Chapter XIV (2)

Proprietors of horses thus injured are commonly very earnest in their solicitations for a professional opinion as to the extent and probable consequences of the accident. No certain judgment can, however, be pronounced, nor should one be given. Any surgical calculation, notwithstanding it may be most prudently qualified, is apt to be misconstrued by the anxiety of distress. The most guarded hint at a probability of recovery is too likely to be seized upon as a positive guarantee of perfect restoration; and the possible evils which may have been alluded to, confusion causes the individual not to remember. Therefore silence is wisdom in these cases, however slight the broken knee may appear in the first instance.

Broken knees are principally caused by the imprudence of him in whom authority is invested. Certain people imagine the public admire the man who chastises a horse. Such persons slash away for every trivial error. Every imaginary fault is punished with the whip, which too often curls around parts that should be respected. The animal, pained and frightened, thinks only of the slasher behind it, and entirely disregards the path upon which its eyes should be directed. The cutting is incessant, and the horse's pace is incautiously fast. An impediment is encountered; the animal trips; it is cast to the ground with violence, while the man is probably rendered fitter for a hospital than for the continuance of his travels.

Other riders and drivers always visit with severity the slightest indication of weak limbs. A sudden drop or a false step is, to such people, the signal for the reins to be jagged, the voice to be raised, and the whip to be freely exercised upon all parts of the animal's body, but mostly about the face and ears. The man likes to behold the poor creature shake its head, and loves to imagine he is then teaching the terrified quadruped to be careful. Equine pupils, no more than human scholars, are to be tutored by barbarity, which may slay the reason long before it can instruct the mind. Composure is imperative to the acquirement of any knowledge. Thrashing calls forth terror, and alarm is synonymous with confusion of mind. The horse is susceptible of a fear which humanity, happily, finds it difficult to conceive; and how far such a creature is calculated to be educated by cruelty, the intelligent reader is left to infer.

Could the animal argue, it might plead that the weakness objected to was caused by exertion made in man's service; that the stumbling gait was consequent upon no negligence on its part; that it afforded the beaten wretch no pleasure to have the knees broken, but, if the quadruped might profess a choice, it would prefer not falling down, etc. etc. If such pleas were properly considered, they perhaps might still the turbulence of the punisher.

The great majority of these injuries are consequent upon the prejudice or thoughtlessness of mankind. Popular admiration is, in this country, much in favor of a good crest. Every animal, no matter how nature may have formed the neck, must carry a good head. The rider, therefore, drags upon the bridle, while the form of nearly every gentleman's harness-horse is distorted by the bearing-rein. The constraint thus enforced not only obliges additional muscular action, but it disqualifies the animal to see the ground. In England there should be no objection to a blind horse, since such of the species as have eyes are, by the prejudices of society, seldom permitted to use them. The horse, being urged on when virtually blindfold, must of necessity stumble upon any unusual impediment being encountered. Such an accident shows no fault in the quadruped; but the man is truly responsible for those consequences which his folly has induced.

When a horse stumbles, never raise your voice--the creature dreads its master's chiding; never jag the reins--the mouth of the horse is far more sensitive than the human lips; never use the lash--the horse is so timid that the slightest correction overpowers its reasoning faculties. Speak to the creature; reassure the palpitating frame; seek to restore those perceptions which will form the best guard against any repetition of the faulty action. When the legs are weak, the greater should be the care of him who holds the reins. No cruelty can restore the lost tonicity of the limbs; therefore all slashing is utterly thrown away. If the reader regard his own safety, let him not, when riding, hold the head up, or, when driving, sanction the employment of a bearing-rein. No inhumanity can convert an animal with a ewe neck into the creature with a naturally lofty crest. The disguise of such a defect as a head badly placed on the neck is an impossibility. Therefore, if you are desirous of a well-carried head, think of it when making the purchase. Pay something more, and any kind of quadruped is obtainable; but be above the meanness which purchases for a low figure, and then endeavors to palm off its cheap article as a jewel procured at the highest price.

When a horse has been down, never judge of the injury by the first appearance. While the animal stands in the yard, order the groom to fetch a pail, with milk-warm water and a large sponge. With these he is to clean the knees--not after the usual coarse and filthy fashion now universal; not by first sopping the part, and then squeezing the soiled sponge into the pail whence more fluid is to be abstracted. The dabbing and smearing a wound simply irritates it; and the dirt, having all entered into the pail, the fluid is rendered unsuited to after cleanly purposes.

To perform the office properly, the knee should not be touched. The sponge should be saturated, then squeezed dry above the seat of injury. The water thus flows in a full stream over the part, and, by the force of gravity, carries away any loose dirt that may be upon the surface. Sopping, dabbing, wiping, and smearing occasion pain, and can remove nothing which may have entered the skin and which is protected from the action of the sponge by a covering of hair; whereas by the plan recommended the dirt is removed, the part is not debilitated, neither is its natural energy destroyed. The last drop of water, moreover, is as clean as was the first, and the animal is not irritated immediately prior to a surgical examination.

The wound being cleansed, a certain time should be allowed to elapse for the horse to recover its composure. It should return to the stable, have a feed of corn, and be watered. Then the real business commences. The animal should be gently approached; its condition should be observed. If any nervousness is exhibited, the person ought to retire, and a further pause should be allowed. If, on the second visit, any unusual symptoms are displayed, have the quadruped led into the yard and blindfolded. Let a man take up the other fore leg, when the knee may be examined with safety.

