on of this affection
and weight bearing is painful in direct proportion to the extent of
injury present. Volar flexion of the phalanges relieves tension on the
parts; therefore, this position is assumed while the subject is at rest.
When considerable tissue has been ruptured, and the condition is very
painful, the foot is held off the ground as in all painful affections of
the extremity.

By palpation evidence of pain is discernible, though very little
swelling occurs. Pain is increased by manual tension of the parts which
is done by grasping the toe of the foot and exerting traction on the
flexor apparatus. Care must be taken in executing such manipulations,
and it is only by comparison of the affected member with the sound one
and noting the difference in the manifestations of discomfort that we
may arrive at the proper conclusion.

Some hyperthermia is to be recognized in acute inflammation, by
comparing the extremities. In the fore legs, navicular disease is
differentiated by noting absence of contraction at the heel. By use of
the hoof testers one may recognize evidence of inflammation of the
navicular apparatus. In inflammation of the posterior ligaments of the
pastern joint, there is also absence of the characteristic stumbling
which is seen in navicular disease.

Treatment.--Rest is the first requisite, and in addition every
mechanical means possible to change the center of gravity in the
phalangeal region, is to be employed. This is best accomplished by
shortening the toe and paring the sole at the toe as much as conditions
will permit. The heel is raised by means of a shoe with moderately high
heel calks.

The iodin-glycerin combination heretofore mentioned may be applied and
the parts covered with cotton and bandage. Subjects require from three
weeks to several months' rest and must be returned to work carefully,
lest the incompletely regenerated tissues suffer injury.

Regeneration of tissue in such cases, as has been pointed out, is slow
and sufficient time for complete recovery must be allowed or relapses
will occur.

Fracture of the First and Second Phalanges.

Etiology and Occurrence.--Fractures of the first phalanx (suffraginis)
occur with respect to frequency, second to pelvic fractures. Often,
almost insignificant injuries cause phalangeal fractures. On city
streets, horses shod with shoes having long calks get caught in frogs of
street railways or by slipping on rails, and phalangeal bones