Regarding the administration of chloroform, no description of the method is needed here, as it will be found fully detailed in most good works on general surgery. Where great immobility is needed, it is one of the most valuable means of restraint we have. Apart from that, its use in any serious operation is always to be advocated, if only on the score of humane consideration for the dumb animal helpless under our hands.
B. INSTRUMENTS REQUIRED.
In addition to those required for operations on the softer structures—such as scalpels, forceps, artery forceps, directors, scissors, etc.—the surgery of the foot demands instruments specially adapted for dealing with the horn.
A great deal will depend upon the operator as to whether these are few or many. The average man of resource will deem a smith’s rasp and one or two strong drawing-knives amply sufficient, and on no account should they be omitted from the list of those ready to hand.
[Illustration: FIG. 45.—THE ORDINARY DRAWING-KNIFE.]
The ordinary smith’s drawing-knife (Fig. 45) is well known to almost everyone, and is well suited for much of the rougher part of the work. The careful following up of pricks, however, and some of the more special operations demanding removal of portions of the lateral cartilages call for instruments of a more delicate character and peculiar construction. These are to be found in the so-called sage-knife, and the modern (French) pattern of drawing-knife.
[Illustration: FIG. 46. a, b, Modern forms of drawing-knife; c, d, e, sage-knives.]
The modern drawing-knife differs from the smith’s instrument in being attached to a straight, instead of a curved, handle, and in usually being sharp on both edges instead of only on one. These are made in various sizes (Fig. 46, a, b), and the blades flat, curved on the flat, or curved at an angle with the edges of the haft.
The sage-knife, as its name indicates, is a knife with a lanceolate-shaped blade. These also may be obtained in varying forms and sizes (Fig. 46, c, d, e). Fig. 46, c, is a single-edged, right-handed sage-knife. Fig. 46, d, is a left-handed instrument of the same type. The double-edged sage-knife is represented in Fig. 46, e.
[Illustration: FIG. 47.—SYMES’S ABSCESS-KNIFE.]
It may be mentioned too, in passing, that the ordinary Symes’s abscess-knife (Fig. 47) is a most useful instrument when performing the operation of partial excision of the lateral cartilages, its peculiar shape lending itself admirably to the niceties of the operation.
One or two good-shaped firing-irons will also be found useful. They will lighten the labour of tediously excavating grooves with the knife, where that procedure is necessary; and, used in certain positions to be afterwards described, will afford just that necessary degree of stimulus to the horn-secreting structures of the foot, which the use of the knife alone will not.