CAPPED ELBOW IN THE HORSE. 797 



a gauze drain inserted to prevent refilling. In spite of this treatment 

 some thickening remains and further bruising is followed by rapid 

 increase of the swelling which soon becomes indurated. Moller does 

 not advise opening the bursa except when it contains pus. Cadiot 

 considers that puncture is only useful when it is followed by destruction 

 of the cystic-lining — for which purpose he prefers the cautery ; while 

 others scrape the lining of the cavity with the curette. 



Stockfleth recommends swabbing out the cavity daily with 1 part 

 of caustic potash to 4 of water ; the other parts of the leg must, of 

 course, be protected against the irritant. The use of the actual 

 cautery seems simpler. Stockfleth employs it to open the inflamed 

 bursa, thus preventing the emphysema which sometimes follows 

 incision. The bursa should only be opened when pus exists in it, 

 or when its walls are very thin, and the contents fluid. Hardness 

 of the swelling shows that it principally consists of indurated 

 connective tissue, and treatment is then limited to destroying or 

 excising the newly-formed material. At one time the first method 

 was largely adopted, arsenic or other irritants, in the form of powder, 

 being passed through an incision as far as the centre of the swelling. 

 Necrosis occurred in the bursa and its surroundings ; after eight to 

 fourteen days, the swelling sloughed, and eventually the wound was 

 filled by granulations and healed. Though this method has certain 

 advantages, yet it may cause serious complications, and therefore 

 operative removal, either by dissection or by ligation, has latterly 

 received preference. 



Ligation is a simple and easy method, and is almost always 

 successful. When the tumour is sufficiently pedunculated to allow 

 an elastic ligature to be applied, it is the method most used by 

 Continental operators. After cutting away the hair and cleansing 

 the skin, a rubber cord, about the thickness of a quill, is passed round 

 the base of the swelling, and drawn as tight as possible. The ends 

 are tied together with string. The ligature soon begins to cut in, 

 and in four to ten days, according to the thickness of the tumour, 

 it falls away. In large tumours it may be necessary to remove and 

 reapply the ligature after two or three days. The surface of the 

 wound should meanwhile be cleansed daily and washed with 

 disinfectants such as sublimate or carbolic solution. On account 

 of its deodorising qualities, permanganate of potash is especially 

 useful. As a preventive measure, careful disinfection is advisable, 

 while at the same time it destroys the unpleasant smell of the mass 

 of dead tissue. Moller prefers passing the ligature over the skin, 

 which is not previously cut through ; the skin is thus drawn together, 



