QUITTOE. 381 



classes, as suggested by Girard : (1) Cutaneous quittor, which is 

 known also as simple quittor, skin quittor, and carbuncle of the coro- 

 net; (2) tendinous quittor; (3) subhorny quittor; and (4) cartilagi- 

 nous quittor. 



CUTANE017S QUITTOR. 



Simple quittor consists in a local inflammation of the skin and sub- 

 cutaneous connective tissue on some part of the coronet, followed by a 

 slough and the fonnation of an ulcer which heals by suppuration. 



It is an extremely' painful disease, owing to the dense character of 

 the tissues involved ; for in all dense structures the swelling which 

 accompanies inflanunation always produces intense pressure. This 

 pressure not only adds to the patient's suffering but may at the same 

 time endanger the life of the affected parts by strangulating the blood 

 vessels. It is held by some writers that simple quittor is most often 

 met with in the hind feet, but in my experience more than tAvo- 

 thirds of the cases have developed in the fore feet. While any part 

 of the coronet may become the seat of attack, the heels and quarters 

 are undoubtedly most liable. 



Causes. — Bruises and other wounds of the coronet are often the 

 cause of cutaneous quittor; yet there can be no question but that in 

 the great majority of cases the disease develops without any known 

 cause. For some reason, not yet satisfactorily explained, most cases 

 happen in the fall of the year. One explanation of this fact has 

 been attempted in the statement that the disease is due to the injuri- 

 ous action of cold and mud. This claim, however, seems to lose 

 force when it is remembered that in many parts of this country 

 the most mud, accompanied by freezing and thawing weather, is 

 seen in the early springtime Avithout a corresponding increase of 

 quittor. Furthermore, the serious outbreaks of this disease in the 

 mountainous regions of Colorado, AVyoming, and Montana are seen 

 in the fall and winter seasons, when the weather is the driest. It 

 may be claimed, and perhaps with justice, that during these seasons, 

 when the water is Ioav, animals are compelled to wade through more 

 mud to drink from lakes and pools than is necessar}'^ at other sea- 

 sons of the year, Avhen these lakes and pools are full. Add to these 

 conditions the further fact that much of this mud is impregnated 

 Svith alkaline salts, which, like the mineral sul)stances always found 

 in the mud of cities, are more or less irritating, and it seems fair to 

 conclude that under certain circumstances mud may become an im- 

 portant factor in the production of quittor." 



aA recent outbreak of quittor near Cheyenne. Wyo., which came under the 

 author's observation, was caused by the mud tlu-oujjh which the horses had to 

 wade to reach the watering troughs. These troughs were furnished with water 

 by windmills, and the iimd iiolcs wore caused by the waste water. More 

 than fifty cases developed inside of two months, or during September and 



