DISEASES OF THE LATERAL CARTILAGES 355 



this end a sage-knife ( right- or left-handed, according as to 

 whether the anterior or posterior portion of the cartilage is 

 to be first removed ) is again passed into the incision. With 

 the cutting-edge of the knife forward, it is gradually reached 

 round and under the hindermost end of the cartilage, and 

 the posterior half of the cartilage separated from underlying 

 structures, and at the same time excised by one clean cut 

 forwards. Using the second sage-knife in a similar man- 

 ner, the cutting-edge this time backwards, it is reached in 

 front of the cartilage, whose anterior half is then excised 

 by a careful cut backwards. Any small portions of cartilage 

 remaining after this are sought for with the finger, and 

 carefully removed by means of a scalpel and a tenaculum. 



The fistulous opening or openings in the skin of the 

 coronet should now be thoroughly curetted, and the whole 

 of the wound dressed as to be described later. 



In removing the anterior half of the cartilage it is highly 

 important to remember the close contiguity to it of the 

 synovial membrane of the pedal articulation. This projects 

 as a small sac between the antero- and postero-lateral 

 ligaments of the joint. Risks of injury to it may be 

 diminished by having the foot secured with a line, and 

 pulled forward by an assistant while the cut is being 

 made. 



Third Method (after Bayer). — This operator recom- 

 mends that, after stripping a half-moon-shaped piece of 

 horn from the seat of operation, instead of raising the skin 

 of the coronet and the attached coronary cushion in two 

 flaps (as Fig. 139, a, a), that the cartilage be exposed by 

 raising up one flap only (Fig. 141, a ), consisting of a por- 

 tion of the sensitive laminae, the coronary cushion, and the 

 skin and underlying structures of the coronet. 



With the horse cast and the preliminary steps over, the 

 thinned horn of the quarter is incised in a semicircular 

 fashion, and the half-moon-shaped piece thus separated 

 from its surroundings stripped off. At about J inch from 

 the incision in the horn, a second incision of similar shape 

 is made through the sensitive structures, with incision 



