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Simple Contusions and Some Sequelæ
Simple Contusions and Some S equela.
249
the pregnant female of our own species, albumen makes its appearance in the urine at least a month before the en d of the period of gestation. If we could form a reasonable idea as t o whether or not a cow was likely to be attacked by the disease, by demonstrating the presence of albumen in the urin e, it would, I believe, be a means of saving a great deal of money which the stock-owner can ill afford to lose. If there is anything tenable in these remarks, I shall be g lad to see them discussed in these columns; and if not they will no doubt soon be confuted by some better informed m ember of our profession.
SIMPLE CONTUSIONS AND SOME SEQUELlE. BY PETER MOIR, M.R.C.V.S ., EDINBURGH.
THE locomotor apparatus of the horse, more particularly that of the fore extremities, by functional d erangement of one or m ore of its numerous parts, throug h accident or disease, furnishes t o the veterinary practitioner clinical cases, great in variety and large in number, that demand from him the exercise of no small amount of patience, and all the skill at his command, for their successful treatment. An injury, of which the only external indication is a slight contusion, may, and frequently has masked a fractured limb, and a simple muscular contusion even some distance from an articulation, may give infinite trouble to the surgeon, and end in disastrous results. . Two cases of simple contusion have lately come under my notice, in which the extensor and fl exor muscles, and the humero-radial articulation were involved, and when we consider that this part of the locomotor apparatus, hy r eason of the important functions it p erforms, not only while a horse is in motion, but also in bearing a large share of the superincumbent weight of its fram ework, possesses a highly vascular and nervous organisation, we should b e prepared, more especially when curative measures for the initial injury have been neglected, to encounter cases likely to give trouble. Case I.-A bay mare, five years old, slipped up on the street, while in harness, falling on her near side. She immediately arose without being taken out of the light van, in which she was working, almost unhurt, th ere being merely a slight abrasion of the skin in the external lateral part of the near fore-arm . Th e mare was kept at slow work for about a week, after the first few minutes going fairly well, but daily becoming more lame, when starting off. Medical advice was then deemed necessary, and I found the fore-arm to be slightly VOL. XL.
R
The Veterinary lourttal. swollen, painful on pressure, and a minute orifice on the abraded part, from which there was a serous discharge, small in quantity, Complete rest and fom entations were prescribed, while the diet also was r egulated. On my next visit, three days afterwards, a well-defined. tense, and painful swelling , situated upward s a nd forwards" about three inches above the extern al orifice, was presented. the least movement of the limb causing g reat pain. There was a slight increase in the discharge from the wound, which, on being probed, admitted the probe to enter about two inches in the directi on of the swelling. The patient was now placed in slings, the orifice enlarged, and the fom entations almost constantly applied to encourage the maturation of what seemed to be a deep, diffused abscess. A weak solution of hydrarg. perch10r. was occasionally inj ected. This treatment was continued for a few days, with no subsidence of the tumefaction or the pain, the former gradually ext ending upwards and inwards b etween the fl eshy parts of the extensors pedis and metacarpi magnus. The discharge was appreciably increased, and a few days later appeared in g reat quantity, in appearance frothy, and distinctly synovial in character. Great r elief was thus afforded to the patient, which favourable condition did n ot continue. The further m edical history of the case may be briefly stated. The synovial fluid collected among the muscular fibres and aponeuroses of the above-named muscular structures time and again. Inflammatory acfion extended to the joint, inducing hi g h sympathetic fever an d g reat loss of appetite. Dry dressings of iodoform, carbolic acid, and chalk, combined, were for som e time u sed, with no effect, and those un toward seque1ce from a simple contusion were only finally arrested in their course by a r adir:al change of treatment. This consisted in the application of ling. cantharid. freely over the whole external lateral aspect of the forearm. The effect was highly satisfactory. The application was rep eated, and three months from the d at e of the accident elapsed before the patient walked sound. A few weeks' quiet grazing r endered h er recovery complete. Case 2.-A bla ck gelding, four years old, used for farm work, while b ein g taken out of the stable was kicked on the outside of the n ear forearm by a horse, when passing it, on its fleshy part, about four or five inches below the humeroradial articulation. It proceeded to its work, to all appearances nothing the worse for the kick, but after three days it became unable to work, through lameness. c
