ^nioved, by squeezing, it was found to have lost 1050 grains. 3. It ^as then minced up, and placed in a water-bath (the temperature not sceeclmg 150° Fahr.) for 24 hours, and again weighed, but the weight Was found to be constant: Water ...... ......... 2717 grains
Flesl1 ............ ... 1123 „
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|
3840
|
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|
lere being present in the muscle water equal to 707 per cent.
t Estimation of Moisture in Hepatic Tissue of a Horse suffering from ^ zoturia".~i. Eight ounces of live* were taken and correctly weighed. ha \ S°me °f tbe fluid being removed> V squeezing, it was found to
aaVG ost 1125 grains. 3. The liver was now minced up and put into
^water-bath (temperature 150° Fahr.) for 24 hours, and again weighed,
en it was found t0 have logt 2i7g graills> 4 jt wag tnen pUt into
We6. jfme bath for 12 hours longer, at the end of which time it was again
eighed, but found to be constant: |
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|
28
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HEALTH AND DISEASE
|
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|
Water ••............. 2478 grains
Flesh...... ......... 1362 „
|
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|
3840
|
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|
There being present in the liver water equal to 64 -5 per cent.
Estimation of Moisture in Muscular Tissue of a Horse in Health.—
A pxece of psose muscle was taken from a horse and weighed. After the water had been expelled, it was found to have lost 50-37 per cent of moisture. Estimation of Moisture in Hepatic Tissue of a Horse in Health.—
A piece of liver was taken from a mare and weighed. After the water had been expelled, it was found to have lost 44"2 per cent of moisture. Analysis of Urine in Health.—Three samples of urine were taken from
three mares, and yielded respectively the following proportion of urea:— 1st sample ... ......... 11-9 parts per 1000
2nd sample ... 19-4
3rdsamPie - '.'.'. '.'.'- '.'.'. ii-38 ;; "
When treated with peroxide of hydrogen and tincture of guaiacum they
gave no coloration, showing the absence of blood; when a small quantity ot blood was added to the urine the hydrogen peroxide and guaiacum gave a distinct blue coloration. Analysis of Urine in "Azoturia".—On Wednesday, June 13th, 1883,
a portion ot urine removed from a bay cart mare suffering from "Azoturia" was submitted for analysis. fes/tub^f .^haracters--Colour, in bulk, chocolate-brown; viewed in a
es e right red, transparent, somewhat thicker than water; a small amount ot granular matter visible in suspension. Specific gravity 1--015. io test-paper it gave a distinctly alkaline reaction. On the addition oi nitric acid there was no effervescence; on being boiled a flocculent piecipitate ot albumen was thrown down. A portion of urine was taken , by ™e §uaiacum test previously employed for the healthy ^LfoTbLd lfUl UUe C°l0rati0n was Produced> indicating the
,i °° ' J^ Portion of blood from the same animal afforded the same reaction. TV wd n
and were f h - h Were eq to 30'36 parts per 100°'
nf +h M a j ~ ^Ue to tne Presence of the colouring matter
the blood and were estimated according to Neubauer's process. The
urea was estimated by Russell and Wesfs process. The ash or total saline matter was found to be equal to 4-61 parte per 1000. The ash contained a very large amount of iron, probably derived from the con- stituents of the blood. The ammonia was estimated by Schlosing's method, and found to be equal to "0039453 parts of urea per 1000. |
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|
29
|
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|
IEEMO-GLOBINUEIA
|
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|
roportion of Chief Constituents in 1000 parts.—
|
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|
969-64
11-59
4-61
14-16
|
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|
Water ...
Urea
Ash
Hippuric Acid
Extractives ^^^^^
Blood and other matters
|
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|
1000-00
|
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|
. From a full consideration of all the facts and circumstances which his
investigation had revealed, he was constrained to look upon the term Azoturia" as a misnomer which could not be sustained in any sense whatever. . Causes.—The immediate cause of the disease is in some way connected
With good living, and the blood has been stated to be surcharged with nitrogenous matter. This is very likely to be the case, but there is no scientific proof of the truth of the proposition. That a change is induced |
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|
Jn the blood by a short period of work after two or three days' rest
|
IS
of
|
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|
*£e> and whatever that change may be it is marked by an escape
a bumen and colouring-matter of the blood with the urine. Symptoms.—The attack is usually very sudden; the subject may all
at once become dead lame behind, as if from a broken limb, or severe injury
^° the loin; the muscles of the quarter are spasmodically contracted and
ard, the animal breaks out into a profuse
eat, and the breathing becomes hurried
aua difficult. There is great discoloration
|
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|
the urine, which may be of a dark-red
or a even porter colour. Sometimes there
oifficulty in staling, when it becomes
pessary to empty the bladder by means
the catheter. In a short time the
aiUmal falls, and is unable to rise. While
°n the ground he fights convulsively with
. ore"hmbs, and raises his head to his
5 as if suffering abdominal pain. The
|
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|
Fig. 211.-Cells of Liver of Horse affected
with Haemo-globinuria |
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|
ranes of the eyes and nose are intensely
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|
edoened, the pulse is quick and full, and the temperature increased.
a Treatment.—A bold dose of aloes should be promptly administered, d?s lf P°ssible> the animal should be slung. This is one of the lew iseases in which some veterinary surgeons advise bleeding; no ou
e readiest way to reduce any deleterious matter which the blood may °ntai*. A sack containing a large quantity of hot bran or other poultice
|
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|
30
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|
HEALTH AND DISEASE
|
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|
completely covering the loins gives relief to the cramped muscles, and
facilitates the action both of skin and kidneys. Enemas of warm water should be thrown into the rectum. When aloes have acted freely diuretics should follow, preferably spirit of nitrous ether, as being stimulating and sustaining. Should the convulsive movements of the limbs and general excitement be considerable, a dose of chloral hydrate should be given, and repeated if necessary. If there is not a free passage of urine the catheter should be used, and the water drawn off from time to time as |
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|
ig. 212. Section of Kidney of Horse affected with Efamo-globimiria
|
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|
A, Glomerulo-nephritis. B y> , ,., MHHM^H^^^^H
Degeneration of its Walls D \ 0 contalnlng Granular Casts. c, Renal Tube, showino-
ment with Blood. p Small T \ ar£e Granular Cast from Urine Tube. E, Vein, showing Engorge"
», small lubes of Henle (healthy). "Tr ^S^^£,S*, With-?lenty °f MCti0n' ^ ^ aPpli6d
diet should be low ZTZ ^ ^^ °f the mUSdeS 6XistS- The crippled for a considerable J' TT* ^^ M™J h°rSeS remain away, and some ^Z J^t ^ ""«* TT*™ W *"* The result of the diseasetT C°mplete US6 °f their hi^'^^s-
croup and thigh, and th ls! ™e rapid 7**°* °f ^ mUSCleS °f the
to the Dart and Z ™ i J be met by a long run at grass, with blisters to the part, and the daily administration of nerve tonics All cases of this kind demand attention from a mlaKfl a . L are such as are commonly seenTn the Vetennamn- These symPtoms
in which the urine does not Lome"T "T ™7> but there ™ °therS
those acute svmnt™ fT discoloured nor does the animal display
acute symptoms of lameness here described. In these cases the horse
|
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|
INFLUENZA OF HORSES 31
3 indisposed, with slight lameness in one of the legs, and until the urine
as been examined there is nothing to indicate the nature of the malady from which he suffers. A little acid applied to the urine reveals at once the nature of the
isease by causing the coagulation and deposit of albumen. |
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|
9. CONTAGIOUS DISEASES
INFLUENZA OF HORSES
|
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|
A low form of catarrhal disease affecting the horse has for a long time
een distinguished from common catarrh by the term influenza or dis-
eniper. It has existed in this country as far back as veterinary history
xtends, prevailing generally in the spring of the year, reappearing some-
tunes in the autumn.
Influenza attracted a special attention in 1872, in consequence of an
^tensive outbreak in the United States, causing enormous loss among horses
e onging to the tramway companies. In consequence of the swelling
nd inflammation of the eyes, which is in many cases one of the symptoms,
acquired the name of "pink eye", but at the time the American
eterinary authorities admitted that there was nothing in its character
distinguish it from the old form of influenza, and they ascribed the
Xcessive mortality to the injudicious treatment to which sick animals
J subjected. The tramway companies insisted on keeping them at
°i'k after the indications of the disease had appeared, with the result
wnich has been referred to.
-Uie new term "pink eye" was accepted in this country as evidence of
ai? existence of a new disease among horses in the States, and consider-
: alarm was created among horse-owners, who realized the risk of
porting the disease from America, an event which really occurred, but
° until several cases of what was considered to be "pink eye" had been
^ ected in different parts of England. It may be observed here that
6 SWeIhng and redness of the eye had always been recognized as a
on Ik-0m ^ certain cases of influenza, and the older practitioners insisted
infl ^^ When the attemPt w&s made to substitute "pink eye" for
to TnZa" Tlle P0Pular feeling, however, was too strong for them, and
red US ^ CaS6S °f influenza' associated with swelling of the eyelids and
t less of the lining membrane, continue to be described as cases of
Dili t ^T.„ »
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HEALTH AND DISEASE
|
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|
Causes.—As influenza affects a considerable number of animals which
are associated together in large establishments, the idea naturally arose that the disease was spread by contagion. In opposition to this theory there is the evidence that one case may be followed by another at the other end of a large stable. In other instances a large number of animals Lwhtw Simuita~ly- The disease also appears in certain localities, reason Vg^^" T^ ^ "^ **"* "* BEPMt
of n ri„t I, contagion theory it is urged that the introduction
it lp»«t nr, introduction of horses into infected stables has,
it -Xs;r;2nteen followed hy an outbreak of the maIady-
the contagia exPeoient m practice to treat the disease as one of
very marked ff'"" nfluenza is distinguished from common catarrh by the
appetite is impl^H^ ^^ ^ &Wmd the ^ ^^ The
in frequency and the] t6mperature rises> the Pulse gradually increases advances. Swelling of TeSS10n. becomes more pronounced as the disease are also observed 1 eyellds and redness of the mucous membrane maybe the head. ' BkchZT^ ^ SWelHng ^^ t0 ^ HmbS' °r
may not, be present M & i nostrils may, or, as in some cases, gait and the constant 7"USCUlar Pam and weakness is shown by the feeble
then another. gB °f Posture and resting of first one limb and In other cases the di^««0 „
system, affectino- the Y .apPears to be concentrated in the digestive nose become yellow ^ Cme%' when the membranes of the eyes and
In other instances the vl.wT ^ End C°ated with a glair^ muCUS-
of the worst cases t piIat017 organs seem to suffer most, and some Results.-InfluenrzrTstenot * g"ngren0US P^monia.
disease; the mortality 1 t under ordinary circumstances, a fatal to 3, 4, 9, and 10 per cent T ^^ by different autnorities to amount
in 1872 the mortality * ' the outbreak which occurred in the States mortality from the disea^ i b ?]! V °rS6S was 7 Per cent The average
Treatment.-The ereatS d t0 be from l to 4 per cent
to the difference in the Vailatlon m the mortality may be put down
cases authorities allow th t 0U mSs 0I> the sick animal. In ordinary arrangement of the diet d' mfdlCmes are of little value, and careful general attention to sani'tar^ ^^ "^ ventllation of stables, and a disease. Avoidance of expos' amngements are sufficient to combat the essential. The disastrous efecT f° dimatic changes and absolute rest are the first indications of the d' COntmmng to keep horses at work after ease are aPParent has already been men-
|
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|
CONTAGIOUS PNEUMONIA OF THE HORSE 33
turned. The main object of treatment should be to uphold the strength
and keep fever in check. For this purpose a dose of spirits of nitric ether m combination with aromatic spirits of ammonia, with a little nitrate of potash morning and evening, is usually sufficient. In cases where serious complications arise, such as pneumonia, bilious
ever, &c., skilled veterinary assistance must be employed. CONTAGIOUS PNEUMONIA OF THE HORSE
, The disease which has lately been described as contagious pneumonia
is generally included in the term influenza; it is, in fact, that form of the
Election m which the central respiratory system is specially implicated.
Causes.—According to Schiitz, contagious pneumonia of the horse is
Ue to a specific organism, an ovoid bacterium, one of a very large class
0 _ microbes, most of which are stained by aniline colours at both ends,
^ith the central portion transparent and colourless. Inoculations made with the microbe of contagious pneumonia of the
°?se produce positive effects in mice, rabbits, pigeons, and guinea-pigs,
a^d injections into the lung structure of the horse produce all the symptoms
01 contagious pneumonia.
A considerable mortality attends this disease, reaching sometimes as
!gh as 20 per cent. Treatment of this disorder would not, of course, be attempted by an amateur. GLANDERS AND FARCY
It cannot be said that the horse is particularly subject to diseases which
j^e propagated by contagion, but it is certainly the case that the animal is l^e victim of one malady which, from its insidious nature and the tenacity Wlth which it clings to the premises in which it breaks out, will bear com- parison with any of the plagues which affect the lower animals. Glanders and farcy, or, more correctly, the one disease glanders, or in
echnical language equinia, which, according to its manifestation in different Parts of the body, is distinguished by one or the other term, has a very ^1(le distribution and a history which is lost in the lapse of time. It as known as far back as available records extend. According to an ^'ticle which was published in Vol. VI, Part 1 of the Journal of the ^°yal Agricultural Society of England, 1895, the first English writer ^n agriculture, Fitzherbert, says, in his Bole of Husbandry, published by trfnST m 1523' When describinS tne "deseases and sorance of horses",
"Glaunders is a desease that may be mended, and cometh of a Vol. ii. 3?
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HEALTH AND DISEASE
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|
34
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|
heate and a sodeyne colde, and appereth at his nosethrylles and betwene
his chall (jowl or jaw) bones. Mournynge on the chyne is a desease in- curable, and it appereth at his nosethryll lyke oke water. A Glaunder, when it breaketh, is lyke matter. Broken winded and pursiveness is but shorte blowynge. . . . The Farcy on is an yll soraunce and maie well be cured in the begynnynge and wyll appere in dyuerse places of his bodye, and there wyll ryse pymples as muche as halfe a walnut-shell, and they will followe a veyne and wyll breake by itself, and as many horses as do playe with him that is sore and gnappe of the matter that runneth out of the sore shall have the same sorance within a moneth after; and therefore keep the sycke from the whole. And if that sorance be not cured betyme he wyll dye of it." Other writers—Dr. Bracken on the Art of Farriery, 1739; Mr. Gibson,
1751; James White, 1802—give their views
as to the nature and origin of the disease. Dr. Bracken does not believe that the affec- tion is contagious any more than a cold or consumption is, in which he is probably correct, as both these diseases are undoubt- edly contagious, but he guards his expres- sion of opinion against any mistake by asserting that the cause of the disease is atmospheric. It is curious to note that the same authority considers the discharge Fig. 213.—Bacillus maiiei from the ulcers of farcy may be contagious. ■ f ■ f Mr. Gibson looks upon glanders as the most
infectious of all maladies that attack the horse. James White also con-
siders glanders a contagious disease, but he believes also that it may arise spontaneously, adding, however, that the most common cause of farcy is contagion from a glandered or farcied horse. That he considered the diseases to be identical is apparent from his remark that they will recip- rocally produce each other. Causes.—Not many years ago numerous causes were quoted as being
directly or indirectly concerned in the production of glanders, as, for in- stance, the debility arising from attacks of acute diseases, insufficient or bad quality of diet, and generally exposure to insanitary conditions. Since the discovery, however, of the infecting organism of glanders by Schiitz and Loffler m 1882, which is known as the Bacillus mallei (fig. 213), only one cause can be referred to, i.e. the transmission of the infecting germ derived from a diseased animal. That the bacillus of glanders is the real |
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|
cause of the disease was proved by Schiitz, who cultivated the
|
organism
|
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|
i. T
|
'fachea „ GLANDERS
3. Se'c Showi»g earliest st
ct'on of Lu aSe of glanderous ulceration. 2. Tortion of Lung, showing superficial nodules of glanders.
» Com snowincr a t.
Me v, ncing case f n3emorrhagia or earliest perceptible stage of pulmonary glanders; B, extended haemorrhage;
ratle of Nasal S ' D' °avity filIed With caseous matter; e, fibroid degeneration of nodule. 4. Ulcerated Mucous
|
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|
35
|
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|
GLANDERS AND FARCY
|
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|
on boiled potato, also on the sterilized serum of the horse and sheep, and
produced glanders in horses and other animals by inoculation with the pure cultures. Infection of Glanders.—Communication of glanders from one horse
to another with which it may be in contact is a fact which is hardly questioned in the present day, but it is also true that in many cases a glandered horse has been kept in a stable with a number of others without any extension of the disease so far as an ordinary clinical examination would enable an observer to determine. This circumstance has been noted Dy some of the older writers. On the other hand, recent investigations prove that the period of incubation, by which term is meant the period which elapses between the introduction of the virus and the declaration °f the disease, is exceedingly variable, although it has been stated by different writers that it may extend from a few days to a year. Incubation.—Experiments go to prove that an inoculated ass, an
animal which is very susceptible to glanders, will be visibly affected in the course of six or seven days. It is, of course, almost impossible to determine the exact date of infection under ordinary circumstances, and there is alsc to be taken into account the question of susceptibility; but altogether the evidence which has been obtained by very careful enquiry leads to the conclusion that when the infective material is introduced into a horse a system through the breathing organs, or an open wound in any part o the body, the disease in some stage will be developed in the course o a few days. It may, however, remain in an absolutely dormant condition f°r months or years, and during this time, although the animal is to a stents and purposes a glandered horse, there may not be any externa evidence whatever of the existence of the disease. It is consequently easy to understand authorities having expressed various opinions m refer- ence to the incubative period. Symptoms of Glanders.—Since the introduction of the mallein test
lt is not of so much importance as it formerly was to estimate the value < certain indications which were once looked upon as sufficient to render an animal suspected. The distinctive symptoms of the worst stage of glanders are not easily mistaken; in fact, they are quite familiar to most persons who have been in any way concerned with the management of horses. Ulceration of the lining membrane of the nostrils, with an adhesive dis- charge at first of semi-transparent character and later of a purulent nature, with swelling of the glands under the jaw, are among the most character- istic symptoms. The local disease of the nasal membrane is common y c°nfined to one side, so far at least as clinical examination can.determ11! ^ and the enlarged glands are always on the side corresponding to |
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36
|
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|
HEALTH AND DISEASE
|
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|
diseased nostril. In the chronic form of glanders the discharge from the
nostril is sometimes so slight as to attract very little attention, and no ulcers can be seen on any part of the nasal membrane, which, however, is frequently pallid or of a bluish discoloration. Even these symptoms are, however, absent in many cases in which a post-mortem examination will prove the animal to be affected with glanders. _ When glanders presents itself in the form of farcy, the real difference
in the symptoms results from the presence of the local disease in the skin, chiefly that of the hind extremities. The nodules and subsequent ulceration m the mucous membrane, which are characteristic of glanders, are accepted as indications of farcy when they appear in the skin. In both forms of the disease there is the same affection of the lymphatic vessels and their associated glands, and the distinctive nodules of glanders which are found in the lungs are also seen in cases of farcy. Accompanying the eruption of the so-called farcy buds in the skin
ol the extremities there is usually a tumefaction of the lymphatic vessels and general enlargement of the affected limb. Indeed, the first symptom oi the disease is commonly a certain degree of stiffness of movement, which Decomes more marked as the swelling increases. Farcy, when treated as a separate disease, was considered to be less serious and more amenable to treatment than danrlPro Tv, ■ • ,, 1
giauueib. in many instances animals apparently recovered
under a course of tonic medicine with liberal rations, but it was allowed that
such recovered animals often exhibited distinctive symptoms of glanders
alter an attack of any acute disease, as influenza or pneumonia.
he symptoms of farcy are so definite that any experienced stableman
rested?11 h ^ C°mPetent t0 decide whether or not the disease
exis e m any horse under his charge, but recent investigations by Algerian
Ixtremeir7liSkriSe0nS' ^ ^ by Professor Nocard' indicate that lt is
e y i te y ior the most marked symptoms to lead to a wrong diag- nosis as there exists in horses a form of inflammation of the lymphatics- which was first noticed W +T„» * ■ c- t at • -in ., u °y tne veterinary surgeons of the Algerian army,
and described by them as suppurating lymphangitis—which presents the
cniet symptoms of farcy, i.e. swelling of the limb, enlargement of the lymph vessels, formation of small tumours (farcy buds) which burst and subsequently undergo ulceration. How extremely close the resemblance between the two diseases—epi-
zootic lyrnphangtHs and farcy^is may be judged from Professor Nocard's remarks in reference to fifty-nine cases of apparent farcy-forty-three only were really the subjects of the true disease (glanders); the other sixteen were affected with suppurating lymphangitis. The two affections may be distinguished by microscopic examination of the matter discharged from |
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|
GLANDERS AND FARCY 37
the pustules in the skin. In epizootic lymphangitis will be observed a
number of small, highly refractile lemon-shaped bodies, some free and others contained in the pus corpuscles. These are the cryptococci by which the disease is caused. Glanders, on the other hand, will be recognized by the mallein test, and, in addition, the inoculation of guinea-pigs and the cultivation of the organism on different media, as potato, bouillon, agar-agar, and serum-gelatine. Such complicated tests are, of course, not likely to be applied excepting in cases where a valuable horse is con- demned as suffering from farcy, and the symptoms are limited to the vmphatics of the extremities. Precautions to be taken to prevent the spreading of Glanders.
It is now perfectly well known that glanders is communicable to the
human subject, and by inoculation to guinea-pigs, sheep, and goats. Cattle 0rily suffer local disease, rabbits are very slightly susceptible. Among the carnivora, lions and other animals of the same class, kept in menageries a*id fed on raw flesh of horses, incur the risk of getting glanderous matter ZQ this way introduced into their systems. Several cases of extensive uWation of the skin of the paws, followed by the death of the animals, ave occurred among lions in different parts of the country. It is satis-
actory, however, to note that the infective matter of glanders does not ^etain its activity for a very long time; exposure to dry air kills it in . ffceen to twenty days; but so long as a horse is affected with the disease 111 any form, a constant supply of the virus is kept up, and susceptible animals, as well as men attending upon the diseased horse, incur a certain amount of risk. Suspected animals, therefore, should be kept in a secure ljIace until the nature of the disease is determined. The injection of l<%Uein will at once resolve any doubt which may exist, and if the sus-
pected horse exhibits the characteristic reaction—that is, rise of tempera- a"? t0 103°' 104°' °r 105°' With signS °f s7stematic disturbance, dulness
and loss of appetite, and a swelling at the seat of inoculation—it is 0 erably certain that the suspected horse is suffering from glanders, and should be destroyed without delay. Glanders is the only contagious disease of the horse which is dealt with
y any general order under the Diseases of Animals Act, 1894. The Glanders and Farcy Order of 1894 gives extensive powers to local
authorities with regard to public warning of the existence of the disease; and *J!°Vement of-diseased or suspected horses, asses, or mules; cleansing disinfection; and also for slaughter of diseased horses and the payment no ComPensation. The first duty of the owner of a diseased horse is to give di tCe °f the faCt °f the existence of the disease to a police constable m his 8 riet, which notice will be communicated to the local authority and to |
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HEALTH AND DISEASE
|
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|
e .Board of Agriculture in order that the necessary measures may be
adopted. Use of Mallein in the Detection of Glanders.—Before the dis-
covery of mallein, a few years ago, the only test which could be applied in doubtful cases was the inoculation of an ass with the nasal discharge. Later on, guinea-pigs were found to answer the purpose even better, and Dr. Woodhead employed a double test by inoculating the most susceptible |
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|
Fig. 214.—Inoculating with Mallein
animal, a guinea-pig, and at the same time a comparatively unsusceptible
one, a rabbit. the guinea-pig died after exhibiting distinct symptoms of glanders,
and the rabbit recovered after showing slight signs of fever, as a rise of emperature with local irritation, or slight ulceration, it was concluded that the horse was affected with glanders. e use of mallein, however, is a much more delicate test, because it is
equally effective when applied to horses which are not suspected, or at least exhibit no sign of disease of any kind, but are known to have been in the same stable with a glandered horse. Mallein is prepared by cultivating |
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|
39
|
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|
STRANGLES OF THE HORSE
|
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|
the bacillus of glanders in bouillon, to which 5 per cent of glycerine has
been added. The vessels containing the cultivation are kept from three to six weeks at a temperature of 100° Fahr. The cultures are then sterilized V steam, and afterwards filtered through unglazed earthenware to separate the dead bacilli. A clear sherry-coloured liquid is obtained, perfectly free from organisms. It has been proved
by numerous experi- |
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ments in this country
|
Fig. 215.—Mallein Syringe
|
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|
and on the Conti-
nent that the injection (fig. 214) of the fluid mallein under the skin °f the neck of a horse produces characteristic reaction, even in cases in which after death only a single glanderous nodule has been found in the lungs. The test has been also applied to healthy horses and to horses affected with bronchial catarrh, pleurisy, strangles, and nasal gleet, but m no instance has the complete characteristic reaction been observed. It uiay, therefore, be considered that the mallein test is perfectly reliable, even in cases in which the disease was in the early stage. |
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STRANGLES OF THE HORSE
Strangles, or pyrogenic fever, or external scrofula, are names given to
this catarrhal disease, which is so very common among young horses. On the question of the infectious nature of the disorder opinions differ very materially. Dr. Twill, in his recent work on the pathology of the domestic animals, describes strangles as an acute infectious disease. Robertson defines it as a specific febrile disease of the horse probably under certain conditions contagious. Williams states in definite terms his opinion that the disease is not contagious, but he admits, nevertheless, that it is better to take precautions against its diffusion by separating the diseased horse from healthy ones. In the popular view the disease is the result of some peculiar condition
°f the system, which leads to the external manifestations characteristic of strangles, in the course, of which the morbid matter is discharged from the Astern, and the animal is supposed to be so much the better for its removal. In favour of the contagion theory there are the facts derived from
experimental enquiry commenced a hundred years back. In these invest*- |
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HEALTH AND DISEASE
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40
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gations strangles was directly transmitted by ^^ ^f *J^.
discharge. Similar experiments have been performed by other gators with negative results. Schiitz, however, discovered an ,<*B^ some years ago, a streptococcus, with pure cultivation <*J ^ ceeded in causing the disease in healthy colts, and from thewn ^
evidence it will be decidedly safe to accept the view that strai g
a contagious disease of the horse. an(j Strangles only occurs in the equine race, including the horse, a^ ,^^
mule. It is common to young horses from two to five years, an ^ sionally it occurs in colts of a few weeks old; also it may appear in y old horses, in which case it is com-
monly spoken of as bastard strangles, and invariably runs a mild course. Symptoms.-It ta genera11? ad;
mitted that the earliest symptoms of
strangles are those of a mild catarrh slight fever, increase of pulsation and discharge from the nostrils, cough and sore throat, followed by a diffuse swell- ing of the glands and cellular tissue under the jaw. One of the difficulties in dealing with the disease as a con- tagious malady arises from the absence of any special symptoms, rendering accurate diagnosis in the early stage |
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Fig. 216.—Steaming for Strangles
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|
impossible. Practically the question^
only one of importance when immediate diagnosis is essentia., as case of the admission of an animal to a show-yard. This difhcu y, however, is lessened by the fact that all catarrhal affections may prove to be more or less contagious, and ordinary benign strangles is pr not more infectious than an ordinary cold in the head. In a few hours, or at most in a day or two, more characteristic symp-
toms of strangles may be looked for. The nasal discharge becomes puru- lent. A swelling under the throat, the beginning of an abscess, wi apparent, and during the formation of pus, fever is more acute, animal's appetite is now impaired, the temperature rises considerably, a the pulse becomes much more frequent. When the suppuration is com- plete, and the abscess beneath the jaw has been emptied, the febn e symptoms gradually disappear. Treatment.—Good nursing appears to be all that is really necessary
in dealing with strangles of the ordinary type; fumigations to the throa |
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ANTHRAX OF THE HORSE il
(% 216) and poultices (fig. 217) are commonly employed for the pur-
Pose of assisting the suppurative process. When mature, the abscess J °UJd be opened, and the matter discharged collected in a basket on saw-dust and burned. The pus cavity should be well syringed out with a 5;per-cent solution of car- °ollc acid, and afterwards £lled with cotton-wool which has been previously wrung out m the same solution. lhe plUg of wool ghould be Ranged every day, and the
Part kept thoroughly clean. 0lt diet and warm clothing, ^lth borough ventilation of fables, constitute the addi- tl0nal treatment which is Squired. y*"^^^- a. Fig. 217.—Poulticing for Strangles
wrangles sometimes as-
mes a chronic, and occasionally a malignant, form, ending in the intro- duction of pus into the circulation (pygemia) or the extension of the sup- purative process to the glandular system; sometimes also blood-poisoning V eptica3mia) occurs when the exudation products become putrid. Cases of ?6 m°re malignant forms of the disease do not come within the scope oomestic treatment, but require skilled professional aid. ANTHRAX OF THE HORSE
. -The disease which is recognized as true anthrax is due to the existence
/* the body of a specific organism, the Bacillus anthracis (fig. 218), a b0?10nless rod which is found in the blood and in a11 the tisSU6S °f the
°dy into which blood can penetrate. The organism belongs to the class aerobic bacteria, that is, living only in air. Without the presence of
°Y§en the anthrax bacillus very quickly dies. Anthrax bacilli are readily
^tiyated in bouillon or gelatine. In the animal body the organism
i . xPUes by the formation of spores, and the almost invariable fatality
of ch results from the introduction of the microbe is due to the formation
a poison during the development of the organism. Anthrax is much
th°rt Prevalent among cattle and sheep than among horses, and when
of6 i^atter are infected it is usually in consequence of a previous outbreak
tne disease among other stock on the farm. Cases which have occurred
ecen%, however, leave no doubt that the horse may be infected with
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42
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HEALTH AND DISEASE
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the disease in its own stable, through the agency of contaminated pro-
vender, hay, or oats; the latter particularly have been proved in several instances to be highly infective to the horses which consume them. Symptoms.—Anthrax in all animals runs its course to a fatal termi-
nation with remarkable rapidity, and there is often nothing in the indications to excite suspicion of the nature of the disease. There are the ordinary signs of fever, rise of internal temperature, quick pulse, and increased respiration. The animals stagger when attempting to walk, and sometimes surfer from colic. The most characteristic symptom is swelling of the throat, extending down-
wards towards the chest; finally there is profuse perspiration, which is followed by death usually within thirty hours from the time of the attack. In most cases a fatal result is the first indication of the existence of the disease. An animal which has been left in apparent health is found dead an hour or two after- wards. The post-mortem appearance indicates-
general congestion of the internal organs, |
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Fig. 218. -Bacillus anthracis
A, Bacilli in chains. B> Bacilli disconnected. |
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with effusion of blood into the tissues and
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cavities of the body and also under the
treJ™!!ftment,~°Wing t0 tLe raPid Pr°gress of the disease, curative
treatment is never a++Q™^+„j • ,r
but it m h aCTemPted m cases which are diagnosed as anthrax,
wlim ^*JV remarked that the diagnosis is extremely difficult, even
1Z-Z ■ \ 1S SUSpeCted t0 be anthrax, from the fact that the S ol'f i 6itable ^ the bl00d ™*1 ^o^y before death, and
led to the introduction n +1 a ^ "^ ^ circumstances which have
sarv to naZTtt 6 dlSease' and with this ™ it will be neces- sary to examine the articles of food by the aid of the microscope and
also by use of cultivative A' microscope, ana °row. The fin 1 f medla on which the organism is known to
the water in which the ,1^ l*00111^011 of guinea-pigs or rabbits with
be necessary. suspected provender has been soaked will probably In cases of the outbreak rv? ±i
be safe to conclude that the am°ng Ws kept * ^^ ** ^
by contaminated ™ i °r§amsm had been introduced into the blood
uy contaminated provender, water „, i;«. i, !
while on a pasture > ' ' nt when horses are attacked
is very hkely that an enquiry will prove that the
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HORSE-POX, TUBERCULOSIS, AND ENDOCARDITIS
, ., . . .. „ a„i,,i,„„= qtnmatitis 3. Tuberculosis: Section
»• Natural Horse-pox simulating Glanders. 2. Natural Horse-pox simulating Aphthous btomatms. 3
of Affected Lung; A A, newly-formed tubercles; BB, tubercles undergoing caseous degeneration, cc, divided blood-
vessels. 4. Endocarditis (valvular disease).
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43
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HORSE-POX
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ground has been contaminated with the infective material conveyed m
refuse from manufactories, or from a previous outbreak of the disease among cattle or sheep. In any case the immediate removal of horses from the place where the disease originated is an obvious precaution which should be at once adopted. Anthrax is easily communicated to man by accidental inoculation
during post-mortem examination or while cutting up carcasses of animals dead of the disease. It is on this account particularly desirable to note that for the purpose of diagnosis a portion of the ear may be cut off and the blood which flows from the cut surface may be used for microscopic examination, cultivation of the organism on artificial media, or for test inoculation, without any serious risk to the operator. Carcasses of animals which have died of anthrax should be burned
or buried uncut and covered with quick-lime. The anthrax bacillus, when cut off in this way from contact with air, very quickly becomes inert, HOESE-POX
Veterinarians in this country do not generally recognize the existence
°f small-pox in the horse. The disease is described by Continental authorities as an eruption on the pasterns, the posterior surface of the joints being chiefly affected. The skin becomes swollen and red, the inflammation extends some distance up the limb, vesicles, or small blisters, followed by pustules, appear and discharge a viscid fluid. A similar eruption appears sometimes in the nose and lips, and also on the mucous membrane of the mouth and nostrils. The disease is admitted to be very rare in this country, and when it does occur it is most probable that it would be mistaken for the disease of the pastern which is known as "grease Horse-pox is a benign affection, terminating in recovery without treatmen m a few weeks. Experimental and accidental inoculations are said to produce in man
an eruption similar to that following the introduction of the vaccine virus, and it is asserted that the disease so conveyed protects the individual fr°m small-pox. GLOSS-ANTHEAX
This is a form of anthrax in which the disease specially involves the
tongue, and, in a less degree, the tissues of the throat. It is not, how- £ver, to be confounded with septic glossitis, a malady in which the tongue becomes considerably enlarged, as the result of excoriation and local poise mg by
inoculation with septic organic matter.
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44
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HEALTH AND DISEASE
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Gloss-anthrax is sudden in its onset, and rapid in its course, proving
fatal in twenty-four to forty-eight hours. It is specially marked by an enlargement of the entire length of the tongue, during which large vesicles or blisters appear on some part of its surface, and occasionally on the cheeks also. Within them is contained a quantity of red and blackish- red watery exudation, but this soon escapes, leaving behind grayish-black unhealthy-looking sores. The tongue is swollen, and partly protrudes from the mouth, at first presenting a red appearance, but soon becoming dark and livid. The enlargement is also observed between the jaws, extending to the throat, and sometimes along the course of the neck. The tumefied state of the tongue renders mastication and swallowing impossible, and considerably embarrasses the breathing. The face in this condition presents a hideous, and at the same time an anxious, expression. I he lining membranes of the eyes and nose are intensely reddened, the pulse is rapid, small, and weak, the temperature of the body increased, and a fatal prostration, speedily associated with twitching and trembling of the muscles^ and patchy sweats, supervenes. Treatment is of no avail in these cases, and they should be summarily
disposed of. As a means of preventing further spread of the disease every sanitary precaution should be taken as regards the horse, the stable, and the litter removed out of it. RABIES OF THE HORSE
It is well known that the bite of a rabid animal is the sole cause of
this disease in the horse. In this country it is always traced to the bite of a rabid dog. The
time which elapses between the inoculation of the animal by the teeth of a dog and the appearance of the disease varies from four to twelve weeks, and cases are recorded in which it is extended to a much longer period.' oymptoms.—If it is known that the horse has been bitten by a rabid
dog, the attendant will carefully watch for the first symptoms of derange- ment. Otherwise, no suspicion being excited, very little attention will be paid to the early symptoms. The horse becomes nervous and excitable, bites at any object within his reach, and occasionally seems disposed to attack the persons to whom he is quite accustomed. In some cases the horse will bite his own skin, and will very likely swallow indigestible substances anything which is lying on the ground. There is always considerable thirst, and those who look for any indications of hydrophobia, dread of water, will be disappointed, as that symptom is peculiar to the human subject. As the disease becomes more pronounced the horse |
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TETANUS OF THE HORSE 45
becomes violently excited, and is affected with spasms of the neck and legs.
hen a stlck is held out the horse will seize it, and may make a feint to attack the person holding it, but, instead of succeeding, the muscular spasm becomes so violent that the horse generally falls, and after a while nses again in an apparently tranquil state. Death usually occurs in less than a week, but, as a matter of common precaution, the horse will be hilled as soon as the nature of the disease is ascertained. TETANUS OF THE HOKSE
Tetanus occupies a somewhat dubious position in the classification of
diseases. Formerly it was looked upon as a tonic spasm of the voluntary muscles, resulting from irritation affecting the nerves from an unhealthy wound. The affection was divided into traumatic tetanus, when it was traced to an injury or wound, and idiopathic, when it occurred inde- pendently of any external wound. It is somewhat remarkable that the older writers insist very strongly
upon the influence of various common causes in the production of this disease. Thus Delatere Blaine, writing in the early part of the present century, refers to tetanus or locked-jaw as a morbid irritation of part or the whole of the nervous system, originating in the brain itself, or ultimately reaching it, according as it is idiopathic or symptomatic. Idio- pathic tetanus, he remarks, is most frequent in the horse, and its causes are, some of them, evident, others, occult. In the list of ordinary causes to which he attributes the disease is
cold, especially when the body is heated, as in the case of a plunge into a river during a hunting run, or a horse standing still during a check after a severe burst, or the constant dripping of water on to the body rom a defective roof of a stable; also the presence of worms in the alimen- tary canal, especially botts in the stomach. Traumatic or symptomatic etanus he traces to various external injuries, contusions, lacerations, and Wounds made in surgical operations. Wounds of tendinous and liga- mentous parts have always been considered to be particularly dangerous. Even twenty years ago tetanus is described as a disease, the general pathology of which is very little known, and writers referred it to an halted polarity of the nerve-centres, or to a bad condition of the blood, °r the effects of cold acting on the sensitive nerves. The views above stated, with certain modifications, obtained until
icolaier, in 1884, discovered that inoculation of mice, rabbits, and guinea-
PJgs with portions of soils, obtained from streets and from fields, produced
ymptoms which were considered to be tetanic in their character. In
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46
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HEALTH AND DISEASE
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the abscess which was formed at the point of inoculation several micro-
organisms were found, and one of them produced similar tetanic symptoms when inoculated into other animals. Some considerable time elapsed before what is now known as the
tetanus bacillus was obtained in the state of pure cultivation, owing to the fact that the microbe was anaerobic, and consequently would not grow in the air. Pure oxygen, it is said, destroys it completely. The bacillus occurs in the form of small motile rods
with the spore at one end, giving to the organism the appearance of a minute drum-stick, and it grows readily on the usual media when kept in an atmosphere of hydrogen. Dr. Sims Woodhead, in his work on Bacteria and their Product, remarks, in reference to the universal distribution of the bacillus, that M. Bos- sano obtained soil from forty-three dif- ferent regions in various parts of the |
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Fig. 219 -Bacillus tetani
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_____________________________! globe, and produced tetanus in white
mice and guinea-pigs with twenty-seven
°T<\i\ v fort^tnree specimens, and from his experiment Bossano con- cluded that soils which contain much organic matter almost invariably contain tetanus bacilli. The information which has been obtained of late years proves that
tetanus is one of the pure contagia, and is due to the introduction of the speemc microbe into the animal system through a wound in some part ot the exterior of the body. Whether or not it is possible that the disease may arise from the introduction of contaminated soil into a wound in any part of the alimentary canal it is impossible to determine. There do not, however, appear to be any facts which would militate against this assumption, and infection occurring in this way-that is, through the agency ot a wound in the interior of the body-would naturally give rise ° a\TI the di8ease was idiopathic in its origin. There can be no doubt, however, that the majority of cases are due to the infliction of a
wound on the exterior of the body, especially in such a position that the injured part is likely to come frequently in contact with the earth. it appears that on entering the wound the bacillus of tetanus locates
itselt m the damaged tissues, and is not distributed throughout the body. Ine poison however, which it produces in the wound during its growth will be readily absorbed and carried to the nerve centres, inducing the irri tation which results in the tetanic spasm of the muscles. |
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TETANUS OF THE HORSE
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47
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Tetanus does not spread from one horse to another by contagion or
infection, but it can be transmitted by inoculation with the pus, or by a portion of the damaged structure of a wound, and there is a certain amount of risk incurred by the persons who dress such wounds if they happen to have any abrasions of the skin of the hands. It is usual to classify the disease according to the part of the body
which is most affected, and in accordance also with the rapidity of its progress. Thus there is acute and chronic tetanus. The terms which are sometimes in use—rheumatismal tetanus as the result of cold, and toxic |
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Pig. 220.—Tetanus
tetanus due to poisoning by strychnine—do not properly come under
consideration in connection with the true contagious disease. When the tetanic spasm affects the muscles of the head and neck the condition is described as trismus. When the spasm affects the muscles of the back, and pulls the head backwards, the term opisthotonos is applied; in the opposite condition the word emprosthotonos was used to indicate the bend- ing of the body forward, and in cases where the spasm affected one side of the body, causing it to curve to that side, the condition was defined as pleurosthotonos. All these states are recognized in different phases of the disease in the human subject, but they are rarely met with in the horse, with the single exception of the first, described as trismus, which is the most common form. Symptoms of Tetanus.—At the commencement of the disease, from
ten to sixteen days after the introduction of the infectious material, some |
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48
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HEALTH AND DISEASE
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stiffness in the muscles of the head and neck may be observed. The
animal exhibits some difficulty in grasping its food, and in most cases the muscular spasm rapidly increases, and the animal is incapable of moving the head and neck. The jaws are locked or brought forcibly together, the tail is elevated, and the legs are stiff and abducted. In this condition any sudden alarm produces an accession of the spasm, and in the horse a characteristic symptom is the sudden retraction of the eye into its orbit, and the thrusting forward over it of the nictitans membrane (haw). In the acute form of tetanus the spasm is perceived to extend rapidly along the muscles of the back, loin, and tail, and to the muscles of the ex- tremities, which are commonly spread out, and are only moved with difficulty. ^ The respiration is always laboured in consequence of the affection of the respiratory muscles, and the nostrils are widely dilated. The surface of the body is commonly covered with perspiration. The duration of the disease varies, according to the acuteness of the attack, from three or four days to several weeks, but the majority of fatal cases terminate within a week. In cases which recover, the muscular stiffness may continue for several weeks, gradually becoming less until it entirely ceases. Generally it may be said that should the animal survive the ninth day recovery is rendered probable. Chronic Tetanus is indicated by a less defined spasm, which com-
monly remains limited to the head and neck; in many cases the animal retains a certain power over the muscles of mastication and can take soft food. Post-Mortem Appearances.—There are no very important changes
recognized in the nerve centres or in the nerve fibres beyond slight con- gestion, which sometimes is apparent in the nerves proceeding from the wound. The blood is dark in colour, and there are patches of blood- coloured exudation under the serous and mucous membranes. The lungs are usually congested, sometimes in a state of gangrene. Commonly the muscles are very dark in colour, and are marked with patches of blood- coloured exudation here and there. Treatment.—Absolute quietude experience has proved to be essential,
lhe late Professor Spooner used to advise his students to lock the stable door and take possession of the key, and this cannot be regarded otherwise than as excellent advice. Where an animal offers no resistance it is desir- able that he should be slung to prevent the injury which results from his struggling to maintain the erect position. When the patient can masticate, any kind of green food or cooked food may be given, otherwise the diet will have to be restricted to gruel, or meat soup thickened with meal, and at all times cold water should be within the animal's reach. The surface of |
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STOMATITIS PUSTULOSUM
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49
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STOMATITIS PUSTULOSA CONTAGIOSA
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the body should be protected from cold by clothing adapted to the season.
Medicines appear to be of little use. When they are employed, narcotics should be selected, and exhibited by the method of hypodermic injection. The injection of large quantities of antitoxic serum has been tried
recently, but with very moderate success, and under most favourable cir- cumstances tetanus must be looked upon as an extremely fatal disorder. STOMATITIS PUSTULOSA CONTAGIOSA
This is a specific contagious disease of a febrile character, in which an
eruption appears in the mouth and on the lips, and sometimes on the skm of the face, rarely on other parts of the body. It is communicable from horse to horse, either by inoculation or by contact of the virus with the mucous membrane of the mouth. It has a period of incubation from one to three days, and runs its course in from ten to twelve days. Foals and young horses are most susceptible to infection, and old
ones least so. The spread of infection usually takes place by means of food and
water, and by the use of infected mangers, troughs, pails, and other stable utensils. It is seldom fatal, but on gaining access to a stable of young horses it
spreads rapidly through them unless prompt measures of precaution are taken for its suppression. One attack of the disease is protective against another for some time,
but for what period is not known. Symptoms.—Save in exceptional cases there is not much constitu-
tional disturbance. A slight rise of temperature, a little increase in the number of pulsations, are the only signs of general disorder. Twenty-four to forty-eight hours after infection, soreness of the mouth
is evinced by the discharge of sticky saliva in the act of feeding, and more or less difficulty of mastication. The mucous membrane of the mouth is at this time of a bright red colour, and here and there small pimples are seen on the inner surface of the lips, or beneath the tongue or the gums, or maybe on the skin of the lips, or on all these parts in succession. Each pimple becomes charged with matter, and is quickly resolved into a roun superficial ulcer with a sharp thin edge, and showing little or no tendency to spread. The eruption may be considerable and closely packed, or it may consist only of a few scattered sores. In some instances the glan beneath the jaw (submaxillary lymphatic gland) is enlarged, and the erup- tion may appear in the nostrils, giving rise to a discharge, when the disease ls sometimes mistaken for glanders. Vol. ii. & 38
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HEALTH AND DISEASE
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50
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With the soreness of the mouth there may or may not be difficulty of
swallowing. About the sixth day the sores begin to heal, while others of more recent eruption will still be in the nodular form or in the early stage of ulceration. The features which distinguish this disease from glanders, with which it
may be confounded, are: (l) the short period of incubation; (2) the rapidity of its spread; (3) the superficial, sharply-defined, thin-edged ulcer; (4) the great rapidity with which the sores heal; (5) the absence of any inflamma- tion of the lymphatic vessels; (6) the sudden onset and the short duration of the nasal discharge. Treatment.—The disease usually runs a benign course, and requires
but little interference on the part of the attendant. The mouth may be washed out two or three times a day with a solution of chlorate of potash, or a weak solution of alum, but beyond this no local applications are needed. General treatment will not go beyond the administration of a little nitrate of potash in the food once a day. The diet should consist of bran, boiled roots, and scalded chaff, over
which a little common salt may be sprinkled. Measures Of Prevention.—In this connection it must be remem-
bered that the chief source of the virus is the saliva. When the disease makes its appearance, the sick should be promptly
removed from the healthy, the bedding should be burned, the mangers and fittings, baskets and buckets, &c, well scoured with a strong solution of soda, and freely disinfected. The floor of the stable should be scraped, well brushed out, and dressed with carbolic solution, or well covered with lime. TUBERCULOSIS OF THE HORSE
It was for a long time believed that the horse was refractory to the
invasion of tubercle, and the impression still remains that the disease is extremely rare in this animal. Recent enquiries, however, tend to prove that this view is erroneous. The improved methods of investigation which have lately been introduced have enabled the pathologist to demonstrate the existence of the tubercle bacillus in various organs—lungs, liver, &c.—in diseases which were formerly described by other names, as caseous degenera- tion, lymphadenoma, and induration, or scirrhus. The detection of the tubercle bacillus in morbid deposits in the glands and other structures is, of course, conclusive, and it may also be said that it is essential for correct diagnosis. Koch's discovery of the tubercle bacillus (fig. 221) established a new
era in the history of consumption and other forms of tuberculous disease. |
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TUBERCULOSIS OF THE HOESE 51
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It is now admitted that all these affections may properly be classed among
the true contagia, depending as they do on the introduction of a specific organism from without. Experimental evidence leaves no room for doubt that the affection
occurs by introduction of the germs into the respiratory organs along with inhaled air, and also into the digestive organs with the food. In the horse, as in most animals, the lungs are more often affected than
other organs, and it may be assumed that the most frequent mode of infection is through the respiratory passages. The animal, however, is not exempt from the other mode of infection. Inoculation with tuberculous matter
causes, in most cases, tuberculosis by the introduction of the virus into the blood. Symptoms.—Even in cases where
signs of disease are present there is nothing to be discovered which is posi- tively indicative of tuberculous deposit —cough, difficulty of breathing under exertion, irregular appetite, and emacia- tion are all signs of tuberculosis, but these may all be due to other affections, _____________________________ and it is not Until an Opportunity for Fig. 221.—Bacillus of Tuberculosis
microscopic examination of expectorated
matter or a post-mortem examination occurs that the existence of the
tubercle is as a rule discovered.
Morbid Appearances.—The structural changes which are met with
depend very much upon the organ which is affected. In the lungs there are sometimes found miliary tubercles, while in other cases masses of deposit an inch or more in diameter are met with. These larger masses contain a quantity of soft yellow material in the centre. The bronchial lymphatic glands, and also the glands in other parts of the body, are some- times enormously enlarged, and present yellow softened masses in their interior, and occasionally patches of calcareous or earthy deposit. Masses of tuberculous matter are occasionally found in the liver, spleen,
and kidneys—more rarely in the intestines. On the lining membranes of the chest and belly isolated tuberculous
patches are met with, but the grapy form, as it is called, which is so common in cattle, is not often seen in the horse. Cases of tuberculous deposit in the bones have been recorded, and are probably more common than is generally supposed, the fact being that cases of disease of the bones m the horse are commonly classed under the head of caries or necrosis, and |
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HEALTH AND DISEASE
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52
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the diseased structures are not submitted to any critical examination for
the detection of the tubercle bacilli. In the event of tubercle being detected, on post-mortem examination of
one horse of a number kept in the same stable, the tuberculin test might be applied experimentally. DOURINE (MALADIE DU COIT)
This is a specific contagious disease which, like rabies, is communicated
only by contact of the virus with an abraded or broken surface. Whether occurring in the male or female horse, it primarily affects the external organs of reproduction, viz. the penis in the male and the vaginal passage in the female. (See Plate XXXV.) In consequence of this, and the frequency with which it is transmitted
from one to the other during the act of copulation, it has been distin- guished as " Maladie du Coit", or Covering Disease. Some distinguished veterinary authorities in France and elsewhere have regarded it as identical with syphilis of man, but there is no real evidence upon which to base such a conclusion. It must be admitted that there are in both certain common features, as there are in other specific affections, but the points of divergence are too many and too decided to allow us to assent to the doctrine of unity, for which Bouley, Trasbot, and some other Continental pathologists are responsible. For the same reasons we dissent from the view that it is identical with glanders. Dourine has appeared as an epizootic in Russia, France, Austria Switzer-
land, and other parts of the Continent from time to time durino- the past century, with disastrous results to the breeding-stock of those countries but we are not aware of its having occurred in any part of Great Britain. Origin.—The cause of this disease is the entrance into the blood of a
species of protozoa—the Trypanosoma equipedum. This is a unicellular organism having a flagellum by which it is capable of considerable activity. So far as at present known it is the only trypanosoma which is not trans- mitted by a biting insect. The common mode of access of the virus is through the medium of the external genital organs during the act of copulation. The spread of the malady is effected more especially by stallions when going from mare to mare during the breeding season. It has been induced experimentally, by Nocard, with matter from a
diseased centre in the spinal cord, and previously, by Herting, with dis- charges from the vaginal mucous membrane. Symptoms.—The period of incubation is said to extend from eio-ht
to twenty-eight days. At the expiration of the term a discharge issues |
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from the penis of the male or the vulva of the female, after which small
red spots appear on the glans or vulva, and on these arise vesicles or blisters, which break, leaving a small spreading sore or ulcer. As the disease progresses the enlargement spreads from the penis to the sheath, and maybe to the scrotum and testicles. In those instances where the disease first attacks the urethral canal a muco-purulent discharge issues from the end of the penis, and urine is discharged with some difficulty. A similar eruption appears on the vaginal mucous membrane of the mare, associated with more or less considerable swelling of the labia, and an ichorous discharge. If the eruption is severe the irritation may extend to the mammary gland and induce the formation of abscesses upon or in it. Both stallions and mares exhibit marked sexual excitement in the course of the early stages of the disease, the former by frequent erections of the penis, and the latter by exhibiting signs of oestrum. The local manifestations may subside, or altogether disappear, after a time varying from several weeks to months, but this is not to be taken as an indication of the termination of the disease, for it is at this time that the general health begins to give way to the ravages of the virus. There is now dul- ness and progressive weakness, shown by shifting the weight first from one leg and then the other. An eruption of the character of urticaria, but usually more enduring, appears about the neck, or the chest and shoulders, or the croup, or on all of these parts in succession, disappearing on the one as it arises on the others. The chief features of the later stages of the disease are progressive paralysis and wasting of the body. Ihe animal knuckles over at the joints, crosses his legs in walking, trips, or trails one or both hind-limbs, and ultimately loses all power behind. Facial paralysis is sometimes present, when the eyelids droop and the
lips hang pendulous and immovable. Finally, emaciation becomes extreme, and death results from blood-poisoning and exhaustion at the expiration of various periods from one to two years. Death results in 70 to 80 per cent of cases, and having regard to
the chronic lingering nature of the malady, and the decrepit useless state to which an animal is reduced by the disease, there can be no real ad- vantage m attempting a cure. To destroy the animal at the outset is tne most rational procedure. SOUTH AFRICAN HORSE SICKNESS
Definition.—A contagious disease, the precise cause of which has not
yet been determined. It is essentially a disorder of the equine species.
occurs m relatively low-lying districts along the eastern coast of South
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Africa, and appears to be in some way connected with climatic conditions.
Its partiality for low, damp regions, especially during heavy rains, and its comparative absence in dry summers, clearly show that wet favours its development. In particularly dry summers very little of the disease is observed,
but when the seasons are wet and rain continuous then horse sickness prevails. February, March, and April are months during which it is most prevalent. For a long time it was looked upon as anthrax, and having regard to the suddenness with which it sometimes appears, the rapidity with which it runs its course, and the post-mortem symptoms of the malady, such an assumption was not without reason. It was, however, shown by Lieut.-colonel Dunn in 1887, that the anthrax bacillus was not present in the blood, and that whatever the cause of the disease may be, it could no longer be regarded as anthrax. Although we have hitherto failed to determine the precise cause of
the malady there is no doubt as to the inoculability of it. Dr. Edington showed that it could be transmitted by inoculating the
blood of a diseased horse directly into the body of a healthy one; but, strange to say, the serous fluid which is effused into the tissues in the course of the disease when inoculated into a healthy horse does not produce it. Speaking of the cause, Captain J. T. Coley, C.V.S., in an able article
in the Veterinary Record says:—"It is at present undiscovered, but probably is a very minute micro-organism, as under the highest power of the microscope, and with the present methods of staining, it is invisible; and it passes through the best-made filters, as proved by the fact that filtered blood serum (infectious) when injected produces the disease, so also does infectious blood when injected or given per orem. Yet none of the serous fluids infiltered into the tissues as a result of the disease produce it when inoculated. " The following are theories and ideas as to the possible modes of infec-
tion, viz. ingestion, inhalation, inoculation. At present one is unable to determine if natural infection takes place by only one or more of these channels, but probably all the above methods of infection are concerned in the spread of the disease, as will be gathered from the following results which I have noted. " The organism evidently requires heat and moisture for its propagation
and vitality, appears to have a miasmatic origin, and to be transmitted by dews, fogs, and winged insects. " Ingestion.—Animals which eat dew-laden grass grown in an infected
district invariably suffer from the disease, but they can eat the same grass |
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with comparative impunity when saturated with rain. I have known
instances of dew-laden grass cut in kloof or valley and given to stabled animals which contracted the disease; and of dew-laden grass from the same kloofs which was well dried in the sun the day after cutting, was also given to stabled animals a few yards distance without any fatal results. " Inhalation.—I believe inhalation plays an important part in the
introduction of the disease into the system. I have known two animals which were taken out of a troop and were ridden a few hours through the dense fog in a kloof contract the disease and die in ten or eleven days later, although, with the exception of mosquito inoculation, there was no other apparent mode of infection, as these animals did not get an opportunity of eating or drinking while away from their station, and they were the only two animals that died from the disease. Edington records one case of spontaneous infection from a horse suffering from the disease to its companion standing in the next stall, the animals being able to smell each other. " Inoculation undoubtedly is a very probable mode of infection, and
more than likely mosquitoes and other winged insects act as hosts and intermediary bearers, when one considers the vast numbers in which they are bred in stagnant water of kloofs saturated with dew. All the pre- ventive measures enumerated hereafter are more or less preventive against inoculation by mosquitoes. " Symptoms.—There are two varieties of the disease known by the
Dutch names, dunpaard-ziekte and dikkopaard-ziekte. In the former the symptoms are, as a rule, comparatively absent until just before death. The animal appears in perfect health and vigour, and within an hour characteristic symptoms may appear, such as hurried respiration, animal lies down and gets up again immediately, soon followed by death in a few minutes. " The symptoms usually seen in the dikkop form appear some days
before death, and gradually become well defined towards the end, viz. the neck, head, and lips become swollen, in some cases enormously, the eyes close, and the lower lip droops. "A sub-variety of this disease is called 'Blawtong', or bluetong, when
the swelling of the neck and head is not marked, but mostly confined to the tongue, which presents a livid blue colour, due to intense venous congestion. " Owing to the absence of symptoms until just before the onset of death,
it was believed the disease was of very short duration. The foregoing symptoms are all that is generally noticed by farmers and horse-keepers, but if the animals in horse-sickness districts, or which have been through |
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such districts, are carefully inspected and their temperature taken daily,
the first symptoms discovered will be fever about the seventh or eighth day after infection; and if my memory serves me correctly, when investi- gating this disease under the supervision of Dr. Edington, the incubation periods in animals experimentally inoculated was from six to eight days. A noteworthy feature about the temperature is that it gradually rises, and seldom, if ever, is below the previous day's temperature, taken at the same time. The morning and evening temperature will be higher than that of the previous day, although the morning temperature may be below that of the previous evening, but will be higher than that of the previous morning, and so gradually increases to 105°, and in some cases' to 107° Fahrenheit, until the final stage is reached, when it suddenly drops to normal or below it. "The primary rise of temperature is soon followed by a dusky-yellow
pinkish discoloration of the conjunctiva, which is congested, and invari- ably petechial or stellate spots are present, which are always well marked; and generally there is a watery discharge from the eyes, and a peculiar dry husky breathing can be detected on auscultation at the trachea. In a day or two these symptoms become more marked, and are followed by oedema of the conjunctiva and eyelids, swelling of the orbital fossa, injection of the nasal mucous membranes, swelling of the neck along the jugular furrows, and in the dikkop, or big-head variety, the head and neck may be swollen to an enormous size, the eyes closed up, and the con- junctiva protruding. These symptoms are followed by weariness. The animal stands lazily, rests its head on the manger or against the wall, resting one leg then the other, and in final stages refuses food, although m the beginning appetite is unimpaired; breathing increased to thirty or over per minute, pulse small, quick, and hard, which soon becomes feeble, often intermittent, and auscultation of the heart generally gives tumultuous or palpitating sounds. There is a jugular pulse, animal lies down and soon gets up again. About this stage a yellow clear fluid discharges from both nostrils. On auscultation at the thorax, the breath- ing is audible, and of a gurgling sound, which gives one the impression there is a fluid in the bronchial tubes; respiration is hurried and laborious, the animal falls or lies down, and dies suddenly. Frequently, a few minutes before death, a great quantity of white froth is blown from the nostrils, and almost invariably at death this froth appears at the mouth and nose, which retains its form, and does not become fluid till some time after death. " This froth is the yellow fluid mixed with air from the lungs and
according to Edington, is blood serum. The commonly observed symptoms |
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are usually evident about the tenth day, and death takes place about
ten or fourteen days after infection, and in the dikkop variety a day or two later. "In 1898 I tried inter-tracheal injections of iodine on a case of the
dikkop variety, and in twenty-four hours I was so much surprised at the improvement which took place that I decided to give this treatment a further test, and try if possible to perhaps improve on the iodine solution, which I found to give me the only satisfactory results. "The inter-tracheal injections used were as follows:—
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R.
Iodine, grs. iv.
Pot. Iod. grs. xii. 01. Terebinth, m. xv Glycerine, 3i. Aqua, boiled, 3i. Injected once or twice daily. |
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R.
Iodine, grs. iv.
Pot. Iod. grs. xii. A. Carbolic, m. xv. Glycerine, 3iss. Aqua, boiled, 3i. |
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" Of thirty-six animals treated in this way seven recovered, twenty-three
died within twenty-four hours, and six died in from two to six days from date of admission. " In some cases this treatment caused the animal undue disturbance,
and coughing for about an hour after the injection; also, if given every twelve hours for two or three days the urine became blood-stained, and on post-mortem examination the kidneys were much enlarged, congested, a livid blue colour on surface, and capsule, if anything, more easily de- tached than normal. " The following season I used intravenous injections, which gave more
satisfactory results, besides causing practically no disturbance to the
animal, so discontinued the inter-tracheal injections.
"R as follows:—
Iodine, grs. iv.
Pot. Iodide, grs. xv. Glycerine. Aqua, boiled, 3i. " A noteworthy feature of this treatment is the immediate effect it has
on the temperature. " In the majority of cases the temperature drops from one or two degrees
within twenty-four hours after the first injection, and a gradual decrease of temperature afterwards is a favourable sign; also, the ecchymosis on the conjunctiva is much improved in twenty-four hours. " If the disease is discovered the first or second day of the fever, two
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or three injections usually effect a cure. If the animal is only treated
early enough in the disease the chances of recovery are greatly increased. " All the recorded cases developed undoubted clinical symptoms of horse
sickness. " In my hands over 66 per cent of such cases recovered; but I do not
claim that all horses with a rise in temperature were suffering from the disease, as coincidences are bound to occur, but I claim that the greater number of them, if left untreated or treated by old methods, would have died of horse sickness." "Preventive Measures.—All animals should be stabled before
sunset, and not removed from stables until some time after sunrise, when the dew and fog have disappeared. Smoke should be kept going through stables or picket-lines, from small smouldering fires on windward side during the night. £< If possible, remove animals to high veldt pastures where frost prevails.
" Protect animals from bites of winged insects, particularly mosquitoes- and their species. " Prevent animals from eating dew-laden grass until it is well dried
in the sun. "Kraal horses with cattle at night, as the ammoniacal gases from
excrement prevent winged insects and mosquitoes from infecting the place. " Animals which have to traverse districts infected with horse sickness,
and remain in them during the night, if not stabled, should have nose- bags on, previously steeped in antiseptic fluid, sanitas for preference. Nose-bags are used by prospectors and game-hunters in infected districts- with success, tar being smeared on bag and nostrils. They are put on before sunset, and taken off after sunrise. This plan prevents crazing, and acts as an antiseptic inhalation. " A weak solution of paraffin-oil, lightly brushed over the animal every
evening, is an excellent preventive to mosquitoes, and should be used on all animals not stabled; and arsenic given daily is also beneficial, perhaps owing to its antiseptic action on the alimentary tract. " Preventive inoculation, if successful, no doubt would be supreme,
as it would enable animals to live and work in the worst horse-sickness districts. " When protective inoculation can be employed throughout the whole
country, and animals rendered immune, it will be of great benefit both from an agricultural and equine point of view. Dr. Edington produced an attached virus and serum for protective inoculation, which experiment- ally he has employed with success, but I am unable to say what the practical results of this method are. |
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'Salted' horses are animals that have recovered from the disease,
and they possess a high degree of immunity. "' They often suffer from secondary fever during the horse-sickness
season, wnich is not attended with much constitutional disturbances, but undoubted cases which recovered are known to have died from a secondary attack of the disease one or more seasons after the first attack." EPIZOOTIC LYMPHANGITIS
English literature is seriously deficient in articles referring to this
disease. True, so far as we are aware, the malady only appeared in this country in 1902, following upon the war in South Africa, and no imme diate need of giving it attention had arisen. Its prevalence in France, Sweden,
India, Russia, Japan, China, Italy, Egypt, &c. &c, had not been con- sidered of sufficient importance to demand the attention of English- men. Seeing that the disease is so
much like farcy, and excepting by means of microscopic inspection or mallein indistinguishable from it, FiS- 222.—Cryptoooccus of Epizootic Lymphangitis
there is no direct evidence of its
absence from our studs, but we think and believe it has but recently
acquired a footing in the country by the return of infected animals from South Africa. Definition.-—A contagious and inoculable disease characterized by the
development of abscesses and cording of the lymphatics of the skin. It is essentially a local disease, due to a minute organism or cryptococcus which gains access to the tissues through an open wound. The organism is lemon-shaped, having one end slightly smaller than the other. It measures from 3 to 4/* in diameter, and is very easily found in the discharge with a suitable microscope. Seen by this means it presents a double contour, and is highly refractile. It is either free or enclosed m pus corpuscles. The classification of the parasite is not quite clearly made out. As to
whether it should be placed among the sporozoa or saccharomyces must be left for the present to those who have given the matter attention. |
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Staining.—Although the organism is readily seen without being first
stained, some may prefer to stain it, and we therefore give the most easy and at the same time most effectual method of carrying out this procedure. " Make a thin smear of pus from the suspected wound, ulcer, or pustule
on a cover glass or slide, fix it in the ordinary manner by passing it three times through the flame, and then proceed to stain with the following preparation:— Nicolle's Violet, saturated solution of gentian violet in 90 per cent of alcohol, 10 cc.
One per cent Aqueous Solution of Carbolic Acid, 100 cc. " Leave the stain on for about five minutes, then run it off, removing the
superfluous stain by waving it for a moment or two in water, and put on:— Grammes Iodine Solution— Iod|ne............ ... 1 part
Iodide of Potassium ......... 2 parts
Distilled Water ............300
" This fixes the stain in the organism. After leaving it in for two
or three minutes run it off and treat with alcohol, which takes the stain out of everything except the various organisms which have taken it up, in fact it will begin to remove it from the cryptococci also if left on for more than a few seconds. " Having now decolorized put on the following counter stain :—
Saturated Solution of Vesuvine (Bismarck Brown), and after having left it on for about three minutes run it off, wash in
water, and dry. The specimen is now ready to be examined under the microscope, or may be mounted in Canada Balsam." (Pallin.) Causes.—Any wound on any part of the surface of the body with
which the virus may be brought into contact offers an opportunity for infection. A brush on the fetlock joint or a crack in the heel will account for its ofttimes occurrence on the hind limbs, a broken knee or a less marked injury to some other part suffices to explain its less frequent occurrence in the fore-legs. Injury to the face, the poll, the withers, or back by the harness will expose the animal to infection, as will also wounds following upon castration and breaking of abscesses in strangles. Zoological Distribution.—Although solipeds would appear to be
the only animals affected by it, it has been said to have occurred in cattle, and in referring to this Pallin remarks: "Care should be taken not to confound it with a disease found among the cattle in Guadeloupe known under the name farcin de hceuf, and due to a bacillus discovered hy Nocard, and which Metschnikoff describes as a streptothrix. This |
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fnllmvine upon breakage of abscesses;
I. A A, abscesses in the course of formation; B, ulceration of skin and subcutaneous tissuetaUO gj£ subcutaneous tissue C inflamed lymphatic vessels. 2. A, abscess in the course of formation; B, ulceration
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following upon breakage of abscesses; c, inflamed lymphatic vessels.
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disease is only transmissible to cattle, sheep, and guinea-pigs, but does not
affect horses or donkeys."
Diagnosis.—Contagious lymphangitis until comparatively recent times
and in every country where it is known has been confounded with farcy. It is only since the adoption of bacteriological methods, and later by reason of the mallein test, that any difference has been recognized. Examination of the matter taken from abscesses in the skin shows at once the crypto- coccus as a minute lemon-shaped organism having a highly refractile double outline. Moreover, the mallein test fails to give the fever reaction and the local swelling commonly associated with glanders. Mallein when used alone leaves the mind in doubt, but if the organism
be present, then there need be no reason to hesitate to give an opinion. Points of difference between epizootic lymphangitis and farcy are at
first sight not great, but in the matter of diagnosis nothing short of finding the cryptococcus on which the disease depends should be considered suft- cient, and especially as this is by no means difficult of accomplishment. The time which elapses between the reception of the poison and the
outbreak of disease is, like glanders, very variable, and may be expected any time between five weeks and four or five months, and in some instances it has been known to exceed a year. One attack of the disease does not prevent a second.
Under the most favoured circumstances the average mortality is sai
to be about " ten to fifteen " per cent, but in a disease which lasts so long, is so liable to recur after long periods, and is generally so uncertain an unsatisfactory, it would be difficult to say exactly what the mortality may be, and in large studs of horses to trifle with a disease of this description would be carrying risk to the verge of ruin. Symptoms.—It is strange that a disease which is considered sufficient y
serious to be scheduled as a contagious and dangerous malady should ave practically no constitutional symptoms. The importance of the disease evidently does not dwell in its life-destroying danger, but in the fact o 1 s contagious and crippling nature. . , The value of a horse depends entirely on our power to use him, an
in this disease he is for the most part and for long periods ^Tj? from our will to do so. Moreover, so long as he remains in our stabe^ he is a source of danger to others, and although he may ultimately becJ™ well again he is nevertheless likely to infect his companions while doing so, and above all to leave the stable a centre of infection. ,, We were surprised a short time ago in looking over an infected s u ^
find all the horses, notwithstanding the disease, in good condition u^ flesh, feeding well, the temperature, and pulse normal, and the coat s e |
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The local symptoms invariably attack the skin, sometimes the mucous
membranes of the nose and eye are also involved, especially as the result of auto-inoculation while scratching or rubbing infected places. All parts of the body, wherever there is a wound to admit the virus,
are liable to become the seat of the disease. From four to six weeks after infection a small hard nodule appears on
the site of inoculation, and the lymphatics about it may be felt beneath the skin, or the latter may be first enlarged or " corded " to the feel. In some cases it has been noticed that a general enlargement of the
limb occurs, and the lymphatic enlargement is only recognized when the swelling has subsided. The primary nodule and lymphatic vessels continue to enlarge until
the latter stand out as distinct lines radiating from the former. At first the nodule is hard and small, but ultimately reaches the size of a walnut or a hen's egg. At this time it is soft and fluctuating, and soon breaks and discharges a quantity of pus, which is remarkable for its thick sticky nature, a character which does not belong to the pus of farcy. This is soon followed by the development of granulations, which not only fill up the cavity but likewise extend beyond it in the form of proud-flesh. With the discharge of pus the edges of the wound have a tendency to fall in, but this is soon prevented, either by the development of granu- lation and the filling up of the wound, or by the ulceration and loss of the skin. In all cases the wound has an indurated base, the surrounding con-
nective tissue having taken on a slowly progressive inflammation, of which abscess is the result. In some instances there are chains of abscesses running along the line
of the thickened lymphatic vessels, and breaking out at varying intervals of time, so that abscesses entire, broken, and in process of repair may sometimes be seen side by side. When a swelling is cut into in the early period of the disease, it is
found to be hard and grayish-white in colour. There is a considerable connective tissue new growth in the part, and as the point of ripening is reached a dark vascular area appears, in the midst of which suppuration proceeds and continues until an abscess is developed. It is, however, not always the case that suppuration is the immediate
result. In some cases the swelling subsides, and apparently for the time it disappears, but sooner or later it reappears and goes through the usual process of abscess formation. When the disease attacks the mucous membrane of the nose, "the
lesions are first noticed in the form of small papules or pimples, which |
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rapidly form into vesicles and burst, forming a well-defined ulcer with
a raised edge and dug-out centre. They are at first isolated, but later become confluent and tend to extend to the cartilage of the septum nasi, causing the mucous membrane to become discoloured and greatly thickened by exuberant granulations, at times forming a kind of polypus which interferes with respiration and causes snuffling. In advanced cases the cartilage becomes spongy and the nasal bones increased in thickness. Enlargement of the submaxillary glands may, but does not necessarily, as it is stated in glanders, accompany nasal symptoms; i.e. it is not con- stant, and does not occur even in advanced cases. However, when it is involved the gland may be somewhat indurated and stiff from suppurative inflammation either affecting it or the surrounding tissues; but it is generally movable, and seldom or never fixed to the jaw and knotty, as in glanders." (Pallin.) Treatment.—Eighty-six per cent of cases of epizootic lymphangitis
are said to recover, but the precautions, and the thoroughness with which they require to be treated, the close attention they demand, extending over long periods, and the possibility of a recurrence—to say nothing of the risk of scattering the disease—has placed it outside the pale of treatment, and unless the horse is of the highest value we would recommend that he be destroyed at once. From the point of view of the sanitary economist, this is the only
course short of allowing it to spread and to gain a permanent footing in our studs. Captain Martin, A.V.D., thinks that stamping out the disease by
slaughter will not act any more quickly than stamping it out by isolation and treatment, and that destruction of cases before giving them a trial with treatment is in his opinion a waste of money, and the only advantage he recognizes is a slight saving of a little trouble. Captain Martin, how- ever, does not fail to recognize the serious nature of the disease. " Its insidious method of spread due to the long incubation period, and the tenacity of life of the organism together with the prolonged treatment necessary for a cure, will always mark the disease as a serious one; but," he says, "there should be no difficulty in eradicating the disease from any stud by careful isolation, and adopting correct methods in the treatment of all wounds." Whatever may be the result of treatment, we beg to differ from
Captain Martin when he says that " stamping out by slaughter will not act more quickly than stamping out by isolation and treatment", and as for the few pounds he thinks we may waste or the little trouble we ttay escape by immediate destruction of the affected animals, we shall |
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have the satisfaction at least of knowing that the animal and its contagion
have been put out of the way for ever, and is therefore incapable of doing harm.
Of the horses attacked in the British army sixty-four per cent have
already been killed. Why, we should like to know, has it been found necessary to destroy all these animals? The only interpretation which can be put upon the action of the army authorities is that of stamping out the disease, and so far as we can see it is the only rational course open to them. It is quite understood that others in their charge suffering from the disease still remain alive, and it is to be hoped that these will sooner or later be dealt with in the same manner. To count on its being recognized early enough, or being treated with that laboratory exactness, when discovered, which Captain Martin lays down as necessary, is placing far too much confidence in both the horse-owning public and the veterinary surgeon. Principally the disease is, at the present time, in our military hospitals,
and if it is not intended to allow it to escape, every horse now suffering from it should be destroyed. Epizootic lymphangitis is contagious, and although not immediately destructive, it is nevertheless dangerous by virtue of its long-continued and crippling effects, and every effort should be put forward to stamp it out while it is confined within a narrow area. The serious aspect of the disease has led the Board of Agriculture and
Fisheries to include it with the contagious affections against the spread of which their efforts are chiefly directed, and an Order which came into operation on the 6th of April, 1904, and drawn very much on the lines of that of glanders, has made it compulsory on the part of any person possess- ing an animal so affected to give notice of it to the police, " when a local Authority, on being satisfied by an inquiry under the preceding article of the existence of epizootic lymphangitis, shall forthwith take such steps as may be practicable to secure the isolation of any horse affected with or suspected of that disease, and for that purpose an inspector of a local Authority may serve a notice in writing ... on the owner or person in charge of any horse, requiring that such horse be detained on or in any field, yard, stable, shed, or other place specified in the notice, and after the service of such notice it shall not be lawful for any person to move such horse from or out of such place of detention, or to permit any other horse to come in contact with any horse to which the notice applies, or to remove from or out of such place any carcase of a horse or any dung, fodder litter, or other thing that has been in contact with any horse to which the notice applies." |
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PLATE XXXIV
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THE DESCENT OF THE TESTICLES
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I. Testicle within the Abdomen before its descent. 2. Testicle within the Abdomen on its way to the Scrotum or Purse. 3. Testicle passing through the Inguinal Ring.
A. Testicle. B. Gubernaculum Testis by which it is guided through. C. Inguinal Ring. D. Spermatic Artery. |
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65
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ANATOMY OF THE MALE ORGANS OF GENERATION
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The Board might even have gone further, and have directed that all
horses should be at once destroyed, and compensation paid to the extent of three-fourths of their value at the time when they became infected. |
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10. THE ORGANS OF REPRODUCTION
ANATOMY OF THE MALE ORGANS OF GENERATION
The principal organs which subserve the function of reproduction in
the male are: (l) the testis, (2) the excretory ducts which convey the spermatic fluid to the urethra, (3) the urethra, (4) the penis. The testis in the foetus first appears behind the kidneys (see Plate
XXXIV) on the under surface of the loins, from which it hangs suspended in a pouch of peritoneum (the mesorchium). At this time it is connected with the scrotum by a band of unstriated muscle (gubernaculum testis), the gradual contraction of which draws the organ through the inguinal canal into the scrotum or purse, which it reaches about the time of birth. Coverings Of the Testicle.—In its descent the testis becomes invested
with two coverings of peritoneum—one, the tunica vaginalis, derived from the roof of the abdomen, is closely adherent to its outer surface; the other, the tunica vaginalis reflexa, forms a loose pouch in which it is enclosed. This membrane is derived from the floor of the belly being pushed before the testicle as it enters the inguinal canal on its way to the scrotum. The two opposing surfaces of these coverings possess the power of secreting a watery fluid, so that, being constantly in a moist condition and perfectly smooth in themselves, the movements of the organ within its sac are permitted to take place with the least possible friction. The Inguinal Canal, about 4 to 6 inches in length, is a passage
through the abdominal wall. Before birth it is occupied, as we have already stated, by the gubernaculum testis (see Plate), which, on the descent of the testicle into the scrotum, gives place to the spermatic cord. It has two openings—one above: the internal abdominal ring, by which the testis enters; and another, much larger, below: the external abdominal ring, by which it emerges into the scrotum. Testis.—The testis (fig. 223) in the horse weighs approximately about
8 ounces. It is oval in shape, with somewhat flattened sides, and hangs suspended by the spermatic cord in the scrotum. The testicle is a gland made up of a number of tortuous tubes enclosed in a somewhat thick, dense, fibrous capsule. A long narrow body termed the epididymis runs along Vol. II. 39
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66 HEALTH AND DISEASE
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the outer part of the upper border; this is not a part of the testicle
proper, but an appendage to it, and consists of the excretory ducts of the organ thrown into a number of closely-united coils. The anterior extremity of this body is large and rounded, and is called the "globus major" (g, fig. 223). The ducts of which it is composed are continuous with those of the testicle. The posterior extremity, much smaller than the anterior, is the "globus minor" (b, fig. 223); from it springs the "vas deferens", or chief excretory duct of the gland.
Tunica Albuginea.—This is
a dense membrane not unlike the
sclerotic coat or white of the eye. It is made up of a number of closely - interwoven strands of white fibres, and encloses within it the glandular or secreting struc- ture of the organ (d, fig. 223). At the superior border of the
testicle an offshoot from this tunie dips down into its substance for a short distance, forming an incom- plete vertical partition, which Sir Astley Cooper named the "media- stinum testis". In this ramify the |
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Fig. 223.—Section of Testis showing the arrangement of
the Ducts composing the Testicle |
small blood-vessels of the gland,
and a net-work of seminal ducts |
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A, Vas Deferens or Spermatic Duct, b, Globus Minor.
c, Vasa Recta or Straight Seminal Tubules. D, Tunica Albuginea. E, Spermatic Tubules forming the Lobules. F, Eete Testis or net-work formed by the straight tubes.
G, Globus Major. H, Tunica Vaginalis Reflexa. I, Sper-
matic Vein. J, Spermatic Artery. |
termed the " rete testis" (f, fig.
223). There are also given off from it numerous fibrous cords, which, after dividing the gland |
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up into a number of incompletely-
separated compartments, become united with the interior of the tunic from which they spring. These strands of fibrous tissue preserve the shape of the gland, and serve as a matrix by which the blood-vessels traverse its structure. The blood supply to the testis is derived from the spermatic artery
(j, fig. 223), whose branches on entering the organ form a close net-work over the inner surface of the tunica albuginea, which is known as the " tunica vasculosa". Gland Substance.—The substance of the testicle is composed of large
numbers of minute convoluted tubes termed "tubuli seminiferi" (e, fig. 223). These are grouped together in small masses or "lobules", and occupy the |
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ANATOMY OF THE MALE OEGANS OF GENERATION
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spaces, already referred to, into which the organ is divided by strands of
fibrous tissue given off from the " mediastinum testis ". Although occupy- ing separate compartments the tubes of one lobule freely communicate with those contiguous with it. The semen secreted by the seminal tubes is conveyed to the " mediastinum testis" by a number of straight ducts, "vasa recta" (fig. 223c), which there unite and form a net-work, the rete testis. The secretion then leaves the testicle by means of the "vasa efferentia", a group of vessels, each of which twists and turns upon itself to form a conical mass, " coni vasculosi", and these together con- stitute the globus major. From the globus major the "vas deferens" or main excretory duct takes its origin, and after twisting and turning about to form the globus minor, continues its course upward along the inguinal canal to the pelvis, where, after reaching the upper surface of the bladder, it becomes enlarged, and after joining with the duct of the vesicula seminalis it opens into the prostatic portion of the urethra by the ejaculatory duct. Spermatic Cord (fig. 224).—
This is the structure by which the
testis is suspended in the scrotum. |
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It is composed of arteries and veins,
the former going to and the latter from the organ, of nerves and lym- |
Fig. 224.—Constituents of Spermatic Cord
A, Vas Deferens or Spermatic Duct. B, Spermatic Vein.
c, Spermatic Artery. D, Internal Abdominal Eing. |
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phatics, as well as the excretory
duct (vas deferens) by which the seminal fluid is conveyed into the urethra. The arteries and veins are remarkable for the winding course they take in approaching and leaving the gland. |
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The Scrotum.—The scrotum, commonly called the "purse",
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is a
It |
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bag in which the testes are suspended by the spermatic cord
is composed of six layers, the chief of which are the skin and the dartos. The skin is an extension of the common integument, but much thinner
and more supple than that found in the more exposed parts of the body. It possesses, besides, a large number of sebaceous glands, whose unctuous |
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HEALTH AND DISEASE
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secretion is constantly being thrown out to lubricate the surface. By this
meaus the scrotum is enabled to move freely over the thighs without irritation. The dartos is a thin pinkish-yellow layer of involuntary muscle and
elastic fibres, largely interspersed with connective tissue. It is situated |
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Fig. 225.—View of the Male Genital and Urinary Apparatus
A, Cowper's Glands. B, Prostate Gland. 0, Dilated portion of Spermatic Duet. D, Vesicula
Seminalis. E, P, Ureters. G, G, Spermatic Vessels and Duct passing through the internal abdominal ring on their way to the Testicle. H, Bladder. I, Layer of Peritoneum. |
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beneath the skin, and forms a pouch for each testicle by interposing a
partition (septum scroti) between one organ and the other. When the dartos contracts the testicle is raised in the purse; at the
same time the skin is corrugated. Vesiculae Seminales.—Two small elongated sacs situated on the upper
surface of the bladder (fig. 225 d); they form reservoirs for the reception of the semen, and secrete a fluid accessory to that of the testicles which is mixed with it. As we have already seen, the duct of each of these bodies unites with that of the corresponding vas deferens to form the ejaculatory |
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ANATOMY OF THE MALE OEGANS OF GENERATION
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G9
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duct through which the semen is discharged into the prostatic portion of
the urethra. THE PENIS
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The penis (fig. 226) is the male organ of copulation.
In a quiescent condition it is hidden away in a double fold of skin
termed the " sheath " or " prepuce ", from which, in a state of erection, it protrudes for some considerable distance. The posterior part of the organ between the perineum and the scrotum, being somewhat closely bound down |
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o
Fig. 226.—The Penis
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1, Transverse Section of Penis. I, Anterior Dorsal Arteries; A, Fibrous Capsule; B, Corpus Cavernosum;
C, E, Accelerator Urinae Muscle; D, Urethra or urinary passage ; F, Retractor Penis Muscle; G, Corpus Spongiosum; H, Septum Pectiniforme. 2, Longitudinal Section of Glans Penis. J, Glans Penis divided; K, Urethral Canal. 3, Penis unsheathed. L, Prepuce or Sheath; M, N, Mucous Membrane thrown into folds; O, Glans Penis. to surrounding structures, is called the " fixed " portion. The rest, which
is enclosed in the sheath, and capable of being projected or withdrawn, is the "free" portion. It commences behind in two branches or crurse, which become attached to the ischial tuberosities, and after uniting pass forward between the thighs, where it is suspended by a layer of elastic tissue, and terminates in front in a rounded extremity enclosed by the glans perns. When in a state of erection it is seen to be covered by a thin moist
unctuous-looking membrane, which is a continuation of the loose skin forming the inner fold of the sheath. At the extremity of the organ this membrane is much reduced in thickness, and after closely investing the " glans " enters the orifice of the urethra, and becomes continuous with its mucous lining membrane. |
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70 HEALTH AND DISEASE
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For the most part the penis is made up of three elongated parallel
bodies, the "corpora cavernosa" and the "corpus spongiosum". The two " corpora cavernosa" (b, fig. 226) commence behind in two
tapering processes called the crurce, which, after uniting together at the root of the penis, continue forward to form the body, and terminate in two rounded extremities over which the glans penis fits like a cap. When divided transversely, the corpora cavernosa are seen to be sur-
rounded by a dense fibrous coat of considerable thickness. Although closely united together at their circumference, they are partly separated by an imperfect septum or partition, which, when viewed laterally, some- what resembles the teeth of a comb; hence it has been termed the "septum pectiniforme". The partition is derived from the outer fibrous coat, and becomes more and more complete as it reaches the root of the penis. The interior of the corpora cavernosa is divided into a number of small cells by a net-work of elastic septa, which interlace each other in all directions, and give the divided surface the appearance of a sponge. At the time of erection all the spaces so formed are filled with blood, their elastic walls are put on the stretch, and the volume of the organ is correspondingly increased. When the blood leaves the cells erection ceases.
The arteries of the corpora cavernosa are derived from the pudic.
Corpus Spongiosum.—This, the smaller of the three bodies com-
posing the penis (g, fig. 226), is situated in a groove which runs along the lower border of the corpora cavernosa. Behind, it commences at the peri- neum in an enlargement termed the " bulb ", and terminates in front in an expanded free extremity, which during erection resembles the rose of a watering-can. This is the " glans penis ". The corpus spongiosum is composed of a loose erectile tissue, similar in
appearance to that of the corpora cavernosa, but of much finer texture. The urethral canal, by which the urine is conveyed from the bladder, is surrounded by it for the greater part of its length, and a thin muscle (accelerator urinae) encloses the whole from the ischial arch behind as far forward as the glans. This muscle, by compressing the urethra from behind forward, expels
the last few drops of urine after the efforts of the bladder have ceased. The Prepuce (l, fig. 226), commonly spoken of as the " sheath ", is a
double layer of loose skin folded inward to form a recess in which the free portion of the penis is enclosed. The inner fold of the prepuce, although continuous with the outer skin,
partakes of the character of mucous membrane. It is thin, supple, vascular, and freely lubricated with an unctuous greasy matter, secreted by numerous |
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ANATOMY OF THE MALE ORGANS OF GENERATION 71
sebaceous glands which exist in and beneath it. It is this substance which,
on becoming inspissated and dry, forms the dark gray masses which accumulate in the scrotum, and sometimes provoke irritation and disease. During erection this inner layer is effaced, and forms a covering to the body of the organ as it protrudes from the prepuce. The sheath is supported by an elastic band—" suspensory ligament" of the sheath—reflected from the under surface of the abdomen. The loud gurgling sound emitted by some horses when in motion is
due to the sudden displacement of air by the to-and-fro movements of the penis within the sheath. URETHRA
The urethra (d and K, fig. 226) is a long tube extending from the
bladder to the end of the penis. It conducts the urine out of the body, and serves also to convey the spermatic fluid and some other secretions accessory to reproduction into the female organs of generation in the act of copulation. In proceeding from the neck of the bladder, the urethra passes back-
wards for a short distance along the floor of the pelvis; then curving down- ward over the ischiatic arch, it takes a direction forward between the two branches or crurae of the corpora cavernosa, from which it continues onward, enclosed in the corpus spongiosum, to the glans penis. There it ends in a small cylindrical projection termed the "urethral tube". On leaving the neck of the bladder it is surrounded by the prostate gland, and then for a farther short distance by a thin muscle, the " compressor urethrae", after which it is enclosed in the corpus spongiosum for the remainder of its course, excepting the small terminal prolongation from the glans penis. These three divisions are distinguished as (l) the "prostatic", (2) the
<£ muscular" or " membranous", and (3) the " spongy" portion. An inspection of the interior of the canal shows it to vary in diameter m different parts of its length. The smallest part is the external opening, which will admit a catheter about half an inch in diameter. It may be concluded, therefore, that any instrument that will enter this opening may be safely pressed on into the bladder. The larger parts are the prostatic, and those situated at either extremity of the spongy portion. Openings into the Urethra.—Besides the inlet from the bladder by
which the urine escapes, there are a number of openings into the urethral canal. In the prostatic portion, on either side of a small ridge of mucous membrane, is the orifice of the " ejaculatory duct", through which the seminal fluid is discharged in the act of copulation. These openings in aged stallions are of considerable size, in some instances sufficiently large |
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HEALTH AND DISEASE
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72
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to admit the point of the index-finger. This fact must be borne in mind
when passing the catheter, lest the instrument becomes lodged in one of them. To guard against it the point should be well pressed down on to the floor of the canal by the fingers acting through the perineum. A little behind the ejaculatory ducts are two rows of small openings
from the prostate gland, and beyond these occur others similarly arranged proceeding from Cowper's glands. MUSCLES OF THE URETHRA
The Accelerator Urinae (e, fig. 227).—This muscle extends nearly
the whole length of the spongy portion of the urethra, commencing at the |
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Fig. 227.—Suspensory Ligament of Penis
A, Erector Penis. B, Suspensory Ligament of Penis. 0, Retractor Penis. D, Corpus Cavernosum.
E, Accelerator Urinse. F, Cremaster Muscle. G, Scrotum. H, Prepuce or Sheath. I, Glans Penis. |
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ischiatic arch and continuing as far forward as the glans penis. It is com-
posed of a thin layer of fibres arranged around the corpus spongiosum, which it almost completely invests. When it contracts, the walls of the urethra are brought together and its contents are expelled. The action of this muscle is specially designed to expel the last small
portion of urine which remains in the canal after the bladder has emptied itself. It also assists in ejecting the semen from the urethra in the act of copulation. |
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ANATOMY OF THE FEMALE ORGANS OF GENERATION 73
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Wilson's Muscle.—This muscle is composed of two portions, one
spread over the upper, and the other over the lower surface of the mem- branous portion of the urethra, At either side the two layers unite together, and are attached right and left to the inner lateral wall of the pelvis. When the two layers of this muscle contract, the walls of the urethra
are brought together, and the escape of urine from the bladder is pre- vented. By the same means it prevents the semen from entering the bladder when it emerges from the vesiculae seminales in the act of copu- lation. Two other muscles, the " ischio-urethral" and the " transverse perinei",
are also concerned in acting upon the urethra. MUSCLES OF THE PENIS
Erector Penis (a, fig. 227).—These are two short, thick fleshy muscles
which arise from the crest of the ischium, and are inserted into the crurse of the penis. They assist in bringing about erection, by preventing the free outflow
of blood from the corpora cavernosa and causing an engorgement of its cells and vessels. Retractor Penis (c, fig. 227).—This consists of two bands of pale
unstriped muscle, which arise from the under surface of the coccygeal or tail bones, and after winding round the rectum converge together below the anal opening, and are continued forward beneath the corpus spon- giosum to the extremity of the penis. Contracting, they draw the penis back into the sheath after erection.
ANATOMY OF THE FEMALE ORGANS OF GENERATION
The entrance to the uro-genital passage in the female is a vertical
fissure some 4 or 5 inches in length, bounded on each side by a skin fold (the labium magnus). The folds meet above at an acute angle, separated from the anus by a bare, usually dark-coloured patch of skin, about 2 inches in extent, known as the " perineum ". Below, the meeting of the lips is more obtuse. Supporting the folds, and passing round the opening, is a voluntary muscle (post sphincter), which is separated from the skin by a considerable quantity of loose areolar tissue. If the labia are separated it will be seen that they are covered inter-
nally by a smooth, moist, pale-coloured mucous membrane. Just within the lips, in the lower angle of the fissure, will be noticed a small prominence |
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74
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HEALTH AND DISEASE
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something like the glans penis of the male. This is the "clitoris"; the
little body is partly contained within a prepuce formed by the coming together of two short folds of mucous membrane corresponding with the " labia minora ". The integument covering the organ and lining its sheath is richly supplied with glands of a sebaceous type, which form a substance similar to the blackish gray secretion (smegma) commonly found in the sheath of the male. The clitoris can be raised and its glans turned |
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Fig. 228.—View of the Genito-urinary Organs of the Mare
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A, Rectum. B, Anus. C, Vulva. D, Vagina. E, Left Horn of Uterus, p, Ovary, g, Fallopian Tube.
H, Its Fimbriated extremity. I, Kidney. J, Ureter. K, Bladder, l, Pelvis, m, Mammary Gland. directly backwards. This action is well seen immediately after urination
and at frequent intervals during the period of oestrum. The cavity between the labia, into which the hand can be introduced,
is the " vulva"; it extends inwards for 4 or 5 inches, and is bounded in front by the rudiment of the hymen, a small membranous fold which separates it from the vagina. The vulva is lined by pink mucous mem- brane, and kept moist by the secretion from numerous small mucous glands embedded in its structure. Outside the mucous membrane there is much loose connective tissue to allow of expansion of the passage during parturi- tion, and large plexuses of veins. Outside this again are muscle fibres |
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ANATOMY OF THE FEMALE ORGANS OF GENERATION 75
continuous with the posterior sphincter, and which in front become
thickened to form an anterior sphincter. Opening on to the floor of the cavity, about 4 inches within the lips, is the urethra or urinary passage (fig. 229, h). This orifice is covered by an ample fold of mucous |
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Fig. 229. —Female Organs of Generation
A, Left Horn of Uterus. B, Fallopian Tube, c, Fimbriated extremity of the same. 3J, Ovary.
E, Broad Ligament. F, Os Uteri, G, Vagina. H, Opening into Bladder. I, Vulva. J, Clitoris. |
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membrane having its free edge directed backwards; above it is the large
orifice leading to the vagina, encircled at its margin by the rudiment of the hymen, a membranous fold often hardly noticeable. When present in a state of full development it is ruptured at the first service, and its remains are then known as the "caruncuke myrtiformes". The vagina extends forwards from the hymen to the uterus, and is about 9 inches in length. Project- |
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HEALTH AND DISEASE
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76
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ing into its anterior extremity for about lj inch is the neck of the
uterus. The vaginal passage is lined by pale-red mucous membrane thrown into longitudinal ridges extending along its whole length. Outside the mucous membrane is a plentiful areolar tissue in which are large venous plexuses and layers of unstriated muscle fibre; outside this again are muscular layers, longitudinal and circular, continuous with those of the uterus. Beneath the vagina are the urethra and the bladder (k, fig. 228), and above it the rectum (a, fig. 228). Uterus (fig. 230).—This is the organ which receives the ovum and in
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Fig. 230.—Uteri with Short and Long Necks
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which the foetus is developed. It is composed of a neck and a body, which
divides into two horns of approximately equal size. The neck is embraced by the anterior extremity of the vagina, into
which it projects after the manner of the end of a tap into a barrel; it is rounded m outline though somewhat compressed from above down- wards. The opening of the neck into the vagina is called the " os uteri externum . The opposite extremity opens into the body of the organ, and is the "os uteri internum". The body of the uterus is about 8 to 10 inches in length, and is situated partly within the pelvis and partly in the abdomen, having the rectum above and the bladder below. The horns are about 8 inches in length, and hang suspended by two broad ligaments from the lumbar portion of the spine. They are somewhat laterally compressed, are concave on their upper surface and convex on the lower. The anterior extremity is obtusely pointed, and receives the |
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77
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ANATOMY OF THE FEMALE ORGANS OF GENERATION
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Fallopian tubes. The opposite extremity is continuous with the body ot
the organ. Structure.—The wall of the uterus is composed of the following
structures arranged in the following order from without inwards: (l) serous or peritoneal covering, which invests the entire organ with the exception of the cervix or neck. (2) Muscular coat, composed of longi- tudinal and circular fibres. (3) Sub-mucous areolar tissue. (4) Mucous membrane raised into longitudinal folds and containing numerous tubular glands. Attachments.—The whole uterus, with the exception of that portion
of the neck within the vagina, is covered with peritoneum, which, branch- ing off from the organ in various directions, forms the ligaments by which it is attached to the rectum above, the bladder below, and to the sides of the pelvis and the roof of the belly. The recto-vaginal ligament leaves the lower face of the rectum and
passes on to the upper surface of the vagina and uterus. The vesico- vaginal ligament leaves the lower surface of the uterus and vagina and passes on to the upper face of the bladder. The broad ligaments are simply the lateral edges of the folds reflected from the sides of the organ and attached at first to the sides of the pelvis, from which they rise to the roof of the abdomen and support the uterine horns. Hence it will be seen that the lateral ligaments form a horizontal partition (fig. 229, e) composed of an upper and a lower layer between which the uterus is placed. The only other ligament of any importance is the round ligament (fig. 231, g). This is a fibro-muscular cord situated between the layers of the broad ligament, and is attached to the con- cavity of the upper part of the horn of the uterus and to the floor of the abdomen in front of the pubic bone. The uterus, therefore, is supported and held in position (l) by the projection of its neck into the vagina, (2) by a peritoneal fold connecting it to the rectum above, (3) to the bladder below, and (4) to the sides of the pelvis. Between the layers of the broad ligaments there are several other
structures of importance in relation to the generative function, about some of which something must be said. There are (l) the Fallopian tubes, (2) ovarian ligaments, (3) the ovaries and the vessels and nerves distributed thereto and to the uterus. The Fallopian tube (fig. 231, b) is contained in the anterior margin of the
broad ligament. It extends from the ovary to the extremity of the horn ■of the uterus. It is 8 or 9 inches long, very tortuous, and through it the eggs are conducted from the ovary or egg-forming gland to the uterus. The uterine extremity of the tube opens into the uterus by a |
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78 HEALTH AND DISEASE
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minute aperture scarcely larger than an ordinary pinhole. The other end
opens into the abdominal cavity, and is attached by about \ inch of its circumference to the ovary (fig. 231). It is trumpet-shaped and surrounded by a fringe of mucous membrane, from which it has been called the "fim- briated extremity ". The Ovary (fig. 231, f) is oval in form and laterally compressed, pale
pink in colour, and weighs about 3 ounces. It hangs in the abdominal cavity, suspended in a special pouch from the internal layer of the broad ligament; its surface is usually very uneven, from the bulging of small |
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Fig. 231.—Fallopian Tube connecting the Uterus with the Ovary
A, Uterus. B, Fallopian Tube, c, Its Fimbriated extremity. D, Opening into the Tube, through
which the Ovum or Egg E, passes from the Ovary r. g, Bound Ligament of the Ovary. |
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cysts, and is scarred here and there, marking the points at which other
cysts have come and gone. It has two curvatures; the greater or convex border is turned upwards and somewhat backwards, and the lesser curvature or "hilum" looks downward and a little forward. This is the attached part and receives the blood-vessels, &c. The two extremities or poles are anterior and posterior; the former gives attachment to the Fallopian tube while the latter is connected with the ovarian ligament. This ligament composed of fibrous tissue and unstriated muscle, extends from the free extremity of the horn of the uterus to the ovary, and occupies the internal of the two layers which form the anterior margin of the broad ligament. The essential portion of the gland consists of small bladder-like bodies
termed " Graafian follicles" or ovisacs (fig. 232, E, g). These, when fully developed, are filled with fluid and contain the eggs. A young Graafian |
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ANATOMY OF THE FEMALE ORGANS OF GENERATION 79
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follicle consists of a spherical cell, the ovum, closely invested by a single
layer of epithelium; these may be seen forming an almost continuous layer near the surface of the ovary. In the deeper parts of the gland, that is to say nearer the hilum, the more developed and larger follicles will be noticed. |
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Fig. 232.—The Ovary
A, Peritoneal Coat, b, d, e, f, Cortical Vesicles, c, Blood-vessels, g, Graafian Follicle. H, Stroma.
I, Graafian Follicle. J, Germinal Spot. K, Germinal Vesicle. L, Attached border. The fully developed or ripe follicles (size about | inch) are sur-
rounded by a fibrous wall, the "tunica fibrosa", containing a capillary plexus. This is lined by several layers of epithelium, "tunica granu- losa", which in one part is elevated into a little mound, "discus proligerus", in which the ovum is embedded; the iest of the cavity, by far the greater part, is filled with an albuminous fluid, "liquor folli- |
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culi". Pathological cysts are
frequently seen in the ovaries, especially of cows and mares, |
Fig. 233.—The Ovum
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_____________________________I a, Zona Pellucida.
.ce left by retraction of Yolk, c, Vitellus or Yolk.
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1, OB, Spa
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D, Germinal Vesicle. E, Germinal Spot.
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varying in size from small ^^^^^^^^^^^^^^^^^^^^
marbles to oranges. These arise in the corpora lutea, and are not to be mistaken for the Graafian follicles. The Ovum.—This is a spherical cell, just visible to the naked eye
(about y-L inch), composed of the following parts:—A transparent finely striated outer investment, the "zona pellucida"; within this is the "vitellus", or "yolk", made up of albuminous and fatty granules consti- |
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80
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tuting the greater part of the contents of the cell. Embedded in the yolk,
generally near the circumference, is a large spherical nucleus, the "germinal vesicle", within which is a nucleolus or "germinal spot". When fully developed, or ripe, the Graafian follicles project from the surface of the ovary, and sooner or later burst, at which time the ovum enters the Fallopian tube and is conveyed to the uterus, where, if fertilized by the male element, it develops into a foetus. Should fertilization not take place then, the egg dies and undergoes disintegration. The small cavity in the substance of the ovary, from which the egg has
been discharged, becomes filled with blood, which ultimately disappears and is succeeded by a small quantity of fibro-gelatinous matter, the " corpus luteum ". Should pregnancy follow the discharge of the ovum, the corpus luteum
becomes much larger, and the changes occurring in it go on much more slowly, so that it persists for a longer time. DISEASES OF THE ORGANS OF REPRODUCTION
OF THE HORSE The male organs of reproduction are not so frequently the seat of
disease as those of digestion or of respiration, but it should be remembered that the comparative immunity enjoyed by our horses, employed both for work and for pleasure, is largely due to the fact that geldings are chiefly in use for the purposes named. The stud animal is liable both to disease and injury to an extent only
realized by those in intimate association with this class of horse. The artificial methods of feeding adopted by the generality of owners
of, stallions renders their charges the more prone to inflammatory diseases, and to this may be added the excitement and abuse incidental to the service season, when each popular sire may be called upon to copulate several times daily for a period of weeks. At rare intervals in this country, but not infrequently upon the con-
tinent of Europe, a malady prevails among breeding animals of a distinctly contagious nature. It is known as maladie du coit, and is transmitted from mare to horse and from horse to mare in the act of coition. It sometimes becomes endemic, and may be the means of provoking abortion. A specific bacillus of abortion has been made out by Bang with regard
to bovines, and it is more than probable that some such deleterious organism will be discovered to affect the mare. While emasculation necessarily reduces the liability to disease in the
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PHYMOSIS OR ENCLOSURE OF THE PENIS
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81
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organs of reproduction, there are troubles connected with the appendages
of the penis which are directly attributable to the diminished function of that organ. PHYMOSIS, OR ENCLOSURE OF THE PENIS
In this condition the penis becomes enclosed within the sheath, and
incapable of being protruded. In new-born colts it is not due to any disease or contraction of the sheath, or enlargement of the penis, but to the folding back of the organ itself. Here interruption to the discharge of urine results in overdistention of the bladder, when the young creature is prompted to posture for urination in the manner adopted by adults, but, being unable to obtain relief, the attendant's notice is attracted to the difficulty under which the colt is labouring. Phymosis in the adult horse or gelding arises from other causes,
among which may be named: external injuries such as occur from the kicks of other animals, blows in jumping timber, or travelling through brush and scrub, accidental or surgical wounds, as a sequel to castration, the existence of an abscess, of warts, tumours of various kinds, or swelling of the penis itself from venereal and other diseases. From the time of castration the penis of the gelding makes but little
growth, and it has been observed that it actually wastes if the operation is performed while adolescent. In the emasculated animal protrusion of the penis is neither so frequent nor complete as in the stallion, and, as a result, the sebaceous secretion, which in the entire horse affords a suitable lubricant to the organ, becomes thick and unhealthy in character, and accumulates in hard, black, irregular masses. It, moreover, mechanically irritates the sheath and parts enclosed in it, thus preventing its withdrawal, and causing at the same time interference with the discharge of urine. Geldings, more particularly those of the heavy draught breeds, when
well fed and insufficiently exercised, are predisposed to swelling of the sheath, which in many instances is excited by the accumulation of the secretion above alluded to within the folds of the integument. Horses at grass are sometimes stung by insects upon which they have lain, and the resulting tumefaction of the sheath interferes with or altogether pre- cludes the extrusion of the penis. Symptoms.—Swelling of the parts is invariably such as to attract
early attention. The other symptoms will depend upon the cause out of which the disease arises. In some cases, where the enlargement is gradually progressive, there is but little pain, but in cases of sudden occurrence, with rapid swelling, there may be sudden uneasiness shown by frequent attempts Vol. II. 40
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to stale, great heat, tenderness of the parts, looking back at the flanks,
and a frequent shifting of the hind limbs. Treatment.—In the case of the new-born foal no other assistance is
required than that of bringing the organ into line. It is best accomplished by introducing an oiled finger into the sheath; and to facilitate the future outward passage of the penis, some vaseline or other suitable unguent should be smeared over it. It has been shown that the causes are various. The treatment will
also vary. Inflammatory action and consequent swelling will best be combated with fomentations, anodyne ointments, and perhaps an aperient or diuretic. Warts and other excrescences may require to be removed and the oedematous sheath scarified (see Operations). In some of the latter cases a course of tonic medicine is advisable. Stings should be removed, if discoverable, and an alkaline lotion applied at the point of their intro- duction. In the great majority of cases the remedy will be found in a careful cleansing of the interior of the sheath. In large animals it is a work of some magnitude, owing to the extent
and capacity of the sheath and the great accumulation possible within it. The most effectual manner of performing this disagreeable operation is to first introduce a quantity of vaseline, and allow an hour or so for it to become incorporated with the offensive secretion to be removed. Next introduce the hand and bring away, in small quantities, all that can be obtained, wTash out with warm water in which some soap-powder has been dissolved, dry with a cloth, and finally inunct with pure lard. Nor should the operator's attention be confined to the inside of the sheath. Many simple cases are much relieved by outward application and such means as will cause the tense skin to stretch and the congested vessels beneath to resume again their normal functions. PARAPHYMOSIS
This condition is the opposite of that described above, and consists in
the horse's inability to withdraw the extended penis within the sheath. The causes are excessive debility, from poverty, old age, or illness,
which occasion effusion into and swelling of the glans penis. Chronic enlargement or morbid growths either upon or within the organ itself or the sheath, the descent of calculi into the urethral canal, paralysis of the penis, injuries, and inflammation resulting from the sexual relation are also causes of this form of the disease. The symptoms are unmistakable, the penis protrudes from its sheath and
is much enlarged, the envelopes of the organ are sometimes swollen to such |
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PLATE XXXV
|
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ParapTiymosis
DISEASES OF THE MALE ORGANS OF REPRODUCTION |
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83
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PARAPHYMOSIS
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an extent as to grip and strangulate it (Plate XXXV). As a result the
swelling is much increased, and unless speedy relief is afforded acute inflammation results. Then the part becomes much discoloured, at first red and painful, changing later to a deep purple. At this time it is tense and cold to the touch, and the morbid sensibility is considerably diminished. In this condition there is danger of mortification unless the strangulation is relieved and the circulation in the part restored. Great pain usually accompanies this more advanced condition, and
the horse is restless, wears a haggard countenance, rapidly loses flesh, and may die of gangrene unless speedy relief is obtained. There is a chronic paraphymosis due to paralysis, and not accompanied with the pain and excessive enlargement above mentioned. Treatment.—Where it is ascertained that debility is the chief factor,
attention to the general health will be most needful, tonics of the mineral class being indicated. Efforts should be made to return the organ by gentle manipulation and
lubrication of the parts with warm olive oil or other simple emollient, but before this is done the penis and its sheath should be thoroughly washed with soap and water. Cold lotions are also recommended as tending to rapid contraction of the erectile tissue. In acute cases, however, such simple palliative measures are not enough.
