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diff --git a/.gitattributes b/.gitattributes new file mode 100644 index 0000000..d7b82bc --- /dev/null +++ b/.gitattributes @@ -0,0 +1,4 @@ +*.txt text eol=lf +*.htm text eol=lf +*.html text eol=lf +*.md text eol=lf diff --git a/LICENSE.txt b/LICENSE.txt new file mode 100644 index 0000000..6312041 --- /dev/null +++ b/LICENSE.txt @@ -0,0 +1,11 @@ +This eBook, including all associated images, markup, improvements, +metadata, and any other content or labor, has been confirmed to be +in the PUBLIC DOMAIN IN THE UNITED STATES. + +Procedures for determining public domain status are described in +the "Copyright How-To" at https://www.gutenberg.org. + +No investigation has been made concerning possible copyrights in +jurisdictions other than the United States. Anyone seeking to utilize +this eBook outside of the United States should confirm copyright +status under the laws that apply to them. diff --git a/README.md b/README.md new file mode 100644 index 0000000..cc97c53 --- /dev/null +++ b/README.md @@ -0,0 +1,2 @@ +Project Gutenberg (https://www.gutenberg.org) public repository for +eBook #67772 (https://www.gutenberg.org/ebooks/67772) diff --git a/old/67772-0.txt b/old/67772-0.txt deleted file mode 100644 index bca28b7..0000000 --- a/old/67772-0.txt +++ /dev/null @@ -1,1373 +0,0 @@ -The Project Gutenberg eBook of A Treatise on Regional Iodine Therapy -for The Veterinary Clinician, by Mart R. Steffen - -This eBook is for the use of anyone anywhere in the United States and -most other parts of the world at no cost and with almost no restrictions -whatsoever. You may copy it, give it away or re-use it under the terms -of the Project Gutenberg License included with this eBook or online at -www.gutenberg.org. If you are not located in the United States, you -will have to check the laws of the country where you are located before -using this eBook. - -Title: A Treatise on Regional Iodine Therapy for The Veterinary - Clinician - -Author: Mart R. Steffen - -Release Date: April 4, 2022 [eBook #67772] - -Language: English - -Produced by: The Online Distributed Proofreading Team at - https://www.pgdp.net (This file was produced from images - generously made available by The Internet Archive) - -*** START OF THE PROJECT GUTENBERG EBOOK A TREATISE ON REGIONAL IODINE -THERAPY FOR THE VETERINARY CLINICIAN *** - - - - - - A Treatise - on - Regional Iodine - Therapy - - for - The Veterinary Clinician - - by - MART R. STEFFEN, M.D.C., V.S. - - Author of Special Veterinary Therapy, - Special Cattle Therapy, Clinical - Diagnosis of Cattle Diseases, - Special Equine Therapy, - Veterinary Clinical - Notes, etc. - - - 1919 - - - Published by - PHARMACAL ADVANCE PUBLISHING CO. - 168 Duane Street, New York - - - - - Copyright 1919 by - Pharmacal Advance Publishing Co. - - - - - CONTENTS. - - - I. Introduction. - - II. General Considerations of Local Iodine Therapy. - - III. Special Considerations of Local Iodine Therapy. - - IV. The Selection of Iodine Preparations for Practical Use. - - V. Method of using Regional Iodine Therapy in the Correction of - Various Pathological Conditions. - - - - -I. - -Introduction. - - -In presenting to the veterinary profession this treatise on Regional -Iodine Therapy, I do so with the object of bringing into the light -certain clinical facts that have to do with the topical application of -iodine in veterinary patients, and to discuss, from the standpoint of -the clinician, those particular pathological conditions to which these -facts apply. - -It will be further my purpose to point out to the reader the special -indications for topical iodine medication which have, in the past, been -overlooked by the practitioner of veterinary medicine. - -Throughout the treatise I shall confine myself to the exposition of -only such matter as I have found to be compatible with the practical -phases of veterinary science in the conduct of my own practice. - - M. R. S. - - Milwaukee, Wis. - March, 1919. - - - - -II. - -General Considerations of Local Iodine Therapy. - - -While it is a fact that iodine is one of the most popular of the -many medicinal agents used by the practitioner of veterinary -medicine and surgery, it also is a fact that iodine--more so than -any other agent--is frequently used in pathological conditions and -under circumstances that lack every scientific indication for its -application. To a certain extent this is true of almost any medicinal -agent in common use, even those whose field of applicability is less -broad than that of iodine; but it is especially noteworthy in the use -of iodine. - -Iodine does not differ from any other therapeutic agent with regard to -individual indications for its application; it has these as prominently -marked as have the alkaloids, physiologically. But it does differ from -almost all other therapeutical agents in the fact that, it has such a -vast field of applicability in which the indications for its use are -supported solely by clinical evidence and in which its action defies -all attempts at an explanation of results attained, on a physiological -basis. - -Although the practitioner may not be able to satisfy his ethical desire -to explain the action of preparations of iodine in the latter class -of pathological conditions, he soon makes the discovery that these -actions and results are, to a very considerable degree, dependent upon -more or less well-marked clinical and physical phenomena. In order -to be able to give to his use of iodine, in its various forms, even -a semblance of ethical practice, and, also, in order to be able to -roughly classify and select the conditions in which he may use iodine -with some expectation of uniform results, it becomes imperative that -the practitioner acquaint himself with these facts and phenomena. Not -only this, but he must acquaint himself, as well, with the peculiar and -individual effects and actions, in a clinical sense, of the different -forms in which iodine is used as a topical or regional application. - -What may be an indication for the use of iodine in one form, may lack -the requisite pathological status for its application in a successful -manner in one of its other forms. Thus, in a given pathological -condition, an ointment of iodine may fall far short of the therapeutic -power that the practitioner expects it to exert, despite the fact that -the case is clearly one for iodine therapy. When, on the other hand, in -the same case, use is made of the tincture of iodine, or of an aqueous -solution of iodine, the desired results may be obtained with almost -amazing promptness. Again, in another class of cases, the reverse may -be true. - -Although, in a goodly proportion of the cases to be discussed in the -following chapters in this treatise, the practitioner must come into -direct and frequent clinical contact with the pathological conditions -themselves in order to become thoroughly acquainted with the clinical -and physical facts referred to, he will derive much benefit from a -careful reading of these chapters, to the extent that he will note not -only new lines of thought with regard to iodine medication, but he -may also lay, in their reading, the foundation for an ethical system -of iodine therapy in so far as this is possible in the light of our -present acquaintance with the subject. - - - - -III. - -Special Considerations of Local Iodine Therapy. - - -When we undertake the consideration of those features of iodine therapy -which have to do with its adaptability to definite remedial ends, we -enter upon a field of thought that may take several forms. - -We are concerned, in this treatise, only with matter relating to -regional, topical, or local applications of the agent under discussion, -and we can well begin the consideration with the identification of the -agent itself and the different forms under which it is most commonly -used. For all practical purposes, we can confine the discussion of the -agent itself to that of the four forms, or preparations, of iodine -in almost universal use by practitioners of veterinary medicine and -surgery. When, in veterinary medicine, allusion is made to iodine, it -is almost, without exception, to one of the following preparations: - - 1. Tincture of Iodine. - 2. Ointment of Iodine. - 3. Aqueous solutions of Iodine. - 4. Oily solutions or mixtures of Iodine. - -Only in rare cases, and then under specific reference, is iodine used -in other forms, or in its elemental state, in veterinary medicine. -Iodine is a very active agent, chemically as well as therapeutically, -and is not readily compatible with other agents. It is for this reason, -that combinations of iodine with other drugs and chemicals are not -common, and therein lies a distinction for iodine that not many other -therapeutic agents can claim; namely, that beneficial effects resulting -from iodine medication are almost, without question, due to it alone; -it is hardly ever applied in combination with synergists which might -obscure the activity of individual ingredients. - -This remarkable therapeutic activity of iodine is such that, when -properly applied in some of its forms, its presence can be demonstrated -in the underlying tissues. After prolonged courses of topical -application, its action is occasionally appreciated, both subjectively -and objectively, in the evidence of more or less clearly defined -constitutional or systemic indications of its presence within the -animal organism. - -From this, it is apparent that, in iodine preparations of a particular -class, we have an agent whose topical remedial effects are, in some -slight measure, due to systemic action; in part at least, this action -being the effect of great physiological activity exerted in the limited -area of its topical application. In some degree this activity of -certain preparations of iodine can be explained by reference to the -chemical properties inherent in iodine as elemental matter, and in its -well-known affinity for certain elemental constituents of the tissues -of the animal organism. - -The foregoing throws some light on the therapeutic accomplishments -of iodine preparations, when topically applied, and, to a certain -extent, explains its _modus operandi_ in a physiological sense--an -understanding somewhat essential from an ethical standpoint. The old -theory, which would ascribe to an increase in function of the regional -lymphatic glands all the agreeable therapeutic effects of local iodine -applications, does not cover enough ground; it is only when we amplify -this theory, with the assumption of the considerations aired in the -foregoing paragraphs, that we find it possible to attain a clear -understanding of the physiological action of iodine preparations -applied regionally. - -_The Clinical Aims_ for topical therapy are to be classified as follows: - - 1. PROPHYLACTIC. - 2. AMELIORATIVE. - 3. CURATIVE. - -Under these three heads, we further sub-classify the actual clinical -conditions, which are indicated, into the following: - - Under 1. Surgical preparatory technique. - - Under 2. Acute pathological conditions, in the corrections of which - topical applications of iodine preparations are used as an adjunct to - internal medication with other agents. - - Under 3. Chronic pathological conditions, in which one or more of - various iodine preparations, locally applied, constitutes the entire - treatment. - -This classification and sub-classification is important and essential -when we endeavor to make our use of iodine conform to ethical -standards; it is also very essential to the attainment of certain -therapeutic ends in actual practice. - - - 1. THE LOCAL APPLICATION OF PREPARATIONS OF IODINE IN THE SENSE OF - PROPHYLACTIC AIM IN SURGERY. - -The exhaustive pre-operative washing and scrubbing of the integument, -that veterinary practitioners applied to their surgical patients in -years past, has given way almost entirely to iodine painting. Even -those surgeons who still adhere to the scrubbing and washing of the -parts about to be incised, complete the process with an application of -iodine thereafter. - -An application of iodine to the skin covering the region that is -about to be invaded by the knife of the surgeon, has been found much -more efficacious and much more reliable than has the washing and the -scrubbing with antiseptic solutions, soaps and other agents. Not only -this, but it has also greatly simplified and shortened an otherwise -tedious, prolonged and sloppy technique. Whereas, the surgeon formerly -spent from fifteen minutes to half an hour scrubbing and washing the -field of operation, he now applies a few coats of iodine tincture--a -few strokes of the swab or brush--and it is done. - -This simplified technique has the added advantage of the total -elimination of basins, brushes, and sponges for use in the preliminary -stages of an operation, as well as the agreeable absence of the -wet, sloppy field that inevitably resulted from the use of the older -method in veterinary practice. Besides, it spares the patient in more -ways than one, especially in the cold months of the year when, in a -veterinary practice, operations frequently have to be performed in cold -stables, or even in the open. - -While the application of tincture of iodine gives ample protection from -skin infection in surgical operations, there are a few things to be -observed that have to do with making the application correctly. First, -in veterinary patients, the hair must be clipped off and the area -shaved clean. The area clipped and shaved should be slightly greater -in extent than the field actually to be invaded by the knife. When -the clipping and shaving have been done, the area should be lightly -brushed with a stiff, dry brush, in order to remove dandruff