354 



bruise wliicli in fact does follow, and ^yllicll soon afterwards l3ecomes 

 characterized by a variety of symptoms — for a capped elbow does not 

 always exhibit the same aspect. In one case there is simply a bruise, 

 with symx3toms of inflammation more or less marked or severe. The 

 parts will be swollen, sometimes enormously, with heat and pain, the 

 swelling- not onl}^ covering the point of the elbow, but sometimes 

 reaching the axilla, and assuming such proportions that there is great 

 difficulty in using the leg, the animal showing signs of lameness even 

 to the extent of the circumflex step, as in shoulder lameness. This 

 cBdematous condition, liowever, does not x-emain stationary. It may 

 b}^ degrees subside or perhajis disappear. In the first instance it will 

 become more distinctly defined, v/ith better marked boundaries, until 

 it is reduced to a soft, round, fluctuating tumor, with or without heat 

 or pain. There is- then either a bloody or serous tumor or a purulent 

 collection, and following the puncture of its walls with the knife 

 there will be an escape of blood, of serum, or of pus, as the case may 

 be, in variable quantities. In either case, but principally in that of 

 the cj'stic form, the tumor will be found to be subdivided by septums 

 or bands running in various directions. 



Various changes will follow the opening of the tumor and the 

 escape of its contents. In a majority of cases, the process of cica- 

 trization will take place, and the cavity fill up by granulation, the 

 discharge, at first abundant, gradually diminishing and the wound 

 closing, usually without leaving any mark. At times, however, and 

 especially if the disease has several times repeated its course, there 

 may remain a x)endulous sac, partly obliterated, which a sufficient 

 amount of excitement or irritation may soon restore to its ijrevious 

 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 lady api)le 

 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 

 oedematous swelling which interferes Avith the work of the animal, maj'- 

 justify a much milder i^rognosis, and aside from their liability to 

 recur may be ranked with the comi^aratively harmless affections. 



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 of its prevention by curing the animal of his habit of resting 

 in the cow-like posture of sternal decubitus. To prevent the animal 



