GRANULATIONS-—-CICATRICES., 197 
substance, which occupy regions in the neighborhood of natural openings, 
may be followed by deformities and accidents more or less serious. 
The large cutaneous cicatrices of the lower segments of the extremities 
bring sometimes, by their retraction, permanent deviations of the bony 
levers ; those situated near articulations interfere with movements; those 
of the coronary band deform the hoof, give rise to quarter-cracks and 
false quarters; others, developed in natural canals or in proximity with 
their openings, promote ectropion, contraction of the esophagus, rectum, 
anus or urethra. 
Among the deformities and the accidents due to cicatrices, there are 
some which can be prevented by more judicious selection of the therapeutic 
means applied to the original lesion, and by a close watching of the 
phenomena of cicatrization. The results obtained by Romary and Smith 
show that it is possible to prevent some deformities in animals by cu¢aneous 
grafting, which gives such happy results to man (Reverdin, Gosselin, Duplay, 
Ollier, Thiersch). 
Their curative treatment demands methods which vary according to 
cases : section of cicatricial bands, forced dilatation of obstructed orifices 
and canals, special operations, and the administration of iodide of potas- 
sium—a medication preferred to overcome sclerous processes. 
In certain regions where glabrous cicatrices are unsightly disfigure- 
ments on a horse, they can be removed by excising a long elliptical 
cutaneous flap, with the cicatrix in the center, and sewing, with silk or 
silkworm-gut suture, the edges of the new wound which have been made 
loose from the tissues underneath. To succeed in obtaining union by first 
intention in such an operation it is necessary to take all the necessary pre- 
cautions for perfect asepsis. 
This treatment can be advantageously applied to valuable horses having 
broken knees if their modes of standing are normal and their extremities 
solid. 
Treatment by operation upon broken knees goes back to 1829. Cherry? 
made the attempt of removing a carpal cicatrix by excision of a vertical, 
elliptical cutaneous flap, with the cicatrix in itscenter. In order to assist 
the sliding of the skin, he also made on each edge of the wound, at some 
distance from it, longitudinal incisions parallel to the borders of the wound. 
This was an application, to the therapeutics of broken knees, of the old 
method of autoplasty, or Celsu's method, used for the treatment of various 
affections of mankind. Cherry was partly successful with a donkey, but 
was “‘disappointed”’ in operating on a horse. Other attempts made by 
1 Cherry, on Broken Knees: The Farrier and Naturalist, 1829, pages 38, 358, 
372. 
