do much to prevent this array of symptoms if the case is seen
early--within the first 24 or 48 hours after the injury; but when
inflammation of the joint is once fairly established the case becomes
one of grave tendencies. Whenever a punctured wound of a joint is
noticed, even though apparently of but small moment, we should apply
without the least delay a strong cantharides blister over the entire
joint, being even careful to fill the orifice of the wound with the
blistering ointment. This treatment is almost always effectual. It
operates to perform a cure in two ways--first, the swelling of the skin
and tissues underneath it completely closes the wound and prevents the
ingress of air; second, by the superficial inflammation established it
acts to check and abate all deep-seated inflammation. In the great
majority of instances, if pursued soon after the accident, this
treatment performs a cure in about one week; but should the changes
described as occurring later in the joint have already taken place, we
must then treat by cooling lotions and the application to the wound of
chlorid of zinc, 10 grains to the ounce of water, or a paste made of
flour and alum. A bandage is to hold these applications in place, which
is only to be removed when swelling of the leg or increasing febrile
symptoms demand it. In the treatment of open joints our chief aim must
be to close the orifice as soon as possible. For this reason repeated
probing or even injections are contraindicated. The only probing of an
open joint that is to be sanctioned is on our first visit, when we
should carefully examine the wound for foreign bodies or dirt, and after
removing them the probe must not again be used. The medicines used to
coagulate the synovial discharge are best simply applied to the surface
of the wound, on pledgets of tow, and held in place by bandages.
Internal treatment is also indicated in those cases of open joints in
which the suffering is great. At first we should administer a light
physic and follow this up with sedatives and anodynes, as directed for
contused wounds. Later, however, we should give quinin or salicylic acid
in 1-dram doses two or three times a day.
WOUNDS OF THE TENDON SHEATHS.
Wounds of tendon sheaths are similar to open joints in that there is an
escape of synovial fluid, "sinew water." Where the tendons are simply
punctured by a thorn, nail, or fork, we must, after a thorough
exploration of the wound for any remaining foreign substance, treat with
the flour-and-alum paste, bandages, etc., as for open joint. Should the
skin and tendons be divided the case is even more serious and is often
incurable. There is always a large bed of granulations (proud flesh) at
the seat of injury, and a thickening more or less pronounced remains.
When the back tendons of the leg are severed we should apply at once a
high-heel shoe (which is to be gradually lowered as healing advances)
and bandage firmly with a compress moistened with a 10-grain chlorid of
zinc solution. When proud flesh appears it is best kept under control by
repeated applications of a red-hot iron. Mares that are valuable as
brood animals and stock horses should always be treated for this injury,
as, even though blemished, their value is not seriously impaired. If the
subject is old and comparatively valueless, the length of time required
and the expense of treatment will cause us to hesitate in attempting a
cure.
GUNSHOT WOUNDS.
These wounds vary in size and character, depending on the size and
quality of the projectile and also the tissue injured. They are so
seldom met with in our animals that an extended reference to them seems
unnecessary. If a wound has been made by a bullet a careful examination
should be made to ascertain whether the ball has passed through or out
of the body. If it has not we must then probe for it, and if it can be
located it is to be cut out when practicable to do so. Oftentimes a ball
may be so lodged that it can not be removed, and it then may become
encysted and remain for years without giving rise to any inconvenience.
It is often difficult to locate a bullet, as it is very readily
deflected by resistances met with after entering the body.
The entering wound is the size of the projectile, the edges are inverted
and often scorched. The wound produced in case of the bullet's exit is
larger than the projectile, the edges are turned out and ragged. A
bullet heated by the friction of the barrel or air often softens and
becomes flattened on striking a bone or other tissue. Modern bullets
that have an outer steel layer may pass through bone without splintering
it. Lead bullets may split, producing two exit wounds. Spent bullets may
only produce a bruise. Should bones be struck by a ball they are
sometimes shattered and splintered to such an extent as to warrant us in
having the animal destroyed. A gunshot wound, when irreparable injury
has not been done, is to be treated the same as punctured wounds, i.
e., stop the hemorrhage, remove the foreign body if possible, and apply
hot fomentations or poultices to the wound until suppuration is fairly
established. Anti-septic and disinfectant injections may then be used.
