385 
Foreign Department. 
EXTRACT FROM THE COMPTE-RENDU (REPORT) OF THE 
TRANSACTIONS AT THE ALFORT SCHOOL DURING THE 
SCHOLASTIC YEAR 1851-52. 
Clinical Chair — N eurotomy. 
( Continued fromp. 336.) 
In the last number we recalled to mind the anatomical 
lesions peculiar in navicularthritic disease : it now remains 
for us to complete the subject by pointing out the results we 
may expect to follow the operation of neurotomy, employed 
for the purpose of palliating the consequences of the disease 
at its various stages. 
Neurotomy is more certain and more prominent in its 
results when navicularthritis has attacked but one foot; 
when the disease is less chronic ; and when the lesions, the 
consequences of it, are of less spread and intensity, than when 
the navicular bone and its tendonous covering are in a great 
measure destroyed by ulceration. Neurotomy is especially 
serviceable against lamenesses proceeding chiefly from pain, 
without too great alteration of structure ; and consequently, 
it ought exclusively to be employed while the disease present 
holds this essential character, and not to be required for more 
than it can yield, by employing it in cases where the lameness 
is likely to fatally persist, even after the disappearance of 
pain in the affected parts. 
Now, navicularthritic disease of very long standing has a 
right to be regarded in this last category. At this period 
pain is no longer the predominant ailment. It is true, it is 
always present in an extreme degree ; but along with it, and 
peramount to it, there exist material lesions, of which it 
in fact is but the expression; and these lesions are of 
such nature that they are no longer compatible with the 
freedom of the motions of the joint of the foot, and con- 
sequently with the free play of the joints above it in the 
limb, seeing that those below are regulated by those above. 
What, indeed, can neurotomy effect when the navicular bone 
is reduced to a third or a half of its original dimensions by 
the dry sort of caries invading it ; when the tendon no longer 
forms here various disjointed filaments, or but an attenuated 
membrane, in place of the powerful aponeurotic expansion 
with which it is terminated in the normal condition; while, 
xxvi. 51 
