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During the night he had much pain, and to-day there is much inflammation round the wounds. I applied the lunar caustic over both wounds and covered the eschar with gold-beater's skin to prevent the contact of the stocking. On the following day the eschar was found to be perfect. The pain had entirely ceased. There was a little vesication round one of the wounds.
Where ligaments have not been destroyed to the extent that reduction is of no practical use, the parts are kept immobilized, if thought necessary. Later, vesication of the whole pericarpal region is done and the subject allowed exercise at will. Carpitis. Etiology and Occurrence.
In the neglected and severer cases of bruise attended by much inflammation, it will be found best to treat the part for a day or two by a cold poultice to give time for the inflammation to subside; otherwise the caustic might induce vesication of the skin, as I have mentioned already, p. 5, and the eschar could not be adherent.
In small puncture wounds the immediate application of a vesicating ointment has given good results, but when infection has taken place to such extent that the animal manifests evidence of intense pain, and lameness is marked and local swelling and hyperesthesia are great, vesication is contraindicated.
At the same time, much attention must be paid to the degree in which the caustic is applied. In cases of recent wounds unattended by inflammation, it may be applied freely; but when inflammation has come on, too severe an application of the caustic induces vesication of the surrounding skin, and the edges of the eschar may in this manner also be loosened and removed.
In the first stages of an acute affection absolute quiet must be enforced; local antiphlogistic applications are beneficial. Later, vesication of a liberal area surrounding the trochanter major is indicated. Where the condition has become chronic in horses that are to be kept at heavy draft work there is little chance for complete recovery.
Still more remarkable are the cases of vesication produced in hypnotized subjects by means of suggestion. Finally, let us recall the persistent story of the stigmatized individuals, who, from the thirteenth century down to our own day, have been quite numerous and present some interesting varieties some having only the mark of the crucifix, others of the scourging, or of the crown of thorns.
I simply evacuated the fluid of the vesication and left the part exposed to dry. On the third day there was no pain or inflammation, and the eschar remained adherent. From this time no remedy was required. The eschar separated leaving the surface healed, in about a month from the occurrence of the accident.
In such cases, it is unreasonable to expect to check the size of the exostosis and, of course, such methods are not employed where lameness causes distress to the subject. Firing usually causes prompt recovery from lameness and is a dependable manner of treating such cases but there remains more blemish following cauterization than where vesication is done.
When the previous inflammation round the ulcer is considerable, however, the application of the caustic would induce vesication, and it should in such a case of course be avoided, and another mode of treatment to be described hereafter must be adopted. I would introduce in this place some observations on the comparative effects of healing by eschar and by scabbing.
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