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It usually occurs in connection with tuberculous conditions, such as bone or joint disease, psoas abscess, or empyema, which have opened externally, and have thereby become infected with pyogenic organisms. It is gradual in its development, and is of a mild type throughout. [Illustration: FIG.
The swelling turned out to be an abscess, which was discharging freely. She has made very little of what she has suffered, only complaining of pain and of her neck being too tender to be touched. This afternoon Graham has been whitewashing as we were anxious to leave the house in good order. Thursday, December 10.
Possibly the baby nephew, in his short ten months of life, did more for his uncle than either knew, for no frozen hearts could do otherwise than melt in the presence of the insistent needs of that gallant little spirit and fragile little body, and a more whole-hearted sister was awaiting him on his return home, which took place at the end of two years, after he had fallen a victim to the prevalent complaint in the R.G.A abscess on the liver.
"With a sharply circumscribed perityphlitic abscess there could be no doubt of the diagnosis of diffuse peritonitis nor of the indication for operation on account of the long continuance of the severe symptoms. But neither this proposition nor that of an exploratory laparotomy, the result of which might have induced the patient to yield, was accepted."
Miss Clarendon meanwhile received from her brother, punctually, once a week, bulletins of Churchill's health; the surgical details, the fears of the formation of internal abscess, reports of continual exfoliations of bone, were judiciously suppressed, and the laconic general reported only "Much the same not progressing cannot be pronounced out of danger."
The local symptoms vary with the seat of the abscess. When it is situated superficially for example, in the breast tissue the affected area is hot, the redness of inflammation gives place to a dusky purple colour, with a pale, sometimes yellow, spot where the pus is near the surface.
After she left another friend called, to whom I mentioned the fact of having a very bad tooth-ache, and asked her if she had ever known any one to have an abscess at the root of a sound tooth. She replied that tooth-ache from that cause was not unfrequent, and that, sometimes, very bad consequences resulted from it. She advised me, by all means, to have the tooth extracted.
The finger introduced into the mouth, and carried over the tongue to the back of the throat, feels there a swelling which projects over the top of the windpipe, and causes the difficulty both in swallowing and breathing. This swelling is the abscess; a prick with the surgeon's lancet lets out the matter, and saves the child.
If this patient had been left distressingly along until he could have thrown off his opium poison and become normal, and allowed the abscess to drain and close, all would have been well. "Upon the next day there were several hemorrhagico-purulent stools, the urine was profuse and voided without pain.
This social, putrefied evil, and the accumulated matter in the South, pestilentially and in various ways influenced the North, poisoning its normal healthy condition. This abscess, undermining the national life, has burst now. Somebody, something must die, but this apparent death will generate a fresh and better life.
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