ON ABSCESS. 
323 
cellular membrane, and is suffered to run on, or should resist 
the means that may be used to subdue it, that inflammation may 
be expected to be productive of abscess. The first effect of the 
inflammatory action is the effusion of adhesive matter, infil¬ 
trated with serum ; hence the swelling, solidity, doughy feel, 
heat, and tenderness of the part. This semi-solid deposition 
becomes the nidus for the purulent matter, which first makes 
its appearance in the very centre of the tumour, being there de¬ 
posited by the mouths of those bloodvessels that so recently 
effused the lymph or adhesive matter, but which now, from some 
unaccountable change of function, secrete pus . The purulent 
matter accumulating, presses against the sides of the solid matter 
inclosing it, and thereby occasions the absorption of the latter ; 
in which way a cavity is formed, growing hourly larger and 
larger until the firm and solid tumour is transformed into a soft 
and compressible one, which the touch of the practitioner recog¬ 
nises to be an abscess. 
According to a general law of pathology (unless the nature of 
the case be such as to render it inexpedient or impossible), all 
abscesses make their way by absorption to the surface of the 
body, in order to evacuate their contents externally: a notable 
and admirable exception to this, however, presents itself in the 
case of an internal abscess breaking into the alimentary canal, 
or air passages, and yet the same end is obtained, viz. that of 
external evacuation. As soon as the purulent matter has arrived 
underneath the skin, the tumour becomes conical or circum¬ 
scribed, and soft and fluctuating : thepart is said to ha \e festered, 
and to be now ripe, or fit for evacuation. At this stage, should 
no surgical means be used, the part of the skin which feels 
softest, and which is commonly the most prominent spot in the 
tumour, and is further indicated by a separation or actual loss of 
hair, will continue to grow thinner and thinner, in medical lan¬ 
guage to point, until it at length bursts from the pressure of the 
matter against it, and the abscess is said to break . 
I know of no case in which it is not advisable to open an 
abscess rather than suffer it to break; and as a general rule it 
is good practice to give vent to the matter as soon, or very soon 
after, it has manifested its presence. During the formation of an 
abscess, we make use of emollient means, fomentations and 
poultices, to encourage the process ; or we endeavour, by what we 
term discutients, to disperse the tumour by producing a re¬ 
absorption of the matter deposited into the system ; it being now 
admitted by pathologists that repelling matter back from whence 
it came is nowise dangerous to the animal body: or, thirdly, we 
apply stimulants to the tumour, such as blisters, which some- 
