till living
tissues around. Under the irritation the latter, as we have said before,
cast the necrosed portion away by a process of sloughing.

Always, however, it is found that the portion to be sloughed off, while
easily separated from the tissues adjacent to its sides, is closely
connected on its lowermost or deeper face with the structures below, and
cannot be torn away without haemorrhage and the causing of acute pain.

_Prognosis_.--With wounds about the feet our forecast should always be
guarded. Even with this, the most simple form of quittor, no decided
opinion should be given until the progress of the case warrants one in
reasonably assuming that complications are absent. Once this point is
decided, a favourable prognosis may be given.

_Complications_.--With cutaneous quittor various complications may arise,
according to the extent of the invasion of the septic matter. Necrosis of
tendon, of ligament, or of cartilage, caries of the bone, or a condition of
synovitis and arthritis may be met with. As these complications are equally
common to sub-horny quittor, we shall reserve their description until
dealing with that condition. _Treatment (Preventive)_.--Immediately after
the infliction of an injury in this position, more especially if it is such
as to lead one to judge that necrosis will follow to any large extent, the
patient should be rested. Ill effects may then be probably warded off by
having the foot immersed in a cold antiseptic solution, and afterwards
bound with an antiseptic pad and bandage.

_Curative_.--When the condition has gone undiscovered until commencing
necrosis and suppuration are plainly discernible, then the wisest course we
can follow is to do all we can to hasten removal of the necrosed portion.

This is best done by promoting the suppurative process by means of warmth
or stimulant applications.

To this end hot poultices, or, better still, hot baths, should be resorted
to. Under their influence a greater supply of blood is directed to the
still healthy tissues enabling them to actively continue the inflammatory
processes necessary to the detaching of the portion necrosed, while, at
the same time, the pus organisms, stimulated by the heat, are stirred into
greater activity, and the readier accomplish their purpose of destroying
the adhesion still existing between the necrotic portion and the
surrounding living tissues.

When prolonged poulticing or bathing cannot be practised, th