84 CLINICAL vp:terinarv medicine and surgery. 



artificial sinus. Still later the dressing was changed each week, and 

 the amount of gauze used as a drain was diminished. 



At the end of a month weight was freely placed on the limb, the 

 sinus suppurated feebly, and drainage was stopped. From this time 

 the horse was exercised daily. When he left hospital at the beginning 

 of the sixth week he walked almost sound. 



The second patient entered hospital a short time before the preceding 

 left, having been like it unsuccessfully treated for some time b}- the 

 colleague who finally sent it to us. 



When I examined the horse it showed marked pain, and could 

 scarcely bring the off fore-foot in contact with the ground. The 

 internal lacuna near the heel showed a fistulous wound, from which ran 

 a little grumous, stinking pus. The hoof was pared out, thoroughly 

 cleansed by immersion in a sublimate bath, and enveloped in a dressing 

 of peat wool, the first layers of which had been moistened with an 

 antiseptic solution. 



I performed the complete operation, making the incision a little 

 larger on the near side by giving to the transverse section, through the 

 plantar cushion and aponeurosis, an oblique direction backwards and 

 towards the inner heel. A few suspicious points, nevertheless, remained 

 on the stump of the tendon. I made a counter-openi'ng in the bend of 

 the pastern, inserted a gauze drain, and dressed the parts with tincture 

 of iodine and iodoform. 



The progress of the case was practically similar to that of the first. 

 Fever was a little more prolonged ; during the first week the tempera- 

 ture remained at 39'5° C. (io3*i° F.). The animal had capricious 

 appetite, placed little weight on the limb, and frequently lifted it with 

 a jerky movement, suggesting lancinating pain. Shortly after operation 

 an abscess developed in the plantar cushion in spite of the drainage. 

 Nevertheless towards the fifteenth day weight was placed on the foot, 

 and improvement was afterwards rapid. In the course of the fourth 

 week a light shoe and a dressing, fixed in position by splints, were 

 applied. 



Some days later the animal began to stand on the foot, and exercise 

 was commenced finally. Drainage was stopped on the thirtieth day. 

 A week later the animal returned to walking work. 



You may remember another case in which, when attempting to 

 remove the whole of the dead part, I opened a S3'novial cavity — without 

 doubt that of the large sesamoid. A quantity of synovia ran from the 

 bottom of the wound, and I was forced to cease the operation. The 



