TREATMENT 137 
is large. This sequel is manifested in two 
ways. In some cases the wound heals every- 
where except at the posterior end, where a 
small fistulous tract remains. Probed it is 
found to be deep. If forceps are introduced 
the slough can usually be taken hold of and 
drawn out. Sometimes the aperture must first 
be enlarged. 
The other manifestation is the appearance 
of a new phlegmonous condition on each side 
of the neck just behind and below the posterior 
end of the wound. The abcess is sometimes 
threatening and unless properly handled may 
end in a new fistulous condition quite difficult 
to handle. The first sign of such a complica- 
tion, which usually occurs at about thirty-five 
to forty days after the operation, must be met 
by making an incision at the posterior end of 
the old wound downward into the abcess cav- 
ity, where a slough of the stump of the liga- 
ment is always awaiting removal. 
It is our practice to make a careful examina- 
tion of the wound at the end of thirty days 
with a view of determining whether or not such 
a slough exists, and to remove it if found. 
Recurrences and Failures 
The failures from the radical operation for 
poll-evil are almost always due to procrastina- 
