DISEASES OF THE FKILOCK, AXKLK, AND FOOT. 451 



O810111U iiK'inbrane covt'iing the bone ami coiiiu bone al>50 are subjects 

 t)f the inflanuniitory process. Neither is this ail; in some of these 

 cases of peditis acute infhimmatiun of the coHin joint is present, ami 

 occasionally suppuration •)!' the joint. A mihl form of periostitis, 

 in which tlie e.xuchitiou is in the outer hiyer of the i)eriosteum only, 

 is a more common condition than is reco^ni/ed <i;enerally by practi- 

 tioners. Intimate ct>nti^uity of structures is the piedisi)osing cause, 

 for the disease either spreads fiom the original seat or the complica- 

 tion occurs as one of the primary results of the exciting cause. In 

 the severer cases in which the exmlate .sei)arates the [)eriosteinn from 

 tlie bone, suppuration, gangrene, and superficial caries are common 

 results. If iidiltration of the bone tissues is rapid the blood supjiiy 

 is cut otf by jiressure upon the ves.sels and death of the collin bone 

 follows. Grave constitutional symptoms maik these changes, which 

 soon prove fatal. 



In the mild ca.ses of periostitis it is by no means easy positively to 

 determine its presence, for there are no special symptoms by which it 

 may be distinguished from i)ure laminiti.s. In a majority of acute 

 ca.ses, though, which show no signs of improvement by the fifth to 

 seventh day. it is safe to suspect periastitis, particularly if the coro- 

 nets are very hot, the pulse full and hard, and the lameness acute. 

 In the foitunately rare cases in which the bone is affected with in- 

 flMiiimation and suj)puration the agony of the patient is intense; he 

 (X-cupies the recumbent position almost continually, never standing 

 for more than a few minutes at a time; suffers fiom the mo.st care- 

 ful handling of the affected feet; maintains a rapid pulse and respi- 

 ration, high temperature, loss of ap[)etite. and great thirst. It is in 

 these cases that the patient continually grows worse, and the appear- 

 ance of siippuration at the top of the hoof in about two weeks after 

 the inception of the disea.se proves the inefficiency of any treatment 

 which may have Ix'en used and the hopelessness of the case. These 

 patients die usually between the tenth and twentieth days either from 

 exhaustion or pyemic infection. 



Gangrene <K'curs in the peiiosteuni as the roult of excessive de- 

 tachment from the bone and compression due to excessive exuda- 

 tion. Other parts of the .sensitive tissues are subject occasionally to 

 the same fate, and at times large areas will be found death 



Pumiced aoJc is that condition in which the horny sole in the neigh- 

 Inirhood of the toe readily crumbles away and leaves the sensitive 

 tissues more or le.ss exposed. It is not a complication of laminitis 

 only, for it is seen under other conditions. A\'illiams has described 

 the horny ti.ssue of pumiced sole as "weak, cheesy, or spongy, like 

 macerated horn, or even grumous (thick, clotU'd)." Crumbling horn, 

 when critically examined, shows almost an entire absence of the 

 cohesive matter which unites the healthv fibers, while the fibers them- 



