ABSCESS FORMATION IN SUBrAROTID LYMPH GLANDS. 329 



Treatment. Early opening of the abscess is desirable, but the use 

 of sharp instruments for the purpose is contra-indicated, as, owing 

 to the displacement of parts, the parotid may be wounded, producing 

 salivary fistula, or the great blood-vessels injured, causing fatal 

 bleeding. 



Viborg describes the following excellent method, which is simple 

 and without danger. A twitch having been applied, and the seat of 

 operation cleansed and disinfected, an incision is made through the 

 skin over the highest point of the swelling, and if possible, below 

 the edge of the parotid, the underlying fascia divided, and the fore- 

 finger inserted. The thick connective tissue or gland structure is 

 now broken down, the free hand meanwhile pressing on the swelling 

 and guiding the inserted finger towards the abscess. This attained, 

 a strong thrust breaks it and allows the escape of a stream of thick 

 creamy pus, which often spurts to a distance of several yards. It 

 may be necessary to operate on both glands. Some operators prefer 

 to make the incision at the lower border of the parotid, below the 

 submaxillary vein. The finger is then passed upwards and inwards ; 

 sometimes the abscess can only be safely opened by using closed 

 round-pointed scissors, as the tissue is very resistant. This method 

 gives equal security against injuring the parotid or important vessels, 

 and gives a depending orifice. 



With drainage of the abscess, fever falls, and difficulties in 

 breathing and swallowing disappear. Healing occurs in eight to 

 fourteen days, but complete closure of the abscess sometimes requires 

 from three to six weeks. Warmth and moist applications (Preisnitz's 

 poultices) appear to favour the breaking down of the swelling ; the 

 pus is removed by pressure and washing out the cavity with carbolic 

 or sublimate lotion ; further treatment is not usually necessary. 

 This procedure, as already stated, is preferable to the use of sharp 

 instruments, and especially to the oft recommended trocar. Cadiot 

 and Dollar describe a case of " cold abscess " in this region which 

 had existed for three months. A little inodorous whitish mucous 

 discharge ran from the nostrils. A swelling occupied the submaxillary 

 and laryngeal regions and extended on either side of the parotid. 

 Swallowing was difficult, and the animal ate and drank slowly. The 

 swelling was opened as above described, a pint of whitish laudable 

 pus evacuated, and a drainage-tube inserted. Recovery was rapid. 

 (" Clinical Veterinary Medicine and Surgery," p. 336.) 



