In the meanwhile, if the character of the infectious material is not so virulent, the disease will take on a slower course and the subject may experience laminitis from supporting weight upon the sound member, or because of continued recumbency, decubital gangrene and emaciation sometimes cause death.  If the subject does not soon succumb, it is compelled to undergo days or even weeks of unnecessary suffering, and too often in such cases, it is later deemed advisable to destroy the animal because of the cost of continuing treatment until the horse is serviceable.  Therefore, it is evident that when such joints as the carpus or tarsus are open and infection exists, if they are not promptly treated and the infectious process checked, it is neither humane nor practical to prolong treatment.

Distinction must be made between the different joints when infected as the condition is much more serious in some cases than in others.  All things considered, perhaps open joints rank, with respect to being serious cases as follows:  elbow, navicular, stifle, tarsus, carpus, fetlock and pastern.  This, of course, is restricted to articulations of the locomotory apparatus.

Treatment.—­Preliminary care in the treatment of an open carpal joint, is the same as has been described in this condition as it affects the scapulohumeral articulation described on page 65.  Likewise the further treatment of such cases is along the same lines except that where it is possible, the parts are kept covered with cotton and bandages.  However, in some cases, animals have been successfully treated without bandaging and by keeping the patient in a standing position and on pillar reins until recovery resulted.  Such cases were of the non-infectious type and recovery was possible within three or four weeks.  Further, the condition is not sufficiently painful in such instances as to prevent the subjects bearing weight with the affected member; hence, no danger of resulting laminitis is incurred.  And finally, where bandages are not employed, the frequent use of antiseptic dusting powders is substituted for cotton as a protector.

When bandaged, such wounds need dressing more or less frequently, as individual instances demand.  The purulent infective inflammation of a carpal joint will require daily dressing; whereas, in other cases (non-infective), semi-weekly change of bandages is sufficient.  Equal parts of boric acid and exsiccated alum constitute a suitable combination for the treatment of these cases, and this powder should be liberally employed.  Tincture of iodin may be injected into the joint capsule where there is provision for its ready evacuation, as conditions seem to require.  Daily injections for three, four or five days, are not harmful and will control infection in many instances.

Thecitis and Bursitis.

Etiology and Occurrence.—­The thecae and bursae of the leg are several in number.  In the carpal region, the flexors of the phalanges are contained together in the carpal sheath, and this is the principal theca in the carpal region.  Each of the tendons is provided with synovial sheaths which are subject to inflammation and occasionally synovitis and distension of these synovial sheaths occur.