RADICAL OPERATIONS FOR QUITTOR 317 



inviting infection, may have caused onward encroachment. 

 However, recurrence may follow failure to drain all of the 

 tracts, failure to establish drainage at dependent parts, but 

 particularly failure to maintain drainage until the central 

 lesion has safely healed. 



Radical Operations for Quittor. 



SYNONYMS.— Resection of the lateral cartilage. 



DEFINITION. — Radical operation for quittor is a 

 total ablation of the lateral cartilage on the affected side, 

 after having exposed it by removing a section of hoof and 

 then making an upward flap of the sensitive laminae, coronet 

 and skin. 



INDICATIONS. — Chronic quittor is a necrotic process 

 affecting the lateral cartilage. It is a slow, creeping mor- 

 bidity beginning at one part of the cartilage, generally the 

 posterior, and traveling forward until the whole structure 

 has been destroyed and replaced by connective tissue. Dur- 

 ing the evolution of the destructive process a number of 

 abscesses form consecutively, point at the coronet, and 

 leave in their wake fistulous tracts which cicatrize slowly. 

 While one tract is cicatrizing another abscess is already 

 evolving to form another, generally a little anterior to the 

 preceding; and the process continues until the anterior ex- 

 tremity of the cartilage is reached. The entire cartilage 

 having been totally destroyed, the quittor is cured spon- 

 taneously and as evidence if its previous existence, there is 

 left a tumefied condition of the quarter that seldom en- 

 tirely disappears. During the evolution of this process 

 there are periodical attacks of lameness resulting from the 

 forming of another abscess and which subside when the 

 abscess bursts. The morbid process may also, in some 

 cases, not entirely rare, attack the underlying synovials and 

 pedal articulation and thus cause incurable complications — 

 in the form of articular or thecal abscesses, ("open joint" or 

 "open sheath"). 



In exceptional instances quittors, — so called,— may con- 

 sist of nothing more than simple suppurative tracts in the 

 sensitive laminae without implicating the cartilage (country 

 quittors.) These cicatrize less stubbornly and always yield 

 to simple treatment. And again, a quittor may attack a part 

 of the cartilage and cicatrize without attacking the remain- 

 der. But these incidents are the exception and not the rule. 

 The average quittor of city horses is "cartilaginous" and 



