395 



to three-quarters of an inch apart. The dasps answer equally as well 

 in quarter crack if the wall is sufficiently thick and not too dry and 

 brittle to withstand the strain. 



In the absence of these instruments and clasps a hole may be drilled 

 through the horn across the fissure, and the crack closed with a thin 

 nail made of tough iron, neatly clinched at both ends. A plate of steel 

 or brass is sometimes fitted to the parts and fastened on with short 

 screws ; while this appliance may prevent much gaping of the fissure 

 it does not entirely arrest motion of the edges for the simple reason that 

 the plate and screw can not be rendered immobile. 



If, for any reason, the above measures fail or can not be used recourse 

 must be had to an operation. The horn is softened by the use of warm 

 baths and poultices, the patient cast and the walls of the fissure are en- 

 tirely removed with the knife. The horn removed is in the shape of 

 the letter V with the base at the coronet. Care must be taken not to 

 injure the coronary band and the laminae. The wound is to be treated 

 with mild stimulant dressings, such as a weak solution of carbolic acid, 

 tincture of aloes, etc., oakum balls and a roller bandage. After a few 

 days the wound will become covered with a new, white horn, and the 

 oakum and bandages only will be needed. As the new quarter grows 

 out the lameness disappears, and the patient may be shod with a bar 

 shoe and returned to work. 



In all cases of sand crack the growth of horn should be stimulated by 

 cauterizing the coronary band, or by the use of blisters. In simple 

 quarter crack recovery will often take place if the coronet is blistered, 

 the foot shod with a " tip," and the patient turned to pasture. 



The shoe, in toe crack, should have a clip on each side of the fissure 

 and should be thicker at the toe than at the heels. The foot should be 

 lowered at the heels by paring, and spared at the toe, except directly 

 under the fissure where it is to be pared away until it sets free from 

 the shoe. 



When any of the complications referred to above arise, special meas- 

 ures must of course be resorted to. For the proper treatment of gan- 

 grene of the lateral cartilage and extensor tendon and caries of the 

 coffin bone, reference may be had to the articles on quittors. If the 

 horny tumor known as keraphyllocele should develop it is to be re- 

 moved by the use of the knife. Since this tumor develops on the in- 

 side of the horny box and may involve other important organs of the 

 foot in disease, its removal should only be undertaken by a skillful 

 surgeon. 



NAVICULAR DISEASE. 



Navicular disease, often called "navicular arthritis " by the English, 

 is an inflamation of the sesamoid sheath, induced by repeated bruising 

 or laceration, and complicated in many cases by inflammation and caries 

 of the navicular bone. In some instances the disease undoubtedly be- 



