CASE or IRREGULAR STRANGLES. 
497 
opinion, that they “ hasten suppuration ” in strangles. 
Theoretically speaking, something may be urged in their 
favour ; but we must not forget that matter will not form 
locally, unless the proper stage of constitutional fever have 
been attained. The local abscess depends upon, and is 
associated with co-existing states of the system. Strangles, 
in fact, seems to be an exanthematous disease, and betrays, 
accordingly, its periods of accession, crisis, and decline. The 
formation of “ healthy pus, ’* too, is a process of regular 
organic growth. Pus cells, and their liquor puris, are not 
dependent on the mere intensity or rapidity of inflammation 
for proper development ; for in a regularly advancing 
phlegmonous tumour under the management of nature 
herself, and owing its increase to peculiar states and resources 
of the system, matter will form as well, and perhaps as 
rapidly, as when a blister is applied over the expected seat of 
suppuration. We have, indeed, seen not a few cases in which 
the tumour receded after being blistered. The artificial 
irritant was too foreign or too severe to effect its desired 
purpose. 
When the tumour advances steadily and naturally, a 
healthy suppuration and subsequent cure are almost always 
uniform, and certain results, provided the patient be judiciously 
nursed and well supported ; here, then, it is difficult to find 
an imperfection on the part of nature which any blister can 
obviate. On the other hand, wdien the tumour succeeds the 
catarrhal symptoms unusually late, or advances slowly and 
imperfectly, and the patient wastes rapidly, instead of feed- 
ing, I do not think that any topical application can “ hasten 
suppuration” as well as very hot water cloths properly 
attached over the swelling, and continually kept at a tempera- 
ture many degrees higher than the body. Hot water dressing 
is grateful, does not irritate, favours exudation, is easily 
applied, and (unlike a filthy blister) is easily removed ; so 
that we can feel the tumour as often as we please without 
inflicting pain. I have generally noticed that the tumour 
suppurates most freely and speedily when the patient drinks 
or eats tolerably well. One now and then meets with cases 
where a blister is applied almost every day in order to “hasten 
the abscess,” instead of doing which it prevents feeding, in- 
duces weakness, and defeats its intended end. On bathing the 
part for a few hours, external soreness is removed, and the 
patient often inclines to eat. In point of fact, the moving 
jaws, external heat with moisture, and increasing strength 
combined, do truly “ hasten suppuration.” 
XXVII. 
65 
