FISTULA IN THE WITHERS. 195 



remedy is simple. Abstain from a repetition of the cause, 

 or have the saddle altered till it can no longer do mischief. 

 At the same time cover the part with a piece of folded linen 

 wetted with a cooling lotion, and give a dose of medicine. 

 Should tumour remain when the inflammation has subsided, 

 the evaporating may be exchanged for a discutient lotion. 

 In some cases, instead of manifesting heat and tenderness, 

 the tumour is of an indolent nature. It probably has an 

 eschar — a black circular piece of dead skin upon its summit. 

 For this a bran poultice, contained in a bag, and confined by 

 a surcingle, is the best application. The eschar must slough 

 before the cure can be accomplished ; and this is promoted 

 *by favouring suppuration. There is another way in which 

 fistulous withers may arise — by a small, circumscribed, and 

 fluctuating tumour ; this is more commonly in the middle of 

 the back. Of it I shall speak hereafter. 



Suppuration may result from the tumour becoming 

 active. When the swelling assumes this action little attention 

 is commonly paid to it, but, from lodgment of pus, and 

 neglect, the sore sinks lower and lower, until it degenerates 

 into fistula. Even under judicious management an ulcer 

 upon the spine is often troublesome, and may run into 

 fistula; though, in general, fistula has an inward origin. 

 Matter once generated underneath the fascia and liga- 

 mentous substance entering into the composition of the 

 withers, speedily becomes, by the movements of the shoulder, 

 diff'used among the muscles, cartilages, and bones, and forms 

 sinuses in difi'erent directions, some of such depth that 

 our ordinary probes are useless. What renders fistula for- 

 midable in practice is its aff'ecting parts of various textures, 

 and complicated connexions ; to this cause also should be 

 added those parts not only being in continual motion, but 

 more or less influenced by almost every movement of the body. 

 Purulent secretion is kept up from the bottom of the 

 wound, the cleansing of which, together with perfect rest, are 

 two objects to be strictly enforced. 



The Treatment must be conducted on the same prin- 

 ciples as poll-evil. As soon as its suppuration appears fully 



