INJURIES--THEIR NATURE AND THEIR TREATMENT.
POLL EVIL.
=Poll evil= consists of a deep abscess, ending in an ulcerous sore which
has numerous sinuses. The situation of the affection is the most forward
portion of the neck, near the top of the head, which part is peculiarly
liable to injury, especially in agricultural horses.
[Illustration: POSITION OF THE HEAD BEFORE AN ENLARGEMENT ANNOUNCES THE
EXISTENCE OF AN ABSCESS ON THE POLL.]
The gentlemen who superintend the laying down of stable floors always
make the pavements of the stalls to slant from the manger to the gangway.
They either know nothing about the habits of the horse, or they disdain
to think about so trivial a matter as the convenience of an animal. Their
stables are built for men; and it is sufficient if the places will hold
whatsoever man chooses to put into such out-buildings.
The horse is most at ease when the position takes the strain off the
flexor tendons. That end is accomplished when the hind legs are the
higher portion of the body, or when the ground slants in precisely the
opposite direction to which the flooring of all present stables incline.
The animal, finding the slope which is most convenient for the builder's
purposes adverse to its comfort, endeavors to compound the matter by
hanging back upon the halter, thus getting the hind feet into the open
drain which always divides the stalls from the gangway.
The rope should be stout which has to sustain the huge weight of the
horse; in proportion to that weight, of course, must be the pressure
upon the seat of poll evil. Pressure, as a natural consequence, stops
circulation. Upon circulation being freely performed, health, secretion,
and even life itself is dependent. The flow of blood to any part of
the body cannot be long prevented without unpleasant sensations being
engendered. Numbness and itching are the first results. The horse tries
to master these by rubbing its head violently against the trevise or
division of the stall. Friction, when applied to an irritable place, is
never a soothing process; when instituted by the huge strength of a horse,
its probable ill effects may be easily surmised. It is, therefore, no
legitimate cause for wonder if some of the fleshy substances, compressed
between the external wood and the internal bones of the neck, become
bruised, and deep-seated abscess is thus provoked.
This, however, is not the sole cause; there are others equally potent and
generally springing from the same source--namely, from human folly. How
much of animal agony might be spared if man, in the pride of superiority,
would deign to waste an occasional thought upon the poor creatures which
are born and live in this country only by his permission and to labor
in his service! Stable doors are commonly made as though none but human
beings had to pass through them. The tallest of mankind, probably, might
enter a stable without stooping; but does it therefore follow that a
horse can pass under the beam without assuming a crouching position? Many
horses learn to fear the doorway. They shy, rear, or prance, whenever
led toward it. Man, however, refuses to be instructed by the action of
his mute servant; those symptoms of fear, which are the bitter fruits
of experience, are attributed to the patient and enduring quadruped as
exhibitions of the rankest vice.
Low doors, such as usually belong to stables, are among the most frequent
causes of poll evil. The horse, when passing through them, is either
surprised by something it beholds outside the building, or checked by the
voice of the groom. The sudden elevation of the head is, in the animal,
expressive of every unexpected emotion. Up goes the crest and crash comes
the poll against the beam of the doorway. A violent bruise is thereby
provoked, and a deep-seated abscess is the sad result.
The horse likewise suffers from the representatives in brutality of him
for whose benefit it wears out its existence. Carters display their
ignorance by getting into violent passions with their teams. "Whooay"
and "kum hup" are shouted out; the huge whip is slashed and snaffle
jagged, till mute intelligence is fairly puzzled. Were mortals in the
like position, subject to the same terrible chastisement, and, at the
same time, forbid to inquire the wishes of their commander, they would
be in no better condition. The panting, sweating, and starting of the
poor, confused quadrupeds announce their terror. The driver, too enraged
to understand himself, and too impatient to delay punishment upon the
objects of his wrath, resorts to the butt-end of his heavy whip. Some
wretched animal is struck upon the poll, for the head is always aimed at
when stupidity quarrels with its own ignorance, and a dreadful disorder is
established.
All the causes of poll evil may, however, be reduced to one--namely, to
external injury. The first result of such a cause is pain whenever the
head is moved. Motion enforces the contraction of the bruised muscles;
and the agony growing more and more acute, the sufferer acquires a habit
of protruding the nose in a very characteristic manner long before the
slightest symptom of the malady can be perceived. When forced to bend
the head toward the manger, it generally hangs back to the length of the
halter; for although so doing occasions pain, the position renders the
necessary angle of the head upon the neck as little acute as possible. The
anguish attendant upon the earlier stages of the disease is exemplified by
the length of time occupied in emptying the manger. At this stage nothing
is apparent; at this period also great cruelty is too often exercised when
the collar is forced over the head regardless of the struggles of the
acutely-diseased animal.
Should the seat of poll evil at this stage of the disease be particularly
examined, the most lengthened inspection, when prompted by expectation,
may fail to detect even an indication of probable enlargement. Pressure,
or enforced motion of the head, excites resistance. A few weeks in
some cases, and the swelling becomes marked or prominent. In others,
the enlargement is never well developed: instances of this last kind
invariably are the most difficult to treat, for in them the seat of the
disorder is always most deeply seated. The size of the tumor is therefore
always to be hailed as a promise that the injury is tolerably near the
surface, and, consequently, more under the influence of remedial measures.
After pressure has been made, the agony occasioned causes the animal to be
difficult of approach. The common method of examination is, however, very
wrong. No good is done by inflicting torture. Something, on the contrary,
is concealed. Place the fingers lightly on the part, and allow them to
remain there till the fear, excited by a touch upon a tender place, has
subsided. Then, and not till then, gradually introduce pressure. The more
superficial the injury, the more speedy will be the response. The longer
the time and greater the force requisite to induce signs of uneasiness,
the deeper, as a general rule, will be the center of the disease.
In either case there is little good accomplished by those applications
which are recognized as mild measures. Fomentations and poultices commonly
waste valuable time, and, at last, prove of no avail. Therefore, blister
over the place. Obviously, the employment of more active treatment is
at present forbidden. Do not, however, give the carter so much liquid
blister, to be rubbed in by his heavy and coarse hand; but lightly paint
over the seat of the supposed hurt with spirituous or acetous tincture
of cantharides. Do this daily till copious irritation is produced, and,
before that dies away, repeat the dressing. Keep up the soreness, but do
no more. Never apply the tincture upon active vesication, otherwise a foul
sore, ending in a lasting blemish, may be the result. Make the poll merely
painful. An additional motive will thereby be instituted to keep the head
perfectly quiet, for constant motion provokes the worst consequences of
poll evil, causing the confined pus to burrow, or to form sinuses.
