_Treatment._--When suppuration ensues, the stitches should be removed, the wound opened up and purified with eusol, and packed. A dressing of ichthyol and glycerine should be employed for a few days. _Erysipelas of the scalp_ may originate even in wounds so trivial as to be almost invisible, or from suppurative processes in the region of the frontal sinuses or nasal fossæ. It tends to be limited by the attachments of deep fasciæ, and seldom spreads to the cheek or neck. Symptoms of cerebral complications, in the form of delirium or coma, and of meningitis may supervene. Cellulitis beneath the aponeurosis from mixed infection is a dangerous complication. DISEASES OF THE SCALP #Infective Conditions.#--It is not uncommon for _localised abscesses_ to occur in the subcutaneous cellular tissue in delicate children, and such collections are not infrequently associated with pediculi, impetigo, or chronic dermatitis. They develop slowly and painlessly, and are only covered by a thin, bluish pellicle of skin. It is not improbable that they result from a mixed infection by pyogenic and tuberculous organisms. As a rule they heal quickly after incision and drainage, but when they are allowed to burst, tedious superficial ulcers may form. Localised abscesses may also form in connection with disease of the cranial bones. _Suppuration_ following upon injuries has already been referred to. _Boils and carbuncles_ are not common on the hairy part of the scalp. _Lupus_ rarely originates on the scalp, although it may spread thither from the face. _Syphilitic_ lesions are common and present the same characters as elsewhere. Gummata may develop in the soft parts, but more commonly they take origin in the pericranium or bone. _Eczema capitis_ is of surgical importance only in so far as it often forms the starting-point of infection of lymph glands by pyogenic and other organisms. #Cystic and Solid Tumours.#--A great variety of swellings is met with in the scalp. _Sebaceous cysts_ or _wens_ are of frequent occurrence, and have been described in Volume I. A _dermoid cyst_ is most commonly situated over the position of the anterior fontanelle, in the region of the occipital protuberance, or at the lateral angle of the orbit. As it frequently lies in a gap in the skull, it may be connected by a pedicle with the dura mater, and is liable to be mistaken for a meningocele. [Illustration: FIG. 177.--Multiple Wens. (Photograph lent by Sir George T. Beatson.)] _Serous cysts_ are occasionally found in the occipital region, and are believed to be meningoceles that have become shut off from the interior of the skull before birth.