Simple treatment recommended for in grown toe-nail. A 40-per-cent. solution of liquor potassa is applied warm to the portion of the nail to be removed. After a few seconds the uppermost layer of the nail will be so soft that it can be scraped oil' with a piece of sharp-edged glass; the next layer is then moistened with the same solution and scraped off; this must be repeated until the remaining portion is as a thin sheet of paper, when it is seized with a pincette and lifted from the underlying soft parts and sev ered. The operation does not require more than half an hour's time, and is painless and bloodless. Puerekhaner (Pittsburgh Med. Rev., Feb., '91).
In ingrowing toe-nails plaster applied diagonally around the toe in such a manner that the soft parts shall be drawn away from the nail without di rect pressure over the latter is some times efficient. A semilunar-shaped piece of plaster is better than a straight strip. It should be applied with the con vexity forward, one horn beginning just behind the nail on the affected side. This will allow the belly to catch the offending soft parts, while the remainder of the piece is carried around the plan tar surface of the toe and over the dor stun, crossing the first end. This dress ing should be changed every three or four days. J. L. Andrews (N. Y. Med. Jour., Mar. 20, '97).
An ingrowing nail is easily cured by the following method: All pressure from the nail is removed by cutting away a piece of the shoe and the lesion is dis infected with hydrogen dioxide until no more "foam" appears. A drop of strong solution of cocaine is then introduced into the base of the ulcer, and a drop of Manse11's solution is applied to the latter. The part is then loosely covered with gauze and the process repeated every sec ond day until the edge of the nail is re leased by retraction of the hypertrophied tissue. The cure is effected within a eouple of weeks without interfering with the patient's vocation. Kinsman (Colum bus Med. Jour., Apr. 4, '99).
The older surgeons used to recom mend evulsion of the nail: an operation performed by forcibly inserting a scis sors under it; but this measure is now condemned because the new nail is gen erally a malformed one and hypertrophy (vide supra) occasionally follows.
fn ingrown toe-nail the following method, modified from that advised by Masters, of England, recommended: A flat strip of silver—Vioo inch thick, inch wide and 1 inch long—is bent into the shape of a fish-hook. The toe having
been cleansed with peroxide of hydrogen and moistened with a solution of co caine, the hook is inserted under the lateral edge of the nail so that the shank of hook curves over the side of toe and lies dose to it. The greater the ulceration, the less the pain in in serting the hook. It is retained in place by adhesive plaster or a bandage. The hook not only protects the flesh from the nail, but it exerts a lifting action on the nail. After a few hours the pa tient suffers no inconvenience from the hook, and in a few days the swelling subsides and the granulations become more healthy. It is well to wear the hook for several weeks after the tissues have healed. Henry Ling Taylor (Inter. Jour. of Sing., Sept., '96).
All cases of ingrowing nail may be cured without recourse to the knife by proceeding as follows: With a flat probe, or a match, a bit of cotton is slipped between the edge of the nail and the inflamed flesh. Another strip of cotton is put along the outer margin of the ulcerated area, and the space be tween these two strips of cotton, and which is occupied by the ulcer, is thickly powdered with nitrate of lead.
The whole is covered with cotton, and the toe is bandaged. The dressings are repeated daily until the incarcerated edge of the nail is plainly visible. Usually four or five dressings suffice. Then the edge of the nail is lifted away from the flesh and a. bit of cotton is introduced under it. As it grows it will gradually take its proper position above the flesh.
The lead is to be discontinued as soon as it appears that the exuberance of the fleshy bed of the nail has been over come. The difficulty seldom recurs. If this does happen it is necessary to re peat the treatment from the beginning. Tardif (Anjou MM., Feb. 1, '93).
Case in which after all usual methods had failed a triangular notch was made midway in the free edge of nail extend ing to its body. From the pointed mar gin of this notch a furrow was made, as near to the quick as possible, with out penetrating it, through the middle of the root as far as the duplicature of skin; a piece of cork was then inserted under the nail, whose biilk Nuis large enough to extend a few lines on either side of the notch, as well as to com pactly fill, without uneasiness, the in terspace between the skin and extremity. .7. G. MacCullum (Mass. Nled. Jour., J an., '99) .