534 
CAPPED ELBOW IN THE HORSE 
only be opened either when pns exists in it, or when its walls are very 
thin, and the swelling is principally bursal. Hardness of the swelling 
shows that it principally consists of indurated connective tissue, and 
treatment is then limited to destroying or excising the newly-formed 
material. At one time the first method was largely adopted, arsenic or 
other irritant, in the form of powder or of small particles, being passed 
through an incision as far as the centre of the swelling. Gangrene 
occurred in the bursa and its surroundings; after eight to fourteen days, 
the swelling separated from the skin and sloughed, and the wound 
was filled by granulations and healed. Though this method has the 
advantage of not stopping the horse’s work, yet it may cause serious 
complications, and therefore operative removal, either by dissection or 
by ligation, has latterly received preference. 
Ligation is a simple and easy method, and is almost always successful. 
When the tumour is sufficiently pedunculated to allow a ligature to be 
applied, it is the method most used by Continental operators. The 
elastic ligature is most useful. After cutting away the hair and cleansing 
the skin, a rubber cord, about the thickness of a quill, is passed round 
the base of the swelling, and drawn as tight as possible. The ends are 
tied together with string. The ligature soon begins to cut in, and in 
four to ten days, according to the thickness of the tumour, it falls away. 
In large tumours it may be necessary to remove and reapply the ligature 
after two or three days. The surface of the wound should meanwhile 
be cleansed daily and washed with disinfectants such as sublimate, 
creolin, or carbolic solution. On account of its deodorising qualities, 
permanganate of potash is especially useful. Cases of tetanus are said 
to have occurred after ligation, but they are not common. As a pre¬ 
ventive measure, however, careful disinfection is advisable, while at the 
same time it destroys the unpleasant smell of the mass of dead tissue. 
Moller prefers passing the ligature over the skin, which is not previously 
cut through ; the skin is thus drawn together, and cicatrisation reduced 
to a minimum. Should the application of an elastic ligature prove 
difficult, on account of the tumour having no neck, a thin cord may first 
be applied, as it does not so readily slip off as the elastic ligature. In 
a few hours the tumour swells, when an elastic ligature can be put on 
with ease. In case of need, slipping may be prevented bypassing a long 
needle completely through the swelling in front of the ligature. 
In using the ligature, the remainder of the tumour must not be cut away 
with knife or scissors, as it always contains large arterial vessels, and 
bleeding of an unpleasant if not positively dangerous character may 
result. When a cord is used, it will be necessary to tighten or renew it 
after a couple of days. 
After-treatment is simple. As soon as the swelling has fallen off 
