CAPPED ELBOW IN THE HORSE AND DOG. 
535 
(which may be somewhat assisted by torsion slowly performed), the 
surface of the wound should be cleansed daily with disinfectants until 
a dry scab has formed, under which healing occurs in eight to fourteen 
days, without leaving any considerable cicatrix. Formation of a scab 
will be promoted by powdering the parts with iodoform combined with 
tannin. 
Enucleation is not so simple as at the first glance it appears, but it is 
eminently “ surgical,” and Dollar prefers it in the majority of old-stand¬ 
ing cases. In this operation the horse must generally be cast, and if 
restless, placed under chloroform, though it is possible to remove large 
growths without casting by previously injecting a few minims of 5 per 
cent, cocain solution at a number of points around the base of the 
tumour. If the horse has been cast, the foot is loosened and drawn 
forward by two cords, or fastened by a modified “ side stick,” and a 
ligature passed through the swelling to afford a better hold. In shaving 
the parts an oval-shaped “ island ” of hair may be left to indicate the area 
of skin subsequently to be removed ; otherwise the skin may be displaced 
and the operator may make an asymmetrical incision (see p. 544). The 
tumour is next separated in the ordinary way. Care is required, however, 
to avoid injuring the fascia of the fore arm and the muscular tissue, which 
might easily produce cellular inflammation, nor should the point of the 
elbow be exposed. After removing the swelling, the wound is treated 
on general principles. As asepsis is not always possible, large vessels 
should be tied, and a firm tampon of carbolised jute sewn up in the 
wound to check bleeding. The tampon is removed next day, and open- 
wound treatment proceeded with. Bud, provided care is taken, relative 
asepsis can often be attained and much better results ensured. In this 
case Dollar carefully cleanses the interior of the wound, rinses it with 
1 in 1,000 biniodide of mercury solution, and powders it with iodoform, 
leaving the flaps open for six to twelve hours. When all bleeding has 
ceased and the surfaces are covered with a serous discharge, he unites 
the flaps with two series of sterilised silk sutures ; one set being used to 
bring together the edges of the skin, and the second set, consisting of 
two or three sutures only, being passed further from the edges and used 
to obliterate any “dead space.” If thought necessary, a drainage-tube 
is inserted. The horse is rested, and kept standing for eight days, or 
may be placed in slings. 
A similar disease occurs in large, heavy dogs, which, when lying on 
hard ground, support themselves on the sternum and elbows. The skin 
alone may be injured and thickened, or callosities form at the affected 
spot, but occasionally the bursa olecrani becomes diseased. The disease 
differs from that in horses, inflammation being almost always confined 
to the bursa, and parabursitis occurring very rarely, consequently the 
