TREATMENT OF SHOULDER ABSCESS. 
2*31 
A pointed bistoury, with its cutting edge directed upwards, is inseited 
from 2 to 8 inches. The pus usually then discharges; but if not, the 
finger is introduced, the fluctuation localised, and the wall of the abscess 
divided with either knife or finger. After discharge of the pus, the 
swelling should be laid open in its entire length, if possible, by a vertical 
incision, thus completely exposing the cavity of the abscess, which is then 
freely curetted. Bleeding may be checked by means of tampons, and 
single vessels ligatured. 
To promote dispersal of the swelling, moist warm applications, wetted 
from time to time with hot water, are employed for eight to fourteen 
days ; they are kept in position with a cloth doubled two or three times, 
and fastened to the neck by a bandage. Jacobs punctured the abscess 
with a trochar, and injected 2 per cent, lysol solution, followed by Lugol s 
solution of iodine. In one case the abscess could not be found. 
Lugol’s solution was injected three times in eight days, and healing 
occurred. Schmidt recently recommended the injection into the swelling 
of a saturated solution of common salt. Active suppuration and per¬ 
foration are said to follow; but a case treated in this way by Schilling 
soon afterwards died from gangrene. Injection of common salt certainly 
hastens suppuration, especially if not sterilised, but as it possesses the 
disadvantage of exposing the animal to grave infection the use of the 
knife is always preferable. 
Where these abscesses have existed for several weeks, and contain no 
large cavity, extirpation becomes necessary. This may be either (1) 
partial, which is only adopted where no sharp margin divides the swell¬ 
ing from the sound textures, and is seldom ineffectual; or (2) total, which 
is specially indicated when the duration of the case has been considerable, 
and there is hence no prospect of reabsorption of swelling aftei opening. 
In most cases free opening of the abscess cavity is sufficient, as above 
mentioned. In old growths as much as possible of the anterior part 
should be removed. Some operators practise local anaesthesia by Sleicli s 
method (see Dollar’s “ Operative Technique ”) ; Malkmus applies a twitch 
and the hippo-lasso. Bayer recommends strict antiseptic precautions, 
and after carefully curetting and disinfecting the abscess cavity applies a 
dressing which is fixed to the button sutures used to close the wound. 
Malkmus has shown that these excessive precautions are unnecessary, 
and that by using interrupted sutures, inserting a drainage-tube, and 
dressing with glutol, the same end is attained. He also insists, however, 
on the importance of curetting the cavity and of observing antiseptic 
precautions. The horse is afterwards kept for a fortnight, on the pillar 
reins, and if great swelling occurs the parts are kept moist with 3 per 
cent, solution of acetate of alumina. If the covering of glutol separates 
from the surface of the wound it is renewed ; in a week the drainage-tube 
