REGIONAL IODINE 
 THERAPY 
 
 SF855 
 155 
 S74 
 1919 
 
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 This book was presented by 
 
 MILTON M. LEONARD, D.V.M. 
 
 TO THE 
 
 VETERINARY MEDICAL LIBRARY 
 
 Nok'H AROlINA STATE UNIVERSITY LIBRARIES 
 
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THIS BOOK IS DUE ON THE DATE 
 INDICATED BELOW AND IS SUB- 
 JECT TO AN OVERDUE FINE AS 
 POSTED AT THE CIRCULATION 
 
 E)«C£PTION 
 
 earlier if thi 
 
 Date due viH be 
 item is RECALLED 
 
 
 150M/01-92— 920179 
 
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. 
 
 i68 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 Prepara- 
 tions for Practical Use. 
 
 V. Method of using Regional Iodine 
 Therapy in the Correction of 
 Various Pathological Conditions. 
 
Introduction. 
 
 In presenting to the veterinary pro- 
 fession this treatise on Regional Iodine 
 Therapy, I do so with the object of 
 bringing into the Hght certain cHnical 
 facts that have to do with the topical 
 application of iodine in veterinary pa- 
 tients, and to discuss, from the stand- 
 point 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 indi- 
 cations for topical iodine medication 
 which have, in the past, been over- 
 looked by the practitioner of veterinary 
 
 medicine. 
 
 5 
 
Throughout the treatise I shall con- 
 fine myself to the exposition of only 
 such matter as I have found to be com- 
 patible with the practical phases of 
 veterinary science in the conduct of my 
 own practice. 
 
 M. R. S. 
 Milwaukee, Wis. 
 March, 19 19. 
 
11. 
 
 General Considerations of Local 
 Iodine Therapy. 
 
 While it is a fact that iodine is one 
 of the most popular of the many medic- 
 inal agents used by the practitioner of 
 veterinary medicine and surgery, it al- 
 so is a fact that iodine — more so than 
 any other agent — is frequently used in 
 pathological conditions and under cir- 
 cumstances 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 es- 
 pecially noteworthy in the use of iodine. 
 
 Iodine does not differ from any other 
 therapeutic agent with regard to indi- 
 vidual indications for its application; 
 it has these as prominently marked as 
 have the alkaloids, physiologically. 
 7 
 
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 at- 
 tempts at an explanation of results at- 
 tained, 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 uni- 
 8 
 
form 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 appli- 
 cation. 
 
 What may be an indication for the 
 use of iodine in one form, may lack the 
 requisite pathological status for its ap- 
 plication 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 thera- 
 peutic power that the practitioner ex- 
 pects it to exert, despite the fact that 
 the case is clearly one for iodine ther- 
 apy. 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 ob- 
 9 
 
tained with almost amazing prompt- 
 ness. Again, in another class of cases, 
 the reverse may be true. 
 
 Although, in a goodly proportion of 
 the cases to be discussed in the follow- 
 ing chapters in this treatise, the prac- 
 titioner must come into direct and fre- 
 quent clinical contact with the patho- 
 logical 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 thoueht 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 sub- 
 ject. 
 
 10 
 
III. 
 
 Special Considerations of Local 
 Iodine Therapy. 
 
 When we undertake the considera- 
 tion of those features of iodine therapy 
 which have to do with its adaptabiHty 
 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. 
 11 
 
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 Io- 
 dine. 
 
 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 iodme that not many other thera- 
 peutic agents can claim; namely, that 
 beneficial effects resulting from iodine 
 medication are almost, without ques- 
 12 
 
tion, due to it alone; it is hardly ever 
 applied in combination with synergists 
 which might obscure the activity of in- 
 dividual ingredients. 
 