We may have to scarify the penis and envelop it in poultices. Where the enlargement is considerable it must be suspended in order to reheA'e the overstretched vessels and facilitate circulation. For this purpose a piece of strong flannel connected at each corner by tapes will be required as for Orchitis. If exercise can be given, without too much motion of the pendulous
and painful organ, it is desirable, as removing venous engorgement and promoting absorption of the effused fluid. Morbid growths must be removed by operation, and in the event^ ot
occlusion of the canal from the descent of calculi or presence of foreign bodies, efforts must be made to dislodge or cut down upon them. Ampu- tation in paralysis, and in cases of cancerous enlargement or warty growths on the glans, is sometimes resorted to, and in the majority of instances with success. (EDEMA OF THE SHEATH
(Edema of the sheath is a form of local dropsy in which the tissues
of the part become soaked with fluid, and consequently swollen, i ie fluid consists of the watery constituents of the blood which have escaped from the blood-vessels as the result of weakness. |
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84 HEALTH AND DISEASE
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An oedematous or dropsical condition of the sheath is so common a
symptom in debilitating diseases as to call for little remark from those in attendance upon horses. It follows upon pulmonary and abdominal affections, specific diseases affecting various organs, as the result of ansemia, of heart failure, organic disease of the liver, accidental injury, surgical operations, bad and insufficient food, and old age. An acute form is sometimes traceable to blows and kicks from bad-
tempered attendants, and the swelling resulting from such violence leads to a very painful condition and difficulties in connection with urination. The more frequent form of oedema of the sheath met with in working
horses is that due to languid circulation, or to the presence of an accumu- lation of sebaceous material in the folds of skin within. The symptoms are too obvious to call for description, save for the
purpose of distinguishing between the simple swelling due to effusion of fluid and the more serious condition of painful and enlarged sheath, which has been described under the heading of phymosis or of paraphymosis. In simple oedema of the sheath the skin is found to pit on pressure of the finger, and the animal does not shrink as if in pain. The inflamed sheath is highly sensitive to manipulation and the skin tense and somewhat hard, and does not, as in the more simple form of the affection, leave a tem- porary dimple when pressed. Treatment.—Constitutional measures are generally called for, and the
remedies accepted as most suitable, where debility or feeble circulation is the cause, are those of the tonic and diuretic class in combination; as, for instance, iron and gentian, with nitrate of potash, or terebinthinous sub- stances, as the so-called Venice turpentine, resin, soap, &c. Small doses of aloes, antimonials, and other drugs which act upon the skin and kidneys are found to remove the fluid, while exercise alone will often have that effect. The abuse of diuretic medicines, in the hands of carters and others, finally renders the animal incapable of doing without them, and it is often only discovered when horses change hands. The inside of the sheath should be explored by the hand, and accumu-
lations of so-called "cod-wax" removed. The parts should be liberally dressed, within and without, with lard or
vaseline, as it is often found to assist greatly in relieving inconvenience to the animal in the passing of urine, besides having a decidedly curative effect. |
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PARALYSIS OF THE PENIS
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85
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PARALYSIS OF THE PENIS
Protrusion of the penis from the sheath, with loss of power to draw it
back again, sometimes arises from paralysis of the muscle by which it is retracted. Inability to withdraw the organ into the prepuce not infrequently
results from a constriction of the inner folds of the sheath following upon injury or disease, but cases have occurred in the experience of the writer where no such condition existed to account for the morbid state, and he is forced to the conclusion that paralysis of the part referred to was the result of loss of nervous power. These cases are more especially found in stallions of the heavier breeds.
As to the particular cause by which the mishap is brought about we
have no explanation to offer. It is not necessarily associated with paralysis of the muscles of locomotion; the desire for service still remains, but a full and competent erection cannot be effected. Such treatment as is usually resorted to, viz.: blisters to the spine, the
administration of the salts of iodine, strychnine and iron tonics, have not been attended with benefit. Where the protrusion is considerable and unsightly, removal of the
organ by means of an operation is the only remedy. AMPUTATION OF THE PENIS
This is not so difficult or so dangerous an operation as it might at first
appear. Various more or less complicated methods have been suggested, but
experience has taught us that the greatest success attends the more simple forms of procedure. As the operation is a painful one it is desirable that chloroform should be first administered. The organ and the sheath should then be thoroughly washed with soap and water, and disinfected with carbolic solution. A ligature of tape is now applied round the neck of the penis immediately behind the glans, and another of strong cord higher up, above the point of incision. The body of the organ may now be divided either with a sharp knife or the dcraseur; if with the knife, the cut surface should be cauterized with the hot iron, and the large vessels which run along the upper border of the organ should be ligatured with srtong silk. If the ecraseur is employed, cauterization will not necessarily be re-
quired. Should bleeding follow the operation cold water is to be applied to the sheath and region of the groin and a cold wet cloth to the loins. |
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86
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ORCHITIS, OR INFLAMMATION OF THE TESTICLES
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Inflammation of the glandular substance whose office it is to secrete
semen. The causes are usually to be found in external violence, inflicted at the
time of "service" by kicks, blows, and misdirected efforts in leaping; excessive intercourse, and over-stimulation by artificial food and administra- tion of drugs with a view to exciting the sexual instinct. The disease may involve only one, or both organs. Symptoms.—A painful
swelling of the injured gland,
enlargement of the scrotum, a tense glistening appearance of the skin, excessive tender- ness to the touch, febrile dis- turbance resulting in loss of appetite, dulness and depres- sion, straddling gait, pain in the region of the loins, and frequent raising of the hind- legs. In some cases abscesses form in the structure of the gland, and ultimately destroy |
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Fig. 234.—Orchitis—Testicle Suspended
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it as a functionizing organ.
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There are others in which
such great violence has been suffered that a portion of the investing membranes and of the common integument are destroyed and eventually slough away. The testicle in this case becomes exposed, in some in- stances necessitating removal. Treatment consists in adopting such antiphlogistic measures as will
most rapidly ensure reduction of the inflammatory condition of the gland. Assuming that in the majority of animals high feeding has been the rule, it will be prudent to prepare for and administer a bold dose of aloes. The diseased testicle should be slung and the whole scrotum surrounded by a poultice (fig. 234). Some entire horses are not under sufficient control to enable the attendants to do this, but every effort should be made to carry it out. Antiseptic lotions, containing some cooling and sedative agents, may be syringed upon the parts in animals not otherwise approachable. Great relief will be afforded by the administration of warm |
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DISEASES OF THE ORGANS OF REPRODUCTION IN THE FEMALE 87
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sedative enemas three or four times a day, and by the application of warm
cloths over the loins. The food should be of a laxative nature, and may further be used as a
vehicle for such febrifuges as nitrate or bicarbonate of potash or soda. In the milder cases brief and gentle exercise should be enjoined, and if the recumbent posture is unobtainable, owing to the pressure and consequent pain, the patient will derive some benefit from slings, which must be attached in such a manner as to ensure their not slipping backwards and coming in contact with the suffering members. DISEASES OF THE ORGANS OF EEPRODUCTION IN
THE FEMALE
These are not of such frequent occurrence in the mare as among some
other domesticated animals, but are usually of serious import. UTERINE HEMORRHAGE OR FLOODING
This accident is less often encountered among quadrupeds than among
bipeds, owing chiefly to structural differences which need not here be specified, and also to the erect posture of the latter favouring gravitation and the continuance of bleeding. Against this the horizontal position of the womb in the former is conducive to the formation of clots and the natural arrest of hemorrhage. In the mare, alarming cases of flooding are sometimes met with, and,
whether due to the accidental rupture of blood-vessels in the act of parturition, to natural weakness of the walls of the uterus, or to anatomical peculiarities, call for immediate attention. Flooding may occur after pre- mature labour or abortion, easy and natural births, or in presentations necessitating manual interference in delivery. Among the more frequent causes, perhaps, may be mentioned the entanglement of the foetal envelopes in the passage during delivery, when they are torn away from their uterine connections before the time has arrived when, in the absence of the foal, such contraction of the womb can be effected as shall close the mouths of the broken vessels. The experienced accoucheur will gently separate the membranes if he finds them retarding delivery; but, as has been pointed out, labour is so sudden and brief in the mare, as a rule, that powerful expulsive efforts may have already done mischief in the absence for only a few minutes of a watchful attendant. It has been observed^among human obstetricians that post partum hemorrhage is frequent or otnerwise in proportion to the rapidity of delivery, and we might, pari passu, look |
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HEALTH AND DISEASE
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88
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for flooding in mares more often than among other domesticated animals
which occupy more time in parturition. This, however, is not the case. The period occupied in delivery would seem to determine the dis-
position to hemorrhage, whether by unaided expulsive efforts on the part of the animal or by artificial interference. The previous state of health of the mare is a factor doubtless to be reckoned with, as it will be obvious that the vessels of a debilitated animal will have less power of contraction than those of a more healthy and robust constitution. Predisposition to hemorrhage is also due in some cases to congenital weakness of the uterine mucous membrane and to injuries sustained in previous difficult labours. Symptoms.—Persons without experience of brood mares might assume
that uterine hemorrhage would necessarily be attended with an immediate discharge of blood per vulvam, but this is far from being the case, for the uterus in its dilated condition may continue to retain it for some time and in large amount without any outward appearance of its presence. Where this is so the more frequent signs are those of trembling, coldness of the surface and extremities, pallor of the visible membranes, a quick but feeble pulse, interrupted heart-beats, and throbbings of that organ, followed by anxiety of countenance, staggering gait, sighing, and inability to maintain a standing attitude. Cold perspiration and muscular tremors invariably ap- pear before the animal finally sinks upon the ground and dies in convulsions. Treatment.—To arrest the blood-flow and sustain the vital powers
must be our first care. The placenta or after-birth is to be removed, fot its presence is a hindrance to that contraction of the womb which is so necessary a sequel to parturition. The mere fact of its removal will in many instances bring about the desired effect, but undue force in effecting this is to be deprecated, and the expert in such matters will strive to remove the placenta by the gentlest traction, while leaving no portion of the viscus unexplored. Experienced veterinary obstetrists recommend the introduc- tion of the hand into the uterine cavity, as its presence and gentle move- ment over the mucous membrane excites the organ to contract, thereby closing the broken vessels. It is important that the organ should be freed from clots of blood, which might otherwise decompose and lead to septic conditions. The accoucheur is here confronted with a difficulty, since he must interfere with nature's ordinary method of arresting hemorrhage by removing the clot, or risk the development of pathogenic organisms and the consequences they entail. The practice of introducing cold water, or a sponge saturated with it, has sometimes proved effectual in arresting uterine bleeding, and on the other hand very hot water has been advocated by some as a styptic agent. Neither the hand nor any medicinal substance should be inserted, with a view to arrest hemorrhage, without employing |
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DISEASES OF THE ORGANS OF REPRODUCTION IN THE FEMALE 89
some antiseptic (see Antiseptics), and regard must be had to the composi-
tion of any drug subsequently employed, or some chemical decomposition may neutralize the effects of the agents used. For example, the mistake is often made of employing permanganate of potash as an antiseptic and glycerine as an emollient, the two being incompatible. A solution of chinosol in the proportion of one in six hundred is very
suitable for irrigating the womb or for saturating the sponge, if it is decided to introduce one. In severe cases, where collapse is feared, the stronger styptic of perchloride of iron or somewhat dilute vinegar may be substituted for cold-water injections. Solutions of tannic acid, or glycerine- of-tannic acid (where permanganate or Condy's fluid has not been used), or of witch hazel should be used. The latter being held in great esteem for the purpose in America. It may be advisable, while these measures are proceeding, to apply cold
douches over the loins, at which time a small dose of some alcoholic stimu- lant should be given. It will be desirable also to give, in the form of draught or ball, one or more of those internal styptics which act through the medium of the circulation: gallic acid, salts of lead, morphia, tincture of iron, ergot of rye, &c. Of the remedies last named, ergot is perhaps of least value in mares, and the fact is mentioned because it is a drug so highly valued in human medical practice. Should we fail with the remedies above named, we have still left a class elsewhere described as revulsives, in the shape of mustard cataplasms, which may be applied over the region of the loins and upon the hollows of the flanks. Vigorous rubbing and hot bandages should be applied to the legs, and plenty of clothing to the body. There should be no attempt to counteract febrile symptoms, that may
subsequently develop, by purgative medicines, but rest should be secured for the organs recently involved in what should always be regarded as a serious mishap. Some bicarbonate of potash may be gh7en in the drinking-water, and the diet should be gently laxative during convales- cence, linseed forming an important item in the menu (see Nursing and Feeding of the Sick). INFLAMMATION OF THE WOMB
Inflammation of the womb is technically known as Metritis, and dis-
tinctions are drawn between endo-metritis and metro-peritonitis, the former affecting chiefly the internal layers of the uterus, while the latter includes the investing peritoneal membrane common to all the abdominal organs. At all times a serious sequel to parturition, it is the more feared from the |
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HEALTH AND DISEASE
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90
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frequency with which septic organisms enter the blood-stream and induce
parturient fever. There is an acute form, running its course very rapidly, a subacute of.
less intensity and of somewhat longer duration, while a third or chronic inflammation of the womb is occasionally encountered, in which the ordinary symptoms are not marked, but a state of debility follows, with irregularities of oestrum which will be more particularly alluded to in a subsequent paragraph. The cause is usually to be found in some abnormal presentment of the
fetus, and the difficulties connected with delivery, but that there are others less obvious may be assumed from the fact that the malady is discovered in mares which have passed through the crisis of parturition without any serious obstacle or apparent trouble. Lactation may be satisfactory, the maternal solicitude fully awakened,
and nothing to indicate a departure from health during the first twenty to forty hours—a rigor indicating approaching inflammation being rare before the latter part of the second day, although, according to some observers, it may be postponed until after the eighth. Shivering (rigor), staring coat, diminished appetite, and a more or less gradual suppression of milk, with a pulse increased in frequency but diminished in force. Other attractive symptoms are shallow and hurried respiration, a rise of two or more de- grees of temperature, a pasty condition of the mouth, redness and swelling of the visible membranes, and coldness of some of the extremities. In the acute form of the malady abdominal pain is indicated by whisking of the tail, looking uneasily round at the flanks, and in some instances striking at the belly with a hind-foot. The lameness noted by some observers would appear to arise more from
pain accompanying movement of the body than from any actual disorder of the limb, but there are undoubted cramps affecting the muscles of the haunch and simulating paralysis. In the more severe cases patches of sweat appear on the quarter, the animal is indisposed to lie down, as in some other affections where the recumbent posture either adds to pain or induces fear of inability to regain the feet. There is a disposition to stand persistently with arched back, and an objection to movement suggestive of laminitis, which is by no means a rare sequel. The womb is often dis- tended with fluid, which can be felt from outside the flank of a thin mare, and finds escape in variable quantities from the genital orifice as a thin, serous, yellowish or dark-red discharge. The lips of the vagina may be tumefied in sympathy with the womb, or as the result of injury in the act of parturition. Where the peritoneum has suffered by extension of the inflammation
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DISEASES OF THE ORGANS OF REPRODUCTION IN THE FEMALE 91
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from the uterus (metro-peritonitis) there is serous effusion into the cavity
of the abdomen, with more or less enlargement and increased roundness, the presence of abnormal fluid being ascertained by percussion of the flanks and the absence of resonance in the lower portion of the belly. A few days, rarely exceeding five, will see a termination in death, unless a healthy reaction is rapidly followed by recovery. In a few instances the disease passes into the chronic form, there is
a considerable abatement of the symptoms, less pain, increased appetite, the enlargement of the vulva is not so noticeable, but the discharge persists and the milk does not return. There is continued debility and probable wasting of the body generally, while a false oestrum occurs at irregular intervals. Treatment consists in irrigating the uterus with antiseptics, emol-
lients, and anodynes, while sustaining the patient's strength with nutritive and easily-digested foods of a laxative character, and otherwise guarding against constipation and keeping down febrile symptoms by the adminis- tration of salines, salicylates, and other agents which are more particularly described under the heading "Parturient Fever". VAGINITIS
By this term is understood an inflammatory condition of the passage
through which the foetus has to pass after leaving the uterus. While commonly associated with metritis, or inflammation of the womb, it may arise independently, as from mechanical difficulties in delivery and the use of obstetric instruments, exerting undue pressure, or actual wounding; from protracted labours or abnormally large offspring. It may be simple and remediable, or associated with lacerated wounds, ulcers, gangrene, and mortification. The symptoms consist of tumefaction of the lips of the vagina, bulging
of the region immediately below, swelling of the mucous membrane lining the canal, with discoloration varying from bright red to purple or almost black, with wounds and abrasions, commonly the latter, and of a super- ficial character, but not rarely of a serious description, where undue force has been employed in the extraction of the foetus. The membrane is dry, of a florid red hue, adhesive, and hot. A difficulty is experienced in pass- ing urine, there is often much itching of the labia, a general febrile con- dition and constipation, which latter would seem to have its origin, at least in part, in deferred defecation arising out of the pain induced by the act. On the second or third day the congested, dry condition of the mem-
brane gives place to a somewhat profuse secretion, which is at first serous, |
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92
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HEALTH AND DISEASE
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occasionally blood-stained, and, as time passes, takes on a muco-purulent
character, with such acrid qualities as to excoriate the skin over which it passes, and denude the parts of hair. Treatment.—Simple vaginitis will often pass away without treatment
in the course of a few clays, but its appearance should never be lightly regarded, since it may become troublesome, if not serious. A gangrenous ulcer may be the source of infective inflammation of the adjacent parts, or the entrance through which septic germs may pass to cause parturient fever. Patches of membrane sometimes slough away, with the result that the passage of the vagina becomes contracted, and parturition is rendered difficult on subsequent occasions. Treatment consists in antiseptic measures, as careful sponging of the
exposed parts with a solution of carbolic acid, or other disinfectant, with glycerine as an emollient, and repeated injection of the same. Measures of this kind are usually successful in the early stages, pro- vided there are no complications in the shape of wounds, but agents of a more astringent description may be called for if breaches in the Avails of the canal are discovered. A lotion consisting of exsiccated or so-called " burnt" alum has been found valuable both as an astringent for ulcerated wounds and an antiseptic where a foetid discharge persists. At the outset a dose of aperient medicine should be administered and a bran dieb pre- scribed. Neglected vaginitis may result in
LETJCORRHCEA
This is a more or less chronic discharge from the vagina. From its fre-
quently white, viscid nature it is known among studsmen as "the whites", and as having its analogue in the human subject, passing under the same name. When white and glutinous in consistence it is also inodorous. In some instances it is of a sanious, foetid, purulent description, and particu- larly evil-smelling, and the skin is found excoriated where the matter has fallen upon it. Anyone who is not in constant attendance upon a mare thus affected
may be led into the error of supposing the malady has disappeared because the discharge is not observable while the standing posture is maintained. In some cases it is more especially noticeable when the creature has occa- sion to micturate, or when lying down gravitation favours its backward discharge. When leucorrhoea has settled into a chronic form there is seldom much
constitutional disturbance, but it is not consistent with a high level of |
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DISEASES OF THE ORGANS OF REPRODUCTION IN THE FEMALE 93
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health, and interferes with reproduction by irregular and imperfect cestra,
uncertain behaviour towards the male, and frequent failure of service. The secretion of milk is diminished in proportion to the continuation and profuse nature of the discharge, and though the appetite may be main- tained, there is some loss of flesh and condition. To discover the parts most implicated resort is had to an instrument known as the vaginascope (fig. 235). The lining membrane of the canal is pallid, relaxed, and comparatively
insensitive to the touch. This applies more especially to the vagina, from which there is a white, thick inodorous discharge, while in others a red, swollen membrane may also display a rough granulated surface. The os uteri fails to con- tract to its normal proportions, and the womb remains more or less flaccid. Treatment. —
Thorough cleansing
within and without, disinfection and re- moval of dried ad- |
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herent matter from ^^^^^^^^^^^^
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Fig. 235.—The Vaginascope
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^^^^^^^^^^
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under and around
the tail and hind-quarters, the injection of astringent agents, and the
administration of mineral tonics. For the first-named purpose a solution of carbolic soap will prove suitable, for the second a weak solution of sulphate of zinc, or permanganate of soda, iodoform, or lysol. For the last the sulphate of iron and copper enjoy a high reputation, combined, maybe, with some vegetable bitter, as gentian root or cinchona. A liberal diet, with a paddock for exercise and a hovel for rest, are
conditions which the prudent horseman will certainly provide. |
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MAMMITIS
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The importance of the udder cannot well be exaggerated. Upon its
integrity and efficiency depends the life of the foal in nearly all cases, foster mothers being difficult to procure, and milk substitutes unsatisfactory. In the chapter dealing with the generative functions, with pregnancy, and parturition the changes wrought in the mammary glands previous to giving birth to young are described, and should render the following remarks on mammitis more intelligible. It is permissible, perhaps, to |
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94
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HEALTH AND DISEASE
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say here that previous to the foal's birth the mammae enlarge, become
more dense, pendulous, and vascular; the teats undergo development, enlargement, distension; the last sign of approaching parturition being the formation of semi-transparent pendulous bodies which attach to their orifices, and are familiarly known as the " wax". At the time of parturition the udder, which, it will be remembered, is
divided into two sections commonly called quarters, is filled with milk ready for the new-comer. Though the development be normal there is increased temperature and sensibility of the mammas: a natural or physio- logical engorgement as distinguished from a pathological one. There may be discomfort, amounting to pain even, with the former state, and its im- portance will be appreciated when it is remembered that impatient mares endanger the life of the young by refusing them permission to suck; nay, more, inflict fatal injuries, not infrequently, upon the foal, while exercising its instinct to "bunt" an udder which does not freely yield nutriment. There are great differences in the temperament of mares, a subject upon which one is tempted to enlarge, but this is not the time or place; suffice it to say that some will endure a good deal of pain in the interest of their young, while in others, notably very young mothers, maternal affection is sometimes almost entirely wanting. Causes.—A hypersemic or congested condition of the mammse at the
time of parturition, or for some days previous to that act, is common, and among experienced breeders and veterinarians it is a moot question whether or no such congestion should not in some cases be mechanically relieved by hand-milking. That the tense and painful state of the glands constitute a danger to both parent and offspring is generally conceded, and the propriety, or otherwise, of manual interference is a question upon which no hard-and- fast rule can be laid. While it has to be borne in mind that the first milk secreted contains a valuable laxative principle (calostrum), of which the foal should partake, a substitute may be obtained where the relief of the engorged mammae is of paramount importance. Mammitis is due to over-repletion with milk, injuries, lying upon cold
wet ground, exposure to east winds, to obstruction of the ducts within the udder, or impervious teats, and in some instances it is believed to be the result of imperfect circulation in the great posterior vena cava. The symptoms of engorgement and actual inflammation of the udder
may be considered together, as the former is not immediately distinguishable from the latter and is in the majority of cases its precursor. When due to over-repletion the malady is gradual in its manifestation. If arising from external violence, inflammation is suddenly developed, the affected parts being swollen, tense, hard, and showing a want of elasticity on manipulation. |
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DISEASES OF THE ORGANS OF REPRODUCTION IN THE FEMALE 95
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In the case of simple congestion sensibility to the touch is not very
marked, and the impression of the finger will not be left upon the enlarged gland, showing the absence of inflammatory effusion. Bodily temperature is not appreciably affected, nor is the appetite impaired. Where actual inflammation exists, the skin of the affected quarter
is very tense and shining, the teat greatly enlarged, and if much red- ness is not seen it is because the skin of this part is commonly very dark in colour. The implicated quarter pits on pressure of the finger, owing to a superficial infiltration of the tissues with fluid exudation. The base of the teat communicates a feeling as of clots or coagula, the presence of which may be confirmed by drawing the teat, or by the introduction of a teat-syphon, when a more or less blood-stained fluid is discovered, containing granulated masses of clotted milk. Pus cells, calostrum, and broken-down epithelium will be found floating in the watery fluid which makes up the bulk of the material coming from an inflamed quarter. In contradistinction to the simple state of congestion above referred to there is more or less constitutional disturbance, the temperature rises considerably, the appetite is somewhat impaired, and there is much local pain. With good management and prompt treat- ment the gland may be restored in the course of a few days, and the secretion of milk re-established gradually. Failing success by simple measures, to be presently alluded to, the
function of the quarter may be arrested for the season and remain pre- disposed to a similar attack after birth of another foal. A degraded secretion, composed of part milk, and some pus, serum, &c, may continue, but the formation of an abscess is not so likely to occur as when the in- flammation runs high and the teat is altogether occluded from the first by solid matter. Instead of the formation of pus, and the gradual pointing of an abscess, it sometimes happens, especially where the origin was external violence, that the whole quarter dies. Its sensibility is gradually lost, it becomes cold, a line of demarcation is observed between the living and dead or dying tissue, and recovery is only possible by the casting on (sloughing) of this gangrenous portion. It need hardly be said that a mare which has lost a quarter should never be put to the stud again. The terminations of mammitis may be briefly described as resolution
or a return of the organ to a normal condition, induration or hardening, atrophy or wasting, gangrene or death of the gland, or the succumbing of the mare herself to the ravages of the disease. Treatment—The early adoption of remedial measures is of the
utmost importance, as in acute cases changes of structure of a permanent and unalterable character take place during the first few days of the malady. |
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96 HEALTH AND DISEASE
Simple engorgement may be relieved by milking with the finger and
thumb, an operation requiring some little practice to be efficiently per- formed, and not necessarily possessed by a good cow-milker. No great quantity is obtainable at one time; the operator must be content to repeat the performance several times during each day if much benefit is to be derived. He should depend, too, upon a soothing manner and gentle manipulation rather than upon severe methods of restraint calculated to annoy the patient, whose will is capable of more or less control of the milk to be yielded. Inunction of the udder with lard or vaseline affords relief by enabling
the skin to stretch. In some cases it is necessary to employ a milk-syphon, as blocking of the teat or great tenderness at the base may render hand .— milking impossible. The
instrument must be intro-
(p^) duced with much care, oil- Fig. 236.-Teat-syphon mg tne point first and em-
ploying only the gentlest
means of pushing it up into the space existing between the glandular struc- ture and the substance of the teat. The aperture of the teat being provided with a delicate sphincter muscle, its resistance must be overcome gradually, or its capacity to contract on subsequent occasions may be impaired, or even destroyed, thus allowing the milk to escape from the gland as fast as- it is secreted. The ring teat-syphon (fig. 236) can be retained in position, where desirable, by tapes attached to the rings and passed over the loins of the patient, but it is extremely liable to come out, and has in some instances caused injury when the animal has lain down. Where abscess commences to form in the gland it is very difficult to
arrest the formation of matter, but it may be controlled in a measure by the administration of aperients and febrifuges, and the employment of mild stimulating embrocations to the udder. If the swelling becomes larce, tense, and painful, with a disposition to bulge or " point" in one direction it will be well to encourage the process by poulticing. Very great relief is afforded by opening the abscess with a lancet, but the operation should not be prematurely performed. When pus has been evacuated the abscess- may be syringed out with an antiseptic lotion from time to time. The animal must be well sustained with nutritive food, but this should not be of a milk-making description in any trouble connected with the udder, the first consideration being to restrain the functional activity of the gland, allay inflammatory action, and prevent its sequelee. Gangrene or death of the mammse must be treated with a view to-
conserving the life of the mare; since the affected organ or a large portion |
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DISEASES OF THE ORGANS OF REPRODUCTION IN THE FEMALE 97
of it must inevitably be lost. Our efforts should be directed to sustaining
her general health, while facilitating the detachment of the destroyed gland, and rendering the adjacent parts aseptic by frequent irrigation with a solution of carbolic acid or some other disinfectant. The further treatment of the case will consist in the administration
of mineral and vegetable tonics, together with a generous diet, pure air, and such gentle exercise as her condition will permit. The gland should be frequently fomented, the sloughing portion gently detached, and strict regard given to cleanliness of the apartment occupied, particularly in respect of the bedding and floor of the box, which should be kept clean, sprinkled with a carbolic powder in cold weather, or washed with a suitable fluid disinfectant if the temperature will permit it. Anything like force in removing the slough is to be deprecated, but its detachment may be con- siderably hastened by judicious traction where the mass does not, by its weight, assist in detaching itself. When the greater portion of the gland has sloughed, the gaping wound left behind is very formidable looking, and the disposition to repair is quite surprising to those who see such cases for the first time, a few days sufficing to fill up the greater part of the cavity, and a month usually serving to effect complete repair of the injured structures, leaving only a cicatrix of much smaller proportions than the tyro could possibly have imagined. While the healing process is going on, the wound should be kept
perfectly clean by gentle sponging, and frequent irrigation with some anti- septic solution should be employed to guard against sepsis or blood- poisoning. PARTURIENT FEVER
Parturient fever can hardly be considered without reference to those
maladies which are its precursors, the chief of which are known as metritis, and divided by pathologists into endo-metritis, as affecting or beginning with the internal surface of the womb, and metro-peritonitis, where first the womb is affected by inflammation, which is subsequently shared by the peritoneal membrane investing it. Any difficulties connected with delivery of the foetus which result in injury to the uterus of the mare may lead to parturient fever, as the result of absorption of septic organisms. Although injuries to the uterus exciting inflammation are mentioned above as the chief, they are not the sole causes, as the entrance into the blood-stream from any other point, as from the vagina, or possibly some muscular injury not immediately associated with the generative system, may have the like ill consequence of infecting the patient at a time when she is peculiarly susceptible to invasion. Vol, II. 41
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HEALTH AND DISEASE
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98
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Symptoms.—It is not always possible to distinguish at first between
metritis and parturient fever and to say at what time septic influences commence, as both are accompanied with suddenly increased temperature; neither is the intensity of the febrile symptoms a particular guide, for metritis and septic poisoning alike vary in degree, and may be severe and fatal or mild and transient. Uterine inflammation or parturient fever may supervene at an early
period, commonly between the second and eighth day after parturition; but much later periods are on record in mares, these animals differing from other domesticated species in the greater length of time after which septic troubles may commence. All may for a time have gone well with the mare, lactation be satisfactory, the maternal instinct fully exercised, and no apparent reason exist for apprehension, yet a sudden and severe rigor may appear accompanied by a rise of two or more degrees of temperature in a few hours. Then follows clulness, loss of appetite, a small, hard, quick pulse, suppression of milk, reduction in the size of the mammary gland, indicating a grave condition and shortly to be followed by shallow breath- ing, a hot and pasty state of the mouth, deep redness of the membranes of the eyes and nose with coldness or variability of the ears and extremities. Abdominal pain, simulating colic, with its better-known symptoms of strik- ing at the belly, looking round at the flanks, stamping the feet, getting up and down, whisking the tail, accompanied with expulsive efforts similar to those known as "after-pains", which all animals involuntarily make in ridding themselves of the placental membranes. Pain, too, is apparent in the hind limbs, taking the form of cramp and a lameness that is paralytic in character. Where parturient fever exists apart from metritic inflamma- tion there is a greater disposition to seek a recumbent posture, the latter being found too painful when an inflamed uterus receives pressure from the abdomen resting on the ground. Where parturient fever is a sequel to metritis there will be swelling of
the vulva and a discharge from the vagina varying in character from a thin serous fluid of pale straw colour to a purplish or chocolate hue. While this is a common symptom it is not necessarily present in those cases where infection has taken place at some other part than the womb. Where fever is accompanied with metritis there is arching of the back in addition to a persistent maintenance of the standing posture, which is only relinquished at the approach of death. With metro-peritonitis there is invariably more or less effusion of serous fluid into the abdominal cavity. If abundant, the movement of fluid is perceptible when hands are placed on opposite sides of the flank and alternately and suddenly compressed. Three or four, at the most five or six, days will witness the termination
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DISEASES OF THE ORGANS OF REPRODUCTION IN THE FEMALE 99
of the malady in death in a large percentage of cases, but there has been a
notable reduction in the fatality of the disease, as arising from inflammation of the uterus, since efficient irrigation of the organ with modern antiseptics has been more generally practised. From the foregoing remarks it may be gathered that prognosis is usually
unfavourable; the more so that the disease is seldom early enough recog- nized and professional assistance sought. Prophylaxis.—Having regard to the causes of parturient fever, too
much care cannot be exercised when assisting delivery, in order to avoid injury to the vaginal or uterine membranes by the operator's nails or instruments, such precautions being especially necessary in the removal of a dead foetus, which may be much decomposed yet comparatively harmless while the genital passages remain uninjured and intact. The practice of passing from a post mortem examination to a case of parturition is doubtless responsible for parturient fever in some instances, and no person who has been so engaged for at least twenty-four hours previously should take part in delivering a mare, and then only after a complete change of clothing and thorough cleansing and disinfection of the hands. No other brood mare should be permitted in the same building with
an animal suffering from the disease under consideration, and the most thorough disinfection of the apartment should be undertaken at the earliest opportunity. To remove or neutralize any septic matters in the uterus will be our
first care, and this will be best effected by injections of warm solutions of such agents as carbolic acid, chinosol, lysol, or permanganate of potash in suitable proportions. Visible wounds in the vagina, incurred in the forcible removal of the
foetus, will be dressed with some rather more active agent than that employed for injection; a one-in-ten carbolic acid and olive-oil lotion being found well adapted to the purpose. As to the administration of remedies intended to act through the
medium of the circulation, these will be chosen for their known action as antiseptics and febrifuges, diminishing the power of the poison circulat- ing in the system, and arresting the rapid consumption of tissue which results from continued high temperature. Among the older agents enjoy- ing a reputation in this respect may be mentioned the hyposulphites of soda and potash. Carbolic acid, deprived of its causticity by solution in glycerine and free dilution, holds a mediate position between the before- named drugs and the more recent additions to the pharmacopoeia, as saly- cilic acid and its compounds. Large doses of quinine are perhaps more |
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HEALTH AND DISEASE
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100
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esteemed among the new school of practitioners than any other medicinal
agent for internal administration. Where constipation is a marked symptom a mild saline aperient may
be administered in the form of sulphate of soda, either given as a draught or, better, in the drinking-water. In extreme cases, where a special value has been attached to the animal, intra-venous injection of antiseptics has been practised. In the convalescent stage tonics and a liberal but easily assimilated diet is advised. |
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INVERSION OF THE UTERUS
To turn the uterus inside out is not an event of common occurrence
in the mare. In the cow it is not only more frequently observed but it is likewise less
serious in its con- sequences, though it is in no case free from danger to the life of the animal. Causes. — Old
mares which have
been long at the stud are more liable to this outward dis- placement of the uterus than are young ones, and the prospects of successful treat- ment are more fa- vourable in the former than in the |
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Fig. 237.—Inversion of the Uterus
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latter. The excit-
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ing cause of inver-
sion of the uterus is excessive straining, commenced during parturition and continued after the birth of the foetus, or the extrusion of the organ may follow immediately after delivery. Symptoms.—After a qeriod of violent straining, of shorter or longer
duration, a fleshy-looking mass is observed to project from the vulva, and quickly to enlarge and extend downwards for a greater or less distance, depending upon the degree of displacement. Should the entire uterus |
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DISEASES OF THE ORGANS OF REPRODUCTION IN THE FEMALE 101
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be inverted it may reach as low as the hocks. If in this condition it
is allowed to hang down, the colour of the exposed membrane changes from red to purple, and may deepen to blackish red. At the same time the organ swells and the mucous membrane becomes soft and easily torn, while at the same time a bloody-looking fluid oozes from the surface. Although at first the mare displays no evidence of severe suffering, active disease in the uterus quickly appears and leads to a fatal issue, unless relief can be afforded. At this time the mare evinces pain by looking towards the flanks, pawing, and general restlessness, in which she may lie down and rise again from time to time. Should help not be at hand the face becomes pinched and anxious, cold patchy sweats appear on the body, the muscles quiver, the legs and ears are cold, the pulse quickens almost beyond numeration, the body temperature is heightened to 105° to 107 and collapse soon puts an end to the case. Treatment.—Inversion of the uterus needs prompt professional attend-
ance, but in saying this it is not to be understood that there is nothing for lay hands to do. On the contrary, the owner or attendants may render most valuable services pending the arrival of the expert. In this connec- tion it is necessary they should know that so long as the uterus is allowed to hang down so long is the circulation in it being obstructed and inflam- mation consequently excited. The blood entering it is in a large measure prevented from leaving it, owing to its depending condition. As it accumu- lates, the organ swells, increases in weight, and assumes a black colour, besides which it becomes soft and foul, at best rendering its return diffi- cult, if not impossible. Until, therefore, the veterinary surgeon arrives some attempt should be made to guard against these objectionable and dangerous conditions. With this object an old, though clean blanket, should be procured, and
being folded once and soaked in a warm solution of carbolic acid, should then be passed under the womb and raised by a couple of men standing one on each side behind the mare, until the displaced organ is brought into a straight line with the vaginal opening. By this means the weight is removed from the part by which it hangs, and the circulation is restored and facilitated. The effect of cold and exposure, which tends to cause con- gestion, may be guarded against by covering it over with a flannel wrung out in warm carbolized water. Failing to procure professional assistance an attempt should be made to return it. Before commencing to do so the hands of the operator should be thoroughly cleansed and dressed with carbolized oil, and should any dirt have become attached to the extruded organ it must be carefully removed by washing with warm carbolized water. The organ should also receive a dressing of carbolized oil over its |
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102
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HEALTH AND DISEASE
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entire surface. When the uterus has become much swollen and con-
gested it will be necessary to effect a reduction in its size before it can be returned. To do this the surface of the mucous membrane will require to be scarified, i.e. be pricked here and there at numerous points with the point of a clean lancet or knife and then fomented with warm carbolized water. In commencing to put it back, that part of the organ nearest to the
vaginal opening should first be pushed inward, and the part next succeed- ing should follow until a considerable portion has been replaced. Then, while it is still supported in position, the doubled fist should be placed against the extreme end of the extruded part, and by careful, gentle, and continued pressure the whole returned to its place. In order to obtain all the available room possible for this purpose the rectum should be emptied of faeces before return is attempted. On completion of the operation the mare will be benefited by a full
dose of tincture of opium to check straining, after which she may be placed in a stall with the hind-legs underpacked with litter so as to elevate the hind parts, and a truss should be adjusted to the vaginal outlet in such a way as to prevent the escape of the viscus again. CYSTIC DISEASE OF THE OVARY
Cystic disease of the ovary is by no means of seldom occurrence in the
mare, and is no doubt the cause of many cases of sterility in this animal which may occur at any period of sexual activity. Cystic disease may appear either as a simple dropsical dilatation of the
Graafian vesicle or in the form of proliferous cysts. Of these two varieties the former is by far the most commonly met with, while the latter is most frequently the cause of dropsy of the ovary which gives so much trouble to the human female. In some cases the disease confines itself to one cyst, which by enlarging
and spreading may cause absorption of the entire organ. In other instances two or more cysts, varying in number in different
cases, develop, and in the course of their expansion are brought together, and by the forcible action and reaction of their walls one upon another cause the partitions to be broken down and the cavities to become con- tinuous. In these cases the fusion of the cysts is generally shown by the irregularly chambered cavity which results. The whole of the ovary may thus be caused to disappear, leaving in its place a large irregular cyst. The contents of these formations is, for the most part, a thin, transparent, watery fluid containing a small quantity of albumen. |
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103
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ANATOMY OF THE EYE
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Another form of cyst is sometimes met with in the ovary and also m
the testicle. This is known as a dermoid cyst, so called on account of its |
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A ^"^ ^HB^ B ________________
Fig. 238.—Cystic Ovary
A, The Ovary Entire. A a, Cysts distended with Fluid. B, Ovary in Section. A A, Cysts or Cavities from which Fluid has been removed. being formed out of the elements of skin and containing one or more skin
products, such as hairs, fat, teeth, &c. These growths are considered to arise out of some error in the develop-
ment of the animal in which they occur, and are essentially congenital. There are no symptoms which will rightly guide us in a diagnosis ot
these affections. They seldom disturb the general health and rarely occasion death. |
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11. THE EYE
ANATOMY OF THE EYE
The eye is an instrument by which light, colour, form, and movement
are recognized, and by which, combined with other faculties, we acquire a knowledge of distance, relation, position, and size of objects. It occupies the fore or outer part of the cavity named the orbit, the
bones of which form a very efficient means of protection to it against injury. It rests on a soft bed of fat, which enables it to yield to direct blows, and it is further protected by a retractor muscle, which with- draws it under cover of the bones, whilst the eyelids and the membrana nictitans (haw) cover it in front. It is consequently only rarely mJu^ The membrana nictitans, or haw, is a triangular piece of cartilage whic gradually becomes thinner from back to front. It is situated m the inner |
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HEALTH AND DISEASE
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104
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canthus of the eye, and is attached to a cushion of fat by its posterior
angle, while in front it presents a very thin edge by which small particles of dust, hairs, insects, and the like,
are removed. If not swept away by the nictitating membrane, they are washed away by the copious secretion of tears which they excite from the lachrymal gland (fig. 246, e). It is moved or rotated by seven
muscles, viz., the four recti, or
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Fig. 239.—Muscles of the Eyeball
A, Superior Rectus Muscle. B, Retractor Muscle,
c, External Rectus Muscle. D, Inferior Rectus Muscle. E, Superior Oblique Muscle. P, Point of Insertion of Inferior Oblique Muscle, o, Optic Nerve. H, Globe of the Eye. I, Iris, j, Pupil. |
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straight muscles, named respectively
the superior, inferior, external, and
internal rectus; the superior and
inferior oblique muscles, and the
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retractor bulbi. The superior oblique
muscle, which turns the eye downwards and outwards, is supplied by the
fourth nerve or trochlearis. The external rectus is supplied by the sixth
cranial nerve, and the remaining five muscles are supplied by the third
nerve. These muscles, with the
exception of the inferior oblique, arise from the back of the orbit, and, passing forwards, are inserted into the fore part of the globe. The inferior oblique muscle arises from the inner part of the floor of the orbit, and, running outwards and upwards, forms a kind of sling ■—supporting the eye together with the tendon of the superior oblique. The superior oblique (fig. 239, e), arising from the back of the orbit, ends in a tendon which runs through a small loop or pulley on the upper |
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Pig. 240.—Section of Eye
A, Lachrymal Gland. B, Levator Palpebrae Superioris.
c, Levator Oculi. D, Sclerotic Coat. E, Choroid Coat. F, Retina. G, Optic Nerve. H, Vitreous Humour. I, Capsule of the Lens. J, Crystalline Lens. K, Aqueous Humour. L, Cornea. M, Iris. N, Upper Eyelid. |
part of the inner wall of the orbit,
and then, changing its direction, runs outwards and a little back- wards, to be inserted into the upper |
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part of the globe.
The ancient division of the structures of the eye into three coats or
tunics, and three humours, is still the most convenient for description. The first coat is composed of the sclerotic and cornea (fig. 240, d, l). |
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105
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A.NATOMY OF THE EYE
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The second coat is formed by the choroid ciliary processes and iris
(fig. 240, E, m). The third coat is the retina, or expansion of the optic nerve (fig. 240, f).
The three humours are the aqueous humour (fig. 240, k), the crystalline lens (fig. 240, j), and the vitreous humour (fig. 240, h). The outermost tunic is a dense, tough, and unyielding membrane,
the inner four-fifths of which is opaque, and named the sclerotic or white of the eye, whilst the outer or front fifth is transparent, and is named the cornea or glass of the eye. The sclerotic is thick behind, where it presents a small opening for the entrance of the optic nerve (fig. 248, 1), and thinner in front, where it becomes continuous with the cornea. The fore part of the sclerotic, or that which forms the white of the eye, is covered with a delicate mucous membrane, named the conjunctiva, which is continued over the cornea as a transparent membrane composed of eight or ten layers of cells. These cells, if injured, can be thrown off and renewed, so that the transparency of the cornea is not impaired after slight lesions. Different as the aspect of the |
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cornea is from the white or sclerotic
portion of the membrane, the ma- terial out of which each is com- |
Fig. 241.—The Choroid Tunic
1, Cut Surface of Sclerotic. 2, Veins of the Choroid (Vense Vortieosas). 3, Ciliary Nerves and Arteries. 4, Ciliary Ligament. 5, Iris. 6, Pupil. |
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posed—connective tissue—is the
same, only that in the sclerotic the fibres are irregularly arranged, whilst in the cornea they are disposed in layers or lamellse one upon another, with many intervening branching cells which enable the nutrient fluid or plasma of the blood to penetrate and nourish the tissue. The cornea is supplied by the fifth pair of nerves, which confer upon it the exquisite sensitiveness of the surface. The Choroid Tunic is composed of a close net-work of blood-vessels,
the outer layer of which is formed by the large veins of the eye known as venae vorticosse (fig. 241, 2). The inner layer is formed by the delicate capillary vessels disposed in loops, and is in contact with the retina. At the back part of the choroid there is a circular opening, like that in the sclerotic, for the passage of the optic nerve to the retina; in front the choroid is folded into a large number of plaits named the ciliary processes (fig. 242, c), which project into the interior of the eye behind the iris. |
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106 HEALTH AND DISEASE
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Numerous dark-looking pigment cells, of irregular forms, are distributed
between the blood-vessels, giving to the membrane a soft, velvety-black colour, except at one part, which forms a broad band just above the en-: trance of the optic nerve. Here the choroid presents a metallic yellowish- green colour, and reflects the light strongly. This appearance is attributed to the peculiar arrangement of some thin
cell-plates found in this part, producing
the phenomena of interference of light, and is believed to assist the animal in perceiving objects in twilight. The Ciliary Processes (fig. 242, c),
which are thickly covered with black pig-
ment, are about one hundred and twenty in number, and are arranged in a circle, projecting into the interior of the globe to become connected with the vitreous humour. They probably play an important |
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Fig. 242.—Interior View of the Eye
a, Pupil. B, Iris, c, Ciliary Processes.
D, Corpora Nigra. |
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part in the secretion of the aqueous humour.
Externally they present a whitish band, |
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which is the ciliary body or muscle. Some
of the fibres of this muscle radiate backwards from the margin of the cornea over the choroid, others are circular; both, when acting, modify the curvation of the lens, and thus influence the accommodation of the eye. The Iris (fig. 241, 5) is a thin membrane composed of blood-vessels and |
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Fig. 243.—Pupil Dilated
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Fig. 244.—Pupil Contracted
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of muscular fibres united together by connective tissue. Some of these
fibres are arranged in the form of a ring around the inner margin of the pupil, while a second set, outwardly placed to these, and connected with them, are disposed in a radiating manner like the spokes of a wheel. In the centre of the iris is an ovoid opening, the "pupil" (fig. 241, 6), |
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107
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ANATOMY OF THE EYE
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on one or both edges of which are a few small black bodies called corpora
nigra (fig. 242, d). The pupil is the opening through which light enters the eye, and by which images of objects in the outer world are permitted to be formed on the retina within. The iris, except in albinos, is perfectly opaque, and acts as a diaphragm, regulating the amount of light that enters the eye. In dim lights the pupil dilates (fig. 243), in bright lights it con- tracts (fig. 244). The Retina.—This, which is the
most internal of the tunics of the
•eye, is a sheet of nerve tissues situated between the choroid coat and the vitreous humour, specially organized to receive and transmit impressions of light. Its structure (fig. 245) is very complex, but it consists essen- tially of an outer layer of rods and cones, followed by several layers of cells and nuclei, with interwoven fibres, which give cohesion and |
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l€llllil«te#£8
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strength to the different layers.
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The fibres of the optic nerve ter-
minate in the retina, and conduct the impressions made upon the re- tina through the optic nerve to the brain. The accompanying woodcut will sufficiently demonstrate the ■structure of the retina as now re- |
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ceived by the best observers.
The Humours of the Eye.—
The aqueous humour (fig. 240, k)
is a limpid fluid which occupies the ■space between the cornea and the lens. The quantity is estimated at about 1 fluid drachm. It appears |
Fig. 245.—Microscopic Section of the Retina,
Choroid, and Part of the Sclerotic 1, Sclerotic. 2, External Vascular Portion of the
Choroid. 3, Internal Vascular Portion of the Choroid. 4, Pigment Cell Layer. 5, Layer of Rods and Cones. C, Membrana Limitans Externa. 7, External Nuclear Layer. 8, External Molecular Layer. 9, Internal Nu- clear Layer. 10, Internal Molecular Layer. 11, Gan- glion Layer. 12, Nerve-fibre Layer traversed by Muller's Sustentacular Fibres. 13, Membrana Limitans Interna. |
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to be secreted by the ciliary pro-
cesses, and undergoes constant renewal. That which is freshly secreted is poured forth into the posterior chamber of the eye, and therefore occupies the space between the back of the iris, in front, and the tips of the ciliary processes, the suspensory ligament of the lens, and the lens itself, behind. The fluid passes through the aperture of the pupil into the anterior chamber of the eye, and escapes by a natural channel situated |
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108
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HEALTH AND DISEASE
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in the angle of this chamber at the line where the iris and cornea are
in contact. The channel is named the canal of Fontana, and communi- cates with another canal named the canal of Schlemm. The Lens (fig. 240, j) is a perfectly transparent biconvex solid body,
about half an inch in diameter. The front surface is less convex than the posterior. It lies behind the iris, and is lodged in a depression of the vitreous humour. It is kept in position by a circular ligament which is formed out of a continuation of the modified outer layer of the retina and extends from the ciliary processes to the margin of the lens. The lens is enclosed in a capsule, which is thick in front and thin
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behind.
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It is composed of long fibres with sawlike edges, which mutually
interlock with those of the adjoining
fibres; and these are arranged in many layers, tne outermost being soft, becoming denser as the central part of the lens is reached. By the lens, parallel or nearly parallel rays of light are brought to a focus on the retina, and a precise image is there formed. Opacity of the lens constitutes cataract. The Vitreous Humour (fig.
240, h) is a semi-fluid, uniform sub-
stance, like white-of-egg in consist- |
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Fig. 246.-The Eye, showing the Lachrymal Gland
A, Superior Oblique Muscle, b, Levator Oouli or
Superior Rectus, c, Abductor Oculi or External Rectus. D, Depressor Oculi or Inferior Rectus. E, Lachrymal Gland, f, Optic Nerve. |
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ence, traversed by numerous delicate
fibres which appear to be the remains of cells with greatly attenuated and |
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elongated processes. It is enclosed
^H in a transparent and very thin mem- brane termed the hyaloid membrane. The vitreous humour presents a
canal running through its centre from behind, which originally contained blood-vessels on their way to the posterior surface of the lens, but both the canal and the blood-vessels disappear in infancy. In front the vitreous humour is hollowed out, so as to give lodgment to the convex surface of the lens in front of it. Near the margin of the lens is a structure named the Zonule of Tinn, composed of fibres which are super- imposed upon the hyaloid membrane and forming the suspensory ligament of the lens, whilst they are so arranged as to present alternate elevations and depressions which correspond to the ciliary processes and the inter- vening spaces. |
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DISEASES OF THE EYE AND ITS APPENDAGES 109
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DISEASES OF THE EYE AND ITS APPENDAGES
It is perhaps impossible to overestimate the importance of perfect
soundness of the eyes of a horse. The extreme inconvenience of a slight defect is very apparent to a rider or driver of an animal which is in the habit of shying when, so far as can be seen, there is nothing to attract particular attention. Unfortunately, even important defects of vision may be attended with
such obscure signs as to be absolutely undiscoverable by the ordinary methods of examination which are at the command of an amateur. The use of the ophthalmoscope by an experienced and highly accomplished observer is often necessary for their detection. In the horse, slight errors in refraction cannot be found out even by an expert, and if they could, there is no remedy, because the optical appliances, which are so valuable in compensating even the least departure from perfectly normal vision in man, are inapplicable to any of the lower animals. Obviously the examiner of a horse's eyes will be quite unable to distin-
guish some of the marked departures from the healthy state unless he has some acquaintance with the eye in its natural condition. With this view the reader is referred to the section on the anatomy and physiology of the eye. Meanwhile he is cautioned that the most ludicrous mistakes are made by persons who, in looking for diseased conditions of the eye of the horse, have not taken the trouble in the first instance to master the normal appearances which can be readily seen without the use of any optical apparatus. EXAMINATION OF THE EYES
For the purpose of making an examination of the eye, the horse should
be so placed by the observer that the light may fall on the organ either from a window or from the stable entrance, while the animal's head is either within the stable or only partly out of it. In this position the examiner will naturally first note the condition of the eyelids and the movements of the eye. If, during this time, the animal happens to be suddenly alarmed, even by the movement of a hand towards the eye, he will also witness the rapid protrusion of the haw (fig. 247) (cartilago nictitans) over the front of the organ, as if to protect it from injury. In the section on anatomy and physiology the structure and uses of this organ are described. Having the eye in a good light, the examiner will note the white portion
of the globe, with its numerous vessels ramifying in all directions, and the |
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HEALTH AND DISEASE
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110
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transparent cornea forming the front of the eye. Looking through the
cornea he will observe the curtain behind it which gives the colour to the eye, and is therefore termed the iris, with the opening in the centre of it, the pupil, through which the light passes, carrying with it the image which is to be depicted on the retina. At the edge of the pupilary opening the small black, pea-like bodies, which have been described as the corpora nigra, will be seen; small, or even extremely minute, at the lower edge of the pupil, considerably larger at the upper edge, these little bodies are |
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Fig. 247.—Examination of the Eye (a, the Haw) 4, Divided Choroid. 5, Divided Retina.
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the pupilary opening, if the eye is in the proper position, the examiner
will see a small pearl-like body at the bottom of the posterior chamber which marks the entrance of the optic nerve (fig. 248, 1); this body is worthy of particular notice as it is frequently mistaken for a cataract. A quarter of an hour occupied in this examination every day for a week
should make the tyro familiar with some of the more important parts of the anatomy of the visual organ and its appendages, so that he will be able to recognize any decided changes resulting from disease without running the risk of making the curious mistakes which are so extremely common. During the examination the observer will note that the eye of the horse
is never for more than a second in one position. In examining the eye of a friend this difficulty entirely vanishes, as the organ can be kept perfectly still while the inspection is being made, but there are positively no means |
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DISEASES OF THE EYE AND ITS APPENDAGES 111
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of securing this fixity in the eye of the lower animals except by putting
them under the influence of an anaesthetic, and anyone desiring to examine the eye is required to train his own eyes to follow the movements of the organ, so that he may keep the part which he wishes to see in view during the time that it is in constant motion. |
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DISEASES OF THE EYELIDS
An account of the different diseases to which the organ of vision is
liable may conveniently deal, in the first instance, with the eyelids, which are frequently implicated in one way or another in disease or injury affect- ing the globe. Blows inflicted intentionally or by accident are the most common form
of injury to the eyelids, and it is often the case that the inflammation, with swelling and redness of the lining membrane extending over the front of the eye and reflected on the insides of the lids, are the only symptoms which result from the blow, unless it has been sufficiently severe to cause a contused wound. Exactly the same kind of symptoms will be present when the inflammation is the result of a cold, or febrile condition of the system, or of the introduction of an irritating substance under the lids, and it is therefore impossible to be quite certain whether the inflammation, swelling, and discharge of tears observed are due to one or other of the causes named unless there is some history to assist the diagnosis. Any manual examination of the diseased eye naturally excites the
animal's fears, particularly should he be unable to see the operator who is engaged in manipulating the part, and unless there is some reason to suspect that the irritation is caused by a foreign body which has entered the eye, it is better to leave the diseased parts alone until the inflam- mation is diminished. The first step in the treatment should be to place the animal in a
position where there is only a subdued light—entire exclusion of light is not necessary. Fomentations of warm water should then be applied, by squeezing the water from a sponge laid on to the skin above the injured organ, or by fixing a piece of soft rag in such a position that the water may run from it over the swollen eye, the least pressure to the diseased parts being avoided. As the inflammation subsides, the lids will gradually open and assume their normal character, and it will now be easy to see it the injury has affected the transparent cornea. Sometimes a white line running obliquely across the front of the eye will suggest a cut from the lash of a whip; in other cases there may be a general opacity over the whole of the transparent structure, and in other instances the symptoms |
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HEALTH AND DISEASE
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112
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which are apparent will satisfy the examiner that the disease in the lids
which was taken to be the result of injury was merely the indication of a much more serious malady—periodic ophthalmia,—which has yet to be considered. LACERATION OF THE EYELIDS
Laceration of the eyelids, upper or lower, generally occurs in conse-
quence of the presence of a nail or a splinter of wood, &c, projecting out from some part of the stall or box, against which the animal may accidentally strike its head during a sudden movement. Occasionally it happens that one of the lids is nearly torn off and left hanging by a small portion which still remains intact. Even this severe form of injury, however, need not discourage the operator, whose first duty is to cleanse the part with a little weak solution of carbolic acid, and then to adjust the edges of the wound with the greatest care, and apply a sufficient number of stitches with a very fine needle, so as to keep them in perfect apposition. No subsequent treatment will, as a rule, be necessary; the thin layer of lymph which exudes from the divided surfaces will act as a most perfect cement, and must on no account be disturbed. Generally, healing takes place by what is called first intention. Now and then, however, a small portion of the damaged structure may fail to unite. In such cases slight stimulation is desirable, when pencilling the edges of the wound very slightly with nitrate of silver will have a good effect. In most cases of injury of the kind described the cure is quite perfect, and when the healing process is concluded, the blemish which is left is exceedingly slight. Some writers on diseases of the eyes of the horse refer to abscesses in
the eyelids associated Avith catarrhal diseases of an acute type. This affec- tion, which is very well known in human beings, i.e. stye (hordeum), is really a small abscess affecting some of the sebaceous or grease follicles on the edges of the lids. In the lower animals, however, this form of disease is very rare. ENTROPIUM AND ECTROPIUM
In consequence of muscular spasm, or from loss of structure due to
disease or injury, burns especially, the eyelids are liable to become more or less distorted. Two forms of distortion are recognized, and distinguished as entropium and ectropium. Entropium.—In this deformity the diseased lid is inverted or turned
inwards, so that the eyelashes are brought in contact with the sensitive con- junctiva, causing considerable pain and inflammation, with an excessive |
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DISEASES OF THE EYE AND ITS APPENDAGES 113
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secretion of tears. The only effective remedy is the performance of an
operation, which consists in taking away a portion of skin a little dis- tance from the edge of the diseased lid, and running parallel to it, for the |
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Fig. 249.—Bntropium or In-turned Eyelid
1, Normal Eye. 2, Eye affected with Entropium (the in-turned lashes shown at a).
3, Eye affected with Entropium (front view). |
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whole distance of the inverted part. The lips of the wound are then
brought together by sutures in such a way as to pull the inverted lid outwards, and keep it in that position until the wound artificially made |
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Fig. 250.—Ectropium or Fig. 251. —Ectropium or Everted Eyelid
Everted Eyelid (Front View)
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heals. On this being completed, the eyelid is found to occupy its natural
position, and the trouble ceases. Ectropium.—This condition is exactly the opposite of the one pre-
viously described; the affected lid is turned outwards instead of inwards, exposing the conjunctival membrane with which it is lined. Like the other deformity, this usually results from burns or from inflammation of the conjunctiva, and almost invariably affects the lower lid. To correct this, vol. II. 42
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HEALTH AND DISEASE
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114
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a caustic pencil should be drawn across the mucous membrane so as
to occasion a slough, when the lid will be drawn up or down in the process of cicatrization. DISEASES OF THE LACHRYMAL APPARATUS
Disease of the lachrymal gland, which secretes the tears, and obstruction
of the lachrymal duct, which carries any excess of their secretion into the nasal cavity, are morbid conditions only occasionally met with in veterinary practice in this country. The same remark may be made of redness and ulceration of the edges of the lids with the loss of eyelashes, " Blepharitis ciliaris"; constriction of the opening of the eyelids, " Blepharophimosis "; irregular arrangement of the eyelashes, " Triachiasis"; adhesion of the eyelid to the globe of the eye, " Symplepharon"; and other affections which are met with in the human subject but are seldom seen in the eye of the horse. DISEASES OF THE CONJUNCTIVA AND CORNEA
Simple Ophthalmia.—Inflammation of the membrane which lines the
eyelid (conjunctiva) is known as simple ophthalmia or conjunctivitis. The disease may present itself in various forms, from the acute to the chronic. In all stages of the disease the normal secretion from the membrane under- goes certain changes, and in the human subject the terms catarrhal, puru- lent, and diphtheritic ophthalmia are employed to indicate the nature of the discharge. Causes of simple ophthalmia are—exposure to cold, the action of
irritating gases, dust, bits of chaff, and other foreign particles, injuries, and it is very often associated with febrile diseases. A distinction may at once be drawn between inflammation of the
conjunctiva resulting from the causes referred to and swelling of the lids arising out of injury. The symptoms in the former case are less sudden in their appearance, generally beginning with slight redness of the membrane and an increased secretion of tears. As the disease ad- vances the discharge becomes thicker, and more or less opacity of the cornea may follow; the animal instinctively avoids exposure to a strong light, and the swelling of the eyelids becomes gradually more marked. The treatment of these cases will depend upon the stage which the disease has reached. If the inflammation is of the sub-acute or chronic form astrin- gent lotions may be applied at once, and a weak solution of sulphate of zinc, two grains to the ounce of water, will be effective. It may be |
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DISEASES OF THE EYE AND ITS APPENDAGES
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115
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applied by gently pulling down the lower lid and dropping the fluid into
the eye by means of a camel's-hair pencil. When the affection is in the acute stage, a mild dose of physic should
be given at the outset, and fomentations of warm water applied to the affected eyes, to be followed by an as- tringent lotion when the inflammation subsides. In cases where ophthalmia is connected with febrile disease—influenza for example—an important point is to place the animal where the eyes will not be irritated by too much light. The main treatment, however, should be directed to the cure of the systemic disease, and it may |
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Fig. 252.—Opacity of Cornea
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be that no local remedies will be needed.
The practice of bleeding from the eye-vein has for a long time been
discontinued. When ophthalmia assumes the purulent form it may be necessary to
apply a more powerful astringent lotion, and a solution of nitrate of silver, three grains to the ounce of distilled water, is generally very effective in altering the character of the discharge, and in removing diphtheritic or granular deposit which sometimes accumulates on the surface of the membrane. Inflammation of the Cornea, "Keratitis".—
Affections of the cornea include inflammation, which
is sometimes followed by suppuration, or the de- velopment of " matter" between the layers of the cornea, and ulceration. In all these morbid con- ditions the conjunctiva necessarily participates. Inflammation of the cornea is invariably at-
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tended with more or less opacity, and may even
proceed to the formation of an abscess, as it is |
Fig. 253.—Staphyloma
A, The grape-like tumour. |
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sometimes termed; but it is necessary to note that
the deposit of pus in the structure of the membrane is only indicated by a diffused yellowness in certain parts of it, and not by the ordinary form of swelling, gradual softening, and finally bursting of the sac and discharge of its contents. It would, however, be expected that when- ever pus is formed a permanent opacity of the cornea in that portion will be the consequence (fig. 252). Ulceration of the cornea is not uncommon in the dog, in one form ol
distemper, but it seldom occurs in the horse. |
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HEALTH AND DISEASE
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116
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An alteration in the form of the cornea, consisting of a protrusion of
the central portion in the form of a grape-like tumour (fig. 253) {Staphy- loma) associated with distension of the globe of the eye, has been met with occasionally as the result of inflammation. It is obvious that no treat- ment which can be employed would prevent the loss of sight in such a case, but when the appearance of the organ is objected to, the tumour may be dissected off with a reasonable probability of the wound closing, or the eye may be entirely extirpated by an operation which is very easily performed and is generally successful. Periodic or Recurrent Ophthalmia.—A form of ophthalmia which
is known as periodic, or sometimes as "moon-blindness", is peculiar to
the horse, and in all probability is chiefly
due to heredity. The cause to which it was formerly attributed, i.e. irritating gases and badly ventilated stables, is evidently inadequate to explain its presence. The fact that other animals are constantly ex- posed to the influence of the same con- ^Ps?5?K ditions without suffering is in itself sufficient Fig. 254.-Recurrent Ophthalmia to throw considerable doubt on the once-
Eye showing an angular condition of the accepteCl explanation,
upper lid the result of a succession of L attacks of Specific Ophthalmia. It is undoubtedly true that the disease
is much less frequent than it formerly was,
and it is also true that for many years past great care has been taken at horse shows to reject all animals which gave evidence of having suffered from the malady. In this way breeding animals affected with the disease have been marked out, and their use largely curtailed in consequence. Symptoms of periodic ophthalmia are in the first instance closely allied
to those of simple ophthalmia, but a great contrast is observed in the more advanced stages. Swelling of the eyelids, redness of the conjunctiva, and discharge of tears are the chief indications of the early stage of the disease. To the experienced examiner the diseased eye presents a characteristic appearance even at the outset of the malady, which becomes more and more pronounced with each succeeding attack. A slight contraction in the centre of the upper lid, the edge of which is drawn upward (fig. 254), gives a peculiar triangular appearance to the opening between the two lids. This is an appearance which is not met with in simple ophthalmia; the swelling is less marked also, and when there is a sufficient space between the partially closed lids to allow the surface of the cornea to be seen, a peculiar amber tinge of the part is observed. This is caused by a yellow |
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DISEASES OF THE EYE AND ITS APPENDAGES 117
exudation into the anterior chamber, which at once distinguishes the
disease from simple ophthalmia. During the progress of periodic ophthalmia various changes take place.
The swelling of the eyelids and the congestion of the conjunctiva gradually decrease. The amber tint, which at first extended over the whole of the cornea, becomes concentrated at the lower part, owing to the deposit of lymph gradually falling to the bottom of the chamber. In- a week or two the whole of the eye begins to become clear, and in from three to six weeks there may be no trace of the disease left, and the organ is to all appearance sound. This condition may possibly continue for the space of a month, or sometimes much longer, but a recurrence of the attack is a matter of certainty. Generally the disease reappears in the same eye, but occasionally the eye originally attacked remains apparently healthy and the opposite eye becomes affected, the course of the disease in it being as nearly as possible identical with that which has been described. Probably owing to peculiarities in the system of the horse, the disease
at different times assumes an extremely acute, or a sub-acute, or chronic form. In some instances it appears to be concentrated in the eye first attacked, which suffers from repeated reappearances of the disease at short intervals, each attack leaving some morbid changes behind it affecting the internal structures, and ending in total blindness of the affected eye, either from the opacity of the crystalline lens or from the deposit of a large quantity of inflammatory material in the anterior chamber, and ultimately the formation of a false membrane lining the inside of the cornea causing a permanent yellow opacity. In this case it is impossible to ascertain what may be the condition of the structures behind the iris, but post-mortem examinations in a few cases have shown that the whole of the internal structures are implicated in the changes which are apparent in the front of the eyes, the vitreous body and the crystalline lens being the seat of the same kind of yellow deposit which occurred in the anterior chamber. In some instances black pigment spots are noticed in front and towards
the outer margin of the lens. These indicate that the iris has been adherent to the lens as a result of the inflammatory attack, and the pigment behind the former has been left on the latter. Sometimes the two remain permanently united. When periodic ophthalmia was much more common than it is in the
present day, it was a matter of observation that if the disease assumed the acute form, and repeated attacks occurred in one eye, ending in blindness, the other eye remained unaffected; but when the affection appeared first in one eye and then in the other, alternately, the result was the gradual impairment of the vision until the sight was entirely lost in both. |
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HEALTH AND DISEASE
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118
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Treatment of the recurrent form of ophthalmia will be the same as that
which has been recommended for the simple form of the disease, including a frequent application of warm water while the inflammation exists, and the use of a mild astringent lotion afterwards. It will, however, be understood from what has been said in reference to the course of the disease, that all treatment must be looked upon as merely palliative. There is no remedy known which has any influence in preventing the recurrence of the affection or in checking those morbid changes which sooner or later terminate in total loss of vision. • CUTANEOUS-PILIFEROUS GROWTH FROM THE CORNEA
Every now and again these hairy growths are noticed to present them-
selves on some portion of the eyeball of a horse. For the most part they are congenital formations, but very rarely they
do not appear until some time after birth. In those cases which are congenital this growth presents itself as an
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Fig. 255. —Cutaneous-Piliferous Growth from the Cornea
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aberration of development. That is, a germ of skin appears in some part
of the eyeball where skin does not and should not occur. They cause the animal a good deal of annoyance and suffering as a
result of their presence, and it is only by removing them with the knife that this can be remedied. For some reason or other these cutaneous growths are most often seen
in oxen and in dogs, and they are less frequently noticed in the horse, in sheep, and in the human subject. A case is recorded as occurring in a bullock in the Veterinary Record,
vol. xxi, p. 235, and other cases are referred to in the Journal of Anatomy and Physiology, vol. xiv, p. 143, and also in the Veterinarian, vol. xxvi, p. 777. |
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DISEASES OF THE EYE AND ITS APPENDAGES 119
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CATARACT
As the term cataract is usually understood, it includes changes in the
crystalline lens, which convert it from a transparent body into an opaque mass (fig. 256), which may be compared to a small biconvex piece of chalk; the appearance, in fact, is the same as that which is constantly noticed in the crystalline lens of fishes when cooked, and seen in the dish as a small globular body of a dense white colour. The professional man, however, recognizes the fact that the term cataract applies to any opaque speck, or number of specks, however minute they may be, which appear in any part of the lens or its capsule; indeed, a cataract may be so ex- tremely minute as to be absolutely invisible to the naked eye, and the use of an ophthalmoscope by an expert is indispensable for the detection of the disease in its initial stage. One of the old veterinary writers, Dr. Bracken, in 1737, describes
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/ I ]\'V \ ,
Complete. |
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Partial.
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Fig. 256,—Cataract
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four varieties of cataract, i.e. white, pearl colour, yellow: and black or
green cataract. All these varieties are said to have been met with recently in different animals, but they are only to be detected on post-mortem examination, so far, at least, as the peculiarity of colour is concerned, and as a rule, post-mortem examinations are not common in connection with the existence of this disease. If the cataract is perfectly visible there is no particular object in making a special examination of the lens after the death of the animal, and if there is no evidence of its existence, it is not suspected, and therefore not sought for; but it must be clear that in all cases cataract at the commencement may be discovered by the use ot optical instruments, and their use is undoubtedly called for in all cases where a horse is in the constant habit of shying, or in any way gives reason for a suspicion that the sight is defective. Besides the division of cataracts as to colour, there is another which
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120
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HEALTH AND DISEASE
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affects the capsule of the lens, capsular cataract, and cataracts which exist
in the substance of the lens, lenticular cataracts (fig. 257). Capsular cataracts usually appear on the front of the capsule, and in the form of small circles or extremely minute specks, the smallest of which are only rendered visible by the use of the ophthalmoscope. With this instrument the examiner has no difficulty in distinguishing capsular cataract by trans- mitting the rays of light obliquely into the eye so as to get a lateral view of the surface of the capsule. From the smallest speck of opacity the disease may be said to grow, often
in radiating lines, until at length the whole of the lens is implicated, and thus a number of separate spots, which are detectable in the early stages of the disease, become consolidated into one opaque mass. A somewhat different series of changes occurs in the development of
cataract by exudation, which seems to affect the whole of the lens at the same time, modifying its transparency very slightly in the first instance, |
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Fig. 257.—Capsular and Lenticular Cataracts
as, Crystalline Lens, b, Capsule of the Lens, c, (Diagram A), Capsular Cataract.
c, (Diagram B), Lenticular Cataract. |
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causing merely a slight cloudiness which gradually becomes more marked,
going on to what is described as a milky condition, and ending in the chalky state which is really complete opacity. It is somewhat remarkable that, to the eye of the examiner, the lens presents a milky appearance, when on post-mortem examination it has been found to present a marked amber tint without the least trace of whiteness in any part. The deposit, how- ever, is sufficiently dense to render the body incapable of transmitting light. It is interesting to notice that the older writers had very much the same idea of the pathology of the disease as is entertained at present. They referred to the opacity of the crystalline humour, and mentioned the circum- stance of the opaque spots affecting the capsule or some of the layers |
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(lamellae) of the lens itself. They looked upon cold, injury, and, in
particular, periodical attacks of inflammation of the eyes as the chief causes of cataract. Bracken and Gibson, in 1737, and James White, in 1802, trace the
disease to repeated attacks of inflammation, and by the terms of their description they leave no doubt in the mind of the reader that the disease to which they trace the origin of cataract is the periodic ophthalmia of later times. Particularly they note that when the cataract is fully formed the ophthalmic disease ceases to appear at the accustomed times. Gibson remarks that the disease known as moon-blindness, which is
one of the terms applied to periodic ophthalmia, was really nothing but the prognostic of the breeding of cataracts, and he adds that he does not remember to have met with a case, excepting in the eyes of a horse, which had been called moon-blindness. James White also speaks of heredity as a cause of moon-blindness, and that of the most intractable sort. Notwithstanding the various causes from which cataract is said to result,
there is no doubt that it sometimes appears without the animal giving any evidence of active disease. The writer has known several instances of this kind, where cataract developed without any obvious cause and without any symptoms of inflammation being presented. The question of treatment has always given rise to a good deal of differ-
ence of opinion. In the time of Drs. Bracken and Gibson the operation of couching, as it was called, was very well known to them, and they agree that the disease cannot be cured by any outward application of remedies, but only by a surgical operation, which they admit is not applicable to the lower animals on account of the impossibility of adjusting an artificial lens to compensate for the loss of the actual one. In this respect, how- ever, the modern oculist may claim some little advance. Dr. Eandolph of the Johns Hopkins hospital published some time ago an account of the removal of two cataracts in a clog. The writer comments on the general belief that artificial lenses are absolutely necessary, and goes on to state that, according to his own experience, their use has been much overrated, and he quotes cases of his patients who obtained, after some considerable practice, a fair degree of vision without the use of spectacles. In support of his opinion he mentions cases of a reproduction of the lens in perfect form after complete removal. Dr. Eandolph's own operations on dogs suggest the possibility of restoring a certain degree of visual power to animals which are perfectly blind. In the case of the dog the operation of the removal of the lens was performed under chloroform on one eye, and in three weeks the sight was so far restored that the dog was able to make his way rapidly through a passage made by placing chairs for the purpose, ana |
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to jump over a chair which was placed in a doorway. The operation on the
second eye was equally satisfactory, and after recovery the animal was used by his owner with other pointers in the field, and was reported to be quite equal to them in his work. Dr. Eandolph ascertained that several similar cases had been reported in
foreign journals. In one case an ass was the subject, with what result is not known; but the fact of the restoration of the lens after removal in dogs, rabbits, and cats renders it at least probable that the same thing might happen in the case of the horse, and the experiment is worth a fair trial, especially when the disease is detected in the very early stage. DISEASE OF THE OPTIC NERVE—AMAUROSIS
Total blindness may be the consequence of disease of the optic nerve, or
its expanded filaments which form the retina within the globe, without the exhibition of any symptoms which would be apparent in the eye to the ordinary observer. In the disease which is known as amaurosis the retina or expansion of the optic nerve is insusceptible to the action of light, which therefore ceases to be a stimulant to the nerve. Consequently the circular fibres of the iris which close the pupil do not contract, and the pupil remains widely dilated even in the strongest light. The eye is perfectly transparent, and to the inexperienced observer affords no indication of unsoundness. If the disease is limited to one eye it may exist for some time without being detected, but the tendency always is for it to extend to the optic nerve of both eyes, and in that event the horse shows that the sight is defective even in the earlier stages of the malady in a manner sufficiently well defined to attract the attention of the attendant, who will probably examine the eye without finding anything wrong. An inspection by a professional man will lead to the discovery of the
inactive conditions of the muscular fibres of the iris, but until the disease has advanced so far as to cause total blindness, the iris will still to some extent contract and lessen the size of the pupil in a strong light. The expert will, however, observe that the contraction is very sluggish, but he may hesitate to diagnose the affection as amaurosis unless he is familiar with the use of the ophthalmoscope. With this instrument there will be no diffi- culty in getting a good view of the optic disc, as the deficient sensibility of the nerve structures will render the horse indifferent to the light which is- thrown into the interior. On getting a view of the optic disc in an amaurotic eye it will at once be evident that the normal pink tint has. been replaced by a white or grayish colour, and the vessels also will be indistinct in consequence of the small quantity of blood circulating in them. |
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DISEASES OF THE EYE AND ITS APPENDAGES 123
When amaurosis has advanced so far that the animal is totally blind
it will generally be comparatively easy to form a correct diagnosis. The dilated and immovable condition of the pupil, which is in no way affected by a strong light, is in itself almost sufficient, but it also may be ascertained in various other ways that the sight is lost. The manner in which the animal progresses is one of the most striking
indications of the existence of blindness. The fore-limbs are lifted un- usually high, the head is elevated, the ears are constantly at attention, and the gait is of the careful, dwelling kind. A common but not infallible test is that of riding the horse, quietly of
course, on to a wall, which he will touch with his nose before becoming aware of its existence. This is a better method than that of making a feint to strike the animal with a stick, because the motion which is given to the air by the movement of the stick and the hand which holds it is often sufficient to induce the horse to jerk the head away under the impression that some foreign body is approaching him, thus leading the lookers-on to suspect that a certain amount of visual power still exists. The great importance of the use of the ophthalmoscope for the examina-
tion of eyes which present any abnormal character, however slight, will be understood when it is remembered that an animal with partial or even complete amaurosis may be passed sound by a careless examiner. No treat- ment is ever attempted for the cure of amaurosis in the lower animals. Small doses of strychnia have been employed in the treatment of the disease in the human subject with slight benefit, which has, however, generally proved to be temporary. Galvanism has also been used, with result of improving the sight for a short time, but neither of these remedies has produced sufficiently good results to justify any recommendation of them in the treatment of amaurosis in the horse. GLAUCOMA
This disease is of very rare occurrence in the horse. It consists of
an increased tension within the eyeball in consequence of an excessive secretion of the aqueous and vitreous humours. As a result of this the eyeball is rendered full and unyielding to the touch, and somewhat elongated from before to behind. By this change of form the animal becomes myopic or short-sighted. One or both eyes may be affected, but it is usually the case that the disease attacks each in succession, and unless combated by treatment results in serious derangement of the in- ternal structures, of which cataract is not an uncommon consequence. The symptoms of glaucoma are variable, but it will be generally found that |
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the pupils are dilated and sluggish in their contraction. The anterior
choroidal veins are large and visible, and the globe is hard and resisting to pressure. The media are quite transparent, but the movements of the animal indicate defective vision. When examined by the ophthalmoscope the surface of the optic disc is found to be more or less concave and pallid, and the veins are remarkably increased in size, while the arteries are diminished. The remedy in these cases consists in the operation of iridectomy, or removal of a portion of the iris. |
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12. THE SKIN (INTEGUMENT) AND ITS APPENDAGES
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The external covering of the body, whether of the vegetable or of the
animal organism, is familiarly known as the skin, a word of somewhat |
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signification the skin
takes its place among the organs of special sense, being largely supplied with nerves which are capable of appreciating the impressions resulting from contact with other bodies, and also impressions of weight and altera- tions of temperature. In describing its structure it is usual to refer to two principal layers, the outer, composed of cells, and called the cuticle or epidermis, and the lower, entitled the derma or chorium or cutis. Cuticle.—The cells comprising the cuticle are arranged layer upon
layer, and derive their nourishment entirely from the secretory vessels of |
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the underlying derma. The cells which are immediately in contact with
the true skin are more or less rounded, but become gradually altered in figure as they approach the surface, passing through the oval, the elongated oval, the elliptical, and finally being resolved into flattened scales which overlap each other much in the same way as do the tiles of a house (fig. 258). These changes in form and substance are occasioned under the combined influence of the upward pressure from below of the new crops of cells, which are constantly being developed, and of the downward pressure of the atmosphere on the surface, aided by the gradual evaporation of the fluid contents of the cells. The outermost layer of the cuticle is commonly |
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Fig. 259.—1, Simple, and 2, Compound Papilla? of the Skin. A, Nerves. B, Capillary Loops.
c, Tactile Corpuscles.
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called the horny layer, while the deeper portion, which consists of the
younger and more recently-developed nucleated cells, some of them con- taining coloured matter (pigment cells), forms what is termed the rete mucosum. These two layers pass gradually one into the other, so that it would be difficult to say at what precise point the separation can be made. The cuticle forms a sufficiently dense covering to protect the sensitive and vascular parts beneath, and as it is constantly being thrown off from the surface in the form of scales, which are familiarly known as scurf, it follows that it must be as constantly renewed from below. It is not, however, to be supposed that the cuticle forms a perfectly continuous coat spread over the structure of the true skin. On the contrary, it is pierced by innumerable openings to afford an exit to the watery excretion of the sweat glands, the fat-like material of the sebaceous follicles, and the hairs which emerge from the openings of the hair follicles. |
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Although the cuticle, as has been shown, consists of different layers
of cells from the deeper, recently-formed globules, through the oval, and elliptical, to the flattened scales, it constitutes a very small portion of the total thickness of the skin. Cutis Or Derma.—The cutis, derma, or true skin, is composed of a
basis of dense fibrous structure, the fibres of which are closely interwoven one with another. Distributed through the meshes of the fibrous base of the skin are various glands and follicles. In the deeper-seated portions there are small masses of fatty tissue embedded in the fibrous net-work. At the superior part of the true skin exists what is called the papillated layer of the derma, so termed from the small papillae which everywhere stud its surface. It consists of vascular and nervous elements. The blood- vessels here are arranged in the form of capillary loops; the terminal branches of nerves wind round minute prolongations of tissue in which the sense of touch exists, and which are consequently termed tactile papillae, or tactile corpuscles (fig. 259). Glands of the Skin.—The glands of the skin are of two kinds:
1, sebaceous or fat-forming; 2, sudori-
parous or sweat glands. Those from which the sebaceous secre-
tion is produced are minute lobulated structures situated in the fibrous tissue of the derma (6, fig. 260). The sebaceous glands are provided with ducts, some of which open on the surface of the cuticle, but by far the greater number pour their secretion into the hair follicles. They are necessarily very numerous in animals |
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Fig. 260.—Section of Skin, showing Glands
and Hair Follicles |
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which have a hair covering. These
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1, Epidermis. 2, Derma. 3, Areolar Tissue.
4, Hair Follicle. 5, Hair. 6, Sebaceous Gland. 7, Sudoriparous or Sweat Gland. 7', Duct of Sweat Gland. 7", Opening of Sweat Gland. |
glands are always most abundant and
of larger size and greater activity in those parts of the skin which are con- |
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stantly subject to movement, as in the
bends of joints, and it is extremely probable that at each flexion and extension of a joint a certain amount of sebaceous matter is squeezed out of the ducts, thus keeping the skin in a soft and supple condition. The sudoriparous or sweat glands are situated deeper in the substance of the true skin than those above described. Some of them even pass beyond it into the subcutaneous areolar tissue. These sweat glands are not lobulated as the sebiparous or sebaceous glands are, but consist of one or more long tubes twisted upon themselves so as to form a more |
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USES OF THE SKIN
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or less rounded or ovoid gland, terminating in a single excretory duct
(7", fig. 260). The canal by which the watery secretion is discharged on to the skin as " sweat" takes a somewhat spiral course, which becomes most evident as the tube passes through the epidermis to terminate in a minute opening on the surface. USES OF THE SKIN
Skin as a Protective Covering.—One most obvious function of the integument is that of binding the structures beneath it in such a way
as to allow freedom of movement, while it keeps them in their relative positions. It varies considerably in its thickness, density, and degree of elasticity in different parts of the body. In the most exposed situations, as the back, it is much thicker and denser than in other parts of the body less exposed to pressure and friction. On the inner surface of the arms and thighs, where it is protected against the forces referred to, its texture is extremely fine, and the hairy covering is either altogether absent, or tne hairs are very sparsely distributed over it. At the bends of joints the presence of a larger number than usual of sebiparous glands renders the skin particularly flexible by virtue of the lubricating action of the secretion which is constantly being poured out by them. The great advantage of this arrangement is rendered all the more evident when anything occurs to disturb it. Any interference with the secretion, or obstruction to the outpouring of the matter secreted, results in the skin in that part becoming dry, scurfy, and inflamed, developing conditions commonly known as chaps and cracks. On the other hand, in certain disordered states the secretion may be formed in excess of that which is required, when it constitutes the disease termed " grease ". Skin as an Organ of Touch.—The skin is described commonly as
an apparatus of touch, a sense which resides in a special manner in the terminal parts of the extremities and the lips. It is, however, distributed more or less over the whole surface, varying in acuteness in different parts of the body. Dr. Carpenter refers, in his Principles of Physiology, to the researches of Prof. E. H. Webber and Dr. Ballard in reference to the relative sensitiveness in different parts of the skin. One test was that of employing the legs of a pair of compasses, the points of which, guarded with pieces of cork, were brought together as close as possible, until the smallest distance at which they could be felt to be apart from one another was reached. This was termed by Dr. Graves as the limit of confusion. A table is given, showing the limit of confusion, from which the following instances are taken. In the first place, the point of |
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the tongue proved to be most sensitive, as it was capable of appreciating
the two points of the compass when the distance between them was only half a line. On the palmar surface of the third finger it was one line; on the red surface of the lips, two lines; on the tip of the nose, three lines; on the skin of the cheek, five lines; on the mucous membrane of the gums, nine lines; on the skin over the sternum or breast, twenty lines; on the skin over the spine of the back, thirty lines. Investigators who followed up Prof. Webber's experiments found, as might have been expected, a con- siderable amount of individual variation, some persons being able to appre- ciate the points at a half, even at a third, of the distance required by others. The sensibility in the skin to impressions of weight has also been tested
by different investigators, and it was found that, on the face, the pressure of a portion of elder pith presenting a surface of nearly -§- inch square, and weighing only ■%% grain, could be distinguished, whilst the tips of the fingers required a weight of -§• grain and more, the toes as much as 8 grains, before any sensation of pressure was felt. In regard to temperature, it was found that the left hand was more sensitive than the right, although the right has the sense of touch most acutely developed. The curious fact was also noticed, that a weaker impression made on a large surface conveys the idea that it is more powerful than a stronger impression on a small surface; thus, if the forefinger of one hand be immersed in water at a temperature of 104°, and the whole of the other at 102°, the cooler water will be felt to be the warmer; further, it is a known fact that water in which a finger can be held will scald the whole hand that is plunged into it. From these experiments it may be gathered that the sense of touch does not afford much assistance in obtaining accurate information as to the temperature of bodies. Indeed, it is well known that the temperature of the surface of the person who makes the experiment has its effect. For instance, a cold hand will appreciate a very slight rise of temperature in anything it touches, whereas it would distinguish little or no change in touching a body which was nearly the same temperature as itself. Skin as an Organ of Absorption.—Absorption through the surface
of the integument has always been a matter of dispute. At one time a system of administration of medicine was in fashion, under the name of the endermic system, and was certainly based on a decided belief in the absorbing powers of the skin, but the system itself implied the use of con- siderable friction with mercurial preparations mixed with fatty materials in the form of ointment, the fatty matter being the more readily absorbed if it were rancid. It is stated that De Collin produced absorption in an experiment to which he had recourse, which consisted in causing water impregnated with cyanide of potassium to fall in drops on a horse's back |
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for several hours; the horse died from poisoning resulting from the passage
of the salt, through the skin, into the system. The power to absorb water through the skin was maintained in former
times, but modern physiology rejects this idea entirely; in fact, the cir- cumstance of patients affected with skin diseases remaining immersed in water for long periods, and still being subject to thirst, and requiring to drink as much liquid as if they were not in the water at all, proves that no appreciable quantity of that fluid is taken in through the skin. On the whole, the power of the skin to absorb fluid is generally accepted as an extremely limited one. It appears, however, that the skin can be permeated by gas. Bichat's experiment proves that the skin of a limb, if immersed in putrid gases, absorbs them, and it is alleged that all kinds of miasma may penetrate into the organism in this way with ease. Common observation suggests that the absorbing powers of the skin may have been underrated; it is admitted that it acts to a certain extent as an organ of respiration, absorbing oxygen and exhaling carbonic acid. It is recorded that Gairlach collected \ oz. carbonic acid in half an hour from the skin of horses at rest, and 3 ozs. at work. The poisonous action of certain fluids when applied to the skin in the ordinary processes of sheep-dipping, and dressing the skin for mange and other diseases, has come under the writer's own notice repeatedly. On one occasion liquid carbolic acid was painted over the skin of two dogs suffering from mange, under a mistaken impression as to the proper mode of using the agent, which should have been mixed with fifty parts of water. The immediate effect was the occurrence of a species of epileptic fit; the animals fell over on to the ground, frothing at the mouth and showing a spasmodic twitching of the muscles. The prompt application of warm water with plenty of soap, by the aid of which the greater part of the lotion was removed, relieved the urgent symptoms, and the dogs ultimately recovered, but they continued to suffer from depression, loss of appetite, and difficulty of movement for several days. On another occasion the dipping of sheep in a mixture of carbolic acid
soap and a small quantity of turpentine, with the addition of 40 parts of water to 1 part of the mixture, was followed by the sudden death of five sheep in succession, after they had been kept in the dipping-tub for the usual two minutes. Directly the fleece had been wrung by the attend- ant for the purpose of removing excess of fluid, the animals rolled over on to the ground in violent convulsions, and were dead in the course of a few seconds. On looking at the mixture, which was the same that had been used repeatedly with perfect success, a quantity of brown scum was discovered on the surface, proving that the carbolic acid had not become Vol. II 43
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130 HEALTH AND DISEASE
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emulsified as it should have been, for the reason, as it was afterwards ascer-
tained, that the water was extremely hard. The addition of some washing- soda to the water had the effect of producing a perfect emulsion, and the process of dipping the flock was continued without any further disaster. It had previously been known that the poisonous action of carbolic
acid was especially marked when the agent was applied to the skin, and the explanation ordinarily given was, that it acted as a powerful depressor of nerve function. It must, however, be allowed that it could not possibly act upon the nerves without being absorbed in the first place through the cuticle, beneath which the nerves terminate on the surface of the true skin. The absorption of fatty material by the skin probably largely depends
on the affinity which it has with the sebaceous secretion, enabling it to pass into the follicles, and there certainly appears to be good reason to suppose that some of the nutritive constituents of milk are thus taken into the system, especially the fatty matters, as young children when incapable of taking nourishment by the mouth have been sustained for some time by being kept for considerable periods in baths of warm milk. Skin as an Organ Of Secretion. — Whatever importance may be
attached to skin as an organ of absorption, its activity as a secreting organ is altogether beyond question. In the first place, the cuticular cells are constantly being thrown off under the influence of attrition, and the vascular surface of the true skin is actively engaged in furnishing material for the reproduction of new cells. Further, the sudoriparous and sebiparous glands discharge both fluid and solid substances, in the form of secretions, which, as will presently be seen, perform important functions. As has already been stated, the sudoriparous or sweat glands, which are extremely numerous, separate a fluid from the blood, a con- siderable quantity of which is constantly being given off as invisible vapour, or insensible perspiration; while under conditions which excite the circulation and still further increase the body temperature, a large quantity of liquid is poured out, carrying with it a considerable amount of solid material, in which is contained various salts of the blood, as well as a large number of acids, including butyric, formic, propionic, and an acid peculiar to the sweat, which is called sudoric. This fluid perspiration is distinguished as sensible perspiration. The reaction of the sweat is generally acid. From some parts, perspiration contains a larger proportion of fat than from others, in association with certain nitrogenous matters, urea among them. It is understood by physiologists that the nervous system has considerable influence in regulating the function of perspiration. One very important purpose which the perspiration serves, is that of
lowering the temperature of the body by evaporation, and another is the |
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APPENDAGES OF THE SKIN 131
removal of a quantity of waste material, or excreta, from the system.
Suppression of the function permits an accumulation of effete products in the body, to the detriment of the general health. One of the first effects which follow is the lowering of the temperature, and certain changes in the fibrin of the blood, which is bound to be increased in quantity, and the occurrence of glandular swellings. In the case of animals which have died after being covered with a coat of varnish, it has been found that crystals of the triple phosphate of lime and magnesia are deposited in the cellular tissue and the muscles. Some of the effete products, however, which accumulate under these conditions are eliminated by the kidneys, and these organs consequently become overtaxed and congested, leading to impairment of their function and consequent retention of the urea, which it is their special province to excrete. Sebaceous Secretion. — Glands which furnish this secretion are
found distributed more or less over the entire body. As we have ex- plained, the majority of them open into the hair follicles, where they discharge their secretion, the use of which is to lubricate the skin and preserve its elasticity and softness. The sebaceous matter consists of two-thirds water, the remainder being fats, extractive matters, a small quantity of albumenoids, and earthy salts. Summary.—To sum up the functions of the skin: first in importance
is the protection which it affords to the sensitive parts beneath; next, there is its sense of touch, variously developed in different parts of the surface of the body; then its power of perception of the weight and tem- perature of bodies, its use in some degree as an organ of respiration, and finally, its influence as an excretory and secretory structure. APPENDAGES OF THE SKIN
The appendages of the skin are only two in number: i.e. hair, and its
modifications in the form of horn, nails or claws. Hair.—Hair arises from the bottom of small pits, or follicles, situated
in the true skin, in some cases passing completely through it into the tissues beneath (4, fig. 260). Each hair is composed of a bulb, a portion of which is concealed in the follicle, and commonly described as the root, and a free portion or shaft which projects from the surface. The bulb of the hair consists of an aggregation of young epithelium. At its lower extremity it is hollowed out, and fits on to a small papilla at the bottom of the hair follicle. Hairs possess a covering of flattened scales or cells arranged, like the
outer layer of the cuticle, in the form of tiles on a roof. The outline |
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of each cell is perfectly well defined on the surface of the hair, as can
be seen by examination under a moderate magnifying power. The epi- dermis extends into the follicle very near to the bulb. Within the epidermis or outer layer is the cortical substance of the hair, in which the pigment granules, to which it owes its colour, are distributed. The cortical substance forms the chief part of the bulk of the hair. It is composed of long elliptical fibres, which may be reduced to their elements, i.e. epithelial lamellae with their nuclei. Under the microscope this portion of the hair exhibits the appearance of longitudinal stripes or fibres. The third portion of the hair is the so-called medullary substance; this occupies the narrow cavity in the centre, which extends from the bulb upward towards the point. The hair follicle, in which the root is em- bedded, is really an involution or doubling down of the skin itself. It presents for notice, proceeding from
the inside of the follicle, a membranous structure, consisting of cells similar to those forming the deep layer of the cuticle, rete mucosum, on which is imposed the internal sheath of the hair, in reality the involuted epidermis. Besides hair of the ordinary kind as described, there are certain varieties which present special characters. For |
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Fig. 261.—Section of Hair Follicle
A, Dermic Coat of Follicle, b, Outer Layer of
Dermic Coat with Blood-vessels, c, Inner Layer of Dermic Coat. D, Epidermic Coat or Root-Sheath. E, Inner Root-Sheath, f, Hair, g, Lymph Space. |
example, what is ordinarily described
as " horse hair", and employed for the purpose of stuffing cushions and weaving into coverings, is an extremely |
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coarse variety, occurring in the fore-
lock between the ears, passing along to the top of the neck as far as the withers, constituting the mane, existing also upon the margin of the eyelids, eyelashes, and growing here and there on the outside of the lips and below the eyes, described as tentaculee. These coarse hairs are developed in the most prominent form upon the tail, from which they grow to an extraordinary length, reaching almost to the ground if left uncut. Similar hairs also grow at the back of the fetlock joints, in- vesting the horny growth which is known as the ergot. The variety of hair which is described as wool, is distinguished by
its fineness and softness. It does not, however, under the microscope, present any elements which differ from those already described. Horn.—This structure may be correctly described as a form of hair
cemented together into a dense mass, and employed to protect those parts |
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of the body—the feet, for example—which are subject to constant attrition.
In the horse there are first and most important the hoofs, which protect the internal foot, the oval-shaped bodies on the inside of the fore-legs immediately above the knee-joint, and the inside of the hind-legs, just below the hock, described as chestnuts, and the bodies which have already been mentioned behind the fetlock-joints, the ergots. A careful exami- nation of all these horny productions will prove that in their elementary structure they are composed of the same elements as the hair which covers the animal body. They rest upon, and are secreted by, a papillated membrane, and consist entirely of cells varying in form and character much the same as they do in the several parts |
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of the hair, from the centre to the surface. The
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Fig. 262.—Lamellae of Horn
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horn fibres or hairs passing from the coronet to
the ground surface, forming the crust, and the horn fibres passing from
the vascular membrane at the bottom of the foot to the ground, forming the sole, may all be resolved into epithelial cells, like those of the cuticle. Altogether, the structure of horn may be said to consist of bundles of hair closely applied to each other to form a compact covering to the parts |
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Fig. 264.—Longitudinal Section of Horn
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Fig. 263.—Transverse Section of Horn
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beneath. In certain diseases, " canker" of the feet, for example, the horn
on the diseased surface always appears in the form of tufts of hair, or of horn fibres, which, in consequence of the disease, have failed to adhere and form a compact structure. The study of the anatomy of the hair of different animals, as compared with the horny production, is an exceed- ingly interesting one, and it is perfectly easy to find the analogues m the hairs of some of the thick-skinned animals, such as the rhinoceros and the elephant, transverse sections of which, when examined by the microscope, can hardly be distinguished from transverse sections of the hoof of the horse. |
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DISEASES OF THE SKIN-
CLASSIFICATION A section on diseases of the skin presents to the writer certain diffi-
culties, not on account of the want of material, but rather from its redundancy. The reader may be inclined to observe, speaking from his own experience, that a very limited literature should be sufficient to deal with the affections which attack the exterior of the animal body. The contrary is in reality the case. Dermatology is a very wide subject, and during the past century a large number of most distinguished medical authorities on the Continent, especially in Germany and France, and also in England, have devoted almost exclusive attention to disorders of the skin. Among the writers in Germany the names of Ferdinand Hebra and Virchow, and in England Willan, Bateman, Erasmus Wilson, Todd Thomp- son, M'Call Anderson, Tilbury Fox, Malcolm Morris, may be mentioned among a host of other distinguished men. Wilkin's system of classification formed the basis of the other different systems which have from time to time attracted the attention of the scientist, but even some of our modern writers still hold that the system of Willan and Bateman is for practical purposes preferable to what is called the natural and the pathological systems of classification. The first attempt to classify diseases of the skin was made by
Hieronymus Mercurialis in 1572, by whom skin affections were divided according to their locality, as those of the head and those of other parts. This simple arrangement was added to by Daniel Turner, in 1743, and by Alibert in 1806, who subdivided the diseases. Scientific classification is said to have begun with Plenck, Vienna, 1776, who took as his basis the objective features of the diseases, grouping Affections of the Skin under fourteen heads: (l) Macules, (2) Pustules, (3) Vesicles, (4) Bullee, (5) Papules, (6) Crusts, (7) Scales, (8) Callosities, (9) Excrescences, (10)
Ulcers, (11) Wounds, (12) Cutaneous insects, (13) Diseases of the nails, (14) Diseases of the hair. This classification to some extent was modified by Willan, who used the
terms (l) Papules, (2) Scales, (3) Exanthemata, (4) Bulke, (5) Pustules, (6) Vesicles, (7) Tubercles, (8) Macules; and Willan's pupil Bateman added
Dermal excrescences. Erasmus Wilson adopted an anatomical system of classification, grouping
the skin affections according to the structures in which they arose, making four divisions: (1) Diseases of the derma, (2) Diseases of the sudoriparous |
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DISEASES OF THE SKIN 135
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glands, (3) Diseases of the sebiparous glands, (4) Diseases of the hair and
hair follicles. Hebra in 1845 adopted a pathological system, dividing skin diseases
into twelve classes: (l) Hyperaemias, (2) Anaemias, (3) Anomalies of secretion of glands, (4) Exudations, (5) Haemorrhages, (6) Hypertrophies, (7) Atrophies, (8) Neoplasms, (9) Pseudoplasms, (10) Ulcerations, (ll) Neu- roses, (12) Diseases caused by parasites. Dr. Tilbury Fox, whose work on skin diseases is constantly referred to
by dermatologists, proposes a system of classification which he considers will be found the best for all practical purposes, in the following ten groups:—(l) Eruptions of the acute specific diseases, such as small-pox, &c. (2) Local inflammations, including erythema, roseola, urticaria (nettle-rash)
and certain medicinal rashes; catarrhal inflammations, as in eczema; papu- lar inflammations, for example, lichen and prurigo; bullous inflammations, including herpes, &c; suppurative inflammations, including pustular erup- tions; squamous inflammations, including pityriasis, rubra, and psoriasis. (3) Diathetic disorders, including strumous and leprous diseases of the skin.
(4) Hypertrophic and Atrophic diseases, as warts, corns; and ichthyosis,
affecting the epithelium; also keloid, fibroma, scleroderma, affecting the con- nective tissue of the skin; and among atrophies, senile decay and atrophy. (5) New formations—cancer, lupus, and rodent ulcer. (6) Haemorrhages,
for example, purpura. (7) Neuroses, as hyperaesthesia, anaesthesia, and pruritis. (8) Pigmentary alterations. (9) Parasitic diseases, including animal or dermatozoic itch, and phthiriasis or lousiness, effects of fleas, bugs, gnats, &c, and vegetable or dermatophysis, as in different forms of ringworm. (10) Diseases of the glands and appendages, sweat glands and sebiparous glands, diseases of the hairs and their follicles, and diseases of nails. This method of classification appears to be most applicable to the skin
diseases of the horse. GENERAL OBSERVATIONS ON THE SUBJECT OF DIAGNOSIS
AND TREATMENT
It may be stated at the outset that the horse is comparatively exempt
from many of the diseases referred to in the systems of classification which have been quoted; but in making this admission it is important to note that the skin diseases of the horse did not attract any particular attention from the older veterinary writers, and even in regard to the authorities of the present time, although they have adopted a system of classification taken with certain modifications from the system accepted by the most distinguished dermatologists, nothing like a special course of study of the |
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136 HEALTH AND DISEASE
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skin diseases affecting the lower animals has yet been initiated in our
schools. It seems to be even now taken for granted that in its veterinary aspect dermatology need not be elevated to the prominent position which it occupies in medical science as applied to the human subject. It will not, however, be out of place to suggest that a closer study of the methods of diagnosis, prognosis, and principles of treatment, might lead to considerable changes in the above views. DIAGNOSIS
To arrive at a correct conclusion as to the nature of any form of skin
disease, the examiner must be armed with practical knowledge of the various types in which eruptive affections are exhibited, the course which the particular eruption follows, and its probable termination; and par- ticularly is it essential that he should know whether the affection is acute or chronic, and whether it is of a kind which comes under the heading of periodicity, and whether it is associated with any form of specific fever. In cases of diseases of the skin which are not attended at the time
of the examination with any kind of eruption, the general condition of the animal and any change in the colour of the skin have to be noted, in order that an opinion may be formed as to the probability of an eruption appearing as the disease advances. In short, it is most important to determine by critical examination the exact nature of what are called by pathologists elementary lesions, all of which are distinguished by certain terms. For example, when the skin is discoloured by some alteration in the quantity or arrangement in the colouring material as the result of the irritating action of parasites, or by chemical agents, the term maculae is applied to the discoloured patches. Stains which are due to the escape of blood from the vessels of the skin are designated purpura, and are therefore excluded from the designation maculae. Erythema means a redness of the skin arising from a determination
of blood to a part. The appearance itself is easily recognized, but taken alone it does not indicate the particular disease out of which it arises, as it may depend upon a variety of causes. Wheals. — This term is used to indicate certain elevations of the
surface of the skin, the centre of which presents a pale colour, having the appearance produced by the sting of the nettle. Wheals are caused by sudden dilatation of the blood-vessels, followed by the escape of fluid from them into the centre of the swelling. These appearances, however, are not generally recognizable in the horse, owing to the colour of the skin and the covering of hair. |
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DISEASES OF THE SKIN 137
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Papules, meaning pimples, are of various kinds, ranging from minute
specks clue to excess of blood in the papillse of the skin, to the larger elevations caused by distension of the follicles, or by the deposition of lymph around them, or by solid deposits in the true skin. There are also papules or pimples formed by the collection of sebaceous secretion within the follicles, and others resulting from hypertrophy or overgrowth of normal structures, forming minute fibrous excrescences or small warts. Vesicles are really small bladders or blisters containing a watery
fluid; they naturally vary in size according to the amount of fluid which they contain. When the bladders are sufficiently extensive to be de- scribed as large bladders they are termed bullae; thus, as the result of an ordinary blister, large and small water bladders, otherwise vesicles and bullse, will easily be distinguished. Pustules.—These elevations are distinguished from vesicles by their
contents. While the vesicle contains clear watery fluid, the pustules always contain pus, and are the result of more active inflammation than occurs in simple vesicular eruption. Vesicles in some diseases become converted into pustules as a consequence of a more intense inflammation arising in the course of the ailment. Squamae.—The word is used to indicate scales, which are obvious
enough on a mere cursory examination. A scaly condition of the skin may be an accidental condition, and simply denote want of cleanliness, or it may be an indication of irritation of the surface, or the outcome of some specific disorder. Pityriasis, or bran disease, is not uncommon in the horse, and is a
good illustration of the condition of skin which is described as squamous. Tubercula are small lumps or large pimples, which are hard and
circumscribed, and are commonly permanent. Occasionally they undergo slow suppuration, but ordinarily remain as small fibrous tumours, which are of no special significance unless they occur on parts of the body with which the harness is brought into contact, as on the shoulders and back. Besides these changes in the skin which have been described, there are
to be found crusts or scabs which consist of the dried exudation matter dis- charged from a broken surface. They vary in their appearance according to the character of the discharge, to the drying of which they owe their origin. Ulcers are well known as complications in certain forms of skin disease.
They consist really in destruction of the tissues of the true skin, arising either from simple inflammation, or from a specific disease, as in glanders. Excoriations are those superficial injuries due to the removal of the
cuticle by friction between two surfaces of the skin, or by the act of |
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138 HEALTH AND DISEASE
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rubbing, scratching, or biting to relieve itching, or from the pressure of
harness. Having satisfied himself as to the existence of one or more of these
morbid conditions, the examiner is in a position to make a preliminary diagnosis, possibly to form also a prognosis, and also to arrive at some conclusion as to the cause of the disease and the principles of treatment. ETIOLOGY
The causes of skin disease are numerous, and will naturally be a subject
of enquiry as soon as a diagnosis is arrived at. First, it will be evident that the causes must be either general or local, but it would appear that the two greatest dermatologists differed widely as to which of these two was in operation. Hebra contends for the local origin of skin diseases, while Erasmus
Wilson adopts the reverse of that doctrine, and advocates the view that skin diseases are, more commonly than not, the expression of some internal derangement. The question is, however, only one of degree, as it is uni- versally admitted that there are skin diseases both of local and constitutional origin. A good idea of the causes which are generally in operation, as well as
example of the diseases they respectively induce, may be gained by reference to the following succinct, and at the same time comprehensive statement, made by Dr. Tilbury Fox in his work on skin diseases:— 1. Poisons of acute specific diseases. Examples, those of small-pox,
scarlatina, rubeola, &c. 2. The circulation of special poisons: (a) of animal origin—as syphilitic;
(b) medicinal substances, e.g. arsenic, belladonna, copaiba, nitrate of silver, iodides, bromides; (c) dietetic, such as shell-fish, giving rise to urticaria, roseola, erythema. 3. Dietetic errors, as in wine-drinkers, high livers, non-vegetarians, &c.
leading to the increase of urea and uric acid in the blood. 4. The tuberculous, scrofulous, and lymphatic dyscrasiae, giving rise to
non-specific eruption—as impetigo, acne. 5. The gouty and rheumatic diathesis, as in lichen agrius.
6. Altered and lowered nutrition, from such causes as bad living,
poverty, misery. 7. The accumulation of excreta in the blood from suppression of natural
discharges, kidney disease, &c. 8. Convalescence from severe and lowering affections, by which the
body is rendered much less able to resist disease. |
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DISEASES OF THE SKIN 139
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9. Climateric or endemic influences, often malarial in nature, which act
by deteriorating the system generally. 10. Disorders of the liver and spleen, leading to pigmentary deposit in
various parts, jaundice and pruritus, &c. This extract has been modified by the omission of certain diseases which
are not recognized in the horse. All the morbid conditions above referred to relate to changes produced in the blood generally by the introduction of poisonous substances, or by the accumulation of animal poisons, or from the failure of the excretory organs to carry them out of the system. There are, however, in addition, to be considered various forms of mal- nutrition which lead to changes in the tissues of the skin. Changes are also produced by local irritants, as chemical agents, bums, and the ravages of parasites. It must be allowed, also, that there are certain conditions of the skin, due to heredity, which dispose the surface to certain forms of disease, such as psoriasis, cancer, and ichthyosis. Further, there are causes which act specially upon the nerves, as frequent contact with local irritants, changes of temperature. The action of local irritants, it may be observed, is frequently connected with occupation, illustrated in the case of horses which are working where building is being carried on, which exposes them to frequent contact with lime, either dry or moist, or in the case of hunters which are commonly used in districts where the soil contains some gritty or irritating particles which act upon the surface, giving rise to what is known as " mud fever ", a disease which is traceable also to the habit of washing the extremities and other parts of the body with warm water after work. To sum up the causes of skin diseases:—1. Changes in the blood
induced by poisons, dietetic errors, tuberculous disease, rheumatic ten- dency, general debility, effects of malaria. 2. Changes in the tissues, due to mal-nutrition, local irritation, whether from chemical or physical agencies, inherited peculiarities of the tissues. 3. Influences which act specially on the nerves, as dirt, exposure to excessive cold or heat, and sometimes organic disease of certain organs which by sympathy excite chronic congestion of different parts of the skin. PROGNOSIS
Having considered the possible or probable causes, the next step will
be to decide as to the duration of the disease, and the chances or otherwise of cure—matters in which the owner of the horse is always particularly interested. Prognosis will be materially assisted by a history of the case. In the first place, the ground may be cleared by the recognition of the |
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140 HEALTH AND DISEASE
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fact that skin diseases, with a few exceptions, are not fatal. Those affec-
tions which are hereditary are the most difficult to cure. Psoriasis, eczema, and urticaria, and, it may be added, those forms of itching which are not associated with any eruption, such as pruritus, are likely to recur, although they may yield to simple treatment. In the case of parasitic disease, such as ringworm and mange, in the
horse, the cure is generally tolerably easy if taken in the early stages; in cases where the animal has been long neglected, especially when the disease is due to the burrowing mite (sarcoptic mange), the cure some- times proves to be absolutely impossible, and in many of these cases the system has become so debilitated by the ravages of the parasite and the unrest of the patient that a fatal result is by no means uncommon. More frequently still it is considered advisable to destroy the subject as incurable. THE PRINCIPLES OF TREATMENT
Reference to the causes which have been indicated will at once suggest
that the remedies required may be purely local, or constitutional, or a combination of the two. In the case of purely local affections, such as the irritation excited by irritants, erythema, simple eczema, and parasitic diseases, local applications will usually suffice, although even in such cases it will have to be borne in mind that the state of the system will mate- rially influence the progress of the disease, and certain changes of diet, or regulations as to exercise and work, may be expedient, if not absolutely necessary. All forms of skin disease which come under the head of acute specific disorders—variola, horse-pox, urticaria from indigestion, medicinal rashes, lead poisoning, nerve diseases, and others of a like kind—will be dealt with by constitutional means; the employment of local remedies will be admissible as palliatives, as, for example, where the itching from medi- cinal rashes, neurotic diseases, sympathetic pruritus, or urticaria ah ingestis renders the animal restless and sometimes prevents it from taking its food. ERUPTIONS OF THE ACUTE SPECIFIC DISEASES
Variola Equina or Horse-Pox.—It is a matter of history that at
one time it was an accepted doctrine, in regard to the origin of vaccine
matter, that the disease in the cow which was described as cow-pox was the result of infection from a disease in the horse which attacks the heels of the animal and is named " grease ". According to Professor E. M. Crookshank, in his classical work on the
pathology of vaccination, the disease was thus described by Jenner: |
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VARIOLOUS ERUPTION
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EMBOLISM OF LUNG
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Showing vesicles, pustules, and ulcers on labia
and tail of mare. |
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A. A. Embolic abscesses.
