618 OPERATIONS ON THE FOOT. 



hemorrhage ; there is blood which sometimes exudes between the 

 borders of the crack, and flows in abundance when the movement 

 is rapid ; and old crack, in similar circumstances, may show pus, 

 sometimes mixed with blood. A misstep, a sprain, may give rise 

 to hemorrhage in cracks which are ordinai'ily dry. In toe-crack, 

 the solution generally involves the thickness of the wall, through 

 which it runs in a line almost parallel to the median plane of the 

 body, while in quarter-crack it is often oblique and irregular, not 

 exactly following the direction of the fibres, but following the 

 thickness of the wall obliquely in such a way that the external 

 solution of continuity is more posterior than the external. If the 

 crack is rather old, and the foot where it exists is contracted, it is 

 generally incurvated, one border covering the other, and some- 

 times they seem to be moulded on each, other, so as to cover and 

 conceal the true crack. 



III. Complications. — Among these we may first mention the 

 inflammation of the recticular tissue, which is first pinched and 

 injui-ed. This may be followed by suppuration and local gangrene. 

 Very often the disease is followed by necrosis of the os pedis, and 

 caries of varying dejDth. In toe-crack cases have been seen of 

 caries of the tendon of the anterior extensor of the phalanges, and 

 even arthritis, though rarely occuring, have been observed. In 

 quarter-crack, one may have cartilaginous quittor and suppurative 

 corns. As before stated, these lesions are indicated by the severity 

 of the lameness, the presence of the blood or pus through the crack, 

 and the extreme sensibility of the part. It is especially when, in 

 the course of treatment, a part of the hoof has been removed, that 

 the keratogenous apparatus has been exposed, that the abnorma- 

 coloration of the podophyllous tissue is seen, in its swollen condi- 

 tion and its sensibility to pressui-e, accompanied with the presence 

 of the pus or sanious discharge, and at times the necrosis of the 

 bone. Sometimes, also, foreign substances, as dirt or gravel, may 

 be found introduced in the cracks, and acting as causes of irrita- 

 tion to the sensitive tissues below. 



A complication, not so frequent, however, according to some 

 authors, is that known as Keraphylocele, and which consists in an 

 hyj)ersecretion of horn, from the coronary band on the inside of 

 the crack. Sometimes the horny growth remains separate from 

 the borders of the crack, and is adherent to the wall only by its 

 base, towards the coronary band ; this is especially the case when 



