1 
808 DEPARTMENT OF SURGERY. 
prone to linger indefinitely. That the healing period of all 
those suppurating hoof affections can be cut short is no spec¬ 
ulative assertion, but a demonstrable fact. Failures can usu¬ 
ally be traced to the difficulty of reaching every recess of the 
infected area. Of course the surgeon’s ingenuity will often be 
taxed to accomplish the task of sterilizing every recess of a 
foot wound, and on account of the frequent restlessness of the 
patient it is not surprising that the job is often given up in 
despair or only half completed. Besides the restless patient 
we have haemorrhage to contend with in paring nail pricks, 
corns, etc. But these inconveniences must be overcome at all 
hazards. We should begin now to prevent lingering if not 
fatal terminations from simple wounds by casting aside the 
methods which savor so much of carelessness. The existence 
of serious obstacles is admitted, but that the obstacles cannot 
be surmounted is not admissible. The extremely restless 
patient can be cast, one less restless can be subdued with a 
twitch, cocaine to the plantars and by morphia narcosis, and 
the haemorrhage can be entirely arrested with an Esmarch 
bandage. In this way the nail prick or corn can be pared 
to its remotest destination. 
In dealing with simple nail pricks, which means those which 
have not pierced the tendon nor bone, the technique is as 
follows : —Cleanliness and asepsis in mind, the shoe is removed* 
and the sole and frog pared smooth. An Esmarch bandage is 
then applied and the wound is traced to its destination. The 
shoe is then replaced and the wound and surroundings patiently 
irrigated with a one per cent, mercuric chloride solution and 
then packed with iodoform or iodoform sugar. The sole is 
then anointed with tar and covered with a large wad of 
tarred oakum. The latter is kept in place with a piece of 
sheet-iron fastened beneath the web of the shoe. This may be 
made still more occlusive by encircling the whole foot with 
tarred fabric bandages. Such a dressing need not be removed 
until the wound is healed. Here we must, however, be governed 
by the circumstances. Having perfectly traced the wound we 
must decide as to the time it will require to regenerate, and 
then leave the bandage on accordingly. 
For more serious punctures the technique is the same except 
in the change of the bandage. There is always considerable 
haemorrhage following the removal of the Esmarch bandage 
in deep seated nail pricks. The blood which finds its way to 
the surface of the dressing will then form an entering channel 