B. Pulmonary haemorrhage.
C. Empty abscess.
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ERUPTIONS OF THE ACUTE SPECIFIC DISEASES 141
" There is a disease to which the horse from his state of domestication
is frequently subject. Farriers have named it the grease; it is an inflam- mation and swelling in the heel, accompanied at its commencement with small cracks and fissures, from which issues matter possessing properties of a very peculiar kind. " If the men who dressed the horses' heels were called upon to milk
cows, they communicated to them the malady known as the cow-pox." Several cases are recorded in proof of this statement, and from one
particular case Jenner was led to believe that the virus which produced cow-pox might be obtained from other parts of the body of the horse. It is now perfectly well known that the facts as stated are correct, but
that the explanation is wrong. The fact is that the horse suffers from a form of variola, and also suffers from cracked and greasy heels, and when horse-pox, equine variola, attacks a horse which happens at the time to be suffering from grease, the characteristic eruption of horse-pox is quite likely to appear in the already irritated skin of the heel, and in such case the matter of greasy heels, together with the variolous contagion, might every now and then be carried to the udder of the cow and produce cow-pox. It would, however, probably be more correct to look upon the recorded outbreaks of cow-pox which followed the act of milking by the hand of a man who had dressed the greasy heels of a horse as mere coincidences. It is quite certain that the matter of ordinary grease will not produce cow-pox; it is equally true that the horse is subject to a genuine variola, which, when transmitted to the cow, induces the other form of variola, i.e., vaccine disease. Horse-pox, or variola, although it undoubtedly occurs in this country
in isolated cases, has never assumed the virulence which it exhibits on the Continent. In Professor Crookshank's work on vaccination several exten- sive outbreaks are described. The first one which has been recorded occurred in 1860, and it is stated that in less than three weeks there were more than a hundred cases. The horses suffered from slight fever, rapidly followed by the local symptoms, swelling of some of the joints, and an eruption of small pustules on different parts of the body, especially on the lips, nostrils, buttocks, and generative organs. In about a fortnight the pustules dried up, the crusts with patches of hair fell off, leaving marked scars. In some instances the pustules appeared inside the nostrils, giving rise
to a suspicion that the animal was affected with glanders. Cases have occurred in this country of eruption of small pustules on the legs, outside of the nostrils, and on different parts of the body, simulating the form of |
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142 HEALTH AND DISEASE
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glanders which affects the skin and is known as farcy. These cases,
which have been described as pseudo-farcy, were in all probability horse- pox. Treatment.—In this affection there is little requiring to be done in
the shape of treatment beyond upholding the animal's general health by careful feeding and stable management. If the bowels are constipated, two or three small doses of sulphate of magnesia given in the drinking water will act as a corrective; it may be desirable to administer a little nitrate of potash in the food once daily during the existence of the disease, to prevent undue swelling of the legs. Local treatment should consist in sponging over the seat of eruption night and morning with a ten-per- cent solution of carbolic acid, and dusting a little boracic acid and flour over the pustules. The diseased animal should be isolated and placed under the care of
special attendants. All brushes, cloths, rugs, bandages, and stable utensils used for the
purpose of the sick, should not be brought into contact with the healthy. After the disease has disappeared, these, as well as the stable and its fittings, must undergo thorough disinfection and cleansing. American Horse-Pox.-—For several years past an eruptive disease
of the skin of the horse, characterized by the development of small pustules, has been recognized in this country, particularly among animals sent for exhibition. For some reason which is not well defined, the disease is considered to have been imported from America; it is usually mild in character, though for the time troublesome; the pustules very soon become dry, and the crusts fall off, leaving small scars which soon disappear. It is essentially a form of ecthyma, and will be treated under that heading. ERUPTIONS DUE TO THE CONTACT OF IRRITATING AGENTS,
OR TO THE CIRCULATION OF SPECIFIC POISONS IN THE BLOOD It is well known that various forms of skin eruptions are due to the
attacks of various insects, as lice, fleas, gnats, gadflies, &c, also from the ravages of acari; and certain vegetable parasites which establish themselves in or on the integument, for example, the well-known ringworm fungus. Eruptions also occur as the consequence of the contact of such agents as mustard, paraffin, solution of carbolic acid, arsenic, and even soft soap; when this agent has been used in strong solution for the purpose of washing the skin, and a quantity of it has been carelessly left upon |
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143
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LOCAL INFLAMMATIONS
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the upper part of the body, extensive eruption along the centre of the
back has been observed, in cattle particularly. It will be noticed that the degree of irritation produced is largely dependent upon the sen- sibility of the skin; when this is thin and delicate, the application of mustard or ammonia will often produce extensive erythema, followed by the formation of vesicles, and ultimately desquamation of the cuticle, and maybe a superficial ulceration, while the same agent applied to an animal with a coarse skin produces little or no effect. The use of arsenic as a caustic in the treatment of warts has sometimes caused extensive inflammation of the skin surrounding the wart, with considerable slough- ing. It has already been stated that horses working where the ground is covered with lime suffer from inflammation of the skin of the legs, accompanied by cracks or fissures. Sometimes inflammation of the glandu- lar structures of the skin arises out of the same cause, accompanied by a considerable discharge of sebaceous fluid. Internal agents, such as articles of food and various drugs, give rise
to eruptions in the skin of susceptible subjects; the eruption known as nettle-rash following the eating of mussels and other shell-fish by man is an instance of an eruption following the consumption of certain kinds of food. Medicinal agents are responsible for a large number of disorders of the skin, of the erythematous, papular, vesicular, and bullous type, all of which are known as drug eruptions. The occurrence of these diseases in the skin of the lower animals from the use of different drugs has not been recognized by veterinary writers, but there is no reason to doubt that they may occur from the continued employment for medicinal purposes of bromides, iodides, mercury, arsenic, salicylic acid, and other agents. Salicylic acid certainly has a marked local effect when given in con- siderable doses to cattle for the removal of large pendulous warts; after the use of the agent for this purpose for some weeks, the skin near the warts becomes inflamed, and the warts fall off in succession, leaving the raw surface, which rapidly heals. The use of the agent is then, of course, discontinued. The fact of the occurrence of eruptions of different kinds from the
action of external and internal agents should, under all circumstances, be taken into account in forming a diagnosis. LOCAL INFLAMMATIONS
A considerable number of the most common affections of the skin of
the horse, among them erythema, urticaria, eczema, ecthyma, &c, come under the head of local inflammations. |
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144
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Erythema is the term applied to any redness of the skin, whether or
not it is associated with an eruption. In its simple form erythema consists of patches of redness, which may be caused by friction, stimulating appli- cations, and, in short, by any irritating substance which will bring about congestion or undue fulness of the vessels. Erythema intertrigo is the name given to the redness produced by
friction between two surfaces of the skin, as sometimes occurs between the arm and the brisket—-that part which is called the axilla; it occurs also in the groin, especially of fat animals. A very characteristic form of erythema in the horse is familiarly known
as " mud fever ", on account of the disease occurring in wet seasons, when the ground is soft and sloppy. It is a common ailment among hunters, especially when cold winds prevail, and the legs and body become splashed with mud and made repeatedly wet and dry in the course of a hard day's hunting. It is somewhat curious that in particular districts the irritation caused by the mud is most marked, and certain parts of the country are credited with having soil contaminated with some irritating matter, which, however, cannot be discovered by most careful examination. The disease is manifested by irritation, soreness, and tumefaction of the
skin, generally accompanied by a certain degree of fever, swelling of the legs sometimes incapacitating the animal for several days. It now and again occurs that the hair falls off in patches, but the blemish thus caused is not as a rule permanent. A similar disease of the skin is also recognized among hacks and
working horses under certain circumstances, irrespective of locality. Animals used for any purposes during muddy weather, and particularly when the nature of their work renders it necessary that they should be constantly in use, often suffer severely. The disease is commonly most marked in the winter-time when snow is on the ground, and more par- ticularly when a sudden thaw takes place and cold easterly and north- easterly winds prevail. In this connection it has been noticed that in certain establishments, where the pressure of work or the shortness of hands occasioned neglect of grooming, the animals which on coming in from their work were turned into their stalls without having the mud washed from the legs and body escaped the mud fever altogether, while those which were carefully groomed and had the mud thoroughly washed from their skins were invariably attacked. As a matter of course, this fact came under the observation of veterinary surgeons, who were, from the nature of their avocation, in the best possible position to test the truth of the presumption that washing the mud from the legs and body of the horses was a cause of mud fever. It took a long time to reconcile |
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145
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LOCAL INFLAMMATIONS
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horse-owners to this apparently unreasonable view, but it is now perfectly
well known that in establishments where washing has been discontinued mud fever and cracked heels are of rare occurrence. In the human subject erythema exhibits itself in a great number of
forms, according to the situation of the disease and the character of the cause which produces it. Erythema intertrigo is one of the forms which occur in the horse when
two surfaces of skin rub against each other, and the term may conveniently be extended to include all those instances of redness following friction from any part of the harness, saddle, or collar. It will be noticed, how- ever, that the irritation induced by friction is not likely to be detected in dark-coloured animals, and the cause therefore is frequently allowed to continue until abrasions occur, and the so-called " shoulder galls" appear. These conditions are common enough among working horses wearing a badly-fitting collar, and are difficult to deal with on account of the impossibility of the healing process taking place so long as the use of the collar is continued. The device which is resorted to, of hollowing out a part of the collar which causes the abrasion, is only partially successful. In order to dry up the abraded surface and harden the skin, an astringent lotion is usually employed; a solution of chloride of zinc, or bichloride of mercury, is generally effectual. A very convenient lotion to be kept in the stables is made by mixing Sir William Burnett's disinfecting fluid, in the proportion of one part to fifty of water, the bottle, of course, being marked with a poison label. Purpura is a form of erythema which occurs in the horse under the
name of purpura hgemorrhagica. This disease consists in extravasation of blood into the tissues of the true skin, either from dilatation and over- distension of the vessels from deranged nerve-function, or from a morbid condition of the blood itself. It can hardly be looked upon as a distinct disease of the skin, but rather as an indication of some serious patho- logical state of the system, which would generally be classed under the heading of blood diseases. So far as the skin itself is concerned, the disease is exhibited in the form of patchy elevations, associated with blood - spots on the visible mucous membranes. The affection appears to be peculiar to the horse, and is met with at the termination of debilitating diseases, such as influenza and strangles. (See Purpura Hsemorrhagica.) Urticaria—commonly described as nettle-rash-—frequently occurs in
the horse during the spring and summer months. The causes are a sudden change of diet, especially from hard corn to fresh succulent herbage, such as grass, clover, rye-grass, vetches, &c, drinking cold water when the Vol. II. 44
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146 HEALTH AND DISEASE
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animal is heated, or the sudden movement of an animal from a hot stable
to a cold, wet atmosphere. The form of urticaria which arises from dietetic errors is distinguished as urticaria ad ingestis. The eruption in this affection occurs very suddenly in the form oi
flattened, more or less rounded elevations, differing much in size, the majority of them being something from an inch to two inches in diameter. They commonly occur on the neck, and frequently over a considerable part of the body, and sometimes the head also. The lumps appear very quickly, and may be so closely
packed as to run together into a single patch the size of a dinner-plate. Sometimes when the eruption is scattered, and the lumps are not much larger than a shilling, the disease assumes a chronic form, and is attended with loss of hair from the raised patches. It is curious that the new hair is always lighter in colour than the rest of the coat. The treatment of the disease con- sists in the administration of a mild laxative, to be fol- lowed by small repeated doses of bicarbonate of soda and chloride of sodium in the food night and morning. |
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Fig. 265.—Urticaria
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Liquor arsenicalis, in doses
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of an ounce to an ounce and
a half, given in the food night and morning, may also be tried where the disease proves obstinate, and failing with this, some vegetable tonic, as gentian and columba root, or quinine, deserve a trial. If there is much irritation, a little Goulard water may be applied to
the seat of eruption, or a liniment of glycerine and oxide of zinc. |
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CATARRHAL INFLAMMATION
Eczema is the most common disease occurring in the horse, typical
of the catarrhal condition of the skin. It consists, in the first instance, of inflammation of the superficial layers of the true skin, with an eruption |
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147
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CATAEEHAL INFLAMMATION
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of small papules, or vesicles, which sooner or later break and discharge
a watery fluid of a somewhat adhesive character, as shown by the gluing of the hair in tufts. Later, small scabs or crusts appear at the seat of eruption, and are frequently rubbed off by the animal trying to relieve the itching, leaving rawT surfaces beneath. Eczema presents itself under several forms. When the attack is mild,
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Fig. 266.—Eczema
without any symptoms of constitutional derangement, the disease is
termed eczema simplex. In more severe attacks, when the inflammation of the skin is more pronounced and the surface is swollen and tinged with red, the term eczema rubrum is used. In the most severe form of the disease the eruption becomes pustular, when the small vesicles are filled with " matter" instead of watery fluid. A fourth form of the disease is characterized by the cuticle of the skin being thrown off from the affected |
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148 HEALTH AND DISEASE
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part in bran-like scales. This is described as squamous eczema, and has
a great tendency to become chronic. Eczema may occur in different parts of the body, but it is perhaps most common in the upper part of the neck and over the quarters. The symptoms of the disease, from first to last, vary according to the stage. Congestion is observable at the commence- ment, indicated in light - skinned animals by a redness of the surface (erythema). This is followed by an eruption of pimples, next vesicles or blisters form and break, and discharge their contents. Should the inflammation be acute, the discharge becomes purulent. From the first there is some irritation and itching, which may induce the animal to rub or bite the diseased parts within reach. Eczema may be distinguished from other skin affections, for being a distinctly catarrhal disorder it is always associated with a discharge of a more or less sticky fluid, and is therefore described as a " moist disease". Treatment must be adapted to the stage of the disorder. In the
simple forms, soothing treatment is recommended; as the disease advances to the pustular stage, tonics and astringents are prescribed, and in the last stage stimulants are advocated. In the simple form, an alkaline lotion with a little glycerine and a small quantity of tincture of opium will relieve the irritation; or in place of the lotion, flour may be sprinkled over the moist parts. In the final stage, when crusts are being formed, a ten-per-cent solution of carbolic acid may be employed, and when the surface becomes dry and covered with scurf, the ointment of the oxide of zinc will be beneficial. Throughout the disease saline laxatives may be administered when necessary, and in the latter stages tonics, such as mineral acids and iron, and in some cases arsenic, will be indicated. Arsenic is most conveniently administered in the form of Fowler's solution, in doses of one ounce to an ounce and a half, which may be sprinkled on the food night and morning, or mixed with the drinking water. PLASTIC INFLAMMATIONS
The diseases included under this heading are lichen and prurigo.
Lichen is a papular disease, which is described by Williams as the
papular form of eczema. It commences by an eruption of small papules, from which a fluid is discharged, and afterwards becomes dry and forms a crust. The disease is most frequently seen on the legs of horses, along the course of the flexor tendons. The exudation which occurs round the hair follicle glues the hairs together, forming small tufts, and gives to the legs the appearance of being covered with tails of rats; in fact, the disease is commonly called " rat tails". |
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149
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BULLOUS INFLAMMATION
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Treatment would be precisely the same as that prescribed for the
pustular form of eczema. Prurigo.—This disease is distinguished by an eruption of slightly
raised papules, which in the case of a horse can be felt more easily than seen. Considerable itching attends the eruption, and as a result of the scratching or biting the irritation rapidly increases; the tops of some of the pimples are frequently rubbed off, and a blood-coloured scab is formed. In severe attacks the disease is complicated with the secondary conse- quences produced by scratching. It is sometimes difficult to distinguish between prurigo and some stages of eczema. Prurigo generally arises from debility, due to insufficient food, hard work, and absence of proper sanitary precautions. It may be looked upon as one of the consequences of bad stable management. The treatment consequently will consist chiefly in liberal feeding,
while at the same time the bowels should be carefully regulated in their action by the occasional administration of a dose of laxative medicine, of which sulphate of magnesia is perhaps the most to be preferred. Vege- table and iron tonics, or both combined, may be necessary where great debility exists. Some cases yield more readily to a run at grass and a course of alterative medicine. As external applications, a lotion of vinegar and water, or glycerine with a solution of the acetate of lead, will be found to allay the irritation. BULLOUS INFLAMMATION
Herpes is the only disease which comes under this heading, so far
as the horse is concerned. It consists of the eruption of vesicles in patches of an irregular form; the vesicles are sometimes very large, and are called blebs or bullae. The lips in the horse are sometimes the seat of the disease, and it also appears round the coronets; the mucous mem- brane of the mouth is also sometimes invaded. A characteristic variety of the disease is herpes circinatus, in which the eruption of vesicles ap- pears on various parts of the body. In this form the disease is commonly described as ringworm; it is, however, quite distinct from the true contagious ringworm, which depends on the presence of a parasitic plant. In herpetic ringworm the vesicles appear in a ring surrounding a patch of healthy skin, whereas in parasitic ringworm the disease commences m the centre and spreads outwards. Herpes depends as a rule upon some derangement of the digestive organs, and ceases when the normal condition is restored. Very little treatment is necessary. The local irritation can be removed by the application of a lotion composed of a solution of the |
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150 HEALTH AND DISEASE
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acetate of lead and glycerine, and any existing derangement of the system
may be met by judicious dieting, and the administration of alterative medicine, as a mixture of equal parts of sulphur, nitrate of potash, and resin, which may be mixed with the food and given morning and evening. SUPPURATIVE INFLAMMATIONS
Diseases occurring in this class are limited to those in which pustules
constitute the primary lesion. In the lower animal the affection which is known as ecthyma is the only disorder which may be considered a typical one., Furunculus, which means merely a boil, is of occasional occurrence in horses, and would naturally come under the same class. Ecthyma commonly appears in the form of pustules of various sizes on
an elevated patch of skin, which is extremely tender to the touch. It may be simple or contagious; the latter form of the disease is the
more prevalent, and is better known in this country as the "American Horse- pox" or the "American Horse Disease", and by some as "German Boil". These terms had no doubt their origin in its common occurrence among imported horses, especially those from America, Canada, and Germany. It is essentially a local disease, which spreads from animal to animal more especially by means of infected clothing and harness; it appears to be necessary that the contact of the skin with the contaminated article must be extremely close. The mere throwing of a soiled cloth over an animal's body is not alone sufficient to transmit the disease; but if it be ridden for a short distance while the infected cloth or saddle is on the back, the disease is almost certain to follow. The appearance of the malady so often on the withers, the lay of the
collar, and the back, is probably to be explained by the favourable influence which the heat and moisture generated in these parts exercise on the pro- pagation of the contagion. Treatment.—This being a local disease will depend mainly on local
applications for its eradication. To commence with, it is desirable that all contaminated clothing should be removed and the employment of contam- inated harness be discontinued. A ten-per-cent solution of carbolic acid should be freely applied on and around the pustules twice a day, not only to bring about speedy healing of the sores, but at the same time to destroy the contagion existing in the discharges. A little boracic acid and flour dusted over the wounds two or three times a day may be used with the same object. In severe cases the food ration should be diminished, and the state of
the bowels may require the administration of a mild aperient. |
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151
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SUPPUEATIVE INFLAMMATIONS
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Fig. 267.—Contagious Ecthyma, or American Boil
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To guard against its further spread, all soiled clothing, harness, brushes,
cloths, sponges, and stable utensils should be thoroughly cleansed and disinfected, and the same should be done with regard to the stall-posts, partitions, and fittings of the box or stall occupied by the diseased horse. |
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HEALTH AND DISEASE
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152
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SQUAMOUS INFLAMMATIONS
Pityriasis and psoriasis are the two affections which come properly
in this class. Pityriasis, as the name implies, is a disease of the skin in which the
surface becomes covered with white scales having the appearance of bran. It is usually associated with poverty, and disappears as the general con- dition improves. Horses suffer from the disease occasionally, but not so frequently as cattle. Treatment.—According to Williams, the disease in the horse is asso-
ciated with presence of oxalates in the urine, and he accordingly advises that carrots and turnips and all kinds of food which furnish sugar should be withheld. We would, however, suggest a liberal allowance of green food when such can be obtained, and a generous but well-regulated corn ration. The chief object to be obtained is to improve the nutritive function of the skin. For this purpose a powder consisting of equal parts of sulphur, resin, and nitrate of potash should be given twice daily, and a dose of solu- tion of arsenic with the mid-day feed. The patient should not be allowed to lead a sedentary life, but be freely exercised every day. Psoriasis.—The characteristic features of this disease are the accumu-
lation of scales in raised patches and thickening of the underlying skin. In the horse psoriasis mostly prevails in the heavier breeds, and especially among animals fed up for exhibition. It is chiefly limited to the neck close to the mane, the inner aspects of the ears, and over the tail. The affection commences in circumscribed spots, which gradually extend and unite to form large scaly patches. In the bends of the joints it is gener- ally the case that cracks appear in the skin from which discharge issues, and from the constant movement in the part the fissures do not readily heal, and the irritation which exists sometimes causes general stiffness of the limb and lameness. The treatment to be employed is chiefly local. Carbolized oil, or zinc
ointment, or in some cases iodine ointment, according to the stage of the disease, may be employed; but it is well recognized that, although the affec- tion may be subdued and kept under for a time, it is extremely difficult to cure. Overfeeding, want of exercise, and dirty stables are common causes of its recurrence when once subdued. |
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SQUAMOUS INFLAMMATIONS 153
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ICHTHYOSIS
This disease is characterized by more or less hypertrophy of the skin as
a whole, but especially by the free and morbid outgrowth and accumulation of epidermis upon it. In man it is congenital and hereditary, and it may be so in the horse,
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Fig. 268.—Ichthyosis
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but the seldom occurrence of the disease in this animal has not afforded an
opportunity of our forming a definite opinion on this point. In the ox it is more common, but inasmuch as it seldom calls for treat-
ment its congenital and hereditary nature still remains a matter to be determined. Ichthyosis is intimately related to a dry and scaly condition of the
skin termed Xeroderma, and between the two affections there does not appear to be any well-marked line of demarcation. When, however, the epithelial collections are considerable, and accumulated into well-defined scales or flakes, the disease is termed Ichthyosis. It would appear, there- fore, that xeroderma and ichthyosis represent degrees of the same disease, |
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HEALTH AND DISEASE
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154
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distinguished from each other by the larger and more compact or flaky con-
dition of the epidermis which is formed in the latter. Symptoms.—Generally the skin is harsh, dry, thickened, wrinkled,
and dirty, and the hair about the diseased parts stares. Patches are seen here and there consisting of superimposed layers of epidermis, which may be removed in thick flakes or hard, compact, horny layers. Sometimes the epithelial growth assumes the form of a more or less cylindrical outgrowth or horny excrescence which requires to be cut off. Some of these epithelial developments are black and dirty, while others wear a white shiny appearance not unlike mica. In the early period of formation they are covered with a bran-like
epithelium which desquamates, but later develops into dense flaky patches. Ichthyosis is a purely local disease, confined to the skin, and so long as
it does not appear on parts to which the harness is applied the patient may suffer but little inconvenience from it. It cannot, however, be cured, and when, as sometimes occurs, it seriously
attacks these parts, the chafing of the collar or saddle altogether incapaci- tates the animal from work. Where it accumulates in large heaps it may be removed by hot water
in which a little soda is dissolved, after which the skin round about it may be massaged and the affected part smeared with vaseline. HYPERTROPHIES AND ATROPHIES
HYPERTROPHIES
VerrilC3B.—Verrucse or Warts are of very common occurrence, and
consist in a local enlargement or overgrowth of all the constituents of the skin. The horse is particularly liable to them; they appear in dif- ferent positions, and frequently in parts which come in contact with the harness; but they are of still more frequent occurrence in parts of the skin which are absolutely free from all risk of pressure or friction, and this fact suggests that neither of these causes can have much to do with their production. On the eyelids, about the lips, on the inferior parts of the abdomen and the sheath, warts are common, and these parts are free from contact with the harness or pressure of any kind. Warts are of different forms, sometimes being diffused and scarcely raised above the surface, involving large portions of the skin. Another form is the ordinary pedunculated wart, which hangs from a pedicle or narrow neck; and there is also a lobulated form which projects from the skin and generally presents a red and sometimes bleeding surface. |
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HYPERTROPHIES AND ATROPHIES 155
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Treatment of warts is essentially of a surgical character; the means
adopted for their removal are various. The most summary method of removing them is by the use of the knife; a ligature in the case of pedun- culated warts is also employed, and caustics are used for warts in any shape or in any position. A favourite compound is arsenic mixed into a paste with honey. The wTart which is |
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to be removed is scraped in
the centre until slight bleeding occurs; to this spot the arsenical paste is applied, and the in- flammation which follows ends in the sloughing of the whole growth; but unless the caustic preparation is employed very carefully, the destructive action of the arsenic will extend be- yond the wart and serious loss of structure is likely to happen. When warts occur in positions where caustics could not safely be used, it is the practice of some to take the affected animal |
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Ill w |
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ail
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Fig. 269.—Section of Wart
Horny Epidermis. B, Deep Layer of Germinal Cells,
c, Fibrous Stroma. D, Blood-vessel. |
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to a slaughter-house and
the warts with the blood of a recently-killed animal. Two or three appli- cations of this treatment are said to cause the growths to shrink and ultimately to fall off. Fibroma.—Fibro-cellular growths in the skin are of occasional occur-
rence in the horse; they are sometimes described as soft warts. The presence of the cellular element in the tumour renders their permanent removal doubtful. They are got rid of for the moment by the use of the knife, but the growth is likely to recur, and in order to arrest this as far as possible it is desirable to employ caustic dressing immediately after the operation. ATROPHIES
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Any form of senile decay would be reckoned amongst atrophies, but the
condition is rarely observed in the horse excepting as the result of continu- ous pressure on a particular part. The hair appears to suffer from this change more than other of the cutaneous structures. |
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HEALTH AND DISEASE
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156
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NEW FORMATIONS
Of the diseases included in this group, i.e. cancer, lupus, and rodent
ulcer, the first is the only one which is recognized in the horse. The disease in that animal is of rare occurrence, and usually affects the internal organs. It can scarcely be referred to, therefore, as a skin disease. HEMORRHAGES
Extravasation of blood into the superficial layer of the true skin is
described as purpura. The hemorrhage occurs as a consequence of some change in the composition of the blood, excessive pressure of blood in the small vessels, or impairment of the functions of the nerves which regulate their calibre. The lesions or blood-stains in the skin may be in the form of spots, small or diffused patches, or marks which look like bruises. The dis- coloration, it should be noticed, is the result of diffused blood and not merely of congestion. Pressure applied to the latter completely removes it, but it does not remove the discoloration by blood when extravasated. As the cause of the extravasation is some serious derangement of the system, the disease is not to be dealt with by local remedies. (See Purpura Hsemorrhagica.) NEUROSES
The diseases which are included in this division are increased sensibility,
diminished sensibility, and perverted sensibility. The last of these is known in the horse as pruritus, which is really, as the word indicates, itch- ing without any recognizable cause; there is no detectable eruption nor any redness save what may result from the part being scratched, in fact itching is the only symptom which has to be dealt with by remedies. In many cases the itching is so excessive that in the language of the groom the horse is driven nearly mad, and in his excitement he tears his clothing, and increases the irritation by rubbing or scratching, causing an eruption and erosions in various parts of the body. The treatment of the disease, which is necessarily associated with general
systematic derangement, belongs more properly to the domain of general medicine, but for the alleviation of the annoying irritation local remedies are indispensable. Dr. James Law of the Cornell University recommends a wash of water slightly soured with oil of vitriol, and rendered sweet by carbolic acid. If this acid lotion fails to afford relief, an alkaline and seda- tive mixture may be employed instead—for example, 2 drachms of carbonate of potash and 2 grains of cyanide of potassium in 1 quart of water. It |
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MALLENDERS AND SALLANDERSS 157
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Fig. 270.—Sallanders Fig. 271.—Mallenders
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is of the first importance that the diet be carefully regulated and the work
be duly adjusted to it. Excess of highly stimulating food must be guarded against. A liberal allowance of carrots and moist bran will prove useful in maintaining a free and regular action of the bowels. Where constipation exists a dose of physic may be required, and should the disease prove obsti- nate an ounce of Fowler's solution of arsenic must be administered morning and evening in the food. MALLENDERS AND SALLANDERS
Eczema in a local form is seen in that condition of the legs known to
stablemen as mallenders and sallanders. Here the disease is confined to the flexures or " bends" of the knees and hocks respectively. In the |
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158 HEALTH AND DISEASE
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former position it is termed " mallenders", in the latter " sallanders ".
(Figs. 270, 271.) With rare exceptions this form of the disease is confined to the heavy breeds of horses, and especially to those with fleshy legs, a thick skin, and a profusion of coarse hair. It is essentially hereditary in its nature, and appears to be brought into existence by the excessive use of highly nitrogenous diet, particularly the indiscriminate use of beans. Not unfrequently it is preceded by swelling of the legs following upon a brief respite from work. Sallanders sometimes ensues upon an attack of acute lymphangitis or
mud fever, and is frequently found to be associated with chronic enlarge- ment of the limbs. HEMOPHILIA, HEMORRHAGIC DIATHESIS, BLEEDERS
By these terms is understood a disposition to bleed on the slightest
provocation. In animals so constituted very slight injuries, which in others would prove perfectly harmless, are attended with profuse hemor- rhage, and in some instances which have come under the notice of the writer, blood has dripped from the skin at numerous points without any obvious cause. In such subjects bleeding from wounds, whether the result of accident or surgical operation, becomes difficult to arrest, and may even proceed to exhaustion or fatal syncope. In the human subject it is recognized as a congenital disease, and in
some cases the predisposition to this form of hemorrhage has been known to be transmitted from parent to progeny, and this hereditary influence is recognized as the chief factor in the origin of the affection. Men are said to suffer from the disease much more than women, the estimated proportion being eleven of the former to one of the latter. Its prevalence in the horse is not considerable, but the tendency to
spontaneous bleeding from the nostrils is well known to exist in certain families of race-horses, and from time to time this weakness has been the cause of bitter disappointment to trainers and owners of thoroughbred stock. In one celebrated family, well known to all who are Interested in the turf, it has exhibited a decided hereditary character, and proved a serious drawback to certain of its members. Symptoms.—Animals which suffer from hsemophilia do not exhibit
any obvious signs of constitutional disease. They invariably carry abun- dance of flesh, are sleek in their coats, and present all the indications of good general health. The most common form which the ailment presents in horses is bleeding from the nose, the mucous membrane of which becomes studded with blood-spots more or less numerous, and so closely packed |
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PAKASITIC DISEASES OF THE HORSE 159
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together in some instances as to form considerable patches. Sometimes
the amount of blood actually discharged is slight, at others it is very considerable. The breakage of the vessels and leakage may also attack the lungs, when it is attended with a convulsive cough and marked distress in breathing. Injuries in the form of contusions usually result in swelling out of all
proportion to the violence inflicted, the enlargement thus occasioned being produced by the escape of blood into the tissues of the part. As a skin affection it shows itself by the presence of numerous small
points, from which blood or blood-stained serosity oozes from the surface of the integument, and hangs from the ends of the hairs in small red or reddish-yellow drops. The diagnosis of the disease is affirmed when the bleeding, whether
in one form or the other, is repeated from time to time, in which case it may give rise to ansemia, loss of condition, and general debility. Treatment.—Animals affected with this disease should not be sub-
jected to severe exertion, and should be protected against all forms of injury. Where operations require to be performed, it must be under- stood that they can only be carried out at the risk of inducing dangerous, if not fatal, hemorrhage. Operations should therefore be avoided if possible. In bleeding from the skin and mucous membrane, small repeated doses of perchloride of iron, alone or in combination with turpentine, may be given whenever the hemorrhage appears. The patient should be kept perfectly quiet, and confined in a cool well-ventilated box. The cessation of bleeding should be followed by the administration of small repeated doses of nux vomica and quinine, which may be given in the food. Whenever a tendency to this disease is known to exist, the general
health should be upheld by a liberal allowance of good food, regular and moderate work, and strict regard to the sanitary condition of the stable and other surroundings. |
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13. PARASITIC DISEASES OF THE HORSE
INTRODUCTORY
Parasites, in the common acceptation of the term, are presumed to
be worms of some kind which infest the internal organs of the higher animals. In reality the word has a much more extensive meaning, as it applies literally to all kinds of organisms which live upon other and higher organisms, and it is quite within the limits of possibility that science may |
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160 HEALTH AND DISEASE
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yet be able to demonstrate that every form of disease depends on the
existence of a parasite. At the present time it is known that certain diseases—for example,
glanders, tuberculosis, and numerous others—are due to the presence of minute organisms only to be recognized under the higher powers of the microscope. A considerable number of diseases occupy a doubtful position in this respect, and a much larger proportion have not yet been suspected to be consequent on the presence of microbes, but additions are con- stantly being made to the number of microbe affections. Parasitism, therefore, in its general sense, applies to a much larger
number of disorders than are usually included in that definition. This section, however, will be exclusively concerned with those diseases which are connected with the presence of parasites which are not microbes. It will be an advantage in the beginning to dispose of certain terms
which will of necessity be used frequently in the following pages. Parasites belong both to the animal and vegetable kingdoms, and they
infest higher organisms of both kingdoms interchangeably, i.e. a parasitic plant may invade an animal as a parasitic animal may invade a plant, and the " host ", as the invaded animal or plant is called, may harbour both kinds at the same time. Parasites form only one division of the lower organisms which infest
higher organisms. The general term which indicates the condition of which parasitism is a part is Symbiosis, meaning merely association. Thus some organisms live upon higher organisms to the advantage of both, and this form of symbiosis is described as mutualism. In another division the lower organism attaches itself to a higher one for the purpose of feeding on the remains of the food which the higher animal scatters around; this kind of association is distinguished as commensalism. It is obvious that the higher organism gains no benefit from this connection, but at the same time it suffers no harm. In a third example of symbiosis, or the association of lower with
higher organisms, the latter is injured more or less by the invasion of the former, which in the exercise of its functions robs its host of a certain amount of nutriment, and during the process of appropriation frequently excretes poisonous substances which are destructive to the tissues of the infested animal or plant. This is true Parasitism. Certain terms are used to define the position of the parasites in or on
the body of the host. For example, the terms ecto-parasites or epi-para- sites include all the organisms which locate themselves on the surface; ento- or endo-parasites include all organisms which invade the interior of the body. |
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YORKSHIRE COACH-HORSE, MISCHIEF
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By Prince George 367 Y. C. S. R., dam by Rarnaby 670 Y. C. S. B.
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PAEASITIC DISEASES OF THE HOESE
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161
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PAEASITES DEEIVED FEOM THE PLANT WOELD
Classification.—Parasitic plants belong for the most part to the large
family of fungi. Their history is in many points obscure, and the various attempts at classification have not been entirely satisfactory. For the present purpose, however, it will be sufficient to refer to three divisions: schizomycetes, saccharomycetes, and actinomycetes. The schizomycetes include the fungi which multiply by division or fission, the saccharomycetes or yeast fungi multiply by budding and the formation of spore, actinomy cetes include the fungi the branches of which radiate from a centre-rayed fungus. Individuals of the two first divisions are found on the surface of the body and in the internal organs of the horse, but so far as is known very few of them produce disease. PAEASITES DEEIVED FEOM THE ANIMAL KINGDOM
Classification.—Animal parasites are divided into three classes:—
1. Protozoa. 2. Helminths. 3. Arthropedes. Protozoa include all organisms of the most simple form—the mere
beginnings of life, in reality—from the small structureless mass of living material (bioplasm) to the different forms of cells consisting of a simple investing membrane containing nuclei or sometimes only granular material. Cells assume various forms—circular, oval, elliptical, and elongated. Protozoa include amoebae, sporozoa, and infusoria. Amoebae have no
defined outline, but consist of small masses of living material capable of moving in any direction, and feeding upon particles of food which they find in the fluid in which they live. Those particles they appropriate by enclosing them in the jelly-like material of which they are composed. Sporozoa are divided into gregarines, coccidia, and psorosperms. They.
have a more definite form than amcebaa, as they are bounded by a cell-wall and contain spores or nuclei. All of these primitive forms of life inhabit stagnant pools, and are consequently taken in by animals which are feeding on the pastures. Their presence has frequently been recognized in the digestive organs of animals, but it is only of late years that the truly parasitic character which some of them assume has been realized. Fatal outbreaks of disease among pheasants and poultry have been traced to the invasion of coccidia, and the presence of the same organism in the ducts of the liver of the rabbit has probably been respon- sible for a considerable mortality among those animals. The true signifi- cance of these lowest forms of parasitic life in the organs of warm-blooded animals is not yet fully appreciated. Vol. ii. 45
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HEALTH AND DISEASE
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162
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Helminths (Worms).—Between the highly organized parasites which
are described as worms and the elementary forms which have just been referred to there do not appear to be any' connecting links; at least none have been discovered. The word worm is popularly believed to indicate creatures of which the earth-worm is an example, but the helminthologist includes in the term animals which differ considerably from each other in form, sufficiently, at least, to lead to their division into two sub-classes, the characters of which are very easily distinguished. In the first subdivision—round-worms or helminths—all the members
have the characteristic forms of the common earth-worm, that is to say, they are round and elongated; but they differ in length from an eighth of an inch to several feet, in other words, from very large to extremely minute worms which can only be seen by the aid of the microscope. Round-worms are found in various parts of the body of their host—
in the skin, the eye, stomach, intestines, in the kidneys, and occasionally in the heart and blood-vessels. The second subdivision includes all flat-worms (flat helminths). There
are two varieties of them, which are known as tape-worms and fluke- worms; the latter being entirely unlike the typical worm, as it resembles a very minute sole, and when it is fully grown it is little more than an inch in length. Both round-worms and flat-worms produce eggs in which embryos are
developed, but it is characteristic of all the division that the young worms do not become mature in the organism of the animal which they infest; in some cases the young worm is hatched out in the intestines or other organs of the host, but before it is fully developed it appears to be necessary that it should be expelled and find an intermediate host outside the animal in which it has lived. In the case of the round-worm this phase in their life-history is still obscure; the intermediate host has not been discovered. In the flat-worms, on the other hand, the changes have been followed from the egg through the body of the intermediate host back to the class of animal originally infested. In the fluke, for example, the embryo bores its way into a small snail, in which it goes through certain changes of form. In the case of the tape-worm the embryo in the body of an intermediate host becomes a hydatid, which is really a small bladder in which the tape - worm head is developed. The transference of the hvdatid to the body of another host is followed by the development of the tape-worm from the head or heads. The only mystery which exists in reference to this parasite relates to the identification of the host, which in a considerable number of tape-worms is not known, although, judging from analogy, there can be no doubt of its existence. To make this mode |
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DISEASES WHICH ARE INDUCED BY PARTICULAR PARASITES 163
of development clear a simple illustration will be sufficient. A certain
hydatid infesting the brain of the sheep, which causes the disease known as gid, will, if given to a dog, be developed into a tape-worm possessing certain well-defined characters which mark its origin. The mature segments of this variety of tape-worm, when given to sheep or taken up by them when feeding on pastures, will produce the hydatid in the brain. Arthropedes.—In this division is included all animals with jointed
limbs, all kinds of insects which, either in their mature or larval form, become parasitic permanently or temporarily to any of the higher animals. Horses are infested by the larval forms of certain flies (diptera), and
by some varieties of lice and acari or mange-mites, which produce diseases of the skin of the animals which they infest. DISEASES WHICH ARE INDUCED BY PARTICULAR
PARASITES
EXTERNAL PARASITES OF THE HORSE
Numerous parasites belonging both to the animal and plant kingdoms
take up their residence on or in the skin of the horse, and occasion consider- able derangement. The common affection which is known as ringworm, on account of the circular form which the eruption assumes, is due to a fine hair-like fungus which is known as the Trichophyton tonsurans or ringworm fungus. Other parasites of the skin are derived from the animal kingdom, as lice, which, without producing any specific affection, cause a great deal of irritation and interfere with the animal's condition. Acari or mites, which cause different forms of mange; larvae (maggots) of certain insects which take up a temporary residence on the skin, and bore their way into it, or are thence transferred by the animal itself, in the act of bcking or biting, to its own stomach, wdiere they undergo a certain amount °f development prior to quitting their hold and being expelled to complete the necessary changes to form the perfect insect. Certain small thread- worms, and a lower form of organic beings belonging to the protozoa, known as psorosperms, also infest the skin. RINGWORM OF THE HORSE
It may be observed at the commencement that ringworm in the horse
ls a comparatively rare affection. In cattle it is constantly found in young animals; very rarely, however, is it seen in an animal after the age of one year. In the horse age does not appear to afford any protection from the disease. |
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HEALTH AND DISEASE
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164
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Symptoms.—In consequence of the common occurrence of a form of
eczema, in which the eruption is distinctly circular, the term ringworm is frequently applied to that disease, which is not associated with the presence of a fungus and is not contagious in its character. In eczema the round patch which characterizes the eruption is developed at once, but in ringworm it commences as a
small pimple and spreads day by day in widening circles until a rounded patch is produced. True ringworm is in all cases due to the growth of the fungus [Tricho- phyton) in the hair follicles, and frequently in the interior of the hair, and the diagnosis of the disease implies the detection of the fungus under the microscope. For this purpose a few hairs and a certain small proportion of scab should be removed from one of the spots of the skin, placed in a little solution of potash, with a few drops of glycerine added, in order to render the opaque scabs transparent. If the disease is ringworm the appearance pre- sented will be that which is indicated in Plate XXXVI, figs. 9 and 10. Another method of diagnosis
has been suggested, which, taken in connection with the clinical symptoms, i.e. itching and the |
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|
Fig. 272,-runoworm
|
appearance of gray scabs along
|
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|
the back, the sides of the withers,
and, in bad cases, on the neck and head, may lead to a correct conclusion; but absolute proof of the nature of the disease can only be obtained by microscopic inspection. The method proposed is as follows:—A few drops of chloroform are allowed to drop on one of the suspected spots; if, after the evaporation of the fluid, some of the hairs present a white or pale- yellow colour, it is concluded that the disease is ringworm. Two varieties of ringworm have been distinguished by writers — the
common kind, in which the scab is gray and the hairs are inclined to break |
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DISEASES WHICH AEE INDUCED BY PARTICULAR PARASITES 165
off short at the mouth of the follicle, owing to their brittle condition; and
another form, in which the scabs are yellow, and the hairs, instead of breaking off, fall out and leave perfectly bare patches of skin. This variety of the disease does not appear to have been recognized in England. Treatment.—It is a somewhat remarkable character of this disease
that while the eruption extends from the centre of the scab by constant distribution of the spores there is a well-defined limit to its progress, and at a certain point the disease undergoes a spontaneous cure. This has been noted particularly in ringworm of calves, and there is no doubt that the continuance of the affection in many cases is largely depen- dent on the general weakness and poor condition of the subject. The average duration of ringworm in the horse is said to be forty to fifty days, but it must be understood to mean that in regard to a certain spot or a certain number of spots a cure will be evident "by the growth of new and healthy hair. Meanwhile, however, any advantage from this spontaneous cessation of the affection is often neutralized by the constant conveyance of the spores (seeds) of the fungus to the other parts of the skin. Con- sequently it happens that as fast as the affection is cured in one place it breaks out in another; hence the necessity for the prompt use of remedies which will destroy the vitality of the fungus as quickly as possible. Various agents are employed in the treatment of ringworm, and it may
be said of nearly all of them that they are perfectly successful, for, unlike the ringworm of the human subject, ringworm in the lower animals is not difficult to cure. Among the agents which are recommended are a solution of corrosive sublimate, 1 to 300 of water, to which a little spirit has been added, or a mixture of 1 part carbolic acid with 10 parts of glycerine. These preparations are to be applied by means of a brush to the spots of
ringworm wherever they are found. Of the ointments which are com-
monly employed, blue mercurial ointment, and red biniodide of mercury, each diluted with six times its bulk of lard or vaseline, are most effective. The treatment in any case will have to be continued until a healthy state °f the skin is indicated by the growth of new hair in all parts of the diseased skin. Transmission of ringworm to other horses, probably also to other
animals, and certainly to human beings, is likely to take place unless proper precautions are used. Care therefore should be taken to cleanse and disinfect thoroughly the stable and its fittings, destroy the litter, and disinfect or destroy all the stable apparatus used about the diseased animals. For the protection of the helper who dresses the animal the shirt-sleeves
should be kept down instead of being turned up, as is usually done, |
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166 HEALTH AND DISEASE
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|
as experience proves that the arms are the parts most likely to be
attacked. PAEASITES OF THE SKIN DERIVED FROM THE ANIMAL
KINGDOM
The skin of the horse is infested by several varieties of parasites,
which occasion disease of the structures, attended with itching, and in some cases with considerable eruption. The two most common affections are known by the terms phthiriasis, when lice are present, and acariasis, when different kinds of acari invade the skin. The latter are the cause of several forms of mano-e. Phthiriasis (Lousiness).—Lice which infest the skin of the horse are
of two kinds: one which, by its sharp-pointed mouth, is able to puncture the skin and live on the blood, hence called Hmmatopinus, and another the head and mouth of which are not adapted for puncturing the skin; this variety feeds on the loosened cuticle and clings to the hair, hence the name, Trichodectes, which is given to it. The two varieties are commonly found together. In very young animals lice are frequently extremely abundant, and by the constant irritation which they produce they prevent the animal from feeding or resting in any comfort. It is consequently important to employ some dressing which will have the effect of killing the parasites. Various agents are in favour for this purpose; the most simple is any kind of fat oil which will destroy the lice by stopping their breath- ing pores, as train-oil and linseed-oil. Mercurial ointment is a very effec- tive remedy, but it is also very dangerous. Tobacco water, made by boiling an ounce of tobacco in a quart of water, is also a very good dressing, or, instead, a solution of carbolic acid 1 part to 50 parts of soft soap and water may be used. In consequence of the invariable presence of numerous eggs on the skin,
which will in all probability escape the action of the dressing, it is neces- sary to repeat it in a week. Afterwards the animal must be examined occasionally in order to ascertain if any more parasites are present. The illustrations in Plate XXXVI, figs. 1 and 2 show the different varieties of lice found on the skin of the horse. Acariasis (Mange).—The parasites which belong to this division are
the different varieties of ticks and mange-mites. The presence of ticks on the skin may be looked upon as an accidental circumstance, from which the horse in its state of domestication is comparatively exempt. The same, however, cannot be said of the invasion of the mange-mites, two varieties of which are commonly found in the horse, one (Psoroptes) the cause of |
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|
PLATE XXXVI
|
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|
EXTERNAL PARASITES OF THE HORSE—After Neumann
|
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|
Hamatopinus macrocephalus equi, female, X 15.
Trichodectes pilosus equi, female, X 15.
Psoroptes communis equi, hexapod larva, X60.
Psoroptes communis eq ui, pubescent female, ventral surface, X 60.
Sarcoptes scabiei equi, ovigerous female, dorsal surface, X 60.
Same as 5, but ventral surface, X60.
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|
Symbiotes communis equi, ovigerous female, ventral surface,
X60.
Horse's tail invaded by tricophyton tonsurans, X200. a, a, mass of exterior spores; i, split summit of hair; c, cells
of epidermis of hair.
». Tricophyton tonsurans, X 50. |
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|
7. Symbiotes communis equi, male, ventral surface, X60.
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|
DISEASES WHICH ARE INDUCED BY PARTICULAR PARASITES 167
common mange and the other a burrowing mite (Sarcoptes) the ravages of
which induce a more severe kind of skin disease, which is difficult to cure owing to the mites burying themselves under the cuticle. Symptoms.—In all forms of mange the prominent symptom in the
first instance is itching, which induces the animal to bite and rub itself, sometimes so vigorously as to cause abrasion of the skin. The disease is first apparent on the withers, the upper part of the neck, the root of the mane. Ultimately it may reach the head, and indeed most parts of the body excepting the extremities. An examination of the skin will lead to the detection of small pimples, and elevations of the cuticle from the exudation which goes on beneath it. The formation of scabs all over the affected surface follows, and these become confluent as the disease advances. Scabs, if violently removed, disclose a raw surface beneath. A peculiar form of mange in the extremities, due to the presence of
a variety of mange-mite, which is known as the Symbiotes on account of being found in clusters or colonies, occurs in the horse, but is only rarely detected, as the itching which induces the animal to rub and bite its legs is generally ascribed to other causes. The acarus usually locates itself in the hind fetlocks, but occasionally it attacks all four limbs, and it is commonly found in cases of grease. The symbiotes appear to be par- ticularly active at night, and a knowledge of this fact is important, because when a horse is found to kick at the stall-rjost or strike his hind- or fore- feet constantly on the floor of the stable during the night, there is reason to suspect the presence of this form of mange (symbiotic mange), and a careful examination of the extremities should be made. The discovery of the symbiotes in the loosened cuticle of the legs will furnish satisfactory evidence of the nature of the disease. The varieties of mange are to be distinguished with absolute certainty
only by microscopic examination of the hair and scabs taken from the parts of the skin which are most affected. The examination is comparatively easy. Scrapings from the diseased parts have to be placed in a drop of water on the slide, teased out with dissecting needles, and covered in the usual way with a thin covering glass, and examined with the half-inch objective. The three varieties of mange-mites which have been mentioned are illustrated in the accompanying plate (Plate XXXVI, figs. 5, 6, 7, 8), and there will be no difficulty in distinguishing them by comparing them under the microscope with the figures. Treatment.—Under ordinary circumstances mange in the horse is
amenable to treatment, but when sarcoptic mange is allowed to run its course, the rapid multiplication of the parasites, and the damage which they do to the skin, and the consequent irritation which results, frequently |
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HEALTH AND DISEASE
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|
168
|
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|
lead to fatal consequences, and it has been found necessary, on several
occasions when the disease has assumed this virulent form, as it does among ponies which are left to run wild in mountain districts, to apply the stamping-out system in order to check the progress of the disease by the slaughter of the affected animals. Mange frequently attacks horses in large working establishments, but
is comparatively unknown in well-managed stables, in which horses are treated with particular care. In the present day it is never allowed to spread, even where horses are congregated in very large numbers, but is at once arrested by proper treatment. It very commonly happens in large establishments, where animals are
under veterinary supervision by contract, that mange dressings are among the remedies which are kept at hand, and as the veterinary surgeon •employed pays periodical visits of inspection, the first symptoms of ■disease are noted, and the remedies are applied at once. As a preliminary to any form of medical treatment it is essential that
:all the affected parts of the skin should be thoroughly washed with hot water and soft soap, applied by means of a hard brush, in order that all the scabs may be removed, so that the agent used may reach the surface of the skin. In instances where the scabs have become exceedingly thick and hard it is recommended to use the curry-comb to remove them. Preparations of mercury, carbolic acid, sulphur, turpentine, and tobacco
are commonly used as dressings, and perhaps it may be said that the selection of the remedy is of less importance than the manner of its appli- cation. One thorough dressing will prove more effective than any number of partial and intermittent applications which leave certain diseased parts untouched. Dressings must of course be repeated, and in each case preceded by a
thorough washing, until the cessation of the disease is indicated by the growth of new hair and the absence of itching. This can be ascertained by rubbing the skin and watching for movements of the animal's mouth, which certainly occur if any irritability remains. Mange, like all parasitic diseases, is classed as a contagious affection
simply because the acari may migrate from a diseased animal to others, or some of the eggs may be transferred by the agency of clothing or stable implements. It is therefore necessary to adopt precautions in all cases by disinfecting or destroying such articles as soon as the disease is cured. |
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DISEASES WHICH ARE INDUCED BY PARTICULAR PARASITES 169
PARASITES OF THE DIGESTIVE SYSTEM OF THE HORSE
Numerous organisms derived from the animal and also from the plant
world inhabit the digestive system of the horse. The majority of them may be passed over with very slight notice, as it has not yet been proved that they are responsible for any morbid conditions, although it is ex- tremely probable that some of them do produce various forms of derange- ment which are referred to other causes. Among the vegetable parasites are numerous fungi, such as the common mould, and others which belong- to the same family. These fungi are found in the mouth, and thence quite through the digestive track. The parasites which are derived from the animal world are extremely
numerous throughout the digestive system. Beginning with the lowest forms of life, there are found many of the
sporozoa and infusoria, some families of which, the Coccidia, are met with in the liver and the epithelial cells of the mucous membrane. But in the horse it has not yet been demonstrated that any special disease attends their presence. Coming to the more important parasites, there are first to be considered
the worms which infest the stomach of the horse. In this country the minute nematode discovered by Professor J. Wortley
Axe in the stomach of the ass, and two varieties described by Professor Peuberthy in the horse, and the larvse of the CEstrus equi, or stomach bot {fig. 273), are the only parasitic worms of the stomach of the equidse; but two varieties of spiroptera, the megastoma and microstoma, are described by Continental helminthologists. The spiroptera, like the Strongylus axei (Cobbold), form small round tumours in the mucous membrane. No special signs of illness appear to attend the presence of these worms in the stomach. With regard to the larvae of the bot-fly, which are found in clusters attached to the cuticular membrane of the stomach, opinions are very much divided, some authorities contending that they produce irrita- tion in the stomach, and sometimes even bore their way completely through the coats of that organ. The rule, however, is that they simply penetrate the mucous membrane sufficiently to enable them to retain their hold until the time comes for them to quit their temporary habitation and assume the pupa, or chrysalis stage, in which the perfect fly is developed. The next illustration was taken from a portion of the stomach, showing
the small tumours of the spiroptera and a number of bots attached to the membrane. A smaller variety of the bot, of a reddish colour, is sometimes seen
clinging to the anus; it is known as the CEstrus hcemorrhoidalis. |
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HEALTH AND DISEASE
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170
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The eggs of the bot-fly are deposited on the hairs of the horse's legs in
the early summer, and they are soon hatched by the sun. The newly- hatched larvae by their movements cause a certain amount of irritation and are licked off by the horse, and in this way are quickly conveyed to the stomach, to the mucous membrane of which they at once attach themselves by means of the hooked mandibles with which they are provided. The larvae remain attached to the cuticular membrane of the |
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|
A, Egg of Bot-Fly as it appears stuck on a hair. B, Egg of Bot-Fly, showing the Operculum or lid. c, Lid
pushed aside and the larva escaping. D, Larva fully developed after having been in the stomach of the horse. E, Head of Larva, showing Hooklets by which it anchors on to the mucous membrane of the stomach. F, Bot-Fly developed from D. G, Larvse of Bot-Fly anchored on to mucous membrane of the stomach of the horse. stomach for some months, probably the greater part of a year. When
sufficiently developed they relax their hold and are expelled. It may be noted here, however, that treatment is of no avail; there are no safe remedies which will cause the bots to abandon their position until the proper time. But the fact of quitting their hold naturally calls attention to their existence, and the use of any remedy at this period is sure to be attended with an apparent success. The smaller red variety, the Oestrus hcemorrhoidalis, deposits its eggs
on the lips of the horse, whence the larvae are transferred to the stomach. They are much less common than the larvae of the Oestrus equi. Of the nematodes which infest the intestines of the horse a large white
or pale-yellow worm, the Ascaris megalocephala, is the most common. |
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DISEASES WHICH AEE INDUCED BY PARTICULAR PARASITES 171
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|
The worm varies in length from 3 or 4 inches up to a foot or more, and
it is occasionally present in such enormous numbers in the small intestines as to fill them completely, necessarily causing a good deal of disturbance. Occasionally a worm passes up the pancreatic duct, and now and then one is found in the duct leading to the liver. When in sufficient numbers to cause obstruction in the intestinal canal they are said to cause symptoms of colic, giddiness, epilepsy, and tetanus; but when only a few are present they do not seem to cause any inconvenience. The illustration repre- sents the general form of these worms of small dimensions (fig. 274). Various remedies are used for the expulsion of
these worms, among them arsenic, calomel, tartar emetic, carbolic acid, turpentine; and recently san- tonine has been employed, and has proved to be more reliable than any of the other agents. The dose for a horse is 15 grains in a ball, with 3 or 4 drachms of aloes. The medicine should be re- peated in a week. Another of the nematode worms is the whip-
worm (Oxyurus curvula), which infests the large intestines and occasionally excites irritation of the |
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|
Fig. 275.—Oxy-
urus of Horse— Female (natural size) vu, Vulva.
a. Anus. |
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|
anus, which is indicated by the horse constantly
rubbing the tail. A marked symptom of the presence of oxyurides is the accumulation of yellow dust-like matter around the anus. This |
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|
is made up of the eggs of the parasite.
The expulsion of these worms is much assisted by occasional
enemas of salt and water. An illustration of this worm is given |
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|
Fig. 274.
Ascaris (about
J nat. size)
|
in fig. 275.
Two other nematode worms are found in the intestine of
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|
the horse. Both of them deposit their eggs beneath the mucous
membrane, giving rise to small tumours. The two parasites are known as (l) the Strongylus armatus and (2) the Strongylus tetracanthus. The latter is the most common and the most destructive. The Strongylus armatus is distinguished by its large mouth, which is armed with a row of cutting teeth arranged close together. The Strongylus tetracanthus has, in addition to the row of teeth like the Strongylus armatus, four large spines, from "which the name is derived, and also inside the mouth a row of sharp hooks. It will be evident, therefore, that the creature is well provided with offensive weapons. The worm is constantly found accumulated in the large bowel, frequently in company with the Strongylus armatus. |
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172
|
HEALTH AND DISEASE
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|
In young animals a serious mortality is often caused by the invasion
of this worm in large numbers, as both the parent worm and the young- ones are true blood-suckers, and the embryos begin their ravages as soon as they escape from the cysts in which they are coiled up under the mucous membrane, in the manner seen in the illustration below, which is taken from a portion of the caecum. In the case of these two parasites, medical treatment has not hitherto
proved very successful. Turpentine, chinosol, perchloride of iron are the most promising remedies. Colts, the animals which suffer most from the invasion of the parasite, may receive san-
tonine in doses of 10 grains in a ball, or mixed with the food every day for three or four days, to be followed by a dose of linseed-oil. Other nematodes have been described by
writers, but they are not of very frequent |
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|
Trenia mamillana
(nat. size). |
occurrence, and it does not appear that they
|
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|
have been found among horses in this country.
Information regarding them may be found in Neumann On Parasites, from which work some of the illusti'ations of the present chapter are reproduced. Very few of the parasites of the next class,
cystic worms or flat-worms (flat helminths), inhabit the intestines of the horse. The common name tape-worm is given to
these parasites. In the horse the few tape- worms which infest the intestines are remark- able for their small size in comparison with |
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|
Taenia pe'rfoliata
(nat. size). Fig. 276.- |
Tsenia plicata
(nat. size). -Tape-worms |
other varieties which are found in cattle, sheep,
and dogs. |
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|
The three varieties are: the Taenia per-
foliata, which is something under 2 inches long and f inch in width; Tcenia plicata, about 3\ inches long and f inch in width; and Taenia mamillana, which is about an inch in length, and a little more than \ inch in width. (Fig. 276.) The pcrfoliata, which is most common, is distinguished by the presence
of a peculiar appendage, forming a kind of collar, round the neck. The parasite inhabits the caecum, seldom being seen in other parts of the intestinal canal. (Fig. 277.) Tcenia plicata is said to be found in the small intestine; sometimes
in the stomach (fig. 278). The Taenia mamillana (fig. 279) is also said to |
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DISEASES WHICH ARE INDUCED BY PARTICULAR PARASITES 173
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|
exist in the small intestine, but there is no record of its having been found
among horses in this country. All these tape-worms are peculiar in being unarmed, that is, are not provided with a double row of hooks, which |
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|
Fig. 277.—Tsenia perfoliata,
Cephalic Extremity (enlarged 7 diameters) |
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|
Fig. 278.—Taenia plicata,
Cephalic Extremity (en- larged 7 diameters) |
Fig. 279. —Tfflnia mamillana,
Cephalic Extremity (enlarged 15 diameters) |
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|
are common in other varieties. Nothing is known of the hydatid stage,
which forms the intermediate condition between the tape-worm embryo and the mature parasite. There are no indications whatever of the existence of the worms
during the life of the horse which they infest, and consequently no treat- ment has ever been attempted. A remark- able case is recorded of the existence of nearly all the parasites which have been described in one horse which was examined by Veterinary Surgeon Krause. There were found 519 Ascaris megalocej)hala, 191 Oxyurus curvula, 214 Strongylus armatus, many thousands of Strongylus tetracanthus, 69 Tcenia perfoliata, 287 Filaria papillosa, and 6 Cysticercus fas- ciolaris. To complete the history of the parasites
which infest the digestive organs of the horse it is necessary to allude to some which are found occasionally in the liver. |
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|
The fluke (Distoma hepaticum) (fig. 280)
|
Fig. 280.—Liver Fluke (Dutoma hepaticum,
Linn.) |
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|
sometimes effects an entrance into the liver
.A, Showing Anatomical details. B, Natural
ducts of llOl'SeS, especially ColtS, which size, c, Ciliated Embryo, or Young Distome. are feeding on wet pastures where the
embryos and larval forms of the parasite are abundant. Sheep, as is
well known, are destroyed in thousands in some localities by the invasion of this parasite, which causes the disease known as rot. A few cases are recorded of foals and colts having suffered from the accidental invasion of the fluke, but the disease among horses must be looked upon as. |
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|
174
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HEALTH AND DISEASE
|
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|
entirely exceptional. The fluke is not one of the worms which finds a
host in that animal under ordinary circumstances. Another parasite which is found in the liver of the horse is the cystic
stage of an extremely small tape-worm found in the intestines of the dog, the Taenia echinococcus. The worm, wdien fully grown, is on an average about \ inch in length, and never exceeds \ inch, but in its cystic (hydatid) stage it is one of the largest which exists. The Cysticercus echinococcus is found frequently in the liver, and
occasionally the lungs, of cattle and sheep; the cysts varying in size from that of a grape to that of an orange, as a rule, but now and then they are found of an enormous bulk. Each cyst contains a fluid in which are found floating a number of tape-worm heads, myriads of which are observed growing on the interior of the cyst. In one form of the parasite small cysts, or daughter-vesicles as they are called, are found abundantly in the fluid. This peculiarity has given rise to a division of the parasite into two classes:—■ 1. The Echinococcus altricipariens, in which the secondary vesicles
exist. 2. The Echinococcus scolicipariens, in which they are replaced by the
small spots on the membrane, and in the fluid the tape-worm heads {Scolices). The presence of these hydatids in the liver and other organs of animals
is often not attended with any indications of disease, even when the liver is so filled with the cysts as apparently to replace the normal structure. On the serous membrane of the chest and abdomen small wandering
echinococcus cysts are occasionally found. There is also a nematode worm {Filaria) which has been found in the peritoneal and pleural cavities of the horse, ass, and mule. It does not appear to have been recorded, however, among the parasites of the horse in this country. In the circulatory system of the horse, parasites are occasionally en-
countered, as the Surra parasite, found in the blood of horses in India, and the embryos of the Strongylus armatus and Strongylus tetracanthus, which locate themselves in the anterior mesenteric artery, and cause a well-marked aneurism. It is comparatively common in the ass. Parasites in the nerve-centres, or in the organs of special sense of the horse, are •extremely rare. There is one case recorded by Woodger of the presence of a hydatid in the brain of a horse. In this case the animal suffered from the same kind of giddiness and tendency to turn in one direction as is known to be characteristic of a sheep similarly affected with hydatid in the brain, and there are a few cases reported of the discovery of the embryos of the armed Strongylus in the blood-vessels of the brain. |
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COMPOSITION OF BONE
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175
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Cases have also been reported of the presence of bots (larvae of the
CEstrus equi) in the brain cavity of the horse, and also in the spinal canal of a pony. Among the organs of special sense, the eye of the horse seems to
be the only one which is invaded by parasites. It is recorded that Van Setten removed a pentastome from the right eye of a horse, and in horses in India the presence of a nematode worm is extremely common. The parasite is easily removed by puncturing the cornea and allowing the aqueous humour to escape, carrying with it the worm. A minute worm (Filaria palpebratus) is occasionally found under the
eyelids of the horse, causing irritation, with swelling of the eyelids and an abundant secretion of tears. |
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14. ORGANS OF LOCOMOTION-BONES
COMPOSITION OF BONE
All bones are made up of two parts: 1, an organic matrix; 2, mineral
matter or bone-ash. If the rib of a horse be macerated for a few days or weeks in dilute hydrochloric acid, the mineral or earthy matter will be dissolved out of it and the animal or organic matrix will remain behind. In this condition it still retains its original form, but, having lost its hardening constituents, it is now soft and flexible, and may be bent in any direction like a piece of india-rubber, or even tied in a knot. If a second rib be placed in a bright clear fire and burnt, all the animal
matter is destroyed and driven off, leaving the earthy substance behind as a white brittle mass, and, as in the previous experiment, still retaining the shape of the bone. The relative proportions of organic and inorganic matter entering into
the formation of bones vary at different periods of life. In young animals the former makes up nearly one-half of the whole, while in the adult it is reduced to nearly one-third, the remaining two-thirds comprising earthy or mineral substance. It is on account of the larger quantity of soft organic matter they contain that the bones of young animals are so much more yielding, and therefore less liable to break, than those of older ones. The earthy substance of a bone consists of phosphate and carbonate of lime in the proportions of 56 per cent of the former and about 13 of the latter. The animal matrix, which is a kind of gelatine, makes up the rest. |
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176 HEALTH AND DISEASE
STEUCTURE OF BONE
When a long bone is cut through it is found to consist of a hard outer
shell of compact tissue enclosing a looser portion made up of thin bony plates, interlacing with each other to form a number of spaces, and called spongy or cancellated tissue. In the centre of this is a cavity {medullary cavity) containing a soft reddish-yellow substance, the medulla or marrow. The compact substance is thick in the shaft of the bone, but thin towards the extremities, which are chiefly made up of cancellated structure. All bones are covered with a dense tough fibrous membrane termed
periosteum. It serves as a matrix in which the blood-vessels ramify and |
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Fig. 281.—Transverse Section of Bone
a A, Haversian Canals. The small irreg-
ular black spots are the Lacunte; the lines radiating from them are the Canaliculi. |
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Fig. 282.—Longitudinal Section of Bone
A A, Haversian Canals. |
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break up into smaller and smaller branches, prior to entering into the bone
tissue through small openings on its surface. A similar fibrous membrane, though more delicate, also lines the interior of bones, and is known as endosteum. This membrane is very thin, though rich in blood-vessels, and affords nourishment to the inner portion of the bone and to the marrow contained in it. Besides the vessels passing into the interior from the periosteum, the long bones have also a nutrient artery, for which a special opening is provided in the shaft of the bone called the medullary foram,en, and others less considerable situated around the extremities {articular foramen). The intimate structure of bone can only be made out by microscopic
examination under a power of 300 to 400 diameters. Although bone looks |
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*
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SKELETONS OF HORSE AND MAN
(The same figures indicate the corresponding parts in each) |
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1. Skull.
2. Atlas.
3. Dentata.
4-8. Cervical vertebra?.
9-27. Dorsal vertebras. 28-33. Lumbar vertebrae. 34-38. Sacral vertebras. 39-52. Coccygeal vertebra. 53. Eibs.
54. Sternum.
55. Scapula.
56. Humerus.
57. Elbow-joint.
58. Olecranon.
59. Ulna.
60. Radius.
61. Pisiform bone.
62. Lunar bone.
63. Cuneiform bone. V a. Carpus.
64. Os magnum.
65. Unciform bone.
66. Small metacarpal. 1
I h. Metacarpus
67. Large metacarpal. J
68. Sesamoid bone.
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69. Fetlock-joint.
70. Os suffraginis. -\
71. Os coronas. Yo. Phalanges.
72. Os pedis or pedal boneJ
73. Navicular bone.
74. Innominatum.
75. Tuberosity of ischium.
76. Hip-joint.
77. Femur.
78. Patella.
79. Stifle-joint (true knee).
80. Fibula.
81. Tibia.
82. Os calcis (true heel).
83. Astragalus.
84. Cuboid.
85. Os magnum. >■ d. Tarsus.
86. Os medium.
87. Os parvum.
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88. Large metata
89. Small metata
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irsal. ~|
irsal. J |
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Metatarsus.
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90. Os suffraginis. -v
91. Os corona. Yf. Phalanges.
92. Os pedis or pedal bone J
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>
m X |
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SKELETONS OF HORSE AND MAN
By permission, from the Mounted Skeletons in the Natural History Museum, South Kensington
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6<5>
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CLASSIFICATION OF BONES 177
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the hard material that it is, we have already pointed out the provisions
which exist in it for an ample supply of blood to circulate in its interior, and repair the waste of tissue that is here as elsewhere constantly taking place. How this is effected will presently be seen. If a very thin transverse section of bone (fig. 281) be made, and sub-
jected to the scrutiny of the microscope, it will be found to present a definite order of arrangement of its several parts, conspicuous among which are a number of openings -gr^ to -^o inch in diameter. These are the Haversian canals, so called from the name of the person (Havers) who first detected them. The Haversian canals are each surrounded by a group of bony rings arranged concentrically or one outside another. In and between these rings will be noticed a number of small spider-like bodies (lacunae) from which fine dark lines (canaliculi) radiate in all directions. If a similar section be made longitudinally, and inspected under a similar power, what in the first appeared as openings will now come into view as tubes traversing the bone tissue (fig. 282), and dividing and reuniting; the same dark lacunae and canaliculi intervening between them. The Haversian canals are so many channels for the accommodation of
blood-vessels, by which the circulation in the bone is carried on. The lacunae are small corpuscles or spaces containing a mass of living
protoplasm, and the fine lines proceeding from them are minute channels which communicate with each other and with the Haversian canals, into- which some of them open. These channels serve the purpose of distribut- ing nutritive matters for the support of the bone tissue. CLASSIFICATION OF BONES
Bones are divided into three classes, distinguished as long bones, flat
°ones, and irregular bones. Long bones make up the extremities, where they give support to the
body, and act as so many levers in the function of locomotion. Each long °one is composed of a central portion or shaft and two extremities. The former is the more compact and narrow, the latter is chiefly formed out of spongy tissue, and is broad, and yields an articular surface covered with cartilage. Flat bones, for the most part, enter into the formation of cavities con-
taming important organs, as the cranium, the chest, and the pelvis. Irregular bones are distinguished by their many angles and depres-
Sl°ns, such as the vertebras, and the bones of the knee and the hock-joint. J-hey are mainly composed of cancellated tissue enclosed in a dense outer *ayer of compact structure. Vol. 11. 46
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178
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HEALTH AND DISEASE
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To whatever class a bone may belong it will have upon it eminences and
depressions. Some of these will be articular, and by uniting with other bones form joints, while others will be non-articular, and give attachment or lodgment to ligaments, muscles, or tendons. GROWTH OF BONES
In the course of the growth of the foetus much of the skeleton is laid
down in a soft flexible substance termed cartilage or gristle, out of which bone is ultimately developed by a succession of changes, including the deposition of mineral matter into its structure. In long bones this process of ossification is first commenced in the centre of the diaphysis or shaft, from which it spreads to the extremities, where it is ultimately met by an •ossifying centre from each. The two ends are termed epiphyses, and ■during the period when the animal is growing they may be, and sometimes :are, broken away from the shaft by muscular contraction and other forms .of violence. Where a considerable projection appears on a bone, as on the upper end of the femur, they are produced from separate centres of ossification and known as apophyses. Growth in length takes place between the ossifying centre in the shaft
and those of the extremities; in thickness it proceeds from the inner surface of the periosteum, which lays down bony matter layer upon layer. Flat bones, such as those which enter into the formation of the cranium,
the scapula or blade bone, &c, are developed between two membranes and not, as in long bones, from a pre-existing model of cartilage. The former is termed intra-membranous ossification, the latter intra-cartilaginous. SKELETON
The skeleton is the bony framework which gives attachment to muscles,
forms cavities for the safe lodgment of the organs essential to life, and gives general support to the body. When the bones are united by their proper ligaments the skeleton is said to be a natural one, but when they are held together by wire, catgut, and other foreign materials, it is termed an artificial skeleton. The skeleton of the horse is made up of about 163 bones, which are
united in various ways to form joints movable or fixed, according to the purpose of the part into which they enter. The skeleton is divided into trunk and extremities. The trunk com-
prises the head and spinal column, the ribs, the sternum, and pelvis. The extremities are distinguished as the fore and hind, or the thoracic and pelvic. |
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VERTEBRAL COLUMN
|
179
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VEBTEBEAL COLUMN
The vertebral column consists of a long series of irregular-shaped bones
termed vertebrae, united together in various ways to form a long undulat- ing column commonly known as the "spine". Vertebrae are divisible into true and false. The former are character-
ized by the presence of a certain group of parts, some of which are absent in the latter. Moreover, true vertebras in health are always free and separate from each other, while false ones may become joined together by bony union. Examples of the latter are seen in the bones of the sacrum and those of the coccyx or tail. Each of the several vertebrae, from the head backward as far as the
commencement of the tail, forms a ring which, when the whole are brought together, constitutes the spinal canal in which is enclosed the spinal cord. The vertebral column contains from 50 to 54 pieces, which for con-
venience of description are divided into four sections, viz.: the cervical, dorsal, lumbar, and sacro-coccygeal. The first 7 bones are the cervical vertebrae or neck-bones; beyond
these are 18 dorsal vertebrae or back-bones, behind which are sometimes 5 but mostly 6 lumbar or loin bones, and beyond these are 5 sacral bones, corresponding to the croup, and 14 to 18 coccygeal or tail bones. For the most part the vertebrae composing these several regions bear
more or less resemblance to each other, but possess some special differ- ences by which bones of one region may be distinguished from those of another. True Vertebrae are characterized by a number of bony prominences
°r processes, a central canal for the accommodation of the spinal cord, a solid discoidal mass or body and an arch (neural arch). The anatomical parts of a vertebra are shown in figs. 4 and 5, Plate XXXVIU. A conspicuous exception to this formula is presented by the first
cervical vertebra, which is a simple ring of bone with two broad slop- lng transverse processes and a small inferior spinous process (fig. 1, Plate XXXVIII). The Processes.—The superior spinous processes of the neck are very
short, those of the. back and loins are long, especially in the region of the withers, where they increase in length from the first to the fifth and then diminish again backward (Plate XXXVII). The inferior spinous processes are for the most part small, and in some
the bones only exist in a very rudimentary state. The two transverse processes, right and left, consist of irregular bony
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180 HEALTH AND DISEASE
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prominences varying in form and size in different parts. In all they
serve for the attachment of muscles, in addition to which those of the dorsal vertebrae are also united to the ribs, with which they have a synovial articulation. In the neck an opening passes through the trans- verse processes of the first six vertebrae, while in the loins these processes are very long and flat, and some of them behind have synovial articula- tions by which they are joined together. The oblique processes are situated on the anterior and posterior parts
of the arch. They form joints with corresponding parts on the bones in front and behind them by broad synovial surfaces, the two anterior of which look upward and inward, while the two posterior look downward and outward. The Body is the thick solid base on which the arch rests, and which
forms the floor of the spinal canal. Its anterior extremity is round or convex, and fits into a corresponding hollow or concavity in the bone before it. Its posterior extremity is concave, and receives the rounded end of the vertebra which follows it. These convexities and concavities are much greater in the cervical vertebrae than in other regions, on account of which the neck is able to move with exceptional freedom in all direc- tions. On either side, in front and behind, a small depression exists on the bodies of the dorsal vertebrae for the accommodation of the heads of the ribs, which fit in between them to form a synovial articulation. The Neural Arch is formed by two plates of bone which spring from
the upper surface of the body on either side, and unite above to form the spinal canal. In the anterior and posterior borders of the neural arch above the body of each vertebra are two notches which, with cor- responding notches in the vertebrae before and behind it, form openings, termed the intervertebral foramina, through which the spinal nerves leave the spinal canal. The False Vertebrae are those of the sacrum, the several pieces of
which are firmly joined together by bony union, and the coccygeal bones, from which some of the parts above described are wanting or exist only in a rudimentary form. PARTICULAR VERTEBRAE
The first vertebra or Atlas (fig. 1, Plate XXXVIII), so described
because in the human family it supports the head, differs in a striking manner from the typical vertebra, being a mere ring of bone, having two broad wings or transverse processes jutting out from the sides. In front it presents two deep concave surfaces, which articulate with corresponding |
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PLATE XXXVIII
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Fig. i. ATLAS (supero-posterior surface)
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5. Inferior tubercle or inferior
spinous surface.
6. Spinal canal.
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Wing.
Supero-anterior foramen.
Postero-inferior foramen. Surface for articulation with axis. |
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DORSAL VERTEBRA (front view)
1. Superior spinous process. 2. Transverse
process. 3. Articulation for tubercle of rib. 4. Articulation for head of rib. 5. Anterior articular face of body. 6. Spinal canal. |
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Fig. 2. ATLAS (antero-inferior surface)
1. Wing. 2. Postero-inferior foramen.
3. Facet for avticulation with condyles of occiput.
4. Inferior tubercle or inferior spinous process
5. Spinal canal.
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DORSAL VERTEBRA (side view)
1. Superior spinous process. 2. Facet for articulation of tubercle of rib. 3. Posterior articular process. 4. Facet for articulation of head of rib. 5- Intervertebral notch 6 Body. 7. Posterior articular surface oi body. 8. Anterior articular surface of body. |
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Fig. 3. AXIS (side view)
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i- Superior spinous process. 4. Odontoid process.
2. Intervertebral foramen. 5. Inferior spinous process. 3 Transverse process. 6. Posterior articular face of body.
7. Oblique process.
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CERVICAL AND DORSAL VERTEBRA
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PARTICULAR VERTEBRA
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181
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convexities or condyles (occi-
pital condyles) at the back of the head. It is by the peculiar construction of this joint that the free up-and-down move- ment of the head upon the neck is rendered possible. Behind is a large single
articular surface with which it is united to the second bone or axis. The spinal opening in this bone is of considerable size, in order to permit the exten- |
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283.—Cervical Vertebra
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sive and varied movements of
the head upon the neck with- |
1 Articular Head. 2 Vertebral Foramen. 3 Transverse Pro-
cess. 4 Spinal Canal. 5 Anterior Articular Process. ° In- ferior Spinous Process. |
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out injury to the spinal cord.
The Axis (fig. 3, Plate XXXVIII) or second bone of the neck is so
called because it serves as a pivot on which the head is moved from side to side. The pivot is provided by a pro- cess of bone (odontoid process) which proceeds from the anterior extremity of the body and passes into the ring of the atlas which is in front °f it. This bone differs from the other cervical vertebrae, in the large size and strength of its superior spinous process, the small size of the transverse processes, and the presence of only two oblique processes, which are behind. The remaining five cervical vertebrae are dis-
tinguished numerically as the 3rd, 4th, 5th, 6th, and 7th. (fig. 283), and although each possesses some minor distinctive feature, it is not neces- sary to dwell upon them here. |
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Fig. 284.—Dorsal Vertebra (Front
View) 1 Superior Spinous Process.
2 Transverse Process. 3 Articula- tion for Tubercle of Rib. 4 Articu- lation for Head of Rib. 5 Anterior Articular Face of Body. 6 Spinal Canal. |
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The Dorsal Vertebrae (fig. 284) present
a good deal in common. Some of them, how-
ler, are readily distinguishable from the others Dy the length of the superior spinous processes. J-his is especially the case with regard to the |
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first eight bones. Of these the length in-
creases to the fifth, and then gradually diminishes backward. The Lumbar Vertebrae (fig. 285) are distinguished from those above
described in the much greater length and width of their transverse pro- |
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182 HEALTH AND DISEASE
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cesses, which are directed horizontally outwards. The last two are much
thicker and somewhat shorter than the rest, and are united to each other |
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Fig. 285. —Lumbar Vertebra
1 Superior Spinous Process. 2 Anterior Oblique Process. 3 Transverse Process. 4 Anterior
Articular Face of Body. 5 Spinal Canal. by the borders of their transverse processes, and to the transverse process
of the sacrum by synovial articulations. The Sacrum (fig. 286) or rump bone, as we have already pointed
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^H Fig. 286.—Sacrum (Side View)
1 1 Superior Spinous Processes. 2 Transverse Process. 3 Articulation for Last Lumbar Vertebra. 4 5 6 7 Superior
Sacral Foramina for the passage of the Superior Sacral Nerves. out, is a large single triangular bone in the adult, resulting from the
welding together of five vertebrae, which are separate in the foetus. It |
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CRANIUM
|
183
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forms that part of the body termed the croup, and is fixed like a wedge
between the dorsal spines of the ossa innominata or hip bones. The Coccygeal Vertebrae, or tail-bones, are from fourteen to
eighteen in number. The first three or four partake very much of the character of true vertebrae, being wanting only in the oblique processes. In the remainder of the tail-bones the proper vertebral characters gradually become more and more obscure until they altogether disappear. Most of the bones of the spine present some peculiarity of form by
which they may be distinguished one from another; but enough has been said to give the reader a general idea of their characters. SKULL
The skull or bony framework of the head is situated at the anterior
extremity of the vertebral column, from which it is suspended by ligaments and muscles, and on which it is capable of being freely moved in all directions. It forms a number of cavities for the lodgment of important organs, as the cranium, the orbit, and the mouth. In the young animal it is made up of thirty-two pieces or separate
bones, all of which, excepting the lower jaw and the hyoid or tongue bone, become united in the adult by ossification. Of the thirty-two bones, the following six are single:— Occipital Bone. Ethmoid Bone. Inferior Maxillary Bone or
Sphenoid Bone. Vomer. Lower Jaw.
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Hyoid or Tongue Bone.
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The rest are in pairs :-
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Parietal Bones. Anterior Maxillary Bones.
Frontal Bones. Malar Bones.
Squamous Temporal Bones. Lachrymal Bones.
Petrous Temporal Bones. Palatine Bones.
Nasal Bones. Pterygoid Bones.
Superior Maxillary Bones. Turbinated Bones (two pairs).
The head is divided into the cranium and the face.
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CRANIUM
As compared with the body, the cranium or brain-case of the horse
ls remarkable for its small size. Of the thirty-two bones forming the skull, fourteen are engaged in enclosing the cranium, of which four are smgle bones, and the rest pairs. |
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HEALTH AND DISEASE
|
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|
184
|
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Occiput. — This bone is situated at the superior extremity of the
cranium, and, as we have already pointed out, furnishes two large con- dyles, by which it articulates with the atlas, or first bone of the neck (15, fig. 289). Above, it forms
the crest or prominence between the ears, while below it gives off a process {basilar process) which passes forward to assist in form- ing the base of the skull. Be- hind, it forms the superior boun- dary of the cranium, where it presents two rounded projections or condyles. Between these is a large opening [foramen magnum), through which the brain is con- nected with the spinal cord. On the outer side of the occipital con- dyles a bony projection (styloid process) is found. This, like other parts of the bone, affords attach- ment to important muscles. Parietal.—The parietal bones
are two, situated immediately be- neath the bone last described and above the frontal bones. They are united by the sagittal suture in the middle line of the cranium, and serve to form the roof of that cavity. Temporal Bones. — These
are four in number, two pairs, dis-
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tinguished from each other as the
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squamous and the petrous tem-
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|
Fig. 287.—Skull (Front Aspect)
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1 Occipital Tuberosity. 2 Parietal Bone. 3 Squamous
Temporal Bone. 4 Superior Orbital Foramen. 5 Lach- rymal Bone. 6 Malar Bone. 7 Inferior Orbital Foramen. 8 Foramen Incissiyum. 9 Anterior Maxillary Bone. J0 Nasal Suture. u Superior Maxillary Bone. 12 Frontal Bone. 13 Frontal Suture. 14 Temporal Fossa. w Sagittal Suture. |
poral bones, the former having a
shell-like structure, while the latter are of great density and hardness. The petrous temporal bones con- |
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tain the organs of hearing.
Squamous Temporal.—These are two flattened portions of bone situated at, and forming the sides of, the brain cavity. From the outer part, near the middle, a long bony eminence proceeds in a downward direc- tion to unite with the orbital process of the frontal bone above, and the |
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CRANIUM
|
185
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malar or cheek-bone below. This is the zygomatic process, on the under
surface of which will be seen a concavity for the reception of the condyle of the lower jaw, the two to- gether forming the inferior maxillary articulation or joint. Petrous Temporal.—Two
small hard irregular bones, but
of considerable importance ow- ing to their having within them |
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the special organs of
They are interposed |
hearing,
between |
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the occipital bones above, and
the parietal and temporal bones below, and assist in forming the lateral walls of the cranium. They are the hardest bones in the skeleton, and from them project several bony processes. One, the external auditory canal, communicates with the middle ear. Another, the sty- loid process, is a long thin piece of bone projecting downward and forward, and behind this is a larger rounded protuberance, the mastoid process, which is hollowed out into a number of small compartments connected with the middle ear. Another small process serves for attach- ment of the tongue bone, and is known as the hyoid process. Sphenoid Bone. — This
bone assists in forming the base
of the cranium. It is situated immediately below the occipital bone, with which it articulates. Its middle part or body is somewhat thick, and from it or wings, and downward two {pterygoid processes). |
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Skull (Posterior Surface)
|
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1 Foramen Magnum. 2 Styloid Process of Occiput. 3 Ex-
ternal Auditory Process. 4 Styloid Process of Petrous Tem- poral Bone. 5 Sphenoid Bone. 6 Pterygoid Process. 7 Superior Maxillary Bone. 8 Palatine Bone. 9 Molar Teeth. 10 Pala- tine Process of Superior Maxillary Bone. u Premaxillarv Bone. 12 Incisor Teeth. 13 Foramen Ineissivum. u Palato-maxillary Foramen. 15 Vomer. 16 Ethmoid Bone. 17 Temporal Con- dyle. 18 Foramen Lacerum Basis Cranii. 19 Basilar Process of Occiput. 2° Petrous Temporal Bone. 21 Occipital Condyle. |
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proceed upward two flattened portions,
narrower and more slender projections |
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HEALTH AND DISEASE
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186
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Ethmoid or Sieve Bone. ■— The ethmoid bone is situated in front
of the sphenoid, and forms the lower part of the division separating the cranium from the face. It consists of two lateral halves, separated by a perpendicular plate (the lamina). Each half in front consists of a number of thin fragile plates of bone, rolled up into small scrolls {ethmoidal cells), and attached to the cribriform plates, i.e. two bony plates having* a number of small holes in them, by which the olfactory nerves escape from the cranium into the nostrils. At the sides it throws up two wing- like processes, which articulate with the frontal bones. Frontal Bones. — These bones form a portion of the inferior wall
of the cranium, as well as that part of the face corresponding to the forehead. They are situated between the parietal bones above and the nasal and lachrymal bones below, and have union with several other bones of the cranium and face. Each of the frontal bones assists in forming an irregular cavity of considerable extent (frontal sinus), which con- tains air and communicates with the nostril. These frontal sinuses are lined by mucous membrane. They give lightness to the head, and in " nasal gleet" sometimes require to be opened in order to give exit to the pus which accumulates within them. They are very small in early life, but enlarge as age advances, and are separated one from the other by a bony partition. BONES OF THE FACE
Nasal Bones.—These bones form the anterior part of the face below,
and are situated beneath the frontal bones, and between the lachrymal and the superior and anterior maxillary bones. They are the slender bones commencing above by a broad extremity and ending below in a pointed process (nasal peak). They form the front boundary wall of the nasal cavities. Superior Maxillary Bones. — The upper jaw - bones are situated
on the side of the face, and join together by means of a flattened plate (palatine process) in the centre of the roof of the mouth, a large portion of which they form. They also form the floor and sides of the nostrils, and the sockets, or alveoli, into which the fangs of the upper grinders or "molar" teeth are implanted. Like the frontal bones, they are hollowed out into sinuses, which sometimes become diseased as the result of direct injury to the jaw, or to disease extending from the fangs of the teeth. In these cases they become filled with matter to which exit has to be given by an operation. Anterior Maxillary Bones. — These bones are situated at the
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187
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BONES OF THE FACE
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lower part of the face, and carry the upper incisor teeth. They are joined
together in front, and also by a thin flexible plate which forms the anterior part of the roof of the mouth and the floor of the nostrils. In the old animal they become inseparably bound together by ossific union. Lachrymal Bone. — This is a small bone situated at the inner angle
of the orbit, which it assists in forming. It has running through it a funnel-shaped cavity {lachrymal fossa), which gives lodgment to a small |
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Fig. 289.—Skull (Side View)
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0 Nasal Peak. 1 Nasal Bone. 2 Inferior Orbital Foramen. 3 Lachrymal Bone. 4 Orbital Cavity. 5 Frontal Bone.
temporal Fossa. 7 Zygomatic Arch. 8 Parietal Bone. 9 Supra-condyloid Process. 10 Occipital Tuberosity.
Petrous Temporal Bone. n External Auditory Hiatus. 13 Maxillary Condyle. 14 Styloid Process of Occipital
Bone. 15 Occipital Condyle. 26 Styloid Process of Petrous Temporal Bone. 17 Temporo-maxillary Articulation. 8 Squamous Temporal Bone. 19 Malar Bone. 20 Superior Maxilla. 21 Mental Foramen. 22 Anterior Maxilla. sac (lachrymal sac), and this is continuous with a long membranous canal
{lachrymal duct), which conveys the tears from the eye into the nostrils. Malar Bone. — This is placed at the outer and inferior part of the
orbit, where it sends a branch backward and joins the temporal bone to iorm the zygomatic arch, and the socket for the lodgment of the eye and its muscles. Palatine Bones.—The palatine bones are situated at the back part
°f the roof of the mouth, and form a narrow border to the posterior nares or opening between the nostrils and the throat. |
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HEALTH AND DISEASE
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188
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Pterygoid Bones.—These are two small slender bones placed imme-
diately above the palate bones. On the outer side of each is a groove or pulley, through which a small
tendon plays, belonging to the muscle {tensor palati) that tightens up the palate in the act of swallowing. The Vomer.—A single bone running along the whole length of the
floor of the nasal cavities, where it occupies a central position. Its anterior border is deeply grooved, and gives lodgment to a flat piece of cartilage |
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Fig. 290.—Lower Jaw
1 Coronoid Process. - Condyle. 3 Molar Teeth. 4 Mental Foramen. 5 Incisor Teeth. 6 Surface for
attachment of Masseter Muscle.
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{septum nasi) by which the nasal passages are divided one from the
other. Turbinated Bones.—These are four in number, two situated in each
nasal passage, where they are attached to the outer walls one above the other. They are long, thin, fragile plates of bone, folded upon themselves into rolls, which extend nearly from one extremity of the nose to the other. They are covered with mucous membrane, and afford a large surface for the distribution of the nerves of smell {olfactory nerves), and for the secretion of mucus. Inferior Maxillary Bone or Lower Jaw.—This is a single bone
composed of two flattened branches, which converge from above down-
ward, and unite in front to form the body. It is the largest bone of |
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THE THORAX OR CHEST
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189
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the face. It carries six molar teeth, or grinders, on each side, and six
incisor teeth in front. In addition, it also gives lodgment to two canine teeth or tusks in the male. Above it forms a hinge joint on either side, where its rounded prominences or condyles are fitted to corresponding depressions in the temporal bones by the interposition of a disc of cartilage. In front of the condyles are two long, thin, and flattened bony pro- minences, the "coronoid processes", which give attachment to muscles of mastication. On the inner sides above, and on the outer sides below, are two openings com- municating with a long- canal, through which pass an artery and a nerve to supply the teeth with blood and sensation. Os Hyoides or
Tongue Bone. — This hone is situated in the
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■J-
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region of the throat, and
is composed of five dis- tinct pieces. One is formed like a spur, hav- ing a short, pointed pro- cess projecting forward, and embedded in the |
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root of the tongue, and
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The Hyoid Bone and the Larynx
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the heel - like branches
directed backwards to be connected with the |
A, Superior or Long Cornu of Os Hyoides. B, Inferior or Short
Cornu. c, Thyroid or Heel-like Process. D, Spur Process. E, Epiglottis. F, Glottis. G, Cricoid Cartilage. H, Thyroid Cartilage.
I, First Ring of Trachea. J, Arytenoid Cartilage. |
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larynx or upper part of
the windpipe. The others, two flat slender pieces on either side (superior and inferior cornua), are united together and attached above to the Petrous temporal bone at the base of the cranium by means of a short rod of cartilage. The several parts composing the bone are joined to- gether by articulations, some of which form free-moving joints, to which the extreme mobility of the tongue is due. |
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THE THORAX OR CHEST
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The bony framework of this cavity is formed by the dorsal vertebrae
above, which we have already referred to, the sternum below, and the ribs which form the sides and part of the roof. |
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190
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HEALTH AND DISEASE
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Sternum or Breast-Bone (fig. 292).—This is a long bone, suspended
from the dorsal spine by the ribs, the first eight of which articulate with it. In early life it is made up of six distinct pieces, united by intervening |
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Fig. 292.—Sternum
1 Cariniform Cartilage. 2 Ensiform Cartilage or Xiphoid Appendage. 3 Inferior Border. Ml Cavities for
articulation with lower extremities of Costal Cartilages. |
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cartilage or gristle. In front it is like the keel of a vessel, owing to the
projection of a flattened piece of cartilage {cariniform cartilage) which curves upward and presents a sharpened border to the front, and below for about two-thirds of its length. The posterior extremity is continued |
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Fig. 293.—Sternum and Costal Cartilages
1 Cariniform Cartilage. 2 Ensiform Cartilage. 3-10 Costal Cartilages. |
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backward by a flat piece of cartilage, called the xiphoid or ensiform
cartilage, and along the superior part of each side of this bone are eight depressions, which receive the inferior ends of the cartilages of the true ribs to form so many synovial articulations or joints. |
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191
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THE THORAX OR CHEST
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The Ribs (Plate XXXVII).—We have already pointed out that there
are eighteen ribs on each side, distinguished numerically as the first, second, third, and so on. The first eight are attached to the sternum and designated true ribs. The remaining ten, having no such connection, are called false ribs. Although they are thus distinguished, they all possess certain common characteristics. They are long, flat, more or less curved or arched outward from the chest, and are, besides, somewhat twisted on themselves. They are all connected with the vertebrae above by two free- moving joints, and below they are at- tached to rods of car- tilage {costal carti- lages), through which the first eight become united by synovial articulations to the upper part of the side of the sternum, as already explained. Each rib possesses a head, a neck, and a tubercle at the su- perior extremity. The head fits into a hollow formed between the bodies of two verte- |
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brae, where it is united
oy ligaments to form a free-moving joint. |
Fig. 294.—Pelvis (Superior Aspect)
1 Anteroinferior Spine of Ilium. 2 Supero-posterior Spine of Ilium.
3 Obturator Foramen. 4 Lateral Ischiatic Notch. s Tuberosity of Ischium. 6 Ischiatic Arch. 7 Symphysis Ischii. 8 Symphysis Pubis. |
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The tubercle forms
another synovial articulation with the transverse process of the vertebra behind. The length of the ribs varies with the position they occupy, ^rom the first to the ninth they increase in length, and then progressively they diminish to the last. Variation is also noticeable in the width, which increases from the first to the sixth or seventh, and then diminishes to the eighteenth. The outward curve they make increases from the first to the last, and
gives rotundity to the body in proportion as it is great or otherwise. Costal Cartilages.—Th ese are cylindrical pieces of cartilage extend-
lng in a forward direction from the lower extremities of the ribs, which they serve to elongate. The first eight are united with the sternum, and |
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HEALTH AND DISEASE
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192
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are the thicker and stronger. They increase in length from before back-
ward to the eleventh, after which they become shorter. The Pelvis (figs. 294, 295).—The bony pelvis or hip girdle consists
of two portions, termed coxse or ossa innominata, which, together with the sacrum and the front segments of the tail-bones, form the cavity of the pelvis. The ossa innominata are flat, irregular bones, which, after forming the
sides of the pelvic cavity, join together below to form its floor. In the fcetus each innominate bone consists of three pieces, termed the ilium, the ischium, and the
pubis. The ilium, the largest of the three, is that portion which unites with the sacrum above, with the acetabulum or femoral joint below, and outwardly forms the " point of the hip". The ischium is that portion which, on leaving the hip- joint, which it assists in forming, passes backward to the point of the buttock, and |
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-Pelvis and Sacrum (Inferior Aspect)
i Anterior Articular Body of Sacrum. 2 Posterior Spinous Process of Ilium.
s Crista of Ilium. 4 Anterior Spinous Process of Ilium. s Neck of Ilium. 6 Acetabulum. 7 Obturator Foramen. 8 Lateral Isehiatic Notch. 9 Ischiatic Arch. '» Tuberosity of Ischium. " Coccygeal Extremity of Sacrum. ^Sub- sacral Foramina. 13 Anterior Articular Process of Sacrum. |
inward to join its
fellow on the opposite side, thus contribut- ing to the floor of the |
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pelvis, and to the for-
mation of a large opening there—the obturator foramen. The pubis is the smallest of the three bones entering into the forma-
tion of the coxa. It is situated in front of the floor of the pelvis, which, together with the foramen just referred to, it concurs in forming. With the ilium and ischium it also joins in making up the acetabulum or cup like cavity into which the head of the femur fits to form the flip-joint. The two pubic bones unite on the floor of the pelvis to form a seam,
or, as it is termed, the symphysis pubis. The cavity of the pelvis is much larger at the front or inlet than at
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THE FORE LIMB 193
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the outlet behind. The pelvic cavity of the mare is larger than that of
the horse in every direction, but especially from side to side. The floor of the female pelvis is distinctly wider than that of the male animal. |
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THE FORE LIMB
The fore extremity is made up of twenty bones: the scapula, humerus,
radius, and ulna above the knee; the scaphoid, lunar, cuneiform, pisiform, trapezoid, os magnum, unciform in the knee; and the large and two small metacarpal bones, two sesa- moid bones, the os suffraginis, os coronse, os naviculare, and os pedis below the knee. Scapula (%s. 296, 297).—This
is the uppermost bone of the fore hmb, a flat triangular segment placed on the side of the chest, where it takes an oblique direction downward and forward. Its base !s turned upward, and its apex con- curs with the humerus to form the shoulder-joint. A broad flat piece °f cartilage is attached to its upper border, and gives increased length to the bone, hence it is termed car- Wage of prolongation, or scapular cartilage. The scapula has three angles: 1, cervical, nearest the ne°k; 2, dorsal, nearest the back; 3> humeral, at the point of the |
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Moulder. The last presents a
shallow oval cavity, which receives the rounded head of the humerus |
Fig. 296.—Scapula (Outer Surface)
i, i Spine of the Scapula. 2 Coracoid Process.
3 Glenoid Cavity for Articulation of Humerus. 4 Dorsal
Angle. 5 Cervical Angle. 6 Cartilage of Prolongation. |
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to form the shoulder-joint. Im-
mediately above it, in front, is a large rough curved offshoot of bone, he coracoid process, which gives attachment to important muscles. The outer surface of the bone is divided into two unequal parts by
a bony ridge or spine. This bone is united with the trunk by muscles
?^Y- It has no synovial articulation or joint connection as in the hind
bmb. |
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Vol. ii.
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47
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HEALTH AND DISEASE
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•194
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Humerus (figs. 298, 299).
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The humerus, or arm-bone, is a bone of
great thickness and density, and is situated between the scapula or blade-bone above and the radius and the ulna below. Externally the body of the bone is deeply grooved by the furroiv of torsion, and presents at about its upper third a somewhat bold pointed pro- jection, the external tuberosity. On the internal surface it presents a rounded prominence, the internal |
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Fig. 297.—Scapula (Tnner Surface)
J Coracoid Process. 2 Glenoid Cavity. 3 Cartilage
of Prolongation. tuberosity, into which important
muscles sain insertion. On the upper extremity are the
broad rounded head and several bony prominences. The former, situated behind, is coated with cartilage, and articulates with the glenoid cavity of |
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Fig. 298.—Humerus (Front Aspect)
1 Bicipital Groove. 2 Small Trochanter.
3 Great Trochanter. 4 External Tuberosity. 5 Shaft with Furrow of Torsion. 6 Epitrochlea or External Condyle. 7 Supra-condyloid Fossa. 8 Epicondyle or Internal Condyle. |
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the scapula or blade-bone to form the
shoulder-joint. The latter comprise a double projection of bone on the outer side, termed the great trochanter. On |
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the inner side is the small trochanter
or tubercle, and between them a prominence which divides the upper
front portion of the humerus into two grooves (bicipital groove). The |
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THE FORE LIMB
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|
195
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|
grooves and intervening tubercle are covered with fibro-cartilage, and
over them plays, pulley-like, the broad
tendon of the flexor brachii muscle, between which and the bone there is a synovial membrane. |
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Fig. 299.—Humerus (Outer Aspect)
1 Great Trochanter. 8 Deltoid Tuberosity.
External Tuberosity. 4 Epitrochlea. 5 Epi-
«°ndyle. 6 Supra-condyloid Fossa. 7 Shaft of Bone with the Furrow of Torsion. 8. Articular Surface or Head. The lower extremity is smaller than the upper,
and in front presents two unequal rounded por- tions separated by a superficial groove. These are the internal and external condyles. Behind is a |
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^eep pit [supra-condyloid fossa), which separates
two prominent ridges from each other, and re- ceives into it a pointed process {peak) on the elbow when the joint is in extreme extension. FOREARM
|
Fig. 300.—The Forearm : Radius
and Ulna 'Ulna. 2 Point of Ulna.
3 Beak of Ulna. 4 Radio-ulnar
Arch. 5 Radio-ulnar Articu- lation. 6 Bicipital Tuberosity. 7 Shaft or Body of Radius.
8 Radio-carpal Articulation.
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Two bones, the radius and the ulna, which in early life are separate,
"Ut in the adult are ossified together, constitute this region. Radius (fig. 300).—This is the longest bone in the fore limb, and
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HEALTH AND DISEASE
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|
196
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extends from the humerus above to the knee below. Its superior extremity
is divided into two concavities by a small ridge, and corresponds with the two convexities and the dividing furrow observed on the lower extremity of the humerus, with which it ar-
ticulates to form the elbow-joint. Behind, towards the outer side, it presents a long roughened surface, where it forms a bony union with the ulna. The lower extremity is some-
what irregular, and articulates with the four bones comprising the upper row of the knee. In front there are three grooves over which three ten- dons play in passing down the limb to their points of insertion. Each tendon is supplied with a synovial membrane to facilitate its move- ments over the bone during flexion and extension of the knee. Ulna (%. 300).—The ulna is a
long tapering bone, united by ossi- fication to the outer and posterior surface of the radius. Its superior extremity is of considerable length and thickness, and projects from the head of the radius in an upward and backward direction. This is the elbow or olecranon process. In front it presents a smooth surface, which articulates with the groove between the condyles of the humerus, and also a hooked projection for- ward termed the beak. CARPUS OR KNEE
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88c
|
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This (fig. 301) is the analogue of the wrist of man. It is made up of
seven, sometimes eight, small irregular bones arranged in two rows of three each, one resting upon the other, with the seventh bone (pisiform) situated at the posterior and outer part of the upper row. |
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|
THE FORE LIMB
|
197
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The bones of the upper row,
enumerating them from within outward, are the scaphoid, lunar, cuneiform, and the pisiform be- hind; those of the lower row are the trapezoid, magnum, and unciform. Sometimes a fourth, termed the trapezium, is found at the inner and posterior part of the lower row. All these bones are united
by short strong ligaments. At their several points of contact they are covered with articular car- tilage or gristle, and enclosed in a synovial capsule. Altogether the knee is admirably adapted, by its many parts, to diffuse and disperse concussion, and at the sarne time for the performance °f that high and free action so much admired by connoisseurs. METACARPAL BONES
These are three in number,
aftd are distinguished as the lara;e Metacarpal bone, which occupies the centre, and two smaller ones at the sides. Os Metacarpi Magnum
\Ug. 303), or large metacarpal,
°r canon bone, extends from the knee to the fetlock joint, which it ssists in forming. It is rounded m front, flattened behind, and Very dense and strong through- out. Its superior extremity ar- ^culates with the lower row of fnee bones, and in front, below |
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Fig. 302.—Fore Leg from the Radius
1 Eadius. 2 Radio-carpal Joint. 3 Pisiform. 4 Cunei-
form. 5 Lunar. 6 Unciform. 7 Os Magnum. 8 Small Metacarpal Bone. 9 Large Metacarpal Bone. 10 Sesamoid Bone. " Fetlock Joint. 12 Suffraginis or First'Phalanx. 13 Superior Pastern Joint. 14 Os Coronse or Second Phalanx. a5 Navicular Bone. " Pedal Joint. 17 Os Pedis or Third Phalanx. |
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the
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articulation, towards the inner
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HEALTH AND DISEASE
|
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|
198
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side, is a roughened prominence into which the tendon of its extensor
muscle is inserted. At the back part of the upper end there is a roughened patch for the attachment of the suspensory and check ligaments. The lower extremity is rounded from before to behind, and divided by a prominent ridge into two nearly equal parts or condyles. The whole of this end is covered with cartilage, and
articulates with a corresponding surface formed by the upper extremity of the os suffraginis, or large pastern bone, and the two small sesamoid bones behind. Os Suffraginis, Large Pastern, or
First Phalanx (fig. 304).—The large pas-
tern is a short stout bone placed between the small pastern below and the fetlock joint above. Its superior extremity is larger than the inferior, and presents two shallow depressions separated by a groove, into which the central ridge and two con- |
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303. —Metacarpal Bones (Posterior
View) 1 Outer Small Metacarpal Bone. 2 Inner
Small Metacarpal Bone. 3 Large Metacar- pal Bone. 4 Nutritive Foramen. 6 Ar- ticular Condyles. 6 Intervening Ridge. |
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Fig. 304. —Os Suffraginis or Large Pastern
Bone |
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|
dyles, already spoken of as existing on the lower end of the canon, are
fitted to form a joint of considerable extent of motion. The lower ex- tremity is small, and divided by a superficial groove into two condyles. Sesamoid Bones (10, fig. 302).—These are two small floating bones situated behind the inferior extremity of the canon. They are somewhat triangular in form, with their bases directed downward, and are closely united one to the other. In front they are covered with cartilage, and articulate with the condyles of the canon bone, thus forming part of the |
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THE FORE LIMB
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|
199
|
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fetlock joint. Behind they are covered with fibro-cartilage, and by
apposition form a groove over which the great flexor tendon of the foot plays like a rope over a pulley. On the outer sides, from the apex downward, a roughened groove gives attachment to the two branches of the suspensory ligament. The under sur- face of the base is also roughened, and from it proceed short strong ligaments (inferior sesamoid), which attach the bones to the pos- terior surface of the large and small pasterns. Os Coronse (fig. 305), small pastern, or second phalanx, is a short bone placed be- tween the large pastern and the os pedis, or foot-bone. One-half of it is enclosed by the hoof, and the rest forms the region of the |
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|
Fig. 305.-
|
Os Coronas and Os Naviculare
(Anterior Aspect) |
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coronet. Its upper extremity presents two
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|
shallow depressions, with which the two con-
dyles of the lower end of the large pastern articulate. The lower end, like that of the suffraginis, is divided by a shallow groove into two con- dyles, by which the bone articulates with the os pedis. The tendon of the extensor pedis muscle is attached to the anterior surface, and that of the flexor pedis perforatus to the inner and outer part of the superior border behind. At the upper and posterior Part it is flattened and covered by fibro - cartilage, thus forming a smooth sur- face over which the tendon °f the flexor perforans freely plays in its course towards the foot-b one. |
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|
Os Pedis (figs. 306,
^07), coffin-bone, or third
phalanx. The coffin-bone is
|
Fig. 306.—Os Pedis (Plantar Aspect)
A, A Inferior Border. B Semilunar Crest. c Plantar Foramina.
D, D Eetrossal Processes. |
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contained in the hoof, of the
shape of which it in a large measure partakes. It is a porous bone,
having a number of holes in its front and sides for the passage of blood-
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200 HEALTH AND DISEASE
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vessels,, and is besides generally roughened for the attachment of the
sensitive laminae., A pointed process (coronal process) projects upward from the superior border in front, which affords attachment for the tendon of the extensor pedis muscle. The under surface is concave, and presents (l) a crescentic ridge (semi-
lunar crest) to which the tendon of the flexor pedis is attached; (2) behind this two .considerable openings (plantar foramina), through which pass the plantar arteries and nerves; (3) still farther back a roughened surface, to which the inferior ligament of the navicular bone is connected. The upper surface is divided by a slight ridge into two shallow cavities, with which the lower extremity of the coronet bone articulates. At the posterior border of this surface a
narrow, smooth, transverse space is provided for the articulation of the navicular bone with the foot - bone. Projecting backward from the inferior border behind are two bony processes, one on either side, termed alcB, or wings. Os Naviculare or
Shuttle Bone (fig. 305).— The navicular bone is a small
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Fig. 307.—Os Pedis (Side View
|
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flattened bone, broad in the
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A Coronal Process. B Superior Border. c, D Basilar and Re-
trossal Processes, forming- one of the ate or wings. E Preplantar Fissure. J? Facet for Insertion of the Extensor Pedis. |
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middle and tapering towards
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each extremity. It is situated
in the hoof, below the os coronas and behind the os pedis, with both of which it articulates to form the coffin-joint. The great flexor tendon passes over its under surface, and between the two a synovial membrane exists to lubricate the surfaces of contact and facilitate movement. The anterior border articulates with the foot-bone, as already explained, and is connected below with the inferior navicular ligament. The posterior border affords attachment to the posterior navicular ligament. To the pointed extremities are attached lateral ligaments which unite the bone with the os pedis, the lateral car- tilages, and the coronet bone. The navicular bone is the seat of that very common ailment, navicular
disease. |
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BONES OF THE HIND LIMB
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201
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BONES OF THE HIND LIMB
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The bones comprised in this region are the femur or thigh-bone, the
patella or knee-cap, and the tibia and fibula. Then come the bones of the hock, the astragalus, calcis, cuneiform magnum, cuneiform medium, cunei- form parvum, and cuboid. The bones below the hock are the same as those already described in speaking of the fore extremity—the three metatarsal, suffraginis, two sesamoid, coronas, pedis, and naviculare. Os Femoris or Thigh-Bone (figs.