 This remarkable therapeutic activity 
 of iodine is such that, when properly 
 applied in some of its forms, its pres- 
 ence can be demonstrated in the under- 
 lying tissues. After prolonged courses 
 of topical application, its action is oc- 
 casionally 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 io- 
 dine preparations of a particular class, 
 we have an agent whose topical reme- 
 dial effects are, in some slight measure, 
 due to systemic action ; in part at least, 
 this action being the effect of great 
 physiological activity exdrted in the 
 limited area of its topical application. 
 13 
 
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 cer- 
 tain elemental constituents of the tis- 
 sues of the animal organism. 
 
 The foregoing throws some light on 
 the therapeutic accomplishments of io- 
 dine preparations, when topically ap- 
 plied, and, to a certain extent, explains 
 its modus operandi in a physiological 
 sense — an understanding somewhat es- 
 sential 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 ap- 
 plications, 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 
 14 
 
attain a clear understanding of the 
 physiological action of iodine prepara- 
 tions 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 condi- 
 tions, which are indicated, into the fol- 
 lowing : 
 
 Under i. Surgical preparatory tech- 
 nique. 
 
 Under 2. Acute pathological condi- 
 tions, in the corrections of 
 which topical applications 
 of iodine preparations are 
 used as an adjunct to in- 
 ternal medication with 
 other agents. 
 15 
 
Under 3. Chronic pathological con- 
 ditions, in which one or 
 more of various iodine 
 preparations, locally ap- 
 plied, constitutes the en- 
 tire treatment. 
 This classification and sub-classifica- 
 tion is important and essential when we 
 endeavor to make our use of iodine con- 
 form to ethical standards; it is also 
 very essential to the attainment of cer- 
 tain therapeutic ends in actual practice. 
 
 I. The Local Application of Prep- 
 arations OF Iodine in the Sense 
 OF Prophylactic Aim in Surgery. 
 
 The exhaustive pre-operative wash- 
 ing and scrubbing of the integument, 
 that veterinary practitioners applied to 
 their surgical patients in years past, has 
 given way almost entirely ~v iodine 
 painting. Even those surge r,ns who 
 still adhere to the scrubbing and wash- 
 ing of the parts about to be incised, 
 16 
 
complete the process with an appUca- 
 tion 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 wash- 
 ing and the scrubbing with antiseptic 
 solutions, soaps and other agents. Not 
 only this, but it has also greatly sim- 
 plified and shortened an otherwise te- 
 dious, 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 elimina- 
 tion of basins, brushes, and sponges for 
 use in the preliminary stages of an 
 17 
 
operation, as well as the agreeable ab- 
 sence of the wet, sloppy field that in- 
 evitably 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 veteri- 
 nary 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 clip- 
 ping and shaving have been done, the 
 18 
 
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 de- 
 posit of filth, oily or greasy in nature, 
 this should first be removed by swab- 
 bing and wiping with gauze or cotton 
 saturated with gasoline, benzine or 
 ether; these remove oily, greasy or 
 fatty filth and evaporate quickly, leav- 
 ing the area perfectly dry and clean. 
 Washing with watery solutions, previ- 
 ous to the iodine application, is not re- 
 commended under any conditions. 
 
 When the area has been clipped, 
 shaved, freed from grease or other 
 filth, and then allowed to become per- 
 fectly dry, the tincture of iodine is 
 applied liberally with a soft brush, or 
 19 
 
with a cotton swab. This is allowed to 
 dry for a minute or two; another ap- 
 plication 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 io- 
 dine be used for disinfecting- purposes 
 on any utensils or apparatus made of 
 metal. The fact that the iodine may 
 injure instruments can not be consid- 
 ered 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 tinc- 
 ture of iodine just before the wound 
 is to be closed with sutures. Whether 
 20 
 
this is good practice, on general prin- 
 ciples, 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, how- 
 ever, it would appear that the iodine 
 could act, in many instances, as an un- 
 desirable irritant when it comes in con- 
 tact with delicate, freshly incised tis- 
 sues. 
 
 As the object, in modern surgery, is 
 to eliminate all things, even the slight- 
 est, 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 inter- 
 fering with the carrying out of that 
 object. 
 
