QUITTORS. 391 



The ordinary Bistmiri cache will not answer the purpose, as it 

 does not cut to its point. The one delineated in the woodcut is 

 specially adapted for quittors and other fistulous sores, as it cuts 

 to its very point, a matter of great importance when it is neces- 

 sary to bottom the wound. Very frequently the long continu- 

 ance of quittor is due to the imprisonment of a piece of necrosed 

 bone, dead cartilage, or other foreign body ; and it will be neces- 

 sary to remove this before a cure can be effected. When the 

 sinus has been opened to its extremity, it is good practice to inject 

 into it a solution of the bichloride of mercury, 3i- ; water, §i. ; 

 a few drops of hydrochloric acid being added to cause the salt 

 to dissolve. One or two injections of this are sufficient to 

 cause the whole exposed surface of the wound to cast off a thin 

 slough, and to leave a healthy granulating surface, requiring no 

 treatment beyond being kept clean. Much harm is done in these 

 cases by the long-continued application of escharotics ; but 

 should the wound look unhealthy after the separation of the 

 slough, it may be necessary to apply the solution a second time. 

 A glass syringe is the best instrument, as lead will be acted upon 

 by the salt and the acid. 



Poultices assist the separation of the slough, and tend to 

 soothe the irritation. They should therefore be applied for 

 several days. 



In quittors of a very intractable nature the whole diseased 

 structures, including the lateral cartilage, have to be removed by 

 surgical operation, which is as follows : — The horse must be cast, 

 a tourniquet applied to the fetlock; an incision is then to be made 

 at the junction of the horny wall and coronary substance, im- 

 mediately below the seat of disease, the skin is to be carefully 

 dissected from the subcutaneous structures, and folded upwards 

 in the form of a flap. When this is accomplished, the diseased 

 portions are to be carefully removed with the scalpel, taking care 

 not to penetrate the articulation, and the skin brought back to 

 its original position, and retained there by firm but not too 

 tight bandages. If the vessels are enlarged, as sometimes will 

 be the case, they ought to be secured by ligature, but generally 

 this is unnecessary, the haemorrhage being prevented by the 

 bandage, and it is always better not to introduce a foreign body, 

 as a ligature, into the wound. 



There are many unqualified men noted for their success in 