308, 309). —This is a large, thick,
strong bone, extending obliquely down- ward and forward from the hip-joint above to the stifle-joint below. The shaft presents a number of roughened places for the attachment of muscles. For the same purpose there are also several bony prominences and ridges, notably the trochanter minor externus on the upper third of the outer sur- face, the trochanter minor internus near the upper third of the inner sur- face. The superior extremity is formed
by the head, a rounded projection which fits into the acetabulum or cup m the innominate bone to form the nip-joint, and on the outer side of |
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this a considerable eminence [tro-
chanter major) for the attachment of sonie of the large muscles of the croup. |
Fig. 308.—Os Femoris (Anterior Aspect)
1 Head. 2 Internal Trochanter. s 4 Tuberosities
for Ligamentous Insertion. 5 Internal and Ex- ternal Trochlea. 6 Trochanter Minor Externus. 7 Great Trochanter. |
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Behind and below the trochanter
major a somewhat deep cavity exists, called the trochanteric fossa, into which some smaller muscles are inserted. The lower extremity presents four large prominences—two behind, the
condyles, which are separated by a deep notch (inter-condyloid fossa), and two in front, the trochlea, with which the patella articulates. Above the |
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202 HEALTH AND DISEASE
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outer condyle behind is a deep depression termed the supra-condyloid
fossa.
Patella (fig. 310).—This is a small irregular bone analogous to the
knee-cap of man, and in the horse fre-
quently becomes displaced. Behind it is covered with articular cartilage, and comes into contact with the trochlea of the femur, over which it plays in pulley-like fashion as a part of the stifle-joint. Tibia or Second Thigh (fig. 311).
—A long bone extending from the
femur to the hock joint. It is broad above and narrow below\ The superior extremity articulates with the condyles of the femur, and is divided into two lateral articular portions by a conical projection {tibial spine). In front, and extending for some distance down the bone, is a projecting ridge, inclining somewhat outward; this is known as |
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Fig. 309.—Os Femoris (Posterior Aspect)
1 Great Trochanter. 2 Trochanteric Fossa.
3 Trochanter Minor Bxternus. 4 Supra-condyloid
Fossa. 5 External Condyle. 6 Inter-condyloid Fossa. 7 Internal Condyle. 8 Internal Trochlea. 9 Nutritive Foramen. lfl Internal Trochanter. 11 Fossa for attachment of Ligamentum Teres.
12 Head of Femur.
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Fig. 310.-
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-Patella (Superior and Posterior
Face) |
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1 Superior Face. 2 Articular Face.
3 External Border. |
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the "tibial crest". On the outer side of the head of this bone above,
a small smooth space is noticed for articulation with the fibula. The lower extremity of the bone, smaller than the upper, presents two
deep grooves and three prominent ridges which are covered with cartilage and articulate with the astragalus to form the " true hock joint ". |
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BONES OF THE HIND LIMB 203
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The inner and outer ridge each bears a projection distinguished as the
internal and external malleolus of the tibia. The former is very prominent, so much so, sometimes, as to give the inner and upper part of the hock an abnormal appearance. These projections afford attachment for strong connecting ligaments uniting the bones of the hock joint. The articular grooves, which they assist
in forming, take an oblique direction from behind outward and forward. The Fibula (3, fig. 311) is a long slender
bone connected with the outer side of the tibia, with the head of which it unites by a small synovial articulation. It is broad above and tapers downwards to the lower third of the femur, where it terminates in a pointed extremity. THE TARSUS OR HOCK
This joint (fig. 312) is composed of six
bones, viz., the calcis, astragalus, cuboid, cuneiform magnum, cuneiform medium, and cuneiform parvum. The Calcis is situated at the posterior and
outer part of the hock, of which it forms the " point ", and gives attachment to the tendons of important muscles as well as to powerful ligaments. It articulates in front with the astragalus and below with the cuboid bone and the cuneiform magnum, on which it rests. |
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Astragalus or Knuckle-Bone.—This
is the largest bone in the hock. It is placed
in front of the calcis, and from it project for- ward two pulley-like ridges separated by a |
Fig. 311.—Tibia (Posterior Aspect)
1 Spine of Tibia. 2 Articulation of
Fibula. 3 Fibula. 4 External Malleolus., s Internal Malleolus. 6 Shaft showing Bony Ridges for Muscular Attachment. |
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deep groove. These ridges are received into
two corresponding grooves already referred to as existing on the inferior extremity of the tibia, and the central ridge on the last-named part fits into the groove separating those on the astragalus. Together these two bones form the true hock joint, to which the movements of flexion and extension of the limb are for the most part due. The astragalus rests upon the cuneiform magnum, with which it forms a flattened gliding-joint of very limited movement. Behind, it articulates with the calcis. |
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204 HEALTH AND DISEASE
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The Cuboid is a small irregularly-shaped bone situated on the outer
and back part of the hock, having the calcis above it and the large and outer small metacarpal
bones below. Inwardly, it articulates with the cuneiform magnum and the cuneiform medium. The Cuneiform
Magnum is a flat bone
covered on its two surfaces with cartilage. It occupies a position between the astragalus above and the cuneiform medium below, and articulates besides with the cuboid, the cal- cis, and the cuneiform parvum. The Cuneiform
Medium is a triangular bone, and, like the mag- num, presents two flat- tened surfaces for articu- lation with the magnum above, and the large metacarpal or canon-bone below. By smaller articu- lations it is also connected with the cuboid and the cuneiform parvum. The Cuneiform
Parvum, the smallest
bone in the hock, is situ- ated at the inner and in- ferior part of the joint, in- |
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Fig. 312.—Bones of the Hock separated
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clining backwards, where
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it articulates with the
large and inner small metatarsal bones below, the magnum above, and the medium in front The outer surface of this bone presents a smooth surface over which one of the tendinous branches of the flexor metatarsi plays in a synovial sheath. |
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6
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DISEASES OF BONES
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205
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Except in very unimportant particulars the bones below the hock
resemble those below the knee, and do not, therefore, require special description. DISEASES OF BONES
RING-BONE
A ring-bone is an enlargement extending over the front, and sometimes
also over the back, of the pastern. It consists of a diffused bony excre- scence growing out of or upon the large or small pastern bone, or both. When affecting the former it is described as high ring-bone (fig. 314), when the latter, as low ring-bone (fig. 313). It is common to all classes of horses, but more especially prevalent in cart-horses and thoroughbreds. |
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A, Extensor Pedis Tendon. B, Os Suffraginis or First Phalanx. Fig. 314.—"High" Ring-
C, Os Coronae. D, Ring-bone. E, Os Pedis. Bone
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Causes.—Horses with upright pasterns, and animals with pasterns of
undue length, are specially predisposed to it. The exciting causes are chiefly blows, concussion, and sprains to the joints. Fracture of the pastern is invariably followed by ring-bone in the form of a reparative callus. It is also induced by the too early and severe work imposed on young, undeveloped animals, and especially when attended with bad shoeing, as where the heels are thrown up too high and an upright posi- tion given to the limb. Symptoms.—A hard, unyielding enlargement, more or less promi-
nent and extensive, is the characteristic indication of the disease. It passes across the front of one or the other of the pastern bones, and sometimes |
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HEALTH AND DISEASE
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206
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encroaches on the posterior surface. The degree and character of the
lameness will vary with the position of the growth. When situated on the small pastern, within the hoof, the lameness is very considerable, and the foot is brought to the ground with the bearing full on the heel. If it be situated behind, the fetlock joint is partially flexed and the weight is thrown on the toe. In other situations the action is not so conspicuously altered, but in all there is more or less severe lameness, with swelling, heat, and tenderness of the part. Treatment.—To subdue existing inflammation should be our first aim.
In this connection a dose of physic, with perfect rest, and the application of hot fomentations and bandaging, must be
resorted to; after which a repetition of blisters, or the application of the actual cautery to the pastern, will be required to check further growth of the excre- scence and to effect its reduction. A long rest is often needed before pain and lameness are removed, and in many instances this desired result is never |
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B--
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attained.
SPLINT
Splint (fig. 315) is a bony excrescence
situated on or near the small splint bones, and is often the means of per- manently uniting the latter to the canon. Not fewer than 90 per cent of our light horses suffer from this ailment, but a large proportion of this number acquire |
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Fig. 315.—Splint
a, Exposed Splint. b, Splint covered by Skin.
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it without suffering any inconvenience.
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Splints may be situated on the inner or
the outer part of the limb, but in the great majority of cases they occupy the first-named position. Some are placed well forward, while others are situated quite at the back of the leg. In the former position they are not of much importance, but in the latter they usually prove troublesome, and provoke most acute and lasting lameness by encroaching upon and irri- tating the ligaments and tendons there situated. These growths assume a variety of forms. Sometimes they are very prominent and project from a narrow base, at others they are quite flat and diffused, and consequently with difficulty recognized. There may be only one large one, or several smaller ones may exist, placed one below another along the course of the |
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DISEASES OF BONES 207
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splint-bone. When involving the knee, splints interfere with the flexion,
or bending, of the joint, and may occasion permanent disablement. The degree of lameness is not always proportionate to the size of the
growth. Splints sometimes develop to a large size without occasioning trouble, while very small ones, Avhen backwardly placed, may give rise to the most acute and abiding lameness. Causes.—Splints are hereditary in a very high degree—more so,
perhaps, than any other affection of the limbs. They usually appear between the ages of two and five years, but they are by no means rare in yearlings, and may occasionally be seen in foals. Owing to the great pre- disposition to them inherited by our horses, they are easily provoked to growth by too early work, and the imposition of heavy weights on the backs of the young and immature. Blows inflicted by one leg upon the other occasionally cause splints, and many cases are referrible to the concussion or jar induced by the high-beating action which some animals display. How far conformation and indifferent shoeing may take part in the
production of splint it is difficult to say, but there are reasons for the belief that they operate as inducing causes. Symptoms.—Although, as a rule, splints are obvious enough either to
the sight or touch, this is by no means always the case. In some instances the greatest care in the manipulation of the limb is required to detect them, and occasionally they evade the most diligent search. This is especially the case when they are small and placed on the posterior aspect of the limb. In the early period of their formation, while the periosteum or covering of the bone is still inflamed, pressure applied to the splint induces pain, and causes the animal to jerk away the leg forcibly. Abnormal heat may or may not be discernible at this time. Pain, however, in the splint itself is not always necessary to splint
lameness. In many instances the defective action remains after all inflam- mation has subsided in the bone. In these cases impaired movement is Mainly due to mechanical irritation excited in the tendons and ligaments °n which the projecting splint encroaches. The lameness resulting from this disease affects the action in various ways, according to the situation °f the growth. When the splint is at the back of the shin the knee is imperfectly
flexed, and the movement of the limb is consequently stiff and short, "hen it encroaches on the knee the same imperfect action is observed, With the addition that the limb is slightly abducted or thrown outward at each step. Splint lameness is aggravated by the jar of hard ground. Treatment.—On the first appearance of lameness from this cause the
horse should cease to work, and be placed in a well-littered box. A dose |
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HEALTH AND DISEASE
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208
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of physic and light diet should be promptly adopted as' preliminaries to
more active treatment. After the effects of the medicine have passed away the leg should be irrigated with cold water for half an hour three times a day, and in the intervals a cold wet bandage should be applied to the affected limb. Should the lameness continue after four or five days, a blister may be applied to the inner and outer side of the leg between the knee and the fetlock, and repeated once or oftener according to the requirements of the case. Should this not succeed, it may be necessary to puncture the splint with the pointed iron, or to insert a seton over it, or, as a last resort, to cut through the covering of the bone (periosteotomy). It need hardly be said that the operations last referred to can only be undertaken safely by the qualified veterinarian. |
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OSTITIS—INFLAMMATION OF BONE
A casual inspection of a bone shows it to consist of several structures.
Outwardly will be noticed a thin fibrous membrane (periosteum). This not only covers the exterior of the bone, but serves as a bed in which blood-vessels break up into small branches before entering it through the minute openings provided
on the surface. With these small vessels fine fibres from the periosteum itself also pass into the tissue of the bone, and become connected with another membrane lining it within termed the endosteum. The several structures may separately suffer from inflammation, but the in- timate connection existing |
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Fig. 318.—Diagrammatic Transverse Section of Tibia and Fibula
A, The two layers of the periosteum with blood-vessels, &c.
B, Bone of the Tibia, c, Bone of the Fibula. D, Endosteum.' E, Marrow. |
between them renders it im-
possible for one to suffer with- out the others being soon |
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involved in the disease.
Inflammation occurring in the periosteum is known as 'periostitis, in the bone as ostitis, and in the lining membrane of the bone as endostitis. Periostitis.—This disease is mostly found to exist in the long bones
of the limbs of young animals when growth of the skeleton is most active, and the vessels of the membrane are highly charged with blood for the supply of its nutritive requirements. |
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DISEASES OF BONES
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209
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It is especially frequent in the shin-bones of young race-horses, where
it is commonly known among trainers and stablemen as " sore shins ". Periostitis may be acute or subacute. In the former case it soon
spreads to the bone, and may cause portions to die and to slough. In the latter, which is the more common form of the disease in the horse, the action is of a more formative kind, and usually results in the thicken- ing of the periosteum and the formation of new bone. . Two factors are concerned in this destructive process:—1. Exudation
is thrown out from the vessels within the bone into the minute canals which they traverse. This continuing, the vessels are pressed upon by the exuded matter, and the circulation of blood being thereby interfered with the nutrition of the bone suffers accordingly. 2. Exudation also takes place from the vessels beneath the periosteum,
hfting the membrane away from the bone, with the result that a portion °i the latter dies, partly from want of the nourishment which the vessels of the periosteum afford to it, and partly also from pressure on the vessels °i the bone itself by the matter exuded around them. Separation of the dead piece of bone from the living must in such
circumstances take place. During this process abscesses form over the site of the injury, and pus (matter) is discharged by one or more openings. in the skin. Symptoms.—Acute pain, great heat, and lameness are early symptoms.
°i the disease. Pressure over the part causes sudden withdrawal of the: nrnb. Swelling soon appears—at first firm, then less resisting, and ulti- mately fluctuating. An abscess forms and breaks, and finally the dead °°ne, if not removed by an operation, crumbles away and escapes in small Particles with the pus. Treatment.—Perfect rest is the first requirement in these cases. An
lncision should be made through the periosteum as soon as the disease is.
tound to exist. This will afford an opportunity for the escape of matter as
t is formed, and prevent any serious separation of the membrane from the
one by its accumulation beneath it. Where this has already taken place
is desirable to make a bold opening, and after irrigating the wound
reely with antiseptic solution continue the treatment on the principles
aid down for dealing with wounds on the antiseptic system. It should
°t be overlooked to remove any dead piece of bone that may exist, as
°°n as it is sufficiently detached to be taken away.
Acute periostitis is only of seldom occurrence, and perhaps the most
ninion examples are those which occur in the lower jaw as the result injury inflicted by the bit. Occasionally it is seen in the bones of he extremities after severe blows. vol. ii. 4g
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210
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HEALTH AND DISEASE
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Chronic Periostitis.—This form of the disease most commonly
presents itself in that affection of the limbs termed sore shins and splints. It may, of course, attack any of
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the bones of the skeleton, but those
of the legs are by far the most fre- quently involved. See Sore Shins and Splints. Acute Ostitis is comparatively
of seldom occurrence in the horse. Why this should be so it is diffi- cult to say precisely, but the absence of those constitutional conditions which favour its production in man is no doubt in some measure a safeguard against it in our equine patients. The fact that amputation is but seldom resorted to in the horse may also contribute to render him less frequently the victim of |
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* ig. 317.—Acute Ostitis
1, Sequestrum or Slough. 2, 2, Cloacae or openings
for escape of pus and dead bone. 3, 3, New bone enclosing the sequestrum. |
this disease.
It is mostly observed in the
bones of the extremities, and es- |
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pecially those below the knees and
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hocks.
Sometimes it is localized or
confined to a particular part, or it may involve a large tract, or even the entire bone. The writer has seen the whole of the os suffraginis or large pastern bone destroyed, and its remains enclosed in a per- forated shell of bony matter, formed around it by the periosteum (figs- 317, 318). It sometimes occurs in |
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Fig. 318.—Acute Ostitis
1, Sequestrum or Slough. 2, New bone enclosing
sequestrum. |
the upper and lower jaw-bones.
Causes.—Acute ostitis is the
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result of injury inflicted on the bone
by external violence, the most severe cases being those in which the bone is penetrated by some sharp instrument, as when the foot bone is punctured by a nail. The example figured was caused by the foot of the horse being brought violently to the ground when attempting to save |
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DISEASES OF BONES 211
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himself in slipping. The disease may also occur in connection with frac-
ture of the bone when the result of extreme violence. Symptoms.—When occurring in the bones of the extremities, it is
attended with acute lameness and suffering. The parts around the bone are much swollen, hot and tender, and considerable difficulty may be experienced in defining the precise stage and nature of the disease. Sooner or later an abscess forms, followed by another and another, from which flows a blood-stained and offen- sive matter. Later the bone begins to crumble
away, and the debris escapes in granular particles with the discharge. The tendency in these cases is to blood-poisoning, and the formation of abscesses in one or another or several °f the internal organs. It is seldom that the patient recovers from such ar* attack so as to be again useful. Chronic Ostitis.—This is the
form in which ostitis most frequently presents itself in the horse. Eing- bones, some splints, and various other excrescences on the bones of the limbs arid other parts of the skeleton are frequently of this nature. At first the affected bone becomes
Porous and spongy (fig. 319), as the Result of the inflammatory exudation Pressing upon the vascular canals of the bone and promoting their absorp- |
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tion and enlargement. As a result of
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Fig. 319.—Karefying Chronic Ostitis
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tnis the bone tissue becomes changed
*rom a close compact structure to a loose and spongy condition. This 8 what is known as rarefying ostitis. As the inflammation abates, the material thrown out of the vessels into
he structure of the bone, by which the rarefaction was produced, is itself inverted into bone. f he effect of this is to change the part from a soft spongy condition
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to
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a state of great density and hardness (fig. 320).
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HEALTH AND DISEASE
|
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212
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Fig. 320.—Chronic Ostitis
A, Lower portion of Radius of horse, showing results of Chronic Ostitis. B, Section of the same,
showing hard, dense condition of the hone. |
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NECROSIS AND CARIES
When bone is so far damaged by disease or accident as to cause it
to die, it is said to be affected with necrosis or caries, one or the other, according to the mode of death. If a considerable quantity of the tissue be destroyed at one time the term "necrosis" is used, but if the bone gradually melts away or breaks down into minute particles during a progressive ulceration it is spoken of as "caries". Necrosis.—Causes. The more common causes of necrosis as it affects
horses are blows and bruises directly applied to the bone; hence it occurs that those bones or parts of bones most superficially placed, and conse- quently most exposed to injury, are especially liable to the disease. Bones deeper seated and enveloped in thick layers of muscle are comparatively |
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DISEASES OF BONES 213
seldom affected. For the above reasons necrosis is found to implicate
the front of the shin or canon bones both in the fore and hind limbs, and also the lower jaw-bone and the ribs. The shin-bones in the act of jumping are not unfrequently brought into forcible contact with posts and rails, gates and stone walls, or they are injured by kicks from other horses, &c. The most common seat of the disease is the lower jaw at the resting-point of the bit, where the resistance to runaways, pullers, and hard-mouthed horses is specially applied. In addition to external violence necrosis may be induced by acute inflammation of bone in any part of the skeleton. Symptoms.—-Where an injury is inflicted on bone sufficiently severe
to destroy its vitality the immediate effects are more or less swelling, beat, and tenderness of the part, and Avhen involving the bones of the extremities more or less lameness. In superficial bones the swelling is not generally considerable and may soon altogether subside, leaving behind, however, an abiding tenderness of the part. Sooner or later the swelling reappears, or if still present becomes considerably increased, while the heat and soreness return with greater severity than before. As the inflammation becomes more and more severe an abscess is formed, which may break, and heal, and break again and again, and finally resolve itself into a chronic running sore. During this time the dead piece of bone is being separated from the living. If a probe be passed mto the wound the harsh grating of its point on the dead bone will be felt. These cases are always of a protracted nature, and when neglected extend over months. When the lower jaw is the seat of injury the animal jibs when ridden
0r driven, or turns the head towards the side on which the disease exists, ■the saliva is raised into foam by champing of the jaws, and may be stained With blood. Feeding is rendered painful, and swelling appears on the outer Part of the injured bone and extends for some distance around it. If the nnger be applied to the spot a wound in the gum will be found correspond- lng to the injured part, through which the dead fragment is readily felt, and if completely detached may be brought away. The odour emitted in these cases is usually very offensive. Although sloughing may have com- pletely taken pi ace, and the dead bone have been quite detached from the iving, it may still be retained unless means are adopted for its removal. Treatment.—Here the aim and object of treatment should be to
ernove the dead bone as speedily as possible, but no attempt should e made in this direction until nature has defined its limits and well- Jgh completed its separation from the living. If after this it is allowed } remain it becomes a source of irritation, and the wound continues to |
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214 HEALTH AND DISEASE
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discharge and refuses to heal. It becomes necessary, therefore, that a
periodical examination of the diseased part should be made, in order that the earliest opportunity may be seized to extract the offending matter. For this purpose it may be necessary to lay the wound open. This done the finger should be introduced, and the necrosed mass will be found probably grown over by granulations or " proud flesh", or. at least united by them to the body of the bone. If detachment has not been completely effected a little force, by means of a small lever placed under the dead fragment, may be sufficient to disconnect it. The dead bone having been removed the wound may be freely dressed
with a strong solution of chloride of zinc, and afterwards treated with antiseptic applications until reparation is complete. OSTEO-POROSIS—BIG HEAD
By this term is understood a swollen, soft, and porous state of the
bones. It is a constitutional disease usually involving the entire skeleton, but manifesting itself with much greater severity in some parts than in others. This is especially the case with regard to the head, from which circumstance it has received the common appellation of "big head". Not only is this difference observed in different regions of the
skeleton, but likewise in different parts of particular bones. In the long bones of the legs, for example, it becomes much more pronounced at the extremities where they unite to form joints, and where, as in the bones of the face, the osseous tissue is naturally of a loose, spongy character (cancellated). Osteo - porosis is essentially a chronic and slowly progressive disease
affecting all classes of horses, both male and female, and at all periods of life, but young animals seem to be more predisposed to it than those advanced in years. It has not been found to exist to any considerable extent in Great
Britain, but in America, India, and Africa it is of more frequent occurrence. Origin.—Although much has been written both in this country and on
the Continent with regard to its origin, the writer is compelled to admit that practically nothing is known as to the causes which give rise to it. Captain Hayes, who refers to numerous cases as coming within his experi- ence in Africa and India, believes that " feeding on unnutritious grasses is one of the chief causes of the malady". This statement, however, receives no support from experience in this country, where the cases hitherto recorded have been stabled animals receiving a liberal supply of good food. By others it has been attributed to damp and insanitary |
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DISEASES OF BONES
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215
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|
stables, and Professor Varnell saw reason to regard it in one instance
as in some way connected with a too exclusive bran diet, and deficiency of bnie in the food. It is quite clear that the precise nature and conditions of the origin of the disease still remain to be determined. Symptoms.—The first noticeable indications of the affection are slight
stiffness and subsequent lameness in one or more of the limbs, with tender- ness over the region of the joints, which sooner or later become enlarged. The disease may attack all the limbs
more or less severely at once, or in |
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Fig. 321. — Osteo-porosis
Bones of the face enlarged, thickened, and
rendered soft and spongy. |
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|
Fig. 322.—Osteo-porosis
Lower Jaw affected by the disease. |
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|
ccession at varying intervals of one to three weeks. At the same time
e head and face attract attention by the gradual obliteration of their arp angles, and the steady increase in size of the head as a whole. At ls time there is no perceptible constitutional disturbance. The animals ed and rest and keep their condition. The swelling of the joints may some extent subside, only, however, to return again and add to the Pernianent enlargement. As the disease progresses the bones continue to increase in size and
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HEALTH AND DISEASE
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216
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|
at the same time to become spongy and soft, so much so in some parts as to
yield to the pressure of the fingers from without. When in this condition the animal has difficulty in rising, and the ligaments of the joints soon fail to resist the weight imposed upon them, and break from their connections with the soft and yielding bones. In the early stages of the disorder the turning
movements are noticeably stiff, and pressure, if applied to the spine, causes pain and shrinking. The head continues to increase in size and to present an unsightly appearance. The lower jaw becomes thick and rounded, and as the bones of the face enlarge, the teeth become loose in their sockets and more or less displaced. At this time mastication is imperfectly performed, nutrition is impaired, and symptoms of constitutional derange- ment appear and continue to become more and more severe to the end. In fatal cases the dura- tion of the disease extends from two to eight months or longer. Treatment. — Osteo-porosis is usually fatal.
It is worthy of note, however, that a case given up to the writer was returned cured after under- going three courses of iodide of potassium and mix vomica at intervals of three or four weeks. Post-mortem Examination.—After death
no special lesions are found to exist in the ab-
dominal or thoracic viscera. Many or all the bones of the skeleton are enlarged (fig. 323), |
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|
Fig. 323.—Osteo-porosis
Metacarpals of horse affected by
the disease. |
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spongy in texture, and soft in consistence.
The capsular membranes of the joints of the
|
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|
extremities are much thickened, and the articular
ends of the bones are denuded of their cartilage, and present a worm-eaten
appearance.
SPAVIN
|
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The term spavin is applied to two distinct forms of enlargement of
the hock, one being a bony excrescence (bone-spavin), and the other a distension of the joint capsule with fluid (bog-spavin). Spavin is also spoken of as occult when the action declares the hock to be the seat of mischief in the absence of any outward physical change. Bog-spavin is dealt with in the section on Diseases of Joints. |
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DISEASES OF BONES
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21'.
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BONE-SPAVIN
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A bony outgrowth on the inner and lower part of the hock is termed
a bone-spavin (fig. 324). The enlargement usually appears towards the front, but it may occupy
a backward position, or extend from front to back. Spavins vary in size as well as in position. Sometimes they are small and with difficulty identified, at others they reach a considerable size. The same variation ap- pears in respect to form. They may present them- selves as rounded, or more or less pointed and ir- regular swellings, or as a projecting ridge, extend- ing across the hock from back to front. Usually they appear on one hock only, but frequently both are affected either simul- taneously or consecu- tively. Hocks of every variety of size and confor- mation, from the biggest |
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and best to the smallest
|
Fig. 324.—Bone-Spavin. A, Spavin.
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|
and weakest, are liable
to become affected, but it goes without saying that the disease is most frequently found in the latter. Causes.—The predisposition to spavin is unquestionably hereditary.
Horses with straight quarters and upright pasterns seem especially liable to it. Sprain and concussion to the joint, acting separately or together, are the exciting causes, and there is reason to think that these accidents are more especially likely to occur when animals are forced in their work under circumstances of fatigue and want of condition and development. J-he outward enlargement is an evidence of the inflammation going on in the articular surfaces of the bones. The great variation found to exist in the conformation of the hocks
°i different horses, and indeed sometimes in the two hocks of the same uorse, has ever been a stumbling-block to the veterinarian in the diagnosis |
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218 HEALTH AND DISEASE
of spavin, and a mine of wealth to lawyers and learned counsel. Coarse-
ness or lumpiness is a recognized condition of normal development in the hocks of some horses, and to distinguish between the natural irregularities of coarseness and those resulting from disease is always difficult and some- times impossible. If these facts were more generally recognized and allowed by veterinary practitioners, much of the litigation which now engages our law-courts would be avoided, and the veterinary profession would be saved from those strange exhibitions of discrepancy which tend to weaken public confidence in their opinion and advice, if they do not engender distrust. Symptoms.—The immediate effect of the jar or sprain giving rise to
spavin is to produce lameness, sometimes slight, sometimes severe. This may or may not pass away, to return again when the enlargement of the hock appears and encroaches upon the connecting ligaments of the joint. The action of the spavined horse is marked by stiffness of the affected limb. In movement the hock is imperfectly flexed and the leg has the appearance of being carried. Compared with the opposite limb the stride is short and limping, and
the quarter is noticed to drop when the foot is brought to the ground. If continued in work the toe strikes the ground and in time becomes worn. Spavin lameness is most severe after a rest, and particularly noticeable when the horse first leaves the stable, but it improves as he goes on. Heat may or may not be detectable in the joint, and as the patient stands the limb is rested on the toe or front part of the foot. Treatment.—On the first appearance of the disease the animal should
cease to work and receive a dose of physic. At the same time fomentations or hot bandages should be applied to the hock until the existing inflam- matory action is subdued. Cold-water irrigation for a few days should follow, after which a
repetition of blisters at intervals of a fortnight or three weeks may suffice to effect a cure. Should, however, the lameness still continue, choice must be made between the operations of firing and setoning, in either of which case a long rest at grass will be desirable. Horses with spavins are frequently restored to service and continue to
work without interruption for the rest of their lives. Others, however, are permanently crippled. The latter result is most frequent when the spavin occupies a forward position. |
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DISEASES OF BONES
|
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219
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METACARPAL PEKIOSTITIS—SORE SHINS
This is an ailment of common occurrence in race-horses, but com-
paratively seldom seen in other varieties. The greater liability of the one over the others is associated with early training, wThile the bones are in active growth, and by their imperfect development specially susceptible to injury and disease. The term " sore shins" has been applied to it on account of the extreme
tenderness and pain found to exist in that part of the leg between the knee and the fetlock joint. The mischief, however, does not always stop here, but may also involve the large, and sometimes the small pastern bones, developing there the same soreness of the surface, and in some instances provoking an outgrowth of bony matter in the form of ring-bone. The fore-limbs, for reasons presently to be stated, are more particularly
the seat of sore shins, although the hind ones are not wholly exempt. Pathologically considered, "sore shins" at the outset consists in an
inflamed condition of the periosteum, or covering membrane of the bone; but unless soon relieved from the operation of the cause, the shin-bone itself soon shares in the disease. At this time the pain and lameness become aggravated, the periosteum is much thickened, and a rough bony growth appears on the surface beneath it. Causes.—Youth, and want of development and power of resistance
m the bone is, as we have observed, the predisposing element to sore shins, and this is materially intensified when, as sometimes occurs, there is a hereditary predisposition to the morbid growth of bone. The exciting cause is to be found in concussion, arising from the
forcible impact of the feet with the hard ground in the act of galloping, when the "jar" is transmitted along the shaft of the bones, whose cover- lng becomes irritated and inflamed. It will, therefore, be seen that in proportion as the ground is hard, and the weight carried by these juveniles ls considerable, so will be the liability to injury. It is for this reason that the disorder appears during seasons of drought, when the ground is dry and resisting instead of being soft and spongy. Symptoms.—The lad who habitually rides a horse in his daily work
ls often the first to detect the oncoming of this disease. He recognizes a growing sense of discomfort arising out of a change in the animal's action and spring. Then it soon becomes obvious that he is going short an his stride, and some difficulty is experienced in setting him going and keeping up the pace. Examination of the legs at this time reveals more 0r less heat and soreness along the course of the canons, and especially |
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220 HEALTH AND DISEASE
|
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|
in front. Later, the legs become somewhat enlarged from the knee
downward, and present a rounded appearance. The fetlocks are "filled", and the swollen parts " pit", when pressed upon, like soft dough. Lame- ness now appears in all the paces, and the animal moves with a stiff, sore gait, which becomes aggravated from day to day when work is continued. Treatment.—In slight cases it may be sufficient to ease a horse in
his work, give him a mild dose of physic, transfer him for a time from the hard turf to the tan, and irrigate the legs two or three times daily with cold water. If, however, the patient has no pressing engagement his work should be reduced to walking, with as little weight on his back as possible. In more severe attacks it is better to throw the horse out of work altogether, and apply hot bandages to the legs during a course of physic. When the inflammatory action has been subdued, then a mild blister
may be applied to the shins from the knee downwards, and repeated in ten days or a fortnight, and again, after a similar period, if circumstances appear to call for it. Iodide of potassium in 1 or 2 dram doses may be given in the food morning and evening for a week, but not until the physic has ceased to act. The medicine should then be discontinued for two or three days, and renewed again for another week, and the same course may be repeated if necessary. In all cases where horses evince the slightest signs of sore shins the weight should be promptly reduced, the pace let down to walking, and, as far as practicable, the work should be done on tan, in cold wet bandages. Many a severe attack may be warded off and horses kept in work by the early adoption of proper measures. In some instances, as the result of neglect, these cases assume a chronic
character. The shins become considerably enlarged and covered with a rough bony growth, wh'ile the periosteum is much thickened, and continues to lay clown bone on the shaft of the canons. Here firing with the pointed iron may prove serviceable after a run of two or three weeks at grass in a clamp meadow. After an attack of this disease horses should not resume work too
early, and care should be taken that the ground is soft, and the pace for a time slow. Cold wet bandages should be worn for a week or two after work has been commenced, and occasional irrigation with cold water will assist in imparting tone to the legs. |
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•221
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FRACTURES
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15. FRACTURES
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When a bone is broken into two or more parts it is said to be fractured.
Fractures assume a variety of forms, each of which presents some feature requiring special consideration, either in regard to diagnosis or treatment. They may be either partial or com- |
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«
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plete; simple or compound; commin-
uted or impacted. When a bone is broken, but the
breach only extends through a portion of its substance, the fracture is said to be partial. If, however, the bone is divided into two separate parts, it i m m m •^;,\mi
is a complete fracture.
A simple fracture is one in which
the broken bone is not connected with an external wound; where such a wound exists and communicates with it the fracture becomes a compound one (fig. 329). If instead of the bone being broken
into two parts it is divided into three or more — smashed — a comminuted fracture results (fig. 325). QTM It sometimes happens that when
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a bone is broken the broken end of
|
IL
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one piece is driven into that of the
other. Such a fracture is said to be impacted (fig. 328). |
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Bones break in various directions;
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'J.
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hence fractures are spoken of as trans-
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Fig. 325.—Fractures
1, Simple. 2, Comminuted. |
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verse, longitudinal, or oblique (fig.
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326).
A transverse fracture follows a line at a right angle with the shaft
01 the bone. This is a comparatively rare form of breakage, but is some- times seen in the scapula, the ilium, the olecranon or elbow, and the calcaneus, or point of the hock. Great importance attaches to the relations which the two or more
roken pieces maintain towards each other after the fracture has taken
piace. In some instances they continue to remain in their natural position
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HEALTH AND DISEASE
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222
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|
throughout the healing process, a condition favourable of course to re-
paration, and very much to be desired. In others, however, the fracture is accompanied or followed by more
or less displacement of the divided parts, and all the bad consequences which attach to it. This separation of the broken pieces may result from the same cause,
and at the same time, as the fracture, or it may occur some time afterwards by the weight of the body forcing the parts asunder; or by movement, or as a result of the contraction of muscles which are attached to them. The liability to displace-
ment is much greater in some bones than in others. In the canon it is almost invariable, while in the pas- tern it is comparatively rare. This difference will be best understood by reference to fig. 327, where it will be seen that nearly the whole of the front and back of the pastern bones, and to a less extent the sides, have attached to them strong ligaments and tendons, so that when either of them is broken the parts |
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Fig-. 326.—Fractures
1, Transverse. 2, Oblique. 3, Longitudinal. |
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are held firmly in their po-
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|
sition, and unless the force
acting upon them is very considerable, displacement is prevented. Displacement of the broken fragments may be immediate, i.e. may occur
at the time of the accident, or it may be deferred for a period varying between a few hours and a few days, and during the interval between the fracture and the separation of the broken pieces many animals have been known to continue to perform ordinary work without showing in- convenience. Causes. — Two classes of causes are recognized as conducing to the
fracture of bones, viz., predisposing and exciting. Predisposing Causes.—For various reasons some bones are more
liable to fracture than others, and this represents their predisposition. In looking over the body it is not difficult to see that certain bones
are much more exposed to collision and to external violence by virtue of their position than others Of these the points of the haunch project- |
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FKACTUKES
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223
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ing from the quarters afford a striking example. They display a special
liability to be brought into forcible contact with door-posts while horses are passing into or out of |
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the stable
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or through
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narrow passages
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and
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to receive the first
impact of the ground where, as sometimes occurs, their hind-legs slip from under them, and they fall help- lessly on their side. The canons or
metacarpal bones, un- protected by muscles, are exposed to the full force of any external violence that may be applied to them, besides which their movements are sharp and forcible, and meet colliding objects with great resistance. The large pastern
also, by virtue of its position, is specially liable to fracture, and |
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m a less degree also
|
Fig. 327.—Principal Tendons and Ligaments of the
Fore Limb |
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the forearm and lower
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2. Outer Side View.
A, Extensor Metacarpi Obliquus.
B, Extensor Metacarpi Magnus,
c, Annular Ligament. D, Extensor Pedis.
E, Extensor Suffraginis.
F, Outer Small Metacarpal or Splint Bone.
G, Outer Branch of the Suspensory Liga-
ment.
H, Flexor Pedis Perforates. I, Subcarpal or Check Ligament. J, Flexor Pedis Perforans. K, Suspensory Ligament. |
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|
thigh.
Age imparts a
state of brittleness to bones which is not found in the young and the adult; hence °ld animals are more |
1. Front View.
A, Extensor Metacarpi Obliquus.
B, Extensor Metacarpi Magnus,
c, Annular Ligament. D, Extensor Pedis.
E, Extensor Suffraginis.
G, Outer Branch of Suspensory
Ligament. The ligaments of the pastern
are more fully shown in fig. 356, page 272. |
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prone to fracture than
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younger ones.
In early life, before the epiphyses or prominences which are connected
with the shafts of bones have become firmly united by ossific union, they |
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224
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HEALTH AND DISEASE
|
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|
are liable to be torn away by muscular contraction, or otherwise forcibly
displaced. Structural alterations, the result of disease, by weakening the bone
tissue, lessen its power of resistance to. ordinary forces, and thereby con- duce to fracture. The navicular bone, after a period of ulceration, breaks beneath the
weight thrown upon it in action. The imperfectly - developed bones of the rickety foal, after bending
under the strain imposed upon them, may sooner or later present a .partial or complete fracture. Various other morbid changes, such as cancer, osteo-porosis, melanosis,.
&c, render bones specially amenable in this direction to causes which they would otherwise resist. Season of the year, and the nature of the surface over which horses
travel, tend to increase the liability or predispose to fracture. In winter, when the roads are covered with ice, and in towns where
horses have to travel over wood pavement or other smooth surfaces made slippery with w7ater, legs, hips, and ribs are in consequence frequently broken. The exciting causes of fracture are: 1, external violence, such as kicks,
collisions, falls, blows, twists, &c.; and 2, muscular contraction. Violence may operate either directly or indirectly, i.e. it may break
the bone to which it is immediately applied, or some other at a distance from it. It sometimes occurs that a horse falling upon the poll, and striking the occipital bone, breaks the sphenoid bone at the base of the brain. Horses fracture the os suffraginis, or long pastern, or even the canon-bone by pitching on the toe while endeavouring to save themselves from a fall, or in jumping or galloping. Examples of fracture as the effect of muscular contraction are seen
in those common accidents which occur to horses while being cast, or in the course of a surgical operation. The violent struggles to free them- selves from restraint too commonly give rise to a broken back, or a broken thigh, or the breaking away of one of the epiphyses or bony projections from the shaft of a bone. Symptoms.—To determine the presence of a fracture in the horse is
sometimes a very difficult, and may be an impossible task. The parts to be dealt with are large, heavy, and do not lend themselves to that thorough and searching examination which is so capable of being made in the smaller animals. Besides, the excitable and refractory character of the horse greatly interferes with that full control so necessary to a successful diagnosis. Of course we can bring to our aid the restraining influence of |
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|
FBACTUEES 225
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|
chloroform, but even this is not an unmixed good. Whether a horse-
be cast before its administration, or be allowed to fall while under its influence, there is in both cases the danger of displacing the broken bones and converting a simple into a compound fracture, or causing a trouble- some displacement of the broken parts. Before any such step is taken it is desirable to exhaust all other means
at our disposal. The symptoms exhibited as the result of fracture will vary according to
the situation and the purpose which the bone serves. Fracture of the long bones of the extremities is not generally difficult
to diagnose. It may be at the time of its occurrence someone heard a " snap". If displacement result, this would be followed by sudden and acute lameness and an inability to support weight on the broken limb. -The parts below the fracture would hang loosely, the toe would sway involuntarily from side to side, or might be directed backwards. Swelling °n the region of the fracture and parts below it soon appears, attended with local inflammation and pain. Of the many symptoms attending a fracture crepitus is the one which
should be specially sought for. It is the sensation or sound which results, from the rubbing of one broken piece against the other. In comminuted fractures, where the bone is divided into several pieces, it is soon made aPparent; but in some cases of simple fracture it is difficult to develop, and a good deal of care, guided by experience, may be needed to bring it about,, and especially in young and fractious animals. When it does not become at once apparent, the upper segment of the:
Droken bone should be firmly held by an assistant, and the lower one: gently rotated, and moved from side to side and from front to back by Mother, while the operator is engaged in manipulating the seat of fracture. By this method the broken ends may be made to rub against each other
^o yield the rubbing sensation or sound which is the evidence required. In some situations, as where a rib or the pelvis is broken, it is im-
possible to carry out this method, for the reason that the parts are so tuated that they do not lend themselves to the kind of manipulation Prescribed. In fracture of the ribs the part will show soreness to pressure, and some
regularity may be felt in the line of the rib when accessible. By gently ■F cssmg the rib inward, or making the animal cough while the fingers rest. mV upon the part, crepitus may be felt. fracture of the front ribs is usually attended with more or less lameness-
ne front limb on the side of the breakage. Fracture of the pelvis may
etirnes be felt by passing the hand up the rectum, or crepitus may be
|
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HEALTH AND DISEASE
|
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|
226
|
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|
heard by applying the ear over the surface of the quarter while the leg is
moved about by an assistant.
The difficulty in question is particularly emphasized in fracture of the
neck of the femur, owing to our inability to restrict the movement of the
detached head and bring the body of the bone into contact with its broken
surface.
In fracture of the thigh or the pelvis or front ribs, where great masses
of muscle intervene between the ear and the fracture, crepitus may not be recognized unless movement of the broken parts one upon the other is of consider- able extent. For various reasons this most important and re-
liable symptom cannot always be made to reveal it- self. The broken pieces may be firmly held together so as to preclude any movement one upon the other such as would yield a rubbing sound. This is fre- quently the case in fracture of the long pastern and some other bones. In impacted fractures (fig. 328), where one piece
of bone is driven into the other, and in incomplete fractures where there is no movement of the imper- fectly-divided bone, and in those instances already referred to where the broken pieces are firmly held together by strong ligaments, no crepitus or rubbing is likely to be heard, and considerable difficulty is experienced in bringing it about where a piece of torn muscle or fascia has insinuated itself between the broken ends of the bone, or where one piece has been drawn some distance away from the other by the force of muscular contraction, as where the point of the |
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|
Fig. 328.—Impacted Frac-
ture of Femur |
elbow is raised from the body of the bone by the
|
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|
great extensor of the arm, or a piece of the patella
is displaced upwards by the straight muscle of the thigh.
A sound simulating crepitus is sometimes heard where the tissues about
the seat of injury become infiltrated with air, or where inflamed tendons
rub against their investing sheaths.
This false crepitus, however, does not emit that harsh grating sound
which is so characteristic of the rubbing together of the rough surfaces ol
a broken bone.
Care must be taken not to mistake a dislocation for a fracture. Where
the latter takes place in the middle of a long bone there is not much danger
|
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|
FEACTUKES 227 '
|
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|
of such an error being committed, but when fractures occur near joints,
the case is altered. Here it should be borne in mind that where dislocation exists the displaced bones are more or less fixed, and the movements of the joints are very much restricted or altogether prevented; whereas in fracture the broken bone exhibits excessive mobility, allowing the limb to be moved in various directions to an abnormal extent. Treatment.—The first consideration which will arise on the occurrence
of a fracture in relation to treatment will be the value of the animal, the prospects of a speedy recovery, and to what extent, if at all, his future usefulness will be compromised. In this connection it will be safe to advise, no less from a sense of
humanity than from consideration of economy, that when the animal is of little value he should be slaughtered at once. If, however, it is other- wise decided, the sooner measures of treatment are adopted the better. Owing to the restlessness and unreasoning; action of |
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|
the patient, delay in
this respect is fraught with the greatest dan- ger. Many a simple fracture, which, if ad- justed at once, would have speedily reunited, Fig. 329.—An Example of Compound Fracture
has been converted
into an incurable compound fracture by the unrestrained use which the
animal has been allowed to make of the injured limb after the occurrence
°f the accident. A horse's highest intelligence fails to realize the advan.-
^age of that perfect quiet upon which the surgeon sets so much store, in
guarding against an extension of the injury and in bringing about its
reparation.
The moment a fracture is suspected every means should be adopted at
°Uce to restrain the animal's movements, and to provide as far as possible agavnst any undue use or disturbance of the injured limb. If away from home, a splint should be extemporized, and the horse got
mto the stable nearest to hand and allowed to remain there while under treatment. If an ambulance cart can be procured without much delay, it ^°uld be desirable to convey him at once wherever he may require to go; Jut it should be kept in mind that the success of treatment is greatly aeilitated by the speedy readjustment of the broken bone. The prospect of treatment—as to whether it is likely to be successful or
|
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|
228 HEALTH AND DISEASE
otherwise—will depend upon a variety of circumstances, all of which should
be well considered before a decision is arrived at. The position of the bone and the nature of the fracture will claim atten-
tion first. A simple fracture without displacement is not a serious matter, unless it occurs in the immediate neighbourhood of a joint, to which the reparative inflammation may extend and occasion some permanent inter- ference with its movements. Compound and comminuted fractures are always more serious than
simple ones, and in all the danger is greatly aggravated where the tissues in the region of the breakage are much bruised or torn, especially where large nerves and vessels are divided by the broken ends of the bone. All these are matters which impart to a fracture in such an uncontrollable subject as the horse a dangerous and discouraging outlook. A young horse, with a sound constitution and a quiet generous tem-
perament, is much more amenable to treatment than an old, declining, irritable subject. In the treatment of fracture three important requirements must
be fulfilled. The broken fragments must first be brought together and placed in their normal position; they then require to be retained there until they have again become firmly united by the natural process of repair. The third requirement involves the care against complications, and
prompt measures of treatment when they arise. If there is no displacement of the broken pieces, but by the history and
general symptoms of the case a fracture is denoted, the second and third indications only will require to be met. It is no rare occurrence for horses to break the bones of their legs and
to continue to work for hours, days, or weeks without any displacement occurring. A case came to the notice of the writer where a horse in the course of a day's hunting suffered a comminuted fracture of the canons of both hind-limbs. He was noticed to be lame after striking them against a stone wall, and was sent home in consequence. After being fed and dressed and " set fair" he lay down, and when the groom returned to him and caused him to rise, the broken fragments parted, and not till then was the existence of a fracture made known. The horse was destroyed, and a post-mortem examination showed both
bones to be broken into several pieces. The means by which fractures are reduced or " set" will vary with the
seat and nature of the displacement. Some are altogether beyond rectifi- cation. This is especially the case in the bones of the spine, and in some bones to which large muscles are attached. By the latter the broken parts |
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FRACTURES
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229
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are prevented from being brought together, or they are pulled away from
each other by forcible contraction when this has been effected. This is very much the case in fracture of the thigh and the humerus.
It is more especially in bones below these, and others about the face,
that success may be hoped for. In the absence of a properly-constructed operating-table, by which a
horse can be taken 'off the ground wThile in a standing posture and again |
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Fig. 330.—Fracture of First Rib of Horse (Inner Aspect)
1, Showing Fracture. 2, Repair of Fracture. 3, The same in section. A, Fracture. B, B, Callus. replaced directly on his feet, the reduction of a fracture in so large and
^controllable an animal as the horse is in the last degree difficult. Without some restraining influence the pain excited by the manipula-
tion of the parts is such as to provoke the most violent opposition. To Prevent this the animal must either be cast and placed under restraint, or *Us resistance must be overcome by the administration of a powerful seda- 1Ve> or of chloroform or some other anaesthetic. Whichever course is Adopted he will require to be brought to the ground, and after the fracture nas been adjusted, to rise again. ■In the one act the damage may be seriously aggravated, and in the
wier the work of setting may be completely undone. In dealing with fracture of the pasterns, canons, and other long bones,
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HEALTH AND DISEASE
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230
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a powerful opiate or a subcutaneous injection of morphia may in some cases
so far overcome the irritability of the animal as to allow of readjustment of the broken parts and the application of retaining appliances. Where this fails the horse should be lifted on to a proper operating - table and placed under the influence of chloroform. By this means a more careful examination of the divided bone may be made, and a correct idea of the direction of the displacement and the extent of damage to neigh- bouring structures is obtained. In this connection it may be desirable to caution the operator against unnecessary manipulation, but when once he has decided what is required to be done, he must not hesitate to apply the necessary force to do it. How that force can best be obtained will be a question for solution when all the facts of the case are known. Hands and apparatus are the means to be applied, and whether one or both are brought into requisition, the direction in which they will be called upon to act will be the same. Eopes and pulleys are in some cases indispensable. In proceeding to reduce the fracture of a long bone, force will require
to be exercised to a greater or less extent in two directions, extension and counter-extension, and for this purpose one rope will need to be applied below the fracture and the other above it. On each steady and continuous traction is to be made by assistants, while the operator regulates the position of the limb according to his requirements, and directs the broken pieces into their normal position. Those to whom traction is con- fided should be reminded that sudden and spasmodic or jerky action may add to the difficulties of the operator by exciting the muscles to violent contraction, or lacerating their fibres and with them other correlated struc- tures. The pull in both directions should be as nearly as possible equal in force and steadily maintained throughout in a line with the natural axis of the limb. Those parts of the limb to which the rope or webbing is applied should be well padded with tow. Where difficulty is experienced in bringing the displaced parts into
their proper position, the lower segment of the limb should be moved in various directions by an assistant while the operator manipulates the frac- ture. Slight rotation, first in one direction, then in another, and a little manoeuvring of this kind will sometimes direct the fragments into their normal position. If, however, exact coaptation cannot be effected, the best that can be done must suffice. We have already pointed out the desirability of early " setting" as
favourable to speedy and complete reparation. Where, however, delay has been allowed to occur, some consideration must be given to the state of the parts before readjustment is undertaken. Eound and about the broken bone the tissues will be swollen, inflamed, and painful, and more or less |
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FRACTURES
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231
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hard and rigid, and the broken pieces adherent to the neighbouring
muscles. These are conditions which seriously interfere with replacement, and may altogether prevent it. In such circumstances no attempt should be made at reduction until the inflammation has been subdued by appro- priate means, and some discrimination will be required as to the desirability of undertaking such a task in the horse at all. When the parts have been returned to their proper position, or as
nearly so as can be effected, the next requirement to be fulfilled is to secure them in such a manner as to prevent their displacement and favour the process of healing. In man, whose intelligence is
always at the service of the sur- geon, this is not a difficult matter, but it is otherwise with the horse. The one may be put to bed,
and all weight having been re- moved from the broken limb, it niay be placed in the position most favourable to reparation, and retained there largely by the will of the patient. No such sense of self-govern-
ment is available to the veterin- ary surgeon. His patient must for the most part support his own height, and cannot be made to obey the behests of his attendant. Fis- 331.—Bandaging a Fore-leg Xlis Care of the limb is iust SO Showing the method of applying the bandage over a pad
^ of cotton-%vool.
much as is dictated by fear of the
pain which its movement excites, and the desire to use it, ever present, is
always being indulged more or less, with the result that reparation is Relayed, frequently imperfect, and not seldom altogether prevented. It ls this want of guiding intelligence, this excitability and restlessness, that Anders bone-" setting" in the horse so uncertain and unsatisfactory. Among the various appliances employed for the purpose of retention,
splints and bandages are the main and the most reliable. In fracture of the extremities the patient should always be placed in slings, and the °Pportunity afforded him to relieve the injured part and rest during the Period of restraint. |
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HEALTH AND DISEASE
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232
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Splints have for their object the restraining of movement by fixing the
limb in such a way that the joints cannot be flexed. Anything which will accomplish this without injuring the part to which it is applied may be employed for the purpose. Narrow strips of wood, thin sheet-iron or tin, leather, gutta percha, strong cardboard, pitch or other adhesive plasters, &c. To obtain the greatest possible benefit from a splint it should be sufficiently long to extend over the joint above and the joint below the fracture. Of course this is not always practicable, but it should always be present to the mind of the
operator to adopt any means in his power to restrict as much as possible the action of the joints of the affected limb. Movement of the fractured
bone is best controlled by ban- dages soaked in some material which will solidify and form an unyielding splice over the seat of the broken fragments. These hardening substances are variously compounded. Nothing, perhaps, is better than starch or flour mixed to the consistence of treacle with the white of egg. Dextrine, burnt alum, and alcohol is recommended by some; and |
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Fig. 332.—Bandaging a. Fore-leg
Showing the bandage completed and tied,
bandage with tapes. |
plaster of Paris, with or with-
out flour, and reduced to the |
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A, End of
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consistence of treacle with
water, is generally regarded as an excellent preparation. These appliances will require to be supplemented with some soft com-
pressible substance, by which the irregularities of the limb may be filled in and the pressure of the bandages equalized over the whole circumference •of the leg. Where this precaution is neglected there is danger of undue compression of the more prominent parts, resulting in sloughing of the skin and the production of troublesome sores with their attendant evils. After " setting " has been completed, the limb should be kept under
close observation for several days. It will sometimes be found to swell in consequence of injury done to the soft tissues at the time of the fracture, |
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FRACTURES 233
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or from excessive pressure applied to a part or the whole in the adjust-
ment of splints and bandages. In these circumstances relief must be given to the strangulated limb either by cutting the bandages or otherwise removing the pressure. If it is allowed to continue, more or less extensive sloughing will result, and a complication will be added to an already serious condition. Compound Fracture.—Whether the fracture be simple or compound,
the method employed for the reposition of the broken fragments will be the same; but the presence of a wound, and maybe also the protrusion of a portion of the broken bone through the orifice, will give new and special features to the case which will require to be taken into account. Where a fragment of bone protrudes through the skin, a very material
difficulty is added to the operation of reducing the fracture, and serious injury may have been inflicted on muscles, nerves, and vessels in its course outward. The protruding portion, which is usually the one uppermost, will
require to be withdrawn into its proper position, and this will call for much force, great extension and counter-extension, and dexterous manipu- lation of the limb. If the projecting bone is considerable, its reposition by this means may fail, and the operator will be called upon to decide between two courses, viz., enlarging the opening, or sawing off a portion of the exposed bone. If the former is decided upon, the enlargement must be made in the direction of the axis of the bone, guarding as much ^s possible against the division of neighbouring vessels and nerves. It may be that, notwithstanding this, complete return of the bone will
be found impossible, in which case the protruding portion, or some part of xt, must be removed by the saw. In carrying out this latter operation care must be taken to preserve the periosteum as far as possible. Where the fracture is a comminuted one, some splinters of bone may be
found to be completely torn away from the shaft and lying loose in the tissues of the part. These must be removed, and at the same time any shreds of broken fascia that may be met with. In the after treatment of the wound the antiseptic method must be strictly carried out. The hair tor th ree or four inches round it should be removed. The wound must be ireed from clotted blood by means of a sponge soaked in a five-per-cent solution of carbolic acid, and freely irrigated with the same solution. A good pad of antiseptic gauze soaked in a three-per-cent carbolic
solution should be applied over the wound and parts around, and over this a further succession of layers of dry antiseptic gauze, the whole being surrounded by a covering of thin mackintosh or some other impermeable material. |
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234 HEALTH AND DISEASE
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The wound will require to be dressed again some time in the course
of twenty-four hours, according to the amount of exudation and satura- tion of the gauze. Another dressing will be necessary in forty-eight hours, after which the carbolic solution used should be reduced in strength to 1 in 40. Subsequent dressing must be made according to the state of the wound. It will be understood that in the setting of the bone in compound
fracture the wound must be left accessible for the purpose of dressing. PARTICULAR FRACTURES
FRACTURE OF THE BONES OF THE SKULL Fracture in this region is comparatively rare, and serious in proportion
as the bone is depressed and the brain subjected to compression and trau- matic injury. Those bones forming the front of the cranium (the parietal) are most
frequently broken, but fracture of those at the base of the cavity (occipital and sphenoid) is most uniformly fatal in its results. The causes which produce the former are mainly concussion, especially
when the front of the head is brought into forcible contact with sharp objects. The latter is invariably the result of striking the poll against hard ground, or a wall, or other such resisting surface, when the horse in rearing loses his balance and falls backwards. In these cases unconsciousness and paralysis immediately follow the
accident, and death results from concussion and haemorrhage into and under the base of the brain. The writer once saw in the practice of the late Mr. Gowing the base
of the cranium of a horse, which had at some time been fractured, but recovered sufficiently to allow of the animal resuming work, and to be afterwards sold without any evidence of the injury being detected. He was, however, the subject of repeated attacks of brain disturbance, which ultimately led to his destruction, and post-mortem examination of the head revealed decided indications of an old fracture involving the two bones referred to above—sphenoid and occipital. Fracture of the parietal bone occurs with or without depression, and
it is frequently difficult in presence of swelling to determine to what extent, if at all, the bone has been driven inwards. If, however, con- sciousness remains undisturbed, and there is no defect in locomotion, it may be inferred for the present that the brain is but little interfered with. But it should not be too hastily concluded that no cerebral |
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PARTICULAR FRACTURES 235
disturbance will supervene later on. For several days after such an
accident the liability to brain trouble will continue. Where the bone is simply split without depression, a dose of physic,
and cold cloths applied to the part, with perfect quiet, are all that is required. If a wound exists, it should be thoroughly cleansed and kept aseptic by
repeated dressing on antiseptic lines. Depressed bone, if provoking brain disturbance, must be levered up,
but where no such disturbance exists it should be left alone, and the course suggested above followed out. FRACTURE OF THE VERTEBRA
Fracture of the vertebral column is an accident which is now and again
brought to the notice of most veterinarians in the course of their practice, but it is by no means an event of common occurrence in this country. Moller, a German authority, avers that he has "frequently seen riding- horses, in violently bucking, or falling over backward, or in arching the neck excessively, fracture a cervical vertebra". Such an experience of one division of the vertebral column, added to that of the others, would seem to warrant the statement that "it is not uncommon in horses"; but the writer is of opinion that Moller's experience is unique and exceptional, and cannot be taken to represent that of the general practitioner. Fracture of the cervical vertebrse, or neck-bones, is of less frequent
occurrence than fracture of the bones of the back and loins. It is seen most frequently in steeple-chase horses and hunters which, having missed their foothold in jumping, or after failing to clear a strong fence, pitch on the face, and bring all the force of impact and weight to bear against the incurved neck. In one case the writer found it to result from the struggles of a horse whose head became fixed between the wall of his stall and the post which supported the manger. It may, no doubt, sometimes arise from a backward fall on the poll. Fracture of a vertebra may involve the body, or the arch of the
bone, or both, or one or more of its processes may be chipped off. When the former are broken through, displacement invariably results, and the spmal cord receives a fatal pressure—fatal, because breathing is arrested in consequence of paralysis of the diaphragm, which receives its nervous supply iiom the cervical spinal cord, which now fails to transmit it. Symptoms.—Fracture of the vertebrae in the middle and lower part of
the neck is speedily fatal, and in any position the same result sooner or later follows. |
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HEALTH AND DISEASE
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236
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FRACTURE OF THE DORSAL AND LUMBAR VERTEBRAE
It is here, in the back or loins, that fracture of the vertebrae most
frequently occurs. In this as in other fractures old animals are much more liable to the mishap than younger ones, owing to their bones containing a larger amount of earthy matter, which adds materially to their brittleness. When fracture occurs in these divisions of the spine it usually involves
one or both of the last two dorsal vertebras, and the first or first and second bone of the loins. Various causes conduce to fracture here. Violent muscular contraction
at the time of being cast for a surgical operation, or during the course of its performance, is one of the most common. Some Continental veterinarians affirm that the accident happens in
the fall, while others regard it as occurring during the struggles which follow. We are satisfied, however, that it occurs at both periods, but we are unable to say to which of these causes it is most frequently clue. Fracture of the dorsal and lumbar vertebras has resulted from violent
straining while being east in the stable with the legs entangled in the tie- rope, and from a heavy load falling on the spine of old horses when the hind-legs suddenly slip from under them. To hunters and chasers it sometimes occurs as the result of jumping short and alighting with the hind-legs in a deep drain, or in the subsequent struggle to reach the bank. Fracture of the vertebrae in the region of the withers or the loins may
result from falling over backwards, and it has been said to have occurred in kicking, and also while galloping and in starting heavy loads. Symptoms.—Pressure on the spinal cord from displacement of the
broken fragments usually occasions paraplegia or paralysis of the hind- quarters. This result may come about at once, or it may be deferred for some hours or, rarely, days. Where pressure exists, the animal sinks to the ground and fails to rise. After it has clone so, the hind-limbs are limp, and project straight out at right angles with the body. The muscles quiver, and patchy sweat appears about the thighs. In the animal's efforts to get up, the fore-end is raised, but the hind extremities are helpless and the quarters incapable of movement. When pricked with a pin there is usually no response, behind the
seat of fracture sensation as well as motion being paralysed. Where these symptoms are wholly present it may be reasonably concluded that fracture exists, but it must be understood that paraplegia or paralysis of the posterior part of the body may result from concussion of the spinal |
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237
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PARTICULAR FRACTURES
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cord, in which case there is a prospect of recovery. It is necessary, there-
fore, that a careful consideration be given not only to the symptoms, but also to the history of the case, especially with regard to its origin. There are two diseases with which fracture of the vertebrae may be con-
founded by persons who have no practical experience of the subject. These are " thrombosis ", or plugging of the iliac arteries, and a dis-
ordered state of the blood termed " haemoglobinuria", both of which are dealt with elsewhere. Animals when suffering from the former ailment lose the power of
motion behind after exertion, but it differs from fracture in the fact that the disablement soon passes away, and the animal rises to his feet and continues in apparent health until exertion is renewed, when the paralysis returns, and this may be repeated again and again for weeks and months. In the latter disease the affected horse is attacked with sudden and
acute lameness in one hind-limb, which sooner or later results in complete disablement and inability to stand. The respiration is hurried, and accom- panied by an outburst of profuse sweating. With this the urine becomes dark or even black, like porter, and on being boiled shows the presence of large quantities of albumen. The symptoms above described serve to differentiate the two diseases from fracture of the vertebrae. Treatment.—Where paralysis is due to concussion the injured animal
should be provided with a deep straw bed, and be allowed to lie quietly for four or five days before any attempt is made to test his powers of movement. A dose of physic should be given at once, and hot cloths well wrung out applied over the spine. Returning innervation of the affected muscles will be shown by slight voluntary movement of the hind-limbs, which will increase day by day until an attempt is made to rise. This, however, should not be hastened by any pressure or encouragement to assume the upright posture, but everything should be done to induce the animal to remain recumbent. To avoid the formation of bed-sores, and minister to his general comfort, he must be carefully turned over from time to time, and friction vigorously applied to the region of the quarter will assist in bringing about restoration of power. As this appears, the administration of small doses of strychnia may be resorted to, and gradually increased as time goes on and the muscles regain their strength. Where the vertebrae are fractured there is little hope of any benefit
being derived from treatment, and the only alternative is slaughter. |
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238 HEALTH AND DISEASE
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FRACTURE OF THE BONES OF THE FACE
Fracture of the facial bones is not as common as might be expected
considering the prominent and exposed position of the face. • From time to time, however, such cases are brought under the notice of the veterinary practitioner as the consequence of external violence. The face is some- times brought forcibly into contact with fixed objects, such as walls, trees, or lamp-posts, when horses run away, or it is struck by other horses while grazing, or brought into collision with various moving bodies. The jaw- bones are sometimes broken by becoming fixed on hooks, in chains, or in trappy positions. FRACTURE OF THE FRONTAL BONE
This bone, forming a considerable area of the face, and arching over the
eye, is much exposed, and sometimes suffers fracture from one or another of the causes referred to above. The fracture may involve that portion of the face situated between
the eyes, or the orbital process which arches over them. The importance of fracture of this bone, whether in the one part or the other, is centred in the degree of displacement which attends it. Fracture without displace- ment in either case does not give rise to any serious symptoms unless the blow is high up and the brain suffers concussion. A little swelling and drooping of the eyelid, and a blood-shot condition
of the mucous membrane of the eye with a discharge of tears, may be all that is to be seen when the orbital process of the frontal bone is broken without displacement. In these cases but little requires to be done. A mild aperient, bran diet, and cold-water irrigation of the part will suffice to keep down local inflammation and assist repair. Where, however, the bone is depressed the eye will at the same time have suffered more or less damage, and the sooner the displaced bone is lifted into its place again the better. This may be effected by the employment of a bone lever and gentle continuous upward pressure, after which irrigation with cold water and a dose of physic are all that will be required. Fracture of that part of the frontal bone between the eyes invariably
occasions more or less injury to the frontal sinuses whose walls they assist in forming, and as these cavities communicate with the nostrils some blood-stained discharge may flow from them. If the force producing the fracture has been very considerable more or less depression of the broken pieces will have taken place, and it may be that the bone has been broken into several fragments. Any displacement should be remedied at once |
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PARTICULAR FRACTURES 239
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by levering up the depressed fragments. This will require that a small
piece of bone shall be removed with a trephine from a suitable position outside the fracture area, and a lever properly padded at the point intro- duced into the opening and the depressed bone raised into its normal position. If the bone should be broken into small pieces replacement will be greatly assisted by manipulating them from the outside, while they are being raised by the lever from within. It may be that one or more of them will require to be removed. If so it should be done at once under strict antiseptic precautions; but it must be pointed out that since no muscles are attached here, and the bone is not exposed to any moving force, or called upon to support weight, there is nothing to occasion displacement when once adjustment of the broken parts has been effected. Haemorrhage into the frontal sinuses is a common result of fracture
of this part of the frontal bone, and should the operation of trephining be called for an opportunity will then be afforded for washing out the blood, for which a tepid antiseptic solution should be employed. Chronic disease of the bone is an occasional consequence of this accident,
and must be dealt with according to the indications of the case. FRACTURE OF THE LOWER JAW
Fracture of the lower jaw may take place through the neck of the right
branch or the left, or both. It may proceed vertically through the body and divide or separate the two branches from each other. It may pass transversely through the body of the bone behind the incisor teeth, or it may detach the styloid process, or sever the condyle from its branch, and in various other ways the bone may be chipped or broken. External violence in one or another of its many forms is accountable
for this mishap, to which in rare instances the bone is predisposed by disease. Kicks from other horses, falls, and collisions are the more common causes, but it sometimes results from the teeth becoming fixed m narrow spaces, and from the careless use of the gag while performing- dental and other operations on the mouth and throat. In young colts, the. parts of whose bones are not yet firmly united together, one branch !s sometimes partly or completely torn away from the other through their connection at the body. At the same time the central incisor teeth alone or together with others are loosened, and perhaps also more or less displaced. Symptoms.—In vertical fracture through the body of the bone there
ls at first considerable flow of saliva from the mouth. The lower lip is |
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240 HEALTH AND DISEASE
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constantly being moved sharply up and down, and in gathering his food
the animal breaks off abruptly. If there is much displacement mastication is interfered with, and the food is dropped from the mouth. The lips- remain somewhat separated from each other, and on opening the mouth the mucous membrane will be found to be torn or placed on the stretch by the parting pieces, or not, according to the presence or absence of dis- placement and the extent to which it has proceeded. When the breakage occurs across the body of the bone behind the
incisor teeth, the chin is more or less depressed, the mouth remains open, allowing a free escape of saliva and maybe more or less protrusion of the tongue. Crepitation is perceived when the broken parts are moved one upon the other. In consequence of the pendulous and disabled state of the lower lip the patient fails to gather his food, or if he succeed it is in a very small measure, and only accomplished with great difficulty and at the expense of much suffering. In fracture of the coronoid process the angle of the jaw on the side
of the injury will be found to be slightly lower than the opposite angle. Mastication is seriously interfered with, and the movements of the jaw lose their natural swing and become restricted and irregular. The animal cannot masticate hard food, and will only take aliment of a soft and sloppy character. Fractures through the neck of the jaw between the molar teeth and the
tusk, without displacement, are sometimes difficult to identify at first, the only symptoms observable being a marked shyness in feeding, in the act of which the saliva becomes churned into foam. Presently, however, a diffused swelling appears around the bone over
the seat of the fracture. This may encroach upon the " mental" nerve as it escapes through the foramen on the outer side of the bone at this part, and for a time partial paralysis of the lower lip is likely to result. If the broken parts are displaced a crepitus or rubbing sensation may be excited by moving one part upon the other. Treatment.—Where displacement exists the parts should first be
brought into their natural position and retained there by suitable means. If the body of the bone be split vertically through the centre and
the parts are displaced, they may be brought into position again by seizing the corner incisor teeth between a pair of large pincers and steadily but forcibly pressing them together. If they are raised one above the other, they must first be brought into line by depressing one piece or raising the other, as the case may be. If this cannot be effected by the hands, the pincers properly padded must be employed. Should the teeth have undergone any displacement they must be
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PARTICULAR FRACTURES 241
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Properly readjusted, after which the broken bone may be fixed in position
by means of copper wire or whip-cord tied round the incisor teeth. To guard against displacement the patient must be made to stand
m the pillar reins, and for two to three weeks his food should be soft and sloppy, such as scalded bran and chaff, boiled roots, &c. In fracture of the branches or the body of
the lower jaw the cradle designed by Mr. Walker of Bradford, shown in fig. 333, may De used or a piece of gutta percha, first soaked ln hot water, should be moulded on to the Under surface and sides of the lower jaw, and *nade to fit into the hollow (intermaxillary space) between its branches. By then punch- lng four or five holes through the front border 0n either side, and one or two into the upper Dorder; it may be made secure by strings or 8traps passing in front of the face and behind the ears. Mr. Walker's cradle is composed of two
lateral portions, fitting to the sides of the face, Suspended from behind the ears by a padded strap a, and kept in position by a brow-band > throat-strap c, and jaw-straps fffe, with Antral portion of wood padded with leather ' to fit between the branches of the jaw, nd two flanges ee to rest on the first molar |
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Fig. 333.—Walker's Face-Cradle
A, Padding to protect Poll, n, Brow-
Band, c, Throat Lash. D, Pad for submaxillary space. To be made of wood and well padded with leather. E, e, Flanges to rest on first molars.
F, P, F, F, Straps passing under lower-
jaw. G, G, Supplementary Strap Slits. H, H, Thumb-screws for lengthening- or shortening the plate: designed by- Mr. Broad, Bath. |
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11 each side of it, the side plates having an
rrangement for adjusting their length and Crews h h for clamping them when adjusted. 11 order that the fianffes should have a level earing and allow the animal to eat, the first Wars on which they rest must be short- ed by tooth shears (fig. 334) or rasp (fig. |
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**)• The apparatus should be so adjusted
to He evenly and without pressing more on one part than another. , ^n the absence of these appliances an adhesive compound of Burgundy v Cn, Venice turpentine, and a little bees'-wax may be plastered over and nd about the seat of fracture in a succession of layers until a thick |
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°ng covering has been obtained
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This when set will give considerable
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SuPport
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to the broken parts.
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Vol. ii.
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50
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242 HEALTH AND DISEASE
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Where both branches of the jaw are fractured Fleming recommends
that the space between them be completely filled up by a large firm pad of tow impregnated with an adhesive mixture, then one bandage after another (covered with the resinous mixture) applied around the jaw, |
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Fig. 334.—Tooth-Shears
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face, and nose. These, when the mixture has hardened, act as a cradle.
The animal may be allowed to drink thick, nutritious gruel out of a wide shallow vessel, or the gruel may be injected into the mouth or |
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Fig. 335.—Tooth-Rasp
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rectum or both. The standing position (for the horse) must be maintained,
and attention be given to the retaining apparatus that it be not dis- placed nor cause abrasion. FRACTURE OF THE ANTERIOR MAXILLARY BONE
The most common form of fracture of this bone is that in which it
becomes broken away from its fellow at their joining, and displaced either to one side or in an upward or downward direction. Fracture through the body or the nasal process may occur, but these forms are compara- tively rare. Kicks, blows, and falls on the mouth are accountable for many cases
of this mishap, and in several instances the writer has seen the bone torn from its fellow in the struggles to remove the incisor teeth from some con- fined position, such as when fixed in an iron ring or between a hook and the wall of the stable. Symptoms.—Some distortion of the face on the side of the fracture,
in which the upper lip is either raised or depressed or drawn to one side, is usually present when displacement takes place. There is some dis- charge of saliva from the mouth for a while, and frequent movement ox the lips. When the body is broken across, the fragment containing the incisor
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FRACTUEE OF THE BONES OF THE FORE EXTREMITY
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243
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teeth is movable and emits a crepitus. When the body of one bone is
broken away from the other the displaced portion may be firmly fixed m an upward, downward, or outward direction. If, as sometimes occurs, *t is also broken across, then it will be freely movable. Treatment.—The simplest form of fracture, and the one most amen-
able to treatment, is that in which one bone is torn away from the other, tn this case replacement may be effected by means of a little pressure and manoeuvring with the hand, or it may require the use of a pair of ar§'e pincers, as already prescribed for the lower jaw, to bring the displaced part into position. Broken teeth must be removed, and any that may be found to be
Pushed out of place should be properly restored to their natural position. Any bits of bone that may be loose and detached must be taken away.
J-t allowed to remain, their presence will excite irritation and pus formation 111 the surrounding tissues and retard reparation. The broken fragments may be retained in position by copper wire
bound round the incisor teeth. During the first forty-eight hours the patient should be kept exclu-
sively on thick gruel, and afterwards on sloppy bran diet, other forms °* aliment being gradually added as the case progresses. It is desirable to keep the horse in pillar reins for a short time after the
Parts have been readjusted. FRACTURE OF THE BONES OF THE FORE EXTREMITY
FRACTURE OF THE SCAPULA OR BLADE-BONE Fracture of the scapula is fortunately of rare occurrence, partly because
is covered with thick muscles and rests on others on the elastic chest aU, partly also because its movements are of limited extent, and in some Sree also on account of its out-of-the-way position. Sudden and violent blows are the chief cause by which fracture of this
ne is brought about. When occurring at the upper angles there is some " ospect of recovery, but fracture of the body of the scapula, or the neck, the articular cavity can hardly be viewed otherwise than as a dangerous Petition. Splints and bandages cannot be applied with the same restrain- ts influence on movement which they afford when applied to those bones 1Cn are below the elbow and away from the trunk. -Lxie symptoms displayed in scapula fracture are very vague. Crepitus 5 always difficult to develop and in most cases impossible. The bone does lend itself like the lower bones of the limb to the required manipulation |
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HEALTH AND DISEASE
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244
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of its broken parts, but where the fracture occurs at the neck pressure
at the point of the shoulder, when the leg is raised from the ground, may cause it to appear. Some swelling will arise about the seat of the injury, and pain will be
evinced in response to deep pressure on the part. Forward movement of the leg is effected with some difficulty, and weight imposed upon it causes severe lameness. Where displacement occurs it is most difficult to bring the broken
parts into position again, and when they are so adjusted it is practically impossible by any bandage or splints or other means to maintain them there. All that can be done is to support the patient in slings and leave the rest to nature. FRACTURE OF THE HUMERUS
The humerus or upper arm is seldom broken. The large muscles which
everywhere enclose it serve as a protection against external violence. When this fracture does occur, and the breakage extends through the
body of the bone, but little difficulty is experienced in the diagnosis. The limb below the fracture displays unusual mobility. It is incapable
of supporting weight, and when the animal is made to move, acute pain and lameness are evinced. The part is much swollen, and by carefully fixing the upper segment of the bone, and moving the lower one, crepitus may be developed Sometimes the external condyle is broken off, and the extensor muscles,
losing their fixed point of action, and being at the same time more or less damaged, fail to antagonize the action of the flexors. As a consequence the leg is drawn inwards and the foot and pastern are flexed on the canon in such a way that the front of the hoof rests on the ground. When the inner condyle is fractured and the attachment of the flexor
muscles becomes weakened, the action of the extensor muscles, overpowering them, draws the foot forward, while the knee, losing its support from behind, falls backward. When weight is imposed upon the damaged leg> this backward inclination of the knee becomes more marked and the concavity in front of the limb is increased. Treatment.—When the shaft of the humerus is fractured there is
not much hope of restoring the animal to a state of usefulness for ordinary physical labour. Where it is of special value for stud purposes an attempt should be made to effect re-position and bring about reparation. The arm is a difficult place on which to apply a splint, and equally so
to adjust a bandage with any prospect of its being retained. We would |
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FEACTUEE OF THE BONES OF THE FOEE EXTREMITY 245
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therefore advise that the patient be placed in slings, and that the ground
be slightly hollowed out to receive the foot of the broken limb. A starch bandage must be applied from below the knee to the middle of the arm, and a thick pitch plaster round the humerus. With this, quietude must be enjoined, and the requirements of the patient supplied without disturbance. FRACTURE OF THE ULNA
The prominent position occupied by the ulna predisposes it to fracture
beyond that of some other bones of the extremities. The olecranon, which lorms the point of the elbow, is more especially the seat of fracture in the horse. Here the breakage may occur deep down in the elbow-joint, or the summit of the olecranon may be broken away, leaving the joint intact. In whichever position the fracture may be, but little can be done to bring about reunion of the parts, and should it by any chance be effected in those cases where the joint is involved, the animal will always remain a cripple. The causes which give rise to fracture of this bone are mainly kicks
and blows, and on one occasion the writer has known it to occur in an ammal while pulling up suddenly to avoid a collision when going at gfeat speed. Symptoms.—In these cases the limb is brought forward with the
•Knee in a semiflexed condition, and the elbow is depressed. Any attempt at progression is marked by considerable downward inclination of the fore- ^Uarter on the injured side. This attitude results from the great triceps Muscle having pulled the broken point of the elbow upward and ceased 0 give support to the limb, while the biceps and the mastoido-humeralis, saving now nothing to antagonize their action behind, draw the limb ^Ward beyond its natural limits. ■Ihe pain and distress caused by this mishap are always considerable,
nd progression is marked by great difficulty in bringing the leg into an
Pright weight-bearing position. When the elbowT-joint is involved, the
ttering is much increased, and general enlargement of the articulation
80°n appears.
Immediately after the accident the detached piece of bone can be felt
move, and the space dividing it from the other portion may be
°gnized, but owing to the upward displacement it is seldom that crepi- taWon can be induced. Treatment .—Nothing can be done to bring the broken pieces together
cl maintain them in position, and there is little hope of any good Resulting from treatment. |
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HEALTH AND DISEASE
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246
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If it should be decided to do anything, we would advise the simple
course of slinging, after the whole limb has been straightened and put into a starch bandage. |
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FRACTURE OF THE RADIUS
Fracture of the radius, or fore-arm, like most other fractures of the
bones of the limbs, is the result of kicks and blows, or false steps, or it may arise in the struggles to recover the leg from some fixed position. A blow on the inner side of the bone, where it is least protected by muscles, is more likely to occasion a fracture than one on the outer side or back of the limb. |
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ifV^T
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Symptoms. — An incomplete fracture of this bone,
without displacement, affords no other evidence of its existence than local pain and swelling, with more or less lameness, and in this form of injury recovery may be looked forward to under proper treatment, and the same may be said of complete fracture when the broken parts continue to hold together. It is when the broken fragments are separated that
the case reaches its more serious aspect. Here the animal fails to bear any weight upon the
limb, and locomotion becomes impossible. The leg below the fracture displays abnormal mobility, and when raised from the ground swings forward and backward and bends from side to side. Crepitation is readily detected, and the part is swollen, hot, and painful to the touch. Treatment.—If the animal is young and docile, and
the tissues in the region of the fracture have not been |
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Fig. 33
Fracture Radius |
i.—Oblique
of the |
seriously damaged, and the parts are promptly brought
together, reparation may possibly be effected. The chances, |
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however, are too often in favour of the contrary result;
and even in the majority of those cases in which a reunion is effected, some deformity, or other equally serious defect, remains behind. It is only, therefore, in animals of considerable value that treatment is
likely to be remunerative where successful. Since quietude is one of the first requirements of treatment, the patient must, as soon as possible, be placed in slings, and if a properly - constructed operating-table is not at hand, whereon chloroform may be given, a dose of morphia will have the effect of rendering him more manageable during readjustment of the broken |
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FRACTURE OF THE BONES OF THE FORE EXTREMITY 247
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bone. Before the bandages and splints are applied it is most essential
that the leg be brought into its natural position. The toe and the knee should be in line, and there should be no deviation either to the right or to the left in the course of the fractured bone. A series of bandages soaked in a mixture of the white of egg and
starch should be applied up the leg from the coronet as far along the arm as it is possible, and then the iron splint designed by Bour- gelat (fig. 337) should be adjusted over them. W course the hollow of the heel and all other depressions in the course of the limb ^ill be filled in with tow, so that the pressure °f the bandages may be equalized. Should no such splint be accessible, then wooden splints Cut to the form and length of the limb must he employed. FRACTURE OF THE KNEE-BONES
This is comparatively rare. When it does
occur it is mostly associated with broken ^nees, and assumes the form of a compound ra°ture, complicated with inflammation of ^e joint and damage to tendons which pass over it. -Fractures here are attended with great pain
an°- suffering and much constitutional dis- Urbance. There is free discharge of synovia 0r "joint oil", inability to support weight on |
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he affected limb, and considerable swelling.
n other than animals of considerable value °r stud purposes the result of treatment, |
Fig. 337.—Iron Splint for Fractures of
the Fore-limb A, A, Screws for adjusting the length
of the Splint. |
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owever successful it may be, will not be such
8 to compensate for the time and trouble which these cases demand, he knee invariably suffers irreparable damage, and the animal remains a eriPple for the rest of his life. Where treatment is resorted to, the horse must be placed in slings,
~ splints and bandages employed to maintain the joint in a state of rest,
Ue at the same time provision should be made in the bandaging for the
ree discharge of matter from the wound in the knee, which must be treated
°n antiseptic principles.
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HEALTH AND DISEASE
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248
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FRACTURE OF THE METACARPAL BONES
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In adult and aged horses the metacarpal bones are generally united
together by ossific union, and it results from this, when fracture occurs, that all the bones are involved in it.
In colts, where they are united by ligaments only, each one of them may be broken independently of the others, but such an occurrence is very occa- sional. Fracture of these bones (fig. 326,
p. 222) is mostly brought about by kicks, jumping into deep hard roads, blows against fences and walls, and slips, &c. The absence of muscles in this
region, and the opportunity thus afforded of a clear view and thorough manipulation of the part, renders diag- nosis an easy matter when displace- ment has occurred. The bone will be seen to bend at the seat of fracture when any attempt is made to put weight upon it. In progression, that part of the limb below the breach has ceased to be under control, and swings about as the body moves forward. Crepitus can be readily produced, and the existence of a fracture becomes at once apparent. Treatment.—Although these cases
are both difficult and uncertain, now and again treatment has its reward in restoration to a state of usefulness, |
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Fig. 338.
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but it is seldom possible to avoid de-
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Bones
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preciation in the value of the animal.
To what extent this factor will assert itself will depend very much upon the degree of displacement and the damage inflicted upon surrounding tissues by the unrestrained movement of the broken fragments after the accident. Fractures without displacement, when they are diagnosed and promptly
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FRACTURE OF THE BONES OF THE FORE EXTREMITY 249
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treated by slinging and suitable splints, offer the best prospects of
success. Where displacement occurs, the bone must be set, and in carrying
out this part of the work every care will require to be taken that the fragments are brought into their proper position. Before splints and bandages (fig. 338) are applied, the knee and the toe must be brought into line, and the leg as a whole rendered straight. Placed in slings, the patient must be disturbed as little as possible, and careful watch kept over the limb, so that prompt relief may be given by relaxing the bandages where undue pressure provokes swelling. Should this precaution fail to be observed, the case will
become complicated by dangerous sloughing, and the re- union of the bone retarded or altogether prevented. |
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FRACTURE OF THE OS SUFFRAGINIS OR LARGE
PASTERN
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Fractures of the large pastern are perhaps the most
common of all affecting the limbs of the horse. They mostly take an oblique direction, extending from
above downwards towards the outer or the inner side (fig. 339), or pass vertically downwards from the upper to the lower extremity. Less frequently the breakage is trans- verse, in which case it mostly occurs towards the lower extremity (fig. 340), and is very frequently comminuted. In oblique fractures the division usually extends into the fetlock joint, while in those taking a vertical course |
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it may also involve the joint formed with the small pastern.
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Fig. 339. —Oblique
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In young horses they are most frequently partial, and take Fracture of Suffra"
the form which is commonly termed " split pastern". In these cases there is no displacement, and treatment is thereby favoured- Fracture of this bone is most commonly met with in race-horses, hunters, and chasers. In the first it results more especially from slips, raise steps, twists, and striking the toe in the ground while going at great speed. In hunters and chasers it also occurs as the result of jump- mg into roads or travelling through deep holding-ground, or dropping the feet into holes. Symptoms.—Following the mishap, there is sudden and severe lame-
ness. If the fracture is comminuted or attended with displacement the *eg is held in the air, and is incapable of bearing weight. |
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HEALTH AND DISEASE
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250
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If the foot be rotated or forcibly flexed on the fetlock, crepitus or
rubbing of the broken pieces will be felt. Great sensibility to pressure along the surface of the bone soon appears, accompanied by a firm diffused swelling. In split pastern the lameness, although sometimes considerable, is less severe, and there is usually no crepitus. The swelling may be inconsiderable, and the existence of a fracture altogether overlooked. Treatment.—No time should be lost in placing the animal in slings.
The shoe should be removed, and the stable littered with 3 or 4 inches of saw-dust or peat-moss. If there is no displacement, which will be readily determined by the undisturbed outline of the pastern, a starch bandage should be applied at once. In making the application, the hollow of the heel should first be filled in with a pad of tow, over which the bandage should be rolled and carried
over the fetlock joint from the coronet, nearly as high as the knee. In those cases in which displacement occurs, the parts should be readjusted and the bone sup- ported by a starch bandage or some more suitable splint. A light, spare diet should be prescribed,
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Fig. 340.—Oblique and Transverse Fractures
of the Os Suffraginis |
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and a little linseed-oil may be incorporated
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with it night and morning until the bowels
are gently acted upon. All that is now needed is to* avoid any sudden excitement, and to keep the animal perfectly quiet. So soon as he begins to throw his weight upon the limb, and to con-
tinue it, the bandage may be removed. More or less enlargement will be found to have developed on the bone in the form of a reparative callus, and subsequent treatment must be directed towards effecting its reduction. For this purpose a repetition of blisters must be applied over the part during a continuance of rest. In some cases a large ring-bone, with more or less lameness, remains as a permanent result of the fracture, while in others but little enlargement follows, and the action is in no respect affected by it. FRACTURE OF THE SESAMOID BONES
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Fracture of the sesamoid bones is by no means of uncommon occurrence.
It happens most frequently in old hunters and chasers when carrying heavy weights over deep ground, and mostly at the end of a long and |
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tiring run.
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The line of the fracture is usually transverse. Sometimes the accident
is confined to one bone, but more frequently it involves both, and now |
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* PLATE XXXIX.
|
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OSTEOPOROSIS
Showing Disease and Descent of the Sesamoid Bones
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Photo by W. Hall &-Son, Bi
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FRACTURE OF THE SESAMOID BONES
|
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Border Lass, aged, broke down (fractured the sesamoid bones of both fore-legs) at
Ringmer Steeplechase, April 10, 1889. Photograph taken seven weeks later |
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FRACTURE OF THE BONES OF THE FORE EXTREMITY 251
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and again it occurs to both fore-limbs at the same time. The bone may
break through the middle, or a piece of the upper angle only may be torn away from the rest. The fracture sometimes follows upon repeated chronic sprain to the suspen- sory ligament, and there is reason to think that in these cases the cohesion of the bone has been diminished by an extension of the inflammatory action from the ligament to the bone to which it is attached, for it frequently occurs that prior to breakage the sesamoid bones have been for some time more or less enlarged. Slipping and false steps in making sharp turns are sometimes account- able for this injury. It has been said that " the accident is quite as
likely to happen while the horse is at rest in his stall as under any circumstances"; but while grant- ing the possibility of such an occurrence, we cannot subscribe to a statement for which experience affords no sort of support. We have repeatedly known horses which have been laid up for some time on account of lameness in the fetlock joint, in which perceptible enlargement of the sesamoid bones existed, to fracture their bones in the stable, or very soon after renewing work, but we have always regarded such cases as having been predisposed to fracture by a process of rarefaction of the bones arising out of inflammation extending from the sprained ligament. Many cases of what is called "breakdown", if
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carefully examined after death, would be found to
result from a giving way of the bones in this weakened condition, and the removal of a fragment by the partially-separated ligament (Plate XXXIX). These cases are attended with lameness more or
less severe, but in the slighter accidents there may be but little distortion of the fetlock joint, and the |
Fig. 341.—Fracture of the
Sesamoid Bones 1, Carpal tendon cut away to
show suspensory ligament. 2, Small metacarpal bone. 3, Sus- pensory ligament. 4, Branch of same. 5, Fractured sesamoid bone's. 6, Deep sesamoid liga- ment. 7, Superficial sesamoid ligament. 8, Intersesamoid ligament. |
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|
writer has found that in course of reparation the
ligament at its point of attachment with the sesamoid bone becomes ossified. Symptoms.—Fracture of the sesamoids results in sudden lameness,
but in degree varying with the nature of the fracture. When this is |
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HEALTH AND DISEASE
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252
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completely across the bone, the broken fragments are forced asunder by
the weight imposed upon them, and the fetlock joint, having lost the support of the suspensory ligament, sinks towards the ground. The weight, now falling more directly upon the heel, gives the toe an inclina- tion upwards. This deformity may not occur immediately, and sometimes only appears two or three clays after the accident, at which time there is much swelling, heat, and pain in the part. It may be that only one sesamoid bone may be fractured, in which case the fetlock joint inclines inward or outward, according as the one side or the other is affected. Although the broken pieces may be much displaced, crepitus may some- times be induced by fixing the suspensory ligament above and forcibly flexing the fetlock joint. Treatment.—Very little can be done in these cases to fit the horse
for remunerative work, but when it is required to put it to the stud, in some cases it may be made serviceable for the purpose. The strain should be taken off the suspensory ligament by the appli-
cation of a high-heeled shoe. The joint should then be supported by a starch bandage, carried from the coronet upwards to the middle of the canon. This having been done, the animal should be placed in slings and kept there eight or ten wTeeks, or longer if necessary, as quiet as possible. In complete fracture, the fetlock joint is sure to remain deformed and
enlarged to a greater or less extent. A repetition of blisters after the patient has been taken out of the slings will help to reduce the enlarge- ment, and give further tone to the injured parts. FRACTURE OF THE NAVICULAR BONE
The frequent occurrence of navicular disease, as a result of which the
bone becomes weakened by ulceration and rarefaction of its tissue, renders the bone in question peculiarly liable to fracture, and this predisposition is still further increased by the position which it occupies, and the weight and concussive force to which it is exposed during locomotion. It is, however, more particularly in horses the nerves of whose feet
have been divided that the accident occurs. While the nerves are intact, and sensation exists in the feet, the animal relieves himself from pain by throwing the weight of the body on the front of the foot, but when sensation has been removed by division of the nerves, pain disappears. The heels are then brought to the ground, and the navicular bone, weakened by disease, is made to bear the full weight and impact of the body. At this time the perforans tendon has undergone more or less
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FRACTURE OF THE BONES OF THE FORE EXTREMITY 253
excoriation and inflammatory softening, and failing in consequence to give
the bone support, a fracture results. It is no uncommon thing for rupture of the tendon to follow upon fracture of the bone. Nails penetrating the frog have been noticed to cause fracture of this
bone, but such an occurrence is very rare indeed. Symptoms. — Evidence of fracture of the navicular bone is difficult
to differentiate from that severe inflammation of the navicular joint and tissues of the foot which sooner or later follows upon neurectomy. A little |
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B, Diseased Bone. Fig. 343.—Fracture of the Navicular Bone
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fulness in the hollow of the heel is first observed, which on pressure is
somewhat yielding, and suggests the existence of deep-seated fluid. The foe has a slight inclination upwards, and the fetlock joint is somewhat depressed. Soon the coronet exhibits an abnormal fullness, and oozing of serosity appears between hair and hoof. The coronal thin border of the latter becomes white by saturation with serosity, and the horn com- mences to separate from the skin, and soon the hoof sloughs, a result which sooner or later follows upon fracture of the navicular bone. Of course nothing in these cases can be done with any prospect of
cure, and the better and more humane measure is to have the animal destroyed. |
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HEALTH AND DISEASE
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254
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FRACTURE OF THE RIBS
|
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Having regard to the large and exposed surface formed by the back
ribs, and the peculiar occupation and surroundings of the horse, fracture of the ribs is much less common than might reasonably be expected. If the front ribs are protected against external
violence by thick muscles, and also by the scapula or shoulder-blade, those behind are possessed of great elas- ticity, and, having no fixed attachment below, are much more capable of yielding to external force without break- ing than those in front. Both, however, are now and again forced beyond their powers of resistance, and a fracture follows. This may be transverse, as in fig. 337, oblique (fig. 344), or vertical, with or without displace- ment. The displaced fragment, if directed inwards, may puncture the pleura or the lung, thus inducing complica- tions of pleurisy or pneumonia, or both, or it may pass through the skin and convert a simple into a compound fracture. Both these events add very materially to the danger
of the case, and too often give it a fatal turn. Causes.—Fracture of the ribs is usually the result
of external violence. Sometimes a kick from another horse, at others a collision with the shaft of a trap, or the pole of a coach or brougham, will cause it; at others it results from a fall on a hard surface, where the legs |
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|
Fig. ,344. — Oblique
Fracture of Rib (third rib, right side, outer aspect) |
slip from under the body and the ribs strike the ground
first and without any break in the fall. Symptoms.—Fractures of the ribs frequently occur
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without displacement, and undergo repair without inter-
ference of any kind. In these cases there is nothing to be seen out- wardly, and, excepting a slight thickening over the line of fracture, there is nothing to be felt. The part is tender to touch, and deep pressure causes the patient to recede from it and to emit a subdued grunt. Ten- derness may be found to exist on neighbouring ribs, and some stiffness will be observed in turning. Where the broken parts are displaced or contused, more or less swelling
appears over the site of fracture. By following the ribs downwards with the fingers before this occurs, the breakage will be recognized as an irregu- larity in its continuity, with more or less projection of one of the broken |
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FRACTURE OF THE BONES OF THE FORE EXTREMITY 255
segments from the general surface. With this will be associated great
soreness at and about the seat of injury. The fracture may be complicated with perforation of the chest or an
external wound. In the former case pleurisy of a local or general character will be excited, or should the lung be punctured or torn, as sometimes occurs, signs of pneumonia will be present, or both may exist together. In these cases the breathing will be more or less disturbed, accompanied by cough, and the more serious symptoms incidental to disease of the chest. An external wound connected with traumatic injury to the pleura and lungs is a serious complication, and one which is invariably attended with the greatest danger. Where the broken ends of the bone are sharp and cutting, the inter-
costal blood-vessel may be divided and give rise to hemorrhage. In fracture of the front ribs severe lameness of the fore-limb on the side
of the injury is of common occurrence. This would seem to result from the movement of the broken bone by the serratus magnus muscle, which not only enlarges the chest in the act of inspiration, but supports the trunk as in a sling (fig. 44, Vol. I) between the fore extremities. Treatment.—In cases of simple fracture, without displacement, it is
good practice to place the animal in slings for a fortnight or three weeks, and then provide him with a good straw bed and keep him quiet. Where displacement has occurred, by which the lung is interfered with,
it might be necessary to attempt re-position notwithstanding that the operation is attended with considerable danger. For this purpose an incision will require to be made over the seat of
fracture. The finger or a suitable lever must then be carefully introduced and brought to bear on the inner side of the front edge of that portion of the bone whose point is directed inwards, and when the chest expands in the act of breathing an attempt should be made to bring the displaced fragment into position by pressing it outwards. Before proceeding with the operation the hair should be closely clipped
off the part, and the skin thoroughly washed with soap and water, and then well irrigated with carbolic or some other antiseptic solution. Instru- ments should also be disinfected, and the wound subsequently treated anti- septically. If the displacement does not interfere with the lung, it is not desirable
to interfere with it. Time and a period of rest in slings is all that can be done to effect a union. Where a wound is produced at the time of the fracture, advantage should
°e taken to rectify displacement, if such exists, by the method above de- scribed under antiseptic precautions. |
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256
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FRACTURE OF THE PELVIS
The large size of the pelvis, its projecting angles and position, render it
specially liable to fracture, and modern road-making in our large towns contributes not a little to this result. Wood pavement, when the surface is first moistened with water, is rendered difficult to travel over at any time, but with heavy loads behind them, where the ground is on the ascent, or slopes, as it usually does, from the centre towards the sides, |
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A, Fracture through the Cotyloid Cavity. B, Fracture of the Symphysis Pubis. c, Transverse
Fracture of the Os Pubis. D, External Fracture of the Ischium. E, Fracture of the External Iliac Angle. F, Fracture of the Internal Iliac Angle. G, Fracture of the Tuberosity of the Ischium. |
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heavy horses frequently fail to keep their legs, and suffer fracture of this
bone by a heavy and helpless fall. When the fall is on the side, and the force is applied to the point of the haunch, a portion of the angle of the ilium may be broken away from its body, or the fracture may take place in some remote and deeply seated part. Draught-horses, when moving heavy loads in two-wheeled carts, are sometimes brought to the ground by their hind-limbs suddenly slipping away from them right and left, when the pelvis is forced to the breaking-point by the weight of the load on the one hand and the struggles of the animal on the other. Blows on the hip while passing at high speed through doorways and
gates, or by collision with some other fast-moving body, are also account- able for accidents of this kind, and in rare instances fracture has been brought about by " casting ", or in the course of a surgical operation. In the hunting-field and the chase, horses have fractured their hips while jumping, as well as by dropping the hind-quarters into a drain as the result of failure to clear a bank. From these and other causes fracture of the pelvis may take place in
one or another of its various parts. Breakage of the point of the haunch (hip down) is the most frequent form which the accident assumes. Less frequently the body or the neck of the ilium may break, or the pubis or |
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257
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FEACTUEE OF THE PELVIS
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ischium which form the floor of the pelvis, or the bony cup (acetabulum)
which is engaged in forming the hip-joint, or the breach may take place through the tuberosity of the ischium where it forms the point of the buttock. Of course more than one of these several parts may be rent at the same time. Symptoms.—Many and various phenomena result from fracture of the
pelvis, and veterinarians have attempted to assign to each particular frac- ture its special set of symptoms, but it cannot be said that they have yet established a reliable code. The physiological disturbance which results from the fracture of any particular part of the pelvic girdle is sometimes so masked and disturbed by injuries occasioned to neighbouring muscles that the symptoms of no two cases of the same fracture sufficiently Resemble each other to ensure correct diagnosis unless the fracture can be localized by the hand through the rectum. Sudden lameness, more or less severe, according to the seat and nature
of the breakage and the extent of displacement, is the immediate effect of the mishap; or the animal may be so far disabled at once as to be unable to rise when down or to stand when up. In some cases there is obvious deformity of the quarter. In fracture of
the neck or the inner angle of the ilium the croup becomes depressed, and when compared with the sound side, while weight is on the leg, it is noticed to be distinctly lower. Fracture of the outer angle of the ilium gives the Quarter a flat appearance on the side of the injury, owing to the broken piece having been pulled downwards by the muscles attached to it. This- ls soon recognized by inspecting the quarters first from before and then from behind. When the outer branch of the ischium is fractured, there may be
ttiore or less swelling in the region of the hip-joint and about the inner aQd back part of the thigh. In fracture of the pubis, swelling of a diffused character appears sooner
0r later between the thighs, about the sheath and scrotum in the horse and the mammary gland in the mare. It may also extend in a forward direction beneath the belly, or in a backward direction to the perineum in tne male or the vagina in the female. Excepting in fracture of the outer angle of the bone (hip down) loco-
motion is very materially interfered with, and the power to bear weight is !ther seriously impaired or altogether destroyed. In progression the limb on the side of the fracture may be moved
nduly outward (abducted) or inward (adducted), or the animal expen- ses difficulty in bringing it forward or in raising it from the ground. ne horse fails to walk straight but moves diagonally with the rump V°L- II. 51
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258
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inclined towards the sound side. In some fractures, especially those
involving the acetabulum or hip-joint, pain is expressed by a more or less audible grunt, by spasmodic twitching of the muscles, and an expression of anxiety and fear. Where the round ligament (fig. 358) is in part or wholly detached from its connection with the cup, the limb ceases to be altogether under muscular control. In any attempt to move it, either the foot goes beyond or falls short of the point it is intended to reach. In one step it is thrown outwards, while in the next it may incline inwards, and the movement of the limb generally is limp. The diagnostic symptom in this, as in all other fractures, is the presence
of a true crepitus or impression which rubbing of the broken pieces together conveys to the hand or the ear. This may be at once evident on manipulation, or auscultation, or only
detected after much careful manoeuvring of the limb of the animal, or it may be altogether absent. In order to bring it about, an assistant should be instructed to move the leg carefully in various directions, inwards, outwards, backwards, and forwards, and to rotate it gently first in one direction and then in the other. During this time the hand or the ear of the examiner should be applied to the point of the ilium, and moved backward from place to place to the point of the buttock, the mind being at the same time concentrated upon it. The hand should then be passed into the rectum and brought into contact with every available part of the pelvis. Any crepitus occasioned by the movement will then be felt, and any swelling or displacement of the broken pieces at once recognized. Crepitus may sometimes be induced and recognized by pushing the animal over from one side to the other, while still keeping the hand on the quarter or in the rectum. The absence of crepitus and severe lameness does not always indicate the absence of fracture, but may be the result of no displacement of the broken bone having taken place. In these cases of doubt the examination should be repeated day by day
for several days, during which the patient must be kept perfectly quiet. Treatment.—The broken pelvis does not lend itself to those measures
of mechanical restraint which are employed so successfully in dealing with some of the bones of the extremities, and we are therefore restricted in our endeavours to effect reparation to the device of slinging and maintaining as nearly as possible an upright posture, thereby avoiding those disturbing efforts involved in lying down and rising again, movements which are sometimes attended with most disastrous results. Whether treatment is likely to be attended with success or not is a
question which the examiner must answer for himself after having made a searching examination. |
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259
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FKACTUKE OF THE PELVIS
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Generally it may be said that, owing to the very imperfect control which
can be exercised over the movements of the horse, and the disturbing effect of the weight of the body acting on the broken bones while in the upright posture, but little can be hoped for from treatment. In fracture of the acetabulum there is only a very remote prospect of a
reunion of the broken pieces being brought about, and much the same may be said of a breach in the floor of the pelvis. We have seen instances of repair in both these fractures, but they are very rare indeed, and in the former case severe lameness continued throughout life. The external angle of the ilium is frequently broken and displaced more
or less in a downward direction without materially affecting the patient's usefulness. In these cases a replacement of the broken fragments cannot be effected owing to the downward pull of the muscles attached to it, but it continues to be connected to the part from which it was torn by a strong band of connective tissue, and the patient suffers only a temporary incon- venience from the accident. Here rest is all that is needed to bring about a satisfactory result. Less frequently, but in a large proportion of cases, the same good result
follows under the same simple course of treatment when the internal angle is broken. Some prospect of recovery offers, where the fracture involves only the
neck of the ilium, so long as there is no displacement, and the same remark applies where the point of the ischium is broken; but it frequently occurs that the parts break away in the course of repair, before it has sufficiently advanced to keep them in position. Except in those forms of fracture last referred to, unless some special
value be attached to the injured animal for stud purposes, the desirability °i prompt destruction should be well considered. Experience teaches that 111 the most favourable cases, where reunion of the broken pieces is com- plete, some deformity of the pelvis, some irreparable interference with nerves or vessels, or wasting of muscles, is left behind to cripple the patient after long and costly nursing. Perfect quietude as far as it can be enforced is the one condition to
be aimed at, and this will be best secured by placing the animal in slings. J-11 doing so it should be observed that the ground is not slippery, and nat it is well covered with peat-moss or saw-dust, or, failing these, a nick covering of sand. Peat-moss being the softest, most adhesive, and least likely to jar the limb, is to be preferred. It may be that the patient ttiay experience some difficulty for a time in emptying the bladder, owing o being unable to extend himself. In such cases the urine must be with- drawn by means of the catheter with as little disturbance to the horse |
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260 HEALTH AND DISEASE
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as possible. Brisk friction or rubbing with a brush over the legs and
quarter will tend to relieve stiffness and afford comfort while under restraint. A diet composed of bran and roots, with a moderate amount of hay,
chaff, and a few crushed oats, is the most suitable, and two table-spoonfuls of linseed-oil incorporated with it three or four times a week will serve to keep the bowels regular. Everything should be done to minister to the comfort of the animal, and time must do the rest. FRACTURE OF THE BONES OF THE HIND EXTREMITY
Fracture Of the Femur.—Notwithstanding the large muscles which
everywhere surround and protect the femur, it is sometimes made to yield to the violence which in one form or another is applied to it. The causes which determine fracture of this bone are mostly kicks from other horses, violent struggling while undergoing operations or in endeavouring to escape from some difficult and confined position. It sometimes results from a slip while attempting to start a heavy load. The seat and nature of the fracture varies in different cases. Some-
times the head is broken off through the neck, at others the diaphysis or shaft is divided in a transverse or oblique direction (fig. 328), or one or both condyles may be separated from the inferior extremity of the body, or the large trochanter broken away from the upper extremity of the bone. The signs of fracture here are not usually difficult to read. Sudden and acute lameness, with inability to bear weight, and difficulty in advancing the limb, are at once manifest. When the animal is made to move, the leg is advanced with an outward swing and displays unnatural mobility. Crepitation is made apparent by passive movement of the broken pieces, first in one direction and then in another. As the animal stands, the quarter sinks into a resting position. Reposition or reduction of the fracture is always difficult, mostly im-
possible; and when accomplished the size, form, and relations of the thigh oppose the application of appliances to retain the broken fragments in apposition. It will be seen, therefore, that unless great value is set upon an animal for breeding purposes treatment is not likely to prove remu- nerative, and should not be encouraged. An unserviceable cripple is with very rare exceptions the only return
for much expense and trouble. Slinging, pitch plasters over the part, and such quietude as can be
procured are the only available if doubtful means of effecting a reunion of the parts. |
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FRACTURE OF THE BONES OF THE HIND EXTREMITY 261
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Fracture Of the Tibia.—Fracture of this bone is comparatively
frequent. Its greater length, more exposed position, and less ample pro- tection by muscles than the femur render it more liable to succumb to external violence. The internal surface of the bone is quite superficial, having no other
covering than the skin. This is its most vulnerable point, and when sharp forcible blows are applied to it, it not unfrequently splits or breaks. Kicks, blows, false steps, collisions with cart-shafts, carriage-poles, and
stone walls, and violent struggling when cast either by accident or design- edly for the purpose of an operation are the causes by which it is chiefly Produced. Symptoms.—The outward manifestations resulting from the mishap
Wrll depend upon the more or less completeness of the fracture. Some- times the bone is only partially broken through, and, the parts being maintained in their natural position, comparatively little pain or incon- venience is suffered; so little, indeed, that in some cases the nature of the injury remains undetected for days and weeks, until by the strain of w°rk the fracture is rendered complete by the parts being torn asunder, or the fragments becoming displaced in the act of lying down or rising from the recumbent posture. In such circumstances the evidence of fracture becomes clear and decisive; the horse fails to support weight on the lnjured limb, which, when raised from the ground, hangs limp and pendu- lous, and crepitus is readily detected in it. Partial fracture may provoke more or less lameness, the seat of which
may or may not be indicated by swelling. But in the absence of swelling, Pressure applied over the surface of the bone will afford material evidence 01 the existence of fracture. Treatment.—Where the fracture is complete the prospect of restoring
phe horse to a state of usefulness is very remote, indeed so much so that it
Xs 0nly where high value is set upon the patient for breeding purposes that
he result would be likely to prove at all satisfactory. In this case the
lttlD should be enclosed in a strong pitch plaster, laid on in a succession of
layers from below the hock as high as the stifle.
-Further support may be given to the broken fragments by strips of
ick cardboard let into the plaster over the region of the fracture. With ls should be conjoined the support of slings and perfect rest. Fracture of the Bones of the Hock.—This is an accident of
exceptionally rare occurrence, and mostly concerns the calcaneum (os
a cty or bone forming the point of the hock. Occupying a prominent . ' Jtion, and standing exposed to external violence, it is remarkable that 1 so seldom suffers fracture. |
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262 HEALTH AND DISEASE
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Kicks, blows, and violent struggling when cast are the most common
causes. In foals the point of the hock is sometimes torn off when rearing and walking backwards on the hind-legs. The symptoms resulting from this mishap are very striking and
characteristic. There is a complete inability to support weight on the broken limb.