and scurf. - -The second--and the most important--point is that the surface that is -to be painted with the tincture of iodine be perfectly dry. In the -event that the area to be painted should contain a deposit of filth, -oily or greasy in nature, this should first be removed by swabbing and -wiping with gauze or cotton saturated with gasoline, benzine or ether; -these remove oily, greasy or fatty filth and evaporate quickly, leaving -the area perfectly dry and clean. Washing with watery solutions, -previous to the iodine application, is not recommended under any -conditions. - -When the area has been clipped, shaved, freed from grease or other -filth, and then allowed to become perfectly dry, the tincture of iodine -is applied liberally with a soft brush, or with a cotton swab. This is -allowed to dry for a minute or two; another application is then made -directly on top of the first one, allowed to evaporate to dryness, and -the field is ready for the incision. - -As iodine readily attacks metals, and spoils the plating on -instruments, no instrument should be allowed to come in contact with -the painted area while it is still moist; neither should the iodine -be used for disinfecting purposes on any utensils or apparatus made -of metal. The fact that the iodine may injure instruments can not be -considered in the light of a disadvantage, if the above precautions are -taken. - -Another practice that has come to be recognized quite generally among -surgeons is that of painting the edges of the surgical wound with pure -tincture of iodine just before the wound is to be closed with sutures. -Whether this is good practice, on general principles, is a matter that -is open to debate. If the painting is done carefully, so that a pool of -iodine tincture is not formed by the surplus gathering by gravitation -into the deeper recesses of the wound, this may be considered good -practice. On the whole, however, it would appear that the iodine could -act, in many instances, as an undesirable irritant when it comes in -contact with delicate, freshly incised tissues. - -As the object, in modern surgery, is to eliminate all things, even the -slightest, that may hinder prompt repair and smooth healing of the -invaded tissues, the presence of such an active agent as pure tincture -of iodine in a surgical wound may be looked upon as interfering with -the carrying out of that object. - -On the other hand, in surgical wounds of an already infected character -in which primary union would be out of the question, the application -of pure tincture of iodine, in liberal amounts, can not be too highly -endorsed. - -The latter statement applies, with even greater force, to all wounds of -an accidental character in the fleshy portions of the anatomy. - -It is also the practice of many veterinary surgeons to apply pure -tincture of iodine to the wound after the sutures have been put into -place. This is a very satisfactory practice, if the painting is done -gently and not too freely. An excess of the tincture of iodine--if -the wound edges have not been coapted perfectly--may result in cause -for stitch abscess when a considerable amount of the iodine becomes -pocketed in some part of the wound under the line of suture. - -In certain animals, whose skins are very tender, the local application -of pure tincture of iodine, previous to surgical incision, is followed, -in a few days, by slight peeling of the integument. This is so rare an -occurrence, however, and of so little consequence, that it need not be -considered, and can not be looked upon as a drawback to this otherwise -salutary practice. - -Aside from its use in the preparation of the surgical field, tincture -of iodine is also used, in a prophylactic sense, to prepare the -skin--in a similar manner--for the entrance of the hypodermic needle -whenever a subcutaneous injection is to be made. It is not practical, -nor necessary, in this instance, to shave away the hair; the site that -has been selected for the needle puncture is merely painted liberally -with the iodine. As in the case of a surgical incision area, so also -here, the parts to which the application is made must be perfectly dry. - - - 2. THE USE OF IODINE AS AN ADJUNCT TO INTERNAL MEDICATION IN THE - CORRECTION OF ACUTE PATHOLOGICAL CONDITIONS. - -Iodine preparations of various forms are very commonly used topically -as an adjunctive treatment to internal medication in the treatment of -a number of acute pathological conditions in veterinary patients. The -object in adding local iodine applications to the handling of such -conditions is varied. In some cases, the object of the practitioner is -to hasten the correction of certain well-marked local manifestations of -the disease with which the patient is afflicted. In other instances, -the aim of the practitioner is toward the prevention of these local -manifestations. Occasionally, in a certain type of pathological -conditions, the practitioner intends, by the use of topical iodine -applications, to enhance the internal treatment being aimed at symptoms -whose entire nature is local in character and confined to a very -limited portion of the anatomy. - -In every case coming under this sub-classification, the effect that -the iodine applications have--the only effect that they are able to -accomplish--is one of amelioration; they can have no direct curative -effect here. While the various conditions that are included under this -head will be fully discussed in following chapters, I will point to the -use of topical iodine medication in the handling of a case of parotitis -as an illustration. While regional applications of iodine are the rule, -in the handling of cases of this affection in veterinary patients, -no one at all versed in the condition as it occurs in practice would -give the credit of ultimate cure to the iodine applications. But all -will admit readily that, while the internal treatment indicated by -the pathology of the condition is correcting the lesion _per se_, the -regional applications of iodine do contribute materially to a smooth -termination of the case in that they do, without question, lessen -the possibility of abscess formation, relieve the pain, and hasten -resolution. - -The conditions included under this heading form, in great part, that -class of cases to which reference was made in the beginning of this -treatise, namely, those in which iodine treatment is largely used under -circumstances and in conditions that lack almost every scientific -indication for its application. Yet, it is in these very conditions, -and under these very circumstances, that topical applications of -iodine are frequently most salutary in effect. And this effect is -enhanced to the degree, as will be pointed out later, to which the -practitioner becomes adept in the selection of the proper form or -preparation of iodine for the particular case in hand. - - - 3. REGIONAL IODINE APPLICATIONS FOR THE CURE OF CHRONIC PATHOLOGICAL - CONDITIONS. - -It is in the correction of chronic pathological conditions, that iodine -therapy finds its greatest field in the practice of veterinary medicine -and surgery. It is in chronic pathological conditions, that iodine, -in various forms, and with various modes of application, so forcibly -demonstrates its therapeutic work, for it is here that iodine is often -the only agent used in the handling of the case, thus constituting the -entire treatment. Under these circumstances, it is never a difficult -matter to decide as to the value of the treatment or the activity of -the agent used. - -Were there no other means of demonstrating the fact that iodine, in -some of its forms, arouses the animal organism to the end, and in the -direction, of marked efforts at regional cure of various pathological -states, we would have evidence of ample weight to convince us of this -in the results that we daily get with its application in a general -practice. - -There is hardly any therapeutic result from which the practising -veterinarian derives more professional satisfaction than he does -from the sure, gradual effect of properly selected and correctly -applied iodine preparations in chronic pathological conditions of -the articulations, from the speedy and specific effect of others in -certain skin diseases, and from the almost miraculous cure of certain -localized infections when the proper iodine medication is applied in -these. - -So sure are the effects of iodine, in a curative way, in certain -diseased conditions among domestic animals, that it has value in this -regard from a diagnostic standpoint. Given a case apparently of this -type for handling, the practitioner can be assured that he has erred in -his diagnosis if iodine, in proper preparation and correct application, -does not effect a cure. To illustrate this, I need only refer to that -diseased condition of the skin commonly termed “ring worm.” - -It is nothing unusual, in a veterinary practice, to see the curative -effects of iodine applications demonstrated in certain chronic -conditions, of the articulations for instance, after various other -means of handling, even including surgical interference, had failed -to effect the desired result. In not a few of such conditions, iodine -applications, in some form, are prescribed as a sort of “last resort” -treatment, even against the hopes of either client or practitioner, for -the accomplishment of anything in the way of benefit. - -Almost any practitioner of veterinary medicine, with whom you may -care to discuss the matter, can point to case after case, in his own -practice, in which a spavin, or a ring-bone, that had been cauterized -or otherwise operated upon with failure, had yielded to a course -of topical iodine applications. In some instances, a cure of this -sort causes a practitioner to lose faith in operative measures for -the correction of the conditions in question. Usually, however, it -impresses upon him, with added force, the thought that he has not -fully acquired the knack--either along practical or scientific -lines--to select his cases properly. Could he be sure that a given -case would yield to applications of iodine preparations, he would much -prefer to treat it that way; but he is not often sure. He has learned -that there are certain cases, although to all appearances, as far as -he is able to tell, not differing from other cases of the same nature, -will yield to actual cautery; he has learned, also, that certain cases -will yield to local applications of certain iodine preparations. But -he finds it difficult to select these cases for the respective forms -of treatment in the general run of his practice. That he may be better -able to serve his clients, and that he may even more highly appreciate -the therapeutic worth of iodine in some of its forms of preparation, I -have made some clinical observations, in my own practice, which I shall -record in the following chapters, and which, I believe, will help to -solve this problem for him. While it is not possible to pick out every -case in which iodine applications will give the desired result, it is -not an exceptionally difficult matter to select the great majority. It -is the opinion of most veterinary practitioners, who have the ethics -of their profession at heart, that the treatment of certain well-known -pathological conditions of the articulations, by means of the actual -cautery, is one of the most disagreeable features of a veterinary -practice. It is one of the things that most veterinary practitioners -are trying to get away from; it smacks more of quackery and dark-aged -farriery than anything else that the veterinarian is obliged to do. -When, on top of this, we view this form of treatment from the angle -of the humanitarian, we fail to understand why otherwise able and -enlightened practitioners will resort to it under any conditions. -True, there are apparently a few forms--a very few--of equine lameness -that will yield to no other form of treatment. Note, I have said -_apparently_ there are some. I believe, in fact, that any case of -lameness located in an articulation is curable, _if it is curable at -all_, by means other than burning the area with a red-hot iron. While -most of us, in practice, do fire cases of articulation lameness, I -believe that we do so for the reason that frequently it is _for us_ the -easiest way to terminate the conditions connected with the case. And I -further believe that every time we resort to the actual cautery, for -the correction of a lameness in an articulation, we admit, in the fact -that we do so resort, that we do not fully understand the condition we -are attempting to cure. This belief is the result of actual contact -with ample clinical material and the observations made in actual -practice covering a period of time extending over more than fifteen -years. - -Other chronic pathological conditions, in which iodine applications -are frequently serviceable, are various new-growths in the integument, -underlying tissues, and in the glandular tissue near the body surface. -It is often possible to accomplish, with topical iodine applications, -results in these conditions which could only be equalled by surgical -interference of much more costly and dangerous character. Iodine -applications are at times resorted to in such conditions as these, -to obviate the scar formation that might result from a surgical -operation. At other times, resort is had to iodine on account of such -objections to surgical interference as cost, danger to the patient’s -life, protracted period of convalescence, or other equally reasonable -objections. - -In the effects that are obtained from the local applications of iodine -preparations, in chronic pathological conditions, these preparations -act not only in a palliative