CHRONIC INFLAMMATION OF THE SENSITIVE LAMINAE. 
813 
upwards. Keratomata, growing from the coronet, generally produce 
deformity of the outer surface of the wall, which is therefore an 
unfavourable sign. In many cases a new growth forms even after 
removal of the first, but this is not invariably the case. 
Treatment. Unless the growth causes pain and lameness treatment 
is better abstained from. In shoeing, the portion of the wall below the 
tumour should be relieved of weight. Sometimes the lameness yields to 
rest and cold moist applications. Persistent lameness can only be cured 
by excision of the keratoma. The affected spot may be thinned with the 
rasp, and the keratoma removed by means of knife and forceps. 
Frohner and Gutenacker divide the wall around the keratoma, remove 
the growth completely, and seek to assist healing of the operation wound 
by antiseptic precautions. 
The great difficulty of this method is to determine the extent of the 
keratoma by examining the outer surface of the wall. To obviate this, 
the wall may be trephined and the extent of the growth ascertained by 
probing. The growth may also be removed by starting from the bearing 
surface of the wall and working upwards until its upper margin is 
reached. If the keratoma is small this concludes the operation. But 
when it is extensive and has produced degenerative processes in the 
laminae and os pedis it may be necessary to excise the diseased laminae 
and to freely curette the bone. 
The operation wound should be treated antiseptically. Complete 
recovery, however, is far from being the rule. The cavity in the os pedis 
may possibly be filled up again, but as the tendency to new growths 
exists in the sensitive laminae, and is not removed with removal of the 
keratoma, the disease not infrequently returns. 
Similar growths occasionally affect the sole. They are commonest 
in flat or “dropped” feet. The tumour is usually hemispherical, the 
base intimately united to the velvety tissue of the sole. Treatment is 
usually confined to thinning the growth, applying poultices, and shoeing 
in leathers. Radical treatment necessitates stripping the sole, or fully 
exposing and wrenching aw T ay the tumour, and is rarely undertaken. 
II.—CHRONIC INFLAMMATION OF THE SENSITIVE 
LAMINAE. 
Considerable spaces sometimes form between the sensitive and horny 
lamime, whilst the surface of the sensitive laminae becomes covered with 
a thin, turbid, fluid secretion. At this point the sensitive laminae appear 
enlarged and displaced. Their surface, which in parts is completely 
exposed, is covered with a thin, purulent secretion, and not infrequently 
shows granulations. 
