52 TERMINATIONS OF INFLAMMATION. 



skin, being, in old confirmed cases, lined with a downy hair, and 

 so thick and callous that its walls resemble cartilage in their 

 hardness. This hardening of the walls was formerly thought to 

 depend upon a morbid disposition of the part, and to require 

 extirpation, as an essential step to the animal's recovery. The 

 applications and operations practised for this purpose were ex- 

 tremely severe, consisting of the actual cautery, arsenic, corrosive 

 sublimate, and other powerful escharotics; but a more enlightened 

 pathology has led to their disuse, and it is now found sufficient 

 simply to remove the cause of the irritation. 



" In treating sinuses, the objects are to promote granulating 

 action on their surfaces, and to press their sides together. They 

 are not healed hj filling up, any more than the original cavity of 

 the abscess, but contract until they become obliterated, or close 

 more directly by union of the opposite surfaces." — (Syme.) 



Great care must be taken to avoid confining the discharge 

 of the sinus, since, if prevented from escaping, it distends the 

 sides of the cavity, and for the same reason it is always proper 

 to afford the matter an opening for its complete escape, either 

 by enlarging the one already existing, or making a new one. 

 The method of doing this will be explained hereafter in connec- 

 tion with the different regions in which sinuses are apt to be 

 seated. 



ULCERATION. 



Ulceration is another result of inflammation : it consists 

 essentially in molecular degeneration of a part, and goes on by 

 three simultaneous processes. (1.) An exudation of inflamma- 

 tory lymph and serum surrounds the mass of young cells, which 

 constantly continue to grow on the surface, and at the margin 

 of the ulcer, causing the destruction of the normal textures. 

 (2.) Cells are thus continually growing on the surface, to be 

 carried off by fresh exudation. (3.) Liquefaction of the 

 gelatinous interstitial material supervenes, and so destruction 

 of tissue takes place continually. — (Goodsir, Aitken.) 



The difference between ulceration and mortification will be 

 described hereafter, but I may here state that I cannot conceive 

 ulceration to be molecular death of a part, but rather the absorp- 

 tion of living degenerate textures, by which gaps or solutions of 

 continuity are formed. 



