798 TREATMENT OF CAPPED ELBOW IN THE HORSE. 



and cicatrisation reduced to a minimum. Should the application 

 of an elastic ligature prove difficult, on account of the tumour having 

 too broad a base, a thin cord may first be applied, as it does not so 

 readily slip off as the elastic ligature. In a few hours the tumour 

 swells, when an elastic ligature can be put on with ease. In case 

 of need, slipping may be prevented by passing a long needle 

 completely through the swelling in front of the ligature. 



In using the ligature, the remainder of the tumour must not be 

 cut away with knife or scissors, as bleeding may result. When a 

 cord is used, it will be necessary to tighten or renew it after a couple 

 of days. 



After-treatment is simple. As soon as the swelling has fallen 

 off (which may be somewhat assisted by torsion slowly performed), 

 the surface of the wound should be cleansed daily with disinfectants 

 until a dry scab has formed, under which healing occurs in eight 

 to fourteen days, without leaving any considerable cicatrix. 

 Formation of a scab will be promoted by powdering the parts with 

 iodoform combined with tannin. Until healing is complete, the horse 

 should remain in slings. 



Enucleation is eminently " surgical," and Dollar prefers it in 

 the majority of old-standing cases. In this operation the horse 

 must generally be cast, and if restless, placed under chloroform, 

 though it is possible to remove large growths without casting by 

 previously injecting a few minims of 5 per cent, cocaine solution 

 at a number of points around the base of the tumour. If the horse 

 has been cast, the foot is loosened and drawn forward by two cords, 

 or fastened by a modified " side stick," and a ligature passed through 

 the swelling to afford a better hold. In clipping or shaving the parts 

 an oval-shaped " island " of hair may be left to indicate the area 

 of skin subsequently to be removed ; otherwise the skin may be 

 displaced and the operator may make an asymmetrical incision. 

 The tumour is next separated in the ordinary way. Care is required, 

 however, to avoid injuring the fascia of the fore-arm and the muscular 

 tissue, which might easily produce cellular inflammation, nor should 

 the point of the elbow be exposed. After removing the growth, 

 the wound is treated on general principles. As asepsis is not always 

 possible, large vessels should be tied, and a tampon of carbolised 

 jute sewn up in the wound to check bleeding. The tampon is 

 removed next day, and open-wound treatment proceeded with. 

 But, provided care is taken, relative asepsis can often be attained 

 and much better results ensured. In this case Dollar carefully 

 cleanses the interior of the wound, rinses it with 1 in 1,000 biniodide 



