MEDIAN NEUROTOMY 167 



ternal portion of the leg the insensibility is incomplete 

 throughout, for here the ulnar nerve contributes largely to 

 the innervation. Complete banishment of sensibility by 

 dividing the median nerve is limited to parts of structures ; 

 no entire articulation, bone, tendon or synovial is entirely 

 deprived of its nerve supply. The greatest effect is upon the 

 internal half of the sesamoidean apparatus and the skin cov- 

 ering that region. The external half of the sesamoidean 

 apparatus and the skin covering it are but partially be- 

 numbed. The skin of the internal heel and the internal part 

 of the navicular apparatus, lateral cartilage, os pedis and 

 laminae are unnerved but the external portions of the same, 

 structures, like those of the fetlock, retain a part of their 

 sensibility. 



HISTORY. — Median neurotomy is a comparatively 

 recent acquisition to the surgery of horses. It was first per- 

 formed by Peters in the year 1885 at Berlin Veterinary Col- 

 lege, and was introduced into America during the 90's, being 

 performed for the first time in this country by Prof. Harger, 

 of the University of Pennsylvania. Its introduction to the 

 profession generally occurred through the medium of a 

 translation of Pellerin's small manual entitled "Median 

 Neurotomy," translated from the French by Prof. Liautard. 

 Following the instruction given in this small book American 

 veterinarians practicing in the large cities, promptly began 

 applying the operation to the indications for which it was 

 recommended. At first, like almost all new lines of treat- 

 ment, it was credited with rather extravagant results, but 

 experience subsequently simmered this fallacy to a -sensible 

 level. It was championed as an absolute cure for the lame- 

 ness of draft-horse tendinitis, coach-horse carpitis, splints, 

 osteophites, ringbones, sesamoiditis and navicular arthritis, 

 but later it was proved that its appropriate range of applica- 

 tion was somewhat more limited. Today median neurotomy 

 is regarded with more suspicion than at any time in its his- 

 tory, because of its proven uncertainty, and is being recom- 

 mended only as a kind of last resort operation when all other 

 treatments have failed. 



INDICATIONS. — Median neurotomy banishes the sen- 

 sibility from such a wide range, from so many important 

 structures, from structures other then those implicated in 

 the disease causing the lameness, that it must never be 

 hurriedly resorted to. Other expedients having failed, it is 

 sometimes excusable. The obstinate cases of lameness, due 

 to lesions in the supporting structures supplied by this 



