ABLATION OP SHOE-BOILS 



433 



and protection against further injury is' usually successful, 

 but after the growth has hardened and the sac has been 

 almost obliterated by encroachment of the hypertrophied 

 tissue, the deformity will persist despite any kind of palliative 

 treatment. A hardened shoe-boil may diminish in size by ac- 

 cidentally escaping injury for a long time or from the constant 

 protection of a "shoe-boil roll," or by preventing de- 

 cumbency ; but a part of the growth- always remains, ever 

 ready to suddenly enlarge under the least provocation until 

 ablation is practiced. 



Fig. 222— Typical Specimen of Shoe-Boil. 



While a shoe-boil is undergoing transformation from a 

 temporary soft enlargement to a permanent hardened body, 

 the wisdom of radical intervention may be doubtful, since 

 so many of them disappear from simple treatment ; but as 

 soon as the permanency of the growth is established beyond 

 doubt, ablation may be insisted upon as positively the only 

 cure. 



RESTRAINT. — The operation can be successfully per- 

 formed only in the recumbent position, and for the ablation 

 of the larger specimens general anaesthesia is advisable. Ex- 



