Chapter XXI: Part 21

For the dry and scaly forms, and indeed for many of the others, as well, the more stimulating ointments and liniments are called for. Cadeac recommends oil of cade, tinctures of cantharides, or a tar liniment made with alcohol, as a supersedent to produce an active inflammation and displace the unhealthy eczematous one. The agent is rubbed upon the skin and the resulting scabs are left for a week when it is washed off with tepid water and the skin is found healthy or greatly improved. As a rule a second dressing of the tar is then applied. Müller strongly recommends Hebra’s treatment with green soap and alcohol (2 ∶ 1) to be rubbed on the affected surface and washed off the following day when all scales and crusts will come off with little trouble. He follows with zinc oxide or lotions of mercuric chloride or silver nitrate. Friedberger and Fröhner use cresol 2 parts, green soap 2 parts, alcohol 1 part; also creosote in alcohol (1:10) or in paraffin (1 ∶ 10). Zuill looks upon sulphur iodide as virtually a specific: sulphur iodide 1 part, sublimed sulphur 7 parts, cod liver oil 7 parts. This is applied once and repeated at the end of ten days, if necessary. Application is made to the whole skin healthy and diseased alike, and rarely requires to be repeated.

Ichthyol is commended by Müller in cases which show great cutaneous thickening with cracks and fissures. It may be made with water (1:5) or in glycerine or lanolin of the same strength. Müller combines it with lime water and olive oil and applies it daily.

Other agents in use are salicylic acid in olive oil (1:3): chrysarobin in paraffin ointment (1:4): naphthalin or naphthol (1:10): resorcin in water (2:100)

LICHEN. HEAT PAPULES. PRICKLY HEAT.

Horses, cattle, sheep and dogs suffer in hot season or hot stables.
Nervous temperament. Delicate skin. Over-driving. Heating foods. Cold
water when heated. Unwholesome food. Indigestion. Chronic affections
of stomach, liver, kidneys, etc. Symptoms: Clusters of small papules
on neck, back, croup, or thighs, crest, tail, exudate concretes, lifts
hairs from follicles, depilation in round spots, or patches,
abrasions, ulceration, corrugated skin. Diagnosis; sudden eruption,
its isolation, subsidence on the coming of cold weather, and
re-appearance with the hot, intense itching. Treatment: As in eczema.
Protect against friction, give shade, and spray with cold water.

Under this name has been described a papular eruption occurring in horses, cattle, sheep and dogs in the hot season, but also occasionally, in winter, in hot, confined stables.

It is seen especially on the neck, back, croup and thighs, is common in fine bred horses with delicate skins, and nervous temperament, and is pre-eminently a disease of hot weather. Over-driving, heating food, a drink of cold water when heated or indigestion connected with unsuitable food may be the occasion of its irruption or tend to perpetuate it. In the same way different chronic affections of the stomach, liver, kidneys or other organs may be causative factors.

_Symptoms._ The affection usually begins with a few minute papules, isolated or in clusters, which dry up into scales or crusts. These are mostly situated at the roots of the mane or tail or on the sides of the neck, withers or trunk, and as a rule produce a pruritus, resembling that of scabies in its intensity. When the exudate agglutinates a tuft of hair, enclosing it in a dense crust, the hairs may be lifted from their follicles and thus small, round spots of depilation appear. If recovery ensues and new hair starts, it differs in color from the old and gives a dappled appearance to the skin. In many cases, however, the points of eruption and encrustation become confluent and an extensive area of bareness, with more or less abrasion, and even ulceration may be formed.

Megnin mentions two cases and the author can adduce another in which the eruption appeared in vertical lines, so that the skin of the trunk was raised in a series of elevated lines or ridges, running transversely to the body, like the stripes of a zebra. In the author’s case the skin seemed to be thrown into a series of folds to the production of which the cutaneous muscle evidently took part. The itching was doubtless the immediate cause.

_Diagnosis_ is based largely on the suddenness of the eruption; on its limitation to a given area instead of spreading from the primary seat of invasion as in acariasis; on the fact that it is usually confined to a single animal and has not spread with the use of the same brush, comb and rubber; and on the absence of acari and vegetable parasites from the affected parts. The absence of chicken roosts or manure is another valuable indication.

_Prognosis._ Appearing in spring or early summer, the disease is liable to persist until the advent of cold weather in fall, and even after a winter’s intermission there is a strong tendency to its re-appearance on the following spring or summer. The intolerable itching interferes seriously with docility and steadiness in harness, and the loss of hair renders the subject very unsightly, and as a family or driving horse practically useless.

_Treatment._ As in cases of eczema the general and special causes should be corrected by hygienic and general medicinal measures, laxatives, diuretics, antacids, tonics, and in the advanced stages, alteratives coming in as important factors. (See under acute eczema). Great care should be taken to prevent irritation by pressure of the harness, and shade and daily cold spraying may be availed of.

PITYRIASIS: SQUAMOUS SKIN DISEASE: HORSE.

Dry, scaly, or powdery affection. Causes: Fine, thin, dry skin with
little hair, race, Arab, Barb, racer, trotter, nervous temperament,
age, dry summer heat, dry winter cold, foul skin, caustic soaps,
ingestion of salt, iodides, bromides, etc., derangement of internal
organs bacteria or cryptogams. Symptoms: scurfy patches, general or
circumscribed, where little hair is, where harness rubs, depilation of
ears, crest, tail, shoulder, back. Diagnosis, from eczema by lack of
pruritus, of rapid extension, of thickening of the skin, from
acariasis by absence of acarus. Treatment: correct disorder of
stomach, liver, or kidneys: green, succulent or nutritive food;
alkalies; arsenic; tonics; locally potash soaps, ointments of tar,
birch oil, creolin, creosote, naphthalin, lysol, mercury, iodine,
salicylic acid, zinc oxide.

This is a skin disease characterized by excessive production of epidermic scales, and depilation without any attendant elevation of the skin. The desquamation may be of fine scales like wheat bran, or of a fine dust like flour.

