PAPERS ON MEDICINE AND PUBLIC HEALTH 263 



danger arises of the enemy bacteria getting through to the 

 next group of glands or into the blood vascular system 

 giving general blood poisoning or constitutional disease. 



Symptomatalogj- is fairly constant, depending upon the 

 type and virulency of the infection, with temperature, 

 swelling, pain, tenderness of the glands, often chills and 

 general aching. Incubation period varies from a few days 

 after the original site is exposed to infection, to several 

 weeks. The duration depends upon the resistance of the 

 individual, tA.'pe of bacteria and its virus, and treatment. 



By far the most important treatment is preventive ; vac- 

 cination is probably premature. Training in hygiene, 

 health habits, sterilization of wounds, and how to keep 

 wounds aseptic, are of great assistance in keeping the axil- 

 lary glands healthy. The active treatment varies with the 

 type of infection. Here we must confine this paper to the 

 simple and pus infections, leaving the tubercular, syphilitic, 

 malignant oedema, tetanus, etc., to special study. The 

 focci of both secondary and primary infections must be 

 well drained and have frequent dressings. Regional skin 

 diseases should have immediate attention. Free catharsis 

 must always be maintained and symptomatic treatment in- 

 stituted. Administration of autogenous vaccine made from 

 secondary infection focci is often of value. External heat 

 must be applied to the axilla continuously until the in- 

 fection is aborted or a diagnosis of abscess formation is 

 made. Then surgical treatment of free drainage and steri- 

 lization of the wound by the Carrol-Dakin method is 

 usually found most effective. 



