038 



DISEASES OF THE TENDONS AND TENDON SHEATHS. 





recorded show that perfect recovery is possible, even after acute 

 suppurative inflammation of this sheath. 



Chronic inflammation of this sheath is also seen in the horse. 

 The clinical symptoms are not well marked ; swelling is moderate, 

 because the connective tissue surrounding the sheath is not much 

 affected. At first, pain is not so great as in the acute disease, but 

 after a time the swelling breaks at some point and a turbid synovia, 

 which may be mixed with pus, is continually discharged. Much 



difficulty is found in closing the 

 wound in the sheath and in pre- 

 venting further infection . Healing 

 is almost always prolonged, and 

 often owing to necrosis one of the 

 tendons gives way. The condition 

 is then incurable, and slaughter 

 is advisable. 



A horse was stabbed in the heel 

 of the right hind foot with a manure- 

 fork, and severe lameness at once 

 set in. Being called the same day, 

 Moller, thoroughly cleansed the 

 wound, bathed the foot in creolin 

 solution, and in the evening applied 

 a large antiseptic dressing. The 

 skin wound healed by primary in- 

 tention, and pain diminished, though 

 lameness continued. Moller there- 

 fore employed for the next few days 

 moist warm applications, but the 

 case did not improve. The animal 

 was then regularly exercised, which 

 greatly diminished the lameness, 

 until one day pain returned in an 

 unusually severe form, and the 

 sheath of the flexor tendon was 

 found to be greatly distended just above the fetlock- joint, and very 

 painful on pressure. The parts were again bathed, and hot poultices 

 applied, but, as they gave no relief, blistering was resorted to. There 

 was, however, little improvement, the swelling persisting. The sheath 

 of the tendon was then opened under antiseptic precautions, allowing 

 the escape of a turbid fluid, which could only be distinguished from pus 

 microscopically, but which was then found to contain no micro-organisms. 

 The examination was made by various persons, and every precaution 

 was taken to avoid error. One peculiarity of this case is very remarkable, 

 viz., that in spite of the great distension of the tendon sheath the connective 

 tissue around it never became the seat of cellulitis. In purulent tendo- 

 vaginitis the tissues round the tendon sheath are almost always attacked 

 with active cellulitis, and in consequence are more or less markedly swollen. 



Pig. 556. — Rupture of the flexor pedis 

 perforans tendon (from a photograph). 