On the other hand, in surgical 
 wounds of an already infected charac- 
 ter 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 en- 
 dorsed. 
 
 The latter statement applies, with 
 even greater force, to all wounds of an 
 accidental character in the fleshy por- 
 tions of the anatomy. 
 
 It is also the practice of many veteri- 
 nary surgeons to apply pure tincture ot 
 iodine to the wound after the sutures 
 have been put into place. This is a 
 very satisfactory practice, if the paint- 
 ing is done gently and not too freely. 
 An excess of the tincture of iodine — 
 if the wound edges have not been co- 
 apted perfectly — may result in cause 
 for stitch abscess when a considerable 
 amount of the iodine becomes pocketed 
 22 
 
in some part of the wound under the 
 Hne of suture. 
 
 In certain animals, whose skins are 
 very tender, the local application of 
 pure tincture of iodine, previous to sur- 
 gical incision, is followed, in a few 
 days, by slight peeling of the integu- 
 ment. 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 injec- 
 tion 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. 
 23 
 
As in the case of a surgical incision 
 area, so also here, the parts to which 
 the application is made must be per- 
 fectly dry. 
 
 2. The Use of Iodine as an Ad- 
 junct TO Internal Medication 
 IN THE Correction of Acute 
 Pathological Conditions. 
 
 Iodine preparations of various forms 
 are very commonly used topically as an 
 an adjunctive treatment to internal 
 medication in the treatment of a num- 
 ber 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 prac- 
 titioner is to hasten the correction of 
 certain well-marked local manifesta- 
 tions of the disease with which the pati- 
 ent is afflicted. In other instances, the 
 aim of the practitioner is toward the 
 24 
 
prevention of these local manifesta- 
 tions. Occasionally, in a certain type 
 of pathological conditions, the prac- 
 titioner intends, by the use of topical 
 iodine applications, to enhance the in- 
 ternal treatment being aimed at symp- 
 toms 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 follow- 
 ing chapters, I will point to the use of 
 topical iodine medication in the hand- 
 ling of a case of parotitis as an illus- 
 tration. While regional applications of 
 iodine are the rule, in the handling of 
 cases of this affection in veterinary 
 25 
 
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 treat- 
 ment indicated by the pathology of the 
 condition is correcting the lesion per sc, 
 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, name- 
 ly, 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 
 26 
 
topical applications of iodine are fre- 
 quently 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 selec- 
 tion of the proper form or preparation 
 of iodine for the particular case in 
 hand. 
 
 3. Regional Iodine Applications 
 FOR THE Cure of Chronic Patho- 
 logical 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 appli- 
 cation, so forcibly demonstrates its 
 therapeutic work, for it is here that io- 
 dine is often the only agent used in the 
 27 
 
handling of the case, thus constituting 
 the entire treatment. Under these cir- 
 cumstances, it is never a difficult matter 
 to decide as to the value of the treat- 
 ment or the activity of the agent used. 
 
 Were there no other means of demon- 
 strating the fact that iodine, in some 
 of its forms, arouses the animal organ- 
 ism to the end, and in the direction, of 
 marked efforts at regional cure of vari- 
 ous 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 re- 
 sult from which the practising veter- 
 inarian derives more professional sat- 
 isfaction 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 
 28 
 
specific effect of others in certain skin 
 diseases, and from the almost miracu- 
 lous cure of certain locaHzed infections 
 when the proper iodine medication is 
 appHed in these. 
 
