I made a post-mortem examination on a typical case of this disease, in which the animal had died on the fourth day after being found on the range slightly lame. The suffering had been intense, yet the only external evidences of the disease consisted in the shedding of the hoof from the right fore foot and a limited swelling of the leg to the knee. The sloughing of the hoof took place two or three hours before death, and was accompanied with but little suppuration and no hemorrhage. The skin from the knee to the foot was thickened from watery infiltration (edema), and on the inside quarter three holes, each about one-half inch in diameter, were found. All had ragged edges, while but one had gone deep enough to perforate the coronary band. The loose connective tissue beneath the skin was distended, with a gelatinous infiltration over the whole course of the flexor tendons and to the fetlock joint over the tendon in front. The soft tissues covering the coffin bone were loosened in patches by collections of pus which had formed beneath the sensitive laminae. The coffin and pastern joints were inflamed, as were also the coffin, navicular, and coronet bones, while the outside toe of the coffin bone had become softened from suppuration until it readily crumbled between the fingers. The coronary band was largely destroyed and completely separated from the other tissues of the foot. The inner lateral cartilage was gangrenous, as was also a small spot on the extensor tendon near its point of attachment on the coffin bone. Several small collections of pus were found deep in the connective tissue of the coronary region; along the course of the sesamoid ligaments; in the sheath of the flexor tendons; under the tendon just below the fetlock joint in front; and in the coffin joint.

But all cases of tendinous quittor are by no means so complicated as this one was. In rare instances the swelling is slight, and after a few days the lameness and other symptoms subside, without any discharge of pus from an external opening. In most cases, however, from one to half a dozen or more soft points arise on the skin of the coronet, open, and discharge slowly a thick, yellow, fetid, and bloody matter. In other cases the suppurative process is largely confined to the sensitive laminae and plantar cushion, when the suffering is intense until the pus finds an avenue of escape by separating the hoof from the coronary band, at or near the heels, without causing a loss of the whole horny box. When the flexor tendon is involved deep in the foot, the discharge of pus usually takes place from an opening in the follow of the heel; if the sesamoid ligament or the sheath of the flexors are affected, the opening is nearer the fetlock joint, although in most of these cases the suppuration spreads along the course of the tendons until the navicular joint is involved, and extensive sloughing of the deeper parts follows.

Treatment.—The treatment of tendinous quittor is to be directed toward the saving of the foot. First of all an effort must be made to prevent suppuration; if the patient is seen at the beginning, cold irrigation, recommended in the treatment for cutaneous quittor, is to be resorted to. Later, when the tumor is forming on the coronet, the knife must be used, and a free and deep incision made into the swelling. Whenever openings appear, from which pus escapes, they should be carefully probed; in all instances these fistulous tracts lead down to dead tissue which nature is trying to remove by the process of sloughing. If a counter opening can be made, which will enable a more ready escape of the pus, it should be done at once; for instance, if the probe shows that the discharge originates from the bottom of the foot, the sole must be pared through over the seat of trouble. Whenever suppuration has commenced the process is to be stimulated by the use of warm baths and poultices. The pus which accumulates in the deeper parts, especially along the tendons, around the joints, and in the hoof, is to be removed by pressure and injections made with a small syringe, repeated two or three times a day. As soon as the discharge assumes a healthy character and diminishes in quantity, stimulating solutions are to be injected into the open wounds. When the tendons, ligaments, and other deeper parts are affected, a strong solution of carbolic acid—1 to 4—should be used at first; or strong solutions of tincture of iodin, sulphate of iron, sulphate of copper, bichlorid of mercury, etc., may be used in place of the carbolic; after this the remedies and dressings directed for use in simple quittor are to be used. In those cases in which the fistulous tracts refuse to heal it is often necessary to burn them out with a saturated solution of caustic soda, equal parts of muriatic acid and water, or, better still, with a long, thin iron, heated white hot.

But no matter what treatment is adopted, a large percentage of the cases of tendinous quittor fail to make good recoveries. If the entire hoof sloughs away, the growth of a new, but soft and imperfect hoof may be obtained by carefully protecting the exposed tissues with proper bandages. When the joints are opened by deep sloughing, recovery may eventually take place, but the joint remains immovable ever after. If caries of a small part of the coffin bone takes place, it may be removed by an operation; but if much of the bone is affected, or if the navicular and coronet bones are involved in the carious process, the only hope for a cure is in the amputation of the foot. This operation is advisable only when the animal is valuable for breeding purposes. In all other cases in which there is no hope for recovery the patient's suffering should be relieved by death. In tendinous quittor much thickening of the coronary region, and sometimes of the ankle and fetlock, remains after suppuration has ceased and the fistulous tracts have healed. To stimulate the reabsorption of this new and unnecessary tissue, the parts should be fired with the hot iron, or, in its absence, repeated blistering with the biniodid of mercury ointment may largely accomplish the same results.

SUBHORNY QUITTOR.

This is the most common form of the disease. It is generally seen in but one foot at a time, and more often in the fore than in the hind feet. It nearly always attacks the inside quarter, but may affect the outside, the band in front, or the heel, where it is of but little consequence. It consists in the inflammation of a small part of the coronary band and adjacent skin, followed by sloughing and suppuration, which in most cases extends to the neighboring sensitive laminae.

Causes.—Injuries to the coronet, such as bruises, overreaching, and calk wounds, are considered as the common causes of this disease. Still, cases occur in which there appears to be no existing cause, just as in the other forms of quittor, and it seems fair to conclude that subhorny quittor may also be produced by internal causes.

Symptoms.—At the outset the lameness is always severe, and the patient often refuses to use the affected foot. Swelling of the coronet close to the top of the hoof causes the quarter to protrude beyond the wall. This tumor is extremely sensitive, and the whole foot is hot and painful. After a few days a small spot in the skin, over the most elevated part of the tumor, softens and opens or the hoof separates from the coronary band at the quarter or well back toward the heel. From this opening, wherever it may be, a thin, watery, often dark, offensive discharge escapes, at times mixed with blood and always containing a considerable percentage of pus.

Probing will now disclose a fistulous tract leading to the bottom of the diseased tissues. If the opening is small, there is a tendency upon the part of the suppurative process to spread downward; the pus gradually separates the hoof from the sensitive laminae until the sole is reached, and even a portion of this may be undermined.

As a rule, the slough in this form of quittor is not deep, and if the case receives early and proper treatment complications are generally avoided; but if the case is neglected, and, occasionally, even in spite of the best treatment, the disease spreads until the tendon in front, the lateral cartilage, or the coffin bone and joint as well are involved.

In all cases of subhorny quittor much relief is experienced when the slough comes away, and rapid recovery is made. If, however, after the lapse of a few days, the lameness remains and the wound continues to discharge a thin, unhealthy matter, the probabilities are that the disease is spreading, and pus collecting in the deeper parts of the foot. In Zundel's opinion, if the use of the probe now detects a pus cavity below the opening, a cartilaginous quittor is in the course of development.

Treatment.—Hot baths and poultices are to be used until the presence of pus can be determined, when the tumor is to be opened with a knife or sharp-pointed iron heated white hot. The hot baths and poultices are now continued for a few days or until the entire slough has come away and the discharge is diminished, when dressings recommended in the treatment for cutaneous quittor are to be used until recovery is completed. In cases in which the discharge comes from a cleft between the upper border of the hoof and the coronary band, always pare away the loosened horn, so that the soft tissues beneath are fully exposed, care being taken not to injure the healthy parts. This operation permits of a thorough inspection of the diseased parts, the easy removal of all gangrenous tissue, and a better application of the necessary remedies and dressings. The only objection to the operation is that the patient is prevented from being early returned to work.

When the probe shows that pus has collected under the coffin bone the sole must be pared through, and, if caries of the bone is present, the dead parts cut away. After either of these operations the wound is to be dressed with the oakum balls, saturated in the bichlorid of mercury solution, as previously directed, and the bandages tightly applied. Generally the discharge for the first two or three days is so great that the dressings need to be changed every 24 hours; but when the discharge diminishes, the dressing may be left on from one to two weeks. Before the patient is returned to work, a bar shoe should be applied, since the removed quarter or heel can only be made perfect again by a new growth from the coronary band.

Tendinous or cartilaginous complications are to be treated as directed under those headings.

CARTILAGINOUS QUITTOR.

This form of quittor may commence as a primary inflammation of the lateral cartilage, but in the great majority of cases it appears as a sequel to cutaneous or subhorny quittor. It may affect either the fore or hind feet, but is most commonly seen in the former. As a rule, it attacks but one foot at a time, and but one of the cartilages, generally the inner one. It is always a serious affection for the reason that, in many cases, it can only be cured by a surgical operation, requiring a thorough knowledge of the anatomy of the parts involved, and much surgical skill.

Causes.—Direct injuries to the coronet, such as trampling, pricks, burns, and the blow of some heavy falling object which may puncture, bruise, or crush the cartilage, are the common direct causes of cartilaginous quittor. Besides being a sequel to the other forms of quittor, it sometimes develops as a complication in suppurative corn, canker, grease, laminitis, and punctured wounds of the foot. Animals used for heavy draft, and those with flat feet and low heels, are more liable to the disease than others, for the reason that they are more exposed to injury. Rough roads also predispose to the disease by increasing liability to injury.

