joints may be affected, and in these cases
it is often best to destroy the horse at once.

The reappearance of the fistula after it has apparently healed is not
uncommon. The secondary attack in these cases is seldom serious. The
lesion should be carefully cleaned and afterwards injected with a
solution of zinc sulphate, 20 grains to the ounce of water, every second
or third day until a cure is effected.

In fistula of the foot we see the same tendency toward the burrowing of
pus downward to lower structures, or in some cases upward toward the
coronet. Prior to the development of a quittor there is always swelling
at the coronet, accompanied with heat and pain. Every effort should now
be made to prevent the formation of an abscess at the point of injury.
Wounds caused by nails, gravel, or any other foreign body which may have
lodged in the sole of the foot should be opened at once from below, so
as to allow free exit to all purulent discharges. Should the injury have
occurred directly to the coronet the application of cold fomentations
may prove efficient in preventing the formation of an abscess.

When a quittor becomes fully established it should be treated precisely
as a fistula situated in any other part of the body; that is, the
sinuses should all be opened from their lowest extremities, so as to
afford constant drainage. All fragments of diseased tissue should be
trimmed away, antiseptic solutions injected, and, after covering the
wound with a pad of oakum saturated with some good antiseptic wash, the
whole foot may be carefully covered with clean bandages, which will
afford valuable assistance to the healing process by excluding all dirt
from the affected part.

Another form of treatment for this class of infections consists in the
use of bacterial vaccines. Such treatment appears to be well adapted for
the purpose, and according to current veterinary literature has met with
success. These vaccines are composed of several strains of the organisms
usually found in these pustular infections of the horse. Two kinds of
vaccines are used: First, autogenic vaccines, which consist of heated
(killed) cultures of the organism or organisms which are causing the
trouble and which have been isolated from the lesions; second, stock
vaccines, consisting of dead organisms of certain species generally
found in these lesions and which are used in diseased conditions caused
by one or the other of these germs. The vaccine is ad