When the hygroma is indur-
ated, deep firing, excision or ex-
tirpation are necessary. In cat-
tle, Saussol divided the tumor
vertically with the bistoury, al-
most entirely removed the yellow
lardaceous mass which forms it,
and cauterized it with the hot
iron ; after a month the recovery
was almost complete, but an ugly
cicatrix was left. Serres made, on
the most projecting portion of the
tumor, two convergent curved in-
cisions, bounding an elliptic flap
of skin, which was excised with
the tumor. The whole of this

Fig. 6o.-Hygroma of the Knee partly ^^^^ ^^^^^ ^^^^^^^^ ^^ thoroughly
ossified and covered with a horny

growth (from Stockfleth). '^^^ possible, and a quilled suture

dressing applied.

With antisepsis more favorable results can be obtained. The technic




HYGROMAS— BURSITIS. 257

used to remove the cicatrices of broken knees is here applicable. The
synovial membranes should be avoided, solid suture be applied and the
region immobilized with a plaster spHnt.

Horny productions on the anterior face of the knees of cattle must
be extirpated. Interference is obviously limited to cases where the growth
is not too large and its surface of implantation not too wide.

///, Hygroma of the Stifle.

Prepatellar hygroma must be distinguished from the femoro-tibio-patellar
hydrarthrosis. In some cases the diagnosis is difificult, and both may exist
together. This hygroma deforms the part, but produces no lameness and
does not incommode the patient.

Puncture with the trocar, iodine injections, line or point firing, depend-
ent puncture with the bistoury, and drainage with antiseptic injections are
the means used when the diagnosis is established.!

Once open, suppuration may last for a long lime. It must be treated
with strong antiseptic or slightly caustic solutions.

IV. Hygroma of the Hock — Capped Hock.

The point of the hock is not infrequently the seat of an oedematous,
phlegmonous or indurated tumefaction, called by old hippiaters " capped
hock." It starts in inflammation of the subcutaneous serous bursse or of
the connective layer which unites the skin to the tendon of the deep flexor
of the phalanges. External blows, kicks, rubbing against the stalls or
other hard bodies are the causes of this affection. It has sometimes mani-
fested itself after anasarca, excessive or premature work, slips or violent ef-
orts (Peuch). It has been observed on both legs without evident cause
(Furlanetto). Often its growth is so rapid that in one night it may be-
come as big as a small orange. In the beginning it is often warm and
painful; its resolution can then be easily obtained. (Fig. 61.)

To pad the sides of the stall and prevent the animal from rubbing its
hocks, and from kicking by having the hind legs hobbled together, are
the first precautions to be taken. The local treatment consists in douches
and astringent applications — vinegar and common chalk, a mixture of
clay, vinegar and sulphate of iron (Delwart). If irritations are kept up

1 The size that this form of hygroma assumes is sometimes enormous. We
had an opportunity to observe one case where it w.as so large that locomotion was
entirely impossible. We tapped it four days in succession, removing on the
first day fifty-two ounces of fluid ; on the second, over twenty-six ; on the
third, six, and on the fourth puncture, four ounces were again removed. In
this case suppuration was comparatively small on account of the free use of
tincture of iodine irrigations which were used. {A. Liautard : Lameness of
Horses, page 153. 1888.)
17



■^'Q



53 VI- iERIXARY SURGICAL THERAPEUTICS.

on the parts, the tumor begins to increase in size, to indurate and to as-
sume a character of chronicity which renders recovery very difficult. All
kinds of vesicating agents have been tried (blisters of cantharides and of
mercurial preparations, etc.). The best results have been obtained by

repeated applications of preparations of
moderate activity. In these seems to be
the secret of success. Thus can be ex-
plained the results obtained with the Weber
preparation, which has shown itself most effi-
cacious in numerous old voluminous capped
hocks. Rest is not necessary ; on the con-
trary, work is advantageous during the treat-
ment.