 So sure are the effects of iodine, in 
 a curative way, in certain diseased con- 
 ditions among domestic animals, that it 
 has value in this regard from a diag- 
 nostic standpoint. Given a case ap- 
 parently of this type for handling, the 
 practitioner can be assured that he has 
 erred in his diagnosis if iodine, in 
 proper preparation and correct applica- 
 tion, does not effect a cure. To illus- 
 trate this, I need only refer to that dis- 
 eased 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 cer- 
 tain chronic conditions, of the articula- 
 tions for instance, after various other 
 29 
 
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 practi- 
 tioner, for the accomplishment of any- 
 thing 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 con- 
 ditions in question. Usually, however, 
 it impresses upon him, with added 
 force, the thought that he has not fully 
 30 
 
acquired the knack — either along prac- 
 tical 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 cau- 
 tery; 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 ap- 
 preciate 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 
 31 
 
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 mat- 
 ter to select the great majority. It is 
 the opinion of most veterinary prac- 
 titioners, who have the ethics of their 
 profession at heart, that the treatment 
 of certain well-known pathological con- 
 ditions 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 
 32 
 
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 lame- 
 ness located in an articulation is cur- 
 able, 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 con- 
 ditions connected with the case. And 
 I further believe that every time we 
 resort to the actual cautery, for the cor- 
 rection 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. 
 33 
 
This belief is the result of actual con- 
 tact with ample clinical material and 
 the observations made in actual prac- 
 tice covering-, a period of time extending 
 over more than fifteen years. 
 
 Other chronic pathological condi- 
 tions, 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 ap- 
 plications, results in these conditions 
 which could only be equalled by surgi- 
 cal interference of much more costly 
 and dangerous character. Iodine ap- 
 plications 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 
 34 
 
as cost, danger to the patient's life, pro- 
 tracted period of convalescence, or oth- 
 er equally reasonable objections. 
 
 In the effects that are obtained from 
 the local applications of iodine prep- 
 arations, in chronic pathological con- 
 ditions, 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 abnormali- 
 ties. 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 at- 
 tending veterinarian is averse to lend- 
 ixig the time consumed. In other of 
 these conditions, the desired result 
 comes very promptly, at times with a 
 35 
 
rapidity that causes astonishment. In 
 all cases yielding to topical iodine 
 therapy, sufficient evidence of the bene- 
 ficial effect derived is discernible with 
 sufficient promptness to encourage the 
 continuance of the treatment. 
 
 36 
 
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 con- 
 sideration of local iodine therapy, what 
 may be an indication for the use of 
 iodine in one form may lack the re- 
 quisite pathological status for its suc- 
 cessful 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 en- 
 Z7 
 
dowed, 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 phar- 
 maceutical dress, greater quantities of 
 available iodine than one very closely 
 allied to it in every other regard. 
 
 Then, too, it is not always the par- 
 ticular form or preparation that in- 
 fluences the effect; frequently this in- 
 fluence 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 vet- 
 38 
 
erinary practice has indicated to me as 
 being as nearly correct as could be ex- 
 pected in a practical way. 
 
 Tincture of Iodine. 
 
 Skin disinfection in Surgery. 
 
 Skin disinfection previous to hypo- 
 dermic injections. 
 
 Adjunctive to systemic medication 
 in the treatment of generalized in- 
 fections 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. 
 39 
 
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 articu- 
 lations. 
 
 Chronic enlargements of osseous 
 structures. 
 
 Chronic tumefactions resulting from 
 specific infection. 
 
 Chronic thickening of tendons. 
 
 Chronic thickening of ligaments. 
 
 40 
 
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 ef- 
 41 
 
fects 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 ex- 
 ists free and uncombined with other 
 agents, in a vehicle that is blandly 
 penetrating and non-irritating. I 
 can highly recommend lodex, as ful- 
 filling exactly these requirements. It 
 can be applied freely and indefinitely, 
 and, even when the course of treat- 
 ment 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 applica- 
 tions for a time because of the local 
 irritating effect. This delays not 
 only the ultimate recovery of the pa- 
 tient, but may even result in the cure 
 being only partly satisfactory. In 
 addition to its non-irritating proper- 
 ties, lodex is much more active than 
 any other ointment preparation of 
 42 
 