When an attempt is made to do so the hock joint sinks towards the ground, and the point of the hock is drawn upwards by the pull of the tendo achillis, the foot is advanced, and the quarter on the injured side inclined downward. In progression the limb as a whole is raised as far as possible, and then trailed forwards with the advancing body. Treatment in these cases offers but little prospect of success. The
tendo achillis, acting upon the broken fragment, displaces it upward beyond readjustment, and where it is practicable to bring the broken parts together it is usually found impossible to maintain them in their natural position. Fractures below the hock may be such as have been described as taking
place below the knee, and will require to be healed on the same lines. |
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16. ARTICULATIONS OR JOINTS
The bones of the skeleton are joined together in various ways to form
joints. The manner in which they are united will depend upon the purpose they are intended to perform, hence joints are divided into three classes according to their respective range of movement. 1. Diarthrodial joints, which enjoy the greatest freedom of action. 2. Amphiarthrodial joints,, whose powers of movement are much more restricted. 3. Syn- arthrodial, or those which are fixed and immovable. Diarthrodial or Free-moving Joints are composed of two or more
bones whose articular surfaces are covered with a thin layer of cartilage
or gristle, and so formed as to permit one to play freely upon the other. They are all enclosed in a sac lined by a delicate membrane for the secretion of synovia or joint-oil, and for the most part the bones axe held together by connecting ligaments. Ball-and-Soeket Joints.—Some diarthrodial joints are formed by
the rounded head of one bone fitting into a cup-like cavity or socket con- tained in another bone. This is the case in the hip-joint (fig. 358), which allows the leg to be moved in all directions—inward, outward, forward, backward—and also to be rotated and circumducted or moved in a circle. Hinge Joints.—Others assume the form of hinge joints, in which
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ARTICULATIONS OR JOINTS
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263
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convexities or prominences on one bone fit into depressions or grooves
m its fellow. In this form of articulation the movement of the joint, like that of a door, is only to and fro or in the direction of flexion and extension. A good example of this class of articulation will be found in the tibio-tarsal or true hock joint (fig. 361), the elbow-joint, &c. Arthrodia Or Gliding Joints.—This variety of diarthrodial joint is
found in the knee (fig. 354) and the hock joints where the small flat bones are closely united together, one upon the other, so as to allow simply a limited gliding motion in various directions. Amphiarthrosis or Mixed Joints.—In this variety the bones are
connected by a disc of fibro-cartilage, and possess just as much movement as the flexibility and compressibility of the joining substance allows. Mixed joints have no smooth surfaces or synovial capsules. Examples of this description of joint are found in the union of the bodies of the vertebrae (fig. 346), where a pad of elastic fibro-cartilage exists and gives to the spine as a whole its flexibility and springiness without permitting undue mobility between each pair of vertebrae. Pivot Joints.—Here a pointed extremity of one bone furnishes a
pivot on which another bone turns. This is the case with the odontoid Process of the dentata or second vertebra (fig. 350), which, as has been previously explained, passes into the ring of the atlas or first neck-bone, and permits a rotary movement of the latter upon the former. Synarthrosis or Immovable Joints.—This form of articulation
Prevails where flat bones are united together by their borders to form
cavities, as in the case of the cranium and the cavities of the face. In s°me of these a joining is effected by the overlapping of thin plates of oone. In others, small tooth-like processes from one bone project into ne other, while a third is united by the dovetailing of small serrations, &c. ARTICULATIONS OF THE TRUNK
Intervertebral Articulations.—All the vertebrae beyond the second
^ as far backward as the first sacral are united together by their bodies
„ processes. The bodies are connected one to another by circular discs
of fii-i • . nyr°-cartilage which intervene between them, and by the superior and
nor vertebral ligaments, the former running along the floor of the
. ebral canab to which it is attached in small festoons. The latter is uated along the under part of the bodies from the sixth dorsal vertebra 10 the sacrum. th l0n 0I" the Processes.—The superior processes are connected by
supraspinous ligament and the inter-spinous ligament (fig. 346). |
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HEALTH AND DISEASE
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264
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The former runs along the tops of the superior spinous processes, to each of
which it becomes attached from the second cervical vertebra to the sacrum. The anterior portion is represented by a broad yellow elastic structure, termed the ligamentum nucha, (fig. 347), which extends from the head backwards as far as the sixth dorsal spine, where it becomes continuous with the second portion or dorso-lumbar, which is continued to the sacrum or haunch. The ligamentum nuchse consists of a superior rounded (funic- ular) portion and an inferior broad flat (lamellar) portion. The former or funicular portion extends from the sixth dorsal spine
to the posterior part of the cranium, where it becomes inserted into the tuberosity of the occipital
bone. This division of the ligament is very strong, and shows a groove run- ning along its superior surface. It is usually covered with a dense mass of fat and connective tissue, which gives round- ness to the superior border of the neck. The lamellar portion
is a broad sheet of yellow elastic tissue attached to |
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Ligaments of Spine (Side View)
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the under surface of that
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1. Supra-spinous ligament. 2. Inter-spinous ligaments. 3. Bodies
of dorsal vertebrae divided longitudinally and vertically. 4. Inferior common ligament. 5. Inter-vertebral discs. 6. Spinal canal. |
last described. It is com-
posed of two layers, one |
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placed closely in apposi-
tion with and connected to the other by a loose fibrous substance. The fibres of these layers pass obliquely forward from the spines of the first five or six dorsal vertebrae to those of the six posterior neck-bones. The supra-spinous ligament gives support to the head and neck, and thereby relieves the muscles from the weight which would otherwise be imposed upon them at all times. Moreover, by its elasticity it allows of a certain degree of stretching, and freedom of movement in all directions. Situated in the middle line of the neck it separates the muscles of one side from those of the other. The dorso-lumbar portion of the supra-spinous ligament is attached
to the summits of all the lumbar and the twelve or thirteen posterior dorsal spines. In front it becomes continuous with the cervical division or "ligamentum nuchse", behind with the sacro-iliac ligament. |
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- AETICULATIONS OF THE HEAD
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265
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IntersphlOUS Ligaments (2, fig. 346).—In the dorso-lumbar region
there is a series of short flat layers of connective tissue passing in a backward and downward direction from the posterior border of the superior spinous process of one vertebra to the anterior border of the one succeeding it. In the cervical region they are composed of elastic tissue to allow of a more extensive and free movement of the neck. |
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Fig. 347.—Ligamentum Nuchas
&., Funicular or cordiform portion. B, Lamellar or flat portion, c, Attachments to dorsal spines.
Nos. 1 to 7, Cervical Vertebrae.
The articular processes of the vertebrae throughout are connected by
ttieans of a capsular ligament, and the same may be said of the articulations °n the transverse processes of the two last lumbar and first sacral vertebrae. |
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ARTICULATIONS OF THE HEAD
It has elsewhere been pointed out that these are for the most part
^movable, and the mode of formation has been described. The Tempero-Maxillary Articulation (fig. 348) or joint formed
oetween the lower jaw and the temporal bone is an exception.
Here the condyles on the superior part of the inferior maxilla fit into
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HEALTH AND DISEASE
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266
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shallow cavities provided by the squamous temporal bones. The condyles
and the cavities are not brought immediately into contact with each other, but are separated by flat pieces of fibro-cartilage moulded on to the opposed surfaces, and having a synovial membrane between them and each of the bones forming the joints. The bones and cartilages are enclosed in a capsular ligament which, as
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Fig. 348.—Temporo-Maxillary Articulation
1. Section through maxillary condyle. 2. Inter-articular fibro-cartilage.
3. Posterior portion of capsular ligament. 4. Anterior portion of capsular ligament.
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we have already observed, is lined by a synovial membrane and strength-
ened by a bundle of fibres on its outer surface. HYOIDAL ARTICULATIONS—JOINTS OF THE TONGUE
These are three in number, two cartilaginous and one synovial. The
cartilaginous or amphiarthrodial joints are formed by the union of the superior extremity of the long horn of the hyoid bone with the petrous temporal bone, and the inferior extremity of the same with the superior extremity of the short horn. The synovial articulation exists between the lower end of the short horn and the body of the bone. See fig. 291, p. 189- ARTICULATIONS OF THE RIBS
All the ribs are connected with the vertebrae above, and the first eight
true ribs are also united with the sternum below, by synovial articulations |
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ARTICULATIONS OF THE HEAD WITH THE NECK 267
or joints, by which means they are enabled to move freely in the required
directions during respiration or breathing. Costo-Vertebral Articulations.—Each of these joints is formed by
the articulation of the head of a rib between the bodies of two vertebrae,
and by the union of the tubercle of the rib with the transverse process of the vertebra behind it. Several small ligaments enter into each joint |
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Fig. 349.—Articulation of the Ribs and Spine
1. Common inferior vertebral ligament. 2, 2, 2. Inferior costo-vertebral ligaments. 3. Inter-
articular costo-vertebral ligament. i. Inter-vertebral fibro-cartilage in section. and unite the rib firmly to the spine, while'at the same time permitting
free play of one bone upon the others. Costo-Sternal Articulations.—These are the joints formed by the
union of the inferior extremities of the cartilages of the eight true ribs with the sternum or breast-bone. Each articulation has a capsular liga- ment lined by a synovial membrane, and two other connecting ligaments extending from the costal cartilage above and below to the sternum— superior and inferior costo-sternal ligaments. ARTICULATIONS OF THE HEAD WITH THE NECK
Occipito-Atloid.—The union of the head with the neck is effected by
the articulation of the two occipital condyles with corresponding concavities |
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HEALTH AND DISEASE
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268
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on the anterior face of the atlas. This joint is enclosed in a capsular liga-
ment (one to each condyle) and is further supported by small muscles passing over it above and below (fig. 350). Atlo-Axoid.—The atlo-axoid joint is formed by the projection of the
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Fig. 350.—Occipito-Atloid Articulation
1, Occipital Bone. 2, Atlas (the upper wall removed to show the odontoid ligament). 3 Axis
or Dentata. 4, Third cervical vertebra. 5, Capsular ligament. 6, Odontoid ligament. 7, Fibrous capsule (partly removed). 8, Interspinous ligament. 9, Fibrous capsule, uniting the articular processes of the vertebrse. odontoid process of the axis into the ring of the atlas, where it is retained
by the odontoid ligament (fig. 351). Other ligaments, the superior and inferior atlo-axoid and the capsular, also enter into the structure of the articulation, |
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ARTICULATIONS OF THE HEAD WITH THE NECK 26&
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Fig. 351.—The Occipito-Atloid and Atlo-Axoid Articulations
A A, Posterior portion of skull. BB, Atlas, c C, Axis or Dentata. I-—Vertical section through the occiput, atlas, and axis. (The occiput is drawn apart from the atlas in order
to sn°w the articular cavity of the latter bone.) 1, The occipital bone. 2, Its basilar process. 3, Occipital con- dyle. 4, Superior arch of the atlas. 5, Its inferior tubercle. 6, Articular cavity (shown viewed in front at 3, Fig. 2, Plate XXXVIII). 7, Spinal canal. 8, Odontoid process of the axis. 9, Its superior spinous process. "> Its inferior spinous process. 11, Spinal canal. ^*-—Vertical section through the same bones in their natural position, showing the ligaments. 12, Superior
0ccipito-atloid ligament. 13, Inferior occipito-atloid ligament. 14, Superior atlo-axoid ligament. 15, Inferior
atlo-axoid ligament. 16, Odontoid ligament. 17, Spinal canal, with the dura mater in position. (The spinal cord has been removed.) |
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270 HEALTH AND DISEASE
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SCAPULOHUMERAL OR SHOULDER-JOINT
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The shoulder-joint results from the union of the glenoid or shallow
cavity on the inferior extremity of the scapula or blade-bone, with the much larger articular surface provided
by the head of the humerus or upper |
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arm.
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This joint, although so large, pos-
sesses only one ligament, the capsular (fig. 352), but it receives the support of a number of muscles which pass over it and are intimately connected with it. The shoulder-joint is capable of de-
scribing a great variety and consider- able range of movement. It allows of flexion, extension, abduction, adduction, rotation, and circumduction. |
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Fig. 352.—Capsular Ligament of Shoulder-Joint
1, Scapula. 2, Humerus. 3, Capsular Ligament. HUMERO-RADIAL OR ELBOW-
JOINT Three bones are engaged in the for-
mation of this joint—the humerus above, the radius below, and the ulna behind. It has two lateral ligaments passing from the humerus to the radius. The outer one is the stronger and shorter of the |
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two; the inner, the longer and smaller.
It has also a capsular ligament of con- siderable extent, lined by synovial mem- |
Fig. 353.—Humero-radial or Elbow-Joint
1, Humerus. 2, Radius. 3, Olecranon process
of ulna. 4, Arciform ligament. 5, External lateral ligament. 6, Anterior ligament. |
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brane. It is essentially hinge-like in its ____________________________
action, and admits only of movements of flexion and extension (fig. 353)
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271
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ARTICULATIONS OF THE CARPUS OR KNEE-JOINT
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ARTICULATIONS OF THE CARPUS OR KNEE-JOINT
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As we have elsewhere pointed out, the
knee is not one joint but several; the chief of which are: 1, the radio-carpal; 2, the car- pal; 3, the carpo-metacarpal. In addition, other small articulations exist on the sides of the bones forming the two rows (fig. 354). The Radio - carpal articulation is
formed by the inferior extremity of the radius or lower arm and the superior sur- face of the upper row of carpal bones, the two parts being suitably modelled to each other. This joint enjoys and imparts to the knee the greatest range of movement. The Carpal joint is that between the
two rows of small bones, and its action, |
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Fig. 354.—The Carpus or Knee-joint
1, Radius. 2, Large metacarpal or canon
bone. 3, Small metacarpal or splint bone. 4, Pisiform bone. 5, Common external liga- ment. 6, Radio-carpal ligament. 7, Carpo^ metacarpal ligament. 8, Anterior liga- ments uniting the two rows of carpal bones. 9, Anterior ligaments proper to the carpo- metacarpal articulation. |
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although considerable, is less exten-
sive than that of the radio-carpal. The Carpo-metacarpal articu-
lation is formed by the inferior sur- face of the lower row of bones and the superior extremities of the three metacarpal bones. In the movement of the knee this joint contributes nothing to flexion and extension, but allows a gliding movement favourable to the action of the joints above. The articulations by which the
bones composing each row are united together laterally are small, and only |
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Fig. 355.—Anterior View of Knee-Joint
1, Radius. 2, Scaphoid. 3, Lunare. 4, Cunei-
form. 5, Os magnum. 6, Unciform. 7, Canon. *• Transverse connecting ligaments. 9, Oblique connecting ligaments. |
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272
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HEALTH AND DISEASE
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allow of such a measure of gliding movement as will enable the larger
articulations to perform their more extensive and important functions. The Ligaments.—The ligaments uniting the bones of the knee are; numerous, and comprise lateral ligaments, or
those passing from the sides of the lower end of the radius—first to the upper row of bones, then, to the lower, and finally to the upper extremity of the metacarpal bones (figs. 354 and 355); inter-osseous ligaments, or those situated between the small bones which they unite; and a capsular ligament. The capsular ligament of the knee is, like
the joint, of considerable extent. Proceeding from above, where it is attached around the articular margin of the radius, it descends, to be similarly connected with the superior extremity of the large metacarpal bone. Behind, it is very thick, and is attached to all the small bones of the Iinee, and below it is continuous with the check ligament which joins the tendon of the flexor pedis perforans. THE METACAKPO-PHALANGIAL ARTICU-
LATION OR FETLOCK-JOINT |
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The bones which enter into the construction
of the fetlock-joint are four in number, the large metacarpal or canon-bone, the os suffraginis or long pastern, and, behind these, two small sesa- moid bones. The lower extremity of the canon-bone rests
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Fig. 356.—Ligaments of the Fetlock-
Joint |
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A, A, Suspensory ligament. B, B,
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Outer and inner branches of same.
c,c, Outer and inner sesamoid bones, upon the superior extremity ot the large pastern,
D> superficial or long sesamoid liga- the convexities of the one fitting into correspond- ment. E, B, Deep or short sesamoid o r
ligament, f, f, Lateral phaiangiai ing concavities presented by the other. The two-
ligament. G, Crucial sesamoid liga- . -. , ,, . , , ,
ment. h, intersesamoid ligament, sesamoid bones are closely united together by a.
i, i, Posterior inter-phaiangiai liga- thick, short, strong ligament (inter-sesamoid liga- ment), and articulate with the back part of the lower extremity of the canon-bone. The importance of this joint as a spring and a means of breaking and dispersing jar or concussion has- rendered necessary a number of ligaments over and above those ordinarily present in a diarthrodial or free-moving joint. |
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FIRST INTEEPHALANGIAL ARTICULATION OR CORONET-JOINT 273
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In addition to a capsular ligament, common to all the bones, there are
also two lateral ligaments uniting the canon with the large pastern, and two lateral sesamoid ligaments, each having two branches extending from the bones of that name forward, one to the lower and outer part of the large metacarpal bone, and the other to the upper and outer part of the long pastern bone (fig. 357). As the sesamoid bones have no support from below, it is necessary
they should have it from above, to prevent their undue descent. This is provided by the suspensory ligament (fig. 356), the lower extremity of which, after dividing into two thick strands, is inserted into these bones. A similar provision is made to prevent too great upward displacement. For this purpose three ligaments (inferior sesamoid), distinguished respec- tively as the long, short, and crucial, connect the sesamoid bones with the posterior border of the os coronse, and with the posterior surface of the long pastern. The movements of this joint are hinge-like and of great range both in
flexion and extension. FIRST INTEEPHALANGIAL ARTICULATION OR
CORONET-JOINT This is a simple joint, of limited action, and formed by the union of the
lower extremity of the os suffraginis with the upper extremity of the small pastern. The ligaments which unite these bones together are a capsular ugament, two strong short lateral ligaments, some of the fibres of which descend and ultimately become connected with the extremities of the navicular bone, and two short posterior ligaments (fig. 357). Its movements are those of flexion and extension.
SECOND INTERPHALANGIAL ARTICULATION OR
COFFIN-JOINT The bones concerned in the construction of this joint are the os coronas
r eoronet-bone, the os pedis or foot-bone, and the os naviculare or navi-
u^ar bone. The two last-named bones are united together in such a
nner as to form two concavities separated by a slight central ridge, to
"ion are applied the two convexities and central groove upon the lower
^ of the coronet-bone.
J-he ligaments of this joint are: 1, The capsular, common to the three
ones. 2. The lateral ligaments uniting the os coronae to the foot-bone,
J-he navicular ligaments: a, the broad or interosseous ligament extending
voi. II. f>,
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HEALTH AND DISEASE
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274
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Fig. 357-—Ligaments of the Pastern and Foot
A, Posterior aspect, outer layer. B, Inner layer. c, Side view. |
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1, Superior sesamoid or suspensory ligament, giving off a band, 2, to the extensor pedis. 3, Lateral
sesamoid ligament. 4, Superficial inferior sesamoid ligament. 5, Deep sesamoid ligament. 6, Crucial ligament. 7, Lateral ligament of the coronet-joint. 8, Posterior interphalangial ligament. 9, Inter- sesamoidal substance over which the tendons pass. 10, Sesamoid bones. 11, Ligamentous substance common to the coronal and navicular bones. 12, Navicular bone. 13, Intersesamoid ligament. 14, Lateral navicular ligament. 15, Anterior lateral ligament of the coffin-joint. from the anterior border of the navicular bone to the under surface of
the os pedis or foot-bone; b, the lateral navicular ligaments which proceed from each extremity of the navicular bone (l) to the wing of the foot-bone, (2) to the inner surface of the lateral cartilage, and (3) to the side of the coronet-bone. The movements of the coffin-joint are flexion and extension.
COXO-FEMOEAL ARTICULATION OE HIP-JOINT
The hip-joint is formed by the union of the head of the femur or
thigh-bone with the cotyloid cavity of the coxa (fig. 358). Four ligaments are engaged in connecting the two bones, viz. the
capsular, cotyloid, round, and pubio-femoral. The Capsular Ligament is attached around the articular margin of
the femur, to the margin of the cotyloid cavity, and to the cotyl°lCl ligament. Its inner surface is lined by a synovial membrane. |
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FEMORO-TIBIAL ARTICULATION OR STIFLE-JOINT 275
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The Cotyloid Ligament is a ring of fibro-cartilage attached around
the margin of the cotyloid cavity. It serves to increase the depth of the cup, and at the same time to give it a yielding margin for the protec- tion of the head of the femur. This ligament bridges over the notch in the inner part of the cup through which the pubio-femoral reaches the head of the thigh-bone. The Round Ligament (Uga-
fnentum teres) is a short, strong
fibrous cord extending from the bottom of the acetabulum to the inner side of the head of the femur. The Pubio-femoral Liga-
ment, although short, is longer and thicker than the round liga- ment. It is derived from the ten- dons of the abdominal muscles, which, in front of the pubes, cross |
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from right to left and left to right,
and then proceed to the head of the femur to be attached beside |
Fig. 358.—Articulation of the Hip-Joint
A, A, Capsular or enclosing ligament. B, Round liga-
ment, c, Pubio-femoral ligament. D, Cotyloid liga- ment. E, Head of femur. |
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the round ligament.
The hip-joint is capable of the most varied and extensive movements.
■Net only is it freely flexed and extended, but as constructed it also permits °f abduction, adduction, circumduction, and rotation of the femur on the acetabulum. |
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FEMORO-TIBIAL AETICULATION OR STIFLE-JOINT
This is the corresponding joint to the knee of man. It is formed by
the union of the femur with the tibia on the one part, and with the patella 0r knee-cap on the other. The femur articulates with the upper extremity °f the tibia by its two condyles, and with the patella by its two ridges 0r trochlea in front. Between the two condyles and the head of the tibia there are two crescentic pieces of fibro-cartilage (semilunar cartilages) which serve to mould the rounded condyles of the thigh-bone upon the natter articular face of the tibia. The three bones composing this joint are united by numerous strong
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li
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garnents, so disposed as to permit the greatest freedom of motion, while
ft the same time offering adequate resistance to the great strain which ls thrown upon them. The ligaments are divisible into three sets, viz. those which connect
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HEALTH AND DISEASE
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276
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the patella to the femur and tibia; those which unite the twTo last-named
bones together; and those which attach the semilunar cartilages to them. Patellar Ligaments.—These are five in number—twTo lateral and
three straight. The lateral ligaments extend from the inner and outer sides of the patella to corresponding parts of the lower extremity of the femur. The straight ligaments, distinguished as the external, internal, and
middle, are attached above to the anterior
surface of the patella, and below to the anterior tuberosity of the tibia. The middle ligament plays over a
synovial bursa in the groove below which it is attached, and is, besides, clothed in a thick cushion of fat. The Femoro-tibial Ligaments are five
in number, viz. two lateral, two crucial,
and a posterior. The lateral ligaments are situated one on either side, and extend from the inner and outer condyle of the femur respectively, to the superior extremity of the tibia on the inner side, and to the fibula on the outer side. The Crucial Ligaments.—These are
two thick short bands situated in the notch which separates the two condyles, where they cross each other like the lines of the |
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Fig. 359.-
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letter X. The anterior branch is attached
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Stifle-joint
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1, Femur. 2, Patella. 3, Middle straight
ligament. 4, External straight ligament. 5, External lateral ligament of patella. 6, Outer condyle. 7, External lateral femoro- tibial ligament. 8, Fibula. 9, Tibia. 10, External inter-articular cartilage. |
to the spine on the upper end of the tibia,
and to the intercondyloid notch and the external condyle. The posterior branch is united by its lower extremity to the superior |
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and posterior part of the tibia, and by its
upper end to the notch between the condyles and to the internal condyle- The Posterior Ligament is practically the posterior section of the capsular ligament of the femoro-tibial articulation. It is attached to the femur, behind and above the condyles, and to the posterior part of the head of the tibia, just below its articular margin. It joins the lateral ligaments, uniting the femur and tibia on either side, and its inner face is lined by synovial membrane. The Interarticular Fibro-cartilages are the crescentic pieces of
dense fibro-cartilage upon which the condyles of the femur are made to |
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THE ARTICULATIONS OF THE TARSUS OR HOCK-JOINT
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277
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rest on the head of the tibia or second thigh. They are hollowed out
above for the reception of the condyles, for which they form a bed. The outer cartilage is attached in front to the base of the spine on the head °f the tibia, and behind by two slips, one to the notch between the con- dyles, and the other to the upper and posterior part of the tibia. The inner cartilage is attached in front
and behind to the base of the spine on the head of the tibia. This joint possesses three synovial mem-
branes, one of considerable extent enclosing the articular surfaces of the patella, and the two ridges or trochlea in front of the lemur, and one to each condyle of the lemur and its corresponding half of the articular face of the tibia. The movements of this joint are essen-
tially those of flexion and extension, but it also enjoys a limited power of rotation. TIBIO-FIBULAR ARTICULATION
This joint, of very small dimensions
and of most limited action, is formed by the union of the inner surface of the head |
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Fig. 360.—Posterior View of Stifle-Joint
1, Femur. 2, Tibia. 3, Fibula. 4,
External condyle. 5, Internal condyle. 6, Internal lateral ligament. 7, Posterior crucial ligament. 8, Internal inter-ar- ticular cartilage. 9, Posterior ligament of cartilage. 10, External lateral ligament. |
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°t the fibula with the upper and outer part
°t the tibia. The two bones are connected ty short, strong fibres, which completely Ground the joint. |
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THE ARTICULATIONS OF THE TARSUS OR HOCK-JOINT
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lat:
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J-he so-called hock-joint, like the knee, is formed of a number of articu-
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aons, by which the various bones are enabled to move one upon the
tier. The extent of movement between the different pieces varies from sbght gliding action to a great range of flexion and extension. tn the tibio - tarsal articulation, or the "true hock-joint", seven
baments are engaged, viz., two external lateral, three internal lateral, ^ an anterior and posterior Jjoth external lateral ligaments are attached above to the tuberosity
ter maleolus) on the lower and outer part of the tibia. The superficial
e' the longer and stronger of the two, passes down the outer side of |
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HEALTH AND DISEASE
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278
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the hock, and in its course becomes united with the astragalus, calcaneus,
cuboides, and finally with the large and outer small metatarsal bones.
The External Deep Ligament, on leaving the outer tuberosity of the tibia, inclines backward, and becomes attached to the astragalus and
the calcaneus.
The Internal Lateral Ligaments are placed one within the other,
and are distinguished as the superficial, the middle, and the deep. All
of them are attached above to the
tuberosity {internal maleolus) on the inner part of the lower extremity ot the tibia. From thence the internal superficial ligament passes downward and becomes connected with (l) the astragalus, (2) the scaphoid, (3) the cuneiform, and (4) the large and in- ternal small metatarsal bones. The Internal Middle Ligament,
situated beneath that last described,
divides into two short strands, one oi which is implanted into the astragalus, and the other into the calcaneus. The Internal Deep Ligament
is a small batch of fibres which be-
comes attached to the astragalus. The Anterior Ligament.—This
presents the form of a broad mem-
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Fig. 361.—External View of Hock-Joint
1, Tibia. 2, Calcis. 3, Astragalus. 4, Os mag-
num. 5, Os medium. 6, Cuboid. 7, Calcaneo- cuboid ligament. 8, Deep set of ligaments connect- ing one bone with another. 9, Large metatarsal bone. 10, Small metatarsal bone. |
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branous or capsular ligament stretch-
ing over the front of the true hock- joint. It is lined by synovial mem- brane, and is that portion of the cap- |
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sule which bulges in what is termed
" bog-spavin". The anterior ligament is united to the lower part of the tibia above, it is attached below to the astragalus and the small bones of the hock in front, and at the sides it blends with the lateral ligaments. The Posterior Ligament is situated behind the joint, and is much
thicker than the anterior, having in its centre a quantity of fibro-cartilage. over which glides the perforans tendon in its course to the foot. Ou either side its fibres mix with those of the superficial lateral ligament, and in front, where it faces the joint, it is lined by synovial membrane- Above it is attached to the tibia, and below to the astragalus and calcaneus. |
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DISEASES OF THE JOINTS
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279
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The joints below the hock are the same as those below the knee,
"which have already been described in considering the articulations of the fore-limb. DISEASES OF THE JOINTS
As we have elsewhere pointed out, joints vary very considerably, not
°nly in their structure, but also in the purpose they serve. Some, as those Dy which the bones of the head are united, are fixed and immovable, while those of the extremities enjoy a considerable range of action, and upon their liberty or freedom of movement depends the power of locomotion. The tormer are formed solely by two bones held together by the interlocking of their serrated edges, while the latter comprise not only two or more bones yhose articular surfaces are encrusted with cartilage, but these are enclosed ln a synovial membrane spread over the internal surface of a sac termed wie capsular ligament. In addition, strong bands of fibrous tissue, in the lorm of "connecting ligaments", unite the bones together. This form of Joint is known as the diarthrotic, and is the most free-moving of the several Varieties. A third variety of joint is found uniting the bodies of the vertebrae.
■ttere, between the bones, a dense cushion of fibrous tissue is interposed.
J-t has no synovial or capsular membrane, as in the case of the diarthrotic
ariety of joint, and its range of movement is very restricted, being-
only so much as to impart to the spine a limited degree of flexibility and
strength. This is known as an amphiarthrotic joint.
Of the three varieties of joints above referred to, it is very seldom that
isease is found to exist in any but those of the diarthrotic class, and in<
ls section the joints of the extremities afford by far the greater number
Samples. Their larger size, more exposed position, great range of action,
Dd liability to jar, concussion, and sprain, are no doubt the factors which
eil in favour of disease.
Joint diseases are brought into existence either by local or constitutional
onditions, or both, as when the latter predispose to the influence of the
lorrner.
it there is one period of life when horses suffer more from joint disease
an another, it is from birth up to six years old, when the burdens they
Ve to bear are badly apportioned to their condition and' strength, and
eri certain constitutional ailments which determine these affections are
m°^ prevalent.
External violence is perhaps the most common exciting cause of joint
,ease. Kicks from other horses, slips, falls, blows, sprains, and penetrating unds by which inflammation more or less severe is excited in one or |
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HEALTH AND DISEASE
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280
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another of the component structures, are the chief inducing factors. Frac-
tures, by extending into the joints, not only provoke in them acute and dangerous disease, but so far damage and impair their action as seriously to compromise further usefulness. Wounds in connection with joints are of especial difficulty and danger, not only on account of the joint having been opened, but because of the entrance into it of septic organisms which excite a suppurating or matter-forming process, first in one structure and then in another, until all have become implicated. Of those constitutional conditions to which joint disease can be referred,
rheumatism offers a striking and by no means an uncommon example. Within sixty yards of where the writer now sits is a gray cob which,
while passing through an attack of influenza fever, suddenly became acutely lame in both fore-limbs, so much so that her movements could only be compared to those of an animal in the last stages of chronic navicular disease. Every joint and sinew in the limbs was perfectly normal, but the heat in the feet and the fulness in the heel clearly indicated some mischief in the navicular joint, which was diagnosed as rheumatism. A blister was applied over the coronets and the mare was turned to pasture, when she became perfectly sound in three weeks. Rheumatism affecting the joints and other structures presents itself also as a sequel of strangles and purpura. In that pysemic condition of foals known as "navel ill", the large joints
of the extremities frequently become distended with pus and serous exuda- tion as the result of pysemic arthritis, and mares, after parturition, now and again suffer from a similar affection, parturient synovitis. Inflammation of the lining membrane of the heart (endocarditis) is
sometimes associated with an abiding inflammation of the joints. N All these possible causes require to be borne in mind when considering
the origin of joint disease. In numerous instances swelling of a joint, resulting from "pysemic arthritis" or "joint ill" in foals, has at first been referred to a kick from the dam or other form of external violence, and the error has only been recognized when other joints becoming affected rendered the view no longer tenable. This leads us to point out that where disease of the same nature attacks one joint after another in the same animal, some constitutional cause should be suspected, whereas disease confined to one joint only will usually be found to result from accident. The Local Origin of Joint Disease varies in different cases. It
may first commence in the synovial membrane, or in the bone or the
cartilage. It does not, however, always confine itself to the structure in which it originates, but frequently extends from one to another until all are more or less involved. Sometimes the connecting ligaments will also become affected and suffer with the rest in the morbid action. |
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ANCHYLOSIS
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281
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Disease most commonly commences in the synovial membrane, and
next in the bones, but seldom in the articular cartilage and connecting ligaments. This greater susceptibility to become primarily affected is no doubt due
to the greater vascularity of the two tissues referred to, and their higher functional activity. Symptoms.—The general symptoms of joint disease are such as result
from an attack of inflammation in one or all of the structures entering into the formation of the articulation. Lameness is more or less severe, according to the structure involved
and the stage of progress of the disease. Swelling of the part, with more or less heat and pain under pressure, will also be observed. ANCHYLOSIS
Anchylosis is that condition of a joint in which the bones forming it are
united in such a way as to restrict or altogether prevent their natural movement taking place. The various means by which this is effected has given rise to a division of anchylosis into true and false. True anchy- losis results when, as a consequence of disease, the two ends of the bones within the capsular membrane become united. False anchylosis is induced when inflammatory products surround and enclose the joint, and become callous or ossified, or in other ways fix the ends of the bones and prevent their movement. Anchylosis may be complete or incomplete. In the former the union
is effected by ossific new growth between or around the ends of the bones forming the joint, and the movement is altogether arrested. In the latter the bones are bound together by fibrous or fibro-cartilaginous tissue, which allows a limited degree of movement to take place in the joint. The uniting medium in this case may sooner or later become converted into bone, by which complete anchylosis is effected. The incomplete form of the disease therefore represents a stage in the development of the complete; in other words, when the fibrous tissue existing in the one becomes ossified, it is converted into the other. Causes.—Anchylosis is the result of inflammation affecting the joint
■or parts about it. External violence, in the form of blows, wounds, sprains, aud other injuries, is the exciting cause. In the matter of treatment, but little can be done to render an animal
°f service for anything but slow work, unless for breeding purposes. To break down the morbid development uniting the bones by physical
force is a practice sometimes adopted in man, but the ultimate success of |
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HEALTH AND DISEASE.
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282
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such an operation depends upon the complete control and obedience of the,
patient, which cannot be obtained in the horse. SYNOVITIS—INFLAMMATION OF THE SYNOVIAL
MEMBRANE
When the lining membrane of a free-moving joint becomes inflamed,,
the disease is known as synovitis. The attack may be acute or severe, subacute, or chronic, in which last
case it continues for a more or less protracted period. The first and second forms may become resolved into the third. Causes.—Synovitis is for the most part induced by blows, sprains, and
penetrating wounds; or it may follow upon exposure to cold and wet; or arise in the course of an attack of pysemia, or after the ingestion of food or water contaminated with lead or copper smoke. ACUTE SYNOVITIS
This form of the disease most frequently results from wounds which
injure or puncture the capsule of the joint, and especially such as are con- taminated with septic matter at the time of or after infliction. The size of the wound is no measure of the danger which may attend it.
A dirty stable-fork entering a joint may prove as destructive as a wound inches in length. Pyaemia is a common cause of acute synovitis in foals, and less frequently in young horses when suffering from strangles. Severe blows and sprains, and acute attacks of rheumatism, especially
when following upon influenza, are also fruitful causes of it. Symptoms.—Lameness more or less severe is the first noticeable
symptom of the disease. The joint becomes distended with synovia, and bulges at points where there is least resistance. The swelling thus formed is tense and fluctuating, and when pressed acute pain is evinced. Soon the outer structures of the joint become enlarged, hot, and tender. The animal stands with the leg in a semi-flexed condition, imposing little or no weight on it. The local suffering soon gives rise to constitutional disturbance, attended with considerable fever and prostration. As the disease progresses the joint becomes filled with pus, the inflam-
mation spreads to structures round and about it, one or more abscesses- form and break, and the purulent contents of the joint escape. In those cases where joint abscess develops, the articular cartilage
undergoes softening and displacement, and the underlying bone becomes exposed and diseased. In such circumstances the function of the joint is |
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INFLAMMATION OF THE SYNOVIAL MEMBRANE 283.
seriously impaired or altogether destroyed, and should the patient recover,,
his or her services can only be reckoned on for breeding purposes. Treatment.—The first concern should be directed towards providing
conditions for affording rest and relief from pain. To this end the floor should be covered with peat-moss, tan, or saw-dust, and the patient should be placed in slings. A dose of physic at the outset will prove beneficial, and the diet should
be light and sparing. Scalded bran with a little chaff, and some roots or green meat will be most suitable for the purpose. The limb should be supported and its movements restricted by the
application of bandages. The joint should then be irrigated with cold water four or five times a
day, and in the intervals the bandages should be repeatedly soaked with it. If a wound exists it should be thoroughly cleansed, freely irrigated
with five-per-cent solution of carbolic acid, and kept aseptic by suitable dressing. Where the pain is acute and the suffering great, the affected joint
should be anointed twice a day with belladonna and glycerine, in the proportion of one part of the former to two of the latter, and if necessary an opiate may be given from time to time to alleviate pain and ensure rest. When the acute symptoms have subsided, the part may be vigorously
rubbed with weak soap liniment, and gently-increasing pressure applied to the swollen joint by means of a bandage. This may require to be followed up by one or more blisters, and a course
of iodide of potassium administered to effect removal of the swelling. CHRONIC SYNOVITIS
Chronic synovitis may follow upon an acute attack of the disease, or
arise directly from an injury inflicted upon a joint. As in acute synovitis, the joint capsule is more or less distended
with fluid, and bulges at certain points where most exposed. The pain, however, is not so severe as in the acute form of the disease. In this connection considerable variation is observed from time to time. One day the patient gives promise of improvement, but this is mostly followed by a set-back sooner or later, and the general tendency of the malady is in the direction of an unfavourable issue. The joint, after becoming filled with serous fluid, may ultimately contain
pus (matter), which sooner or later escapes through abscesses on the surface. The appetite becomes indifferent, the constitutional disturbance is severe, |
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HEALTH AND DISEASE
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284
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and the patient succumbs to the exhausting effects of protracted suffering
associated with blood-poisoning. On the whole these cases offer but little hope of successful treatment.
The system should be sustained by good food, with stimulants when
required, and the local treatment should be pursued on the lines laid down for acute synovitis. LOOSE CARTILAGES IN JOINTS
It sometimes occurs that small bodies, varying in size from a pea to a
walnut, are found loose in the cavities of joints, especially the larger ones, such as the stifle, hock, or knee. These formations are generally ovoid in shape and somewhat flattened.
In colour they are yellowish-gray or grayish-white, and vary in composition not only in different cases but in the same joint. Some are composed of cartilage or fibro-cartilage, interspersed or not
with bony matter, while a few are almost entirely made up of the last- named substance. Some of these formations originate as outgrowths from the internal
surface of the synovial membrane, from which they hang suspended for a time, and are then broken away by the movements of the joint and become free or, as they are termed, " loose cartilages". Others more distinctly cartilaginous in type commence as small ex-
crescences along the margin of the articular cartilage, and these, like those last referred to, are rubbed off, and when disconnected move about the joint, interfering with action and causing pain and lameness, which may be continuous or. intermittent. As to whether these excrescences grow after their detachment from their
place of origin it would be difficult to say, but there is reason to think that such is sometimes the case. Symptoms. —While connected with the synovial membrane or the
cartilage these growths may occasion very little disturbance, and even when detached, small ones, while in a soft, fibrous, or cartilaginous condition, do not seriously interfere with action; but the larger and harder ones provoke serious attacks of lameness by becoming fixed between the ends of the bones and the capsular membrane and otherwise damaging the joint. In a case which occurred in a three-year-old colt under the care of the
late Mr. Joseph Axe of Doncaster, and which the writer had an opportunity of seeing and examining after death, the patient was slightly lame of the near hind - leg for several weeks before the seat of lameness could be localized. Suddenly the animal became incapable of advancing the limb, |
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RHEUMATIC ARTHRITIS 285
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and exhibited considerable pain when caused to move. The stiiie-joint then
began to swell owing to distension of the capsule with fluid; there was also considerable heat and tenderness to pressure. The swelling continued, but the lameness almost entirely disappeared in a week, only, however, to return with increased severity a fortnight later. This subsidence and return of the acute symptoms was repeated on three or four occasions, each time leaving the joint larger and the lameness more severe. Ultimately the colt was destroyed, and three loose cartilages (fig. 362), one being an inch and a half long and three-quarters of an inch wide, were removed from the joint capsule. The two smaller ones consisted of fibro-cartilage, and the largest of
cartilage interspersed with bony matter. The joint contained a large |
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Fig. 362.—Loose Cartilages removed from the Capsule of a Stifle-joint
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quantity of dark, straw-coloured fluid, and the synovial membrane was
considerably inflamed and thickened. Treatment.—Nothing short of the removal of the offending bodies
by a surgical operation can be of service in these cases, but the difficulty interposed to an accurate diagnosis by the thickness of the skin, the ligaments, and parts about the joint, renders such a course as unreliable as it is dangerous. The remedy, indeed, may prove even worse than the disease.
EHEUMATIC ARTHRITIS
In this disease we recognize a local expression of a constitutional
disorder arising out of some as yet undefined noxious principle in the blood. Aged animals are more especially its victims, but it sometimes also
affects the young. In the former it assumes a chronic type, while in the latter the attack
is more frequently of the acute variety. |
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286 HEALTH AND DISEASE
Causes.—These are predisposing and exciting. Most if not all subjects
of this affection inherit a constitutional condition which predisposes them to suffer when exposed to one or another of the various exciting causes. Of these the principal are exposure to wet, and cold easterly and north- easterly winds, hard and continuous work, sprains, concussions, blows and other injuries to the joints, influenza, and strangles. Symptoms.—The disease may be confined to a single joint, but more
often it invades two or more. The large joints, as the knee, the hock, the stifle, and the fetlock, are those most frequently involved. In its chronic form rheumatic arthritis commences with stiffness, observed more particu- larly after exertion. For some time it may continue without materially interfering with the animal's movements. Then a slowly progressive enlarge- ment appears—at first resulting from distension of the capsular membrane with synovia, but later the bones of the joint throw up irregular nodular swellings around and about their articular ends, and these, encroaching on and irritating the surrounding ligaments and tissues, provoke additional enlargement. Pain and lameness are now more or less marked, and the action of the affected joint becomes not only restricted but difficult. In long-abiding cases the cartilage may be removed from the articular
ends of the bones, whose rough surfaces, when brought into contact with each other, impart to the hand and the ear a crepitating sensation or sound. In this disease there is no tendency to the formation of abscess, but the morbid action is expended in provoking enlargement and condensation of the extremities of the bones and tissues connected with the joint. Treatment.—In this connection much importance attaches to an early
recognition of the disease, when a dose of physic, followed by a short course of iodide of potassium, and a brief rest, will usually check its progress. Where it has been allowed to advance so far as to produce considerable swelling, massage and friction should be freely applied to the joint two or three times a day, and in the intervals it should be enclosed in a warm flannel bandage. The food should include a liberal amount of carrots or other succulent roots or grasses, with bran and a small ration of scalded corn and sweet hay. With this may be given an ounce of linseed-oil night and morning, with
a full dose of iodide of potassium and carbonate of potash. If the joints are very painful they may be anointed with belladonna liniment twice a day. Should this not have the desired effect, a mild iodine blister repeated at short intervals may yield good results. Horses giving evidence of this affection should have a dry lair and be
protected as far as possible from cold and wet, especially while heated. |
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PYEMIC ARTHRITIS
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287
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PYEMIC ARTHRITIS
This is one of the most destructive of joint ailments. Foals a few days
^old are its most common victims, although now and again older horses suffer from it also. It ranks with the infective diseases, and results from the entrance of septic organisms into the blood-stream through a wound or broken surface. It is very destructive of joints, and the patient rarely recovers. Causes.—It occurs in foals a few days after birth, when the newly
broken navel-string affords an opportunity for the entrance of septic organisms into the blood-stream through the vessels of the cord. Males are more frequently attacked than females. The most susceptible
period is from five days to three weeks old. The onset of the disease is marked by slight dulness and depression,
■with a disposition to lie about. This is quickly followed by swelling on ■one or more of the joints, chiefly the stifle, knee, hock, or elbow. From the rapidity with which the swelling develops and the intensity
of the lameness, owners and attendants frequently refer the disorder to injury inflicted by the dam,—an impression which is sometimes difficult to remove until joint after joint becomes involved in the disease. The enlargement of the joint commences by distension of the capsule, and soon ■extends to the surrounding tissues. It is hot, firm, and painful to the touch; small, soft, fluctuating points appear here and there, which break and discharge a quantity of yellowish-gray pus (matter). The lameness is very severe and mostly forbids the imposition of weight upon the limb, which is carried or lightly brought into contact with the ground during progression. In addition to these local symptoms there are noticeable a high tem-
perature, increased respiration, great prostration, an indisposition to suck, and other signs of a fever attack. Death usually takes place from the fourth to the eighth day after the
onset of the disease. In some cases it kills in thirty-six hours, and in others it is prolonged over three or four or more weeks. Treatment of pysemic arthritis is discouraging to the last degree, and
the percentage of recoveries so small as to be regarded as a negligible quantity. It is rare indeed that recovery takes place, for in addition to extensive
disorganization of joints the blood is saturated with the poison of pyaemia, and the young thing has but little strength to resist it. In the few cases where life is preserved the damaging effects of the
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HEALTH AND DISEASE
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288
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disease on the affected joints leave the animal a cripple for life and
an undesirable possession. Having regard to the serious losses which this affection annually
occasions in our large and fashionable studs, and the resistance it offers to treatment, it behoves breeders of horses to give every consideration to those more reliable measures by which the disease may be prevented. It has been already pointed out that a wound to be infected, and
organisms to infect it, are the essential factors in the origin of the disease, and to protect the one against the other is all that is needed to ensure its prevention. To do this requires a considerable amount of care and attention, first
as regards the sanitary condition of the box and its surroundings, and secondly as to the navel wound by which the poison enters the body of the foal. The foaling-box should be large, well-ventilated, efficiently drained,
and situated away from the crew-yard and other filthy sites. It should have a washable floor, and an interior the whole of which can be readily disinfected and washed or lime-whited. At the commencement of every season it should receive a thorough cleansing and disinfection from floor to> ceiling, and this should be repeated from time to time as foaling proceeds. The box should be well littered with clean straw, which must be removed and replaced by a fresh supply as each mare passes out. At the same time the floor should be freely dressed with disinfecting solution and covered with lime. So soon as the foal is born the navel-string should at once receive a
thorough soaking with a five-per-cent solution of carbolic acid, and half an hour after be dusted over with boracic acid powder. If it is necessary to ligate or tie anything round it, catgut, macerated for some time in carbolized oil, should be used. In all well-appointed studs a bottle con- taining a link of this material is kept ready for use. It is of the first importance that whoever has the handling of the
umbilical cord should not only have clean hands but should have pre- viously dressed them with an efficient disinfectant. The navel, the cord attached to it, and skin about it, should be freely
disinfected three or four times a day with fluid dressing, and afterwards covered with a powder of boracic acid and iodoform. Until healing of the umbilical wound has been completed foals should
not be allowed to scamper over manure heaps, or dirty roads, or any unclean surface. |
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SPRAINS TO JOINTS, TENDONS, AND LIGAMENTS 289
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SPRAINS TO JOINTS, TENDONS, AND LIGAMENTS
-Lhe severe efforts which horses are called upon to make, and often
Qcler the most trying circumstances, render them specially liable to
^ertax the muscles, tendons, ligaments, and joints of the extremities,
r lrt other words unduly stretch or strain them. Sprain is one of the
°st common ailments affecting the legs of horses. It may consist in
Mere overstretching of the fibres of a structure, or some may at the
Same time be ruptured.
Its origin cannot be considered altogether apart from conformation,
r ^ is found that any considerable departure of the legs from the
Perpendicular tending to disturb the centre of gravity has the effect of
^equally distributing the weight of the body, and predisposing certain
r rts on which it falls in excess to sprain. Knees in-bowed or out-bowed,
ees set unduly backwards, feet turned outward or inward, cow hocks,
various other defects of conformation are conditions favourable to
thi§ accident.
. xg joints, besides providing a large surface of support to diffuse and
lrmze concussion, are also furnished with large strong ligaments by
1 CJi they are able to resist sprain, while small joints, whose connecting
ctures are wanting in substance and strength, more readily yield to the
0rce applied to them.
, J-hese unfavourable conditions are aggravated when left out of con-
ration in the operation of shoeing. When one part of the crust is
_ uv lowered beyond another the already unequal distribution of the
bnt on the structures which bear it may be materially increased.
arrow, leggy horses, which lack stability owing to their narrow base
Pport, are rendered liable to sprain by their tendency to slip.
, le exciting causes of sprains consist in violent extension of the
ures involved; but Williams observes "extension is not always the
01 a strain, as a muscle may be injured by the opposite condition,
,, . y> violent contraction, its fibres and their thecse broken across
kfieir 1
e-,i ng axes, or its tendinous fibres torn from their attachments at
*J* or both of its extremities".
iu ^S anC'" ^se s^ePs> severe efforts at draught, or in the gallop or ca ^' °r *n smuggling to remove a limb from a fixed position, are °t the violent extension from which sprains result,
th ^ Ptoms.—These will vary with the structure affected. Generally rest' 0raPnse lameness, tenderness of the part with or without swelling, voi limb in such a way as to relieve tension and take the weight 53
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290 HEALTH AND DISEASE
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off the injured organ. These will be dealt with in the articles on sprains
to special structures. BOG-SPAVIN
This disease is of an entirely different nature from that referred to
in the section on " Diseases of the Organs of Locomotion ". It is presented by a soft fluctuating enlargement at the upper and inner part of the hock- joint, arising out of distension of the capsule (fig. 363) of the true hock- joint with synovia or "joint oil". Causes.—It most commonly occurs in young horses between one and
three years old. The
heavy breeds are especially liable to it, and most so animals of lymphatic tempera- ment, with round fleshy legs, coarse hair, thick skin, and feeble energy. The predisposition
to bog-spavin is essen
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It
(1
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tially hereditary
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may also be acquire1
by causes which induce poverty and weak- ness. Young colts 01 |
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Fig. 363.—Bog-Spavin
B, The distended joint with the skin removed. |
rapid growth when
badly nurtured readily |
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contract the disease-
The exciting causes are overwork while young, and sprains to the join*' but large numbers of cases are induced by the pernicious system of forcing' which young stock undergo during their show-yard career, and we hav known many fine specimens of the heavy breeds to have been hopelessly ruined in their infancy by this practice. Symptoms.—Bog-spavin may arise suddenly, or it may appear J
a slow and progressive manner. The former is mostly the case wne the result of sprain, and also as a consequence of high feeding and conhn ment. Work and wear lead to a more gradual and often a more abiding
"t is
enlargement of the joint. Where the disease is sudden in its onset, & usually attended with pain and lameness, and the joint is hot, tense, a
painful to pressure.
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SPRAIN OK STRAIN
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291
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The amount of swelling varies in different cases, sometimes it is very
considerable, in which case it is not confined to the front of the joint, but ls also seen on either side near to the seat of thorough-pin, for which it is °rten mistaken. It must be pointed out that the lameness is not always in Proportion to the size of the swelling. Very large bog-spavins are some- times found to occasion but slight defect in action, while smaller ones may De attended with severe lameness. Treatment.—In this disorder the object of treatment will be—1, to
subdue inflammation; 2, to promote absorption of the fluid existing in the
°apsule of the joint; 3, to prevent excess of secretion;
and 4, to bring about contraction of the overstretched
and enlarged joint capsule. Where the disease is
attended with inflammatory symptoms, or is brought
about by dietetic causes, a dose of physic should be
promptly administered and the animal put on a bran
let- Hot fomentations to the part, or what is
qually beneficial, douching the joint with cold water
°r half an hour to an hour three times a day, will
De necessary. Should the latter course be adopted,
oW-water bandages must be applied to the part in
ne intervals and frequently changed.
After the inflammatory action has been subdued
ouster should be applied over the entire surface the hock, and repeated if necessary twTo or three tt^s at intervals of three to four weeks. fn the more chronic cases, firing, and blistering
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Fig. 364.—Bog-spavin Truss
or Compress |
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er the fired surface, will require to be resorted to.
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Oide of potassium, given in doses of 2 to 3 drams
ornmg and evening, will assist in the reduction of the swelling. Where f verty exists a liberal ration of good food should be allowed, together with iron tonics. Animals suffering from bog-spavin are benefited by a run at grass
er the inflammation has been reduced, and in some cases the absorption tne fluid may be hastened by the application of a suitable* compress to the affected joint (fig. 364). |
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SPRAIN OE STEAIN
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sprain is an injury to a ligament, a tendon, a muscle, or a joint,
nich there is over-extension and sometimes laceration of fibres and ay°e displacement of parts. |
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292 HEALTH AND DISEASE
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Ligaments and tendons, with one or two notable exceptions, are in-
elastic, and tear rather than stretch when a force is applied beyond their power of resistance. The apparent elongation in a " break down " is due to the rupture of a number of fibres in more than one place, and not to actual fracture across the ligament. In the case of strain so violent as to dissolve the connection of one part with another, the separation will usually be found close to the bone and not in the middle or seemingly weakest portion. The ligament or tendon tears away from its attachment, or carries with it a thin layer of bone. The rarity of complete rupture of a ligament in the middle portion
is due to the close weaving of its fibres into a dense rounded bundle, whereas at the ends the fibres spread out to afford a wider attachment to the bones, and are consequently more loosely connected with each other. The great strain put upon certain ligaments, when a draught- horse exerts himself to start a load, is easily borne while the pull is a straight one, but if he be suddenly turned, and a twisting and unequal force is applied to the fibres, rupture is very likely to occur. The force which will extend the fibres of a tendon, or ligament, or muscle will of necessity injure the nerves and blood-vessels concerned in their inner- vation and nutrition; the pain suffered is due to pressure upon, or else laceration of, the former, and the swelling which follows to the escape of fluid from the latter into the structure of the part. In the process of repair additional enlargement results from the de-
position of new matter, which may be in excess of that actually required. Some of this surplus matter will in time be removed, but it frequently happens that a considerable amount remains behind as a chronic swell- ing after all active disease has ceased. This undue development of reparative tissue will in some instances
interfere with the action of the part and impair its function. In whatever manner he attempts it, the surgeon's chief concern is to get rid of super- fluous growth and to restore the parts as nearly as possible to their normal state. SPRAIN OF THE FLEXOR BRACHII
In the anatomical portion of this work the flexor brachii muscle is
described as largely tendinous. It is wholly so in the portion which passes over the bicipital groove in front of the humerus, where it acts as a rope over a pulley before gaining insertion into the head of the radius. Being situated at the point of the shoulder it is much exposed to injury from blows, as well as to sprains, in performing its office of flexing the forearm upon the humerus. |
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SPRAIN OR STRAIN
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|
293
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Symptoms.—Save in exceptional cases this accident is easy of diag-
nosis. The muscle is comparatively superficial, and can be seen and felt to be swollen and tender to pressure, and to stand out distinctly from the surrounding structures. There is difficulty in raising the limb from the ground, and when this is attempted the toe is directed downward or the toot may drag on the ground; if the limb be flexed at the knee and then forcibly drawn backward the animal evinces pain. The bursa in front of the shoulder when sharing in the inflammation becomes more or less distended With fluid. It not unfrequently happens that Uijury to this muscle is associated with disease attecting the upper end of the humerus (bicipital groove) or arm-bone at their point of contact, and the shoulder-joint may also be involved at the same time. Owing to the large pro- Portion of fibrous tissue entering into the com- position of the flexor brachii it is rendered specially prone to ossification as the result of inflammation. This change into bone com- mences in the tendinous portion and may in- olve the whole of its substance by degrees, n case of other muscles of a more fleshy character, it will be remembered that atrophy and not ossification results from injury and subsequent disuse. ■t>y some it is affirmed that it is almost
invariably the right shoulder which is affected,
n<A that the trouble is frequently incurred at
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Fig. 365.—The Flexor Brachii
(internal aspect) 1, Scapula. 2, Humerus. 3, Radius.
4, Ulna. 5, Flexor Brachii. 6, Ten- don of origin of Flexor Brachii. |
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. 0ugh. If that be so" an animal once affected
ting manner should not again be employed
tor Ploughing.
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Treatment .—The chief aim is to give re-
c e to the injured muscle, and for this purpose the patient should be
nned to the stable. At first hot fomentations will be needed to
nee existing inflammation. As soon as the acute lameness has passed
y blistering may be resorted to, and repeated once or twice according
ne circumstances of the case. After this a turn out on a level pas-
■■ will prove beneficial. A blister-charge over the injured region is a
_ rite method of treatment in some districts where experience of the
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which
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nt has given opportunities of observation on the different means
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niay be employed.
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HEALTH AND DISEASE
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294
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SPRAIN OF THE RADIAL OR SUPRA-CARPAL LIGAMENT
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This accident occurs in resisting over-extension of the superficial flexor
muscle of the fore-limb when undue weight is imposed upon it (fig. 354). Symptoms.—Besides lameness, there is heat, swelling, and tenderness
just above and behind the knee-joint, with more or less inability to bear weight on the affected limb. In severe cases the leg is advanced some- what stiffly and with as little bending of the knee as possible. Treatment.—In slight cases the frequent applica-
tion to the part of a cooling lotion, consisting of chloride of ammonium and nitrate of potash dissolved in water, with the addition of spirits of wine and acetic acid, conjoined with rest, may suffice to bring about a cure. In sprain of a more severe character hot fomentations, followed by counter-irritation or blistering and in some cases even firing, may be called for. A dose of physic to cool the system, and a grass diet if available, are useful adjuncts to the measures prescribed. SPRAIN OF THE CHECK LIGAMENT
This ligament (fig. 366), it will be remembered,
has its origin behind the knee, and joins the perforans tendon about one-third of the distance between the |
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Fig. 366.—The Check
Ligament 1, Flexor Pedis Perforatns.
2, Flexor Pedis Perforans.
3, Check Ligament.
4, Sheath.
5, Suspensory Ligament.
6, Extensor Pedis.
7, Flexor Metacarpi Exter
nus.
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knee and fetlock-joint.
Sprain of this important structure is not uncommon,
especially in draught-horses when engaged in moving heavy loads out of deep holding ground or over slipper/ surfaces. In race-horses and hunters it usually occurs |
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in the last efforts of a hard finish, or towards the close
of a long run when the muscles are tired, and the ligaments are called upon to bear an undue amount of weight and resist the impulse of velocity. Symptoms.—This accident is indicated by the appearance of a hot
painful enlargement immediately below and behind the knee, accompanied by considerable lameness, the most prominent feature of which is that the heel of the foot is not brought to the ground in progression, and the weight of the body is quickly transferred to the opposite limb. When standing? the fetlock is maintained in a semi-flexed condition, and such weight as the foot receives is imposed upon the anterior part. With the effusion and swelling which follows severe sprain to this structure it may be difficult to determine accurately what parts are involved, and to what extent. |
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SPEAIN OR STRAIN
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295
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In slight cases, too, where the lameness is not considerable, a good
deal of care is needed to discover the seat of trouble. When this is so the leg should be raised and the canon forcibly extended on the operator's knee. At the same time the operator must firmly compress the ligament between the fingers along its length, noticing while so doing any tender- ness which the animal may display, or any enlargement the part may show by comparison with the opposite ligament. Treatment.—The aperient dose recommended in connection with
sprains of other structures is advisable here, and the lines of treatment 1Ji the last article should be followed, with the addition of placing a high- heeled shoe on the foot so that the injured ligament may be relieved from traction and put to rest. Care will be needed not to allow the heels to be raised too long lest in the course of reparation shortening of the tendons result. SPRAIN OF THE SUSPENSORY LIGAMENT
The reader who has studied the anatomy of the limb, and informed
himself of the origin, attachments, and divisions of this structure (figs. 356 and 366), will be prepared to learn that the ligament may be sprained m one of its branches, in both, or through its body at a point before its division takes place; or it may be ruptured or torn away from the sesamoid bones so completely that the fetlock-joint, losing its support, descends towards the ground. In slight sprains the reverse is the case; instead of the fetlock-joint coming to the ground and the toe inclining upward, the patient will endeavour to impose weight on the latter, and straighten the; hmb more or less in the effort. Race-horses and hunters most frequently suffer by this accident in the:
tore-legs, and among draught-horses it is more often noted in the hind- limbs. Injury to these weight-bearing structures is always a serious matter,
and calls for so much time and patience that animals of little value seldom repay treatment. This is especially the case where, as sometimes occurs, *t is associated with fracture of the sesamoid bones. Every degree of lameness may be associated with injury to the sus-
pensory ligament. In all but the very slightest cases more or less swelling aPpears at and about the seat of injury. There is heat in the part, and Pam is provoked by pressure. To relieve the ligament from traction when standing the fetlock is maintained in a semi-flexed condition. In the severer cases the entire limb, from the knee downward, becomes more or less enlarged, and there is an entire inability to support weight. Treatment.—Where the ligament is seriously sprained a dose of
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HEALTH AND DISEASE
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296
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physic should be given at once, then a high-heeled shoe should be applied
to the foot and the patient put into slings. Hot fomentations should be applied to the part three or four times daily, and hot-water bandages in the intervals. This will have the effect of reducing existing inflam- mation, after which irrigation with cold water will give tone to the vessels and restore healthy action. A long bandage firmly applied to the leg from the knee downward will give needed support to the fetlock-joint, which will be rendered still more efficient if a thick pad
of cotton-wool or tow be placed in the space be- tween the fetlock and the heel. As soon as possible the patient should be re-
moved from slings and allowed to lie down. Firing or blistering, or both, should be resorted to in due course with the twofold object of inducing absorp- tion of superfluous material from the seat of in- jury, and of thickening the skin so as to afford
a bracing support to the part.
SPRAIN OF THE PERFORANS AND
PERFORATUS TENDONS This may occur to either one or the other
separately, or to both at the same time, when the muscles to which they belong are over-fatigued, and fail to act in time and with sufficient force to prevent excessive traction on the tendons. The hand familiar with the horse's leg will
have but little difficulty in distinguishing between
_____________________ injury of either or both of these structures, and
rig'!fdPeSSrtu1itndons0railS those strains of ligaments adjacent which have
already been described. They are found to be
swollen, hot, and softer than in health, and the enlargement, in bulging backwards as well as laterally, gives.the tendons a convex or "bowed appearance (fig. 367). Lameness is always present in recent cases, and during the inflammatory stages which supervene upon the accident; but there are many chronic sprains of these structures of a slowly progres- sive character which do not render a horse unworkable or even palpably lame to the ordinary observer. They have been described as coming "unstitched", by which term we are to suppose that in overworked horses a softening and weakening process is induced in the tendons by long-abiding strain and irritation, and a few fibres at a time rupture |
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SPEAIN OR STRAIN
|
297
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|
here and there, and not in any particular line or order. In these cases
the action is at first stilty, or, as it is sometimes expressed, " proppy", and sooner or later there is a disposition to "knuckle over" at the fetlocks in the animal's attempt to take the weight off the injured tendons and throw it forward more immediately on to the bony columns. Treatment.—The means advised for sprains of the suspensory and
check ligaments are suitable for injuries to the back tendons, as the per- forans and perforatus are called. SPRAIN OF THE FETLOCK-JOINT
By a sprained fetlock-joint is generally understood a stretching or
rupture of some or all of the ligaments which unite the bones, but a not infrequent result or concomitant of such strain is inflammation of the capsular ligament and the synovial membrane which lines its interior. These injuries are perhaps in the majority of cases incurred by slipping when travelling over smooth surfaces, by treading on rolling stones or in rabbit holes, by false steps, in jumping, or in the case of draught-horses in starting heavy loads. More or less heat, pain, and swelling in the joint, with a corresponding
degree of lameness, will usually direct our attention to the structures involved. In very slight cases no perceptible change may be at once observed in the part, but a little passive movement of the joint in the direction of flexion and extension, if applied with moderate force, will have the effect of locating the injury. Where the joint itself is concerned the swelling will present here and there an elastic fluctuating character indi- cating the presence of an excess of fluid in the articular capsule. Treatment.—The frequent application of evaporating lotions over the
seat of injury, combined with rest and an aloetic purge, will usually suffice m mild cases. In the more severe strains, inducing acute inflammation of the structures of the joint, with its attendant pain and enlargement, hot fomentations should be promptly and freely applied until the inflam- matory symptoms subside. After each fomentation flannel bandages should be placed upon the joint and repeatedly wrung out in hot water. Absolute rest and quiet is imperative in this form of injury, and, when
necessary, advantage should be taken of slinging in order to enable the patient to relieve the injured part of weight. A period of cold-water ligation, and then blistering or firing, or both, conjoined with a long rest in a soft damp meadow, will reduce existing enlargement, and, if practicable, complete the cure. |
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HEALTH AND DISEASE.
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298
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SPRAINED BACK
When a horse's hind-feet slip under him, and especially if carrying;
a heavy load, he may suffer a strain of the muscles of the back, or in jumping those under the loin may be sprained. Horses, when jumping a. drain and falling short, sometimes suffer sprain in their struggles to gain the bank. In some instances of this kind valuable animals have been destroyed under the erroneous impression that the back was broken,, when a more careful diagnosis and judicious treatment would have, restored the animal to a state of usefulness. Paralysis is a symptom common to both broken back and sprained
back, but in fracture of the spine, or serious compression of the cord, there is not only inability to rise, but inability to flex the hind-legs in any degree. In the case of sprain of the muscles of the back there remains, some capacity for movement in the legs, although the patient may be unable immediately to rise. Where there is doubt the prostrate animal should be raised by means,
of slings, and although he may knuckle over at the fetlocks at first, and show great distress and imperfect control of the hind-legs for a time,, the absence of spinal injury will soon become apparent by returning power of the limbs to support the weight of the body. In the case of fracture or injury to the spinal cord the hind-quarters-
will continue to hang helplessly in the slings, and no effort is made to- stand, though the distressed creature may make fruitless attempts with his front-feet to secure a footing. In sprain of the back, in which the injury is not so severe as to preclude the animal from getting up, there will still be a difficulty in bringing the hind-legs under him, but this will ■ gradually disappear as reparation proceeds and the muscles regain their tone. Following upon disablement from this cause, more or less wasting or
atrophy of the injured muscles will sometimes appear. The movements of the hind-limbs are for a time weak, and the fetlocks knuckle over now and again during progression. Treatment.—Although a serious accident, sprain of the back may be
regarded hopefully, the,majority of cases making slow but complete re- covery. Rest in slings has been mentioned already; soothing fomentations- applied over the region of the back and warm enemas given frequently will prove helpful; an aperient dose of aloes at first and subsequent careful regulation of the bowels by judicious dieting is also advised. At a later period, and prior to a run at grass, a blister over the loins
is applied, and, if necessary, repeated. With a view to promoting the |
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SPRAIN OR STRAIN
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299
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renewal of muscular tone and power, strychnine and iron in small
repeated doses will also be helpful. |
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SPRAIN AND RUPTURE OF THE FLEXOR METATARSI
The function of this muscle is to flex the canon on the hock and
advance the limb. The action displayed by our best movers is for the most part due to its vigorous contractions. Arising from the lower end °f the femur or thigh-bone, it terminates below in a number of strong tendinous cords, some of which are inserted into the small bones of the |
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Fig. 368.—Rupture of the Flexor Metatarsi
tarsus and others in the upper and front part of the metatarsal or canon
bone. Sprain to this muscle or its tendon, although not of common occur-
rence, is more frequently the cause of lameness behind than is generally allowed, and the writer has observed on several occasions the development °f spavin to follow upon sprain to the tendons which insert themselves lnto the bones of the hock. Whether in these cases the ossific develop- ment was the direct consequence of the sprain cannot be definitely stated. The causes which stretch and strain the flexor metatarsi are chiefly
those which unduly and forcibly extend the limb, such as violent kicking, Groping backward on to the front of the fetlock while carrying or drawing great weights, severe efforts in withdrawing the feet from deep ground or |
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HEALTH AND DISEASE
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300
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rabbit holes while galloping, or when fixed in railway points, as occurs
to horses engaged in shunting. Symptoms.—In sprain to the tendons of this muscle the horse moves
the leg forward with difficulty. There is inability to bend the hock, and the limb is carried forward with a slight outward swing. When standing, the heel of the foot is raised and the hind-quarter is depressed. Heat and slight swelling over the seat of injury will be observed, and deep pressure causes pain. Where, as sometimes occurs, the muscle becomes ruptured, the leg
is drawn directly backward and the sole of the foot inclined upward. The gastrocnemii tendons (hamstrings), having now nothing to anta-
gonize their action, become relaxed and thrown into folds. Treatment.—Complete rest and cold-water irrigation should first be
resorted to, and is usually all that is needed. Where, however, lameness continues after sprain of the tendon has been so dealt with for two or three weeks, a blister should be applied to both sides of the hock-joint, and repeated if necessary. It must on no account be applied to the front or bend of the joint, where the tendons are situated. CURB
A curb is an enlargement on the posterior part of the hock-joint,
about 4 or 5 inches below its point. Pathologically it consists in an in- flammatory thickening of the sheath of the flexor pedis perforans tendon as it passes down the back of the leg. An enlargement of the calcaneo- cuboid ligament, i.e. a strong ligament uniting the bones of the hock behind with the splint and canon bones below, is also spoken of as curb by some, and by others certain forms of spavin are included in the term. Causes.—Curbs are common to all varieties of the horse, but they are
most frequently seen in the lighter breeds, and especially in hunters and thoroughbreds. The causes out of which they arise must be considered under two heads,
viz. predisposing and exciting. Of ■ the former, heredity is a marked factor quite apart from conformation, for it is noticeable that the produce of some horses and mares, against the make and shape of whose limbs nothing can be said, show a special liability to the disease. It must be observed, however, that conformation is a conspicuous feature in the origin of curb. Animals with short calces, or, in other words, wanting in prominence and length of hock-point, are singularly liable to the disease, and the same may be said of others whose hind-limbs slope unduly for- ward, and are brought more immediately under the weight of the body- |
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CURB
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301
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In both these cases the condition generally described as "curby" or "sickle"
hocks is represented (Plate XIII, Vol. I). It is also said that hocks, when small at their point of union with the canon—"tied-in" hocks, as they are termed—are specially prone to develop curbs. The exciting causes of this disease are such as impose sprain or undue
tension on the ligaments and tendons behind the hock; hence it results when animals are called upon to carry too much weight, and especially when young or out of condition. In any case, it may be induced by galloping in deep ground, jump- ing, kicking, rearing, and heavy draught. Symptoms.—The existence of a curb
is indicated by the presence of a curved or convex enlargement at the lower part of the nock behind, where it breaks the straight line which usually marks the course of the leg between the point of the hock and the fetlock (fig. 369). In some instances it is Very slight, and the appearance may re- quire to be verified by careful manipulation, while in others it presents a very consider- able and pronounced enlargement. In the diagnosis of curb the fact must not be over- looked that in some horses whose hocks are 'rough" or coarse in conformation, undue development of the head or upper extremity °f the outer splint-bone may give the part a curby appearance, especially when the curb ls viewed from the outer side. Careful ex- amination, however, will show that the un- due prominence is limited to the seat of the |
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°uter splint-bone, and does not extend across
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Fig. 369.—Curb
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*he back of the hock as in curb proper.
In addition to swelling, more or less heat, pain, and lameness usually
result as the immediate effects of the injury. The action of the horse is Peculiar in the fact that the animal, in endeavouring to relieve the injured Part, throws the weight of the body on the toe or the. front of the foot, according as the case is severe or otherwise, and progresses much after the banner of a horse suffering from spavin. In the slighter forms of the disease lameness is but little in evidence, and sometimes hardly perceptible, save when weight is placed on the back or special effort is made in draught. |
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302 HEALTH AND DISEASE
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Treatment.—When the injury is severe and the lameness acute, the
liorse must be placed in a state of absolute rest, and the part well fomented with hot water every three or four hours, and a hot bandage should be worn in the intervals. Strain on the injured structures should be removed by applying a high-heeled shoe to the foot and directing the weight towards the toe. A dose of physic and a temporary reduction of the corn ration will assist in dispersing existing inflammation. When this has been done a blister or two, with rest, will suffice to reduce the swelling. It is seldom that this is altogether removed, but where active treatment is promptly applied a great reduction may be effected in it. Hand-rubbing the part repeatedly with even pressure is often attended with benefit. In cases where the
injury is slight, irri- gation with cold water for a day or two, followed by a blister and a short rest, is all that is needed. Where the en-
largement is consider- able and lameness |
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Fig. 370.—Curb
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continues after these
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1, Good hock with curb.
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measures have been
carried out, firing either by the puncturing or lining method will require to be adopted. Young horses predisposed to curb should be carefully conditioned
under slow exercise before being put to work. . In the laudable endeavour to restrict the spread of hereditary diseases
in horses, the Royal Commission of Horse-breeding drew up a schedule of diseases, the existence of any one of which should disqualify a thorough- bred sire from receiving a premium. The list of disqualifying ailments included spavin, ring-bone, side-bone, diseases of the feet, cataract, roar- ing, and whistling, but curb, one of the most hereditary of horse diseases, had no place in it. It was not surprising, therefore, to find that a large percentage of the rejections at a recent show of the Hunters' Improvement Society were on account of curbs. It is no excuse for such a course to say, as has been said by some, that the lameness resulting from this disease sooner or later passes away, since the fact remains that it con- stitutes unsoundness, and largely depreciates the value of its victims. |
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BOWED KNEES
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303
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BOWED KNEES
This affection is very common in foals at the time of birth, and to
$nch an extent does it occasionally exist, that the breeder is doubtful as to whether the young animal will ever become upright upon his legs. How- ever, it is often the case that young foals, more or less malformed in this 'direction, become quite straight upon their limbs as time goes on; indeed, such a formation is generally more pleasing to the breeder, if not present to too great a degree, than that called calf-kneed, a position the reverse of the one we have just described. In the latter case the anterior part of the fore-leg, in a line from above downwards, is concave, and the posterior part- is convex; and while in knees bowed forward the owner looks for daily improvement in the form of his foal's legs, in the backward malformation he is assured from experience that no improvement can be anticipated. In the adult horse we occasionally observe " bowed knees" in legs that were originally upright, or perhaps had only a slight tendency to be bowed; the animal having been put to hard work on the road, or hunted for three or four years, by the time he has become eight years old his legs are so de- formed, so much over at the knees, that while standing they appear incapable °f supporting the weight of the fore parts of his body. There are many persons who consider such horses unsafe both to ride and drive; but experience teaches us that these fears are, to a great extent, unfounded. it is not to be understood, however, that we consider such a form of the fore-legs as safe as those we term perfect. But let us endeavour to •ascertain what gives rise to this affection in the working horse, since to ■account for congenital deformity in the foal would be altogether beside the purpose. Various hypotheses have been advanced as to what parts are impli-
cated which would cause this alteration in the form of the carpus. Some persons consider it to depend on a relaxed and lengthened state of the extensors, others on that of the ligamentous tissue at the anterior part of the knee; and as;ain there are others who assert that it consists in an inordinate contraction of the flexors, and to such an extent that the equi- librium of the two sets of muscles (namely, the flexors and extensors) is destroyed. Now, although the last hypothesis seems the most feasible, still the results of my dissections of the fore-legs of horses thus affected—and which were purposely selected—certainly do not confirm any of those opinions. The only muscles likely to produce a curving forward of the knee are
the three which flex the metacarpus on the carpus, their attachments being |
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HEALTH AND DISEASE
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304
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superiorly to the condyles of the humerus, inferiorly to the trapezius, and
two small metacarpal bones; but in these the scalpel develops nothing abnormal either in their muscular tissue or the tendinous structure by which they are inserted and intersected, nor should we expect to find anything, seeing their function is not interfered with. At the posterior part of the carpus numerous ligaments are found, which
are so arranged as to admit of extension only in a forward-direction, while the bones present tuberous projections for the attachment of other liga- ments, the direction of which is from above downwards, obliquely crossing- each other (crucial). May it not be that these ligaments at the posterior part of the knee
become so deranged as to cause this affection? I am inclined to think such is the case. I know of nothing else that would so effectually prevent the full extension of the limb. It may be asked, What is the primary cause? Does the scalpel develop any lesion of this ligamentous tissue? In the specimens I have examined, all have shown the same peculiarities. I liave carefully removed the muscles, both the flexors and extensors, taking care not to divide the annular ligaments, or, in fact, any of those proper to the carpus; after which I have endeavoured to straighten the leg, but invari- ably have failed. The abnormal position was persistent, and that to the same extent as before the muscles were removed. Further, to test the share the ligaments took in the flexure, I have made as many as four transverse sections through them, each of which was followed by an altered position of the bones, thus allowing the limb to be easily placed in a straight line, and of necessity leaving a considerable space between the divided ends of each ligament. The question that now arises is, Can anything be done to remedy this defect, either by the employment of the knife, mechanical contrivance, or any other means? It would seem that the ligaments at the posterior parts of the carpus
are in the first instance slightly sprained, giving rise to a disposition on the part of the animal to refrain from putting them on the stretch, as thisr no doubt, would produce a certain amount of pain. To avoid this when standing the extensors are a little relaxed, thus allowing the knee to come somewhat forwards, thereby removing the tension of the ligaments pos- teriorly. This state of parts we observe only occasionally; for when the animal is excited, or at work, the limbs resume their natural position. This- goes on for a time, but the cause alluded to being still in operation, the abnormal position becomes permanent; and the burste which are situated at the lateral, inclining to the posterior, part of the limb, a little above the knee, are now more than usually filled, which, if the animal be a valuable one, induces the owner to seek advice. This being determined on, it is |
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«J
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PLATE XL
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Photo by \V. A. Koucli
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WELL-SHAPED FOAL
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FOAL WITH BOWED LEGS
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THE MUSCULAK SYSTEM
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305
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usually recommended that the horse be placed on a mash diet, and have a
<iose of purgative medicine administered to him, and that afterwards he be
ohstered once or twice and have a long; rest—not less than two months.
J-ne general result of such a course of procedure is that the animal comes
UP much improved. He is put to work, which, if hard, in the course of
Wo or three months causes his legs again to become as bad as ever. Still
e ls worked on, until finally he is permanently bowed at the knees, not
emg able, as when at first affected, to stand at times upright.
lhe impediment now consists in a slight thickening and consequent
nortening of the ligamentous tissue we have before referred to. -ko treatment in this advanced stage would be of any avail, whether
Medicinal, surgical, or mechanical. Such a horse must be considered as unsound, if the affection exist in more than a slight degree; for although we daily observe horses thus deformed doing their work well, still, on the other hand, many of them show blemished knees, the result of falls. |
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17. THE MUSCULAR SYSTEM
-There are two kinds of muscle, distinguished as striated or voluntary
and non-striated or involuntary. Striated muscle is red in colour, and forms nearly one-half of the
entire weight of the body. It clothes the bones of the skeleton and
nioves them in obedience to the will, hence the term " voluntary " muscle.
A voluntary muscle consists of an aggregation of bundles of fibres
nited by connective tissue in which blood-vessels and nerves ramify
0 nourish and innervate them.
A- muscle fibre, as seen under the microscope, is a minute, pale, faintly
yellow filament. It is composed of an outer sheath or sarcolemrna, within nich is contained a contractile substance. J-he sheath is a very thin, transparent, structureless membrane. It K Jesses no power to contract, but, being elastic, is capable of accommo- lng itself to the necessary changes which its contents undergo. J-he contractile substance enclosed in the sarcolemrna consists of a mber of delicate filaments placed side by side, termed fibrillcB. Each riha is composed of a chain of minute bodies called sarcous elements. nese are united in such a way as to give the fibre a succession -fansverse markings, hence the term striated muscle; other but less lnct striations occur along its length, as a result of the contact of the **** fibrilla. |
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Vol. ii.
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54
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HEALTH AND DISEASE
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306
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Non-Striated muscle is of a pale grayish hue, and enters into the
structure of hollow organs, such as the stomach and bowels, the uterus and bladder, the blood-vessels, the bronchial tubes, &c. &c. It consists of a number of minute spindle-shaped fibre-cells, about 4-^0- to 3-5-^ of an inch in breadth and -g^Q to -g-^g- of an inch in length. Non-striated muscle is not under the control of the will, its movements are therefore involuntary) and carried on by reflex action. Voluntary muscles are distinguished from one another by various names.
Of these some refer to their action. Those which bend a joint, for instance, are termed flexors, while others which straighten it again are known as extensors. There are also levators, depressors, abductors, adductors, con- strictors, dilators, &c. &c. Others are distinguished by their length, as the long muscle of the back,
longissimus dorsi, the short muscle of the tongue, hyo-glossus brevis. Size, form, position, direction, and other qualities are also invoked as a means 01 recognition. Voluntary muscles, with few exceptions, exist in pairs—one on either
side of the body or organ in whose function they are engaged. They are attached by their extremities to two or more bones, which they cause to move at the instigation of the will. When in action one extremity of the muscle is fixed, the other is
movable. The former is termed its origin, or the part from which it acts; the latter is its insertion, or the part upon which it acts and moves. I11 some instances the extremities are alternately fixed and movable; what is at one time the origin is at another the insertion. This is the case with the mastoido-humeralis, a long muscle running from the arm to the back 01 the head. If when the arm is fixed the muscle contracts, the head is drawn downwards and to one side; and conversely when the head is fixed, the arm is raised. Tendons.—Muscles are attached to bones either directly by their fleshy
fibres or by tendons which proceed from them. Tendons transmit tO action of muscles to the bones to be acted upon. They exist in the for10 of dense rounded cords of various lengths, or as more or less broad, flat' expanded sheets. In the latter condition they are spoken of as aponeuroti tendons, and are found in their highest development in connection with to muscles of the belly, where they assist in forming the abdominal wail ■ The long cord-like variety are met with in the extremities, where the ni°l important extend from above the knees and hocks downward to the te and pasterns. Some tendons are partly or completely surrounded by a fibrous sheat >
and this is lined by a synovial membrane, which, being also reflected on |
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MUSCLES OF THE FACE AND HEAD * 307
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the tendon, enables the latter to move freely through the former. This is
more especially the case in the vicinity of joints, as the knee, hock, and fetlock, where movement is most active. Where tendons play over pro- jecting points of bone or other prominences, a small, round sac lined with synovial membrane is placed between them to facilitate the movement of the one over the other. These are known as synovial bursae. MUSCLES OF THE FACE AND HEAD
The muscles of the face comprise a number of longer or shorter strips,
most of which are attached by one extremity to the bones above, and by the other to parts about the lips and nostrils below. Those attached to the |
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Fig. 371.—Muscles of Horse's Head
A, Temporalis muscle. B, Levator palpebrse. c, Orbicularis palpebrarum. D, Supernaso-labialis or
Levator labii superioris alaeque nasi. E, Supermaxilo-labialis or Levator labii superioris proprius. p> Supermaxilo-nasalis or Dilator naris lateralis, o, Orbicularis oris. H, Mento-labialis. I, Maxilo-labialis °r Depressor labii inferioris. J, Zygomaticus. K, Buccinator. L, Parotid duct. M, Masseter muscle. N, Parotid gland, o, Jugular vein. P, Mastoido-humeralis muscle. °Wner are for the most part muscles of prehension, and serve to gather up
^e food and retain it in the mouth during mastication. With one or two Xceptions the muscles of the face are arranged in pairs, one being on one 8lde and the other on the other. When in action some of them draw the lips upwards, others acting in
11 opposite direction pull them downwards, hence they are called levators and depressors respectively. J-he orifice of the mouth is acted upon by a single muscle that
circles the lips (orbicularis oris), and when in action diminishes |
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HEALTH AND DISEASE
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308
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the size of the opening, as may be seen in the act of drinking. A
similar muscle (orbicularis palpebrarum) surrounds the eyelids, which it closes. Besides these there are others much larger and stronger, one forming
the anterior part of the cheeks (buccinator and caninus). These are attached to the upper and lower jaw, along the margins of the sockets which contain the fangs of the molar teeth. When in action they throw the food out of the channel of the cheek on to the grinding surface of the teeth. Other muscles in this region are engaged in dilating the nostrils, and
thus ministering to the function of respiration. |
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MUSCLES OF THE FACE AND HEAD
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309
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Origin.
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Action.
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Name.
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Insertion.
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•Buccinator and Caninus.
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Attached to the tuberosity
of the superior maxilla, to the anterior border of the inferior maxilla be- hind the last molar tooth, and to the outer surface of the sockets of the molar teeth of the upper and lower jaw. Below it blends with the angle of the mouth. Has no bony attachment.
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To keep the food
between the upper and lower molar teeth during mastica- tion. |
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Orbicularis Oris.
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Closes the lirjsand
assists in gather- ing the food, in drinking, and in mastication. |
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Encircles the lips.
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Dilator Naris Superioris.
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From the side of the nasal
peak. |
To dilate the false
nostril. |
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Into the false
nostril and the anterior turbin- ated bone. Into the cartilage
at the anterior extremity of the posterior tur- binated bone. Into the upper
lip. |
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dilator Naris Inferioris.
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From the anterior and
superior maxillary bones. |
To dilate the false
nostril. |
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Repressor Labii Superi
oris. |
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From the anterior maxillary
bone above the upper in- cisor teeth. From the lower jaw beneath
the incisor teeth. |
the
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To depress
upper lip. |
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Lev
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ator Menti.
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Into the sub-
stance of the chin. |
To raise the lower
lip. |
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Masseter.—A broad, thick, square muscle situated on the outer face
1 the lower jaw. It is largely intersected by tendinous layers and covered y a strong fibrous membrane. Origin.—From the zygomatic ridge of the upper jaw-bone by a strong
br°ad tendon. -insertion.—Into the external surface of the upper broad portion of the
terior maxilla or lower jaw. Action.—It brings the teeth of the lower jaw forcibly into contact with.
°se of the upper in grinding the food. It is the most powerful of the Uscles engaged in mastication. Pterygoideus Internus.—A broad, thick, flat muscle situated on the ernal aspect of the superior broad portion of the lower jaw. |
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HEALTH AND DISEASE
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Origin.—From the sphenoid and palatine bones.
Insertion. — Into the inner surface of the lower jaw opposite the
masseter. Action.—To bring the lower jaw into contact with the upper, and to
move it from side to side in the process of mastication or grinding the food. PterygoideilS Externus.—A short, thick, fleshy muscle situated
within and in front of the articulation of the lower jaw with the temporal bone. Origin.—From the sphenoid bone at the base of the skull.
Insertion.—Into the inner part of the neck of the lower jaw below the
articular condyle. Action.—To move the lower jaw forward and to one side in the act of
mastication. Temporalis.—This muscle lies on the side and front of the cranium,
extending into the temporal fossa. Origin.—From the outer surface of the parietal, squamous temporal,
and frontal bones, in the temporal fossa, and from the sphenoid bone. Insertion.—Into the coronoid process of the lower jaw and the anterior
border of the same bone continuous with it. Action.—To assist in masticating the food by bringing the lower jaw
into contact with the upper and moving it from side to side. Stylo-Maxillaris.—This is a short, thick muscle situated in the region
of the throat. Origin.—From the styloid process of the occipital bone above m
company with another small muscle—the digastricus. Insertion.'—Into the angle of the lower jaw.
Action.—By pulling the last-named bone away from the upper jaw it
opens the mouth. MUSCLES OF THE EXTERNAL EAR
The external ear consists of a short bony tube projecting from the
petrous temporal bone, termed the external auditory canal, together with three pieces of cartilage, and a number of muscles, vessels, and nerves, &c. The Cartilages are distinguished as the conchal, the annular, and the
scutiform. The conchal cartilage forms the framework of all that portion of the ear which stands erect. It presents a large vertical opening on one side for the reception of sound, and is attached below to the annular cartilage, a small ring of gristle connected with the auditory process of the petrous temporal bone. The scutiform cartilage is a small, flat, somewha |
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THE SUPERFICIAL MUSCLES EXPOSED
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THE SUPERFICIAL MUSCLES EXPOSED
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MUSCLES OF THE EXTERNAL EAR
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311
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triangular cartilaginous plate situated in the front of the base of the
concha, to which it is attached. The cartilages of the ear are for the purpose of collecting and transmitting sound to the essential organ of hearing within the temporal bone, and to effect this purpose thej, and especially the concha, require to be moved in various directions. This is effected by means of the following muscles, which are connected with them:— Zygomatico-Aurieiilaris.—This comprises two thin slips of muscle
arising from the zygomatic process of the squamous temporal bone. They |
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Fig. 372.—Muscles of the Ear. Fig. 373.—Muscles of the Ear. Fig. 374.—Muscles of the Ear.
'Anterior aspect; outer and deep layers.) (Lateral aspect.) (Posterior aspect.)
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1, Temporalis. 2, Parieto-auricularis interims. 3, Parieto-auricularis externus. 4, Scuto-auricularis
internus. 5, Zygomatico-auricularis. 6, Scutiform Cartilage. 7, Scuto-auricularis externus. 8, Corru- gator Supercilii. 9, Parotido-auricularis. 10, Splenius. 11, Tendon of Sterno-cleido-mastoideus. 12, Mas- seter. 13, Cervico-auricularis externus. 14, Cefvico-auricularis medius. 15, Obliquus Capitis Superior. become inserted into the scutiform cartilage, and into the outer and inferior
part of the concha. Action.—To draw the ear forward.
ParietO-Auricularis Externus.—A broad, thin muscle spread over
the superior part of the forehead and covering the temporalis muscle. Origin.—From the parietal crest or bony ridge in the centre of the
forehead. Insertion.—By two slips, one to the inner margin of the scutiform
cartilage and the other to the inner and anterior part of the conchal cartilage. Action.—To draw the ear inwards and direct the opening forward, as
when « pricked »'. ScutO-Auricularis Externus.—This muscle attaches the scutiform
cartilage to the inner side of the concha. It assists in drawing the ear inwards and directing the opening forward. |
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HEALTH AND DISEASE
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312
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CervicO-AuriculaPlS.—Three muscles are included in this term—the
superficial, the middle, and the deep. Origin.—All three arise from the ligamentum nuchge at the summit of
the head, where they are placed one upon another. Insertion. — The superficial cervico-auricularis is inserted into the
middle of the inner surface of the concha, the middle one into the outer side of the same cartilage, and the deep one into the posterior aspect of its base. Action.—To turn the ear so that its opening shall be directed outward
or backward. Parotido-Auricularis.—A long, thin, ribbon-shaped muscle situated
on the external surface of the throat in contact with the parotid gland. Origin.—From the outer surface of the parotid gland, from which it
ascends to be inserted into the outer part of the base of the concha, immediately beneath the opening. Action.—To abduct or move the ear outwTard.
Parieto-Auricularis Internus.—A triangular muscle placed beneath
the one last described. Origin.—From the superior part of the parietal crest.
Insertion.—Into the inner side of the base of the conchal cartilage.
Action.—To draw the ear inward towards the centre of the poll.
Scuto-Auricularis Internus.—This muscle is composed of two small
divisions, which cross each other somewhat obliquely. Origin.—From the inner surface of the scutiform cartilage.
Insertion.—Into the posterior part of the base of the concha.
Action.—Assists in directing the opening of the ear outwards, and also
backwards when required. Mastoido-Aurieularis.—A very small muscle, situated at the inner
side of the root of the ear. Origin.—From the margin of the auditory process of the petrous
temporal bone. Insertion.—Into the base of the conchal cartilage.
Action.—Not definitely known.
The basement cartilages of the ear rest upon a cushion of fat, which
facilitates their rapid movement in various directions. MUSCLES OF THE HYOID REGION
Mylo-Hyoid.—This muscle is situated beneath the tongue and between
the branches of the lower jaw. With its fellow they stretch across ixO&- one branch to the other, and support the tongue as in a sling. |
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MUSCLES OF THE HYOID REGION
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313
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Origin.—From the inner face of the lower jaw behind the molar
teeth. Insertion.—From the point of origin its fibres pass under the tongue
and meet those of the muscle from the opposite side in the centre, where they blend together. Behind they are inserted into the spur-like projection of the tongue bone. Action.—This muscle lifts the tongue towards the palate, and assists in
mastication and swallowing. Genio-HyoideilS.—-This is a long, narrow muscle, with tapering ex-
tremities, situated beneath the tongue. Origin.—From the lower jaw, near the symphysis or joining of the two
branches. Insertion.—Into the spur-process of the hyoid or tongue bone.
Action.—To draw the hyoid bone forward and assist in protruding the
tongue. Stylo-Hyoid.—Situated in the region of the throat.
Origin.—From the superior and posterior part of the long cornu of the
hyoid or tongue bone. Insertion.—Into the outer part of the heel-like process of the same
bone, where its tendon divides to allow the middle tendon of the digastricus to pass between its branches. Action.—To draw the larynx and the tongue backwards and upwards.
Hyoideus Transversus.—This is a small single muscle placed between
the two small cornua of the tongue bone. It is attached to the inner surface of each, and crosses over from one side to the other. Action.—To maintain the small cornu in position during the various
movements of the tongue. KeratO-Hyoid.-—A small, flat, triangular muscle situated at the root of
the ton g-ue. Origin.—From the posterior border of the lower end of the long cornu,
and from the posterior border of the small cornu. Insertion.—Into the upper border of the heel process of the tongue
bone. Action.—To raise the heel process and elevate the larynx.
The Digastricus.—This is composed of two small muscular masses
united by a short tendon; hence it is called digastric or a double-bellied muscle. Origin.—With the stylo-maxillaris from the styloid process of the
°ccipital bone. The tendon intervening between the two bellies plays through a division above referred to in the tendon of another muscle (stylo- hyoid) against the tongue bone. |
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314
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HEALTH AND DISEASE
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Insertion.—The second belly is inserted into the posterior border of the
lower jaw behind the chin. Action.—To raise the hyoid bone and assist in opening the mouth.
Occipito-Styloid.—A very short, small, flat muscle situated at the
posterior part of the base of the skull. Origin.—From the anterior part of the styloid process of the occipital
bone. Insertion.—Into the upper extremity of the long cornu of the hyoid
bone (bone of the tongue). Action.—To draw the bone of the tongue upwards and backwards.
MUSCLES OF THE TONGUE
Stylo-GlOSSUS.—A long, narrow, flat muscle situated on the side of
the tongue. Origin.—From the outer part of the inferior extremity of the long,
cornu of the tongue bone. Insertion.—Into the tip of the tongue.
Action.—Acting with its fellow on the opposite side, it would pull
the tip of the tongue upwards. Acting alone, it would draw it to one side. Great HyO-GloSSUS.—Situated in the substance of the tongue.
Origin.—From the heel-like process and body of the tongue bone.
Insertion.—Into the front part of the mucous membrane of the tongue
along the greater portion of its length. Action.—To draw the tongue backwards and upwards.
Genio-Hyo-GloSSUS.—A broad, thin, fan-shaped muscle placed in the
centre of the tongue. Some of its fibres pass downwards to the tip, others to the centre, and a third portion to the root of the tongue. Origin.—From the inner surface of the lower jaw, near the symphysis,
or union of the two branches. Insertion.—Into the under surface of the mucous membrane, along its
middle, from the tip to the root. Action.—The lower portion of the muscle when contracting would draw
the tongue into the mouth, the upper division would cause it to protrude. The central part would pull it away from the roof. Small HyO-GloSSUS.—A very small muscle surrounded by fat and
situated at the root of the tongue. Origin.—From the inferior extremity of the small cornu and the body
of the tongue bone. Insertion.—Into the posterior part of the substance of the tongue-
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SECOND LAYER OF MUSCLES EXPOSED
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SECOND LAYER OF MUSCLES EXPOSED
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MUSCLES OF THE PHARYNGEAL REGION 315
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In passing forward to its insertion it crosses over the hyoideus trans-
versa. Action.—To retract the tongue.
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Fig. 375.—Muscles of the Tongue, Soft Palate, and Larynx
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1, Tensor Palati. 2, Occipito-Styloid (right). 3, Occipito-Styloid (left). 4, Palato-Glossus. 5, Stylo-
Hyoid Pharyngeus. 6, Thyro-Pharyngeus. 7, Crico-Pharyngeus. 8, Palato-Pharyngeus. 9, Crico- Thyroideus. 10, Sterno-Thyroideus. 11, Thyro-Hyoideus. 12, Stylo-Glossus. 13, Genio-Hyoideus. 14, Great Hyo-Glossus. 15, Genio-Hyo-Glossus. 16, Oesophagus. Palat0-Gl0SSUS.—A small collection of muscle fibres arising from the
side of the pharynx and becoming inserted into the root of the tongue. Action.—To constrict the fauces. MUSCLES OF THE PHARYNGEAL REGION
PterygO-PharyngeilS.—A thin, flat, triangular muscle lying above
the pharynx. Origin.—From the pterygoid process, from which its fibres spread out
fan-like and become inserted into the upper and lateral aspect of the pharynx. Some of its fibres intermix with those of the palato-pharyngeus. Action.—To constrict the pharynx.
Hyo-PharyngeuS.—A small muscle situated on the inferior and
lateral parts of the pharynx in front. Origin.—From the heel process of the hyoid bone.
Insertion.—Into the roof of the pharynx, where its fibres interlace with
those of its fellow. Thyro-Pharyngeus.—Situated behind the one last described.
Origin.—From the outer surface of the thyroid cartilage.
Insertion.—Into the roof of the pharynx, where its fibres interlace with
those of its fellow. |
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HEALTH AND DISEASE
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316
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Crico-Pharyngeus.—Placed behind the thyro-pharyngeus.
Origin.—From the outer surface of the cricoid cartilage.
Insertion.—Into the roof of the pharynx, where its fibres interlace with
those of its fellow. Action.—The three muscles last described constrict the pharynx.
Stylo-PharyngeilS.—A triangular muscle situated above the pharynx.
Origin.—From the inner surface of the long cornu of the hyoid bone.
Insertion.—Below it spreads out its fibres and becomes inserted into
the outer edge of the pharynx. Action.—To dilate the pharynx.
MUSCLES OF THE SOFT PALATE
Palato-Pharyngeus.—This muscle lies in the posterior part of the
soft palate. It is attached to its fellow on the opposite side, to the outer wall of the pharynx, and to the superior border of the thyroid cartilage. Action.—To tighten the soft palate, and raise it during swallowing.
Tensor Palati.—A small, flat, thin muscle placed above the pharynx.
Origin.—From the styloid process of the petrous temporal bone.
Insertion.—The tendon of this muscle plays over a pulley-like arrange-
ment on the free process of the pterygoid bone, and, after spreading out, becomes inserted into the posterior wall of the pharynx. Action.—To render the front portion of the palate tense.
Levator Palati.—A thin band of muscle situated above the pharynx.
Origin.—With the muscle last described from the styloid process of the
temporal bone. Insertion.—Into the soft palate.
Action.—To raise the velum palati.
MUSCLES OF THE LAEYNX
Thyro-Hyoid Muscle.—A flat triangular muscle spread over the side
of the thyroid cartilage. Origin.—From the entire length of the heel process of the hyoid or
tongue bone. Insertion.—Into an oblique ridge on the outer side of the thyroid
cartilage. Action.—To raise the larynx and draw it forward.
Hyo-Epiglottideus.—A short, small bundle of fibres situated at the
root of the tongue in a mass of fatty tissue. Origin.—From the upper surface of the body of the hyoid bone.
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MUSCLES OF THE LARYNX 3 IT
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Insertion.—Into the front and lower part of the epiglottis.
Action.—To draw the epiglottis forward and downward after it has
been pushed over the glottis in the act of swallowing. CricO-Thyroid Muscle.—A small, narrow muscle placed on the outer
side of the cricoid cartilage. Origin.—From the upper and anterior part of the cricoid cartilage.
Insertion.—Into the inferior part of the thyroid cartilage.
Action.—To maintain the two cartilages in position during the action
of the more movable parts, while at the same time permitting a certain amount of liberty between themselves. Posterior Crico-Arytenoid Muscle.—It occupies the upper and
back part of the larynx, a great portion of which it covers. It is the
largest and most powerful of the intrinsic muscles connected with this organ. Origin.—From the posterior broad surface of the cricoid cartilage.
Insertion.—Into the outer angle of the arytenoid cartilage.
Action.—To draw the arytenoid cartilages apart and dilate the opening
into the larynx. Lateral Crico-Arytenoid Muscle.—A small muscle situated on the
upper and posterior part of the larynx.
Origin.—From the upper part of the anterior border of the cricoid
cartilage. Insertion.—Its fibres, passing upwards and backwards, become inserted
into the outer angle of the arytenoid cartilage with the posterior crico- arytenoid muscle. Action.-—To constrict the laryngeal opening.
Thyro-Arytenoid Muscle.—This muscle is composed of two small
bundles of fibres situated on the inner side of the thyroid cartilage, where they are separated from each other by the interposition of a pouch of mucous membrane (ventricle of the larynx). Origin.—From the inner surface of the body of the thyroid cartilage.
Insertion.—By some of its fibres into the outer border of the arytenoid
cartilage. Others mingle with those of the arytenoid muscle. Action.—To constrict the larynx.
Arytenoideus Muscle.—A pair of small muscles situated on the
upper and posterior surface of the arytenoid cartilages. They are united ln- the middle line by the intermixing of their fibres, and are inserted into the posterior surface of the arytenoid cartilage. By some this muscle is said to constrict the laryngeal opening, and by
others to dilate or open it. |
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318
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HEALTH AND DISEASE
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MUSCLES OF THE NECK
RhOHlboideuS.—This is a long triangular muscle situated at the upper
border of the neck, where it commences at the second cervical vertebra and extends backward to the fifth dorsal vertebra. Origin.—From the superior border of the ligamentum nuchse and the
superior spinous processes of the 2nd, 3rd, 4th, and 5th dorsal vertebrae. Insertion.—Into the inner surface of the cartilage on the upper border
of the scapula. Action.—To draw the scapula upwards and forwards. Acting when the
scapula is fixed, it would incline the neck to one side. Levator Angllli Scapulae.—A muscle of considerable size spread
over the lower half of the side of the neck, from which its fibres converge toward the cervical angle of the scapula. Attachments.—To the transverse processes of the four or five posterior
cervical vertebrae, and to the internal surface of the upper extremity of the scapula, just in front of the serratus magnus. Action.—This muscle, like the one previously described, may act from
either extremity. When the neck is made a fixed point it would pull forward the upper end of the scapula and cause the shoulder point to recede. When the scapula is fixed, the muscle acting alone would draw the neck to one side, or, acting with its fellow, the neck would be lifted up- SplenillS.—A broad, triangular, flat muscle, situated on the side of
the neck, and extending from the summit of the head backward to the withers. Origin.—From the superior spinous processes of the 2nd, 3rd, and 4th
dorsal vertebrae and the upper border of the ligamentum nuchee. Insertion.—Into the mastoid crest of the temporal bone and the trans-
verse processes of the first five cervical vertebrae. Action.—Acting alone, the splenius draws the head and neck towards
the side upon which it acts. When co-operating with its fellow on the opposite side, they elevate the head and neck. The CompleXUS.—This is a strong, fleshy muscle deeply seated on
the side of the neck, in close apposition with the ligamentum nuchse* which divides the right from the left complexus. It extendi from the back behind to the head in front, becoming narrower as it passes upwards. Origin.—From the spinous processes of the 1st, 2nd, 3rd, and 4th dorsal
vertebrae, from the transverse processes of the first six, and from the articular tubercles of all the cervical vertebrae. Insertion.—Into the posterior part of the occipital bone.
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MUSCLES OF THE NECK 319
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Action.—Contracting alone, it would bend the neck to one side.
Acting together with its fellow on the opposite side, it elevates and extends the head. Trachelo-Mastoideus.—Situated on the side of the neck beneath the
•splenius. It is a long muscle, composed of two fleshy divisions which pass from the head downwards to the anterior extremity of the back. Origin.—It takes its origin from the transverse processes of the first
two dorsal vertebrae, and from the articular tubercles of the last six cervical vertebrae. Insertion.—Into the mastoid process of the temporal bone, and to the
wing of the atlas by a flat tendon common to the splenius and mastoido- humeralis. Action.—When acting alone, the trachelo-mastoideus draws the head
and neck to one side. When acting with the corresponding muscle of the other side, it raises the head. Spinalis Colli.—Five thick, short strands of muscle deeply seated on
the side of the neck in proximity with the bones. They are in continuation of similar short muscular fasciculi, presently to be noticed, in the regions of the back and loins. Origin.—From the oblique processes of the five posterior cervical
vertebrae or neck bones. Insertion.—Into the spinous processes of the 2nd, 3rd, 4th, 5th, and
6th of the same. Action.—To extend the neck, and to fix the bones in accordance with
the action of other of the cervical muscles. Intertransversales Colli.—These are six short muscles placed on the
side of the neck in apposition with the vertebrse. Each extends from the oblique process of one vertebra to the transverse process of the one preced- ing it, except in the case of the two first. Action.—To draw the neck to one side.
Obliquus Capitis Superior.—A short, thick, square muscle situated
on the side of the poll. It is largely intersected by strands of tendinous tissue, and covers over the articulation between the occiput and the first cervical vertebra. Origin.—From the anterior border and under surface of the wing of the
atlas. Insertion.—Into the mastoid crest and the styloid process of the
occiput. Action.—To incline the head to one side and to assist in extending it.
Obliquus Capitis Inferior is a thick, fleshy muscle, somewhat longer
lnan the last described, and situated immediately below it. |
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HEALTH AND DISEASE
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320
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Origin.—From the outer surface of the superior spinous process of the
second cervical vertebra (axis or dentata). Insertion.—Into the superior surface of the wing of the atlas.
Action.—To rotate the atlas on the dentata. Its action is shown in a
striking manner when the horse shakes his head. Rectus Capitis Posticus Major.—A short, fleshy muscle placed
beneath that last described, and partly divisible into two portions.
Origin.—From the superior spinous process of the dentata or second
cervical vertebra. Insertion.—Into the posterior part of the occipital bone.
Action.—Assists the complexus major in extending the head on the
neck. Rectus Capitis Posticus Minor.—A small, wide, flat muscle placed
beneath that last described, and extending over the articular capsule of the
joint formed by the occiput and the first cervical vertebra. Origin.—From the superior surface of the atlas.
Insertion.—Into the posterior surface of the occiput.
Action.—It assists in extending the head on the neck.
Cervical Panniculus.—This is a thin layer of muscular tissue spread
over the front of the neck, extending from the breast below, upward, to behind the jaws, and on to the sides of the face. Below, it is attached to the cariniform cartilage of the sternum, to which
it converges from either side. Above, it becomes closely adherent to the muscles in front of the neck, which it braces and supports. Cervical Trapezius.—See muscles of the back.
Mastoido-Humeralis.—This is a long, broad, fleshy muscle, extending
from the top of the head downward along the side of the neck over the point of the shoulder to the humerus or upper arm bone. Origin.—Above from the mastoid process and crest of the occipital
bone, and from the transverse processes of the first four cervical ver- tebrae. Insertion.-—Into the upper third of the ridge on the outer part of the
humerus. Action.—This is a muscle of considerable power and importance, being
specially instrumental in raising the limb from the ground and carrying ii forward in progression. Upon it chiefly depends that grand shoulder action so much admired in our oest harness horses. It is capable of acting in two directions: when the head is fixed i*
raises and advances the fore-limb; when the fore-limb is fixed, as in a standing posture, it draws the head to one side, or, acting with its fellow' on the opposite side, it pulls it downward. |
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CLYDESDALE STALLION, HOLYROOD
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Owner, Marquis of Londonderry
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MUSCLES OF THE NECK
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321
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Sterno-Maxillaris. —This is a long, narrow muscle situated in front
°f the neck, along the entire length of which it runs from the breast below to the lower jaw above. Its inferior portion is united with its fellow on the opposite side. About the middle of the neck they separate and pass upward and outward to their destination. The jugular vein runs on the outer border °f this muscle. Origin.—From the cariniform cartilage in front of the sternum.
Insertion.—By a short, flattened tendon into the angle of the lower jaw.
Action.—When acting with its fellow it draws the head downward.
Acting alone, it pulls it to one side. Sterno-ThyrO-HyoideilS.—A long slender muscle, which becomes
tendinous about the middle of the neck and then divides into two thin, narrow, muscular branches. It passes along in front of the trachea or windpipe. Origin.—Joined with its fellow on the opposite side, it arises from the
cariniform cartilage in front of the sternum. Insertion.—By one division into the posterior border of the thyroid
cartilage of the larynx, by the other into the body of the hyoid or tongue bone. Action.—To depress the hyoid bone and larynx.
Subscapulo-Hyoideus.—A long, flat, narrow muscle, passing obliquely
up the neck from beneath the scapula or blade-bone to the space between the branches of the lower jaw. It separates the jugular vein from the carotid artery in the upper
balf of the neck. Origin.—By a thin, flat tendon from the fascia on the under surface of
the scapula. Insertion.—Into the body of the hyoid bone (bone of the tongue).
Action.—To draw the hyoid bone downwards.
Rectus Capitis AntlCUS Major.—Situated at the side and front of
the upper part of the neck, it extends from the fifth cervical vertebra to the base of the skull. Origin.—From the transverse processes of the 3rd, 4th, and 5th bones
°f the neck. Insertion.—Into the base of the skull at the junction of the basilar
Process of the occiput with the sphenoid bone. Action.—To draw the head to one side, or to flex it, according as it acts
"7 itself or with the corresponding muscle on the other side. Rectus Capitis Anticus Minor.—A small, flat, fleshy muscle placed
°eneath the articulation of the head with the neck. Origin.—From the under surface of the atlas.
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Insertion.—Into the basilar process of the occipital bone and the body
of the sphenoid bone. Action.—Acting with its fellow on the opposite side, it flexes the head
on the neck. Rectus Capitis Lateralis.—A small, fleshy muscle placed beneath
the atlas. Origin.—From the body of the bone last named.
Insertion.—Into the styloid process of the occipital bone.
Action.—To assist in flexing the head on the neck.
Scalenus.—This muscle is situated in front of the first rib, and
extends upwards as high as the fourth neck bone. It is composed of two unequal parts, the lower of which is the larger. Between them the axillary plexus of nerves passes on its way to the under part of the scapula, to be distributed to the fore extremity, and parts about the chest, breast, and shoulder. The axillary artery, in leaving the chest to be distributed to the fore-limb, winds round the anterior border of the first rib immediately beneath this muscle. Origin.—From the transverse processes of the last four cervical
vertebrae. Insertion.—Into the anterior border and outer surface of the first rib.
Action.—By drawing the first rib forward, it assists inspiration. When
the rib is fixed and the muscle contracts, the neck would be drawn down- ward and to one side. LongUS Colli.—The long muscle of the neck occupies the under sur-
face of the bodies of all the cervical and the first six dorsal vertebrae. Attachment.-—To the bodies of the first six dorsal vertebrae. This
portion proceeds forward, to be inserted by a strong tendon into the sixth cervical vertebra. That portion situated in front of the neck has its origin in the transverse processes of the last six cervical vertebrae, and in the bodies of the first six. Its terminal tendon gains attachment to the tubercle on the under surface of the atlas. Action.—To bend the neck as a whole, or any part of it.
MUSCLES OF THE BACK AND LOINS
Trapezius. —Situated beneath the skin on the side of the neck and
withers. It is a flat, triangular muscle, divided by a tendon into two portions, and sometimes described as two muscles—the cervical and dorsai trapezius. Origin.—In front from the superior border of the ligamentum nuchse,
from which its fibres pass downwards and backwards. Behind from the |
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superior spines of the dorsal vertebrae from the 3rd to the 10th, whence
its fibres pass downward and forward. Insertion.—Into the tubercle on the outside of the spine of the scapula.
Action.—The cervical or neck portion acting alone would pull the
shoulder upwards and forwards. The dorsal or back division acting alone would draw it upwards and backwards. Latissimus Dorsi.—A flat, triangular muscle spread over the back
and loins, where it commences in a broad aponeurotic tendon. It extends obliquely downward and forward over the side of the chest, and, gradually becoming narrower, passes between the fore-limb and the trunk to reach the humerus or upper arm bone. Origin.—From the superior spines of all the lumbar and the fourteen
posterior dorsal vertebrae. Insertion.—By a short tendon into a small tubercle on the internal
surface of the humerus or upper arm bone. Action.—To flex the humerus on the scapula and incline the leg towards
the trunk. Serratus Anticus.—Situated on the side of the chest. The serratus
anticus consists of a number of fleshy slips, whose fibres are directed back- wards and end above in a flat aponeurotic tendon. Origin.—From the 2nd to the 13th dorsal spines.