Place the palm of the hand over the joint. Hold it there to ascertain if any heat or swelling is to be detected. Should there be swelling, make gradual and gentle pressure upon it with the thumb or one finger. If, upon suddenly removing the hand, an indent is conspicuous, it argues considerable effusion, and justifies fear as to the result. Should neither heat nor swelling be remarked, further pressure is to be made with the thumb upon the knee. The force should be gentle at first and gradually increased. If the action is sustained well, or even moderately endured, it allows of hope being entertained. But should the horse attempt to rear upon the first impress of the thumb, the result is very dubious. The absence of agony is far from anything approaching to a positive proof, as bone and synovial membrane, tendon and ligament, do not take on acute inflammation when first injured; but, from the response thus elicited, a fair inference as to the probability may be drawn.

Should the skin be lacerated, the probe must be employed. Such injuries are very deceptive. They may be much more extensive than the size of the wound would indicate. The probe being of metal, ought not to be thrust violently against every exposed part. This kind of proceeding can effect no good. The probe should be held lightly between the thumb and fore finger; no pressure should be made upon it--the instrument ought rather to fall of its own gravity than be forced into the flesh. A thin piece of wire can be readily driven into soft structures; but where an actual division exists, no opposition necessitating force will be encountered.

Broken knees always happen when the horse is in motion. The onward impulse is not by the fall immediately destroyed; but after the horse is down there always exists an impetus which has a tendency to propel the body forward. Should the skin of the knees be divided by the fall, the after-force obviously cannot affect the upper line of such division; but the lower edge of skin will present an acute obstacle to the roughened ground, and will, by the grating of the body, in all probability be rent from its attachments. When the animal rises, the action and the elasticity natural to the integument will occasion the torn portion of the skin which has been driven backward to once more assume its original position. By this means a kind of bag or purse is formed upon the knee. Grit, mud, and all kinds of impurities may be retained and concealed within this pouch. These will be disposed to irritate the structure with which they are in contact; suppuration is certain to be established, and sad consequences have followed such sacs not being early detected.

Such a cavity having been discovered, the next object is to ascertain its dimensions. That is done by gradually moving the probe along its sides. Should it be small, it will be sufficient that a hole be made through its most depending portion with a sharp seton needle. If it be large, the needle should be armed with a piece of tape knotted at one end. The sac being punctured, the needle is to be drawn through the opening, the tape being left in the cavity, and a seton is thus formed. The seton should be knotted at the other end, and moved its entire length every night and morning. It will prevent all premature attempts to heal, will stimulate the soft parts to suppuration, and will remove the dirt, as the tape affords a guide to the secretion. When inserting a seton into the knee, always use a large curved needle. The size of the instruments should never be regulated by any foreign standard, but should always be proportioned to the magnitude of the patient and the intention of the operator.

Three days subsequent to the full establishment of suppuration, cut off one of the knots, and, laying hold of the other knot, withdraw the seton. Its advantages by this time are gained, and its longer stay, by hardening the opening through which it passed, would occasion lasting blemish.

The reason of its insertion is thus explained. Where foreign matter is confined, no wound will heal; the orifice may close, but soon after abscess forms. This process is repeated until the suffering is long protracted. Danger is generally proportioned to the duration of the evil, where wounds not of a mortal character are concerned. By the agency of the seton, the foreign matter is removed and the healing process thereby considerably expedited. After the above plan, all blemish may be lost by the expiration of the third month, and the once injured knee restored to its uses, being as fine as any other part of the body.

Everything being accomplished as it is here directed, no attempt must in the first instance be made to poke out any particle of dirt which the probe may touch. The bagging skin being divided by the seton having been established in the sac, no further thought need, for the present, be given to a common but most vexatious attendant upon the customary treatment for broken knees.

The animal should be returned to its usual stall and have the head "racked up." Some cold water should then be procured, with every quart of which two ounces of tincture of arnica should be blended. A portion of this fluid ought, with a clean sponge of moderate size, to be poured into a saucer; the groom must have strict orders to take the sponge, and, having saturated it with the fluid, to squeeze it quite dry, allowing the liquor to run over the injured knee--after the manner previously illustrated, as washing the wound. Two men are required for this office, which should be performed every half hour throughout the day and night for half a week. The injury being thus made continuously wet, the cold produced by evaporation keeps down inflammation, while the arnica is a potent remedy for bruises and all kinds of contusions or lacerations.

If at the expiration of the period named no swelling appears, and suppuration seems to be thoroughly established by means of the seton, the halter may be released to a great extent, a cradle being merely fixed upon the horse's neck; the animal will thereby be permitted to lie down and to enjoy its natural rest.

But should the joint be much enlarged, should the part have become acutely sensitive, while the horse resolutely refuses to bear any weight upon the injured limb, then withdraw the seton, give the animal two pots of stout per day, and all the oats mingled with old beans which it will consume. Untie the head and place the horse in slings; employ the arnica lotion night and day, until the slough is thrown off, which, having taken place, change the liquid application for the solution of chloride of zinc--one scruple to the pint of water--and continue to employ this last lotion after precisely the same manner as has been previously directed.

