TREATMENT OF CAPPED ELBOW IN THE HORSE. 
533 
immediate treatment the swelling may sometimes disperse, but more 
frequently it becomes chronic, resorption being incomplete, and indura¬ 
tion occurring in the parabursal tissue. When a large swelling disperses 
after existing for some time, a loose fold of skin remains, which detracts 
from the animal’s appearance. Resorption, however, is not infrequently 
prevented by repeating bruising. The animal may continually lie in the 
position described, injuring the bursa and its neighbourhood, and chronic 
thickening may occur in the parabursal connective tissue, rendering 
resorption impossible. 
When the skin is injured suppuration may occur in the bursa, and 
after some time be followed by fluctuation and perforation. Metastatic 
bursitis produced during strangles is always of this character. As the 
disease seldom causes lameness, prognosis in working-horses is always 
favourable as far as continued usefulness is concerned. The older the 
condition the less the chance of complete recovery, but firm swellings 
may be removed with the knife. 
Treatment. An excellent preventive consists in causing the horse to 
wear a stout cushion extending across the chest just behind the elbows. 
This cushion, if applied regularly every night, sometimes causes small 
capped elbows to disappear. Another mode of prevention is to apply a 
well-padded “ boot,” covering the heels, or to strap a thick straw pad 
extending above and below the knee to the back of the limb. This 
checks the animal when it attempts to flex^ the knee, and prevents it 
taking up the undesirable position. Fresh swellings are treated by cold 
applications, and if further bruising be prevented, complete dispersal 
often results. Resorption is assisted by repeatedly applying irritants, 
which favour resolution. At the same time they render the skin sore, and 
thus prevent the animal lying on the diseased spot and renewing the 
injury. A 10 per cent, iodide of mercury ointment maybe applied every 
two or three days. 
The bursa should not be opened except when pus is present. Where 
the lining has been destroyed by suppuration, recovery may occur, 
otherwise granulations do not form readily, on account of the peculiar 
nature of the bursal surface. More frequently, serous fluid is actively 
secreted, prevents the granulations around the incision healing, and 
finally leads to sinus formation. It is therefore necessary, when the 
bursa is opened before suppuration has occurred, to destroy the membrane 
by irritants. 
Stockfleth recommends swabbing out the sac daily with 1 part of 
caustic potash to 4 of water; the other parts of the leg must, of course, 
be protected against the irritant. The use of the actual cautery seems 
simpler. Stockfleth employs it to open the diseased bursa, thus prevent¬ 
ing the emphysema which sometimes follows incision. The bursa should 