Insertion.—Into the anterior borders and outer surfaces of all the ribs
from the 5th to the 13th. Action.—By drawing the ribs forwards and upwards it enlarges the
chest and assists in inspiration. Serratus Posticus.—Situated behind the one last described, of which
xt seems to be a continuation. It is composed of a flat or aponeurotic tendon and a number of fleshy segments. Origin.—From the spinous processes of the seven posterior dorsal
vertebrse and the two anterior lumbar. Insertion.—Into the outer surfaces and posterior borders of the eight or
ftine last ribs. Action.—To pull the ribs backwards and assist in expiration.
Longissimus Dorsi. — This is the longest, the largest, and most
powerful muscle in the body. It is situated on the arches of the ribs, ln close connection with the spines of the dorsal and lumbar vertebrse, and extends from the ilium behind, over the loins and the back to the tourth cervical vertebra in front. Origin.—From the internal surface and anterior border of the ilium
r haunch bone, and the ligament (sacro-iliac) connecting it with the Sacrum, and from the sacral bone. |
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Insertion.—It has numerous connections in its course towards the neck.
1. To the spinous, transverse, and articular processes of the lumbar vertebrae.
2. To the spinous and transverse processes of the dorsal vertebrae. 3. To
the external surfaces of the 14th and 15th posterior ribs. 4. To the spinous processes of the last four cervical vertebrae. Action.—Acting with its fellow on the opposite side, it extends the
spine. By its attachments to the cervical vertebrae it raises and supports the neck, and by its connection with the ribs it assists in expiration. It is the principal muscle concerned in rearing, kicking, and jumping. Transversalis Costarum.—This is a long, narrow muscle, stretching
across the ribs a little distance from the spine. Origin.—It is composed of two sets of tendons. By one set it arises
from the transverse process of the first lumbar vertebra and the anterior borders of the ribs. By the other it is inserted into the posterior edges of the fourteen anterior ribs and into the transverse process of the last cervical vertebra. Action.—To assist in expiration.
The Semispinalis of the back and loins.—This is situated on the
sides of the spines of the dorsal and lumbar vertebrae, and extends along
their entire length from the sacrum to the neck. It is made up of a number of short slips passing obliquely upward and forward. Origin.—1. From the sacrum behind. 2. From the articular pro-
cesses of the lumbar vertebrae. 3. From the transverse processes of the dorsal vertebrae. Insertion.—Each slip becomes inserted into the spinous process of the
third or fourth vertebra in front of the one from wThich it arises. Action.—To fix the bones during the action of the large spinal muscle,
and to assist in extending the spine. Retractor C0Sta3.—A small, thin, triangular muscle arising from the
transverse processes of the lumbar vertebrae. Insertion.—Into the posterior border of the last rib.
Action.—To assist in expiration.
By some this muscle is considered to be part of the internal obl:q.ue
muscle of the abdomen. MUSCLES OF THE INFERIOR LUMBAR REGION
Psoas Magnus.—This is a broad, flat muscle placed beneath the loins,
and extending from beneath the spine backward to the upper part of the thigh. Origin.—From the bodies of the last two dorsal vertebrae, from tn
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under surfaces of the last two ribs, and from the transverse processes of the
lumbar vertebrae. Insertion.—By a short tendon common to this and another muscle—
the iliacus—into the internal trochanter of the femur or thigh bone. Action.—To flex the thigh on the pelvis and rotate it outwards. When
both thighs are fixed it arches the back by flexing the spine. When a horse rears, this muscle is mainly concerned in preventing him falling backwards. |
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Fig. 376.—Muscles of the Lumbar and Pubio-Femoral Regions
1, Intercostal Muscles. 2, Psoas Parvus. 3, Psoas Magnus. 4, Iliacus. 5, Quadratus Lumborum.
6, Sartorius. 7, Pubic Tendon of Abdominal Muscles. 8, Fascia of the Thigh. 9, Semimembranosus. 10, Semitendinosus. 11, Rectus Femoris. 12, Adductor Longus. 13, Vastus Internus. 14, Adductor Brevis. 15, Pectineus. Psoas Parvus.—Situated beneath the loins on the inner side of the
Muscle last described. Origin.—From the bodies of the three or four last dorsal and all the
lumbar vertebrae. Insertion.—To a small bony eminence (ilio-pectineal) on the front of
tne ilium. Action.-—When the loins are fixed, it draws the pelvis forward and
nexes it on the spine. When the pelvis is fixed, it roaches the back. IliaGUS.—The iliacus is a stout, fleshy muscle, extending from the
under part of the ilium or haunch bone to the thigh. Origin.—From the under surface of the ilium.
Insertion.-—To the small internal trochanter on the inner surface of the
ernur by a tendon common to this muscle and the psoas magnus. Action.—To flex the femur on the pelvis and rotate the femur outwards.
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QuadratUS Lumborum.—Situated underneath the loins, and covered
over below by the great psoas muscle. The quadratus luniborum is composed of several flat, narrow slips of muscle, whose fibres pass in a direction forward and inward, extending from the sacrum to the last rib but two. Origin.—From the sacro-iliac ligament behind.
Insertion.—By its outermost slip to the posterior border of the last rib,
by the others to the ends of the transverse processes of the lumbar vertebrae and the under surfaces of the three last ribs at their junction with the spine. Action.—To draw the last rib backward and incline the lumbar vertebra?
to one side. Intertransverse Muscles of the Loins.—These are short, flat
muscles filling in the spaces between the transverse processes of the
lumbar vertebrse. They are attached to the anterior border of the trans- verse process of one vertebra and the posterior border of the one in front of it. Action.—They incline the loins to one side.
MUSCLES OF THE TAIL
Erector Coccygis. Origin.—From the sides and upper extremities of the three or four
sacral spines. Insertion.—To the superior surfaces of the tail bones by a succession ot
small tendons. Action.—When acting with the corresponding muscle of the opposite
side it would raise the tail. Acting alone, it would elevate it and incline it outwards. Depressor Coccygis.—This muscle is situated beneath the tail, and
consists of two muscular segments. Origin.—From the under surface of the sacrum.
Insertion.—Into the inferior face of the bones of the tail.
Action.—It pulls the tail downward or to one side, according as it acts
together with its fellow or alone. Curvator Coccygis.
Origin.—From the spines of the two or three posterior lumbar verte-
brse and from the posterior sacral bones. Insertion.—Into the side of the bones of the tail.
Action.—To move the tail to the side on which the muscle acts.
Compressor Coccygis.—A small triangular muscle situated at the
posterior part of the pelvis. |
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NECK AND TRUNK
11. External Intercostal Muscles.
12. Obliquus Interims.
13. Iliacus.
14. Gluteus Medius (Iliac portion).
15. Inferior Ilio-Sacral Ligament.
16. Sacro-Sciatic Ligament.
17. Great Sacro-Sciatic Foramen.
18. Gluteus Interims.
19. Quadratus Femoris.
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DEEP MUSCLES OF
1. Complexus.
2. Trachelo-Mastoideus.
3. Obliquus Capitis Inferior.
4. Obliquus Capitis Superior,
5. Rectus Capitis Anticus Major.
6. Scalenus.
7. Sterno-Thyro-Hyoideus.
8. Lateralis Sterni.
9. Longissimus Dorsi.
10. Transversalis Costarum.
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AXILLARY REGION 327
Origin.—From the internal surface of the sacro-sciatic ligament, and
from the ischiatic spine. Insertion.—Into the last sacral and the two first coccygeal or tail
bones. Action.—This muscle forcibly depresses the tail.
AXILLARY REGION
Superficial Pectoral.—Situated on the inner aspect of the arm. It
is broad above, and becomes narrower as it descends. In front it presents a thick fleshy mass, while its posterior part is flat and thin. This muscle forms the prominence so conspicuous in front of the breast. Origin.—From the lower border of the sternum or breast-bone, where
its fibres are interwoven with its fellow on the opposite side. Insertion.—Into the ridge in front of the humerus bounding the
tnusculo-spiral groove, and into the fascia covering the inner surface of the arm. Action.—To adduct or draw the limb inward towards the trunk, and to
tighten the fascia and brace the muscles of the arm. By some anatomists this muscle is divided into two parts, termed the
anterior and posterior superficial pectoral. Anterior Deep Pectoral.—A long fleshy muscle extending from the
side of the sternum upward in front of the scapula or blade-bone. Origin.—From the side of the sternum and the cartilages of the first
four ribs. Insertion.—Into the fascia covering the external surface of the scapula.
Action.—To pull the scapula backwards and downwards.
Posterior Deep Pectoral.—This is a broad, flat muscle of consider-
able length. It extends from the under surface of the abdomen along the side of the chest to the inner aspect of the arm. Origin.—From the fascia covering the under surface of the abdomen
ai*d the posterior part of the sternum. Insertion.—Into the internal tubercle of the humerus, the tendon of
0rigin of the biceps, and. the fascia which binds it down to the bicipital groove. Action.—To pull the scapula, and with it the limb as a whole, in a
backward direction. |
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MUSCLES OF THE FOEE EXTREMITY
EXTERNAL SCAPULAR REGION SupraspinatUS.—This muscle lies on the outer surface of the scapula
or blade-bone, the anterior half of which it covers. Origin.—From the whole of the outer surface of the scapula in front
of its spine, and from the spine itself. Insertion.—Below this muscle ends in two short tendons, which become
inserted into the inner and outer tubercle on the head of the humerus respectively. The large tendon of the biceps passes between them. Action.—To extend the humerus on the scapula.
Infraspinatus.—A fleshy muscle covering the posterior half of the
external surface of the scapula. Origin.—From the entire outer surface of the bone behind the central
ridge or scapular spine. Insertion.—By two short tendons, one into the outer tubercle of the
humerus, the other into the upper part of the ridge beneath it. A synovial bursa intervenes between the latter and the external tubercle over which it plays. Action.—It abducts the humerus or upper arm and rotates it outwards.
The Deltoid Muscle.—A short muscle on the outer aspect of the
shoulder and arm. Origin.—By a broad sheet of tendon from the scapular fascia, and from
the posterior or dorsal angle of the scapula. Insertion.—Into the external tubercle of the humerus.
Action.—To flex the humerus on the scapula and rotate it outwards.
Teres Minor.—Situated beneath the muscle last described.
Origin.—From the posterior border, and the lower part of the outer
surface of the scapula. Insertion.—Into the lower part of the bony ridge beneath the outer
tubercle of the humerus. Action.—To abduct the arm and rotate it outwards. Acting with the
teres major, it bends the upper arm on the scapula. INTERNAL SCAPULAR REGION
Subscapularis.—A broad, flat muscle covering over the internal f&ce
of the scapula or blade-bone, where it is lodged in a hollow or " fossa > which it fills. Origin.—From the internal surface of the scapula.
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Insertion.—Into the inner tuberosity on the head of the humerus. A
small synovial bursa is interposed between the tendon and the bone. Action.—To adduct or draw the shoulder towards the body.
Teres Major.—A narrow muscle tapering towards the extremities,
and situated on the internal face of the shoulder. Origin.—From the posterior or dorsal angle of the scapula, and from
the fascia underlying the subscapularis in front of it. Insertion.—With the latissimus dorsi, into a small tubercle on the
inner surface of the humerus. Action.—To flex the humerus on the shoulder and rotate it inwards.
Coraco-Humeralis.—A short muscle situated on the upper aspect of
the humerus or upper arm-bone. Origin.—From a small tubercle on the inner side of the lower extremity
of the scapula. Insertion.—By two divisions, one into the inner surface and the other
into the front of the humerus. Action.—To rotate the arm-bone inward and adduct the shoulder.
Scapulo-Humeralis Gracilis.—A very small slender muscle situated
at the back of the shoulder-joint. Origin.—From the lower part of the scapula behind, immediately above
the articular cavity. Insertion.—Into the posterior part of the humerus just below its head,
and into the capsular ligament of the joint. Action.—It prevents the capsular ligament of the shoulder-joint from
insinuating itself between the two bones. MUSCLES OF THE ARM
Flexor Brachii (Biceps of Man).—A long, round muscle with tapering
ends, largely intersected with bands of tendinous tissue. Origin.—From a bony projection (coracoid process) at the lower and
front part of the blade-bone. Insertion.—To a roughened bony eminence on the inner and upper
Part of the radius or lower arm, and by a band of fibrous tissue to the
ensheathing fascia of the arm. The tendon of this muscle passes over the
r°nt of the shoulder-joint and then over the " bicipital groove" on the
s,«nmit of the humerus.
Between the tendon and the groove there is a large synovial bursa to
Militate the play of the one over the other. Action.—It flexes the fore-arm on the humerus, and by tightening up
e investing fascia gives support to the muscles in this region. |
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Humeralis Externus.—This is a long fleshy muscle partly encircling
the upper arm. Origin.—It arises from the posterior part of the head of the humerus,
and winds round the outer side of the bone in the furrow of torsion. Insertion.—After crossing the elbow-joint, it becomes inserted partly
into the inner side of the head of the radius and partly also into the ulna. Action.—To flex the fore-arm on the humerus and rotate it outwards.
Scapulo-Ulnaris.—A broad, thin muscle extending from the scapula
to the elbow, on the inner aspect of the arm. Origin. —By a broad, thin aponeurotic tendon from the posterior border
of the scapula. Insertion.—Into the superior and posterior part of the olecranon or
elbow and into the fascia of the arm. Action.—To extend the lower on the upper arm, and to tighten the
fascia of the fore-arm to give the muscles support. Triceps Extensor Cubiti.—This is the largest muscle of the fore
extremity. It fills in the triangular space between the hinder edge of the shoulder
and the point of the elbow. It is made up of three portions or heads, dis- tinguished as the caput magnum or large head, the caput parvum or smali head, and the caput medium or intermediate. The caput magnum or large head arises from the posterior border of the
scapula as high as the dorsal angle, and the caput medium arises from the upper and outer part of the humerus. The caput parvum arises from the inner face of the same bone. Insertion.—All three divisions are inserted into the point of the elbow.
A synovial bursa is interposed between the tendon of the caput magnurA and the bone. Action.—To extend the fore-arm on the humerus.
Anconeus.—A small fleshy muscle situated in the angle between the
elbow and the arm. Origin.—From the lower extremity of the humerus behind.
Insertion.—Into the anterior and outer part of the ulna.
Action.—To assist in extending the lower on the upper arm.
Flexor Metacarpi Intemus (Internal Flexor of the Metacarpus or
canon).—This muscle lies on the inner and back part of the radius or i°r arm, with which it is in contact. Origin.—From the inner surface of the internal condyle of the humer
or upper-arm bone. |
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Insertion.—The tendon of iusertion commencing some distance ab
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the knee passes over a groove on the lower extremity of the radius,
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MUSCLES OF THE FORE EXTREMITY
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*s there surrounded by a synovial membrane; continuing downwards, it
becomes inserted into the head of the inner small metacarpal bone. Action.—To flex the knee-joint.
Flexor Metacarpi Medius (Middle Flexor of the Metacarpus or
canon).—Situated behind the fore-arm to the outer side of the preceding Muscle. It is divided above into two parts, the posterior of which is the smaller. Origin.—By its anterior and larger division from the internal condyle
°i the humerus immediately behind the internal flexor. By its posterior division from the upper and posterior part of the point of the elbow (olecranon). Insertion.—Into the upper border of the pisiform bone.
Action.—To bend the knee.
Flexor Metacarpi ExternilS (External Flexor of the Metacarpus or
canon).—Placed on the outer and posterior part of the fore-arm. Origin.—From the point of the ridge on the outer and inferior extremity
°* the humerus. Insertion.—By two tendons—(l) a broad flat one into the upper border
°t the pisiform bone; (2) a short round one into the head of the external sQiall metacarpal bone. The latter passes over a groove and through a synovial sheath on the outer surface of the pisiform bone. Action.—To bend the knee.
Flexor Pedis PerforatUS.—Superficially placed behind the lower
arm. Origin.—From a ridge on the inner and inferior part of the humerus
y a tendon common to this muscle and the flexor pedis perforans. Insertion.—About the middle third of the radius the tendon of this
uscle is joined by a strong band of fibrous tissue (superior check ligament). s tendon then passes behind the knee, where it is enclosed in the carpal eath, and, coursing its way downwards, ultimately divides into two short ailches, which become inserted into the posterior upper border of the aU pastern bone (second phalanx). Action.—To flex the pastern and the knee. Flexor Pedis Perforans.—This muscle is situated behind the lower
> with which it is in contact. It is composed of three unequal portions
ne humeral, the ulnar, and the radial. The humeral is much the largest
ne three, and constitutes the chief bulk of the muscle.
i ri9ln.—It arises (l) from a ridge on the inner and inferior part of the
erus; (2) from the upper and posterior part of the ulna; (3) from the
Posterior surface of the radius.
lsertion.—The three portions unite and form one common tendon,
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which proceeds downwards to the foot. In its course it passes, in com"
pany with the flexor pedis perforatus tendon, over the back of the knee, where it is bound down by the carpal sheath and lubricated wit» synovia. Below the knee it is joined by a strong fibrous band, the checK ligament or inferior carpal ligament. Thence it continues downward behind the canon, over the fetlock-joint, where it is encircled by tendinous offshoot from the perforatus. Behind the pastern it passes between the divided tendon of the flexor pedis perforatus, and ultimately enters the foot, where, after widening out beneath the navicular bone, i becomes inserted into the under surface of the os pedis. Action.—To flex the pastern on the fetlock, and through it the knee also-
Lumbricales.—These are two very small muscles, one of which lS
situated on each side of the tendon of the flexor pedis perforans. Origin.—From the sides of the perforans tendon.
Insertion.—By a very fine glistening tendon into the fibrous pad behin1
the fetlock-joint. Action.—No doubt at one time these muscles played an important par
in the function of the foot, but in their present attenuated condition theJ serve but little or no purpose. Extensor Metacarpi Magnus.—This is a muscle of considerable
size and strength, and gives to the upper part of the arm in front 1 prominence and width. Origin.—In common with the extensor pedis from the outer surfa
of the external condyle, and from the ridge above it. Insertion.—By a strong tendon which, after passing over a groove o
the lower part of the front face of the tibia and the knee-joint, becorfl inserted into a bony prominence on the superior and anterior part of large metacarpal or canon bone. In passing over the knee, the tend of insertion plays through a synovial sheath, which facilitates its m° ments during flexion and extension of the joint. Action.—To extend the canon and knee bones on the fore-arm.
Extensor Metacarpi Obliquus.—A small muscle placed on the oute
side of the lower arm.
Origin.—From the external surface of the radius. ■.
Insertion.—The tendon of this muscle passes obliquely forward a
inward over a groove on the radius to reach the inner side of the »'
. l or where it becomes inserted into the head of the inner small metacarpal
splint bone.
Action.—To extend the canon on the fore-arm and rotate it outward •
Extensor Pedis.—This muscle lies on the outer part of the fore-ar ; inclining to the front and immediately behind the extensor metac
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MUSCLES OF THE RIBS
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Magnus. It consists of two unequal portions, each having a separate
tendon. Origin.—From the outer and lower part of the humerus, the lateral
ligament of the elbow-joint, and the upper and outer part of the radius. The two tendons of this muscle pass over a groove in front of the lower
end of the fore -arm, then over the front of the knee-joint, where they are enclosed in a synovial sheath and bound down by the annular ligament °f the knee. On reaching the canon, the outer tendon joins with that of the extensor suffraginis. The inner and main division proceeds downward °ver the front of the large metacarpal bone to the fetlock-joint, where it plays over a small synovial bursa. Lower down it is closely attached to the os suffraginis, or large pastern-bone, in the middle of which two branches of the suspensory ligament—an inner and outer—join it. Thus reinforced, it passes over the small pastern and enters the hoof. Insertion.—Into the pyramidal process of the os pedis, or foot-bone. Action.—To extend the fetlock on the canon and the knee on the fore-arm. Extensor Suffraginis.—A small muscle situated on the outer part
1 the fore-arm, between the extensor pedis and the flexor metacarpi externus. Origin.—From the external lateral ligament of the elbow-joint, and
r°m the external tuberosity and outer side of the radius and ulna. Insertion.—The tendon of this muscle, after passing over a groove on
fre inferior and outer part of the radius or fore-arm, and through a synovial
fteath on the outer side of the knee, becomes united with the outer branch
the tendon of the extensor pedis and a fibrous slip from the external
"1(1e of the carpus. Thus strengthened, it passes along the outer front part
the canon-bone to the fetlock-joint, where it plays over a synovial bursa
^ becomes inserted into the anterior and upper part of the first phalanx
r large pastern.
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fore
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Action.—To extend the fetlock on the canon and the knee on the
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arm.
MUSCLES OF THE EIBS
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. Serratus Magnus.—A broad fan-shaped muscle situated on the side
ne chest and partly concealed beneath the shoulder.
Attachments.—Below, to the outer surface of the first eight ribs, by
• responding number of slips, which give it a serrated border from which
t, ^es its name. Above, to the under surface of the upper extremity of
e scapula or blade-bone.
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Action.—When the horse occupies a standing position, this muscle,
with its fellow on the opposite side, supports the trunk as if in a sling (fig. 44, Vol. I). When it acts from the chest it pulls down the posterioi angle of the scapula and moves the point of the shoulder upward and forward. When the limb is fixed, it pulls the ribs upward and forward, and by enlarging the chest becomes a muscle of inspiration. External Intercostal Muscles.—These form a series of thin, flat
muscles occupying the spaces between the ribs from near the spme
downward to their inferior extremities. The fibres take an oblique direction from before downward and backward. Each muscle originate from the posterior border of one rib and is inserted in the anten01 border of the rib succeeding it. Action.—To draw the ribs upward and forward and assist in ]11'
spiration. Internal Intercostal Muscles.—Placed beneath the muscles last
described. These also occupy the spaces between the ribs, and in additio1
extend between the sternal cartilages below. They resemble the extei- nal intercostals in their general form, but their fibres take an opp°slt course, viz. downward and forward, so that the two sets cross each othe like the lines of the letter X. Origin.—From the anterior borders of the ribs.
Insertion.—Into the posterior borders of the ribs in front.
Action.—To assist in expiration.
Levatores Costarum.—These are situated beneath the longissn»u
dorsi, and form a long series of small flat muscular slips passing downwa and backward from the spine to the superior part of the ribs. . Origin.—They arise from the transverse processes of the dors
vertebrse. Insertion.—Into the outer surface of the rib behind the vertebra ff°
which each respectively arises. Action.—To draw the ribs forward and assist in inspiration.
Triangularis Sterni.—A flat muscle situated on the floor of ta
chest from one extremity to the other. Origin.—From the superior surface of the sternum.
Insertion.— By a series of slips into the cartilages of the ribs, ir
the 2nd to the 8th. Action.—To assist in expiration.
Lateralis Sterni.—A thin, narrow, flat muscle placed on the on
part of the chest in front. Origin.—From the external surface of the first rib. ,
Insertion.—From its origin it passes obliquely downward and
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ward, and is inserted into the outer part of the sternum and the 3rd and
4th sternal cartilages. Action.—It is not definitely known whether it contributes to inspiration
or expiration. ABDOMINAL MUSCLES
Panniculus CarnosUS.—This is a thin, broad sheet of muscular tissue
Spread over a large extent of the surface of the body, especially the sides °i the shoulder, chest, and belly, the front of the neck, and the sides of "the face. It is connected above and below with considerable aponeurotic "tendons, which attach it to the dorsal and lumbar spines, the flank, the inner side of the arm, the neck, and the abdominal tunic. Insertion.—By its fleshy fibres into the under surface of the integu-
ment. It is this muscle which imparts that vigorous movement to the skin when flies or other matters irritate it and require to be dislodged. Abdominal Tunic.—When the panniculus carnosus is removed, a
broad sheet of yellow elastic tissue is exposed, spread over the under surface and sides of the abdomen, to which the term " abdominal tunic " ls given. This elastic layer is thick behind, and gradually thins as it passes forwards and upwards over the sides of the belly. Posteriorly it divides and gives a layer to the sheath, which it supports
as in a sling. In the stallion this segment is of considerable thickness, arid assists in sustaining the penis when in a state of erection. It is known as the " suspensory ligament of the sheath ". In the female a similar division takes place, by which each milk-gland
becomes invested in an elastic capsule. Generally considered, the abdo- minal tunic supplies a large bandage, which braces up the abdominal Muscles and enables them to support the weight of the organs con- ained in the belly. In old brood mares it is of considerable thickness, °wmg to the additional weight imposed upon the walls of the belly during succession of pregnancies. The muscles proper to the abdomen are eight in number, four on either
ue. They comprise the external oblique muscles, the internal oblique, e transversalis, and the straight. -the three first named possess broad, aponeurotic tendons, all of which
Uverge towards the centre of the belly and intermix their fibres, as a ult of which a dense white band is formed, extending from the pubis
lnd to the sternum in front. This band is termed " linea alba" or
ite line ^ little behind the middle of this line a lozenge-shaped space
spears, in which the umbilical opening or navel originally existed. |
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336 HEALTH AND DISEASE
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ObliqilUS Abdominis Externus (External Oblique Muscle of the
Abdomen).—This is the outermost and the largest of the abdominal
muscles. It is broad behind and narrow in front, and gives off a wide aponeurotic tendon, which passes obliquely downward and backward. Origin.—From the outer surface of the thirteen or fourteen posterior
ribs and from the tendon of the latissimus dorsi. Insertion.—Its fibres take an oblique direction downward and back-
ward, and give off a wide aponeurotic tendon, which becomes inserted into (l) the linea alba in the centre of the belly, (2) the pubis, (3) the external angle of the ilium or haunch-bone. Between the two last named points of insertion the tendon forms an arch known as " Pou- part's ligament". Near the pubis its fibres divide and form an ellip" tical opening, the external ring for the passage of the testicle into the scrotum. Action.—To flex and arch the back and to assist in expiration. By
forcible compression of the abdomen it becomes an active agent in urina- tion, defcecation, and parturition. Obliquus Abdominis Internus (Internal Oblique Muscle of the
Abdomen).—Like the muscle last described, the internal oblique muscle is flat, and comprises a thick, fan-shaped fleshy portion spreading out from above forward and terminating in a broad aponeurotic tendon. *-t is situated in the region of the flank, and its fibres proceed from behind downward and forward, and in so doing cross those of the external oblique muscle as they pass backwards. Origin.—From the external angle of the ilium or haunch-bone, and
the contiguous fibres of Poupart's ligament. Insertion.—Into (l) the symphisis pubis, (2) the linea alba, (3) and
the cartilages of the last four or five ribs. Action.—The same as the external oblique.
Rectus Abdominis (Straight Muscle of the Abdomen).—A long'
somewhat wide muscle passing from the sternum or breast-bone in front t the pubis behind. It is situated between the broad tendons of the interna oblique and the transversalis muscles, and forms the principal part of tn floor of the abdomen. It is marked by a number of transverse lmefT (linese transversee), due to short tendinous intersections. It joins * fellow in the middle line of the belly. Origin.—From the sternum, and cartilages of the ribs from the oi
to the 9th. Insertion.—Into the anterior border of the pubis.
Action.—To flex the spine, and, by compressing the abdomen, to ass
in expiration, urination, defoecation, and parturition. |
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Transversalis Abdominis (Transverse Muscle of the Abdomen).—
The innermost of the abdominal muscles. Like those already referred to, it consists of a flat fleshy portion and a broad aponeurotic tendon. Origin.—From the lower extremities of the false ribs, and from the
transverse processes of the lumbar vertebrae. Insertion.—Into the linea alba and the ensiform cartilage. The
internal surface of this muscle is covered by peritoneum. Action.—The same as the oblique muscles.
Diaphragm or Midriff.—The diaphragm is the muscular and ten-
dinous partition which divides the chest from the abdomen (fig. 377). |
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Fig. 377.—The Diaphragm and Sub-lumbar Muscles, seen from below
1, Fleshy periphery of Diaphragm. 2, Tendinous centre of Diaphragm. 3, Right Pillar. 4, Left
"'liar. 5, Psoas Magnus. 6, Psoas Parvus. 7, Iliacus. 8, Tensor Fascias Latse. 9, 9, Rectus Femoris. ■10, Adductor Longus. 11, Sartorius (cut to show underlying muscle). 12, Gracilis. 13, Obturator Externus. 14, Quadratus Femoris. 15, Crureus. 16, Quadratus Lumborum. 17, Hiatus Aorticus and Posterior aorta. 18, Foramen Sinistrum and (Esophagus. 19, Foramen Dextrum and Vena Cava. 20, Ensiform Cartilage. t passes obliquely downward and forward from the spine above to the
sterimm below. It is convex in front and concave behind. The muscular
Portion is situated around the circumference, and encircles a broad, flat,
glistening tendon. Connected with the latter are two fleshy bundles
tuated in the centre towards the spine; these are known as the pillars
the diaphragm, and are united with the tendinous portion in the centre.
ree openings are observed in this partition. 1. The Foramen sinistrum,
lough which the oesophagus or gullet passes from the chest into the
^odomen. This is situated above, a little to the left of the middle line.
• i-he Foramen dextrum, by which the posterior vena cava reaches the
est- It passes through the middle of the central tendon. 3. The
V°L. II. 56
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HEALTH AND DISEASE
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338
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Hiatus Aorticus gives passage to the posterior aorta, the vena azygos, and
the thoracic duct. It is situated immediately beneath the spine, and is formed by the separation of the two muscular pillars. Action.—When the diaphragm contracts it passes in a backward direc-
tion, and in so doing enlarges the chest so that the lungs may be filled with air. It is, therefore, a muscle of inspiration. |
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THE ABDOMINAL CAVITY, OR CAVITY OF
THE BELLY Placed behind the chest, from which it is separated by the diaphragm;
the abdominal cavity passes backward and becomes continuous with the pelvis. It is the largest cavity of the body, bounded above by the loins 01 lumbar division of the spine, below and at the sides by muscles. tendons, and elastic tissue, already described. Contained within it are che stomach and bowels, the liver, pancreas, spleen, kidneys, and numerous vessels; nerves, and lymphatic glands. In the female it also contains the ovaries and the horns of the uterus. For convenience of description of the position of parts within it the
abdomen is arbitrarily divided into nine portions, of which three are situated in front, three in the middle, and three behind. This division is effected by cutting the body across by two imaginary vertical planes, one passing through the lower extremity of the fifteenth rib, the other trans- versely through the external angle of the haunch-bone. The three divisions thus made are subdivided by two longitudinal planes which fall through the centre of Poupart's ligament on the right and left side respectively, anC cut each of the three primary divisions into a central and two latere portions. As a result of this we get the nine parts described and figure below. |
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MUSCLES OF THE CROUP
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339
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MUSCLES OF THE CEOUP
Superficial Gluteus.—The most superficial muscle of the croup. It
ls V-shaped, and situated immediately beneath the gluteal fascia. Origin.—By its anterior arm from the point of the ilium or haunch-
oone. By its posterior arm from the gluteal fascia. Passing downward these two branches converge and unite. Insertion.—Into the trochanter minor externus, a bony prominence on
the outer face of the thigh-bone. Action.—To abduct or draw the thigh outward.
Middle Gluteus.—This is a thick, broad, fleshy muscle to which the
croup owes its characteristic roundness. In a forward direction it extends for some distance over the loins, and terminates behind in the upper extremity of the femur or thigh-bone. Origin.—(l) From the superior surface of the longissimus dorsi in front.
(2) From the superior or dorsal surface of the ilium, and the sacro-sciatic and the ilio-sacral ligaments. Insertion.—By three branches into the upper extremity of the femur.
Action.—To extend the thigh on the pelvis and incline the entire limb
Outwards. When the hind limbs are fixed it assists in rearing. Acting from before as a fixed point it takes part in kicking. The Deep Gluteus.—A small but strong muscle placed between the
0ne last described and the hip-joint. Origin.—From the superior surface of the ilium and from the ischium
aWe the hip-joint. Insertion.—Into the margin of the lower division of the great trochanter
°f the femur. Action.—To abduct the limb and rotate it inwards.
MUSCLES OF THE HIP AND THIGH
Tensor Vaginae Femoris.—A thin triangular muscle situated in front
01 the thigh, having its base directed downwards. By its posterior border t ls intimately connected with the anterior branch of the superficial gluteal Uscle, and below it gives off a somewhat broad aponeurotic tendon. Origin.—From the external angle of the ilium or haunch-bone.
-Insertion.—Into the fascia lata, or membrane investing the muscles of
the second thigh. Action.—It braces up the muscles and flexes the thigh on the pelvis.
Rectus Femoris (Straight Muscle of the Thigh).—This is a thick,
nded muscle covering the front of the femur.
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340 HEALTH AND DISEASE
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Origin.—By two short tendons, one from the upper and the other from
the under surface of the ilium in front of the hip-joint. Insertion.—•Into the upper and anterior part of the patella.
Action.—To flex the femur on the pelvis and extend the tibia or lower
thigh on the stifle. Vastus Externus.—A fleshy muscle covering the whole of the outer
surface of the thigh-bone. Origin.—From the outer surface and front of the femur.
Insertion.—Into the upper and outer part of the patella or " knee-cap
of the stifle-joint. Action.—To extend the tibia or lower thigh-bone on the femur.
Vastus Internus.—A thick fleshy muscle lying on the inner face of
the thigh-bone. Origin.—From the internal surface and front of the femur.
Insertion.—Into the upper part of the patella and its internal lateral
ligament. Action.—To extend the tibia on the femur.
Rectus Parvus.—A small short muscle placed in front of the hip-
joint immediately in contact with the capsular ligament. Origin.—From the ilium above and in front of the joint. It passes
between the vastus externus and internus. Insertion.—Into the superior part of the femur in front.
Biceps Femoris.—A long, thick, fleshy muscle extending from the
superior part of the croup to the stifle. It is narrow above and widens out below, where it is divided into three segments. Origin.—From the superior spines of the sacrum, the sacro-sciatic liga'
ment, the gluteal and coccygeal fascia, and the tuberosity of the ischium. Insertion.—By the three lower divisions: (l) Into the anterior part o
the patella or knee-cap; (2) into the crest of the tibia; (3) into the fascia of the leg. This muscle is maintained in its position behind the femur by a strong
band of connective tissue which attaches it to the upper and posterior pal* of that bone. • T ' "f11*1
Action.—It flexes the tibia or leg-bone on the femur, and, acting WUi
its fellow on the opposite side, it assists in supporting and balancing %^ body in the act of rearing. The Semitendinosus.—Situated immediately behind the biceps. A
long fleshy muscle arising by two heads, and extending from the summit the haunch to the superior part of the tibia. Origin.—By one head from the spines of the sacrum and the sac
sciatic ligament, and by the other from the tuberosity of the ischium. |
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MUSCLES OF THE HIP AND THIGH 341
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Insertion.—Into the crest of the tibia and the fascia of the leg.
Action.—To flex the stifle and rotate the leg inwards. It also assists in
the act of rearing, and braces up the fascia of the leg in support of the muscles. Semimembranosus.—A somewhat considerable muscle placed behind
aQd to the inner side of the one last described, and extending from the root of the tail downward to the inferior extremity of the thigh. Origin.—From the under surface of the ischium and its tuberosity,
aud from the fibrous aponeurosis at the base of the tail. Insertion.—Into the internal condyle of the femur.
Action.—To adduct the limb and extend the thigh on the pelvis.
When the femur is fixed it assists in rearino-. INTERNAL CRURAL REGION
SartorillS.—This is a long slender muscle partly contained in the
abdominal cavity, after leaving which it traverses the inner part of the thigh. Origin.—From the fascia (iliac fascia) on the under surface of the ilium
0r haunch-bone. Insertion.—Into the internal straight ligament of the patella.
Action.—To adduct the leg and flex the femur on the pelvis. Gracilis.—A flat four-sided muscle situated beneath the skin in the ^Qer aspect of the thigh, which it wholly covers. Origin.—From the under surface of the pelvis along the side of the
Scmo-pubic symphysis, where its fibres interlace with those of its fellow 11 the opposite side. Insertion.—Into the internal straight ligament of the patella and the
eternal face of the tibia. Action.—To adduct the leg and brace up the fibrous investment of the
§ (tibial aponeurosis). -Lhis muscle is attached to the sartorius in front. "6ctineus.—The pectineus is a conical muscle, with its base directed
PWards. It is divided above by the pubio-femoral ligament which passes ween its two segments on its way to the hip-joint. Vfigin.—By two branches from the under surface of the pubis. -Insertion.—Into the inner surface of the thigh-bone about its middle. •Action.—To adduct and flex the thigh and rotate it inwards. „ Adductor Parvus.—A small muscle deeply situated in the substance 0t the thigh. rigin.—From the under surface of the pubis.
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342
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Insertion.—Into the middle of the posterior aspect of the femur.
Action.—To adduct the limb and rotate it outwards.
Adductor Magnus.—A long thick muscle placed on the inner part of
the thigh. Origin.—From the under surface of the ischium and from the tendon ox
the gracilis. Insertion.—By two divisions: (l) Into the posterior surface of the
middle third of the femur; (2) into the same bone above the internal condyle. The femoral artery passes between the two insertions. Action.—To adduct the limb.
Quadratus Femoris.—This is a small flat band lying deep in the
substance of the thigh behind. Origin. — From the under surface of the ischium in front of the
tuberosity. Insertion.—Passing in a forward and downward direction it becomes
inserted into the posterior aspect of the femur, a little below the bony projection (trochanter minor internus) on the inner side of the bone. Action.—To extend the femur on the pelvis and adduct the leg.
Gemelli.—A small, flat, thin muscle situated behind the last described.
Origin.—From the external border of the ischium.
Insertion.—Its tendon joins with those of the obturator internus and
pyriformis, and the three together become inserted into the trochanter!0 fossa (a pit behind the head of the thigh-bone). Action.—To rotate the femur outwards. Obturator Externus.—This is a small, thin, flat muscle situated
beneath the pelvis. It covers the obturator foramen, and its fibres con- verge outwards, and end in a short flattened tendon. Origin.—From the under surface of the pubis and ischium.
Insertion.—Into the trochanteric fossa behind and below the head ot
the femur. Action.—It assists in extending the femur on the pelvis and rotating
the hip outwards. Obturator Internus.—A small flat muscle situated on the floor of
the pelvis, where it is spread over the obturator foramen. Origin.—From the inner circumference of the obturator opening.
Insertion.—By a tendon common to this muscle and the pyriformis to
the large depression (trochanteric fossa) on the upper and back part of tne femur. Action.—It rotates the femur outwards.
Pyriformis.—A small flat muscle situated within the pelvis.
Origin.—From the internal surface of the ilium near the hip-joint.
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MUSCLES OF THE LEG
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343
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Insertion.—Into the trochanteric fossa, a deep cavity behind and below
the head of the thigh-bone. Action.—To rotate the femur outwards.
MUSCLES OF THE LEG
OUTER ASPECT OF THE LEG Extensor Pedis.— This muscle is situated on the outer and front
aspects of the limb between the stifle and the hock-joint. It is thick in the middle and tapering towards the extremities. Origin.—By a short strong tendon (together wTith a branch from the
flexor metatarsi) from a depression on the inferior extremity of the femur " between the trochlea and the external condyle. Insertion.—The tendon, which commences above the hock, is tied down
by three transverse bands, one above the hock, another below it, and a third in front of it. It then passes in front of the canon, where it is joined by the tendons of two muscles, viz. the peroneus and the flexor metatarsi parvus. In passing over the fetlock-joint a synovial bursa intervenes between it and the capsular ligament. About the middle of the first Phalanx (suffraginis) it is joined on either side by a strip from the sus- pensory ligament, and ultimately becomes attached to the coronal process °f the os pedis, or foot-bone. Action.—To extend the foot and pastern and flex the hock.
Peroneus.—A small elongated muscle placed behind the one last
described on the outer side of the leg. . Origin.—From the outer part of the fibula and the external lateral
hgament of the stifle. Insertion.—The tendon of the peroneus in its downward course passes
0ver a groove on the outer and lower extremity of the tibia or leg-bone,
hence over the outer side of the hock-joint, where it is contained in a
canal and invested by a synovial sheath. On emerging from its enclosure
passes obliquely forward and joins the tendon of the extensor pedis
111 the middle of the canon. Action.—To assist the last-named muscle.
Flexor Metatarsi.—The flexor metatarsi is placed on the anterior
ia- outer face of the tibia, and extends from the stifle to the hock-joint. Origin.—A tendinous band from this muscle blends with the tendon of
^m of the extensor pedis, and is attached to the lower extremity of the
. ruur between the external condyle and trochlea. The muscular division
connected with the upper and outer part of the tibia.
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344 HEALTH AND DISEASE
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Insertion.—In front of the hock the tendon breaks up into several
branches, which become inserted into the front of the upper extremity oi the large metatarsal bone (canon) and into the small bones of the hock- One of these branches passes over a synovial membrane on the cuneiform parvum. Action.—To flex the hock.
Extensor Brevis.—A short, flat, thin muscle situated in front and
below the hock-joint beneath the tendons of the extensor pedis and peroneus. Origin.—From the outer part of the os calcis and the astragalus.
Insertion.—Into the extensor pedis tendon.
Action.—To assist the extensor pedis.
POSTE-KIOR ASPECT OF THE LEG
Gastrocnemius.—A short stout muscle situated behind the leg. ^
consists of two separate portions, which converge and unite below to fori11 a single strong tendon. Origin.—From either side of the supracondyloid fossa at the lower and
back part of the femur. Insertion.—Into the middle of the summit of the os calcis, or point ot
the hock. A small synovial bursa is interposed between the anterior face of the tendon and the portion of the os calcis in front of it. By this means the parts move freely over each other when the hock is flexed. Prior to its insertion into the point of the hock the tendon of this
muscle is joined by that of another small muscle—the soleus. Action.—To extend the hock.
Soleus.—A small muscle situated on the outer aspect of the leg.
Origin.—From the outer surface of the head of the fibula.
Insertion.—Into the tendon of the gastrocnemius.
Action.—To assist in extending the hock.
Flexor Pedis PerforatuS (Superficial Flexor of the Pastern).—Thi3
is a round cord-like muscle in which tendinous tissue predominates. I* ** placed in front of the gastrocnemius, which completely covers it. Origin.—From a deep depression (supracondyloid fossa) at the inferi°
and posterior part of the femur. In passing down the leg the tendon c this muscle gets behind the gastrocnemius tendon by winding round J inner side. It then spreads out and becomes attached by means of shor^ tendinous slips to either side of the point of the hock to which it ll0 forms a cap. A small synovial bursa is interposed between the two par to facilitate the movement of one upon the other. |
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MUSCLES OF THE LEG
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345
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Insertion.—Continuing its course down the back of the canon it ulti-
mately divides into two branches and becomes inserted into the upper and posterior part of the second phalanx or small pastern-bone. The perforans tendon passes between these two branches on its way to the foot. Action.—To flex the pastern on the fetlock-joint, and extend the hock
on the tibia. PopliteilS.—Situated behind the stifle-joint, over which it passes
obliquely downward and inward in close contact with the upper extremity •of the tibia. Origin.—From the external condyle of the femur by a short tendon
which is lubricated with synovia in passing over the joint. Insertion.—Into the upper and posterior part of the tibia.
Action.—To flex the tibia on the femur, and rotate it inwards.
Flexor Pedis Perforans (Deep Flexor of the Foot).—A long muscle
Situated behind the tibia or leg-bone, with which it is in contact. Origin.—From the posterior surface of the tibia and the fibula.
Insertion.—After passing over the back of the hock, where it moves
through a synovial membrane and is bound down by the tarsal sheath, the tendon of this muscle continues its course downward, and becomes inserted mto the under surface of the pedal or foot-bone. About the upper third of the metatarsus or canon it is joined by the
■check ligament, as in the fore-limb. Action.—It flexes the foot and fetlock, and assists in extending the
hock. Flexor Pedis Accessorius (Accessory Flexor of the Foot and
Pastern).—A small muscle situated at the back of the leg on the inner side of the one last described. Origin.—From the upper and back part of the head of the tibia or leg-
"bone. Insertion.—After passing through a groove on the inner side of the
hock-joint, where it is lubricated with synovia, the tendon of this muscle continues downward to blend with that of the flexor pedis perforans about *ne upper third of the canon bone. Action.—To assist in flexing the foot and fetlock.
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346 HEALTH AND DISEASE
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18. DISEASES OF THE JOINTS, MUSCLES,
TENDONS, AND LIGAMENTS (See also pp. 279-305)
DISLOCATIONS
Dislocation results where the articular ends of bones which enter
into the formation of a joint are displaced. Bones forming joints are held together by ligaments and muscles.
When dislocations occur these are sprained or ruptured to a greater or less degree in the forcible separation of the bones. Dislocations may be divided into congenital, and acquired or acci-
dental, in each of which displacement may be only partial or complete. In the former it is invariably brought about by some arrest of develop- ment, or injury to parts sustained during gestation. " At the period of birth we occasionally meet with congenitally mal-
formed limbs, depending either on the flexors or the extensors being too short. It is by far most commonly the flexors which are implicated, thus causing the animal to go on his toes, thereby distorting the limb or limbs. This distortion may be so slight, that in the process of development, if clue attention be paid to the shape and position of the feet, no opera- tion, either mechanical or surgical, is required. But should the limk> be to a greater extent malformed, it will be necessary to pay even more than usual attention to the feet, and, as soon as time will admit ot shoes being placed on them, let it be done. These shoes should have a piece of iron projecting from the toe, from 2 to 3 inches in lengthr and slightly curved upwards (fig. 380). At the same time the heels ro«st be kept low. "The kinds of deformities met with in the growing horse are: first,
congenital and extreme flexure of the pedal bone upon the os corona (Plate XLII, fig. 1), depending upon the perforans tendon being too short, secondly, permanent flexure of the pastern bones upon the large metacarpa bone (Plate XLII, fig. 2). The perforatus tendon being too short will be found productive of this distortion; sometimes it is also connected wrW1 disease of the dense membranous sheath which invests it posteriorly- Depending upon the degree or angle at which the bones are placed, mus be our remedial measures. If the distortion be but slight, mechanic* means only need be resorted to; if greater, a surgical operation conjoine with some mechanical contrivance will be found to be absolutely necessary- " In the second instance, where the extensors are too short the to
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>
H a
X
r |
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2 3 4 5
MALFORMATIONS OF THE LEGS
I. Contraction of Perforans tendon. 2. Contraction of Perforatus tendon. 3. Contraction of Perforatus and Perforans tendons.
4. Contraction of Extensor Pedis tendon. 5. Overshot Fetlock Joint. 6. Contraction of Subcarpal or Check Ligament. |
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DISLOCATIONS
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347
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will be turned up (Plate XLII, fig. 4), the animal going on the posterior
part of the foot and maybe the fetlock. This depends upon the tendon of the extensor pedis being too short. The ligament also, which extends from the outer and inferior part of the knee to the upper and anterior part of the first phalanx, takes its share in producing this effect. Here also, as in the first instance, must our remedies be regulated by the amount or degree of distortion. " Thirdly,—Occasionally we meet with instances of a bowing outwards
of the fetlock-joints. In such cases the external lateral ligaments are too long, and the internal ones too short. Or in others, which are rare, the reverse of this exists; when the fetlock-joints will approach each other too near, the feet turning outwards. Of course, under such circumstances, the lateral ligaments Avould be the reverse of the former as to their comparative length. In either instance we should not be justified in Resorting to any surgical operation. In some slight cases, if proper atten- tion be paid to the shape of the feet during the period of development, ttiuch may be done towards improving the position of the bones we are now considering. "Another kind of deformity often exists below the parts we have
Deen describing, namely, at the joints formed by the pedal bone and os coronse, and to a slight extent between the os coronae and os suffraginis. J-his, although there may be a natural tendency to it, often develops during the growth of the animal, from a neglect of those who superintend the rearing of colts, especially as to the wearing away of the hoofs; blowing the inner and front part of the foot to be elongated, thereby throwing the weight and the wear upon the outside of the foot, and thus Producing that condition commonly called ' pigeon-toed'. Or, on the other hand, the outer and anterior part of the hoof may become similarly Ungated, and the weight is then thrown upon the inner side, the effect °t which is obvious. " In a horse with congenital malformed limbs, the bones, in the
Process of growth, become fashioned to the form of the limb, so that if
^e animal be neglected until he has arrived at adultism, no procedure,
either surgical or mechanical, will produce the effect we are desirous of
otaming. But during growth, the parts being then pliable, by altering
"Q position of the foot, and by some contrivance placing the limb in a
ate favourable to cause a proper development, our object may be gained.
In young horses it is common to meet with a knuckling forwards of
tile hind fetlocks (Plate XLII, fig. 5), so much so that at times the front of
. e joint is on a perpendicular line with the toe. This condition is seen
most cases only at times, generally when the animal is standing; or,
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HEALTH AND DISEASE
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348
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he may walk in this manner, except at intervals. The veterinary
surgeon is often called upon to give an opinion respecting these cases. He examines the joints by careful manipulation, and he minutely traces the tendons along their length, but finds no lesion of any kind present. There may be, however, more or less fulness of the bursse above the fetlock. The question has often been asked : ' What is the pathology of this affec- tion, and what parts are implicated which cause the animal to place himself in this position?' It seems to be a commonly received opinion that putting horses to hard work too early is the principal exciting cause, and the result of my own observations leads me to think that this is correct. It is likewise asserted by some persons, that bad constitutions, independent of early and hard work, tend to induce it. This probably may be the case; still, we see the affection in horses having the best constitutions. Colts with naturally formed upright pasterns are, if worked too early, particularly predisposed to become thus affected. " The next question is: What can be done to restore the parts to
their normal condition? At this stage of the affection no operation is indicated, because we can detect no shortening of the tendons or liga- ments. I would advise that the animal be thrown altogether out of work; that mild blisters be applied to the fetlock-joints, and repeated a second or a third time; after which the horse should be allowed as long rest as may be considered necessary. But even after this, the owner must not be too sanguine as to the benefit to be derived from such treatment. If due time is allowed, the horse may return to his work and show no signs of his former affection, and in some instances he will continue sound; but it is more likely, after having been worked hard fov a time, we shall find that the parts will return to the same condition as at first. This may continue for an indefinite period, depending upon the severity of the work the animal is put to, before the affection merges into permanent flexure of the fetlock-joint. If we now examine the limb from a little above the fetlock posteriorly downwards to the insertion of the perforatus tendon, we shall detect a rigidity of structure, which in most cases is attended with thickening. Nothing now wi" restore the limb to its former position but an operation, and the propriety of its being performed we will now consider. " The incapability to extend the foot depends, no doubt, as in all
deformities of the kind, upon the length of the tendons or ligaments, between their two fixed points, being from some cause or other diminished- We shall here find that this abnormal condition of the tissue exists at such a part as either forbids or allows of relief by operation, whicli is the only means by which the obstacle to either flexion or extension |
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DISLOCATIONS
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349
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can be remedied. The cases referred to, in most instances, depend on
the perforatus and its outer dense fibrous membrane, extending from the superior part of the sesamoid bones to where the tendon becomes inserted into the supero-posterior part of the os coronse, and which is continuous with the fibrous frog, becoming more or less thickened, and sometimes semi - cartilaginous; consequently they are shortened at this particular part. Taking a view of the anatomical relationship of these structures, forming as they do a synovial sheath for the perforans, and also their pathological condition, we should not be justified in using the scalpel, especially as the only chance of effecting our object would be by operating below the fetlock-joint, and this we should not be warranted in doing."—Varnell. ACCIDENTAL DISLOCATIONS
Accidental dislocations are as numerous almost as the joints them-
selves; horses, by the nature of their employments and the dangers to which they are exposed, incur injuries which dislocate and damage the joints of the limbs, and less frequently those of the spine and other parts of the skeleton. The liability to dislocation is much greater in some joints than in others. This depends partly on the form and character of the joint itself, and partly also on the strength of the ligaments and muscles which unite and support it. The rarity of dislocation of the hip is due to the depth of the cup into which the head of the femur fits, and the strength of the ligaments and muscles which bind them together. The relative frequency of luxation of the patella may be ascribed to the facility with which the bone is under some cir- cumstances enabled to glide over the outer small ridge of the femur Upon which it plays. Luxation of certain bones, notably the patella, is sometimes due to
extreme debility and weakness, while in others it follows upon contraction of the tendons induced by hard work, sprains, and other injuries, familiar examples of which are to be seen every day in our streets. " Upright" *s the term used to denote such cases of partial dislocation occurring in the Region of the pastern; but they are not infrequently seen in a condition in which the lower extremity of the canon-bone projects beyond the level of the articular surface of the suffraginis, or upper pastern-bone. |
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350 HEALTH AND DISEASE
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SHOULDER SLIP
By this term is understood a loosening of the union between the
bones forming the shoulder-joint, in consequence of which the head oi the humerus or arm-bone is outwardly displaced from the shallow cavity into which it fits on the lower end of the scapula or blade-bone. This disease is invariably associated with paralysis of the muscles of the shoulder, which sooner or later waste, and by ceasing to give support to the joint allow the bones to become displaced, and the limb as an organ of support to be weakened and deformed. It is more especially seen in young horses engaged in agricultural work, although adults a?e by no means exempt from it. Causes.—The precise origin of the disease is but imperfectly under-
stood. That the muscles of the shoulder are paralysed is clear enough, but as to how that paralysis is brought about there is considerable diversity oi opinion. By some it is regarded as the result of an injury to the supra- scapular nerve by blows, and over-stretching in the performance of certain backward movements of the shoulder and limb, involving great strain. By others it is said to arise out of inflammation of the muscles of the shoulder, induced by the stretching they undergo when slipping in and out of the furrow in the act of ploughing, and in habitually walking on an irregular surface. Of the two alleo-ed causes our view is in favour of the formei'- We cannot understand shoulder-slip being of such rare occurrence in f»ce of the very large number of young horses which are every day at plough, following the occupation which is said to induce it. Symptoms.—These vary somewhat in different cases as far as refers
to the onset of the disease. In some there are no clearly-defined local symptoms until the muscles have become noticeably atrophied, and as they waste the shoulder is seen to shrink, leaving the spine in the centre of the blade-bone standing out prominently as a sharp projecting ridge with a hollow on either side. At the same time the point of the shoulder bulg'eS outward, and the foot of the affected limb is drawn inward towards the other one, so that the leg, instead of following a straight line from the shoulder to the ground, takes a slanting direction inwards. In respect t locomotion, the main features of these cases are a disposition to trail tn toe, inability to bring the limb well forward, and the outward movemen which it describes when an attempt is made to do so. When the weight o the body is placed upon it, the shoulder is forced outward, and there is ' perceptible descent of the quarter on the affected side. These symptoms may be preceded by more or less heat and swelling
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DISLOCATIONS
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351
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the region of the joint, which subsides as the disease progresses and the
muscles waste. Treatment.—Rest from work in a straw yard or paddock is the first
requirement to be complied with, but in no case should the animal be con- fined to the stable. Movement is most desirable as a means of exciting nutrition and restoring wasted muscles, so long as it is not carried beyond mere exercise. The frequent application of stimulating embrocations over the affected region, with vigorous rubbing, is also recommended to the same end. With regard to general treatment, nux vomica and sulphate of iron
in two-drachm doses will benefit the local ailment by improving the general health and toning up the wasting muscles. To this must be added good food in liberal rations. |
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DISLOCATION OF THE PATELLA
The patella is a small floating bone situated at the point of the stifle
and corresponds to the knee-cap |
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of man (fig. 378). It enjoys a
large range of up - and - down motion in playing over two Prominent ridges on the lower extremity of the femur or thigh-bone. The outer ridge is naturally much smaller than the inner one, and this will re- quire to be borne in mind when eonsidering the particular direc- tion in which the displacement Usually occurs. Moreover, a large muscle, the " biceps fe- ^oris ", is inserted in the outer Part of the patella, to which there is no corresponding muscle °n the inner side in antagonism *ith it. |
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Dislocation of this bone in
ne horse, as in man, is com-
|
Fig. 378.—The Patella and its relation to the other bones
of the Hind Limb A, Pelvis; B, Femur; c, Patella; D, Fibula; E, Tibia.
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paratively common, and is most
requently seen in young animals from a few weeks to two years old,
though older subjects are by no means exempt from it. |
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352 HEALTH AND DISEASE
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Causes.—The early occurrence of the displacement of this bone in
foals, and its persistence, in the absence of any obvious cause, led the late Professor Varnell to attribute such cases to a congenital smallness or want of development of the outer ridge referred to above, which permits the bone in certain movements to be displaced outwardly by the pull of the biceps femoris. Post-mortem examinations on animals so affected have convinced the
writer of the accuracy of this conclusion, and further that, associated with this deficiency of development of the articulation, there is also a corre- sponding attenuation and weakness of its connecting ligaments, which favours the displacement of the bone. General weakness is no doubt a cause of luxation of the patella, as
evidenced by its frequent occurrence in poor, weakly, overgrown foals, and after such debilitating diseases as influenza and strangles. The displacement usually occurs in an upward and outward direction,
and although it is impossible to say precisely and fully how this comes to pass, there can be no doubt that it is in great measure determined by the smallness of the outer ridge of the trochlea of the thigh-bone, and the outward pull of the biceps femoris muscle. As a result of violence, it is seen to follow upon some extraordinary
twist of the limb in the act of slipping, jumping, or rearing. Symptoms.—These will vary somewhat with the nature of the case.
When the mishap is the effect of weakness the displacement is usually sudden and transient, coming and going without any apparent reason, and being repeated at varying intervals again and again, each time passing away without assistance. The affected limb is noticed to be suddenly jerked backward and held for a moment in an extended position, and then to resume its place again. This may be confined to one leg, but it is commonly the case that both are more or less affected. Here the dis- placement is only partial, and although it may be repeated from time to time for some days or weeks, it ultimately passes away without assistance as the animal acquires strength. In more complete displacement the leg is fully extended backward
(fig. 379) and cannot be advanced, and the animal stands in this position helpless and immovable. The displaced bone may be felt on the upper and outer side of the joint. Treatment.—Replacement of the bone may sometimes be caused to
take place by a mere cut of the whip. For the most part, however, it is difficult to effect in cases of forcible displacement. Before attempting t° reduce the dislocation the extended limb must be brought forward by means of a rope attached to the pastern, and then passed through a collar |
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PLATE XLII1
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Drawing the Leg forward
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The Leg kept in Position
DISLOCATION OF THE PATELLA
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DISLOCATIONS 353
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or a ring in the manger, or over a beam (Plate XLIII, fig. 1). This having
been done, the hand is placed beneath the bone, which is pressed in an upward and forward direction. If the leg at the same time continues to be forcibly advanced, the patella will soon yield to the pressure, and with a sudden click fall into its place. To keep it there is the next requirement, and for this purpose the leg
must be made secure to a collar round the neck (Plate XLIII, fig. 2), and the animal tied up to the rack, or put in slings, and kept perfectly quiet. |
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Fig. 379.—Dislocation of the Patella
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A sharp blister must then be applied over the region of the stifle, and,
addition, it is recommended that a shoe, thicker at the toe than at the
eeK and having a projecting piece of iron attached to the former, be
£ut on. g0 soon as the effects of the blister have passed away, it may
•" desirable to repeat it before the animal is relieved of restraint.
Where the mishap results from general weakness, or slow growth and
velopment of the parts concerned, a liberal supply of good food is of the
importance, and this should be supplemented by sulphate of iron and
x vomica, given alternately night and morning in the corn.
-Ihe patient should be confined to a small shed or loose-box, and
tered over the stifle from time to time, until the displacement ceases
10 occur.
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Vol ii.
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57
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354:
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HEALTH AND DISEASE
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SPRAIN OF THE BACK SINEWS
The accidental overstretching and rupture of the fibres composing the
back sinews is of common occurrence, and is usually designated break- down. The structure most frequently implicated in this accident is a short
ligament (fig. 366), which proceeds from the upper and back part of the canon-bone, and joins the flexor pedis or main tendon of the leg about three inches below the knee. The seat of injury is invariably at the point of union of the two parts. Horses of the heavy breeds and others engaged on the turf are specially
liable to the mishap in consequence of the severity of their work. Causes.—Horses light of bone, and whose sinews lack size and
strength, are more predisposed to this disease than others of stouter build, as are also those with big, heavy frames and small limbs. The exciting causes are heavy draught, slipping and sliding on smooth pave- ment, and severe efforts in galloping and jumping, particularly under cir- cumstances of fatigue, as at the end of a quickly-run race or steeplechase, when the muscles are tired and the weight of the body is forcibly thrown on the passive structures. Symptoms.—As a result of this accident an enlargement mostly makes
its appearance in the course of the tendons, about three inches below the knee. It is sometimes small and hardly perceptible, while at others it may reach the size of a walnut, or even larger, and extend a considerable distance downwards. When pressed, the horse winces and lifts the leg sharply from the ground. The part, moreover, is hot and inflamed. *D standing, the heel of the foot is slightly raised, or the leg may rest on the toe. The amount of lameness will depend upon the severity of the strain- In progression the horse moves short, and imposes the weight mainly °n the front part of the foot to relieve the injured part from traction. Treatment.—In this connection it is important that the injure
structure should, as far as possible, be placed in a state of rest. ?° this purpose the ordinary shoe will require to be removed at once an replaced by one having a thick or wedge heel. Hot fomentations shou then be applied for an hour or two, and followed by the continuous us of hot flannel bandages to the leg. A dose of physic and absolute qul must also be enjoined. , When the inflammation and pain have been in a large measure reduce
hot fomentations may be changed for cold water irrigation and cold hn bandages. It may be that in slight cases these, with a short period of ?e |
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WIND-GALLS
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355
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wdl suffice; but where the sprain is severe and the enlargement con-
siderable, a blister will afterwards require to be applied to the leg between the knee and the fetlock, and repeated once or oftener according to the progress of the case. It often happens that the shortest way to a cure is to fire the part as soon a§ the inflammation has dispersed, and blister over the fired surface. In bad sprains there is a tendency to contraction and
shortening of the injured tendon, resulting in "knuck- ling over " of the fetlock-joint. To guard against this the wedge-heeled shoe should not be worn too l°ng, but gradually reduced in thickness until the contraetionoftheVck sinews heel is brought to a level bearing with the parts in of the Leg after treatment for r. & or Sprain
lront. If in spite of this the tendon should contract
unduly, a shoe having a short lever projecting from the toe (fig. 380), and
a low, thin heel, must be adjusted to the foot and worn for a few weeks. If this fail, then the shortened tendon may require to be cut through in 0rder that the parts displaced may resume their normal position. |
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WIND-GALLS
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These are small, rounded, fluctuating enlargements occurring in the
neighbourhood of joints, more especially on the outer and inner aspects of the fetlocks, and also on the hocks and knees (fig. 381). Wind-galls are divided into tvvo classes, according to the Part they implicate. In one Case they result from a drop- 8lcal and unduly distended state of the capsular mem- brane of the joint with syno- ia, when they are known as
articular wind-galls". In
le other they are due to a
s"nilar state of distension of tlxe synovial sheath of a |
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Fig. 381.—Wind-Galls, a, Tendon of the Flexor Perforates.
The swollen bursa? or wind-galls are shown at x x. |
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ndon, as in thoroughpin.
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J-hey appear either as
lated swellings or in rows of two or three. To the uninitiated it §nt appear that each of the wind-galls observed about the fetlock- |
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356 HEALTH AND DISEASE
|
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|
joint is a separate and distinct sac. This, however, is not necessarily
the case. For the most part they result from a distended state ot the synovial sheath that invests the flexor tendons from a point just above the fetlock to the foot. That the swelling is not observed along the entire length of the sheath results from the fact that at certain points it is tightly bound down by strong ligaments, while the intervening spaces where the bulging takes place offer only slight resistance to its outward pressure; all the same, there is a general over-fulness of the sheath from one end to the other. Causes.—Wind-galls, like the kindred ailment thoroughpin, are un-
questionably hereditary. Besides this predisposing influence, it is also observed that horses of lymphatic temperament, i.e. such as have a thick skin, coarse hair, fleshy legs, exhibit a special liability to the disease, as do also animals with heavy fleshy bodies and small limbs. The exciting causes are long-continued severe work, which is especially
operative in the case of young immature animals and such as are u1' differently nourished. Repeated sprain to the tendinous sheath from heavy draught, slipping, and other forms of violent exertion very largely conduce to bring about the disease. They are also a result of long standing in a confined space in the course oi
protracted illness, such as influenza, pneumonia, pleurisy, and rheumatism- Symptoms.—Wind-galls are readily identified as small boggy swell-
ings in the vicinity of joints, varying in size from a hazel-nut to a smal hen's egg. In the fetlock-joints they occur on the inner and outer side at the same time. The more material enlargements appear behind and above the fetlock-joint between the suspensory ligaments and the flexor tendons- They usually come by slow growth, and are at first soft and yielding, bu as they increase in size they get hard and tense, especially when the foot is on the ground. Excepting when associated with rheumatism or sudden sprain they seldom give rise to acute lameness, and it is only when ° considerable size, and the mechanical play of the tendons and joint are interfered with, that the action becomes materially disturbed. At this tin* there is more or less heat in the part, and digital pressure occasion marked pain. Treatment.—In this connection it may be said that the best and moS
lasting results are obtained when treatment is resorted to in the early stages of the disorder, while the walls of the joint capsule or tendon-shea are still free from serious structural change. When by protracted irritatio and neglect they have become thickened and callous it is hopeless to tin of bringing the membrane back to a normal state, although further advan of the disorder may in ■ some measure be kept in check. |
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THOROUGHPIN 357
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Whether the disease results from undue wear or inherent weakness of
the parts, withdrawal from work is the first step to be observed. What should follow will depend upon the stage and duration of the malady. If *t is of but recent occurrence, a mercurial charge of pitch-plaster applied to the legs from the middle of the canon to the coronet, and a few weeks at grass, may be all that is necessary. In more advanced cases, a course of massage, cold-water irrigation, and tight bandages put on wet is to be followed by a repetition of iodine-blisters at intervals of a fortnight during six or eight weeks' rest. Before adjusting bandages in these cases, it is an advantage to roll up pieces of tow into fairly firm pads and bind them on the wind-galls. By adopting this course pressure is ensured on the spot where it is most needed, and absorption is promoted. ^n the more aggravated cases, where, in addition to distension of the capsule of the joint or tendon, there ls also considerable thickening of the sac, deep firing an(I blistering will require to be resorted to, and further benefit may result if iodide of potassium be given daily in two- or three-dram closes. In the ^ore extreme cases, involving the tendon-sheath only, *t may be necessary to remove the fluid by means of che aspirator, and inject into the cavity a solution °* iodine to prevent further filling of the sac. THOROUGHPIN
A thoroughpin is recognized as a fluctuating en-
argement situated above and behind the hock-joint,
between the tendo-Achilles or " ham-strings " and the
)°wer part of the leg-bone (fig. 382). The swelling
more or less rounded or ovoid in form, and goes
( lr°ugh from one side to the other, hence the term
thoroughpin ". The enlargement consists of a dis-
Qsion of the synovial sheath of the flexor pedis
ndon with fluid, and is of the same nature as those
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taller swellings which appear on and about the
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Fig. 382.—Thoroughpin
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etlock-joints, termed "Wind-galls". The liability
tins disease is especially marked in heavy draught-horses, and par-
uiarly when in early life they are forced by high living and idleness rapid accumulation of flesh for show purposes. ^Uses.—As in bog-spavin, so in thoroughpin, the predisposition to it
Questionably hereditary, so much so in some instances that the writer |
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1
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358
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HEALTH AND DISEASE
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|
has known it to appear in every animal bred by certain mares, and in many
of the produce of certain affected sires. Horses with straight, weak hocks, short at the point, are its most common victims. The inducing causes are excessive feeding, and the too early and severe
working of ill-conditioned colts. It is often contracted by yearlings at play, and by older animals from severe sprains otherwise induced. Hard work on slippery ground is a common cause of thoroughpin in its more chronic and progressive form. It is frequently associated with bog-spavin, of the nature of which it very much partakes. Symptoms.—The enlargement which constitutes the special feature oi
thoroughpin may develop in a few hours to a considerable size. This is especially the case in young
animals, and in older ones also where it arises out of severe sprain. Other cases are leSS sudden in their appearance, and gradually increase in size througn a long period of time. In tn© former case pain and lameness is usually sudden and severe, the swelling hot and tense, Hke a forcibly distended bladder, and there may be more or less genera filling of the joint. The enlarge- |
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Fig. 383.—Compresses for Thoroughpin
|
ment is sometimes much mor
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considerable on one side tha
the other, at others it is uniform on the two aspects. In action tn limb is moved stiffly with an inclination outward. At rest it is main tained in a flexed condition, the weight being imposed on the soun leg. Where the disease comes on gradually lameness may for a tun be altogether absent, owing to the accommodation which by growth a expansion the tendon-sheath is enabled to afford the slowly-increasi & fluid. The time, however, comes sooner or later when the sheath is unduj
.In
and suddenly stretched, and pain and lameness result in consequence. old chronic cases of this kind the tendon-sheath becomes very nin
thickened, and sometimes by undergoing calcareous degeneration is c
verted into a hard bone-like substance. It sometimes occurs that ^
enlargement similar to the one described presents itself on both si
of the hock as a result of bog-spavin. Where this is the case a sim1
fullness will mostly be observed in front over the seat of the last-na
disease.
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CAPPED ELBOW
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|
359
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Treatment.—The line of treatment to be adopted will depend entirely
°n the way in which the disease presents itself. If the enlargement is sudden in its appearance, and attended with inflammation of the structures involved, the patient must be put to rest and subjected to the same treat- ment as that prescribed under similar circumstances for bog-spavin. In chronic cases firing and blistering will be resorted to at once, after
which pressure applied by means of a suitable compress (fig. 383) may further reduce the enlargement. In some instances it may be desirable to °pen the sac, and after letting out its con- tents inject it with tincture of iodine or some other irritant. This, however, is a Procedure that can only be safely decided upon and undertaken by the experienced Practitioner. CAPPED ELBOW
When a rounded swelling occurs on the
point of the elbow, the part is said to be capped ". Sometimes the enlargement is s°bd throughout, at others it consists of a Sac containing a straw-coloured or blood- stained fluid. Causes.—Capped elbow (fig. 384) is
the result of injury inflicted by the inner Qeel of the shoe, either in the act of lying down or while being down, or as a result 01 slipping while attempting to rise. In these cases the foot has been allowed to grow too long, or the heel of the shoe is unduly extended backwards so as to strike 0r irritate the elbow. |
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Symptoms.—The swelling may appear
|
Fig. 384.—Capped Elbow
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11 a few hours, or it may be of slow growth. ^^^^^ ^^^^^^^
the injury is severe the tumour develops rapidly, and is besides hot
ail(i tender and mostly fluctuating to the touch, like a cavity filled with fluid. If, on the other hand, the elbow suffers only slight but rePeated irritation by contact with the shoe, the growth is slow to develop. ^t first it is somewhat soft, but as it increases in size it becomes hard aild solid, and exhibits but little pain or tenderness unless, as frequently aPpens, it is contused, when it may inflame and develop an abscess. In °uie instances these excrescences are allowed to reach a considerable size |
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360 HEALTH AND DISEASE
|
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amounting to several pounds in weight. Capped elbow seldom causes
lameness, but it is very unsightly. Treatment.—Where the injury is but slight, a dose of physic and
repeated fomentation of the part wTill be all that is needed to disperse the swelling; but where it is
severe and the enlargement considerable, it will most likely require to be laid freely open and the con- tained fluid evacuated. This should be followed by the injection of a small quan- tity of tincture of iodine into the sac, and the re- peated daily application of |
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Fig. 385.—Pad to prevent Capped Elbow.
|
weak carbolic solution and
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due regard to cleanliness.
If the tumour is hard and callous, it should undergo a course of blistering or be dissected out; or if hanging by a narrow neck, it must be cut oft, with due precautions against hemorrhage or bleeding. Horses which habitually injure the elbow should wear an elbow-pad (fig. 385) round the pastern, or a bandage may be wTound round the foot when they are in the stable and at liberty to lie down. |
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CAPPED KNEE
This condition is analogous to that already described as capped elbow-
It consists of a prominent—sometimes pendulous—enlargement, the result of an inflamed and swollen state of the skin and subcutaneous connective tissue. It differs, however, from the last-named affection in the less fre- quent formation of matter within it and a greater disposition to become hard and callous. It is more commonly seen in cart-horses than in the lighter breeds, and in cattle the growth often attains to an immense size. Causes.—Capped knee is invariably the result of violence applied t°
the part, mostly following upon a fall or repetition of falls, when the ski" and parts beneath become contused and swollen. In some horses it results from a habit of falling on the knee in the act of lying down, while others contract it by striking the manger or the log at the end of the halter m the act of pawing. Kicks and blows may also induce it. Symptoms.—In some cases capped knee is of slow growth, especially
where the part continues to receive a succession of slight contusions, as i° |
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CAPPED KNEE
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361
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some of the causes referred to above. When this is so, the enlargement
usually presents the appearance and character of a solid organized tumour, resulting from the repeated irritation to which it has been exposed. When it originates suddenly from a severe blow, it may assume the form of a cyst and contain a quantity of yellow or blood-stained fluid, or should the injury be sufficiently severe to excite acute inflammation in the skin and underlying tissue an abscess may result. Symptoms.—From what has been said, it will be understood that the
swelling constituting " capped knee" is a disease of the skin and sub- cutaneous tissue, and has no reference whatever to another form of enlarge- ment in front of the joint resulting from a distension of the sheath of the extensor tendon of the metacarpus. In the disease in question the swelling when of slow growth is hard and callous; when of more rapid formation it assumes the form of a fluctuating swelling which may or may not be attended with pain. In all cases where an abscess develops, the part is hot and painful, and in a less degree pain is manifested for a while where the tissues become infiltrated with blood-stained fluid only. The latter con- dition may assume a chronic form and continue long after all soreness has subsided. Treatment.—Where indications of chronic enlargement of the knee
appear as a result of bruising in the act of lying down, the horse should be placed in a loose-box and be provided with a thick bed of peat-moss. This alone in such cases is sufficient to put an end to the trouble. Where, however, the growth has become considerable and undergone organization, its complete removal is impossible save by a surgical operation. Some reduction, however, may be effected in it by a course of blistering, and its further development will be prevented by protecting the animal from a ^petition of the injury that brought it on. If the enlargement is found to contain a watery fluid, the contents must
be drawn off by the aspirator and a little tincture of iodine injected into the sac. This having been done, a bandage should be tightly bound round the knee in order to prevent its refilling, and at the same time to induce the disconnected skin to unite again to the parts beneath. For this purpose the horse should be kept tied to the rack or placed in slings aud prevented from lying down. Where the swelling is hot and painful, and there is reason to suspect
the existence of an abscess, hot fomentations should be applied to the part,
aud so soon as any indications of " pointing" appear it should be freely
°pened with the knife and free vent given to the contained " matter".
Tl ....
J-Ue sac should then be well syringed out with carbolic solution or some
Equally efficient disinfectant, and the wound treated on the antiseptic
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362
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system. At the same time it is to be observed that the displaced skin oi
the knee forming the wall of the abscess must be bound down by means of a bandage, as previously suggested, and the horse kept in the standing posture. CAPPED HOCK
When an enlargement appears on the point of the hock, the part is said
to be "capped" (fig. 386). There are two conditions to which this term is applied—one involving the skin and tissue beneath it, and the other the synovial membrane interposed between the bone (calcis) and the tendon passing over it. A short description of the anatomy
of this part will render this difference intelligible. The point of the hock comprises a bony prominence, over which is spread an expanded portion of the tendon of the gastrocnemius in- ternus muscle, and in order that the latter may more freely move over the former, a synovial sac is interposed be- tween the two and supplies the necessary fluid to lubricate the apposed surfaces. On the posterior aspect of the tendon there is a considerable quantity of cellular tissue, which by its looseness enables the skin to move freely over Fig, 386.—Capped Hock the point of the hock, and thus to
accommodate itself to the extremes of flexion and extension during
progression. Injury to this cellular structure results in inflammation (cellulitis) and
swelling, which, when attended with an accumulation of fluid in the part? constitutes a serous abscess. The other form of the disease is always one of distension of the synovia*
sac with synovial secretion; but inasmuch as it does not concern the summit of the hock, but only appears at the sides, the term " capped hock" ought never to have been applied to it. Causes.—Whether the enlargement be of one description or the other)
it is invariably the result of external violence. The most common cause *s injury done to the point of the hock in lying down on a badly littered floor, or by slipping and striking the part in the act of rising. Pitching on tn |
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363
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CAPPED HOCK
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hocks when falling backwards in rearing is sometimes the cause, and in
many cases it is referable to kicking. The slighter cases of this disease result from rubbing the points of the hocks repeatedly against the wall or stall-posts while rubbing the tail. Symptoms.—Of the two forms of the malady, that arising out of
injury to the subcutaneous cellular tissue is by far the more common, and, it may also be said, the less important. Capped hocks usually appear suddenly. The size and nature of the
swelling will vary with the manner of its production. Where it is excited by repeated rubbing the growth is small at first, and gradually increases in size so long as the cause continues in operation. Blows inflicted in any of the several ways indicated above are followed by sudden swelling, which will be proportionate to the injury. Sometimes it is very considerable, hot and painful to the touch. In consistence it may be firm or tense and fluctuating like an inflated bladder. The latter conditions indicate the presence of fluid beneath the skin, which mostly consists of blood-stained serum (serous abscess). It is very seldom that lameness results from this form of the disease,
although it sometimes occasions slight stiffness for a few strides when recently produced. The second and exceptional form of the disease is readily distinguished
from the first by the fact of the enlargement appearing at the sides of the point of the hock and not on the point itself. It is, moreover, always in the nature of a fluctuating swelling, and, as a rule, inconsiderable in size, ft not infrequently gives rise to lameness, and when complicated with disease of the bone is troublesome and serious. Treatment.—Slight cases of true capped hock do not require much
treatment. Cold-water irrigation and cold sponging for a few days, coupled with removal of the cause, and, later, a little hand rubbing daily with gentle pressure, will suffice. Where, however, the swelling is considerable and the hock much inflamed, a dose of physic should be administered at once, and hot fomentations applied freely to the injured part; Wlth the decline of the inflammation, cold-water irrigation may be sub- stituted for hot fomentation. Daily exercise or light work will be beneficial rather than otherwise when the tenderness has disappeared, and a little gentle hand rubbing with pressure may aid in removing the swelling. Where the enlargement proves obstinate a mild blister may be applied and repeated 11 necessary. It frequently happens in the more severe cases that a per- manent and unsightly enlargement remains after all has been done; but nere is a tendency to diminish in size as time goes on, so long as no Urther injury is permitted to be inflicted. Where the enlargement assumes |
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HEALTH AND DISEASE
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364
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the form of a serous abscess of considerable size, the fluid may be removed
by means of an aspirator or by subcutaneous puncture. FILLED LEGS—(EDEMA
(Edema is a state of disease in which the tissues of a part become
infiltrated or saturated with the watery constituents of the blood, causing more or less swelling of a soft, doughy character. It frequently occurs in the legs of horses, when they are said to "fill". This form of swelling' although sometimes considerable, is rarely attended with pain, and for the most part is soon dispersed, although liable to recur so long as the cause continues in existence. Causes.—Filling of the legs is brought about by many and various in"
fluences, but of these general weakness and want of condition are by far the most common. Hence it is noticed in animals after an attack of sickness, and especially if attended with long standing and want of rest, as in pneu- monia, pleurisy, and some other disorders and accidents. Heart-disease, by enfeebling the circulation, invariably gives rise to
more or less swelling of the limbs, as do also occasionally functional derangements of the liver, the results of over-feeding and idleness. And the same may be said of functional and structural impairment of the kidneys, tending to the suppression of urine. Horses when first stabled after a run at grass are peculiarly liable to oedema, and it is very commonly associated with certain forms of influenza and fever. Horses which inherit a disposition to inflammatory oedema, or, as it is called, " Monday morning disease", are commonly the subjects of these less serious attacks of "filling of the legs". Severe work over hard ground also provokes it in hunters and racers. Symptoms.—Ordinary filling of the legs presents itself as an enlarge-
ment between the pasterns and the knees in front, and the hocks behind- To the feeling, the swelling is doughy and " pits on pressure ", i.e. a pit lS left wdierever the pressure of the fingers is applied. There is no consider- able rise of temperature or pain in the part, and beyond slight stiffness the action is not interfered with. The hind-legs, being farthest from the centre of circulation, are more
subject to oedema than the fore ones, but it commonly occurs that all tne extremities are more or less affected. Treatment.—In a disease having its origin in so many and sucn
diverse causes, it would be impossible to lay down any single course ° treatment capable of meeting all its requirements. In those cases resultm» from debility the aim and object should be to build up the system by ' |
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SAND CEACK 365
liberal diet, and impart tone to the body by the administration of vegetable
and mineral tonics, of which nux vomica and sulphate of iron are the most appropriate. Gentle exercise daily will tend to disperse the swelling, and the liberty of a loose-box will greatly assist in preventing its return. When oedema is the result of heart-disease there is little to be done
calculated to effect any permanent good: regular and careful dieting, light Work, an occasional aperient dose of aloes, and such measures as will improve the general health are best calculated to disperse and, as far as can be, control the swelling. Sudden and severe exertion and fatigue aggravate the mischief, and should therefore be carefully guarded against. When the fault is traceable to derangement of the liver or digestive
organs, a dose of physic, followed by a restricted diet and a course of alterative medicine, will suffice to restore the balance again. All cases of oedema are benefited by small repeated doses of nitrate of potash, and more especially so when the disorder arises out of the faulty action of the kidneys. Massage and vigorous rubbing, with the application of dry linen bandages to the legs, will prove serviceable. In some cases wet bandages and cold- Water irrigation with exercise will have the desired effect when aided by a short course of diuretic medicine. This treatment is specially applicable to animals whose legs are weakened by hard wear. |
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19. DISEASES OF THE FEET
SAND CRACK
This term is used to denote a fissure or rent in the crust or wall of the
hoof. Usually the crack extends from above downward or from below Upward, in the direction of the horn fibres. It may appear in any part of the hoof, but there are certain positions specially liable to it. In the draught-horse it is most commonly seen in front of the hind-feet, while in nght horses it chiefly arises in the inner quarter of the fore-feet. The reasons for this difference may possibly be found in the fact that in the former the front of the foot is subjected to considerable strain in heavy draught, while the inner and weaker quarter of the light horse is most exposed to concussion. Causes.—The predisposing conditions to sand crack are found in the
two opposite states of inordinate thickness and density, and thinness and Jaxity of hoof-horn. Horses with strong upright feet are specially liable to this disease, as are also animals whose feet are flat and weak, with horn of |
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366
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HEALTH AND DISEASE
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coarse texture. When these conditions are associated with undue dryness,
as occurs in the heat of summer, and in horses whose feet are in a chronic febrile condition, the liability to crack is much increased. The exciting causes are concussion and strain to the feet under draught or on slippery ground. It may also be induced by treads over the coronet. Horses with high action in front suffer more than others of less showy
gait, and especially when overladen with flesh and indulged in too much rest and standing. Symptoms.—Cracks usually commence at the coronet, and extend
downward. When slight they are frequently covered with overhanging hair, and for a time evade detection. If the animal be continued in work) they increase in length and depth day by day>
and extend through the crust to the quick. I11 this condition the lameness—at first only slight —becomes severe, owing to the sensitive struc- tures being torn and pinched between the edges of the fissure. Blood may ooze from the line of the crack, and if neglected, fungous growth (proud flesh) sprouts out, and with it an offensive discharge of pus or " matter". Lameness in this disease is always present where the rent reaches the sensitive parts. It is aggravated by |
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Fig. 387.—Sand Crack
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fast movement, and when ascending °r
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descending a hill. In those cases whei'e
cracks are superficial, they may continue and grow out without causing inconvenience. Treatment.—'For the radical treatment of sand crack the horse should
be thrown out of work, the edges of the crack pared away from top t° bottom, and the sensitive parts thoroughly cleansed and dressed with ant1' septic solution. With a view to prevent the fissure extending downward) a groove should be burnt into the hoof across the line of the crack belovV- This may be done with an ordinary firing iron. All that is now require is to protect the wound from dirt by cotton-wool secured by means ° tape, and to dress it repeatedly with a solution of carbolic acid. J-*1 growth of horn should be stimulated by the application of a mild bliste over the coronet, and this may be repeated twice or thrice at intervals ten days if necessary. Where it is desired to continue the horse in work, various expedients »
resorted to for keeping the edges of the crack together and preventive movement. This may be effected by drilling one or more holes through t |
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SHELLY FEET 367
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edge of the crack on both sides, and driving fine nails or pieces of wire
through them, and clinching them at both ends (fig. 387). A more effective means of doing this is the Vachette clamp (fig. 388), but to insert it a special set of instruments is required, comprising a cautery iron and |
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Fig. 388.—Sand Crack Clamped
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Fig. 389.—Tools for Clamping Sand Crack
A, Iron; E, Forceps for turning-in the
ends of the clamp c. |
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Fig. 390.—Sand Crack, showing method
of paring the crust. |
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forceps (fig. 389). A piece of tape tightly bound round the hoof will
s°metimes suffice to keep the parts together where the work is not heavy. ^ all cases of this disorder the crust immediately under the crack should ®Q pared away sufficiently to prevent any bearing at this point on the 8hoe (fig. 390). In quarter cracks a bar shoe should be substituted for the ordinary one. |
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SHELLY FEET
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Although not a disease, shelly feet mark the existence of a serious
e^ect in the secreting properties of the horn-producing structures of the °°t- Large numbers of otherwise valuable animals are rendered trouble- 0rne and sometimes practically worthless in consequence of a want of |
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HEALTH AND DISEASE
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368
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adequate protection and indifferent quality of the horn composing the hoof;
the coarseness and brittleness of its fibres and looseness of its texture rendering it apt to break away on the slightest provocation, and to afford the shoe a most insecure attachment to the foot. Shelly feet are necessarily weak feet. The crust in these cases is usually thin, the heels are low, the feet flat and spreading, and the soles lack both substance and strength. They are besides hot, dry, and brittle, frequently marked by ridges and furrows, indicating irregularity in secretion, and in consequence of these conditions the crust readily breaks away as the result of " nailing". Causes.—In the great majority of cases of this kind, heredity is the
chief predisposing factor. Some horses at a very early age, and before being stabled, manifest a decided brittleness of hoof-horn, which is seriously aggravated when the forces of domestication come into play. Of these, the undue allowance of highly stimulating food in the absence of adequate work is a common exciting cause; as is also excessive burning in the fitting of shoes, and the impairment of the circulation of the foot resulting from undue paring of the frog and its removal from the ground. A shelly condition of the foot sometimes dates from an attack of
influenza, fever, or some other febrile ailment, and it invariably follows in a higher or lower degree on all attacks of fever in the feet (laminitis). Treatment.—Where this condition exists, the most salutary effect may
be obtained from a run at grass in a damp meadow and a course of stimulat- ing applications to the coronets. If the weather is dry and the pastures parched, little or no benefit will result from turning out in the daytime. In these circumstances a run in a wet yard by day and in the pasture by night will afford the best results. As an application to the hoof, glycerine, worked up with a little fish-oil and tar, will be found useful while the animal is in the stable. In shoeing, as little heat as possible should be applied to the crust, and the frog should be allowed to grow and come to the ground. Beans, maize, and barley are undesirable additions to the food where a tendency exists to brittleness of the hoofs. SEEDY TOE
The crust or wall of the hoof is composed of two layers: an outer one
made up of closely-packed horn fibres, Bnd an inner one composed of horny laminse. In a normal condition these parts blend with each other in close union, forming one solid, continuous whole. In the condition known as seedy toe, the horn uniting them under-
goes decay and breaks up into a blackish-gray granular-looking debriSi which, when removed, leaves behind a space or gap between them. |
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SEEDY TOE 369
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Although termed seedy toe, the disease is not confined to the part
indicated, but is frequently found to exist in the quarters, and sometimes to extend round the hoof from one part to the other. In its more limited form it presents a superficial hollow in the toe,
but it may extend upward to any height towards the coronet. It is not confined to any particular description of hoof. Horses with strong feet - as well as others whose feet are weak are alike affected by it. An attack of laminitis imparts a special predisposition to it. Lameness may not exist until the disease has made considerable
advance, and it is in consequence frequently found when not suspected. |
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t'ig. 391.—Seedy Toe. Vertical and transverse sections of foot, showing the horn fibres (a)
separated from the horn laminae (6). ^ave in exceptional cases, it is amenable to treatment, although frequently
demanding a long period of rest. Causes.—Various causes have been assigned for this morbid condition
°* the hoof horn. By some it has been referred to injury done by the
°bp of the shoe. By others to " long-continued strain on the feet which
was not sufficient to produce actual laminitis ", and to the " weight-bearing
surface of the foot being limited to the wall by bad shoeing"; while
°thers again regard it as the result of the repeated application of excessive
eat in the fitting of the shoe. Injury inflicted upon the horn-secreting
structures of the crust by blows applied to the coronet has also been
lQught by some to be a sufficient cause. This, however, has been
ejected to on account of the disintegrated horn never being found at
le coronet, or in any part of the crust, excepting when associated with
hole in the toe, from which it has been concluded that the disease
"°nimences below and extends upwards. It appears to us that no ex-
yOL. II. 58
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370
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HEALTH AND DISEASE
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planation of the origin of seedy toe will suffice which does not embrace
and answer this objection. In this connection we are of opinion that the foundation of seedy toe
is sometimes, if not always, laid by an injury to the coronet, provoking the secretion of a loose and defective horn, and that the seedy or disin- tegrated condition in which it is found does not follow until this part of the crust has grown down to the ground and the degraded horn has become exposed to dirt and moisture. Under the influence of the latter it breaks up into the small seed-like particles from which its name has been derived. In 1884 Professor Axe called attention to a nematode worm which
he had discovered while microscopically examining the horny debris from a diseased hoof. In reporting the case in the Veterinarian he speaks of finding " thousands of minute, elongated parasites, with their ova, larvse, and structural remains". The late Professor Cobbold recognized the possible importance of the find, and from his knowledge of the structure and the habits of kindred parasites he had no hesitation in assuring Professor Axe " of their capability to permeate and break down the structure of the hoof in the manner observed in seedy toe". How they are enabled to accomplish this feat of destruction he explained ty referring to "a formidable boring-tooth or spike with which they ;U'e armed at their oral extremity". Professor Axe points out that these parasites are not always to be
detected in seedy feet; but it seems quite clear, from the numbers in whicn they existed in the specimen referred to, that they had found an " agi"ee' able nidus for their growth, development, and propagation", and by their presence and peculiar armature must contribute in no small measure to the extension of the disease whenever they gain an entrance to tn hoof, which Professor Axe points out they may do in an ordinary way through cracks and old nail holes. Dr. Cobbold provisionally named the parasite Pelodera Axei an
described it as follows:— " Mouth with broad vestibule and horny style; oesophagus long, wit
a large round bulb below, armed with dental plates; tail in both sex long, subulate, very finely pointed; male with two short, nearly eq.u spicules, no bursa; female viviparous. " Habitat.—Hoof of the horse (Equus caballus).
" Measurements.—Males -^ of an inch long, females ■£$ inch; bread
of the male -q^-q inch, and of the female -j^ inch; length of longer spi°u qjq inch, of the boring tooth -^q inch; ovum, with coiled embryo, -g^ inch by -g--^ inch; reproduce |
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371
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SEEDY TOE
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and anal outlet in the male placed j^q of an inch above the point of the
tail." Professor Angelo Baldoni of Bologna says the cause of seedy toe is
a mould which he terms Achorion Kerathophagus, whose peculiar culture ground is horny tissue. Treatment.—As in these C£IS6S 9j hole exists in the crust, and there
is no possibility of bringing about a reunion of the two layers, the most radical and successful method of procedure is to remove all the outer fibrous layer from the toe upwards to a point where separa- tion ceases. By this means the cavity is done away with, and the accumulation of dirt and mois- ture, which acts prejudicially upon the horn, is prevented. It now remains to await the
reproduction of the parts removed and the downward growth of a sound hoof. As a means of expediting this,
a little weak ointment of can- tnarides or the biniodide of mer- cury may be applied round the coronet, and repeated at intervals °f seven to ten days during a rUn at grass. A light bar shoe, thin at the heels, should be ap- plied to the foot, so that the |
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height of the body is made to
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Fig. 392.—Pelodera Axei
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1. Male.
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tail backwards and relieve the
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young. 4. Young female.
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weak crust in front. Where a
Pasture is not available, the horse should be made to stand on peat- moss, tan, or saw-dust, and have a wTet swab constantly applied to the crust. Where little or no lameness exists, it is sometimes found desirable to
ontmue the horse in work until a more convenient time arrives for sub- jecting him to the operation. When this is decided upon, the " seedy" *atter should be removed from the crack, and the cavity, after being ashed out with a solution of carbolic acid, well packed with tow and a e°niposition of tar and grease. |
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HEALTH AND DISEASE
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372
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KERATOMA—HORN TUMOUR
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A tumour composed ot
horn sometimes forms on the internal face of the hoof, from which it projects inwards, and by continued pressure imbeds itself in the substance of the pedal or foot bone, some ot which it causes to be ab- sorbed. These growths may be elongated, ovoid, or cone- shaped. They mostly occur at the toe, but, rarely, also appear |
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Fig. 393.—Keratoma or Horn Tumour
Notch or groove in the pedal bone resulting from pressure
of Keratoma. |
at the coronet, from which they
extend downwards towards |
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the lower border of the foot.
Keratoma is produced by an abnormal growth of horn from the lamin* or papillse of the vascular tissues by which the hoof is secreted. Causes. — These
growths have their origin in some injury or irrita- tion of the horn-secreting structures. A blow °r tread on the coronet may be the exciting cause, but more commonly ^ would seem to have some connection with injury done to the toe, which is generally believed *° be inflicted by too mucn force being used in ham- mering down the to clip. Injury by a nail |
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driven too near the qu1'
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Fig. 394.—Keratoma or Horn Tumour
Transverse section of foot, showing Keratoma (a) in situ. |
may also be the starting'
point, or it may follow |
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__________________ ^^^^^^^^^^^ crack in the hoof. Ho
ever produced, there is evidently a chronic state of congestion excited
the horn-forming structures at the seat of the morbid growth. |
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THRUSH 373
The development of these tumours is slow and progressive, and there
is reason to believe that but little or no inconvenience or suffering arises during their early formation; but as they become larger they not only press directly upon the sensitive quick, but tend to cramp the whole of the internal parts of the foot, and cause absorption of the pedal-bone. The horse then becomes more or less lame. If the tumour is in front, he inclines the weight of the body towards the heel. There may be a bulging in the horn over the seat of the mischief, but it is just as likely that no outward change may be observed. Treatment.—But little can be done in these cases short of removing
the tumour, and this seldom succeeds in curing the lameness, and fre- quently aggravates the mishap. Some relief may be afforded if the shoe be carefully seated out in such
a way as to remove the pressure from the seat of the growth. Should the tumour be in front, a bar shoe gradually thinned off towards the heels may be applied to the foot, so as to incline the weight backwards and away from the diseased part. THRUSH
Thrush consists in a congested condition of the sensitive frog associated
with a discharge from the cleft and a ragged state of the horn. It is Mostly seen in the fore-feet, although the hind ones now and again give Evidence of the disease. Causes.—The causes of thrush are constitutional and local. In regard
to the former the malady is found more especially in animals of a plethoric habit, and especially when too highly fed and allowed to lead a sedentary hfe. Old animals suffer more frequently from thrush than young ones, not s° much on account of age itself as the diseases incidental to it. This refers Riore especially to navicular disease, during which thrush almost invariably 0ccurs from time to time at longer or shorter intervals. Long standing 0ri hot, decomposing manure, or peat-moss saturated with moisture, is a fruitful cause of the disorder. Bad shoeing, in the course of which the frog 18 unduly pared and removed from contact with the ground, and allowed to become hard, dry, and shrunken, is perhaps the most common predis- posing factor. It often follows a turn out to grass during wet weather. Wherever it exists it indicates a disordered state of the vascular parts
°t the foot, and should receive prompt attention. Symptoms.—-The presence of thrush is indicated by an offensive
discharge from the cleft of the frog. The matter is grayish-white in c°lour, and varies in consistence from that of cream to that of soft cheese. |
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374 HEALTH AND DISEASE
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Rarely it is of a dark watery character. In the former condition it is
chiefly made up of young horn cells mingled with varying small propor- tions of pus corpuscles, and occasionally with blood. Usually this disease is unattended with lameness, but in some instances it is very marked, and may be severe. Horses with thrush travel badly on rough roads, owing to the tender frogs being brought into contact with stones. Treatment.—In all cases of thrush the system of shoeing should
receive attention, and strict injunctions be given to the shoeing-smith to bring the frog gradually to the ground and remove no part of it save such portions as are ragged and disconnected with the parts beneath. A dose of physic or a course of saline medicine may be given in the case ot plethoric animals, and the work should be increased. As a means of assisting the discharge and bringing about a healthy
state of the parts, astringent applications should be made to the frog, after the cleft has been thoroughly freed from dirt, by careful washing with carbolized water. The dressings most commonly used, and which are most effective for the purpose, are sulphate of copper or alum mixed with tar and a little carbolic acid. A solution of chloride of zinc is also a useful application; the ointment of the red oxide of mercury is equally beneficial- Tar dressing is sometimes applied by means of a pledget of tow, and covered over by a leather sole, and if it is required that the horse should work, this protection is in some instances necessary. Besides protecting' the diseased part from injury, it has also the advantage of excluding dirt; but it forbids the removal of the application without the removal of the shoe. This difficulty may, however, be in some measure overcome by the use of movable leather pads. CORN
Definition. — A corn is a bruise to the sole of the foot occurring
at the inner heel, in the angle between the crust and its inflection-— the " bar". The almost invariable occurrence of the injury at this point would seem to be due in part to the inner quarter being weaker and- more yielding than the outer one, and in part also to its being more immediately under the centre of gravity. The fore-feet are almost invariably its seat, and of these one or botn
may be affected. Causes.—The chief predisposing conditions to corn are the con-
formation and structure of the feet, and indifferent shoeing. With reg;>lC to the former, it may be remarked that flat feet with low, weak hee >- and thin soles and crust are those most likely to contract the diseaS • Feet of a strong, upright, and blocky type, although less frequently |
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CORN
|
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375
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|
affected, are, nevertheless, liable to attack. As to shoeing, excessive
paring of the sole, removal of the bars, and undue lowering of the heels, all tend to weaken the part and expose it to injury. Shoes, when made too short and narrow at the heels, if insecurely nailed to the foot, or worn too long, are liable to displacement, and by becoming embedded within the crust occasion a bruise to the sole. After one or two attacks of corn, predisposition to the malady is
very much increased, and some horses are seldom entirely free from it. These chronic cases are chiefly due to a diseased and asperous condition °f the heels of the coffin-bone, resulting from former attacks, which irritate or injure the sensitive structures on which they rest. Symptoms. — The actual existence of a corn is only made known
after a portion of horn has been removed from the sole, in the angle between the bar and the crust, when a red spot varying in size from a Pea to a sixpence will be found. The quantity of horn necessary to be taken away will depend on the time the corn has been in existence, i.e. whether it is an old corn or a recent one. In the former case the dis- coloration will be near the surface, and readily exposed and quickly " pared out". In the latter it will be deep down, near to the sensitive l°ot, and a considerable amount of horn may require to be removed before it is brought into view. The farther a corn is away from the surface the more recent it is, and the more likely it is to bs a cause of lameness. Sometimes in paring a corn a quantity of dark-looking fluid escapes from between the hornv and sensitive sole; it is then said to De a " suppurating" corn. Other symptoms of the disease are heat, Specially over the inner quarter, tenderness to pressure, and lameness. During progression the animal's step is short, and the foot is brought
to the ground with the bearing specially on the outer side. In severe examples of suppurating corn the leg sometimes becomes swollen as high as the fetlock, or even the knee, and evinces considerable pain to pres- sure. In such cases the lameness is frequently referred to the leg, while the corn is altogether overlooked, until attention is directed to the for- mation of an abscess at the coronet, through which the matter in the f •toot escapes. This condition is known as a quittor. Treatment.—A mild dose of physic is a good preliminary to the
lQcal treatment of corn. The foot will require to be carefully pared over toe seat of injury, and should it be found to contain " matter", free vent ■^ust be given to it. The foot should then be put into a pail of ^arm carbolized water for half an hour, and afterwards transferred to a a°t poultice of linseed-meal and bran. Before the poultice is applied, ne corn should be dressed with a solution of carbolic acid, and covered |
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HEALTH AND DISEASE
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376
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|
over with a pledget of cotton-wool, so that none of the bran and meal
may enter the wound. When the inflammatory action has been subdued, poulticing may cease, and the carbolized dressing may be applied three times a day, with the cotton-wool covering made secure by tapes or cross-sticks, and the foot enclosed in a bag or boot. Later, a blister over the coronet and cold water swabs to the feet, conjoined with rest, will complete the cure. In mild cases of the disease' cold-water irrigation, wet swabs to the
feet, and rest on a soft surface are all that is required. Leather soles and "stopping" should be worn for some time alter
the lameness has disappeared, and by some animals at all times. LAMINITIS—FEVER IN THE FEET
Definition.—Laminitis consists of an inflamed condition of the sensi-
tive laminse, or, more properly, of the entire thickness of the layer ot skin which intervenes between the hoof and the pedal or foot bone. ±n addition, however, to this, the foot bone itself is invariably in a state of general congestion, and in acute and protracted cases undergoes very marked changes of form and structure in consequence. The disease lS much more prevalent in the heavier than in the lighter breeds of horses, and among stallions especially during the early period of the season when their services are first called for. Causes. — By some heredity is regarded as a predisposing factor m
the production of the disease, and there is much to be said in favour ° this view of its origin. Animals with wide, flat feet, low at the heels, and wanting in hoof-horn, are especially liable to contract it, but n°n can be said to be altogether exempt from it. The exciting causes &1 many and various. Among them may be mentioned high feeding durin» a long period of idleness, the injudicious use of certain kinds of grain> especially barley, beans, and wheat when new. It is also provoked oy long and fast driving on hard roads, particularly in horses with hig beating action and heavily fleshed. It frequently follows upon protracted disease of the organs of t»e
chest, which compels the sufferer to stand for long periods without r moving the weight from the feet; and, for reasons which cannot be cleai ) stated, it sometimes comes on after foaling, and less frequently in c01 sequence of the action of a dose of physic. It may also result fr0 exposure to cold and wet after a long and fatiguing journey. Symptoms.—The onset of laminitis is usually sudden, and little
no warning is given of its oncoming. The fore-limbs are most frequen / |
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PLATE XLIV
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Posture in Laminitis of the Fore-feet
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Laminitis in Fore- and Hind-feet
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LAMINITIS
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LAMINITIS—FEVER IN THE FEET 377
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affected, but sometimes the hind ones are also implicated at the same
time. In this disease the posture and gait are very diagnostic. The
animal stands in a crouching position, with the fore-feet extended far
in advance of him, and the hind-legs are brought forward under the
body to sustain the weight of
which the fore ones have been
relieved. When made to move,
the action is short, jerky, and
painful, and the weight of the
body is thrown on the heels.
The feet are hot to the touch
at first, and may later become
quite cool. If struck with a
hammer, however lightly, pain
is induced. In severe attacks
the suffering is very intense,
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and constitutional disturbance is
evinced by an anxious expression
of the face, hurried breathing, a
|
Fig. 395.—Laminitis
1, Coronary cushion. 2, Healthy horn. 3, Cicatricial horn.
4, Os pedis displaced by pressure. 5, Heel displaced by pressure. |
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quick hard pulse, heightened
temperature, restlessness, and patchy sweats. The mucous membranes
of the nose and eyes are of a deep-red hue, the mouth is hot and clammy,
and the bowels are constipated. In cases where the hind-feet are also
affected it is difficult to induce the animal to move, and he stands fixed
to one spot, or falls to the ground, where he remains unable to rise.
Unless relief is speedily afforded, the feet undergo marked changes
of a permanent character. The soles "drop", owing to the coffin-bones having become separated from the hoof and displaced, and the front of the foot sinks in, so that while the one becomes convex or unduly prominent, the other becomes concave or depressed (fig. 395). |
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Later, rings appear on the hoof owing
|
Fig. 396.—Laminitis
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to irregularity in the secretion of horn,
and the texture of the latter becomes loose and shelly (fig. 396). The toes increase in thickness and become rounded, and have a tendency to turn upward. Treatment. — In all cases of this affection the bowels should be
unloaded as speedily as possible by a full dose of physic, and if the patient is seen at the outset, blood should be taken from the jugular |
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378
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HEALTH AND DISEASE
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|
vein, particularly in the case of plethoric animals. To relieve the feet
of the weight of the body and mitigate suffering, the patient may be put into slings and kept there as long as he is able to endure the position. Should he become restless, he may be liberated and allowed to lie down, where he should be encouraged to remain. In either case a good bed is to be provided, comprising a foundation of peat-moss, with a fair cover- ing of straw. The latter will be required to pack the body and protect the head from injury when struggling on the ground. When practicable, the shoes should be removed without delay, and
the feet placed in hot bran poultices, which will require to be renewed frequently, and in no case allowed to become cool. If the pain is very severe and the constitutional disturbance runs high, a full dose of morphia- may be injected beneath the skin, and repeated once or oftener accord- ing to the requirements of the case. When substantial relief has been afforded and the inflammatory
symptoms subside, poulticing may be discontinued, and the feet freely and repeatedly irrigated with cold water, and as soon as possible the patient may be made to move about the box. If a pond is accessible, he should be led into it and allowed to remain with the affected feet in water for several hours at a time, or, failing this, a deep layer of wet clay may be laid in the stall, where he should be made to stand. Gentle walking exercise on a soft surface of tan or manure should be enforced for short periods two or three times a day, and finally a sharp blister should be applied to the legs, from the coronets as high as the middle of the canon, and repeated once or more at suitable intervals if required. When the soreness has passed away from the blistered surface the patient may be turned into a soft meadow, by preference one adjoining a river. If shoes are applied to the feet, they should be short and moderately thin at the heels, so as to admit of the weight being thrown on to the posterior part of the foot. Death from laminitis is by no means rare in severe attacks of tne
disease, and structural changes with or without deformity of the fee almost invariably result in a greater or less degree. QUITTOR
This is a fistulous wound on any part of the coronet just above tn
hoof, having one or more openings communicating with each other unde the skin by pipes or channels (sinuses), and usually involving the deepe structures at this part. The cause of quittor is an injury to the coronet, such as a trea >
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QUITTOR 379
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or bruise from other causes; or it may result from a stab from a sharp
instrument; or from injury to the sensitive parts of the foot at the sole, as from pricks in shoeing, festering corns, or bruises on the sole, or any other accident, followed by the formation of matter (suppuration) under the horny hoof. It is sometimes induced by frost-bites in the winter, the matter following the inflammation so produced burrowing into the deeper tissues of the coronet. The parts affected in quittor are the
skin and underlying tissue (cutaneous quittor), or it may extend to the liga- ments so called (tendinous quittor), or deeper still, to the gristle (cartilaginous quit- tor), or it may penetrate under the horny toot (sub-horny quittor), and even to the bone itself and the joints. It most fre- quently attacks the heels and extends for- |
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wards to the quarters, and even to the front
|
Fig. 397.—Quittor
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of the coronet, or it may commence at the
latter and extend in a backward direction. Heavy horses are more often
affected than the lighter breeds, but this is only because they are more exposed to injuries of the coronet. Moreover, it is generally the inner side of the foot that is affected, probably because corns, which are common causes of the malady, are most frequently found there, and the animal is more likely to tread on the inner side of the foot than on the outer. The principal symptom is a hot and painful swelling on the coronet,
usually on the bulb of the heel, where matter forms (abscess), and finally bursts through the skin just above the hoof. If the wound is probed We shall probably find channels (sinuses), running in more than one direction, usually, however, downward behind the coronary band at the top of the hoof; others may pass horizontally round the coronet either 1X1 a forward or backward direction. These latter frequently form fresh centres of suppurative inflammation, the skin either just in front of or a Jittle behind the original wound swells, forms matter, and breaks, forming a second wound; and this may go on until there are several wTounds on the skin, leading by narrow canals (sinuses) to one another, and so forming a net-work of channels in the tissues of the foot. As may be imagined, tnis gathering and channelling process is a very painful one, and makes t,le animal very lame, so much so in some cases that the limb is con- stantly being lifted from the ground in an uneasy manner. From the w°unds a more or less copious purulent discharge flows, which is most |
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380 HEALTH AND DISEASE
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|
offensive when the gristle or the ligamentous or bony tissues are involved.
Under all circumstances the disease is a tedious and slow one when these lowly organized tissues become affected, and the prospects of immediate success cannot be said to be very encouraging. The treatment consists in giving free liberty for the escape of all
matter (pus). This is usually effected by opening the sinuses with a knife (bistoury) specially constructed for the purpose. When the sinuses run in a downward direction the horn covering the channels must be rasped away as thin as possible, and then the pipe laid open; but this is far easier to put in black and white than it is actually to put it into practice; nor is it unattended with danger, for one may possibly injure the underlying structures and even open the joint, especially if the sinus is situated towards the front of the foot, and the horse is at all restive, as it fre- quently is. In these circumstances it is far safer to cast the animal than run any risk of injuring the joint, or of the animal injuring the operator. Another method, and not one to be despised, is to cauterize wTith a hot iron. Here again we must be careful of the joint. We remember once operating on a horse's hind-foot by this method in the standing position; and although all ordinary precautions were taken, such as placing a twitcli on the nose and holding the fore-limb of the same side up, we had n° sooner touched the wound with the heated iron than he kicked violently out and unfortunately struck the iron, which penetrated the foot-joint' with the result that he died within two or three days. We relate tins unfortunate accident to show how dangerous an ordinary simple operation may be, especially with a restive animal. Another and safer method is to plug the sinus with caustic, such as
corrosive sublimate or arsenic, and after the " core slough" has come ou (which takes from four to six days), the wound should be injected wittj an antiseptic lotion. Or caustic and antiseptic liquids may be injecte repeatedly into the wounds. These are often followed by stimulative injections, such as the tincture of iodine. A blister rubbed on t'1 coronet sometimes starts healing action in the wound. The cartilage n'C quently becomes diseased, rendering the malady a formidable one to trea • In fact, cauterize by what method we may, or inject whatever lotio we may, nothing seems to be of any use. In such a case recourse is ha on the Continent to extirpation or cutting away of the cartilage, which * > it is needless to say, a somewhat formidable operation, and altogetn beyond the resources of the amateur; even in the hands of the most skin veterinary surgeon it frequently fails to bring about the desired result. We may say that all wounds inflicted on the feet of horses are attend
with danger and are liable to lead to abiding disease, because it is so ve / |
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CANKER
|
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|
381
|
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|
difficult to keep them clean—a most essential point with all wounds.
