THE TREATMENT OF PICKED-UP NAIL. 83 



tincture of iodine, and apply a first dressing, with or or without a shoe. 

 If the end of the perforans tendon does not granulate throughout, or 

 the necrotic tissue fails to separate, drainage may be supplemented by 

 antiseptic injections made through the opening in the bend of the 

 pastern. Some months ago you were able to watch the progress of 

 two cases thus treated. They recovered without further interference. 

 I may briefly recapitulate the facts in connection with the first. 



At the commencement of last September we received a horse 

 which had picked up a nail in the middle zone of its off hind foot, 

 and had already been twice operated on by the veterinar}- surgeon 

 who sent it. 



No weight was placed on the foot, and the animal showed evidence 

 of frequent lancinating pain. On examining the hoof the operative 

 wound in the plantar cushion was seen. Its deeper part formed a sinus, 

 from which discharged a considerable quantity of greyish \-iscous pus. 

 The aponeurosis was necrotic, and the tendon sheath had become trans- 

 formed into a suppurating cavity. 



The same day I practised the complete operation. Necrosis had 

 extended for a long distance in the perforans tendon, and I N\as unable, 

 without risking injury of the synovial cul-de-sac, to remove the entire 

 mass of the eschar. I made a counter-opening in the bend of the 

 pastern, irrigated the wound with an antiseptic liquid, inserted a gauze 

 drainage-tube, and then, with the end of a director en\eloped in 

 wadding, I swabbed with tincture of iodine that portion of the tendon 

 stump in which I had been obliged to leave a fragment of necrotic 

 tissue. The parts were coxered with a layer of iodoform, the foot 

 enveloped in a large dressing. 



On the four following days the animal showed acute pain. During 

 the greater part of the time it remained lying down, and took little 

 food. Fever was marked, the temperature oscillating between 39*3° 

 and 39*9° C. (1027° and 103*8^ F.). 



On the fifth day the dressing was renewed. I changed the gauze 

 drain, again touched the necrotic portion of the tendon with tincture 

 of iodine, and applied a new cotton-wool dressing. From the next day 

 the condition improved. The appetite increased, the fever diminished, 

 and the lancinating pains became less frequent. The impro\ement was 

 continued on the following days. Gradually the horse began to place 

 weight on the affected limb. The dressing was allowed to remain until 

 the end of the second week. At that time the wound was granulating 

 throughout almost its entire surface, only the navicular bone still 

 showing a small dry point. The gauze being changed, a dressing and 

 shoe were applied, and antiseptic injections made daily through the 



