Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: It does not matter whether the condition has been caused by an abrasion or has originated in a cyst of the dorsal bursa, procrastination is inadvisable. We have found, however, in the cases of typical fistulae that the evacuation of the contents of the sac one week before the radical operation is performed, is good practice, because it fortifies the tissues against post-operative infections of a grave character. Where strict aseptic conditions are maintained in the operation and the patient has skillful after-care, this precaution is not as essential as when careless methods prevail or when the after-care must be consigned to untrained hands. It is, therefore, recommended, as a routine measure in field practice, to lance the cyst, evacuate the liquid and flocculent contents and then submit the sac to casual irrigations one week to ten days before operating. In the case of old fistulae originating as cysts and which have become infected from any source or in the traumatic variety having either superficial or deep pus accumulations, lancing one week before operating is likewise helpful in that surgical shock is modified and there is less soiling of the surgical wound with pus during the operation. These suggestions need not be laid down asabsolute laws, but it is advisable to follow them where it is desired to take advantage of every helpful influence. They are most important in subjects enfeebled from hard work or privation and when from any cause a clean operation and good after-care cannot be carried out. External applications such as liniments and blisters we do not recommend. They only complicate matters by irritating the skin and encrusting it with dried excretions difficult to remove in preparing the field for operation later, and so far as we have been able to... --This text refers to an alternate Paperback edition.