INFLAMMATION OF TENDON, ETC., OF GLUTEUS MEDIUS MUSCLE. 667 
and that, under certain circumstances, disease may extend to the latter, 
seems mistaken. 
Symptoms. In recent acute inflammation there is increased warmth, 
swelling and pain on pressure over the great trochanter. When resting 
the limb is usually flexed, though sometimes no change can be detected 
until the horse is exercised. When moving, the forward stride is 
shortened ; less frequently, there is a tendency to lift the limb before the 
last phase of the stride is complete. The animal generally moves 
obliquely, as does the dog, the sound side being thrust forward, and the 
limb kept in a position of pronation, i . e ., rotated inwardly. By placing 
the hand on the middle trochanter during movement distinct crepitation 
may sometimes be detected (tendovaginitis crepitans) ; at a later stage 
the muscles of the quarter become atrophied. 
The slighter, and especially the chronic, forms of lameness are often 
only apparent when turning or when moving heavy loads, the horse then 
drawing with the sound leg, and endeavouring to shorten the period of 
loading of the diseased one. 
A similar form of lameness, however, is seen in other diseases, such 
as old cases of fractured pelvis ; the diagnosis must therefore be based 
principally on the local changes. The crepitation sound is the most 
trustworthy, for both the swelling and pain may be caused by the upper 
trochanter. 
Treatment. Recent cases, exhibiting acute inflammatory symptoms, 
are best treated by absolute rest, and cold applications, such as poultices 
or fomentations. Blisters may afterwards be used, and, if unsuccessful, 
can be followed by setons ; the actual cautery has been employed with 
good results. Rest should be continued for some time after the dis¬ 
appearance of lameness : too early a return to work is liable to be 
followed by relapse. Some horses only recover sufficiently for light 
draught. 
VI.—PARALYSIS OF THE HIND LIMB. 
Anatomy. The muscles of the hind limb receive their nerve supply from 
several sources, viz. : (1) the anterior and posterior gluteal nerves, which 
originate from the lumbo-sacral plexus and issue from the great sacro-sciatic 
opening in company with the gluteal vessels and great sciatic nerve ; (2) the 
great sciatic ; (3) the anterior crural; and (4) the obturator. 
The anterior gluteal nerves supply the three gluteal muscles and the tensor 
vaginse femoris ; the posterior gluteal, parts of the superficial and deep 
gluteal muscles, the biceps femoris, the skin at the back of the thigh 
at a point 4 or 5 inches below the tuber ischii, the semi-tendinosus muscle, 
and give off a branch to the internal pudic, which supplies the perineum. 
The great sciatic or ischiatic nerve originates from the lumbo-sacral 
plexus, and gives off branches in its passage down the limb to the 
obturator internus, pyriformis, gemelli and quadratus femoris. Its 