The foregoing treatment has been proposed because the tincture, when
applied by means of a brush, penetrates the hair more quickly, acts quite
as energetically, and is less likely to run down upon other parts than the
oil of cantharides, which the heat of the body always renders more liquid.
It is advised to be used, because it establishes an external inflammation.
Inflammations in living bodies, like fires preying upon inanimate
substances, have an attraction for each other. All injuries which lead
to suppuration likewise have a tendency to move toward the surface; and
these two laws, acting together, very probably may tend to the speedier
development of poll evil, thereby shortening the sufferings of the animal.
Should they not have that effect, the vesicatory is beneficial. About the
head of the horse are numerous layers of thin tendon, which are termed
fascia. Through this substance matter absorbs its way with difficulty. It
is, therefore, almost imprisoned, and motion always disposes the pus to
seek new outlets. Thus pipes or sinuses are formed; these constitute one
of the worst symptoms attendant upon poll evil.
[Illustration: POLL EVIL DURING THE FIRST STAGE.]
As soon as the swelling appears, watch it attentively. Wait till some
particular spot points, or till it feels softer, if it be not more
prominent than the surrounding substance. Then have the animal cast. Being
down, take a keen knife and open the spot before indicated. That being
accomplished, pause while the secretion flows forth. Afterward insert into
the cut a small, flexible probe. When its progress is impeded, employ the
knife with a director. Continue doing this till the seat or center of the
disease has been gained.
Remember, however, you are not hacking at the family loaf; it is living
and sensitive flesh you are wounding. Therefore, be very careful your
knife is thoroughly sharpened, and is of sufficient size; mind, also,
that all the cuts run smoothly into one another, so as to leave clean
surfaces for the healing process to unite. Having reached the heart of
the disorder, proceed to empty out all the concrete matter. That done,
wash out the part with a syringe and the coldest spring water. Afterward
examine the cavity. Excise any loose pieces of tendon or of ligament, and
cut until a healthy aspect is everywhere presented. Then rub the sides
of the deep-seated wound with lunar caustic. Let the horse rise, giving
orders that the sore is to be thoroughly moistened thrice daily with the
solution of the chloride of zinc, one grain to the ounce of water, and,
placing a rag dipped in a solution of tar over the wound to keep off the
flies, return the horse to the stable.
If the disease be left to run its course, the swelling generally
increases, while numerous openings at last disfigure the enlargement. From
such drain a glairy discharge. This adheres to the surrounding parts,
and, joined to the miserable expression of the countenance, gives to the
horse a peculiarly unpleasant appearance. The flesh wastes under the
perpetual anguish, and the half-conscious aspect of the creature justifies
a suspicion that the brain is affected.
In that case, proceed as before directed concerning casting the horse and
the knife with which you operate. Have the blade rather too large than too
small. Most veterinary instruments are mere adaptations of those employed
by the human surgeon. The author never remembers to have seen anything
approaching to the magnitude of a proper horses operating knife in the
hands of his fellows. A small blade compels numerous small cuts. The part
is rather snipped asunder than divided by one clean incision. The recovery
is thereby materially delayed; and the lengthened operation greatly
deteriorates from its chances of success, not to dwell upon the increased
suffering occasioned to the quadruped.
The horse being down, do not attempt any display of your proficiency. Look
well and long at the part intended to be operated upon. Decide in your
own mind the course in which the knife is to move. That course should
be influenced by the direction in which you may probably separate the
greater number of sinuses. In the engraving inserted below there are four
holes, each indicating the presence of a sinus. The supposed direction of
the knife is laid down by dotted lines. The primary and lower incision
includes three of the pipes. That made, another connects the other sinus
with the longer incision; the after-labor necessitates the cleaning of the
central sac, removing all the hanging pieces, also probing the sinuses,
and making sure all are fairly opened. If any are found unopened, a
director should be inserted, and the channel should be connected with the
chief wound by means of a smaller knife.
[Illustration: POLL EVIL IN ITS SECOND STAGE, OR WHEN READY FOR OPERATION.]
Two cautions are necessary to be given with regard to the treatment of
poll evil: Never permit the knife to be applied upon the root of the
mane. Underneath the hair which decorates the neck of the horse lies an
important ligament, by means of which the head is chiefly supported. All
the evils which might be anticipated may not spring from the division
of that development; but it is well to spare it, although the prostrate
animal should have to be turned over, and the operation have to be
continued on the other side. Also, when working the creature subsequent to
its recovery, never use a collar. Wounds, although perfectly healed, are
apt to remain morbidly sensitive; serious accidents, over which the reader
would deeply grieve, may occur from the harness touching the part which
once was diseased. A breast strap is, therefore, to be much preferred.
There are several popular methods of treating this disease. All, however,
are cruel; one is barbarous; when properly conducted, none are efficient
under the direction of a person possessing the smallest feeling. The
injection of potent caustics in solution, or violent compression upon an
exquisitely tender swelling even until the force employed amounts to that
power which can bring the sides of a distant internal cavity together,
drive out the corruption, and hold the part in that position while healing
is established, have been largely advocated. Whoever could increase the
suffering of a mute and patient life to that degree which the last method
necessitates would merit a much severer punishment than the writer can
afford space to detail. Of these modes of cure the author can profess no
experience. He has, however, seen injections used; in no instance have
they been successful. The time which they occupied was enormous, and the
expense with which they were attended by no means small. The man who
hopes to eradicate this disease should never have recourse to them.
Another process, formerly very popular, consisted in slicing the living
flesh in a very coarse and vulgar manner; that, however, was merely
preparatory. The chief dependence was placed in boiling liquor, which
was inhumanly poured into the wounds. After such a method were all
sinuous sores treated by an ignorant and uneducated quack, who especially
delighted in eradicating such forms of disease. The writer has heard
terrible descriptions given of the agony produced, and equally revolting
has been the picture of the filth employed by this unqualified horse
doctor. While, however, the course which has been mentioned is reprobated,
our heaviest condemnation should alight upon those persons who could so
violate the sacredness of their trusts as to surrender any creature to the
torments of so horrible a remedy.
