with tendinous, ligamentous or cartilaginous necrosis. After enlarging
the wound, continued irrigation or antiseptics should be used.
Ankylosis is a termination, less unfavorable than to other joints, on
account of the limited motions which the arthrodia performs ; but it is
often accompanied with voluminous periostitis, which, later on, imposes
The articulation of the foot, though protected by the superior bor-
der of the wall, is one of those where traumatic lesions are most
frequently observed. In days gone by, when cartilaginous quittor was
operated by the entire extirpation of the fibro cartilage, it frequently
happened that the lateral cul-de-sac of the articular synovial was open.
Already in 1828, Pauleau spoke of the relative benignity of those
wounds of the joint of the foot. Vatel has several times opened it on
purpose, without observing the slightest accident ; the animals recov-
ered quickly and as well as those in which the synovial was respected.
However, the rule is not without exception. With well-made antisepsy,
the opening of the articular synovial during the operation for quittor is
still less dangerous than before. A thorough washing of the wound
with the solution of Van Swieten and an iodoformed dressing prevent
all complication. Considerably more serious is the prognosis, when the
joint has been perforated with a dirty infected instrument or when its
opening is due to the mortification of peri-articular tissues (cracks,
quittor, complicated nails in the foot). Then, almost always, the joint is
invaded by suppurative inflammation, ordinarily ending by ankylosis.
Our publications contain, however, examples of rapid recovery of
those lesions, which seemed to imply a fatal termination. Pauleau
(1829), in one case of articular fistula, situated in front of the coronet,
used first "antiphlogistic means, then thinned out the hoof covering the
diseased tissues, and made a camphorated dressing with pads dampened
with tincture of aloes. Six days later the synovial discharge had
stopped ; shortly after, recovery was complete. Mercier has related two
recoveries of pedal arthritis with Rabel water. In the first, the articu-
lation was the seat of high inflammation, the febrile reaction was great,
purulent synovial discharge took place from the fistula ; a first dressing
gave no result, the eleventh day Rabel water began to be used ; in ten
days healing was completed ; the joint kept the freedom of all its
motions. In the second case the horse had a nail in the foot, which, ,
according to the author, involved positively (?) the phalangeal joint :
544 VETERINARY SURGICAL THERAPEUTICS.
between the third phalanx and the small sesamoid. Delafond obtained,
in two months the cure of an arthritis due to a nail in the foot. In the
case related by Courdouan, the lesions were of extreme severity.
■' The weight of the hoof alone made the joint open two centimeters at
least, and if we try to flex it laterally, it dilates so much that a stroke of
bistouri at each commissure of the wound would separate entirely the
hoof from the third phalanx ; the little sesamoid is separated almost
completely ; it holds only by one of its extremities." Emollient baths
and alcohol dressings brought on ankylosis in a month without great de-
formity. Delorme tells, without detail, that with a blister he obtained in
twelve days the recovery of a very severe wound of the articulation of
the two last phalanges. In Observation III. of Verrier, it was the case
of a pedal arthritis which had occurred after the operation for nail in the
foot. After vainly trying emollients, tincture of aloes, blisterings, injec-
tions in the fistulas, the author used aegyptiacum, introduced some of it
as deep as possible with a probe ; all the fistulas healed in fifteen days. In
the case of Foelen, the articular borders of the second and third pha-
langes could be felt with the finger, through a wound of the internal side
of the foot. Every day a pad of oakum covered with aegyptiacum was
applied on the wound ; in three weeks recovery was complete. Saude,
after the operation for nail in the foot, with lesions of the navicular bone,
had to treat an arthritis. The inferior wound was dressed with
glycerine, alcohol was injected in the fistulas of the coronet ; six weeks
later, all lameness had disappeared, even in trotting. In a case of nail
in the foot with fracture of the navicular bone, where Humbert re-
moved the bone, three weeks after, recovery was certain. Sesamoidectomy
has been unsuccessful with Moller and all those who have tried it.
Since the communication made before the Societe Centrale de
Medecine Ve'te'rinaire in 1853 by Bouley, continued irrigation has been
the classical treatment of pedal arthritis, following necrosis of the anterior
lateral ligament or an opening of the lateral cul-de-sac of the synovial.