_Causes._ The disease is especially characteristic of animals in which the skin is naturally fine, thin and dry and covered sparsely with hair. It is therefore more common in the Arabian, Barb, English racer, American trotter and other breeds of a nervous organization than in the heavier draught breeds. Old horses in which the skin is drier and the hair thinner are more subject to it than the young. Again it has been especially noticed in the heats of summer with thin coat and a withering action of radiant heat on the skin, and less frequently in winter when the blood is driven from the surface by cold. Much also depends at times on the lack of grooming, on the accumulation of dust and dried up secretions about the roots of the hair, and on washing with caustic irritant soaps especially in long-haired regions. It has even been claimed that the ingestion of salt, potassium iodide, or bromide, etc., contributes to the affection. There is undoubtedly a certain individual predisposition to the disease, shown as already stated in certain breeds, but also inherent in particular families and even animals, and associated not only with the character of the skin, but also probably with variations in the activities and products of various internal organs. In man pityriasis versicolor is associated with a specific fungus, and in the horse Megnin has described cases in which the surface of the skin and especially the hair follicles show a mass of epidermic cells mingled with mycelium and an abundance of spores.

_Symptoms._ The scurfy product and depilation may be found in patches scattered indiscriminately over the body (generalized), or confined to particular regions (circumscribed) as to the head, ear, crest, tail, or the parts that receive the friction of the harness. It may commence as a dry, rigid, state of the skin under the headstall with loss of hair and the excess of dandruff. From this or from another point the extension takes place slowly and with comparatively little irritation or itching. The hair is pulled out with great ease, and from its spontaneous evulsion, more or less baldness appears progressing slowly from the original centres of the disease. It may leave the whole crest divested of the mane, or the tail of its hairs (rat tail), or the ears may become bare and scurfy. Again the parts subject to friction like the back of the ears, the crest, in front of the shoulder, or the seat of the saddle may be the main seats of depilation and baldness.

It is to be distinguished from dry eczema mainly by its tendency to spread over a larger area in place of confining itself to circumscribed patches, and more particularly by the absence of the marked thickness and rigidity of the skin which characterize eczema. From acariasis it is distinguished by the lack of the intense itching, of the tendency to more or less moist exudation and above all by the absence of the acari.

_Treatment._ It is well to correct any disorder of any of the internal organs, notably of the stomach, liver or kidneys, and to encourage a free circulation in and secretion from the skin. To fill the latter indication green food, ensilage, roots, sloppy mashes of bran, oilcake and the like may be given. Also bicarbonates of soda or potash or other alkaline diuretics, and in certain obstinate cases a course of arsenic. The alkalies tend to eliminate offensive and irritant matters and to lessen the irritation in the skin. A course of tonics is often valuable.

Locally Cadeac recommends potash soaps rubbed well into the affected parts. If this should fail some of the stimulant ointments as of tar, oil of tar, oil of white birch, oil of cade, creoline, creosote, lysol, naphthalin, may be tried. Megnin strongly recommends a combination of ointment of biniodide of mercury, 1 part, to mercurial ointment 3 parts. Others advocate salicylic acid (10 to 20%) mixed with Lassar paste which is compounded of 1 part each of zinc oxide and starch in 4 parts vaseline.

PITYRIASIS IN CATTLE.

On neck and dewlap; Causes: anæmia, debility, spoiled food,
starvation, constitutional predisposition. Symptoms: shedding hair and
scales without skin thickening, or itching. Treatment: green soap,
tar, creolin, lysol, naphthalin, etc. Alkaline lotions: generally
nutritive, succulent food, bitters, iron, arsenic, etc.

This is noticed especially on the neck and dewlap in connection with anæmia, low condition, unsuitable, innutritious and spoiled fodder and a constitutional predisposition. It has the same general characters as in the horse, an excessive production of dandruff or dry scales without any marked change in the thickness of the skin or in its circulation. Treatment consists in the application of green soap, pure or medicated, with tar, creolin, lysol, or other empyreumatic product. Lotions of carbonate or bicarbonate of potash are often effective. Any disorder of digestion, or of the urinary or hepatic functions, or of general nutrition should be corrected, and in most cases, a course of bitters, with iron and arsenic is desirable. A good, indoor hygiene or a run on succulent grass in the open air may be resorted to with benefit.

PITYRIASIS IN THE DOG AND CAT.

Head, neck and back of overfed, old house dogs. Symptoms: floury
dandruff, with little itching or redness, on limited areas; in cats
over the whole back, where stroking causes electric development, the
collecting of the hair in tufts, and insufferable irritation. Hair
constantly shedding without necessarily bare patches. Treatment:
simpler, restricted diet, correct internal disorders, laxatives,
arsenic, locally solutions of alkalies, borax, potassium sulphide,
sulphur iodide, baths.

In dogs this affection attacks especially the head, neck and back of pet and house dogs gorged with dainties, and particularly in those that are already becoming aged. The affected parts are covered with a floury or branlike product lying upon a dry surface usually devoid of irritation or congestion, though it may be distinctly congested and reddened, and even the seat of pruritus. The affection is usually confined to limited areas, more or less destitute of hair, and without showing a disposition to active extension. In the cat, however, it may affect the whole dorsal aspect of the body, being associated with extreme electrical susceptibility, so that on being stroked the hair at once collects in tufts, crackles, and in the darkness sparkles, and the animal at first fawning on the hand, will fly at and scratch it after a few strokes. The scaly product is excessive and drops off abundantly when handled, without, however, leaving thin or bare patches.

_Treatment_ is mainly in the line of a simpler and more natural diet, the avoidance of sugar and cake, the correction of disorders of the digestion, or of the hepatic or urinary functions, the exhibition of an occasional laxative, and of alteratives, especially Fowler’s solution.

Locally, alkaline lotions, carbonate or bicarbonate of soda or potash, borax, sulphide of potassium and iodide of sulphur are often useful. A moderately strong solution of common salt with glycerine in water is an useful alternate, and a warm saline or bran bath may soften the skin and modify its nutrition.

