464 FISTULOUS PAROTID DUCT. 



zinc and water may be used. But when the cartilage that 

 tops the spines is affected, without delay saw it off, leaving 

 a healthy surface of bone. When the sinuses, hkewise, are 

 slit open, to cut from within outwards produces less pain, 

 which in surgery is a consideration. After the incision 

 has been made, lay into the opened sinus some tow, satu- 

 rated in the strong solution of chloride of zinc, the which 

 after twenty-four hours may be removed, and the wound 

 subsequently dressed with the milder lotion. 



Fistulous sternum. — Occasionally the point of the ster- 

 num also becomes so much tumefied by blows or pressure, 

 as to proceed to suppuration ; when here, likewise, a fistu- 

 lous state of the wound is not uncommon. The treatment 

 of this must be regulated by circumstances, but, on surgical 

 principles, must follow the rules laid down for sinuses in 

 general. 



FISTULOUS PAROTID DUCT. 



A fistulous parotid duct presents an unnatural salivary 

 outlet in some parts of its passage. A recent wound of 

 the duct itself will show Uttle more, at first, than the mere 

 opening bedewed with Hmpid moisture, excepting the saliva, 

 which during feeding will pour from the aperture like blood 

 from an artery: the appearance of the opening soon 

 changes, first to ulcerous edges, and at length into the 

 true fistulous ulcer: an old orifice attains an almost car- 

 tilaginous hardness. The salivary fistula may alw^ays be 

 distinguished from any other by the nature and circum- 

 stances of the discharge, which is particularly plentiful after 

 fasting, and will then be forced out in a jetting stream ; at 

 other times it runs down the face. The fluid itself is semi- 

 transparent ; but, not unfrequently, from ulceration in the 

 gland, it becomes tinged with pus, and occasionally stained 

 by a little blood. These cases are usually the conse- 

 quence of either accidental injury, or of abscesses resulting 

 from strangles. The cure was formerly attempted by means 

 of the budding-iron, which fearful agent became a favourite 

 with veterinarians, under the fallacious teaching of Mr. 

 Coleman. The iron was applied at a dull heat, and was 

 tried over and over again, with increased severity. The 

 iron was thought to create an eschar, which acted as a 



