d, under which there
has been packed oakum and tar, affords good protection.

Quittor.

This name is employed to designate an infectious inflammation of the
lateral cartilage and adjoining structures. The disease is characterized
by a slowly progressive necrosis and by a destruction of more or less of
the cartilage and by the presence of fistulous tracts.

Etiology and Occurrence.--The disease is due to the introduction of
pus producing organisms into the subcoronary region of the foot under
conditions which favor the retention of such contagium and extension of
infection into contiguous tissues.

Morbific material is introduced into the region of the lateral cartilage
by means of calk wounds and other penetrant injuries of the foot. A
sub-coronary abscess which, because of lack of proper care or because of
virulency of the contagium or low vitality of the subject, is quite apt
to result in cartilaginous affection and its perforation by necrosis
follows.

Symptomatology.--Quittor is readily diagnosed on sight in many
instances. Where there is dependable history or other evidence of the
chronicity of an infectious inflammation of the kind, quittor is easily
identified. If no positive evidence of the disease exists, by means of
careful exploration of sinuses with the probe, one may distinguish
between true cartilaginous quittor and superficial abscess formation
that is often accompanied by hyperplasia.

Lameness depends upon the extent of the involvement as it affects the
structures contiguous to the cartilage. A variable degree of lameness is
manifested in different cases.

Treatment.--Two general plans of handling this disease are in vogue.
One, the more popular method, consists in the injection of caustic
solutions of various kinds into the fistulous openings with the object
of causing sloughing of necrotic tissue and the stimulation of healthy
granulation of such wounds. The other mode consists in either complete
surgical removal of the cartilage or its remaining portions, or removal
of the diseased parts of curettage.

When quittor has not extensively damaged the foot and the lateral
cartilage is not partly ossified as it is in some old chronic cases, the
complete removal of the lateral cartilage by means of the Bayer
operation or a modification thereof is indicated. A complete description
of the Bayer operation as well as Merillat's operation for this disease
(the latter consisting in part, in the remova