SPECIAL INJURIES OE BONES. .tf§ 



hinvi the joint between the upper and lower iaw, with a hard 

 object to be i^ix. at the Dottom. Their extraction can only be 

 undertaken by one intimately acquainted with the parts. 



POLL EVIL. 



This is of two kinds: ist, A simple abscess, the result of a 

 blow or other local injury, and which is only serious because 

 of the strong enveloping fibrous membranes that imprison the 

 matter beneath them ; and 2d, disease of the joint between the 

 head and the first bone of the neck, or between the first two 

 bones. The first, if unrelieved, will usually give rise to the 

 second, since the surface of the bones becomes the seat of 

 disease which gradually extends to and involves the joint. The 

 milder form may be distinguished by the superficial position of 

 the swelling and fluctuation, and by the comparative freedom 

 and ease with which the head is moved, whereas in the other 

 the head is carried very stiffly and cannot be moved on the neck 

 without extreme suffering. 



Treatment. — When seen early with only a slight inflammatory 

 swelling behind the poll and no fluctuation, purge and keep a 

 cooling lotion (tincture of arnica 2 oz., iodide of potassium i 

 dr., vinegar i qt., camomile infusion i qt.), constantly applied 

 to the i^art, the patient at rest, and the head tied up to the 

 rack. If matter has formed and fluctuation is felt, however 

 deep, it must be opened at once. Select the part where fluctua- 

 tion is most marked and plunge a knife into the cavity. Then 

 with a bent probe find the lowest point oi the sac and cut down 

 upon this, making a large opening from which the matter may 

 flow as it forms. A tape should be tied in the wound and the 

 sac syringed out daily with a stimulating wash (chloride of zinc 

 \ dr., water i qt.), until from the disappearance of swelling and 

 matter it becomes evident that the sack is obhterated, when the 

 tape may be cut, pulled half-way out, and left hanging from the 

 lower wound until the upper is closed, when it may be com- 



