516 FISTULA. 



mation is neglected, it soon leads to the formation of an abscess, 

 which may be known by a feeling of shifting or changing under 

 pressure of the lingers. 



Remedies 1. The tumefied parts should be kept constantly 

 wet by means of bandages thoroughly saturated in a mixture com- 

 posed of equal parts of pure cider vinegar and cold water. This 

 treatment should be well persevered in for a few days. Should the 

 tumor in the meantime increase in its size and the parts develop 

 much heat, a poultice of bruised flaxseed should be applied twice 

 daily for forty-eight or ninety-six hours, or until the tumor mani- 

 fests a fluctuating feeling. You will please note that no procrasti- 

 nation should be indulged in, such as waiting patiently for the 

 tumor to break of its own accord, but as soon as the pus or matter 

 can be distinctly felt by pressure, make an incision slantingly with 

 a sharp knife upon the right side of the neck at the base of the 

 abscess. The incision or cut must not be made so deep as to come 

 in contact with the spinal cord or marrow. The opening at the base 

 of the tumor should be made sufficiently large to allow the pus to 

 freely escape as fast as it forms. A seton should be passed down 

 from the natural opening at the top of the tumor through the 

 artificial opening made at its base. Before inserting the seton it 

 should be dipped in tincture of cantharides. This will be found 

 the safest and best plan to adopt for promoting healthy granulation 

 and adhesion of the walls of the tumor. The fistulous track is not 

 probably very long and the tape-seton will work its way gradually 

 but efficaciously out, by which time the cure is made. A stimulus 

 is also necessary, to be applied to the interior of the tumor by 

 re-saturating the seton, in three or four days after it is first inserted, 

 with a solution made by dissolving ten grains of nitrate of silver 

 in one ounce of cold water. This latter named stimulus should be 

 applied twice per week until a healthy discharge of pus appears ; 

 then stop. In the opening, from the top down to the artificial 

 opening at the bottom, should be injected three times a week a 

 lotion composed of one drachm of chloride of zinc dissolved in 

 one pint of cold water. Apply the zinc lotion in half an hour after 

 using the cantharides tincture and the nitrate of silver solution. 

 The tincture of cantharides should only be applied once, and the 

 nitrate of silver solution on the third or fourth day after and con- 

 tinued as long as found necessary ; but the zinc-lotion should be 

 applied once daily until a healthy granulation takes place; then 

 every second or third day until the parts heal soundly. If pipes 

 are really found they must be opened to the bottom else no healthy 

 state can be expected. 



2. When the fistula makes its appearance, rowel both sides or 

 the shoulder; if it should break, take one ounce of verdigris, one 

 ounce of oil-resin, one ounce of copperas, pulverize and mix 

 together. Use as a salve. 



3. Take of Spanish flies one ounce, gum euphorbium three 



