NEUROTOMY 
183 
lying down, and prevent him by any possibility reaching bis 
wounded pasterns with bis mouth. And now, wet linen bandages 
should be rolled round bis pasterns ; they will serve to support the 
sutures, and at the same time will keep the parts cool, and so 
moderate the approaching inflammation. With the same view a 
dose of physic may be given while he is under confinement. The 
grand object is to obtain union of the divided skin by the first 
intention, or by adhesion without suppuration. And to this pur- 
pose, nice and continued approximation of the severed edges, with 
quietude of limb and coolness of body, are the best measures we 
can take. Should any festering make its appearance in the 
wounds, which sometimes, despite of our best precautions, will 
happen, let the bandages be removed, and the sutures drawn out, 
and the wounds be treated with simple dressings or poultices, as 
they seem to require. 
The High Operation, as it is called in relation to the one we 
have been describing, which by way of distinction is named the 
low operation, is demanded whenever the seat of lameness for 
which neurotomy is deemed advisable is above the foot or pastern, 
in the fetlock perhaps, or above that even. Remembering that the 
metacarpal nerve of the inner side is closely connected with the 
metacarpal artery, and that both, along with the accompanying 
vein, maintain their course along the inner border of the flexor 
tendons, the latter will prove a sufficient guide to the operator for 
finding them ; and our account of their course, at page 178, will 
shew him how in point of relation one to another they will be 
found situate. On the outer side of the leg, however, the course of 
the nerve is different. There, it has no attendant artery, and is 
to be found, as our former description will point out, rather behind 
than alongside of the flexor tendons; in the space, in fact, be- 
tween them and the suspensory ligament. Having exposed the 
nerve by an incision in the direction of its course, the steps of the 
operation are the same here as in the case below, save and except 
that due attention must be paid to the presence of the cross branch 
of nerves forming the communication between the metacarpal nerv- 
ous trunks. Originating high up, as this branch does on the inner 
side of the leg, and terminating low down on the outer side, were 
the two high operations for neurotomy on the same leg performed 
in directly opposite places, as the low operations are, it is evi- 
dent nervous communication with the sensorium would remain 
uncut off, unless such divisions of the trunk nerves were both 
made either above or below the places of junction of the com- 
municating branch. For this reason it is that, in high neurotomy, 
the operation is commonly performed above the branch on the inner 
side of the leg ; below it on the outer. 
