208 
T. B. ROGERS. 
a larger injection, by its infiltration of the overlying connective 
tissue, tends to obscure the operation. 
I have never bandaged the leg above the seat of the injec¬ 
tion, or attempted to diffuse the fiind by pressure, and an expe¬ 
rience of more than 150 cases warrants the statement that such 
a course is necessary. 
I make consecutive injections over all four nerves, and as 
soon as the last one is made, proceed to divide the nerve first 
injected. 
The veterinary hypodermic syringe has usually too long, 
and stout a needle for this operation, while the human needle 
is too delicate. A short slightly curved needle, of calibre be¬ 
tween the two, is the ideal instrument; it is not so apt to be lost 
should the patient swing his leg when he feels the puncture, 
and the curve renders it less liable to injure the vessels. 
A drop of carbolic acid should be added to every four 
drachms of the cocaine solution. 
Means of restraint. —A twitch may be used while making 
the injections, although many patients are quieter without it ; 
no other restraint is necessary. 
Position of the limb. —The leg is flexed at the knee, and ex¬ 
tended at the fetlock, is slightly abducted when the outside is 
to be operated on, while for the inside, it is so strongly adducted 
as to cross the opposing member. (I have operated on a few 
cases, for ringbone, in the posterior extremity; in these I had an 
assistant hold the limb like the smith does to dress the hind foot, 
but I am frank to say that I prefer to cast in these cases). 
The operation. —Instruments required—a good sized scalpel, 
scizzors curved on the flat, a large stout aneurism needle 
with serrated point, and a curved, probe-pointed tenotome, are 
all the instruments necessary. I have for some years used this 
aneurism needle instead of forceps, and find it much preferable 
to them; it has the great advantage of allowing the operator to 
do his own sponging, it tears the connective tissue rapidly and 
neatly, and is used after exposure of the nerve, to pass under it 
and stretch it. 