This, together with the class of tissues involved in quittor, and the con- stant movement going on at this part, renders such cases very unthankful ones to treat even under the most favourable circumstances; and when any inattention or neglect in dressing and cleanliness takes place on the part of the attendant, it makes it almost impossible to effect a cure. Again, animals so affected are usually restive, and the attendant having insufficient or no help, soon gets disheartened at the slow progress his patient makes; for which perhaps there is some excuse. Whatever method of treatment is adopted in these fistulous wounds, we are confident it is quite as important to get an attendant (nurse) who will religiously carry out the instructions given to him by the medical adviser, as it is to select a proper remedy, because there is not a method or a line of treat- ment that is not at times successful and at other times the opposite. To prevent quittor all injuries to the coronet, however slight, should
be placed under treatment at once, and all injuries to the sole of the foot, followed by the formation of pus, should be thoroughly opened to allow the free exit of the matter below, and thus prevent as much as possible the probability of the matter ascending up the wall of the hoof. CANKER
This is a malignant disease of the feet characterized by the develop-
ment of a soft, spongy growth on the frog or sole, or both, attended by a thick, offensive discharge of the consistence of soft cheese. It is more common in the heavy than the light breeds, and in the hind than the fore feet. The disorder may be confined to one foot alone, or it may affect two, or all of them may suffer. Pathologically, it is essentially a papil- loma or overgrowth of the papillae of the sensitive foot, and in this respect ls allied in its nature to grease, by an extension of which from the leg to the foot it is sometimes produced. Causes.—The inducing causes are such as provoke irritation in the
sensitive foot, hence it commonly follows upon an attack, or more fre- quently upon a succession of attacks, of "thrush". It may also arise out °i various forms of injury to the foot, as corns, pricks, sand crack, and Quittor; and, as already remarked, it sometimes results' from the down- ward extension of grease in the heel. By some it is regarded as a specific disease, and this may ultimately prove to be the case. Symptoms.—A grayish-white offensive discharge, very much like
vnat is seen in thrush, is the first indication of the disease. This is accompanied by a soft, spongy swelling of the sensitive frog or sole, in |
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HEALTH AND DISEASE
|
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|
382
|
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|
the course of which the horny covering becomes broken up into coarse,
brush-like fibres, having no disposition to cohere and form sound horn (fig. 398). Later, the horn-producing power of the affected parts be- comes enfeebled and ultimately destroyed, and a thick fleshy growth appears, covered with enlarged papillae and a stinking mass of degraded horn cells (fig. 399). Unless arrested, the disease spreads from the horn-denuded sole to the heels and quarters until the foot becomes stripped of its hoof and greatly disorganized. In the early period of the disease, and even when it is considerably advanced, lameness may be altogether absent or very inconsiderable, and the slow progress of the malady enables horses affected by it to continue in work for some time; but as the foot becomes more and more bereft of its horny covering) |
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|
Canker
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|
pain and lameness increase until the animal, though
otherwise healthy, is rendered unworkable and useless. Treatment.—When these cases are promptly taken in hand and judi- ciously treated, arrest of the disease is possible; but in the great majority °i instances the hopeful period is allowed to pass by before anything is done, when it runs its course unchecked. Once fairly established, the prospects of recovery are very remote, and in the most favourable circumstances success can only be looked for after months of treatment and an outlay often exceeding the value of the patient. Whei'e
treatment is determined upon, a dose of physlC should be given at the outset, followed by a restricted diet. The diseased foot should then be thoroughly cleansed and disinfected by long i*11" mersion in a pail of antiseptic solution, the active principle of which may be carbolic acid, perchloric of mercury, or chloride of zinc. This clone, aJ loose horny shreds should be removed, as wei as horn underrun by the disease. Where fung°u |
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Kg
|
growth is exuberant it should be removed, eitne
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-Canker
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|
by the hot iron lightly applied or by some causti
agent, such as strong solution of chloride of zinc, powdered perchloric of mercury, sulphuric acid, or nitrate of silver. On the top of the causti application a thick pad of tow should be placed so as to impart pre sure to the diseased surface, and when bound on to the foot the who may be transferred to a suitable "boot", and the dressing renewed intervals of two or three days for so long as may be necessary. The » however, are not cases in which amateur doctoring is likely to succee |
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CHEONIC VILLITIS 383
|
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|
They require the services of the most enlightened and painstaking prac-
titioner, who will recognize the changes for good or ill as they occur, and will regulate his treatment accordingly. |
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CHEONIC VILLITIS
Beneath the hoof-horn extending round the coronet is a prominent
band of fibrous tissue called the coronary cushion. Its surface is covered with a large number of closely-packed vascular villi—little projecting bodies which have been likened to the pile on velvet (fig. 400). Each of these little processes fits into a small hole in the coronary
groove of the hoof, and from them the crust is produced and reno- vated. This being the case, it is most important to the integrity and strength of the crust that the coronary cushion should be in a healthy condition; and so long as it is so, the horn which it forms is ample in quantity, and possesses the normal hardness, toughness, density, and thickness. When, however, inflammatory disease |
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|
•affects the secreting villi and the
fibrous cushion, from which they proceed, the horn becomes altered |
Fig. 400.—Villi ot the Coronary Cushion and
Growth of Horn a, Villi of the Coronary Cushion, b, b, Horn of the hoof,
with tubes in transverse section, c, Vessels of the villi. |
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m quality, and, losing the cohesive
property by which its fibres are bound together, it becomes dry, loose
m texture, and crumbles away. This changed condition is due to two factors—(1) the altered nature of the horn secreted; (2) the separation °f the secreting villi from one another by the swelling and expansion °f the coronary cushion, whereby the horn fibres are made to stand apart from each other, and fail to form that close compact mass of horn which the crust presents in a healthy condition. Causes.—Some horses inherit a dry and brittle state of the hoof-horn,
*md are specially liable to chronic villitis. Blows to the coronet are the chief exciting causes, and the writer has also seen it follow upon a severe blistering, quittor, and sand crack. Symptoms.—Chronic villitis most frequently affects the front region
°t the coronet. Sometimes it attacks but a small surface, at others it extends for some distance towards the quarters. It commences by swelling, |
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HEALTH AND DISEASE
|
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|
384
|
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|
with some heat and tenderness to pressure over the affected surface. Lame-
ness may or may not exist at first; but where the disease continues to extend, and the swelling becomes considerable, the foot is brought to the ground with the bearing thrown upon the heel, as in laminitis, and lame- ness is pronounced. The horn in front of the coronet, instead of being smooth, now presents a rough and broken appearance. It is loose in texture, and flaky masses may be broken away with the finger. The crust at this point has a tendency to develop a ring-like character, to crack cross-ways, and to separate from its connection with the coronary cushion. When this takes place there is a slight oozing of serosity, and blood and matter may also be discharged. Treatment.—It is usually the case that no attention is given to-
this disease in its primary stage, and it is not until considerable swelling appears at the coronet and serious changes have taken place in the horn that any notice is taken of it. All injuries to this region, however slight, should receive prompt atten-
tion. A day or two in the stable, with cold, wet swabs to the part and a mild dose of physic, may be the means of preventing the injury from assuming a chronic character. Where this has already become established the toe should be shortened, the heel of the foot lowered, and the heels of the shoe thinned from the quarters backward. The object of this i& to take the bearing from the front of the foot and relieve the affected part. A mild counter-irritant may then be applied to the coronet every three or four days, but no attempt should be made to blister, nor should an irritant of any kind be employed if there is oozing or discharge from the junction of horn and hair. Moderate pressure to the enlarged coronet is attended with benefit in some cases. This may be applied by means of tea-lead folded in such a way as to bear equally upon it, and fixed by means of a bandage. The patient may be turned into a wet pasture wearing the lead conr
press, after a course of counter-irritation to the coronet. If there is oozing from the injured coronet the horse should be confined
to a loose-box, and after the wound has been thoroughly cleansed wrtn warm carbolized water it should be freely dusted over with iodoform and covered with a pad of cotton-wool. This, secured by a bandage, will sefV to keep the dirt out and encourage healing. When again put to work, care should be taken to keep the heel dovvD
and the toe short, so that as little bearing as possible be made to fell J front of the foot. Although an animal suffering from this affection may by judicious
treatment be kept in work for some time, the liability of the hoof to crac |
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PRICKS AND WOUNDS TO THE SOLE AND FROG
|
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|
385
|
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|
at the coronet, or to be torn away from its connection with it, is always
present, and may at any time call for rest and active treatment. PEICKS AND WOUNDS TO THE SOLE AND FEOG
The feet, notwithstanding their dense horny covering, are by no means
proof against pricks and other penetrating wounds. In the operation of shoeing, a misdirected nail is often accountable for the former, and the sole of the foot is frequently injured by forcible contact with sharp substances such as glass, wire, nails, and other sharp pieces of metal, stick, &c. Pricks in shoeing, although mostly referred to want of care on the
part of the shoeing-smith, are by no means so frequently due to this cause as is generally alleged. Horses with shelly, weak feet, or feet whose crust is much broken away, sometimes render the safe lodgment of a nail an almost impossible task, and, however careful a man may be, such feet can only be shod at great risk. It is, however, true that badly-driven nails, the careless stamping of nail-holes, defective pointing of nails, and badly- fitted shoes are not infrequently responsible for injuries to the feet by pricking and binding. It is, however, to be borne in mind that some horses are of such a vicious and uncontrollable character as to render such accidents possible in the hands of the most careful workman. Apart from shoeing, horses doing town work frequently pick up nails on the road, in the forge, or in yards or sheds where packing is going on, or in other places where nails, fragments of metal or glass are always to be found. The frog, its commissures and cleft, being the softer parts of the sole,
offer the least resistance to penetrating substances, and for this reason it is here that injury most frequently occurs. The danger attaching to pricks to the foot is not confined to the puncture alone, but is materially added to by any septic matter which may at the time be conveyed to the " quick " or vascular structures within. The injury may be comparatively harmless, or serious, or even fatal, in
its effects, according to the depth of penetration and the nature of the structures concerned in it. This will vary from a mere puncture of the sensitive sole or frog to a more extensive and penetrating wound involving the pedal-bone, the perforans tendon, the navicular joint, or the navicular hone itself. The immediate effects of a prick to the foot are not always such as to
attract attention at once, and it sometimes occurs that several days elapse before its existence is suspected; but as time goes on, and the injured part ^flames and suppurates, pain and lameness are developed, and a search alter the cause is provoked. Vol. II. 59
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HEALTH AND DISEASE
|
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|
386
|
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|
It is good practice, in all cases of lameness where the cause is obscure,
to remove the shoe and thoroughly explore the foot, and especially so where the lameness is sudden in its onset or the animal has been recently shod. Not infrequently this task is omitted because the fetlock is enlarged,
hot, and tender, and the conclusion is too hastily arrived at that the joint has been subjected to sprain. After days of acute suffering, the error is made known by the appearance of an abscess at the coronet, when it becomes clear that the swollen joint was the result of extension of inflam- mation from the injured foot. In searching the foot every nail and nail - hole should be closely
examined as the shoe is removed, and any moisture upon the one or oozing from the other must be taken to indicate mischief. A thin layer of horn should then be removed from the sole and frog, and the foot pinched round its outer edge, the operator noting at the time any flinching which may De evinced at any particular point. Where a prick is found to exist, all horn must be taken away from around it until the bottom is reached and the sensitive structures laid bare. If it is found that a piece of nail, or glass, or wire has been broken off and become embedded in the tissues, it can then be removed. Any neglect or oversight in this connection is likely to be followed by most serious results. The wound must now be treated antiseptically. In the first place the
foot should be immersed in a pail of warm carbolized water or a 3-per-cent creolin solution and thoroughly cleansed, after which the wound should be irrigated with a solution of bichloride of mercury of the strength of 2 parts in 1000. A thick pad of cotton-wool or some other suitable well- baked dressing should then be applied to the part and secured by a bandage or strips of wood stretching across from one side of the foot to the other, and fixed between the shoe and the crust. The foot may now be enclosed in a clean leather boot. Should the inflammation be severe, it is desirable to administer a dose
of physic, and a cold wet swab applied over the crust will be found to keep the horn moist and afford relief. The wound will require to be dressed from time to time either wlW
carbolic solution or dry dressing in the form of iodoform alone or mixe with boracic acid. When overlooked or neglected these penetrating wounds give rise
serious complications, of which abscess in the foot is the most frequen development. As a result the horn becomes separated from the sensiti parts beneath, giving rise to that condition known as "quittor", wnlC is treated of elsewhere. Necrosis or sloughing of injured bone may also |
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SIDE-BONES
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387
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among the results. Joints may be laid open, tendons and their sheaths
inflamed, and the leg may swell as the result of inflammation extending along the cellular tissue (cellulitis) from the foot upwards. In all these conditions the lameness is severe, and in some no weight
can be borne on the foot. The animal stands with the toe lightly resting on the ground, lifting up the leg now and again and holding it suspended m the air as the result of pain. The slighter injuries, when promptly attended to, readily yield to treat-
ment and a few days' rest. In all cases of pricks to the foot in which swelling of the coronet or
Persistent lameness remains after subsidence of the acute symptoms, a repetition of blisters over the pas- tern during a rest at grass will prove beneficial. SIDE-BONES
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Side-bones are hard, unyielding
formations situated immediately
above the coronet towards the
heel. Pathologically considered,
they
consist in a transformation
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< -V.
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" 7.' i^l
w
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W
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if*
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°f the lateral cartilages into bone
|
Fig. 401.—Pedal Bone, showing ossification of lateral
cartilages constituting "side-bones" |
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Dy the deposition into their struc-
ture of calcareous salts. This change is sometimes preceded by inflam- mation of the tissue of the cartilage, but in a large percentage of cases 110 such antecedent state exists. The liability to this disease is much greater in heavy than in light
■horses, and whether it occurs in the one or the other it almost invariably affects the fore-feet. Before the days of the Shire Horse Society, a very large proportion of
°Ur heavy horses became victims of the disease, resulting in a diminution |n their value from 25 to 75 per cent. Thanks to the rigid veterinary lnspection instituted by this Society, and more or less completely adopted °y others, the prevalence of the malady has been so far reduced as to encourage the hope of its becoming as rare as it was common. Causes.—Side - bone is one of the most pronounced of hereditary
peases. Its tendency to arise in the progeny of affected animals is now
Known to every horse-breeder of experience, and we owe it to the growing
recognit,ion of this fact, and the more judicious selection of breeding stock,
nat the existence of the disease has been so largely curtailed. In some
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HEALTH AND DISEASE
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388
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|
families the hereditary disposition to side-bone is so strongly marked as to
respond to the most feeble of exciting causes. These commonly take the form of blows to the coronet, concussion to the feet, sprain of the cartilages, too early and severe work, especially on deep strong land where short turnings and heavy pulls are required at the headlands. High-heeled shoes and high calks are also said to excite it, but these bear a small proportion, if any, to the other inducing causes. Symptoms.—The actual presence of side-bone is made known when
the cartilage or a part of it has become hard and unyielding and lost its natural elasticity and spring. This change, with rare exceptions, com- mences deep down at the point where the cartilage is connected with the pedal or "coffin" bone. There is, therefore, a period in its early develop- ment when it may not be recognized with certainty owing to its enclosure within the hoof. In the course of time, however, it becomes obvious to the touch, and in many instances to the sight also, appearing as a rounded prominence on the coronet towards the heel. The disease may affect only one foot, or both, or one side of a foot, or both cartilages may be involved at the same time or consecutively. In some instances side-bones are ot slow growth, while in others the whole of the cartilage undergoes rapid ossification. Lameness is by no means a necessary result of side-bone. Numerous cases occur without giving rise to any obvious change in the animal's action, while others are attended with considerable pain or even complete disablement. In the latter examples the foot is hot, the action short, and the tread wanting in firmness, with an inclination to the sound side of the foot, if such there be. When in the stable the animal stands with the heel slightly raised from the ground, and if both feet are
affected
the weight is shifted from one limb to the other at longer or shorter
intervals. Treatment.—In all cases of foot-lameness in heavy horses where no
obvious cause for it exists, side-bone should be suspected and prompt treatment adopted. Where a pond is available the horse should be made to stand in it two or three hours a day for a week, and should be after- wards blistered over the coronet and pastern every fortnight for three times, or oftener if required. In the intervals he should be turned into a damp meadow or river-side pasture, or into a yard well littered with peat or tan. Should blistering fail to remove the lameness, firing must be next resorted to. In old cases firing should be adopted at once. Cutting fissures in the hoof by means of a saw, or dividing the nerves of the foot, are the last and heroic measures of side-bone treatment. |
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NAVICULARTHRITIS—NAVICULAR DISEASE
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|
389
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NAVICULARTHMTIS—NAVICULAK DISEASE
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This is a disease of the foot, and, excepting perhaps splints, one of the
most common causes of lameness from which horses suffer. From a rough estimate, it may be said that not less than 60 to 70 per cent of our light horses, and more of the heavy ones than is generally be- lieved, sooner or later become affected by it. Just as a splint is the bane of young horses, so is navicular disease the common affliction of old ones. While the former, however, is amenable to treatment, and seldom becomes permanently hurtful, the latter is practically incurable and progres- sively destructive, so that once established it goes on from bad to worse, and ultimately cripples its victim and renders him physi- cally useless. It was not until the early part
°f the nineteenth century that anything was known of this most destructive ailment. Until then the lameness arising out of it had been for a long time attributed to various imaginary conditions, as well as some real ones, hence it |
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Fig. 402 —Navicular Disease
a, Healthy bone; B, Primary disease of bone, giving
rise to softening and erosion of the cartilage at numerous points; C, Bone showing loss of cartilage and underlying excavations; D, Large carious surface resulting from con- fluence of small excavations. |
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received and became known by a
variety of terms, according with the various views entertained as to its seat and origin. From its |
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supposed existence in the muscles
°f the shoulder and chest it was by some designated "chest founder"; while
others, regarding it as the result of contraction of the feet, spoke of it as ' contraction ", which was alleged by the leading veterinary authorities to arise out of a diseased condition of the sensitive laminae intervening between the pedal-bone and the hoof. About the year 1804, Moorcroft, a |
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HEALTH AND DISEASE
|
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390
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distinguished member of the veterinary profession, first indicated the actual
seat and nature of the disease, which he spoke of as "coffin-joint lameness". A few years later Mr. James Turner very considerably added to our know- ledge of the malady, since which time it has been known by the term navicular disease, and more recently as navicularthritis. As to the precise nature of the disorder, it is now pretty generally
regarded by veterinary surgeons as an ulceration or caries of the navicular bone. Commencing at first in a subacute inflammation of the ossific struc- ture, the bony tissue gradually undergoes solution and removal at one or several centres, as a result of which minute holes occur near to the surface and gradually extend themselves
inward and outward, until two or more joining together form large ulcers and excavations, dur- ing which the articular cartilage covering the bone undergoes a process of softening and removal. The bone having lost its smooth- ness, now presents a rough and eroding surface to the flexor ten- don on which it rests, with the result that by constant rubbing of the latter against the former, the tendon becomes irritated and |
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Tig. 403. —Sections of Navicular Bone, healthy and diseased
A, Section of healthy bone; B, Section of diseased
bone permeated by carious tracts. |
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inflamed, and later swollen and
softened, when its weakened fibres |
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gradually break away and impart
to its articular surface a rough and ragged condition. Associated with these changes in the bone and tendon, chronic changes in the synovial membrane are also observed, so that one after another all the structures of the joint sooner or later become implicated in the disease. If during its progress the patient is allowed a prolonged rest, the tendon frequently unites with the bone, when all movement between the two ceases to exist. Rupture of the tendon and fracture of the bone are ulterior consequences of the disease. Causes.—From the great difference in susceptibility to this affection
presented by different animals, and the evidence afforded by the family history of some, heredity would seem to exercise an important predisposing influence in its causation. That bad shoeing, by inducing weakness and contraction of the foot,
operates also as a predisposing factor there is no room to doubt, and |
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NAVICULARTHRITIS—NAVICULAR DISEASE
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391
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|
especially is this the case with regard to horses which are confined to the
stable in a standing position for long periods, while receiving large quantities of highly stimulating food. The exciting cause is almost invariably due to concussion acting upon
feet deprived of their elasticity by long-continued abuse. Animals with high hammering action suffer most, but long-continued wear on hard roads affects all alike. The most sudden and acute cases are found among hunters as the result of encountering deep drops in jumping into hard roads under heavy weights. Symptoms.—As we have seen, under ordinary circumstances navicular
disease is slowly progressive, while in others it is sudden in attack, and runs from the first a more or less acute course. In the former case the onset of the disease is hardly perceptible. If in a riding horse, the first indication of the oncoming affection is mostly experienced by the rider, who recognizes a sense of discomfort in the animal's movements arising out of a loss of his ordinary elasticity and firmness of tread; but even this for a time is subject to variation, so much so, that the owner may be led to doubt the truth of his own impressions. As time goes on, however, evidence of another kind soon presents itself. The animal is noticed to move feelingly, at first on one limb only, then after a while on the other, and then on both; but it is rarely that the defect of action is uniform on the two sides. To-day it is worst on the near one, when the animal is induced to relieve it by throwing the weight of the body mainly on the off. This, however, soon results in aggravation of mischief in the latter, when the lameness becomes worse than in the former one, and so the relative severity of the disease alternates from time to time between one limb and the other. As to the character of the lameness, it is peculiar in the increasing
shortening of the stride, the gradual loss of knee action, and tendency to move the entire limb in a stiff and stilty fashion. The action altogether becomes short and wanting in liberty, and especially so on hard ground. Un a soft surface when relieved of concussion it is less marked, but in advanced cases still evident even to the inexperienced eye. The lameness in navicular disease is seriously aggravated by work, and
is very pronounced on the morning following an active day. Moreover, as the disease becomes established, there is a disposition in the animal to believe the heel of the foot from pressure and to throw it towards the toe. Ihis has the effect of occasioning tripping and stumbling, and rendering the horse disagreeable if not actually unsafe both to ride and to drive. Still further evidence of the existence of navicularthritis may be found
*Q changes taking place in the form and character of the feet. Here it is |
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HEALTH AND DISEASE
|
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|
392
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|
observed that the heels become gradually narrow, the sole concave or
arched, the quarters deep, the frog small and wasted, and the feet generally upright and blocky in appearance. Horses suffering from navicular disease are very liable to thrush, and the feet are warmer than normal. It cannot be said, however, that cold feet are inconsistent with the existence of the disease. It should be noticed that the contraction of the feet is seldom uniform, so that one will mostly be observed to be smaller than the other. Some assistance in diagnosis may be obtained by careful observation of
the posture of the patient when in the stable. In this connection it is observed that the feet are placed alternately in positions of rest, either by raising the heel from the ground, flexing the pastern, or advancing the foot straight out in front of the body—"pointing". Treatment.—There is little hope of effecting a cure in this disease
when once it is established, but a good deal may be done by judicious management to restrain its progress and palliate its effects. In the very earliest stages of the malady it is quite conceivable that a long rest on a soft damp surface and a repetition of blisters to the coronet might effect a cure; but it is comparatively seldom that any serious attention is given to the case at this early period of its existence, and it is not until some con- siderable advance has been made that a reliable diagnosis can be effected. All cases are benefited by a run at grass, provided the ground is fairly wet and soft; but in dry seasons, when these conditions are not only reversed, but flies are also troublesome, a considerable aggravation of the disease is likely to result. When rest and blistering are resorted to, the condition of the horse should be kept up; and when he returns to the stable the feet should be irrigated with cold water morning and evening) and covered with swabs in the intervals. Setons inserted through the frogs were once very much in vogue,
but
the benefit resulting from them was not found to go beyond that derived
from blistering the coronets. Where these measures fail, it only remains to relieve the animal from pain by dividing the plantar nerves and remov- ing a portion to prevent their reunion. It must be understood that the operation referred to does not check the
progress of the disease. On the contrary, it rather tends to aggravate it; for all feeling having been removed from the foot, the animal ceases to favour it, and by indiscriminate use adds to existing trouble. Where horses are worked to the end after the operation of neurotomy, either the diseased bone fractures or the flexor tendon beneath it ruptures. The first is evidenced by a return of the pain and lameness, attended
with swelling around the coronet and a separation of the hoof from the sensitive structures of the foot. The second is manifested by a sudden |
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CONTRACTED FEET 393
swelling appearing in the hollow of the heel, by which it is rendered convex
instead of concave. At the same time the toe shows a disposition to turn up in consequence of the tendon having broken away from the pedal-bone. CONTRACTED FEET
It is not far from the truth to state that there are few horses in active
work whose feet are not more or less contracted. In saying so much, we are not overlooking the fact that horses' feet vary considerably in form and size in different individuals. Some are large, low at the heels, and other- wise weak, while others are narrow and deep and upright, with great strength and thickness of horn. Among the latter are found examples conspicuous for their length from before backward (mule feet), and also for their narrowness. Animals having feet of this conformation are not infrequently regarded with sus- picion, and are even sometimes con- demned as being the
subjects of disease and consequent de- formity. It is, how- ever, the Opinion of Fig. 404.— Normal Hoof and Contracted Hoof most experienced
men that feet of this character and conformation, i.e. resembling those
of the mule, are of all kinds the best and most enduring. As, however, We have previously observed, all, whether they be of one description or another, become more or less contracted under the influence of domesti- cation and the abuses of shoeing (fig. 404). It must be recognized that a certain measure of contraction is quite
consistent with freedom from lameness and disease; but there can be no doubt that the persistence of such a state, and the conditions by which it is fostered, will sooner or later impair the general function of the foot and lay the foundation for structural change. It needs hardly to be observed that in a state of nature the unshod
foot enjoys the fullest liberty, and every part is free to act in unison with every other; indeed, under these circumstances the natural form and dimensions are maintained by a just proportion in the waste and repair of the healthy parts; but when, as in domestication, the balance of these two |
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HEALTH AND DISEASE
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|
394
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forces becomes upset, then it is that deformity and disease usurp the place
of symmetry and health. The causes that conduce to this unhealthy state are several, the first
and most pernicious being the operation of shoeing. Here the very means designed to defend the foot expose it to the worst
forms of abuse, viz. removal of the frog or sole, cutting away the "bars", and rasping the surface of the crust. By paring down the frog, this all-impor- tant organ, by nature intended to meet the ground, and by so doing to open out the heels, is thrown out of action; wasting and shrinking, the consequences of inactivity of the mutilated parts, then soon appear, to be followed by obvious contraction. If, as is usual, the bars, which may
be
deemed to be the buttresses of the heels, are also pared and weakened, the
mischief is profoundly aggravated; and it is still more so, when to these habitual evils of shoeing is added the equally grave one of rasping the surface of the crust. By this mischievous practice the natural defence against evaporation of moisture from the foot is removed and a state of morbid dryness induced, which not only conduces to brittleness of the hoof, but also to contracting of the already weakened heels. Long-continued standing and forced rest, which some horses experience,
broken only at intervals by short periods of exercise, lend themselves to this evil consequence by throwing the entire foot out of use. Inactivity) especially when accompanied by high feeding, sooner or later ends in abid- ing congestion of the feet. This is followed by wasting of the sensitive parts, contraction of the hoof, and slowly-developed lameness, the cause of which is seldom suspected. In presence of the abuses referred to, work, like idleness, brings about the same result. Removed from contact with the ground, the frog ceases to perform its natural office, and while both feet and legs endure the jar against which it was designed to protect them, it at the same time shrinks and wastes for wrant of work, ending sooner or later W atrophy, deformity, and disease. To avoid contraction of the feet, the frog must be allowed to come to the ground, the bars must be preserved in their natural strength, and paring the sole and rasping the surface of the crust must be forbidden. Long standing in stalls should, as far as possible, be guarded against, and where rest is to be unbroken, the shoes should be re- moved and the horse allowed his liberty, either in a box well littered with tan or peat-moss, or in a yard or soft pasture where every part of the foot would be brought into action. On the Continent, and more recently in England, mechanical contrivances have been devised and applied with the object o* restoring contracted feet to their normal condition. The means employed for this purpose is a shoe made with two movable heels having on the foot surface a small sloping wedge which is brought to bear on the inner sides oi |
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STEINGHALT 395
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the heels of the foot, and then by means of an expanding screw passing
from one heel of the shoe to the other outward, pressure is made on the parts, and by increasing the force from time to time the heels are caused to open. It need hardly be said that the change brought about in this way can only be temporary, and may be mischievous. As the foot contracts by wasting, so it must expand by growth, and to render the change permanent there is necessary the exercise of those natural forces which regulate its vital activities and conduce to re-establish in it a condition of health. |
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20. DEFECTIVE ACTION AND INJURIES
ARISING OUT OF IT STRINGHALT
This is a spasmodic upward jerk of the limbs during progression. It is
chiefly observed in the hind extremities, but rarely also affects the fore ones. In the former it is marked by a convulsive flexion of the hock, when the
canon is raised high up towards the abdomen, with which it is on occasions brought into contact. This disordered movement may affect one or both hind-legs equally, or in different degrees. It is almost exclusively confined to the walk and the trot, and varies
from time to time in the suddenness and extent of the morbid movement. It is exaggerated after rest, and also by excitement. In many instances horses are taken to shows which while at home are perfectly free from the defect, but which no sooner get into the show ring than they develop stringhalt in a very marked form. In some animals it is very slight, and only observed in turning. In
others it is intermittent, and only seen now and again. Hackneys, whose hock action is now so much developed, are more frequently affected by it than any other variety of the horse. Stringhalt has been attributed to a variety of causes—some anatomical,
others pathological—and it has been variously located in the stifle, the hock, and the pastern, and attributed to laceration of muscles of the thigh, to rupture of the tendons inserted into the point of the hock, and to ulcera- tion of joints. In this country it is pretty generally regarded by veterin- arians as a nervous affection, but the proof of this, as of all other alleged causes, is still wanting. |
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HEALTH AND DISEASE
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396
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INTERFERING
In this term are included a variety of disordered movements, during
which the foot of one limb is brought into more or less forcible contact with another, giving rise to wounds and contusions of various degrees of severity on the part struck. Brushing, cutting, overreaching, and speedy cutting are the more
common defects to be dealt with under this heading. BRUSHING
This takes place when the foot of one limb habitually though lightly
strikes the inner side of the fetlock or coronet of the corresponding leg of the opposite side. The defect may be confined to one leg in front or behind, or it may involve two, or the whole of them. A repetition of the act causes soreness and swelling of the part struck, and may induce lameness. CUTTING
Cutting is distinguished from brushing only in the fact that the blows
are more severe and inflict a wound in the skin. Causes.—Conformation plays an important part in disordering the
movements of the limbs and inducing these injuries. Large, spreading feet, long, sloping pasterns, with inward or outward
inclination of the toes, also conduce to it. In the latter case there is always a tendency on the part of the fetlock-joints to approach each other, and the more pronounced this is the greater is the risk of striking. Weakness from old age, overwork, insufficient food, or disease is also a
fruitful cause. Young horses fresh from the pastures, which have not yet learnt the use
and control of their legs when under saddle or between shafts, are most commonly addicted to brushing and cutting, and especially when tired or out of condition. Defective shoeing, especially when coupled with faulty conformation,
also conduces to this mishap. A shoe fitted too full, i.e. allowed to project beyond the crust on the inner side, is a frequent cause of it in young horses and in others when tired. Cutting occurs much more frequently in the hind fetlocks than in the
front ones, particularly where horses are engaged in carriage work. This discrepancy in favour of the front legs may, as Goubaux and
Barrier affirm, be " owing to the fact that the separation between the hind' |
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INTERFERING
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397
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feet is generally less marked than that between the fore-feet"; but we are
of opinion that this is not the only cause of the difference. The hind limbs being more especially engaged in propulsion, are more likely to have their line of action disturbed in acting upon the ground than the fore ones, which are more essentially supports, and it is not unlikely that the existence of calkins on the hind feet tends still further to misdirect the movements of the limbs. Horses whose legs are long and set close together on a narrow trunk are
frequently the subjects of brushing and cutting, as are also others whose feet are brought close to each other by the inward tendency of their limbs. Cutting may also result from the accidental
displacement of a shoe, or when the clinches are badly laid down. However well balanced a horse's move-
ments may be, he is often induced to cut when travelling over slippery roads. ; The more serious effects of brushing and j I
cutting are:—(l) Injury to the plantar nerve \ as it passes over the fetlock-joint; (2) bruises to the sesamoid bones, which may provoke an ossific growth; (3) destructive cellulitis, resulting from the introduction of septic Fig. 405.-Shoe to remedy'"cutting- matter into the wounded skin. Any attempt to mitigate or overcome this defect must be based upon a
consideration of the cause out of which it arises. Where defective confor- mation is the cause, some attempt must be made to alter the direction of movement by the employment of a specially-formed shoe; what particular shape it should take is a question which has often to be decided by experi- ment. Before anything is done in this connection, the feet should in all cases be carefully examined without the shoes. It will then be seen whether there is any difference in the height of the inner as compared with the outer quarter of the wall, and whether the foot is taking a regular bearing all round. Any disparity in the first point should be rectified, and the crust made
Wei from heel to toe and from side to side. Where these conditions have been provided, a shoe should be tried whose inner branch is somewhat straight, and fitted well under the edge of the hoof (fig. 405). If this has not the desired effect, the edge of the crust of the inner quarter must be rasped down, the inner branch of the shoe made narrow, deep, rounded 0rF at the edge, and fitted well under the crust. The blow is usually inflicted by the inside toe, but may also be caused
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398 HEALTH AND DISEASE
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by the heel, especially in those cases where the toes are turned out. ^
may likewise be delivered by the middle of the crust, when the clinches, if not properly laid down, occasion nasty wounds in the skin. It is very difficult, and sometimes impossible, to prevent this faulty
action. Horses with long pasterns, whose toes turn out, are perhaps the least amenable to treatment. In these cases the injury may be inflicted by the inner part of the toe or by the heel, against both of which some provision should be made. A shoe with the inner branch straight, set well under at the heel, and well rounded off at the inside toe, is most likely to minimize the trouble if it does not altogether remove it. Where this fails, a three-quarter shoe (fig. 408) with the toe similarly
dealt with may be tried. In old horses work should be apportioned to their powers, and young
ones should be carefully conditioned and trained in the various evolutions they will be required to perform before being sent to active work. The weak must be strengthened by good living, and the sick withdrawn
from
work.
OVERREACH
This results when the toe of the hind-foot strikes the heel or coronet oi
the fore one on the same side. Somewhat serious wounds are occasionally |
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Fig. 406.—Overreaching
Toe of Shoe with rounded inner edge.
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a, Point of Contact.
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inflicted by this movement, and horses are not only lamed, but riders are
sometimes dismounted, and suffer serious injuries in consequence. The damage to the fore-foot is inflicted by the inner margin of the t°e
of the hind shoe, and not, as is frequently supposed, by the front or outei edge. This accident is favoured by that peculiar conformation in wdiich a sh°i
body is set upon long legs. Animals low in front are also more predispose to overreach than others of the reverse type, and the danger is augments when the hind-feet have been allowed to grow unduly long. It mostly results when horses galloping over heavy land fail to ge
their fore-feet clear away from the ground before being overtaken aB |
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INTERFERING
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399
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struck by the hind ones. Jumping on to rising ground, or being suddenly
checked when going at racing speed, are not uncommon causes of the mishap. As a means of preventing overreach, the hind shoes should be rounded
on the inner edge of the toes. If the hind-feet are overgrown, they should be shortened and the shoes well set back behind the margin of the toe. The fore-feet also must be kept within reasonable limits in regard to length. FORGING
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This is a defect in the action of the limbs which allows the toe of the
bind shoe to strike the under surface of the corresponding fore one. The |
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Fig-. 407.—Forging
B, B, Points struck in forging; c, c, Points on Toe of Hind Shoe which strike the Fore Shoe. D, Toe of
Fore Shoe with inner edge bevelled.
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P°int struck varies in different cases, and may be anywhere between the
toe and the heel. The striking point of the hind shoe is the toe and parts to right and left of it. Besides the loud clacking noise produced by this disordered movement, the heel of the fore-foot may suffer injury, the shoes ^ay be pulled off, or the animal may be thrown down by locking of the aiQd and the fore shoes. As in overreach so in forging, conformation must be recognized as a
Predisposing factor. Leggy horses with short bodies, and others whose ind limbs are too much inclined forward, display a special liability to this defective movement. |
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|
HEALTH AND DISEASE
|
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|
400
|
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|
Young animals, however well set up, when weak or fatigued by over-
exertion, frequently forge until an improved condition is established. Loose and careless driving encourages any tendency to it that may exist from the causes referred to above. Forging is sometimes determined by defective shoeing. The hind-feet
are not only allowed to grow unduly long, but the shoes are fitted full and given too much prominence at the toes. Where these conditions are allowed to exist behind, they are almost invariably present in front as well. It results from this that the long fore-feet do not clear the ground before being overtaken and struck by the long hind ones. The feet in these cases may not appear to be of undue length, but in
relation to the peculiar long-striding action of the animal they often prove to be so. To guard against forging, it is important that horses be driven well up
to the bit at a moderate pace, well fed, and not overworked. The fore shoe should be narrow and well seated out on the ground surface, and the foot restricted in length. The hind-foot should be shortened at the toe, and the shoe fitted well
under the crust, so that the latter is somewhat in advance of the former. It is also desirable that the toe of the shoe should be nicely rounded off, the heel allowed to take its natural bearing instead of being raised by calkins. SPEEDY CUTTING
When horses strike the inner side of the knee, or parts immediately
below or above it, with the foot of the opposite leg, they are said to " speedy cut". Causes.—All causes of this accident are mainly connected with con-
formation and action. Thus horses with narrow chests, whose legs are close together, are particularly liable to it, and especially so if the toes should happen to turn out, or the legs be set too far back. The tendency to speedy cut is considerably aggravated by weakness and fatigue, hence the mishap occurs most frequently in ill-conditioned animals, or in those better conditioned at the end of a journey, when tired and incapable oi exercising full or complete control of the limbs. The liability to this mishap is materially increased by the mode oi
action, but it does not, as has been said by some, arise entirely in con' sequence of this being "high". The wTorst speedy cutter the writer ever saw was an animal whose action was quite the reverse of this. Any horse may "speedy cut" by an accidental movement in gallopine>
or in draught, but the habitual " speedy cutter" almost invariably presents |
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|
INTERFERING
|
||||||||||||||||||||
|
401
|
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|
some defect of conformation. The danger resulting from it is not only that
it tends to disfigure and to provoke lameness in the animal itself, but equally so in that it tends to stumbling and to imperil the safety of the rider or driver. Symptoms.—These are shown in the act of riding and driving by an
occasional stumble, or the animal may halt and go lame for a few strides, or continue so for some time, according to the severity of the blow or the soreness of the part from previous injury. Where the injured limb has been recently struck, a very slight blow on the previously injured part will excite acute lameness. In some animals the local symptoms are but slight, and seldom exceed a superficial abrasion with slight chronic thickening of the skin. In others deep contusion results, when the part be- |
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|
comes hot, swollen, and painful to the touch,
|
Fig. 408.—Three-quarter Shoe
|
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|
or a serous abscess may develop, which will
be known by the sudden appearance of a soft, fluctuating enlargement on the part struck. In cases where the injury is severe and deep matter is sometimes formed, the leg becomes generally enlarged, and acute lameness results. Chronic callous swellings arise after a repetition of such injuries, and the bones of the knee may become in- volved in the disease. Where these latter conditions exist the joint is imperfectly flexed, and the action permanently impaired. Treatment.—Simple contusions will re-
quire to be met by hot fomentations or hot bandages applied to the injured part. This, conjoined with rest and a mild dose of physic, will generally suffice to effect a cure. Where an abscess is developed, whether containing serum or pus (matter), it must be laid open and the contents evacuated. The wound should then be freely irrigated with carbolic |
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|
Fig. 409.—South's Rational Shoe
(Charlier system). |
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|
or some other antiseptic solution, and covered
|
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|
over with a pad of cotton-wool held on by
a firmly-adjusted bandage. If after the wound has healed any thickening
remains, a mild blister may be applied, and repeated once or more, if Necessary. Any enlargement of the part remaining after treatment will render it liable to be injured again. |
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|
60
|
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|
Vol. u.
|
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|
HEALTH AND DISEASE
|
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|
402
|
|||||||||
|
Prevention.—In regard to prevention, this must take the form of pro-
tecting the limb, and giving an altered form and bearing to the offending foot. The former may be effected by the application of a suitable boot. The latter will require that the inner quarter of the crust be rasped down and the shoe fitted close in. Three-quarter shoes (fig. 408) or the Charlier system (fig. 409) may be tried where the other methods fail, and the feather-edged shoe will in some instances have the desired effect. Speedy cutters should not be allowed to wear their shoes too long. |
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|
21. WOUNDS AM) THEIR TREATMENT
WOUNDS
A wound is a division or rent in the soft parts of the body, the result
of violence. Wounds differ in kind according to the manner of their production, and
are classed as follows:— 1. Incised Wounds.
2. Lacerated Wounds.
3. Contused Wounds.
4. Punctured Wounds.
There is also a fifth kind—poisoned wounds—which includes all wounds
into which poisonous matter or virus has entered. Incised wounds are such as are produced by a sharp-cutting instru-
ment, as a razor or knife. Here the divided surfaces are smooth and regular, and lend themselves most readily to readjustment. Moreover, the healing process in this description of wound is greatly favoured by the absence of any bruising or tearing of the flesh. The liability to haemorrhage is much greater, however, than in the other varieties. This is referable to the fact that the vessels, instead of being torn and frayed out at their broken ends, are cut clean through, so that the blood, besides having a free and open passage, meets with no broken shreds of tissue about which to coagulate. Lacerated wounds result when hooks or blunt instruments enter
the flesh and are forcibly torn out. In this case the broken surface is more or less rough and irregular, and loose shreds of tissue sometimes hang from the divided parts. Bleeding is much less considerable than in incised wounds, as in the breaking of the torn vessels their coats become detached from each other, and the inner ones are retracted within the |
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|
WOUNDS
|
|||||||
|
403
|
|||||||
|
outer one, and thus help to plug up the orifice. Then again, the torn
end of the vessel affords a rough and ragged surface about which the blood more readily coagulates than when the vessel is clean-cut. Contused WOUnds are produced when, in addition to a division
of the tissues, the surrounding parts are more or less bruised. The contusion or bruising, when considerable, has the effect of rupturing the vessels and causing the injured parts to be infiltrated with blood after the manner of a black eye, or it may so far damage the tissues as to cause them to die and to slough. In any case their vitality is impaired to a greater or less extent, and the power of healing correspondingly diminished. Contused wounds, therefore, as we shall presently see, require special consideration in the matter of treatment, since it is not only necessary to bring the divided surfaces together, but to restore vitality in the injured part. Punctured WOUnds are produced by stakes, and pricks with small,
sharp- or blunt-pointed instruments, as when nails enter the feet, and stable-forks the limbs and other parts of the body. Here, as in the case of incised and lacerated wounds, the tissues will be cut by a sharp-pointed instrument, and torn by a blunt one. In the latter case there would be, in addition to the severance of the tissues, more or less bruising of the parts through which it passed, and, as in the case of a contused wound, healing would be rendered more difficult, and the con- dition of the part more dangerous. It is not, however, to these considera- tions alone that punctured wounds owe their importance. They are usually deep, and the divided surface of the tissues is out of sight. Deep- seated vessels, nerves, and other structures may be severed, and, what !s of the first importance, dirt, decomposing matter, or a part of the instrument itself, may lodge in the wound and complicate the injury. Poisoned Wounds.—These are wounds into which one or another
°f the many forms of poison or virus has gained admittance, either at the time when it was inflicted, or afterwards by accidental contact with them. Although wounds, and the body generally, may suffer by the entrance of mineral poisons, those derived from the vegetable or animal kingdom are by far the more common and hurtful. Nor does it always require that the animal supplying the poison should itself be the subject °f disease, as shown by results which follow the sting or bite of insects and serpents. Most commonly, however, animal poisons are either the Products of disease or decay. The former is exemplified in the bite of the rabid dog, and the contamination of a healthy wound with the virus °t glanders; while the latter finds expression in the inoculation of wounds •ty decomposing animal matter. |
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|
HEALTH AND DISEASE
|
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|
404
|
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|
HEALING OF WOUNDS
The manner in which the divided surfaces of a wound are united is
not always the same. How this will be effected will depend upon a variety of circumstances, notably the time which elapses between the infliction of the wound and the readjustment or apposition of the parts, the manner in which they are brought together, the nature of the cut surfaces, the presence or absence of foreign matter, the extent of injury done to the surrounding tissues, &c. The time occupied in the process of healing, aS most people know, may be very short or very long, according to the extent of the wound and the particular method by which healing lS effected. By careful observation and enquiry, it has been shown that the healing
of wounds may take place in five different ways, viz.:—1. By immediate union. 2. By primary adhesion, or union by the adhesive inflammation- 3. By blood-clot. 4. By granulation, or by the second intention. 5. By scarring under a scab. To the lay mind, these expressions do not convey much meaning, but by a little explanation they may be made just &s intelligible as they appear to the professional reader. Immediate Union.—In healing by immediate union, the divided
parts, on being brought together, are caused to adhere in the first instance by the sticky nature of the matter which then covers their surface, an°- in a short time—sometimes not more than twenty-four hours—a firm and perfect connection is re-established between the previously divided parts. Examples of this kind of healing are noticed when, on cutting the finger* the parts are brought together and tightly bound up, when, on removing the wrapping, complete repair is found to have been effected without inflammation or discharge, and with little or no pain or swelling. In this case no scar remains to mark the seat of the injury, and no
new tissue intervenes between the newly-united surfaces; they have simply grown together. Primary Adhesion.—Here, instead of the divided parts growing
together directly, as in immediate union, without the intervention of new material, the two surfaces of the wound become covered over with a thin layer of cells incorporated with a quantity of adhesive matter which ha exuded from the vessels. Some of the former resemble the round,' colour less corpuscles of the blood, but they soon begin to change their form J lengthening out into thread-like bodies, and ultimately to be resolved i° a layer of connective tissue by which the divided parts are firmly an permanently reunited. In the course of these changes, new blood-vess from the old ones in the adjoining tissue shoot out into the uniting s |
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|
WOUNDS
|
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|
405
|
|||||||
|
stance, and organization having been thus established, repair is completed
by the growth of a layer of cuticle over the united parts. This mode of healing is unattended by any local or general disturbance, and illustrates what takes place in " healing by the first intention". Healing by Blood-Clot.—Healing by blood-clot differs but little
from that just described. It occurs when, in consequence of the edges of a wound not being brought immediately into apposition with each other, the space between them becomes filled with blood-clot, into which white blood corpuscles and plasma cells soon penetrate. By a process of development the latter are resolved into fibrous tissue,
which, as in healing by the first intention, form the permanent bond of union between the divided parts. These two modes of union can only be effected where the lips of the wound are undisturbed and all causes of irritation are excluded. Healing by Granula-
tion.—If, instead of heal- ing by one of the three methods referred to above, an incised wound be left open, it is noticed that the Surface SOOn becomes COated Fig. 410.—Wound Healing hy Granulation
OVer with a pale, o-lairy Sub- 1> Discharge. 2, Margin of sore. 3, New epithelium at edge
1 „ . . of sore. 4, Epithelium unaffected by the wound. 5, Blood-
StailCe Composed Of white vessel. 6, Deep organizing layer beneath granulation. 7, Hair.
blood cells in the midst of
a quantity of sticky albuminoid matter, which together have passed out
of the blood-vessels of the part. Sooner or later, according to the extent of damage the tissues have sustained, small, raised points begin to appear here and there above the glairy film, until the entire surface of the wound is dotted over with little, rounded, fleshy-looking granules, or, as they are termed, granulations. These by enlarging coalesce or run one into another, and having formed a continuous layer on the surface of the wound, begin again to throw out granulations as before, and by a repetition of the process the breach is filled in and repair is com- pleted (fig. 410). As the granulations grow and mature they soon begin to shrink, and in doing so draw the sides of the gaping wound together. At the same time they lose their red colour, become dense and firm in con- |
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|
HEALTH AND DISEASE
|
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|
406
|
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|
sistence, and are finally resolved into a tough connective tissue, as indicated
by the white, glistening scar which remains on the site of the wound. As to the nature and source of granulations, they are made up of little
heaps of closely-packed cells permeated by minute blood-vessels. The former are derived from connective tissue cells which previously existed in the injured structures, and which, under the influence of irritation excited in the part as a result of the injury, have been caused to multiply, while the new vessels with which they are supplied are offshoots from the old ones. In this mode of healing, many of the cells intended for the purpose of tissue-formation die and are east off as pus cells, and constitute the white, creamy discharge commonly termed " matter". When, in the course of healing, granulations are in excess, and project
beyond the wound as a fleshy excrescence, they are usually spoken of as " proud flesh ". The three forms of healing first referred to are unattended with danger
or suffering to the patient; but in the more prolonged process of suppu- ration and granulation involved in the fourth, various complications may arise by which the general health is more or less seriously impaired, or life imperilled. These untoward results occur for the most part before the surface of the wound is completely covered with granulations, and are brought about by the entrance of bacteria into the wound, and their repro- duction there, giving rise to what is commonly termed "blood-poisoning"- Besides contaminating the blood, bacteria also operate prejudicially
against the healing of wounds. The chemical products they give out irritate and inflame the injured part, and produce a more or less copious outflow of pus, and delay the healing process. Blood-poisoning presents several forms and degrees of severity, from
a slight traumatic fever to a fatal collapse, or the development of a suc- cession of abscesses in different parts of the body, extending over a more or less protracted period. The fluids contained in and upon the surface of a wound serve as a-
suitable habitat or breeding-ground for a variety of micro-organisms, which not only undergo rapid multiplication, but in the course of their growth and development give off chemical products which in certain conditions ox the wound become absorbed into the system, and produce that form ot blood-poisoning known as septic intoxication. Large wounds are the more dangerous because of the large supply of this septic product they yield, and the greater extent of absorbing surface they present. The period ot greatest danger is during the first six or seven days, or until the wound becomes covered with granulations, which form a barrier against the absorp- tion of the poisonous bacterial products. |
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|
407
|
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|
WOUNDS
|
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|
In addition to the poison they form in the wound, some micro-
organisms are themselves capable of entering the blood and tissues of the body. Here they grow and multiply, and add to the store of poison entering from without, and by their presence produce that condition of the body known as septicemia. When the invading organisms enter the blood in large numbers, they
may provoke it to coagulate around them, and the small clots so formed, by plugging the capillary vessels, form scattered centres of inflammatory action and pus formation in different organs and parts of the body, con- stituting another variety of blood-poisoning—pyaemia. The more seriously the tissues are damaged at the time when the
wound is inflicted, the more vigorous is the growth and action of the invading organisms. The diminished vitality of the one having reduced their powers of resistance, renders them more amenable to the action of the other. It is for this reason that torn and contused wounds heal so much more slowly than others inflicted with a sharp instrument. Although, as we have seen, the evil consequences resulting from bacteria
and their products may be serious, and even fatal, their occurrence in the horse is, comparatively speaking, rare. Every day horses with deep, gaping wounds may be seen, having no protection of any kind, and little or no medical care, yet they pass through their trouble with little or no more discomfort or suffering than is occasioned by the prolonged period of healing resulting from the local inflammation which the micro-organisms and their products excite. Still, notwithstanding the natural resistance which wounded flesh offers
to the entrance of bacteria and their products into the system, it happens from time to time that the one proves too feeble to exclude the other, hence it has been found necessary in the treatment of wounds to resort to special methods by which to destroy and exclude from them all offending organisms. This mode of treatment, first devised and practised by Lord Lister, is known as the antiseptic system. It is based on the fact that such bacteria as prove inimical to wounds, and endanger life by poisoning the blood, are capable of being destroyed or inhibited in their action by the application of various dressings composed of certain chemical substances m the form of powder or solution. The more common agents employed tor this purpose are carbolic acid, perchloride of mercury (corrosive subli- mate), iodoform, boric acid, &c. See pp. 420, 421. Healing under a Scab.—This is nature's method of repairing
bounded parts, and in suitable circumstances the best that can be de- nser! It is well illustrated when, after the surface of the skin has been broken, the blood and other exuded matters are allowed to dry upon it, |
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|
HEALTH AND DISEASE
|
|||||||
|
408
|
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|
and form, as they will, a complete defensive covering or scab. In this con-
dition all foreign substances which would irritate and inflame the wound are excluded from it, and so long as this state continues, healing proceeds rapidly without interruption. Anything, however, that inflames and pi'0' vokes the formation of pus (matter) beneath the scab, interferes with the process and delays reparation. GENERAL TREATMENT OF WOUNDS
As wounds vary in their nature and character, the details of treatment
require to be modified accordingly. There are, however, certain general principles applicable to wounds of every description which must be observed if treatment is to be made a surgical success. In this connection the clue* objects to be attained are:—(l) To arrest haemorrhage; (2) to cleanse thoroughly and free the wound from all dirt and foreign matter; (3) to render the broken surface aseptic; (4) to bring the divided parts into close apposition with each other and retain them in that position; (5) to exclude all dirt and micro-organisms from the wound after adjustment; (6) to prevent movement of the part and avoid all other sources of irritation. A certain amount of inflammatory action results when a wound is
inflicted, and this will be greater or less according to its size, the period of exposure after infliction, and the mode of production. Serious inflammation tends to retard healing, and should therefore be kept under control as far as is practicable. The common practice of applying hot oils to wounds is much to be deprecated, inasmuch as they produce inflaffl' mation and increase the discharge of pus, and interfere with the healing process. Arrest Of Bleeding.—The method to be adopted for this purpose
will depend upon the size of the divided vessels. When these are sra&"> the less the part is interfered with the better. A short period of exposure to cold air will usually suffice to stop the flow; should it fail, the edges o the wound may be brought together with gentle pressure, or the wounde surface may be irrigated with clean cold water, or pressed upon for ■ minute or two by a pad of clean lint or cotton-wool soaked in a solutio of tincture of iodine in the proportions of 20 drops to the ounce of water- When the haemorrhage is profuse, and the blood spurts out or fl°w away from certain points of the wound in distinct streams, the divide vessels must be sought for, and either twisted, or raised with forceps an tied round with aseptic gut or silk. It should be pointed out, howeve > that ligatures tend to retard the healing of wounds, and where possio should be dispensed with. |
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|
GENERAL TREATMENT OF WOUNDS
|
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|
409
|
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|
Cleansing.—When haemorrhage has ceased, the time will have arrived
for cleansing the wound and preparing it for adjustment. This should be done with gentleness and care, lest bleeding be induced to recur. Everything brought into contact with the wound should be clean, and
rendered aseptic by suitable dressings. The removal of all adherent blood |
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|
Fig. 411.—Various Methods of Arresting Bleeding
1, Probe lifting an artery while the forceps hold back its sheath. 2, Needle inserted and threaded.
3, Tying a ligature. 4, Correct knot for a ligature. 5, Effect of a ligature on an artery: a, the severed ends of inner coat turning inwards; b, b, blood-clots. 6, Cheeking bleeding by a tourniquet. In the illus- tration a pad is placed on the artery and bound down by a bandage; a stick is used as a tourniquet, and is kept in position by a second bandage. 7, Closing an artery by torsion. The artery is seized with one pair of forceps and twisted about twelve times by the other to sever the inner coat. and foreign matter may be effected by allowing a stream of cold carbolized
solution to flow over the wound, and if necessary the surface should be carefully wiped over with a loose pledget of wool or lint soaked in carbo- lized water or some other disinfectant. In penetrating wounds inflicted by stakes and other sharp implements, broken splinters are sometimes left behind, and unless sought for and removed will prove a source of lasting |
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|
410
|
HEALTH AND DISEASE
|
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|
trouble. They invariably give rise to profuse suppuration and discharge of
matter, which only ceases when the offending body has been removed or passed away. In some instances wounds containing fragments of foreign substances
will heal over, only, however, to break out again after the formation of an abscess, either at the seat of the original wound or in the more immediate vicinity of the impacted body. To bring the divided parts of a wound into their original position is a
most important step towards effecting a speedy reunion, but it is only in the case of incised wounds, where the surfaces are level and clean-cut, that this is capable of being efficiently carried out, and even here the greatest care is sometimes needed lest the advantages offered be lost. This is especially the case in deep wounds, where some difficulty is experienced in keeping the deeper parts of the apposed surfaces together. If for want of support they should fall away from each other, while the more superficial part of the wound closes over, an opportunity is offered for matter to accumulate between the disconnected parts below, and ultimately to break through the united tissues above. SPECIAL TREATMENT OF WOUNDS
Incised Wounds.—Of the several descriptions of wounds, that which
is "clean-cut" lends itself most readily to adjustment and rapid healing. The divided surfaces are regular, smooth, and easily brought into exact apposition, and the tissues being but slightly damaged should, under favourable conditions, heal by the first intention. In the treatment to be adopted it will be necessary, in the first place,
to arrest haemorrhage by one or another of the methods referred to under that head. Then with sharp scissors the hair is removed close to the skin, or, if possible, shaved for a considerable distance round about the wound, and the skin thoroughly washed with soap and Lister's " Strong Mixture", consisting of a 5-per-cent solution of carbolic acid and -2 per cent (1 in 500) of corrosive sublimate. Brushing at the same time with a pretty strong nail-brush will assist in rendering the cleansing efficient. The soap should then be washed off with the antiseptic solution, and
all adhering blood removed from the wound, together with any foreign matter that may have entered it. This will be done at first -with the fingers — picking off any tangible particles, and then by flooding the wound with a 5-per-cent solution of carbolic lotion. The two surfaces of the wound are now brought together, and this must be understood |
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|
SPECIAL TREATMENT OF WOUNDS
|
411
|
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|
to mean the entire surfaces of the divided parts, and not merely the
outer edges or lips; for unless perfect coaptation of the more deeply seated parts is effected, any serum which may exude from the divided surfaces will gravitate to the bottom, and by increasing in amount tend to force the parts asunder and prevent healing; besides which it serves as a breeding-ground for micro-organisms should the wound prove not to be aseptic. When the wound is of no considerable depth, but little difficulty will
be experienced in effecting complete apposition of the divided structures; but in dealing with deep wounds special care and special methods of retention will require to be resorted to. In either case, the edges of the wound must be brought together by silk, wire, or catgut suture (pp. 416, 417), interrupted or continuous, as may be deemed desirable, and after the hairless surface has been freely sponged with carbolic solution, the wound must receive its per- manent antiseptic dressing. Of the various substances employed for this purpose, the double cyanide of mercury and zinc gauze introduced by Lord Lister some years ago is regarded by our best surgeons as the most efficient and reliable. Before being used, it is wrung out in, or moistened with, a solution of carbolic acid (l in 40) or corrosive sublimate (1 in 4000), and then applied over the wound, and for some distance around it. In this connection it should be pointed out that merely to cover the wound itself is to run great risk of failure by exposing it Fis- il2-~ ° . n • i Drainage-
to attack from organisms which may obtain access from without, Tube
and defeat the object in view. Over this first layer of gauze four, five, or six others are placed, and these are covered by a thick layer of sterilized wool. Where practicable, a light bandage should be applied on the whole, so as to bring slight pressure to bear in maintaining com- plete apposition of the divided parts. In deep incised wounds gravitation of blood and serosity to the more
depending parts, leading to the formation of a cavity or pocket, and hindrance to healing, may take place, and will require to be provided against. This may be done in some cases by the careful application of pressure through the dressing, in others deep stitches will require to be inserted in order to bring the deeper parts of the wound into apposition, °r a drainage-tube (fig. 412) must be inserted for a short time to allow for escape of any matter which may exude. If the wound has been rendered aseptic and protected from subse-
quent disturbance and contamination, complete healing should be effected lri from ten to fourteen days, when the dressing may be removed and |
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|
412
|
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|
HEALTH AND DISEASE
|
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|
the stitches withdrawn. Movement of the part, however, must be
restricted for another week or ten days to allow of the union being perfected. It must, however, be understood that the prospect of wounds in a
horse healing by the first intention, even when made by the knife oi the surgeon, is seriously interfered with by the dirty surroundings oi the patient, the casual and imperfect after-attention he receives, and the difficulty in restricting movement of the part. These are so many obstacles to success which can only be overcome in exceptional cases. It results, therefore, that, however desirable it may be to bring about this mode of healing, the veterinary surgeon has in the main to rely on the more prolonged and tedious process of granulation. Again, it is seldom that casualties of this kind are brought under
his notice until many hours, or even days, have passed since their occur- rence; and further, the implements by which wounds in horses are inflicted are mostly of the dirtiest possible description, being frequently covered with dust, decomposing filth, or earth, in which the bacillus of tetanus too often lurks. Moreover, the hair and skin through which they pasS are more or less soiled and laden with bacteria. The advantages therefore offered even by an incised wound are largely discounted at the outset by these unfavourable conditions. If, after being set up and dressed in the manner prescribed, the wound
should show signs of soreness and pus formation, the dressing must De removed, and escape of the pus provided for by the insertion of a drainage-tube into the most depending part. The wound should then be redressed daily as before, until pus formation ceases. Should this not be accomplished, all the stitches must be removed, the wound laid open, allCl washed well with carbolic solution (1 in 20). Then the surface must t>e sponged over with undiluted liquefied carbolic acid, and the wound stufteo- with the double cyanide gauze sprinkled with iodoform. This dressing should be changed daily, and the skin around the wound must be cleanseo and disinfected at the same time with the 5-per-cent carbolic lotion. In large wounds thus dealt with, the lips must be supported, eitnel
by bandages or by sutures, in the position most favourable to healing- Lacerated Wounds.—This variety of wound is usually inflicted by
blunt instruments, such as hooks, nails, pieces of iron or wood, whjC are forcibly driven into the flesh. Lacerated wounds in the horse &1 commonly associated with more or less severe bruising or contusion ° the divided parts, which seriously complicates and retards the heanD» process. Moreover, the surfaces and edges of the wound are so irregU* that they cannot be brought together with that perfect coaptation f |
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|
ARAB STALLION, MESAOUD
|
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|
Sire, Aziz, bred by Ali Pasha Sherif; dam, Yemama, bred by Ali Pasha Sherif. A great Prize-winner and successful Sire
The Property of Wilfrid Scawen Blunt, Esq.
|
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|
SPECIAL TEEATMENT OF WOUNDS
|
|||||||
|
413
|
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|
favourable to the healing of incised wounds. In some instances long
shreds of fibrous tissue, being parts of tendons or fascia, hang from the torn surface of lacerated wounds, and if left to slough, as they frequently are, materially interfere with and delay healing. The desirability or otherwise of removing them at once, will be a question for consideration before proceeding to repair the damage. When the injury is inflicted by stakes from hedges, or pieces of wood
from fences, or other sources, some parts of these are frequently broken off and left in the wound. It is important, therefore, that careful search be made at the outset for any foreign body which may remain embedded in the flesh, with a view to its removal. Thorough cleansing and dis- infection must follow preparatory to dressing, somewhat on the lines laid down in connection with incised wounds. But since the torn tissues are more likely to enclose and retain organisms, gentle brushing with a soft nail-brush should be resorted to. When all dirt has been removed, the surface of the wound should be sponged over with liquefied carbolic acid in an undiluted state. In those cases where, in consequence of the depth of the wound, certain parts of its surface are not accessible, a solution of carbolic acid (l in 20) may be injected into the recesses which cannot be otherwise dealt with. As in these cases healing by granulation is the most we can hope for, everything should be clone to protect the wound from organisms and neutralize the products of such as may gain access to it. To this end the wound should be sprinkled with iodoform, and then stuffed with double cyanide gauze, and the whole covered in with a thick layer of antiseptic wool. This dressing must be applied every day, and the surrounding skin
thoroughly cleansed and freely dressed with carbolic lotion (l in 20). The treatment for Contused Wounds is the same as that for
Lacerated AVounds. Punctured Wounds.—Punctured wounds result when sharp-pointed
instruments, such as forks, nails, pieces of wire, splinters of wood, &c, enter the flesh. The danger attaching to them will be in proportion as they are deep,
and as they enter one or another of the various cavities of the body, or lay open vessels or divide nerves, or as the instruments by which they are inflicted are clean or dirty. The horse is specially liable to this variety of wound in connection
with the feet, either as the result of nails being driven into the quick in the act of shoeing or being trodden upon during progression. In whatever way they are produced there is always more or less
danger connected with them, on account of the introduction into them |
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HEALTH AND DISEASE
|
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|
414
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|
of foreign matter of a septic character, which poisons the wound and
may set up serious local and constitutional mischief. Punctured wounds frequently escape attention, until acute swelling
and the formation of abscess bring them into notice. When, however, they are known to exist, such results may frequently be guarded against by prompt and proper treatment. In this connection the extent, direction, and relations of the wound
should first be determined, if possible, by means of a small aseptic probe carefully applied. While this is being done it should be specially noted whether any foreign body has been left in the wound or not. Where it is practicable, punctured wounds should be syringed out
with carbolic lotion (1:20). If matter accumulates, a counter-opening must be made at the most depending part to allow of its escape, or they should be laid freely open and treated as a common wound. In dealing with punctured feet the horn is usually stained a dark
colour in the track of the nail, and a dark serous fluid escapes, or may be pressed from the orifice. All the horn along the course of the puncture should be removed
down to the quick, and any part of the horny sole which may be found to be detached from the sensitive sole must be removed. Being a non- vascular structure it cannot again reunite, and may afford lodgment to foreign matter and become a means of keeping up irritation in the part. After being freely laid open, the wound must be irrigated with carbolic
lotion and covered with a thick layer of antiseptic wool sprinkled with iodoform. The shoe should then be lightly tacked on, and the dressing supported by strips of cane passed across the foot and secured between the shoe and the crust. Where these wounds receive prompt attention, six or seven days suffice
to effect reparation. If neglected, the pent-up matter will force its way upward towards the coronet and break through the skin, giving rise to quittor. After the dressing has been applied, the foot should be put into a
" boot" to protect the wound from dirt, or if necessary a carbolized poultice may be applied over it. Poisoned Wounds are for the most part due to one or another of the
various micro-organisms which gain an entrance to them. In addition there are the stings of insects, such as bees and wasps, which sometimes attack our horses, and produce serious mischief. In these cases the stings must he removed, as far as possible, and the part dressed with ammonia. Snake-bites, which happily are of rare occurrence in this country, are
occasioned by the introduction of a secretion formed in the fangs of the |
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DISINFECTION OF INSTBUMENTS AND APPLIANCES
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415
|
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teeth of the snake, and injected into the tissues in the act of biting.
Except in the Common Adder (Pelias berus) we have no venomous reptiles in this country, and the poison from this creature is comparatively feeble and harmless. In snake-bites, treatment, to be effective, must be prompt; a ligature should be tied tightly round the part, above the wound, which should be laid open and encouraged to bleed freely; excision of the bitten part, and the application of lunar caustic, or the actual cautery may also be resorted to. DISINFECTION OF INSTRUMENTS AND APPLIANCES
As we have already pointed out, bacteria and their products are not
only obstacles to the healing process, but the active causes of the diseases incidental to it. It is desirable, therefore, that everything brought into ■contact with the wound in the way of treatment should be rendered free from these offending organisms. Sponges, cloths, and brushes, instruments, and sutures, as well as the
hands of the operator, should each and all be dealt with antiseptically before being brought into use. Sponges in their ordinary condition teem with bacteria of various kinds,
and unless rendered thoroughly aseptic, may prove a fruitful source of mischief. Before being employed for surgical purposes they should be well washed out in soap and water, and then transferred to a fairly strong solution of soda, and after soaking in this for a couple of hours they should be wrung out in cold water, and kept immersed in a l-in-20 solution of carbolic acid for four or five days or until required. Imme- diately before use they should be rinsed in a l-in-2000 sublimate solution, or l-in-40 carbolic lotion. Where sponges so treated are not accessible, pads of absorbent wool
steeped in carbolic or sublimate solution may be substituted. By some practitioners these are preferred, and generally employed, for the reason that after use they can be thrown away, and thus the trouble and risk of infection by sponges are averted. Whether sponges or swabs of wool are used, the act of cleansing should
always be carried out by wiping the skin in the direction away from the Wound, and neither the one nor the other should be allowed to touch the latter until again soaked in the disinfectant. Cloths and towels used for the hands and other purposes require to
be soaked for three or four hours in a solution of carbolic acid (l in 20), and all instruments employed in the operation must be similarly dealt with. Ligatures and sutures of catgut should be soaked in carbolic solution
|
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HEALTH AND DISEASE
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416
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of the strength last referred to for four or five days, and silk should be
treated in the same way, after first being boiled for twenty or thirty minutes. By the adoption of this course, suppuration in the track of the stitches is guarded against, and healing is facilitated. |
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SUTURES OR STITCHES
Various kinds of sutures are employed for bringing together and secur-
ing the edges of wounds during healing. The materials used for this- purpose are chiefly flexible wire, cat-
gut, silk, horse-hair, and silk-worm gut. Sutures are either interrupted or continuous. The interrupted variety is perhaps the most commonly em- ployed in veterinary practice, and too frequently without due regard to the nature of the wound and the prospect of speedy union. |
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Fig. 413.—Interrupted or Simple Suture
|
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Interrupted or Simple Sutures
are used more especially for wounds of
irregular shape, or situated in positions difficult of access or in which there is tension. They are formed by threads passed from side to side through the lips of the wound and separately tied. Fig. 413 gives an example of this suture, showing the knot as it
should be, lying well to one side of
the incision.
Uninterrupted or Continuous
Suture. — This form of suture is
employed where the wound or in- cision is superficial though extensive. |
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Fig. 414.—Continuous Suture
|
The blanket or button-hole stitch (fig-
|
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|
414) is the one most to be preferred.
The stitch is commenced at one extremity of the wound, and after the needle has been passed through the two lips it " is then carried under the slack of the thread, so that the loop of each stitch after being tightened shall be at right angles to the edge of the wound, while the portion inter- vening between the stitches is parallel to it". To fasten it off, the needle is passed in the opposite direction through the edges of the incision, and tied as shown in the diagram. In the employment of continuous sutures care should be taken that the edges are perfectly coapted, and that n° puckering or wrinkling result from it. |
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SUTUKES OE STITCHES
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|
417
|
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The Twisted Suture.—This variety of suture is much employed in
veterinary surgery, especially in connection with short superficial wounds. It is formed by inserting two or more pins or needles, or other suitable material, through the lips of the incision. The pins should be placed at equal distances apart of not less than half to three-quarters of an inch, and |
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Fig. 415.—Twisted Suture
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Fig. 416.—Circular-twist Suture
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should be made to enter the skin from half an inch to an inch from one of
its edges, and to reappear at the same distance from the other on the opposite side. The requisite number of pins having been introduced, a piece of silk,
catgut, or some soft thick thread or other material should be twisted around each one of them in the form of the figure 8 (fig. 415), or it may be made to describe the circular twist (fig. 416). In carrying the suture from one pin to the other, the crossing of the thread should be made to lie over the line of the wound as shown in the diagrams. |
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The Quilled Suture (fig.
|
Fig. 417.—Quilled Suture
|
|||||||||||||||||||
|
417) is employed in the adjust-
ment of deep wounds, the surfaces of which it maintains in apposition, while the edges are brought together by additional sutures of wire, silk, or other material. The quilled suture consists of a series of interrupted sutures tied on
either side of the wound to a quill, stout pencil, or some other and stronger cylindrical substance, according to the amount of support the divided parts may require. |
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Vol. II.
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61
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HEALTH AND DISEASE
|
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418
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The introduction of the quilled suture is best effected by means of
a curved needle with an eye towards the point (fig. 418). This, on being armed with a double thread of the material employed, is passed through the lips of the wound from side to side. The looped end is then seized with the left hand and retained on one side of the wound, while the needle is withdrawn, leaving the double thread projecting from the other side. This having been repeated as often as necessary, the loops are twisted,
and the cylindrical material above referred to, after being notched here and there to receive the thread, is passed through them. A second piece of the same substance is tied to the opposite side of the wound by the free ends of the projecting threads. Stitching up the Wound.—In dealing with superficial wounds, or
with those to which pressure may be applied, the edges, after being brought accurately together, are secured by one or another of the several forms of suture, according to
the character of the wound. Fig. 418.—Curved Suture Needle with Eye at Point " 1S imPOrtant VO.
inserting stitches that
they be made to take a good hold, to guard against tearing out. For this purpose they should be passed through the skin at least half an inch from the wound on one side, and brought out a similar distance from it on the other. If interrupted stitches are used they must be placed from half an inch to an inch apart. The edges must be per- fectly level one with the other, so that folding or puckering of the skin may be avoided. In order to assure this, the edges should be brought into apposition and the points marked through which the sutures are to pass, or the edges should be held together by an assistant. The stitches must not be tied until all have been inserted, and then care must be taken not to draw them tighter than is necessary to bring the lips of the wound together. Overdrawn sutures obstruct the circulation of the tissues through which they pass, and excite irritation in the part, and interfere with the healing process. Where a bandage can be applied over the dressing, its employment is
most desirable, and in some cases it is indispensable to a speedy reunion of the wound. By careful adjustment it should be made to exercise gentle and uniform pressure on the divided parts, and by so doing keep them i11 close apposition, thereby preventing the accumulation of effused fluid, and favouring the healing by the first intention. In those cases where bandages cannot be applied with effect, and
especially in the case of large wounds inflicted on parts of the body where |
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SUTURES OR STITCHES 419
|
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|
the detached skin and flesh has a tendency to become displaced by its own
weight, deep stitches of stout flexible wire or catgut should be inserted (stitches of relaxation) at some distance from the edges of the wound, in order to remove any strain or undue tension from those unit-
ing the edges of the wound
(stitches of coaptation). Plasters.—There are many
wounds in the horse which do not admit of being bandaged, and difficulty is experienced in maintaining antiseptic dress- ings in position. In some of |
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these cases strong plasters may
|
Fig. 419.—Various Patterns of Suture Needles
|
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|
be found to answer the purpose.
Thin strips of leather smeared on one side with shoemakers' wax, strong
glue, or some other adhesive composition may be made to secure them. Where plasters are employed the patient should be tied up in such
a way as to pre- vent them being |
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rubbed off.
|
Fig-. 420.—Suture Needle, French Pattern
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Needles of
various forms and |
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sizes are employed
|
Fig. 421.—Suture Needle, grooved, for Wire
|
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for the insertion
of sutures. Of these some are |
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straight, others
|
Fig. 422.—Suture Needle with Screw Spring Eye for Wire
|
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|
curved, either
throughout their length or towards the point (fig. 419). The point the needle IS Fjg 423._Wire-cutting Forceps and Needle-Holder
m some cases
round, in others flat, and in others again triangular. An eye for the
reception of the thread exists at one extremity, and for some purposes also at the other. When an eye occurs at the point, the needle should °e grooved to let in the thread and facilitate its passage through the flesh. A special form of needle is provided for metallic sutures; on either side °f the end of the needle proceeding backward from the eye is a groove into |
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HEALTH AND DISEASE
|
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|
420
|
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|
which the wire is pressed after it has been threaded (fig. 421), or the end
of the wire is in other examples passed into a hole at the end of the needle (fig. 422). Difficulty is sometimes experienced in forcing needles through the skin
or other hard tissues. This is overcome by the employment of suture forceps (fig. 423), which allows of additional pressure being exercised upon the needle, and guards against that tendency to slip which occurs when the fingers alone are employed. ANTISEPTICS EMPLOYED IN THE TEEATMENT OF
WOUNDS
" Carbolic Acid, the first antiseptic introduced by Lister, has a direct
germicidal action in strong solutions and an inhibitory effect in wTeaker ones. The crystals when heated with 10 per cent of water constitute an oily fluid known as pure or liquefied carbolic acid, which is a powerful though superficial caustic, and may be employed without much fear to infected lesions, in order, if possible, to sterilize them. Thus it is always well to treat tuberculous wounds with this fluid after scraping them, in order to destroy any portions of tuberculous material which may have escaped the spoon. The liquid carbolic dissolves in water on the applica- tion of a little warmth, and the l-in-20 and l-in-40 solutions are those mainly employed; the former is an efficient and potent antiseptic, and must be used carefully on delicate skins. Carbolic acid is frequently somewhat crude and impure, and many of the irritative and toxic phenomena are due to cresylic acid and other substances which should not be present. General absorption of this reagent leads to darkening of the urine, which may become olive-green or even black in colour, and this carboluria is often associated with a rise in temperature and some intestinal irritation, whilst diseased kidneys may be seriously affected. It is more likely to occur when weaker solutions are employed than when the liquefied or pure acid is applied. The latter is seldom absorbed." " Corrosive Sublimate is a valuable though very poisonous remedy
which is usually employed in solutions of 1 in 2000, 1 in 1000, or 1 in 500. Occasionally the last of these three solutions has 5 per cent of carbolic acid added to it, constituting what is known as Lister's strong mixture. Subli- mate solutions are inhibitory in action rather than germicidal, but are potent and reliable. They have less power of penetration than carbolic acid, but have no hardening or roughening influence on the skin. If, how- ever, a dressing soaked in a sublimate solution (1 in 2000) is kept for long in contact with the skin, it acts as a direct irritant, and may lead to an |
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ANTISEPTICS EMPLOYED IN THE TREATMENT OF WOUNDS 421
abundant formation of pustules, owing to the activity of the germs in the
deeper parts of the cutis which have not been destroyed by the antiseptic. Instruments should not be placed in sublimate solutions, as, even if plated, they soon lose their bright appearance." " Biniodicle of Mercury is a potent antiseptic which has been chiefly
employed in the form of a l-in-500 solution in 70 per cent methylated spirit for the purification of the hands or of the skin of the patient." "Boric Or Boracic Acid is a mild and weak antiseptic which may
be utilized when stronger remedies might prove harmful, e.g. in plastic operations. It is also useful when antiseptic fomentations are required in treating inflammatory phenomena." " Iodoform is a yellow powder of characteristic and unpleasant odour,
which probably acts by being decomposed in the tissues and slowly giving off iodine. Commercial iodoform is usually contaminated with a variety of germs, as may be shown by dusting it over a film of nutrient gelatine and allowing them to develop. It is, therefore, wise to wash the iodoform before use in l-in-20 carbolic lotion or some such antiseptic. Its chief value is in septic or tuberculous wounds, and indeed it seems to have a specific inhibitory action upon the development of the bacillus of tuber- culosis. It may be suspended in glycerine (10 per cent), and, after sterili- zation by heat, injected into tuberculous tissues, joints, or abscesses, or if open wounds exist, gauze soaked in this emulsion, as it is incorrectly termed, may be packed into them with advantage." " Chinosol is a yellow substance harmless and free from toxic qualities.
It is freely soluble in water, and possesses powerful antiseptic properties." " Lysol is another useful antiseptic derivative of coal-tar. It is freely
soluble in water, and, as a 2-per-cent solution, may be used in syringing out cavities such as the vagina, external ear, &c. One of its great advantages is that the solution is somewhat sticky, and tends to cling to the tissues and prolong its action." "Permanganate of Potash and Peroxide of Hydrogen both
act in the same way as oxidizing agents. They are necessarily unstable, and
cannot be utilized for dressing, and are therefore chiefly employed in the disinfection of cavities or wounds already contaminated. The most potent of these is peroxide of hydrogen, which is sold as a fluid capable of setting free ten or twenty times its volume of nascent oxygen. It is quite unirri- tating, and may be poured directly into a septic wound or even into the peritoneal cavity; forthwith it commences to effervesce, liberating its oxygen and forming a frothy foam which is likely to bring to the surface any loose foreign bodies. Its use is particularly indicated in the treatment of septic ulcers, carbuncles, sloughy abscess cavities, and the like. Per- |
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422 HEALTH AND DISEASE
manganate of potash is used in solutions of varying strength, and acts more
slowly. It has the disadvantage of staining the tissues with which it is brought in contact."—Rose & Carless. BROKEN KNEES
The knee is said to be " broken" when the skin is cut partially or
completely through. In the former case it may be of little moment, but in the latter it is always more or less serious, for in addition to the skin, important structures beneath may suffer more or less injury at the same time. The sheaths of the tendons may be opened, the tendons themselves may be lacerated or even divided, the bones may be bruised, or the joint may be contused and punctured. Causes.—Forcible contact with the ground as the result of stumbling
is the immediate cause of broken knee. Horses stumble for many and various reasons. Of these, some have reference to conformation and condition, others to weakness, want of energy, or disease, while not a few are the outcome of bad shoeing and neglected feet. Horses with upright pasterns whose toes are turned out, and others with narrow chests whose action is close, are more or less addicted to stumbling, also animals with heavy heads and fleshy, ill-carried necks. Want of condition and a
natural deficiency of nervous energy likewise conduce to it. Diseases of the feet, especially navicular disease and corns, are often the precursors of broken knees. Animals addicted to brushing or speedy cutting are also rendered liable to fall. Disproportion in the thickness of the shoes, as when they are unduly high at the heel or the toe, may also lead to stumbling. Symptoms.—A broken knee is a very patent defect, but the severity
and serious nature of the injury can only be determined by a careful examination of the injured part. The skin may not be completely divided, although the wound is considerable in extent. The lesion, on the other hand, may be comparatively small, but may extend deep down towards or into the joint. In other instances the joint escapes injury altogether, but the tendons beneath the skin are seriously contused and torn, and their sheaths are laid open. The amount of lameness present will, of course, depend upon the extent
of the injury and the structures involved. A mere skin wound rarely occasions more than a slight stiffness, but any implication of the joint is attended with great pain and disablement, as well as a good deal of general systemic disturbance, and in a less degree the same may be said of injuries affecting the tendons. In injuries to the joint the leg is rested on the toe, |
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|
CRACKED HEELS
|
|||||||
|
423
|
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|
and the animal declines to impose weight on the affected limb. Passive
movement of the knee occasions considerable pain, and should the joint be opened the wound discharges a yellowish, transparent, glairy fluid, which later on coagulates over the orifice in the joint into a soft jelly-like sub- stance. A considerable amount of swelling invariably results when the articulation is injured, and the patient seldom escapes without more or less permanent enlargement or stiffness of the injured joint. Treatment.—A clean stable is the first requirement of animals suffer-
ing from wounds. This provided, the part must be thoroughly cleansed from all dirt by means of warm carbolized water. It should then be care- fully probed to determine its depth and the structures injured, and to discover and remove any grit or other foreign matter that may exist in it. Should it be found that the joint is implicated, the patient should be put into slings. The wound should then be prepared and freely dressed with a solution of carbolic acid and covered with a thick pad of absorbent wool, and secured by a clean flannel bandage. Both the wool and the bandage should be well baked before being used. The dressing will require to be renewed morning and evening for the first two days. Afterwards the renewal will only require to be made once daily. The patient should receive a mild dose of physic, and be placed on a light diet, including a liberal allowance of green meat or roots. If the tendons are torn* as they sometimes are, the loose shreds must be
carefully removed close up to the body of the tendon by means of suitable scissors. In slighter injuries of the knee the horse may be put on the pillar reins, and prevented from lying down, while the wounds are dressed as prescribed. When bruising of the parts is very extensive and swelling considerable,
bandages well wrung out in hot water may be applied over the dressing for two or three hours after the accident, and repeated if necessary. Where the wound in the knee has been considerable, the parts should be allowed to undergo complete repair before the patient is allowed to lie down, or the uniting structures may be forced apart, and the wound again laid open. CRACKED HEELS
By cracked heel is understood a crack or breach in the skin of the heel.
It is to all intents and purposes a wound, but owing to its peculiar posi- tion it requires to be specially considered. Wounds of the skin are not as a rule difficult to deal with; but when they occur in parts of the body where movement is constantly going on, the healing process is always more or less delayed, and sometimes rendered difficult to effect. |
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|
HEALTH AND DISEASE
|
|||||||
|
424
|
|||||||
|
Cracks in the heel almost invariably run crossways, sometimes extend-
ing from one side of the heel to the other, at others being much shorter, when they are situated to the inner or the outer side of the heel just below the fetlocks; or a crack may occur in both positions, or it may be placed lower down in or towards the hollow of the heel. Hind-legs and fore-legs alike are subject to this affection, but it is more
common in the former than the latter. This difference is probably due to the facts: (l) that the hind-legs are farther from the centre of circulation than the fore ones, and therefore more liable to aggravated attacks of con- gestion and inflammation of the heels; (2) that in badly-regulated stables they are more exposed to moisture and filth, conditions which contribute so much to the production of the disease. Causes.—In large numbers of cases predisposing influences play an
important part in the cause of cracked heels. In this connection it is noticed that horses of lymphatic temperament, whose limbs are prone to swell from slight disturbing causes, are specially liable to the disease. Animals in whom the circulation is enfeebled by age or poverty, and
others of a plethoric habit of body, are equally susceptible. The exciting causes of cracked heels are such as produce inflammation
of the skin, hence it follows upon injuries done by ropes in casting either for operations, or by accident in the stables, and as the result of an exten- sion of inflammation from the foot in certain forms of disease and accident. The most common exciting cause, however, is the repeated exposure of
the heels to wet and snow during the prevalence of biting easterly winds. Snow when mixed with salt and dirt, as sometimes encountered on the streets of our large towns, is a common inducing cause of inflammation and cracking of the skin of the heels. The disease is also produced by washing the legs in cold weather and leaving them exposed to dry. The action of cold and wet in the induction of cracked heels may
be
stated as follows:—Cold, whether it is produced by cold air or the rapid
evaporation of water, causes the blood-vessels of the skin to contract, and the quantity of blood circulating in the part is consequently reduced. I* the application be continued for a lengthened period, or made repeatedly at short intervals, as when a horse's legs are allowed to become wet again and again and to dry under the influence of cold winds, the contracting power of the vessels is gradually reduced, and sooner or later becomes for the time being exhausted. As a result of this, the pressure of the blood within the vessels begins to assert itself and to overcome their resistance. A reaction now sets in, and the vessels which have been caused to
contract under the influence of cold open out and become widely dilated and at the same time morbidly distended with blood. This state of things |
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|
CRACKED HEELS
|
|||||||
|
425
|
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|
continuing, results in inflammation, when the skin, before cool, now becomes
red, swollen, hot, and tender. At the same time moisture oozes through the surface, and the tissues having lost their cohesion, split across in conse- quence of the frequent bending of the joint. Cracked heels are invariably attended with more or less lameness. In
progression, and especially at starting, the legs are raised some distance from the ground, and are sometimes sharply caught up and suspended in the air. The limb about the fetlock-joint, and maybe as high as the knee or hock, is swollen and more or less painful to the touch. A discharge of a sticky and sometimes of an offensive character flows from the wound, and the horse stands with the fetlock-joint in a semi-flexed condition. Treatment.—The objects of treatment will be to subdue existing in-
flammation and bring about healing of the wound. The first of these indications will be best accomplished by the prompt administration of a dose of physic; at the same time the diet should be carefully regulated, and consist for the most part of bran and a little crushed corn. After the physic has ceased to operate, a little green food, carrots, or other roots should be supplied morning and evening. In the matter of local treatment, a poultice of linseed-meal or boiled
carrots should be placed on the heel and secured by a long flannel bandage wound round the leg as high as the knee. The bandage should be so adjusted that the pastern cannot be flexed, or the lips of the wound will be repeatedly drawn apart during movement, and healing thereby delayed. The poultice should be changed not less than three times daily, as when
allowed to get foul it tends to irritate rather than soothe. When the inflammation has subsided, the wound should be dressed two
or three times a day with some antiseptic powder or solution, and covered by a pledget of cotton-wool and secured by a bandage as before. As soon as may be, the wool and bandage should be discontinued, and the part kept freely dusted over with a powder composed at first of boracic acid and flour or prepared chalk, to which a little alum may be added later. Where, as is sometimes the case, the edges of the wound become callous and refuse to heal, a little caustic must be freely applied to them, so as to excite a fresh granulating or healing surface. When the wound has healed, and the skin resumes its normal condition,
it should be carefully guarded against undue exposure to wet and dirt, as & return of the mischief may be easily provoked by these means. |
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126
|
HEALTH AND DISEASE
|
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ULCERS
There are two varieties of ulcers as properly understood, viz.
the
simple or common ulcer and the specific or infective. The former is due
to some local derangement of nutrition, the consequence of impaired circulation or innervation of the parts. The latter results from the action of specific organisms which have gained access to the body. The non-infective ulcer assumes a variety of forms, of which the following axe of special interest to the veterinarian and the horse-owner. The Simple Ulcer is a sore in which the process of healing has
been arrested and followed by a more or less rapid extension of the wound. A number of causes may be individually or collectively concerned in bringing about this retrograde action. Among them the chief are mechanical irritation, as the chafing of a collar or a saddle, or any other part of the harness; undue movement of the injured part, such as occurs when the wound is situated on the aspect of flexion or extension, of a joint, or over the seat of much-used muscles. It may also be induced by pressure. Ulcers of this kind are covered with yellowish-red granulations, which
are usually flush with the margin of the skin, and the edges are but slightly if at all thickened. When severely irritated, acute inflammation is excited in these ulcers,
and the surrounding skin becomes thickened by serous infiltration; there is also great soreness, and a free discharge of pus from the surface. The edges of the wound now present a somewhat irregular and sloughy appearance. The Indolent or Callous Ulcer.—The callous ulcer is most fre-
quently found on the shoulders and backs of old horses as the result ot ill-fitting collars and saddles, or on the withers, or in the heels. It lS usually preceded by a succession of abrasions, during which the skin and subcutaneous tissues become infiltrated and thickened, and the vessels surrounded and compressed by a contracting undergrowth. As a conse- quence the blood-supply to the part is diminished, its vitality is weakened, and the skin is predisposed to ulcerate. The callous ulcer is more or less hollowed and like a saucer. Ihe
edges are thickened, and raised above the general surface, which is usually smooth, and of a pale-yellowish colour. It discharges a small quantity ° thin, sero-purulent fluid, and shows little or no disposition to throw np granulations. The skin round and about the wound, and the tissue beneat it, are hard and thickened, and firmly adherent to the underlying parts. |
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ULCERS
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427
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Weak Ulcers.—" The simple ulcer or the healing sore is very apt to
become a weak ulcer as the result of defective blood-supply, either from too small a quantity of blood being sent to the part, as in cases where the vessels are diseased, or from deficient quality of blood, for example, during the progress of some constitutional disease. In this form of ulcer the granulations become smooth and somewhat yellowish, the secretion thin and small in amount, and very apt to scab, and the edges pale and flat. In other cases of weak ulcer the granulations become cedematous, and this is more especially the case where there is some general cause of oedema or some local interference with the circulation, such as com- pression of veins from the contraction of the sore, &c. Or again, we have another form of weak ulcer, where the granulations show excessive growth. This is chiefly the case where the ulceration is due to inability of the sore to contract. In such cases the granulations become promi- nent, vascular, soft, and bleed readily, and we have the condition which is popularly spoken of as ' proud flesh'. " These simple ulcers again may become attacked with some septic
virus which leads to what is called the phagedsenic ulcer. In the latter case the ulcer becomes covered with grayish pulpy material, which rapidly infiltrates the surrounding skin and cellular tissue, and extends both super- ficially and deeply at the bottom of the sore, leading to extensive and very rapid destruction of the part, and not uncommonly to the death of the patient."—Watson Cheyne. Treatment.—In the treatment of ulcers, as in the treatment of
w*ounds, it is desirable to remove all causes of irritation, and especially the septic discharge with which they are usually covered. In this connection the antiseptic method applied to wounds must be resorted to here. The hair must be removed from around the ulcer, and the skin cleansed and rendered aseptic. The ulcer must then be disinfected. This may be accomplished either by the application of a solution of chloride of zinc (40 grains to the ounce), or by touching the surface with nitrate of silver, or by scraping away the septic granulations and sub- sequently applying undiluted carbolic acid. Following this, the wound should be dressed every day with boracic-acid ointment, half strength, and covered with three or four layers of boracic-acid lint. In some cases of callous ulcer, gentle pressure will be found of service where bandages can be applied, or a mild blister to the edges of the wound may hasten the healing process. In long-standing cases, the actual cautery may be lightly applied to the surface of the sore with good result, followed by the application of boric-acid dressings. Specific Infective Ulcers are the result of the action of pathogenic
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HEALTH AND DISEASE
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428
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or disease-producing bacteria. The more common examples in the horse
are seen in that form of glanders termed farcy. Recently a contagious form of lymphangitis has been introduced into this country from South Africa, in which specific ulceration of the skin is a leading feature of the affection. Maladie du Coit, a venereal disease prevailing on the Continent and
but seldom seen in this country, offers another example of this class ot ulcer. For particulars of these ailments, refer to them under their respective
headings. SINUS AND FISTULA
These are narrow, more or less elongated wounds, opening on to the
surface by a small orifice. Sinuses usually communicate with an abscess, and are the channels by
which pus makes its escape. Where injury occurs to muscles, bones, or other structures, resulting m
suppuration, the prospect of healing after the matter has been evacuated will greatly depend upon the extent to which motion can be restricted. Where the part is in continued action, as occurs in the region of the poll, the pus has a tendency to burrow among the muscles, and to keep up the irritation and prevent healing; it is on this account that what is known as " poll evil" proves so abiding and intractable an ailment. Sinus invariably follows the long confinement of matter when formed
in the feet as the result of a prick; or it may arise from the lodgment ot some foreign substance, as a splinter of wood, in the flesh; or from the too early closing of a wound before the deeper parts have healed; or from the presence of a piece of dead bone in the process of sloughing, or which has sloughed as the consequence of injury or disease. The treatment of a sinus will, of course, depend upon the cause by
which it was produced and is made to continue. Where movement is the offending factor, means must be adopted to
stop the action of the muscles as far as possible, and bring the part into a state of rest. Confined pus must be evacuated either by laying the canal freely open
along its entire length, or by making a counter-opening at the most de- pending part, and allowing free drainage. All partitions in the cavity to which the sinus may lead should be divided, and pockets made to communicate, to facilitate the escape of pus. Where foreign bodies exist* they must be removed before reparation can be hoped for. |
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SINUS AND FISTULA 429
The sinus, whether laid open or under-drained, should be dressed once
or twice, at an interval of two days, with undiluted carbolic acid or a solution of chloride of zinc of the strength of 1 in 40, to be followed by the daily application of iodoform and a covering of gauze and antiseptic wool. Some practitioners plug old, obstinate sinuses with cotton-wool dressed with perchloride of mercury and arsenic, and allow the dressing to remain until the sinus is healed. Sinuses of recent formation may be found to yield to strong boracic
ointment and boracic lint as a dressing. Fistula is an unnatural canal or wound with an opening at one
extremity on the skin, and at the other into one or another of the various |
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Fig. 424.—Fistula of the Parotid Duct
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cavities or conduits of the body; or it may extend between two cavities, as
between the bladder and the vagina—vesico-vaginal fistula. Thus a wound in the wall of the abdomen may communicate with some
part of the intestine, or one in the cheek may have connection with the parotid duct (fig. 424), through which feculent matter in the one case and saliva in the other may escape. It is the constant passage of these solids and fluids through the canal, and the impossibility of rendering them aseptic, which makes fistulous wounds so troublesome to heal. Treatment in these cases must be directed towards arresting the
outflow of the discharge and directing it into and along its proper channel. Sealing over the outer orifice with collodion is in some cases sufficient to bring about healing in fistula of parotid duct. In others the surface of the fistula must be brought into a healthy condition by antiseptic treatment to induce healing, or, if possible, laid freely open |
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HEALTH AND DISEASE
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430
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and scraped, and treated as an ordinary wound. In some chronic cases
the orifice has been caused to close by touching it lightly with the actual cautery. FISTULOUS WOUNDS
POLL EVIL
This term signifies a wound on the poll, or that part of the neck
immediately behind the ears. It usually consists of one or more sore places in the skin communicating by pipes (sinuses) with a cavity seated more or less deep down in the tissues, sometimes extending to the bones, the whole constituting what is termed a " fistula". Causes.-—It is caused by an injury, frequently inflicted by the horse
striking his head against some hard substance, as a low beam, ceiling, or doorway, or against the floor or wall in the act of rolling, or by a violent blow with any hard substance, as a whip-stock, fork-handle, &c, bruising the skin and underlying structures so as to interfere with the circulation of the part. It has also been caused by stretching these parts by the injudicious use of the bearing-rein, and by badly-fitting or heavy bridles chafing the poll. The symptoms at first depend a good deal upon the severity of the
injury. If this be slight we may only find a small swelling on the nape of the neck, which soon passes away again after a short period of rest, even without any treatment at all. At others there is a small hard knot left, which upon the slightest injury—and with such a swelling injuries are easily inflicted—rapidly enlarges to the size of a cricket ball or more. This swelling is very painful to the touch, and causes the animal to carry his head in a stiff manner, with the nose slightly poked forward and upwards to relieve the tension of the muscle at the back of the neck. After a time —usually from one to three weeks—there appears a soft place on the swelling, which shows us that the part has gathered and formed matter (pus), which has found its way to the surface (pointed). If not opened it will soon burst through the skin and discharge a thin yellowish-red matter, which after a few hours changes to a yellowish-white colour. When the matter is allowed to remain pent up in the tissues, it wif
burrow between the muscles in all directions, and occasion a wound ^ several pipes (sinuses), which proves, as a rule, a very formidable one to cure, particularly if the pax-wax or great ligament of the neck, or the boneS below, become involved. The matter (pus) may run down the neck betwee the muscles—even as low as the shoulders, as we once had occasion observe; or the neck bones (cervical vertebrse) may become disease |
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FISTULOUS WOUNDS
|
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431
|
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|
giving rise to death (necrosis) of the bones, or to their permanent enlarge-
ment and union with each other (anchylosis), producing a chronic stiff neck; or the ulceration may extend even to the spinal canal, causing pressure on the cord and consequent paralysis, or epileptic seizures, or sudden death. One or both sides of the neck may be affected. The Treatment.—In the early stages, when the swelling is hot and
tender, the treatment should consist of cold applications to the part, such as cold douches, which may be applied by fixing a hose-pipe to a tap, or by syringing two or three buckets of cold water over the poll three or four times daily with a garden syringe. Then apply linen cloths soaked in a solution of sal ammoniac and saltpetre in water. During this time the animal should be kept on bran mashes or other light food, and receive a dose of physic, to be followed by green foods in summer or roots in winter. Should this line of treatment not be successful in allaying the inflammation and reducing the swelling, we may be sure that it means to gather, particu- larly if it becomes more painful to the touch. As soon as we are satisfied that it is gathering (forming an abscess), we should encourage the process as much as possible, for the sooner we can get the matter to the surface the better. This is best effected by the application of hot-water fomentations and stimulating lotions. If the swelling does not seem inclined to " point" quickly, a smart blister to the most prominent part of it will usually hasten on the process. Directly the abscess " points " we should lose no time in opening it, and this should be done at the lowest part of the cavity, so that a natural drainage may be obtained and retention of the matter avoided. If this can only be properly done at this stage, we shall find very little difficulty in healing the breach,—i.e. when the great ligament of the neck and the bones are not affected. If, however, as is usually the case, the wound is neglected at this stage,
the matter (pus) begins to burrow between the muscles, forming pipes (sinuses) in various directions; these must be bottomed and laid freely open. There are various means of doing this. Some prefer the knife, but this, even in skilful hands, is not always successful, because the pipes run in such intricate and awkward directions that it is extremely difficult to follow them; others, again, use caustics, and destroy the pipes and the surrounding structures. There are several of these agents; one of the oldest, best, and perhaps the commonest, is corrosive sublimate. Arsenic is often used, but it requires great care; and even with the most discreet it will sometimes act tar beyond their expectations, and damage or destroy neighbouring struc- tures, which adds to the trouble of the case by causing delay, and may also prevent recovery. If the cautery has been successful, all that is required atter is cleanliness and the application of some astringent and antiseptic |
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HEALTH AND DISEASE
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4.32
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lotion, as carbolic acid. Occasionally, however, the healing process
"hangs fire", as the old practitioners used to say, and then a stimulating lotion to encourage granulation is required. Another line of treatment is to pass a piece of tape (seton) besmeared
with some digestive ointment to the very bottom of the wound and bring it out again at a lower level. This is a very common and sometimes successful practice when both sides of the neck are affected, the tape being passed from one side to the other and allowed to remain until the wound has healed, leaving only the canal through which the tape passes, when it may be removed and the canal allowed to heal up. When either the great ligament of the neck or the bone is diseased, it
becomes a very formidable case, because both these structures have a slow circulation and little reparative material is brought to them. Then again, they are so deeply situated that it is difficult to get at them to cut away any diseased part. When, therefore, either of these structures is involved, we may be sure it will take a long time—even months—before a cure can be effected. Finally, we may say there is no hard-and-fast line of treat- ment in these cases, but each has to be taken on its own merits and treatment adopted accordingly. Prevention.—It will be readily seen from the foregoing that poll evil
may be prevented by having the stable doors and ceiling high enough to prevent the horse striking the top of its head, also having light and well- fitting bridles, and a kindly-disposed and attentive groom or horse-keeper, so that should any chafing occur he would give it immediate attention, and so ward off a most troublesome disease. FISTULOUS WITHERS
This may be defined as a sinuous wound on the wither, or that part
between the neck and back at the top of the shoulder-blade. Causes.—These are similar to those of poll evil, viz. injuries, and are
usually inflicted by the collar or saddle bruising the skin and tissues beneath, on the top, or at the side of the withers. It may be caused by the structures being pinched between the collar and a badly-fitting saddle. A very common cause is the chafing produced by the edge of the rug>
especially when it is fixed by a buckle or strap at the breast and the rug shifts back until its edge is drawn tight over the withers and chafes the skin at this part; or it may result from injury inflicted while rolling; ° being cast in the stable, or from a bite from another horse. The symptoms at first are usually a small swelling, which is rathe*
sore and tense, on the top of the withers, or it may be to one side. If ^ |
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FISTULOUS WOUNDS
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433
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is neglected and the cause not removed, the skin will very soon be broken,
and then matter (pus) is formed and oozes from it. When only the skin and the tissue immediately under it are affected, little trouble need be anticipated, but if the cause is not removed the deeper structures (muscle and fascia) and even the bones (vertebral spines) may become diseased. Horses that have very high withers, and those poor in flesh, are most liable to be chafed by ill-fitting harness. Animals also of the heavier |
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Fig. 425.—Fistulous Withers
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class are more often affected, probably because the harness of such animals
is not so carefully fitted, nor kept in such good condition, the loads are heavier, and the work much rougher than with those of the lighter breeds. Frequently the bruise is so severe that matter forms (abscess), which
after a time burrows amongst the muscles, and finally breaks out through the skin on one side of the wither. The matter is assisted in finding its way between the muscles by the movement of the parts during progression. In this way pipes (sinuses) are formed in various directions leading to the open wound at the surface. The treatment consists in the first place of removing the irritant,
whatever it may be, and keeping the animal as quiet as possible, to prevent Vol. II. 62
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434 HEALTH AND DISEASE
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the muscles moving on each other. If the skin is not broken, and the
swelling appears tense, hot, and painful, cold applications may be applied to try and reduce the inflammation and the swelling. These may be in the form of cold-water douches and cooling lotions applied by soaking linen cloths and placing them across the wither. If in the course of a few days the swelling does not disappear and the pain subside, but on the contrary continue to increase, we may expect that suppuration is taking place and that an abscess is about to form; that being so, the sooner we get the matter to the surface the better. To this end, hot water fomentations must be diligently applied, together with some stimulating liniment, such as that of ammonia and turpentine. When this does not succeed, a blister will often be beneficial. As soon as the swelling points, it should be lanced and wTell opened up to the lowest part of the cavity, so as to give free exit to the matter (pus) and allow of the removal of any dead tissues that may exist, and drainage of the abscess may be effected by passing a piece of tape (seton) through the wound, being careful to bring it out at a lower level than the floor of the cavity, so that no matter may be allowed to accumu- late there. Sometimes the pus will have burrowed behind the shoulder-blade, in
which case a depending opening must be made or a seton passed through it. At other times the projections of the backbones (vertebral spines) will be diseased, in which case they must be freely scraped or removed by the veterinary surgeon. Fistulous withers, like poll evil and quittor, are tedious cases at the
best of times, especially if the deeper structures are involved, particularly the bones and fibrous tissue (fascia). In all cases where the diseased part can be found—which is not always an easy task—it is best to remove it with the knife. When this cannot be determined, the wound throughout should be well cauterized, with the hope of bringing away the injured and offending tissue. If this is not accomplished and the wound heals up on the outside, as it frequently will, a fresh abscess will form sooner or later, and the whole process will have to be gone through again; therefore it is useless to let the wound heal at the surface before the inside has grown up sound, or, in other words, the wound should be made to heal from the bottom. It is an old but sometimes successful practice to " plug" the sinus to the very bottom with some caustic, such as corrosive sublimate, or arsenic, or a mixture of the two. This destroys the tissues for some distance around, and frequently brings away the damaged structure that prevented healing in the first instance. When this happens the result is very satisfactory, because as soon as the dead part (slough) is removed, the wound at once begins to close, and only requires to be kept clean and |
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FISTULOUS WOUNDS
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435
|
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have antiseptic lotions applied at frequent intervals to ensure a cure.
When the wound has healed, two or three weeks should be allowed to pass over before the animal is again put to work, so that the injured part may become thoroughly restored. Prevention.—Always have well-padded and properly-fitting harness
and clothing, and as soon as any sign of chafing occurs, at once remove the offending agent. In this way many tedious and painful wounds may be avoided. FISTULOUS CORONET
This is treated of under the heading of " Quittor " on p. 378.
SORE SHOULDERS AND SHOULDER ABSCESSES
" Sore shoulders" is an expression which is applied to a variety of
pathological conditions, from the most superficial abrasion to inflammation and abscess deeply seated in the structure of the part. It is almost exclu- sively confined to harness horses and others engaged in heavy draught, and for the reason, no doubt, that the collar they wear is the exciting cause of the malady. Young horses which are collared for the first time, horses with thin, delicate, and sensitive skin, and others on whose shoulders small fibrous tumours or eczematous eruptions appear, are most frequently the victims of sore shoulders. Now and again animals with none of these predisposing conditions are
made to suffer by violent irritation to the surface and contusion of the deep-seated tissues. Collars that are ill-fitted, badly-formed, and imperfectly-stuffed, are the
actual or inducing causes, and their mischievous effects are intensified by cold, wet weather, when the skin is chafed and chapped. The more numerous and simple forms of the affection are mere abra-
sions. The cuticle is rubbed off, the sensitive skin is exposed and thickened by inflammatory swelling, and maybe the hair leaves its follicles. It is, besides, hot and sore, and when seen on a white horse there is more or less redness of the surface. In this condition the application of the collar provokes pain, and the
animal obstinately refuses to throw himself into it, and attempts to remove the pressure by backing. Young horses are frequently ill-used by ignorant grooms on account of this resistance to suffering, and from quiet, willing workers are converted into unmanageable and useless brutes. The continuance of work after this primary chafing results in sores of
greater or less extent and depth, with, in some cases, sloughing of the skin or the formation of superficial abscesses. |
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436 HEALTH AXD DISEASE
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In some horses the skin on the site of the collar is studded with small
tumours about the size of a bean or a marble, which are caused to enlarge by the constant chafing, and sooner or later to break into obstinate sores. Eczematous and other eruptions in this situation are also soon converted
into superficial wounds by the same means. Now and again an inflammatory swelling appears, at first of limited
extent, but gradually increasing in size over a period of weeks or months until it reaches the dimensions of a cricket ball or a moderate-sized turnip. Its growth is slow, and may for some time be hardly perceptible. At
first it does not seriously incommode the animal, but as it develops sore- ness increases, and the time sooner or later arrives when the collar cannot be borne. It commences as a hard, diffused fulness, which slowly spreads. After several weeks or months a fluctuating point appears on the surface, indicating the presence of an abscess, which in due course breaks and discharges its contents. Treatment.—In all cases of sore shoulders, whatever its form may be,
the cause should be removed. This will require that the use of the collar be discontinued, or substituted by a breast collar. Frequently this is all that will be necessary, but a dose of physic and a few days' rest will hasten recovery. Where a local application is needed, the part should be well washed and
dried, and then dusted over with a powder composed of boracic acid and flour twice or thrice a day. A weak solution of alum or carbolic acid is also a useful application. Shoulder abscess, to which we have referred above, is usually deeply
seated among the muscles of the part, and requires a considerable time to come to the surface. It is usual with some practitioners to apply a repetition of blisters to the part at suitable intervals, with the object of exciting inflammation in the tissues, to hasten its formation, and those who are not skilled in surgical practice might safely adopt this course and wait results. Others cut down upon the abscess, evacuate the pus, and lay the cavity open; or, should no pus be found to exist, the growth is removed wholly or in part, according to circumstances, and the wound treated in the ordinary way. (See Special Treatment of Wounds, p. 410.) |
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FIRST AID TO THE SICK AND INJURED
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437
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22. FIRST AID TO THE SICK AND INJURED
It is important that horse owners and those in charge of animals should
be able to render temporary assistance in the case of accident or sudden illness, as by timely aid valuable lives are saved, while, for want of some elementary knowledge such as the St. John's ambulance classes provide, animals as well as men lose their lives or suffer permanent disablement unnecessarily. The good Samaritan who would render assistance to an animal by the
way, or the other on his own premises, is met with an initial difficulty almost unknown to those whose help is offered only to fellow-men. Horses, even the smallest of them, are not easily controlled when suffering acute pain added to fright; they cannot be reasoned with, or lifted when they fall, by the power of any one person, and furthermore, active as well as passive opposition is too frequently offered to those who would give succour to a wounded animal. Whether on the road, in the field, or in the stable, occasions arise when
horses need prompt and energetic assistance from their attendants while professional aid is being summoned. On the road, broken knees, collisions, &c, may divide the flesh and set
up profuse bleeding from an artery or vein of large calibre, and unless haemorrhage is promptly arrested death may be the result. In the hunting field one looks for a certain number of accidents and
injuries, but how few owners and attendants are in any way prepared to deal with them! In the stables, horses get loose and injure one another, or, getting
"cast" as it is called, spend their strength in useless efforts to.regain their feet, and in the absence of assistance frequently suffer irreparable injury. In many ways, then, both in the stable and the field, "first aid" may be wanted. The bewilderment of sudden and novel circumstances, and the natural
revulsion that is felt to blood by all who have received no training in surgery, put the horseman to a disadvantage when called upon to render help for which he is quite unprepared. In the chapter on wounds it has been pointed out that bringing the edges together is of the first impor- tance, and here again the reader may be reminded that the first and most likely step towards arresting haemorrhage is to be gained in that way. Often a number of small vessels pouring out their contents at the same time alarm the amateur in surgery, but are of no serious consequence, and it is found that when brought together by the closing of the wound with |
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438 HEALTH AND DISEASE
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some mechanical contrivance, these vessels are closed or a clot is formed,
and further bleeding prevented. How is a gaping wound to be closed by a man without appliances?
