DISEASES OF THE LATEEAL CAKTILAGES 333 



Treatment [Preventive). — Immediately after the infliction 

 of an injury in this position, more especially if it is such as 

 to lead one to judge that necrosis will follow to any large 

 extent, the patient should be rested. Ill effects may then 

 be probably warded off by having the foot immersed in a 

 cold antiseptic solution, and afterwards bound with an anti- 

 septic pad and bandage. 



Curative. — When the condition has gone undiscovered 

 until commencing necrosis and suppuration are plainly 

 discernible, then the wisest course we can follow is to do all 

 we can to hasten removal of the necrosed portion. 



This is best done by promoting the suppurative process 

 by means of warmth or stimulant applications. 



To this end hot poultices, or, better still, hot baths, 

 should be resorted to. Under their influence a greater 

 supply of blood is directed to the still healthy tissues 

 enabling them to actively continue the inflammatory pro- 

 cesses necessary to the detaching of the portion necrosed, 

 while, at the same time, the pus organisms, stimulated by 

 the heat, are stirred into greater activity, and the readier 

 accomplish their purpose of destroying the adhesion still 

 existing between the necrotic portion and the surrounding 

 living tissues. 



When prolonged poulticing or bathing cannot be prac- 

 tised, then the swelling should be stimulated with a sharp 

 cantharides blister, repeated, if the case demands it, at 

 intervals of a few days. 



Should the swelling show distinct signs of pointing, and 

 an abscess is plaii^ly the condition to be dealt with, its con- 

 tents should be liberated by a free use of the knife. In this 

 connection it is important to insist on the fact that the 

 opening should be made large enough. One bold incision 

 from the uppermost limit of the swelling down to the 

 coronary margin of the wall is usually sufficient. 



Even when pointing is not very evident, and suppuration 

 is plainly more or less diffuse, benefit may still be derived 

 from the use of the knife. In this case a deep scarification 

 of the part is indicated. Three, four, or more vertical 



