LYMPH EXTRAY AS ATE. 
I 
845 
tive tissue. The etiology is essentially the same as previously 
described (which was written in 1880). Doubt respecting di¬ 
agnosis can hardly be entertained, when these symptoms and 
history are considered ; at first the small size, however, may 
be a factor of indecision, but from the character of continually 
increasing, this is not a permanent hindrance. The principal 
diagnostic sign is the latter history, together with the fact 
that the cavity is never completely filled. By gently tapping 
the swelling with the finger, a species ol quivering is estab¬ 
lished. Shortly after the separation the skin loses its elas¬ 
ticity and sensibility, and since its blood supply has been per¬ 
ceptibly diminished, it is predisposed to gangrene. In gen¬ 
eral the prognosis is favorable if the case comes under correct 
handling. Suppuration seldom appears, but when a portion 
of the skin becomes gangrenous and falls away, then the pro¬ 
cess is a protracted one and tedious. The therapy consists in 
energetic surgery ; in small enlargements elastic bandages 
generally succeed in eight or ten days. In the most cases, 
broad incision, antiseptic washing and bandaging alone suc¬ 
ceed. The following is an account of a typical case. Horse 
used for riding purposes; in the afternoon a swelling the size 
of one’s hand was observed, which towards evening became 
larger and caused the owner to send the animal to the college- 
Status prczsens: The general health is good, no pyrexia or 
lameness, but the wounded limb somewhat extended forward. 
On the exterior of the right thigh is to be seen a swelling one 
inch high, and extending over a space as large as a medium 
sized dinner plate ; the swelling is not uniform, but bags in¬ 
teriorly, giving a more bulging appearance to this portion ; 
the same is soft and fluctuating, and upon the skin no wound 
or loss of hair is visible. The history developed the fact that 
while being brought to the riding floor, the patient had slip¬ 
ped and afterward slid some -distance, but immediately rose 
to his feet, and shortly after went through with his exercise ; 
nothing abnormal was observed until afternoon. Upon first 
seeing the subject my opinion was that the collection pro¬ 
ceeded from a large blood vessel, and therefore declined to 
incise it, but ordered cold fomentations. Through the canula 
