The practice of surgery . ependent on a constitutionalcause; for, in such cases, discussion is not unlikely to follow patientperseverance, even under circumstances by no means promising. Shouldacute or subacute accession supervene, however, the abscess becomingtense and crescent, let incision be no longer delayed. In obstinate examples of pericranitis, causing mere change of struc-ture, with slight swelling, but great pain, the general health is apt togive way greatly from want of sleep, and consequent exhaustion. Insuch cases it is essential to give opiates ; and, if the more proper altera-ti
The practice of surgery . ependent on a constitutionalcause; for, in such cases, discussion is not unlikely to follow patientperseverance, even under circumstances by no means promising. Shouldacute or subacute accession supervene, however, the abscess becomingtense and crescent, let incision be no longer delayed. In obstinate examples of pericranitis, causing mere change of struc-ture, with slight swelling, but great pain, the general health is apt togive way greatly from want of sleep, and consequent exhaustion. Insuch cases it is essential to give opiates ; and, if the more proper altera-tives have proved ineffectual, mercury may be given in guarded doses(Principles, 3d Am. Ed. p. 398). Affections of the Cranium. Abscess and ulcer of the cranium occur from ordinary causes, andare amenable to ordinary treatment (Principles, 3d Am. Ed. p. 411). Caries of the skull is preceded and accompanied by interstitial absorp-tion (Principles, 3d Am. Ed. p. 281), and seldom occurs but with a vice Fig. 11. Fig. 12. ****;:. Fig. 11. Interstitial Absorption in progress, in thecranium; at a, just began; at b, more advanced. Itmay stop here, producing a merely cancellous stateof the tissue; or it may advance, becoming mergedin ulceration, and producing caries, as in Fig. 12. Fig. 12. Different portions of the same Skull asFig. 11; at c. ulceration established, surrounded byinslerslilial absorption: at </. caries, with necrosisin the centre; interstitial absorption still accom-panying. AFFECTIONS OF THE CRANIUM. 83 of system; seeming to be rather a symptom and sign of this than toconstitute a disease in itself. And the predisposing vices of systemare scrofula in the young, syphilis, mercurio-syphilis, or the ill effectsof mercury alone in the adult. Treatment, accordingly, is chiefly con-stitutional. Locally, the diseased structure is exposed, and removal ofthe carious surface is effected by the gouge, or by escharotics, chlorideof zinc, or red oxide of mercury [Principles, 3d Am
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