DIAGNOSIS OF SHOULDER LAMENESS. 787 



inflammation of the muscles of the limb, hypertrophy of the heart, and 

 fatty liver. The disease appeared suddenly, with symptoms of fever, and 

 proved fatal in eighteen hours. The case closely resembled septic cellulitis 

 or malignant oedema. 



(5) Inflammatory swelling and new growths sometimes interfere 

 with movement. Thus acute or chronic swelling of the prescapular 

 and axillary glands, resulting from glanders, strangles, or infective 

 local disease of the fore-limbs, may cause shoulder lameness. Gerke 

 reports several cases of the kind. 



A horse, lame for two years and a half, showed on post-mortem a 

 swelling as large as a man's fist beneath the shoulder, surrounding the 

 axillary plexus. Another, which had suffered from shoulder lameness 

 for four years, exhibited swelling and degeneration of the axillary glands. 

 In both cases there was excessive atrophy, not only of the muscles, but 

 even of the hoofs. 



In these conditions the limb is often abducted, both during 

 movement and when weight is placed on it. Intermittent shoulder 

 lameness may be caused by swelling of the axillary glands. Chronic 

 inflammation and suppuration in the skin of the shoulder may produce 

 such swelling of the lymph glands. Scholz found an abscess near 

 the axillary artery in a horse which had suffered from metastatic 

 strangles, and subsequently from lameness. 



(6) In addition, shoulder lameness may be produced by lesions 

 of the nerves, as in suprascapular paralysis. 



The diagnosis of " shoulder lameness " chiefly depends on the 

 negative results of local examination ; the more careful the local 

 examination, the rarer will be the diagnosis shoulder lameness. The 

 practitioner should avoid basing his opinion on single symptoms, 

 or attaching too great weight to the indications of palpation. As 

 the striding movement is chiefly dependent on the action of the 

 shoulder muscles, it is naturally much interfered with, and therefore 

 shoulder lameness is generally characterised by difficulty in advancing 

 the swinging limb. The stride is shortened, and, as a rule, uncertain. 

 The foot is imperfectly lifted ; it tends to strike the ground, 

 especially when the surface is uneven, or when the foot meets with 

 obstacles. In leading the horse uphill, or in circling (especially if 

 the lame leg is inwards), lameness is generally more marked. The 

 limb, when being advanced, is not infrequently turned outwards. 

 Lameness appears equally on hard and soft ground — in fact, may even 

 be more marked on the latter. When trotting, the head is often 

 nodded in a pronounced way, but even this symptom is not constant. 

 It is generally present, however, in disease of the levator humeri, 

 and of the other extensors of the shoulder, because of the pain induced 



