QUl ITOR. 
57 
around it. If, with a view to cut off this contamination, we 
destroy the carious spot with the iron or some caustic, we pro¬ 
duce another kind of irritation, which, in the majority of cases, * 
also ends in caries, even prior to the separation of the slough; 
or else, should the slough first be detached, the cartilage, not 
^ • being from its nature capable of granulation, and in consequence 
exposed to the air, speedily takes on inflammation and caries, 
and we have all our work to do over again. And there will 
arrive a time even when one cannot employ cauterization with¬ 
out danger ; when the caries has destroyed the cartilage down 
to the capsular ligament which it covers, or when the cartilage 
has become so attenuated that the caustic can no longer sepa¬ 
rate but a thin pellicle from it. What is to be done under such 
circumstances ? It seems to me not to admit of hesitation : 
the cartilage is the carious part; it must be removed ; and es¬ 
pecially may be since the operation does not render the horse so 
useless as has been represented. 
The two first cases clearly demonstrate that this theory is not 
built upon specious reasoning alone : it harmonizes with the 
facts ; it arises out of them. In both these horses, caries exist¬ 
ed anteriorly to any treatment; which accounts for the ineffica- 
ciousness of the sublimate ; even though in one case applied a 
second time : the operation therefore became indispensable. 
If, on the other hand, the sinus is situated in the heel, as in 
the cases III and ly, although the fibro-cartilaginous tissue is 
carious, yet, there being here ’demonstrable cellular tissue, we 
can conceive the part capable of an eliminatory inflammation: 
and we shall with more reason look for this, should one of those 
cartilaginous knobs, surrounded by fibro-cellular tissue, happen 
to be the seat of the caries. According to this, the solution of 
the second part of the problem becomes equally obvious; the 
salutary effects of the caustic and iron being explicable as fol¬ 
lows :—In destroying parts contiguous to the caries, a slough is 
produced the same as in cauterization of caries in the anterior 
portion of the cartilage; but an effect that cannot follow there, 
is produced here, in this more vascular tissue : the character of 
the inflammation becomes changed, it assumes the suppurative 
form; granulations arise (though tardily) underneath the slough, 
which is elevated and detached by the pus; and the wound, 
now a simple one, speedily cicatrises. 
There are even instances of spontaneous cures of carious car¬ 
tilage of the heel. One occurred this very year at the Alfort 
School. The subject of it was placed under the care of pupil 
Leroy ; the actual cautery had been tried twice ; caustics ano¬ 
ther time; but the caries remained. The horse halted and 
suffered greatly. Nothing but emollient poultices were applied, 