CONTAGIOUS PUSTULAR DERMATITIS IN THE HORSE. ACNE.

History. Cause: bacillus. Symptoms; incubation 6 to 15 days, skin
tenderness, heat, swelling like peas, hazel nuts, vesicles, pustules,
exudation, concretions among hairs, depilation, healing in 15 days.
Leaves white spots with lighter hair. Extension by grooming: general
eruption: subcutaneous swelling, sloughs, delayed healing.
Lymphangitis. Diagnosis: from chaps and bruises, from horse pox, from
impetiginous eczema, from urticaria, from farcy. Prevention,
quarantine new horses, separate diseased, disinfect skins of the
unaffected, disinfect stables and harness. Treatment: soapy wash:
germicide lotions.

This has been largely described as an imported disease thus on the European continent it is the English variola, and in England the Canadian contagious pustular affection. Yet the first authentic account dates back to 1841–2 when Goux found it attacking an entire squadron of the French army in a fortnight. Axe described it in England in imported Canadian horses in 1877, and Weber observed it in the same year on the continent, where it was attributed to imported English horses. In 1883 it was noted by Schindelka, in 1884 Siedamgrotzky inoculated it from the horse on two rabbits and two Guinea pigs, and to horse and goat. The rodents developed a “malignant œdema” at the point of inoculation and died in six days. Grawitz and Dieckerhoff cultivated the bacillus on ox or horse serum and found it 2μ in length, dividing by segmentation into round or ovoid refractive spores, which may remain connected as diplococci or short chains and which color deeply in fuchsin. It grows most rapidly at a temperature of 37° C., growth ceases at 17° C., and it is destroyed in half an hour at 80° to 90° C. Preserved, dry, it remained virulent for four weeks and produced the characteristic eruption when rubbed on the skin of the horse, ox, dog, sheep or rabbit. It proved fatal to all rodents, including white mice. The microbe is found abundantly in the pus and crusts and is easily shown when these are treated with potash. It produces no putrid fermentation.

_Symptoms._ When inoculated it had an incubation of six to fifteen days followed in mild cases by swelling heat and tenderness of the skin with collection of the hair in erect tufts. Next day there are rounded elevations like peas or hazel nuts, discrete or confluent on the swollen patches. These nodules, at first firm and resistant soon become soft in the center, forming vesicles and finally pustules, which burst in five or six hours and exude an abundant liquid which concretes in a thick amber colored mass. The hairs in the center of the resulting raw surface are easily detached leaving bare spots the size of a dime, with often times a slough attached in the center. When this is finally eliminated the surface gradually cicatrices and recovery may be complete in fifteen days. The skin remains long dappled from the partial discoloration of the epidermis in the seat of the pustules. The malady is local and hyperthermia is rarely seen. The submaxillary and pharyngeal lymph glands are usually swollen and indurated, but this disappears speedily after the subsidence of the eruption.

In certain cases the extent of the primary eruption is greater from the first, or it extends through reinfection by combs, brushes and rubbers used in grooming or by friction by the harness, the affected skin is hot, painful, congested and thickened throughout its entire substance, the pustules are much more numerous, often confluent, and may even implicate the subcutaneous connective tissue. The crusts formed on the sores may acquire a breadth of 1 inch to 1½ inch. Considerable abscesses may be formed and the lymph glands communicating with the affected part are hot and swollen. Even after the opening and discharge of the abscess, the base of the sore remains indurated and indolent, and centres of softening and caseation may appear so that healing is delayed for one or two months or more. In such cases extensive cicatrices remain after recovery. Lymphangitis is a common accompaniment with even abscess of the lymphatic glands.

_Diagnosis._ From chafing and bruising by the harness, this is easily recognized by its appearing also on other parts than those covered by the harness, by the development of the characteristic pustules, by its following a regular cycle of eruption and subsidence covering a definite period of usually 15 days, and by the indisposition to maintain itself indefinitely under the friction of the harness.

From _horsepox_ it is distinguished by the habitual avoidance of the common seats of election of that disease (heels, lips, nostrils, buccal and nasal mucosæ, lips of the vulva), by the absence of hyperthermia, and by the comparative absence of the remarkable amber-like concretions which characterize horsepox in the lower limb.

From _impetiginous eczema_ it is diagnosed by its contagious and inoculable properties, by the absence of the early falling of the hair from the circumscribed rounded nodules, and by the absence or moderate character of the pruritus which is usually intense in the eczema.

The eruption of _urticaria_ appears much more suddenly, shows no tendency to form vesicles nor pustules, is not inoculable, and subsides often as suddenly as it appeared when the irritant food materials have been expelled from the alimentary canal.

From acute _farcy_ it is distinguished by the moderate degree of the implication of the lymph vessels and glands, by the white creamy nature of the contents of the pustules, as compared with the glairy, oily nature of the farcy discharge, by the absence of coincident nasal ulcers, submaxillary nodular swellings or other lesions of glanders, by its short course and tendency to spontaneous early recovery, and by the absence of reaction under the mallein test.

In all cases the known prevalence of the contagious pustular dermatitis in the locality, or the introduction of strange horses which exhibit sequelæ of the lesions will assist greatly in the diagnosis.

_Prevention._ If animals are introduced from an infected or unknown locality they should be kept apart from others for two weeks. In a stable where it has already appeared the diseased and healthy should be carefully separated and the skins of those as yet unaffected may be washed with a solution of mercuric chloride (1 ∶ 1000) or creolin (1 ∶ 100). The walls of the stable should be whitewashed, and all stable utensils disinfected in boiling water or one of the above named antiseptics. The harness demands particular attention.

_Treatment._ This is essentially germicide. After a soapy wash, any one of the usual disinfectants may be used: aluminum acetate, (1 ∶ 15), mercuric chloride (1 ∶ 1000), carbolic acid (1 ∶ 50), creolin (1 ∶ 50), copper sulphate (1 ∶ 50), etc. Lead acetate 2 parts, alum 1 part and water 50 parts, has been found to be effective.