Should pus accumulate in the tissues, openings must be made at the most
depending parts for its escape. Wounds from shotguns fired close to the
animals are serious. They are virtually lacerated and contused wounds.
Remove all the shot possible from the wound and treat as directed for
contusions. When small shot strike the horse from a distance they stick
in the skin or only go through it. The shot grains must be picked out,
but as a rule this "peppering" of the skin amounts to but little.
POISONED WOUNDS.
These injuries are the result of bites of snakes, rabid dogs, stings of
bees, wasps, etc. A single sting is not dangerous, but an animal is
often stung by a swarm of insects, when the chief danger occurs from the
swelling produced. If stung about the head, the nostrils may be closed
as a result of the swelling, causing labored breathing and possibly
asphyxiation. Intoxication may be produced by the absorption of this
poison and is manifested by staggering gait, spreading of the legs,
paralysis of the muscles, difficult respiration, and a rise of
temperature. Death may follow in five to ten hours.
_Treatment._--Douse animal with cold water and apply any alkaline
liquid, such as soapsuds, bicarbonate of soda, or weak solution of
ammonia. Internally give alcohol, ether, or camphor to strengthen the
heart. In case of bites by rattlesnakes, moccasin, or other poisonous
snakes, a painful swelling occurs about the bitten part, which is
followed by labored breathing, weakness, retching, fever, and death from
collapse. The animal usually recovers if it can be kept alive over the
third day. In treating the animal, a tight ligature should be passed
about the part above the wound to keep the poison from entering the
general circulation. Wash out the wound thoroughly with antiseptics and
then apply a caustic, such as silver nitrate, or burn with a hot
instrument. A subcutaneous injection of one-fourth dram of 1 per cent
solution of chromic acid above the wound is also beneficial. Cold water
may be applied to the wound to combat the inflammation. Bites of rabid
dogs produce an infected wound, and the virus of rabies introduced in
this manner should be removed or destroyed in the wound. Therefore
produce considerable bleeding by incising the wound, wash out thoroughly
with 10 per cent solution of zinc chlorid, and then apply caustics or
the actual cautery.
HARNESS GALLS (SITFASTS).
Wounds or abrasions of the skin are frequently caused by ill-fitting
harness or saddles. When a horse has been resting from steady work for
some time, particularly after being idle in a stable on a scanty
allowance of grain, as in winter, he is soft and tender and sweats
easily when put to work again. In this condition he is liable to sweat
and chafe under the harness, especially if it is hard and poorly fitted.
This chafing is likely to cause abrasions of the skin, and thus pave the
way for an abscess or for a chronic blemish, unless attended to very
promptly. Besides causing the animal considerable pain, chafing, if long
continued, leads to the formation of a callosity. This may be
superficial, involving only the skin, or it may be deep-seated,
involving the subcutaneous fibrous tissue and sometimes the muscle and
even the bone. This causes a dry slough to form, which is both
inconvenient and unsightly. Sloughs of this kind are commonly called
"sitfasts" and, while they occur in other places, are most frequently
found under the saddle. (See also p. 475.)
_Treatment._--Abrasions are best prevented by bringing the animal
gradually into working shape after it has had a prolonged rest, in order
that the muscles may be hard and the skin tough. The harness should be
well fitted, neither too large nor too small, and it should be cleaned
and oiled to remove all dirt and to make it soft and pliable. Saddles
should be properly fitted so as to prevent direct pressure on the spine,
and the saddle blankets should be clean and dry. Parts of the horse
where chafing is likely to occur, as on the back under the saddle,
should be cleaned and brushed free of dirt.
The remedies for simple harness galls are numerous. Among them may be
mentioned alcohol, 1 pint, in which are well shaken the whites of two
eggs; a solution of nitrate of silver, 10 grains to the ounce of water;
sugar of lead or sulphate of zinc, 20 grains to an ounce of water;
carbolic acid, 1 part in 15 parts of glycerin, and so on almost without
end. Any simple astringent wash or powder will effect a cure, provided
the sores are not irritated by friction.
