[Illustration:  FIG. 55.—­THE SHOE WITH PLATES. A, The plates in position; B, the plates separated from the shoe.]

[Illustration:  FIG. 56.—­THE QUITTOR SYRINGE.]

The plates are of metal, preferably of thin sheet iron or zinc, and are slipped between the upper surface of the shoe and the foot after the manner shown in Fig. 55.  The plates themselves are shaped as depicted in Fig. 55, a, b, c, a and b curved to meet the outlines of the shoe, and c shaped so as to wedge tightly over the posterior ends of the side plates, and between them and the shoe.  A distinct advantage of the plate method of dressing is that a certain amount of pressure may be maintained on the sole and frog, a very important consideration in connection with some of the diseases with which we shall later deal.

When dealing with sinuous wounds of the foot, another favourite mode of applying dressings is by means of the syringe, and no better instrument for all cases can be found than that known as a quittor syringe (Fig. 56).

A further mode of applying dressing, and one frequently practised in connection with the foot, is known as ‘plugging.’  This is almost sufficiently indicated by its name.  It consists in rolling portions of the dressing into little cylinders, wrapped round with thin paper, and introduced into a sinus or other position where considered necessary.

D. PLANTAR NEURECTOMY.

As a last resort in the treatment of many diseases of the foot the operation of neurectomy is often advised.  It will be wise, therefore, to insert a description of the operation here.

Derivation of the Word.—­For many years the operation was known simply as ‘nerving’ or ‘unnerving,’ and it was not until 1823, at the suggestion of Dr. George Pearson, that Percival introduced the word neurotomy to signify the operation with which we are now about to deal.  The word neurotomy, however, used strictly, means the act or practice of dissection of nerves, and, when applied to the operation as practised to-day, describes only a step in the procedure.

As the operation really consists in cutting down upon, and afterwards excising a portion of the nerve, the modern appellation of neurectomy—­from the Greek neuron, a nerve; and tome, a cutting, signifying the cutting out of a nerve or the portion of a nerve—­is far more suitable.

According as the nerve operated on is the plantar or the median, the operation is known as plantar or median neurectomy.