720 OPERATIONS ON THE FOOT. 



But, ordinarily, the disease progresses slowly, destroying the 

 cartilage by degrees, and the diseased process ceases only when 

 the caries has reached the ligament of the joint, which it some- 

 times also attacks. The tissue of the fibro-cartilages has not 

 the force of reaction possessed by other inflamed structures, and 

 which is so well marked in cellular tissue. A process of suppura- 

 tion, such as rapidly eliminates the mortified structure, cannot 

 very readily take place in it, and when by natural forces the cari- 

 ous spot is eliminated and pushed outward, the surrounding tis- 

 sues are most commonly already affected. These undergo the 

 same alterations, and are eliminated in the same manner until 

 the entire cartilage is destroyed. This process of caries by repe- 

 tition may last a year. 



In its progressive stage, the disease may spread to surround- 

 ing parts, such as the os pedis, the plantar aponeurosis, the liga- 

 ment of the joint, or the sesamoid sheath, all of which may be- 

 come the seat of inflammation. They are diagnosticated by the 

 greater pain and more marked lameness, symptoms which are 

 comparatively light in the simple necrosis of the cartilage. 



Finally, as a possible complication of cartilaginous quittor, one 

 may observe an entire emaciation of the animal, an alteration of 

 the fluids due to a putrid or purulent infection; some authors 

 claim to have even seen glanders and farcy follow it ; this is inad- 

 missible. 



IV. Diagnosis. — Cartilaginous quittor is recognized only 

 when there is a wound from which escapes the product of the 

 suppuration and of the necrosis. This pus has nothing charac- 

 teristic, notwithstanding what has been said. If it is thinner 

 than that of a simple solution of continuity of the region, or that 

 of simple quittor ; if it is less foetid than that of bony caries, it 

 has, however, of itself some sjiecial characters, varying according 

 to the subject and the degree of the disease, and especially resem- 

 bhng much that of sub-horny quittor. If the escape of the pus is 

 slow, and it is desired to carefully examine it, a simple pad of 

 oakum, kept by a few turns of bandages on the fistulous opening, 

 will, when removed, give a sufficient opportunity to recognize its 

 nature. 



The probing will often assist in distinguishing the cartilagin- 

 ous from the simple or sub-horny quittor. In these last, the fis- 

 tula is less profound, and does not reach the thickness of the 



