KEUR0T0MY 129 



tice. To urge, to recommend, to perform these operations 

 at every turn is undefensible and disastrous. But by select- 

 ing suitable cases, wisely weighing every circumstance con- 

 nected therewith, and acquainting the interested persons as 

 to the possible outcome, a city practitioner's usefulness can 

 be manifestly enhanced. 



GENERAL CONTRA-INDICATIONS. - Neurotomy 

 must never be advised for new, acute, changeable, or severe 

 lamenesses ; for any lameness due to an active inflammatory 

 process; for lameness due to an exostosis encroaching upon 

 'a ginglymoid articulation; for lameness accompanied by ex- 

 tensive alterations of important structures whose diminished 

 strength will prove inadequate to support the added strain ; 

 for lameness in horses submitted to violent exercise; for 

 lamenesses in horses afflicted with a rarefying disease of the 

 bones, whether directly due to the condition or not. 



A review of these innumerable conditions shows at once 

 the great number of restrictions to be placed upon neurotomy 

 operations. These restrictions must be respected absolutely. 

 It matters not how eager is the desire to effect a cure ; how 

 obstinate any given condition is certain to prove with the or- 

 dinary palliative lines of treatment; or how vigorously the 

 operation is urged, neurotomy is forbidden under circum- 

 stances above mentioned. It seems that every veterinarian 

 with a penchant for surgery, has yielded at one time or an- 

 other to this burning desire to cure every lame horse by 

 neurotomy, until brought to the realization of his error by. 

 numerous disasters, such as casting off of hoofs, breaking 

 down of supporting tendons or failures to relieve the lame- 

 ness. 



Active inflammations ~or severe lamenesses must be car- 

 ried along with palliative treatments until they pass into a 

 chronic stage before they become indications for any kind of 

 nerving operation. The exostosis that is just beginning to 

 encroach upon a hinge diarthrosis is exceptionally hazardous. 

 It is only when the exostosis has completely or at least almost 

 completely, ankylosed the joint, that neurotomy becomes at 

 all safe. Whenever there are extensive structural altera- 

 tions, such as degenerated tendons, deformities of the feet, 

 especially dropping of the soles, the operation is positively 

 forbidden, because in these instances the strength of the 

 feet is insufficient to withstand the strain which was min- 

 imized by lameness while the sensibility was undisturbed. 

 Horses submitted to violent exercise, whether racing, fast 

 road work, fast street work or heavy draft work, are not 



