540 
A. ZUNDEL. 
general inflammation, and the foot becomes hot and very painful. 
If the necrosed scar becomes loose and sloughs off,being detached by 
suppuration, improvement soon ensues; but as the necrosis of the 
tendon has generally a tendency to spread, there is an increase in the 
character of the symptoms. If the wound extends to the sesa¬ 
moid sheath from the start, the synovial fluid is observed escaping, 
first pure, but soon becoming milky and purulent in aspect, if the 
sheath has become inflamed, and easily coagulating in yellowish 
clots. The pain is then very great, much more so than when the 
aponeurosis alone is diseased. At times, by rapid closing of the 
plantar wound, or obstruction of the fistula, a warm swelling forms 
itself in the back of the coronet, which raises the skin by degrees 
and becomes elevated, prominent at one point, and giving a feel¬ 
ing of fluctuation. This swelling ends in ulceration, and allows 
the escape, sometimes, of an abundant synovial, purulent discharge. 
The wound of the small sesamoid and of its ligament adds 
nothing to these series of symptoms. The probing of the tract 
will only determine it by the sensation of roughness which it will 
give; but generally one must be careful in using the probe, espe¬ 
cially when the flow of synovia is absent. If the foreign body 
has pierced through the ligament, or has penetrated in the coffin 
joint, phalangeal arthritis is the consequence. The same result 
is likely to follow excessive inflammation of the foot and the 
macerating effect of the suppuration, in which case the tendon 
may soften down and give way. It may then also happen that 
this tendon retracts by the contraction of the muscular fibres, and 
can then be traced upwards to the back of the coronet, or of the 
fetlock, according as the giving way has taken place higher or 
lower. 
With arthritis there is a hot, painful swelling of the whole 
coronet, with diffused oedema above the fetlock and the cannon, 
and extending upwards to the whole leg, complicating the lesion 
by lymphangitis and painful swelling of the lymphatic glands. 
Then subcutaneous abscesses are found round the coronet, with 
gangrene of the tissues; while again, there may be only an exten¬ 
sive fibro-plastic exudation, which ends in calcareous organization 
and anchylosis. 
