172 DISEASES OF THE FEET. 



cankered. Having by means of the knife and cautery removed 

 every known particle of disease, the next procedure is to pack 

 the surface of the sole and frog, thus exposed, ' with a powerful 

 astringent or caustic dressing. A great favourite of mine consists 

 of equal parts of sulphate of copper, iron and zinc, mixed with 

 strong carbolic acid, a very little vaseline being added to give the 

 mass cohesion. The dressing, covered by a pledget of tow, is held 

 in position by a shoe with an iron or leather sole, and the 

 dressing and the tow together should be of sufficient bulk to 

 produce slight pressure on the sole when the nails of the shoe are 

 drawn up. ... On the second day following, the shoe should 

 be removed and the foot redressed. Commencing at the edge of 

 the sound horn, as the most dependent part of the foot, all new 

 horn, no matter what its condition, m,ust be pared to the quick, 

 especial care being taken to effectually remove any lingering 

 disease. . . . After all disease has been excised, carefully 

 clean the foot with waste, thoroughly protect any raw surface 

 resulting from over-cauterisation by some mild agent, such as a 

 saturated calomel ointment, re-apply an astringent dressing (I 

 would suggest spirits of turpentine with as much iodoform as 

 would dissolve in it) over the whole affected surface, and nail 

 on the shoe. This method of procedure should now be thoroughly 

 carried out daily for a time, and as it is proceeded with, a 

 successful issue soon becomes assured in neaxlj every case. When, 

 in spite of these efforts, the disease still persists, depend upon it, 

 the fault is with the operator, who has failed to eradicate some 

 centre of infection. Under these circumstances it may be necessary 

 to re-cast the patient, re-pare the foot, and by the aid of eye, knife 

 and cautery endeavour to find the cause, and having found it, 

 which can invariably be done, remove it. The usual treatment 

 will then speedily be successful. As the case proceeds, dressing 

 every other day will soon be sufficient, then twice a week, and 

 finally once a. week until completely cured. 



" During this healing process, and after the complete eradication 

 of canker, it may be again repeated. No agent seems to have a 

 more beneficial effect than calomel, and for this purpose it is best 

 used in dry powder. Under this dressing any remaining spot of 

 canker is readily detected by the wet condition of the calomel when 

 the shoe is removed next day. In dealing with such a spot, a very 

 good plan, after all apparently diseased tissue has been excised, 

 is to touch the cankered part with solid nitrate of silver, or a 

 feather dipped in one of the strong mineral acids, and then re- 

 apply calomel over the surface. In successful treatment the shoe 

 must be removed each time. An adjustable plate will not do, as 

 no man can thoroughly pare and examine a foot with the shoe 