In poll evil, the only certainty reposes on the knife. When properly
employed, the operation is brief; the temporary agony bears no proportion
to the years of subsequent relief thereby secured. To be properly
employed, however, it should be used as though the person invested with
it was, for the time, divested of all feeling. He who accepts it must
think only upon what he is about to perform, and must summon resolution
to do it quickly. In surgery, hesitation is positive cruelty; the knife,
to be curative, should be gracefully moved through the living flesh.
All notching and hacking are tortures, and worse than folly; the blade
should sweep through the substance; and, to prevent the struggles of
the quadruped from interfering with the intentions of the surgeon, all
that will be necessary is for some person to sit upon the cheek of the
prostrated animal.
FISTULOUS WITHERS.
This disease, in its chief characteristics, closely resembles poll evil.
It, however, differs from that disorder in one fortunate particular; poll
evil must come to maturity before its cure can be attempted with any hope
of success. Injury to the =withers= is easiest eradicated when attacked
upon its earliest appearance; both, however, in their worst periods,
proceed from pus being confined, from it decomposing and its establishing
numerous sinuses. When disease has reached this stage, the only certain
cure is the free but skillful use of the knife.
=Fistulous withers=, in the first instance, is an injury to one of the
superficial burst which nature has provided to facilitate the movement of
the vertebral, points spinal under the skin. The hurt is occasioned by
badly-made saddles, but more especially by the ladies' saddles. Some fair
equestrians delight to feel their bodies lifted into the air, and enjoy
the trivial shock of the descent; such movements, however, necessitate
the weight should be leaned upon the crutch and stirrup. This kind of
exercise is never indulged in by good female riders, as no saddle, however
well constructed, can resist the constant strain to one side. Friction
is produced; a bursa is irritated, and the animal will, under the best
treatment, be rendered useless for a fortnight. Rolling in the stalls
is also reported to have occasioned this affection; so likewise is the
heavy hammer of the shoeing smith, intemperately employed to chastise the
transient movement of an observant horse.
When first produced, the remedy is certain and easy. A swelling about
the size of an egg appears near the withers, upon the off side of the
body. Go up to the horse upon that side; have with you a keen-edged and
sharply-pointed knife of pocket dimensions. Stand close to the animal;
then impale the tumor, and, having the back of the blade toward the
quadruped, cut quickly upward and outward. Mind, and stand very close to
the center of the body, as the pain of this trivial operation is apt to
make the creature lash out and prance. At the spot indicated a person is
perfectly safe; neither hoof nor leg will touch that particular place, or
even come near it. Rest one hand on the back, and by your voice reassure
the startled creature.
[Illustration:
THE SLIGHT ENLARGEMENT WHICH, BADLY TREATED OR UNATTENDED TO, MAY
END IN FISTULOUS WITHERS.
]
The swelling being divided, exchange the knife for a lunar caustic case;
smear over the interior well with the cautery, and all the business is
over. Never, however, attempt to pass by the heels of a steed which has
been pained. The animal may suspect your motives, and the hind feet of the
horse are the most powerful weapons of offense and of defense. Have the
creature backed from the stall ere you attempt to quit it. Subsequently
keep the wound moist with the lotion composed of chloride of zinc--one
grain to the ounce of water; also have the part covered with a rag,
moistened with solution of tar. In nine or ten days the incision will have
healed, and after the lapse of a fortnight the animal may return to its
ordinary employment.
Should this remedy be neglected, pus is soon formed within the
enlargement, and the formation is accompanied by swelling, heat, and
pain. The horse is useless, and continues thus till the affection is
eradicated. The animal cannot wear a collar; it cannot endure a saddle;
at length numerous holes are formed upon the enlargement. These are the
mouths of so many sinuses, and from each exudes a foul discharge. The poor
quadruped evidently suffers greatly; it will almost stand still and starve
rather than brave agony by violent motion.
The only remedy is by operation; make an incision so as to embrace the
greatest number of holes. Then cut from the other openings into the main
channel; this done, have the sides of the wound held back, while the
center of corruption is cleaned out. Such is a very filthy and unpleasant
office; if the bones are affected, all the diseased parts must be removed.
When slight, the tainted portions may be scraped away; when of long
standing, the spines of the vertebræ have been sundered with the saw and
thus taken from the body. At any risk, none but healthy bone must be
suffered to remain; all discolored or white portions of the bony structure
must be extirpated, and none but that which, is of a healthy pink color
suffered to continue. If a particle of unhealthy, osseous growth is left
behind, the wound may close, but it will break out again, and the disease
become as bad as ever.
[Illustration: A HORSE WITH FISTULOUS WITHERS IN THE WORST STAGE.]
The cleansing being accomplished, apply the cloth over the wound, and keep
wet with the lotion formerly directed to be used.
Sometimes the sinuses will take a dangerous direction, and, favored by
the action of the shoulder, will burrow from the withers to the chest or
elbow. Then the knife cannot be employed. Should a pipe incline to this
course, but be of comparatively short extent, insert a little bichloride
of mercury down the channel. This is best done by powdering some of the
salt. Dip the elastic probe, which has recently been down the sinus, into
the powder. Reinsert it, and continue to repeat this action till all the
bichloride is expended.
If the sinus should have run its entire course, but not have found an exit
below, then employ a long guarded seton needle, such as can be purchased
at all veterinary instrument makers. Insert this in its guarded state,
and, having pushed it as far as it will go, give, upon the end of the
handle, a moderately sharp blow; this will force out the cutting edge and
drive the point through the flesh. Pass a long tape, with a knot at the
further end of it, through the opening near the point, and withdraw the
instrument, leaving the tape in after another knot has been tied at the
other extremity.
Thus a seton is established, and a depending orifice is instituted. The
tape will act as a drain to the morbid secretion, while the irritation
produced by it will also remove the callous lining of the pipe. A healthy
action will thereby be established; and so soon as the inferior wound
discharges a full stream of thick, creamy pus, the seton may be cut out,
with a conviction that its office is fulfilled.
[Illustration: A GUARDED SETON NEEDLE.]
[Illustration: THE SETON NEEDLE PROTRUDED, AND SECURED WITHIN THE HANDLE
BY MEANS OF A SCREW.
The screw being loosened, the button is struck, and the sharp needle
shoots forward, cutting its way through any interposing obstacle.]