Penetrating point firing has its patrons;
we have used it with success, but it is
slow, not to be depended upon, and leaves
scars. Puncture is insufficient. Iodine
injections have given recoveries to Leblanc,
Cambron, Verrier, Liard, and many others.
Leblanc's case was the size of the fist, of long
date, and had resisted many forms of treat-
ment. The animal was very nervous and
had to be thrown to receive the injection
Fig. 6i. — Capped Hock. (i percent, tincture iodine, 2 per cent, of
water). After fifteen days, the liquid col-
lection having returned, a second injection was made. Recovery
was complete. The mare treated by Cambron had a capped hock as big
as a child's head ; puncture gave escape to one and a half liters of
fluid. A first injection being followed only by improvement, a second was
made, and the tumor disappeared entirely. Verrier injected two volumin-
ous capped hocks on the same horse ; he saw the animal three months
afterwards entirely recovered. Ahorse treated by Liard (obs. 6) was also
cured by one injection : after three months the growth was reduced three-
quarters of its size, and ultimately disappeared. Another horse (obs. 5),
after the injection, rubbed its hock against the stall, the sac opened, sup-
purated and filled with granulations ; later the tumor subsided, but the
point of the hock carried a cicatrix.

Free incision made without asepsis exposes the lesion to severe compli-
cations : at times it becomes a suppurative phlegmasia of long duration, or
the growth indurates and considerably increases. Even when made an-
tiseptically and completed with a wadded dressing, the operation does not
seem to have given such brilliant results. Besides, it requires a long rest.




HYGROMAS— BURSITIS. 259

Heil says he has cured some capped hocks l)y rupture obtained as
follows : While the sound hind leg is flexed and held up by an assistant,
a ligature sufficiently tight to be inconvenient to the horse is put on the
diseased leg above the hock ; the leg that was raised is let go ; the animal
mal'.es violent efforts to free itself from the ligature ; the hygroma bursts ;
its contents spread into the surrounding connective tissue and are absorbed.
The trouble will not return.

The same treatment cannot be applied to all capped hocks. In general,
if the lesion is recent, douches, cold baths, astringents, massage and tan-
nic liniment are to be prescribed. If the tumor is older, but of moderate
size, it should still be treated with liniment or light blisters ; if it is larger,
and has still preserved the character of a cyst, actual cauterization or an
iodine injection may be selected. With indurated capped hocks of large
size, needle firing and also tannic liniment should be used. If the growth
becomes phlegmonous, it should be opened and the cavity washed out with
antiseptics.

F. Hygroma of the Fetlock.

Most authors describe under the name of hygroma of the fetlock the
distension of the synovial sheath that assists the sliding of the anterior ex-
tensor of the phalanges upon the anterior face of that region. Thus
formed, the tumor is ordinarily soft, fluctuating, painless, and well bilobed
when it is large. We will study it in the chapter on Tendinous Synovial
Dropsies. The true hygroma of the fetlock, like that of the knee, is sub-
cutaneous, developed between the skin and tendon. Diffused, spread,
and sometimes oedematous at the start, it becomes circumscribed and in-
durated with time, but rarely becomes very large. Its treatment differs
little from that of benign forms of hygromas of the knee. Recent tumors
generally yield to pressure, massage or light absorbents. Old hygromas
demand puncture with irritating injections, cauterization or incision.

VI. Hygroma of the Canon.

This is always localized on the internal face of that region, is due to
blows from the inner side of the shoe or corresponding quarter of the foot
of animals with irregular gaits, and sometimes it accidentally comes to
horses with sound standing and normal action.

Its characters differ. Sometimes it is chronic, and appears under the
aspect of a soft, elastic tumor, well-defined and without manifest inflam-
matory phenomena : such a one would be treated with puncture and
iodine injections or with deep penetrating point firing. Acute and phleg-
monous, it forms a warm, painful tumor, extending more or less on the
canon; with its surroundings indurated and its center fluctuating, the only



2 JO VETERINARY SURGICAL THERAPEUTICS.

thing to do is to puncture it on the most dependent part. Antiseptic
care easily brings recovery. If there is undermining of the skin, puncture
is not enough, because the wound would close too rapidly ; a drainage-tube
is necessary to permit the escape of pus and the injections of antiseptic
washes. Seton is less recommendable.

Hygroma of the Withers. (See Diseases of the Withers, vol.2.)
Hygroma of the Poll. (See Diseases of the Poll, vol. 2.)

111.

NEOPLASMS.

Tumors of serous bursas are exceptionally rare. The walls of these
cavities may, however, be the starting-point for neoplasms of various
kinds : sarcomas, fibromas, myxomas, fibrochondromas and epitheliomas.
Fibromas and sarcomas are most ordinarily observed.

The characters vary with the nature of the lesions. The clinical diag-
nosis is somewhat difficult, since the marked induration of many chronic
hygromas may resemble a true neoplasm.

