If the practitioner is somewhat proficient as a surgeon, and has at his command facilities for doing surgery, the second method is preferable in many cases. By using a local anesthetic on the plantar nerves and confining the subject on an operating table, restraint should be perfect. The solar surface of the foot is first thoroughly cleansed, the puncture wound is enlarged in the nonsensitive structures and the parts are then moistened with phenol or other suitable antiseptics. By means of a small probe the puncture is explored and, depending on the character of the wound and the structures involved, surgical intervention is varied to suit the case. If necessary, all of the insensitive frog is removed, and in wounds affecting the region of the heel the tissues may be incised from the puncture outward dividing all of the tissues outward and backward to the surface. A suitable surgical dressing is then applied. If, on the other hand, the puncture extends into the navicular bursa, the radical operation is perhaps indicated, though not until one is sure that infection of the bursa and serious consequences are to follow if this operation is not performed. Detailed description of the technic of this operation belongs to the realm of surgery and a good discussion of it is to be found in William's work on veterinary surgical and obstetrical operations. One may summarize the discussion of treatment of nail puncture by saying that emergency care as herein described is of first consideration. In every case an immunizing dose of anti-tetanic serum should be given. Subsequently, the method employed must suit the character of the wound, existing facilities for handling the subject and the skill and aptitude of the practitioner. FOOTNOTES: [Footnote 5: Manual of Veterinary Physiology, by Major-General F. Smith, page 590.] [Footnote 6: Manual of Veterinary Physiology by Major-General F. Smith, page 589.] [Footnote 7: Regional Veterinary Surgery and Operative Technique, Jno. A.W. Dollar, M.R.C.V.S., F.R.S.E., M.R.I., page 765.] [Footnote 8: Dr. Roscoe R. Bell in the Proceedings, N.Y. State Veterinary Medical Society, 1899.] [Footnote 9: American Veterinary Review, Vol. 35, P. 456.] [Footnote 10: "Radial Paralysis and Its Treatment by Mechanical Fixation of Knee and Ankle," Geo. H. Berns, D.V.S. Proceedings of the American Veterinary Medical Association, 1912, p. 219.] [Footnote 11: As quoted by Berns, in Radial Paralysis, etc., Proceedings of the A.V.M.A., 1912.] [Footnote 12: Veterinary Surgical Operations, by L.A. Merillat, V.S., p. 507.] [Footnote 13: A paper presented before the Illinois Veterinary Medical Assn. by Dr. H. Thompson of Paxton, Ill., American Veterinary Review, Vol. 15, p. 134.] [Footnote 14: "Fractures in Foals," by Dr. Wilfred Walters, M.R.C.V.S., American Journal of Veterinary Medicine, Vol. 8, p. 669.] [Footnote 15: American Veterinary Review, Vol. 26, p. 1068.]