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Well, he entered my room, and bowed to me with the pus standing, as usual, in drops on his eyelashes, his feet shuffling about, and his tongue unable, at first, to articulate a word. To this he demurred for quite a long time he demurred, but at length he accepted the offer. Next, he was for drinking the tea without sugar, and renewed his excuses, but upon the sugar I insisted.
Where it approaches the surface the skin becomes soft and thin, and eventually sloughs, allowing the pus to escape. An abscess forming in the deeper planes is prevented from pointing directly to the surface by the firm fasciæ and other fibrous structures.
These had latterly increased in severity so as to deprive him entirely of his night's rest and of appetite. I found the region of the elbow greatly swollen, and on careful examination found a fluctuating point at the outer aspect of the articulation. I opened it on the antiseptic principle, the incision evidently penetrating to the joint, giving exit to a few drachms of pus.
The characteristic greenish-grey or yellow granules are seen in the pus, and when examined microscopically reveal the colonies of actinomyces. Less frequently the maxilla becomes affected, and the disease may spread to the base of the skull and brain.
In the knee, excision is rarely necessary; but in the elbow it may be called for to obtain a movable joint. In #inherited syphilis# the earliest joint affections are those in which there is an effusion into the joint, especially the knee or elbow; and in exceptional cases pyogenic infection may be superadded, and pus form in the joint.
The Chevalier de Montaign was the favourite of the Dauphin, and much beloved by him for his great devotion. He fell ill, and underwent an operation called 'l'empieme', which is performed by making an incision between the ribs, in order to let out the pus; it had, to all appearance, a favourable result, but the patient grew worse, and could not breathe.
In this garden will be found not "silver bells and cockle shells and pretty maids all in a row," but a choice mixture of typhoid bacilli, pus germs, the germs of putrefaction, tubercle bacilli, and the little seeds which, if planted in our own bodies, would blossom as pneumonia or diphtheria. The fly is an unmitigated nuisance and should be wiped out. No half-way measures should be considered.
The gangrenous mass was without true pus, and consisted chiefly of broken-down, disorganized structures. The reaction of the gangrenous matter in certain stages was alkaline. 9th.
And leaving his material body, he entered into the bowels of the earth. Coming into contact with the earth, he created the different metals. Force and scent arose from his pus; the Deodar pine from his bones; glass from his phlegm; the Marakata jewel from his bile; and the black iron from his liver. The clouds were made from his nails, and corals from his veins.
A badly infected wound should be left open unless satisfactory drainage for the pus and wound secretions can be provided. Wounds across the muscle and in parts that are quite movable should not be sutured. The after-treatment consists in keeping the animal quiet, if the wound is in a part that is quite movable, and preventing it from biting, licking or nibbling the injury.
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