However, never turn animals afflicted with fistulous withers or with
poll evil out to grass. In the last disease, the motion of the head, the
outstretching of the neck, and movement of the jaws occasion agony; and
in the first instance, the necessity for perpetual action entails so much
misery as soon renders the life worthless. The horse which is not worth
the best of food in the best of stables, should not be doomed to a life of
starvation and of torture. It is the shame of society that rich men are
tempted by a few pounds to dispose of the creature which has been maimed
in their service. Wounds endured when obeying the wishes of the master
should endear the slave unto his lord. In the case of the willing steed,
the law is reversed. The owner blemishes; and instead of nursing the
wounded life, he disposes of it. The injured animal is sold to the first
purchaser for so much as the damaged article will fetch.
FISTULOUS PAROTID DUCT.
This is a most serious evil, rather than a quickly-killing disease.
The animal which is thus afflicted may endure for years; but each meal
consumed and each day survived rates as a period of misery. When it is
considered how much the happiness of the lower order of beings depends on
merely feeding and living, it will be at once apparent how much the horse
has lost when all enjoyment has departed from eating; when mere existence
is embittered by being a prolongation of the suffering. The digestion
becomes deranged, because the saliva, or a valuable secretion imperative
to the proper performance of the function, is absent; while every movement
is a pain occasioned by the agony of a diseased stomach and the anguish
attendant upon a fistulous sore. The wretched creature, in this condition,
speedily becomes an object of disgust to the most humane master; and,
according to the convenient morality of modern times, is therefore sold
to the highest bidder. Purchased only for the work which remains in the
carcass, a fearful doom lies before the sick and debilitated quadruped.
It rapidly sinks lower and lower, at each stage of its descent the food
growing more scanty as the labor becomes more exhausting.
The =parotid duct= is the tube by which the saliva secreted by the gland
is, during the act of mastication, conveyed into the mouth and mingled
with the food. The parotid gland lies at the spot where the neck joins the
jaw; within the interior of that body numerous fine hollow vessels connect
and unite. These at each junction become larger and fewer in number, till
at length they all terminate in one channel, which is the duct immediately
about to be considered. It leaves the gland and travels for some space
upon the inner side of the jaw; after which it curls under the inferior
border of the bone and runs in front of the large masseter muscle of the
horse's cheek.
Its injury is frequently occasioned by hay-seeds or particles of food,
during the process of comminution, entering the open mouth of the duct;
these, subsequently becoming swollen, prevent the free egress of the
saliva. The secretion, nevertheless, goes forward and accumulates within
the tube, which it greatly distends. A confined secretion produces the
most exquisite agony. The motion of the jaw stimulates the gland to pour
forth its fluid; thus every mouthful which the animal is forced to eat not
only is the cause of suffering, but likewise occasions additional pressure
to a channel already enlarged to bursting, and which at length bursts.
[Illustration: THE PAROTID DUCT DISTENDED BY A SALIVARY CALCULUS.]
Another provocative is calculus, or stone, which is sometimes taken from
the cheeks of horses, they being of enormous comparative magnitude;
the natural tube would not admit a pea. Concretions have been removed
from this narrow passage as large as a pullet's egg. Such an obstacle
not only impedes the flow of saliva, but produces additional anguish by
the distention it occasions, and by the hinderance so hard a substance
offers to every motion of the animal jaw during the necessary period of
mastication.
Every puncture made into the substance of the duct, and every rupture
of the canal, speedily becomes fistulous sores. The saliva constantly
pours through the opening thus instituted; the healing process is thereby
prevented, and the edges of the wound rapidly become callous. It is,
however, painful to be obliged to state that the stable fork, in the hand
of an intemperate groom, is the instrument by which these punctures are
too frequently occasioned.
Gentlemen when engaging people to attend upon their animals should always
be very particular concerning temper. An irritable person, however smart
he may appear, is obviously disqualified for such an occupation. A man
of an evil temper should never be engaged. Still, the great majority of
present grooms are rather conspicuous for an exuberance of conceit, than
remarkable for any openness of countenance. Smartness may gratify the
pride of the master; but it is difficult to comprehend in what manner it
possibly can benefit his horse.
There is an old proverb which, being "the condensed wisdom of ages,"
teaches that "the master's eye fattens the steed." Most of modern masters
dislike nothing so much as trouble. The stable is given over to the
servant. No Eastern despot is so absolute as the groom in his dominions:
he kicks and abuses its inhabitants at his pleasure. If the free exercise
of his will occasions injury, a lie is easily invented and readily
believed by the lazy superior. All that comes into or passes out of the
building pays toll to the invested ruler. Five per cent. is levied upon
the hay and corn merchant; the dung is sold as a legitimate perquisite;
the bills of the harness and the coach makers are taxed one shilling
in the pound by the most ignorant groom, and often much higher by the
properly initiated. Thus the idle man pays dearly for his ease. There is
no luxury so expensive as a want of wholesome energy.
[Illustration: A HORSE, HAVING A FISTULOUS PAROTID DUCT, IN THE ACT OF
EATING.]
The process of mastication causes the saliva to be secreted. At each
motion of the jaw it is squirted forth with violence; every drop of the
fluid passes through the false opening--no portion finds its way into the
mouth. The running of the stream down the cheek wears away the hair, while
the absence of a valuable constituent toward perfect digestion occasions
the diet not to nourish the body. The animal loses flesh, and quickly
assumes a miserable appearance, which makes the proprietor long to rid his
sight of so pitiable an object.
The cure for this disease was aptly illustrated by Mr. Gowing, the
excellent veterinary surgeon of Camden Town. That gentleman made an
adhesive fluid, by either saturating the strongest spirit of wine with
gum mastic, or dissolving India-rubber in sulphuric ether. Then, when the
horse was not eating, he pared off the hardened edges of the wound till
blood issued therefrom. He subsequently allowed the bleeding to stop, and
placed over the orifice a piece of strained India-rubber. Over that he put
a thin layer of cotton; fastened one end of the cotton to the hair of the
cheek by means of the adhesive preparation. That being dry, he tightened
the cotton and glued down the opposite extremity. Next he attached another
layer of cotton, and subsequently another. Afterward he fastened more
cotton, some of it crossways; and, having added as many layers as would
make a good body, saturates the whole with the adhesive solution before
alluded to.
The hair affords a good ground to which any other substance can be
fastened; but it is rendered better by being thoroughly washed with soft
soap and warm water. The ablution deprives the skin of the horse of its
naturally unctuous secretion, and permits the adhesive application a
better chance.
The horse should be allowed no food which necessitates mastication. The
head should be fastened to the pillar-reins during the process of cure.
Thin gruel only should be presented while treatment is progressing,
and that should be continued until the covering falls off. Should the
wound not be healed, allow a couple of days to elapse; but give no solid
food. Permit the horse to rest on refuse tan--not straw, which might be
eaten--during all this time. Afterward renew the attempt, and repeat it
again if necessary--though the first trial generally succeeds.
