CHRONIC MOIST ECZEMA (IMPETIGO) AT THE MANE AND TAIL.
Fleshy neck, thick mane and tail, lymphatic constitution, profuse perspiration, lack of cleanliness, alkaline soaps, plethora, foul stable, pus microbes. Symptoms: itching or tenderness, shedding hair, thinning of mane and tail, skin thickened, ridges and folds, tenderness, moisture, crusts raise hairs from follicles, fœtor, sores and ulcers, matted hairs. Treatment: remove general and local causes, cleanse, cool, pure stable, clip, reduce grain; cooling, laxative food, soothing or stimulating applications, zinc oxide, talc, olive oil and diachylon plaster, iodoform, silver nitrate, oil of cade, or of white birch, sulphur iodide, Canada balsam and sulphur, green soap, dusting powders, ointments.
This condition is especially common in horses with a profusion of long hairs in the mane and tail, and in the heavy draught animal with a thick, fleshy neck. In such the skin is very sensitive, and when profuse perspiration soaks the skin, or concretes and decomposes about the roots of the hairs, the local irritation necessary to the production of the eruption is present. A lack of careful grooming is therefore a common cause, yet soap left in washing the mane or tail may be no less injurious. Plethora has its influence in many cases, and the ammoniacal fumes from a wooden stable saturated with excretions are not to be ignored. Finally in cases accompanied by pustular eruption, the pus microbes must be recognized as factors.
Symptoms. There may be marked itching or extreme tenderness of the part affected or in the absence of both there may occur a gradual shedding of the long hairs, so that an increasing thinness of the mane and tail (rat tail) becomes apparent. The skin covering the affected parts is thickened, inflamed and thrown into ridges and folds, one rubbing against another. The surface feels moist or is covered by crusts formed by the condensation of the moist exudate, and embracing the hairs and drawing them out of their follicles. Beneath the concretions the skin is soaked in the tenacious fœtid liquid discharge. The hair follicles become atrophied in connection with the evulsion of the hairs, or under congestion the hairs stand rigidly erect, and bristly or curly. As the freer secretion abates, the exudate become more purely scally or encrusted, but the skin remains thickened and thrown into folds. Under the inveterate rubbing or gnawing the skin is often extensively abraded and large open sores are formed which are indolent and slow to heal. That matting together of the hairs which has been known as plica Polonica is often the result of the disease of the hair follicles and the accumulation of scabs which takes place in this disease, rather than to a special infection like gregarina (coccidiosis).
Treatment. The first consideration must be to remove all general and local causes of eczema, insure perfect cleanliness and good grooming in any case in which these may been lacking, purify the air of the stable if that has been foul, procure a cool environment when that has been too hot, clip the patient if habitually soaked with perspiration by reason of a heavy coat, suspend or moderate the work if that has been too exacting, withhold a heating grain ration (corn, buckwheat, barley, wheat, peas, beans), and furnish cooling, laxative, easily digested food. In the cases before us the acute, irritable stage has usually passed, so that the more stimulating applications may be safely used, yet in many old standing cases a fresh eruption may have taken place, which would demand for a time the most soothing applications only. Apart from such cases the more stimulating dressings are applied at once.
The affected surface is exposed by clipping or shaving off the long hairs, thus at once removing a source of heat and irritation and allowing of the direct and thorough application of the dressing. Among the astringent and stimulant applications oxide of zinc ointment and benzoated oxide of zinc are among the simplest and least likely to irritate, but the stronger applications can usually be borne. The Lassar paste consists of two parts each of finely powdered talc and zinc oxide, four parts of vaseline and three per cent. of salicylic acid. Oxide of bismuth may substitute the zinc oxide. Three parts of olive oil and four of diachylon plaster melted together and stirred until cool, makes another mildly astringent and sedative application. Iodoform 1 dr. to an ounce of vaseline is an excellent agent. A mixture of iodoform and tannin is used as a dusting powder by Friedberger and Fröhner: or silver nitrate solution (6:100) may be used. Tar ointment (1:8) with a little subcarbonate of potassium added makes an excellent application. Oil of cade and oil of white birch may be used in the same way, the latter being the most desirable as a rule. Ammonia chloride of mercury as an ointment (1:10), often acts well and the black wash, formed by the decomposition of calomel with potash is often serviceable. Iodide of sulphur and vaseline (1:10) is often an excellent resort. An ointment of equal parts of Canada balsam and sulphur or iodide of sulphur in four parts of vaseline is often effective. Other valuable preparations are ointments (10%) of ichthyol, naphthol, chrysarobin or pyrogallol. Hebra’s last resort of green soap is never to be forgotten, the affected skin being thickly smeared with the soap which is left to dry on, and is repeated and rubbed in, for several days in succession. It may seem at first to aggravate the disease by reason of the solution and removal of the covering of the vesicles or pustules and the exposure of a pink sensitive surface, but day by day this improves and the skin becomes smooth and more natural. After a few days of this treatment, it may, if necessary, be followed by astringent or stimulant dressings, or the varied medicaments may be incorporated with the soap so as to form one dressing to be applied from the first. When a healthy action has been once established, all that is required further may be cleanliness, with the use of bland dusting powders or ointments to establish the cure.
CHRONIC ECZEMA OF THE CARPUS AND TARSUS; MALANDERS: SALLENDERS.
Eruption in bends of carpus and tarsus and downward: Causes: lymphatic temperament, constitutional predisposition, deranged internal organs, excessive secretions, modified, congested skin, friction between dermal folds. Symptoms: stiffness, heat, thickening and redness, vesicles or oozing, crusts, erect hairs, shedding hair, squamæ, cracks, abrasions, fissures, subcutaneous engorgement, lymphangiectasis. Treatment: Cleanse, get pure air, regular exercise, non-stimulating food, avoid cold water, mud, slush, caustic soap, lime, sharp sand, foul organic matter. Massage. Light bandages. Bland ointments. Dusting powders. Rest. Iodoform. Starch. Zinc oxide. Boric acid. Magnesia. Bismuth. Lycopodion. Lead. Tannin. Pyoktannin. Stimulating ointments. Green soap. Arsenic.
The bends of the carpus and tarsus in heavy, lymphatic, coarse skinned horses are especially subject to eczema followed by a dense scabby eruption, which in the old farrier’s nomenclature was known as malanders in the fore limb and sallenders in the hind. It is not always confined to the joints but may extend down the limb, especially on the back, where the hair is coarser and the skin thicker, as far as the fetlock or even to the hoof.
In the matter of causation much depends on the general constitutional state which tends to eczema, and on the torpor or derangement of some of the internal organs the functions of which are interdependent with those of the skin. Something too must be attributed to the freer secretions of these parts in coarse bred horses, to the accumulation of such secretions and of extraneous irritants under the long hair, to the sluggishness of the circulation in the limbs which has to overcome the force of gravitation, and to friction between the thick folds of skin in flexion, and stretching in extension. Swelling of the lower limbs is at once a cause and an effect of the disease.