ABSCESSES. 195 



If the abscess, instead of becoming pyramidal and pointing to a sur- 

 face, spreads in breadth, and circumference, it should be opened at once, 

 because in such case there is no tendency to become encysted or circum- 

 scribed. Abscesses under strong fascia should also be opened at once, 

 because that membrane will resist for a length of time the ulcerative 

 process by which the suppurative matter gains its exit, and in conse- 

 quence a sinus will probably form unless an artificial opening is made. 

 Abscesses which are caused by the presence of irritant fluid should 

 obviously be opened without delay, as well as those in loose areolar 

 tissue, because in such cases there would be an undue tendency to spread. 

 Abscesses in the neighbourhood of joints or of important organs should 

 also be opened early, lest the ulcerative process should affect those 

 structures. 



The suppurative process, if it is unduly slow, may be assisted and 

 hastened by the application of fomentations or poultices, or by a light 

 blister; but it is essential that this latter agent should not be applied 

 until the abscess shows signs of coming to a head. Too early an appli- 

 cation of such an agent is apt to disperse the matter which is forming or 

 about to form. 



For abscesses in internal parts we can do nothing more than place the 

 patient in a condition favorable for their development by good feeding, 

 good care, <fec. 



It is hardly ever, we may remark, desirable to check or disperse the 

 matter formed or seeking to form. The tendency to form an abscess is 

 usually an indication that there is something in the system which nature 

 for her own wise reasons wishes to eliminate. 



397. Modes of opening Abscesses. 



An abscess, in parts which can be reached, is usually opened by the 

 knife when the proper time has arrived, i. e. a little before it would 

 burst naturally. Two advantages are gained by opening it artificially, 

 namely, first the opening may be made at the point most favorable for 

 the escape of the pus, and secondly a slighter blemish is made by a 

 clean incision than by the large irregular opening made by nature, i. e. 

 by the process of ulceration of the integuments. 



Any pus which remains after opening should as far as possible be 

 squeezed out gently, and the cyst or sac may be injected with warm water 

 from a syringe twice a day for two or three days, and the edges of the 

 wound must be carefully kept clean. In some cases irritation of the cyst 

 may supervene, with fever and pain and a discharge of sanious pus. To 

 the warm water recommended above some slightly stimulating lotion, 

 such as diluted ammonia, may be added with a view of bringing about a 

 healthier action of the parts. In other cases the presence of a foreign 

 body may prevent the abscess from healing, and possibly a sinus may 

 result. Prior, however, to the formation of a sinus, such cases are best 

 treated by applying stimulants to the surface or by injecting stimulating 