If a sitfast has developed, the dead hornlike slough must be carefully
dissected out and the wound treated carefully with antiseptics. During
treatment it is always best to allow the animal to rest, but if this is
inconvenient care should be taken to prevent injury to the abraded or
wounded surface by padding the harness so that chafing can not occur.
BURNS AND SCALDS.
These wounds of domestic animals are fortunately of rare occurrence;
however, when they do occur, if at all extensive, they prove to be quite
troublesome and in many cases are fatal. According to the severity of
the burn we distinguish three degrees: First degree, where there is a
simple reddening of the skin; second degree, where there is a formation
of vesicles, or blisters; third degree, where there is a complete
destruction of vitality of the tissues, such as would occur in charring
from direct contact with flames or from escaping steam. Besides the
burns caused by flames and steam, there are other causative agents, such
as chemicals (caustic alkalis and acids), lightning stroke, and
occasionally the broken trolley wires of electric railways. When a large
surface of the skin is burned or scalded, the animal (if it does not die
at once from shock) will soon show signs of fever--shivering, coldness
of the extremities, weakness, restlessness, quick and feeble pulse, and
labored breathing. No matter which agent is a factor in the production
of burns, the lesions are practically of the same nature. The extent and
site of the burn should lead one in the determination and course of
treatment. Burns of the shoulder and those about the region of the elbow
or other parts where there is much movement of the tissues are grave,
and, if at all extensive, treatment should not be attempted, but the
immediate destruction of the animal is advised. A burn of the third
degree, where there is a destruction of the vitality of large areas of
tissue, even on parts not subject to much motion, is extremely tedious
to treat; in fact, it is questionable whether the treatment and keep of
the animal will ever be compensated for, even though recovery does take
place; this, in any event, will require at least six or eight weeks.
Burns caused by lightning stroke and trolley wires are liable to occur
in irregular lines, and, unless death occurs at once, they generally are
not serious.
_Treatment._--Treatment should be prompt and effective. If the burns are
extensive, the constitutional symptoms should be combated with whisky
and milk and eggs, or ammonia carbonate, strychnin, caffein, or other
stimulant to prevent shock. In the local treatment, to alleviate the
pain, the application of cold water in some form and the hypodermic
injection of morphine are to be recommended. In burns of the first
degree, where there is only a superficial inflammation, lead carbonate
(white lead) ointment is very good. Carron oil (limewater and linseed
oil, equal parts) is a standard remedy, but a modification of it known
as Stahl's liniment is perhaps better. This is composed of linseed oil
and limewater each 200 parts, bicarbonate of soda 100 parts, and thymol
1 part. The scorched surface should be covered with this liniment and
then with a layer of borated gauze or absorbent cotton, to protect from
the air. The application should be frequently renewed. Carbolated
vaseline may be used in place of the above. In case the burn is more
extensive, the following solution may be used: Picric acid 2 parts,
alcohol 40 parts, water 400 parts. The lesion should be thoroughly
cleansed with this solution used on absorbent cotton. The vesicles, if
any appear, should be opened with a clean needle, allowing the skin to
remain. Strips of gauze or absorbent cotton saturated with the solution
should now be applied and renewed only occasionally. In burns of the
second and third degrees more satisfactory results may be obtained with
nonpoisonous, dry dressing powder, such as is used in ordinary open
wounds, as tannic acid 8 parts and iodoform 1 part, or a salve made of
this powder and a sufficient quantity of vaseline. When sloughing of the
tissues takes place the wounds should be cleansed with a warm 3 per cent
solution of carbolic acid, all loose fragments of tissue removed, and
either a dry, antiseptic dressing powder or carbolated vaseline ointment
applied to exclude the air. Granulation tissue (proud flesh) should be
controlled by the application of silver nitrate in the form of a caustic
pencil.
