LAMENESS: ITS CAUSES AND TREATMENT. 381 
Treatment—So long as the danger of recurrence is the principal 
bad feature of capped elbow the most important consideration is that 
of devising a means for its prevention. 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 ap- 
parent, since most animals are obliged to lie down when they sleep, 
though it is true that a few take their sleep on their feet. The ques- 
tion of shoeing here enters into the discussion. The shortening of 
the inside branch of the shoe, which is the one with which the pres- 
sure is made, may be of advantage, and especially if the truncated end 
of the shoe is smooth and filed over to remove all possibility 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 considered 
by many the best of the preventive methods, and the advantage to be 
obtained 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 never- 
theless practical, and followed by good results. 
The therapeutic treatment is also important. The edematous 
swelling, when recognized by its external appearance and the existing 
inflammation, should be treated without delay. Warm fomentations, 
repeated several times daily, are then indicated, the degree of warmth 
being as high as can be borne comfortably. They are easily applied 
and often yield decided relief in a few hours. In some cases, how- 
ever, astringents, in the form of poultices or pastes, are used in 
preference; these are made to cover the entire swelling and allowed 
to remain, drying after a short time, it is true, and perhaps falling 
off, but are easily renewed and reapplied. An excellent astringent 
for these cases is a putty made of powdered chalk and vinegar (ace- 
tate of lime), and the whole swelling is then covered with a thick 
coating of soft clay made into a mass with water. 
These simple remedies are often all that is required. Under their 
use the swelling passes off by degrees and after a short interval the 
animal is fit for work again, but not uncommonly instead a swelling 
develops, puffy, not painful, and perhaps giving a sensation of crepi- 
tation when pressure is applied with the finger. It is soft, evidently 
contains a liquid, and when freely opened with a good-sized incision 
discharges a certain quantity of blood, partly liquid and partly coag- 
ulated, and perhaps a little hemorrhage will follow. The cavity 
should then be well washed out and a plug of oakum introduced, 
leaving a small portion protruding through the cut to prevent it 
