214 NEUROTOMY. 



grand object is to obtain union of the divided skin by the first 

 intention, or by adhesion without suppuration. And to this end, 

 nice and continued approximation of the severed edges, with 

 quietude of limb and coolness of body, are the best measures we 

 can take. Should any festering make its appearance in the 

 wounds, which sometimes, despite of our best precautions, will 

 happen, let the bandages be removed, and the sutures drawn out, 

 and the wounds be treated with simple dressings or poultices, as 

 they seem to require. 



The High Operation, as it is called in relation to the one we 

 have been describing (which by way of distinction is named the 

 low operation) is demanded whenever the seat of lameness for 

 which neurotomy is deemed advisable is above the foot or pastern, 

 in the fetlock perhaps, or above that even. Remembering that the 

 metacarpal nerve of the inner side is closely connected with the 

 metacarpal artery, and that both, together with the accompanying 

 vein, maintain their course along the inner border of the flexor 

 tendons, the latter will prove a sufficient guide to the operator for 

 finding them ; and our account of their course, at page 208, will 

 shew him how in point of relation one to another they will be 

 found situate. On the outer side of the leg, however, the course of 

 the nerve is different. There, it has no attendant artery, and is 

 to be found, as our former description will point out, rather behind 

 than alongside of the flexor tendons; in the space, in fact, be- 

 tween them and the suspensory ligament. Having exposed the 

 nerve by an incision in the direction of its course, the steps of the 

 operation are the same here as in the case below, save and except 

 that due attention must be paid to the presence of the cross branch 

 of nerve forming the communication between the metacarpal nerv- 

 ous trunks. Originating high up, as this branch does on the inner 

 side of the leg, and terminating low down on the outer side, were 

 the two high operations for neurotomy on the same leg performed 

 in directly opposite sites, as the low operations are, it is evident 

 nervous communication with the sensorium would remain uncut off, 

 unless such divisions of the trunk nerves were both made either 

 above or below the places of junction of the communicating 