Probabilities, however remote they may seem to be, are here endeavored to be anticipated; although the author's experience cannot recall a single case where the arnica lotion has been used with proper assiduity, and any but the most happy results have followed. When an animal has fallen violently to the earth, and has been, in the first instance, shown to the writer with much tumefaction and excessive tenderness, a slough has in exceptional cases followed; but never has the enlargement or the sensitiveness increased under the proper use of the arnica lotion. The slough, moreover, in such instances, has been superficial, only entailing loss of hair, and never occasioning open joint.

All horses are exposed to these accidents for the reasons already stated. Whenever such misfortunes occur, employ the arnica lotion. Should the skin be divided, still use the arnica lotion until copious suppuration is established. The secretion once seen, resort to the lotion formed of chloride of zinc and water--one grain to the ounce--which operates most marvelously upon all suppurating wounds.

No absolute period can be stated which a case of broken knees, when severe, ought to occupy. The danger, however, is generally passed by the expiration of a week, and the cure commonly entails loss of services for a couple of months.

AN ORGANIZED KNEE, ENSUING AFTER A LONG COURSE OF THE ORDINARY
TREATMENT.
]

THE APPEARANCE OF THE KNEE SUBSEQUENT TO THE HEALING OF THE WORST
CASE THE AUTHOR EVER HAD UNDER HIS CARE.
]

When adopting the foregoing mode of treatment, no bandages are to be employed. Such wrappers only augment the heat inherent in every species of inflammation. They dam up the pus and speedily become foul and offensive rags; cleanliness is one of the primary requisites toward good surgery.

No caustics of any kind are imperative or even necessary. The two lotions, if used with proper zeal, will accomplish all that can be desired. The arnica lotion should, however, be in all cases applied night and day during the early stage; the chloride of zinc lotion ought to be employed only during the time man is usually out of bed.

The wound, in ordinary cases, should not be washed or touched. Should proud flesh start up, such is positive proof of the negligence of the groom, whose duty it was to apply the chloride of zinc lotion. If the mode of treatment here laid down be strictly pursued, the author can with confidence promise a satisfactory and a speedy cure. To enforce the value of the measures recommended, the portraits of two knees, which were subjected to the opposite processes, have been presented. Both were copied from living subjects in the sixth week after the misfortune had occurred.

OPEN SYNOVIAL CAVITIES.

The primary cause of these fearful accidents is the pride of mankind; gentility is always striving to impose upon credulity. It loves to be mistaken for something better than it really is. After all, this vice of society is nothing more than the child's game of "Lords and Ladies," played by grown-up persons. A horse having a naturally defective neck is obtained; no barbarity is too abhorrent to repress the hope of making people believe the steed thus deformed is a creature of extremest value. The animal, if ridden, has the chin pulled in close to the neck; if driven, the free carriage of the body is prevented by the cruel bearing-rein. The horse progresses in agony, while gentility sits smiling at the result of its artifice. The horse cannot see the ground before it, because of the constraint imposed upon the head; it cannot fix attention upon its duty, because of the agony which the cunning of gentility inflicts upon the lips. The pace is always rapid; the action is high as in the case of blindness; and the animal generally comes to the earth with violence. The skin upon the knees is divided, and the structures beneath are penetrated. One or more =synovial sheaths= are opened, while the cavities formed by the junction of the separate bones may be lacerated.

Sheath or joint may not be immediately opened by the fall, but either may have their integrity destroyed through the slough induced by the contusion consequent upon a broken knee. Moreover, various accidents will occasionally happen--misfortune is of infinite variety. The synovial bursæ, sheaths, or cavities of the hind legs are occasionally punctured by the quadruped kicking violently while in harness. The capsule, embracing the tendon of the flexor brachii upon the point of the shoulder, has been opened by the animal drawing a vehicle being run into; or by the horse running away and coming in contact with some obstacle. Any synovial cavity within the body may be penetrated by an unfortunate combination of circumstances; or by the unbridled passion of the groom, who may have a pitchfork near at hand. So also they have been cut into by the arrogance of unskillful operators. However, it matters not how the misfortune may arise, the mode of treatment and the manner of cure is in all such cases exactly the same.

Neither, as regards the primary effect, is it of subsequent importance whether air be admitted into an opened bursa or sac, a synovial sheath, or the interior of a joint. All of these structures are formed into bladders or closed cavities. They all contain a similar secretion, which is a transparent, albuminous fluid, resembling white of egg. They all are of one use, or all serve to facilitate motion. The bursa is the smallest; the synovial sheath is the next in magnitude; and joints may be much the largest. The secondary effects are proportioned to their size, but in the first instance much constitutional disturbance will attend the opening of each.

These structures are not formed to endure the presence of atmosphere; air is admitted a short time after each displays inflammation. This creates symptoms of irritability, and air will enter before we see the wound. The secondary effect is, however, most to be dreaded. Bursæ are small bladders, or closed sacs, distributed over the body, and located wherever the natural motions possibly might originate friction. Sheaths always embrace tendons, being essentially closed sacs. The secondary effects of tendinous sheaths are so much the more to be dreaded than those attending punctured bursæ, because the last generally lie loosely between highly-organized parts; whereas a sheath is partly fixed upon a tendon, and tendon, being lowly organized, is more difficult to cure when it is diseased. However, joints are much worse than the preceding two; because in these the synovial membrane is partly spread over the cartilage, which lies upon the articular surfaces of bones. Now, cartilage is the most lowly organized substance in the entire body. When disease fixes upon it the morbid condition is so slow, so irritating, and so difficult to eradicate, that science almost despairs of the issue.

