ON THE ANTISEPTIC PRINCIPLES 279 



in the stream of pus that flows out beneath it; the dressing 

 being changed daily until the sinus is closed. 



The most remarkable results of this practice in a patho- 

 logical point of view have been afforded by cases where 

 the formation of pus depended on disease of bone. Here 

 the abscesses, instead of forming exceptions to the gen- 

 eral class in the obstinacy of the suppuration, have resem- 

 bled the rest in yielding in a few days only a trifling dis- 

 charge, and frequently the production of pus has ceased 

 from the moment of the evacuation of the original contents. 

 Hence it appears that caries, when no longer labouring as 

 heretofore under the irritation of decomposing matter, 

 ceases to be an opprobrium of surgery, and recovers like 

 other inflammatory affections. In the publication before 

 alluded to, I have mentioned the case of a middle-aged man 

 with a psoas abscess depending in diseased bone, in whom 

 the sinus finally closed after months of patient persever- 

 ance with the antiseptic treatment. Since that article was 

 written I have had another instance of abscess equally grat- 

 ifying, but the differing in the circumstance that the disease 

 and the recovery were more rapid in their course. The 

 patient was a blacksmith, who had suffered four and a half 

 months before I saw him from symptoms of ulceration of 

 cartilage in the left elbow. These had latterly increased in 

 severity so as to deprive him entirely of his night's rest and 

 of appetite. I found the region of the elbow greatly swol- 

 len, and on careful examination found a fluctuating point at 

 the outer aspect of the articulation. I opened it on the an- 

 tiseptic principle, the incision evidently penetrating to the 

 joint, giving exit to a few drachms of pus. The medical 

 gentleman under whose care he was (Dr. Macgregor, of 

 Glasgow) supervised the daily dressing with the carbolic 

 acid paste till the patient went to spend two or three weeks 

 at the coast, when his wife was entrusted with it. Just two 

 months after I opened the abscess, he called to show me the 

 limb, stating that the discharge had been, for at least two 

 weeks, as little as it was then, a trifling moisture upon the 

 paste, such as might be accounted for by the little sore 

 caused by the incision. On applying a probe guarded with 

 an antiseptic rag, I found that the sinus was soundly closed, 