Symptoms.—When the disease commences as a primary inflammation of the cartilage, lameness develops with the formation of a swelling on the side of the coronet over the quarter. The severity of this lameness depends largely upon the part of the cartilage which is diseased, for if the disease is situated in that part of the cartilage nearest the heel, where the surrounding tissues are soft and spongy, the lameness may be very slight, especially if the patient is required to go no faster than a walk; but when the middle and anterior parts of the cartilage are diseased, the pain and consequent lameness are much greater, for the tissues are less elastic and the coffin joint is more liable to become affected.

Except in the cases to be noted hereafter, one or more fistulous openings finally appear in the tumor on the coronet. These openings are surrounded by a small mass of granulations which are elevated above the adjacent skin and bleed readily if handled. A probe shows these fistulous tracts to be more or less sinuous, but always leading to one point—the gangrenous cartilage. When cartilaginous quittor happens as a complication of suppurative corn, or from punctured wounds of the foot, the fistulous tract may open alone at the point of injury on the sole.

The discharge in this form of quittor is generally thin, watery, and contains pus enough to give it a pale-yellow color; it is offensive to the sense of smell, due to the detachment of small flakes of cartilage which have become gangrenous and are seen in the discharge as small, greenish-colored particles. In old cases it is not unusual to find some of the fistulous openings heal at the surface; this is followed by the gradual collection of pus in the deeper parts, forming an abscess, which in a short time opens at a new point. The wall of the hoof, over the affected quarter and heel, in very old cases becomes rough and wrinkled like the horn of a ram, and generally it is thicker than the corresponding quarter, owing to the stimulating effect which the disease has upon the coronary band.

Complications may arise by an extension of the disease to the lateral ligament of the coffin joint, to the joint itself, to the plantar cushion, and by caries of the coffin bone.

Treatment.—Before recovery can take place all the dead cartilage must be removed. In rare instances this is effected by nature without assistance. Usually, however, the disease does not tend to recovery, and active curative measures must be adopted. The best and simplest treatment, in a majority of cases, is the injection of strong caustic solutions, which destroy the diseased cartilage and cause its discharge, along with the other products of suppuration. In favorable cases these injections will secure a healing of the wound in from two to three weeks. While the saturated solution of sulphate of copper, or a solution of 10 parts of bichlorid of mercury to 100 parts of water, has given the best results in my hands, equally as favorable success has been secured by others from the use of caustic soda, nitrate of silver, sulphate of zinc, tincture of iodin, etc. No matter which one of these remedies may be selected, however, it must be used at least twice a day for a time. The solution is injected into the various openings with force enough to drive it to the bottom of the wound, after which the foot is to be dressed with a pad of oakum, held in place by a roller bandage tightly applied. While it is not always necessary, it is often of advantage to relieve the pressure on the parts by rasping away the hoof over the seat of the cartilage; the coronary band and laminae should not be injured in the operation.

If the caustic injections prove successful, the discharge will become healthy and gradually diminish, so that by the end of the second week the fistulous tracts are closing up and the injections are made with much difficulty.

If, on the other hand, there is but little or no improvement after this treatment has been used for three weeks, it may reasonably be concluded that the operation for the removal of the lateral cartilage must be resorted to for the cure of the trouble. As this operation can be safely undertaken only by an expert surgeon, it will not be described in this connection.

THRUSH.

Thrush is characterized by an excessive secretion of unhealthy matter from the cleft of the frog. While all classes of horses are liable to this affection, it is more often seen in the common draft horse than in any other breed, owing to the conditions of servitude and not to the fault of the breed. Country horses are much less subject to the disease, except in wet, marshy districts, than are the horses used in cities and towns.

Causes.—The most common cause of thrush is the filthy condition of the stable in which the animal is kept. Mares are more liable to contract the disease in the hind feet when filth is the cause, while the gelding and stallion are more liable to develop it in the fore feet. Hard work on rough and stony roads may also induce the disease, as may a change from dryness to excessive moisture. The latter cause is often seen to operate in old track horses, whose feet are constantly soaked in the bathtub for the purpose of relieving soreness. Muddy streets and roads, especially where mineral substances are plentiful, excite this abnormal condition of the frog. Contracted heels, scratches, and navicular disease predispose to thrush, while by some a constitutional tendency is believed to exist among certain animals which otherwise present a perfect frog.

Symptoms.—At first there is simply an increased moisture in the cleft of the frog, accompanied with an offensive smell. After a time a considerable discharge takes place—thin, watery, and highly offensive, changing gradually to a thicker puriform matter, which rapidly destroys the horn of the frog. Only in old and severe cases is the patient lame and the foot feverish—cases in which the whole frog is involved in the diseased process.

Treatment.—Thrushes are to be treated by cleanliness, the removal of all exciting causes, and a return of the frog to its normal condition. As a rule, the diseased and ragged portions of horn are to be pared away and the foot poulticed for a day or two with boiled turnips, to which may be added a few drops of carbolic acid or a handful of powdered charcoal to destroy the offensive smell. The cleft of the frog and the grooves on its edges are then to be cleaned and well filled with dry calomel and the foot dressed with oakum and a roller bandage. If the discharge is profuse, the dressing should be changed daily; otherwise it may be left on two or three days. Where a constitutional taint is supposed to exist, with swelling of the legs, grease, etc., a purgative, followed by dram doses of sulphate of iron, repeated daily, may be prescribed. In cases where the growth of horn seems too slow a Spanish-fly blister applied to the heels is often followed by good results. Feet in which the disease is readily induced may be protected in the stable with a leather boot. If the thrush is but a sequel to other disease, a permanent cure may not be possible.

CANKER.

Canker of the foot is due to the rapid reproduction of a vegetable parasite. It not only destroys the sole and frog, but, by setting up a chronic inflammation in the deeper tissues, prevents the growth of a healthy horn by which the injury may be repaired. Heavy cart horses are more often affected than those of any other class.

Causes.—The essential element in the production of canker is the parasite; consequently the disease may be called contagious. As in all other diseases due to specific causes, however, the seeds of the disorder must find a suitable soil in which to grow before they are reproduced. It may be said, then, that the conditions which favor the preparation of the tissues for a reception of the seeds of this disease are simply predisposing causes.

The condition most favorable to the development of canker is dampness—in fact, dampness seems indispensable to the existence and growth of the parasite; the disease is rarely, if ever, seen in high, dry districts, and is much more common in rainy than in dry seasons. Filthy stables and muddy roads have been classed among the causes of canker; but it is very doubtful whether these conditions can do more than favor a preparation of the foot for the reception of the disease germ.

All injuries to the feet, by exposing the soft tissues, may render the animal susceptible to infection; but neither the injury nor the irritation and inflammation of the tissues which follow are sufficient to induce the disease.

For some unknown reason horses with lymphatic temperaments—thick skins, flat feet, fleshy frogs, heavy hair, and particularly with white feet and legs—are especially liable to canker.

Symptoms.—Usually, canker is confined to one foot; but it may attack two, three, or all of the feet at once; or, as is more commonly seen, the disease attacks first one then another, until all may have been successively affected. When the disease follows an injury which has exposed the soft tissues of the foot, the wound shows no tendency to heal, but instead there is secreted from the inflamed parts a profuse, thin, fetid, watery discharge, which gradually undermines and destroys the surrounding horn, until a large part of the sole and frog is diseased. The living tissues are swollen, dark colored, and covered at certain points with particles of new, soft, yellowish, thready horn, which are constantly undergoing maceration in the abundant liquid secretion by which they are immersed. As this secretion escapes to the surrounding parts, it dries and forms small, cheesy masses composed of partly dried horny matter, exceedingly offensive to the sense of smell. When the disease originates independently of an injury, the first evidences of the trouble are the offensive odor of the foot, the liquid secretion from the cleft and sides of the frog, and the rotting away of the horn of the frog and sole.

In the earlier stages there is no interference with locomotion, but later the foot becomes sensitive, particularly if the animal is used on rough roads, and, finally, when the sole and frog are largely destroyed the lameness is severe.

Treatment.—Since canker does not destroy the power of the tissues to produce horn, but rather excites them to an excessive production of an imperfect horn, the indications for treatment are to restore the parts to a normal condition, when healthy horn may again be secreted. In my experience, limited though it has been, the old practice of stripping off the entire sole and deep cauterization, with either the hot iron or strong acids, is not attended with uniformly good results.

I am of the opinion that recovery can generally be effected as surely and as speedily with measures which are less heroic and much less painful. True, the treatment of canker is likely to exhaust the patience, and sometimes the resources, of the attendant; but after all success depends more on the persistent application of simple remedies and great cleanliness than on the special virtues of any particular drug.

First, then, clean the foot with warm baths and apply a poultice containing powdered charcoal or carbolic acid. A handful of the charcoal or a tablespoonful of the acid mixed with the poultice serves to destroy much of the offensive odor. The diseased portions of horn are to be carefully removed with sharp instruments, until only healthy horn borders the affected parts. The edges of the sound horn are to be pared thin, so that the swollen soft tissues may not overlap their borders. With sharp scissors cut off all the prominent points on the soft tissues, shorten the walls of the foot, and nail on a broad, plain shoe. The foot is now ready for the dressings, and any of the many stimulating and drying remedies may be used; but it will be necessary to change frequently from one to another, until finally all may be tried.

