PREVENTION, SYMPTOMS AND TREATMENT 279 



hyperemia is secured by suction, as cupping and the use of other suc- 

 tion apparatus, and also by placing an elastic ligature about a part 

 sufficiently tight to prevent the return of venous blood but not so 

 tight as to obstruct the arterial inflow. This latter method is the one 

 which has recently been employed in veterinary surgery and is the 

 method we will describe. 



Bier finds that passive hyperemia is useful in infections and 

 inflammations, particularly of limbs and joints, because of the fol- 

 lowing actions : 1. Bactericidal effect. 2. Relief of pain. 3. Res- 

 olution of inflammatory deposits and relief of stiffness in joints. 

 4. Arrest of absorption of toxins into circulation. 5. Shortening 

 or aborting infections. 



Methods of application. — A rubber Esmarch bandage, about 

 three inches wide and five feet long, is applied about the limb of a 

 horse, between the wound and the body, tight enough to produce a 

 warm edema below the bandage. The bandage is kept in place 

 twenty hours out of the twenty- four in severe cases ; or ten hours in 

 the twenty- four in milder infections. Just how tight to apply the 

 bandage is not possible to describe. In the human, relief of pain 

 and a red edema is the desideratum. In the horse, the chief point is 

 to avoid producing a cold limb because of too great constriction. 

 Some animals will bite or paw and so displace the bandage. The 

 rubber bandage should have tapes sewed on each end and is wrapped 

 about the limb and kept sufficiently tight by tying the two tapes to- 

 gether. The bandage is placed in the fore limb on the forearm 

 above the chestnut one day, and the next below the knee (on the 

 metacarpus), and so shifted from day to day. In the hind limb the 

 bandage is placed one day about the middle of the tibia and the next 

 day below the hock. It should always be placed as far proximally 

 from the lesion (that is, as near the body) as possible, but in the 

 horse it cannot be affixed at groin and axilla as in man. The 

 position of the bandage is shifted from day to day to avoid necrosis 

 of the skin. It is well to protect the rubber by a cloth bandage over 



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