PEMPHIGUS IN HORSE, OX, PIG AND DOG.

On rare occasions the horse or ox is attacked with a skin eruption, attended with the formation of bullæ or blisters, from the size of a hazel nut to a hen’s egg, or larger. It is sometimes shown sporadically and at others appears at once in a large number of animals in the same herd. The _causes_ are obscure, yet the enzootic appearance of the affection is suggestive of a common factor entering probably by the food. Loiset and Seaman have recorded enzootic outbreaks in cattle and Dieckerhoff in the horse.

_Symptoms_ are cutaneous congestion with the formation of swellings like a walnut, but exceptionally as large as the fist, on the head, neck and thorax, which in 2 to 4 days form a large central vesicle, with yellowish serous contents. Cases in the ox (Loiset, Seaman) had a similar eruption on the loins, quarters and hind limbs, some of the swellings attaining the size of a hen’s egg, and with similar contents. Later these ruptured, crusted over and healed, with, for a time, a smooth glistening surface. Winkler records cases in swine and Schneidemühl in dogs, but the condition is rare in both animals.

_Treatment._ To a nutritious, non-stimulating and easily digestible diet, may be added a course of arsenic and, in low condition, of bitters. Locally dusting powders of zinc oxide, boric acid, starch and lysol. Should the exudate form these into hard cakes, they may be replaced by carbolized oil or, better, a 5 per cent. mixture of ichthyol in vaseline.

CRACKED HEELS IN HORSES. SCRATCHES.

Special susceptibility and exposure of posterior pastern region.
Divisions. Causes: local irritants, decomposing manure, chill water,
slush, mud, pools of liquid manure, septic irritation, stones, sand,
lime in mud, salted snow or ice, washing heels, caustic soaps,
stubble, clipped or singed hair, stocking of limbs, lymphangitis,
sprains, arthritis, anæmia, cardiac, urinary or hepatic disease,
parasites, heavy bedding, constitutional predisposition. Symptoms:
redness, heat, tenderness, swollen, erect hairs, lameness, knuckling,
or exudate, crusts, scabs, abrasions, chaps, fissures, ulcers, loss of
pliancy, engorgment of limbs, fœtid secretion. Prognosis according to
cause. Treatment: remove causes, give rest, cleanse limb and stable,
astringent antiseptic lotions, sulphurous acid, carbolic acid,
creolin, lysol, pyoktannin, chrysophanic acid, moderate laxative food,
diuretics, arsenic, bandaging, hand rubbing, exercise.

The affections of the heel or posterior part of the pastern in horses are largely modified by the anatomical character of the skin in this region, and the special exposure to inimical agents, so that it is convenient to consider them under special headings, even though the eruption may be of the same kind with that seen in other parts. The dermatitis of this region, which are not primarily contagious may be conveniently divided into 1st, such as are unattended with free secretion, and 2d, those that implicate the sebaceous glands and are marked by an offensive discharge. Cracked heels belong to the former category.

The _causes_ are extremely varied, consisting in the application of irritants of many kinds, to the susceptible skin in a system too often already predisposed to skin disease.

Standing on reeking dungheaps, or on heating manure in filthy stalls subjects the heels, and especially the hind ones, to ammonia and other irritating fumes, and when taken out to the cold air, chill water and mud, the sensitive parts suffer. Again in the farm yard and even in neglected stalls the hind feet are immersed in pools of liquid manure, the ferments and toxic matters of which dry on the skin, attack the surface and determine septic congestions and inflammations. On country roads where there is no pretense of pavements, or macadam, the mud in spring and fall is a source of great irritation on certain soils which contain small flat stones, pebbles or sand, or in which lime or decomposing manure is a prominent feature. Standing in snow or slush, especially if chilled by salting, produces partial or complete congelation with the result of chillblains or even more active and destructive inflammation or sloughing. The habit of washing the heels and allowing them to dry spontaneously in the stall is only less injurious by the chill induced. This is still further aggravated by the use of caustic soaps on the already tender skin. The lighter breeds of horses, devoid of long hair on the pasterns, though less subject to the _greasy_ secretion, are even more exposed to chills and direct injuries, and suffer readily and often persistently from erythema and cracks. In many cases trouble comes from the ends of stubble and other vegetables acting on the skin. A common fault is the close clipping and even singeing of the hair in the hollow of the heel. The stiff, bristly ends of the hairs on one fold of the pastern continually prick the skin of the adjacent fold when the animal is in motion and not only is this irritating to the healthy skin, but it becomes incomparably more so when that is congested and tender. Even in summer the deep dust on unpaved roads, mixing with the normal secretions of the heel, rolls into semi-solid masses between the folds and proves the more irritating, the greater the admixture of sand or solid bodies. A common cause is the stocking of the limbs, with the attendant congestion, distension and debility of the skin. This may be due in its turn to a great variety of proximate or remote causes, lymphangitis, sprains, arthritis, osteitis, anæmia, cardiac, urinary or hepatic disorder, parasitisms, etc., so that accessory causes must often be widely sought. Even an excess of straw around the hind limbs will cause stocking in some animals which escape on bare pavement. Finally we must take into account that constitutional predisposition in some animals that makes them liable to inveterate skin diseases under the slightest causes.

_Symptoms._ In the _milder forms_ there may appear a redness, with heat, tenderness and swelling in the hollow of the pastern, the hairs stand stiffly erect, and the surface may be perfectly dry. The affected limb has the pastern more upright than the others and the fetlock starts slightly forward. In a nervous, sensitive horse the skin is so tender and rigid, that the animal can hardly be persuaded to use the limb, and goes dead lame for a considerable distance until it has become more pliant.