The list from which a selection may be made comprises wood tar, gas tar, petroleum, creosote, phenic acid; sulphates of iron, copper, and zinc; chlorid of zinc, bichlorid of mercury, calomel, caustic soda, nitrate of silver, chlorid of lime; carbolic, nitric, and sulphuric acids.

In practice I prefer to give the newly shod foot a bath for an hour or two in a solution of the sulphate of iron made by adding 2 ounces of the powdered sulphate to a gallon of cold water. When the foot is removed from the bath it is dressed with oakum balls dipped in a mixture made of Barbados tar 1 part, oil of turpentine 8 parts, to which is slowly added 2 parts of sulphuric acid, and the mixture well stirred and cooled. The diseased parts being well covered with the balls, a pad of oakum sufficiently thick to cause considerable pressure is placed over them, and all are held in place by pieces of heavy tin fitted to slip under the shoe. The whole foot is now incased in a boot or folded gunny sack and the patient turned into a loose, dry box. The dressings are to be changed daily or even twice a day at first. When they are removed, all pieces of new horny matter which are now firmly adherent must be rubbed off with the finger or a tent of oakum. As the secretion diminishes, dry powders, such as calomel, sulphates of iron, copper, etc., may prove of most advantage. The sulphates should not be used pure, but are to be mixed with powdered animal charcoal in the proportion of one of the former to eight or ten of the latter. When the soft tissues are all horned over, the dressings should be continued for a time, weak solutions being used to prevent a recurrence of the disease. If the patient is run down in condition, bitter tonics, such as gentian, may be given in 2-dram doses twice a day and a liberal diet of grain allowed.

CORNS.

A corn is an injury to the living horn of the foot, involving the soft tissues beneath, whereby the capillary blood vessels are ruptured and a small quantity of blood escapes which, by permeating the horn in the immediate neighborhood, stains it a dark color. If the injury is continuously repeated, the horn becomes altered in character and the soft tissues may suppurate or a horny tumor develop. Corns always appear in the sole in the angle between the bar and the outside wall of the hoof. In many cases the laminae of the bar, of the wall, or of both, are involved at the same time.

Three kinds of corns are commonly recognized—the dry, the moist, and the suppurative—a division based solely on the character of the conditions which follow the primary injury.

The fore feet are almost exclusively the subjects of the disease, for two reasons: First, because they support a greater part of the body; secondly, because the heel of the fore foot during progression is first placed upon the ground, whereby it receives much more concussion than the heel of the hind foot, in which the toe first strikes the ground.

Causes.—It may be said that all feet are exposed to corns, and that even the best feet may suffer from them when conditions necessary to the production of the peculiar injury are present. The heavier breeds of horses generally used for heavy work on rough roads and streets seem to be most liable to this trouble. Mules rarely have corns.

Among the causes and conditions which predispose to corns may be named high heels, which change the natural relative position of the bones of the foot and thereby increase the concussion to which these parts are subject; contracted heels, which in part destroy the elasticity of the foot, increase the pressure upon the soft tissues of the heel, and render lacerations more easy; long feet, which by removing the frog and heels too far from the ground deprive them of necessary moisture; this, in turn, reduces the elastic properties of the horn and diminishes the transverse diameter of the heels; weak feet, or those in which the horn of the wall is too thin to resist the tendency to spread, whereby the soft tissues are easily lacerated. Wide feet with low heels are always accompanied with a flat sole whose posterior wings either rest upon the ground or the shoe, and as a consequence are easily bruised; at the same time the arch of the sole is so broad and flat that it can not support the weight of the body, and in the displacement which happens when the foot is rested upon the ground the soft tissues are liable to become bruised or torn.

It is universally conceded that shoeing, either as a direct or predisposing cause, is most prolific in producing corns. One of the most serious as well as the most common of the errors in shoeing is to be found in the preparation of the foot. Instead of seeking to maintain the integrity of the arch, the first thing done is to weaken it by freely paring away the sole; nor does the mutilation end here, for the frog, which is nature's main support to the branches of the sole and the heels, is also largely cut away. This not only permits of an excessive downward movement of the contents of the horny box, but it at the same time removes the one great means by which concussion of the foot is destroyed. As adjuncts to the foregoing errors must be added the faults of construction in the shoe and in the way it is adjusted to the foot. An excess of concavity in the shoe, extending it too far back on the heels, high calks, thin heels which permit the shoe to spring, short heels with a calk set under the foot, and a shoe too light for the animal wearing it or for the work required of him, are all to be avoided as causes of corns. A shoe so set so as to press upon the sole or one that has been on so long that the hoof has overgrown it until the heels rest upon the sole and bars becomes a direct cause of corns. Indirectly the shoe becomes the cause of corns when small stones, hard, dry earth, or other objects collect between the sole and shoe. Lastly, a rapid gait and excessive knee action, especially on hard roads, predispose to this disease of the feet.

Symptoms.—Ordinarily a corn induces sufficient pain to cause lameness. It may be intense, as seen in suppurative corn, or it may be but a slight soreness, such as that which accompanies dry corn. It is by no means unusual in chronic corns to see old horses apparently so accustomed to the slight pain which they suffer as not to limp at all. But they are generally very restless. They paw their bedding behind them at night and often refuse to lie down for a long rest. The lameness of this disease, however, can hardly be said to be characteristic, for the reason that it varies so greatly in intensity; but the position of the leg while the patient is at rest is generally the same in all cases. The foot is so advanced that it is relieved of all weight, and the fetlock is flexed until all pressure by the contents of the hoof is removed from the heels. In suppurative corn the lameness subsides or entirely disappears as soon as the abscess opens. When the injured tissues are much inflamed, as may happen in severe and recent cases, the heel of the affected side, or even the whole foot, is hot and tender to pressure. In dry corn and in most chronic cases all evidences of local fever are often wanting. It is in these cases that the patient goes well when newly shod, for the smith cuts away the sole over the seat of injury until all pressure by the shoe is removed and lowers the heels so that concussion is reduced to a minimum.

If a corn is suspected, the foot should be examined for increased sensibility of the inside heel. Tapping the heel of the shoe with a hammer and grasping the wall and bar between the jaws of pincers with moderate pressure will cause more or less flinching if the disease is present. For further evidence the shoe is removed and the heel cut away with the drawing knife. As the horn is pared out, not only the sole in the angle is found discolored, but in many instances the insensible laminae of the bar and wall adjacent are also stained with the escaped blood. In moist and suppurative corns this discoloration is less marked than in dry corn and even may be entirely wanting. In these cases the horn is soft, often white, and stringy or mealy, as seen in pumiced sole resulting from founder. When the whole thickness of the sole is discolored and the horn dry and brittle it is generally evidence that the corn is an old one and that the exciting cause has existed continuously. A moist corn differs from the dry one in that the injury is more severe. The parts affected are more or less inflamed, and the horn of the sole in the angle is undermined by a citron-colored fluid, which often permeates the injured sole and laminae, causing the horn to become somewhat spongy.

A suppurative corn differs from others in that the inflammation ends in suppuration. The pus collects at the point of injury and finally escapes by working its way between the sensitive and insensible laminae to the top of the hoof, where an opening is made between the wall and coronary band at or near the heels. This is the most serious form of corns, for the reason that it may induce gangrene of the plantar cushion, cartilaginous quittor, or caries of the coffin bone.

Treatment.—Since a diversity of opinion exists as to what measures must be adopted for the radical cure of corns, the author will advise the use of those which have proved most efficient in his hands.

As in all other troubles, the cause must be discovered, if possible, and removed. In the great majority of cases the shoeing is at fault. While sudden changes in the method of shoeing are not advisable, it may be said that all errors, either in the preparation of the foot, in the construction of the shoe, or in its application may very properly be corrected at any time. Circumstances may at times make it imperative that shoes be worn which are not free from objections; as, for instance, the shoe with a high calk; but in such cases it is considered that the injuries liable to result from the use of calks are less serious than those which are sure to happen for the want of them.

For a sound foot perfectly formed, a flat shoe, with heels less thick than the toe, and which rests evenly on the wall proper, is the best. In flat feet it is often necessary to concave the shoe as much as possible on the upper surface, so that the sole may not be pressed upon. If the heels are very low the heels of the shoe may be made thicker. If the foot is very broad and the wall light toward the heels, a bar shoe resting upon the frog will aid to prevent excessive tension upon the soft tissues when the foot receives the weight of the body. A piece of leather placed between the foot and shoe serves largely to destroy concussion, and its use is absolutely necessary on some animals to enable them to work.

Last among the preventive measures may be mentioned those which serve to maintain the suppleness of the hoof. The dead horn upon the surface of the sole not only retains moisture for a long time, but protects the living horn beneath from the effects of evaporation; for this reason the sole should be pared as little as possible. Stuffing the feet with flaxseed meal, wet clay, or other like substances, or damp dirt floors or damp bedding of tanbark, greasy hoof ointments, etc., are all means which may be used to keep the feet from becoming too dry and hard.

As to the curative measures which are to be adopted much will depend upon the extent of the injury. If the case is one of chronic dry corn, with but slight lameness, the foot should be poulticed for a day or two and the discolored horn pared out, care being taken not to injure the soft tissues. The heel on the affected side is to be lowered until all pressure is removed and, if the patient's labor is required, the foot must be shod with a bar shoe or with one having stiff heels. Care must be taken to reset the shoe before the foot has grown too long, else the shoe will no longer rest on the wall, but on the sole and bar.