iodine with which I am acquainted, 
 and it has the remarkably note- 
 worthy property of leaving no stains. 
 Although the ointment is a rich blue- 
 black in appearance, it may be ap- 
 plied to the treated area with the 
 bare hand, and will not stain the 
 fingers. This is a quality not pos- 
 sessed by any other active iodine 
 ointment to my knowledge. lodex 
 can be obtained from all large whole- 
 sale drug houses and distributors of 
 veterinary supplies. It is a Menley 
 & James product. Should the veteri- 
 narian have difficulty in obtaining 
 lodex from his regular supply house, 
 I would advise him, rather than ac- 
 cept a substitute, to obtain it from 
 them direct, by writing to their New 
 York Office at No. i68 Duane Street. 
 I have used many iodine prepara- 
 tions in my practice during the past 
 fifteen years, and have found in lodex 
 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 detract- 
 43 
 
ing agents, it is blandly penetrating 
 and, therefore, will positively not ir- 
 ritate 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. 
 
 lodex is one of those preparations, 
 so rare, that the veterinarian soon 
 learns to appreciate highly and with- 
 out which he finds it difficult to con- 
 duct 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 thera- 
 peutic requirements, and he is able 
 to obtain with it results that he did 
 not think possible before he made its 
 acquaintance. lodex exceeds in ac- 
 tivity the other iodine preparations 
 to the same extent that an autog- 
 enous bacterin exceeds in specifivity 
 that of a stock bacterin, and I would 
 44 
 
advise that every practitioner of 
 veterinary medicine who has not yet 
 made its acquaintance write at once 
 to Menley & James, No. i68 Duane 
 Street, New York City, for a trial 
 package. I make this recommenda- 
 tion with a full realization of the fact 
 that lodex is a proprietary agent, 
 and the veterinarian will, in the light 
 of my numerous contributions to 
 ethical veterinary literature, correct- 
 ly infer that lodex 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. 
 
 45 
 
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 Preparatons of Iodine. 
 
 Although, from a chemical stand- 
 point, the mixture of tincture of io- 
 dine with water would be considered 
 wrong, I have found that the addi- 
 tion of one dram of tincture of io- 
 dine to a quart of sterile water makes 
 a most satisfactory combination for 
 use in veterinary practice for a num- 
 ber of diseased conditions. 
 
 In mal-odorous catarrhal diseases, 
 a mixture such as this makes a fine 
 wash. 
 
 46 
 
In the treatment of foul-smelling ul- 
 cers 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-smell- 
 ing hoof troubles. 
 
 As a wash for the veterinarian's 
 hands and arms, to prevent infec- 
 tion and remove odors, after the 
 handling of after-births, dead fe- 
 tuses, 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 valu- 
 able, in a veterinary practice, because 
 it can be made up extemporaneously 
 47 
 
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 prac- 
 titioner's attention to that preparation 
 of iodine known as Lugol's solution, 
 because there is one condition that the 
 veterinary practitioner comes into con- 
 tact 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 man- 
 ner, in certain cases of periodic ophthal- 
 48 
 
mia in horses. It is injected hypo- 
 dermically 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 ap- 
 plications, frequently repeated. I do 
 not doubt that just as good and lasting 
 results could be obtained, in this con- 
 dition, from daily inunction of the in- 
 dicated area with an oily iodine pre- 
 paration. 
 
 It remains to be said that, in this 
 condition, internal medication is usually 
 indicated and the iodine, in any form, 
 applied regionally, merely acts adjunc- 
 tively in any case. I have made men- 
 49 
 
tion of this use of iodine preparations 
 because some practitioners treat per- 
 iodic 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 prep- 
 arations in which the active ingredient, 
 and, therefore, the ingredient to be de- 
 pended upon for results, is iodine. 
 Iodine, to begin with, as an elemental 
 article, is costly. The veterinarian may, 
 therefore, be sure that, whenever an 
 50 
 
iodine preparation, of a certain stated 
 strength, is offered for sale at a price 
 considerably lower than that of recog- 
 nized preparations of a similar char- 
 acter, the lower price is possible only 
 because of the fact that the iodine con- 
 tent 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 veteri- 
 narians fail to get satisfactory results 
 from topical iodine applications. They 
 permit their better judgment, in the 
 selection of the preparations, to be in- 
 fluenced too markedly by price; the 
 preparation that they select fails to give 
 the expected results because it is an 
 51 
 
