356 



cut to prevent it from closing pl•enlatul'el5^ It may be taken off the 

 next day, and a daily cleansing will then be all that is necessary. In 

 another case the tumor becomes very soft in its whole extent, with evi- 

 dent fluctuation and a well-defined form. The discharge of the fluid 

 is then indicated, and a free incision will be followed by the escape of 

 a quantity of thin, j^ellowish liquid from a single sac. The irritation 

 of tlie lining membrane with the finger nails, and the introduction 

 of a tent of oakum, as before, but which should be changed every 

 two or three days, during which time the parts should be kept free 

 from suppuration, will inaugurate a speedy change and recovery 

 will soon follow. But if the cavity is found to be subdivided in its 

 interior by numerous bands, and the cyst proves to be multilocular, 

 the j)ai'titioning sacules should be torn out Avith the fingers, and the 

 cavity then treated in the same manner as the single or unilocular 

 sac. Another condition is that when the tumor is warm and has been 

 painful, and has been soft and fluctuating indistinctly^ or only at a 

 given point, the evidence is of an abscess again indicating the use of 

 the knife for a free incision for the exit of the contents, tlie general 

 and first indication in all suppurative collections. 



But cases occur when all the treatment that has been detailed has 

 failed to effect a full recovery, and, instead of closing properly, the 

 cavity has become the seat of granulations other than those of a 

 healthful and benign character, having assumed a new and peculiar 

 form, and appearing in that of a fibrous tumor, quite apt, if not 

 evicted, to constitute a mere eyesore, profitable and pleasing to no 

 one. A change of treatment is of course then in order. The inflam- 

 mation, having a disposition to become chronic, will require stiinulat- 

 ing treatment in order to counteract that tendency by the quickened 

 activity of the process of absorption, and we must again draw upon 

 the resoui'ces of experience in the form of the blisters, the fomenta- 

 tions, the iodine, and the mercurial helps as heretofore mentioned. 

 Good results may always be insured from their judicious and timely 

 administration while combating the aberrations of nature, but little, 

 from them or from any of the allies of the curative art, by their unin- 

 telligent and misdirected emijloyment. In applying the jDowerful 

 mineral inunctions much patience and wisdom are demanded. It 

 should be done by carefully and perseveringly rulibing in small quan- 

 tities daily; it should be done softly and gently, not with force of 

 arms, nor with the expectation of producing an astonishing effect by 

 heavy dosing and main strength in a few hours; it should be after 

 the manner of a siege rather than that of a charge. The object must 

 be to induce the drugs to permeate the affected part until the entire 

 mass is penetrated. Of course cases will be encountered which resist 

 every form of treatment but the last of all (in dealing with external 

 and excessive growths). The tumor remains as a fixed fact; it cor 

 tinues to grow; it is large and pendulous at the elbow; its weight is 



