454 CLINICAL VETERINARY MEDICINE AND SURGERY. 



On leaving hospital on the 20th April the horse was able to resume 

 work. 



158. iVn eleven-year-old entire horse, left in hospital 7th November, 

 1898. 



Five weeks before had picked up a nail in the near fore-foot. The 

 wound was unsuccessfully treated by caustics and antiseptics. On the 

 4th November signs of complication appeared, the injured foot being 

 carried clear of the ground. The veterinary surgeon in charge recom- 

 mended sending the animal to Alfort. 



State 0)1 Entry. — The animal had great difficulty in descending from 

 the ambulance, and force was required to make it walk to its box. No 

 weight whatever could be placed on the near fore-foot. The general 

 condition was bad, and the face showed signs of suffering. 



On removing the dressing a large fungating sinuous wound, covered 

 with yellowish-white discharge, was seen towards the middle of the 

 external lateral lacuna. 



Tr&atment. — Thinning of the frog and sole, and moist applications 

 to the foot. 



Next day, although the temperature was only 38*6° C, operation 

 was considered necessary. The horse was cast on the right side on 

 the table. The near fore-foot was carefully fixed, the sole stripped, 

 and the operation for picked-up nail performed. The plantar cushion 

 was divided at right angles to the surface of the sole, about three 

 eighths of an inch behind the point of the frog. The insertion of the 

 perforans tendon was spared as much as possible. It was lifted with a 

 retractor to allow the lower surface of the navicular bone to be scraped. 

 Its surface of insertion on the pedal bone was preserved in its entirety. 

 The interosseous ligament had been injured by the nail, opposite the 

 anterior margin of the navicular bone, and at this point was several 

 times touched with tincture of iodine. The wound was washed out 

 with warm salt solution, and with i in 1000 sublimate solution ; then, 

 using a director, enveloped in wadding saturated with tincture of 

 iodine, the superior cul-de-sac of the small sesamoid sheath was care- 

 fully disinfected. 



A traumatol dressing was applied, the parts plugged with gauze 

 and surrounded with a cotton-wool dressing. After operation the 

 temperature was 39"5° C, in the evening 38*6° C. During the night 

 the horse ate its food. 



Next morning the general condition was good. Temperature 

 38-4° C, evening 38-6° C. 



From the loth to the 17th November the temperature varied be- 

 tween 38*0° and 38*8° C. There was little stabbing pain. The appe- 

 tite was preserved, and everything showed that healing was occurring 

 regularly. 



On the 1 8th the dressing was removed. A quantity of blood- 

 stained discharge was found under the gauze. Except on the navicular 

 bone the wound was granulating throughout. It was cleansed, irrigated 

 with warm sublimate solution powdered with traumatol, and covered 

 with a new cotton-wool dressing. During the following days the 