I believe in cutting moist corns out. If there is inflammation, cold baths and poultices should be used; when the horn is well softened and the fever allayed, pare out the diseased horn, lightly cauterize the soft tissues beneath, and poultice the foot for two or three days. When the granulations look red, dress the wound with oakum balls saturated in a weak solution of tincture of aloes or spirits of camphor and apply a roller bandage. Change the dressing every two or three days until a firm, healthy layer of new horn covers the wound, when the shoe may be put on, as in dry corn, and the patient returned to work.

In suppurative corns the loosened horn must be removed, so that the pus may freely escape. If the pus has worked a passage to the coronary band and escapes from an opening between the band and hoof, an opening must be made on the sole, and cold baths made astringent with a little sulphate of iron or copper are to be used for a day or two. When the discharge becomes healthy, the fistulous tracts may be injected daily with a weak solution of bichlorid of mercury, nitrate of silver, etc., and the foot dressed as after operation for moist corns. When complications arise, the treatment must be varied to meet the indications; if gangrene of the lateral cartilage takes place it must be treated as directed under the head of cartilaginous quittor; if the velvety tissue is gangrenous, it must be cut away; if the coffin bone is necrosed, it must be scraped, and the resulting wounds treated on general principles. After any of the operations for corns have been performed, in which the soft tissues have been laid bare, it is best to protect the foot by a sole of soft leather set beneath the shoe when the animal is returned to work. Only in rare instances are the complications of corns so serious as to destroy the life or usefulness of the patient. It is the wide, flat foot with low heels and thin wall which is most liable to resist all efforts toward effecting a complete cure.

BRUISE OF THE FROG.

When the frog is severely bruised the injury is followed by suppuration beneath the horn, and at times by partial gangrene of the plantar cushion.

Causes.—A bruise of the frog generally happens from stepping on a rough stone or other hard object. It is more liable to take place when trotting, running, or jumping than when at a slower pace. A stone wedged in the shoe and pressing on the frog or between the sides of the frog and the shoe, if it remains for a time, produces the same results. A cut through the horny frog with some sharp instrument or a punctured wound by a blunt-pointed instrument may also cause suppuration and gangrene of the plantar cushion. Broad, flat feet with low heels and a fleshy frog are most liable to these injuries.

Symptoms.—Lameness, severe in proportion to the extent of the bruise and the consequent suppuration, is always an early symptom. When the animal moves, the toe only is placed to the ground or the foot is carried and the patient hobbles along on three legs. When he is at rest, the foot is set forward with the toe on the ground and the leg flexed at the fetlock joint. As soon as the pus finds its way to the surface the lameness improves. If the frog is examined early the injured spot may usually be found; later, if no opening exists, the pus may be discovered working its way toward the heels. The horn is loosened from the deeper tissues, and, if pared through, a thin, yellow, watery and offensive pus escapes. In other cases a ragged opening is found in the frog, leading down to a mass of dead, sloughing tissues, which are pale green in color if gangrene of the plantar cushion has set in. In rare cases the coffin bone may be involved in the injury and a small portion of it may become carious.

Treatment.—If the injury is seen at once, the foot should be placed in a bath of cold water to prevent suppuration. If suppuration has already set in, the horn of the frog, and of the bars and branches of the sole, if necessary, is to be pared thin so that all possible pressure may be removed, and the foot poulticed. When the pus has loosened the horn, all the detached portions are to be cut away. If the pus is discharging from an opening near the hair, the whole frog, or one-half of it, will generally be found separated from the plantar cushion, and is to be removed with the knife. After a few days the gangrenous portion of the cushion will slough off from the effects of the poultice; under rare circumstances only should the dead parts be removed by surgical interference. When the slough is all detached, the remaining wound is to be treated with simple stimulating dressings, such as tincture of aloes or turpentine, oakum balls, and bandages as directed in punctured wounds. When the lameness has subsided, and a thin layer of new horn has covered the exposed parts, the foot may be shod. Cover the frog with a thick pad of oakum, held in place by pieces of tin fitted to slide under the shoe, and return to slow work. Where caries of the coffin bone, etc., follow the injury the treatment recommended for these complications in punctured wounds of the foot must be resorted to.

PUNCTURED WOUNDS OF THE FOOT.

Of all the injuries to which the foot of the horse is liable, none are more common than punctured wounds, and none are more serious than these may be when involving the more important organs within the hoof. A nail is the most common instrument by which the injury is inflicted, yet wounds may happen from glass, wire, knives, sharp pieces of rock, etc.

A wound of the foot is more serious when made by a blunt-pointed instrument than when the point is sharp, and the nearer the injury is to the center of the foot the more liable are disastrous results to follow. Wounds in the heel and in the posterior parts of the frog are attended with but little danger, unless they are so deep as to injure the lateral cartilages, when quittor may follow. Punctured wounds of the anterior parts of the sole are more dangerous, for the reason that the coffin bone may be injured, and the suppuration, even when the wound is not deep, tends to spread and always gives rise to intense suffering. The most serious of the punctured wounds are those which happen to the center of the foot, and which, in proportion to their depth, involve the plantar cushion, the plantar aponeurosis, the sesamoid sheath, the navicular bone, or the coffin joint.

Punctured wounds are more liable to be deep in flat or convex feet than in well-made feet, and as a rule, recovery is neither so rapid nor so certain. These wounds are less serious in animals used for heavy draft than in those required to do faster work; for the former may be useful, even if complete recovery is not effected. Lastly, punctured wounds of the fore feet are more serious than of the hind feet, for the reason that in the former the instrument is liable to enter the foot in a nearly perpendicular line, and, consequently, is more liable to injure the deeper structures of the foot; in the hind foot, the injury is generally near the heels and the wound oblique and less deep.

Symptoms.—A nail or other sharp instrument may penetrate the frog and remain for several days without causing lameness; in fact, in many cases of punctured wound of the frog the first evidence of the injury is the finding of the nail or the appearance of an opening where the skin and frog unite, from which more or less pus escapes. Even when the sole is perforated, if the injury is not too deep, no lameness develops until suppuration is established. In all cases of foot lameness, especially if the cause is obscure, the foot should be examined for evidence of injury.

The lameness from punctured wounds, accompanied with suppuration, is generally severe, the patient often refusing to use the affected member at all. The pain being lancinating in character, he stands with the injured foot at rest or constantly moves it back and forth. In other cases the patient lies down most of the time with the feet outstretched; the breathing is rapid, the pulse fast, the temperature elevated, and the body covered with patches of sweat.

When the plantar aponeurosis is injured, the pus escapes with difficulty and the wound shows no signs of healing; the whole foot is hot and very painful. If the puncture involves the sesamoid sheath, the synovial fluid escapes. At first this fluid is pure, like joint water, but later becomes mixed with the products of suppuration and loses its clear, amber color. Suppuration generally extends up the course of the flexor tendon, an abscess forms in the hollow of the heel, and finally opens somewhere below the fetlock joint. The whole coronet is more or less swollen, the discharge is profuse and often mixed with blood, yet the suffering is greatly relieved from the moment the abscess opens.

If the puncture reaches the navicular bone the lameness is intense from the beginning; but the only certain way to determine the existence of this complication is by the use of the probe; and unless there is a free escape of synovia it must be used with the greatest of care, else the coffin joint may be opened. If the coffin joint has been penetrated, either by the offending instrument or by the process of suppuration, acute inflammation of the joint follows, accompanied with high fever, loss of appetite, etc. The ankle and coronet are now greatly swollen, and dropsy of the leg to the knee or hock, or even to the body, often follows. If the process of suppuration continues, small abscesses appear at intervals on different parts of the coronet, the patient rapidly loses flesh, and may die from intense suffering and blood poisoning. In other cases the suppuration soon disappears, and recovery is effected by the joint becoming stiff (anchylosis).

When the wound is forward, near the toe, and deep enough to injure the coffin bone, caries always results. The presence of the dead pieces of bone can be determined by the use of the probe; the bone feels rough and gritty. Furthermore, there is no disposition upon the part of the wound to heal.

Besides the complications above mentioned, others equally as serious may be met with. The tendons may soften and rupture, the hoof may slough off, quittors develop, or sidebones and ringbones grow. Finally, laminatis of the opposite foot may happen if the patient persists in standing, or lockjaw may cause early death.

Treatment.—In all cases the horn around the seat of injury should be thinned down, a free opening made for the escape of the products of suppuration, and the foot placed in a poultice. If the injury is not serious, recovery takes place in a few days. When the wound is deeper it is better to put the foot into a cold bath or under a stream of cold water, as advised in the treatment for quittor.

If the bone is injured, cold baths, containing about 2 ounces each of sulphate of copper and sulphate of iron, may be used until the dead bone is well softened, when it should be removed by an operation. The animal must be cast for this operation. The sole is pared away until the diseased bone is exposed, when all the dead particles are to be removed with a drawing knife, and the wound dressed with 3 per cent compound cresol solution or a 5 per cent solution of carbolic acid, oakum balls, and a roller bandage.

Wounds of the bone which are made by a blunt-pointed instrument, like the square-pointed cut nail, in which a portion of the surface is driven into the deeper parts of the bone, always progress slowly, and should be operated upon as soon as the conditions are favorable. Even wounds of the navicular bone, accompanied with caries, may be operated on and the life of the patient saved; but the most skillful surgery is required and only the experienced operator should undertake their treatment.

