324 OPERATION t PREPARATIVES. [BOOK II. 



the fistulous case or cyst before spoken of, which 

 is a film, or skin-like substance, formed of cellular 

 membrane, thickened by the heat of the disorder. 

 (See Book I. Sect. 27.) In this event, the tumour 

 has become decidedly fistulous, and is to be treated 

 as such, when the great length of time it may have 

 been suffered to make head, and its now extended 

 surface, warrant that conclusion. The knife is 

 almost the only remedy, notwithstanding a super- 

 ficial tumour will in some cases break and discharge 

 matter of itself ; this, however, never happens with 

 the deep-seated abscess, which lies close to the 

 bone, and destroys not only it, but the muscular 

 substance of the poll, and the end of the cervical 

 ligament also. In these series of abscess or fistulous 

 tumour, nothing but the knife can ever reach the 

 disorder, and it must be employed fearlessly, but 

 with a commensurate share of skill, after the skin 

 has been prepared with fomentations, &c. Let the 

 parts be softened and drawn with poultice of oat- 

 meal, put on luke-warm twice a day ; and if the 

 effect be not visible to the eye and touch, as before 

 described, increase the powers of the poultice by 

 the addition of onion chopped and mixed with the 

 poultice whilst warm. Or, a mere change may be 

 adopted, and a bread poultice applied instead ; for, 

 notwithstanding oatmeal is stronger, yet have we 

 occasionally found the milder have more effect when 

 the former had not succeeded entirely. The poul- 

 tice should be provided in sufficient quantity to 

 cover the whole swelling two inches thick at least, 



