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"I thought," he replied, "that it would have been indecorous to have appeared not to understand Her Majesty." This made me laugh so much that I was obliged precipitately to quit the Chamber. The Queen died of an abscess under her arm.
Diagnosis. Pain referred along the course of the sciatic nerve on one side, or, as is sometimes the case, on both sides, is a symptom of tumours of the uterus, the rectum, or the pelvic bones. It may result also from the pressure of an abscess or an aneurysm either inside the pelvis or in the buttock, and is sometimes associated with disease of the spinal medulla, such as tabes.
With the formation of pus the skin becomes soft and boggy at several points, and eventually breaks, giving exit to a quantity of thick grumous discharge. Sometimes several small collections under the skin fuse, and an abscess is formed in which fluctuation can be detected. Occasionally gases are evolved in the tissues, giving rise to emphysema.
"Diagnosis: Acute diffuse appendicular peritonitis, probably also perforation; circumscribed perityphlitic abscess." "Operation was considered but not performed. Removal to the hospital for the purpose of an operation was absolutely declined by the patient." "I saw him upon the following day, the fourth of the disease."
When the infection becomes active, the contents of the cavity are transformed into a greenish-yellow pus from which the staphylococcus can be isolated, and the cavity is lined by a thin film of granulation tissue which erodes the surrounding bone and so causes the abscess to increase in size.
But his tissues are still swarming with the bacilli, and any indiscretion, either of diet, exposure, or exertion, at this time, may result in forming a secondary colony, or abscess, somewhere in the lungs, the liver, or the muscles.
The size of the abscess ranges from that of a cherry to that of a walnut, but specimens in museums show that, if left to Nature, the abscess may attain much greater dimensions. The affected bone is not only thicker and heavier than normal, but may also be curved or otherwise deformed as a result of the original attack of osteomyelitis. The clinical features are almost exclusively local.
The formation of pus under these conditions may not be attended with any of the usual signs of suppuration, and beyond some induration around the wound and a slight tenderness on pressure there may be nothing to suggest the presence of an abscess. Acute Suppuration of a Mucous Membrane.
We reply, that if they had tried a million wrong things, and shrunk from the right one, they would be only so much the worse. If there is local swelling, and signs that an abscess is forming, then treat as recommended for Abscess. Inflammation of the Bowels. See Bowels. Inflammation of the Brain. See Brain. See also Knee; Limbs, Inflamed; Lungs, etc. Inflammatory Outbreaks.
We had been at the cottage nearly a week, when I received a letter from Anderson; he informed me that he had visited old Nanny, who had made her will in due form, and confided it to him, and that he thought that she was more inclined to listen to him than she had before been; that my father and mother and sister were well, and that Spicer had been obliged to go into the hospital with an abscess in his knee, occasioned by running something into it, and that it was reported that he was very ill, and, in all probability, amputation must take place.
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