or ameliorative sense, but literally in -a curative manner. They accomplish, in these conditions, solely and -wholly through their own activity, the removal of the condition and -the correction of the respective abnormalities. While, in some of the -conditions under discussion, the desired result is attained only after -very prolonged treatment with iodine, the condition is usually of such -a character that neither the owner of the animal nor the attending -veterinarian is averse to lending the time consumed. In other of these -conditions, the desired result comes very promptly, at times with a -rapidity that causes astonishment. In all cases yielding to topical -iodine therapy, sufficient evidence of the beneficial effect derived is -discernible with sufficient promptness to encourage the continuance of -the treatment. - - - - -IV. - -The Selection of Iodine Preparations for Practical Use. - - -Next in importance to the proper selection of cases amenable to topical -iodine application, is the selection of the particular preparation of -iodine to be applied. As I have already pointed out, in the chapter -on the general consideration of local iodine therapy, what may be an -indication for the use of iodine in one form may lack the requisite -pathological status for its successful application in another. - -While the effect that the various preparations produce probably does -not vary to a great extent, the ability to exert this effect does vary -in the different preparations. Because of certain physical properties -with which the vehicle carrying the iodine is endowed, certain -preparations of iodine are more active in a given condition than -others. Others, again, hold the iodine in such a manner that it is more -readily available for the needs of the case under treatment, while yet -another preparation may hold, within its pharmaceutical dress, greater -quantities of available iodine than one very closely allied to it in -every other regard. - -Then, too, it is not always the particular form or preparation that -influences the effect; frequently this influence is, for the most part, -in the pathological condition itself. Without going into the details of -what must be especially considered in the selection of the preparation -to be used in a given pathological condition, I have here set down -the observations that I have made, in my own practice, and which my -experience with this branch of veterinary practice has indicated to me -as being as nearly correct as could be expected in a practical way. - - -TINCTURE OF IODINE. - - Skin disinfection in Surgery. - - Skin disinfection previous to hypodermic injections. - - Adjunctive to systemic medication in the treatment of generalized - infections with local manifestations, such as septicemia, - actinomycosis, acute glandular swellings as a complication to fevers, - parotitis, and distemper. - - First aid application for sprains of ligaments, tendons, and bursae. - - First aid application in puncture wounds, and wounds in the region of - the hoof, articulations, and bone bruises and contusions. - - Injection into abscess cavities after the liberation of their contents - by surgical means. - - Moist parasitic skin diseases. - - As an adjunctive in all conditions of an acute character in which it - is desired to enhance the action of systemic medication aimed at the - correction of local manifestations. - - For the rapid absorption of acute swellings, such as sternal cysts, - cysts in the fleshy parts from kicks or bruises. - - As an injection into the synovial sack of enlarged bursae, after the - contents have been drawn off. - - -OINTMENT OF IODINE. - - Chronic enlargements of the articulations. - - Chronic enlargements of osseous structures. - - Chronic tumefactions resulting from specific infection. - - Chronic thickening of tendons. - - Chronic thickening of ligaments. - - Chronic thickening of localized areas in the skin. - - Inoperable superficial tumors, when non-septic. - - Tumefactions accompanying chronic degenerative processes, such as - fistulae, deep sinuses, and ulcers. - - For the absorption of old scar tissue. - - As a hoof dressing. - - Parasitic skin diseases. - - Herpes tonsurans. - - As a packing for abscess cavities, fistulae and sinuses. - - Mammitis. - - Orchitis. - - Chronic arthritis, spavin, ringbone. - - Side-bone lameness. - - Removal of splints, curb, buck shin. - - Goiter. - -Ointments of iodine are especially serviceable in all conditions in -which it is desired to obtain the remote effects of topical iodine -medication, and in which the effect desired is a gradual, intensive -saturation of the parts treated with the iodine. In choosing an iodine -ointment for this use, the veterinarian should select a preparation in -which the iodine exists free and uncombined with other agents, in a -vehicle that is blandly penetrating and non-irritating. I can highly -recommend Iodex, as fulfilling exactly these requirements. It can be -applied freely and indefinitely, and, even when the course of treatment -is exceptionally prolonged, the parts to which it is being applied -show no sign of being irritated. With other preparations, it is often -necessary to discontinue the applications for a time because of the -local irritating effect. This delays not only the ultimate recovery -of the patient, but may even result in the cure being only partly -satisfactory. In addition to its non-irritating properties, Iodex is -much more active than any other ointment preparation of iodine with -which I am acquainted, and it has the remarkably noteworthy property -of leaving no stains. Although the ointment is a rich blue-black in -appearance, it may be applied to the treated area with the bare hand, -and will not stain the fingers. This is a quality not possessed by any -other _active_ iodine ointment to my knowledge. Iodex can be obtained -from all large wholesale drug houses and distributors of veterinary -supplies. It is a Menley & James product. Should the veterinarian have -difficulty in obtaining Iodex from his regular supply house, I would -advise him, rather than accept a substitute, to obtain it from them -direct, by writing to their New York Office at No. 168 Duane Street. -I have used many iodine preparations in my practice during the past -fifteen years, and have found in Iodex the ideal veterinary iodine -ointment because, as I have already pointed out, the iodine in it -appears to be in a free state, uncombined with detracting agents, it -is blandly penetrating and, therefore, will positively not irritate the -most tender animal skin, and it does not stain the hands with which it -is applied. - -Comparing its properties and its marked activity with that of other -iodine ointments, it is by far the most economical for the veterinarian -to use. - -Iodex is one of those preparations, so rare, that the veterinarian soon -learns to appreciate highly and without which he finds it difficult to -conduct his practice, once he has made its acquaintance. He finds that -there are so many conditions in which it is the only pharmaceutical -article that exactly fills all the therapeutic requirements, and he is -able to obtain with it results that he did not think possible before -he made its acquaintance. Iodex exceeds in activity the other iodine -preparations to the same extent that an autogenous bacterin exceeds -in specificity that of a stock bacterin, and I would advise that -every practitioner of veterinary medicine who has not yet made its -acquaintance write at once to Menley & James, No. 168 Duane Street, -New York City, for a trial package. I make this recommendation with a -full realization of the fact that Iodex is a proprietary agent, and the -veterinarian will, in the light of my numerous contributions to ethical -veterinary literature, correctly infer that Iodex must indeed be an -agent of more than ordinary merit. - - -OILY SOLUTIONS OR MIXTURES OF IODINE - - Sub-acute and chronic skin lesions. - - Acute, dry skin diseases. - - For injection into synovial bursae when the tincture of iodine is - contra-indicated. - - To anoint arms and hands in the handling of obstetrical cases. - - For direct application to mucous membranes. - - Ringworm. - - As a moist dressing for wounds of long standing. - - Garget. - - Dry, scaly affections of hoofs and of the legs of poultry. - - Open joint. - - Injection for puncture wounds. - - All chronic surface conditions in which the use of iodine ointments - would not be practicable. - - -AQUEOUS PREPARATIONS OF IODINE. - -Although, from a chemical standpoint, the mixture of tincture of iodine -with water would be considered wrong, I have found that the addition of -one dram of tincture of iodine to a quart of sterile water makes a most -satisfactory combination for use in veterinary practice for a number of -diseased conditions. - -In mal-odorous catarrhal diseases, a mixture such as this makes a fine -wash. - - In the treatment of foul-smelling ulcers and fistulous tracts, it - should be used with an irrigator after the parts have been cleaned up - and just before the usual dressing is applied. - - To stimulate the process of healing in wounds and lacerations such as - barbed-wire cuts and tears. - - As a moist dressing applied on gauze in old wounds. - - As a soaking solution for foul-smelling hoof troubles. - - As a wash for the veterinarian’s hands and arms, to prevent infection - and remove odors, after the handling of after-births, dead fetuses, - and other conditions of a similar nature. - -When this preparation is used at all, it should be applied liberally; -it is cheap and the cost need never be considered. It is additionally -valuable, in a veterinary practice, because it can be made up -extemporaneously anywhere that water can be obtained, as all -veterinarians carry, in their medicine case, a supply of tincture of -iodine. - -The strength may be increased if desired; however, I have found the -proportions, as given above, the most satisfactory. - -In my experience, I have found that I can do everything that it is -possible to do with iodine preparations by using the medicaments -already indicated. - -However, I would draw the practitioner’s attention to that preparation -of iodine known as Lugol’s solution, because there is one condition -that the veterinary practitioner comes into contact with quite -frequently in which this iodine preparation has been found to give some -very good results. - -Lugol’s solution of iodine has been found to act, in a very favorable -manner, in certain cases of periodic ophthalmia in horses. It is -injected hypodermically in the region of the fatty pad just over the -affected eye. While this is not truly a topical application, the effect -that is exerted is the same as that resulting from repeated inunctions -of other active iodine preparations. The use of Lugol’s solution, -in this manner, is only to be preferred because it accomplishes the -desired end more rapidly, and with less expense of time, than would -be required by topical applications, frequently repeated. I do not -doubt that just as good and lasting results could be obtained, in this -condition, from daily inunction of the indicated area with an oily -iodine preparation. - -It remains to be said that, in this condition, internal medication is -usually indicated and the iodine, in any form, applied regionally, -merely acts adjunctively in any case. I have made mention of this -use of iodine preparations because some practitioners treat periodic -ophthalmia in this manner and have claimed good results repeatedly. - -Before I proceed to the discussion of the special application of -iodine, in a number of pathological conditions in animals, I would urge -the veterinarian to give more thought to the forms and preparations of -iodine of which he makes use. It is a rather common occurrence that a -practitioner will allow agents of well-known therapeutic efficiency to -be displaced, by others of doubtful activity, on account of a small -difference in the cost of the same. This is especially true in the -case of preparations in which the active ingredient, and, therefore, -the ingredient to be depended upon for results, is iodine. Iodine, to -begin with, as an elemental article, is costly. The veterinarian may, -therefore, be sure that, whenever an iodine preparation, of a certain -stated strength, is offered for sale at a price considerably lower than -that of recognized preparations of a similar character, the lower price -is possible only because of the fact that the iodine content is not as -represented. - -In choosing preparations of iodine, for use in his practice, the -veterinarian can easily deprive himself of much of the success -that goes with correct iodine therapy, if he allows his choice of -preparations to be influenced, to any great extent, by the cost of the -article. - -This is the chief reason, and there is probably no other, why some -veterinarians fail to get satisfactory results from topical iodine -applications. They permit their better judgment, in the selection -of the preparations, to be influenced too markedly by price; the -preparation that they select fails to give the expected results because -it is an inferior preparation, either in the strength or the quality -of the iodine it is said to carry. Commonly, both strength and quality -are inferior. - -Well made and honestly prepared iodine preparations are cheaper than -almost anything that the veterinarian uses, in a pharmaceutical -way; a little of a good iodine preparation “goes a long way”; and -it accomplishes what it does solely through the exertion of its own -energy. Almost never, it might be said, are other agents expected to -assist it in its action. For this reason, it is very essential that -the preparation be of correct