POLL-EVIL. 191 



matter. And willingly \vould I agree with them, if I could 

 entertain the notion^ that no harm would result greater than 

 in a case of common abscess. When, however, I think what 

 mischief there may be going on while I am waiting for possi- 

 bilities, I cannot withhold my hand. It becomes a question 

 of some consequence, in what manner the knife is to be used. 

 The object being not only to give the matter vent, but to 

 procure such an orifice, that the cavity shall clear itself 

 as fast as the pus is collected. A dependent opening would 

 prevent all settlement : but that is impracticable. Should 

 the abscess point at any part, that spot should be made 

 the place of puncture; the sac ought afterwards to be 

 freely laid open, till we can examine into the condition of 

 the interior. We may find the matter has occupied a single 

 sac : on the other hand, it may be deep-seated ; or there 

 may be more than one abscess, and no communication be- 

 tween them. Should, however, the pus have remained long 

 pent up, the probability is that any separations which may 

 have existed have given way. From the chief cavity, how- 

 ever, sinuses most likely run in various directions, bounded 

 by sloughs and bottomed hj carious bone. 



Our next object should be, to establish counter- openings 

 to the one we have made ; the situation and amount of 

 which must depend on the direction and number of the 

 sinuses. The side of the neck will be the situation for any 

 counter-opening that may be required; through which punc- 

 tures may be made with a sharp-pointed seton -needle, and 

 a tape may be left hanging from the wound to drain ofi' 

 any matter that may subsequently be secreted. Should any 

 carious bone be felt, it should be removed with a pair of 

 forceps : this done, the cavity had better for a day be crammed 

 full of fine tow, which will stop the bleeding and frustrate 

 all union by adhesion. 



The Principle of Cure in these cases consists in the sup- 

 pression of all morbid action, and the establishment of 

 healthy operations : objects which, where the sinuses and 

 cavities are of much depth, we stand but little chance of soon 

 accomplishing, except it be by laying the sinuses open at 