The results indicated show that every effort should be made to ward off the secondary effect. Therefore, when an accident of this nature occurs, proceed with the utmost gentleness. Having procured a large sponge and a pail of milk-warm water, saturate the sponge and squeeze it dry, above the injury. Do not touch the sore, but allow the fluid, as it gravitates, to wash off all or any foreign matter. With regard to the wound, dirt seldom enters that. When it does, the suppuration which must ensue upon the accident will more effectually remove it than could hogsheads of water, however unfeelingly it might be employed.

The part having been rendered clean, the wound is to be attentively observed. When nothing but blood or serum, or thin, discolored fluid can be seen, this argues the more important structures are entire. Should there be among, and yet distinct from, those discharges, a transparent, glairy liquid flowing forth, such is absolute proof some synovial membrane has been severed. The size of the current and the abundance of the secretion are also evidences not to be despised. Probabilities may be inferred from these circumstances. If the amount of the synovia be small, there is hope that a bursa only has been interfered with; when the amount is large, it demonstrates that either a sheath is punctured or the joint itself may have been opened. Synovial cavities between bones may be larger, and are much more active than the sheaths of tendons; therefore the magnitude of the current should be observed; although, when the integrity of many parts has been destroyed, little absolute dependence will be placed upon the comparative quantity of the synovial secretion.

THE TENDONS WHICH CROSS THE OUTSIDE OF THE KNEE-JOINT.

Explanation of No 1.

1. The extensor metacarpi tendon.
2. The extensor metacarpi obliquus tendon.
3. The extensor pedis tendon.
4, 5, 7. Connecting and restraining bands between the tendons.
6. The extensor suffraginis tendon.
8. The flexor metacarpi externus tendon.
9. The back sinews.
]

THE TENDONS WHICH CROSS THE INSIDE OF THE KNEE-JOINT.

Explanation of No. 2.

1. The extensor metacarpi tendon.
2. The extensor metacarpi obliquus tendon.
3. The flexor metacarpi internus tendon.
4. The back sinews.

The letter _a_ denotes the only spot where the knee-joint could
probably be opened by a fall without lacerating a synovial sheath or
injuring a tendon.
]

Anatomy is, under the circumstances, a fair guide. Where numerous structures are involved, a well-grounded learning is requisite for accurate judgment; but as regards the knee of the horse, the spot whence the synovial discharge issues is of all importance. The incision must either be very deep and gaping, (all subjacent structures being divided before the knee-joint can be exposed,) or else the wound must affect a very circumscribed place. The reader, by consulting the above anatomical engravings of the horse's knee, will remark how closely it is laced about with tendon. Each of the tendons, when crossing the joint, is embraced in a synovial sheath. From such information, it will instantly be seen how far more likely a sheath is to be lacerated than the joint is to be punctured.

The single point where the joint could be entered without severing tendon, lies rather on one side than directly in the center. The vulnerable spot is therefore not exposed to the full force of the blow. To lay bare the joint by an ordinary fall several parts must be divided. Rarely is an accident witnessed of so fearful an extent. Generally that which is spoken of as open joint proves to be no more than punctured sheath, the presence of synovia being commonly accepted as the proof. But when the joint is really laid open, the immense flow of synovia--so many sheaths being severed--should at once prove the fact.

The probe must next be used. In the first instance it should be employed to ascertain whether the fall has left any purse or sac at the inferior part of the joint. All which was enforced respecting the use of metallic wire to a raw wound must here be observed. The probe had better be altogether discarded than employed with the smallest approach to rudeness.

THE MANNER OF OPENING THE DIRT SAC, IN CASE ONE SHOULD BE PRESENT
WITH OPEN JOINT.
]

The suspected sac having been discovered, a large spatula is placed below the knee. A knife with a keen point, but with the edge only sharpened for one-third of its length, is to be used. Upon the cutting point of the knife a piece of beeswax is firmly moulded. The wax answers the purpose of a temporary probe; the blade, thus guarded, is cautiously inserted beneath the loose flap of skin. When the bottom of the pouch is reached, a certain amount of resistance will be encountered; through this the knife is driven. The force cuts in twain the wax, and pushes through the integument the blade, which the spatula guides from the leg. This operation should be performed quickly; the hand should simply be carried downward, and then brought upward when all is concluded; care, however, being taken that the withdrawal of the knife does not injure any part save those it was designed to cut.

Should the horse be nervous, it is desirable to blindfold the animal and order the groom to hold up the sound leg; the creature can then only rear. When thus disabled, that movement is rendered difficult, and it is proportionably slow. The operation, if properly performed, should be over before action can be prepared for; and by the knife a considerable incision is made in the bottom of the sac, through which all grit or dirt can, with the pus, readily pass.