and ample strength, that it contain the -iodine in a form readily available by the tissues, and that the vehicle -carrying the iodine have no detrimental action of its own. - -There is still another point that I wish to bring out, and that is in -regard to the fee that the practitioner charges for the handling of -a case with more or less costly iodine preparations. Usually, his fee -is too low. The practitioner should consider the fact that, in not -a few of the cases in which he uses topical iodine treatment, he is -actually depriving himself of a surgical fee, and the charge that he -makes for the treatment, in place of the operation that would otherwise -be required, should, in some degree at least, offset the loss thus -apparent. In some cases, it is even possible to get a larger fee under -these conditions, for, frequently, the owner of an animal would much -prefer that a given condition be cured without a surgical operation, -and would offer no serious objection to a higher fee for the correction -of the condition by a prolonged course of topical iodine medication. In -the case of a valuable animal, where scar formation might depreciate -the value, the smooth results, that are not uncommonly attained -with iodine preparations, actually deserve to be rated as much more -agreeable, and, therefore, worth a larger fee, than a surgical -operation. - -Whenever resort is had, by the veterinarian, to applications of iodine, -in considerable amounts, he should not hesitate to inform the client -that the agent used is costly, and that a special charge will be made -therefor. - -Many veterinary practitioners have come into the habit of writing -prescriptions for all iodine preparations that they find it necessary -to use, while all other medicines they dispense out of their own -pharmacy. I do not consider this good practice, for several reasons. -The main fault that I find in this is the one making it possible for -the client to have the prescription refilled without consulting the -veterinarian. It is nothing unusual for a prescription to be given to -neighbors or relatives, thus depriving the veterinarian of his fee. -Another reason that I have for finding fault with this practice, is -that many druggists will not fill a veterinary prescription honestly; -seeing that it is “only for a horse” or a cow, they do not hesitate -to use drugs, in compounding the prescription, that they would not -think of putting into a prescription for a human being--old drugs, -drugs of inferior quality, and the like. For these, as well as other -equally important reasons, the veterinarian should dispense all iodine -preparations, just as he does all others. He should not be deterred, -from using these preparations, on account of the slightly higher price -which he must pay for them, if he makes it a point to impress the worth -of the article on his client, and charges the fee that he should. - - - - -V. - -Method of Using Regional Iodine Therapy in the Correction of Various -Pathological Conditions. - - -If the reader has made an effort to follow me in what I have said in -the foregoing chapters of this treatise, he will have no difficulty in -applying, to cases occurring in his practice, many of the suggestions -offered. - -In this, the closing chapter of the treatise on regional iodine -therapy, I intend to refer to a small number of conditions, in the -handling of which I have found great satisfaction in the use of the -preparations heretofore mentioned, and, at the same time, I shall -endeavor to explain my own particular methods of using the preparations. - -I have already disposed of the manner in which the applications of -tincture of iodine are made, previous to incision of the integument, -in surgical operations. Aside from this quite common use of this -preparation, I have found tincture of iodine of great worth as an -application to calk wounds in the coronary region of the equine foot. -When the injured horn has been pared away under the wound in the -coronary band, and the loose particles of flesh and hair cleaned away, -the wound is freely painted with pure tincture of iodine. This painting -is to be repeated several times daily, until recovery takes place. -Severe infections rarely occur if the applications are begun within a -few hours after the accident occurs. - -Whenever tincture of iodine is used, for the correction of an -abnormality in the horse and cow, it must be applied very liberally if -the effect is desired with any degree of promptness. This, together -with the fact that the tincture is quite irritating to the skin of -animals--a fact that precludes an extensive course of treatment with -this preparation--makes iodine, in this form, an agent that is chiefly -of use in acute conditions, and it is, therefore, the agent of choice -to act as an adjunctive treatment to the internal handling of such -conditions as septicemia, strangles, distemper, parotitis, lymphangitis -of a localized character, and acute inflammations in tendons, -ligaments, and synovial bursae. In any of these conditions, it is best -applied with a small, rather stiff brush, painting it liberally, over -the parts involved, several times daily. If the parts become very much -irritated from these applications, the treatment must be stopped and -the area treated with a coating of vaseline or lard. - -The oily preparations of iodine are especially useful in various skin -diseases, ring-worm, and the parasitic form of scratches in horses. -The secret, in the successful handling of these conditions with -oily preparations of iodine, lies in the abstinence from water; the -parts should be given one thorough washing, when treatment is first -begun, after which no more water should be applied. If the parts need -cleansing, while the course of treatment is under way, it should be -done in a dry manner, with clean cloths or cotton wads. - -Oily preparations of iodine may also be used to anoint the arms of the -surgeon during the handling of infected cases of obstetrics. Pouring a -quantity of the preparation into the palm of the hand, and then rubbing -it gently over the skin of both hands and arms, proves a reliable -barrier to infection from a decomposed fetus or after-birth. - -In applying the oily preparations of iodine, to lesions on the -integument, it is always necessary to massage them into the tissues -quite vigorously; when this is done a single application each day -suffices. - -Other indications for the oily preparations, as well as for aqueous -preparations, of iodine, have been pointed out in the chapter devoted -to the selection of iodine preparations for practical use. - -Ointments of iodine--which, for me, mean Iodex--have, by far, the -most extensive field of application, and the uses to which an iodine -ointment may be put have already been quite clearly indicated. I -will, however, remark some of the points to be considered in using -Iodex in such cases as spavin lameness and similar affections of the -articulations. - -In choosing, for treatment with Iodex, a case of spavin lameness, the -practitioner should select only those cases in which the horse warms -out of the lameness; these cases can positively be cured by Iodex -applications. Do not attempt to cure the lameness caused by spavin in -which the horse will not warm out of the lameness; these cases are not -only impossible of cure by this means but by other means, excepting -neurectomy, as well. - -When the case has been selected, the Iodex should be applied, not -only in the immediate vicinity of the exostosis, but entirely around -the hock involved. An application should be made every morning and -every evening, in the following manner: Apply a thin coating of Iodex -and massage it into the hock for at least five minutes; then apply -another very thin coating, allowing this to remain on the surface. -The applications must extend over a period of from five to seven -weeks--about such a length of time as is required to effect a cure -with actual cautery--and, during the first few weeks of this period, -the animal should be at rest. After the second week, it may indulge in -light exercise in a lot or paddock, but may not be worked. - -Cases of spavin, treated in this manner--cases selected for treatment -as above outlined--are not only cured of lameness, but, in many cases, -the enlargement also disappears. - -The same results are obtained in cases of lameness from ringbone, -sidebone, splint and curb. - -Buck shins can be entirely absorbed with applications of Iodex as -directed above. - -Other conditions, in which the effects of Iodex frequently are most -remarkably satisfactory, are goitre, fibrous tumors on the body -surface, hygroma, and tendonous and ligamentous enlargements. - -The applications, in these conditions, are made in a manner similar to -that in spavin, massaging the Iodex thoroughly into the parts involved. - -In bringing this treatise to an end, I would again urge the -practitioner to add Iodex to his therapeutic armament, and use it not -only in the conditions of which I have here made mention, but in many -other indications for iodine therapy which come up almost daily in -every veterinary practice. - - - - -Transcriber’s Notes - -Page 24: “as an an adjunctive” changed to “as an adjunctive” - -Page 44: “exceeds in specifivity” changed to “exceeds in specificity” - -Page 46: “Aqueous Preparatons” changed to “Aqueous Preparations” - -*** END OF THE PROJECT GUTENBERG EBOOK A TREATISE ON REGIONAL IODINE -THERAPY FOR THE VETERINARY CLINICIAN *** - -Updated editions will replace the previous one--the old editions will -be renamed. - -Creating the works from print editions not protected by U.S. copyright -law means that no one owns a United States copyright in these works, -so the Foundation (and you!) can copy and distribute it in the -United States without permission and without paying copyright -royalties. 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Steffen—A Project Gutenberg eBook - </title> - <link rel="coverpage" href="images/cover.jpg" /> - <style type="text/css"> - -body { - margin-left: 10%; - margin-right: 10%; -} - -abbr[title] { - text-decoration: none; -} - - h1,h2,h3,h4,h5,h6 { - text-align: center; /* all headings centered */ - clear: both; -} - -p { - margin-top: .51em; - text-align: justify; - margin-bottom: .49em; - text-indent: 1em; -} - -.p2 {margin-top: 2em;} -.p4 {margin-top: 4em;} -.p0 {text-indent: 0em;} - -hr { - width: 33%; - margin-top: 2em; - margin-bottom: 2em; - margin-left: 33.5%; - margin-right: 33.5%; - clear: both; -} - -hr.chap {width: 65%; margin-left: 17.5%; margin-right: 17.5%;} -@media print { hr.chap {display: none; visibility: hidden;} } - -hr.r5 {width: 5%; margin-top: 1em; margin-bottom: 1em; margin-left: 47.5%; margin-right: 47.5%;} - -div.chapter {page-break-before: always;} -h2.nobreak {page-break-before: avoid;} - -table { - margin-left: auto; - margin-right: auto; -} -table.autotable { border-collapse: collapse; } -table.autotable td, -table.autotable th { padding: 4px; } - -.tdl {text-align: left;} -.pagenum { /* uncomment the next line for invisible page numbers */ - /* visibility: hidden; */ - position: absolute; - left: 92%; - font-size: smaller; - text-align: right; - font-style: normal; - font-weight: normal; - font-variant: normal; -} /* page numbers */ - -.blockquot { - margin-left: 5%; - margin-right: 5%; -} - -.center {text-align: center; text-indent: 0em;} - -.right {text-align: right; text-indent: 0em;} - -.smcap {font-variant: small-caps;} - -/* Transcriber's notes */ -.transnote {background-color: #E6E6FA; - color: black; - font-size:smaller; - padding:0.5em; - margin-bottom:5em; - font-family:sans-serif, serif; } - -.small {font-size: 0.8em;} -.big {font-size: 1.2em;} - - </style> - </head> -<body> -<p style='text-align:center; font-size:1.2em; font-weight:bold'>The Project Gutenberg eBook of A Treatise on Regional Iodine Therapy for The Veterinary Clinician, by Mart R. Steffen</p> -<div style='display:block; margin:1em 0'> -This eBook is for the use of anyone anywhere in the United States and -most other parts of the world at no cost and with almost no restrictions -whatsoever. You may copy it, give it away or re-use it under the terms -of the Project Gutenberg License included with this eBook or online -at <a href="https://www.gutenberg.org">www.gutenberg.org</a>. If you -are not located in the United States, you will have to check the laws of the -country where you are located before using this eBook. -</div> - -<p style='display:block; margin-top:1em; margin-bottom:1em; margin-left:2em; text-indent:-2em'>Title: A Treatise on Regional Iodine Therapy for The Veterinary Clinician</p> -<p style='display:block; margin-top:1em; margin-bottom:0; margin-left:2em; text-indent:-2em'>Author: Mart R. Steffen</p> -<p style='display:block; text-indent:0; margin:1em 0'>Release Date: April 4, 2022 [eBook #67772]</p> -<p style='display:block; text-indent:0; margin:1em 0'>Language: English</p> - <p style='display:block; margin-top:1em; margin-bottom:0; margin-left:2em; text-indent:-2em; text-align:left'>Produced by: The Online Distributed Proofreading Team at https://www.pgdp.net (This file was produced from images generously made available by The Internet Archive)</p> -<div style='margin-top:2em; margin-bottom:4em'>*** START OF THE PROJECT GUTENBERG EBOOK A TREATISE ON REGIONAL IODINE THERAPY FOR THE VETERINARY CLINICIAN ***</div> - - - - - -<h1> A Treatise<br /> -<span class="small">on</span><br /> -<span class="big">Regional Iodine - Therapy</span></h1> - -<p class="center p2"> for<br /> -<span class="big">The Veterinary Clinician</span></p> - -<p class="center p2">by<br /> -<span class="big">MART R. STEFFEN, M.D.C., V.S.