Ed£torial. Afte r a few days' rest the horse moved much better, sufE ... ciently w ell in the opinion of the owner to resume its duties, which it did for a couple of d ays, then being r eturned to the stable more l am e than before. The appearances presented in this case were slight (Edema of the forearm, and a small wound on the skin, giving exit to a discharge of frothy fluid, small in quantity, serou s, and partly purulent. The lam eness was excessive, and the p atient was at once placed in sli ngs. The owner was informed th at th e case was ot a serious nature, aggravat ed by being returned to work when unfit for it. B esides g iving complete rest, treatment was directed towards allaying the inflammatory action that extended very r a pidly towards the intern al structures of the injured r egion, also to coagulate the discharge vvhich was but sligh t. After the horse had b een under treatment about a fortnight, showing no sign of improvement, an accident occurred. During the nig ht the patient released itself from the slings, probably from strugglin g in a paroxysm of pain, which was very intense on the slightest movement of the limb . He was found lyin g on his n ear side, making fruitless efforts to get up. On consulting with the owner, it was d ecided instead of replacing the horse in the "lings, to d estroy him . P ost-mortem examination r evealed marked congestion of the articul a tory surfaces of th e humerus and radius, and a lesion in the external, lateral, and capsular ligaments of the joint, so large as to b e visible to the naked eye. This communicated direct with the outer wound, the appearances a ltogether verifying the opinion that the case was a hopeless one. There can be no doubt that my clients paid very dearly for their failure to realise the serious consequen ces that might ensue from persisting to subject their h orses to work imme.: diately after they were injured, althou g h those injuries were seemingly trivial. The old saying, so frequently applied to human affairs, "that g reat events from little causes spring," has a very pertinent application to that class of injuries, exemplified in those cases above d etailed.
0bitortaI. a few days the Council of th e Royal College of Veterinary Surgeons will be called up on to perform one of its most important functions, indeed, it may be said, "its most important function," namely, to appoint a new Board, who will p erform the most onerous and difficult duty of examining WITHIN
249
the pregnant female of our own species, albumen makes its appearance in the urine at least a month before the en d of the period of gestation. If we could form a reasonable idea as t o whether or not a cow was likely to be attacked by the disease, by demonstrating the presence of albumen in the urin e, it would, I believe, be a means of saving a great deal of money which the stock-owner can ill afford to lose. If there is anything tenable in these remarks, I shall be g lad to see them discussed in these columns; and if not they will no doubt soon be confuted by some better informed m ember of our profession.
SIMPLE CONTUSIONS AND SOME SEQUELlE. BY PETER MOIR, M.R.C.V.S ., EDINBURGH.
THE locomotor apparatus of the horse, more particularly that of the fore extremities, by functional d erangement of one or m ore of its numerous parts, throug h accident or disease, furnishes t o the veterinary practitioner clinical cases, great in variety and large in number, that demand from him the exercise of no small amount of patience, and all the skill at his command, for their successful treatment. An injury, of which the only external indication is a slight contusion, may, and frequently has masked a fractured limb, and a simple muscular contusion even some distance from an articulation, may give infinite trouble to the surgeon, and end in disastrous results. . Two cases of simple contusion have lately come under my notice, in which the extensor and fl exor muscles, and the humero-radial articulation were involved, and when we consider that this part of the locomotor apparatus, hy r eason of the important functions it p erforms, not only while a horse is in motion, but also in bearing a large share of the superincumbent weight of its fram ework, possesses a highly vascular and nervous organisation, we should b e prepared, more especially when curative measures for the initial injury have been neglected, to encounter cases likely to give trouble. Case I.-A bay mare, five years old, slipped up on the street, while in harness, falling on her near side. She immediately arose without being taken out of the light van, in which she was working, almost unhurt, th ere being merely a slight abrasion of the skin in the external lateral part of the near fore-arm . Th e mare was kept at slow work for about a week, after the first few minutes going fairly well, but daily becoming more lame, when starting off. Medical advice was then deemed necessary, and I found the fore-arm to be slightly VOL. XL.