In the paper of Trasbot (1877), there is a remarkable example of re-
covery: a horse, affected with quittor, complicated with necrosis of the
anterior lateral ligament and opening of the synovial, was submitted to
irrigations three days after the operation ; the wound cicatrized in
ten days. Like many other veterinarians, we have obtained similar
results. To insure the irrigation of the wound, it is often necessary
to apply a drain. The superiority of continued irrigation upon the
other means recommended before antisepsy is demonstrated by many
But for quiet animals, easy to dress, we prefer the disinfecting solu-
tions in baths, injections and with dressings. As we write this article.
CLOSED IDIOPATHIC ARTHRITIS. 545
^e have in our care a magnificent animal cured from a pedal arthritis
with baths and antiseptic dressings. Hydrotherapy, carried on for
twelve days, had failed to produce any improvement.
In the quite numerous cases where lameness remains, high neurotomy,
that of the median or of the sciatic, must be resorted to.
CLOSED IDIOPATHIC ARTHRITIS.
Between closed and traumatic arthritis there is the difference which
exists between contusion and contused wound : no foreign body coming
from the outside has entered the joint ; that explains the rarity of sup-
puration in closed articular inflammations. We do not speak here of
the infectious arthritis ; they will be considered farther on. Those that
we will examine now result from local causes which, without opening
the synovial, promote inflammation in them.
Wounds of joints which are not penetrating, violent contusions,
sprains, luxations, epiphysar fractures, are the usual causes.
Closed arthritis is announced by heat, soreness and swelling. The
synovial secretes freely ; in its inside the fluid accumulates and
dilates the weak points, but the peripheric oedematous swelling frequently
conceals the dilatations. The characters of the intrasynovial effusion
have permitted their division into serous, pseudo-membra?ious or purulent-
To reduce the inflammatory manifestations is the first indication of
treatment. General and local bleeding are useless. Even for the artic-
ulation of the foot, the traditional local bleeding at the toe is abandoned ;
it exposes to suppurative infection of the sub-horny structures. Em-
ollient ointments, poultices, white lotion compresses, camphorated
alcohol, are not as good as cold (baths, douches, continued irriga-
tion) or immobilization with an appropriate bandage. " Immobility
\s, par excellence, the antiphlogistic treatment of an inflamed joint "; it
insures rest for the tissues and allows the rapid repair of articular le-
sions. Speaking of sprain of the fetlock, we have shown the beneficial
effects of the bandage of Delorme. By the immobility and compression
it produces, this bandage constitutes a good treatment for more exposed
articular phlogosis. Its application is simple upon the phalangeal
joints, that of the fetlock, knee and hock. With the superior articula-
tion of the extremities (shoulder, elbow, hip, stifle) pitched plasters are to
be recommended. There is often advantage to combine immobilization
with refrigeration. Many practitioners, from the start, use blistering
preparations, so as to modify the synovial inflammation; they are ad -
54^ VETERINARY SURGICAL THERAPEUTICS.
vantageous only when the inflammatory phenomena are moderate or
have already subsided.
If the synovial dropsy is very abundant, puncture of the joint
must be made. On the most prominent point of the tumefaction, the
skin is shaved, soaped and washed with alcohol or Van Swieten. The
trocar and hands of the operator should be carefully disinfected. The
extracted fluid is sometimes clear, at others a little fibrinous, now red-
dish or already cloudy and on the road to suppuration. In this last case,
the washing of the serous may prevent suppurative arthritis. With an
aseptic syringe, or, better, with Dieulafoy or Potain aspirator, an injection
is made in the synovial, with a solution of sublimate i p. looo or phenic
acid 3-5 p. 100 ; this is afterwards drawn out; it is renewed until the
fluid that comes out is limpid, and free from the clots that soiled the first
injections. The washing finished, the wound is closed with collodion and
the region covered with a wadded dressing. Thus the joint is purified
as much as possible. But the result is not always favorable ; when al-
ready pyogenous microbes brought by the circulation to the joint, have
begun their depredations, often the joint becomes purulent, and the pus
makes its way outside, necrosing the peri-articular tissues. The treat-
ment then must be that of traumatic arthritis.
Closed arthritis, not complicated, leaves often after itself a joint stiff,
sore, impotent, with a certain degree of hydarthrosis. Hot effusions,
massage, compression, blistering and firing are the means to be resorted
to. After a sufficient rest, work can be resumed gradually. At times
the chronic form is complicated with periostosis and false ankylosis.
