tic arthritis exists, the condition is at once grave.
An open and infected tendon sheath, while not so serious, constitutes a
condition which is distressing, and recovery is slow even under the most
favorable conditions. Where a heavy, rigid and sharp nail enters the
foot, in such manner that fracture of the third phalanx (os pedis)
occurs, this complication makes for a protraction of the condition.
Experience teaches that the natural course and termination in these
cases are modified by the location and depth of the injury, virulency of
the contagium and resistance of the subject to such infection.

Prevention.--In all horses which are kept at such work that exposure
to nail punctures is frequent, a practical means of prevention of such
injuries consists in the employment of heavy sole leather or suitable
sheet metal to cover the sole of the foot and, at the same time, confine
oakum and tar in contact with the solar surface to prevent the
introduction of foreign material between the foot and such protecting
appliances. Further, if drivers and owners could be impressed with the
serious complications which so frequently attend wounds of this kind,
undoubtedly many cases which are now lost, because of ignorance or
neglect on the part of the teamsters or proprietors of horses, would be
saved by prompt and rational treatment.

Treatment.--The treatment of this condition falls so largely within
the dominion of surgery that we can give little more than an outline
here.

In cases where there exists no evidence of open joint or open tendon
sheath as judged by the site of the puncture and degree of lameness
present (after having thoroughly cleansed the solar surface of the foot
and enlarged the opening in the nonsensitive sole) a little phenol is
introduced into the wound. In such cases, where it is possible for the
antiseptic to contact every part of wound surface to the extreme depths
of the puncture, infection is prevented when such treatment is promptly
administered. This may be considered as first aid, or emergency care,
and is indicated in all wounds of the foot whether the injury be serious
or almost insignificant.

Subsequently one of two general courses may be pursued in the treatment
of cases of nail puncture. One, by the employment of means to keep the
wound patent and injection of suitable antiseptics, or agents that are
more or less caustic in conjunction with strict observance of asepsis
and wound protection. T