Before concluding, it may be well to arm the reader against those
practices generally adopted by horse doctors. These practices consist in
the use of the red-hot budding iron, which is among them a very popular
application to a =fistulous parotid duct=. The theory which induces this
resort is, a belief that the heated iron induces an eschar, and the
wound closes before the crust falls off. Red-hot iron is, however, far
more disposed to destroy substance than to favor growth; and, probably,
its curative properties could have gained faith among no other class.
Possibly there exists no other body which would credit that, to burn a
hole larger, was the best way to close it. Another artifice is to inject
caustic lotions up the duct, and thereby occasion the gland to slough out.
Against such cruelty the author is pleased to think little need be said.
The operation, when successful, causes so much irritation as endangers
the life; for the body of the gland is permeated by so many and such
important vessels as render the termination always very dubious.
PHLEBITIS, OR INFLAMMATION OF THE VEIN.
Formerly it was the custom to bleed horses for everything and for nothing.
It was not even suspected that a creature which exists only to labor unto
the limit of possibility is far more likely to be the victim of debility
than of repletion. It never occurred to any master that his wretched
animal wanted blood putting into it rather than abstracting the smallest
quantity of blood from it. However, formerly bleeding was a favorite
resort with the apothecary, and the old veterinary surgeon seems to have
followed the bad example. Aged people have informed the writer that they
remember the time when, on a Sunday morning, a long shed was filled with
agricultural horses standing in a row. These victims were all waiting
to be bled. The veterinary surgeon's assistant used to take the fleam,
and to open a vein in the first animal's neck. Then he would proceed to
the second; and thus, in turn, he would open the jugulars of the entire
number. No account was taken of the quantity of blood lost; that flowed
forth till the last had been operated upon, when all the creatures stood
simultaneously draining forth their lives.
The veterinary surgeon's assistant subsequently returned, and pinned up
the orifice of the first horse; then he went and performed that office for
the succeeding animal. Thus he, a second time, progressed down the row,
pinning up as he proceeded; and the poor horses often tottered before he
came. All this was done for a human fancy: man thought the loss of blood,
at spring and autumn, beneficial to all kinds of life. The writer has
heard of old ladies who were very skillful in bleeding cats. Most cats,
however, resist such an application of medical talent; not so the horse:
this animal submits itself patiently to the master's will. The creature
seems to recognize that it has no right to exist except by the permission
of its owner. There is no living being which acknowledges so abject a
dependence.
In return it is made a sport of the idlest whims. Hence horses, after
bleeding, were all thought to be much benefited. They were expected to
perform greater labor and to continue in sounder health. In vain did the
disease visit the stable more frequently; to no purpose was diminished
capability displayed. The ungrateful bodies of the "plaguy beasts" were
blamed, which would go wrong even after mortal science had expended its
wealth upon them. Man never doubted his own wisdom; he never questioned
his own conduct; and it is astonishing the quantity of prejudice which is
from year to year perpetuated for the want of a small amount of so cheap
an article as mental inquiry.
The worst of the evil still remains to be told. The creatures, being bled,
were esteemed so greatly benefited as to require no subsequent attention.
=Phlebitis= was consequently, in other days, a rather common affection.
If neglected, the disease may terminate in death. In cases aggravated by
mistaken measures, the disorder mounts to the brain, and occasions awful
agonies. Taken early and properly administered to, this disposition is
easily arrested. It was formerly wrongly treated, and was traced to an
erroneous origin. Phlebitis was, to the perfect satisfaction of learned
judges seated on the bench, attributed to the surgeon's want of care. So
serious an evil was imagined to be caused by culpable neglect during a
trivial operation. It was thought to have been provoked by the use of a
foul instrument, or by employing anything else to strike a fleam than a
properly-made blood-stick.
Experiments, however, which were instituted at the Royal Veterinary
College, have proved that no want of care, during the performance
of bleeding, can provoke the disorder. Wretched horses, in that
establishment, have been punctured with dirty, rusty, blunt, and jagged
fleams; all manner of blood-sticks have been employed in every description
of way. These have been struck violently and tapped in the gentlest
fashion. Every possible sort of pinning up has been adopted; but the
utmost endeavor of intentional perversion could not produce inflammation
of the vein. There appears to be only one ascertained cause: that is,
bleed; do not tie up the head, but turn it into a field, or present
fodder to be eaten off the ground, and the animal will have phlebitis.
The pendulous position of the head and the motion of the jaws alone
seem capable of starting inflammation in the jugular vein. Therefore,
should the reader ever permit a horse to be bled--which, save in extreme
cases, is perfectly unnecessary--let him remember to place the animal
subsequently in the stable, to tie the halter to the rack for twenty-four
hours, and, during the same space, to abstain from allowing any food.
These injunctions, however, do not refer to the bleedings sometimes
adopted to counteract acute disease.
There is one circumstance which should always be well considered before
any horse is bled: Certain animals have a constitutional predisposition
toward this peculiar form of disease. The horse whose vein shall inflame
no man can, by sign, mark, or investigation, pick from a herd. It is,
however, an ascertained fact that particular animals, of no fixed breed,
and apparently characterized by no recognized state of body, have a
mighty tendency to exhibit this particular disorder. The horse may appear
unexceptionable as regards health; but, nevertheless, strike it with
a fleam or puncture it with a lancet, and phlebitis will undoubtedly
be generated; none of the usual precautions can _always_ prevent the
misfortune. Such predisposition evidently depends on a determinate
condition of system which science has hitherto failed to recognize.
This fact, or eccentricity in the constitutions of isolated horses, ought
to be generally known. Men have recovered heavy damages in courts of law,
and blameless veterinary surgeons have been ruined, by circumstances over
which the utmost stretch of human precaution could possibly exercise no
control. However, a more extended knowledge concerning the real origin of
this disorder may do some good, since it will guard juries from delivering
wrongful verdicts, and may tend to check that love of venous depletion
which is still too prevalent with ignorant horse owners.
There was formerly a great diversity of opinion concerning a supposed
eccentricity in the facts observed during this disease. If a horse was
bled in the neck, and subsequently exhibited phlebitis, the brain became
affected. If an animal was depleted from the fore leg, and displayed the
disease, the heart became involved. In one case, the disorder proceeded
from the center of circulation; and in the other, it mounted directly
toward the organ. A great many hypotheses were published to explain or to
account for this imaginary peculiarity. Much nonsense was spoken, and more
was written, to point out the real cause of an imaginary difference. Yet,
calmly viewed, the seeming diversity appears to agree with the commonest
law of nature. Phlebitis always closes the vessel at the seat of injury.