(See Art/i?-itis Deformans and Ankylosis^ When these lesions exist in
the lower joints of extremities (knee, fetlock, phalangeal articulations)
radial or tibial neurotomies are indicated. Several horses suffering with,
chronic arthritis of the knee were neurotomized by MoUer and did work
in trotting afterwards.
In animals, besides traumatic and essential closed arthritis, numerous
other articular inflammations exist, whose pathogeny, for some at least,
is yet unknown. They are not due, like the former, to external violence,
sprains, action of mechanical, physical or chemical agents ; all seem to
constitute manifestations or epiphenomena of general or infectious
We will only name x!c^% glanderous arthritis , so frequently observed in.
INFECTIOUS ARTHRITIS. 54/
former times. Produced by the specific bacillus, its severity depends
altogether upon the affection to which it belongs. Pneumonia, Peri-
pneumonia, variola, are sometimes accompanied with arthritis, which
may assume rheumatismal character and end in suppuration. Purulent
infection frequently gives rise to multiple arthritis with rapid development.
The bacteriological study of the pus of the diseased joints reveals the
presence of the staphylococci or the streptococci. Distemper m^y be ac-
companied with arthropathies. Megnin has seen one case in which
recovery was raidly obtained by blisterings and administration of arsenic
internally. However, rheumatismal arthritis is rare ; the streptococcus
of Schiitz is essentially pyogenous ; suppuration is the ordinary ter-
mination of its articular localizations.
■ Tuberculous arthritis has been observed in cattle, pigs, cats and birds.
If articular tuberculosis can be primitive, exist in the absence of any
visceral lesion, most ordinarily it is sccojidary and represents a single
accident of the bacillosis. The experiments of Max Schliller, repeated
several times, have shown that it is easy to produce it in bruising a
joint in infected subjects. Most of tuberculous arthritis of animals are
without doubt occasioned by accidental traumas ; the contusion trans-
forms the injured region into a spot of less resistance, opening at the
same time the blood-vessels, which pour out their bacilli. The altera^
tions may begin in the synovial, but most ordinarily the epiphysis are
affected first ; a center of caries is developed and also fungositus which in-
oculate the S3-novial ; later, lesions are found in all the tissues of the joint.
According to their characters, tuberculous arthritis have been divided into
various forms — arthritis with hydarthrosis, with riziform granulations,
cold abscess, fungoid arthritis — forms which have been as yet but little
studied in our animals. According to the virulence of the bacillus and
the resistance of the tissue, the lesions are acute, sub-acute or chronic.
Articular tuberculosis is not very rare in bovines (Guillebeau and Hess,
Moller, Noack, Lucet). Under the name of rheumatismal arthritis
(Goux), goutte (Pradal), /ungoid artJvitis (Requier), have been described
in swine arthropathies, whose nature has not yet been determined^
If some among them seem to be related to rachitism or rheumatism there
are others which seem of tuberculous nature (Violet). Bergstrand has
related a case of bacillar arthritis of the metatarso-phalangeal joints in a
pig. Tuberculous arthritis is very rare in dogs. Nocard has seen it
once in a cat. In domestic gallinaceans and birds that are kept in cap-
tivity, they are relatively frequent. Larcher has given a very good
description of their clinical manifestations. When they are in the way
of development, the inferior extremities are taken with spasmodic move-
ments ; the birds have difficulty to stand on their legs, the walk is
548 VETERINARY SURGICAL THERAPEUTICS.
Staggering, lame ; many stand immobile, as if paralyzed. If one of the
superior legs is affected, the animal has difficulty to fly or perhaps is
unable to. The joints are the seat of partial tumefactions, first soft,
later indurated and without tendency to diminish. Sometimes the
various layers which compose them dry off and successively exfoliate; at
others they ulcerate ; the wounds resulting from this ulceration are fis-
tulous, with fungoid edges, bleeding, and present at their bottom a
yellowish scaly or granular matter. Articular surfaces are extensively
altered, sometimes the bones necrosed. Bacilli are found in various
numbers in the affected tissues and in the peri-articular carious deposits,
where in general they are less frequent. We have gathered several
cases of tuberculous arthritis of hens, with lesions very rich in bacilli.
The researches of Eberlein have shown that, on phthisical parrots, tuber-
culous arthritis is counted in the proportion of 25 p. 100.
