DISEASES OF THE LATERAL CARTILAGES 343 



products within, and at the same time paves the way for 

 operative measures which may be necessary later on. 



With the breaking of the abscess and the discharging of 

 its contents, we may in some measure ascertain the con- 

 dition we have to deal with. The probe is used, and the 

 abscess cavity explored. The size of the wound, its depth 

 below the upper margin of the wall, the structures involved, 

 and other information, may be thus obtained. 



At first, however, the nature of the wound, and the 

 character of the discharges, must largely guide us as to 

 the treatment we adopt. In many cases, even where the 

 abscess cavity is far below the upper margin of the wall. 

 and is presumably in an unfit position to drain and heal, a 

 regular application of an astringent and antiseptic dress- 

 ing is sufficient to bring about resolution. If, however, the 

 discharge from the wound continues to be liquid, and the 

 wound itself at one spot refuses to heal, it may be judged 

 that a portion of necrotic tissue is situated under the wall, 

 and affecting the laminae, the cartilage, or ligament, as the 

 case may be. If this is so, then operative measures must 

 be determined on (see Removal of the Wall, p. 349). 



Blisters. — Instead of the poultice and hot baths, the 

 pointing of the abscess and the casting off of the slough 

 may be brought about by the application of a sharp can- 

 tharides blister. We have, in fact, seen many cases where 

 this treatment was adopted prior to the formation of a 

 fistula, and also in cases where one or more fistulous open- 

 ings already existed, where repeated blisters to the coronet 

 have alone been sufficient to effect a cure. 



We are bound to admit, however, that the treatments of 

 poulticing and blistering are only expectant — we might 

 almost say empirical. At any rate, we admit to ourselves 

 that what we have advised and carried out is not in itself 

 curative, but only a means of assisting Xature to satisfac- 

 torily work her own ends. Empirical or not, however, we 

 believe that in every case of quittor it is wise in practice to 

 at first adopt some such simple measure, for in nearly even- 

 instance where operative measures are practised, the patient 



