DEEP-SEATED INGUINAL ABSCESS AFTER CASTRATION. 43 



Up to the 13th September suppuration remained abundant, and the 

 sweUing around the wound considerable, but the other symptoms — 

 especially the serous infiltration of the limb and difficulty in movement 

 ■ — steadily diminished. On the i8th the intra-abdominal swelling was 

 limited to the cord, which was, however, hard, conical in shape, and 

 smooth on the surface. 



From that date up to the 30th September the wound gradually 

 contracted, its surroundings diminished in size by re-absorption of the 

 interstitial exudate, and the purulent discharge diminished daily. On 

 the 8th October, when our patient left hospital, the wound was only 

 two and a half to two and three quarters inches in length — the margins 

 a little swollen, the suppuration almost entirely ceased. By compara- 

 tive examination of the upper inguinal regions one simply detected 

 the persistence opposite the inguinal ring of a narrow indurated zone, 

 and a rather firm condition of the cord for a distance of an inch or two. 



After castration by ordinary methods abscesses sometimes develop 

 under the dartos. Their nature is well known. They result either 

 from too early union of one of the operation wounds — union occurring 

 while suppurative inflammation is still going on in subjacent tissues ; 

 or from retention of a foreign body — one of the strings used for 

 fastening together the branches of the clams, for example. But deep- 

 seated abscesses in the inguinal space, where the pus remains enclosed 

 for several months, as in the case just mentioned, are exceedingly rare. 



Apart from its inherent interest, however, this case teaches a lesson 

 you should never forget. I have repeatedly shown you that in wounds 

 of the horse's foot, when the intensity of the general symptoms 

 suggests grave local mischief, and when after removing the horn the 

 subjacent sensitive tissues appear simply to be inflamed round about 

 the wound, it is necessary to incise these tissues, and to seek below 

 them the principal diseased centre. The same line of conduct applies 

 to diseases of other regions, more particularly to those of complex 

 anatomical structure. When the local lesions met with in superficial 

 parts do not sufficiently explain the functional and general disturbance 

 which have led to surgical interference, you must seek beyond, and 

 explore the depths. With exact anatomical knowledge, prudent 

 technique, and antiseptic precautions, exploration of these regions is 

 unattended with danger. 



