INFLAMMATION OF THE FLEXOR TENDONS. 845 



Old thickenings are best treated by firing. In this case the chief 

 effect is produced by the mechanical action of the inflammatory 

 swelling and cicatricial shrinkage in the cutis. The lines, running 

 obliquely from the front downwards and backwards, should not 

 be wider apart than half an inch, nor should they cross at the back 

 of the perforatus tendon. After the scab has fallen, the above- 

 described pressure dressing can be again applied. 



If, in old thickening of the tendons, firing is out of the question, 

 a compress dressing saturated with "water glass" solution is useful, 

 especially in small swellings, and where the animal cannot be rested, 

 but precautions must be taken against dirt or sand getting under it 

 and causing chafing. 



The animals must be kept from heavy work for some time, but 

 can be put to exercise as soon as lameness has quite disappeared. 

 During this stage riding-horses must be kept from jumping and 

 continued rapid trotting, nor should they ever be suddenly 

 pulled up. 



In shoeing horses with disease of the perforans, the heels should 

 be spared, the toe shortened as much as possible, and shoes with 

 calkins or thick heels used. For many years it has been disputed 

 whether raising the heels by calkins exercises any influence on the 

 angle of the phalanges towards the ground ; it now seems agreed 

 that this is certainly the case, for the pedal and coronet joints at 

 least, and for the former to a greater extent than for the latter. The 

 position of the fetlock-joint and the fetlock angle are, however, 

 scarcely affected by the dorsal flexion so produced in the pedal and 

 coronet joints ; raising the heels, therefore, has no effect on the 

 suspensory ligament, but it is useful in inflammation of the perforans 

 tendon. 



Tenotomy is the only method of treating severe " knuckling " 

 due to contraction of the tendons, but is only useful if no joint be 

 involved, and if the contracted tendon be not adherent to its sheath 

 or aponeurosis at some point below the seat of operation, because 

 in order to allow the fetlock to resume its normal position, the lower 

 end of the divided tendon must retract. Where the knee is 

 simultaneously bent, the upper portion of the tendon must also be 

 able to retract to allow the knee to straighten, but the operation 

 is then seldom of use because the bent position is due to shortening 

 in the flexor muscles of the knee and metacarpus. Tenotomy is 

 useless in rheumatic tendinitis, because of the extensive adhesions 

 existing between the tendons and aponeurosis. Before operating, 

 lameness must be allowed to subside, one of the conditions of success 