With some aggravation of the condition the skin is felt to be somewhat rough and uneven by reason of the encrustations of epidermis, dried secretions and dust over its surface, which may convey to the finger a slightly oily sensation. In many cases these epidermic and exudation products form scabby elevations, and a chronic condition of this kind may persist indefinitely, constituting what is known in America as _scratches_. This will vary by reason of the detachment of these concretions with the formation of abrasions and sores of various sizes, which may heal, or extend by coalescence, chapping, or ulceration.

In other cases, even at an early stage, the formation of chaps or cracks is a marked feature. At times this may seem to be the result of over distension in the inflamed superficial layers of the skin which have lost their natural pliancy and cohesion. They will, sometimes, form under slight exercise, but not when at rest. They may simply extend through the epidermis, exposing the papillary layer, or in bad cases one or more fissures may extend through the integument and expose the tendons beneath. They may extend forward on the sides of the pastern or upward over the back of the fetlock and metatarsus.

In all cases, when the local inflammation is acute, some swelling of the limbs appears, and this keeps pace with the character and extent of the trouble. With extensive chaps or fissures it becomes extreme, extending up toward the hocks and attended by great pain and stiffness. The sores become the seat of active suppuration, with it may be considerable destruction of tissue. Even in the milder forms there may often be seen a fœtid muco-purulent secretion in the depth of the folds of the pastern, and in the worst cases this extends to the whole surface after the manner of _grease_.

_Prognosis._ The milder uncomplicated cases recover readily and perfectly under rest and judicious treatment; the more advanced cases are liable to leave swelled legs with susceptibility to a relapse, and in cases associated with a constitutional diathesis or chronic internal disease, recovery may become problematical and uncertain.

_Treatment._ In all cases the cause must be done away with, whether filthy stalls, reeking dunghills, septic pools, work in irritating road mud, or melting snow, washing the heels with caustic soaps, drying them in cold draughts, pricking with stubble or clipped hairs, and all the causes of stocking of the limbs. If heels are washed, use pure tepid water, and, if necessary, the best Castile soap, and rub them dry at once. If this cannot be done bandage them rather than leave them in a cold draught.

Give rest in a clean stall and thoroughly clean the affected heel, then wrap in a bandage wet with an acetate of lead or sulphate of zinc lotion (1 ∶ 50), or apply benzoated oxide of zinc, or cream of glycerine and salicylic acid.

When chaps have formed they will often promptly heal under standard solution of sulphurous acid 1, glycerine 1, and water 1. This is applied on soft cotton and covered by a rubber bandage to confine the acid. The sulphurous acid solution should be recently prepared, since it will prove injurious if it has oxidized into sulphuric acid. To one or other of these preparations the addition of a little carbolic acid, creolin, pyoktannin, or lysol will often prove useful. When the cracks have healed, zinc ointment, chrysarobin ointment, chrysophanic acid 1, vaseline 15, or other soothing and antiseptic agent may be employed till all inflammation has subsided, and the animal must not be returned to work until the skin has been restored to its former healthy and elastic condition.

It may be desirable to greatly restrict the grain during treatment and even to giving cooling laxatives or diuretics. With a constitutional diathesis arsenic or other alterative may be tried, and any internal disease must be attended to. For stocking, use careful bandaging, hand-rubbing and exercise.

With the formation of the deeper fissures the same antiseptic agents may be employed, or salol, iodoform, glutol, aristol, or some tincture of iodine, or iodide of starch may be used. A weak solution of copper sulphate has often an excellent effect. The measures advised below for _grease_ will usually apply in this condition.

SEBORRHŒA OF THE DIGITAL REGION: DIGITAL IMPETIGO, GREASE: STREPTOCOCCIC
DERMATITIS IN HORSES.

A sequel of erythema or cracked heels. Causes: constitutional
predisposition in lymphatic draught horses, rare in ass and mule,
anatomical conditions, wet damp regions, digestive disorder,
overfeeding and lack of exercise, diseases of liver or kidney, change
to stable life, cold water, slush, mud, salted snow, steaming manure,
urine in mares, infection, streptococcus pyogenes. Symptoms: swelling,
heat, and tenderness of pastern hollow, itching, hairs erect, unctuous
exudate, vesicles, excoriations, discharge opaque, grayish, sticky,
fœtid, chaps, knuckling, resting on toe, kicking: in severe cases
discharge purulent, more opaque, sloughs, excessive granulations,
“grapes,” extensions forward, upward, downward, canker, quittor, sand
crack, etc. Lesions: first, congestion of derma, hair follicles full,
hairs loose, connective tissue infiltrated, or thickened, ligaments:
and bones involved, grapes in superposed clusters pediculated.
Diagnosis: from horsepox. Treatment: remove causes, secure
cleanliness, laxative, diuretics, moderate grain ration, or tonic
regimen; locally, soothing antiphlogistic, antiseptic treatment, lead,
zinc, phenol, creolin, lysol; when advanced, antiseptic dusting
powders, calomel, salicylic acid, iodine, zinc oxide, salol, or
solutions, zinc chloride, tar. Value of changes. For “grapes” actual
cautery, excision, ligature.

This may develop as an advanced condition of the erythema or cracked heels already described. Yet it is so distinctive in its habit of profuse secretion, the eruption of vesicles or pustules and the abundant, fœtid sebaceous discharge that it deserves a special consideration.

_Causes._ Something depends on constitutional predisposition. This is preëminently a disease of the heavy, lymphatic, draught horse, being rare in racers and trotters, with fine sinewy limbs, no long hair on the fetlock, delicate skins, and less abundant sebaceous glands. It is almost, though not quite, unknown in the spare limbs of ass and mule, and though claimed by Reynal as attacking cattle its occurrence is equally rare in them. Much of this may be attributed to conformation. The limb of the draught horse is so much thicker and coarser, with a great excess of connective tissue and lymph plexus which become readily gorged in idleness, inducing stocking, congestion and debility of the whole limb. This same condition operates as a powerful predisposition to lymphangitis. Again the great length and profusion of the long hairs, entails the necessary compliment of an excessive development of the sebaceous glands which become over-stimulated by congestion, and afford a much more open and favorable infection atrium for the pus microbes. These structural conditions are much more marked in the draught horses of wet regions as in Ireland, the western counties of Great Britain, Belgium, Holland, and the Atlantic provinces of France, and in these the affection is remarkably prevalent. In our Eastern States and on the Plains, where the progeny of imported draught horses lose their digital hair, the malady is comparatively rare. A similar immunity has long been noticed in the horses of Spain and Africa. Disturbances of the digestion in heavily fed horses, subjected to transient confinement in the stall, and diseases of the liver and kidneys, must be recognized as further predisposing causes. The age of five and six when many horses change hands, and are subjected to extreme changes of stabling, feed and work, has furnished the greatest number of cases.