The examination concludes with a second resort to the probe. The instrument is in surgery of great use; but as it is commonly employed, reason may doubt whether injured life has been much benefited by its invention. It generally is raked and poked about as though the person holding it was determined, at all hazards, to ascertain the length, breadth, and every irregularity of the wound he is asked to cure; much harm is thereby done. Delicate attachments which, if not interfered with, might induce speedy reunion, are thus broken down, and the injury aggravated; while the operator thinks he ought to know all about the lesion he is to treat, and supposes that he can possibly do no harm with an instrument which the best schools order to be employed.

A good surgeon has no curiosity to gratify; all he desires to know is so much as will enable him to benefit the patient placed under his care. Therefore never abuse the probe in cases of open synovial cavities. Imagine the distance the bones are from the surface; and, if the probe can enter a very little beyond that distance, such a fact demonstrates the cavity to be exposed. When a horse is before you with synovia running from a wound upon the knee, have the leg slightly flexed; look for the most free space, and into that insert the probe. The bones of the knee-joint are directly under the skin; and, when no opposition is encountered for three-quarters of an inch, be sure the joint is exposed.

Most of the cases narrated as opened joints were simply punctures into synovial sheaths; as such, they were sufficiently serious, but not of so important a character as is assumed for them. Synovia is placed between the ends of bones, its use being to prevent the friction which otherwise would be occasioned by the movement of one hard body upon another. Being confined in a circumscribed sac and incapable of much compression, the liquid performs all the uses which could appertain to the most solid substance. When the fluid--which, from its thick appearance and unctuous feel, was formerly termed "joint oil"--has escaped, the bones grate against each other, inflammation ensues, all neighboring parts sympathize, and the constitution suffers from intense irritation.

THE INJURED LEG, HARD, HOT, TENSE, AND SWOLLEN--ALL RESULTING FROM
THE INJUDICIOUS EMPLOYMENT OF BANDAGES.
]

Something of this kind happens when a synovial sheath is punctured. The tendon comes in contact with its investing synovial membrane; but there are reasons why that circumstance is not so serious as when the lubricating fluid is released from the cavity of a joint. Tendons support no weight, and their motion is, with the sick, almost optional. The bones are the pillars on which the body rests; even while the frame is prostrated, a certain degree of pressure is upon them; for that reason, and also because tendon is more highly organized than cartilage, the first-mentioned substance is endowed with the greater renovating energy. An open joint is consequently far more serious than a punctured sheath.

Notwithstanding the serious nature of these accidents when wrongly treated, few injuries yield more kindly to proper measures than open joint. However, should the ordinary treatment of caustics and bandages be adopted, the entire limb, before the expiration of a week, will be hot, hard, and tense. The health of the animal will be seriously affected by the continued irritation, and the body will rapidly become emaciated. The foot of the limb will with evident difficulty be held from the ground. Should not death interpose--the animal being unable to lie down, and the entire weight being cast upon the sound limb--the foot attached to the healthy member frequently becomes affected with the worst form of incurable laminitis.

OSSEOUS STRUCTURE HAS BEEN THROWN OUT, CAUSING ENLARGED KNEE AND
PERMANENT BLEMISH--THE RESULTS OF USING BANDAGES.
]

EXTENSIVE LOSS OF HAIR, GENERAL ENLARGEMENT OF THE KNEE, AND
ORGANIZED THICKENING OF THE SCAR--RESULTING FROM THE USE OF
BANDAGES.
]

Even should such a misfortune as laminitis not occur, the after-deformity and blemish renders the horse almost worthless. The bones sympathize in the general disease, and a large osseous deposit is engendered to mark the surgical inaptitude. When bony growth does not follow, the parts lying immediately over the knee thicken; the skin sloughs, and, the integument never being restored, a full knee with a lasting blemish is the consequence.

OPEN SYNOVIAL JOINTS.

The more favorable terminations are never to be anticipated when the barbarity of bandages and the cruelty of caustics are sanctioned. The horse which recovers from such treatment is, by an enlarged and blemished limb, rendered an object painful to contemplate, and is entirely unsuited to any gentleman's uses, while the life of the creature is rendered burdensome. There is nothing in the proper treatment which a child might not safely apply. The measures create no pain and require no force; they rather soothe than irritate, and therefore are always submitted to with complacency.

OPEN JOINT ENSUING UPON BROKEN KNEE, AND SOLELY CAUSED BY THE ABUSE
OF BANDAGES.
]

THE GENERAL APPEARANCE OF AN OPEN JOINT WHEN FIRST SUBMITTED TO THE
NOTICE OF THE SURGEON.
]

The animal, when first brought in, never displays symptoms indicating the full extent of its injury. The part which has been wounded generally presents something like the aspect represented in the engraving on the right. Commonly there is an evident flow of synovia, but the most careful examination can seldom detect positive evidence of an open joint.

The full extent of the evil cannot be known before the slough takes place. This is certain to follow upon the customary bleeding, physicking, low diet, bandages, and caustics being employed. As recovery is wished for, all such aggravations must be rejected. Proceed, in the first instance, as has been directed for broken knee; and these things being done, give the following drink:--

Sulphuric ether One ounce.
Laudanum One ounce.
Water Half a pint.
Give this without noise or violence.

Treat the frightened animal with even more gentleness and patience than would be bestowed upon a sick child. A harsh word may now, when the system is shaken and every nerve unstrung, do that harm which no medicine can repair.

