DISEASES OF THE LATERAL CARTILAGES 351 
meanwhile being kept clean with an antiseptic pad and 
bandage, or by liberal applications of an antiseptic powder. 
The septic materials are in this way destroyed, and the 
wound heals without further complication. We must admit, 
however, that the cure of the lesion is generally at the 
expense of slight lameness, due, in all probability, to inflam- 
matory tissue adhesions between the flexor perforans and 
the perforatus, and to a partial destruction of the synovial 
membrane of the sheath. 
If, in spite of the antiseptic irrigations, the fistula per- 
sists, then nothing remains but to resort to excision of the 
aponeurosis, as described on p. 222. 
When Necrosis of the Lateral Cartilage ts present.—In this 
case we may at first try the ordinary treatments of poulticing 
and blistering, of antiseptic caustic injections, and of plug- 
ging. In some cases a cure is effected. Should these fail, 
however, and we intend to see the finish of our case, then 
operative measures must be determined on. This means 
cutting down upon the diseased cartilage, and either 
removing the necrosed portion, or excising the cartilage in 
its entirety. ee 
The latter method is seldom practised in this country. 
As it is the most radical of the twe, however, we shall 
describe it here first. a. . 
Extirpation of the Lateral Cartilage.—The operation of 
-tirpating the lateral cartilage is by no means a new one, 
being introduced, according to Zundel, by the senior 
Lafosse in 1754. It consisted in removing a portion of the 
wall by grooving and stripping it, and of excising the 
exposed cartilage by means of a sage-knife. 
As to what portion of, and how much of the horn of, the 
quarter should first be removed, and as to what particular 
direction each groove should take, opinion among the older 
writers varied considerably. This we know now is not an 
important matter, and it is sufficient to say that the first 
preliminary is a thinning down of the horn of the quarter 
with the rasp over the position occupied by the cartilage. 
At the present time there are two or three modifications 
