107G DISEASES OF THE FOOT. 



that not the slightest trace of operation could be detected on 

 examining the hoof : and the animals themselves worked for years 

 on the streets of Berlin. 



Bayer has modified the above operation with the view of producing 

 fewer and simpler incisions, facilitating the escape of discharge, and 

 enabling the operator clearly to see each stage in the removal of the 

 lateral cartilage. 



On the day before casting, the horn covering the seat of operation 

 is thoroughly thinned, the parts are freely scrubbed with a brush and 

 disinfecting solution, and thereafter enveloped in several thicknesses 

 of linen saturated with a strong disinfectant. 



The horse is cast and the foot secured as previously described. 

 General anaesthesia is desirable, but if local anaesthesia is preferred 

 cocaine solution must be injected at several points around the coronet, 

 and operation must be carried out more quickly than when chloroform 

 is given. The hair is shaved from around the coronet and over the 

 fetlock, and an Esmarch's bandage and tourniquet applied to the 

 limb. The horn is then completely removed from the crescent- 

 shaped surface beneath which lies the lateral cartilage (see Fig. 572). 

 Instead of now lifting the coronary band, &c, from the surface of 

 the lateral cartilage, Bayer makes an incision through the sensitive 

 structures, corresponding with, but about £ inch within, the incision 

 through the horn. The ends of this incision are prolonged upwards, 

 dividing the coronary band, &c, as high as the upper margin of the 

 lateral cartilage. The flap so outlined must now be carefully freed 

 from the underlying lateral cartilage, which is next removed either 

 wholly or in part, depending on the extent to which it is diseased. 

 Sometimes the gouge or the chisel and mallet must be used to extirpate 

 ossified portions of the cartilage. In the event of a large vessel 

 being divided in the process it should, if possible, be ligatured. The 

 fistulous opening on the coronet and any fistulous tracts must be 

 freely curetted. After making quite sure that no necrotic fragments 

 have been overlooked the parts are thoroughly cleansed with an 

 active disinfectant and freely dusted with iodoform ; the flap is 

 then brought into position and secured with a series of interrupted 

 sutures. Bayer endeavours to preserve all sound tissue, and therefore 

 removes as little as possible from the coronet and, from the lateral 

 cartilage, only diseased portions. It is quite certain, nevertheless, 

 that disease processes in the cartilage extend very much farther than 

 they appear to do, and that apparently sound portions are either 

 in process of necrosis or very readily become infected after operation. 

 Dollar, who has operated many times, prefers to remove the entire 