With malignant tumors, early and complete extirpation is here, as in
similar cases, the only efficacious treatment. Such is it also for benignant
growths which produce functional disturbances. Cauterization is to be
used only in cases of induration of an inflammatory nature produced by
chronic hygromas.



CHAPTER III.

MUSCLES.

I.

TRAUMATIC LESIONS.

Bruises {contusions') of muscles have external causes (traumas) and inter-
nal causes (fractures, luxations). They vary from the slightest excitement
{inuscular stupor') to complete rupture or crushing. The more elastic skin
yields without breaking, while the muscle underneath is cleanly divided or
bruised. Commonly, the alterations consist in fibrillar ruptures with
bloody infiltration or only in a partial division : hemorrhage takes place,
the cavity is filled, and a hematoma is formed.

Rest, douches in some cases, wadded paddings, are the treatment useful
in the beginning. Even when there is partial or total rupture, the thera-
peutic is not yet very active. (See Ruptures.) Later, massage is to be
employed. When a sero-bloody collection remains, it is necessary to have
recourse to puncture followed by an alterative injection, methodical pres-
sure or incision. (See Contusions.) If the traumatic center suppurates,
free openings and antiseptic irrigations are necessary. In cattle, bruises
of the gastrocnemius are often accompanied with suppuration. Puncture
and carbolic injections insure recovery. (Stockfleth.)

Pricks with aseptic instruments heal promptly. If they are infected,
they are accompanied with severe phlegmasic phenomena and suppuration,
and must be treated according to the rules indicated in the chapter on
Pricks in general.

Wounds with shajp instruments affect the muscle more or less deeply
and in various directions. If they are parallel to its axis, they have no
tendency to open widely ; there is but a slight slit, which will close rapidly.
If, on the contrary, the organ is divided transversely, there is first an
abundant hemorrhage, both ends separate, and the wound gapes. What-
ever may be its extent or its character, it must be carefully disinfected,
especially if the injuring body is dirty ; and the leg must be put into
the best position to favor the closing together of the ends of the muscle.
This is sometimes difficult to realize. The leg should be kept extended
with an unremovable bandage in cases of the section of an extensor, and
flexed if there is section of a flexor : attempts " may be made to bring

261



202 VETERINARY SURGICAL THERAPEUTICS.

both divided ends together by sutures ; but generally they are cut by the
threads. Complications must be guarded against ; dressings must be ap-
plied on the legs ; on the trunk, ordinarily one is satisfied with washings
and the use of absorbing powders. In most cases a thick fibrous layer is
formed between the two muscular stumps ; the muscle becomes digastric.
One must also watch the progress of the repairing phenomena ; it is
possible that the cicatricial tissue will contract adherences with the sur-
rounding bone, thus destroying the action of the muscle ; though ordin-
arily these fibrous adhesions break up and the leg returns to its normal func-
tion.

In all animals, contused wounds are the most common and also the
most serious. They expose them to all the complications of extensive
traumatisms. The bloody exudation, the laceration of injured parts, and
the abundant connective tissue interposed between the various muscular
layers are so many conditions which promote suppuration and the mi-
gration of pus into more or less distant regions. In the observation of
RigoUat, ihe great scapulo-humeral muscle had been entirely divided by a
kick at its insertion in the humerus ; there was a wound twelve centimeters
long, five wide and four deep. Balls that pierce through a muscle make
a canaliculate loss of substance. If the wound has been made during con-
traction of the muscle, when it relaxes the tract does not correspond any
more to the cutaneous and aponeurotic openings, and if suppuration oc-
curs, it accumulates in the tract. The wound should be carefully dis-
infected in every part (irrigation, antiseptic bath), and, if possible, it
should be protected with a dressing. The wounds of the trunk should be
irrigated two or three times a day with disinfecting fluids, then covered
with antiseptic or simply absorbing powders. In the traumatisms of the
croup or of the thigh, subcrustaceous cicatrization is obtained easily : the
wound having been disinfected, and then dusted with tannin, coal-tar,
or charcoal, covers itself with a scab, under which cicatrization goes on
without abundant suppuration. In wounds made with substances soiled
by earth, septicaemia and tetanus are particularly to be feared. If the pus
filtrates between muscular layers, counter-openings should be made.
Drains will permit the thorough cleansing of the wounds. The thera-
peutics of tearings does not differ from that of contused wounds.

II.

RUPTURES.

Solutions of continuity of muscles by their contraction are the ones
which truly deserve the name of ruptures. When traumatic, they belong
to the chapter on Contusions.

