TREATMENT 87 
answer for the after-care, but where the cavity 
was found badly infected or in instances where 
the operation was not a perfectly clean one, it 
is essential that the powder be renewed no less 
frequently than three times a day for the first 
four days. By attending with great care to 
this large wound, the discharges will not be 
abundant, but when the whole area of exposed 
flesh is allowed to become contaminated the is- 
sue is copious. It is, therefore, important to 
pay strict attention to the wound, treating it 
skillfully during the first four days. After 
four days there is less danger of grave infec- 
tions gaining any headway in the wound as 
the tissues are then better protected against 
microbian invasion. 
The drainage tube is managed much like a 
seton. We fasten a spike across one end and 
then pull it through from the other end and 
give the holes and lumen a good cleaning. A 
stylet is needed to dislodge the dried pus that 
chokes it. By bending it about, cleaning its 
holes and ramming a stylet through its lumen 
and then rinsing it well with a strong antisep- 
tic solution, it can be kept perfectly clean and 
open. The next day the same manner of hand- 
ling is repeated except that it is drawn to the 
opposite side. 
Cases having an osseous complication should 
