mon is treated, and we shall at once obtain a clue to what ought to be our general outline of procedure in the case before us. In the case of simple tumour, without any or but very indistinct sense of fluctuation, a brisk dose of purgative medicine, and a blister, will probably tend to its resolution, and so at once accomplish a cure. Unless there existed much heat and tenderness in the swelling, I should, myself, prefer this summary mode of treatment to the application of cooling and discutient lotions; though they, under circumstances of inflammation running too high for blistering, are the remedies we ought in the first instance to employ. In such a case as incipient poll-evil, it becomes a leading object of treatment to prevent, if possible, the formation of abscess and its subsequent eruption; and I know of nothing so likely to effect this, as the application of blisters in combination with general evacuations: we must take care, however, not to push this practice to an imprudent length.

TREATMENT OF THE ABSCESS.-As soon as suppuration becomes established, and fluid sensibly fluctuates under our fingers, we had better at once give it free egress. By suffering it to remain, the pus will burrow among the tendons and ligaments, and surrounding muscles, forming sinuses and caverns which we shall afterwards find it difficult beyond measure to dispose to take on granulative action. Some practitioners would rather postpone the opening of the abscess to the last extremity, in hopes of producing absorption of the deposited matter, and so superseding the necessity of any opening at all. And willingly would I agree with them in opinion, so long as I could entertain any such notion, providing no other harm resulted than in a case of common abscess-such as strangles : when, however, I come to think what a world of mischief there may be going on inwardly while I am waiting for the absorption of the pus, which at the best cannot now but be remote and improbable, I cannot hold my hand from giving vent to the collected fluid. It becomes a question, however, and one of some consequence, in what manner and place this is to be effected. The object is, not only to give the matter vent, but to procure

POLL-EVIL-PRINCIPLE OF CURE.

195

such a subsequent issue for it, that it shall run away as fast as collected. A dependent opening would at once prevent any collection or settlement: but that is impracticable. Should the abscess point at any one part, I should unhesitatingly say, that that spot should be made the place of puncture; and ought afterwards to be so freely laid open, that we could introduce even our fingers, and examine into the condition of the interior. We may find (and this is the most favourable case) that the matter has simply occupied a single subcutaneous sac or cavity: on the other hand, it may have lodged deep-seated; or there may be more than one abscess, and no communication between them. Should the pus, however, have remained long pent up, the probability is that any original partitions or separations that might have existed, have now given way, and that one cavity includes all: from which, however, pipes, and sinuses, and burrows, most likely run in various directions, bounded by sloughy ligament and tendon, and bottomed by carious bone.

Our next object should be, if possible, to establish counteropenings to the one we have already made; the situation and number of which must in course depend on the depth, direction, and number of the sinuses the abscess may contain. The side of the neck will in general be the situation for any counteropening that may be required; through which part one may be made by thrusting in either a straight bistoury or a double-edged scalpel or a trocar, in a direct line with the bottom of the abscess: a mode of operation much in vogue at the French veterinary schools; though they commence with the lateral opening. This lateral incision should be dilated in a direction backward, if required. Should any carious bone be felt, if possible, it should be removed with a pair of dressing forceps: this done, the incisions had better for the present be crammed full of fine tow; which will soak up the blood and discharges, at the same time that it frustrates all union by adhesion. In fact, either this mode of dressing must, with such view, be kept up; or (which some prefer) setons be passed through the sore-in at one opening and out at another.

THE PRINCIPLE OF CURE in such cases consists in the sup

pression of all morbid action, and the establishment in its place of healthy or healing operations: objects which, experience teaches us, in cases where sinuses and cavities of much depth or long duration exist, we stand but little chance of accomplishing, unless through the aid of counter-openings in the manner just recommended, or by laying the sinuses open at once by an incision through their parietes; a mode of practice excellent when it can be adopted, but one in poll-evil seldom to be recommended (even if possible), on account of the vast thickness of substance commonly required to be cut through. In laying so much stress upon these operations, it is far from my intention or desire to discard other and simpler means of healing sinuses, such as medicated injections of various kinds, and particularly the employment of pressure, from which have resulted in similar cases very beneficial effects*. My object is to impress on the mind of the young veterinarian, that operating on poll-evil early, often proves, in the end, a more speedy and effectual method of cure than what must appear at the outset to him, a so much simpler and safer mode of practice.

