22 ON A NEW METHOD OF TREATING 



Nevertheless, as the pus was proceeding from beneath the crust impregnated 

 with carboHc acid and was still quite odourless, I did not altogether despair of 

 attaining my object. In order to make the crust more effectual, I extended 

 it for about three-quarters of an inch at the part from which the pus was escap- 

 ing, by a piece of lint dipped in carbolic acid, which, when mixed with pus, 

 forms a sort of curdy mass which answered pretty well for a crust. A consider- 

 able quantity of matter, of moderate consistence and greenish-white colour, 

 was then pressed out from the limb. A new tin cap having been made, large 

 enough to cover the whole of the extended crust, the fomentation was continued 

 as usual. 



Next day it was evident, from the sense of fluctuation, that reaccumulation 

 had occurred in the abscess, but no further discharge had taken place. On 

 removing the tin cap, however, pus was seen to well out from a new situation 

 at the upper edge of the crust. A piece of lint dipped in carbolic acid was at 

 once placed on this part, and the matter was pressed out and carefully collected 

 measuring 3 oz., of moderate consistence and yellowish- white colour, still without 

 odour except that of carbolic acid. The crust having been somewhat extended 

 at the situation of the new opening, the whole was freely treated with carbolic 

 acid, the tin cap readjusted, and fomentation continued. 



During the rest of the week that followed the first evacuation of the abscess 

 the same treatment was pursued with the most satisfactory results. Some pus 

 was usually seen on the fomenting flannel both morning and evening, and some 

 was pressed out of the limb from the orifice last formed, but the amount rapidly 

 diminished in quantity, and also became thinner and more transparent, while it 

 continued free from odour. It may be worth while to mention in detail the 

 quantities obtained from the limb in the morning of each of these days. On 

 the seventeenth day it was an ounce and a half, somewhat thinner than before ; 

 on the eighteenth, two drachms and a half, decidedly thinner ; on the nine- 

 teenth, half a drachm, much thinner and more transparent ; on the twentieth, 

 a quarter of a drachm, similar in quahty ; and on the twentj^-first, six drops 

 only, and almost free from opacity. Finally, in the evening of that day no 

 discharge was seen on the flannel, nor could any be squeezed out from the limb. 

 Meanwhile the calf, which had increased markedly in circumference just before 

 the abscess opened, steadily diminished, and in the thigh all swelling disappeared 

 from over the seat of fracture, so that the end of the upper fragment, previously 

 quite obscured, could be distinctly defined. His general health, too, had im- 

 proved ; his tongue had become quite clean, and he had acquired for the first 

 time since his admission a genuine appetite, the pulse continuing about 72. 



I suspect, however, that this success made us relax a httle our vigilant 