Muscular tears have been especially observed in horses ; they are not so



RUPTURES. 263

common in cattle or dogs, but are seen in swine (Ostertag) and birds
(Larcher) frequently. Complete rupture of muscles is much less com-
mon than that of tendons or of bones ; when it occurs, it is either the fleshy
part which is affected or, as is more commonly the case, the musculo-tendin-
ous portion. Incomplete ruptures involving only a few fibres are facts of
daily occurrence : the partial ruptures of the ilio-spinalis muscle in horses
secured in a recumbent position are frequently observed, (^t^ Myositis.)

Lesions of degeneration of muscular fibres promote ruptures. In man,
these degenerations have been observed in typhoid fever, smallpox and
other infectious diseases ; they are also observed in animals during an-
alogous affections. Rupture may sometimes occur in muscles absolutely
sound, under the influence of a violent contraction. Muscles in condition
of activity have an enormous resisting power. Experiments have shown
that in dogs the biceps is ten times more resisting during life than after
death ; from this some have concluded that rupture was impossible during
the state of contraction for them. Antagonistics are those which would
bring on distension and rupture of the relaxed muscle ; but inco-ordinated
contraction may overcome the resistance of the muscular fibre, and it is
thus that the great majority of ruptures take place.

In colts and in calves, sometimes, during the few hours following birth,
one observes pseudo-paralysis of one or several members, due to muscular
ruptures. On a two-day-old colt which was unable to stand up, and was
killed, Knoll found the anterior extensor of the phalanges ruptured on
the right anterior leg. Sussdorf has reported a similar case. Whether the
accident is the result of powerful contraction of the muscles, as Sussdorf
believes, or of dystokial difficulty, it is always serious, and treatment ought
not to be undertaken except on animals of great value.

In adults, muscular ruptures are observed especially after violent efforts,
falls, slips or blows. Partial ruptures involve the superficial or the deep
part of the organ ; long muscles are more exposed than the others ; thin,
flat muscles, those that are not surrounded by a restraining aponeurosis,
rupture most commonly in their superficial layers ; the muscles that have
a thick sheath rupture rather towards the center (Rigot). As the fibres do
not give way on the same level, the surface of the fracture is always ir-
regular and ragged. An exudation of blood fills the space left between the
divided ends.

Ruptures of the following muscles have been recorded : Pectoral, mas-
ioido-humeralis, subscapularis, coraco-radialis, extensors of the fore- arm,
ilio-spi?ialis, antenor crural muscles, bifcmoro-calcaneal, tibio-premciatar-
sal, and diaphragm. The observations 2, 3 and 4 of the report of Rigot
relate to the rupture of the subscapularis muscle. Tearings of the
coraco-radialis are at times partial and again complete. Goubaux has



264 VETERINARY SURGICAL THERAPEUTICS.

reported two observations of rupture of this muscle : in a twelve-year-
old horse destroyed for dissection, he found on both legs a cicatrized
rupture of the long flexor of the forearm ; in a seven-year patient which
was very lame in the left fore leg, he found in that muscle five cystic
pouches, evidences of previous ruptures, and also the cicatrix of a com-
plete rupture of its inferior tendon. Nesbit has made the post-mortem
examination of a horse in which on both legs the coraco-radialis muscle
was torn from its scapular attachments/ Peuch records the following in-
teresting observation : A horse running away struck against the angle of
a wall, fell down and had some difificulty in getting up. On examination,
he found that "a little below the right scapulo-humeral articulation, in
the middle part of the long flexor of the forearm, there was an oblong
tumor the size of the fist extending to the middle of the anterior brachial
region; it was hot and painful." The animal rested only on its toe.
The general symptoms were such that two days afterwards it was de-
stroyed. At the autopsy, there was a diffused hemorrhagic center, a
partial rupture of the mastoido-humeral muscle and on the bicipital
groove a rupture of the width of two fingers ; also a transverse solution of
continuity of the coraco-radial muscle. At the autopsy of a horse that had
hown symptoms of sprains of the loins, Rigot found the great psoas
swollen, softened and partially torn. In tears of the gluteal muscles, of
the superficial (long vastus) especially, the diseased leg is dropped, its bony
supports half flexed ; in walking, the step is shortened, the motion of
the leg is limited, the toe drags on the ground ; later there is a local
simple depression, or a deformation of the region brought on by the
atrophy of the muscle. The troubles of locomotion last sometimes for a
long while. In a horse cast on the left side for castration, Raynaud
observed, on the right gluteal region, near the origin of the tail, a some-
what large swelling, though not very painful ; in walking, the muscles
of that region contracted with difficulty, the leg was dragged along and
moved in abduction. The author made a diagnosis of I'upture of the long
vastus and middle gluteus. There remained a slight motion of abduction
and a depression at the point of rupture. Partial ruptures and those of
the patellar \rm?,Q.\e5 are not rare. Delwart, Haubner, Schmidt, Hoffmann,
and Bassi have recorded dnstances of them in horses; HoUmann and
Meyer, in cows. Delwart says he has observed the laceration of the

