390 Veierhiary Medicine. 



In case of abscess advancing forward, a doughy, painful swelling 

 may show in the right or left jugular furrow. A previous chill 

 may have suggested the formation of abscess, and a similar oc- 

 currence with spreading tenderness over the chest or abdomen 

 may indicate the escape of pus into one of these cavities. As 

 cases of this kind in solipeds are usually an irregular form of 

 strangles, the earlier symptoms of this affection throw light on 

 the true nature of the later lesion. 



Treatment is eminently unsatisfactory. It must be directed to 

 control and limit the primary disease and thus ward off the more 

 dangerous sequel. In strangles the securing of an early matura- 

 tion and free discharge of the intermaxillary or pharyngeal ab- 

 scess will do much to ward off such complications as we are con- 

 sidering. When mediastinitis has set in it may be treated like 

 pleurisy or pericarditis-, but less hopefully ; when empyema or 

 suppurative pericarditis is discovered, drainage and antisepsis 

 will be in order. When an abscess points at the lower part of 

 the jugular furrow we must favor its maturation, open as early 

 as permissible and treat the sac antiseptically. 



When the mediastinal exudate has become organized and 

 presses on important organs nothing can arrest its progress nor 

 relieve the organs from pressure. 



NEOPLASMS OF THE MEDIASTINUM. 



The respiratory, nervous, circulatory and digestive disorders 

 that result from inflammation of the mediastinum are still more 

 common as the result of new growths in this situation. 



Fibroid degeneration (sclerosis) of the lymph glands may 

 be set down as the simplest of such conditions. Under the in- 

 fluence of some irritant, often ptomaines or toxins from a dis- 

 eased lung, bronchium, pericardium or pleura, the lymph glands 

 become congested and gradually hypertrophied. At first of a 

 more or less vivid red, they become gradually pale, firm, and 

 hard, the fibrous elements of the gland increasing in thickness, 

 and the inflammatory exudate becoming organized into fibrous 

 tissue, thereby causing compression and even atrophy of the 

 gland tissue. When the afferent trunks bring not only toxic 

 matters but also pus cocci, numbers of small abscesses, miliary 



