DISEASES OF THE HOESE. 355 



closing. usiiall_y without leaviug- anj" mark. At times, however, and 

 especiallj^ if the disease has several times repeated its course, there 

 may remain a pendulous sac, partly- obliterated, which a sufficient 

 amount of excitement or irritation ma}' soon restore to its previous 

 dimensions and condition. 



In other cases an entirely different process takes place. The walls 

 of the cavity, cyst, or abscess become ulcerated and thickened, the 

 granulations of the sac become fibrous in their structure and fill up 

 the cavit}', and it assumes the character of a hard tumor on the back 

 of the elbow, sometimes partly and sometimes entirely covered by the 

 skin. It is fibrous in its nature, painless to the touch, well defined 

 in its contour, and may vary in size from that of a small apple to 

 that of a child's head. 



This last form of capped elbow is the most serious of any, resisting 

 all known forms of mild treatment, and removable by the knife only. 

 The other forms, even that with the inflammatory aspect and its large 

 edematous swelling which interferes with the work of the animal, may 

 justify a much milder prognosis, and, aside from their liability to recur, 

 may be ranked with the comparatively harmless affections. 



Treatment. — So long as the danger of recurrence is the principal bad 

 feature of capped elbow the most important consideration is that of 

 devising a means for its prevention. To prevent the animal from h'ing 

 down is evidently the simplest method of keeping the heels and the 

 elbow apart; but the impracticabilit}- of this prescription is apparent, 

 since a majority of animals are obliged to lie dowii when they sleep, 

 though it is true that a few take their sleep on their feet. The ques- 

 tion of shoeing here enters into the discussion. The shortening of the 

 inside branch of the shoe, which is the one with which the pressure is 

 made, may be of advantage, and especially if the truncated end of the 

 shoe is smooth and filed over to remove all possibility of pressure and 

 contusion upon the skin. The protection of the skin of the elbow by 

 interposing soft tissues between that and the shoe, or by bandaging the 

 heel with bags or covering it with boots, is considered by many the 

 best of the preventive methods, and the advantage to be secured by 

 resorting to it can not be overlooked when the number of horses which 

 develop shoe boil whenever the use of the boot is intermitted is con- 

 sidered. In order to prevent the animal from assuming the sternal 

 decubitus, many give preference to the plan of fastening a piece of 

 wood across the stall at some distance from the front wall or manger. 

 It is a simple expedient, primitive, perhaps, but nevertheless practical 

 and followed by good results. 



The therapeutic treatment is also important. The edematous swell- 

 ing, when recognized by its external appearance and the existmg 

 inflammation, should be treated without delay. Warm fomentations, 

 repeated several times daily, are then indicated, the degree of warmth 



