COMPOUND FRACTURE, ABSCESS, ETC. 21 



which had been still touched daily with carbolic acid, the fomentations also 

 having been continued. The swelling, however, had not subsided, and the 

 redness, though varying in extent and degree, had never disappeared from over 

 the seat of fracture. On the fifteenth day a defined prominence made its appear- 

 ance at this part in a space about as large as the palm of the hand, a little further 

 forward than the crust, and a sense of fluctuation was to be perceived in it. 

 In the evening Dr. Cameron, on changing the fomentation, saw more pus than 

 he thought could be accounted for by the superficial excoriation round the crust, 

 and next morning, on removing the flannel, I found it soaked with similar dis- 

 charge ; a considerable quantity also lying between the tin splint and the limb. 

 On raising the tin cap, the matter was seen welling out from beneath the lower 

 edge of the crust. It was perfectly free from odour, confirming the conclusion 

 I had previously arrived at that this abscess was not in any way caused by 

 decomposition from atmospheric influence. The long period that elapsed before 

 it made its appearance, together with the absence of any serious constitutional 

 disturbance, clearly showed that the carbolic acid had effectually answered 

 the purpose for \N'hich it was applied, the constant oozing of blood from the 

 small wound having doubtless been in the patient's favour, by preventing 

 decomposition from penetrating far into the interior before he came under 

 treatment. We know that a mass of extravasated blood occasional]}- becomes 

 the seat of suppuration without the existence of any external wound. A curious 

 instance of this occurred lately in my practice, in a boy who fell down the hold 

 of a ship. upon his head, and, besides serious cerebral symptoms, exhibited at 

 once a remarkable prominence of the right eyeball, evidently due to extravasa- 

 tion of blood into the orbit. There being no wound, I expected that the blood 

 would be absorbed ; but after the lapse of several days, the prominence of the 

 eye showed increase rather than diminution, and the boy began to complain 

 of supraorbital pain. Fluctuation then became perceptible, and pus was evacu- 

 ated by incision, after which the eyeball gradually resumed its natural position. 



Such I supposed to be the nature of the abscess in C 's case, and previous 



experience made me fear that, if decomposition of its contents should occur, the 

 irritation of the fetid pus might cause very serious consequences from rapid 

 extension of suppuration among the imperfect and feeble products of the 

 organization of the blood in the yet swollen limb. 



Hence I had intended to evacuate the matter by aid of carbolic acid in 

 such a way as to prevent decomposition. As the abscess was not near the 

 surface at the part where it appeared to be pointing. I had reckoned on having 

 plenty of time for my operations, and was greatly disappointed to find that it 

 had discharged itself spontaneously. 



