SHOULDER LAMENESS IN THE HORSE. 
481 
may be due either to strain or rheumatic cause. You ask, how 
could it be strained, and I answer that it usually occurs in pro¬ 
gression ; a foothold is taken which suddenly gives way, the 
limb being violently thrust backwards, the force of the impres¬ 
sion being thrown upon the fulcrum of the leverage. Or in 
rising from the recumbent position, the same may occur. 
Treatment. If of recent origin, hot fomentations and sweat¬ 
ing with hot blankets covered by impervious material, as rubber 
or oil-silk, in conjunction with anodyne liniments. In case this 
form of treatment should prove ineffectual within a week, or if 
the patient has been lame for one week or more prior to submis¬ 
sion to the veterinarian, resort should at once be had to strong 
counter-irritation. With me two setons are at once introduced 
into the shoulder, one on either side of the course of the superior 
third of the muscle ; these setons are usually anointed with a 
simple antiseptic ointment, or in case of chronic lesion or phleg¬ 
matic subject they are medicated with irritants. The counter- 
irritant response to setons is far superior to that from cantha- 
rides ointment or from the actual cautery in this region, and 
not nearly so apt to blemish, and furthermore the action may be 
kept up indefinitely by allowing them to remain in situ . When 
the setons have been removed and the tracts healed, the patient 
should be turned to pasture if in season; if during the winter 
months, exercise in a large paddock or barn-yard, or led to the 
halter. This period of passive exercise should be prolonged for 
about two months, or for a considerable time after all evidences 
of lameness have passed away. I lay particular stress upon 
secondary exercise for the reason that it is my conviction that 
recovery occurring under such conditions is very apt to be per¬ 
manent, while if accomplished in an attitude of perfect immobil¬ 
ity the lameness is prone to return when the horse is put to work. 
The prognosis is usually good, but the period of extended 
rest from active exercise after subsidence of the lameness must 
be insisted upon at the time the forecast is made. In a few 
instances structural changes occur and lameness is the per¬ 
manent result. 