If there is an escape of pure synovial fluid from a wound of the sole, without injury to the bone, a small pencil of corrosive sublimate should be introduced to the bottom of the wound and the foot dressed as directed above.

The other complications are to be treated as directed under their proper headings.

After healing of the wounds has been effected, lameness, with more or less swelling of the coronary region, may remain. In such cases the coronet should be blistered or even fired with the actual cautery, and the patient turned to pasture. If the lameness still persists, and is not due to a stiff joint, unnerving may be resorted to in many cases with very good results. If the joint is anchylosed, no treatment can relieve it, and the patient must either be put to very slow work or kept for breeding purposes only.

"Prick in shoeing" is an injury which should be considered under the head of punctured wounds of the foot. The nails by which the shoe is fastened to the hoof may produce an injury followed by inflammation and suppuration in two days, by penetrating the soft tissues directly or by being driven so deep that the inner layers of the horn of the wall are pressed against the soft tissues with such force as to crush them. In either case, unless the injury is at the toe, the animal generally goes lame soon after shoeing, when the first evidence of the trouble may be the discharge of pus at the coronet. If lameness follows close upon the setting of the shoes, without other appreciable cause, each nail should be lightly struck with a hammer, when the one at fault will be detected by the flinching of the animal.

Treatment consists in drawing the nail, and if the soft tissues have been penetrated or suppuration has commenced, the horn must be pared away until the diseased parts are exposed. The foot is now to be poulticed for a day or two, or until the lameness and suppuration have ceased. If the discharge of pus from the coronet is the first evidence of the disease, the offending nail must be found and removed, the horn pared out, and a weak solution of carbolic acid or compound cresol injected at the coronet until the fistulous tract has healed.

CONTRACTED HEELS, OR HOOFBOUND.

Contracted heels, or hoofbound, is a common disease among horses kept on hard floor in dry stables, and in such as are subject to much saddle work. It consists in an atrophy, or shrinking, of the tissues of the foot, whereby the lateral diameter of the heels is diminished. It affects the fore feet principally; but it is seen occasionally in the hind feet, where it is of less importance, for the reason that the hind foot first strikes the ground with the toe, and consequently less expansion of the heels is necessary than in the fore feet, where the weight is first received on the heels. Any interference with the expansibility of this part of the foot interferes with locomotion and ultimately gives rise to lameness. Usually but one foot is affected at a time, but when both are diseased the change is greater in one than in the other. Occasionally but one heel, and that the inner one, is contracted; in these cases there is less liable to be lameness and permanent impairment of the animal's usefulness. According to the opinion of some of the French veterinarians, hoofbound should be divided into two classes—total contraction, in which the whole foot is shrunken in size, and contraction of the heels, when the trouble extends only from the quarters backward. (Pl. XXXV, figs. 4 and 7.)

Causes.—Animals raised in wet or marshy districts, when taken to towns and kept on dry floors, are liable to have contracted heels, not alone because the horn becomes dry, but because fever of the feet and wasting away of the soft tissues result from the change. Another common cause of contracted heels is to be found in faulty shoeing, such as rasping the wall, cutting away the frog, heels, and bars; high calks and the use of nails too near the heels. Contracted heels may happen as one of the results of other diseases of the foot; for instance, it often accompanies thrush, sidebones, ringbones, canker, navicular disease, corns, sprains of the flexor tendons, of the sesamoid and suspensory ligaments, and from excessive knuckling of the fetlock joint.

Symptoms.—In contraction of the heels the foot has lost its circular shape, and the walls from the quarters backward approach to a straight line. The ground surface of the foot is now smaller than the coronary circumference; the frog is pinched between the inclosing heels, is much shrunken, and at times is affected with thrush. The sole is more concave than natural, the heels are higher, and the bars are long and nearly perpendicular. The whole hoof is dry and so hard that it can scarcely be cut; the parts toward the heels are scaly and often ridged like the horns of a ram, while fissures, more or less deep, may be seen at the quarters and heels following the direction of the horn fibers. (Plate XXXVI, fig. 10.) When the disease is well advanced lameness is present, while in the earlier stages there is only an uneasiness evinced by frequent shifting of the affected foot. Stumbling is common, especially on hard or rough roads. In most cases the animal comes out of the stable stiff and inclined to walk on the toe, but after exercise he may go free again. He wears his shoes off at the toe in a short time, no matter whether he works or remains in the stable. If the shoe is removed and the foot pared in old cases, a dry, mealy horn will be found where the sole and wall unite, extending upward in a narrow line toward the quarters.

Treatment.—First of all, the preventive measures must be considered. The feet are to be kept moist and the horn from drying out by the use of damp sawdust or other bedding; by occasional poultices of boiled turnips, linseed meal, etc., and greasy hoof ointments to the sole and walls of the feet. The wall of the foot should be spared from the abuse of the rasp; the frog, heels, and bars are not to be mutilated with the knife, nor should calks be used on the shoe except when absolutely necessary. The shoes should be reset at least once a month to prevent the feet from becoming too long, and daily exercise must be insisted on.

As to curative measures, a diversity of opinion exists. A number of kinds of special shoes have been invented, having for an object the spreading of the heels, and perhaps any of these, if properly used, would eventually effect the desired result. But a serious objection to most of these shoes is that they are expensive and often difficult to make and apply. The method of treatment which I have adopted is not only attended with good results, but is inexpensive, if the loss of the patient's services for a time is not considered a part of the question. It consists, first, in the use of poultices or baths of cold water until the horn is thoroughly softened. The foot is now prepared for the shoe in the usual way, except that the heels are lowered a little and the frog remains untouched. A shoe, called a "tip," is made by cutting off both branches at the center of the foot and drawing the ends down to an edge. The tapering of the branches should begin at the toe, and the shoe should be of the usual width, with both the upper and lower surfaces flat. This tip is to be fastened on with six or eight small nails, all set well forward, two being in the toe. With a common foot rasp begin at the heels, close to the coronet, and cut away the horn of the wall until only a thin layer covers the soft tissues beneath. Cut forward until the new surface meets the old 2-1/2 or 3 inches from the heel. The same sloping shape is to be observed in cutting downward toward the bottom of the foot, at which point the wall is to retain its normal thickness. The foot is now blistered all round the coronet with Spanish-fly ointment; when this is well set, the patient is to be turned to pasture in a damp field or meadow. The blister should be repeated in three or four weeks, and, as a rule, the patient can be returned to work in two or three months.

The object of the tip is to throw the weight on the frog and heels, which are readily spread after the horn has been cut away on the sides of the wall. The internal structures of the foot at the heels, being relieved of excessive pressure, regain their normal condition if the disease is not of too long standing. The blister tends to relieve any inflammation which may be present, and stimulates a rapid growth of healthy horn, which, in most cases, ultimately forms a wide and normal heel. In old, chronic cases, with a shrunken frog and increased concavity of the sole, accompanied with excessive wasting of all the internal tissues of the foot, satisfactory results can not be expected and are rarely obtained. Still, much relief, if not an entire cure, may be effected by these measures.

When thrush is present as a complication, its cure must be sought by measures directed under that heading. If sidebones, ringbones, navicular disease, contracted tendons, or other diseases have been the cause of contracted heels, treatment will be useless until the cause is removed.

SAND CRACKS.

A sand crank is a fissure in the horn of the wall of the foot. These fissures are quite narrow, and, as a general rule, they follow the direction of the horny fibers. They may occur on any part of the wall, but ordinarily are only seen directly in front, when they are called toe cracks; or on the lateral parts of the walls, when they are known as quarter cracks. (Plate XXXVI.)

Toe cracks are most common in the hind feet, while quarter cracks nearly always affect the fore feet. The inside quarter is more liable to the injury than the outside, for the reason that this quarter is not only the thinner, but during locomotion receives a greater part of the weight of the body. A sand crack may be superficial, involving only the outer parts of the wall, or it may be deep, involving the whole thickness of the wall and the soft tissues beneath.

The toe crack is most likely to be complete—that is, extending from the coronary band to the sole—while the quarter crack is nearly always incomplete, at least when of comparatively recent origin. Sand cracks are most serious when they involve the coronary band in the injury. They may be complicated at any time by hemorrhage, inflammation of the laminae, suppuration, gangrene of the lateral cartilage and of the extensor tendon, caries of the coffin bone, or the growth of a horny tumor known as a keraphyllocele.

Causes.—Relative dryness of the horn is the principal predisposing cause of sand cracks. Excessive dryness is perhaps not a more prolific cause of cracks in the horn than alternate changes from damp to dry. It is even claimed that these injuries are more common in animals working on wet roads than those working on roads that are rough and dry; at least these injuries are not common in mountainous countries. Animals used to running at pasture when transferred to stables with hard, dry floors are more liable to quarter cracks than those accustomed to stables. Small feet, with thick, hard hoofs, and feet which are excessively large, are more susceptible to sand cracks than those of better proportion. A predisposition to quarter cracks exists in contracted feet, and in those where the toe turns out or the inside quarter turns under.

Heavy shoes, large nails, and nails set too far back toward the heels, together with such diseases as canker, quittor, grease, and suppurative corns, must be included as occasional predisposing causes of sand cracks.



