Diseases of the Horse's Foot

by H. Caulton Reeks

Directly this appears it is a wise plan to thin the wall down with the rasp immediately below the swelling. To some extent it relieves the pressure of the inflammatory products within, and at the same time paves the way for operative measures which may be necessary later on.

With the breaking of the abscess and the discharging of its contents, we may in some measure ascertain the condition we have to deal with. The probe is used, and the abscess cavity explored. The size of the wound, its depth below the upper margin of the wall, the structures involved, and other information, may be thus obtained.

At first, however, the nature of the wound, and the character of the discharges, must largely guide us as to the treatment we adopt. In many cases, even where the abscess cavity is far below the upper margin of the wall, and is presumably in an unfit position to drain and heal, a a regular application of an astringent and antiseptic dressing is sufficient to bring about resolution. If, however, the discharge from the wound continues to be liquid, and the wound itself at one spot refuses to heal, it may be judged that a portion of necrotic tissue is situated under the wall, and affecting the laminæ, the cartilage, or ligament, as the case may be. If this is so, then operative measures must be determined on (see Removal of the Wall, p. 349).

Blisters.—Instead of the poultice and hot baths, the pointing of the abscess and the casting off of the slough may be brought about by the application of a sharp cantharides blister. We have, in fact, seen many cases where this treatment was adopted prior to the formation of a fistula, and also in cases where one or more fistulous openings already existed, where repeated blisters to the coronet have alone been sufficient to effect a cure.

We are bound to admit, however, that the treatments of poulticing and blistering are only expectant—we might almost say empirical. At any rate, we admit to ourselves that what we have advised and carried out is not in itself curative, but only a means of assisting Nature to satisfactorily work her own ends. Empirical or not, however, we believe that in every case of quittor it is wise in practice to at first adopt some such simple measure, for in nearly every instance where operative measures are practised, the patient must be laid aside for at least several weeks, whereas in this way he may be kept at work and a cure effected at the same time.

The Actual Cautery.—Largely of the same empirical nature, yet doing something a little more calculated to destroy necrotic tissue and bring about its sloughing is the use of the cautery, both actual and potential.

The actual cautery may be beneficially employed for the relief of sub-horny quittor in at least two ways.

In the first place, it is often used—a blunt 'point-firing' iron being the instrument—instead of the knife as a means of evacuating the contents of the coronary abscess. Those who use it for this purpose are able to say this in its favour: it brings about the opening of the abscess without the unsightly hæmorrhage attending the use of the knife, and at the same time just as effectually empties it. The opening made is not nearly so likely to close prematurely—that is, before a proper course of treatment of the wound has been carried out—and so leave necrotic tissue at its bottom. The intense tissue reaction it sets up is productive of a large slough, cast off by highly active inflammatory phenomena, which means that the remaining wound is one in which no dead tissue is left, and which is more amenable to treatment.

We have also seen the actual cautery used in sub-horny quittor, where that disease has reached a chronic fistulous stage, as a means of cauterizing the whole length of the lining of each fistulous passage.

At the present day this method is regarded as barbarous, and savouring too largely of the methods and practice of the old empirics. There is no denying the fact, however, that it is at times followed by a speedy and complete cure of what has for months been an intractable and apparently incurable quittor; and, honestly speaking, we ourselves can see nothing very greatly against the operation in certain cases save its appearance. In that it is certainly rough, and is not calculated to favourably impress the more critical of our clientele. With the animal chloroformed, however, much of what can really be urged against it disappears, and on farms and other places where a skilled and competent dressing of an operation wound cannot be looked for, it is sometimes wise to advise this method of treatment in preference to more advanced methods of operating. So far as we can judge, the after-effects are very little worse than those following other operative measures, more especially when a suitable case has been chosen.