nulation, the discharge, at
first abundant, gradually diminishing and the wound closing, usually
without leaving any mark. At times, however, and especially if the
disease has several times repeated its course, there may remain a
pendulous sac, partly obliterated, which a sufficient amount of
excitement or irritation may soon restore to its previous dimensions and
condition.

In other cases an entirely different process takes place. The walls of
the cavity, cyst, or abscess become ulcerated and thickened, the
granulations of the sac become fibrous in their structure and fill up
the cavity, and it assumes the character of a hard tumor on the back of
the elbow, sometimes partly and sometimes entirely covered by the skin.
It is fibrous in its nature, painless to the touch, well defined in its
contour, and may vary in size from that of a small apple to that of a
child's head.

This last form of capped elbow is the most serious of any, resisting all
known forms of mild treatment, and removable by the knife only. The
other forms, even that with the inflammatory aspect and its large
edematous swelling which interferes with the work of the animal, may
justify a much milder prognosis, and, aside from their liability to
recur, may be ranked with the comparatively harmless affections.

_Treatment._--So long as the danger of recurrence is the principal bad
feature of capped elbow the most important consideration is that of
devising a means for its prevention. To prevent the animal from lying
down is evidently the simplest method of keeping the heels and the elbow
apart; but the impracticability of this prescription is apparent, since
most animals are obliged to lie down when they sleep, though it is true
that a few take their sleep on their feet. The question of shoeing here
enters into the discussion. The shortening of the inside branch of the
shoe, which is the one with which the pressure is made, may be of
advantage, and especially if the truncated end of the shoe is smooth and
filed over to remove all possibility of pressure and contusion upon the
skin. The protection of the skin of the elbow by interposing soft
tissues between that and the shoe, or by bandaging the heel with bags or
covering it with boots, is considered by many the best of the preventive
methods, and the advantage to be obtained by resorting to it can not be
overlooked when the number of horses which develop shoe boil whenever
the use of the boot is intermi