ABSCESS. 79 



it should happen that pus is not found on making the incision after all, the 

 best thing has been done with the view of cutting the inflammation short." 

 But we should seize the proper moment. Too much haste may impede 

 the recovery, and sometimes the swelling may persist after the incision has 

 been made. We may avoid these troubles if we open the abscess when the 

 fluctuation can be felt in at least two-thirds of the tumour. There aiie cases 

 when it should be opened early, as, for instance, in deep abscesses in 

 muscles and near joints, and especially when there is danger of pressure on 

 an important organ, as in the case of an abscess which interferes with the 

 breathing. Agreeably to the foregoing remarks, we may treat abscesses 

 according to the following principles : check the formation of pus ; remove 

 it when it has formed ; render the cavity healthy ; and encourage the wound 

 to heal. 



PRACTICAL TREATMENT.— When an abscess begins to form, 

 its development should be checked, if possible, by the frequent 

 apphcation of eucalyptus oil, oil of turpentine, or a blister of 

 biniodide of mercury ointment (1 to 8). If pus has collected, the 

 abscess should, if practicable, be treated under the strictest 

 antiseptic precautions. With this object, by means of an aspirator, 

 all the pus may be removed by alternately withdrawing fluid and 

 pumping in water ; render the cavity free from putridity by filling 

 it with an antiseptic solution, preferably, one of hydrogen 

 peroxide (p. 67) ; and after withdrawing the needle of the aspirator, 

 cover the part with five or six layers of antiseptic cotton-wool, 

 over which gutta-percha tissue may be placed, so as to exclude 

 putrefactive germ^s. This dressing may be kept in its place by a 

 bandage. The part will probably heal in about a week's time 

 without the formation of any more pus. An aspirator is a form 

 of syringe or pump, provided with a hollow needle by means of 

 which fluid can be drawn off from or pumped into a closed cavity, 

 like an abscess, for instance, while preserving the cavity from 

 the admission of air. Given neither the opportunity nor the 

 appliances for treating the case according to the foregoing model 

 manner, follow it, as nearly as possible, by using a syringe instead 

 of an aspirator, after opening the abscess with the knife. If pus 

 continues to form, though in decreased amount, wash out the 

 cavity by injecting the antiseptic solution (whichever one we use) 

 at least twice a day, and it may be advisable to fill up the cavity 

 with antiseptic cotton-wool, which should be changed each time 

 the injection is employed. A saturated solution of iodoform in 

 ether or in eucalyptus oil might be tried. If these means be not 

 sufficient to ensure drainage, it may be necessary to pass a seton 

 through the lowest point at which fluid collects. Any portions 

 of dead bone or other foreign body should be removed ; if allowed 

 to remain, its presence will probably keep the part in a suppurating 

 condition. If the abscess assumes a sluggish course, it will 



