IHB SKIN. 239 



larging. The pain may at this time subside somewhat, the stiffness 

 disappear, but the swelling continues and increases in size. It fluctu- 

 ates upon pressure, and either opens or its contents become inspissated, 

 dry up, leaving a tumor that gradually develops the common character- 

 istics of a fibrous tumor. When the enlargement has opened we should 

 carefully examine its cavity, as on its condition will wholly depend our 

 treatment. 



Treatment. In the earliest stages, when there is soreness, enlarged 

 lymphatics, but no well-marked swelling, the trouble may be frequently 

 aborted. To do this requires both general and local treatment. A 

 physic should be given, and the horse receives one ounce of powdered 

 saltpeter three times a day in his water or feed. If the fever runs high, 

 twenty drop doses of tincture of aconite root every two hours may be 

 administered. lyocally we will find much relief by pouring cold water 

 from a height upon the inflamed spot for an hour at a time three or 

 four times a day. Cooling lotions, muriate of ammonia, or saltpeter and 

 water, sedative washes, as tincture of opium and aconite, cloroform lini- 

 ment, or camporated oil are also to be frequently applied. I have seen 

 a number of cases presenting these initial symptoms of fistula thus 

 aborted that required no other treatment than the avoidance of the orig- 

 inal cause. 



When, however, the formation of pus is inevitable, this must be hur- 

 ried as much as possible. Hot fomentations and poultices are to be con- 

 stantly used, and as soon as fluctuation can be plainly felt the abscess 

 wall is to be opened at its lowest point. In this procedure lies our hope 

 of a speedy cure. If the parts are so laid open by the knife that the 

 pus must escape as fast as it is formed, and where there is left no possi- 

 bility of its burrowing between the muscles, forming pockets or sinuses, 

 the parts rapidly and permanently heal without any mediation whatever, 

 as though we had been dealing with a simple abscess of the withers, and 

 not a true fistula at all. 



Attention is again called to the foregoing directions to the necessity 

 of probing the cavity when opened. If upon a careful examination with 

 the probe we find that there are no pockets, no sinuses, but a simple, 

 regular abscess wall, the indication for treatment is to make an opening 

 from below so that the matter must all escape. Rarely is anything more 

 needed than to keep the orifice open and to bathe or inject the parts 

 with some simple antiseptic wash that is not irritant or caustic. A low 

 opening and cleanliness constitute the essential and rational treatment. 