Having given the drink, look at the animal and take the pulse. Should the appearance denote inward comfort, should the pulse be natural, give no more drinks; but if the eye is in constant motion, if the horse breathe hard and start at sounds, if the head is held high and the ears are active, repeat the ethereal draught, and continue repeating it every hour until the foregoing symptoms abate.

The object of the medicine being gained, have the horse quietly led into a stall; the stall it has been used to is the best, and the favorite neighbor need not be removed. But all other quadrupeds which might disturb the sick animal should be taken out of the building. A good, clean bed should be shaken down, and the diet must be suited to the symptoms. If the pulse is at all low, no hay should be allowed till it amends; should the arterial beat denote oppression, a rather large proportion of beans may be blended with the oats. If the breathing is short, the countenance unhappy, and the eye sleepy, while a very quick and feeble pulse only is to be detected, give four of the ethereal drinks in the twenty-four hours. Also allow two quarts of stout daily.

All horses should be accustomed to drink beer; with very little teaching they abandon their teetotal habits, and will by very expressive action signify delight at the sight of a pewter pot. The best means of introducing the beverage to their notice is, in the first instance, to break a penny loaf into pieces, to soak the pieces in the beverage, and then to offer them, one by one, from the hand of the master or the favorite attendant. Animals quickly learn to recognize their owners. The dog will bestow such a welcome upon its proprietor as is never lavished upon any stranger. The horse also learns to recognize the individual whose property it has become. See the animal which has carried the groom without excitement to the door, and which has walked before the house with pendant head and listless ears: the moment the door opens and the master appears, all dejection is cast off; the creature cannot stand still when the foot is in the stirrup; and, immediately the weight is felt upon the back, the happy quadruped prances gayly off, often at the risk of unseating him who has provoked this demonstration of excessive pleasure.

The master who is unknown has earned his fate by his neglect, and probably may live to repent his inattention to the duties which Providence has intrusted to his charge. The affections of the meanest creature that breathes are blessings which the highest and the proudest may well stoop to gain. The love of a horse is not to be despised; the noble quadruped is easier controlled by its uncultivated impulses than by all the restraints which brutes have invented or fools have adopted. It should enter into the considerations of every life assurance company, whether the man who takes out a policy is of a nature likely to be loved by the animals which he possesses.

Beer is everywhere procurable, and it is not to be altogether contemned as a medicinal stimulant. Many a horse which is now lost upon every hard field-day would have been saved if the animal had been pulled up at the nearest public house to be presented with a slice of bread and a pint of beer. Such nourishment would not load the stomach; but it would serve to keep off that utter exhaustion from which too many steeds fail.

The animal being in its stall, then apply the lotion, composed of tincture of arnica, two ounces; water, one quart. Use this by means of a sponge and saucer. Pour some of the liquor into the receptacle. Saturate the sponge and squeeze the fluid upon the leg, but above the injured knee. Do this after the manner which is illustrated as the proper mode of washing the wounded part.

Continue with the arnica lotion, night and day, for half a week. No periods can be named for applying the sponge, as inflammations, and therefore the drying powers, vary in different individuals; but the knee should be always wet. This should be attended to for the first three days and a half, during which the halter should be tied to the rack. At the end of that time turn the horse very gently round. Remember the condition of the limb, and allow time for the performance of an action which is always an effort to the most agile of the equine species, as few stalls are a single inch too wide.

The animal being with its face to the gangway, and fastened by the pillar-reins, place the slings before it. Leave the creature to contemplate the apparatus for half an hour. Then take the cloth and hold it up to the inspection of the quadruped. Afterward place it between the fore and hind legs--pausing and speaking kindly should alarm be displayed. Thus by degrees fix it to the pulleys and bring it near to the abdomen, which, however, should by no means be touched. Then caress the creature's head, and present some of its favorite food: eating generally tranquilizes the mind of an animal. So much being done, proceed to fix the straps upon the chest and withers. Then fondle the sufferer again, and it will permit the hind tackle to be arranged.

When all is fixed, leave a pail of water suspended from one pillar, and put an elevated trough, charged with favorite provender, in front of the horse. Let it be watched till a week from the date of the injury has expired, and never left during that period even for an instant. If any restlessness is exhibited, the attendant should approach and caress the creature. Quadrupeds--though none comprehend the precise meaning of the language--love to be praised. The hand, fondly applied to the skin, and the human voice, modulated by kindness, seem to convey a purport to animals which they will suffer pain to deserve. The writer lately had a favorite dog, whose aversion was dry bread. It would hold the detested morsel in its mouth for hours, looking most uncomfortable, but making no attempt at mastication. Yet, upon praise being lavished, the eye would brighten, and, rather than prove unworthy of so much commendation, the hardest and stalest crust would be chewed and swallowed.

