CAPPED ELBOW 85 



ulcerated, and the swelling consists of an abscess cavity with very thick 

 walls. 



There are no important symptoms beyond the swelling. This, how- 

 ever, at times attains enormous proportions, and in rare cases the patient 

 may go lame. Rarely, however, is the articulation itself affected. 



Treatment depends upon the age of the injury. If the case is a recent 

 one, the injury having been inflicted within twenty-four hours, the swell- 

 ing will frequently subside and the fluid disappear by reabsorption by 

 assiduous fomentation of the part. If the skin has not become thickened 

 the swelling may be punctured and the contents discharged. The punc- 

 tured wound, however, should be kept patent by the insertion of a plug 

 of tow or cotton-wool to prevent its closing too soon, otherwise the 

 swelling will probably re-form. Setons are also frequently inserted with 

 the object of facilitating drainage. Soon after setoning the swelling 

 subsides, but after a few days it tends to become quite firm and hard, 

 owing to new generation of connective tissue with induration. 



When the swelling is of this nature, further treatment depends upon 

 the class of animal. Should the animal be one which can be readily 

 spared tor a length of time, and the growth is pedunculated, an elastic 

 ligature is frequently placed round the base of the growth. But this is 

 necessarily a slow process, and cannot be adopted in the majority of 

 cases. Moreover, in cases where the growths are very hard with broad 

 bases ligatures cannot be applied. Another method of treating such 

 cases is to puncture in two or three places, and introduce either the 

 actual cautery or a caustic injection. 



The surgical method of treating the affection is by excision. The 

 animal is cast or placed under a general or local anaesthetic. The usual 

 preliminary treatment of the part by shaving, washing, and disinfecting 

 is adopted, and two curved cutaneous incisions made which meet at 

 their extremities, so that a long elliptical piece of skin will be removed 

 with the growth. The skin is now dissected free from the growth. 

 During this dissection the edge of the blade should be directed 



