DISEASES OF THE LATERAL CARTILAGES 351 



meanwhile being kept clean with an antiseptic pad and 

 bandage, or by liberal applications of an antiseptic powder. 



The septic materials are in this way destroyed, and the 

 wound heals without further complication. We must admit, 

 however, that the cure of the lesion is generally at the 

 expense of slight lameness, due, in all probability, to inflam- 

 matory tissue adhesions between the flexor perforans and 

 the perforatus, and to a partial destruction of the synovial 

 membrane of the sheath. 



If, in spite of the antiseptic irrigations, the fistula per- 

 sists, then nothing remains but to resort to excision of the 

 aponeurosis, as described on p. 222. 



When Necrosis of the Lateral Cartilage is present. — In 

 this case we may at first try the ordinary treatments of 

 poulticing and blistering, of antiseptic caustic injections, and 

 of plugging. In some cases a cure is effected. Should 

 these fail, however, and we intend to see the finish of our 

 case, then operative measures must be determined on. This 

 means cutting down upon the diseased cartilage, and either 

 removing the necrosed portion, or excising the cartilage in 

 its entirety. 



The latter method is seldom practised in this country. 

 As it is the most radical of the two, however, we shall 

 describe it here first. 



Extirpation of the Lateral Cartilage. — The operation of 

 extirpating the lateral cartilage is by no means a new one, 

 being introduced, according to Zundel, by the senior 

 Lafosse in 1754. It consisted in removing a portion of the 

 wall by grooving and stripping it, and of excising the 

 exposed cartilage by means of a sage-knife. 



As to what portion of, and how much of the horn of, the 

 quarter should first be removed, and as to what particular 

 direction each groove should take, opinion among the older 

 writers varied considerably. This we know now is not an 

 important matter, and it is sufficient to say that the first 

 preliminary is a thinning down of the horn of the quarter 

 with the rasp over the position occupied by the cartilage. 



At the present time there are two or three modifications 