The treatment of articular tuberculosis of animals is of secondary
interest. (See Tuberculosis.^
I. — Articular Rheumatism.
Acute articular rkeuftiatism, specially common in cattle, observed also
in horse, dog and pig, is a special disease, differing from the pseudo-
rheumatism which sometimes occurs with pneumonia, distemper, pleuro-
pneumonia, puerperal infection. To support its specific nature, are in-
voked : I, the febrile symptoms and the characteristic initial period
of infectious diseases ; 2, the simultaneous attack of joints more or
less apart from each other; 3, the endocarditis which sometimes comes
and complicates rheumatism ; 4, its apparition in model stables or where
cold could not be incriminated (Friedberger and Frohner). Cold enters
in the genesis of this affection only as an occasional cause.
If bacteriological researches have not yet entirely elucidated the
pathogeny of rheumatism of man, they have shown that the diseased
synovials contain ordinarily micro-organisms, most commonly sta-
phylococci (Bouchard and Charron). Schiiller has found in them a
short bacillus, which, inoculated to animals, gives rise to articular
The beginning, often insidious, may make one suspect the presence of
an internal disease. But the lameness, the local pain and hyperthermia,
the multiplicity of the joints affected, the ambulatory character of the
inflammation, are sufficient to establish the diagnosis. The observatioa
reported by Trasbot in the Archives of 1877 is truly typical. During
the development of these arthritis, there often occur other rheumatisma^
manifestations upon the visceral serous, specially upon the endocardium.
As soon as rheumatism is diagnosed, a proper hygiene shall be
INFECTIOUS ARTHRITIS. 549
prescribed. The patient shall be kept in a warm stable, protected from
-drafts of air and dampness. In winter, he will be covered with blankets
and his legs bandaged. For food, he will receive warm mashes.
Bleeding, advocated for a long time, has a doubtful efficacy. Tartar
-emetic and other agents have also for a long time enjoyed a reputation
little deserved. To-day all authors agree 'in recognizing the superiority
of salicylate preparations. Successively the alkalines, salicyline,
salicylic acid, have been used, then salicylate of soda, which has shown
itself more efficacious than the others. To large animals it is given in
doses from 60 to 100 grammes ; to dogs, a few grammes only. This
agent quietens the pains and lowers the temperature. Lately, antypyrine,
exalgine, phenacetine, sulphate of quinine, salol, naphtol, have been
recommended ; their action is inferior to that of the treatment by sali-
cylates. If this should be contra-indicated (renal lesions, albuminuria),
sulphate of quinine and bicarbonate of soda shall be used. Local
applications (phenicated or camphorated ointment, that of populeum
acid, laudanum, poultices) have but little effect. Suppuration, which
is exceptional, is due to a secondary infection.
Chronic articular r/ieumafis?n may appear at once under that form or
follow the acute state. Swelling and pain vary in their severity.
Localized to the legs, the affection gives rise to a continued or inter-
mittent lameness. After a certain time, the articular borders tumefy,
crackings are heard in the joint, osteophytes develop on the edges
of the articulation. The lesions keep growing, and become dry de-
formans arthritis. The treatment of this chronic form differs little from
that of the acute, but is little beneficial. It is again by well under-
stood hygiene, avoiding cold and dampness, the use of salicylates, bicar-'
bonate of soda, arsenic, that improvement of the general condition can be
looked for. Locally, tincture of iodine, blisters, cauterization have seemed
advantageous. If there is large synovial dropsy, puncture is resorted
to. On a steer, Persillet has used with success puncture and compres-
sion with wool bandages.
// — Arthritis of Milch Cows — Post-Partujti Arthritis.
This arthritis, also c^Wtd pseudo-rheiwiatismal, is almost always local-
ized to the stifle, sometimes to the knee or the hock. It is character-
ized by a severe lameness, swelling of the joint, and synovial dilata-
tions. Studied by Coulbeaux, Pauleau, Heu, Rossignol, Auer, Fur-
lanetto, its etiology has remained obscure for a long time. Pauleau,
who has treated more" than eight hundred cases, has remarked that
•*' most ordinarily it precedes or follows abortion, or that it manifests
VETERINARY SURGICAL THERAPEUTICS.
itself after a laborious calving or an incomplete delivery." The same:
author accuses also barns badly kept, where cows lay always in the:
dirt. To-day, it is admitted that this arthritis may follow parturition,,
abortion, or appear as accidents of metritis, of some inflammatory-
affections of the genital organs, aphthous fever, enteritis, mammitis-
(Rossignol). It is not yet known if it is determined by an intrasynovial
microbian puUulation, or by toxines elaborated in the genital organs.
