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If pus is formed, one or more small incisions are made and a light moist dressing placed over the wounds to absorb the discharge, but no drain is inserted. The whole of the inflamed area should be covered with gauze wrung out of a 1 in 10 solution of ichthyol in glycerine.
When any secreted fluid is produced in an unusual quantity, and at the same time the power of absorption is increased in equal proportion, not only the heat of the gland becomes more intense, but the secreted fluid becomes thicker and milder, its thinner and saline parts being re-absorbed: and these are distinguishable both by their greater consistence, and by their heat, from the fluids, which are effused by the retrograde motions of the lymphatics; as is observable towards the termination of gonorrhoea, catarrh, chincough, and in those ulcers, which are said to abound with laudable pus.
Where the periosteum has been perforated by pus making its way to the surface, there are defects or holes in the involucrum, called cloacæ. As these correspond more or less in position to the sinuses in the skin, in passing a probe down one of the sinuses it usually passes through a cloaca and strikes the dead bone lying in the interior.
The track itself was filled with thick pus which extended into the ventricles. Peabody reports a most remarkable case of recovery from multiple arrow-wounds. In a skirmish with some Indians on June 3, 1863, the patient had been wounded by eight distinct arrows which entered different parts of the body.
On the next day I found that the poultice had not been applied; there were more pain and swelling; an eschar was formed over the puncture which I removed and thus gave issue to a considerable quantity of pus; I again enjoined the application of a cold poultice kept constantly moist and cold with water. On the succeeding day, the inflammation had greatly subsided.
It may be called for later if the limb is likely to be useless, as, for example, when the whole shaft of the bone is dead without the formation of a new case, when the epiphyses are separated and displaced, and the joints are disorganised. Flat bones, such as the skull or ilium, must be trephined and the pus cleared out from both aspects of the bone.
Not infrequently the white corpuscles die in the contest, and then may accumulate in the form of pus and make their way through the skin to be discharged directly. The battle between these phagocytes and the bacteria goes on vigorously. If in the end the phagocytes prove too strong for the invaders, the bacteria are gradually all destroyed, and the attack is repelled.
He could not very well say: "I would rather you would not," although for some reason he felt that way. It was soon clear to their initiated minds that the oculist did not know the exact nature of the trouble. He admitted that the case perplexed him. He, too, must make an examination of the pus.
"Are you sure of doing it, Ambroise?" cried the old man, trembling. "As sure as I am of my own existence. The king, my old friend, has a morbid ulcer pressing on his brain, which will presently suffice it if no vent is given to it, and the danger is imminent. But by boring the skull I expect to release the pus and clear the head. I have already performed this operation three times.
When it is about to burst externally, it may be difficult to distinguish a tuberculous abscess from one due to infection with pyogenic organisms. Even when the abscess is opened, the appearances of the pus may not supply the desired information, and it may be necessary to submit it to bacteriological examination.
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