Diseases of the Foot. 383 



clinches usually reveals one liiglier than the rest, and if 

 this is a posterior one it is all the more suspicious. A 

 nail may be driven too near the quick and yet not cause 

 lameness for a week or two, until some slight shifting in 

 the position of the shoe causes it to press painfully. 



Treatment. In slight cases the withdrawal of the nail 

 may be all that is necessary. In more severe it may be 

 requisite to punch the nail holes nearer to the toe, to 

 drive the nails low, to apply cold water or other soothing 

 agent to the foot and to rest for a day or two. If matter 

 has formed the course of the offending nail must be fol- 

 lowed with the drawing-knife, the pus evacuated and the 

 parts treated afterward as in suppurating corn. If the 

 bone has been reached and a dead scale exists on tlio 

 surface this must be cut down upon and removed. 



INCISED AND PUNCTURED WOUNDS OF THE SOLE. 



That part of the foot which is uncovered by the shoe is 

 liable to penetrating wounds from nails, glass and other 

 sharp bodies on the ground, as well as nails, pitchforks, 

 broken planks, etc., against which they may kick. Such 

 wounds are dangerous according to their dej^th and posi- 

 tion. If fi-om a clean nail, and no deeper than just to 

 penetrate the quick, they are usually of little consequence, 

 and a Httle tar or gutta-percha may be used to fill the 

 wound, if any, until it is seen whether inflammation will 

 ensue. If deeper, a vertical wound will be most seriouh 

 in the middle third of the sole, because of the implication 

 of the flexor tendon and small sesamoid bone, and the 

 risk of pedal sesamoiditis, or even an open coffin-joint result- 

 ing. If in the anterior third, the danger lies mainly in 

 injury to the lower surface of the coffin-bone, with death 

 and removal of a thin scale which must be thrown ofi 

 before the wound can close. If in the posterior third the 

 elastic frog alone is wounded and will heal very readily. 



Treatment will vary accordingly. The simple removal 

 of (ihe foreign body may suffice. Cold appHcations may be 