In a case of femoro-tibial arthritis that we have observed, the sowing
of the synovia has given cultures of a micrococcus having all the char-
acters of the staphylococcus albus.
Ordinarily, the march of the disease is chronic or sub-acute. In ex-
Fig. 113. — Femoro tibio-patellar arthritis. (From a photograph.)
ploring the stifle, one observes a puffy swelling of the region, but the
synovial tumors, especially the internal, indicate plainly the articular
dropsy. At a more advanced period, the walls of the distended synovial
may become calcareous. The process does not end in suppuration.
"Never," says Pauleau, "have I seen, at any period of the disease, pus
formed in the diseased parts."
The prognosis is serious. The affection is very tenacious ; left to
itself, it rapidly brings on loss of flesh ; death sometimes occurs in
A.ntisepsy of the genital organs after parturition or abortion is at
present the only prophylactic indications.
Pauleau and many other practitioners have noted the little eflficacy
of irritating topics and of the numerous liniments recommended..
Cauterization succeeds often. The cow represented in fig. 113 entered
INFECTIOUS ARTHRITIS. 55 I
our clinic in August, for a femoro-tibial arthritis ; we treated it with needle
firing. After six weeks, recovery was complete. Blistering frictions
with nitrate of mercury have been recommended (Heu), or those of
bichromate of potassa (Guittard). Furlanetto prefers this in the pro-
portion of 4 parts of bichromate to 30 of lard. Pauleau has obtained
numerous successes with cauterization by sulphuric acid. Out of 806
cases treated, he only had 57 failures. He proceeds as follows :
" He takes half a decilitre of sulphuric acid sold in commerce and a
brush made with a wooden stick, as big as the finger, having a little
pad of old linen at one end. The hair is cut over the pre-eminent
tumors. The head of the animal is held firmly by an assistant ; another,
placed on the side opposite that to be operated on, takes hold of the
tail with one hand and of the teats with the other ; he pulls towards
him the mammae to isolate it from the sick leg, and permits the ap-
plication of the drug on the inside tumor. The mammae is covered
with a coat of greasy substance to protect it from the contact of the acid.
" With the brush dipped in sulphuric acid, the surface of the tumor is
frictioned. A simple embrocation would not be sufficient, a friction of
one minute is necessar)\ Care is taken so that the fluid does not
spread beyond the diseased parts, nor drop between the toes. If the
animal is affected on both sides together, it is better to operate on the
second leg only four or five days after the first. The operation done, the
animal is returned to her barn and tied short to prevent her biting her-
self. After fifteen minutes she is left loose. If the cow show articular
lancinating pains, it is proper to make, on the diseased part, several
frictions with camphorated alcohol, and only after four or five days,
Avhen the animal begins to rest on his leg, to apply the radical treat-
" Two days after the friction, the external enlargement is entirely
flattened, the internal has diminished in size only. The skin, covered
with scabs, has the appearance of being tanned. There is scarcely any
swelling round the eschar. However, in fine skin individuals, the
tumefaction may become very large and run down along the leg. I
prescribe only frictions of camphorated alcohol with the addition of a
little ammonia (i part in 20).
" Fifteen days, three weeks, perhaps a month or more will pass before
the scabs become loose. Even when the skin is destroyed in its whole
thickness, there must be no fear about the sloughs of skin which take
place especially at the internal face of the joint, where during walking
there are constant rubbings ; those sloughs recover perfectly.
" In summer, the wounds are dressed with empyrheumatic oil to keep
ilies away ; in winter tincture of aloes or spirits of turpentine is used.
552 VETERINARY SURGICAL THERAPEUTICS.
The definite result of the treatment is most ordinarily a radical cure of
the patients." '
Rossignol has obtained good results with one simple slight applicatioa
of trade sulphuric acid.
According to various authors, the sudden arrest of the lochia, occur-
ing in a cow well delivered, will occasion sometimes an arthro-synovitis
of the hocks. This affection, already mentioned by Lecouturier, Deneu-
bourg and others, would disappear in a few days. Furlanetto advises
the salicylate of soda internally and frictions of warm oil on the hocks.
The application on the loins of a sachet containing hot ashes will stim-
ulate the return of the lochia.
///. — Arthritis of Netv-Borns.
Arthritis of young animals is an affection which occasions consider-