TREATMENT 91 
aperture through muscle tissue does not drain 
in the surgical sense. Such an aperture leaks 
pus but does not drain the cavity dry enough 
to serve the purpose for which drainage is 
needed. It does not matter how many drain- 
age incisions are made through muscle tissue, 
the cavity would still overflow unless the aper- 
tures are held wide open with a tube. The 
same may be said of setons. While pus is ab- 
sorbed by them (in very limited quantities) 
they do not empty the cavity and are, there- 
fore, worthless. To heal a wound as large as 
the one required to expose the diseased part of 
a fistula of the withers, it is essential that it be 
kept free from accumulations of its secretions. 
Accidents and Sequelae 
Septicemia is the commonest sequel of the 
operation. It is predisposed by enfeebled 
states of the patients but can often be traced 
to badly directed surgical work. Failure to 
obey the common laws of modern surgery as 
regards asepsis is always disastrous in opera- 
tions of this magnitude, and since this one is 
performed often in a pus ridden region, dirty 
internally and externally, and must often be 
done where conditions are none too favorable, 
the operation exacts its full toll of fatality 