Fast work on hard roads, jumping, and blows on the coronet, together with calk wounds of the feet, are accidental causes of quarter cracks in particular. Toe cracks are more likely to be caused by heavy pulling on slippery roads and pavements or on steep hills.

Symptoms.—The fissure in the horn is ofttimes the only evidence of the disease; even this may be accidentally or purposely hidden from casual view by mud, ointments, tar, wax, putty, gutta-percha, or by the long hairs of the coronet.

Sand cracks sometimes commence on the internal face of the wall, involving its whole thickness excepting a thin layer on the outer surface. In these cases the existence of the injury may be suspected from a slight depression, which begins near the coronary band and follows the direction of the horny fibers; but the trouble can only be positively diagnosed by paring away the outside layers of horn until the fissure is exposed. In toe cracks the walls of the fissure are in close apposition when the foot receives the weight of the body, but when the foot is raised from the ground the fissure opens. In quarter crack the opposition is true; the fissure closes when the weight is removed from the foot. As a rule, sand cracks begin at the coronary band, and as they become older they not only extend downward, but they also grow deeper. In old cases, particularly in toe cracks, the horn on the borders of the fissure loses its vitality and scales off, sometimes through the greater part of its thickness, leaving behind a rough and irregular channel extending from the coronet to the end of the toe.

In many cases of quarter crack, and in some cases of toe crack as well, if the edges remain close together, with but little motion, the fissure is dry; but in other cases a thin, offensive discharge issues from the crack and the ulcerated soft tissues, or a funguslike growth protrudes from the narrow opening.

When the cracks are deep and the motion of their edges considerable, so that the soft tissues are bruised and pinched with every movement, a constant inflammation of the parts is maintained and the lameness is severe.

Ordinarily the lameness of sand crack is slight when the patient walks, but it is greatly aggravated when he is made to trot, and the harder the road the worse he limps. Furthermore, the lameness is greater going downhill than up, for the reason that these conditions are favorable to an increased motion in the edges of the fissure. Lastly, more or less hemorrhage accompanies the inception of a sand crack when the whole thickness of the wall is involved. Subsequent hemorrhages may also take place from fast work, jumping, or a misstep.

Treatment.—So far as preventive measures are concerned, but little can be done. The suppleness of the horn is to be maintained by the use of ointments, damp floor, bedding, etc. The shoe is to be proportioned to the weight and work of the animal; the nails holding it in place are to be of proper size and not driven too near the heels; sufficient calks and toe pieces must be added to the shoes of horses working on slippery roads; also, the evils of jumping, fast driving, etc., are to be avoided.

When a fissure has made its appearance, means are to be adopted which will prevent it from growing longer or deeper; this can only be done by arresting all motion in the edges. The best and simplest artificial appliance for holding the borders of a toe crack together is the Vachette clasp. These clasps and the instruments necessary for their application can be had of any prominent maker of veterinary instruments. (Pl. XXXVI.) These instruments comprise a cautery iron, with which two notches are burned in the wall, one on each side of the crack, and forceps with which the clasps are closed into place in the bottom of the notches and the edges of the fissure brought close together. The clasps, being made of stiff steel wire, are strong enough to prevent all motion in the borders of the crack. Before these clasps are applied the fissure should be thoroughly cleansed and dried, and if the injury is of recent origin the crack may be filled with a putty made of 2 parts of gutta-percha and 1 part of gum ammoniac. The number of clasps to be used is to be determined by the length of the crack, the amount of motion to be arrested, etc. Generally the clasps are from one-half to three-quarters of an inch apart. The clasps answer equally as well in quarter crack if the wall is sufficiently thick and not too dry and brittle to withstand the strain.

In the absence of these instruments and clasps a hole may be drilled through the horn across the fissure and the crack closed with a thin nail made of tough iron, neatly clinched at both ends. A plate of steel or brass is sometimes fitted to the parts and fastened on with short screws; while this appliance may prevent much gaping of the fissure, it does not entirely arrest motion of the edges, for the reason that the plate and screw can not be rendered immobile.

If, for any reason, the measures above fail or can not be used, recourse must be had to an operation. The horn is softened by the use of warm baths and poultices, the patient cast, and the walls of the fissure entirely removed with the knife. The horn removed is in the shape of the letter V, with the base at the coronet. Care must be taken not to injure the coronary band and the laminae. The wound is to be treated with mild stimulant dressings, such as compound cresol solution, a weak solution of carbolic acid, tincture of aloes, etc., oakum balls, and a roller bandage. After a few days the wound will be covered with a new, white horn, and only the oakum and bandages will be needed. As the new quarter grows out, the lameness disappears, and the patient may be shod with a bar shoe and returned to work.

In all cases of sand crack the growth of horn should be stimulated by cauterizing the coronary band or by the use of blisters. In simple quarter crack recovery will often take place if the coronet is blistered, the foot shod with a "tip," and the patient turned to pasture.

The shoe in toe crack should have a clip on each side of the fissure and should be thicker at the toe than at the heels. The foot should be lowered at the heels by paring, and spared at the toe, except directly under the fissure, where it is to be pared away until it sets free from the shoe.

When any of the complications referred to above arise, special measures must be resorted to. For the proper treatment of gangrene of the lateral cartilage and extensor tendon and caries of the coffin bone reference may be had to the articles on quittors. If the horny tumor, known as keraphyllocele, should develop, it is to be removed by the use of the knife. Since this tumor develops on the inside of the horny box and may involve other important organs of the foot in disease, its removal should only be undertaken by a skillful surgeon.

NAVICULAR DISEASE.

Navicular disease is an inflammation of the sesamoid sheath, induced by repeated bruising or laceration, and complicated in many cases by inflammation and caries of the navicular bone. In some instances the disease undoubtedly begins in the bone, and the sesamoid sheath becomes involved subsequently by an extension of the inflammatory process. (Plate XXXIV, fig. 5.)

The Thoroughbred horse is more commonly affected than any other, yet no class or breed of horses is entirely exempt. The mule, however, seems rarely, if ever, to suffer from it. For reasons which will appear when considering the causes of the disease, the hind feet are not liable to be affected. Usually but one fore foot suffers from the disease, but if both should be attacked the trouble has become chronic in the first before the second shows signs of the disease.

Causes.—To comprehend fully how navicular disease may be caused by conditions and usages common to nearly all animals, it is necessary to recall the peculiar anatomy of the parts involved in the process and the functions which they perform in locomotion.

It must be remembered that the fore legs largely support the weight of the body when the animal is at rest, and that the faster he moves the greater is the shock which the fore feet must receive as the body is thrown forward by the propelling force of the hind legs. This shock could not be withstood by the tissues of the fore feet and legs were it not that it is largely dissipated by the elastic muscles which bind the shoulder to the body, the ease with which the arm closes on the shoulder blade, and the spring of the fetlock joint. Even these means, however, are not sufficient within themselves to protect the foot from injury; so nature has further supplemented them by placing the coffin joint on the hind part of the coffin bone instead of directly on top of it, whereby a large part of the shock of locomotion is dispersed before it can reach the vertical column represented by the cannon, knee, and arm bones. A still further provision is made by placing a soft, elastic pad—the frog and plantar cushion—at the heels to receive the sesamoid expansion of the flexor tendon as it is forced downward by the pressure of the coronet bone against the navicular. Extraordinary as these means may appear for the destruction of shock, and ample as they are when the animal is at a slow pace or unweighted by rider or load, they fail to relieve the parts completely from concussion and excessive pressure whenever the opposite conditions are present. The result, then, is that the coronet bone forces the navicular hard against the flexor tendon, which, in turn, presses firmly against the navicular as the force of the contracting muscles lifts the tendon into place. It is self-evident, then, that the more rapid the pace and the greater the load, the greater must these contending forces be, and the greater the liability to injury. For the same reason horses with excessive knee action are more liable to suffer from this disease than others, concussion of the foot and intense pressure on the tendon being common among such horses.

Besides the above-mentioned exciting causes must be considered those which predispose to the disease. Most prominent among these is heredity. It may be claimed, however, that an inherited predisposition to navicular disease consists not so much in a special susceptibility of the tissues which are involved in the process as in a vice of conformation which, as is well known, is liable to be transmitted from parent to offspring. The faults of conformation most likely to be followed by the development of navicular disease are an insufficient plantar cushion, a small frog, high heels, excessive knee action, and contracted heels. Finally, the environments of domestication and use, such as dry stables, heavy pulling, bad shoeing, punctured wounds, etc., all have their influence in developing this disease.

Symptoms.—In the early stages of navicular disease the symptoms are generally very obscure. When the disease begins in inflammation of the navicular bone, the animal while at rest points the affected foot a time before any lameness is seen. While at work he apparently travels as well as ever, but when placed in the stable one foot is set out in front of the other, resting on the toe, with fetlock and knee flexed. After a time, if the case is closely watched, the animal takes a few lame steps while at work, but the lameness disappears as suddenly as it came, and the driver doubts whether the animal was really lame at all. Later the patient has a lame spell which may last during a greater part of the day, but the next morning it is gone; he leaves the stable all right, but goes lame again during the day. In times he has a severe attack of lameness, which may last for a week or more, when a remission takes place and it may be weeks or months before another attack supervenes. Finally, he becomes constantly lame, and the more he is used the greater the lameness.