' Professor Robertson has an animal destroyed because of severe osteo poro-
sis. There was a great deformy, his body hanging between both fore legs, it
the scapulae having a horizontal position. At the post mortem it was found
that on the right side the coracoid process had given way and on the left the
tendon of the coraco radialis had ruptured about three-quarters of an inch from
its attachment. (Amer. Vet. Review, vol. 21, p. 623.)



RUPTURES. 265

anterior straight muscle ; l)ut the reading of his case shows that the lesions
he met had occurred during an attack of hemoglobinuria. At the post-
mortem examination of a horse whose " entire muscular system " was dis-
colored, Salle and Sergent £ound ruptures of the short adductor, of the
thigh, and of the external ischio-tibial muscle.* ^ Krashe has recorded
the case of a horse which was lame for a long while in one hind leg, and
which one morning was found with it all deformed ; the leg and thigh
were much tumefied, the femur and tibia almost on a straight line, the
hock much flexed on the tibia, to such an extent that at each step the
point of the hock would touch the ground. Having been destroyed, at
the post-mortem examination the gastrocnemius externus and internus
were entirely torn at their superior attachment and extensively diseased
with old degenerating myositis. A plate in Stockfleth's "Surgery"
shows a cow whose hock almost touches the ground, and in which the
gemini of the corresponding leg were found ruptured near their femoral in-
sertion.3 Some muscular ruptures are accompanied with some spinal
diseases; that of the abdominal muscles ordinarily gives rise to hernia:
that of the intercostals to pneumocele. In the observation of Jacotin,
under the title of " Rupture of the Aponeurosis of the Great Serratus,"
as in that of Bouley of " Rupture of the Tendon of the Postea-Spinatus," it
was a question of a paralysis of the sus-scapular nerve.

' Dr. Pendry has recorded the case of a trotting-horse which became lame
and which by the peculiar history he suspected to be suffering with in-
complete fracture of the femur. After a few days of treatment (shngs and
blister) the animal was found in the morning with a fracture of the lower
extremity of the tibia. On making minute dissection of the leg and examining
the condition of the ischio-tibial muscles he found a laceration of the anterior
portion of the long vastus muscle, with large ante-mortem clots on its deep sur
face. (Amer. Vet. Review, vol. 8, p. 412.)

^ Cases of rupture of the flexor metatarsi are recorded in the American
Veterinary Review by Abele, in which recovery was quite rapid. After three
weeks the lameness was hardly perceptible. (Vol. 20, p. 573.) In the observa-
tion of Ivusk the horse walked quite sound after four weeks and resumed work
a week later. (Vol. 21, p. 257.) A fatal case is also recorded from the clinic
of a veterinary college in Chicago, in which at post mortem was found " an
almost entire rupture of the tendinous portion of the flexor metatarsi with partial
rupture of the muscular portion. " The accident occurred while the horse was at
work ; he slipped on the ice, and on attempting to rise his near hind foot slipped
back. (Vol. 22, p. 767.)

3 Dr. Schreibler has reported a case of complete laceration of the gastroc-
nemius tendon in a greyhound, which was completely severed. The separate
ends of the tendon were about one inch apart and the rupture about an inch
and a half from the apex of the os calcis. The leg was placed in splints and
left for about a month, when the dog was discharged. There remained much
lameness, due to excessive atrophy of the muscles of the leg, (Amer, Vet,
Review, vol, 5, p. 467.)



266 VETERINARY SURGICAL THERAPEUTICS.

The diagnosis is sometimes difficult. Recent complete rupture is
generally recognized by the swelling, the great abnormal sensibility of the
region and the functional disturbances, which vary according to the muscles
affected. Old, it is characterized by the presence of a notch or depres-