We are bound to admit, however, that the treatments of poulticing and blistering are only expectant—­we might almost say empirical.  At any rate, we admit to ourselves that what we have advised and carried out is not in itself curative, but only a means of assisting Nature to satisfactorily work her own ends.  Empirical or not, however, we believe that in every case of quittor it is wise in practice to at first adopt some such simple measure, for in nearly every instance where operative measures are practised, the patient must be laid aside for at least several weeks, whereas in this way he may be kept at work and a cure effected at the same time.

The Actual Cautery.—­Largely of the same empirical nature, yet doing something a little more calculated to destroy necrotic tissue and bring about its sloughing is the use of the cautery, both actual and potential.

The actual cautery may be beneficially employed for the relief of sub-horny quittor in at least two ways.

In the first place, it is often used—­a blunt ‘point-firing’ iron being the instrument—­instead of the knife as a means of evacuating the contents of the coronary abscess.  Those who use it for this purpose are able to say this in its favour:  it brings about the opening of the abscess without the unsightly haemorrhage attending the use of the knife, and at the same time just as effectually empties it.  The opening made is not nearly so likely to close prematurely—­that is, before a proper course of treatment of the wound has been carried out—­and so leave necrotic tissue at its bottom.  The intense tissue reaction it sets up is productive of a large slough, cast off by highly active inflammatory phenomena, which means that the remaining wound is one in which no dead tissue is left, and which is more amenable to treatment.

We have also seen the actual cautery used in sub-horny quittor, where that disease has reached a chronic fistulous stage, as a means of cauterizing the whole length of the lining of each fistulous passage.

At the present day this method is regarded as barbarous, and savouring too largely of the methods and practice of the old empirics.  There is no denying the fact, however, that it is at times followed by a speedy and complete cure of what has for months been an intractable and apparently incurable quittor; and, honestly speaking, we ourselves can see nothing very greatly against the operation in certain cases save its appearance.  In that it is certainly rough, and is not calculated to favourably impress the more critical of our clientele.  With the animal chloroformed, however, much of what can really be urged against it disappears, and on farms and other places where a skilled and competent dressing of an operation wound cannot be looked for, it is sometimes wise to advise this method of treatment in preference to more advanced methods of operating.  So far as we can judge, the after-effects are very little worse than those following other operative measures, more especially when a suitable case has been chosen.