In the lameness from navicular disease the affected leg always takes a short step, and the toe of the foot first strikes the ground; so the shoe is most worn at this point. If the patient is made to move backward, the foot is set down with exceeding great care, and the weight rests upon the affected leg but a moment. When exercised he often stumbles, and if the road is rough he may fall on his knees. If he is lame in both feet the gait is stilty, the shoulders seem stiff, and, if made to work, he sweats profusely from intense pain. Early in the development of the disease a careful examination will reveal some increased heat in the heels and frog, particularly after work; as the disease progresses this becomes more marked, until the whole foot is hot to the touch. At the same time there is an increased sensibility of the foot, for the patient flinches from the percussion of a hammer lightly applied to the frog and heels or from the pressure of the smith's pincers. The frog is generally shrunken, often of a pale-red color, and at times is affected with thrush. If the heels are pared away so that all the weight is received on the frog, or if the same result is attained by the application of a bar shoe, the animal is excessively lame. The muscles of the leg and shoulder shrink away and often tremble as the animal stands at rest. After months of lameness the foot is found to be shrunken in its diameter and apparently lengthened; the horn is dry and brittle and has lost its natural gloss, while circular ridges, developed most toward the heels, cover the upper part of the hoof. When both feet are affected the animal points first one foot then the other, and stands with the hind feet well forward beneath the body, so as to relieve the fore feet as much as possible from bearing weight. In old cases the wasting of the muscles and the knuckling at the fetlock become so great that the leg can not be straightened and locomotion can scarcely be performed. The disease generally makes a steady progress without inclining to recovery—the remission of symptoms in the earlier stages should not be interpreted as evidence that the process has terminated. The complications usually seen are ringbones, sidebones, thrush, contracted heels, quartercracks, and fractures of the navicular, coronet, and pastern bones.

Treatment.—But few cases of navicular disease recover. In the early stages the wall of the heels should be rasped away, as directed in the treatment for contracted heels, until the horn is quite thin; the coronet should be well blistered with Spanish-fly ointment, and the patient turned to grass in a damp field or meadow. After three or four weeks the blister should be repeated. This treatment is to be continued for two or three months. Plane shoes are to be put on when the patient is returned to work. In chronic cases the animal should be put to slow, easy work. To relieve the pain, neurotomy may be performed—an operation in which the sense of feeling is destroyed in the foot by cutting out pieces of the nerve at the fetlock. This operation in nowise cures the disease, and, since it may be attended with serious results, can be advised only in certain favorable cases, to be determined by the veterinarian.

SIDEBONES.

A sidebone consists in a transformation of the lateral cartilages found on the wings of the coffin bone into bony matter by the deposition of lime salts. The disease is a common one, especially in heavy horses used for draft, in cavalry horses, cow ponies, and other saddle horses, and in runners and trotters.

Sidebones are peculiar to the fore feet, yet they occasionally develop in the hind feet, where they are of little importance since they cause no lameness. In many instances sidebones are of slow growth and, being unaccompanied with acute inflammation, they cause no lameness until such time as, by reason of their size, they interfere with the action of the joint. (Plate XXXIV, fig. 4.)

Causes.—Sidebones often grow in heavy horses without any apparent injury, and their development has been attributed to the over-expansion of the cartilages caused by the great weight of the animal. Blows and other injuries to the cartilages may set up an inflammatory process which ends in the formation of these bony growths. High-heeled shoes, high calks, and long feet are always classed among the conditions which may excite the growth of sidebones. They are often seen in connection with contracted heels, ringbones, navicular disease, punctured wounds of the foot, quarter cracks, and occasionally as a sequel to founder.

Symptoms.—In the earlier stages of the disease, if inflammation is present, the only evidence of the trouble to be detected is a little fever over the seat of the affected cartilage and a slight lameness. In the lameness of sidebones the toe of the foot first strikes the ground and the step is shorter than natural. The subject comes out of the stable stiff and sore, but the gait is more free after exercise.

Since the deposit of bony matter often begins in that part of the cartilage where it is attached to the coffin bone, the diseased process may exist for some time before the bony growth can be seen or felt. Later, however, the cartilage can be felt to have lost its elastic character, and by standing in front of the animal a prominence of the coronary region at the quarters can be seen. Occasionally these bones become so large as to bulge the hoof outward, and by pressing on the joint they so interfere with locomotion that the animal becomes entirely useless.

Treatment.—So soon as the disease can be diagnosed active treatment should be adopted. Cold-water bandages are to be used for a few days to relieve the fever and soreness.

The improvement consequent on the use of these simple measures often leads to the belief that the disease has recovered; but with a return to work the lameness, fever, etc., reappears. For this reason the use of blisters, or, better still, the firing iron, should follow on the discontinuance of the cold bandages.

But in many instances no treatment will arrest the growth of these bony tumors, and as a palliative measure neurotomy must be resorted to. Generally this operation will so relieve the pain of locomotion that the patient may be used for slow work; but in animals used for fast driving or for saddle purposes, the operation is practically useless. Some years ago at Fort Leavenworth I unnerved a number of cavalry horses that were suffering from sidebones, and the records show that in less than seven months all were more lame than ever. Since a predisposition to develop sidebones may be inherited, animals suffering from this disease should not be used for breeding purposes unless the trouble is known to have originated from an accident.

RINGBONE.

A ringbone is the growth of a bony tumor on the ankle. This tumor is, in fact, not the disease, but simply the result of an inflammatory action set up in the periosteum and bone tissue proper of the pastern bones. (Plate XXXIV, fig. 1.) (See also p. 313.)

Causes.—Injuries, such as blows, sprains, overwork in young, undeveloped animals, fast work on hard roads, jumping, etc., are among the principal exciting causes of ringbone. Horses most disposed to this disease are those with short, upright pasterns, for the reason that the shock of locomotion is but imperfectly dissipated in the fore legs of these animals. Improper shoeing, such as the use of high calks, a too great shortening of the toe and correspondingly high heels, predispose to this disease by increasing the concussion to the feet.

Symptoms.—The first symptom of an actively developed ringbone is the appearance of a lameness more or less acute. If the bony tumor forms on the side or upper parts of the large pastern, its growth is generally unattended with acute inflammatory action, and consequently produces no lameness or evident fever. These are called "false" ringbones. But when the tumors form on the whole circumference of the ankle, or simply in front under the extensor tendon, or behind under the flexor tendons, or if they involve the joints between the two pastern bones, or between the small pastern and the coffin bone, the lameness is always severe. These constitute the true ringbone. Besides lameness, the ankle of the affected limb presents more or less heat, and in many instances a rather firm, though limited, swelling of the deeper tissues over the seat of the inflammatory process. The lameness of ringbone is characteristic in that the heel is first placed on the ground when the disease is in a fore leg, and the ankle is kept as rigid as possible. In the hind leg, however, the toe strikes the ground first, when the ringbone is high on the ankle, just as in health, but the ankle is maintained in a rigid position. If the bony growth is under the front tendon of the hind leg, or if it involves the coffin joint, the heel is brought to the ground first. In the early stages of the disease it is not always easy to diagnose ringbone, but when the deposits have reached some size they can be felt and seen as well.

The importance of a ringbone depends on its seat and often on its size. If it interferes with the joints or with the tendons it may cause an incurable lameness, even though small. If it is on the sides of the large pastern, the lameness generally disappears as soon as the tumor has reached its growth and the inflammation subsides. Even when the pastern joint is involved, if complete anchylosis results, the patient may recover from the lameness with simply an imperfect action of the foot remaining, due to the stiff joint.

Treatment.—Before the bony growth has commenced the inflammatory process may be cut short by the use of cold baths and wet bandages, followed by one or more blisters. If the bony deposits have begun, the firing iron should always be used. Even when the tumors are large and the pastern joint involved, firing often hastens the process of anchylosis and should always be tried.

When the lower joint is involved, or if the tumor interferes with the action of the tendons, recovery is not to be expected. In many of these latter cases, however, the animal may be made serviceable by proper shoeing. If the patient walks with the toe on the ground, the foot should be shod with a high-heeled shoe and a short toe. On the other hand, if he walks on the heel, a thick-toed and thin-heeled shoe must be worn.

Since ringbone is considered to be one of the hereditary diseases, no animal suffering from this trouble should ever be used for breeding purposes.

LAMINITIS, OR FOUNDER.

Laminitis is a simple inflammation of the sensitive laminae of the feet, characterized by the general phenomena attending inflammation of the skin and mucous membranes, producing no constitutional disturbances except those dependent upon the local disease, and having a strong tendency, in severe cases, to destructive disorganization of the tissues affected.

Causes.—The causes of laminitis are as wide and variable as in any of the local inflammations, and may be divided into two classes—the predisposing and the exciting.

Predisposing causes.—From personal observation I do not know that any particular construction of foot or any special breed of horses is predisposed to this disease, neither can I find anything to warrant the assumption that it is in any way hereditary; so that while we may easily cultivate a predisposition to the disease, it does not originate without an exciting cause. Like most other tissues, a predisposition to inflammation may be induced in the sensitive laminae by any cause which lessens their power of withstanding the work imposed on them. It exists to an extent in those animals unaccustomed to work, particularly if they are plethoric, and in all that have been previous subjects of the disease, for the same rule holds good here that we find in so many diseases—i. e., that one attack impairs the functional activity of the affected tissues and renders them more easy of a subsequent inflammation. Unusual excitement by determining an excessive blood supply, bad shoeing, careless paring of the feet by removing the sole support, and high calkings without corresponding toe pieces must be included under this head.

