PERIOSTITIS—OSTEITIS—OSTEOMYELITIS., 455 
gutta-percha bandage. According to the disposition and weight of the 
animal, he will be placed in slings or left loose. The local inflammation 
passed off, if lameness remains, firing or neurotomy (median or sciatic) is 
indicated. When several legs are affected, the patient had better be 
destroyed. 
Fracture of the smai sesamoid occurs most commonly as complica- 
tion of old navicular disease or as the result of a punctured wound (nail) 
of the foot; it may also occur after a jump or under the influence of a 
violent effort. We observe it quite often in the feet of horses which are 
used for the exercises of surgery or of shoeing. 
The diagnosis is very difficult. With wound from nail in the foot, it is 
only made out when the bone has been exposed. In a similar case, 
Humbert removed the whole bone and placed the horse under continued 
irrigation ; three months after-he was able to trot. This case, however, is 
unique. Méller has performed several times this sesamozdectomy, always 
-with fatal results. If the fracture occurs without apparent cause, without 
‘traumatism, as in the case of Mollereau, positive diagnosis is impossible ; 
‘the accident can only be suspected. ‘The severity of the lameness, the 
sensibility of the foot and coronet to torsion and extension, allow only the 
.affirmation of the presence of very severe lesions at the bottom of the foot. 
Long rest, cold irrigations, later on neurotomy, constitute the treatment. 
“The patient of Howell recovered only a long time after firing of the 
-coronet. Notwithstanding the use of slings, blistering of the coronet, 
continued irrigation, the patient of Mollereau grew worse. It had to be 
‘killed. The small sesamoid was broken in several pieces, and the tendon 
-of the perforans entirely ruptured. 
IV. 
PERIOSTITIS—OSTEITIS—OSTEOMYELITIS. 
Intimately related in their anatomical connections and functions, made 
‘solidary of each other by the blood-vessels which penetrate them, the 
vatious constituting parts of bones—periosteum, bony tissue, and marrow 
—may be affected by the same morbid causes,.altered in the same or in 
different degrees, according to whether they are attacked at once or 
‘successively invaded. It is also possible for the inflammation to remain 
Jocalized a certain length of time or again during all its course only to 
‘the periosteum or the bony tissue itself. 
' Acute periostitis terminates in resolution, suppuration or the passage to 
chronic state. Resorption of inflammatory products and the return to 
normal state of the affected tissue is seldom seen. If the inflammation 