</span></p> - -<p class="center"> Author of Special Veterinary Therapy, - Special Cattle Therapy, Clinical - Diagnosis of Cattle Diseases, - Special Equine Therapy, - Veterinary Clinical - Notes, etc.</p> - - -<p class="center p4 big"> 1919</p> - - -<p class="center p2"> Published by<br /> - <span class="smcap">Pharmacal Advance Publishing <abbr title="company">Co.</abbr></span><br /> - 168 Duane Street, New York -</p> - - -<hr class="chap x-ebookmaker-drop" /> -<div class="chapter"> - -<p class="center p2"> Copyright 1919 by <br /> - Pharmacal Advance Publishing <abbr title="company">Co.</abbr> -</p> - -</div> -<hr class="chap x-ebookmaker-drop" /> - -<div class="chapter"> -<h2 class="nobreak" id="CONTENTS">CONTENTS.</h2> -</div> - -<hr class="r5" /> -<table class="autotable"> -<tr> -<td class="tdl"> -<a href="#I">I.</a> -</td> -<td class="tdl"> -<a href="#I">Introduction.</a> -</td> -</tr> -<tr> -<td class="tdl"> -<a href="#II">II.</a> -</td> -<td class="tdl"> -<a href="#II">General Considerations of Local Iodine Therapy.</a> -</td> -</tr> -<tr> -<td class="tdl"> -<a href="#III">III.</a> -</td> -<td class="tdl"> -<a href="#III">Special Considerations of Local - Iodine Therapy.</a> -</td> -</tr> -<tr> -<td class="tdl"> -<a href="#IV">IV.</a> -</td> -<td class="tdl"> -<a href="#IV">The Selection of Iodine Preparations for Practical Use.</a> -</td> -</tr> -<tr> -<td class="tdl"> -<a href="#V">V.</a> -</td> -<td class="tdl"> -<a href="#V">Method of using Regional Iodine Therapy in the Correction of Various Pathological Conditions.</a> -</td> -</tr> -</table> -<p><span class="pagenum" id="Page_5">[Pg 5]</span></p> - - -<hr class="chap x-ebookmaker-drop" /> - -<div class="chapter"> -<h2 class="nobreak" id="I">I.<br /><br />Introduction.</h2> -</div> - - -<p>In presenting to the veterinary profession this treatise on Regional -Iodine Therapy, I do so with the object of bringing into the light -certain clinical facts that have to do with the topical application of -iodine in veterinary patients, and to discuss, from the standpoint of -the clinician, those particular pathological conditions to which these -facts apply.</p> - -<p>It will be further my purpose to point out to the reader the special -indications for topical iodine medication which have, in the past, been -overlooked by the practitioner of veterinary medicine.</p> - -<p><span class="pagenum" id="Page_6">[Pg 6]</span></p> - -<p>Throughout the treatise I shall confine myself to the exposition of -only such matter as I have found to be compatible with the practical -phases of veterinary science in the conduct of my own practice.</p> - -<p class="right"> -M. R. S.</p> -<p class="p0"> -Milwaukee, Wis.<br /> -March, 1919.<br /> -</p> -<hr class="chap x-ebookmaker-drop" /> - -<div class="chapter"> -<p><span class="pagenum" id="Page_7">[Pg 7]</span></p> - -<h2 class="nobreak" id="II">II.<br /><br />General Considerations of Local Iodine Therapy.</h2> -</div> - - -<p>While it is a fact that iodine is one of the most popular of the -many medicinal agents used by the practitioner of veterinary -medicine and surgery, it also is a fact that iodine—more so than -any other agent—is frequently used in pathological conditions and -under circumstances that lack every scientific indication for its -application. To a certain extent this is true of almost any medicinal -agent in common use, even those whose field of applicability is less -broad than that of iodine; but it is especially noteworthy in the use -of iodine.</p> - -<p>Iodine does not differ from any other therapeutic agent with regard to -individual indications for its application; it has these as prominently -marked as have the alkaloids, physiologically.<span class="pagenum" id="Page_8">[Pg 8]</span> But it does differ from -almost all other therapeutical agents in the fact that, it has such a -vast field of applicability in which the indications for its use are -supported solely by clinical evidence and in which its action defies -all attempts at an explanation of results attained, on a physiological -basis.</p> - -<p>Although the practitioner may not be able to satisfy his ethical desire -to explain the action of preparations of iodine in the latter class -of pathological conditions, he soon makes the discovery that these -actions and results are, to a very considerable degree, dependent upon -more or less well-marked clinical and physical phenomena. In order -to be able to give to his use of iodine, in its various forms, even -a semblance of ethical practice, and, also, in order to be able to -roughly classify and select the conditions in which he may use iodine -with some expectation of uniform<span class="pagenum" id="Page_9">[Pg 9]</span> results, it becomes imperative that -the practitioner acquaint himself with these facts and phenomena. Not -only this, but he must acquaint himself, as well, with the peculiar and -individual effects and actions, in a clinical sense, of the different -forms in which iodine is used as a topical or regional application.</p> - -<p>What may be an indication for the use of iodine in one form, may lack -the requisite pathological status for its application in a successful -manner in one of its other forms. Thus, in a given pathological -condition, an ointment of iodine may fall far short of the therapeutic -power that the practitioner expects it to exert, despite the fact that -the case is clearly one for iodine therapy. When, on the other hand, in -the same case, use is made of the tincture of iodine, or of an aqueous -solution of iodine, the desired results may be obtained<span class="pagenum" id="Page_10">[Pg 10]</span> with almost -amazing promptness. Again, in another class of cases, the reverse may -be true.</p> - -<p>Although, in a goodly proportion of the cases to be discussed in the -following chapters in this treatise, the practitioner must come into -direct and frequent clinical contact with the pathological conditions -themselves in order to become thoroughly acquainted with the clinical -and physical facts referred to, he will derive much benefit from a -careful reading of these chapters, to the extent that he will note not -only new lines of thought with regard to iodine medication, but he -may also lay, in their reading, the foundation for an ethical system -of iodine therapy in so far as this is possible in the light of our -present acquaintance with the subject.</p> -<hr class="chap x-ebookmaker-drop" /> - -<div class="chapter"> -<p><span class="pagenum" id="Page_11">[Pg 11]</span></p> - -<h2 class="nobreak" id="III">III.<br /><br />Special Considerations of Local Iodine Therapy.</h2> -</div> - -<p>When we undertake the consideration of those features of iodine therapy -which have to do with its adaptability to definite remedial ends, we -enter upon a field of thought that may take several forms.</p> - -<p>We are concerned, in this treatise, only with matter relating to -regional, topical, or local applications of the agent under discussion, -and we can well begin the consideration with the identification of the -agent itself and the different forms under which it is most commonly -used. For all practical purposes, we can confine the discussion of the -agent itself to that of the four forms, or preparations, of iodine -in almost universal use by practitioners of veterinary medicine and -surgery.<span class="pagenum" id="Page_12">[Pg 12]</span> When, in veterinary medicine, allusion is made to iodine, it -is almost, without exception, to one of the following preparations:</p> - -<ol> -<li> Tincture of Iodine.</li> -<li> Ointment of Iodine.</li> -<li> Aqueous solutions of Iodine.</li> -<li> Oily solutions or mixtures of Iodine.</li> -</ol> - -<p>Only in rare cases, and then under specific reference, is iodine used -in other forms, or in its elemental state, in veterinary medicine. -Iodine is a very active agent, chemically as well as therapeutically, -and is not readily compatible with other agents. It is for this reason, -that combinations of iodine with other drugs and chemicals are not -common, and therein lies a distinction for iodine that not many other -therapeutic agents can claim; namely, that beneficial effects resulting -from iodine medication are almost, without question,<span class="pagenum" id="Page_13">[Pg 13]</span> due to it alone; -it is hardly ever applied in combination with synergists which might -obscure the activity of individual ingredients.</p> - -<p>This remarkable therapeutic activity of iodine is such that, when -properly applied in some of its forms, its presence can be demonstrated -in the underlying tissues. After prolonged courses of topical -application, its action is occasionally appreciated, both subjectively -and objectively, in the evidence of more or less clearly defined -constitutional or systemic indications of its presence within the -animal organism.</p> - -<p>From this, it is apparent that, in iodine preparations of a particular -class, we have an agent whose topical remedial effects are, in some -slight measure, due to systemic action; in part at least, this action -being the effect of great physiological activity exerted in the limited -area of its topical application.<span class="pagenum" id="Page_14">[Pg 14]</span> In some degree this activity of -certain preparations of iodine can be explained by reference to the -chemical properties inherent in iodine as elemental matter, and in its -well-known affinity for certain elemental constituents of the tissues -of the animal organism.</p> - -<p>The foregoing throws some light on the therapeutic accomplishments -of iodine preparations, when topically applied, and, to a certain -extent, explains its <i lang="la" xml:lang="la">modus operandi</i> in a physiological sense—an -understanding somewhat essential from an ethical standpoint. The old -theory, which would ascribe to an increase in function of the regional -lymphatic glands all the agreeable therapeutic effects of local iodine -applications, does not cover enough ground; it is only when we amplify -this theory, with the assumption of the considerations aired in the -foregoing paragraphs, that we find it possible to<span class="pagenum" id="Page_15">[Pg 15]</span> attain a clear -understanding of the physiological action of iodine preparations -applied regionally.</p> - -<p><i>The Clinical Aims</i> for topical therapy are to be classified as -follows:</p> - -<ol> -<li> <span class="smcap">Prophylactic.</span></li> -<li> <span class="smcap">Ameliorative.</span></li> -<li> <span class="smcap">Curative.</span></li> -</ol> - -<p>Under these three heads, we further sub-classify the actual clinical -conditions, which are indicated, into the following:</p> - -<div class="blockquot"> - -<p class="p0">Under 1. Surgical preparatory technique.</p> - -<p class="p0">Under 2. Acute pathological conditions, in the corrections of which -topical applications of iodine preparations are used as an adjunct to -internal medication with other agents.</p> - -<p><span class="pagenum" id="Page_16">[Pg 16]</span></p> - -<p class="p0">Under 3. Chronic pathological conditions, in which one or more of -various iodine preparations, locally applied, constitutes the entire -treatment.</p> -</div> - -<p>This classification and sub-classification is important and essential -when we endeavor to make our use of iodine conform to ethical -standards; it is also very essential to the attainment of certain -therapeutic ends in actual practice.</p> - - - -<h3>1. <span class="smcap">The Local Application of Preparations of Iodine in the Sense of -Prophylactic Aim in Surgery.</span></h3> - - -<p>The exhaustive pre-operative washing and scrubbing of the integument, -that veterinary practitioners applied to their surgical patients in -years past, has given way almost entirely to iodine painting. Even -those surgeons who still adhere to the scrubbing and washing of the -parts about to be incised,<span class="pagenum" id="Page_17">[Pg 17]</span> complete the process with an application of -iodine thereafter.</p> - -<p>An application of iodine to the skin covering the region that is -about to be invaded by the knife of the surgeon, has been found much -more efficacious and much more reliable than has the washing and the -scrubbing with antiseptic solutions, soaps and other agents. Not only -this, but it has also greatly simplified and shortened an otherwise -tedious, prolonged and sloppy technique. Whereas, the surgeon formerly -spent from fifteen minutes to half an hour scrubbing and washing the -field of operation, he now applies a few coats of iodine tincture—a -few strokes of the swab or brush—and it is done.</p> - -<p>This simplified technique has the added advantage of the total -elimination of basins, brushes, and sponges for use in the preliminary -stages of an<span class="pagenum" id="Page_18">[Pg 18]</span> operation, as well as the agreeable absence of the -wet, sloppy field that inevitably resulted from the use of the older -method in veterinary practice. Besides, it spares the patient in more -ways than one, especially in the cold months of the year when, in a -veterinary practice, operations frequently have to be performed in cold -stables, or even in the open.</p> - -<p>While the application of tincture of iodine gives ample protection from -skin infection in surgical operations, there are a few things to be -observed that have to do with making the application correctly. First, -in veterinary patients, the hair must be clipped off and the area -shaved clean. The area clipped and shaved should be slightly greater -in extent than the field actually to be invaded by the knife. When -the clipping and shaving have been done, the<span class="pagenum" id="Page_19">[Pg 19]</span> area should be lightly -brushed with a stiff, dry brush, in order to remove dandruff and scurf.