Burns due to mineral acids may be first treated by flushing the parts
with a copious quantity of cold water or by the application of whiting
or chalk. Either use a large quantity of water at the start or use the
chalk first, then wash with water. If the irritant has been a caustic
alkali, such as potash, lye, ammonia, or soda, then vinegar should be
the first application. Stahl's liniment is probably the best general
application for all burns for the first week; then this should be
followed by the ordinary antiseptic wound dressings.
GANGRENE.
Gangrene, or mortification, denotes the death of the affected part, and
is mostly found attacking soft tissue near the surface of the body.
Gangrenous areas may occur as a result of shutting off their blood
supply. Constitutional diseases, such as ergotism, anthrax, and
septicemia, predispose to gangrene. As external causes we have acids and
alkalies, freezing and burning, contusions and continuous pressure that
interrupt the circulation. There are two forms of gangrene--dry and
moist. Dry gangrene is most often seen in horses from continuous lying
down (decubitus) or from uneven pressure of some portion of the harness.
_Symptoms._--There is a lack of sensation due to the death of nerves. In
dry gangrene the skin is leathery and harsh, while in moist gangrene the
tissues are soft, wrinkled, and friable; the hair is disturbed, and the
skin is usually moist and soapy and sometimes covered with blebs. The
tissue surrounding the moist gangrenous patch is usually inflamed,
swollen, and hot, but this is less noticeable in the case of dry
gangrene. Moist gangrene often spreads and involves deeper tissue,
sheaths of tendons and joints producing septic synovitis or septic
arthritis leading to pyemia and death. Dry gangrene is seldom dangerous,
but the rapidity of its spread will indicate its virulence.
_Treatment._--The preventive treatment consists in avoiding all the
influences that tend to disturb the nutrition of the tissues, such as
excessive cold or heat or continuous pressure. Gangrene following
decubitus may be prevented by using soft bedding and frequently turning
the animal from one side to the other. In dry gangrene moist heat in the
form of poultices or anointing the tissue with oils and fats will be
found beneficial in hastening the dead tissue to slough off. When the
outer skin begins to suppurate, it should be removed with a pair of
pincers, and the patch treated as an open wound. In moist gangrene the
tissue should be thoroughly disinfected with a 3 per cent solution of
compound cresol, or particularly an alcoholic tincture of camphor.
Continuous irritation with antiseptic fluids prevents the accumulation
and absorption of poisonous liquids. Incisions into the dead tissue may
be made, and when sloughing commences the tissue should be removed with
forceps and the resulting wound treated as in dry gangrene.
ULCERATION.
An ulcer is a circumscribed area of necrosis occurring on the skin or
mucous membrane and covered with granulation tissue. It is a process of
destruction, and when this process is going on faster than regeneration
can take place, we have a gnawing, or eating, ulcer. When such an ulcer
increases rapidly in size it is termed a phagedenic ulcer. A fungoid
ulcer is one in which the bottom of the ulcer projects beyond the edge
of the skin. These ulcers secrete milky or bloody-white liquid called
ichor. When the ulcer is of an ashen or leaden color, with the bottom
and sides formed of dense, hard connective tissue, which gives but
little discharge and is not sensitive, it is termed callous, torpid, or
indolent ulcer.
_Causes._--As in the case of gangrene, disturbances of circulation are
among the most frequent causes. A wound to a tissue with slight
recuperative power may be followed by ulceration, as in tumors. Certain
germs may produce ulcers, as the glanders bacilli, which cause the
ulcerations on the nasal septum in glanders.
_Treatment._--This consists in removing the exciting cause at once. The
secretions of the ulcer should be washed off with antiseptic solutions
and the formation of granulation tissues stimulated by antiseptic
salves, such as carbolated vaseline, lead ointment, or by dressings of
camphor. Air should be kept from the ulcer by occlusive dressings. Where
the ulcers are inflamed, warm lead water or lead water and laudanum will
be found efficacious. Callous ulcers are best removed by a curette,
knife, or hot iron and then treated like a common wound. Mechanical
irritation should be avoided.
ABSCESSES.
These consist of accumulations of pus within circumscribed walls, at
different parts of the body, and may be classed as acute and cold or
chronic abscesses.
