728 OPERATIONS ON THE FOOT. 



tlie direction recommended by Lafosse, Sr., Eey, or Renault. This 

 groove, made first with the widest, and finished with the narrow- 

 est of the drawing knives, must not touch the podophyllous tissue, 

 and still must run thi'ough the entu'e thickness of the wall, with- 

 out producing hemorrhage. In this step of the operation, as 

 Girard correctly observes, short cuts of the knife are always bet- 

 ter and quicker than those made by scraping or dragging with 

 the instrument. It is also important to come down to the soft 

 tissue at the coronary band first, and successively downward to 

 the inferior border of the waU, as otherwise, as the instrument is 

 moved from above downward, with a certain amount of force, it 

 might slip and cause a serious division or laceration of the podo- 

 phyllous tissue. The separation is then made of the wall from 

 the sole by another groove, extending from the end of the groove 

 already made, on the quarter, back to the heels. This is done 

 without difficulty, with a smaU drawing-knife, when the foot has 

 been properly prepared. There is, however, one point which 

 usually offers more or less resistance when the quarter is removed. 

 It is that where the wall is continued to the bars. This resistance 

 is sometimes so considerable that if much traction is made, the 

 wall will break more or less in front of the heels, where it is com- 

 paratively thin, and it may consequently become necessary to re. 

 move, by itself, the portion which has remained attached. This 

 little accident, however, can be avoided by ascertauiing certainly 

 before the extraction of the wall is effected, that the continuity of 

 the wall and bars has been cut off. This being the case, the com- 

 plete separation of the wall from the sole is made by running the 

 sharp edges of the double sage knife through the structure of the 

 living tissue underneath. The resection of the quarter can then 

 be proceeded with. 



For this purpose, a properly constructed lever is carefully in- 

 troduced into the groove before mentioned, at the wall and sole of 

 the foot. The inferior and anteiior angle of the hoof at this point 

 being then carefully raised, an assistant grasps it with the nippers, 

 turns it back and tears it slowly, while the surgeon, with such a 

 motion of the lever as may be necessary, assists in the tearing off 

 of the portion of the quarter requiring removal. If adhesions 

 remain, interfering with this manij)ulation, they are removed by 

 cutting with a sharp instrument. As this separation of the wall 

 reaches about to the coronary band, the separation is very easy, 