</p> - -<p>The second—and the most important—point is that the surface that is -to be painted with the tincture of iodine be perfectly dry. In the -event that the area to be painted should contain a deposit of filth, -oily or greasy in nature, this should first be removed by swabbing and -wiping with gauze or cotton saturated with gasoline, benzine or ether; -these remove oily, greasy or fatty filth and evaporate quickly, leaving -the area perfectly dry and clean. Washing with watery solutions, -previous to the iodine application, is not recommended under any -conditions.</p> - -<p>When the area has been clipped, shaved, freed from grease or other -filth, and then allowed to become perfectly dry, the tincture of iodine -is applied liberally with a soft brush, or<span class="pagenum" id="Page_20">[Pg 20]</span> with a cotton swab. This is -allowed to dry for a minute or two; another application is then made -directly on top of the first one, allowed to evaporate to dryness, and -the field is ready for the incision.</p> - -<p>As iodine readily attacks metals, and spoils the plating on -instruments, no instrument should be allowed to come in contact with -the painted area while it is still moist; neither should the iodine -be used for disinfecting purposes on any utensils or apparatus made -of metal. The fact that the iodine may injure instruments can not be -considered in the light of a disadvantage, if the above precautions are -taken.</p> - -<p>Another practice that has come to be recognized quite generally among -surgeons is that of painting the edges of the surgical wound with pure -tincture of iodine just before the wound is to be closed with sutures. -Whether<span class="pagenum" id="Page_21">[Pg 21]</span> this is good practice, on general principles, is a matter that -is open to debate. If the painting is done carefully, so that a pool of -iodine tincture is not formed by the surplus gathering by gravitation -into the deeper recesses of the wound, this may be considered good -practice. On the whole, however, it would appear that the iodine could -act, in many instances, as an undesirable irritant when it comes in -contact with delicate, freshly incised tissues.</p> - -<p>As the object, in modern surgery, is to eliminate all things, even the -slightest, that may hinder prompt repair and smooth healing of the -invaded tissues, the presence of such an active agent as pure tincture -of iodine in a surgical wound may be looked upon as interfering with -the carrying out of that object.</p> - -<p><span class="pagenum" id="Page_22">[Pg 22]</span></p> - -<p>On the other hand, in surgical wounds of an already infected character -in which primary union would be out of the question, the application -of pure tincture of iodine, in liberal amounts, can not be too highly -endorsed.</p> - -<p>The latter statement applies, with even greater force, to all wounds of -an accidental character in the fleshy portions of the anatomy.</p> - -<p>It is also the practice of many veterinary surgeons to apply pure -tincture of iodine to the wound after the sutures have been put into -place. This is a very satisfactory practice, if the painting is done -gently and not too freely. An excess of the tincture of iodine—if -the wound edges have not been coapted perfectly—may result in cause -for stitch abscess when a considerable amount of the iodine becomes -pocketed<span class="pagenum" id="Page_23">[Pg 23]</span> in some part of the wound under the line of suture.</p> - -<p>In certain animals, whose skins are very tender, the local application -of pure tincture of iodine, previous to surgical incision, is followed, -in a few days, by slight peeling of the integument. This is so rare an -occurrence, however, and of so little consequence, that it need not be -considered, and can not be looked upon as a drawback to this otherwise -salutary practice.</p> - -<p>Aside from its use in the preparation of the surgical field, tincture -of iodine is also used, in a prophylactic sense, to prepare the -skin—in a similar manner—for the entrance of the hypodermic needle -whenever a subcutaneous injection is to be made. It is not practical, -nor necessary, in this instance, to shave away the hair; the site that -has been selected for the needle puncture is merely painted liberally -with the iodine.<span class="pagenum" id="Page_24">[Pg 24]</span> As in the case of a surgical incision area, so also -here, the parts to which the application is made must be perfectly dry.</p> - - -<h3>2. <span class="smcap">The Use of Iodine as an Adjunct to Internal Medication in the -Correction of Acute Pathological Conditions.</span></h3> - -<p>Iodine preparations of various forms are very commonly used topically -as an adjunctive treatment to internal medication in the treatment of -a number of acute pathological conditions in veterinary patients. The -object in adding local iodine applications to the handling of such -conditions is varied. In some cases, the object of the practitioner is -to hasten the correction of certain well-marked local manifestations of -the disease with which the patient is afflicted. In other instances, -the aim of the practitioner is toward the<span class="pagenum" id="Page_25">[Pg 25]</span> prevention of these local -manifestations. Occasionally, in a certain type of pathological -conditions, the practitioner intends, by the use of topical iodine -applications, to enhance the internal treatment being aimed at symptoms -whose entire nature is local in character and confined to a very -limited portion of the anatomy.</p> - -<p>In every case coming under this sub-classification, the effect that -the iodine applications have—the only effect that they are able to -accomplish—is one of amelioration; they can have no direct curative -effect here. While the various conditions that are included under this -head will be fully discussed in following chapters, I will point to the -use of topical iodine medication in the handling of a case of parotitis -as an illustration. While regional applications of iodine are the rule, -in the handling of cases of this affection in veterinary<span class="pagenum" id="Page_26">[Pg 26]</span> patients, -no one at all versed in the condition as it occurs in practice would -give the credit of ultimate cure to the iodine applications. But all -will admit readily that, while the internal treatment indicated by the -pathology of the condition is correcting the lesion <em>per se</em>, the -regional applications of iodine do contribute materially to a smooth -termination of the case in that they do, without question, lessen -the possibility of abscess formation, relieve the pain, and hasten -resolution.</p> - -<p>The conditions included under this heading form, in great part, that -class of cases to which reference was made in the beginning of this -treatise, namely, those in which iodine treatment is largely used under -circumstances and in conditions that lack almost every scientific -indication for its application. Yet, it is in these very conditions, -and under these very circumstances, that<span class="pagenum" id="Page_27">[Pg 27]</span> topical applications of -iodine are frequently most salutary in effect. And this effect is -enhanced to the degree, as will be pointed out later, to which the -practitioner becomes adept in the selection of the proper form or -preparation of iodine for the particular case in hand.</p> - - -<h3>3. <span class="smcap">Regional Iodine Applications for the Cure of Chronic -Pathological Conditions.</span></h3> - -<p>It is in the correction of chronic pathological conditions, that iodine -therapy finds its greatest field in the practice of veterinary medicine -and surgery. It is in chronic pathological conditions, that iodine, -in various forms, and with various modes of application, so forcibly -demonstrates its therapeutic work, for it is here that iodine is often -the only agent used in the<span class="pagenum" id="Page_28">[Pg 28]</span> handling of the case, thus constituting the -entire treatment. Under these circumstances, it is never a difficult -matter to decide as to the value of the treatment or the activity of -the agent used.</p> - -<p>Were there no other means of demonstrating the fact that iodine, in -some of its forms, arouses the animal organism to the end, and in the -direction, of marked efforts at regional cure of various pathological -states, we would have evidence of ample weight to convince us of this -in the results that we daily get with its application in a general -practice.</p> - -<p>There is hardly any therapeutic result from which the practising -veterinarian derives more professional satisfaction than he does -from the sure, gradual effect of properly selected and correctly -applied iodine preparations in chronic pathological conditions of -the articulations, from the speedy and<span class="pagenum" id="Page_29">[Pg 29]</span> specific effect of others in -certain skin diseases, and from the almost miraculous cure of certain -localized infections when the proper iodine medication is applied in -these.</p> - -<p>So sure are the effects of iodine, in a curative way, in certain -diseased conditions among domestic animals, that it has value in this -regard from a diagnostic standpoint. Given a case apparently of this -type for handling, the practitioner can be assured that he has erred in -his diagnosis if iodine, in proper preparation and correct application, -does not effect a cure. To illustrate this, I need only refer to that -diseased condition of the skin commonly termed “ring worm.”</p> - -<p>It is nothing unusual, in a veterinary practice, to see the curative -effects of iodine applications demonstrated in certain chronic -conditions, of the articulations for instance, after various other<span class="pagenum" id="Page_30">[Pg 30]</span> -means of handling, even including surgical interference, had failed -to effect the desired result. In not a few of such conditions, iodine -applications, in some form, are prescribed as a sort of “last resort” -treatment, even against the hopes of either client or practitioner, for -the accomplishment of anything in the way of benefit.</p> - -<p>Almost any practitioner of veterinary medicine, with whom you may -care to discuss the matter, can point to case after case, in his own -practice, in which a spavin, or a ring-bone, that had been cauterized -or otherwise operated upon with failure, had yielded to a course -of topical iodine applications. In some instances, a cure of this -sort causes a practitioner to lose faith in operative measures for -the correction of the conditions in question. Usually, however, it -impresses upon him, with added force, the thought that he has not -fully<span class="pagenum" id="Page_31">[Pg 31]</span> acquired the knack—either along practical or scientific -lines—to select his cases properly. Could he be sure that a given -case would yield to applications of iodine preparations, he would much -prefer to treat it that way; but he is not often sure. He has learned -that there are certain cases, although to all appearances, as far as -he is able to tell, not differing from other cases of the same nature, -will yield to actual cautery; he has learned, also, that certain cases -will yield to local applications of certain iodine preparations. But -he finds it difficult to select these cases for the respective forms -of treatment in the general run of his practice. That he may be better -able to serve his clients, and that he may even more highly appreciate -the therapeutic worth of iodine in some of its forms of preparation, I -have made some clinical observations, in my own practice, which I shall -record<span class="pagenum" id="Page_32">[Pg 32]</span> in the following chapters, and which, I believe, will help to -solve this problem for him. While it is not possible to pick out every -case in which iodine applications will give the desired result, it is -not an exceptionally difficult matter to select the great majority. It -is the opinion of most veterinary practitioners, who have the ethics -of their profession at heart, that the treatment of certain well-known -pathological conditions of the articulations, by means of the actual -cautery, is one of the most disagreeable features of a veterinary -practice. It is one of the things that most veterinary practitioners -are trying to get away from; it smacks more of quackery and dark-aged -farriery than anything else that the veterinarian is obliged to do. -When, on top of this, we view this form of treatment from the angle -of the humanitarian, we fail to understand why otherwise able and<span class="pagenum" id="Page_33">[Pg 33]</span> -enlightened practitioners will resort to it under any conditions. -True, there are apparently a few forms—a very few—of equine lameness -that will yield to no other form of treatment. Note, I have said -<em>apparently</em> there are some. I believe, in fact, that any case of -lameness located in an articulation is curable, <em>if it is curable -at all</em>, by means other than burning the area with a red-hot iron. -While most of us, in practice, do fire cases of articulation lameness, -I believe that we do so for the reason that frequently it is <em>for -us</em> the easiest way to terminate the conditions connected with the -case. And I further believe that every time we resort to the actual -cautery, for the correction of a lameness in an articulation, we admit, -in the fact that we do so resort, that we do not fully understand the -condition we are attempting to cure.<span class="pagenum" id="Page_34">[Pg 34]</span> This belief is the result of -actual contact with ample clinical material and the observations made -in actual practice covering a period of time extending over more than -fifteen years.