Exciting causes.—The exciting causes of laminitis are many and varied. The most common are concussion, overexertion, exhaustion, rapid changes of temperature, ingestion of certain feeds, purgatives, and the oft-mentioned metastasis.

(1) Concussion produces this disease by local overstimulation. The excessive excitement is followed by an almost complete exhaustion of the functional activity of the laminated tissues, the exhaustion by congestion, and eventually by inflammation. But congestion here, as in all other tissues, is not necessarily followed by inflammation; for, although the principal symptoms belonging to true laminitis are present, the congestion may be relieved before the processes of inflammation are fully established. This is the condition in the many so-called cases of laminitis which recover in from 24 to 48 hours. They should be called congestion of the laminae.

Laminitis from concussion is common in trotting horses that are raced when not in condition, especially if they carry the obnoxious toe weights, and in green horses put to work on city pavements to which they are unaccustomed. Concussion from long drives on dirt roads is at times productive of the same results, notably when the weather is extremely warm, or at least when the relative change of temperature is great. But the exhaustion of these circumstances must prove an exciting cause as well as the long-continued concussion. This combination of causes must also determine the disease at times in hunters, for the weight of the rider increases the demands made upon the function of these tissues, and their powers are the sooner exhausted.

(2) Overexertion, as heavy pulling or rapid work, even when there is no immoderate concussion, occasionally results in this disease. Here also exhaustion is a conjunctive cause, for overexertion can not be long continued without exhaustion.

(3) Exhaustion is nearly as prolific a source of laminitis as is concussion, for when the physical strength is impaired, even though temporarily, some part of the economy is rendered more vulnerable to disease than others. To this cause we must ascribe those cases which follow a hard day's work, in which at no time has there been overexertion or immoderate concussion.

The tendency to laminitis in horses on sea voyages results from the continual constrained position the animal maintains on account of the rocking motion of the vessel.

If one foot has been blistered, or if one limb is incapacitated from any cause, the opposite member, doing double duty, soon becomes exhausted, and congestion, followed by inflammation, results. When one foot only becomes laminitic, it is customary to find the corresponding member participating at a later date; not always because of sympathy, but because one foot had to do the work of two.

(4) Rapid changes of temperature act as an exciting cause of laminitis by impairing the normal blood supply.

This change of temperature may be induced by drinking large quantities of cold water while in an overheated condition. Here the internal heat is rapidly reduced, the neighboring tissues and blood vessels constrained, and the blood supply to these organs greatly diminished, while the quantity sent to the surface is correspondingly increased. True, in many cases there has not been sufficient labor performed to impair the powers of the laminae, and laminitis is more readily induced than congestion or inflammation of the skin or other surface organs, because the laminae can not relieve themselves of threatened congestion by the general safety valve of perspiration. A cold wind or relatively cold air allowed to play upon the body when heated and wet with sweat has virtually the same result, for it arrests evaporation and rapidly cools the external surface, thereby determining an excess of blood to such organs and tissues as are protected from this outside influence. In many instances this happens to be some of the internal organs, as the lungs, if the previous work has been rapid and their functional activity impaired; but in numerous other instances the determination is toward the feet, and that it is so depends upon two very palpable facts: First, that these tissues have been greatly excited and are already receiving as much blood as they can accommodate consistently with health; second, even though these tissues are classed with those of the surface, their protection from atmospheric influences by means of the thick box of horn incasing them renders them in this respect equivalent to internal organs.

A more limited local action of cold may excite this disease, by driving through water or washing the feet and legs while the animal is warm or just in from work. Here a very marked reaction takes place in the surface tissues of the limbs, and passive congestion of the foot results from an interference with the return flow of blood which is being sent to these organs in excess. These are more liable to be simple cases of congestion, soon to recover, yet they may become true cases of laminitis.

(5) Why it is that certain kinds of grain will cause laminitis does not seem to be clearly understood. Certainly they possess no specific action upon the laminae, for all animals are not alike affected; neither do they always produce these results in the same animal. Some of these feeds cause a strong tendency to indigestion, and the consequent irritation of the alimentary canal may be so great as to warrant the belief that the laminae are affected through sympathy. In other instances there is no apparent interference with digestion nor evidence of any irritation of the mucous membranes, yet the disease is in some manner dependent upon the feed for its inception. Barley, wheat, and sometimes corn are the grains most liable to cause this disease. With some horses there appears to be a particular susceptibility to this influence of corn, and the use of this grain is followed by inflammation of the feet, lasting from a few days to two weeks. In these animals, to all appearances healthy, the corn neither induces colic, indigestion, nor purging, and apparently no irritation whatever of the alimentary canal.

(6) Fortunately purgative medicines rarely cause inflammation of the laminae. That it is, then, the result of sympathetic action is no doubt more than hypothetical, for when there is no derangement of the alimentary canal a dose of cathartic medicine will at times bring on severe laminitis.

(7) Almost all the older authorities were agreed that metastatic laminitis is a reality. In my opinion metastatic laminitis is nothing more nor less than concurrent laminitis, and presents little in any way peculiar outside the imperfectly understood exciting cause. The practitioner who allows the acute symptoms of the laminitis to mislead him, simply because their severity has overshadowed those of the primary disease, may lose his case through unguarded subsequent treatment. This form of laminitis is by no means commonly met with. It may be found in conjunction with pneumonia, according to Youatt with inflammation of the bowels and eyes, and according to Law and Williams sometimes with bronchitis.

Symptoms.—Laminitis is characterized by a congregation of symptoms so well marked as scarcely to be misinterpreted by the most casual observer. They are nearly constant in their manifestations, modified by the number of feet affected, the cause which has induced the disease, the previous condition of the patient, and the various other influences which to some extent operate in all diseases. They may be divided into general symptoms, which are concomitants of all cases of the disease, subject to variations in degree only, and special symptoms, or those which serve to determine the feet affected and the complications which may arise.

General symptoms.—Usually, the first symptom is the interference with locomotion. Occasionally the other symptoms are presented first. As the lameness develops the pulse becomes accelerated, full, hard, and strikes the finger strongly; the temperature soon rises several degrees above the normal, reaching sometimes 106 deg. F.; it generally ranges between 102.5 deg. and 105 deg. F. The respirations are rapid and panting in character, the nostrils widely dilated, and the mucous membranes highly injected. The facial expression is anxious and indicative of the most acute suffering, while the body is more or less bedewed with sweat. At first there may be a tendency to diarrhea, or it may appear later as the result of the medicines used. The urine is high colored, scant in quantity, and of increased specific gravity, owing to the water being eliminated by the skin instead of the kidneys. The appetite is impaired, sometimes entirely lost, but thirst is greatly increased. The affected feet are hot and dry, and as much as possible are relieved from bearing weight. Rapping them with a hammer, or compelling the animal to stand upon one affected member, causes intense pain. The artery at the fetlock throbs beneath the finger.

Special symptoms.—Liability to affection varies in the different feet according to the exciting cause. Any one or more of the feet may become the subject of this disease, although it appears more often in the fore feet than in the hind ones. This is due to the difference of the function, i. e., that the fore feet are the bases of the columns of support, receiving nearly all the body weight during progression and consequently most of the concussion, while the hind feet become simply the fulcra of the levers of progression, and are almost exempt from concussion.

One foot.—Injuries and excessive functional performance are the causes of the disease in only one foot. The general symptoms, as a rule, are not severe, there being often no loss of appetite and no unusual thirst, while the pulse, temperature, and respiration remain about normal. The weight of the body is early thrown upon the opposite foot, and the affected one is extended, repeatedly raised from the floor, and then carefully replaced. When made to move forward the lame foot is either carried in the air while progression is accomplished by hopping with the healthy one, or else the heel of the first is placed upon the ground and receives little weight while the sound limb is quickly advanced. Progression in a straight line is more easy than turning toward the lame side.

Both fore feet.—When both fore feet are affected the symptoms are well marked. The lameness is excessive and the animal almost immovable. When standing the head hangs low down, or rests upon the manger as a means of support and to relieve the feet; the fore feet are well extended so that the weight is thrown upon the heels, where the tissues are least sensitive, least inflamed, and most capable of relief by free effusion. The hind feet are brought forward beneath the body to receive as much weight as possible, thereby relieving the diseased ones. If progression is attempted, which rarely happens voluntarily during the first three or four days, it is accomplished with very great pain and lameness at the starting, which usually subsides to an extent after a few minutes' exercise. During this exercise, if the animal happens to step upon a small stone or other hard substance, he stumbles painfully and is excessively lame in the offended member for a number of steps, owing to the acute pain which pressure upon the sole causes in the tissues beneath. The manner of the progression is pathognomonic of the complaint. Sometimes the affected feet are simultaneously raised from the ground (the hind ones sustaining the weight), then advanced a short distance and carefully replaced; at almost the same moment the hind ones are quickly shuffled forward near to the center of gravitation.

In other instances one foot at a time is advanced and placed with the heel upon the ground in the same careful manner, all causes of concussion being carefully avoided. In attempting to back the animal he is found to be almost stationary, simply swaying the body backward on the haunches and elevating the toes of the diseased feet as they rest upon their heels. In attempting to turn either to the right or left he allows his head to be drawn to the one side to its full extent before moving, then makes his hind feet the axis around which the forward ones describe a shuffling circle.