Non possumus, is the answer that rises speedily to the lips of him wTho has never tried. Besides, so many accidents occur within call of professional aid that the habit of dependence becomes established, so that we regard a serious piece of surgery as only possible with a powerful armamentarium of modern appliances. These are useful, nay, admirable, but nearly every civilized man carries with him some sort of means of stopping bleeding: a piece of string, a scarf-pin, or common pin on his waistcoat corner, a pocket- knife, a handkerchief, the lining of his hat and coat. With some of these, and the hair in his horse's tail or mane, he can secure the edges of a gaping wound or plug a deep one. If he has pins they can be pushed through the skin, and with hair from the animal's mane a figure-of-eight suture may be made, to confine and compress the parts. The handkerchief may serve either as plug or bandage, or, failing sufficient length, material can be obtained from the coat-lining or some other garment less valuable than the life of the patient. Without pins, the happy possessor of a pocket-knife can make skewers from the nearest hedgerow, and if not pointed enough to go through the always tough skin of a horse, the small blade will make the hole and the extemporized wooden pins be made to follow, when the figure- of-eight suture before referred to will be the plan to adopt. In many cases of accident far from home, if actual haemorrhage does not
preclude movement, by which it would of course be excited, it is well to remember that a horse can accomplish a short journey with comparatively little pain or risk which he would be quite unable to perform when allowed to become stiff. It is, therefore, advisable to decide at once whether to wait succour or attempt removal. Injuries are often in such a position that none of the foregoing sugges-
tions are at all applicable, as, for instance, when a horse falls on his chin and cuts his tongue badly. First aid in such a case is best rendered by compelling the patient to keep his mouth shut, tying him round the muzzle with the neck-scarf or pocket-handkerchief. The saliva and heat of the mouth will do all that is needed to keep the wound from injury. Horses that have received injuries to the face, when in collision with
others or the vehicles they draw, may have divided vessels inside the cheeks or the nostrils. The arteries are seen spurting with blood, but the horseman has no forceps to pick them up with prior to being tied with the piece of string with which we have supposed him to be provided; but his own fingers may be used to produce the necessary compression to arrest bleeding until assistance comes to hand. |
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FIRST AID TO THE SICK AND INJURED
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439
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Injuries, again, may be under the flank, or in other situations where it
may be possible to stuff the handkerchief into the wound or employ cold in the form of water from the nearest stream, pump, or other source. If he can gain attention from a passer-by and communicate with a
dwelling-house, it is most likely that vinegar or alum or spirit can be obtained, any one of which, diluted with water, is an approved styptic. First aid may be, and indeed often is, too impetuous and ill-considered,
as in the case of staked wounds, the horseman rashly attempting to remove a foreign body which a veterinarian would first very cautiously examine as to direction, &c. (see Punctured Wounds). The sufferer from a staked wound should not be walked home without a plug of some kind in the orifice, as without it air is drawn into the loose tissues under the skin, causing much after-trouble. Some portion of the rider's apparel can be spared for this purpose, or suitable material such as tow or cotton-wool may be obtained at the nearest house. Joints injured by sprain or collision should be supported by whatever
in the way of a bandage the horseman can contrive. A stocking is the most serviceable garment, which with the aid of a penknife may be made double the length. First aid in joint injuries often consists in the patience requisite to wait for an ambulance. An injury capable of being cured may be, and often is, rendered hopeless by making the patient walk a long distance, when the nearest stable should in any case be the longest journey the animal should be induced to take. Where, after a fall or collision, blood is found to be flowing from the
nostrils, the mouth, or other orifices, the patient should not be moved until it is ascertained if the fluid is from a large artery or vein, superficial and unimportant, or deeply seated and serious. By its colour and volume the horseman may be able to decide, and, while waiting for skilled assistance, render first aid by the application of cold water to the head, loins, or other parts. In every kind of injury in which dirt or other foreign matter is present,
as in the eye, an effort should be made to remove it without waiting for the surgeon. If antiseptics (such as are now to be found in every household) are not at hand, then clean water may be used. Of the many accidents which horses are liable to meet with in the
field and upon the road, it is impossible to treat fully in this chapter, and the more important injuries and diseases are elsewhere treated at length. We cannot, however, leave this branch of the subject of first aid, without reference to the comparatively frequent accident in low-lying districts of horses getting into ditches or drains and failina; to extricate CO O
themselves. The usual bump of locality, which is a horse's strongest
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point, often fails him here, for though he may not fall, but deliberately
walk into a ditch, he forgets how to return, and, wandering hopelessly up and down in the deep mud, becomes exhausted and chilled, so that he soon succumbs if not released from his unfortunate predicament. If he is discovered while able to make an effort, the first thing to do is
to administer a stimulant while sending for ropes and another horse. He may be in mid-stream, but can be reached by placing a ladder or gate across or into it. A halter should be put on, and if there is room to turn him, and the shelving portion of the bank not so far off but that the almost exhausted animal could walk to it, he should be carefully led, with words of encouragement, to the spot. He may, taking hope again, have sufficient strength to get out when the opportunity is presented to him, and especially if assisted by a rope passed under the buttocks. Eare, indeed, is it to meet with any bad result from the apparently barbarous plan of roping the neck and pulling on it with great force. The ligaments of this part are very powerful, as will be remembered, and the animal no doubt adds resistance to the strain by rendering the muscles rigid and so bracing up the bones. We know that when suddenly applied while the animal is unprepared, less force has caused a broken neck; for instance, when frightened in a forge, a horse has been known to break his neck by throwing himself back in the halter. In urgent cases, roping the neck should be resorted to without hesitation, even though the power of a horse l>e required to extricate the unfortunate animal from his awkward position. Collapse is a condition calling for first aid. It is usually the result of
some serious injury, and may be recognized by pallor of the membranes, coldness of the skin, sighing, trembling, reeling, and anxiety of counte- nance. When the result of previous illness, loss of blood, or serious injury, any alcoholic stimulant will prove serviceable, but whisky is to be preferred if at hand. The reader may be reminded that water is a restorative too often forgotten in cases of collapse. It quickly fills up the vessels, and if the patient will not drink it it should in that case be administered by the drenching-bottle—not, however, if the animal is unconscious. In that state any attempt to administer fluids by the mouth involves danger of suffocating the patient, and must be abandoned. Cold affusions to the head are also restoratives, and, as we have pointed
out elsewhere, are commonly employed to re-establish consciousness after chloroform has been given to the extent of producing total anaesthesia. Much of the first aid required by horses belongs neither to the depart-
ment of medicine nor that of surgery, but to practical horse management and the tact of experience. Much of the damage done to or by a runaway occurs after the animal
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has come to the ground, and the horseman should learn to control an
animal in this position, and know the quickest way in which to release a fallen horse, whether in single or double harness. It should be borne in mind that, in any kind of trace-harness, both traces are set at liberty by undoing the hame-strap. A horse fallen in ordinary single harness should have first the breeching-strap undone and passed through the back-band (he will most likely be lying on the buckle of the other side). It is not essential that the belly-band should be released, though better to do so if time permits, but with the hames and breeching undone he can get up readily. First aid to the sick among horses generally consists in obtaining for
them a suitable environment, removal from the field, or from the com- panionship of others, the provision of an airy loose-box, the preparation of an abundant supply of hot water, bandages, gruel, poultices, &c, which will be found fully dealt with in the chapter on nursing. Sick or injured horses incapable of travelling on their own feet are
usually conveyed in " floats" or bullock carts, the floors being near the ground, and thus facilitating ingress and egress. |
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23. MEDICINES
INTRODUCTORY
The medical treatment of man and beast has for so many centuries been
associated in the mind of the public with the administration of drugs, that any attempt to combat disorders without them is regarded with suspicion by the less-educated portion, and of the majority it may be said there is a sense of dissatisfaction where the human or animal physician neither writes a prescription nor supplies a bottle of medicine. The advice to the average horse owner to apply cold water or change the diet is received in the spirit of Naaman when told to dip seven times in the river Jordan for the cure of his leprosy. Nor is this ail the fault of the public; the medical art when no longer confined to the priests, who doctored souls and bodies indiscriminately,, soon drifted into the hands of persons who sold mysterious medicaments for the cure of various diseases, their remuneration consisting in the profits on such sales, just as the prescribing chemist continues to do to this day despite all medical laws forbidding him to " act as an apothe- cary ". |
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If we read the advertisement pages of any agricultural or sporting
journal we shall find ample reason to doubt if the technical instruction afforded by university extension schemes does not fall far short of the requirements of the time, since greater fortunes are now amassed by advertisers of quack medicines than was ever the case before in the history of the world. There is a very general popular belief that some herb or herbs exist which will effectually cure any and every disease, if we can but succeed in their discovery and proper application. These bad old traditions will take long to break down, and in self-
defence, in order to obtain a just fee for his professional skill, the country veterinary surgeon is sometimes compelled to prescribe some harmless stuff for a client who sees value for money only in some tangible form like a big bottle. The owner of a horse with a cough is apt to suppose that its cure can and ought to be effected by a bottle of medicine or some balls if they are "good" for such a purpose; nay, he has been taught to believe it by the cure-alls advertised and the early works on farriery, whose authors speak of " a certain cure " for this or that disease which they did not them- selves understand, but merely " poured drugs of which they knew little into bodies of which they knewr less ". It is not generally understood that the same disease may result from
a variety of causes, and no panacea can therefore be expected. The conditions under which the patient has been living must be enquired into, the nature of his work, food, water supply, clothing; and a broad view must be taken of the circumstances of the case, and the line of treatment to be pursued will depend on the nature, origin, and stage of the disease. The importance of hygienic conditions and good nursing are becoming
better understood both by the professional and amateur horse doctor, but the latter, with less knowledge of drugs, has the greater faith in their efficacy. Let it not be supposed that we underestimate the value of drugs when judiciously employed, but that we desire to impress our readers with the fact that drugging is no effectual substitute for rational treatment. The cause of a disorder should be sought and removed, and drugs may
assist the process in many instances. Time may be gained in facilitating a natural process, pain saved, and even life preserved, which without their aid would have been lost; but the list of specifics can be counted on the fingers of one hand. Perhaps no class of medicines are more abused than aperients, the
habitual use of which do not cure constipation but induce an artificial need of their repetition, where judicious dieting without drugs would help the body to return to that healthful condition for which it is always striving in spite of improper diet and exposure to unfavourable conditions. The |
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tendency to recover from, as well as to resist, disease is commonly spoken
of as the vis medicatrix natures, and should be the prescriber's chief reliance. Expectant treatment, or waiting for nature to assert its preserva- tive influence on the life and well-being of each living creature, is more adopted by the experienced physician than the amateur, who desires some heroic remedy that shall cut short diseases, many of which pass through successive well-known stages, and anything that would hinder the process might prove fatal to the patients. The variolous diseases, for instance, must pass through their various phases of incubation and eruption, papu- lation, vesication, or pustulation, desquamation, and final recovery, which latter cannot take place if .the course of the disease be interrupted by improper treatment. There are no remedies known even to the best informed which will cure such diseases as variola, whether in man or horses, and any treatment adopted should be of the expectant order. Excessively high temperatures may be reduced by judicious administration of drugs; constipation may be relieved or other special symptoms allevi- ated; but the disease having a certain course to run, the patient must be kept under the most favourable conditions as to food, clothing, diet, and atmosphere. To prescribe for horses, a knowledge of their organs, the functions they
perform in health, and the nature of those departures from health which we call disease, is absolutely indispensable. In addition to this we require a knowledge of therapeutics, or the action of medicines, in order to employ them successfully. This department of veterinary science has not made progress in propor-
tion to surgery, hygiene, and other branches of medicine. No sufficiently accurate observations are recorded over a long period of the action of drugs upon animals in health, but out of the collective experience of our best veterinary surgeons a workable amount of knowledge has been evolved. The horse owner who reads this remark will naturally wonder that the schools have not taken the matter to heart, and devoted much more labour to that side of the practice of medicine which always appeals most to the layman. One of the obstacles to progress in our knowledge of the action of drugs
upon the horse in health is the Anti-vivisection Act, which makes penal the administration of the simplest drugs by way of experiment, while permit- ting many barbarous practices if done with the object of curing disease or rendering animals more useful or profitable. Our knowledge of the action of drugs, we have said, is unsatisfactory,
and although we have borrowed largely from the older profession of human medicine, wTe have an accumulated knowledge of an empirical kind which is |
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valuable, although we cannot give a reason in all that pertains to it " for
the faith that is in us ". With all the advantages enjoyed by our medical friends, their practice is still largely empirical, and the scientific reason is often not forthcoming until a century or two has proved the utility even of such medicines as quinine and sulphur. MEDICINES AND THEIR PREPARATIONS
The following useful formulae may be taken to represent those " stock "
medicines which are kept in readiness in large studs for ordinary and un- complicated cases which may be anticipated where any considerable number of horses are employed. The purgative or aloetic ball is, in the language of the horseman, called
"physic" or a "physic ball", to the exclusion of all other medicines with equal rights. While unwilling to perpetuate a wrong impression, it is absolutely necessary that our readers should be quite clear as to the mean- ing of the term. They are spoken of as so many " dram" physic-balls, and this always relates to the number of drams of aloes contained in the bolus, and not to its gross weight, which will be about one-third more. A dram or so of ginger in powder is usually found in each dose, and is given with a view to preventing any griping effects from the aloes. The cheap, ready-made balls obtained at drug-stores are too often made
from Cape and Socotrine aloes, which long experience has proved to be less suitable for horses than the variety known as, and chiefly obtained from, Barbados. The materials used to give a proper consistence to a mass are various;
the common object desired is a substance that can be cut and manipulated into a shape that it will retain when wrapped in paper. Soft soap is a con- venient material if the ball is to be used immediately, but hardens too much if kept as a mass. Glycerine, castor-oil, linseed- and rape-oil are also used, the first-named retaining the moisture and consistence desired, and not having the objection of greasing and staining the wrapper, which is the invariable consequence of employing oils, unless a gelatine capsule is sub- stituted for paper; but these again offer a disadvantage in being slippery when wet, and therefore more likely to escape from the hand in the act of being administered. (See Administration of Balls.) The formula recommended by Professor Tuson of the Royal Veterinary
College has been largely adopted. It is as follows:— Barbados Aloes ... ... ... 8 ounces.
Powdered Ginger ... ... ... 2 ounces.
Kape-Oil ... ... ... ... 1 ounce.
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These ingredients are melted together in a " water bath" (fig. 426) and
incorporated by constant stirring. Another formula, which was published by Messrs. Elliman, and claims
to be plastic, ductile, and soluble, is given below:— |
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Best Barbados Aloes
Glycerine
Castor-Oil
Powdered Unbleached Ginger ...
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10 parts.
1 part. 1 part. \ part. |
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The aloes are directed to be dissolved in glycerine with the aid of the
water bath, the castor-oil added, and the ginger stirred in lastly. The dose of aloes, when intended as
a purgative, varies considerably according to age, size, and breed, besides which it is found that in some districts a larger quantity is required to take an equal effect. In the southern part of England four
drams may be considered a fair dose for a carriage horse or hackney, and five or six, or even seven, for a draught-horse; but these doses are considerably exceeded in Scotland and some of the western |
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Fig. 426.—Water Bath
1, Earthenware lining. 2, Inlet for water.
3, Tap for drawing off water. |
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counties of England with apparent safety.
Much larger doses were formerly given, |
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but without proper preparation.
Preparing for Physic.—Bran mashes only should be allowed for
twelve to twenty hours before giving the ball; all dry food removed, and abundance of drinking water, not quite cold, should be administered. Thus prepared for, a five-dram dose will probably prove more active than a larger quantity given on the top of dry hay or hard corn. The full effect of an aloetic purge is not realized for about eighteen
hours, and to facilitate its action exercise is prescribed, but it should be discontinued as soon as purging commences. The animal should not be called upon for active exertion until the physic has " set" or the faeces resumed their ordinary consistence, and the appetite for hard food has returned and been appeased. Condition Balls.—The term " condition " as applied to horses may
imply two quite different states. As used by the hunting man or the owner of race-horses it means hard condition—firmness of muscle and the fullest development of the powers of heart and lungs, to sustain the animal |
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during long-continued exertion—and it is brought about by a system of
training which has become a fine art. A physic-ball is often the first act in the preparation, and other balls or powders for conditioning follow. They appear to have the effect of getting rid of effete material, and enabling the subject to derive the utmost benefit from the food consumed and the carefully-apportioned exercise enforced. Appended is a recipe for a famous proprietary ball which has been largely used in racing- and hunting-stables |
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The above dose is given twice a week for about three weeks, and then
an interval allowed, as there is danger of over-stimulating the liver. Show or dealer's " condition " is as opposite from the fine-drawn racer or
"fit" hunter as possible in a horse in good health. Even the best judges of horses are favourably impressed by the round and sleek appearance of the dealer's horse that has been fed upon boiled foods and " stodges". The purchaser sees in such a horse a good "doer", and the seller is able to conceal some defects by loading on fat. To enable the horse to digest and accumulate a large amount of fattening food while taking but little exercise, recourse is had to such drugs as assist to prevent fermentation in the digestive tract and further act upon the kidneys and skin, giving a soft and glossy appearance to the latter. The spices and so-called "foods" sold for this purpose are chiefly com-
posed of salt, fenugrec, and lentil flour. A favourite ball for this kind of conditioning is composed of equal parts of ginger, aniseed, gentian, grains of paradise, and liquorice made up with treacle or glycerine. MEDICINES WHICH ACT UPON THE BLOOD, AFFECTING
THE NUTRITION OF THE ENTIRE BODY The character and composition of the blood, and the part it plays in
the animal economy, has been dealt with in that part of this work devoted to physiology. It has been shown that every part of the body depends upon the blood for the supply of those materials which maintain it in health and repair the waste that is always going on. Every tissue, nerve, muscle, bone, skin-cell, and hair-follicle depends
upon the blood-stream for its maintenance, every gland for its functional activity. |
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The nutritive material so constantly being given up by the blood for
the sustenance of the body is renewed by the food in its passage along the digestive canal. The blood also serves as a vehicle to remove waste pro- ducts from the body, chiefly by the lungs, kidneys, and skin, and through its medium the body is affected in various ways for good or ill. If from any cause it is deficient in the materials needed for repair or secretion, the body as a whole or some part thereof will suffer, as will also be the case if some deleterious matter be allowed to remain in the blood-stream in excessive quantity, or beyond the time when it should be separated and passed out. It is intended by the foregoing remarks to show how the nutrition of
the body may be affected by introducing into the blood agents which, being carried to all parts of the system, exercise some influence upon its tissues. The preparations of iron in forms not detrimental to digestion, together
with suitable diet, appear to increase the production of red corpuscles and improve the general health. It is sometimes desirable to employ substances which, instead of in-
ducing the red blood corpuscles to give up oxygen freely, will arrest combustion. Where the body-heat has risen above the normal standard, and a condition of fever prevails, we employ for this purpose quinine, alcohol, salicine, and some other agents, the effect of which is to reduce temperature. Medicines also act upon the blood by increasing the amount of albumen,
salts, fat, phosphorus, &c. BLOOD TONICS
These are remedies which supply materials in which the blood is
deficient, and thereby improve its quality; as the greater number of them also increase the red colouring matter of the corpuscles, they are called hsematinics. Iron.—At the head of the list stands iron. The preparations most in
use for horses are the sulphate in crystal or exsiccated, then come reduced iron, saccharated carbonate and phosphate, tincture (steel drops), iodide of iron, and arseniate of iron. The citrate and tartrate might sometimes be used for horses with advantage, although much more costly than the first- named preparations, which are most largely employed. Action and Use of Iron.—Iron in its various forms, but more
particularly in certain solutions, has a direct effect upon the tissues with which it comes in contact and before it enters the circulation. |
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It is more or less strongly astringent in proportion to the strength
of the solution, and may be made to exert its influence on various external and internal parts, as the mouth, throat, gullet, stomach, and bowels. Blood and other albuminous fluids are coagulated by the salts of iron, and this property is made use of in medicine to arrest haemorrhage or bleeding both from internal organs and external parts. Its constringing effect leads to its employment in obstinate cases of diarrhoea and catarrhal conditions of mucous membranes generally. By the administration of iron the faeces are blackened as a result of the
formation of sulphide of iron in the intestinal canal. With the horse we have seldom those irritable conditions of the stomach which in the human subject preclude the use of iron. Any existing difficulty in this direction may be overcome by selecting the least irritating preparations, as the saccharated carbonate and reduced iron. The chief value of iron is due to its action upon the red corpuscles, and
through them upon the organs and tissues of the body. It is therefore prescribed in cases of wasting and mal-nutrition, and in haemorrhage to arrest the flow of blood, as well as in the case of chronic discharges from mucous membranes. It is also given in purpura and similar blood disorders. In combination wTith other agents, as strychnine and arsenic, quinine
and vegetable bitters, iron is given as a nerve-tonic and muscle-builder. With iodine it is prescribed for the removal of effusions, as those in the chest cavity resulting from pleurisy, and for the reduction of glandular swellings and bony deposits on the limbs and other parts of the body. As an astringent application it is sometimes used for grease and applied to indolent sores and ulcers. As an antidote in cases of arsenical poisoning, iron is used in the form
of hydrated oxide. DRUGS FOR REDUCING THE ALKALINITY OF THE BLOOD
The chief of these are the salts of soda, potash, lime, and magnesia.
The potash salts in veterinary use are the carbonate, bicarbonate, nitrate, acetate, chlorate, tartrate, iodide, and bromide. The potash salts have varied uses, and produce different effects accord-
ing to the preparations used and the dose prescribed. Thus the bicarbonate is very largely used in some forms of dyspepsia, especially in those cases where the acid secretion of the stomach is in excess and requires to be neutralized; it is also employed as a febrifuge. The tartrate and acid tartrate are slightly aperient in large doses. The nitrate is perhaps more used in veterinary practice than any other drug in the pharmacopoeia, and |
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449
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probably, it may be added, more abused than any other by grooms and
carters. Its action is febrifuge, and it is referred to here on that account; but its chief action being in connection with the kidneys, it will be more fully considered in dealing with drugs acting upon those organs. Potash salts, more particularly the carbonate and bicarbonate, enter the blood rapidly and increase its alkalinity. The red corpuscles already contain potash, and appear to possess a great affinity for it, the number of red blood corpuscles being increased rapidly when potash and iron are given together. By increasing the amount of water passed by way of the kidneys, they tend to promote absorption of fluids effused into the tissues and cavities of the body. The action of a combination of potash and iron in this respect is well known to stablemen and others, who use it to disperse those temporary swellings of the legs so commonly resulting from rest or overwork. Chlorate of potash is a valuable drug in some cases on account of its
antiseptic properties. In soreness of the throat and the mouth it is pre- scribed as a gargle or mouth-wash, or it may be applied as a powder to abraded surfaces. Potassium chloride is a powerful caustic employed for the destruction
of living tissues in the form of morbid growths such as warts, proud flesh, and other abnormal excrescences, callous sinuses, and fistulous surfaces. By it "proud flesh" is removed, as well as the callous sinuses of fistulous wounds, such as occur in poll evil, quittor, &c. Diluted freely with water, it has powerful antiseptic and disinfectant properties, being largely used under the name of Burnett's fluid. Permanganate of potash is a valuable salt, and largely used as an anti-
septic, deodorizer, and disinfectant; and being a perfectly harmless sub- stance, is employed for injections into the mucous cavities of the body, as well as for mouth-washes and gargles. It is considered valuable in cases after difficult parturition, for which it
is used in the proportion of about ten grains to each pint of warm water injected into the uterus. Soda.—The preparations used in veterinary treatment are the car-
bonate and bicarbonate, sulphate, hyposulphite, biborate (borax), and chloride (common salt). In the last form it is a constant constituent of the blood and of all the tissues of the body; horses, like man, appear to be benefited by the introduction of this salt of soda into their food. Most horses like it, and readily lick it from salt rolls or salt rock. Soda salts do not enter the blood so readily as those of potash, and they are most fre- quently prescribed for neutralizing acidity in cases of acute indigestion and gastric disturbances, and as a saline aperient. Sulphate of soda is an excel- lent aperient, and has been in use for many years under the name of Vol. II. 63
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450
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Glauber's salt. Hypophosphites are thought to be beneficial in restoring
nutritive function in some febrile diseases. The general uses of soda are the same as those of potash and magnesia.
Except in the form of sulphate of soda, the drug is not much employed by veterinry surgeons. The sulphate is one of the most valuable drugs we have, and in small
doses is alterative and diuretic, and in large ones aperient. (See Aperients.) The solution of bicarbonate of soda is a valuable antacid; which may be
used in such cases as those for which bicarbonate of potash is prescribed. Being tasteless, horses may be induced to take it in the drinking water when refusing other saline medicines. Lime.—Preparations of lime are seldom used in the treatment of
horses, but the carbonate, in the form of chalk, is sometimes employed as an antidote to poisoning by corrosive acids, and as an astringent in diarrhoea. COOLING MEDICINES, ANTIPYRETICS
The class of medicines known as "cooling" are those which, like
quinine, retard the discharge of oxygen from the red corpuscles of the blood instead of facilitating the process, as do iron and potash in com- bination. Antipyretics (Greek anti, against, and puretos, fever). — Besides
quinine, which stands at the head of the list, and the action of which has been already explained, there is salicine, whose action in reducing temperature is very marked, though the modus operandi is not yet clearly defined. A number of synthetical compounds of German origin much in vogue
in human practice are employed by some veterinarians, but their utility in equine practice cannot be said to have been established. The large doses required, and the considerable cost, preclude their use on a large scale in establishments where their therapeutical value could be best tested. Among them may be named antipyrin, antifebrin, kairin, phenacetin, &c. The veterinarian is accustomed to regard saline aperients as " cooling "
medicines, and they undoubtedly do reduce temperature in an indirect manner (see Aperients). Remedies which act upon the skin and kidneys also lower the animal heat, and the application of cold water does so by evaporation and the subsequent determination of blood to the surface. Clothing, by inducing perspiration and increased activity of the skin, also tends to lower the general temperature. There are other drugs which depress the activity of tissues, and pro-
vided the loss by waste remains the same, a lowering of temperature |
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follows. To this class belong alcohol and digitalis, strophanthus, aconite,
and belladonna. These drugs in proper doses do not reduce the normal temperature
of the healthy animal, but there is general agreement among practitioners as to their effect in cases of pyrexia. Quinine, as most of our readers are aware, is obtained from the bark of
the cinchona tree (fig. 427). There are several varieties, some of which are richer in the alkaloids than others. The virtues of the bark were more or less known to the South American Indians before the Jesuits introduced it to Europe. QUININE AND SALICINE
Uses of Quinine.—As a stomachic or bitter tonic quinine is one of
the most valuable remedies known to medicine, promoting appetite, diges- tion, and assimilation, and raising the general tone of the system after attacks of fever and other diseases, which leave the animal in a state of weak- ness. In doses of one or two drams no bad consequences are to be feared, but, judging by its indiscreet use in man, it may be supposed that exces- sive quantities would have a like effect in inducing giddiness, impaired vision, &c. So far as we are aware, no one has entered upon the costly experi- ment of over - dosing horses with quinine, but its value in quantities not exceeding half an ounce at a time is now very generally recognized among veterinary surgeons. Combined with alcohol, it has been
found one of the most useful agents |
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Fig-. 427.—Cinchona lancifolia
1, Flowering branch. 2, Section of flower.
3, Fruit. 4, Older quill of bark (Columbian), soft. 5, Younger, showing patches of cork. 6, Hard bark (Carthagena). |
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in the treatment of that prostrating
fever generally termed influenza. By its action on the blood it
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arrests fermentation and destroys or
inhibits the action of blood-poisons. This is seen after difficult parturition, with rising temperature and threatening dissolution. In purpura hsemor- rhagica it is used with good results in alternation with turpentine and alcoholic stimulants. Its germicidal properties render it useful for |
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452
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certain forms of sore throat due to septic matter. The growth of dele-
terious organisms is checked by its presence outside the body, and in this connection it may be reasonably assumed that its activity is still continued when introduced into the living organism. Quinidine, cinchonine, and the other alkaloids of cinchona bark are
credited with the same medicinal powers, but not in the same degree. It is possible that the combination of them with quinine in some way exerts a better influence than quinine alone, as there are many good observers who claim to get better therapeutical results from a tincture of the bark, than from the latter given as a powder. Salicine, when obtained from willow bark, is an expensive agent in
the large doses required for horses. The bark of the poplar-tree and the flower-buds of the meadow-sweet also contain it, but not in sufficient pro- portion to be of any practical value as a source of supply. Salicylic Acid is obtained by passing a stream of carbonic acid
through a heated mixture of caustic soda and carbolic acid, but its natural source of supply is from the oils of winter-green or sweet birch. Actions and Uses.—In the reduction of high temperatures and the
treatment of rheumatism it is the most active remedy known. Some of the obscure lamenesses of a shifting and intermittent character have been quickly banished by its use. Salicine and salicylic acid appear to act in much the same way as quinine, and excessive doses produce the same train of symptoms. Salicylate Of Soda is very much employed in reducing temperatures,
but its liability to excite abnormal action of the heart requires special care and observation where its use is to be continued. MEDICINES WHICH ACT ON TISSUE CHANGE
ALTERATIVES
Alteratives comprise a number of drugs of importance to the horse
owner. It has been previously stated that they alter the nutrition of the body and bring about certain desired results, not only in relation to disease, but also in the process of training the horse in health for particular pur- poses. These results are obtained without any marked action upon any particular organ. It is supposed that alteratives act by inducing minute chemical changes in the economy which are quite inappreciable by ordinary methods of observation, but yet of a more or less lasting character. If given medicinally, their action may remain permanent, but an animal artificially "prepared" or got up for show purposes, and maintained in |
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MEDICINES WHICH ACT ON TISSUE CHANGE
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453
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show condition by their aid, will often fade or lose his bloom when after
long use they are discontinued. The glossy skin beloved of horse dealers and exhibitors is often the
result of a course of arsenic, antimony, sulphur, and nitre, which are chiefly employed on account of their action upon the skin. Sulphuric acid (oil of vitriol) is the chief agent of the teamster, who too often relies on such mix- tures to impart sleekness to the coat, which can only be otherwise obtained at considerable expenditure of manual labour. Arsenic.—The preparations used in veterinary medicine are white
arsenic (arsenious acid), solution of arsenic, and the arseniates of iron and copper. This drug is a deadly poison, and should not be administered for any purpose save by the advice of a qualified veterinary surgeon, and in no case upon an empty stomach, as it is irritating to the mucous membrane of the alimentary canal. Notwithstanding this, carters and others are in the habit of giving large doses after fasting, for the expulsion of worms, and sometimes this has fatal consequences. As an alterative, arsenic is given in small doses gradually increased. If
given in a ball, the dose can be accurately apportioned and controlled, and combined with an alkaline solvent; but the practice of giving it as a powder is dangerous and objectionable, inasmuch as it is liable to fall to the bottom of the manger and to accumulate there, later to be taken as a fatal dose when that receptacle is licked clean after a bran mash or other moist food. The solution Liquor arsenicalis, or Fowler's solution, is the most satisfactory preparation, as it may be given in the food without incur- ring the risk referred to above. When arsenic has been administered for some considerable time, and it is desirable to discontinue its use, the dose should be gradually reduced and not suddenly discontinued, a remark that applies more or less to all alteratives. Action and Uses Of Arsenic. — Externally it is employed as a
caustic in the form of a paste to destroy warts and other growths, and in weak solution as a parasiticide. Besides its alterative action when given internally, it is sometimes employed as a stomachic or stimulant to the stomach to aid digestion. It combines with the blood corpuscles, and the more readily when in combination with iron. All the organs and tissues of the body receive it from the blood, and for a time it remains incorporated with them; but it is eventually eliminated by the liver, the kidneys, and the skin, through the medium of their respective secretions, the bile, the urine, and the sweat. Intractable skin diseases, especially those of a constitutional character,
may often be treated successfully with arsenic given in the food. Where animals are known to suffer from periodical outbreaks of skin disease, a |
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454
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course of arsenic, especially if given during the moulting period, may have
the effect of checking its eruption. In the chronic cough of broken wind, arsenic has been found a valuable
remedv. ASTRINGENTS
Astringents are agents which cause constriction or contraction of the
tissues to which they are applied, and diminish the amount of secretion from mucous membranes. The action of astringents may be local or remote. In the former case
they are brought directly into contact with the part, as in the case of gargles, injections, eye-washes, &c. In the latter it is necessary that they be first absorbed into the blood, and by it be conveyed to the part to be acted upon. Cold, in the form of ice, evaporating lotions, or freezing- mixtures, is spoken of as an astringent. The mineral acids, and their salts also, if soluble, have a similar effect, particularly the salts of lead, zinc, iron, copper, aluminium, silver, and mercury. Among the chief vegetable astringents used in veterinary medicines may be mentioned gallic and tannic acids, and the barks of trees which have astringing or binding pro- perties due to these or similar constituents. Oak bark and oak-galls are among the most powerful; white elm bark, catechu, witch-hazel, and others are more or less employed on account of their astringent properties. The immediate effect of such agents upon mucous surfaces, and soft
parts generally, is to contract them, whilst some also coagulate the albumen with which they are brought into contact. The action upon living tissues is somewhat similar to that of tanning
skins, by the formation of a tanno-gelatin. Some astringents administered as internal medicines counteract the
relaxed condition of mucous surfaces, and some possess the property of arresting haemorrhage. Externally applied, remedies of this class arrest excessive secretions
and discharges of pus, serum, and mucous or muco-purulent discharges, as, for example, in abscesses, ulcers, and catarrhal diseases of a more or less chronic character. Astringents in the more popular acceptation of the term are those
remedies usually employed to arrest diarrhoea only, but it will be seen from the foregoing remarks that their uses are very diversified. Certain astringents have the property of causing contraction of the
blood-vessels, decreasing the amount of blood circulating in the parts, and so lessening the quantity of secretion given off by it. The mineral acids, sulphuric especially, have this astringent effect. |
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MEDICINES WHICH ACT ON TISSUE CHANGE 455
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Nut-Galls.—Although tannic acid is extracted from nut-galls (fig. 428),
yet in practice we find powdered galls have certain advantages over the active principle for some purposes, while tannic acid is best suited to others. Powdered galls are less astringent than tannic acid, and rather more so than oak bark, elm bark, or catechu. They are not absorbed with the facility of alum, or iron, but have the effect of coagulating albumen. In horse practice they are used in electuaries for relaxed and sore throat, and abrasions of the mouth and fauces generally, where a somewhat con- stringing effect is desired from an agent that is not likely to be taken up into the circulation. The powder is also prescribed with success, as a ball, in cases of polyuria or profuse staling. Tannic Acid.—The action and uses of tannic acid,
or tannin as it is sometimes called, are similar to those of nut-galls above described, but it has the additional advantage of solubility. Where the bowel discharges are of such a character
as to suggest abraded surfaces, tannin is administered with great advantage not only on account of its power to check secretion, but also because of its action on the bleeding vessels. It is soluble in water and spirit, and has a special affinity for glycerine. Gallic Acid.—This astringent is nearly allied to
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tannic acid, both in chemical composition and therapeutic
value and uses. Oak Bark.—The bark from young trees and the
smaller branches is preferred for medicinal purposes, as |
Fig. 428.—Nut-Galls
1, 2, Nut-Galls
(Aleppo) from Quer- c\is infectoria. 3, Transverse section. |
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containing a relatively larger amount of the astringent
principle than is to be found in other portions. It has a special value in the treatment of chronic diarrhoea and bowel discharges of a dysenteric type. It is usually prescribed in the form of decoction, both as an internal remedy and as an application to languid sores and indolent ulcers. Catechu is a vegetable extract of special value as a bowel astringent,
and is frequently combined with opium and chalk. It is prescribed as a powder, tincture, and infusion. Kino is similar in its action, and chiefly employed as an intestinal
astringent or gargle. Alum.—There are a number of compounds of alumina, but that com-
monly known as " alum " is a sulphate of ammonia and alumina. Veteri- nary surgeons value the drug highly, and employ it for a variety of |
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HEALTH AND DISEASE
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456
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purposes. It is used in several forms—as a crystal of irregular shape, as
a powder, and as burnt, exsiccated, or dried alum, that is after it has been deprived of its water of crystallization. Externally it is used for all the purposes to which other astringents are
applied, except as a styptic, as it has no very marked influence in arresting hsemorrhage of a serious character. In the dried form, alum is very much more active than in the other conditions, and is a valuable dressing for wounds, ulcers, and foetid discharges of various kinds. In combination with flour and oxide of zinc it is used for cracked and chapped heels, and for grease and skin eruptions upon the legs and belly. For injuries to the tongue, or any part of the oral cavity, alum is
invaluable. It has been found, in cases where the cheeks and gums have been denuded of membrane, or the tongue has suffered serious laceration, that a solution of alum speedily brings about the formation of a protective covering. In some forms of diarrhoea, and in prolapsus of the womb or bowel, it is an excellent astringent. It is also employed as an eye lotion, in powder as an insufflation, and in solution as an injection up the nostrils in cases of ozena. It has long been esteemed for drying up the milk of mares when, through loss of the foal or other causes, it is desirable to arrest the mammary secretion. Iron.—In addition to its great value as a tonic, iron is one of our most
valued astringents. There are a great many preparations of it, of which the following are in most common use in veterinary practice: sulphate, carbonate, and solution of perchloride. For arresting haemorrhage outside the body, the solution of perchloride
is a most efficient preparation. It enters into the astringent lotions em- ployed in the treatment of thrush, grease, and other diseases attended with foul discharges and fungoid growths. Copper.—The salts of copper are used in much the same way as those
of iron, but the sulphate, which is the preparation most employed, is more astringent than that of iron. In grease, thrush, and canker it is employed as a lotion or in powder, either alone or in combination with other astrin- gents. It has the most drying effect of any of the astringent metallic salts when applied to raw surfaces. In special cases it is prescribed as an intestinal astringent. Zinc.—The preparations of zinc used in the medical treatment of horses
are the sulphate, acetate, chloride, oxide, carbonate, and oleate. The salts vary very much in their astringent and caustic properties. The oxide and carbonate are but very slightly astringent, and in this
connection are used only as cooling and drying agents. The acetate, sul- phate, and chloride in weak solutions are astringent. |
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CHESTNUT HUNTER GELDIiNG, ARTIST
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By Highthorn. The Property of John Hadland, Esq., Beverley.
Winner of Numerous Prizes. |
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DEUGS WHICH ACT ON THE HEART AND BLOOD-VESSELS 457
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Silver.—Only one salt of silver is used in horse practice, and that is the
nitrate, or lunar caustic as it is also called. As a weak solution it may be prescribed as a mouth-wash, when a spongy state of the gums indicates the need of a sharp and quickly-acting astringent that will not require frequent repetition, as might be the case if tannin or some of the simpler washes were employed. For the suppression of soft granulations and the forma- tion of a level scab, nitrate of silver is probably the best of all the metallic salts, and is much used in the treatment of broken knees and other skin wounds, when the object in view is to secure the least possible permanent blemish. As an eye lotion it is and has been long in repute for a variety of
affections of the visual organs. By its effects upon the vascular structures of the eye it causes absorption of specks or cloudiness of the cornea if they are not of long standing. In small doses internally administered it is astringent, and occasionally prescribed when ulceration of the stomach or bowels is suspected. Bismuth.—As a bowel astringent this drug is valuable either in
solution or powder. In the latter form and with chalk it appears to act mechanically by forming a smooth coating over the mucous membrane. Chalk, or carbonate of lime, is a safe and often effective astringent in
cases of diarrhoea, particularly in those instances in which a general acidity of the intestines gives rise to it. DRUGS WHICH ACT ON THE HEART AND
BLOOD-VESSELS Drugs in this section are conveniently divided into four classes, namely:
heart stimulants, heart tonics, heart sedatives, and those which act on the blood-vessels (a) by contracting them, and (b) by relaxing them. |
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Disordered blood-distribution may be due either to the heart or its
blood-vessels acting improperly, or to both. In another section the composition of the blood has been described, and
the method of its distribution in health; but an animal may possess good |
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HEALTH AND DISEASE
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458
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blood and perfect vessels by which to convey the life-fluid to all parts of
the body, and yet perish, if the heart fails in its work as a central pumping station, or if the blood-vessels of one organ are surcharged, while the nutrient supply fails to reach others. The causes of disordered circulation are irregularities of the heart,
whose contractions may be too forcible, too feeble, or irregular; or the heart may be capable of doing its work efficiently, but the vessels may offer undue resistance by reason of their calibre being abnormally con- tracted; or, on the other hand, they may be so far relaxed as to permit too free a flow of blood to a particular organ, causing congestion. Eemedies which affect the heart and blood-vessels are therefore of great
importance, and deserve careful consideration. HEART STIMULANTS
It has been elsewhere explained that the heart is a muscular organ
which, by its contractions, propels the blood over the body. If it contracts with inadequate force the cavities are not properly emptied, nor the blood- vessels filled, and nutrition is impaired. If by shock or haemorrhage an insufficient blood-supply is sent to the brain, its functions are suspended, and the animal faints and falls. The recumbent position thus assumed is favourable to recovery, and with removal of the cause the heart's action may be restored. When syncope threatens a horse he staggers, and in trying to keep upon his feet gives us some warning of his condition, which it is well to heed for his sake as well as our own safety. Trembling, sighing, and staggering will be noticed, and an examination of the mem- branes shows them to be blanched, or pallid, like the countenance of a person about to swoon. If a heart stimulant is given, the function of the organ will probably be restored for the time, and the brain again recovering its due supply of blood, consciousness will return. Any failure of the heart acts upon its own substance, which, like every
other part of the body, derives its nourishment from the blood. The heart receives its stimulus through the nervous system, and it has
within it certain minute nervous bodies (ganglia) designed to excite and carry on the rhythmic movements which are commonly called " beats • Remedies which influence the beats of the heart do so through these nerve- centres being acted upon by agents which have entered the blood-stream- They are further controlled by the pneumogastric nerve, which slows the action of the organ, and by the sympathetic nerves, wdiich excite it; and it is through the medium of these that stimulants are able to increase both the frequency and the force of the muscular contractions. |
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DRUGS WHICH ACT ON THE HEART AND BLOOD-VESSELS 459
Heat is a rapid stimulant when applied to the walls of the chest, or as
a hot fluid passed into the stomach; but in the equine patient we have to rely chiefly upon drugs, and of these alcohol, ammonia, ether, and camphor are the chief. Ammonia is a gas dissolved in water, but in that condition is not
often employed in horse practice. The chief preparations are:—
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Strong Liquid Ammonia.
Dilute Liquid Ammonia. Aromatic Spirit of Ammonia. |
Carbonate of Ammonium.
Chloride of Ammonium. Acetate of Ammonium. |
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Liniment of Ammonia.
Actions and Uses.—Ammonia is a stimulant when applied to the
skin, the neutral salts having the least action and the strong liquid the greatest, the latter producing vesicles like an ordinary blister. Weak solutions are used to neutralize the stings of insects, which are usually acid. When inhaled, ammonia rouses the heart and quickens the pulse and respiration. It is employed in this way as a restorative after operations under chloroform when the patient is disposed to remain too long under its influence. The liquid is particularly irritating to the nostrils, and should not be brought into actual contact either with the thin skin covering them or the membrane within. Ammonia has a stimulating effect also when passed into the stomach,
and the preparations to be preferred for internal administration are the aromatic spirit (sal volatile), largely diluted, or a solution of the carbonate. In the latter form it not only increases the heart's action, but stimulates the stomach and bowels before it enters the circulation. For this reason it is a valuable remedy in flatulent colic, and for various forms of indigestion it is prescribed with vegetable tonics. It is given in respiratory affections because it stimulates the membranes
of the bronchial tubes to expel mucous matter from their surface. The acetate is employed as a febrifuge, and promotes the action of the skin. Chloride of ammonium is given in chronic diseases of the liver, and as
an external remedy it is used in combination with other drugs as a cooling or evaporating lotion for inflamed joints and tendons. Ether.—This drug has long been a constituent of colic draughts, and
is one of the most rapidly diffusible stimulants, [ts action upon the heart is very marked, and it is employed in a variety of ways, subcutaneous injection being the most rapid. It is also used as an anaesthetic. Camphor.—Camphor is a concrete volatile oil obtained by sublimation
from the twigs of the camphor tree, which grows in the Dutch Indies, |
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HEALTH AND DISEASE
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460
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China, and Japan. It is a valuable drug in veterinary practice, and is
given internally as well as applied to the skin in various ways. Its chief preparations are spirit of camphor and the compound tincture (better known as paregoric elixir), camphor liniment (camphorated oil), and camphor water. Action and Uses.—Externally applied, camphor acts as a stimulant
to the skin, and is employed as a liniment, in combination with oil, ammonia, soap, and other ingredients, for relieving sprains and stiffness of muscles and joints. It is a stomach stimulant and anti-spasmodic, controlling those con-
tractions of the intestine which occur in some forms of colic, and is pre- scribed for persistent diarrhoea. It is also a heart stimulant, and is given in febrile diseases, more par-
ticularly to overcome nervous prostration following upon attacks of delirium. Large doses cause excitement and convulsive movements of the muscles. Alcohol.—Alcohol in the form of brandy, whisky, or other spirit, if
not very much diluted, acts as a stimulant both when externally applied and internally administered. The immediate effect of alcohol on entering the blood is to increase the heart's contractions in both number and force, and subsequently to reduce temperature, as elsewhere explained. In cases of fever and prostration, suitable doses of alcohol, whether as wine, spirit, or beer, are found to steady the pulse and reduce the number of respirations; but there are exceptions to be met with among horses as among men. An idiosyncrasy sometimes exists by which individuals are unable to benefit by alcohol, and other stimulants must take its place. The effect of this agent should be carefully watched, as the dose is often excessive and loss oi appetite results in consequence. In approaching convalescence the amount should be gradually diminished and not abruptly discontinued. In pul- monary congestion alcohol is a valuable remedy, and in its popular forms readily obtainable. Considerable doses are given, and often with the greatest benefit in the early stages of the affection. In the form of malt liquors, with gruel, it is given with advantage m
convalescence from gastric and intestinal inflammations. HEART TONICS
The heart tonics of known value in equine medicine are digitalis and
strophanthus. Digitalis.—The leaves of the purple foxglove are the part of the plant
chosen for medicinal uses. Dried and finely powdered, they are employed in veterinary practice. An infusion and a tincture are likewise made from them, and an active principle is obtained and known as digitalin. |
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DRUGS WHICH ACT ON THE HEART AND BLOOD-VESSELS 461
Action and Uses.—A tonic effect upon the heart is claimed for
digitalis, as it increases the force of its contractions while lessening their number. By stimulating the nerves which contract the blood-vessels a better tone is imparted to them, and the circulation is rendered more efficient. Strength is given to the feeble heart, and when irregular or intermittent, it is made to act in a steady and rhythmic manner. It is found to have a beneficial effect in horses for a short time, but its con- tinued administration results in irritation of the stomach and inappetence. Poisonous doses act by causing spasm of the heart and consequent death from cardiac paralysis. Digitalis excites the kidneys to excrete a larger amount of urine than usual, and for this reason it is employed in the removal of dropsical swellings. It is also given in combination with other drugs in cases of chronic
cough, and with apparently beneficial results. Strophanthus is the plant from which the arrow poison is derived,
and its action in large doses is to paralyse the heart and other involuntary muscles. It is more soluble and rapid in its action than digitalis, but its effects are not so enduring. Continued administration, however, is less often attended with gastric disturbances. There are some cases of valvular trouble for which digitalis is unsuited, but in which strophanthus may be used with advantage. HEART SEDATIVES
Eemedies which diminish both the force and frequency of the heart-
beats, thereby producing a soothing effect, are called heart sedatives. By their depressing effect upon the heart they may be said in a certain sense to weaken its action, and if given without judgment are very dangerous. In the case of plethoric horses with high temperatures, aconite is given to slow the heart's action, but is not persisted in. Aconite, hellebore, and antimony are the chief drugs of this class. Aconite.—The monk's-hood (Aconitum Napellus) is the plant from
which the Pharmacopoeia preparations of this drug are made. They are aconitine—the active principle,—extract, tincture, liniment, and ointment. Judging from the behaviour of horses, we may conclude that aconite
applied to the more sensitive portions of the skin—the tongue and mouth generally—produces the tingling sensation so noticeable when brought in contact with similar parts on ourselves. The sensibility of the nerve ends being reduced by aconite, advantage is taken of the fact to employ lini- ments and ointments containing it with the object of allaying pain in acute rheumatism and painful swellings of various kinds, provided always that the skin is not abraded. When given internally, the effect upon the heart |
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HEALTH AND DISEASE
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462
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can be detected, in the diminished beat of the pulse and reduced numbers
of respirations, in a few minutes. It is given in inflammation of the lungs and acute abdominal troubles, and is a constituent of some colic medicines. Its action should be carefully noted, and its use discontinued as soon as the desired effect upon the heart is made apparent in the pulse. DRUGS WHICH ACT UPON THE BLOOD-VESSELS
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These are practically divided into two classes—namely, those which
cause the vessels to contract and consequently permit a smaller amount of blood to pass through them, and those which
dilate them and permit of a greater quantity to flow through them. When a portion of the body is in a state of active inflammation, we employ the first class of remedies. In veteri- nary practice we have frequent recourse to the cold douche, cold lotions, and bandages, ice, &c, for the reduction of inflamed joints and to control haemorrhage. In the second class we place hot fomentations
and poultices, mustard and warm embrocations, as their effect is to produce temporary dilatation of the vessels of the skin and enable the blood within to distend them to their greatest capacity. In this way mustard applied over the chest walls in pul- monary inflammations gives relief to the vital or- gans by diverting blood from them to the surface. |
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Fig. 429.—Ergot of Rye
1, Spanish ergot. 2, Russian
ergot. |
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Stimulating the legs with liniments, and hand-
rubbing, has the same influence in bringing about |
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a more general distribution of the blood, which in
internal inflammation is centred upon some more important organ or organs. In addition to the methods of relaxing superficial vessels as illus- trated above, there are also remedies which have a like effect upon internal organs, and by bringing more blood to the part, increase their physiological activity. Among those used in veterinary practice may be mentioned ginger, capsicum, pepper, grains of paradise, and some others of doubtful value employed in the treatment of impaired digestion. Drugs which relax the vessels of the skin, as alcohol, nitrate of potash, acetate of potash, and nitrous ether, produce a sensation of warmth for a short time, and this is why alcohol is popularly believed to increase the warmth of the body, although it has already been shown that its ultimate effect is to reduce temperature. |
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DKTJOS WHICH ACT ON THE HEABT AND BLOOD-VESSELS 463
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The most recent and effectual remedies for dilating the blood-vessels
all over the body are the nitrate of amyl and nitro-glycerine. The former has to be inhaled to produce its effect, and the latter is given internally. They are used for heart spasm (angina pectoris), and in asthma, broken wind, and convulsions. In poisonous doses paralysis of both motion and sensation results, and death by cessation of respiration. We have now to consider those drugs which are credited with pro-
ducing the opposite effects upon blood- vessels. Ergot Of Rye (fig. 429) is one
of the most active drugs in causing contraction of the small blood-vessels in man and some of the domesticated animals; but its action upon horses is uncertain, and even in large doses its effects are not so marked as upon dogs. It probably has some medi- cinal value, and is therefore mentioned in this connection. It is thought by some to be the cause of abor- tion when taken as ergotized grasses, but experiments in which pregnant animals have been dosed with large quantities do not bear out the theory. . It is given to mares after parturition, with a view to induce contraction of the womb, and has been recommended *%■ 430-—witch-hazel (HamawMis virginM) for inflammation Of the Coverings of *> Hamamelis (portion in flower). 2, Segment of
. -i-i i flower. 3, Bark with cork. 4, Bark with cork
the Dram and Spinal COrd. removed. 5, Bark, inner surface.
Witch - hazel (Hamamelis vir-
ginica).—This is a shrub (fig. 430) growing freely in many parts of North America. From the flowers and dried bark are made the medicinal pre- parations in use. These are extract, powder, distilled extract, and ointment. Uses.—For haemorrhage, witch-hazel is used both as an external ap-
plication and an inward remedy. It is applied as a lotion to arrest bleeding from wounds, and given for haemorrhage from the lungs and abdominal organs. For piles in young foals it is an excellent remedy, and is employed both topically and internally. The dry extract, which has not been officially recognized in the Pharmacopoeia, makes an excellent oint- ment for soft granulating wounds with a tendency to bleed. The dilute lotion is sometimes applied to inflamed eyes. |
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464 HEALTH AND DISEASE
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Lead.—As an external cooling and astringent lotion, lead, in the form
of diacetate, or Goulard's extract, has long been recognized as a useful remedy by veterinarians. It is applied to ulcers, cracked heels, mallenders and sallanders, and in olive or linseed oil it makes an efficacious lotion for that eruption commonly known as " mud fever". It enters into several lotions and ointments for the treatment of grease. With glycerine it forms a glycerole of lead, and is applied in poultices and upon painful surfaces. Goulard lotion diluted with distilled water is a favourite ap- plication in the treatment of inflamed eyes. Internally administered lead is powerfully astringent, affecting the
mucous membrane lining the stomach and bowels. In cases of dysentery it has a soothing and healing effect upon the abraded surfaces of the bowel, and is given in conjunction with opium to arrest hsemorrhage in distant organs, as the lungs, kidneys, and womb. It is readily taken up by all the tissues, and lead-poisoning is not
uncommon among animals in the neighbourhood of lead-mines. (See Poisoning.) DRUGS WHICH ACT ON THE STOMACH AND DIGESTIVE
SYSTEM
All those organs concerned in digestion have need of consideration
in this chapter, the stomach, the intestines, the liver, pancreas, and glands which are found in the intestinal walls. The effects of medicines of the class here to be described cannot be limited to a single organ, but are due to their action generally upon several parts of the complex system by which digestion is effected. Remedies affecting the digestive system are divided into the following
classes:— DRUGS WHICH ACT ON THE STOMACH
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Carminatives
Camphor, Aniseed,
Cayenne, Asafcetida,
Ginger, Carraways,
Peppermint, Fenugreek.
Drugs which Soothe the Stomach
Hydrocyanic Acid, Belladonna,
Bismuth, Cocaine,
Soda, Chloroform.
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DRUGS WHICH ACT ON THE DIGESTIVE SYSTEM 465
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REMEDIES WHICH ACT ON THE BOWELS AND LIVER
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Remedies for Constipation
Bran and Linseed Mashes, Olive Oil,
Linseed Oil, Glycerine, Castor Oil, Sulphur.
Simple Purgatives
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Remedies for Flatulence
The Alkaline Bicarbonates, as,
Potash, Soda, Magnesia. Essential Oils, as,
Mint, Aniseed,
Peppermint, Cassia,
Cloves, Carraway.
The Ethers and Spirituous Liquors, Am-
monia, &c. Remedies for Intestinal Worms
Anthelmintics
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Cream of Tartar.
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Epsom Salts,
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Glauber's Salts,
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Drastic Purgatives
Aloes, Croton Oil, |
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Gamboge,
Jalap. |
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Purgatives which Increase the Flow of Bile
Calomel, Euonymin, Podophyllin, Aloes.
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A consideration of the structure of the stomach and the process of
digestion as carried on in it by means of the gastric juice and its con- stituents, aided by the mechanical movements and temperature of the viscus, controlled by nervous forces, will enable the reader to understand that drugs may be administered which, by their stimulating, or slightly irritating, effect upon the lining membrane, cause a determination of blood to the part, and consequently increase the production of gastric fluid, or cause an increase in the strength of the muscular contractions of the walls of the stomach, and a more active movement of the food contained in it. There may be sufficient, nay excessive, quantity of gastric juice produced, but it may be deficient either in pepsin or hydrochloric acid. If a general state of debility indicates such deficiency as the cause of indigestion, medi- cines are given with the object of supplying the want of the one or the other, until Nature again succeeds in secreting the desired quality or quantity. Stomachic stimulants are agents which have been found by experience to rouse the stomach from a state of torpor to greater activity, enabling it to perform its functions more rapidly and completely. The opposite condition of morbid irritability may be the cause of trouble, when the horse refuses to eat and eructations are observed; animals like the dog, in whom vomition is easily excited and performed, return the food almost immediately. In such irritable states of the stomach, gastric seda- |
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64
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VOL. II.
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HEALTH AND DISEASE
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466
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tives are desirable, as they reduce the irritability, and give rest to the
glands whose office it is to secrete the juice. Carminatives or Ant-Acids are those remedies which are employed
to correct acidity of the stomach, a form of indigestion which is often persistent, causing pain and discomfort, which is more or less relieved by eructations from the mouth and the passage of gases from the bowel. Chronic " wind-suckers " often suffer in this way. Bitter Tonics, by their action on the stomach, increase the flow
of gastric juice and excite the nerves which regulate the muscular move- ments; the appetite is thus increased as well as the power of digestion. The bitter vegetable drugs most generally employed for horses are gentian, calumba, quassia, hops, chamomile, and cinchona. They may be given in the form of powder mixed in the food, previously damped, and to which a little table salt has been added. Most horses will take bitter drugs in this way, and if one refuses, he may be made to take them in the form of a ball, or a draught may be made of the infusion or extract. Some of these remedies have excellent effects in small doses, but prove hurtful if habitually used over long periods. Calumba Root is one of our most valued drugs in flatulent forms
of dyspepsia with loss of appetite. It is more likely to be refused in the food than some of the other bitters, and gives better results when used in the form of infusion and prescribed in conjunction with nux vomica and mineral acids. In the acid forms of stomach trouble it is combined with bicarbonate of soda with good results. The infusion must not be made with hot water, on account of the starch contained in the root, and must be quite fresh, as it is prone to rapid decomposition; but a tincture may be prepared which will keep indefinitely. Cascarilla Bark and infusion or extract of Chamomile Flowers
have the same effect as the remedies previously mentioned; but it is found
that some individuals will not tolerate one kind of bitter, while they may derive much advantage from another—hence the desirability of considering a variety of tonics of this class. Gentian Root is the favourite par excellence in veterinary practice,
and appears to be beneficial where a stomach tonic is indicated. Most horses will take the ground root in their food, and it may be variously combined with the bicarbonates of soda and potash. It may be given as a recently made infusion, or the extract dissolved in water, or incorporated in a bolus. Quassia.—Chips of quassia wood are infused and employed as a bitter
tonic, more especially when intestinal worms are supposed to be the cause of digestive troubles. The infusion is also injected into the bowels to |
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*
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|
MEDICINAL PLANTS—I
|
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4. Cascarilla (Croton Eleuteria);
a. Branchlet.
b. Female flower enlarged.
c. Male flower enlarged.
d. Bark.
e. Cross section of bark enlarged.
5. Calumba (Jateorhiza Calumba):
a. Leaves and flowers reduced.
b. Male flower enlarged.
c. Female flower enlarged.
d. Rhizome and roots reduced.
e. Slice of root.'
6. Gentian (Gentiana luted):
a. Upper part of flower spike.
b. Fruit.
c. Part of rhizome.
d. Part of root.
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|
1. Hop (Humulus Lupulus):
a. Male flower. |
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|
b.
c. d. e. /■ 9- |
Female flower.
Strobile. Female flower enlarged.
Male flower enlarged. Fruit enlarged. Section of fruit enlarged. |
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|
Cardamom (Elettaria Cardamomum):
a. Raceme. |
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|
b.
|
Cardamom.
|
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|
Section of fruit and seeds enlarged.
Grain of Paradise (Amomum, Melegueta) enlarged.
Section of Grain of Paradise. Section of seed, natural size. |
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|
d.
|
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|
/• ^^
3. Quassia (Picrcena ex
a. Leaves and flowers reduced.
b. Male flower enlarged.
c. Hermaphrodite flower enlarged.
d. Cross-grained slice of wood (the
"Quassia" of trade).
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|
PLATE XLV
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MEDICINAL PLANTS-
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|
DKUGS WHICH ACT ON THE DIGESTIVE SYSTEM 467
destroy certain classes of worms. Where a large dose is desirable the
extract may be dissolved or given as a ball. Quassia is more irritating than any of the tonics previously mentioned, and does not suit all cases, but is used a good deal in large studs, where economy is a great consideration. Cardamoms have a mildly tonic and stimulating effect upon the
stomach, but are not much employed in equine medicines, as they are not only expensive but inferior to gentian, calumba, and quassia as tonics, and might with equal propriety be considered among those drugs called carminatives. Hops. — As a veterinary drug, this valuable remedy has received
inadequate attention at the hands of practitioners. As a stimulant to appetite it is not surpassed by gentian or any of the other drugs previously named. Where a restless watchfulness and irritability supervenes on such debilitating diseases as influenza, hops may be recommended as having a sedative influence upon the nervous system. Cinchona or Peruvian Bark has been mentioned in connection with
its chief alkaloid, quinine. Acid Tonics.—" Acid Tonics" and the " mineral acids" are fre-
quently referred to in other parts of this work treating of disease. They are an important class of remedies, and the chief of them in use for horse ailments are the following:— Dilute Hydrochloric Acid,
„ Nitric Acid, „ Nitro-hydrochloric Acid, „ Phosphoric Acid, „ Sulphuric Acid, ,, Sulphurous Acid. Uses of Acids. — It will be inferred from previous references to
digestion and digestive troubles that acids similar to those normally secreted will prove valuable when Nature's laboratory fails to produce them in sufficient quality or quantity. In the use of acids as an aid to digestion two factors should be borne in mind, viz., while acids increase the dissolving or digesting power of the gastric juice when food is in the stomach, they have the effect upon an empty stomach of retarding the secretion of natural acid, they should always therefore be given imme- diately after food and not before a meal. The seeming contradiction of giving alkalis in some cases where acid secretion is defective, is explained by the fact that those remedies excite activity on the part of the acid- forming glands. The converse effect is observed upon glands which pro- duce an alkaline fluid, they being stimulated to action by acids, and |
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HEALTH AND DISEASE
|
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|
468
|
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|
their secretion lessened by alkalis. From these considerations the reason
for giving alkaline tonics before meals, and acids after them, will be obvious to the reader. In the section on the physiology of digestion it has been explained
how the fluids of the first portion of the duodenum act upon the partially digested food as it leaves the stomach, and here again the remedies under consideration continue their work. The continued employment of acids for a length of time is not desirable, as they may establish an artificial need for them, or result in catarrh of the stomach. Besides the use of acids in various forms of indigestion, they are
serviceable for their constringing action upon the lining membrane in cases of diarrhoea with a tendency to pass blood. Dilute sulphuric acid is generally preferred, or an old-fashioned aromatic acid in which ginger and cinnamon play a not unimportant part. Sulphuric acid is given to arrest haemorrhage in different organs, as
the liver, kidneys, uterus, and lungs. For all the purposes previously named it will be understood that the
dilute acids of the Pharmacopoeia are implied, the strong preparations being destructive caustics, and on account of this property being sometimes employed to remove warts and check the progress of malignant growths. If used as escharotics, care should be exercised in not allowing them to come in contact with healthy parts, or to burn the hand of the person making use of them. DRUGS WHICH ACT ON THE LUNGS AND AIR-
PASSAGES The respiratory apparatus may be influenced in two principal directions
by the administration of drugs, which may be divided into stimulants and depressants. The reader who would properly understand their modus operandi is referred to the chapter dealing with the physiology of the breathing organs. It will be there seen that the minute blood-vessels of the lungs are
spread over the walls of the air-vessels which constitute the parenchyma or lung substance in the form of a net-work, where it is brought into contact with the air inspired, or with gases accidentally or intentionally drawn into the lungs in the act of inspiration. The diameter of the minute air-tubes is capable of being increased or
diminished by their involuntary muscular fibres, while the larger tubes derive greater firmness from the presence of rings of cartilage which pre- vent them from being altogether closed under any circumstances. |
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|
DKTJGS WHICH ACT ON THE LUNGS 469
|
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|
The lining membrane of the air-passages contains mucous glands
which secrete a bland fluid for lubricating and moistening the surface, and is further clothed with fine hair-like processes (cilia), which, waving gently, like a field of corn in the wind, carry any superfluous secretion to be expectorated along the bronchial tubes towards the larynx, whence it passes out by the nose. The structure of the lungs facilitates the exchange of gases in the
process of respiration, and this is largely regulated by the movements of the heart; upon its force and frequency the amount of work thrown upon the lungs will depend. A proper understanding of the subject is essential to the treatment of pulmonary diseases upon any rational basis. The confusion which exists in the minds of horse-owners and others as to con- gestion and inflammation of these organs arises from want of knowledge of the distribution of blood from the different sides of the heart, and its destination. Circulation of blood in the lungs is quickened by any agent which stimulates the heart. Remedies having this effect are referred to under the head of stimulants, as alcohol, ammonia, strophanthus, digitalis, essential oils, &c. A stimulating effect upon the air-passages and the membranes which
line them is produced by warm food and copious draughts of fluid. Some alkaline preparations, as acetate of ammonia, and other drugs, derived both from the vegetable and mineral kingdoms, have the effect of increasing the amount of secretion poured out from the respiratory surfaces when congestion has induced undue dryness. Among the remedies that thus increase the amount of material in the
air - tubes may be mentioned iodide of potassium, ipecacuanha, squills, camphor, turpentine, benzoin, balsams of Tolu and Peru, stramonium, &c. Notwithstanding the disadvantage our equine patients possess of being
unable to expectorate in the ordinary sense of the term, they yet derive great benefit from the class of remedies known in human practice as ex- pectorants. The dryness of the membranes in cases of bronchitis may by their judicious administration be relieved, and the superfluous mucus got rid off by way of the nostrils. By reducing the force and frequency of the heart's action, the circula-
tion of blood in the lungs may be reduced in speed as well as volume, and for this purpose aconite is often prescribed. Counter-irritants, as mustard plasters, turpentine, and ammonia liniments, by withdrawing blood from the pulmonary vessels to contiguous structures, relieve the overloaded lungs, and aid in restoring the circulation to its normal condition. In some chronic forms of disease, as in the bronchial catarrh of old
horses, it may be desirable to reduce the activity of the glands and |
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HEALTH AND DISEASE
|
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|
470
|
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|
diminish the output of mucus. Warm applications to the skin, and such
drugs as opium, ether, chloroform, belladonna, and hyoscyamus, have this effect. While remedies employed in the treatment of diseases of the air-
passages and lungs are broadly divided into stimulants and sedatives or depressants, there are some which act in both ways. EEMEDIES WHICH STIMULATE THE LUNGS AND
AIR-PASSAGES
Enough has already been said to show that all remedies which act as
stimulants or tonics to the heart will strengthen the circulation of blood through the lungs. The symptom which most clearly points to the use of a lung or heart stimulant is a blue or purplish colour of the visible membranes, particularly the schneiderian. In the acute stage of congestion of the lungs, when an indifferently-
conditioned hunter is overtaxed, this blueness is very marked, and a judicious stimulant from the rider's flask may avert a dangerous illness. Ammonia, either given as a draught in water or inhaled, is one of the most effectual lung stimulants. The drugs elsewhere described as car- minative have a quickening effect upon the circulation of blood in the lungs, and the stream appears to flow more freely as a result of such agents as unload the liver and bowels; very marked improvement often follows the administration of small closes of aloes and calomel, which in some indirect way have been proved by trainers to increase the respiratory power of the animals entrusted to them. Expectorants may act, as previously suggested, by increasing the power
of secretion and quantity of mucus, by loosening the too tenacious and insufficiently fluid matter, or by adding mechanical force to expel the accumulated material. There are coughs in which the animal is " too sore to cough"; a great desire exists, but the animal dares not yield to it because of the greater pain resulting. An expectorant which alters the character of the spit may make it possible, with much less effort, to get rid of the cause of irritation. In the treatment of horses we are somewhat restricted; we may not give an emetic, which is found in the dog to expel mechanically accumulated material in the bronchi. The relief thus obtained in so-called " stomach " coughs does not necessarily point to that viscus as the seat of disease, but rather gives proof of mechanical assistance afforded in the pressure forward of bronchial mucus, when, by the act of vomition the diaphragm is pressed against the lungs. While, as we have already indicated, expectorants act in a |
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MEDICINAL PLANTS-II
|
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|
5. Ipecacuanha {Cephaelis Ipecacuanha):
a. Plant.
b. Flower enlarged.
c. Root.
d. Section of root enlarged.
6. Storax (Styrase officinale):
a. Plant.
6. Section of flower enlargsd.
c. Fruit.
7. Stramonium (Datura Stramonium):
a. Plant reduced.
b. Section of fruit reduced.
c. Seed enlarged.
8. Myrrh (Balsamodendron Myrrha):
a. Plant.
b. Leaf enlarged.
c. Fruit with husk half-removed.
d. Piece of myrrh.
|
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|
1. Copaiba (Copaifera Langsdorffii):
a. Plant reduced.
b. Flower enlarged.
c. Fruit reduced.
2„ Balsam of Tolu {Myroxylon toluifera):
a. Plant reduced.
b. Flower, natural size.
3. Balsam of Peru (Myroxylon Pereirce):
a. Plant reduced.
b. Section of flower enlarged.
4. Camphor (Laurus Camphora):
a. Plant reduced.
b. Flower enlarged.
c. Stamina and staminodes enlarged,
d. Pistil enlarged.
e. Fruit.
|
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|
PLATE XLVI
|
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|
MEDICINAL PLANTS-II
|
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|
DRUGS WHICH ACT ON THE LUNGS 471
|
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|
variety of ways, it may be said that their chief and most general action
is to stimulate the circulation of the blood in the lining membranes of the air-tubes and produce an increased secretion. Inhaling the vapour of hot water is one of the most simple and effective means of producing this desirable action, and medicaments of various kinds are frequently added. Of these may be mentioned the balsams of Peru and Tolu, copaiba and storax, camphor, myrrh, benzoin, and other volatile drugs, while for certain specific diseases agents are prescribed for inhalation for their anti- septic and other qualities rather than as pure stimulants or expectorants. Among this class, carbolic acid, turpentine, tar, eucalyptus, and other essential oils play an important part in the treatment of disease. Special apparatus is now made for giving inhalations, but in its absence the nose-bag may be made to do duty, with some hot bran and scalded hay, care, however, being taken not to scald the muzzle of the patient, as too frequently happens. REMEDIES WHICH SOOTHE THE LUNGS AND AIR-PASSAGES
Keduction of the volume of blood circulating in the lungs is the most
certain means of reducing their irritability, and a determination of blood to a particular part is combated by remedies which create a diversion from what are commonly called vital centres to the skin or subcutaneous tissues; hence the use of poultices and fomentations, warm liniments, and still more active vesicants, as mustard. The internal application of heat to the air-passages is afforded by the inhalation of steam, and the effect is to cause dilatation of the air-passages, more particularly of those with which contact is most direct. The effect of saline and other aperients is also soothing to the lungs for the same reason that a diversion of blood to the bowels relieves the pressure in the respiratory system. Another means of soothing the air-passages and reducing circulation of blood in the lungs is rest from all muscular exertion. It is noticeable in horses how cough is excited by movement and allayed by repose. The circulation may also be lessened by such drugs as aconite, anti-
mony, and ipecacuanha. REMEDIES WHICH REDUCE EXPECTORATION
Eemoval of the cause of, or allaying, the irritability of the air-passages
is to be desired, and the treatment for respiratory troubles is more gener- ally dealt with under the heading of pulmonary diseases. It is, however, found that acid tonics in combination with such soothing agents as bella- donna, hyoscyamus, camphor, and opium have the effect of reducing the |
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|
472
|
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|
HEALTH AND DISEASE
|
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|
volume of, or drying up, the phlegm which is a troublesome symptom
of chronic bronchitis. REMEDIES WHICH RELIEVE SPASM OF THE AIR-PASSAGES
AND COUGH
These, with our equine patients, are rather of a dietetic than medi-
cinal order, although what may be called artificial aid is given by drugs in the alleviation of the spasmodic cough of chronic asthma or broken wind (see p. 11 of this volume). The chief of them are: arseniates of iron and copper, oils, fats, as suet and lard, and the sedative agents already referred to, namely, opium, belladonna, camphor, conium, lobelia, dulcamara, &c. DRUGS WHICH ACT UPON THE SKIN
To enumerate all the drugs which act directly or indirectly upon the
skin, when applied externally or administered internally, would be to name many of the agents in the Pharmacopoeia. It will be understood, therefore, that this title is given to such as have a special or marked action upon the integument of the particular animal under consideration. In the portion of this work dealing with the physiology of the skin,
the great difference between human skin and that of the horse has been alluded to. While the administration of certain drugs may be depended upon to
have an almost certain effect in producing sweating in man, no such pro- nounced effect is seen in horses. " There is no drug", says Col. Smith, who has investigated the subject very thoroughly, " which produces sweating in horses." It must be understood, however, that this remark applies to visible perspiration. We cannot well believe that the insensible perspiration which is always going on is not materially influenced by drugs whose action upon the general condition of the skin has been well known to practical horsemen for ages. (See Alteratives.) The importance of drugs acting upon the skin when externally applied
is frequently alluded to in other chapters, as when blisters are applied over the seat of inflamed organs and parts of the body suffering from various forms of injury. Drugs which are believed to increase the amount of sweat are called
sudorifics or diaphoretics. Among them may be mentioned, as being most in favour with veterinary practitioners, acetate of ammonia, bicarbonates of potash and soda, camphor, ipecacuanha, antimony, and Dover's powder, which is a combination of opium, ipecacuanha, and potash sulphate. |
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|
DEUGS WHICH ACT UPON THE SKIN 473
|
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|
Pilocarpine is said to have a diaphoretic action by some observers, but it is
not in general use. The want of a drug in veterinary practice which will make a horse
sweat is not so much felt as medical practitioners sometimes imagine, since the equine patient can generally be made to perspire by the use of additional clothing and an increase in the temperature of the stable. REMEDIES FOR EXCESSIVE SWEATING
These are usually to be sought in hygienic conditions rather than in
the administration of drugs. When horses sweat unduly with only moderate exertion, it is usually a sign of weakness or want of condition. If any drugs are prescribed, those of the tonic class will be chosen. Belladonna and atropine are believed to restrain sweating in horses,
as they also do, and in a higher degree, in the human subject, but their use is only indicated under circumstances of disease. DRUGS WHICH IMPROVE THE CONDITION OF THE SKIN
These have been dealt with at some length in the pages devoted to
alteratives and tonics, more particularly in reference to those combinations of vegetable and mineral drugs which have so long enjoyed a reputation for conditioning. DEUGS WHICH ACT UPON THE KIDNEYS, BLADDER, AND
GENEEATIVE ORGANS
In horse medicine this class is at once the most important and the
most abused. Drugs which increase the amount of urine passed are called diuretics, and in the hands of the groom and carter have been productive of an incalculable amount of injury. Diuretics are employed for so many purposes, and with such obvious
results, that their popularity is easily accounted for. While increasing the actual quantity of fluid passed, they give relief to the kidneys by washing out the uriniferous tubes, and carrying away any accumulated mucus and fine saline particles which might eventuate in the production of calculi. They lower temperature and relieve the common symptoms of fever, and cause the removal of some of its products in the urinary discharges. In all diseases of the horse in which there is enlargement of the extremities and other depending parts from infiltration of fluid into the tissues, diuretics have a marked and immediate effect. In certain |
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474 HEALTH AND DISEASE
|
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|
diseased conditions of the integument, as grease, cracked heels, mud fever,
as well as obstructions and inflammatory swellings in the lymphatic or other vessels, diuretics are of great value. The abuse consists chiefly in giving diuretics to healthy animals with
a view to saving labour and making the skin glossy. In this connection it may be well to remind readers that a horse's urine being thick occa- sionally, more especially when green food is substituted for dry, is not necessarily a symptom of disease—but the majority of grooms would seem to regard it as such. The error is also frequently committed of giving diuretics to horses
whose kidneys are already too active, and passing too much urine, with the common result that a harmless excess of secretion is converted into active disease. The diuretic drugs most generally approved for horses are nitrate of
potash (nitre), resin, soap, turpentine, spirit of nitrous ether (sweet spirit of nitre), balsam of copaiba, and the oils of juniper and aniseed. There are many drugs having more or less diuretic action, but the above list in- cludes all those in common use and of well-proved therapeutic value. REMEDIES WHICH SOOTHE THE KIDNEYS
Of an opposite class to diuretics are the remedies which suppress excess
of function, and relieve the kidneys of pain and pressure by withdrawing blood from them and lessening the volume and rapidity of the circulation within them. When the kidneys are excited from any cause, the human practitioner is able to afford them direct and immediate relief by causing a free action of the skin. In order to " soothe the kidneys" the veteri- nary practitioner has to resort to large and frequently renewed cataplasms, and with these he incorporates emollients and sedatives, as belladonna extract, opium, or poppy-head infusions, hyoscyamus, hops, chamomile flowers, and possibly soft-boiled turnips or other " roots", as they are commonly called. To these measures he adds the frequent use of enemas of warm water and belladonna extract with glycerine. A very soothing effect is often apparent from this mode of internal " fomentation" when the precaution is taken by a good nurse to use the fluid at a correct temperature and cause it to be retained by holding the tail down. (See Administration of Medicines.) DEUGS WHICH ACT ON THE BLADDER
These for the most part are such as act also upon the kidneys; but
some few, as copaiba, and the balsams of sulphur, cubebs, buchu, and bear- |
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|
DRUGS WHICH ACT UPON THE KIDNEYS, ETC. 475
berry, appear, like nux vomica and its chief alkaloid (strychnia), to have
a tonic effect upon the muscular layers of the bladder, aiding it to contract and expel its contents when from various causes there is difficulty in doing so. REMEDIES WHICH ALLAY IRRITABILITY OF THE BLADDER
The situation of the bladder renders it rather improbable that remedies
applied externally directly affect it. It is nevertheless common practice to endeavour to influence it by application to the loins of poultices, blisters, and various other medicaments. Drugs internally administered have great effect upon the bladder, and should be given in bland fluids, as linseed tea, milk, barley-water, &c. Opium and belladonna are found to have the most soothing effect, whether administered in the form of draught or pessaries introduced into the canal. REMEDIES WHICH ACT UPON THE GENERATIVE ORGANS
In this connection there is little to be said. Cantharides has often
been known to excite both male and female animals sexually, and its abuse has induced many cases of bloody urine and strangury, inflammation of the kidneys, and even death. Iodides have in some instances caused wasting of the testicles, and
in the mare, to savin and ergot abortion has been attributed. Only in poisonous doses does the former so act upon the uterus, and the latter appears to be quite innocuous if we are to accept the conclusions of con- scientious experimenters. It is probable that the tendency of ergot to diminish the calibre of the small blood-vessels and contract involuntary muscles may have some modifying influence upon the uterus in cases where labour pains or straining continue after parturition. Opium has also the effect of a sedative or anodyne upon the womb of the mare in cases of inflammation or undue excitement following upon foaling. Cocaine injected in solution, or introduced in form of pessary, also stays those expulsive efforts which too often result in inversion of the uterus, but its influence is very evanescent, and it is best employed as a temporary remedy while opium is gaining control of the parts implicated. |
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476
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DRUGS WHICH ACT UPON THE NERVOUS SYSTEM
If the reader has studied the part of this work dealing with the dis-
tribution and function of the nerves, he will understand that the whole animal machine depends upon them to keep its various organs working together in harmony and sympathy one with another. The question as to what drugs act upon the nervous system can only be answered in a limited sense. It is probable that no drug can act without its aid, but there are special agents which experience and experiment have demon- strated to have a particular and well-marked action on nervous tissue, and to these we give the title which appears above. If we desire to affect a particular nerve or branch, we cannot select an
agent that will speed like an arrow to the spot indicated and affect no other, but we must seek to obtain the desired effect through the medium of the blood. The agent will have to be taken into the circulation, and there will be distributed over the nervous system in an equal degree. HYPNOTICS OR SOPORIFICS
Drugs which conduce to sleep are called by the above names, and their
action upon man is fairly uniform except where some special idiosyncrasy exists; but with regard to horses we are not so well informed. They are light sleepers as a rule, and in health seldom repose for longer than four or five hours. The nervous temperament of the animal does not permit him to abandon himself to that complete oblivion which is a more or less acquired habit by civilized man enjoying perfect security of life. Drugs which have a soothing influence upon the nervous system, and invite sleep rather than compel it, are called by the above names, but those which over- power the brain and master the inclinations are known as Narcotics. The same agent may act as a gentle soporific in small doses and as a powerful narcotic in large ones. Drugs which relieve pain conduce to sleep, the anodyne effect of opium having been understood perhaps longer than that of any other drug. Chloral Hydrate, although discovered by Liebig in 1832, did not
come into use in this country until quite thirty years later, and its value in veterinary medicine was not ascertained until some years after the medical profession had proved its efficiency as a therapeutic in human practice. It is extremely distasteful to horses owing to the hot burning sensation
it imparts to the mouth, and in a lesser degree to the skin also, while it acts as a powerful irritant to abraded surfaces. |
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DRUGS WHICH ACT UPON THE NERVOUS SYSTEM 477
It is an antiseptic, and in the proportion of one hundred grains to the
pint of water prevents decomposition. It has not the constipating effect of opium, and is a more direct spinal sedative. Dose.—From three to six drams, but larger ones can be given with
safety. Excessive doses produce profound slumber, complete insensibility, and shallow breathing. The pulse, though at first quickened, becomes soft and indistinct, the pupils are contracted, and complete muscular relaxation is also observed. In poisonous doses death results from reduced tempera- ture and paralysis of the heart. The smaller animals can be recovered from excessive doses by stimulants and the application of hot-water bottles, blankets, bandages, and friction to the skin. The same measures, so far as they can be applied to so large an animal as the horse, would be available in case of an overdose. It is given to horses in the treatment of meningitis and other irritable
conditions of the spinal cord and nerve-centres, and by some it is used as an ingredient in colic mixtures. Its effect in cases of spasmodic contraction of the bowels is produced through the medium of the nerves by which they are supplied, but chloral is not considered to be an anodyne in the same sense as opium. Bromides of Potassium, Sodium, and Ammonium.—These salts
of bromine, with a base of either of the above, are used where a soporific
or mildly-sedative action is desired. The large dose required, an ounce or more, to produce any marked effect, and the considerable cost of the drugs, are practical objections to their use in veterinary practice, while it is pro- bable that better results can be obtained from smaller doses of chloral hydrate. NERVE TONICS AND STIMULANTS
These terms are applied to drugs whose action improves the nutrition
of nerve-substance, and thus strengthen and brace up the nervous system generally. In our patient, the horse, we have not those hysterical conditions and
obscure nervous diseases to deal with that have called into existence a number of specialists among human practitioners, yet it may be said that of all domestic animals the horse is the most " nervous" or excitable. From a variety of causes he is liable to become " run down ", and a nerve tonic or stimulant is often the remedy most calculated to pull him up again. It has been observed during recent years that the symptoms of nervous
collapse have been very marked in most of the attacks of so-called influ- enza. The close observer, brought up among horses and familiar with their habits and expressions, can hardly doubt that they suffer from nervous |
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478
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HEALTH AND DISEASE
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headache and depression of spirits at times, giving rise to sleeplessness,
timidity, and other indications of cerebral disturbance, and there can be little doubt that many of those sudden periodical changes of temperament and habit frequently observed in horses, and attributed to vice, have their origin in disorders of the nervous system. Nux Vomica.—This drug, or its alkaloid, strychnia, has been long in
repute among veterinarians. It is employed in the form of powdered seeds, or " nuts" as they are called, extract,
and strychnia in solution. The more elegant preparations, as Easton's syrup and various citrates, are sometimes employed, but are not in general use for horses. Actions and Uses.—The intense
bitterness of this drug does not usually
debar us from prescribing it, as few horses object to it. It is often advan- tageously combined with the simpler vegetable bitters previously referred to as stomach tonics; it may also be given with iron or alkalies. When pre- scribed with acids, the liquor strychnise is advised. The use of the drug is seldom pushed to extremes with horses, although with man, and the dog also, in certain forms of paralysis, it is |
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Tig. 431.—Nux Vomica (Strychnoa nux vomica)
1, Section of fruit. 2. Seed (Ceylon). 3, Section
of seed (Ceylon). 4, Seed showing ridge (Ceylon). 5, Seed (Madras). 6, Same seed showing ridge. 7, Seed of Strycknos ignatil. |
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administered until slight spasmodic
movements in the voluntary muscles are observed. In excessive doses vio- |
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lent muscular contractions, sometimes
resulting in general rigidity of the body, are induced. Its action on the bowels renders it a valuable medicine in some forms of constipation arising from imperfect innervation, more particularly in the case of old animals, or the subjects of chronic functional disease of the alimentary canal. After long-continued use the system becomes more and more indifferent to its action, and is less affected by it than at first. It is for this reason advisable to begin with a small dose and increase it gradually if the course of treatment is to be a long one. Or it may be desirable to discontinue its use for a time and resort to it again. It is one of the drugs used by grooms who "travel" stallions, as it
imparts tone to the system and sustains sexual desire. |
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DRUGS WHICH ACT UPON THE NERVOUS SYSTEM 479
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ANAESTHETICS AND ANODYNES
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These are certain drugs which so blunt the senses that little or no pain
results from causes which in their absence induce it. They have a local or general effect according to the mode of application. Some, as cocaine, veratrium, and aconite, when applied to the skin, deprive the nerves of the part of sensation, so that they may be cut or even burned without causing pain at the time. This action is called local anaesthesia, and the agent em- ployed, an anaesthetic. Ether spray or other applications
producing intense cold by rapid evapo- ration have also the effect of producing insensibility, but experience has proved that this method of producing anses- thesia is sometimes attended with after consequences of a very undesirable character. Evaporating lotions, com- posed largely of the cheaper forms of spirit, are frequently prescribed to reduce pain in inflamed limbs, tendons, and joints, their effect being the result of the cold induced in the part. The application of ice and ice-water is attended with similar results. General Anaesthesia is produced
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Fig. 432.—Opium Poppy (Papaver somniferwm)
1, Capsule showing Turkish method of incision to get
opium. 2, Seed. 3, Section of seed. |
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by the inhalation of drugs such as
chloroform and ether, and the same |
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end may be attained by introducing
them into the blood either through the stomach or by subcutaneous injec- tion. These agents, by acting on the brain and spinal cord, induce sleep and insensibility to outward impressions and inward pain, and in the latter connection rank with that class of agents termed anodynes. Given in certain doses, they soothe the whole body and reduce the activity of different organs; then they are classed as sedatives. Since their effect is also to relieve spasm, they are known as anti-spasmodics. Opium and its Alkaloids.—At the head of the list stands opium,
where Percival, the father of veterinary medicine, placed it, and described it as " the sheet anchor of the veterinarian ". Its method of production need not be described here. |
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480
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HEALTH AND DISEASE
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Opium as imported is a blackish-brown, pasty-looking substance. The
chemist is able to separate from it some nineteen or twenty alkaloids, of which the chief are morphia and codeia. The preparations used in veteri- nary practice are the gum, the powder, tincture (laudanum), morphia, and occasionally codeia. When an aqueous preparation is required the extract is rubbed down
with hot water. The compound tincture (paregoric elixir) is also some- times prescribed. The chief method of administering morphia is by subcutaneous injec-
tion. This course is adopted as a matter of convenience, and not, as in the human subject, to avoid those derangements of the stomach and bowels which so commonly follow its use when given by the mouth. Action and Uses.—Externally
the tincture and extract of opium are
used to allay pain, and it is gener- ally believed that greater anodyne effects are produced upon an abraded surface than when applied to an unbroken skin. In inflammatory oedema, and sprains to tendons, joints, and contusions, its application in con- junction with acetate of lead and spirit of wine has long been resorted to on account of its soothing and sedative properties. |
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Fig. 433.—Belladonna (Atropa Belladonna)
1, Corolla opened. 2, Pistil. 3, Fruit. 4, Section
of fruit. |
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Internally administered, opium af-
fects horses in different ways and in |
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proportion to the dose. In small doses
it is a stimulant. Long continued it becomes astringent and induces con- stipation, although a medium dose be employed. Its effect in controlling pain and spasm of the intestine has been recognized for ages. It is also employed in diarrhoea and other diseases in which purging is a prominent symptom. Large doses are sometimes given to restive horses that will not submit
to operation, and that for special reasons cannot be submitted to other forms of restraint; and in a few instances only is the same degree of excite- ment observed to follow its use, as marks its immediate effects on man. Belladonna, and Atropia, its active principle, belong to the same
class of anodyne and sedative drugs as opium, and may be alternated |
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DRUGS WHICH ACT UPON THE NERVOUS SYSTEM 481
with or used in conjunction with it. Besides allaying pain and spasm
when externally applied or internally administered, it would seem to be specially beneficial in its action upon the organs of vision and upon the urinary and generative apparatus. The pupil of the eye is dilated, either by internal doses or the more convenient method of dropping a solution of atropia on the surface of that organ. In some diseases in which the iris is liable to become fixed to adjacent parts under conditions of inflam- mation, this is prevented by causing the pupil to be dilated and removing the iris from contact with the structures referred to. Opium has the contrary effect, and causes the pupil to contract.
In irritability of the bladder and kidneys belladonna is found to be a
valuable drug, controlling pain and inducing normal secretion, while its properties render it of great value when injected into the uterus of mares after painful labour or inflammatory action from eversion or other accident. The preparations of belladonna used in equine practice are the extract,
tincture, liniment, and plaster. Atropia, its active principle, is invariably employed in solution, either
as drops for the eyes or for subcutaneous injection. Hyoscyamus or Henbane is a drug of like therapeutic effect to
belladonna, but not in general repute among veterinarians. It may, however, be employed with advantage in the few cases where some idio- syncrasy brings disappointment to the prescriber who has given bella- donna. Its action is invariably milder and the results apparently better when given in combination with some other sedative. Tobacco.—This powerful narcotic is more in favour with amateur
horse doctors than with veterinary surgeons. The manufactured tobaccos are very variable in medicinal power, and when required as a drug Virginian shag is usually selected, as containing more resinous and albu- minous matters, which in other kinds are more or less removed by partial fermentation. Action and Uses.—Externally applied it is more or less irritant.
Internally it causes muscular relaxation, and in this way acts as an antispasmodic in bowel and other affections. An infusion of it is employed for the destruction of external parasites,
and is often applied in conjunction with sulphur in cases of mange. It is sometimes given to destroy worms in the intestines, and a small
plug of it introduced into the rectum with the view of getting rid of " fundament" bots and other parasites which infest the terminal portion of the bowel. Tobacco smoke injected into the rectum by means of suitable apparatus appears to give relief in some cases of colic. Vol. II. 65
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HEALTH AND DISEASE
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482
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Grooms and other horsy persons introduce tobacco into the sheath
of horses and the vagina of mares under the impression that it incites them to urinate. If it does so, it is only by its local irritant effect upon the parts. Indian Hemp (Cannabis Indica.)—-In veterinary practice this
potent drug was first used by veterinary surgeons serving in India, and would long since have been brought into general use but for the variable strength in which it is produced, and the consequent uncertainty of its action. |
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Pig. 434.—Tndian Hemp {Cannabis Indica) Kg- 435.—Calabar Bean {Physostigma venenosum)
1, Male flower. 2, Female flower. 3, Perianth 1, Pistil. 2, Appendage to style. 3, Bean. 4, Long
unrolled. 4, Fruit. 5, Longitudinal section of fruit. section of bean. 5, Cross-section of bean. 6, Cross-section of fruit.
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Its action is antispasmodic, anodyne, and in large doses powerfully
narcotic. It is usually prescribed in the place of opium, or in combina- tion with chloral and other sedatives. In controlling cerebral excitement it stands higher than opium, and its effects are more lasting than those of chloral. In experiments made upon healthy horses, it was observed that some few of them manifested a preliminary period of excitement so common to the human subject when under its influence. Calabar Bean.-—This product of the Niger and Old Calabar river
was known to the natives as a poison long before Europeans thought to apply it to medicinal uses. |
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DRUGS WHICH ACT UPON THE NERVOUS SYSTEM 483
Its action is that of a powerful sedative to the spinal cord, allaying
its excitability, paralysing voluntary muscles, and reducing the sensibility of the skin. It has been found to control the spasms of tetanus, and its active principle, eserin, is employed to contract the pupil of the eye in opposition to belladonna or atropine, when, as has already been pointed out (see Belladonna), it is desirable to keep the inflamed iris from contact with parts to which it may adhere. In cases of impaction of the bowel, it has the reputation of exciting
peristaltic action and facilitating the removal of the offending matter more quickly than any other agent. Hemlock (Conium maculdtum).—The "hemlock rank", which the
cow is recommended in our nursery rhymes not to eat when " growing on the weedy bank ", was a favourite poison with the ancients, and the one by which Socrates cut short his useful life. It is not much used as a horse medicine, although under some circumstances it is known to produce very powerful effects upon the animal. Cocaine, the active principle of Coca or Cuca, has proved a great
boon to the veterinary practitioner, and especially in connection with surgical operations, which have not only been rendered easy of perform- ance by it, but have also been deprived of much of the danger that used to attend them. A four-per-cent solution dropped into the eye enables one to examine
it, and remove any hay seeds or other foreign bodies, while the anges- thetic effect may be continued long enough to perform many operations. Injected under the skin, firing and cutting operations can be performed with a minimum of pain and restlessness on the part of the animal. ANTISEPTICS
Antiseptics are agents which either arrest or prevent putrefaction or
decomposition. The word is derived from two Greek words—anti, against, and sepein, to rot. Decomposition, in the sense here understood, is due to the presence of minute organisms, and true antiseptics, being inimical to their existence and multiplication, render its occurrence im- possible. By the employment of these agents in one or another of their various
forms, surgery, both in its application to man and the lower animals, has been revolutionized. Not only by their use have operations which formerly resulted in great mortality been stripped of their danger and rendered safe, but others of a more formidable and important character have been rendered possible and in a large measure successful. So much Vol. II. 652
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HEALTH AND DISEASE
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484
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so, that there is at the present time hardly an organ in the body to
which the surgeon's knife has not safe access, and whose disease it does not challenge. In the use of antiseptics for surgical purposes, they are not only freely
applied to wounds, but also to the instruments to be used in operating and the hands which use them, and may be also to the air of the apart- ment in which operations are carried out. Surgeons distinguish between agents which merely prevent the develop-
ment of pathogenic organisms and those which actually destroy them. One of the most valuable antiseptics is carbolic acid.
Carbolic Acid.—This is a product of the distillation of coal-tar, and
is chemically known under the several names of phenic acid, phenol, and phenylic alcohol. The colourless, needle-shaped crystals of pure carbolic acid are not convenient for surgical purposes unless broken down with glycerine or some other solvent. A comparatively impure acid is equally efficacious, and in general use more economical and convenient. The preparations of value to the veterinarian are glycerine of carbolic acid, carbolic lotion, carbolic ointment, and carbolic oil. Carbolic acid is both a disinfectant and an antiseptic, and though only
mixable with or soluble in water to a small extent, it can be made more so by the addition of glycerine, and is then employed in different propor- tions for a great variety of purposes. Strong solutions destroy living organisms, while dilute preparations merely prevent their growth. Besides being an antiseptic, carbolic acid is also a caustic when applied undiluted to the skin, leaving a white mark as evidence of the superficial layers being destroyed. Acute pain is felt at the moment of application, but the sensibility of the integument is subsequently diminished. It is a valuable agent in the treatment of ulcers, cracked heels, and
such diseases. Ringworm and other affections having their origin in low forms of life are successfully combated with strong carbolic appli- cations, which are mostly made in the form of an ointment. Some forms of skin irritation are allayed by weak lotions of carbolic acid, while the mange mite and other external parasites are either imme- diately killed by it or caused to quit the body of their host. Applied internally, it is a safe and useful agent in the treatment of
those ulcerative conditions which affect mucous membranes, more espe- cially those of the nostrils, mouth, throat, and other parts accessible to the surgeon. The foetor of the breath arising from dental troubles, and referred to
at some length, is subdued by a suitable mouth-wash in which carbolic acid is the active ingredient. |
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ANTISEPTICS 485
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It is occasionally employed as an inhalation in certain forms of catarrh
in which malignant sore-throat is a prominent symptom. Carbolic acid is prescribed internally in some instances where the
production of gases from fermented ingesta is a direct cause of flatulent colic and other intestinal troubles. Sulpho-carbolateS Of Soda and Zinc are products of the union of
sulphuric and carbolic acids with bases of the metals sodium and zinc. Sulpho-carbolate of soda, as an internal remedy, is particularly adapted
to those fermentative conditions of the stomach and bowels referred to in the last paragraph. It appears to have all the antiseptic advantages of carbolic acid without its irritative effects. The sulpho-carbolate of zinc is chiefly used as a dressing for wounds. In addition to its antiseptic proper- ties it has a beneficial action in the repression of too profuse granulations or " proud flesh". Resorcin, another product of fractional distillation of coal-tar, is in its
action very similar to carbolic acid, but possessed of other properties not yet fully understood. It has been used by veterinary surgeons only for a short time, but is
highly spoken of by them in the treatment of wounds, and for the pre- vention of fermentation in the stomachs of animals which have gorged themselves with food. It is thought to be an antipyretic, because it produces copious perspira-
tion, followed by reduction of temperature. CreaSOte is another, and one of the oldest, of coal-tar distillations used
in medicine. Inhaled, it is quite as effectual as carbolic acid, and much safer. As an ointment, it is destructive of parasitic life without unduly
irritating the skin of the patient, and as an antiseptic dressing it is also a useful agent. Boric or Boracic Acid is a mild antiseptic, and frequently employed
as a mouth-wash where the stronger agents above mentioned might prove too irritating or productive of nausea. As a lotion it is used for wounds and saddle-galls, and, in combination with oxide of zinc and flour, to check the spread of ulcers and dry up raw surfaces wdrich cannot be protected by mechanical appliances. Sulphurous Acid is the gas that is set free by burning sulphur. It is
an old-fashioned disinfectant of great potency, and occasionally prescribed as an inhalant in place of those referred to above. Dissolved in water, and of certain strength, it retains the same name, and further diluted forms a valuable lotion in the treatment of ringworm, grease, and thrush. It is but rarely employed as an internal remedy, its action being very similar to |
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486
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carbolic preparations, but not as effectual in arresting the disengagement of
intestinal gases. Permanganate Of Potash.—With the exception perhaps of carbolic
acid, this very beautiful product of the chemist's art is in more universal demand than any other remedy of its class. Its purple crystals are readily soluble in water in any proportion required, and its virtues depend upon the large proportion of oxygen which it contains and readily gives up to unite with and destroy organic substances. Condy's Fluid, so generally prescribed, is said to be composed of two
grains of permanganate of potash to each ounce of water, but the makers have denied the statement. It is, however, believed that sodium is the alkaline base of the salt, and it is for all practical purposes the same as potash in its action. The annexed table, showing the relative activity of various disinfectants,
is copied from The Household Physician, and justifies the high regard in which permanganate of potash is held:— |
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1 part of carbolic acid in
1 part of boracic acid in
1 part of chlorine in ...
1 part of eucalyptol in
1 part of camphor in ...
1 part of permanganate of potash in
1 part of oil of cloves in
1 part of peppermint oil in ...
1 part of thymol in ...
1 part of corrosive sublimate in
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It will be seen that one grain in 3000 of water is capable of hindering
the growth of organisms. Iodoform.—A yellow crystalline powder, in which iodine, carbon, and
hydrogen combine to form a valuable compound, with a somewhat offensive odour and powerful antiseptic properties. In horse practice it is used in the treatment of foul ulcers and unhealthy wounds. In cases of ozena it is injected up the nostrils by means of an insufflator. Mixed with oxide of zinc, flour, and other diluents, it is dusted over abraded surfaces and injured tissues as a preventive of putrefaction where septic influences are known to be at work. Perchloride of Mercury.—A solution of this substance, which is
commonly called corrosive sublimate, is the most powerful antiseptic known
to science, and, freely diluted (see the table above), is employed as an antiseptic agent, and also in the preparation of instruments and appli- ances for surgical operations. It is injected into the various cavities of the |
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ANTISEPTICS
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487
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body, applied as a lotion externally, and used in the preparation of lint
gauze, cotton, and other antiseptic dressings. For disinfecting purposes, the strength recommended is from 1 in 1500 to 1 in 10,000 parts. Four grains in a quart of distilled water is the proportion commonly employed for washing the hands and appliances to be used in operations. It was largely clue to Dr. Koch that this agent to a great extent sup-
planted carbolic acid, as that eminent bacteriologist made the most exhaustive ■experiments upon the anthrax bacillus and other deadly organisms, and found it to be the most efficient of the many antiseptics then in use. It may, how- ever, be stated here that Lister, the father of antiseptic surgery, has gone back to his first love, and recently ■declared his preference for carbolic acid as a surgical dressing. Eucalyptus. — An essential oil
from the blue gum-tree, is regarded as an antiseptic, and is in favour where insanitary conditions predispose horses to fever and impart an unhealthy condition to wounds. Septic8emia, strangles, influenza, and purpura are among the diseases in which euca- lyptus is advantageously employed for disinfecting purposes, both by inhalation and as an outward appli- Fig. 436.-Eucalyptus gbbuh,s , • 1, Section of unopened flower. 2, Anthers.
cation. 3j Seotion of fruit_
Thymol is a crystalline substance
derived from oil of thyme, but has not been used to any extent in veterinary medicine. Menthol is another concrete volatile oil but seldom found in the
veterinarian's pharmacy. It is, however, a powerful antiseptic, and may be substituted for iodoform where the odour of that drug is particularly objectionable. Sanitas, so much appreciated in great studs and horse repositories
where a disinfectant and deodorizer are both in request, is a proprietary preparation, its properties being due to eucalyptus and a species of pine oil. Chlorine Gas is one of the oldest and most efficient of disinfectants,
which has been displaced by changing fashion rather than from any failure to serve its purpose. In the convenient form of supersaturated lime-chloride, |
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HEALTH AND DISEASE
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488
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or, more strictly speaking, chlorinated lime, it may be sprinkled upon stable
floors or placed in vessels about the building. Where the disinfection of unoccupied stables is the object to be attained, a more effective method is that of mixing common salt, binoxide of manganese, and sulphuric acid in a suitable vessel, closing the doors and windows, and allowing the chlorine gas evolved to permeate the whole structure. It has the disadvantage of irritating the air-passages of living animals, and damaging brass and other stable-fittings; reasons which, in a measure, account for so effective an agent having fallen into desuetude. Burnett's Disinfecting Fluid is a strong solution of chloride of zinc.
Antiseptic and disinfectant, correcting the fcetor of ulcers and unhealthy wounds, but retarding the formation of new material to such an extent that it is in more frequent request for other purposes, such as the destruction of fistulas, proud flesh, and morbid growths. MISCELLANEOUS DRUGS
Mercury (Quicksilver).—Mercury is a liquid metal, and in various
forms of chemical combination is largely employed in veterinary medicine in both internal and external disorders. The preparations used in the treatment of horses are calomel, bichloride or perchloride of mercury (corrosive sublimate), gray powder, blue pill, red and white precipitate, nitrate of mercury, iodide and biniodide of mercury, yellow oxide of mercury, mercurial ointment, oleate of mercury, &c. Action and Uses.—As an external remedy mercury is used for
various skin diseases, particularly those caused by parasites, both animal and vegetable. The blue ointment, which is simply a mixture of mercury and lard, with a small proportion of suet to harden it, was formerly very much used, but at the present time has given place to the cleanlier pre- parations of ammoniated mercury, the red oxide, and the nitrate, while the red iodide or biniodide, as it is respectively called, is the material most used in blisters, and was originally introduced as a substitute for firing. The bichloride or perchloride (the change of nomenclature gives rise to
confusion, and we therefore use both terms) is an invaluable chemical for the destruction of external parasites, as well as those minute organisms which are now regarded as the cause of so many specific contagious diseases. Besides its medicinal use it is employed as an antiseptic for the sterilization of instruments, and the hands of the operator in the course of surgical operations. Calomel is the chief salt of mercury given to horses. It is not, however, in great favour. As a liver stimulant it is largely employed in human and canine medicine, but in the horse it is feared on account of |
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its sometimes drastic effects. That it is valuable as an alterative is,
however, a matter of common knowledge among those who have the care and conditioning of horses for fast work. Though the action of mercury upon the system is obscure, it is neverthe-
less marked. It is absorbed from the blood by every tissue of the body, and to produce its constitutional effects it is frequently prescribed in the form of solution of the perchloride. It influences nutrition in some obscure way, and excites absorption of various morbid deposits. When given over a long period it tends to accumulate in the system, and to prejudicially influence the health of the animal, and can be found in the tissues after death. Inflammatory deposits are caused to be absorbed by it, and it was one of the remedies used in the coaching days when glandered teams were kept at work by the use of such drugs and enabled to enjoy a certain measure of health. Mercurial poisoning is generally spoken of as salivation, because the
first prominent symptom is a profuse discharge of saliva from the mouth, accompanied by swollen and inflamed gums, a very offensive odour from the breath, pasty tongue, loss of appetite, &c. In our patient, the horse, it is seldom the result of intentional drugging. It has been known to occur, however, as the result of a horse licking itself or other animals when mercurial ointment has been lavishly employed for skin troubles. It may also result where animals have picked up mercurial pigments, and in the neighbourhood of quicksilver furnaces it sometimes appears from the con- sumption of herbage contaminated with fine particles of cinnabar—the mineral from which it is chiefly obtained. In advanced cases of mercurial poisoning, lassitude, wasting, and the passage of blood-stained fseces are among the more prominent symptoms. There is no specific antidote to mereury as a poison, but animals frequently recover from its effects when removed to a suitable environment, receiving plenty of fresh air and a libera] diet supplemented by milk, eggs, and linseed. Iodine.—In this product of sea-weed we have a most valuable remedy
for the treatment of a variety of equine troubles. For veterinary purposes the chief preparations employed are the tincture, the liniment, and the ointment, iodide of iron, biniodide of mercury, iodide of arsenic, and iodo- form. Action and Uses.—Externally, iodine is used as a skin irritant,
the tincture being painted on to small areas of skin in the treatment of ringworm and other localized parasitic affections, as well as for the reduction of glandular and other swellings. It is also applied to un- healthy wounds and indolent ulcers. In the form of iodoform it is injected up the nostrils in certain varieties of nasal gleet, and largely |
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used to wounds as an antiseptic dressing. For blistering purposes the
biniodide of mercury is commonly employed in veterinary practice. (See Mercury, page 488.) Internally, iodine is usually prescribed in combination with potassium,
iron, or arsenic; the former to excite absorption of effused fluids or glan- dular enlargements, and the latter as tonics and alteratives. (See Iron and Arsenic, pp. 447 and 453.) Cystic swellings and hydrocele, after the fluid contents have been evacuated, are sometimes injected with tincture of iodine to prevent further accumulations. Iodine preparations given internally pass quickly into the circulation,,
and to all the organs. They are rapidly eliminated by the kidneys and the skin, and are to be found in the saliva, urine, nasal mucus, sweat, and in the milk. Iodides too long continued irritate the salivary glands and skin, and all the organs concerned in separating it from the body. This con- dition is known as Iodism. Taken together the symptoms resemble saliva- tion by mercury, there being a spongy condition of the gums, with increased flow of saliva, defluxion of tears, loss of appetite, and prostration, with wasting of the testicles and other glands. Iodides have the effect of remov- ing the rheumatic poison from subjects of that disease (see Rheumatism, page 21 of this volume), and are given in cases of lead and mercurial poisoning on account of their chemical affinity for those metals and the comparatively harmless compounds resulting. Phosphorus.—Phosphorus is " a non-metallic element obtained from
bones ", and by itself is seldom administered to equine patients. It effects changes in certain tissues, especially bone, and in small and long-continued doses increases their density. It is a very active poison in any but frac- tional doses, and speedily induces fatty heart, liver, and other organs. It is given in obscure cases of paralysis and debility in combination with mineral tonics. Phosphoric acid is prescribed with vegetable bitters, and the salts are prescribed for colts with soft bones (rickets). Phosphates of lime, iron, soda, and magnesia are given as a syrup to assist bone formation in young animals. Sulphur.—Sulphur is a drug of much general utility in veterinary
practice, and is one of the few "specifics" referred to in our opening re- marks. The chief preparations used are sublimated sulphur, commonly called
flowers of sulphur, precipitated sulphur, sulphur ointment, sulphurated potash, and numerous combinations with other metals as sulphides, sul- phites, hyposulphites, and sulphates. Actions and Uses.—Sulphur, either as an ointment or as a lotion
with oil as the vehicle, has been used for skin diseases from time imrne- |
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morial, being known to the ancients as a specific for itch in man and mange
in animals. The mange mite cannot live in its presence, or in that of sulphuretted hydrogen or sulphurous acid, both of which are developed when sulphur is brought into contact with the skin. Sulphurous acid, as has already been explained (see page 485), is the
product of sulphur burned in the air, and is a valuable disinfectant and parasiticide. Horses are sometimes made to inhale it in diseases of the throat and nostrils, and with apparent benefit. Sulphur is given as a mild aperient or gentle laxative, and often com-
bined with epsom salts. In small doses it is alterative and diaphoretic, and when given for some time it assists to impart the glossy appearance of the skin, for which alterative powders containing it are so much valued. Sulphuretted hydrogen passed into water, and used quickly, has the
same destructive influence upon lice as the flowers of sulphur, but con- venience dictates the use of a solution of sulphuretted potash, a preparation which holds the gas in loose chemical union, but which gives it up freely to water. It is an unstable compound, however, and for this reason is not so often employed as it might be. |
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