rous, and sometimes deep enough to lead to exposure of the sensitive
structures beneath, complicating the quittor with a sand-crack of a
peculiarly objectionable type.

_Pathological Anatomy of the Diseased Cartilage_.--The bulk of observers
appear to agree in the statement that in quittor the necrotic cartilage is
pea-green in colour, and recognise it by that characteristic. In size the
necrotic portion thus recognisable varies from the tiniest speck to a
portion the size of a horse-bean. Commonly, however, it is about as large
only as a pea. It is seen to be more or less detached from the rest of
the cartilage, to which it is adherent by one of its extremities only. In
general appearance we can best liken it to the split half of a green pea,
whilst others have compared it with the green sprouting of a seed. The
portions of cartilage nearest the necrotic piece are also slightly green in
colour, thus indicating that here also the diseased process has commenced.
This peculiar change of colour in the affected cartilage is of great
importance to the surgeon. It enables him when operating to distinguish
with some degree of certainty those portions of the cartilage which are
healthy and those which are not.

_(b) Necrosis of Tendon and of Ligament_.--This complication of quittor
is, as we have said before, treated by other writers as a distinct form of
the disease, and described by them under the heading of Tendinous Quittor.

This simply means, of course, that the diseased process has extended to
either of the flexor tendons, to the tendon of the extensor pedis, or,
perhaps, to the ligaments of the pedal articulation.

Of the flexor tendons, the perforans is the one commonly attacked, by
reason, of course, of its more superficial position. At times, however,
especially when its aponeurotic expansion is diseased, the necrosis of the
perforans spreads until the aponeurosis is eaten through and the phalangeal
sheath penetrated. Septic materials gain entrance thereto, and commence to
multiply. In this way the flexor perforatus is invaded, and comes to share
in the diseased process.

The extensor pedis is usually attacked by extension of the disease from a
necrotic cartilage, or results from the infliction of a severe tread in a
hind-foot. In this case the diseased structure has nothing between it and
the articulation, the synovial membrane in one position actually lining its
inner face. The result is that a condition of syno