ld be torn out with the fingers and the
cavity then treated in the same manner as the unilocular sac. In still
another case the swelling may be warm and painful with indistinct
fluctuation, or fluctuation only at a certain point. This indicates an
abscess, and necessitates an incision to drain the pus, followed by the
careful cleansing and dressing of the wound.

But cases occur in which all the treatment that has been described fails
to effect a full recovery, and instead a fibrous tumor begins to
develop. A change of treatment is, of course, then in order. The
inflammation being chronic will necessitate stimulating treatment of the
part in order to increase the process of absorption. We must again draw
upon the resources of experience in the form of blisters, the
fomentations, the iodin, and the mercurial ointments, as heretofore
mentioned. Good results may always be insured from their judicious and
timely administration. In applying the powerful mineral inunctions much
patience and wisdom are required. It should be done by carefully and
perseveringly rubbing in small quantities daily; it should be done
softly and gently, not with force, nor with the expectation of producing
an astonishing effect by heavy dosing and main strength in a few hours;
it should be after the manner of a siege rather than that of a charge.
The object is to induce the drugs to permeate the affected part until
the entire mass is penetrated. Of course cases will be encountered which
resist all forms of medical treatment. The tumor remains as a fixed
fact; it continues to grow; it is large and pendulous at the elbow; its
weight is estimated in pounds; it is not an eyesore merely, but an
uncomfortable, burdensome mass, excoriating all the surrounding parts
and being itself excoriated in turn; mild treatment has failed and is no
longer to be relied on.

Resort must now be made to surgical methods, and here again we must
choose between the ligature, the cautery, and the knife. Each has its
advocates among practitioners. In a case like the present, one of the
difficulties arises in connection with the application and retention of
bandages and other dressings after the amputation has been performed. It
is a somewhat difficult problem, owing to the conformation and
proportions of the body of the patient, and involves the exercise of
considerable practical ingenuity to adjust and retain the appliances
necessary to insure a good final result.

In the