292 DISEASES OF THE HOESE'S FOOT 



l^rotect the sole by means of a leather or rubber pad and 

 tar stopping, or by usmg the Huflederkitt described on 

 p. 148. In every case the nails must be kept well back 

 in order to avoid the weakened and degenerated horn at 

 the toe, and to take advantage of the greater growth of 

 horn at the heels. 



The wisdom of thus removing the whole of the adventi- 

 tious horn may be questioned. Although a foot of a nearly 

 normal shape is obtained, it must be remembered that the 

 grave alterations within it are unchanged, and that in cer- 

 tain positions the operation must have carried us nearer 

 the sensitive structures than is advisable. 



All other treatments failing, the operation of neurectomy 

 has been advised. This we do not think wise. One would 

 imagine that, with degenerative processes already going on 

 in the foot, the tendency to gelatinous degeneration, always 

 to be looked for in neurectomy, would be increased. This, 

 as a matter of fact, is the case, and is borne out by the 

 statements of those who have tried this method of treat- 

 ment. In many cases the lameness even is not got rid of. 

 Even where it is, the operation is afterwards followed by a 

 great tendency to stumble, by sloughing of the hoof, or by 

 a marked increase in the adventitious horn, and a conse- 

 quent greater deformity of the foot. 



Sooner than risk neurectomy, it seems to us wiser to give 

 a trial to the operation advocated by M. G. Joly, namely, 

 that of ligaturing one of the digital arteries on each affected 

 foot. This operation is performed in the same position as 

 is the higher operation of plantar neurectomy, and may be 

 either internal or external. The vessel is exposed, and a 

 double ligature, preferably of silk, placed on it. The artery 

 is then divided between the two ligatures. The immediate 

 effect of the operation is to cause a considerable diminution 

 in the arterial pressure, and so lessen the intensity of the 

 ostitis in the os pedis. Its consequences are not so serious 

 as those of neurectomy, and it decongests tissues which 

 neurectomy congests. 



In cases related by M. Joly this operation, practised both 



