341 



DISEASES OF MUSCLES AND TENDONS. 



SjJrains. — This term expresses a more or less complete laceration 

 or jaelcling of the fibers of the muscles, tendons, or the sheaths sur- 

 rounding and supporting them. The usual cause of a sprain is external 

 violence, such as a fall or a powerful exertion of strength, with fol- 

 lowing symptoms of soreness, heat, swelling, and a suspension of 

 function. Their termination varies from simple resolution to sup- 

 puration, and commonly plastic exudation difficult to remove. None 

 of the muscles or tendons of the body are exempt from liability to this 

 lesion, though naturally from their uses and the exposure of their 

 situation the extremities are more liable than other regions to become 

 their seat. The nature of the prognosis will be determined by a con- 

 sideration of the seat of the injury and the complications likely to 

 arise. The treatment will resolve itself into the routine of local 

 applications, including warm fomentations, stimulating liniments, 

 counter irritation by blistering, and in some cases even firing. Rest, 

 in the stable or in a box stall, will be of advantage by promoting 

 the absorption of whatever plastic exudation may have formed, or the 

 absorption may be stimulated by the careful and iDcrsevering applica- 

 tion of iodine in the form of ointments of various degrees of strength.- 



There are many conditions in which not only the muscular and 

 tendinous structures proper are affected by a sprain, but, by conti- 

 guity of parts, the periosteum of neighboring bones may become 

 involved, with a comx)lication of periostitis and its sequelse. 



Lameness of the shoulder. — The frequency of the occurrence of lame- 

 ness in the shoulder from sprains entitled it to precedence of mention 

 in our present category. For, though so well covered with its mus- 

 cular envelope, it is often the seat of injuries which, from the complex 

 structure of the region, become difficult to diagnosticate with satis- 

 factory precision and facility. The flat bone which forms the skeleton 

 of that region is articulated in a comparatively loose manner with 

 the bone of the arm, but the joint is, notwithstanding, rather solid, 

 and is jDOwerfuUy strengthened bj^ tendons passing outside, inside, and 

 in front of it. Still, shoulder lameness or sprain laay exist, origi- 

 nating in lacerations of the muscles, the tendons or the ligaments 

 of the joint, or perhaps in diseases of the bones themselves. " Slip of 

 the shoulder" is a phrase frequently applied to such lesions. 



The identification of the particular structures involved in these 

 lesions is of mucli imj^ortance, in view of its bearing upon the ques- 

 tion of prognosis. For example, while a simple superficial injury of 

 the spinatus muscles, or of the muscles by which the leg is attached 

 to the trunk, may not be of serious import and may readily yield to 

 treatment, or even recover spontaneously and without interference, 

 the condition is quite changed when a case of tearing of the flexor 

 brachii, or of its tendons as they pass in front of the articulation, 



