I have so lately given elsewhere a detailed account of the method
by which this is effected (Lancet, July 27th, 1867), that I shall
not enter into it at present further than to say that the means
employed are the same as those described above for the
superficial dressing of compound fractures; viz., a piece of rag
dipped into the solution of carbolic add in oil to serve as an
antiseptic curtain, under cover of which the abscess is evacuated
by free incision, and the antiseptic paste to guard against
decomposition occurring in the stream of pus that flows out
beneath it; the dressing being changed daily until the sinus is
closed.
The most remarkable results of this practice in a pathological
point of view have been afforded by cases where the formation of
pus depended on disease of bone. Here the abscesses, instead of
forming exceptions to the general class in the obstinacy of the
suppuration, have resembled the rest in yielding in a few days
only a trifling discharge, and frequently the production of pus
has ceased from the moment of the evacuation of the original
contents. Hence it appears that caries, when no longer labouring
as heretofore under the irritation of decomposing matter, ceases
to be an opprobrium of surgery, and recovers like other
inflammatory affections. In the publication before alluded to, I
have mentioned the case of a middle-aged man with a psoas abscess
depending in diseased bone, in whom the sinus finally closed
after months of patient perseverance with the antiseptic
treatment. Since that article was written I have had another
instance of abscess equally gratifying, but the differing in the
circumstance that the disease and the recovery were more rapid in
their course. The patient was a blacksmith, who had suffered four
and a half months before I saw him from symptoms of ulceration of
cartilage in the left elbow. These had latterly increased in
severity so as to deprive him entirely of his night's rest and of
appetite. I found the region of the elbow greatly swollen, and on
careful examination found a fluctuating point at the outer aspect
of the articulation. I opened it on the antiseptic principle, the
incision evidently penetrating to the joint, giving exit to a few
drachms of pus. The medical gentleman under whose care he was
(Dr. Macgregor, of Glasgow) supervised the daily dressing with
the carbolic acid paste till the patient went to spend two or
three weeks at the coast, when his wife was entrusted with it.
Just two months after I opened the abscess, he called to show me
the limb, stating that the discharge had been, for at least two
weeks, as little as it was then, a trifling moisture upon the
paste, such as might be accounted for by the little sore caused
by the incision. On applying a probe guarded with an antiseptic
rag, I found that the sinus was soundly closed, while the limb
was free from swelling or tenderness; and, although he had not
attempted to exercise it much, the joint could already be moved
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