R
The Veterinary lourttal. swollen, painful on pressure, and a minute orifice on the abraded part, from which there was a serous discharge, small in quantity, Complete rest and fom entations were prescribed, while the diet also was r egulated. On my next visit, three days afterwards, a well-defined. tense, and painful swelling , situated upward s a nd forwards" about three inches above the extern al orifice, was presented. the least movement of the limb causing g reat pain. There was a slight increase in the discharge from the wound, which, on being probed, admitted the probe to enter about two inches in the directi on of the swelling. The patient was now placed in slings, the orifice enlarged, and the fom entations almost constantly applied to encourage the maturation of what seemed to be a deep, diffused abscess. A weak solution of hydrarg. perch10r. was occasionally inj ected. This treatment was continued for a few days, with no subsidence of the tumefaction or the pain, the former gradually ext ending upwards and inwards b etween the fl eshy parts of the extensors pedis and metacarpi magnus. The discharge was appreciably increased, and a few days later appeared in g reat quantity, in appearance frothy, and distinctly synovial in character. Great r elief was thus afforded to the patient, which favourable condition did n ot continue. The further m edical history of the case may be briefly stated. The synovial fluid collected among the muscular fibres and aponeuroses of the above-named muscular structures time and again. Inflammatory acfion extended to the joint, inducing hi g h sympathetic fever an d g reat loss of appetite. Dry dressings of iodoform, carbolic acid, and chalk, combined, were for som e time u sed, with no effect, and those un toward seque1ce from a simple contusion were only finally arrested in their course by a r adir:al change of treatment. This consisted in the application of ling. cantharid. freely over the whole external lateral aspect of the forearm. The effect was highly satisfactory. The application was rep eated, and three months from the d at e of the accident elapsed before the patient walked sound. A few weeks' quiet grazing r endered h er recovery complete. Case 2.-A bla ck gelding, four years old, used for farm work, while b ein g taken out of the stable was kicked on the outside of the n ear forearm by a horse, when passing it, on its fleshy part, about four or five inches below the humeroradial articulation. It proceeded to its work, to all appearances nothing the worse for the kick, but after three days it became unable to work, through lameness. c
Ed£torial. Afte r a few days' rest the horse moved much better, sufE ... ciently w ell in the opinion of the owner to resume its duties, which it did for a couple of d ays, then being r eturned to the stable more l am e than before. The appearances presented in this case were slight (Edema of the forearm, and a small wound on the skin, giving exit to a discharge of frothy fluid, small in quantity, serou s, and partly purulent. The lam eness was excessive, and the p atient was at once placed in sli ngs. The owner was informed th at th e case was ot a serious nature, aggravat ed by being returned to work when unfit for it. B esides g iving complete rest, treatment was directed towards allaying the inflammatory action that extended very r a pidly towards the intern al structures of the injured r egion, also to coagulate the discharge vvhich was but sligh t. After the horse had b een under treatment about a fortnight, showing no sign of improvement, an accident occurred. During the nig ht the patient released itself from the slings, probably from strugglin g in a paroxysm of pain, which was very intense on the slightest movement of the limb . He was found lyin g on his n ear side, making fruitless efforts to get up. On consulting with the owner, it was d ecided instead of replacing the horse in the "lings, to d estroy him . P ost-mortem examination r evealed marked congestion of the articul a tory surfaces of th e humerus and radius, and a lesion in the external, lateral, and capsular ligaments of the joint, so large as to b e visible to the naked eye. This communicated direct with the outer wound, the appearances a ltogether verifying the opinion that the case was a hopeless one. There can be no doubt that my clients paid very dearly for their failure to realise the serious consequen ces that might ensue from persisting to subject their h orses to work imme.: diately after they were injured, althou g h those injuries were seemingly trivial. The old saying, so frequently applied to human affairs, "that g reat events from little causes spring," has a very pertinent application to that class of injuries, exemplified in those cases above d etailed.
0bitortaI. a few days the Council of th e Royal College of Veterinary Surgeons will be called up on to perform one of its most important functions, indeed, it may be said, "its most important function," namely, to appoint a new Board, who will p erform the most onerous and difficult duty of examining WITHIN