INJURIES TO THE MUSCLES AND FASCLE OF THE QUARTER. 925 



Treatment consists in the first stages in rest ; if pain be present, 

 hot fomentations often give relief ; at a later stage massage and 

 exercise are indicated, and if recovery is delayed, counter-irritation 

 may be tried. 



(6) Bruises and wounds are commonest in horses, especially in 

 winter, and are caused by kicks, or falls in the street. They also 

 result from thrusts with the carriage-pole, from collisions, or from 

 animals slipping in front of the carriage and being dragged or run 

 over. In army horses wounds and bruises result from falls, kicks, 

 lance thrusts, sabre cuts, or falling on the rider's spur. 



Blows may rupture large blood-vessels and produce extensive 

 hsematomata. Sometimes the skin and muscular tissue are torn 

 through. The biceps femoris is often the seat of such injury, and 

 in collisions the semi-tendinosus and semi-membranosus muscles 

 are liable to be extensively injured. In heavy horses, wounds from 

 stable-forks are often followed by septic cellulitis, which extends 

 and produces destruction of the intermuscular connective tissue of 

 the buttock, sometimes even necrosis of the tuber ischii. After the 

 cellulitis has subsided, sinuses may remain and give great trouble. 



Prognosis and treatment follow general principles, but one fact 

 should always be borne hi mind, viz., that the extravasation which 

 follows bruising, and sometimes violent over-extension of muscle is 

 seldom troublesome, if not too early incised. 



In fresh cases, continuous cold irrigations and complete rest are 

 most useful. By putting the patients to work or moving them too 

 early, fresh bleeding and increase of the hsematoma are favoured. 

 To assist resorption, small extravasations may, after the third or 

 fourth day, be treated by massage ; for larger ones, such treatment 

 is seldom beneficial, or takes longer than healing after puncture with 

 evacuation of the contents. Nevertheless, the knife should not be 

 used before the fifth or sixth day after the appearance of swelling, 

 partly because of the danger of after-bleeding, partly of infection and 

 cellulitis. In five to six days thrombus formation is so far completed 

 that bleeding is no longer probable, and the walls of the hematoma 

 are sufficiently infiltrated with plastic material as to check the 

 penetration of decomposition products. For the same reason, the 

 opening should be made at the lowest point, the cavity emptied of 

 coagulated blood as far as possible, and washed out with a disinfectant. 

 A drainage-tube may be necessary. By adopting these precautions 

 rapid healing is secured. Needless to say, careful disinfection is of 

 the greatest importance. 



(c) Wounds confined to the skin of the buttock often heal by 