External causes we find in all those conditions already enumerated which favor chapped heels. Wet, mud, gritty masses, irritant fumes of manure, cold, heat, filth are potent factors. In connection with these are the pus and septic microbes that are always present in stables, farm yards, manure, street dust, etc. No one of these can be adduced as the constant and exclusive cause, and it is inevitable that a complex infection should be present, yet the propagation and persistence of the disease may often be connected with the streptococcus pyogenes.

As emphasizing the importance of such external irritants and infections, it should be noted that the disease bears an appreciable relation to the filth and wet of the stable and farm yard, and to the absence of cleanliness in dealing with the feet, and that the extension of good pavement and protection from road mud have invariably lessened its prevalence. The irritant action of the urine renders mares more susceptible in the hind limbs than horses.

_Symptoms._ The disease may appear as a swelling, heat and tenderness of the hollow back of the pastern, involving the fetlock and lower part of the metatarsus or metacarpus, and this may last for one or two weeks, the engorgement lessening or disappearing during exercise and reappearing when at rest in the stall. The local tenderness is great as manifested by the prompt and excessive lifting of the leg when the heel is touched, as well as by the lameness when first moved, which subsides with further exercise. Itching may be shown by kicking the floor, or by a disposition to rub the pastern. The hairs of the affected part are rigidly erect, and a slightly moist, soapy sensation is felt on the skin. Close examination may detect the presence of small vesicles with as yet limpid contents, but the greater part of the liquid product is traceable to the openings of the hairs and gland ducts. This is followed by small excoriations taking the place of the ruptured vesicles, and the discharge becomes more profuse, opaque, white or grayish white, sticky, and fœtid. It covers the entire affected surface, mats together the hair in tufts and forms a thicker grayish border. The hairs are loosened in their follicles and easily pulled out. The erosions become complicated by chaps, and the swelling increases around the pastern and above the fetlock. When at rest in the stall the foot may be rested on the toe only, or held suspended and occasionally kicked backward as if to dislodge the cause of irritation, yet if moved the patient may gradually get over the greater part of the lameness, and the swelling partially subside.

In severe, protracted cases the discharge becomes essentially purulent, but often with a darker, greenish, reddish or blackish tinge, and portions of the skin may slough, leaving deep intractable sores. Still more commonly the raw surfaces become the seat of hypertrophied granulations, which grow out to form raw, red fungous like, pediculated neoplasms familiarly known as _grapes_. Between these the spaces are filled with tufts of hairs and the condensed discharges, in process of active septic change, and giving off a most repulsive odor. Like the preceding eruption these _grapes_ may extend around the front and sides of the pastern, and upward beyond the fetlock, but especially behind.

This advanced condition shows no tendency to spontaneous recovery and the connective tissue and lymphatic plexus becoming involved, the leg often swells to enormous dimensions, from six to twelve inches in diameter at the fetlock. It may last indefinitely until the patient is worn out, or it may extend to other organs by contiguity or embolism. Canker of the frog and sole, fistula (quittor), sand crack and seedy toe may be named as complications, also septicæmia or pyæmia with abscesses in the lungs, liver, brain or bowels.

_Lesions._ In the first stage there is mainly the congestion of the skin extending into the large and numerous hair follicles of the pastern. If pressed, a transparent serum bedews the surface, and if sectioned the follicles around the hair bulb are seen to be distended by a similar product. The hairs are easily pulled out. The subcutaneous connective tissue is filled with a yellowish serosity and at intervals may be seen a red point of vascular stagnation or blocking. Later these products are more abundant and those on the now swollen and excoriated surface are distinctly fœtid. The infiltrated lymph plexuses in the connective tissue are more distended, their walls thickened and consolidated, and the rigid skin is thus firmly bound to the structures beneath. A careful examination shows the presence of subepidermic vesicles of various sizes. The congestion may extend deep enough to involve the periosteum of the digital bones and the ligaments of the joints. The _grapes_ are each attached by a pedicle from which branch out cauliflower-like, fine papillary processes, that aggregate into a solid cluster. They are very vascular and grow out cluster above cluster until they reach large dimensions.

_Diagnosis from Horse Pox._ Since the days of Jenner the claim has been constantly made that _grease_ and _horse pox_ were one and the same. Horse pox is however to be distinguished by its transient course, its inoculability, its incubation of three days, its abundant exudate concreting on the hairs of the pastern as a yellow mass suggestive of crystalline structure, by the red pit in the skin in which this mass is imbedded, by the spontaneous recovery in about 15 days, and by the immunity on a subsequent inoculation. It is communicable to cattle and to man, producing the characteristic large umbilicated vesicle and scab.

_Treatment._ The first consideration is to remove the causes of local irritation and infection, give a clean sweet stall, with dry floor, and allow no contact with putrid liquids, mud, cold water, melting snow or other irritant. If exercise is needful to obviate _stocking_ of the legs give it on dry clean ground.

If inflammation runs high with fever and costiveness a laxative will be valuable and it may be well to follow this in some cases with cooling diuretics. When the animal has been on a heavy grain ration this should be largely cut down in keeping with enforced idleness, or restricted work. If on the other hand condition is low, and the discharge profuse a more generous ration may be desirable.

