760 
DISEASES OF THE METATARSUS. 
these swellings with the actual cautery are mentioned under “ Treatment 
of enlarged synovial cavities in the fore limb.” 
In the hind limbs such enlargements often become indurated, i.e., the 
tendon sheath is chronically thickened, sometimes to the extent of \ or 
f of an inch. As a rale, the flexor tendons are diseased, and there is 
lameness, which may become severe after hard work. It is best seen 
when weight is placed on the limb, and is accompanied by plantar flexion 
of the phalanges. The swellings are hard and immovable, the flexor 
tendons can scarcely be felt through them, and when the parts are firmly 
pressed the animal shows pain. 
Such enlargements are most troublesome in riding and draught 
horses, though, in other animals, they interfere with usefulness and 
sometimes render the horse unworkable ; they are little amenable to 
treatment. When recent, i.e., not more than a few weeks old, they may 
be diminished by the use of bandages, blisters, or firing, but later the 
sole means of removing the lameness is neurectomy of the posterior 
tibial nerve. Good results often follow this operation, but occasionally 
the flexor tendons become elongated, producing flexion of the hock ; in 
a case of Holler’s this was so marked as to prevent the animal being 
used. Hendrickx has had similar results. 
II.—INFECTIOUS INFLAMMATION OF THE LOWER 
SYNOVIAL SHEATH OF THE PERFORANS TENDON. 
Acute infectious inflammation of the above-named tendon sheath 
usually follows mechanical injuries like stabs with stable-forks, wounds 
from the plough, harrow or scythe, or contused wounds, the result of 
running away. It is usually attended with suppuration, and is particu¬ 
larly dangerous, because the tendons themselves are so frequently 
implicated. The symptoms consist in severe lameness, inability to 
stand on the limb, and discharge of a purulent synovia from the wound 
in the tendon sheath. There is usually cellulitis of the surrounding 
tissues. Fever is not infrequently present, and the animal lies 
continuously. 
The prognosis should be reserved, because death may follow either 
from general infection or as a result of the animal continuously lying- 
down, or, in the event of its standing, severe laminitis may develop in 
the opposite foot. When the tendon itself is injured the prognosis is 
always unfavourable, as necrosis almost always follows. Necrosis, how¬ 
ever, not infrequently occurs even without the tendon being wounded. 
Treatment may succeed if commenced early, and consists in the most 
careful disinfection of the parts ; in some cases it is advisable to operate 
and open the tendon sheath. 
