343 



has several times repeated its course, there may remain a pendulous 

 sac, partly obliterated, which a sufficient amount of excitement or irri- 

 tation may soon restore to its i^revious 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 granu- 

 lations of the sac become fibrous in their structure and fill up the cav- 

 ity, 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 con- 

 tour, and may vary in size from that of a small lady 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 

 oedematus 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. 



So long as the danger of recurrence is the iDrincipal bad feature 

 of capped elbow, the most important cousideration is that of devis- 

 ing 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 from lying down is evidently the simplest method of 

 keeping the heels and the elbow apart. But the impracticability of this 

 prescription is apparent, since a majority of animals are obliged to lie 

 down when they sleep, though it is true that a few take their sleep on 

 their feet. The question 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 possi- 

 bility 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 con- 

 sidered 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 inter- 

 mitted, is considered. 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 cedematous 

 swelling, indicative by its external appearance and the existing inflam- 

 mation of the diseased condition, requires the use, without delay, of 

 all the means attainable for its abatement, with the accompanying pain 

 and the heat, with whatever may tend to accelerate the absorption of 

 the exudate. Warm fomentations, repeated several times daily, are then 



