CHAPTER VI 

 ABSCESS, CYST, SINUS, FISTULA, AND POLYPUS 



Abscess. 



Definition. — An abscess may be defined as a circumscribed 

 area containing pus. It may occur in any part of the body, 

 and is a common sequel to a violent blow or to the intro- 

 duction of some foreign body, such as a needle, fish-bone, 

 piece of wood, etc. 



Symptoms. — With an ordinary abscess there is a good 

 deal of heat and tenderness on pressure ; this is followed by 

 a swelling which is soft on palpation, fluctuating, and less 

 painful. If not interfered with, this occasionally becomes 

 absorbed, but it is much more likely to burst and leave a 

 nasty jagged wound. 



A ' cold ' or ' chronic ' abscess is also met with, the en- 

 capsuled pus being surrounded by very much thickened 

 walls, and the exterior may or may not be painful on 

 pressure. 



The surgeon must be careful not to confound it with a 

 hernia or a cyst. The introduction of a knife into the former 

 w^ould be especially serious if the operator was not prepared 

 for such a contingency. 



Treatment. — Hot fomentations or poultices, with sedative 

 lotions to ease the pain, should be applied until the swelling 

 is ready for operative interference. When just ripe the abscess 

 should be lanced in its softest and most dependent part, the 



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