104 
ROBERT DICKSON. 
An incision two and a half inches long is now made with a con¬ 
vex bistoury, either parallel to the tendon or slightly oblique 
and across its direction, this incision extending down to the 
bursa. The tendon can now be felt and outlined. The bursa 
is now raised up with the forceps and opened, exposing the ten¬ 
don ; this is raised up by a curved director and divided with the 
tenotomy knife, the wound being closed with one stitch and an 
antiseptic dressing applied, which completes the operation. 
At the present day we have improved upon the method de¬ 
scribed, and in my practice the following method has given the 
best results. 
Instruments .—Scissors, convex bistoury, curved director, 
and neurotomy band or two blunt tenaculums. 
Preparation of Patient .—The operation is performed stand¬ 
ing, the patient being placed upon the floor in a good light, and 
if possible good antiseptic surroundings, standing with the leg 
upon which you wish to operate eight inches in front of the 
opposite. The front foot of the affected side is held up by an 
assistant, and a twitch applied. The hair is closely clipped 
from the inside of the hock, and the operating surface rendered 
as near aseptic as possible. 
Technique .—A dram of a ten-per-cent, solution of cocaine 
is now injected over the tendon at the point of operation, and 
when the part has responded to the cocaine an incision one and 
a half inches long is made in a downward and forward direction 
directly across the course of the tendon, this incision extending 
through all tissues down to the bursa. The neurotomy band 
or tenaculums are now brought into use and applied so that 
the lips of the incision are held wide apart and the bursa ex¬ 
posed, which is raised with the forceps and divided with either 
scissors or bistoury, exposing the tendon, which is now raised 
with the curved director and divided with the bistoury. The 
wound is closed with one stitch, a heavy thick layer of collodion 
is applied over the incision, a layer of antiseptic cotton over 
that, and all held in place by bands of adhesive plaster. The 
wound is dressed on the following day and continued until cica- 
