The Neck. 483. 



the latter are cut, they will retract and thus give vent to the 

 flow of blood. Tubercular glands. The best incision for 

 the removal of these glands in the upper part of the an- 

 terior triangle is a transverse one, which crosses the neck 

 in the crease just over the cornu of the hyoid bone. A sim- 

 ilar transverse incision should be employed in the lower 

 part of the posterior triangle, but in the other parts of the 

 neck it should be directed obliquely, i.e., in the direction of 

 the fibres of the sterno-mastoid muscle. While the re- 

 moval of newt-adherent glands is oftentimes a compar- 

 atively simple matter, yet the majority o*f cases in which 

 operative work is undertaken, present glands, which, from 

 inflammatory processes, have become adherent to the ad- 

 jacent structures, especially the veins, and hence the sur- 

 geon, who is not thoroughly conversant with his anatomy,, 

 should not undertake this operation, since it is 

 not a case of "cut and tie." So many structures are 

 grouped within a comparatively limited area in the neck, 

 that important nerves such as the spinal accessory, pneu- 

 mogastric, phrenic, etc., may be severed, or veins, which 

 in this condition are often enlarged, wounded, with the 

 possibility, among other dangers, of the admission of air 

 into the circulation. Cervical Abscesses. In opening 

 these, Hilton's method, already referred to when dealing 

 with axillary abscess, should be employed, and the forceps 

 should be inserted in a direction, as far as possible, away 

 from important structures. Souchon advises graduated 

 dilatation by means of canulae, gradually increasing in 

 size. Parotid Abscess. The opening to relieve this con- 

 dition should be carefully made, because of the number of 

 important structures in relation to the gland, thus we 

 have: The external carotid, giving off its terminal 

 branches ; the trunk, formed by the temporal and internal 

 maxillary veins ; the facial nerve ; the auriculo- temporal and 



