ABSCESS. 79 



the pus. There is no object whatever in permitting an acute abscess to go 

 on till it reaches the skin. To do so is simply to allow the formation of a 

 much larger cavity, and the consequent destruction or interference with the 

 tissues in the neighbourhood ; and if it should happen that pus is not found 

 on making the incision after all, the best thing has been done with the view 

 of cutting the inflammation short." But, as Cagny and Gobert wisely 

 remark, '* \A'e should seize the proper moment. Too much haste may imjjede 

 the recovery, and sometimes the swelling may persist after the incision has 

 been made. . We may avoid these troubles if we open the abscess when the 

 fluctuation can be felt in at least two-thirds of the tumour. There are cases 

 when it should be opened early, as, for instance, in deep abscesses in muscles 

 and near joints, and e.speciallV when there is danger of pressure on an im- 

 portant organ, as in the case of an abscess which interferes with the breath- 

 ing." Agreeably to the foregoing remarks, we may treat abscesses according 

 to the following*^ principles: check the formation of pus; remove it Avhen it 

 has formed ; render the cavity healthy ; and encourage the wound to heal. 



PRACTICAL TREATMENT. — ^When an cabscess begins to form, 

 we may try to check its development by the frequent ai^plication of 

 eucalyptus oil, oil of turpentine, or a blister of biniodide of 

 mercury ointment (1 to 8). If pus has collected, ^Ye should, if prac- 

 ticable, treat the abscess under as strict antiseptic precautions as 

 w^e are able to adopt. With this object, we may, by means of an 

 aspirator, remove all the pus by alternately withdrawing fluid and 

 pumping in water ; render the cavity free from putridity by filling 

 it -with an antiseptic solution, preferably, one of hydrogen peroxide 

 (p. 67); and after withdrawing the needle of the aspirator, cover 

 the part with five or six layers of antiseptic cotton wool, over wdiich 

 gutta-percha tissue may be placed, so as to exclude putrefactive 

 germs. This dressing may be kept in its place by a bandage. 

 We can then hope that the part will heal in about a week's time 

 wdthout the formation of any more pus. An aspirator is a form of 

 syringe or pump, provided w^ith a hollow^ needle by means of which 

 fluid can be drawn off from or pumped into a closed cavity, like an 

 abscess, for instance, wdiile preserving the cavity from the 

 admision of air. If we have neither the opportunity nor the ajipli- 

 ances for treating the case according to the foregoing model 

 manner, we may follow it, as nearly as jDossible, by using a syringe 

 instead of an aspirator, after opening the abscess -with the knife. 

 If pus continues to form, though in decreased amount, we may have 

 to w^ash out the cavity by injecting the antiseptic solution (which- 

 ever one we use) at least twice a day, and it may be advisable to fill 

 up the cavity with, antiseptic cotton-wool, wdiich should be changed 

 each tiine the injection is emjD'loyed. A saturated solution of 

 iodoform in ether or in eucalyptus oil might be tried. If these 

 jneans be not sufficient to ensure drainage, we may have to pass a 

 seton through the loAvest point at which fluid collects. Any por- 

 tions of dead bone or other foreign body should be removed ; for 

 if allowed to remain, its presence will probably keep the part in a 



