vitis is easily set up,
and the case aggravated by that and by arthritis.

With the flexor tendons attacked pain is always very great, and lameness is
excessive. This, however, is not sufficiently characteristic to enable us
to determine the precise seat of the necrotic changes. Later, however, a
tender but hard enlargement made its appearance in the hollow of the heel,
which enlargement, later still, became soft and fluctuating. At this stage
there is also considerable swelling along the whole course of the tendons,
as high up as the knee or the hock. The foot is carried forward with all
the phalangeal articulations flexed, and in many cases the limb is unable
to take weight at all. Manipulated after the manner of examining the
tendons for sprain, this swelling is found to be extremely painful. The
animal flinches from the hand, and shows every sign of acute suffering.
This condition may, in fact, be mistaken for sprain, and is only to be
distinguished from it by carefully noting the history of the case--first,
the appearance of the swelling in the hollow of the heel, and, secondly,
the _after_-swelling of the upper portions of the tendons.

The formation of the abscess, the after-discharge of its contents, and the
final establishing of a fistula, are processes greatly prolonged in this
form of quittor. It will readily be understood why this should be so when
one remembers the depth at which the suppurative process is going on, the
thickness of the metacarpo-phalangeal sheath, and the resistant nature of
the material of which this latter is made, and which must be penetrated
before the condition becomes observable.

After the opening of the abscess, which usually takes place in the hollow
of the heel, there is left the fistulous wound which obstinately refuses to
heal. Or it may be, again, that there are several of these fistulas, each
opening in the heel, and the mouth of each marked by a small, ulcer-like
projection. The discharge continually oozing from these keeps the heel
constantly wet with a thick purulent discharge, which is nearly always
blood-stained, and very often foetid.

This constitutes what is known as tendinous quittor in its worst form,
for more often than not there is associated with it inflammation of
the navicular bursa, caries of the bones, or arthritis of the pedal
articulation.

With the extensor pedis attacked matters are not quite so grave, in spite
of the fact that the articulation is clo