Watching is necessary, because many horses when thus imprisoned, being left alone, grow terrified and injure themselves by struggling their bodies out of the slings. The presence of any human being assures the timidity and checks the active imagination of a solitary animal. The author well knows that the learning of the present time denies imagination to animals. Shying, is only the creature imagining something which is not actually before it. What are dreams but positive evidences of imagination? All people have heard the suppressed bark and seen the excited limbs of the dog as it slept upon the hearth rug. How many grooms have been surprised, upon their earliest visit, to see the stable knocked to pieces and the horse prostrated amid the ruin it has created! How is this to be explained if imagination be not present in the animal? This is the author's interpretation of the mystery. Dreams are active, in proportion to the immaturity of the reason. Children often wake up in tears, and continue screaming in terror for long periods if unattended to. The horse starts out of a fearful vision; darkness is about it; the fear augments; the animal begins kicking; the sound made by its own feet increases the creature's alarm; it lashes out frequently until it has pounded part of its dwelling into atoms and disabled itself to that degree which makes the highest punishment the greatest mercy.

A high trough is required to guard against the effects of that itching which attends the healing process, and provokes the animal to strike its knees. This it would do against the manger were its head in the customary position. Were a wall before it, the knees might still be laid open; but with a high trough nothing is within the reach of its injured joint. Even supposing one of the slender supports, by the cunning of excitement, to be struck, the substance should be too light to offer any dangerous resistance, the blow being far more likely to overturn the machine than to lacerate the limb.

When the quadruped has remained sufficient time in the slings to have become familiar with them, pull up the cloth so that it may slightly touch but not press against the belly. Then well secure it, and leave the animal to rest its wearied limbs, or not, as it pleases. Its suffering joints will soon teach the horse to bear the entire weight upon such a support, and to sleep comfortably in the contrivance. With a few, and only a few examples, living in slings has induced such confirmed constipation as necessitated a daily resort to bran mashes. Most horses, however, speedily accept and grow fat, enjoying the relief thus afforded. Only one caution need be given--look well to the tackle. The horse is very heavy, and should a single fastening prove insecure, the result might convert a healing wound into a hopeless injury.

THE ALBUMINOUS BALL, WHICH FORMS IN SHAPE OF AN OPEN JOINT WHEN
TREATED WITH A SOLUTION OF CHLORIDE OF ZINC.
]

With the employment of slings, change the lotion for one composed of chloride of zinc, one scruple; water, one pint; this need be applied only during the day. It is too weak to occasion pain, and should be used with the saucer and sponge, after the manner of washing a broken knee or open joint, which has been previously illustrated. The strength, nevertheless, is sufficient to coagulate the albumen of the synovia. Thus it forms a species of natural bandage which excludes the air, while at the same time it stimulates the flesh and causes that to heal under the protection of its own albuminous secretion.

The coagulated albumen frequently accumulates in front of the knee. The author has seen it attached to the part quite of the size and very near to the form of the largest apple. It must on no account be touched, however large it may grow or however insecure it may appear. Respect it, and it will fall off when its service is accomplished. The cure is nearly completed when the white ball falls. Shortly after the wounds being closed, and pressure made with the fingers--not with the thumb--can be endured, the slings may be removed; though the healing should be further confirmed before the horse is allowed to stand opposite to any substance against which it may strike what recently has been a fearful open joint.

WOUNDS.

To this species of injury the horse is much exposed from the recklessness or incompetence of those who assume to hold the reins of authority. Occurrences which are politely termed "accidents," generally entail suffering upon the blameless animal. The common provocatives of such _accidents_ are either the drunkenness of man or his utter ignorance of the mental attributes of the quadruped he has possession of. The first cause shall be passed over in disgust; the second merits some consideration, being rather a universal than an individual fault.

When a horse pauses, always endeavor to ascertain the motive; the reason may be groundless. By gentleness, convince the creature that its fears are without foundation, and you earn a supremacy as well as win a gratitude which will always be cheerfully acknowledged. Never employ the whip to correct "the obstinacy of the brute." The horse is naturally very fearful; were it not so, man would never have obtained that mastery which is imperative for domestication. Elderly gentlemen should never thrust their heads out of carriage windows and shout to the driver to "go on." Such implied chiding may urge the coachman to display severity, and the horse is dangerous when alarmed. So long as the animal continues calm, the superiority of man is submitted to; but once excite the terror of the quadruped, and all earthly restraint is powerless. Dread assumes the form of the wildest fury, and the horse tears onward, insensible to mortal punishment and blind to every danger.

It is in this manner the most terrible wounds are produced. Such injuries, in surgical language, are defined to be "solutions of continuity," or "separations of the skin and soft parts underneath." Neither of these definitions, however, includes a bruise or a contused wound. Therefore, for the present purpose, a =wound= will be interpreted an injury inflicted by external violence.

A =lacerated wound= may be too trivial to attract the surgeon's notice, as a scratch. It may also be a very serious affair, as when a cart-wheel runs against a horse's thigh, tearing the flesh asunder. Laceration is generally accompanied by contusion, though contusion forms no necessary part of a lacerated wound. When such injuries are inflicted, they are mostly followed by little hemorrhage; yet it is far from unusual for an animal thus hurt to perish. Shock to the system is the most serious of the primary effects. Beyond that the immediate consequence appears to be insignificant. Little blood is lost, for the vessels are stimulated by the violence which rends these tubes and the soft structures asunder. Stimulation causes the torn mouths of the arteries and veins to close or to retract. The ragged coats of the vessels, the loose fibers of the flesh, and the jagged cellular tissue likewise fall over the orifices, and help to stay the flow of the vital current.

