116 FISTULA AND POLL-EVIL 
stubbornly attached, and carpeted here and 
there with dormant granulations it prevents 
cicatrization of the abscess cavity. It is this 
stubborn viability of the ligamentum nuche 
that is responsible for the chronicity of poll- 
evil. 
This stage, like that of fistula of the with- 
ers, continues indefinitely, healing at one place 
and bursting at another and all of the while 
transforming the muscles into fibrous tissue. 
The inflammatory process extends into the per- 
iosteum of the atlas, into the capsule of the oc- 
cipito-atlantoid articulation, into the meninges 
and brain, into the neural canal and into the 
spinal cord, producing the variety of compli- 
cations for which poll-evil is known. 
An old poll-evil left to sojourn unmolested 
or one indifferently treated usually exhibits 
the following morbid states: a tumefied poll, 
one or more apertures discharging pus, scars 
of previous apertures, encrustations of dried 
pus matted into the mane and surrounding 
hairs, extended head from fibrous anchylosis 
of the occipito-atlantoid articulation and a wab- 
bly gait that becomes more and more accentu- 
ated until the patient is unable to rise. See: 
tioned, the poll is found to have been trans- 
formed into a mass of hard, fibrous tissue, 
which fuses all of the component structures in- 
