770 DISEASES OF THE WITHERS. 



the seat it occupies. If superficial, and on the lateral faces of the 

 region, it is not serious. If on the median line, it assumes a more 

 severe character. If deep, it is also of a dangerous nature, unless 

 it is simi^le or Hmited; but, on the contrary, if the quantity of the 

 pus has continued to increase, and infiltration has taken place into 

 the cellular tissue separating the muscular laj^ers ; or the sup- 

 puration has penetrated under the cartilage of the scapula; it 

 wni have assumed the most complicated form of the disease, with 

 chances of recovery of a very doubtful character. "When the pres- 

 ence of the pus has been detected, the immediate indication is to 

 assist its discharge by a free incision down to the bottom of the 

 cavity. The incision must be made on the most dependent part 

 of the tumor ; in such manner as to prevent the collection from 

 settling in a cul-de-sac. A means of drainage must be provided, 

 and the tube is preferred to the tent of oakum, or even to the 

 seton, as more sure to reach all parts of the collection, and the 

 more thoroughly to wash out the cavity. 



Jf, however, the suppuration has not been detected, the appli- 

 cation of local stimulation is indicated by means of warm com- 

 presses, hot poultices and the like ; a constant watchfvdness being 

 maintained, meanwhile, in order to detect the presence of the pus 

 at the earhest moment of its formation ; when it must be immedi- 

 ately evacuated. 



{9) Wounds. — Kesulting from every variety of traumatic 

 agencies, these injuries will necessarily vary ia their extent and 

 the nature of the tissues which are involved. 



They therefore extend from the most trifling hurt of the skin 

 to the severest lacerations of the important ligamentous, cartila- 

 ginous and bony structures contained in the region under con- 

 sideration. With such a diversity in their form and nature there 

 must also be a corresponding range in the character of the prog- 

 nosis to be announced, from that of rapid spontaneous recovery, 

 without interference, to the gravest of terminations. 



One of the principal indications in the treatment of woimds of 

 the withers is to prevent as much as possible the filtration and 

 deposit of pus through the various layers of the region, and facih- 

 tate the cicatrization, by placing them in a state of immobihty, 

 and according to Bouley and Nocard, the best method of secirring 

 this suspension of movement is to apply a broad bhster all around 

 the wound, and to repeat the appHcation after a few days. The 



