NEUROTOMY. 211 



where the fingers, pressing inwards, are found to sink into a sort of 

 hollow, let him commence his incision, and carry it boldly down- 

 ward to the extent requisite — say, an inch or an inch-and-a-half. 

 Let the knife be sharp, and let sufficient force of hand be used in 

 making the incision to divide the skin cleanly and completely 

 through at once, so as to lay bare (should the incision have been 

 judiciously made) the plantar nerve, crossed obliquely at its lower 

 part by the ligament of the pad. When the incision through the 

 skin has been made too low down, or with an obliquity from behind 

 forward, instead of being in a direct line with the border of the 

 tendon, it has happened that this ligament (and no nerve) has pre- 

 sented itself; and the result of this has been, either that the liga- 

 ment has been mistaken for the nerve, and divided, and excised 

 instead of it ; or, that its presence has much embarrassed the 

 operator in finding the nerve. The circumstance, however, of the 

 superficial situation of the ligament — its lying so immediately 

 underneath the skin that by uncareful dissectors it is often taken 

 off with the skin, together with that of its oblique course, and that 

 of its glistening (tendinous) aspect, confirmed by the proof, that, 

 when pinched or pricked, no sensation is expressed, will at all 

 times clear up any doubt which may exist on this matter. If the 

 ligament happen to obtrude itself in his way, which it will now 

 and then, the operator must push it with his scalpel — -better back- 

 wards than forwards — out of his way; or he may, if found requi- 

 site, even cut it away altogether, without, that I know, any great 

 harm being likely to accrue therefrom. Indeed, honestly speaking, 

 the use of this ligament — for use it undoubtedly has — is wrapped 

 in some obscurity. Having exposed the nerve, a blunt hook or 

 aneurismal needle, carrying a ligature, may be passed underneath 

 it; and now, that we have got with our hook or ligature possession 

 of it, is the time to satisfy ourselves that we have really raised the 

 nerve, and not the ligament, or the plantar artery : for the latter, 

 as well as the former, has been a source of delusion, though I need 

 hardly say that pulsation will set the case of the artery at rest ; 

 nor is it scarcely necessary for me to add, that the very act of 

 laying hold of the nerve to raise it, and most certainly pinching or 



