swellings are recognized by palpation,—­the characteristic indentations which may be made in dropsical swellings are pathognomonic indicators.  In this manner it is easy to differentiate post-operative or post-traumatic edemas which may or may not cause lameness.  At any rate, it is essential to take into account all determinate conditions that may assist in the prognosis of any given case, for the purpose of being able to outline rational remedial measures.  To be able to distinguish between the generalization of a septic infection in its incipiency, and a more or less benign edema, is largely possible by digital manipulation alone.  An extremity may be greatly swollen because of the existence of chronic lymphangitis, influenza, or an acute septic infection occasioned by the introduction of pathogenic and aerogenic organisms.  Since the effect produced by these dissimilar ailments are productive of conditions that may terminate favorably or unfavorably, it becomes necessary for the diagnostician to develop a trained, discriminating, tactile-digital sense, in order to correctly interpret existing conditions, and handle cases in a rational and skillful manner.

In order to ascertain the extent and exact location of a tumor, an exostosis, or other enlargements, the diagnostician, here also, needs to be in possession of a trained tactile sense and in addition if he be fortified with an accurate knowledge of normal anatomy and pathology, he is able to arrive at proper conclusions, when digital manipulations have been employed.  Fibrous tumors are sometimes located in the inferior part of the medial side of the tarsus—­exactly over the seat of bone-spavin.  Such tumors, when the affected member is supporting weight, are not to be distinguished from exostoses; but as soon as the affected leg ceases to bear weight, it may be passively flexed and the nature of the enlargement recognized because it may be slightly displaced by digital manipulation.  Displacement, of course, is not possible with an exostosis.

A necessary qualification, which the diagnostician must possess, is that of being able to judge carefully the nearness of any given exostosis to articular structures.  Also, the extent or area of the base of an exostosis as well as its exact position, needs be determined before one may estimate the probable outcome in any case,—­whether treatment should be encouraged or discouraged by the practitioner.  Periarticular ringbone may, because of the size and location of the exostosis, constitute a condition which cannot be relieved in any way in one case, and in another, because of the manner of distribution of such osseous deposits, the condition may be such that prompt recovery will follow proper treatment.  In the examination of an exostosis of the tarsus, it is particularly important to determine the exact location of the exostosis—­whether or not the spavin involves the tibial tarsal (astragulus) bone very near its tibial articular portions.  Obviously, if articular surfaces of joints are involved, complete recovery cannot result despite the most skillful attention given the subject.