134 FISTULA AND POLL-EVIL 
one side than from the other. Sometimes in 
misdirected plunges of the scalpel into the poll 
the ligament may all be left on one side, some- 
times two-thirds is on one side and one-third 
on the other, ete. And again, if the incision 
was not made straight there may be more liga- 
ment anteriorly than posteriorly on a given 
side. These are points to keep in mind at all 
times. The point is to remove all of it along 
the affected zone, but no more than is necessary 
posteriorly. ar 
Packing and Suturing. Third Step—The 
wound is now wadded with a hemostatic pack 
of oakum and sutured securely. We make no 
attempt to wad the cavity so very tight posteri- 
orly on account of the danger of spinal pres- 
sure, although it must be well filled. The ob- 
ject in making a safe hemostatic pack for poll- 
evil is to distribute the pressure evenly over 
the whole cavity. That is, severe pressure from 
hard lumps of the oakum must be avoided, es- 
pecially at the posterior end of the wound. 
‘When the patient is standing again the poll 
and bloody neck are washed off with liberal 
ablutions of water and then the poll is covered 
with a layer of oakum or cotton soaked in mer- 
euric chlorid solution and this is held in place 
with a hood made from muslin or common bur- 
lap. 
