320 



remained intact or may have been more or less extensively lacerated. 

 It seldom happens that more than one toe at a time will turn up, yet 

 still the lesion in one will be followed by its occurrence in another. 

 Commonly two feet of a biped, the anterior or posterior, are affected, 

 and we recall one case in which the two fore and one of the hind legs 

 were included at the same time. The accident, however, is quite as 

 likely to happen while the horse is at rest in his stall, and he may be 

 found in the morning standing on his fetlocks. One of the earliest of 

 the cases occurring in our own experience had been under our care for 

 several weeks for suspected disease of the fetlocks, the nature of which 

 had not been made out, when, apparently improved by the treatment 

 which he had undergone, the patient was taken out of the stable to be 

 walked a short distance into the countr3',but had little more than started 

 when he was called to a halt by the fracture of the sesamoids of both 

 fore legs. 



While there are no positive premonitory symptoms known of these 

 fractures we believe that there are signs and symptoms which come 

 but little short of being so, and the appearance of which will always 

 iustify a strong suspicion of the truth of the case. These have been 

 indicated when referring to the soreness in standing, the short " mine, 

 iug" gait, and the tenderness betrayed when pressure is made over the 

 sesamoids on the sides of the fetlock, with others less tangible and 

 definable. 



These injuries can never be accounted less than serious, and in our 

 judgment will never be other than fatal. If our theory of their pathol- 

 ogy is the correct one, and the cause of the lesions is truly the soften- 

 ing of the sesaraoidal bony structure and independent of any changes 

 in the ligamentous fibers, the possibility of a solid osseous union can 

 hardly be considered admissible. 



In respect to the treatment to be recommended and instituted it can 

 only be employed with any rational hope of benefit duriug the incuba- 

 tion, and with th-s anticipatory purpose of prevention. It must be sug- 

 gested by a suspicion of the verities of the case, and applied before any 

 rupture has taken place. To prevent this and to antagonize the causes 

 which might precipitate the final catastrophe — the elevation of the 

 toes — resort must be had to the slings and to the application of firm 

 bandages or splints, perhaps of plaster of Paris, with a high shoe, as 

 about the only indications which science and nature are able to offer. 

 When the fracture is an occurred event, and the toes, one or more, are 

 turned up, any further resort to treatment will be futile. 



DISEASES OF JOINTS. 



Three classes of injury will be considered under this head. These 

 are, affections of the synovial sac; those of the joint structures, or of 

 the bones and their articular surfaces, and those forms of solution of 

 continuity known as dislocations or luxations. 



