DISEASES OF THE LATERAL CARTILAGES. 341 



forward with all the phalangeal articulations flexed, and 

 in many cases the limb is unable to take weight at all. 

 Manipulated after the manner of examining the tendons 

 for sprain, this swelling is found to be extremely painful. 

 The animal flinches from the hand, and shows every sign 

 of acute suffering. This condition may, in fact, be mis- 

 taken for sprain, and is only to be distinguished from it by 

 carefully noting the history of the case — first, the appear- 

 ance of the swelling in the hollow of the heel, and, secondly, 

 the a/ter-swelling of the upper portions of the tendons. 



The formation of the abscess, the after-discharge of its 

 contents, and the final establishing of a fistula, are pro- 

 cesses greatly prolonged in this form of quittor. It will 

 readily be understood why this should be so when one 

 remembers the depth at which the suppurative process is 

 going on, the thickness of the metacarpo-phalangeal sheath, 

 and the resistant nature of the material of w r hich this latter 

 is made, and which must be penetrated before the condition 

 becomes observable. 



After the opening of the abscess, which usually takes 

 place in the hollow of the heel, there is left the fistulous 

 wound which obstinately refuses to heal. Or it may be, 

 again, that there are several of these fistulas, each opening 

 in the heel, and the mouth of each marked by a small, 

 ulcer-like projection. The discharge continually oozing 

 from these keeps the heel constantly wet with a thick 

 purulent discharge, which is nearly always blood-stained, 

 and very often foetid. 



This constitutes what is known as tendinous quittor in 

 its worst form, for more often than not there is associated 

 with it inflammation of the navicular bursa, caries of the 

 bones, or arthritis of the pedal articulation. 



With the extensor pedis attacked matters are not quite 

 so grave, in spite of the fact that the articulation is closely 

 situated thereto, for in this case the more superficial position 

 of the diseased structure allows both of readier exit of the 

 discharges and of easier removal of the necrosed portion 

 and after-treatment of the wound. 



