442 now TO MAKE THE FAEM PAY. 



ence. If removed, by any means, before this is accomplisbed, 

 it must necessarily proportionably fail in its effects. 



•' The preparation of the foot, then, requires no mean skill. 

 The tools must be sbarp, the movements of the operator careful 

 and deliberate. As he shaves down nearer the quick, he must 

 cut thinner and thinner, and with more and more care, or else 

 ho will either fail to remove the horn exactly far enough, or he 

 will cut into the fleshy sole and cause a rapid flow of blood. I 

 have already remarked that the blood can be staunched by 

 caustics ; but they coagulate it on the surface in a mass which 

 requires removal before the application of remedies, and in the 

 process of its removal the blood is very frequently set flowing 

 again, and this sometimes several times follows the application 

 of the caustic* Cutting down to the crack between the horny 

 and fleshy sole is not enough. The operator must ascertain 

 wliether there is any ulceration between the outside horny 

 walls and the fleshy part of the foot, or at the toe, or whether 

 tliere is even a rudiment of an unreached sinus or cavity in 

 any part of the foot where the ulceration has penetrated or is 

 beginning to penetrate. The practised eye decides these ques- 

 tions rapidly from the characteristic appearances, without the 

 removal of unnecessary horn ; but the new beginner must feel 

 his way along cautiously removing more horn where there is 

 doubt, but so removing it that he will not unnecessarily cause 

 an effusion of blood, or uncover the healthy quick, or disarrange 

 the proper bearing of the foot. If the foot is in the third state, 

 the removal of the maggots, the cleaning of the ulcers, the 

 proper excision of the dead tissues, etc., require much time, 

 eometimea more than half an hour to each foot. The most ex- 



• The toe vein bleeds very freely, and it often requires some time and 

 trouble to staunch it. 



