Lameness of the Horse / Veterinary Practitioners' Series, No. 1

by John Victor Lacroix

SECTION II.

DIAGNOSTIC PRINCIPLES.

To observe attentively is to remember distinctly.—Poe.

Before treatment is administered in constitutional disturbances resulting in disease, cause is logically sought; so, in order to handle effectively any case of lameness, it is necessary first to discover the source of the trouble and contributing conditions affecting the structures. Hence, diagnostic ability is the prime requisite; and a thorough knowledge of pathologic anatomy or of surgical technic is of little value if this knowledge is not applied with the insight of the trained diagnostician.

The cruel and unnecessary methods employed by those untrained for diagnostics, cannot be too vigorously condemned. For instance, the application of an active and depilating vesicant upon a large area on the gluteal or crural region, in a case where the practitioner "guesses" the condition to be one of "hip lameness," constitutes an exposition of gross ignorance, and at once stamps the perpetrator as a crude bungler without scientific insight whose works are no credit to his profession. How much better it would be, if the practitioner does not see fit to call in a competent consultant, to prescribe a suitable agent to be given internally, and to recommend complete rest for the subject.

In establishing a diagnosis in such cases, the student or practitioner seldom has recourse to laboratory assistance, and his work is done by means of physical examination; therefore, a thorough knowledge and a clear conception of the physiology of locomotion are essential. Memorizing nosological facts without an understanding of underlying principles is of no more practical benefit for qualification as a diagnostician in cases of lameness, than is the employment of similar methods in the study of theory and practice. A knowledge of the dosage of drugs does not in itself qualify one as being competent to administer such therapeutic agents to a proper effect. How much is a practitioner benefited by the knowledge that a high temperature is usually present in septic intoxication, if he is not possessed of a scientific understanding of anatomy, physiology, bacteriology and pathology, as well as the principles of clinical diagnosis?

In order to determine the reasons for certain symptoms manifested by the subject, an analysis of these symptoms is the proper method of procedure, insofar as this is possible. If one may reason that an animal assumes a certain position while at rest to allow relaxation of an inflamed tendon or ligament, such a fact enables the diagnostician to recall that this is indicative of some specific ailment. In acute tendinitis, the subject while at rest, maintains the affected member in volar flexion because this position permits relaxation of the inhibitory apparatus, including the inflamed tendon. Likewise, the various abnormal positions assumed,—adduction, abduction, undue flexion or pointing—have their own significance and are taken into account by the trained diagnostician in the course of an examination.

In the examination of lame subjects, where the cause is not obvious, a systematic method of diagnosis is pursued even by the most expert practitioners. In all obscure cases of lameness a methodical and thoroughly practical examination of the animal according to an established procedure is necessary to determine the nature and source of the affliction.