The disease, therefore, in each case, is prevented from descending, and
consequently ascends above the orifice--the only peculiarity being the
relative situations of the structures involved.
This affection is most common after blood has been taken from the neck.
That seeming preference for a particular part may, however, be nothing
more than a circumstance dependent upon the greater number of animals
which have their jugulars opened. Were the brachial or the saphena veins
punctured as frequently as the vessel which carries the blood from the
brain, the apparent difference might appear in the opposite direction.
However, from whichever vessel the depletion is effected, always tie the
quadruped's head up, and present no food. A stall is to be preferred to
a loose box, as the confined space is more likely to prevent action.
Motion is the source of all danger. This fact was aptly illustrated by
an anecdote which used to be related by the late Mr. Liston, the eminent
surgeon. In his lecture, that gentleman surprised his class by stating
that the last person whom he bled perished of phlebitis. Bleeding is the
most simple operation in human surgery. Most surgeons leave this office
to the apothecary; consequently it was rather a condescension in one who
deservedly ranked so high in his profession to stoop to such an act. What,
therefore, could possibly cause disease to follow the operation, when
performed by him who was accustomed to surgery upon its grandest scale?
The cause was soon explained. The person operated upon chanced to be a
lunatic. This insane individual embraced the notion that the healing
process was much favored by constant motion; consequently he kept on
flexing and extending his arm with all the violence which is natural to
the demented. In vain was every effort made to persuade him from so mad an
action. He clung with extraordinary pertinacity to his unwholesome theory.
On the following day, Mr. Liston was surprised to find his patient in bed,
but still moving the arm in which disease had already declared itself.
Measures were taken to keep the limb quiet, but it was found impossible
to accomplish this in a satisfactory manner; and when Mr. Liston again
called, the patient was no more!
A vein being about to inflame, the earliest intimation of the fact is
given by the separation of the lips of the wound, while through the
opening drains a small quantity of a thin discharge. Should this warning
excite no attention, a round and hard swelling appears. That may be like
a hazel-nut in size, or it may resemble half a chestnut in magnitude;
and this is soon followed by a swollen state of the vein superior to the
orifice.
[Illustration: A HORSE WITH PHLEBITIS, OR INFLAMMATION OF THE VEIN, IN THE
SECOND STAGE.]
Then supervenes the second stage of the disorder. Unhealthy abscesses are
formed along the course of the vein. As these mature, they burst, and send
forth an unsightly and filthy liquid resembling thin, contaminated pus. On
examination, these tumors are found to be united. They penetrate to the
interior of the vessel, and are joined together by numerous sinuses. They
literally constitute so many holes in the neck.
[Illustration: THE THIRD STAGE OF PHLEBITIS.]
If no attention be now paid to the aggravated symptoms, worse speedily
ensues. In the direction formerly indicated the vessel feels hard under
the skin. Supposing this sign to be neglected, unhealthy pus issues in
quantity from the wounds and soils the neck. This secretion is soon
converted into a dark, impure, and fetid discharge resembling decayed
blood. The horse grows dull and stupid; the inflammation ultimately
affects the brain, when the suffering and the life are extinguished in the
violent agonies of phrenitis.
The cure is easy, but everything depends upon the energy of him who
undertakes it. When the lips of the wound which have been brought together
by means of the twisted suture--as the "pin with tow wrapped round it"
is professionally termed--display a tendency to separate, and, instead
of being dry, appear moist, let no prejudice incline toward the ancient
practice of fomenting and poulticing the injury. Without the loss of a
moment in hesitation, withdraw the pin; remove the substance which was
twined round it, and apply a moderate-sized blister immediately over
and around the puncture. Should the disease have ascended up the neck,
still rub in a blister; only a proportionate amount of surface must then
be acted upon. If the case be as bad as possible, and yet the animal is
alive, still a blister is indicated.
[Illustration: THE TWISTED SUTURE.
A pin is first stuck through the lips of the wound; a portion of
tow, thread, or hair is then wrapped round the pin, and, to complete
all, the point of the pin is lastly clipped off.
]
With the progress of the disease a larger space should always be subjected
to irritation, so as to cover every part the most active imagination could
suppose to be involved. One blister, moreover, will not suffice; another,
and another, and another must be employed, till every sign of disorder
has vanished. They must, however, be applied in quicker succession as the
symptoms are more urgent, while a greater interval may be allowed between
each when the affection is less serious. In the worst stage of phlebitis,
another blister must be put over the part upon which the irritation of the
first has not entirely ceased to act. In the second stage, the surface
must have been barely healed before another vesicatory is resorted to.
During the primary symptom, a single application frequently is sufficient;
or, at most, two blisters generally suffice.
When the vessel assumes the corded state, a blister can effect no more
than to check the progress of the disorder; no agency, however, which
science has placed at the disposal of man can restore the uses of the
vein. The vessel is lost, and lost forever. If a foul and black discharge
issue from the openings, insert a director and enlarge the wounds, joining
the holes by slitting up the sinuses which unite them; but do not cut the
entire extent of the hardened vessel, as in that case you may be deluged
in blood. The employment of the knife and the free use of blisters
constitute the chief means toward the cure of phlebitis. The sinuses must
be laid open. The probe should then be most patiently employed, for every
sinus _must_ be slit up. This may be done at once, when the hardness
indicates the vessel to be closed above the part which the incision
interferes with. To such an extent the knife may always be employed, while
blisters after blisters are used, regardless of the severe wounds over
which they are applied.
Much relief is afforded by the large and pendulous incision, through
which the corruption freely finds an exit. Some horses, however, from the
pain occasioned by the raw and inflamed condition of the neck, will not
allow the blister to be rubbed in after the ordinary fashion, especially
when the irritation caused by the former application has not thoroughly
subsided. In cases of this sort, do not employ the twitch or resort to
greater restraints. Exercise your reason. Regard the painful aspect of
the wounds. Ask yourself how you should enjoy the hard hand of a groom
violently scrubbed over such a part, were the soreness upon your own body.
