OPERATION AGAINST URACHAL URINATION 465 



plantar aponeurosis and cannot be separated from it except 

 by sharp dissection. 



A through-and-through transverse incision of the plantar 

 aponeurosis is now made over the level of the navicular bone, 

 whose axis it should follow as near as possible in order to 

 avoid cutting into the inferior navicular ligament if made 

 too far anteriorly, or the superior ligament if made too far 

 posteriorly, which accident would at once invite the spread of 

 the infectious matter directly into the articulation. Necrotic 

 portions of the tendon around the tract of the nail are excised, 

 the fibro-cartilage on the inferior surface of the bone is 

 curetted off and the whole area of the sheath is swabbed with 

 pure tincture of iodine and then -packed with iodoform gauze. 



The foot is dressed by packing the surgical cavity with 

 antiseptic cotton and wrapping with abundance of muslin 

 bandages. 



At the end of twenty-four hours the dressing is removed, 

 the sheath irrigated with hydrogen peroxide and then swab- 

 bed with tincture of iodine, the'surface of the wound dusted 

 with iodoform and the cotton and bandages reapplied. 



On the second day the foot is shod loosely with a flat 

 shoe which is utilized subsequently to retain the daily anti- 

 septic and protecting dressings, consisting of iodoform dusted 

 over the wound, cotton wadding, a piece of stiff leather that 

 fits evenly but loosely into the inner circle of the shoe, and 

 two pieces of hoop-iron to hold the latter in place. (Fig. 241.) 



This daily dressing is continued until granulations have 

 filled the cavity and all discharge has ceased. 



Operation Against Urachal Urination. 



Pervious urachus of the young is a very common affliction 

 of all domestic mammals. The navel extremity of the urachus 

 fails to close and as a consequence the urine, instead of being, 

 voided through the urethra, continues to flow through the 

 pre-natal channel. The abnormality, which is usually noticed 

 a few days after birth by the wetness of the skin surround- 

 ing the navel, either corrects itself without interference in a 

 week or so or else persists until complications from infection 

 end disastrously. Only small quantities of urine may flow 

 through this unnatural channel, or the entire capacity of the 

 bladder may be discharged at each act of micturition. Gener- 

 ally, however, the discharge occurs through both channels, 

 a small part through the urachal and the major part through 

 the urethral route. 



