Treatment—­(a) Preventive.—­Seeing that many of these cases have their starting-point in stabs or penetrating wounds of the sole, we shall be concerned first with a consideration of the correct treatment to be adopted when we know the wound to have reached the articulation.

Only too frequently the treatment practised is that of poulticing.  In other portions of this work we have pointed out the advantages that a continued antiseptic bathing has over the application of a poultice, the greater readiness with which the solution comes into contact with the deeper parts of the wound, and the far greater chance there is of maintaining water in an antiseptic condition than there is of keeping a poultice in the same state.  There is no doubt, that in this case also, the cold or warm antiseptic bath is to be preferred to the poultice.  It is questionable, however, whether even the bath is sufficient for our purpose here.  We have in this case a deep punctured wound, and a wound that in every probability is infected with the organisms of pus or of putrefaction.  It is a wound, moreover, which is likely to impede the thorough access to it of the solution in which the foot is fomented, on account of the flakes of coagulated fibrin which fill it.

The most rational treatment, therefore, if we get to the case early enough, is to irrigate the wound freely with a solution of carbolic acid in water (1 in 20), or with a solution of perchloride of mercury (1 in 1,000), injected by means of a glass syringe, or the pattern of syringe devised for quittor.  This injecting should be done thoroughly, and by that we mean that several syringefuls of the solution should be injected, the joint after each injection being manipulated so as to distribute the solution as far as possible over it.  When this is done the opening in the sole may be plugged with a little perchloride of mercury, or, better still, with a little piece of tow saturated with a concentrated solution of perchloride of mercury or a solution of iodoform in alcohol and an antiseptic pad of tow or lint placed over all.  The foot should then be bandaged and encased in a boot or sacking protective.  The bandage should be removed daily and the antiseptic pad changed.  At each visit the animal’s condition must be carefully noted.  So long as constitutional disturbance is slight, the foot appears comfortable, is free from marked heat and tenderness, and pawing movements are absent, and so long as the discharge on the pad appears non-purulent, free from marked odour, and small in quantity, then this dressing may be persisted in.