252 THE NATURE AND TREATMENT OP 



force by which the constituents of blood are transformed into 

 osseous structure, must necessarily be enfeebled by the morbid 

 l^bit, so that the power to produce metamorphoses is necessa- 

 rily diminished. It is my opinion that big-head usually com- 

 mences in the fibrous tissues which are found in the internal 

 surface of bones. A very peculiar feature of these fibrous tu- 

 nics is, that when they once become diseased they run rapidly 

 to purulency ; and this accounts for the large amount of puru- 

 lent matter often found in the cavities of jaw bones, when 

 buried or exposed to a drying process. It is then, however, in 

 a spongy state. 



A very distinguished French writer contends that " fibrous 

 tunics or tissues hardly ever contribute to the formation of 

 pus." This is evidently an error ; for when the periosteum, — 

 covering of bones, — which covers the fang of a tooth, and 

 gives a lining to the cavity into which it is inserted, becomes 

 inflamed, it suppurates, and the tooth has to be removed. I 

 contend that it is the most common tissue, that excites the flow 

 of those exudations from arterial capillaries, which becomes 

 converted into pus ; hence in this way I account for the col- 

 lections of pus often found on and under fibrous ligamentary 

 tissues, and coverings of muscles, also upon and beneath the 

 periosteum, and in the vicinity of fibrous tissues in other parts 

 of the -system. 



The surgical treatment of a case of this kind, is to liberate 

 the pent-up pus or matter. "With this object in view I cast the 

 subject, and after having brought him under the influence of 

 ether, I make an incision through the integuments, etc., and 

 expose the bone ; then by means of a pair of common bone 

 forceps, I make an opening into the same, liberate the impris- 

 oned matter, and inject the cavity with pryroligneous acid. 

 Having removed as much as possible of the morbid matter, I 

 then cram the cavity with equal parts of powdered bloodroot 

 and bayberry bark. The external wound must not be closed 

 by suture, but left open so as to allow of a free discharge from 

 the parts, for the healing process must begin at the upper part 

 of the cavity, and the integument should be the last to heal. 



