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In some cases where infection of this extravasation of blood and serum occurs, instead of desiccation and discoloration of the insensitive parts, there is, in time, manifested a circumscribed area of destruction of the insensitive sole and the abscess may, where no provision for drainage exists, burrow between sensitive and insensitive laminae and perforate the tissues at the coronet.
We did no logic nor philosophy at Harbury, and at Oxford it was not so much thought we came to deal with as a mistranslation and vulgarization of ancient and alien exercises in thinking. There is no such effective serum against philosophy as the scholarly decoction of a dead philosopher.
True, it would appear that to-day a way of escape may be offered by the discovery of the anti-toxine for fatigue. "Just think!" exclaims Claparède, "a serum against fatigue. How valuable this would be!"
One or two of the prisoners suffered untold agonies, blood-poisoning evidently setting in to aggravate the action of the serum. The primitive sanitary arrangements which prevailed brought one plague upon us. We suffered from a pestilence of flies which under the circumstances was not surprising, everything being conducive to their propagation. They swarmed around us in thick black clouds.
Supplies of one sort exceeded the demand, while other things were entirely lacking. Food of the kind that was needed by the very ill was scarce, expensive and difficult to secure at any price. But the things that have been done are marvellous. Surgery has not failed. The stereoscopic X-ray and antitetanus serum are playing their active part.
The result in this case, as in many similar ones which I had occasion to observe during and after the ice-bag treatment, was that the inflammation in the lungs had been arrested and suppressed during the stage of destruction, when the air cells and tissues were filled with exudates, blood serum, pus, live and dead blood cells, bacteria, etc., leaving the affected areas of the lungs in a consolidated, liver-like condition.
Clinical Use of Serums. Every precaution must be taken to prevent organismal contamination of the serum or of the apparatus by means of which it is injected. Syringes are so made that they can be sterilised by boiling. The best situations for injection are under the skin of the abdomen, the thorax, or the buttock, and the skin should be purified at the seat of puncture. If the bulk of the full dose is large, it should be divided and injected into different parts of the body, not more than 20
In the quiescent stage the lesion is represented by a small cavity in the bone, filled with clear serum, and lined by a fibrous membrane which is engaged in forming bone. Around the cavity the bone is sclerosed, and the medullary canal is obliterated.
There was a very simple way of ascertaining this by making out an inventory of the contents of the lymph liquid, and when this was done, they were found to consist of water, albumen, and the salts of serum; there was even a little fibrine; the only thing wanting was globules.
The contents may be clear yellow serum or watery pus; sometimes a small spicule of bone is discharged. Valuable information, both for diagnosis and treatment, is afforded by skiagrams.
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