In the old days, "horse balls" were basically horse pills - large pills that were forced down the sick horse's throat using a nasty looking device called a balling iron. Because horses are so big, then the doses they need are big too.
Most modern horse medicines come in smaller pills, pellets, or a powder or liquid designed to be mixed with foods, so the days of "balling" a horse are gone - but for the longest time it was the primary means of delivery.
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