Local treatment is essentially soothing and antiphlogistic, and in view of the infection should be antiseptic. _White lotion_ (acetate of lead and sulphate of zinc of each ½ oz., water 1 quart) has been long used with fair success, for although lead sulphate is thrown down, it is in part freed again through contact with the exudate. It will be materially improved by the addition of 1 dr. carbolic acid, creolin, lysol or chloro-naphtholeum or by some other antiseptic. Lead acetate alone with an antiseptic is an excellent substitute. In mild cases the surface may be wet with the lotion several times a day: while in severe ones the lotion may be applied on a bandage kept constantly wet. When secretion is well established it may be better to use dry applications, as calomel; salicyclic acid 10 parts, with iodine 10 parts; calomel and lamp black; carbolated oxide of zinc or burned alum, salol, etc. After washing and drying the skin, dust this freely even into the deepest wrinkles and cover with cotton and bandage. Dress twice daily. For very fœtid cases, Robertson recommends zinc chloride 1 oz. in 1 qt. water with the addition of glycerine and phenol, and again a saturated solution of copper sulphate with carbolized glycerine. For profuse secretion after the subsidence of active inflammation Renal highly recommends wood tar with 5 to 10 drops of sulphuric acid to the ounce. Under these circumstances a powder of gloss starch 5 ozs. with iodine ½ oz. may be employed twice daily. Or again, 1 oz. each of carbolic acid, tincture of iodine and glycerine may be employed. When one agent seems to be losing effect, it is well to change for another and never to neglect the regular dressing, until full recovery has been secured.

In case of _grapes_ the actual cautery is the most efficient measure. Heat a blacksmith’s fire shovel to a bright red and use this to cut through the pedicles, a cool shovel being kept constantly beneath it and in contact with the pedicles, so as to protect the adjacent skin from injury by the radiated heat. The lower shovel must be dipped in cold water at very frequent intervals to cool it and prevent cauterization of the skin between the pedicles. This not only removes the diseased and infected masses, but leaves the stumps of the pedicles aseptic. Another method is to cut off the “grapes” and staunch the blood with the actual cautery at a dull red heat. Still another is to tie the pedicle of each excrescence separately so as to cut off circulation and secure sloughing. This is, however, a long, tiresome process, and entails prolonged contact with much infecting dead tissue. After either method the parts must be dressed with antiseptics, and dealt with generally like cases in which the excrescences had not formed.

CUTANEOUS HEMORRHAGE: BLOODY SWEAT: HÆMATIDROSIS. HÆMATOPEDESIS.

Forms of cutaneous hæmorrhage; in specific diseases; in parasitism; in
insect bites; in congestions of sweat glands; in deranged innervation;
in hæmophilia. Section of sympathetic. Salt on sciatic. Hysteria.
Sclerosis of cord. Inflammation. Symptoms: drops, crusts. Hæmorrhagic
nodules. Treatment: styptics, cold, ice, snow, tannin, matico, iron
chloride, alum, gelatine, atropine, ergot, lead acetate, quinia.
Gravitation.

The escape of the blood by the skin is seen in a variety of morbid conditions, due it may be to profound changes in the blood and capillary walls, as in petechial fever, anthrax, scorbutus, septicæmia, swine erysipelas, etc., in which this is only a subsidiary phenomenon of a general disorder:—to the presence of parasites (Filaria hæmorrhagica,) in the skin:—to insect bites:—to violent congestions implicating the sweat glands (bloody sweat):—or to deranged innervation of the part as in cases of trauma of the sympathetic or sciatic nerve, or disease of the nerve centres. It may further be a manifestation of hæmophilia in which any slight lesion becomes the occasion of persistent hæmorrhage.

Cases that appear in the course of specific contagious diseases and those dependent on filaria will be considered under these headings, and we may confine our attention here to the forms of sweating and oozing of blood from independent causes. German writers draw attention to its frequency in eastern horses, attributing it to the great development of the vascular system especially of the skin, but its comparative infrequency in the English racer and American trotter would throw doubt on this doctrine. It may be questioned whether the frequency of the disease in Oriental horses is not to be ascribed rather to filariasis. This idea is not contradicted by the especial prevalence of the bleeding in summer when the filaria is most active, but when also the skin is the most vascular and its tissues most relaxed.

Of nervous hæmorrhages we have the experimental examples of Bouchard and Simon from section of the sympathetic nerve in animals, also those of Glen and Mathieu from irritation of the sciatic in dogs with common salt. In man the nervous causation has been seen in hysteria, under profound nervous shock, in sclerosis of the cord, and even as the result of auto-suggestion. This influence is constantly operative in violent inflammations in which diapedesis and minute hæmorrhages into the affected tissues are marked phenomena, and under such a cause the gland ducts especially are the seat of transudation. When the skin is abraded, cracked, or blistered it occurs also on the surface of the exposed derma.

_Symptoms._ With active local congestion or inflammation the blood usually oozes in drops from the surface, and drying concretes into dark red crusts. In other instances, however, it drops from the surface, or even flows, producing anæmia and even death. Into such cases hæmophilia presumably enters. Hæmorrhagic swellings like wheat kernels or beans also form in the skin.

_Treatment._ Apart from the contagious and parasitic diseases, and scurvy, the general treatment will be styptic. Cold water, ice, snow, a stream from a hose, solutions of tannin, matico, iron chloride or sulphate, alum or gelatine may be employed. Internally the iron salts, gelatine, atropine, ergot, lead acetate, or quinia may be given. In hæmophilia the gelatine especially should be tried both locally and generally. When it is possible, as in the case of the head, gravitation should be availed of. Elsewhere a compress bandage may be used.

ULCERATION. GANGRENE. BED SORES.

Causes: inflammation, exudation, obstructed circulation, lesions in
trophic nerve centres, sclerosis, toxins, ergot, caustics, freezing,
gangrene, microbes, cryptogams, spoiled fodder, white skins,
buckwheat, insolation. Symptoms: inflammation, molecular
disintegration, dry sloughs. Treatment: camphorated spirit or
vaseline, antiseptics, phenol, salicylic acid, iodoform, iodine,
creolin, lysol, tar, detach sloughs.

