which may coexist is, of course, indicated.

Exposure of the plantar nerves by an incision behind the medial
malleolus, and subjecting them to forcible stretching, has been employed
by Chipault and others in the treatment of perforating ulcers of the
foot.

The ulcer that forms in relation to callosities on the sole of the foot
is treated by paring away all the thickened skin, after softening it
with soda fomentations, removing the unhealthy granulations, and
applying stimulating dressings.

_Treatment of Ulcers due to Constitutional Causes._--When ulcers are
associated with such diseases as tuberculosis, syphilis, diabetes,
Bright's disease, scurvy, or gout, these must receive appropriate
treatment.

The local treatment of the _tuberculous ulcer_ calls for special
mention. If the ulcer is of limited extent and situated on an exposed
part of the body, the most satisfactory method is complete removal, by
means of the knife, scissors, or sharp spoon, of the ulcerated surface
and of all the infected area around it, so as to leave a healthy surface
from which granulations may spring up. Should the raw surface left be
likely to result in an unsightly scar or in cicatricial contraction,
skin-grafting should be employed.

For extensive ulcers on the limbs, the chest wall, or on other covered
parts, or when operative treatment is contra-indicated, the use of
tuberculin and exposure to the Rontgen rays have proved beneficial. The
induction of passive hyperaemia, by Bier's or by Klapp's apparatus,
should also be used, either alone or supplementary to other measures.

No ulcerative process responds so readily to medicinal treatment as the
_syphilitic ulcer_ does to the intra-venous administration of arsenical
preparations of the "606" or "914" groups or to full doses of iodide of
potassium and mercury, and the local application of black wash. When the
ulceration has lasted for a long time, however, and is widespread and
deep, the duration of treatment is materially shortened by a thorough
scraping with the sharp spoon.

#Treatment in relation to the Condition of the Ulcer.#--_Ulcers in a
weak condition._--If the weak condition of the ulcer is due to anaemia
or kidney disease, these affections must first be treated. Locally, the
imperfect granulations should be scraped away, and some stimulating
agent applied to the raw surface to promote the growth of healthy
granulations. For this purpose the sore may be covered with gauz