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 
 52 
 
for the handling of a case with more 
 or less costly iodine preparations. 
 Usually, his fee is too low. The prac- 
 titioner 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, 
 53 
 
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 wTiting prescrip- 
 tions 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 noth- 
 ing unusual for a prescription to be 
 54 
 
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 compound- 
 ing the prescription, that they would 
 not think of putting into a prescrip- 
 tion for a human being — old drugs, 
 drugs of inferior quality, and the like. 
 For these, as well as other equally im- 
 portant 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 im- 
 press the worth of the article on his 
 client, and charges the fee that he 
 should. 
 
 55 
 
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 men- 
 tioned, and, at the same time, I shall 
 endeavor to explain my own particular 
 methods of using the preparations. 
 
 I have already disposed of the man- 
 ner in which the applications of tincture 
 of iodine are made, previous to incision 
 56 
 
of the integument, in surgical opera- 
 tions. Aside from this quite common 
 use of this preparation, I have found 
 tincture of iodine of great worth as an 
 appHcation to calk wounds in the coro^ 
 nary 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 abnormal- 
 ity 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 
 57 
 
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 inflam- 
 mations in tendons, ligaments, and 
 synovial bursae. In any of these con- 
 ditions, 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 dis- 
 eases, ring-worm, and the parasitic 
 58 
 
form of scratches in horses. The secret, 
 in the successful handUng of these con- 
 ditions 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 sur- 
 geon 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 
 59 
 
into the tissues quite vigorously; when 
 this is done a single application each 
 day suffices. 
 
 Other indications for the oily prep- 
 arations, as well as for aqueous prep- 
 arations, of iodine, have been pointed 
 out in the chapter devoted to the selec- 
 tion of iodine preparations for practical 
 use. 
 
 Ointments of iodine — which, for me, 
 mean lodex — 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 lodex in such cases as spavin 
 lameness and similar affections of the 
 articulations. 
 
 In choosing, for treatment with lodex, 
 a case of spavin lameness, the practi- 
 tioner should select only those cases in 
 60 
 
which the horse warms out of the lame- 
 ness; these cases can positively be cured 
 by lodex applications. Do not at- 
 tempt 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 neurec- 
 tomy, as well. 
 
 When the case has been selected, the 
 lodex should be applied, not only in 
 the immediate vicinity of the exostosis, 
 ibut entirely around the hock involved. 
 An application should be made every 
 morning and every evening, in the fol- 
 lowing manner : Apply a thin coating 
 of lodex and massage it into the hock 
 for at least five minutes ; then apply an- 
 other very thin coating, allowing this 
 to remain on the surface. The appli- 
 cations must extend over a period of 
 from five to seven weeks — about such 
 a length of time as is required to effect 
 61 
 
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 man- 
 ner — cases selected for treatment as 
 above outlined — are not only cured of 
 lameness, but, in many cases, the en- 
 largement also disappears. 
 
 The same results are obtained in 
 cases of lameness from ringbone, side- 
 bone, splint and curb. 
 
 Buck shins can be entirely absorbed 
 with applications of lodex as directed 
 above. 
 
 Other conditions, in which the effects 
 of lodex frequently are most remark- 
 ably satisfactory, are goitre, fibrous 
 tumors on the body surface, hygroma, 
 62 
 
and tendonous and ligamentous en- 
 largements. 
 
 The applications, in these conditions, 
 are made in a manner similar to that in 
 spavin, massaging the lodex thorough- 
 ly into the parts involved. 
 
 In bringing this treatise to an end, 
 I would again urge the practitioner to 
 add lodex 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. 
 
 63