</p> - -<p>Other chronic pathological conditions, in which iodine applications -are frequently serviceable, are various new-growths in the integument, -underlying tissues, and in the glandular tissue near the body surface. -It is often possible to accomplish, with topical iodine applications, -results in these conditions which could only be equalled by surgical -interference of much more costly and dangerous character. Iodine -applications are at times resorted to in such conditions as these, -to obviate the scar formation that might result from a surgical -operation. At other times, resort is had to iodine on account of such -objections to surgical interference<span class="pagenum" id="Page_35">[Pg 35]</span> as cost, danger to the patient’s -life, protracted period of convalescence, or other equally reasonable -objections.</p> - -<p>In the effects that are obtained from the local applications of iodine -preparations, in chronic pathological conditions, these preparations -act not only in a palliative or ameliorative sense, but literally in -a curative manner. They accomplish, in these conditions, solely and -wholly through their own activity, the removal of the condition and -the correction of the respective abnormalities. While, in some of the -conditions under discussion, the desired result is attained only after -very prolonged treatment with iodine, the condition is usually of such -a character that neither the owner of the animal nor the attending -veterinarian is averse to lending the time consumed. In other of these -conditions, the desired result comes very promptly, at times with a<span class="pagenum" id="Page_36">[Pg 36]</span> -rapidity that causes astonishment. In all cases yielding to topical -iodine therapy, sufficient evidence of the beneficial effect derived is -discernible with sufficient promptness to encourage the continuance of -the treatment.</p> -<hr class="chap x-ebookmaker-drop" /> - -<div class="chapter"> -<p><span class="pagenum" id="Page_37">[Pg 37]</span></p> - -<h2 class="nobreak" id="IV">IV.<br /><br />The Selection of Iodine Preparations for Practical Use.</h2> -</div> - - - -<p>Next in importance to the proper selection of cases amenable to topical -iodine application, is the selection of the particular preparation of -iodine to be applied. As I have already pointed out, in the chapter -on the general consideration of local iodine therapy, what may be an -indication for the use of iodine in one form may lack the requisite -pathological status for its successful application in another.</p> - -<p>While the effect that the various preparations produce probably does -not vary to a great extent, the ability to exert this effect does vary -in the different preparations. Because of certain physical properties -with which the vehicle carrying the iodine is endowed,<span class="pagenum" id="Page_38">[Pg 38]</span> certain -preparations of iodine are more active in a given condition than -others. Others, again, hold the iodine in such a manner that it is more -readily available for the needs of the case under treatment, while yet -another preparation may hold, within its pharmaceutical dress, greater -quantities of available iodine than one very closely allied to it in -every other regard.</p> - -<p>Then, too, it is not always the particular form or preparation that -influences the effect; frequently this influence is, for the most part, -in the pathological condition itself. Without going into the details of -what must be especially considered in the selection of the preparation -to be used in a given pathological condition, I have here set down -the observations that I have made, in my own practice, and which my -experience with this branch of veterinary<span class="pagenum" id="Page_39">[Pg 39]</span> practice has indicated to me -as being as nearly correct as could be expected in a practical way.</p> - - -<h3><span class="smcap">Tincture of Iodine.</span></h3> - -<div class="blockquot"> - -<p>Skin disinfection in Surgery.</p> - -<p>Skin disinfection previous to hypodermic injections.</p> - -<p>Adjunctive to systemic medication in the treatment of generalized -infections with local manifestations, such as septicemia, -actinomycosis, acute glandular swellings as a complication to fevers, -parotitis, and distemper.</p> - -<p>First aid application for sprains of ligaments, tendons, and bursae.</p> - -<p>First aid application in puncture wounds, and wounds in the region of -the hoof, articulations, and bone bruises and contusions.</p> - -<p>Injection into abscess cavities after the liberation of their contents -by surgical means.</p> - -<p><span class="pagenum" id="Page_40">[Pg 40]</span></p> - -<p>Moist parasitic skin diseases.</p> - -<p>As an adjunctive in all conditions of an acute character in which it -is desired to enhance the action of systemic medication aimed at the -correction of local manifestations.</p> - -<p>For the rapid absorption of acute swellings, such as sternal cysts, -cysts in the fleshy parts from kicks or bruises.</p> - -<p>As an injection into the synovial sack of enlarged bursae, after the -contents have been drawn off.</p> -</div> - - -<h3><span class="smcap">Ointment of Iodine.</span></h3> - -<div class="blockquot"> - -<p>Chronic enlargements of the articulations.</p> - -<p>Chronic enlargements of osseous structures.</p> - -<p>Chronic tumefactions resulting from specific infection.</p> - -<p>Chronic thickening of tendons.</p> - -<p>Chronic thickening of ligaments.</p> - -<p><span class="pagenum" id="Page_41">[Pg 41]</span></p> - -<p>Chronic thickening of localized areas in the skin.</p> - -<p>Inoperable superficial tumors, when non-septic.</p> - -<p>Tumefactions accompanying chronic degenerative processes, such as -fistulae, deep sinuses, and ulcers.</p> - -<p>For the absorption of old scar tissue.</p> - -<p>As a hoof dressing.</p> - -<p>Parasitic skin diseases.</p> - -<p>Herpes tonsurans.</p> - -<p>As a packing for abscess cavities, fistulae and sinuses.</p> - -<p>Mammitis.</p> - -<p>Orchitis.</p> - -<p>Chronic arthritis, spavin, ringbone.</p> - -<p>Side-bone lameness.</p> - -<p>Removal of splints, curb, buck shin.</p> - -<p>Goiter.</p> -</div> - -<p>Ointments of iodine are especially serviceable in all conditions in -which it is desired to obtain the remote effects<span class="pagenum" id="Page_42">[Pg 42]</span> of topical iodine -medication, and in which the effect desired is a gradual, intensive -saturation of the parts treated with the iodine. In choosing an iodine -ointment for this use, the veterinarian should select a preparation in -which the iodine exists free and uncombined with other agents, in a -vehicle that is blandly penetrating and non-irritating. I can highly -recommend Iodex, as fulfilling exactly these requirements. It can be -applied freely and indefinitely, and, even when the course of treatment -is exceptionally prolonged, the parts to which it is being applied -show no sign of being irritated. With other preparations, it is often -necessary to discontinue the applications for a time because of the -local irritating effect. This delays not only the ultimate recovery -of the patient, but may even result in the cure being only partly -satisfactory. In addition to its non-irritating properties, Iodex is -much more active than any other ointment preparation of<span class="pagenum" id="Page_43">[Pg 43]</span> iodine with -which I am acquainted, and it has the remarkably noteworthy property -of leaving no stains. Although the ointment is a rich blue-black in -appearance, it may be applied to the treated area with the bare hand, -and will not stain the fingers. This is a quality not possessed by -any other <em>active</em> iodine ointment to my knowledge. Iodex can -be obtained from all large wholesale drug houses and distributors -of veterinary supplies. It is a Menley & James product. Should the -veterinarian have difficulty in obtaining Iodex from his regular supply -house, I would advise him, rather than accept a substitute, to obtain -it from them direct, by writing to their New York Office at <abbr title="number">No.</abbr> 168 -Duane Street. I have used many iodine preparations in my practice -during the past fifteen years, and have found in Iodex the ideal -veterinary iodine ointment because, as I have already pointed out, the -iodine in it appears to be in a free state, uncombined with detracting<span class="pagenum" id="Page_44">[Pg 44]</span> -agents, it is blandly penetrating and, therefore, will positively not -irritate the most tender animal skin, and it does not stain the hands -with which it is applied.</p> - -<p>Comparing its properties and its marked activity with that of other -iodine ointments, it is by far the most economical for the veterinarian -to use.</p> - -<p>Iodex is one of those preparations, so rare, that the veterinarian soon -learns to appreciate highly and without which he finds it difficult to -conduct his practice, once he has made its acquaintance. He finds that -there are so many conditions in which it is the only pharmaceutical -article that exactly fills all the therapeutic requirements, and he is -able to obtain with it results that he did not think possible before -he made its acquaintance. Iodex exceeds in activity the other iodine -preparations to the same extent that an autogenous bacterin exceeds -in specificity that of a stock bacterin, and I would<span class="pagenum" id="Page_45">[Pg 45]</span> advise that -every practitioner of veterinary medicine who has not yet made its -acquaintance write at once to Menley & James, <abbr title="number">No.</abbr> 168 Duane Street, -New York City, for a trial package. I make this recommendation with a -full realization of the fact that Iodex is a proprietary agent, and the -veterinarian will, in the light of my numerous contributions to ethical -veterinary literature, correctly infer that Iodex must indeed be an -agent of more than ordinary merit.</p> - - -<h3><span class="smcap">Oily Solutions or Mixtures of Iodine.</span></h3> - -<div class="blockquot"> - -<p>Sub-acute and chronic skin lesions.</p> - -<p>Acute, dry skin diseases.</p> - -<p>For injection into synovial bursae when the tincture of iodine is -contra-indicated.</p> - -<p>To anoint arms and hands in the handling of obstetrical cases.</p> - -<p>For direct application to mucous membranes.</p> - -<p><span class="pagenum" id="Page_46">[Pg 46]</span></p> - -<p>Ringworm.</p> - -<p>As a moist dressing for wounds of long standing.</p> - -<p>Garget.</p> - -<p>Dry, scaly affections of hoofs and of the legs of poultry.</p> - -<p>Open joint.</p> - -<p>Injection for puncture wounds.</p> - -<p>All chronic surface conditions in which the use of iodine ointments -would not be practicable.</p> -</div> - - -<h3><span class="smcap">Aqueous Preparations of Iodine.</span></h3> - -<p>Although, from a chemical standpoint, the mixture of tincture of iodine -with water would be considered wrong, I have found that the addition of -one dram of tincture of iodine to a quart of sterile water makes a most -satisfactory combination for use in veterinary practice for a number of -diseased conditions.</p> - -<p>In mal-odorous catarrhal diseases, a mixture such as this makes a fine -wash.</p> - -<p><span class="pagenum" id="Page_47">[Pg 47]</span></p> - -<div class="blockquot"> - -<p>In the treatment of foul-smelling ulcers and fistulous tracts, it -should be used with an irrigator after the parts have been cleaned up -and just before the usual dressing is applied.</p> - -<p>To stimulate the process of healing in wounds and lacerations such as -barbed-wire cuts and tears.</p> - -<p>As a moist dressing applied on gauze in old wounds.</p> - -<p>As a soaking solution for foul-smelling hoof troubles.</p> - -<p>As a wash for the veterinarian’s hands and arms, to prevent infection -and remove odors, after the handling of after-births, dead fetuses, -and other conditions of a similar nature.</p> -</div> - -<p>When this preparation is used at all, it should be applied liberally; -it is cheap and the cost need never be considered. It is additionally -valuable, in a veterinary practice, because it can be made up -extemporaneously<span class="pagenum" id="Page_48">[Pg 48]</span> anywhere that water can be obtained, as all -veterinarians carry, in their medicine case, a supply of tincture of -iodine.</p> - -<p>The strength may be increased if desired; however, I have found the -proportions, as given above, the most satisfactory.</p> - -<p>In my experience, I have found that I can do everything that it is -possible to do with iodine preparations by using the medicaments -already indicated.</p> - -<p>However, I would draw the practitioner’s attention to that preparation -of iodine known as Lugol’s solution, because there is one condition -that the veterinary practitioner comes into contact with quite -frequently in which this iodine preparation has been found to give some -very good results.</p> - -<p>Lugol’s solution of iodine has been found to act, in a very favorable -manner, in certain cases of periodic ophthalmia<span class="pagenum" id="Page_49">[Pg 49]</span> in horses. It is -injected hypodermically in the region of the fatty pad just over the -affected eye. While this is not truly a topical application, the effect -that is exerted is the same as that resulting from repeated inunctions -of other active iodine preparations. The use of Lugol’s solution, -in this manner, is only to be preferred because it accomplishes the -desired end more rapidly, and with less expense of time, than would -be required by topical applications, frequently repeated. I do not -doubt that just as good and lasting results could be obtained, in this -condition, from daily inunction of the indicated area with an oily -iodine preparation.