120 SURGERY. 



After the operation, cold water is all that need be applied. The 

 operated eye should be exclusively used for a few days. A fungous 

 granulation often rises from the wound, which may be removed by 

 the knife, scissors, or lunar caustic. 



CLUB-FOOT. 



This deformity may either be congenital or acquired. The con- 

 genital form is dependent upon some disturbance of the cerebro- 

 spinal system, that produces irregular contraction of the muscles, 

 by which antagonism is destroyeoT 



The accidental causes by which it may be acquired, are injuries 

 and diseases of the foot or ankle, convulsions, scarlet fever, cica- 

 trices, rickets, &c. 



The principal varieties are three : — 1. Talipes Varus, in 

 which the foot is turned inward, as in figure 49, and rests upon 



its outer edge. There are various grades and modifications of 

 varus. The foot is not dislocated, but the bones deviate from 

 their normal direction, and their articular surfaces are partially 

 separated. The astragalus is least altered in position. The liga- 

 ments on the outer side are lengthened, and those on the inner 

 are shortened. The tendons of the tibialis anticus and posticus, 

 and the tendo Achillis, are most contracted; the peronei are re- 

 laxed. 



2. Talipes Valgus (fig. 50). The foot is everted, and rests on its 

 inner edge. It is a rare form of club-foot. The ligaments on the 

 inner side are relaxed. The peronei muscles are contracted, and 

 the tibialis anticus and posticus elongated. 



3. Talijjes Equinus. — In this variety the foot rests upon the 

 ball, or upon the toes. After a person has walked for a number of 

 years the deformity is increased, as is represented in the drawing 



