614 DISEASES AND THEIR TREATMENT. 



After the acute signs of inflammation have subsided, if the lameness still re- 

 mains, the application of the so-called counter-irritants Will be rendered necessary. 

 These consist of rubefacients, blisters; setons, and the actual cautery. The actions 

 of these remedies differ only in degree, in rapidity, and in performance, not in the 

 nature of the exudation which they produce. Without entering into any speculative 

 discussion upon the question, superficial irritants are beneficial in all cases of chronic 

 lameness, whether it be caused by disease in bone, cartilage, ligament, tendon, or 

 any other structure ; and they are often more decidedly beneficial when applied to 

 the diseased structure itself than to the skin covering it: For example, a lameness 

 arises from bone spavin ; its eradication is much more certain and rapid when a 

 pointed cautery is applied to the diseased bones than when the hock is fired in the 

 ordinary way. Again, a spavin has been fired and blistered repeatedly without ben- 

 efit ; the bones are "punched" (a barbarous operation, and only to be performed in 

 extreme cases), violent inflammation is excited in the diseased bones, which for a 

 time increases the lameness; but this gradually subsides, and the original lameness is 

 found to be removed. 



I am of the opinion that the curative action of external irritants is not due to 

 their producing metastasis or counter-irritation ; but that they excite within the orig- 

 inally diseased structure a reparative inflammation, partaking in its nature of what 

 is described by Virchow as the " secretory inflammation," which, superseding the 

 original diseased process (whether that be inflammation pure and simple or its effects, 

 ulceration, caries, or a formation of a low form of fibrous tissues), excites the forma- 

 tion of reparative material by which the breaches are united, ulcers healed, and dis- 

 eased action removed. 



To illustrate this view, I will bring forward two familiar examples: 1. The heal- 

 ing of a sinus or fistula, after the application of a blister, or of the actual cautery to 

 the skin contingent to it ; and 2. The removal of phlebitis (inflammation of the vein 

 in the neck after bleeding) by a blister. 



In the first instance, we find that a sinus heals after a blister or cautery, by the 

 formation of an organizable exude, which completely fills up the cavity of the 

 sinus ; and, in the second. We find that a blister assists in the obliteration of the in- 

 flamed vein, hot by removing the inflammation from it, but by promoting the forma- 

 tion of a large quantity of reparative lymph, and hastening its further development 

 into fibrous tissues, by which the vessel is transformed at the inflamed part into a 

 fibrous cord. Now if the curative action were due to the removal of inflammation, 

 we should find that in the first case the relief would be only of a temporary nature, 

 the sinus would still remain, being generally the cause and not the effect of the 

 morbid action ; and in the second, that the inflammation being remoyed from the 

 coats of the veins, the vessel would, upon removal of the clot, become pervious. 

 But such is not the case. Let the clot be removed ever so often, -it is sure to form 

 again, and nothing has the power of overcoming the inflammation of the vessel until 

 it has been transformed into an organized cord, a process most materially hastened 

 by the application of a blister. 



I think it may therefore be accepted that external irritants — whether they be 

 simply rubefacients, producing a mere redness of the skin, vesicants or blisters, 

 which cause elevations of the cuticle' by fluid underneath it, or cauterization and 

 tetons, which promote the suppurative action — remove lameness by assisting nature 

 in a process of repair. 



Rubefacients may be employed in the less severe forms of lameness, in sprains of 

 tendons, or in slight affections of joints, along with rest and fomentations, after the 

 more acute symptoms have passed away. 