The dangers attending lacerated wounds spring, in the first instance, from collapse. This possibility being overcome, the immediate peril has been surmounted; all injuries of this nature are commonly attended, however, with more or less contusion. The force necessary to tear open a portion of the body will, of necessity, bruise or kill some part of the flesh. Any animal substance, when deprived of vitality, must be cast off by a living body; a slough must follow. Now that process is attended with hazard in proportion as it is tardily accomplished. The period of its occurrence is always one of anxiety; for when this process takes place, the stimulation that originally caused the vessels to retract no longer exists. All mechanical opposition to hemorrhage is, with the loss of the dead matter, generally removed. Everything, therefore, depends upon the fibrinous deposit--a sort of glutinous material secreted by the body, which is commonly largely poured forth when any slough by natural and speedy action is effected. Should the frame be so far debilitated as to prevent all secretion of fibrin, the most frightful bleeding must ensue.

The horse which has not recovered from the original injury will then sink under the terrible depletion. Therefore, it is impossible to form any opinion of the injurious effects or of the consequences likely to follow a lacerated wound before some time has elapsed.

An =incised wound= implies a division, more or less deep, of the soft parts. This form of injury produces less shock to the system, and generally heals more quickly than any other. The principal danger is encountered at the moment when the wound is inflicted; vessels may be sundered, and they are cut in twain with the least possible irritation to the parts within which they are situated. The veins and arteries, therefore, do not generally retract any more than do the soft structures. A gash into a fleshy substance always produces a gaping wound, which is wide in proportion to the depth and length of the injury. From that hurt the dark-colored venous blood drains in a stream, while the bright scarlet or arterial blood is propelled forth in jets, sometimes to a considerable distance. These jets correspond with the pulsations of the heart; but as syncope or fainting takes place, the emission ceases with the beating of the circulatory center.

The danger consequent upon an incised wound is ever measured by the extent of the hemorrhage. When large arteries are divided, that fact is easily told by the size and the force of the jets sent forth. A strong horse may, from that cause, be dead in ten minutes. To enforce the difference between a lacerated and an incised wound, the reader is reminded of those painful cases, frequently recorded in the newspapers, where a limb is by machinery torn from a poor man's body, and scarcely a drop of blood marks the deprivation; also of death by severing a throat, when sensation ceases ere the stream has flowed forth. The last is an incised, the first is a lacerated wound.

An =abraded wound=, in its mildest form, is simply a graze. The reader will, however, remember how acutely painful such accidents always are. The horse's sufferings are not highly estimated by the generality of people; nevertheless, an injury of this description is not to be despised, even when witnessed on the animal. A broken knee, as it generally is exhibited, is nothing more than an abrasion. An abraded wound may simply mean that the insensible outer covering of the skin has been injured; it may also imply that the soft structures beneath have been sundered. Wounds of this kind are not free from danger when of magnitude. Little blood may flow, but the cutis is the most sensitive structure of the entire body. A needle's point cannot enter any part of the skin without sensation warning the person of a puncture. In human operations, division of the skin, or separation of the cutis, is known to constitute the major portion of the patient's agony.

The suffering attendant on the latter class of injuries is increased by almost every abrasion forcing grit or dirt into the substance of the cutis. This, of course, is generally washed out. The torture accompanying a large abraded surface is, therefore, very great; and horses when suffering from accidents of such a nature sometimes sink from the irritation consequent upon the injury. When the animals survive, the roots of the hair too often have been destroyed, and a perpetual blemish is the result.

The engraving supposes the soft parts to have been divided, in order
to show the ragged nature and large extent of the injury, with
the comparatively small opening by which this amount of harm is
characterized.
]

A =punctured wound= is always dangerous; the hazard in this, as in every species of injury, is greatly increased when inflicted on parts liable to any vast amount of motion. Thus, punctures occurring over the stifle-joint too often set our best surgery at defiance. The muscles of the hind leg contract with every movement of the body. Added to that, the part abounds with fascia.

The majority of these wounds heal by suppuration. Fascia is a substance no pus can penetrate, and which is more easily rent than punctured. The exit of the secretion, therefore, is opposed in many directions, while the ceaseless motion occasions the matter to burrow. The sinuses thus produced are by the fascia guided to the stifle-joint; and, when once the synovial cavity is polluted by the intrusion of the unhealthy pus, all the best efforts of science are useless.

When a punctured wound occurs, the skin, being elastic, stretches before the instrument by which the wound is inflicted. The soft parts beneath the skin, not being elastic to the same degree as the integument, break down before the penetrating force. They are torn or lacerated; for generally the muscles receive a larger injury than would be calculated from the size of the instrument by which the blow was inflicted. The rent flesh must be cast off by a slough--corruption generally attends that process. Much of the pus secreted cannot find an exit through the opening in the skin; a large portion of it is confined within the puncture. There it decays, and, being impelled by the motion of the limb, readily finds its way in all directions save the upward one.

No judgment approaching to accuracy can be formed at the first sight of a punctured wound. The probe may ascertain the depth of the injury, but it cannot tell the extent of damage done to the interior of the body. Therefore, whether the hoof is pierced by a nail, or the muscles are lacerated by the shaft of a cart--be the instrument large or small--the consequences likely to follow upon the injury cannot be foretold.