In all cases in which the skin is violently inflamed, and particularly when the seat of an abundant exudation or infiltration which blocks circulation and retards nutrition, the tissues are especially liable to death, molecular or by sloughing, and formation of bedsores. As a general cause lesions of the trophic centres in the medulla and cord must be accepted as a cause of the imperfect nutrition and lack of vitality. This is seen in sclerosis of the cord, but may appear as the result of poisoning of the myelon as well as the gangrenous tissues by absorbed toxins. Again a common cause of circumscribed cutaneous gangrene is the capillary contraction and obstruction of ergotism. This usually involves all the tissues, soft and hard, at the distal end of a member or organ, causing the separation of all at one common level, but in less severe forms the skin only sloughs, in the form of round or irregular masses, usually around the coronet, and the resulting sores heal up under an appropriate diet. Cauterization and freezing may be a further occasion of gangrene. Finally, the local operation of the microbes of gangrene, determines both ulceration and sloughing. Cryptogams on spoiled fodders (trefoil, lupins, vetches, rusty gramineæ) are also charged with developing gangrene.

White skins or white patches on the skin are especially liable to suffer as in cases of fagopyrism and “grease”. The action of the solar rays in summer must therefore be accepted as a concurrent cause.

_Symptoms._ The first symptoms are usually those of cutaneous congestion or inflammation. Redness, swelling, pitting on pressure, or tension, are accompanied or followed by vesicles, chaps or erosions. The margins of the sores become thick and irregular, often undermined, and they gradually increase by breaking down of tissue in their depth or on their margin. In other cases patches of skin dry or wither up, either in superficial layer or throughout its entire thickness, and these dried extra vascular sloughs are gradually detached by granulation beneath. The surrounding tumefaction is always extensive and the sores may expose the deep seated structures—tendons, ligaments, fascia, bones, joints—causing widespread destruction.

_Treatment._ If the disease is due to capillary occlusion of nervous origin, compresses with camphorated spirit, followed by camphorated vaseline may be of advantage. If otherwise, antiseptics will be in order: carbolated vaseline, salicylic acid cream, iodoformed vaseline, a weak iodine ointment, creolin, or lysol in water, tar water. When the dead tissues are partially separated the detachment may be hastened with knife or scissors and the sores treated like a septic sore.

CUTANEOUS HYPERTROPHY. ELEPHANTIASIS. PACHYDERMIA.

Chronic thickening of skin and lymph plexuses, horse hind limb after
eczema, grease, glanders, ox neck and head, knees, shoulder.
Calcification. Treatment: laxatives, diuretics, exercise, elastic
bandage, friction, astringents, iodine.

Chronic thickening of the skin is most commonly seen in horses as a sequel of lymphangitis in the hind limb, the engorgment of the lymph plexus and thickening of its walls being associated with a general productive inflammation and thickening of the derma until the fetlock may be thirty inches or more in diameter. It may follow eczema, grease or chronic glanders. In cattle a productive dermatitis in the region of the head and neck, has led in the experience of the author to a similar distention of the lymph vessels and morbid thickening of the skin. The pads and calluses which form on the knees of the camel and on other parts subject to friction, furnish examples of hypertrophy of another kind. Again the thick dense cutaneous plates on the shoulders of the old boar may serve to illustrate a physiological hypertrophy. The writer has seen thickening of the skin in the seat of an incision made in spaying the pig and the deposition of earthy salts so as to form a distinct calcification.

_Treatment_ is very unsatisfactory, yet something may be done by laxatives, diuretics, regular exercise, an evenly applied elastic bandage when in the stable, massage and the use of astringent and dilute iodine ointments. It is much more important to prevent the lesion by cutting short the morbid condition on which it depends. When developed, attention is usually given to prevent its advancement and to utilize the animal at slow work.

ICHTHYOSIS. FISH-SKIN DISEASE.

This consists in a scaly formation of the epidermis which is also formed in excess, and is supposed to be dependent on disordered trophic innervation. In new born calves suffering in this way Van Stettin found an excess of phosphate of lime in the epidermis. The calves usually die in a few days.

FURUNCULUS. BOIL.

Definition: pustule with necrotic core. Digital region. Microbes.
Symptoms: Prevention: antisepsis. Treatment: phenol, iodine, alcohol,
boric or salicylic acid, iron, bitters, calcium sulphide, sulphur,
sodium sulphite.

A deep seated inflammation of the derma resulting in suppuration with the formation of a central adherent necrotic slough or core.

Boils are not uncommon on the digital region of horses in winter; or where the parts are exposed to street mud containing an abundance of decomposing organic matter. They are unquestionably due to pyogenic microbes, and have been largely associated with staphylococcus pyogenes aureus. As they often come out in successive crops, it may be assumed that the second focus is infected from the first, or that there is a special susceptibility in the particular animal system, or that both these factors contribute to the result. Debility, and traumas contribute to bring about the infection.

_Symptoms._ A nodular, hot, and very painful swelling, implicating the substance of the true skin, and surrounded by a hot, swollen zone, progresses to suppuration in the centre, yet when it bursts, or is opened, a core or small mass of necrotic, tough, fibrous tissue is found to be firmly adherent in the center of the bottom of the sore.

_Prevention._ Must be sought in sustaining the general health and in preserving the greatest cleanliness of stables and skin. Washing with a weak antiseptic solution when returning from muddy streets may be of use.

_Treatment._ When developing, the application of carbolic acid in crystal or on the end of a glass rod may often relieve the pain and destroy the microbes. Next day the part may be painted with tincture of iodine. If already opened the phenol may still be applied and followed after five minutes by alcohol to check the caustic action. Or boric or salicylic acid may be applied. To counteract the constitutional tendency, iron, bitters and other tonics and antiseptics, calcium sulphide, sulphur and sodium sulphite may be given.

HYPERPLASIA OF THE SKIN.