Act upon the response. Procure a long-haired brush, such as pastry-cooks
use to egg over their more delicate manufactures. Go then into the next
stall. Speak kindly to a sick inferior that is at your mercy. Have the
creature led forth, and, with the brush just described, smear the part
with oil of cantharides or liquid blister. The extract of the Spanish fly
does not occasion immediate agony, and the application of oil will cool or
soothe the anger of the wounds.
With the jugular vein inflamed, the horse, during the period of treatment,
should consume no solid food. Hay tea, sloppy mashes, and well-made gruel
should constitute its diet. However, the gruel must not be given in such
quantities or made so thick as the same substance would be allowed to a
healthy horse. Gruel may not be very sustaining to the human being, but it
is nothing more than the oat divested of the shell or refuse part. To the
equine species such food, whether given dry or boiled in water, is highly
stimulating; and, as fever invariably accompanies inflammation, oats in
any form evidently are contraindicated. Should the animal, however, become
ravenous, a portion of potatoes, being first peeled, may be boiled to
a mash. Some water and a sufficiency of pollard ought to be added, and
the whole presented in such a state as requires no mastication, but in a
condition that will allow the mixture to be drawn between the teeth. The
same thing may be done with carrots and with turnips, only all mashed
roots, except potatoes, should be passed through a colander, and moistened
with some of the water in which they are boiled.
Any animal, during treatment, should be placed in a loose box. No creature
should be turned into the field. It is cheaper to pasture than to stable
a horse; but the constant motion of the legs, as the field is traversed,
is injurious to the punctured vein of the limbs, while the pendulous state
of the head and the perpetual movement of the jaws are most prejudicial
when venesection has been performed upon the neck. The stable is, in every
point of view, the cheapest and the best residence. The head of the animal
must be tied to the rack throughout the day; while, at night, the halter
may be lengthened, permitting the creature to lie down; but the floor
should be littered with tan, as straw might be eaten.
Let the horse remain thus for six weeks subsequent to the completion of a
cure. Then give gentle exercise to the extent which it can be borne--the
quantity being small, and the pace very slow at first, but gradually
augmented. This exercise should be maintained for three months. The
animal may afterward return to slow work; but if the neck is the place
affected, it must not wear a collar or be harnessed to the shafts for
the next six months. At the end of that time the horse may return to its
customary employment; but, if ridden or driven, it is always well to bear
in mind the late affliction, and to grant more than the usual time for the
performance of the journey. At the expiration of the year, the smaller
veins, having become enlarged, have adapted themselves to the loss which
the circulation has sustained, and the horse may resume full work.
For the first year, gruel, crushed and scalded oats, with two bundles
of cut grass per day, should constitute the diet. The manger should be
heightened, and the halter be so arranged as to prevent the head being
much lowered. Do all in your power to render useless violent mastication;
and, as the horse never chews when the operation is unnecessary, the
animal will obviously second your endeavors.
At the expiration of twelve months the animal which has lost a vein may be
sold, and, _in law_, has been accounted sound. Such a blemish, however,
is far from a recommendation; in this case law and common sense may be at
variance. The reader, therefore, is advised never to purchase a nag in
such a condition without insisting upon a special warranty, in which it is
provided that the animal is to be taken back should the loss of a vessel
be productive of any evil effects within the space of one twelvemonth.
BROKEN KNEES.
These accidents affect the exterior of the central joint of the fore
legs. They may be very trivial or very serious: they may simply ruffle
the hair or scratch the cuticle covering the integument; the same cause
may, however, remove the hair and lay bare the cutis. Moreover, the wound
is often aggravated by the nature of the road on which the animal is
traveling. A fall upon a very rough surface might even destroy a portion
of the skin, and deprive more or less of the cellular tissue of vitality.
[Illustration: BROKEN KNEES OF VARIOUS DEGREES OF INTENSITY.
The hair ruffled and the cuticle scratched.
The hair removed and the true skin exposed.
The skin destroyed and the cellular tissue injured.]
Accompanying such accidents there is generally some amount of contusion.
When it falls, the horse is in motion, and the impetus lends violence
to the descent. Probably the animal is being ridden when it comes to
the ground. The weight of the blow is not only then proportioned to the
heavy body of the horse and the rate at which it is progressing, but its
effect is augmented by the load upon its back. These considerations render
=broken knees= the proper dread of every horse proprietor. An animal
may stumble and come down which, prior to the mishap, would have been
sold cheap for several hundreds. It may be raised from the ground with
almost all its worth demolished. The nature of the hurt is not, however,
always shown at first. The chief danger, in broken knees, lies in the
accompanying contusion. The horse which rises without a hair ruffled, but
which fell with violence, is always, with informed persons, a cause of
considerable anxiety. Contusion is to be more dreaded in its consequences
than is the largest wound when devoid of anything approaching to a bruise.
The reason why contusion is thus gravely regarded is because, when that
occurs in severity, the vitality of all the coverings to the knee is
destroyed, and, in very bad cases, even the bones are materially injured.
All dead parts must be cast from a living body; and no man can predicate
how deep may be the injury, or how important may be the structures which
shall be opened, when the slough takes place.
Proprietors of horses thus injured are commonly very earnest in their
solicitations for a professional opinion as to the extent and probable
consequences of the accident. No certain judgment can, however,
be pronounced, nor should one be given. Any surgical calculation,
notwithstanding it may be most prudently qualified, is apt to be
misconstrued by the anxiety of distress. The most guarded hint at a
probability of recovery is too likely to be seized upon as a positive
guarantee of perfect restoration; and the possible evils which may
have been alluded to, confusion causes the individual not to remember.
Therefore silence is wisdom in these cases, however slight the broken knee
may appear in the first instance.
Broken knees are principally caused by the imprudence of him in whom
authority is invested. Certain people imagine the public admire the man
who chastises a horse. Such persons slash away for every trivial error.
Every imaginary fault is punished with the whip, which too often curls
around parts that should be respected. The animal, pained and frightened,
thinks only of the slasher behind it, and entirely disregards the path
upon which its eyes should be directed. The cutting is incessant, and
the horse's pace is incautiously fast. An impediment is encountered; the
animal trips; it is cast to the ground with violence, while the man is
probably rendered fitter for a hospital than for the continuance of his
travels.