When an abscess occurs about a hair follicle it is called a boil or
furuncle; when several hair follicles are involved, resulting in the
formation of more than one exit for the inflammatory products, it is
called a carbuncle.
ACUTE ABSCESSES.
Acute abscesses follow as the result of local inflammation in glands,
muscular tissue, or even bones. They are very common in the two former.
The abscesses most commonly met with in the horse (and the ones which
will be here described) are those of the salivary glands, occurring
during the existence of "strangles," or "colt distemper." The glands
behind or under the jaw are seen to increase slowly in size, becoming
firm, hard, hot, and painful. At first the swelling is uniformly hard
and resisting over its entire surface, but in a little while becomes
soft (fluctuating) at some portion, mostly in the center. From this time
on the abscess is said to be "pointing," or "coming to a head," which is
shown by a small elevated or projecting prominence, which at first is
dry, but soon becomes moist with transuded serum. The hairs over this
part loosen and fall off, and in a short time the abscess opens, the
contents escape, and the cavity gradually fills up--heals by
granulations.
Abscesses in muscular tissue are usually the result of bruises or
injuries. In all cases in which abscesses are forming we should hurry
the ripening process by frequent hot fomentations and poultices. When
they are very tardy in their development a blister over their surface is
advisable. It is a common rule with surgeons to open an abscess as soon
as pus can be plainly felt, but this practice can scarcely be
recommended indiscriminately to owners of stock, since this little
operation frequently requires an exact knowledge of anatomy. It will
usually be found the better plan to encourage the full ripening of an
abscess and allow it to open of itself. This is imperative if the
abscess is in the region of joints, etc. When open, we must not squeeze
the walls of the abscess to any extent. They may be very gently pressed
with the fingers at first to remove the clots--inspissated pus--but
after this the orifice is simply to be kept open by the introduction of
a clean probe, should it be disposed to heal too soon. If the opening is
at too high a level another should be made into the lowest portion of
the abscess so as to permit the most complete drainage. Hot fomentations
or poultices are sometimes required for a day or two after an abscess
has opened, and are particularly indicated when the base of the abscess
is hard and indurated.
The cavity should be thoroughly washed with stimulating antiseptic
solutions, such as 3 per cent solution of carbolic acid, 3 per cent
solution of compound cresol, 1 to 1,000 bichlorid of mercury, or 1 per
cent permanganate of potash solution. If the abscesses are foul and bad
smelling, their cavities should first be syringed with 1 part of
hydrogen peroxid to 2 parts of water and then followed by the injection
of any of the above-mentioned antiseptics.
COLD ABSCESSES.
Cold abscess is the term applied to those large, indolent swellings that
are the result of a low or chronic form of inflammation, in the center
of which there is a small collection of pus. They are often seen near
the point of the shoulder, forming the so-called breast boil. The
swelling is diffuse and of enormous extent, but slightly hotter than
surrounding parts, and not very painful upon pressure. A pronounced
stiffness, rather than pain, is evinced upon moving the animal. Such
abscesses have the appearance of a hard tumor, surrounded by a softer
edematous swelling, involving the tissues to the extent of a foot or
more in all directions from the tumor. This diffused swelling gradually
subsides and leaves the large, hardened mass somewhat well defined. One
of the characteristics of cold abscesses is their tendency to remain in
the same condition for a great length of time. There is neither heat nor
soreness; no increase nor lessening in the size of the tumor; it remains
in statu quo. If, however, the animal should be put to work for a short
time the irritation of the collar causes the surrounding tissues to
assume again an edematous condition, which after a few days' rest
disappears, leaving the tumor as before or but slightly larger. Upon
careful manipulation we may discover what appears to be a fluid deep
seated in the center of the mass. The quantity of matter so contained is
very small--often not more than a tablespoonful--and for this reason it
can not, in all cases, be detected.
Cold abscesses are mostly, if not always, caused by the long-continued
irritation of a loose and badly fitting collar. There is a slow
inflammatory action going on, which results in the formation of a small
quantity of matter inclosed in very thick and but partially organized
walls that are not so well defined as is the circumference of fibrous
tumors, which they most resemble.