WINDGALL. 289 



tumour : assigning as his reason, that the fluid ought to be forced 

 out by pressure rather than be suffered to run out of itself, and that, 

 as soon as it be all pressed out, great care ought to be taken to 

 close the wound, and to keep applied for some days a compress and 

 bandage upon it, with the addition, if we like, of some discutient 

 lotion. He objects to the aperture being made beneath, because 

 the fluid would then run away by itself and prevent any healing, 

 and so might cause it to become fistulous. 



A Seton, passed from an aperture above through to one below, 

 or from side to side, would certainly have the effect of giving vent 

 to the discharge as it became secreted ; but, exposing to the air 

 and creating suppurative action in such a joint-like cavity as a 

 bursa, we regard as highly objectionable and dangerous practice : 

 we have known the worst of consequences ensue from it, and we 

 have, on that account, for some considerable time past, abandoned 

 all thoughts of setoning synovial structures. 



Should it happen, after the discharge of the fluid, that the 

 wound made by the instrument heals forthwith, fresh secretion 

 will be certain to be poured out, and the sac to become re-filled. 

 More commonly, however, it happens that the secreted fluid con- 

 tinues, in part, to find escape for a few days through the puncture, 

 in the course of which time inflammation sets in and closes up the 

 opening : the only danger being now that of greater inflammatory 

 action and swelling following than is agreeable either to our patient 

 or to ourselves. Antiphlogistic treatment, constitutional as well as 

 topical, will, of course, in such a case be called for to a given 

 extent; the object being, not to drive away the inflammatory 

 action, but to keep it within such limits as shall conduce to the 

 end we have in view ; viz. the eff'usion of lymph into the sac, 

 instead of pus, and through that of the adhesion of its sides and 

 ultimate obliteration of its cavity. On the other hand, should it 

 so happen that the inflammation is insufficient for the object we 

 have in view, we have it in our power to augment it in the part 

 either by some external application or by some stimulant or es- 

 charotic injection. All this, however, as well as the other points 

 of treatment, will have to be more defined and detailed when we 

 come to treat of individual windgalls. 



VOL. IV. pp 