</p> - -<p>It remains to be said that, in this condition, internal medication is -usually indicated and the iodine, in any form, applied regionally, -merely acts adjunctively in any case. I have made mention<span class="pagenum" id="Page_50">[Pg 50]</span> of this -use of iodine preparations because some practitioners treat periodic -ophthalmia in this manner and have claimed good results repeatedly.</p> - -<p>Before I proceed to the discussion of the special application of -iodine, in a number of pathological conditions in animals, I would urge -the veterinarian to give more thought to the forms and preparations of -iodine of which he makes use. It is a rather common occurrence that a -practitioner will allow agents of well-known therapeutic efficiency to -be displaced, by others of doubtful activity, on account of a small -difference in the cost of the same. This is especially true in the -case of preparations in which the active ingredient, and, therefore, -the ingredient to be depended upon for results, is iodine. Iodine, to -begin with, as an elemental article, is costly. The veterinarian may, -therefore, be sure that, whenever an<span class="pagenum" id="Page_51">[Pg 51]</span> iodine preparation, of a certain -stated strength, is offered for sale at a price considerably lower than -that of recognized preparations of a similar character, the lower price -is possible only because of the fact that the iodine content is not as -represented.</p> - -<p>In choosing preparations of iodine, for use in his practice, the -veterinarian can easily deprive himself of much of the success -that goes with correct iodine therapy, if he allows his choice of -preparations to be influenced, to any great extent, by the cost of the -article.</p> - -<p>This is the chief reason, and there is probably no other, why some -veterinarians fail to get satisfactory results from topical iodine -applications. They permit their better judgment, in the selection -of the preparations, to be influenced too markedly by price; the -preparation that they select fails to give the expected results because -it is an<span class="pagenum" id="Page_52">[Pg 52]</span> inferior preparation, either in the strength or the quality -of the iodine it is said to carry. Commonly, both strength and quality -are inferior.</p> - -<p>Well made and honestly prepared iodine preparations are cheaper than -almost anything that the veterinarian uses, in a pharmaceutical -way; a little of a good iodine preparation “goes a long way”; and -it accomplishes what it does solely through the exertion of its own -energy. Almost never, it might be said, are other agents expected to -assist it in its action. For this reason, it is very essential that -the preparation be of correct and ample strength, that it contain the -iodine in a form readily available by the tissues, and that the vehicle -carrying the iodine have no detrimental action of its own.</p> - -<p>There is still another point that I wish to bring out, and that is in -regard to the fee that the practitioner charges<span class="pagenum" id="Page_53">[Pg 53]</span> for the handling of -a case with more or less costly iodine preparations. Usually, his fee -is too low. The practitioner should consider the fact that, in not -a few of the cases in which he uses topical iodine treatment, he is -actually depriving himself of a surgical fee, and the charge that he -makes for the treatment, in place of the operation that would otherwise -be required, should, in some degree at least, offset the loss thus -apparent. In some cases, it is even possible to get a larger fee under -these conditions, for, frequently, the owner of an animal would much -prefer that a given condition be cured without a surgical operation, -and would offer no serious objection to a higher fee for the correction -of the condition by a prolonged course of topical iodine medication. In -the case of a valuable animal, where scar formation might depreciate -the value, the smooth results,<span class="pagenum" id="Page_54">[Pg 54]</span> that are not uncommonly attained -with iodine preparations, actually deserve to be rated as much more -agreeable, and, therefore, worth a larger fee, than a surgical -operation.</p> - -<p>Whenever resort is had, by the veterinarian, to applications of iodine, -in considerable amounts, he should not hesitate to inform the client -that the agent used is costly, and that a special charge will be made -therefor.</p> - -<p>Many veterinary practitioners have come into the habit of writing -prescriptions for all iodine preparations that they find it necessary -to use, while all other medicines they dispense out of their own -pharmacy. I do not consider this good practice, for several reasons. -The main fault that I find in this is the one making it possible for -the client to have the prescription refilled without consulting the -veterinarian. It is nothing unusual for a prescription to be<span class="pagenum" id="Page_55">[Pg 55]</span> given to -neighbors or relatives, thus depriving the veterinarian of his fee. -Another reason that I have for finding fault with this practice, is -that many druggists will not fill a veterinary prescription honestly; -seeing that it is “only for a horse” or a cow, they do not hesitate -to use drugs, in compounding the prescription, that they would not -think of putting into a prescription for a human being—old drugs, -drugs of inferior quality, and the like. For these, as well as other -equally important reasons, the veterinarian should dispense all iodine -preparations, just as he does all others. He should not be deterred, -from using these preparations, on account of the slightly higher price -which he must pay for them, if he makes it a point to impress the worth -of the article on his client, and charges the fee that he should.</p> -<hr class="chap x-ebookmaker-drop" /> - -<div class="chapter"> -<p><span class="pagenum" id="Page_56">[Pg 56]</span></p> - -<h2 class="nobreak" id="V">V.<br /><br />Method of Using Regional Iodine Therapy in the Correction of Various -Pathological Conditions.</h2> -</div> - - -<p>If the reader has made an effort to follow me in what I have said in -the foregoing chapters of this treatise, he will have no difficulty in -applying, to cases occurring in his practice, many of the suggestions -offered.</p> - -<p>In this, the closing chapter of the treatise on regional iodine -therapy, I intend to refer to a small number of conditions, in the -handling of which I have found great satisfaction in the use of the -preparations heretofore mentioned, and, at the same time, I shall -endeavor to explain my own particular methods of using the preparations.</p> - -<p>I have already disposed of the manner in which the applications of -tincture of iodine are made, previous to incision<span class="pagenum" id="Page_57">[Pg 57]</span> of the integument, -in surgical operations. Aside from this quite common use of this -preparation, I have found tincture of iodine of great worth as an -application to calk wounds in the coronary region of the equine foot. -When the injured horn has been pared away under the wound in the -coronary band, and the loose particles of flesh and hair cleaned away, -the wound is freely painted with pure tincture of iodine. This painting -is to be repeated several times daily, until recovery takes place. -Severe infections rarely occur if the applications are begun within a -few hours after the accident occurs.</p> - -<p>Whenever tincture of iodine is used, for the correction of an -abnormality in the horse and cow, it must be applied very liberally if -the effect is desired with any degree of promptness. This, together -with the fact that the tincture is quite irritating to the skin<span class="pagenum" id="Page_58">[Pg 58]</span> of -animals—a fact that precludes an extensive course of treatment with -this preparation—makes iodine, in this form, an agent that is chiefly -of use in acute conditions, and it is, therefore, the agent of choice -to act as an adjunctive treatment to the internal handling of such -conditions as septicemia, strangles, distemper, parotitis, lymphangitis -of a localized character, and acute inflammations in tendons, -ligaments, and synovial bursae. In any of these conditions, it is best -applied with a small, rather stiff brush, painting it liberally, over -the parts involved, several times daily. If the parts become very much -irritated from these applications, the treatment must be stopped and -the area treated with a coating of vaseline or lard.</p> - -<p>The oily preparations of iodine are especially useful in various skin -diseases, ring-worm, and the parasitic<span class="pagenum" id="Page_59">[Pg 59]</span> form of scratches in horses. -The secret, in the successful handling of these conditions with -oily preparations of iodine, lies in the abstinence from water; the -parts should be given one thorough washing, when treatment is first -begun, after which no more water should be applied. If the parts need -cleansing, while the course of treatment is under way, it should be -done in a dry manner, with clean cloths or cotton wads.</p> - -<p>Oily preparations of iodine may also be used to anoint the arms of the -surgeon during the handling of infected cases of obstetrics. Pouring a -quantity of the preparation into the palm of the hand, and then rubbing -it gently over the skin of both hands and arms, proves a reliable -barrier to infection from a decomposed fetus or after-birth.</p> - -<p>In applying the oily preparations of iodine, to lesions on the -integument, it is always necessary to massage them<span class="pagenum" id="Page_60">[Pg 60]</span> into the tissues -quite vigorously; when this is done a single application each day -suffices.</p> - -<p>Other indications for the oily preparations, as well as for aqueous -preparations, of iodine, have been pointed out in the chapter devoted -to the selection of iodine preparations for practical use.</p> - -<p>Ointments of iodine—which, for me, mean Iodex—have, by far, the -most extensive field of application, and the uses to which an iodine -ointment may be put have already been quite clearly indicated. I -will, however, remark some of the points to be considered in using -Iodex in such cases as spavin lameness and similar affections of the -articulations.</p> - -<p>In choosing, for treatment with Iodex, a case of spavin lameness, the -practitioner should select only those cases in<span class="pagenum" id="Page_61">[Pg 61]</span> which the horse warms -out of the lameness; these cases can positively be cured by Iodex -applications. Do not attempt to cure the lameness caused by spavin in -which the horse will not warm out of the lameness; these cases are not -only impossible of cure by this means but by other means, excepting -neurectomy, as well.</p> - -<p>When the case has been selected, the Iodex should be applied, not -only in the immediate vicinity of the exostosis, but entirely around -the hock involved. An application should be made every morning and -every evening, in the following manner: Apply a thin coating of Iodex -and massage it into the hock for at least five minutes; then apply -another very thin coating, allowing this to remain on the surface. -The applications must extend over a period of from five to seven -weeks—about such a length of time as is required to effect<span class="pagenum" id="Page_62">[Pg 62]</span> a cure -with actual cautery—and, during the first few weeks of this period, -the animal should be at rest. After the second week, it may indulge in -light exercise in a lot or paddock, but may not be worked.</p> - -<p>Cases of spavin, treated in this manner—cases selected for treatment -as above outlined—are not only cured of lameness, but, in many cases, -the enlargement also disappears.</p> - -<p>The same results are obtained in cases of lameness from ringbone, -sidebone, splint and curb.</p> - -<p>Buck shins can be entirely absorbed with applications of Iodex as -directed above.</p> - -<p>Other conditions, in which the effects of Iodex frequently are most -remarkably satisfactory, are goitre, fibrous tumors on the body -surface, hygroma,<span class="pagenum" id="Page_63">[Pg 63]</span> and tendonous and ligamentous enlargements.</p> - -<p>The applications, in these conditions, are made in a manner similar to -that in spavin, massaging the Iodex thoroughly into the parts involved.</p> - -<p>In bringing this treatise to an end, I would again urge the -practitioner to add Iodex to his therapeutic armament, and use it not -only in the conditions of which I have here made mention, but in many -other indications for iodine therapy which come up almost daily in -every veterinary practice.</p> - - -<hr class="chap x-ebookmaker-drop" /> - -<div class="chapter transnote"> -<h2 class="nobreak" id="Transcribers_Notes">Transcriber’s Notes</h2> - -<p><a href="#Page_24">Page 24</a>: “as an an adjunctive” changed to “as an adjunctive”</p> - -<p><a href="#Page_44">Page 44</a>: “exceeds in specifivity” changed to “exceeds in specificity”</p> - -<p><a href="#Page_46">Page 46</a>: “Aqueous Preparatons” changed to “Aqueous Preparations”</p> -</div> -<div style='display:block; margin-top:4em'>*** END OF THE PROJECT GUTENBERG EBOOK A TREATISE ON REGIONAL IODINE THERAPY FOR THE VETERINARY CLINICIAN ***</div> -<div style='text-align:left'> - -<div style='display:block; margin:1em 0'> -Updated editions will replace the previous one—the old editions will -be renamed. -</div> - -<div style='display:block; margin:1em 0'> -Creating the works from print editions not protected by U.S. copyright -law means that no one owns a United States copyright in these works, -so the Foundation (and you!) can copy and distribute it in the United -States without permission and without paying copyright -royalties. 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