on of scar
tissue. An anaesthetic is rarely called for, except in children. The
abscess is first evacuated by means of a large trocar and cannula
introduced obliquely through the overlying soft parts, avoiding any part
where the skin is thin or red. If the cannula becomes blocked with
caseous material, it may be cleared with a probe, or a small quantity of
saline solution is forced in by the syringe. The iodoform is injected by
means of a glass-barrelled syringe, which is firmly screwed on to the
cannula. The amount injected varies with the size of the abscess and the
age of the patient; it may be said to range from two or three drams in
the case of children to several ounces in large abscesses in adults. The
cannula is withdrawn, the puncture is closed by a Michel's clip, and a
dressing applied so as to exert a certain amount of compression. If the
abscess fills up again, the procedure should be repeated; in doing so,
the contents show the coloration due to liberated iodine. When the
contents are semi-solid, and cannot be withdrawn even through a large
cannula, an incision must be made, and, after the cavity has been
emptied, the iodoform is introduced through a short rubber tube attached
to the syringe. Experience has shown that even large abscesses, such as
those associated with spinal disease, may be cured by iodoform
injection, and this even when rupture of the abscess on the skin surface
has appeared to be imminent.

Another method of treatment which is less popular now than it used to
be, and which is chiefly applicable in abscesses of moderate size, is by
_incision of the abscess and removal of the tuberculous tissue in its
wall_ with the sharp spoon. An incision is made which will give free
access to the interior of the abscess, so that outlying pockets or
recesses may not be overlooked. After removal of the pus, the wall of
the abscess is scraped with the Volkmann spoon or with Barker's flushing
spoon, to get rid of the tuberculous tissue with which it is lined. In
using the spoon, care must be taken that its sharp edge does not
perforate the wall of a vein or other important structure. Any debris
which may adhere to the walls is removed by rubbing with dry gauze. The
oozing of blood is arrested by packing the cavity for a few minutes with
gauze. After the packing is removed, iodoform powder is rubbed into the
raw surface. The soft parts divided by the incision are sutured in
layers so as to ensure primary uni