The wound being cleansed, a certain time should be allowed to elapse for the horse to recover its composure. It should return to the stable, have a feed of corn, and be watered. Then the real business commences. The animal should be gently approached; its condition should be observed. If any nervousness is exhibited, the person ought to retire, and a further pause should be allowed. If, on the second visit, any unusual symptoms are displayed, have the quadruped led into the yard and blindfolded. Let a man take up the other fore leg, when the knee may be examined with safety.
Place the palm of the hand over the joint. Hold it there to ascertain if any heat or swelling is to be detected. Should there be swelling, make gradual and gentle pressure upon it with the thumb or one finger. If, upon suddenly removing the hand, an indent is conspicuous, it argues considerable effusion, and justifies fear as to the result. Should neither heat nor swelling be remarked, further pressure is to be made with the thumb upon the knee. The force should be gentle at first and gradually increased. If the action is sustained well, or even moderately endured, it allows of hope being entertained. But should the horse attempt to rear upon the first impress of the thumb, the result is very dubious. The absence of agony is far from anything approaching to a positive proof, as bone and synovial membrane, tendon and ligament, do not take on acute inflammation when first injured; but, from the response thus elicited, a fair inference as to the probability may be drawn.
Should the skin be lacerated, the probe must be employed. Such injuries are very deceptive. They may be much more extensive than the size of the wound would indicate. The probe being of metal, ought not to be thrust violently against every exposed part. This kind of proceeding can effect no good. The probe should be held lightly between the thumb and fore finger; no pressure should be made upon it—the instrument ought rather to fall of its own gravity than be forced into the flesh. A thin piece of wire can be readily driven into soft structures; but where an actual division exists, no opposition necessitating force will be encountered.
Broken knees always happen when the horse is in motion. The onward impulse is not by the fall immediately destroyed; but after the horse is down there always exists an impetus which has a tendency to propel the body forward. Should the skin of the knees be divided by the fall, the after-force obviously cannot affect the upper line of such division; but the lower edge of skin will present an acute obstacle to the roughened ground, and will, by the grating of the body, in all probability be rent from its attachments. When the animal rises, the action and the elasticity natural to the integument will occasion the torn portion of the skin which has been driven backward to once more assume its original position. By this means a kind of bag or purse is formed upon the knee. Grit, mud, and all kinds of impurities may be retained and concealed within this pouch. These will be disposed to irritate the structure with which they are in contact; suppuration is certain to be established, and sad consequences have followed such sacs not being early detected.
PROBING THE SAC OF A BROKEN KNEE.
A SETON BEING INSERTED THROUGH
THE SAC OF THE KNEE.
Such a cavity having been discovered, the next object is to ascertain its dimensions. That is done by gradually moving the probe along its sides. Should it be small, it will be sufficient that a hole be made through its most depending portion with a sharp seton needle. If it be large, the needle should be armed with a piece of tape knotted at one end. The sac being punctured, the needle is to be drawn through the opening, the tape being left in the cavity, and a seton is thus formed. The seton should be knotted at the other end, and moved its entire length every night and morning. It will prevent all premature attempts to heal, will stimulate the soft parts to suppuration, and will remove the dirt, as the tape affords a guide to the secretion. When inserting a seton into the knee, always use a large curved needle. The size of the instruments should never be regulated by any foreign standard, but should always be proportioned to the magnitude of the patient and the intention of the operator.