DISEASES OF THE LATERAL CARTILAGES 341 
forward with all the phalangeal articulations flexed, and 
in many cases the limb is unable to take weight at all. 
Manipulated after the manner of examining the tendons 
for sprain, this swelling is found to be extremely painful. 
The animal flinches from the hand, and shows every sign 
of acute suffering. This condition may, in fact, be mis- 
taken for sprain, and is only to be distinguished from it by 
carefully noting the history of the case—first, the appear- 
ance of the swelling in the hollow of the heel, and, secondly, 
the after-swelling of the upper portions of the tendons. 
The formation of the abscess, the after-discharge of its 
contents, and the final establishing of a fistula, are pro- 
cesses greatly prolonged in this form of quittor. It will 
readily be understood why this should be so when one 
remembers the depth at which the suppurative process is 
going on, the thickness of the metacarpo-phalangeal sheath, 
and the resistant nature of the material of which this latter 
is made, and which must be penetrated before the condition 
becomes observable. 
After the opening of the abscess, which usually takes 
place in the hollow of the heel, there is left the fistulous 
wound which obstinately refuses to heal. Or it may be, 
again, that there are several of these fistulas, each opening 
in the heel, and the mouth of each marked by a small, 
ulcer-like projection. The discharge continually oozing 
from these keeps the heel constantly wet with a thick 
purulent discharge, which is nearly always blood-stained, 
and very often foetid. 
This constitutes what is known as tendinous quittor in 
its worst form, for more often than not there is associated 
with it inflammation of the navicular bursa, caries of the 
bones, or arthritis of the pedal articulation. 
With the extensor pedis attacked matters are not quite 
80 grave, in spite of the fact that the articulation is closely 
situated thereto, for in this case the more superficial position 
of the diseased structure allows both of readier exit of the 
discharges and of easier removal of the necrosed portion 
and after-treatment of the wound. 
