75.9 
DISEASES OF THE TENDONS AND TENDON SHEATHS. 
clot, which, however, cannot be detected by palpation. This explains 
why, in old-standing cases, neither blistering nor firing, nor even extrac¬ 
tion of the fluid contents and injection of iodine solution, is successful, 
and why operation and removal of the organised contents are alone of 
use. Such operation is quite safe, even when suppuration occurs. 
Recovery follows, after strict asepsis, though considerable thickening 
may be left. When the swelling is extensive, a portion of the distended 
bursa and skin covering it may be removed, the edges of the wound 
brought carefully together, and a com¬ 
press dressing applied (see also “ Treatment 
of Enlarged Synovial Cavities in the Fore 
Limb ”). 
Frick saw a peculiar affection of this bursa. 
The primary swelling and thickening of the walls 
of the bursa was unaccompanied by pain. Sup¬ 
puration followed, and a chocolate-coloured, thin, 
fluid pus, containing white flocculi, was dis¬ 
charged. Slight lameness was then shown (sup¬ 
porting leg lameness), and the granulations which 
surrounded the wound became rather exuberant. 
As the wound obstinately refused to heal the 
horse was killed. On post-mortem examination 
the bursal cavity was found to communicate with 
the fetlock-joint. Both contained turbid, choco¬ 
late - coloured fluid. The thickened synovial 
membrane was covered with fungous granula¬ 
tions, the cartilage of the fetlock-joint showed 
local ulceration, and the portions of bone thus 
exposed were granulating. Microscopical ex¬ 
amination of the discharges and granulations 
revealed the presence of tubercle bacilli. 
(e) Distension of the sesamoid sheath is 
commoner in the hind than in the fore 
limb. As a rule, it is caused by irritation, 
and appears slowly. Lameness, which is 
seldom troublesome, is rarelv seen unless the 
flexor tendons are affected ; but the swelling forms a blemish diffi¬ 
cult to remove. Careful local examination shows which condition is 
present, and should always be resorted to, as the lameness often dis¬ 
appears after long rest. Provided the swelling has not long been in 
existence, the parts should be tightly bandaged after work; massage 
often removes swelling in young horses, but firing is surer. The 
swelling should never be incised, for the result is often fatal. Removal 
of contents by Pravaz’s syringe, or by trochar, is only of temporary 
benefit ; nor does injection of iodine prevent resecretion, which may 
occur in a few minutes. The precautions to be observed in opening 
Fig. 284.- Distension of the 
metatarso-phalangeal (sesa¬ 
moid) sheath. 