Other riders and drivers always visit with severity the slightest
indication of weak limbs. A sudden drop or a false step is, to such
people, the signal for the reins to be jagged, the voice to be raised, and
the whip to be freely exercised upon all parts of the animal's body, but
mostly about the face and ears. The man likes to behold the poor creature
shake its head, and loves to imagine he is then teaching the terrified
quadruped to be careful. Equine pupils, no more than human scholars, are
to be tutored by barbarity, which may slay the reason long before it can
instruct the mind. Composure is imperative to the acquirement of any
knowledge. Thrashing calls forth terror, and alarm is synonymous with
confusion of mind. The horse is susceptible of a fear which humanity,
happily, finds it difficult to conceive; and how far such a creature is
calculated to be educated by cruelty, the intelligent reader is left to
infer.
Could the animal argue, it might plead that the weakness objected to was
caused by exertion made in man's service; that the stumbling gait was
consequent upon no negligence on its part; that it afforded the beaten
wretch no pleasure to have the knees broken, but, if the quadruped might
profess a choice, it would prefer not falling down, etc. etc. If such
pleas were properly considered, they perhaps might still the turbulence of
the punisher.
The great majority of these injuries are consequent upon the prejudice
or thoughtlessness of mankind. Popular admiration is, in this country,
much in favor of a good crest. Every animal, no matter how nature may
have formed the neck, must carry a good head. The rider, therefore, drags
upon the bridle, while the form of nearly every gentleman's harness-horse
is distorted by the bearing-rein. The constraint thus enforced not only
obliges additional muscular action, but it disqualifies the animal to see
the ground. In England there should be no objection to a blind horse,
since such of the species as have eyes are, by the prejudices of society,
seldom permitted to use them. The horse, being urged on when virtually
blindfold, must of necessity stumble upon any unusual impediment being
encountered. Such an accident shows no fault in the quadruped; but the man
is truly responsible for those consequences which his folly has induced.
When a horse stumbles, never raise your voice--the creature dreads its
master's chiding; never jag the reins--the mouth of the horse is far more
sensitive than the human lips; never use the lash--the horse is so timid
that the slightest correction overpowers its reasoning faculties. Speak
to the creature; reassure the palpitating frame; seek to restore those
perceptions which will form the best guard against any repetition of the
faulty action. When the legs are weak, the greater should be the care
of him who holds the reins. No cruelty can restore the lost tonicity of
the limbs; therefore all slashing is utterly thrown away. If the reader
regard his own safety, let him not, when riding, hold the head up, or,
when driving, sanction the employment of a bearing-rein. No inhumanity can
convert an animal with a ewe neck into the creature with a naturally lofty
crest. The disguise of such a defect as a head badly placed on the neck is
an impossibility. Therefore, if you are desirous of a well-carried head,
think of it when making the purchase. Pay something more, and any kind of
quadruped is obtainable; but be above the meanness which purchases for a
low figure, and then endeavors to palm off its cheap article as a jewel
procured at the highest price.
When a horse has been down, never judge of the injury by the first
appearance. While the animal stands in the yard, order the groom to fetch
a pail, with milk-warm water and a large sponge. With these he is to clean
the knees--not after the usual coarse and filthy fashion now universal;
not by first sopping the part, and then squeezing the soiled sponge into
the pail whence more fluid is to be abstracted. The dabbing and smearing a
wound simply irritates it; and the dirt, having all entered into the pail,
the fluid is rendered unsuited to after cleanly purposes.
[Illustration: THE PROPER WAY TO WASH A BROKEN KNEE.]
To perform the office properly, the knee should not be touched. The sponge
should be saturated, then squeezed dry above the seat of injury. The water
thus flows in a full stream over the part, and, by the force of gravity,
carries away any loose dirt that may be upon the surface. Sopping,
dabbing, wiping, and smearing occasion pain, and can remove nothing which
may have entered the skin and which is protected from the action of the
sponge by a covering of hair; whereas by the plan recommended the dirt
is removed, the part is not debilitated, neither is its natural energy
destroyed. The last drop of water, moreover, is as clean as was the
first, and the animal is not irritated immediately prior to a surgical
examination.
The wound being cleansed, a certain time should be allowed to elapse for
the horse to recover its composure. It should return to the stable, have
a feed of corn, and be watered. Then the real business commences. The
animal should be gently approached; its condition should be observed. If
any nervousness is exhibited, the person ought to retire, and a further
pause should be allowed. If, on the second visit, any unusual symptoms are
displayed, have the quadruped led into the yard and blindfolded. Let a man
take up the other fore leg, when the knee may be examined with safety.
Place the palm of the hand over the joint. Hold it there to ascertain if
any heat or swelling is to be detected. Should there be swelling, make
gradual and gentle pressure upon it with the thumb or one finger. If,
upon suddenly removing the hand, an indent is conspicuous, it argues
considerable effusion, and justifies fear as to the result. Should neither
heat nor swelling be remarked, further pressure is to be made with the
thumb upon the knee. The force should be gentle at first and gradually
increased. If the action is sustained well, or even moderately endured,
it allows of hope being entertained. But should the horse attempt to rear
upon the first impress of the thumb, the result is very dubious. The
absence of agony is far from anything approaching to a positive proof,
as bone and synovial membrane, tendon and ligament, do not take on acute
inflammation when first injured; but, from the response thus elicited, a
fair inference as to the probability may be drawn.
Should the skin be lacerated, the probe must be employed. Such injuries
are very deceptive. They may be much more extensive than the size of the
wound would indicate. The probe being of metal, ought not to be thrust
violently against every exposed part. This kind of proceeding can effect
no good. The probe should be held lightly between the thumb and fore
finger; no pressure should be made upon it--the instrument ought rather
to fall of its own gravity than be forced into the flesh. A thin piece
of wire can be readily driven into soft structures; but where an actual
division exists, no opposition necessitating force will be encountered.
Broken knees always happen when the horse is in motion. The onward
impulse is not by the fall immediately destroyed; but after the horse is
down there always exists an impetus which has a tendency to propel the
body forward. Should the skin of the knees be divided by the fall, the
after-force obviously cannot affect the upper line of such division; but
the lower edge of skin will present an acute obstacle to the roughened
ground, and will, by the grating of the body, in all probability be rent
from its attachments. When the animal rises, the action and the elasticity
natural to the integument will occasion the torn portion of the skin which
has been driven backward to once more assume its original position. By
this means a kind of bag or purse is formed upon the knee. Grit, mud, and
all kinds of impurities may be retained and concealed within this pouch.
These will be disposed to irritate the structure with which they are in
contact; suppuration is certain to be established, and sad consequences
have followed such sacs not being early detected.
[Illustration: PROBING THE SAC OF A BROKEN KNEE.]
[Illustration: A SETON BEING INSERTED THROUGH THE SAC OF THE KNEE.]