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The disease begins on the foot as an indurated patch, which becomes discoloured and permeated by black or yellow nodules containing the organism. These nodules break down by suppuration, and numerous minute abscesses lined by granulation tissues are thus formed. In the pus are found yellow particles likened to fish-roe, or black pigmented granules like gunpowder.
Treatment. If an abscess is suspected, there should be no hesitation in exploring the interior of the bone. It is exposed by a suitable incision; the periosteum is reflected and the bone is opened up by a trephine or chisel, and the presence of an abscess may be at once indicated by the escape of pus.
I made a free incision in the part first affected, evacuated a little pus, and directed a poultice to be applied. On the following day, there was less pain but still great swelling at the back of the hand, which, I think, would have been removed had the caustic been used. I now applied the caustic freely within the orifice. On the following day there was less swelling and discharge.
I then applied a fomentation to the part, which highly answered the intention; and after three or four times dressing, the wound began to discharge a thick pus or matter, by which means the cohesion But perhaps I do not make myself perfectly well understood?" "No, really," answered the lieutenant, "I cannot say I understand a syllable."
Pleural and peritoneal adhesions to the organs within the body cavities are common. The carcass of a tubercular cow. The tubercle usually undergoes a cheesy degeneration. Old tubercles may become hard and calcareous. Sometimes the capsule of the tubercle is filled with pus. A yellowish, cheesy material within the capsule of the tubercular nodule or mass is typical of the disease.
The primary source of infection is dealt with on the usual lines. If the lymphangitis affects an extremity, Bier's elastic bandage is applied, and if suppuration occurs, the pus is let out through one or more small incisions; in other parts of the body Klapp's suction bells are employed. An autogenous vaccine may be prepared and injected.
The layer of coagulated blood and lymph becomes liquefied and is thrown off, and instead of granulations being formed, the tissues exposed on the floor of the ulcer are destroyed by the bacterial toxins, with the formation of minute sloughs and a quantity of pus. The discharge is profuse, thin, acrid, and offensive, and consists of pus, broken-down blood-clot, and sloughs.
It is seldom advisable to wash out an abscess cavity, and squeezing out the pus is also to be avoided, lest the protective zone be broken down and the infection be diffused into the surrounding tissues.
Even surgeons thought it a necessary part of the process of healing, and the approving term "laudable pus" was applied to a soft, creamy discharge, without either offensive odor or tinge of blood, upon the surfaces of the healing wound; and the hospital records of that day noted with satisfaction that, after an operation, "suppuration was established."
By a similar procedure the effects of the anthrax bacteridium and the microbe of pus may be combined and the two diseases may be superposed, so as to obtain a purulent anthrax or an anthracoid purulent infection. Care must be taken not to exaggerate the predominance of the new microbe over the bacteridum.
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