THE DRESSINGs that have been recommended and employed for the cure of poll-evil are by far too numerous for me to attempt any account of, even were the majority of them worthy of it, which I believe they are not. A better understanding of the nature and effects of inflammation has led to much improvement in our practice in regard to cases of wounds and sores. We have nearly, I hope quite, done with that "infernal practice" (as Taplin denominates it) of pouring scalding hot dressings into the sinuses a practice certainly not warranted even on the score of comparative efficacy, and highly condemnable on that of humanity, when we come to consider how many milder dressings there are that will answer quite as good an end. Should we be so fortunate as to discover a healthy interior to the abscess-one, though possessing sinuses, yet those not fistulous or callous-the simpler our dressings are, the better. All that such a case will require is to freely dilate the external

* I shall speak of these under the head of Fistula of the Withers.

POLL-EVIL-DRESSINGS.

197

wound, so as to expose the cavity as much as possible, and to dress it daily with some spirituous tincture*, or slightly escharotic applicationt. Such good fortune, however, we can hardly expect: we must look for fistulous sinuses, for sloughy ligamentous surfaces, for carious bone, and even for open joints. When the sore is in a sloughy condition, and sinews or ligaments and bones are already laid bare, caustic dressings of all kinds are to be scrupulously avoided, and such as are of a stimulant and sanative nature used in their stead. Time must be given for the separation of sloughs, for carious bone to become detached and cast off; and not until that process is completed are we to look for any attempt at granulation§. In fact, throughout the treatment of poll-evil (in whatever stage it may be) we must be guided by the principles on which inflammation in general is treated; varying them with the peculiarities and circumstances of the case before us, and ever bearing in mind that our art consists rather in removing impediments or obstructions to healing, than in any power we possess either of generating or promoting that process itself. Poll-evil is one of those diseases on undertaking the treatment of which it behoves us to consider well the nature of the case; and from that to make a sort of calcu

Either with the common or the compound tincture of myrrh; or else with tincture of benzoin. Occasionally, by way of change, spirits of turpentine may be employed. Mr. Simpson has used chloride of lime with

success.

The common escharotic dressings (they are likewise stimulant in their effect) are solutions of blue, white, or green vitriol, in the proportion of a drachm of either of these metallic salts to an ounce of water.

The sloughing process, especially where bone is involved, is often much promoted by the use of the nitric acid lotion; for which see page 184.

§ These sloughy sores in general emit quantities of offensive ichorous and purulent matters, which make the animal's poll and neck in a very filthy condition every time be presents himself to be dressed; and render a thorough washing and cleansing indispensable before any fresh dressings can be used. Much of this may be prevented by powdering the surface of the sore (after dressing it) with some absorbent powder-such as charcoal, bark, or bole armenian; and after that, greasing the hair upon which the discharge is likely to fall.

lation in our mind, not only as to the probability or possibility of cure, but also as to the space of time such process of recovery is likely to occupy, in order that we may guard ourselves against incurring censure when we expected to have reaped, and perhaps really deserved, commendation. Cases that have become desperate from their duration, or from mismanagement or neglect, must not be taken in hand at all (if we would respect our reputation), but with an understanding of that nature with the owners of such horses, that would leave us nothing to lose by way of professional character, but all to gain. The uncertainty of cure, together with the time such cure would certainly occupy, supposing it should be accomplished, form considerations which, when set against the value of the animal, in some cases suggest the pistol-shot as the most desirable end our poor patient can be brought to, as well on the score of humanity as on that of pecuniary policy.

The disease on which I am now going to treat is so nearly allied in its nature to poll-evil, that not only will their descriptions serve, reciprocally, to elucidate each other, but much of what is said on one subject will be found equally applicable to

the other.

FISTULA IN THE WITHERS.

The liability of the part we call the withers to injury, either from the pressure, pinching, or rubbing of the saddle or harnesspad or collar, brings it occasionally under our notice as the subject of disease; though much seldomer than used to be the case, owing to the improvements that have taken place in saddlery, as well as to the greater degree of attention paid to such concerns by horse-owners in general. Indeed, a case of fistula in any well-conducted horse establishment would, in these times, be considered discreditable: poll-evil and fistula being both of them diseases resulting from mismanagement, or negligence, or abuse, and not from any natural or unavoidable causes. Not many years ago these noisome maladies made quite dreadful havoc among our farmers' teams, and coach and post horses. I well remember,